Urology Commons^™

Testing For Homologous Recombination Repair Or Homologous Recombination Deficiency For Poly (Adp-Ribose) Polymerase Inhibitors: A Current Perspective, Thomas J Herzog, Ignace Vergote, Leonard G Gomella, Tsveta Milenkova, Tim French, Raffi Tonikian, Christian Poehlein, Maha Hussain

Department of Urology Faculty Papers

Poly (ADP-ribose) polymerase inhibitors (PARPis) have demonstrated clinical activity in patients with BRCA1 and/or BRCA2 mutated breast, ovarian, prostate, and pancreatic cancers. Notably, BRCA mutations are associated with defects in the homologous recombination repair (HRR) pathway. This homologous recombination deficiency (HRD) phenotype can also be observed as genomic instability in tumour cells. Accordingly, PARPi sensitivity has been observed in various tumours with HRD, independent of BRCA mutations. Currently, four PARPis are approved by regulatory agencies for the treatment of cancer across multiple tumour types. Most indications are specific to tumours with a confirmed BRCA mutation, mutations in other HRR-related genes, …

Screening For Social Determinants Of Health To Improve Care In Pediatric Patients With Recurrent Urinary Tract Infections: A Scoping Review, Emily Gray Msn, Fnp-C, Michelle Rickard Dnp, Cpnp-Ac

Doctor of Nursing Practice Projects

Purpose: To describe what is known about how SDoH screening impacts adherence to treatment in pediatric patients with recurrent UTIs.

Prostate Imaging Reporting And Data System Score (Pi-Rads) And Glutathione S-Transferase P1 Methylation Status (Gst-P1) In The Diagnosis Of Prostate Cancer Patients With Borderline Psa Values, Marius Stan, Vladimir Botnarciuc, Andra Iulia Suceveanu, Andreea Cristina Costea, Adrian Paul Suceveanu, Laura Mazilu, Ciprian Iorga, Tony Hangan, Corneliu Tudor, Dragos Epistatu, Sergiu Chirila, Viorel Gherghina, Felix Voinea

Journal of Mind and Medical Sciences

Objectives. The objective of this study was to evaluate the potential use of Prostate Imaging – Reporting and Data System version 2 (PI-RADS) in combination with Glutathione S-transferase P1 (GST-P1) expression for an improved diagnosis of prostate cancer, in patients with inconclusive values of prostate-specific antigen (PSA). Materials and Methods. The study was conducted on 80 patients for whom PSA values were evaluated and were found to be inconclusive (4-10 ng/ml). These patients underwent imagistic evaluation (PI-RADS), followed by transurethral prostate biopsy, with the evaluation of GST-P1 expression and histopathological examination (for diagnosis confirmation). Results. By combining the results of …

Presentation And Predictors Of Metastatic Testicular Cancer: A Contemporary Population-Based Analysis, Yash Shah, Hanan Goldberg, Thenappan Chandrasekar

Student Papers & Posters

Introduction

• Testicular cancer (TC) is the most common solid malignancy in males aged 14-44, with incidence rising globally, although there are few established risk factors besides cryptorchidism.
• While 70% of men present with localized TC, 18% have regional spread and 12% have metastases. Moreover, one-third of patients diagnosed with Stage I TC actually have occult metastases.

Small Bowel, Appendix, And Conduit Fistula Formation After Ileal Conduit Urinary Diversion., Shivangi Bhatt, Gina Rooker, Kyle Schuyler

Tower Health Research Day

No abstract provided.

Surgical Challenges And Considerations In Tri-Modal Therapy For Muscle Invasive Bladder Cancer, Adam S. Feldman, Girish S. Kulkarni, Trinity J. Bivalacqua, Peter C. Black, Scott Delacroix, Seth P. Lerner, Ashish M. Kamat, Wassim Kassouf

Urology Faculty Publications

Trimodal therapy (TMT) for muscle invasive bladder cancer has become an accepted alternative to radical cystectomy and has become integrated into national guidelines as standard a treatment option. The urologist plays a critical role in proper patient selection, thorough transurethral resection, ongoing cystoscopic surveillance and management of local recurrences. There exists multiple patient related and tumor related factors, which contribute to the selection of TMT vs. radical cystectomy for a patient with muscle invasive bladder cancer. Although the ideal patient for TMT has a tumor which can undergo a visibly complete resection, has no associated hydronephrosis, does not invade the …

Genitourinary And Sexual Symptoms And Treatments In Transfeminine Individuals: A Qualitative Exploration Of Patients' Needs, Paul Chung, Vishal Swaminathan, Sabina Spigner, Joon Yau Leong, Jessica Bulafka, Rosemary Frasso

Department of Urology Faculty Papers

Introduction: Medical providers may not be familiar with the genitourinary and sexual symptoms of transgender and non-binary (TGNB) individuals. This lack of familiarity may hinder a provider's ability to address these issues as patients may hesitate to report symptoms due to fear of stigma, misgendering, and being treated disrespectfully.

Aim: To describe the array of genitourinary and sexual symptoms in transfeminine individuals.

Methods: Upon institutional review board approval, researchers used semi-structured interviews with 25 transfeminine individuals assigned male at birth to explore urinary and sexual symptoms on a sample of convenience. Participants were recruited and interviews were conducted until saturation …

Steap1-4 (Six-Transmembrane Epithelial Antigen Of The Prostate 1-4) And Their Clinical Implications For Prostate Cancer, Michael Xu, Latese Evans, Candice L Bizzaro, Fabio Quaglia, Cecilia E Verrillo, Li Li, Julia Stieglmaier, M J Schiewer, Lucia R Languino, William Kevin Kelly

Department of Urology Faculty Papers

Six-Transmembrane Epithelial Antigen of the Prostate 1-4 (STEAP1-4) compose a family of metalloproteinases involved in iron and copper homeostasis and other cellular processes. Thus far, five homologs are known: STEAP1, STEAP1B, STEAP2, STEAP3, and STEAP4. In prostate cancer, STEAP1, STEAP2, and STEAP4 are overexpressed, while STEAP3 expression is downregulated. Although the metalloreductase activities of STEAP1-4 are well documented, their other biological functions are not. Furthermore, the properties and expression levels of STEAP heterotrimers, homotrimers, heterodimers, and homodimers are not well understood. Nevertheless, studies over the last few decades have provided sufficient impetus to investigate STEAP1-4 as potential biomarkers and therapeutic …

Effect Of Nicotine On Immune Suppression And Prostate Cancer Pathogenesis, Sirin Saranyutanon

Theses and Dissertations

Tobacco or cigarette smoking is the leading cause of several diseases, including cancer, in the United States and worldwide. Epidemiological data provide strong evidence for an association of nicotine with prostate cancer risk and recurrence, but experimental data is largely lacking. Nicotine is an addictive ingredient of tobacco products and other alternatives, however, its role in prostate tumor biology has not been explored. Further, while a role of smoking in immunosuppression has been demonstrated, the effect of nicotine on immune function is largely unknown. We hypothesized that nicotine suppresses immune function by promoting alternative polarization of macrophages and promotes prostate …

A Scoping Review Of Penile Implant Biofilms-What Do We Know And What Remains Unknown?, Joon Yau Leong, Courtney E Capella, Maria J D'Amico, Selin Isguven, Caroline Purtill, Priscilla Machado, Lauren J Delaney, Gerard D Henry, Noreen J Hickok, Flemming Forsberg, Paul H Chung

Department of Urology Faculty Papers

Background: Penile prosthesis (PP) is a gold standard for treatment of erectile dysfunction given its reliability and efficacy. Infection remains the most feared complication of prosthetic surgery, which usually results in device removal, and places a significant economic burden on the healthcare system. While biofilms have shown to support the persistence of microorganisms, the degree by which this matrix is truly pathogenic remains unknown given its high prevalence even in asymptomatic patients. We aim to review and summarize the current literature pertaining to biofilm formation in the setting of PP surgeries in clinically infected and non-infected cases.

Methods: Searches were …

Shockwave Lithotripsy Of Upper Urinary Tract Calculi - Outcomes Of A Multicentre International Prospective Observational Study, Fernanda C. Gabrigna Berto

Electronic Thesis and Dissertation Repository

Introduction

Shockwave lithotripsy (SWL) is a surgical procedure used in urolithiasis treatment. Several factors can influence its results. This study aims to evaluate “real-world” success rates and identify predictors of treatment success in patients undergoing SWL.

Methods

Adult patients undergoing SWL for urolithiasis at three institutions in Canada and Oman were prospectively enrolled. Treatment success after a maximum of two SWL sessions was assessed by post-operative imaging. Logistic regression assessed for predictors of treatment success.

Results

Between May 2021 and February 2022, 271 patients were prospectively enrolled. Overall success rate was 46.1% after one SWL session, and 58.3% after two …

The Role Of Urinary Modulators In The Development Of Infectious Kidney Stones, Brendan Wallace

Electronic Thesis and Dissertation Repository

The pathogenesis of infectious kidney stones is poorly understood, while equally unclear is the role of urinary modulators and bacteria. An experimental model was created and utilized to test a variety of urinary modulators and bacterial strains commonly associated with struvite and calcium phosphate stones to evaluate their potential roles in influencing crystal formation. Modulators such as acids, citrate, and osteopontin had strong inhibitory effects on infectious crystal formation while the remaining modulators had neutral, mixed, or positive effects. Lastly, it was determined that the presence of urease may not directly lead to calcium phosphate and struvite stones in all …

Case Study Of Metformin-Induced Lactic Acidosis, Kajel Patel, Kishan Patel

Stratford Campus Research Day

Metformin induced lactic acidosis is when high levels of metformin cause dangerously high levels of lactic acid. Here is a case report of a 72-year-old female who came in for nausea, vomiting, and diarrhea found to have a high suspicion for metformin induced lactic acidosis. She stabilized in the emergency department, nephrology and ICU was contacted, and she went for emergent dialysis. For many patients the prognosis of metformin induced lactic acidosis is poor. This patient was made comfort care by her family.

Case Report: Segmental Testicular Infarction, Nicholas Coan, Ronald Clearie, Amanda Maciag, Joseph Pagano, James Espinosa, Alan Lucerna, Neelesh Parikh

Stratford Campus Research Day

We report a case of a 45-year-old male who presented to the Emergency Department with acute onset left testicular pain and was diagnosed with left sided segmental testicular infarction. The differential diagnosis of acute onset testicular/scrotal pain can include critical urological diagnoses such as testicular torsion and testicular tumors. In the absence of global flow disruption on ultrasound Doppler, emergent surgical intervention is not needed. While ultrasound aids in the Emergency Department’s management of acute testicular pain, it does not rule out the need for an additional outpatient work-up or imaging. Conservative management with pain control, outpatient scrotal MRI, and …

Incidental Finding Of Unusually Large Renal Cyst During Point Of Care Ultrasound, David Ho, Jeffrey Gardecki

Stratford Campus Research Day

Renal cysts are common, and their frequency and size increase as patients age. Renal cysts are derived primarily from tubules and can occur anywhere between Bowman’s capsule to the renal papilla. The cysts are composed of abnormally differentiated epithelial cells encapsulating a cavity of fluid. These abnormally differentiated cells are due to defects in the structure and function of cilia, the structures responsible for detecting urine flow as well as the epithelial composition of the epithelial architecture and repair. According to Campbell Urology, there are three processes in which renal cysts increase in their size – proliferation of epithelial cells …

Factors And Outcomes Contributing To Pelvic Lymph Node Dissection In Non-Muscle Invasive Bladder Cancer, Young Son, Brian Thomas, Lance Earnshaw, Mark Quiring, Erica Martel, Benjamin Fink, Raeann Dalton, Thomas Mueller, Philip Dorsey

Stratford Campus Research Day

Bladder cancer represents the 6th most common for men and is classified into muscle-invasive bladder cancer (MIBC) and non-muscle-invasive bladder cancer (NMIBC). NMIBC (T1, Ta, Tis), accounting for approximately 75% of new bladder cancer diagnoses, is limited to the mucosa, submucosa, and lamina propria. Studies have approximated the rate of recurrence in NMIBC between 50 - 70%, which sometimes progresses to muscle invasive disease. Management of NMIBC ranges from surveillance, intravesical chemotherapy to radical cystectomy (RC) and is dependent upon the TNM staging and grading of the tumor. Clinically, staging is determined via imaging, physical exam, and histology on transurethral …

Testicular Torsion Education: Improving Awareness Among Boys And Their Caregivers Regarding The Urgency Of Evaluating Scrotal Pain, Abby Taylor

Capstone Experience

Introduction: Testicular torsion is a urologic emergency that requires prompt medical evaluation and surgical intervention. The length of time from onset of the torsion to evaluation in the emergency department is often delayed due to lack of knowledge of the urgency of the situation amongst boys and their caregivers. We hypothesize that an animated educational video will increase awareness of the condition and prompt urgent evaluation in the emergency department.

Methods: A 5-minute animated educational video was created following a boy, Danny, as he develops testicular torsion. Four population groups: boys, parents, school nurses, and pediatricians, completed group-specific pre- and …

Urinary Incontinence: Understanding The Silent Plight Of Women, Yasmin Nadeem Parpio, Anmol Minaz, Sonia Ijaz Haider

School of Nursing & Midwifery

Urinary incontinence (UI) is defined as the complaint of involuntary loss of urine. UI affects both men and women but is more common in women. It has been identified as a World Health Organization priority. The burden related to UI at local, national, and global levels is huge and its impact in terms of physical, social, mental, and financial aspects makes it a concerning issue. However, there exist several barriers in terms of knowledge and attitude in seeking healthcare among women experiencing UI. This calls upon a multi-disciplinary approach involving professionals from different disciplines and tackling it with collaborative and …

Dna-Pkcs: A Targetable Protumorigenic Protein Kinase., Emanuela Dylgjeri, Karen E Knudsen

Department of Cancer Biology Faculty Papers

DNA-dependent protein kinase catalytic subunit (DNA-PKcs) is a pleiotropic protein kinase that plays critical roles in cellular processes fundamental to cancer. DNA-PKcs expression and activity are frequently deregulated in multiple hematologic and solid tumors and have been tightly linked to poor outcome. Given the potentially influential role of DNA-PKcs in cancer development and progression, therapeutic targeting of this kinase is being tested in preclinical and clinical settings. This review summarizes the latest advances in the field, providing a comprehensive discussion of DNA-PKcs functions in cancer and an update on the clinical assessment of DNA-PK inhibitors in cancer therapy.

Surgeons And Ethical Challenges In Operating Room, Nazim Syed Muhammad, Syed Shahabuddin

Section of Urology

Ethics lie in the heart of professionalism. In surgery, it represents an essential element, with surgeons facing ethical challenges in their routine practice. The rapid expansion of surgical technology and innovation along with the use of resources and consideration of conflict of interest have brought up the need for the development of current surgical code of ethics. Operating room represents a stressful environment where patients' lives depend upon careful preparation, planning and execution. The progression of surgery within the operating room must be done in harmony and in line with the ethical principles of autonomy, beneficence, non-maleficence and justice. Discussion …