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Full-Text Articles in Urology
Rates Of Urinary Tract Infection In Transgender Women Postvaginoplasty Vs Cisgender Women: A Retrospective Cohort Study In A Large Us Health Network, David Gilbert, Aishwarya Gautam, Tomasz Tabernacki, Megan Mcnamara, Rachel Pope, Shubham Gupta, Kirtishri Mishra
Rates Of Urinary Tract Infection In Transgender Women Postvaginoplasty Vs Cisgender Women: A Retrospective Cohort Study In A Large Us Health Network, David Gilbert, Aishwarya Gautam, Tomasz Tabernacki, Megan Mcnamara, Rachel Pope, Shubham Gupta, Kirtishri Mishra
Student Scholarship
Objective: To describe urinary tract infection (UTI) risk 3-month postvaginoplasty (VP) in transgender women (TW) compared to cis women (CW). Methods: Using TriNetX (TriNetX, Inc, Cambridge, MA), we built cohorts of 2041 TW and 48,374,745 CW. Outcomes were ≥1 instance of UTI or Cystitis, and assessed from 3-6, 3-12, 3-36 months, and 3 months-10 years post-VP. TW and CW were age-cohorted (18-39, 40-59, 60-74) and compared at each time interval. Kaplan-Meier was used to account for loss to follow-up, along with hazard ratios and log-rank tests to determine significance (P <.05). Results: For all time intervals and age ranges, TW had a significantly (P <.0001-P = .0088) higher probability of developing a UTI compared to CW. The largest difference was ages 40-59 ten-year post-VP. In this analysis, CW and TW had a 12.96% and 29.34% cumulative outcome incidence, respectively. Cox proportional hazard analysis demonstrated increased hazard for TW compared to CW. Hazard ratios between CW and TW ranged from 1.363 (ages 18-39 at 10 years, 95%CI: 1.119,1.660) to 3.522 (ages 60-74 at 12 months, 95%CI: 1.951,6.360). Conclusion: We found a significantly higher probability of TW developing UTIs compared to age-cohorted CW. Contributing factors may include difficulties with neovaginal perineal hygiene, lack of commensal bacteria and vaginal mucosa, larger urethral meatus, high rates of meatal stenosis, and nonnative bacteria introduced through dilators and douching. These findings may help improve quality of postoperative care in TW.
Legal Outcomes Of Litigation After Iatrogenic Genitourinary Trauma, Helen H. Sun, Crystal An, Andrew Drozd, Nicholas Sellke, Kimberly Tay, Kirtishri Mishra, Kyle Scarberry, Shubham Gupta, Nannan Thirumavalavan
Legal Outcomes Of Litigation After Iatrogenic Genitourinary Trauma, Helen H. Sun, Crystal An, Andrew Drozd, Nicholas Sellke, Kimberly Tay, Kirtishri Mishra, Kyle Scarberry, Shubham Gupta, Nannan Thirumavalavan
Researchers, Instructors, & Staff Scholarship
Objective: To evaluate plaintiff and defendant characteristics associated with iatrogenic genitourinary (GU) trauma litigation and outcomes of closed claims. Methods: LexisNexis was queried in April 2023 using terms related to GU organs and injury, and manually reviewed for iatrogenic cases. Case details including defendant, organ involvement, and legal outcome were obtained. Multinomial regression analysis was performed to identify factors associated with outcome. Results: Four hundred ten cases involving 611 defendants were identified, with the ureter the most commonly affected organ (202/410, 49.3%). Most cases involved adult plaintiffs (380, 92.7%) and resulted in favor of the defense (227, 55.4%). Injuries resulted …
Evaluation Of Outcomes Between The Top-Down Versus The Bottom-Up Approach For Retropubic Midurethral Sling, Vidushri Mehrotra, John Pearl, David Sheyn, Susan D. Wherley
Evaluation Of Outcomes Between The Top-Down Versus The Bottom-Up Approach For Retropubic Midurethral Sling, Vidushri Mehrotra, John Pearl, David Sheyn, Susan D. Wherley
Student Scholarship
Introduction and hypothesis: Retropubic midurethral sling (MUS) placement is the gold standard for the treatment of stress urinary incontinence in the USA. The procedure can be approached from either a top-down or a bottom-up direction, but there is a paucity of contemporary data regarding outcomes between these approaches. The aim of this study was to provide updated clinical outcomes data. Methods: This was a retrospective cohort study of women undergoing the retropubic MUS procedure alone or at the time of pelvic organ prolapse repair between 2010 and 2020 at a single academic medical center. The electronic medical record was used …
Trends Over 20 Years Of Antimicrobial Prophylaxis For Artificial Urinary Sphincter Surgery, Helen H. Sun, Michael Callegari, Eric Zhou, Erin Jesse, Megan Prunty, Jonathan E. Shoag, Kyle Scarberry, Kirtishri Mishra, Shubham Gupta
Trends Over 20 Years Of Antimicrobial Prophylaxis For Artificial Urinary Sphincter Surgery, Helen H. Sun, Michael Callegari, Eric Zhou, Erin Jesse, Megan Prunty, Jonathan E. Shoag, Kyle Scarberry, Kirtishri Mishra, Shubham Gupta
Faculty Scholarship
Introduction and Objective: Perioperative antimicrobial prophylaxis is crucial for prevention of prosthesis and patient morbidity after artificial urinary sphincter (AUS) placement. While antibiotic guidelines exist for many urologic procedures, adoption patterns for AUS surgery are unclear. We aimed to assess trends in antibiotic prophylaxis for AUS and outcomes relative to American Urological Association (AUA) Best Practice guidelines. Methods: The Premier Healthcare Database was queried from 2000 to 2020. Encounters involving AUS insertion, revision/removal, and associated complications were identified via ICD and CPT codes. Premier charge codes were used to identify antibiotics used during the insertion encounter. AUS‐related complication events were …