Urology Commons^™

Comparison Of Same-Day Discharge Robotic-Assisted Radical Prostatectomy In An Ambulatory Surgery Center Versus Hospital Setting, Nishant S. Kumar Bs, Ranko Miocinovic Md, Tom D. Beris Md, Maya Goyal Bs, Vineet Kumar Bs, Amit R. Patel Md

Medical Student Research Symposium

Introduction

Robotic-Assisted Radical Prostatectomy (RARP) is the predominant surgical approach for localized prostate cancer in the United States and over 50% of RARP are performed as ambulatory or same-day discharge encounters. Current literature supports that RARP performed in the outpatient setting are as effective and have no increase in complications compared to those performed inpatient and cost nearly 20% less than those performed inpatient.

Methods

Between May 2021 and December 2021, two-high volume robotic surgeons at an independent multi-specialty physician group performed RARP in both a freestanding ambulatory surgery center (ASC) and in an affiliated hospital. Data on demographics, clinical …

Tadalafil Monotherapy Is A Reasonable Alternative For The Treatment Of Lower Urinary Tract Symptoms In Patients With Comorbid Benign Prostatic Hyperplasia And Erectile Dysfunction, Daniel M. Ibrahim, Anam Ahmed, Swetha Reddy, Meet S. Patel, Nabeel Sumbal, Adam Chaban, Aminah I. Fayyaz

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report appraising

Oelke M, Giuliano F, Mirone V, Xu L, Cox D, Viktrup L. Monotherapy with tadalafil or tamsulosin similarly improved lower urinary tract symptoms suggestive of benign prostatic hyperplasia in an international, randomized, parallel, placebo-controlled clinical trial. Eur Urol. 2012;61(5):917-925. https://doi.org/10.1016/j.eururo.2012.01.0131

for a vigorous 75-year-old man with benign prostatic hyperplasia (BPH) and erectile dysfunction (ED) who discontinued dutasteride due to intolerable sexual side effects.

Race Has No Impact On Prostate Cancer-Specific Mortality, When Comparing Patients With Similar Risk Of Other-Cause Mortality: An Analysis Of A Population-Based Cohort, Shane A. Tinsley, Marco Finati, Alex Stephens, Giuseppe Chiarelli, Giuseppe O. Cirulli, Eric M. Williams, Chase Morrison, Caleb Richard, Keinnan Hares, Akshay Sood, Nicolos Buffi, Giovanni Lughezzani, Carlo Bettocchi, Andrea Salonia, Alberto Briganti, Francesco Montorsi, Giuseppe Carrieri, Craig G. Rogers, Firas Abdollah

Medical Student Research Symposium

Background: Other-cause mortality (OCM) can serve as a surrogate for access-to-care. The authors sought to compare prostate cancer-specific mortality (PCSM) in Black versus White men matched based on their calculated OCM risk.

Methods: The Surveillance, Epidemiology, and End Results (SEER) database was queried for Black and White men diagnosed with prostate cancer between 2004 to 2009, to collect long-term follow-up. A Cox regression was used to calculate the OCM risk using all available covariates. This calculated OCM risk was used to construct a 1:1 propensity score matched (PSM) cohort. Then, a competing-risks multivariable tested the impact of race on PCSM. …

Variation In Treatment Recommendations For Low-Risk Prostate Cancer: A Focus On Active Surveillance Across Physician Specialties, Sinyu Yang B.S., Tiffany Chu B.S., Cathryn Bock Ph.D, Jinping Xu M.D.

Medical Student Research Symposium

Prostate cancer (PC) is the second leading cause of cancer-related death in men globally, with 1 in 8 men in the US diagnosed during their lifetime. For Low-Risk Prostate Cancer (LRPC), management options include Watchful Waiting (WW), Active Surveillance (AS), or curative treatments such as prostatectomy or radiation. While curative treatments can have significant long-term side effects like urinary incontinence and sexual dysfunction, AS is less invasive and preferred due to fewer adverse effects. However, variations in physician training may lead to differing recommendations, potentially causing confusion or frustration for patients consulting multiple specialists. This study investigates whether treatment recommendations—AS, …

Pessary Use In Urology Clinics, Kathy Z. Lu Bs, Emily Brodowsky Md, Alex Stephens Ms, Samantha Raffee Md, Humphrey Atiemo Md

Medical Student Research Symposium

Introduction: Pessaries are a non-invasive treatment option for patients with pelvic organ prolapse (POP) or stress urinary incontinence (SUI). There is currently limited data regarding pessary usage among urology patients. The aim of this study is to determine the patient characteristics that predict long term pessary usage versus surgical intervention.

Methods: A 10-year retrospective review of pessary usage in women with either SUI or POP was performed. Patients were stratified into pessary longevity of less than or greater than one year. Quality of life measures before and after pessary use included pads per day, incontinence symptom index (ISI) scores, and …

Amniotic Bladder Therapy In Patients With Interstitial Cystitis/Bladder Pain Syndrome, Jack Considine, Codrut Radoiu, Sophie Wittenberg, Nivedita Dhar Md, Raghav Madan Md, Jack Vernocke Md, Aron Liaw Md, Alaa Hamada Md

Medical Student Research Symposium

Introduction and Objectives: Our study hypothesis postulates that if patients with Interstitial Cystitis/Bladder Pain Syndrome (IC/BPS) bladders exhibit increased inflammation, fibrosis, and urothelial dysfunction, then treatment modalities that modulate inflammation and fibrosis, while promoting a regeneration may have a therapeutic effect in such patients. Amniotic membrane (AM) has been shown to foster a regenerative wound-healing environment. This study investigates the safety and efficacy of bladder injections of AM in patients with treatment resistant IC/BPS.

Methods: Fifteen consecutive treatment resistant IC/BPS patients (mean age 50.7 ± 14.4 years) with a median disease duration of 7 years (5-12 years) were …

Exploring The Effects Of Amniotic Bladder Therapy On Female Sexual Dysfunction In Interstitial Cystitis/Bladder Pain Syndrome Patients, Jonathan D. Lutchka, Jack Vercnocke Md, David Pearlman Md, Aron Liaw Md, Nivedita Dhar Md

Medical Student Research Symposium

Introduction and Objectives: Female sexual dysfunction (FSD) is commonly associated with Interstitial Cystitis/Bladder Pain Syndrome (IC/BPS). FSD manifests as abnormalities in sexual desire, arousal, orgasm, pain, distress, and satisfaction. Our primary objective was to assess the impact of micronized amniotic membrane injections (AM) on FSD and lower urinary tract symptoms using comprehensive measures, including the multi-domain Female Sexual Function Index (FSFI), the Pain Visual Analog Scale (VAS), and the Interstitial Cystitis Symptom Index (ICSI) and Interstitial Cystitis Problem Index (ICPI).

Methods: Study participants included patients diagnosed with IC/BPS and FSD refractory to traditional therapies. Under general anesthesia, these …

Hif Expression In Clear-Cell Renal Cell Carcinoma (Ccrcc) Tumors Of Adults With And Without Obstructive Sleep Apnea (Osa), Olivia Heppell, Carlos Guerra Londono, Nilesh Gupta

Medical Student Research Symposium

Introduction: Upregulation of hypoxia-inducible factors (HIF) is an important pathological feature shared by clear cell renal cell carcinoma (ccRCC) and obstructive sleep apnea (OSA). However, it is unclear whether OSA alters the pathogenesis of ccRCC via HIF expression.

Methods: A retrospective cohort of adults undergoing nephrectomy for ccRCC was identified electronically (IRB#16040-1). The diagnosis of OSA was established with preoperative STOP-BANG scores or polysomnography. A consecutive sample of 20 individuals with and 20 without OSA was selected. Clinical characteristics and pathology results were reviewed. Resected tumor sections were immunohistochemically stained for HIF-1& HIF-2 at antibody dilutions of 1:150. Intensity and …

Clinical Pathway Using Arabic Written Medical Information To Improve Incontinence Healthcare Utilization, John F. Knapp, Codrut Radoiu, Emma Ross, Jack Vercnocke Md, Aron Liaw Md, Nivedita Dhar

Medical Student Research Symposium

Introduction and Objective: Metro Detroit holds ~13% of all Arabic speakers in the U.S.A. and 91% of those in Michigan. Evidence supports that patients who do not speak the local language have poor access to healthcare. This study describes our preliminary experience of managing Arabic only speaking women with bothersome stress urinary incontinence (SUI) from May 2022 to October 2023. These women routinely request same-sex interpreters, which is not always possible, leading to a lack of detailed translation. A potential solution is to use Arabic written medical information (AWMI). The purpose of the study was to retrospectively look at the …

Gender Gap In Industry Payments To Urologists, Matthew Davis, Mohit Butaney, Alexandra Rogers, Taylor J. Malchow, Samantha Wilder, Alex Stephens, Sohrab Arora, Akshay Sood, Alexander Cole, Quoc-Dien Trinh, Craig Rogers, Firas Abdollah

Medical Student Research Symposium

Background: The Open Payments Program (OPP) was established in 2013 under the Sunshine Act, which mandated that medical device and pharmaceutical manufacturers submit public records of any financial incentive given to physicians. The study aim is to characterize the gap in general and research payments between male and female urologists over the past 7 years.

Methods: The study sample included all urologists in the US who received at least one general (GP) or research payment from 2015 to 2021. In order to identify urologists’ genders, the OPP was matched with the National Provider Index dataset. Payments to male …

Inhibiting Phosphatidylinositol 4-Kinase Iiialpha With Gsk-F1 Reduces The Plasma Membrane-Associated Phosphatidylinositol Phosphate Lipid Messenger Levels In Prostate Cancer Cells, Codrut Radoiu, Diego Sbrissa, Sreenivasa R. Chinni

Medical Student Research Symposium

Inhibiting phosphatidylinositol 4-kinase IIIa with GSK-F1 reduces the plasma membrane-associated phosphatidylinositol phosphate lipid messenger levels in prostate cancer cells

Codrut Radoiu, Diego Sbrissa, Sreenivasa Chinni

Department of Urology and Pathology, Wayne State University School of Medicine, Detroit, MI 48201, USA

Background: The role of chemokine signaling in prostate cancer metastasis has demonstrated to be a promising focus of research and a potential target for abating malignant cell invasion and metastasis. CXCR4, a GPCR, is overexpressed in prostate cancer cells, with downstream signaling involved in cellular migration, proliferation and survival when it is activated by its ligand, CXCL12. Upon …

Evaluating The Role Of Lvi As An Indicator For Adverse Outcomes In Patients With Upper Tract Urothelial Carcinoma And Its Histological Subtypes, Ivan Rakic, Matthew Davis, Nicholas Corsi, Alexander Stephens, Chase Morrison, Sohrab Arora, Taylor Malchow, Akshay Sood, Craig Rogers, Firas Abdollah

Medical Student Research Symposium

Lymphvascular invasion (LVI) is recognized as an adverse prognostic factor in many cancers. Our aim is to assess the prognostic ability of LVI in UTUC urothelial carcinoma (UC) and micropapillary urothelial carcinoma (MPUC) subtypes as a predictor of overall survival (OS) using a large North American cohort.

Our cohort included 9750 cM0 UTUC patients who underwent a radical nephroureterectomy (RNU), between 2004 and 2015, within the National Cancer Database (NCDB). The main variable of interest was LVI status, and its interaction with pathological nodal (pN) status. Kaplan-Meier curves were used to estimate the OS. Cox regression analysis tested the impact …

External Beam Radiation Therapy Carries Lower Risk Of Sexual Dysfunction As Compared To Radical Prostatectomy In Treatment Of Patients With Localized Prostate Cancer, Aamod S. Dekhne

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report appraising:

Donovan JL, Hamdy FC, Lane JA, et al. Patient-Reported Outcomes after Monitoring, Surgery, or Radiotherapy for Prostate Cancer. N Engl J Med. 2016;375(15):1425-1437. https://doi.org/10.1056/NEJMoa1606221

for a patient with localized prostate cancer and concerns regarding future sexual dysfunction.

Fecal Microbiota Transplantation May Have Clinical Utility In Reducing Incidence Of Recurrent Urinary Tract Infection, Jeremy A. Grekin

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Tariq R, Pardi DS, Tosh PK, Walker RC, Razonable RR, Khanna S. Fecal microbiota transplantation for recurrent Clostridium difficile infection reduces recurrent urinary tract infection frequency. Clinical Infectious Diseases. 2017 Oct 30;65(10):1745–1747. doi: 10.1093/cid/cix618

Pten Loss Mediated Akt Activation Promotes Prostate Tumor Growth And Metastasis Via Cxcl12/Cxcr4 Signaling, M Conley-Lacomb, Allen Saliganan, Pridvi Kandagatla, Yong Q. Chen, Michael L. Cher, Sreenivasa R. Chinni

Wayne State University Associated BioMed Central Scholarship

Abstract

Introduction

The chemokine CXCL12, also known as SDF-1, and its receptor, CXCR4, are overexpressed in prostate cancers and in animal models of prostate-specific PTEN deletion, but their regulation is poorly understood. Loss of the tumor suppressor PTEN (phosphatase and tensin homolog) is frequently observed in cancer, resulting in the deregulation of cell survival, growth, and proliferation. We hypothesize that loss of PTEN and subsequent activation of Akt, frequent occurrences in prostate cancer, regulate the CXCL12/CXCR4 signaling axis in tumor growth and bone metastasis.

Methods

Murine prostate epithelial cells from PTEN^+/+, PTEN ^+/− , and PTEN^−/− (prostate …

A Unique Case Of Urinary Bladder Simple Melanosis: A Case Report And Review Of The Literature, Bo Jin, Syed Y. Zaidi, Melvin Hollowell, Christopher Hollowell, Husain Saleh

Wayne State University Associated BioMed Central Scholarship

Abstract

Melanosis refers to abnormal or excessive deposition of melanin pigment in the cells and/or tissue, which can be seen in any organ but commonly in skin and oral mucosa. Melanosis of the urinary bladder is an extremely rare benign condition and only a handful of cases been reported in the English literature before. In this article, we report a new case of urinary melanosis, describe the differential diagnostic features from pseudomelanosis and offer clues for correct diagnosis. We also provide comprehensive review of the literature on the subject.

Prevalence, Evaluation And Management Of Overactive Bladder In Primary Care, Wellman W. Cheung, Nadia H. Khan, Karmina K. Choi, Martin H. Bluth, Miriam T. Vincent

Wayne State University Associated BioMed Central Scholarship

Abstract

Background

Patients with overactive bladder (OAB) are under-diagnosed in the primary care setting. Primary care physicians (PCP) approach to the patient and appropriate patient disclosure may contribute to under-diagnosis.

Methods

An outpatient primary care setting was used to determine the prevalence and characteristics of OAB. Patients who visited the family medicine outpatient clinic were invited to answer a self-administered questionnaire. It included questions on evidence of lower urinary tract symptoms (modified Overactive Bladder-Validated 8-question Screener [OAB-V8]), relevant medical and surgical history, and demographic data. Relationship between OAB and other independent variables were analyzed using chi-square and risk ratio (RR) …

Analytical Approaches To Detect Maternal/Fetal Genotype Incompatibilities That Increase Risk Of Pre-Eclampsia, Neeta Parimi, Gerard Tromp, Helena Kuivaniemi, Jyh Nien, Ricardo Gomez, Roberto Romero, Katrina Ab Goddard

Wayne State University Associated BioMed Central Scholarship

Abstract

Background

In utero interactions between incompatible maternal and fetal genotypes are a potential mechanism for the onset or progression of pregnancy related diseases such as pre-eclampsia (PE). However, the optimal analytical approach and study design for evaluating incompatible maternal/offspring genotype combinations is unclear.

Methods

Using simulation, we estimated the type I error and power of incompatible maternal/offspring genotype models for two analytical approaches: logistic regression used with case-control mother/offspring pairs and the log-linear regression used with case-parent triads. We evaluated a real dataset consisting of maternal/offspring pairs with and without PE for incompatibility effects using the optimal analysis based …

Paradoxical Antiproliferative Effect By A Murine Mammary Tumor-Derived Epithelial Cell Line, Esteban N. Gurzov, Sanaa M. Nabha, Hamilto Yamamoto, Hong Meng, O Graciela Scharovsky, R Daniel Bonfil

Wayne State University Associated BioMed Central Scholarship

Abstract

Background

Despite significant advancement in breast cancer therapy, there is a great need for a better understanding of the mechanisms involved in breast carcinogenesis and progression, as well as of the role of epigenetic contributions from stromal cells in mammary tumorigenesis. In this study, we isolated and characterized murine mammary tumor-derived epithelial and myofibroblast cell lines, and investigated the in vitro and in vivo effect of cellular soluble factors produced by the epithelial cell line on tumor cells.

Methods

Morphology, immunophenotype, cytogenetics, invasiveness, and tumorigenicity of epithelial (LM-234ep) and myofibroblast (LM-234mf) cell lines isolated from two murine mammary adenocarcinomas …