Urology Commons^™

Association Between Antibiotic Prophylaxis Before Cystectomy Or Stent Removal And Infection Complications: A Systematic Review, Luca Antonelli, Kirby Sebro, Abdelilah Lahmar, Peter C Black, Saum Ghodoussipour, Jill M Hamilton-Reeves, Jay Shah, Jensen Bente Thoft, Seth Paul Lerner, Carlos Llorente, Ilaria Lucca, Mark A Preston, Sarah P Psutka, John P Sfakianos, Susanne Vahr Lauridsen, Stephen B Williams, James Catto, Hooman Djaladat, Wassim Kassouf, Katherine Loftus, Siamak Daneshmand, Christian D Fankhauser

Faculty, Staff and Students Publications

Context: Patients undergoing radical cystectomy frequently suffer from infectious complications, including urinary tract infections (UTIs) and surgical site infections (SSIs) leading to emergency department visits, hospital readmission, and added cost.

Objective: To summarize the literature regarding perioperative antibiotic prophylaxis, ureteric stent usage, and prevalence of infectious complications after cystectomy.

Evidence acquisition: A systematic review of PubMed/Medline, EMBASE, Cochrane Library, and reference lists was conducted.

Evidence synthesis: We identified 20 reports including a total of 55 306 patients. The median rates of any infection, UTIs, SSIs, and bacteremia were 40%, 20%, 11%, and 6%, respectively. Perioperative antibiotic prophylaxis differed substantially between …

Transcriptional Differences In Identical Twins With Different Reproductive Capacities: A Case Report, Katherine Campbell, Alexandra Dullea, Christian Ramsoomair, Kyle Schuppe, Armin Ghomeshi, Kajal Khodamoradi, Himanshu Arora, Carolina Jorgez, Ranjith Ramasamy

Faculty, Staff and Students Publications

Disorders of sperm production can be classified quantitatively as oligospermia (low sperm count) or azoospermia (no sperm during ejaculation). Numerous genes have been implicated in spermatogenesis. We describe a case of two identical twins who presented with different reproductive capabilities. One brother was infertile due to azoospermia, and the other, although oligospermic, previously naturally fathered a child. They were found to have differential gene expression based on RNA sequencing analysis. In the man with azoospermia, we found elevated E2F1 and HOXB9 gene expressions when compared with his brother, suggesting that the increased RNA expression of these genes could influence sperm …

Bladder Mucosal Cystitis Cystica Lesions Are Tertiary Lymphoid Tissues That Correlate With Recurrent Urinary Tract Infection Frequency In Postmenopausal Women, Marianne M Ligon, Brooke Liang, Stacy M Lenger, Priyanka Parameswaran, Siobhan Sutcliffe, Jerry L Lowder, Indira U Mysorekar

Faculty, Staff and Students Publications

PURPOSE: We identify correlates and clinical outcomes of cystitis cystica, a poorly understood chronic inflammatory bladder change, in women with recurrent urinary tract infections.

MATERIALS AND METHODS: A retrospective, observational cohort of women with recurrent urinary tract infections who underwent cystoscopy (n=138) from 2015 to 2018 were identified using electronic medical records. Cystitis cystica status was abstracted from cystoscopy reports and correlations were identified by logistic regression. Urinary tract infection-free survival time associated with cystitis cystica was evaluated by Cox proportional hazards regression. Exact logistic regression was used to identify factors associated with changes to cystitis cystica lesions on repeat …

Quantifying The Number Of Us Men With Erectile Dysfunction Who Are Potential Candidates For Penile Prosthesis Implantation, Sirikan Rojanasarot, Abimbola O Williams, Natalie Edwards, Mohit Khera

Faculty, Staff and Students Publications

INTRODUCTION: Penile prosthesis implantation (PPI) is a treatment option recommended in clinical guidelines for erectile dysfunction (ED). However, a limited number of urologists perform PPI procedures in the United States.

AIM: To quantify the number of insured men with ED in the United States and project the number of potential candidates for PPI in 2022.

METHODS: An Excel-based disease impact model was constructed using a top-down estimation approach. The starting US male population consisted of adult men from 2022 US Census data after exclusion of age-specific mortality rates from the National Vital Statistics Reports. Men with health insurance were included …

Color Doppler Ultrasound Imaging In Varicoceles: Is The Difference In Venous Diameter Encountered During Valsalva Predictive Of Palpable Varicocele Grade?, Kelly Lehner, Catherine Ingram, Utsav Bansal, Colleen Baca, Adithya Balasubramanian, Nannan Thirumavalavan, Jason M Scovell, Saneal Rajanahally, Matthew Pollard, Larry I Lipshultz

Faculty, Staff and Students Publications

OBJECTIVE: The clinical grading system for varicoceles is subjective and dependent on clinician experience. Color Doppler ultrasound (US) has not been standardized in the diagnosis of varicoceles. We aimed to determine if US measurement of varicocele could be predictive of World Health Organization (WHO) varicocele grade.

METHODS: Men who presented for either scrotal pain or infertility to a tertiary men's health clinic underwent physical examination, and varicoceles were graded following WHO criteria (0=subclinical, 1, 2, 3). US was used to measure largest venous diameter in the pampiniform plexus bilaterally at rest and during Valsalva maneuver. Receiver operator characteristic curve analysis …

Tissue-Specific Dna Methylation Variability And Its Potential Clinical Value, Ryan H Miller, Chad A Pollard, Kristin R Brogaard, Andrew C Olson, Ryan C Barney, Larry I Lipshultz, Erica B Johnstone, Yetunde O Ibrahim, James M Hotaling, Enrique F Schisterman, Sunni L Mumford, Kenneth I Aston, Tim G Jenkins

Faculty, Staff and Students Publications

Complex diseases have multifactorial etiologies making actionable diagnostic biomarkers difficult to identify. Diagnostic research must expand beyond single or a handful of genetic or epigenetic targets for complex disease and explore a broader system of biological pathways. With the objective to develop a diagnostic tool designed to analyze a comprehensive network of epigenetic profiles in complex diseases, we used publicly available DNA methylation data from over 2,400 samples representing 20 cell types and various diseases. This tool, rather than detecting differentially methylated regions at specific genes, measures the intra-individual methylation variability within gene promoters to identify global shifts away from …

Peyronie's Disease: An Outcomes-Based Guide To Non-Surgical And Novel Treatment Modalities, Amit G Reddy, Michelle C Dai, Jeffrey J Song, Hudson M Pierce, Sagar R Patel, Larry I Lipshultz

Faculty, Staff and Students Publications

The clinical landscape of Peyronie's disease is everchanging. There has been growing interest in non-invasive therapeutic options that could assist patients with achieving a meaningful reduction in penile curvature without surgical intervention. These therapies are wide-ranging in terms of their mechanisms of action, efficacies, and short- and long-term safety profiles. Recently, an abundance of outcomes literature on longstanding and novel non-surgical treatment modalities has been published. For sexual medicine providers hoping to offer patients the most up-to-date and evidence-based treatments for the management of Peyronie's disease, it can be challenging to gain a thorough understanding of this body of literature. …

The Emotional Impact Of Urinary Tract Infections In Women: A Qualitative Analysis, Larissa Grigoryan, Aruni Mulgirigama, Marcy Powell, Guido Schmiemann

Faculty, Staff and Students Publications

BACKGROUND: While many studies address the clinical management of participants with uncomplicated urinary tract infection (uUTI), the emotional impact of uUTIs has been investigated less often. The aim of this qualitative study was to understand the emotional experience of women with uUTIs.

METHODS: This was a qualitative, exploratory, in-depth interview-based study conducted among women in the United States (US) and Germany. Women aged ≥ 18 years with at least one uUTI treated with antibiotics in the past year were recruited through a patient community panel and physician referrals. Participants were recruited using purposive sampling to include an equal split of …

Validating Use Of Electronic Health Data To Identify Patients With Urinary Tract Infections In Outpatient Settings, George Germanos, Patrick Light, Roger Zoorob, Jason Salemi, Fareed Khan, Michael Hansen, Kalpana Gupta, Barbara Trautner, Larissa Grigoryan

Faculty, Staff and Students Publications

OBJECTIVE: To validate the use of electronic algorithms based on International Classification of Diseases (ICD)-10 codes to identify outpatient visits for urinary tract infections (UTI), one of the most common reasons for antibiotic prescriptions.

METHODS: ICD-10 symptom codes (e.g., dysuria) alone or in addition to UTI diagnosis codes plus prescription of a UTI-relevant antibiotic were used to identify outpatient UTI visits. Chart review (gold standard) was performed by two reviewers to confirm diagnosis of UTI. The positive predictive value (PPV) that the visit was for UTI (based on chart review) was calculated for three different ICD-10 code algorithms using (1) …