Urology Commons^™

Tamsulosin Use After Shock Wave Lithotripsy: A Systematic Review, Katherine Harte

Senior Honors Projects

Urolithiasis, or the formation of stones in the urinary tract, is a potentially painful process that impacts many people across the world. However, the results of clinical trials disagree on the proper treatment and management of kidney stones. One way to help those who have kidney stones is to perform extracorporeal shock wave lithotripsy (SWL), a medical procedure in which shock waves are directed towards kidney stones to prevent them from migrating and causing pain. Following SWL, patients are sometimes given additional medications, such as alpha blockers (e.g., tamsulosin), to aid in the passage of the stones. However, the benefits …

Candidemia Following Ureteric Stent Placement In A Patient With Type 2 Diabetes Treated With Canagliflozin, Rishi Raj, Jon Hendrie, Aasems Jacob, Derick Adams

Internal Medicine Faculty Publications

A 38-year-old female patient with well-controlled type 2 diabetes mellitus treated with canagliflozin underwent ureteral stent placement for obstructive renal calculi. Ten days following ureteroscopy and ureteral stenting, she developed fevers and blood cultures grew Candida glabrata (C. glabrata). The patient was successfully treated with an extended course of broad-spectrum antibiotics and antifungal agents. The clinical presentation of candidemia is indistinguishable from bacteremia resulting in delay in diagnosis and treatment. Candiduria is commonly seen in patients with type 2 diabetes, however it rarely leads to candidemia in an otherwise healthy person following a relatively simple urologic procedure. Sodium-glucose …

Traumatic Bladder Ruptures: A Ten-Year Review At A Level 1 Trauma Center, John Barnard, Tyler Overholt, Ali Hajiran, Chad Crigger, Morris Jessop, Jennifer Knight, Chad Morley

Faculty & Staff Scholarship

Abstract

Bladder rupture occurs in only 1.6% of blunt abdominopelvic trauma cases. Although rare, bladder rupture can result in significant morbidity if undiagnosed or inappropriately managed. AUA Urotrauma Guidelines suggest that urethral catheter drainage is a standard of care for both extraperitoneal and intraperitoneal bladder rupture regardless of the need for surgical repair. However, no specific guidance is given regarding the length of catheterization. The present study seeks to summarize contemporary management of bladder trauma at our tertiary care center, assess the impact of length of catheterization on bladder injuries and complications, and develop a protocol for management of bladder …

Pediatric Testicular Torsion: Does Patient Transfer Affect Time To Intervention Or Surgical Outcomes At A Rural Tertiary Care Center?, Tyler Overhoolt, Morris Jessop, Osama Al-Omar, John Barnard

Faculty & Staff Scholarship

Background: Testicular torsion (TT) is a urologic emergency that requires prompt surgical intervention. In rural Appalachia, patients are often transferred from surrounding communities due to lack of urologic care. We hypothesized that those transferred would have delayed intervention and higher rates of orchiectomy when compared to those who presented directly to our hospital. Methods: We performed a retrospective review of patient charts with an ICD-9 diagnosis of TT from 2008 to 2016. Patients met inclusion criteria if diagnosis was confirmed by operative exploration. We compared rate of testicular loss and time until surgical intervention between groups. Results: Twenty-three patients met …

Propensity-Matched Analysis Of Patient-Reported Outcomes For Neoadjuvant Chemotherapy Prior To Radical Cystectomy, M. A. Feuerstein, L. Goldstein, B. Reaves, A. Sun, M. Goltzman, B. A. Morganstern, A. Shabsigh, D. F. Bajorin, J. E. Rosenberg, B. H. Bochner, +7 Additional Authors

Journal Articles

© 2019, Springer-Verlag GmbH Germany, part of Springer Nature. Purpose: To evaluate patient-reported outcomes (PROs) for bladder cancer patients undergoing neoadjuvant chemotherapy (NAC) prior to radical cystectomy (RC) using longitudinal data and propensity-matched scoring analyses. Methods: 155 patients with muscle-invasive bladder cancer scheduled for RC completed the European Organization for Research and Treatment of Cancer questionnaires, EORTC QLQ-C30, EORTC QLQ-BLM30, Fear of Recurrence Scale, Mental Health Inventory and Satisfaction with Life Scale within 4 weeks of surgery. A propensity-matched analysis was performed comparing pre-surgery PROs among 101 patients who completed NAC versus 54 patients who did not receive NAC. We …

Distal Corporoplasty Using An Autologous Tunica In The Management Of Penile Prosthesis Pseudo Aneurysm, Michel Apoj, Elizabeth A. Phillips

Articles

Inflatable penile prosthesis placement is an effective and safe treatment option for erectile dysfunction. The 5-year revision rate is low (7%) and revisions are most likely due to infection or mechanical problems with the device.

Penile prosthesis aneurysm is a rare complication that is managed surgically. The choice of graft used during tunical reinforcement is critical to avoid subsequent complications. The use of autologous grafts from distant tissue often leads to deformations of penile tissue in addition to the increase in operative time, morbidity, and cost of the operation. The use of synthetics increases the susceptibility to infection and decreases …

Improving Midstream Urine Collection For Urine Culture Through The Use Of A Novel Device, Flipcatch, Christopher Neely, Dante Varotsis, Helen Xu

Phase 1

Background : A midstream, clean-catch urine sample is the gold standard for diagnosing urinary tract infections and determining treatment. The current method of collection is not standardized, frustrating both patients and providers. The current method results in a high rate of contaminated samples (30-40%), which often need to be repeated in order to obtain a diagnosis and antibiotic susceptibility data. A design project was conducted in order to create a more effective urine collection device with the goals of decreasing contamination and improving patient and provider experience.

Methods : We conducted interviews of patients, allied health professionals, physicians, and clinical …

Assessing Clinical Reasoning Skills Using Script Concordance Test (Sct) And Extended Matching Questions (Emqs): A Pilot For Urology Trainees, Syed Muhammad Nazim, Jamsheer Jehangir Talati, Sheila Pinjani, Syed Raziuddin Biyabani, Muhammad Hammad Ather, John J. Norcini

Section of Urology

Introduction: Clinical reasoning skill is the core of medical competence. Commonly used assessment methods for medical competence have limited ability to evaluate critical thinking and reasoning skills. Script Concordance Test (SCT) and Extended Matching Questions(EMQs) are the evolving tests which are considered to be valid and reliable tools for assessing clinical reasoning and judgment. We performed this pilot study to determine whether SCT and EMQs can differentiate clinical reasoning ability among urology residents, interns and medical students.
Methods: This was a cross-sectional study in which an examination with 48 SCT-based items on eleven clinical scenarios and four themed EMQs with …

Is Sildenafil Citrate Effective In Treating Erectile Dysfunction Secondary To Upper Motor Neuron Spinal Cord Injury?, Mackayla R. Probasco

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not “Is sildenafil citrate effective in treating erectile dysfunction secondary to upper motor neuron spinal cord injury?”

STUDY DESIGN: A systematic review of three peer-reviewed primary studies published in English between the years of 2008 and 2010.

DATA SOURCES: Two double-blind, randomized, placebo-controlled trials and one open, before-after study, evaluating if sildenafil citrate is effective in treating erectile dysfunction secondary to upper motor neuron (UMN) spinal cord injury (SCI). Data sources collected using Alt HealthWatch, CINAHL Plus and PubMed.

OUTCOME(S) MEASURED: The clinical outcome of erectile function …

Is Electroacupuncture Effective In Improving Quality Of Life For Women With Urinary Incontinence?, Shelby Kaminsky

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective evidence based medicine (EBM) review is to determine whether or not “Is electroacupuncture effective in improving quality of life for women with urinary incontinence?”

STUDY DESIGN: A systematic review of 3 peer-reviewed studies published between the years of 2014 and 2017.

DATA SOURCES: Two randomized placebo-controlled studies and one comparative study evaluating if electroacupuncture (EA) and/or the use of tolterodine improves the quality of life and therapeutic effects of those with urinary incontinence (UI). Sources were selected from PubMed and Cochrane Library based off of their relevance to the clinical question and the outcomes …

Incidentally Found Metastatic Prostatic Carcinoma In A Therapeutic Orchiectomy Specimen, Zeeshan Uddin, Muhammad Bilal, Mohammad Ayaz Khan

Department of Pathology and Laboratory Medicine

Metastatic tumour involving the testis is a rare event. Incidental discovery of metastatic cancer in a therapeutic orchiectomy is even rarer. We report a case of metastatic adenocarcinoma prostate found incidentally in one of the bilateral therapeutic orchiectomy specimens. The patient was a 55-year-old man presenting with back ache and generalized body aches. Clinical examination showed malignant feel of prostate. Bone scan revealed metastatic disease and a serum PSA level of >100 ng/ml. Clinical diagnosis of carcinoma prostate was established and subsequent bilateral orchiectomy for hormonal deprivation was performed. On gross examination of left testis, there was a small 0.7 …