Urology Commons^™

Innovating Cauti Prevention: The Cauti Café And Multidisciplinary Catheter Stewardship At The Bedside, Erik Enquist, Jennifer Neal, Naz Akhavan, Harnishad Binner

All Podium Presentations

No abstract provided.

Urobiome Composition Varies With Vesicoureteral Reflux Grade And History Of Febrile Urinary Tract Infection, Theresa C. Barrett, Kelvin Li, Adam Fitch, Asha Patel, Bhanu Sharma, Jacqueline Holden, Kermina Abdelsayed, Nina N. Kowalewski, Sridhar Narla, Daniel Bushnell, Barbara A. Methé, Catherine S. Forster

Department of Medicine Faculty Papers

Vesicoureteral reflux (VUR) is a risk factor for urinary tract infection (UTI). However, data describing the urobiome in children with VUR are limited. Here, we characterized the urobiome in children with and without VUR to better understand its potential role in VUR pathogenesis. Catheterized urine samples were obtained from children who presented for voiding cystourethrogram (VCUG) between 12/1/2020 and 10/3/2023. Children were excluded if they had any surgical procedures of the genitourinary tract in the 30 days prior to VCUG or were on treatment antibiotics at the time of VCUG. 16S rRNA gene sequencing and taxonomical classification identified the urobiome. …

Progesterone Receptors Drive Advanced Breast Cancer Phenotypes Including Circulating Tumor- And Stem-Like Cell Expansion In The Context Of Esr1 Mutation, Thu H. Truong, Noelle E. Gillis, Amy R. Dwyer, Rosemary J. Huggins, Kyla M. Hagen, Sai Harshita Posani, Nuri A. Temiz, Carlos Perez Kerkvliet, Ellie M. Piepgras, Julie H. Ostrander, Geoffrey L. Greene, Carol A. Lange

Department of Urology Faculty Papers

Endocrine therapy resistance remains a major challenge in the treatment of advanced estrogen receptor positive (ER+) breast cancer. This can be driven by acquired mutations in the estrogen receptor gene (ESR1), such as Y537S or D538G, that results in constitutive estrogen-independent ER activity. Progesterone receptors (PR) are important modifiers of ER activity, in part via direct binding. We previously showed that PR mediates expansion of cancer stem-like cell (CSC) populations. In this study, we sought to define whether PR function changes in the context of ESR1 mutations. PR readily interacted with wild type (WT), but not Y537S or D538G ERs. …

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.

Metastatic Castrate-Resistant Prostate Cancer To The Penis Resulting In Malignant Priapism And Urethral Obstruction, Courtney Stewart, Joon Yau Leong, William Kevin Kelly, Mihir Shah

Department of Urology Faculty Papers

A 76-year-old male with metastatic castrate-resistant prostate cancer was found to have metastatic disease to the urethra and penis on PSMA PET scan. This resulted in constant pain due to obstruction of blood flow through the corpora cavernosum resulting in priapism and urethral obstruction. The patient underwent a radical penectomy, partial urethrectomy and perineal urethrostomy creation. Final pathology confirmed metastatic prostatic adenocarcinoma. Although rare, prostate cancer can metastasize to the corpora spongiosum or cavernosa. Treatment options are limited, and surgical excision with urinary diversion is likely to provide the most durable outcomes for one's quality of life.

Evolving Strategies In Prostate Cancer: Emerging Approaches And Unmet Needs From The Bridging The Gaps In Prostate Cancer Expert Panel, Rana Mckay, Benjamin Maughan, Alicia Morgans, Neal Shore, Evan Yu, Ravi Madan, Jacob Berchuck, Bradley Carthon, Steven Finkelstein, Leonard Gomella, Michael Gorin, Andrew Hahn, Stacy Loeb, Vivek Narayan, Daniel Petrylak, Charles Ryan, Karine Tawagi, Phuoc Tran, Tanya Dorff

Department of Urology Faculty Papers

BACKGROUND: The expansion of treatment options for prostate cancer (PC) has improved disease-specific and overall survival outcomes but has also raised questions about the optimal level of treatment needed for patients based on their individual prognosis and accounting for potential toxicity, incorporating quality of life considerations.

METHODS: A panel of experts met to discuss current controversies in the care of patients with PC across the disease continuum. Multidisciplinary experts review advances and persistent uncertainties in biomarker-guided assessment, imaging, and systemic therapy for prostate cancer. The discussion outlines priority gaps in evidence that must be addressed to optimize individualized patient care. …

The Effects Of Bone-Remodeling Therapy On Survival, Pain, And Skeletal Related Events In The Setting Of Renal Cell Carcinoma With Bone Metastases: A Multicenter Investigation From A Large Global Health Research Network (Trinetx), Brian H. Im, Kevin K. Zarrabi, Aaron R. Hochberg, Mihir M. Shah, Md, James R. Mark, Joseph K. Izes, Patrick T. Gomella, Costas D. Lallas, Leonard G. Gomella, Adam R. Metwalli

Department of Urology Faculty Papers

INTRODUCTION: Renal cell carcinoma (RCC) is the most common renal malignancy-bone metastases (BM) are indicative of aggressive disease with a poor prognosis. We aim to evaluate the overall mortality of patients with RCC with and without BM, and to elucidate the effects of bone-remodeling therapy on mortality, incidence of skeletal-related events, and opioid usage patterns in patients with BM.

METHODS: A retrospective cohort study was conducted using TriNetX, a large, collaborative network sourced from electronic medical records of over 110 million patients from over 100 healthcare organizations. All adult patients with RCC and RCC with BM were queried.

RESULTS: There …

Micrornas In Prostate Cancer Liquid Biopsies: Early Detection, Prognosis, And Treatment Monitoring, Seyyed Mohammad Yaghoubi, Erfan Zare, Sina Jafari Dargahlou, Maryam Jafari, Mahdiye Azimi, Maedeh Khoshnazar, Solmaz Shirjang, Behzad Mansoori

Student Papers, Posters & Projects

Prostate cancer (PCa) is a common malignancy in men worldwide, with incidence projected to rise in the coming years. Traditional screening and diagnostic methods, such as prostate-specific antigen (PSA) testing and biopsy, face limitations in specificity and invasiveness. Circulating microRNAs (miRNAs) have emerged as stable, non-invasive biomarkers obtainable via liquid biopsies (blood, urine, semen) that could transform PCa management. These small regulatory RNAs reflect underlying tumor biology and are detectable at early disease stages, enabling improved early detection when used alongside or in place of PSA. Distinct miRNA expression patterns correlate with tumor aggressiveness. For example, miR-141 and miR-375 are …

Acute Aortic Dissection Masquerading As Testicular Torsion: A Case Report, Bruce M. Lo, Megyn K. Christensen, Coral E. Byrns, Benjamin Chidester

Department of Emergency Medicine Faculty Publications

Introduction: Aortic dissection is a rare but life-threatening condition with a high mortality rate if diagnosis is delayed. Aortic dissection classically presents with sudden-onset, sharp pain in the chest or back. However, atypical presentations can also occur, which could lead to a delay in diagnosis.

Case Report: A patient initially presented to the emergency department (ED) with left testicular pain ongoing for several hours. On examination, he had tenderness in the left lower quadrant abdomen and left testicle. A testicular ultrasound revealed decreased blood flow to the left testicle, raising concern for testicular torsion. The patient was taken to the …

A Practical Phenotyping Framework For Male Lower Urinary Tract Symptoms Using Remote Multi-Day Urinary Diagnostics, Jeremy Watts, Daniel Godelfer, John Knoedler, Ashley Sturdy, Steven Kaplan, Ilya Sobol

Department of Urology Faculty Publications

Objective

To describe the distribution of predefined Index Symptoms and Diagnostic Profiles in a cohort of men undergoing Remote multi-day urinary diagnostics (RMUD) for lower urinary tract symptoms (LUTS).

Methods

We retrospectively analyzed 1,047 RMUD performed with CarePath® in men referred for LUTS across 18 sites. RMUD combined multi-day frequency-volume and uroflowmetry data with the IPSS. Six Index Symptoms were operationalized: (1) low flow with elevated IPSS (device trial criteria), (2) overactivity, (3) primary overactivity (overactivity without obstructive RMUD findings), (4) nocturia, (5) nocturnal polyuria (NP) using the ICS NP index, and 6) no qualifying voids. Combinations of the Index …

Leveraging Virtual Reality And Haptics To Teach Surgical Skills: A Usability Study On Retropubic Midurethral Slings, Lauren Siff, Ginger S. Watson, Jerome Dixon, Moshe Feldman, Franklin Bost, Philippe J. Giabbanelli

VMASC Publications

Traditional methods to learn soft-tissue surgical procedures rely on cadaver labs or patient-based learning, which are costly and geographically limited, and raise ethical questions. Virtual reality (VR) with haptic feedback offers a scalable alternative, but most current platforms emphasize bone-based rather than soft-tissue procedures learned by feel. We developed a VR+haptic simulation for preoperative training of retropubic midurethral sling (MUS) surgery. This study examines the usability of this platform with thirteen expert urogynecologic surgeons and subsequently makes improvements (e.g., in haptics) to evaluate the platform with twelve trainees based on the NASA Task Load Index for workload and a UTAUT-informed …

Improving Prostate Cancer Patients’ Experience And Understanding With A Pre-Ct Simulation Checklist In Genitourinary Radiation Oncology, Christopher Le

Doctor of Nursing Practice Final Project Abstract

Improving Prostate Cancer Patients’ Experience and Understanding With a Pre-CT Simulation Checklist in Genitourinary Radiation Oncology

Purpose

The purpose of this quality improvement (QI) project was to implement a Pre-CT Simulation checklist for Prostate cancer patients in the outpatient Radiation Oncology Genitourinary clinic to improve patients’ experience and comprehension on their Simulation Day.

Background

The CT simulation is a critical step in treatment planning. Lack of clear, concise, consistent instruction and education preparation prior to simulation day can delay planning and treatment. Currently, there is no standardized checklist to ensure patients are educated and prepared for their CT simulation day. …

Lipid And Foam Cell Accumulation As Novel Pathological Features Of Benign Prostatic Hyperplasia, Dita Julianingsih, Samara V. Silver, Thaissa Horne, Kasun Gunawardena, Savannah Ward, Alicia Malewska, Douglas Strand, Julius Nyalwidhe, Ilya Sobol, Petra Popovics

Department of Biomedical and Translational Sciences Faculty Publications

Background

Benign prostatic hyperplasia (BPH) encompasses a heterogeneous set of pathological processes that instigate lower urinary tract symptoms (LUTS). Using a mouse model of steroid hormone imbalance-induced lower urinary tract dysfunction, we identified luminal lipid-laden foamy macrophages, although their presence and contribution to human pathology have not yet been established. The objective of this study was to determine whether luminal macrophages are associated with human BPH and to assess how lipid accumulation relates to underlying pathological features and clinical parameters.

Methods

Whole-mount tissue sections from simple prostatectomy specimens and prostates from healthy donors were used to evaluate the association of …

Evaluation Of Mycoplasma Genitalium Positivity And Co-Infection With Chlamydia Trachomatis And/Or Neisseria Gonorrhoeae At Various Care Sites Across The United States, Rebecca Lillis, Rodney Arcenas, Christy M. Boraas, Steven E. Chavoustie, Lashonda Crane, Nicole D'Empaire, Aaron C. Ermel, Glenn Harnett, Federico Hinestrosa, Stacey House, Joseph Miller, Anthony Mills, Ronald Poblete, Stephen Young, Barbara Van Der Pol

School of Medicine Faculty Publications

OBJECTIVES: We evaluated Mycoplasma genitalium (MG) positivity and co-infection with Chlamydia trachomatis (CT) and/or Neisseria gonorrhoeae (NG), based on results from a trial assessing clinical performance of the Cobas® Liat CT/NG/MG point-of-care test. METHODS: A prospective, US, multicenter, noninterventional study assessed MG positivity in prospective urine samples (male) and clinician-collected vaginal swabs (female) from symptomatic/asymptomatic patients aged ≥14 years attending various clinical settings. Participants were designated positive or negative for MG, CT, and NG based on combined results from three US Food and Drug Administration-approved assays and one laboratory-developed test. MG co-infection with CT and/or NG was assessed. RESULTS: Among …

A New Application For Bolt Cutters In Urogynecology: Challenging Removal Of An Impacted Pessary, Carolyn M. Payne, Courtney B. Ritchie, Tanaz R. Ferzandi

HCA Healthcare Journal of Medicine

Background

Pessaries are commonly used to treat pelvic organ prolapse. While these devices generally pose negligible risk, serious morbidity can be associated with neglected use.

Case Presentation

A 91-year-old woman began to experience acute pain related to an impacted pessary. An Exam in the operating room under anesthesia revealed that the pessary was deeply embedded within the vaginal canal and was noted to have a hard metal wire under a rubber exterior. An intraoperative orthopedic consult was obtained to facilitate discussion and selection of tools outside the typical gynecological scope to remove the pessary. A combination of bolt cutters and …

Treatment Patterns For Genitourinary Syndrome Of Menopause: A Trinetx Analysis, Anushka Ghosh, Maria D'Amico, Yash B. Shah, Whitney R. Smith, Mihir S. Shah, Costas D. Lallas, Alana M. Murphy

Department of Urology Faculty Papers

BACKGROUND: Genitourinary syndrome of menopause (GSM) is a highly prevalent, underdiagnosed condition that can significantly impair quality of life (QoL). This study evaluates real-world treatment trends for GSM to better understand current management practices and highlight ongoing gaps in care. The background is in a different font than the rest of the abstract.

METHODS: We queried the TriNetX database for patients with a diagnosis of postmenopausal atrophic vaginitis (ICD N95.2) and treatment information from 2004-2024. A combination of RxNorm and International Classification of Diseases-10 (ICD) codes was used to classify disease and treatment type, including topical estrogen (RxNorm 4083, 4099), …

Low Utilization Of Intracavernosal Injection And Penile Doppler Ultrasound In The Evaluation Of Erectile Dysfunction And Peyronie's Disease, Joon Yau Leong, Tyler Gaines, Zachary J. Prebay, David Ebbott, Paul H. Chung

Department of Urology Faculty Papers

INTRODUCTION: Despite the diagnostic value of intracavernosal injections (ICI) and penile Doppler ultrasound (PDUS), there remain barriers to widespread clinical adaptation of these methods. The study aimed to evaluate the practice patterns of utilization of ICI and PDUS in the assessment of erectile dysfunction (ED) and Peyronie's disease (PD).

METHODS: Using the TriNetX database (Cambridge, MA, USA), adult (≥18 years) male patients with a diagnosis of ED on oral phosphodiesterase-5 (PDE5) inhibitors were identified. Current Procedural Terminology codes were utilized to identify patients who underwent further evaluation with ICI or PDUS, as well as penile prosthesis placement after PDUS. A …

Evaluating The Impact Of A Community-Based Prostate Cancer Screening Program, Amy Leader, Kristine Pham, Nicola Cianci, Hannah Knapp, Fatuma Doka, Suzanne Barron, Oleksandr Kolesnikov, Jordan Dehoratius, Katie Bradley, Le'ann Robles, Robert Giamboy, Olivia Dahlgren, Leonard G. Gomella

Kimmel Cancer Center Faculty Papers

BACKGROUND: One out of eight men in the U.S. will be diagnosed with prostate cancer during his lifetime. Black men are more likely to be diagnosed with and die from prostate cancer than other males, contributing to significant prostate cancer disparities. Early detection, often by routine screening, allows for more options for treatment and an increased chance of survival. Barriers to screening contribute to prostate cancer disparities, particularly among those who lack regular access to health care. Community based screening programs may overcome barriers to prostate cancer screening.

METHODS: An urban, NCI-designated cancer center collaborated with a national prostate cancer …

Travel Time To Treating Facility And Mortality In Men With Prostate Cancer, Stephan M. Korn, Filippo Dagnino, Danesha Daniels, Zhiyu Qian, Hanna Zurl, Klara K. Pohl, Mei Chin Hsieh, Brenda Y. Hernandez, Andrea Piccolini, Alexander P. Cole, Amanda J. Reich, Joel S. Weissman, Quoc Dien Trinh, Hari S. Iyer

School of Public Health Faculty Publications

IMPORTANCE Geographic access to prostate cancer care may influence outcomes but is often measured using straight-line distance, which may not accurately capture the travel burden experienced by patients. OBJECTIVE To evaluate the association between estimated travel time from patients’ residence to treatment facilities and all-cause and prostate cancer–specific mortality. DESIGN, SETTING, AND PARTICIPANTS This retrospective cohort study used data from the Multilevel Epidemiologic Tumor Registry for Oncology, a nationally representative, investigatorinitiated, population-based cancer registry that integrates geomasked residential and treatment facility information from multiple US state cancer registries. The study included patients aged 40 to 99 years from Hawaii, Louisiana, …