Urology Commons^™

Defining And Detecting Bacterial Consortia Within Urine Samples Of Patients With Symptomatic Urinary Tract Infection, Annah Vollstedt, Dakun Wang, Natalie Luke, David Baunoch, Kirk J. Wojno, Kevin Cline, Natalie Gaines, Howard Korman, S Mohammad Jafri, David Wenzler, Frank Burks, Larry Sirls

Conference Presentation Abstracts

Introduction: Bacterial consortia are non-random patterns of bacterial communities that work synergistically to provide growth and survival advantages over planktonic, free-floating, microbes. In this study, we aim to characterize bacterial consortia identified by multiplex polymerase chain reaction (M-PCR) in symptomatic patients with polymicrobial urinary tract infections (UTI). Methods: We performed a retrospective analysis of 2493 UTI-symptomatic patients over the age of 60 from 37 geographically disparate urology clinics from July 2018 to February 2019. M-PCR was performed to detect 24 different bacterial species. A cutoff of 10 detections was used to distinguish a bacterial consortium from a random association of …

Are Consortia Polymicrobial Urinary Tract Infections More Symptomatic Than Monomicrobial? Results From A Multi-Institutional Study, Annah Vollstedt, Dakun Wang, Natalie Luke, David Baunoch, Kirk J. Wojno, Kevin Cline, Natalie Gaines, Howard Korman, S Mohammad Jafri, David Wenzler, Frank Burks, Larry Sirls

Conference Presentation Abstracts

Introduction: Polymerase chain reaction (PCR) has been shown to be more sensitive in the detection of polymicrobial infections in patients with urinary tract infection (UTI). Bacterial consortia are non-random communities of microbes that may act synergistically to provide growth and survival advantages. We aim to investigate the relationship between bacteria detected by PCR, and the presence of consortia, with clinical findings in patients with symptomatic UTI. Methods: We performed a retrospective analysis of 2493 UTI-symptomatic patients over the age of 60 from 37 geographically disparate urology clinics in the U.S. from July 2018 to February 2019. Clinical findings, including UA …

Fractional Carbon Dioxide Vaginal Laser For The Treatment Of Urinary Symptoms: Preliminary Short-Term Results, Annah Vollstedt, Lauren Tennyson, Michael Rezaee, Ly Hoang Roberts, Larry Sirls, Priya Padmanabhan, Kenneth M. Peters

Conference Presentation Abstracts

Introduction: It has been proposed that fractional carbon dioxide (fCO2) vaginal laser can also treat stress urinary incontinence (SUI) by increasing collagen production. The aim of our study was to evaluate the effect of vaginal fCO2 laser therapy in patients complaining of SUI. Methods: This is a prospective, open-label study of women over 18 years old with complaints of urogenital symptoms. Women with a history of vaginal estrogen use within the last 3 months were excluded. Participants received 3 laser treatments 6 weeks apart. Cough stress test (CST) was performed at each visit. Incontinence-Quality of Life (I-QOL), Questionnaire for Urinary …

Concordance Between Antibiotic Resistance Genes By Multiplex Polymerase Chain Reaction And Antibiotic Susceptibility By Pooled Antibiotic Sensitivity Testing In Symptomatic Patients With Urinary Tract Infection, Annah Vollstedt, Dakun Wang, Natalie Luke, David Baunoch, Kirk J Wojno, Kevin Cline, Natalie Gaines, Howard Korman, S Mohammad Jafri, David Wenzler, Frank Burks, Larry Sirls

Conference Presentation Abstracts

Introduction: Studies have shown many genes influence antibiotic resistance, and the relationship between genotypic and phenotypic antibiotic resistance is unclear. We sought to analyze the concordance between the presence of antibiotic resistance (ABR) genes and antibiotic susceptibility results in urine samples collected from symptomatic UTI patients. Methods: Urine samples were collected from patients presenting with possible UTI to 37 geographically disparate Urology clinics from July 2018 to February 2019. Multiplex polymerase chain reaction (M-PCR) was used to test for 33 different ABR genes. Samples in which at least one organism was identified at a quantity of ≥104 cells per mL, …

Innovative Workflow To Collect Home Urine Samples From Symptomatic Patients Sheltered In Place During Covid-19, Andrew Korman, Siddharth Ramanathan, Jonathan Korman, Sadhna Ramanathan, Savitha Balaraman, Natalie Luke, Rajan Dewar, Kirk J. Wojno, Larry Sirls, Howard Korman

Conference Presentation Abstracts

Introduction: The two main challenges during the COVID 19 pandemic were to keep essential employees safe and to provide timely care to patients. We devised a novel urine specimen home pickup strategy for our patients with hematuria, irritative voiding symptoms as well as bladder cancer to address these issues. Methods: An employee dropped off necessary equipment for the urine sample to symptomatic patients’ houses. A clean catch specimen was collected and the sample left at the front door. The driver wearing PPE picked up the sample within 30 minutes and delivered it to the lab. Dipstick analysis was performed. Patients …

Functional Constipation Induces Bladder Overactivity Associated With Upregulations Of Htr2 And Trpv2 Pathways., Nao Iguchi, Alonso Carrasco, Alison X. Xie, Ricardo H. Pineda, Anna P. Malykhina, Duncan T. Wilcox

Manuscripts, Articles, Book Chapters and Other Papers

Bladder and bowel dysfunction (BBD) is a common yet underdiagnosed paediatric entity that describes lower urinary tract symptoms (LUTS) accompanied by abnormal bowel patterns manifested as constipation and/or encopresis. LUTS usually manifest as urgency, urinary frequency, incontinence, and urinary tract infections (UTI). Despite increasing recognition of BBD as a risk factor for long-term urinary tract problems including recurrent UTI, vesicoureteral reflux, and renal scarring, the mechanisms underlying BBD have been unclear, and treatment remains empirical. We investigated how constipation affects the lower urinary tract function using a juvenile murine model of functional constipation. Following four days of functional constipation, animals …

Holep Perioperative Outcomes Using Three Different Holmium Laser Technologies In A Community Hospital Setting, Michael Li, Nicholas Russo Bs, Alexis R. Brown Pa-C, James Johannes Md

Posters

No abstract provided.

Methenamine Prophylaxis For Recurrent Urinary Tract Infections In A Tertiary Referral Center, Cameron A. Wade

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Purpose: Methenamine hippurate (MH) is a urinary antiseptic, indicated for prophylaxis of recurrent urinary tract infections (UTIs) but with only few and limited studies regarding its efficacy. To help address this knowledge gap we reviewed our experience with MH for UTI prophylaxis, focusing on women with recurrent uncomplicated UTIs.

Materials and Methods: The University of Kentucky electronic health record was queried to identify adults who were prescribed MH from the Urology clinic between January 2013 and January 2019. Charts were reviewed to assess patient-reported UTI frequency, demographics and relevant health factors. Treatment success was defined as 0-1 UTI in 6 …

Efficacy And Safety Of Once-Daily Vibegron For Treatment Of Overactive Bladder In Patients Aged ≥65 And ≥75 Years: Subpopulation Analysis From The Empowur Randomized, International, Phase Iii Study, Susann Varano, David Staskin, Jeffrey Frankel, Denise Shortino, Rachel Jankowich, Paul N. Mudd

Physician Associate Studies Faculty Publications

Background

Overactive bladder (OAB) is common among older adults. The efficacy and safety of vibegron for the treatment of OAB were demonstrated in the international, phase III EMPOWUR trial. This subpopulation analysis from EMPOWUR assessed the efficacy and safety of vibegron in patients aged ≥ 65 and ≥ 75 years.

Methods

In EMPOWUR, patients with OAB were randomly assigned 5:5:4 to receive once-daily vibegron 75 mg, placebo, or tolterodine 4 mg extended release, respectively, once daily for 12 weeks. Coprimary efficacy endpoints were change from baseline at week 12 in average daily number of micturitions and urge urinary incontinence (UUI) …

Simulation Based Team Training In Surgery - A Review, Syed Muhammad Nazim, Qamar Riaz

Section of Urology

The healthcare environment in surgery is complex, dynamic and often ambiguous. Besides subject knowledge and technical skills, other competencies, such as team work, communication skills and situation awareness, are required to ensure better patient-related outcome. Teams that demonstrate poor non-technical skills make more technical errors, often resulting in patient morbidity or mortality. Different hospital-based locations, such as operating rooms, intensive care units, emergency rooms and surgical wards, are the areas where poor team dynamics prevail. Simulation-based team training is a strategy to provide inter-professional training and experiential learning opportunities for surgeons, anaesthetists and allied health professionals. It helps them to …

Surgical Education And Training, Ather Enam, Hammad Ather, Nadeem Ahmed Siddiqui

Section of Neurosurgery

No abstract provided.

Workplace Based Assessment: Tools To Assess Competencies In A Clinical Setting, Amber Shahmim Sultan, Rahila Ali, Sara Shakil, Rehan Nasir Khan

Department for Educational Development

The apprenticeship model has been used for long in surgical training. It initially provides opportunity to the trainee to observe the attending surgeon, followed by gradual introduction to surgical technique under direct supervision and later with detached supervision. The attending provides informal feedback at different intervals to the trainee. Several changes have been made in postgraduate programmes with a shift towards using workplace-based assessment tools for formative and summative evaluation of the trainee's clinical skills.

Internet Transparency Of Local Men’S Health Clinics In Nebraska, Jinfeng Jiang, Jordan Stegman, Christopher M. Deibert

Graduate Medical Education Research Journal

An overview of Men’s Health Clinics offering Testosterone Therapy in a Midwest State.

Introduction/ Background – Since 2001, there has been a 300% increase in the use of Testosterone therapy. However, there remains limited published data on the demographics of facilities and providers that advertise this service. This study aims to look at such demographics of advertised Men’s health clinics in Nebraska.

Methods/ Materials – An internet search was conducted with the phrases “Nebraska Male health clinics, Nebraska Low T/testosterone, Nebraska Hormone Replacement Therapy”. All clinics that were found offering Testosterone therapy with Men’s health in their mission statement were …

Author Reply., Selin Isguven, Paul H. Chung, Priscilla Machado, Lauren J. Delaney, Antonia F. Chen, Flemming Forsberg, Noreen J. Hickok

Department of Radiology Faculty Papers

No abstract provided.

Intraoperative Icg-Nir Fluorescence Angiography Visualization Of Testicular Perfusion In Operations For Testicular Torsion, Colton D. Wayne, Mohammad A. Emran, Leon Smith-Harrison, P. Stephen Almond, Haroon I. Patel, Shannon Koehler

MEDI 9331 Scholarly Activities Clinical Years

Purpose: Indocyanine Green (ICG) near-infrared (NIR) fluorescence angiography is used in assessing testicular perfusion after reduction of testicular torsion to assess tissue viability.

Introduction: Determination of viability of a testicle after reduction of a testicular torsion has been performed by numerous methods including visual assessment, Doppler ultrasound, and cutting the testicular capsule. Each of these has limitations, are not always reproducible, and may involve damage to the testicle and confusion of capsular blood flow for internal perfusion. A possible alternative to these methods is the use of ICG-NIR fluorescence angiography. ICG was FDA-approved in 1959 and has been …

Interobserver Reliability Of The Renal Nephrometry Scoring System: Experience From A Developing Nation, Kumail Khandwala, Dawar Khan, Zainab Hussain, Nida Sajjad, Muhammad Ismail Alvi

Department of Radiology

Introduction: The RENAL (radius, exophytic/endophytic properties, nearness of tumor to the collecting system or sinus in millimeters, anterior/posterior, location relative to polar lines) nephrometry score (RENAL-NS) has been described as a structured and quantifiable method to describe a renal tumor’s relevant anatomic features as they relate to the complexity of the lesion. We aim to evaluate a tumor’s RENAL-NS and to assess the reproducibility of the score among different observers.
Methods: This retrospective study included 49 patients diagnosed with renal cell carcinoma (RCC) who had complete computed tomography (CT) data, RENAL-NS, and histopathology results. All patients underwent renal surgery/intervention at …

The Correlation Between Stone Nephrolithometry Score And Hemoglobin Drop In Patients Undergoing Percutaneous Nephrolithotomy, Mohammad Shoaib, Muhibullah Bangash, Basit Salam, Hammad Ather

Section of Urology

Objective: In this study, we aimed to determine the correlation between the STONE score [(S)ize of the stone, (T)opography or location, degree of (O)bstruction of the urinary system, (N)umber of stones, and (E)valuation of Hounsfield units] and postoperative hemoglobin drop in patients undergoing percutaneous nephrolithotomy (PCNL).
Methods: This was a prospective observational study and all adult patients aged 18-65 years undergoing unilateral, single-tract PCNL using 26 Ch. Amplatz sheath for renal calculi were included. The five variables of the STONE nephrolithometry score were calculated prior to the procedure. The stone-free rates were assessed on imaging at four weeks and complications …

Relationship Of Spot Urine Oxalate To Creatinine Ratio And 24 Hours Urinary Oxalate Excretion In Patients With Urolithiasis, Syed Bilal Hashmi, Lena Jafri, Hafsa Majid, Jamsheer Jehangir Talati, Wajahat Aziz, Aysha Habib Khan

Department of Pathology and Laboratory Medicine

Background: The evaluation of 24 h urinary oxalate excretion is the gold standard for diagnosing hyperoxaluria in patients with recurrent urolithiasis. However, 24 h urine sample collection is cumbersome. Therefore we aim to see if oxalate to creatinine ratio in random urine sample can be used as an alternative.
Materials and methods: A cross-sectional study was conducted at Section of Chemical Pathology, Department of Pathology and Laboratory Medicine Aga Khan University Karachi from 1st February to December 31, 2019. A total of 62 adult patients, 18-60 years of age with history of kidney stones presenting to the clinical laboratory for …

Perspectives And Experiences Of Transgender And Non-Binary Individuals On Seeking Urological Care., Paul H Chung, Sabina Spigner, Vishal Swaminathan, Seth Teplitsky, Rosemary Frasso

Department of Urology Faculty Papers

OBJECTIVE: To describe perspectives and experiences related to urology care-seeking of transgender and non-binary (TGNB) individuals assigned male at birth.

MATERIALS AND METHODS: This HIPAA-compliant study was IRB approved and followed Consolidated Criteria for Reporting Qualitative Studies (COREQ) guidelines. Through semistructured interviews, perspectives, and experiences of individuals related to urology care-seeking were explored. Open-ended questions were designed to elicit a range of responses rather than quantifiable data. Thematic codes were developed and explicitly defined. Codes pertaining to patient experiences were assessed and described.

RESULTS: Twenty-five TGNB individuals assigned male at birth were interviewed. Participants reported an array of factors that …

Identification Of Plasma Glycosphingolipids As Potential Biomarkers For Prostate Cancer (Pca) Status, Ashley J. Snider, Michael C. Seeds, Laurel Johnstone, Justin M. Snider, Brian Hallmark, Rahul Dutta, Cristina Moraga Franco, John S. Parks, Jeannette T. Bensen, Corey D. Broeckling, James L. Mohler, Gary J. Smith, Elizabeth T.H. Fontham, Hui Kuan Lin, William Bresette, Susan Sergeant, Floyd H. Chilton

School of Public Health Faculty Publications

Prostate cancer (PCa) is the most common male cancer and the second leading cause of cancer death in United States men. Controversy continues over the effectiveness of prostate-specific antigen (PSA) for distinguishing aggressive from indolent PCa. There is a critical need for more specific and sensitive biomarkers to detect and distinguish low-versus high-risk PCa cases. Discovery metabolomics were performed utilizing ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS) on plasma samples from 159 men with treatment naïve prostate cancer participating in the North Carolina-Louisiana PCa Project to determine if there were metabolites associated with aggressive PCa. Thirty-five identifiable plasma small molecules were …