Urology Commons^™

Non-Invasive Predictors Of Response To Tamsulosin For Benign Prostatic Obstruction, Mohammad Shoaib, Muhibullah Bangash, Wajahat Aziz, Hammad Ather

Section of Urology

Objectives: To identify non-invasive predictors of response to tamsulosin 0.4 mg in patients with benign prostatic obstruction (BPO).
Methods: Males ≥ 50 years of age with lower urinary tract symptoms (LUTS) suggestive of BPO for over three months were included in the study. We assessed change in the mean International Prostate Symptom Score (IPSS) and maximum flow rate (Qmax) after six weeks of medical therapy. Clinical and uroflowmetry parameters were compared between two groups of patients with >25% vs. <25% change in the IPSS after treatment. Pre- and post-treatment post-void residue (PVR), Qmax, and IPSS were compared by independent t-test, univariate/multivariate regression analysis.
Results: A total of 121 patients were included. At presentation, the mean prostate size was 35.7±12.2 grams and the mean IPSS …

Collaborative Review: Factors Influencing Treatment Decisions For Patients With A Localized Solid Renal Mass., Thenappan Chandrasekar, Stephen A. Boorjian, Umberto Capitanio, Boris Gershman, Maria Carmen Mir, Alexander Kutikov

Department of Urology Faculty Papers

CONTEXT: With the addition of active surveillance and thermal ablation (TA) to the urologist's established repertoire of partial (PN) and radical nephrectomy (RN) as first-line management options for localized renal cell carcinoma (RCC), appropriate treatment decision-making has become increasingly nuanced.

OBJECTIVE: To critically review the treatment options for localized, nonrecurrent RCC; to highlight the patient, renal function, tumor, and provider factors that influence treatment decisions; and to provide a framework to conceptualize that decision-making process.

EVIDENCE ACQUISITION: A collaborative critical review of the medical literature was conducted.

EVIDENCE SYNTHESIS: We identify three key decision points when managing localized RCC: (1) …

Testicular Dislocation After Unstable Pelvic Ring Injury., Zachary Bernhard, Devon Myers, Braden J Passias, Benjamin C Taylor, Joaquin Castaneda

Trauma and Acute Care Articles

Reproductive and genitourinary complications following pelvic ring injuries have been described; however, testicular dislocation is rare and can cause significant morbidity if not managed appropriately. We describe a case of testicular dislocation after pelvic ring injury and outline the subsequent management and outcome, and seek to identify areas of improvement to ensure expedient and appropriate care in the setting of these injuries. Our case describes a 29-year-old male who presented to a level-one trauma center following a motorcycle collision. An anteroposterior compression type II rotationally unstable pelvic ring was identified on imaging. He was hemodynamically unstable and computed tomography (CT) …

Urosim, Robert Abishek, Bryan Nardone, Jasmine Wang, Christopher Wetzel, Rob Pugliese

Phase 1

Designing a more cost-efficient method for ureteroscopy simulation training that involves 3D printing an anatomically-accurate model of a patient’s renal pelvicalyceal system.

Two-Year Outcomes Of The Artisan-Snm Study For The Treatment Of Urinary Urgency Incontinence With The Axonics Rechargeable Sacral Neuromodulation System, Andrea Pezzella, Rebecca Mccrery, Felicia Lane, Kevin Benson, Chris Taylor, Kenneth M. Peters

Conference Presentation Abstracts

Introduction: Sacral neuromodulation is a guideline-recommended therapy for treatment of urinary urgency incontinence (UUI) patients [1]. The Axonics® System is the first FDA-approved rechargeable SNM system that is qualified to delivery therapy for at least 15 years. The ARTISAN-SNM study is a prospective, pivotal study, designed to evaluate the safety and effectiveness of the Axonics System for UUI treatment. Clinical outcomes at 2 years are presented. Methods: 129 UUI participants across 19 centers in the US and Europe were implanted with the Axonics System in a single, non-staged procedure. Clinical outcomes were reported from 3-day bladder diaries, a validated quality …

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, …

Changes In Patient Reported Outcome Measures After Treatment Of Female Urethral Stricture, Alyssa Gracely, Giulia I. Lane, Pansy Uberoi, Una Lee, Ariana Smith, Priya Padmanabhan

Conference Presentation Abstracts

Introduction: There is a paucity of patient reported outcome measures (PROM) data for women with urethral strictures. Prior literature focuses on anatomic success, with almost no data describing patient centered outcomes. To fill this critical gap, we aim to evaluate change in PROM among women who underwent surgery for stricture. Methods: Data were collected as part of a multiinstitutional retrospective cohort study of women treated for urethral stricture between 2010-19. Median change between baseline and postoperative follow-up on the American Urological Association Symptom Index (AUA-SI) and Urinary Distress Inventory (UDI-6) were assessed using paired Wilcoxon signed-rank tests. Results: Of the …

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: Previous studies have shown that the fractional carbon dioxide (fCO2) vaginal laser improves genitourinary symptoms of menopause. It has been proposed that 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 patient complaining of SUI. Methods: Women over 18 years old with complaints of urogenital symptoms who had been off vaginal estrogen for at least three months were enrolled in this open-label prospective trial. Participants received 3 laser treatments approximately 6 weeks apart. Stress test was performed on …

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 …

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 …

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 …

Stimwave For Pudendal Neuralgia, Ly Hoang Roberts, Joshua Volin, Teresa Mccartney, Annah Vollstedt, Kenneth M. Peters

Conference Presentation Abstracts

Introduction: Pudendal neuralgia is a chronic and debilitating condition with 10- 25% of patients refractory to traditional therapies including sacral neuromodulation. Prior studies have shown chronic pudendal nerve stimulation with Interstim® (Medtronic, Inc., Minneapolis, MN) is effective for this patient population. This study reports on a wireless system to power an implanted lead at the pudendal nerve, StimWave®, to treat pudendal neuralgia. Methods: Retrospective chart review identified patients with pudendal neuralgia who had a lead placed at the pudendal nerve and powered wirelessly according to patient need. Clinical outcomes were assessed at post-operative visits as well as phone calls. Non-validated …

Parental Leave Satisfaction In Physicians Compared To Non-Physicians, Aryana Sharrak, Ly Hoang Roberts, Annah Vollstedt, Melissa Fischer, Esther Han

Conference Presentation Abstracts

Introduction: United States is one of the last two countries without a national parental leave mandate. Professional women of child-bearing age are uniquely impacted by the lack of a robust standardized policy. The purpose of this study is to investigate parental leave satisfaction amongst physicians versus non-physicians. Methods: After IRB approval, a 34-question electronic survey was developed through Qualtrics®, to ascertain satisfaction across professions. This was distributed via Facebook to Physician Moms Group, Beaumont Parenting Group, and Nurse Moms Group. Descriptive characteristics are reported. Statistical analysis included t- test and chi-square test. Results: Out of 816 respondents, 96% (n= 782) …

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, …

Factors Influencing General Surgeons To Involve Urologists In Bladder Trauma Management, Joseph Schultz, Paul Chung, Md

Phase 1

Introduction: Bladder trauma injuries, which are graded by severity, often require immediate care and surgical management by General Surgeons (GS) or Urologists. This study seeks to understand the inconsistencies that exist in collaboration between GS and Urologists in bladder trauma management. We hypothesize that the decision for GS to involve Urologists in bladder trauma management is a multifactorial decision with severity of bladder trauma being the primary determining factor as opposed to other factors like provider experience or hospital setting.

Methods: This cross-sectional descriptive study surveyed GS to determine how likely they were to involve Urologists in bladder trauma …

Incomplete Bladder Emptying And Urinary Tract Infections After Onabotulinumtoxina Injection For Overactive Bladder In Men And Women: Multi-Institutional Collaboration From The Sufu Research Network, William Stuart Reynolds, Anne M. Suskind, Jennifer T. Anger, Benjamin M. Brucker, Anne Pelletier Cameron, Priya Padmanabhan

Conference Presentation Abstracts

Introduction: OnabotulinumtoxinA (BTX) is an effective third-line therapy for overactive bladder (OAB), however the potential for adverse events may prevent patients from initiating therapy. The objective of this study is to report rates of incomplete emptying and urinary tract infection (UTI) in men and women undergoing BTX for OAB and to identify potential risk factors for these adverse events. Methods: Eleven clinical sites performed an IRBapproved retrospective study of adult women and men undergoing first-time BTX injection (100 units) for non-neurogenic OAB in 2016. Exclusions included: post void residual (PVR) >150ml, prior BTX, pelvic radiation, or catheterization. Clinical data was …

Estudio De Asociación Entre La Estirpe Histológica Y El Estadio Clínico De Los Tumores Testiculares Con Los Marcadores Tumorales [Correlation Study Of Histologic Pattern And Clinical Stage Of Testicular Tumors With Tumor Markers], Edson David Rodríguez-Valle, Miguel Maldonado-Ávila, Yunuen Rodríguez-Sánchez, Fabiola Arévalo-García, Jorge Jaspersen-Gastelum, Juan Carlos Lopez Alvarenga, Arturo Reading-Bernal, Joel Nava-Palacios, Eloy Rico-Frontana, Mario Silvino Almanza-González

School of Medicine Publications

Background: Testicular tumor is the most frequent solid tumor in men between 20 and 34 years of age. Testicular tumors can be histologically divided into germ cell tumors, which present in 90–95% of cases, and non-germ cell tumors, which present in around 5%. Tumor markers are crucial for the diagnosis, classification, and prognosis of testicular tumors, as well as for surveillance after treatment. Objective: To know the actual prevalence of testicular cancer at our service, determine the clinical and pathologic characteristics of testicular cancer, and correlate tumor marker levels with histologic pattern and clinical stage of the disease. Methodology: A …

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.