Urology Commons^™

Publisher Correction: Piezo1 Regulates Meningeal Lymphatic Vessel Drainage And Alleviates Excessive Csf Accumulation, Dongwon Choi, Eunkyung Park, Joshua Choi, Renhao Lu, Jin Suh Yu, Chiyoon Kim, Luping Zhao, James Yu, Brandon Nakashima, Sunju Lee, Dhruv Singhal, Joshua P Scallan, Bin Zhou, Chester J Koh, Esak Lee, Young-Kwon Hong

Faculty, Staff and Students Publications

No abstract provided.

Surgical Success Following Robotic Upper Urinary Tract Reconstruction, Results From A Global Network Of Healthcare Organizations, Zachary Prebay, Adam Schneider, Sohan S. Shah, Mauro Dispagna, Mihir S. Shah

Department of Urology Faculty Papers

INTRODUCTION: Available data on robotic ureteral reconstruction procedures is concentrated from high volume centers. To better understand generalizability of success, we used a network of healthcare organizations (HCOs) to evaluate surgical success following robotic-assisted pyeloplasty (RP), ureteral reimplantation (RR), and ureteroureterostomy/ureteroplasty (RU).

METHODS: We searched the TriNetX database for adult (>18 years old) patients undergoing RP, RR and RU. Our primary outcome was need for drain placement (nephrostomy or ureteral stent) from 4 weeks to 10 years postoperatively. We evaluated risk factors (RF) for drain placement (vascular disease, kidney disease, diabetes (DM), smoking history, radiation history, age, body mass …

Frailty And Nutritional Status Predict Postoperative Complications In Radical Cystectomy Patients, David E Hinojosa-Gonzalez, Gal Saffati, Gustavo Salgado-Garza, Cecilio Armengol-García, Bailey Slawin, Sienna Blackwell, Jennifer M Taylor, Jeremy R Slawin

Faculty, Staff and Students Publications

Introduction: Radical cystectomy (RC) is associated with significant morbidity and mortality. While frailty and nutritional status have emerged as important predictors of surgical outcomes, their impact on RC complications remains incompletely characterized. We aimed to evaluate the relationship between frailty (using the Modified Frailty Index-5 [mFI-5], nutritional status (using the Nutritional Risk Index [NRI]), and postoperative outcomes in patients undergoing RC.

Methods: We conducted a retrospective analysis of the American College of Surgeons National Surgical Quality Improvement Program database. Frailty was defined as mFI-5 score ≥2 and malnutrition as NRI ≤97.5. Hypoalbuminemia was defined as preoperative albumin ≤3.5. Outcomes included …

Rapid Percutaneous Nephrostomy Stent Encrustation In Pregnancy: Navigating Your Stone Challenge, Victor M. Feldbaum, Roberto Morales, Shawn R. Ramsey, Michael L. Douso

HCA Healthcare Journal of Medicine

Background

Surgical management of kidney stones in pregnancy can be a serious problem for both mother and fetus.

Case Presentation

A 20-year-old woman with a second trimester pregnancy presented to the emergency room with renal calculi. She required surgical intervention and a left nephrostomy tube after consultation with urology. Five weeks later, her tube was solidified in place unbeknownst to her care team. She required several surgeries, dealt with encrustation remnants, infections, radiation exposure, persistent infection requiring antibiotic management, and, ultimately, an early delivery at 37 weeks.

Conclusion

At the time of writing, this was the first case to describe …

Management Of Stone Disease In The Spina Bifida Patient, Meghan F. Davis, Kyle L. Yu, Arun K. Srinivasan

Department of Medicine Faculty Papers

PURPOSE OF THE REVIEW: This review provides a detailed overview of the specifics of presentation, diagnosis, and management of upper and lower urinary tract stone disease for individuals with spina bifida.

RECENT FINDINGS: Recent studies highlight the significant burden of stone disease for spina bifida patients. Individuals with spina bifida require lifelong urologic care. They are more likely to have stone disease and have complications from management. This is a particularly salient issue for patients who have undergone bladder augmentation. Given the frequency and severity of these issues, it is critical that urologists be familiar with the nuances of stone …

Urology Resident Associate: A Promising Alternative For The Unmatched Urology Applicant, Jayson Kemble, Grace Handleman, Chad A. Lagrange, Christopher M. Deibert

Graduate Medical Education Research Journal

Background. Demand for urology residency spots frequently outstrips supply, with unmatched urology applicants having limited options while waiting for reapplication. We aim to demonstrate our experience with a year-long Urology Resident Associate (URA) position, which merges the role of junior resident and APP with the mission to reduce resident workload and further the training of an unmatched urology applicant.

Methods. A year-long, non-Accreditation Council for Graduate Medical Education (ACGME) accredited URA position was created at our institution in 2023 and filled by an unmatched applicant to our program. The URA was given all the roles and responsibilities of a …

Comparative Effectiveness Of En-Bloc Vs Conventional Transurethral Resection For Non-Muscle-Invasive Bladder Cancer A Systematic Review And Meta-Analysis, David E Hinojosa-Gonzalez, Gal Saffati, Troy La, Jackson Cathey, Juan C Angulo-Lozano, Gustavo Salgado-Garza, Jonathan Walsh, Bailey Slawin, Shane Kronstedt, Kate Lowrey, Jeremy R Slawin

Faculty, Staff and Students Publications

Introduction: Transurethral en-bloc resection of bladder tumor (ERBT) has emerged as an alternate technique to conventional transurethral resection of bladder tumor (cTURBT). While theoretically advantageous, the comparative effectiveness of ERBT across various technical approaches remains unclear. We performed an updated systematic review and meta-analysis to evaluate perioperative, pathologic, and oncologic outcomes of ERBT vs. cTURBT.

Methods: We systematically searched PubMed, EMBASE, Scopus, and Google Scholar for randomized controlled trials (RCTs) comparing ERBT and cTURBT. The primary outcome was recurrence-free survival (RFS). Secondary outcomes were operative time, complication rates, detrusor muscle presence, and need for repeated resection. Meta-analyses were performed, with …

Evaluating Dosimetric Outcomes In A Prostate Rapid Plan Model: A Comparison Of Prostate Treatment Plans With And Without Standardized Planning Structures, Erica Wartman

Masters Projects

Abstract

Knowledge-based planning (KBP) using RapidPlan (RP) has demonstrated the ability to produce high quality radiation therapy treatment plans while reducing time. This study evaluated whether the inclusion of department specific standardized planning structures, including rings and other optimization tools, improves plan quality when using a prostate and lymph node RP model, or if the model alone is sufficient to provide a quality plan without the use of these additional planning structures.

Ten previously treated Prostate+LN patients were replanned using the departmental RP model in Varian Eclipse treatment planning system.1 For each patient, two plans were created, one with standardized …

Evaluating Coplanar And Noncoplanar Treatment Plans For The Varian Halcyon And Varian Truebeam For Intact Prostate Patients., Ashley Coppage

Masters Projects

Prostate cancer is among the most treated malignancies with radiation therapy, where precise dose delivery is critical for tumor control and minimizing toxicity. VMAT is widely adopted due to its efficiency and conformity; however, the choice between coplanar and non-coplanar beam arrangements remains an area of ongoing investigation, especially with newer platforms like Halcyon and TrueBeam. This retrospective dosimetric study compares coplanar and non-coplanar volumetric modulated arc therapy (VMAT) treatment plans for intact prostate cancer patients using the Varian Halcyon and Varian TrueBeam systems. Plans were created using a standardized protocol within Eclipse v16.1, with all Halcyon plans employing coplanar …

Changes In Post-Transplant Serum Testosterone Levels In Men Undergoing Lung Transplantation: A Pilot Study Using The Trinetx Research Network, Austin Thompson, Danly Omil-Lima, Jaime Abraham Perez, Erin Jesse, Mohit Khera, Kenneth Chavin, Nannan Thirumavalavan

Faculty, Staff and Students Publications

Hypogonadism is understudied in men requiring solid organ transplants, particularly among lung transplant recipients. Improvement in serum testosterone levels has been reported in kidney and liver transplantation. Using the TriNetX Research Network, we performed a retrospective cohort study to evaluate the incidence of peri-transplant hypogonadism and the natural course of serum testosterone following successful lung transplantation. Men aged ≥ 18 with a lung transplant and total testosterone drawn within one year pre- and post-transplant were included. Men with receipt of testosterone therapy were excluded. A low testosterone (< 300 ng/dL) and normal testosterone (≥300 ng/dL) cohort was created before employing descriptive and analytic statistics to investigate the incidence of peri-transplant hypogonadism and the change in serum testosterone levels following lung transplantation. In our entire cohort, lung transplantation was not associated with a significant increase in post-transplant serum testosterone (329.86 ± 162.56 ng/dL pre-transplant and 355.13 ± 216.11 ng/dL post-transplant, p = 0.483). The number of men with low testosterone decreased by 9.8% following lung transplantation but was not significant, p = 0.404. In this pilot study, no significant change in the number of hypogonadal men nor serum testosterone levels was observed among men undergoing lung transplantation.

Long-Term Testosterone Pellet Insertion In Women With Low Libido Shows No Evidence Of Erythrocytosis And A Minimal Side Effect Profile, Beatriz S Hernandez, Gal Saffati, Katherine A Lowrey, Amit Reddy, Bridget S Park, Jeffrey J Song, Gabrielle Lyon, Mohit Khera

Faculty, Staff and Students Publications

Background: Testosterone therapy for low libido in women has become increasingly prevalent in recent years. While numerous testosterone formulations exist and have been studied in women, there has been little data assessing the safety and efficacy of subcutaneous testosterone pellet use in this population. The primary objective of this study is to understand the biochemical effects and side effect profile of female patients who underwent testosterone pellet insertion in a clinical practice.

Methods: A retrospective chart review of female patients who underwent testosterone pellet insertion from 2009 to 2022 was undertaken. Women taking 75 and 100 mg testosterone pellets were …

Five-Year Outcomes Of Water Vapor Therapy Versus Doxazosin, Finasteride, And Combination Therapy For Lower Urinary Tract Symptoms Secondary To Benign Prostatic Hyperplasia: Cohort Data From The Medical Therapy Of Prostatic Symptoms (Mtops) Trial, Bronwyn Long, Amandip Cheema, Olivia Copelan, Cara Joyce, Marina Feffer, Kevin T. Mcvary

Biostatistics Collaborative Core: Faculty Publications and Other Works

Objective: To compare 5-year clinical and subjective treatment outcomes of water vapor thermal therapy to MTOPS trial cohorts receiving doxazosin, finasteride, or combination therapy.

Methods: MTOPS subjects who received doxazosin, finasteride, combination therapy, or placebo (ClinicalTrials.gov NCT00021814) were compared to the treatment arm of a randomized controlled trial of thermal therapy using the Rezūm System (NCT01912339). Only MTOPS subjects who met criteria for the Rezūm trial were included (prostate volume 30-80 cc, IPSS ≥ 13). Inverse probability weighting by the propensity score was used to adjust for potential confounding variables. Subjective, objective, and clinical progression outcomes were compared …

Vigorous Physical Activity As A Potential Environmental Risk Factor In Renal Medullary Carcinoma, Daniel D Shapiro, Sagar S Mukhida, Andrew W Hahn, Ayman Isahaku, Schyler M Turner, Jessica P Cheng, Pankaj K Chauhan, Susan S Thomas, Beei Chan, Zita D Lim, Nizar M Tannir, Maria Chang Swartz, Pavlos Msaouel

Faculty, Staff and Student Publications

Purpose: Renal medullary carcinoma (RMC) is a rare but aggressive kidney cancer affecting young individuals with sickle hemoglobinopathies. Prior retrospective case-control and mouse modeling studies suggest a mechanism linking vigorous intensity physical activity to increased RMC risk in individuals with sickle hemoglobinopathies. This study aimed to prospectively investigate the association between vigorous intensity exercise and RMC.

Materials and methods: This study used a validated questionnaire to prospectively assess reported physical activity in a large cohort of patients with RMC compared to the activity of individuals without RMC. Between 2022 and 2024, patients with RMC (N = 39) were prospectively surveyed …

Familial Hypocalciuric Hypercalcemia Across Three Generations: Exploring Coexistent Primary Hyperparathyroidism, Liada Itzel Guerrero Arroyo Md, Anda Raluca Gonciuela Md, Sachin Majumdar Md

Posters

FHH due to CASR R220W variant may present with phenotypic variability, including features classically associated with PHPT. Genetic testing is essential in ambiguous cases to avoid unnecessary surgical interventions.

Quality Over Quantity-Current Challenges Of Robotic Surgery In Poland, Marcin Kubiak, Jacek Doniec, S Vincent Grasso, Andrew Gumbs, Amir Nour Mohammadi, Katarzyna Sędłak, Zuzanna Pelc, Stanisław Góźdź, Wojciech Załuska, Artur Bachta, Paweł Rybojad, Kamil Torres, Timothy M Pawlik, Marek Zawadzki, Andrzej Budzyński, Karol Rawicz-Pruszyński

Rowan-Virtua School of Osteopathic Medicine Departmental Research

Since its introduction in 2010, a dynamic growth of robotic-assisted surgery (RAS) has been observed in Poland. The number of healthcare institutions implementing RAS has tripled in the last 36 months, with 80 surgical robots currently utilized on a national scale. While urological procedures dominate RAS utilization (73%), adoption in gynecology (12.2%) and gastrointestinal surgery (8.5%) is rising, driven by recent National Health Fund reimbursement policies. However, significant fragmentation and alarmingly low numbers of individual RAS procedures were identified: 47.7% of surgeons perform less than 40 cases annually. Parallel to expanding the robotic surgery reimbursement program, several standardized actions are …

Cefdinir Use For Adults With Urinary Tract Infections In The Emergency Department, Emily Vo, Brittanii Prahl, William Barany, Barbara Branneman, Jack Huber

2025 Swedish FISH (Fostering Interdisciplinary Solutions in Healthcare) Conference

No abstract provided.

Artificial Intelligence Use In Medical Education: Best Practices And Future Directions, Rasheed A. M. Thompson, Yash B. Shah, Francisco Aguirre, Courtney Stewart, Costas D. Lallas, Mihir S. Shah

Department of Urology Faculty Papers

PURPOSEOF REVIEW: This review examines the various ways artificial intelligence (AI) has been utilized in medical education (MedEd)and presents ideas that will ethically and effectively leverage AI in enhancing the learning experience of medical trainees.

RECENT FINDINGS: AI has improved accessibility to learning material in a manner that engages the wider population. It has utility as a reference tool and can assist academic writing by generating outlines, summaries and identifying relevant reference articles. As AI is increasingly integrated into MedEd and practice, its regulation should become a priority to prevent drawbacks to the education of trainees. By involving physicians in …

Port Site Metastasis After Robotic Assisted Laparoscopic Radical Prostatectomy: Diagnosis Via Prostate-Specific Membrane Antigen (Psma)-Targeted 18f-Dcfpyl Pet/Ct, Joon Yau Leong, Maria D'Amico, Courtney Capella, Leonard Gomella, Joseph Izes

Department of Urology Faculty Papers

We present a case of port site metastasis (PSM) that was identified in an 82-year-old man with an elevated prostate-specific antigen (PSA) to 3.9 ng/mL, concerning for biochemical recurrence after robotic-assisted radical prostatectomy, adjuvant radiation, and six months of androgen deprivation therapy with an undetectable PSA post-treatment over 10 years ago. A 2.1 cm solitary tracer avid nodule on the right lateral abdominal wall with no other evidence of recurrence or metastatic disease was found on prostate-specific membrane antigen (PSMA)–targeted ¹⁸F-DCFPyL PET/CT scan. The patient underwent local excision of this metastatic lesion, and final pathology revealed metastatic prostatic adenocarcinoma.

Evaluation Of An External Urinary Device Protocol And Practices In Hospitalized Female Patients: A Quality Improvement Project At A Rural Midwestern Hospital, Melissa Leibnitz, Ashley Causa, Susana Lopez

Doctor of Nursing Practice Projects: College of Nursing

Aims and Objectives- 1: Describe and measure current implementation and management practices of the PureWick™. 2: Describe and measure current outcomes in the use of the PureWick™ device including mobility scores, skin breakdown, Braden scores, moisture-associated dermatitis, CAUTIs, PAUTIs, hospital LOS, HAIs and HPIs. 3: Measure the survey results from staff regarding the current PureWick™ practices. 4: Propose recommendations for an improved EB protocol for the PureWick^TM.

Background: Currently, the PureWick^TM device has been utilized by facilities as an alternative to indwelling urinary catheters in an effort to reduce the incidence of CAUTI. Since the introduction …

Real-World Management Of High-Risk Prostate Cancer Post-Radical Prostatectomy: Insights From A Regional Quality Collaborative, Aaron R. Hochberg, Annie H. Ho, Rasheed A. M. Thompson, Matthew B. Buck, Costas D. Lallas, Christine Ibilibor, Jeffrey J. Tomaszewski, Serge Ginzburg, Andres Correa, Robert Uzzo, Marc C. Smaldone, John F. Danella, Thomas J. Guzzo, Daniel J. Lee, Laurence Belkoff, Jeffrey Walker, Jay D. Raman, Roderick K. Clark, Adam Reese, Bruce Jacobs, Thomas Jang, Keith J. Kowalczyk, Meghan Smith, Mihir S. Shah

Department of Urology Faculty Papers

Background/Objectives: Data from clinical trials showing the non-inferiority of early salvage radiotherapy were recently incorporated into societal guideline statements. However, questions remain regarding ideal prostate-specific antigen (PSA) criteria for salvage, and how to apply these findings to pathologic lymph node-positive (pN+) disease. We investigated variance in management of clinically localized prostate cancer found to have high-risk features after radical prostatectomy. Methods: We retrospectively identified patients from May 2015 to January 2024 utilizing a multi-institutional, regional collaborative database. The primary outcome was identifying factors associated with the receipt of adjuvant versus salvage therapy. Factors associated with secondary treatment were assessed via …