Urology Commons^™

Breakthroughs In Hormonal Male Contraception, Alexander Patton, Seth Vann

Physician Assistant Capstones, 2020-current

Objective: Assess the efficacy of a nestorone plus testosterone gel at suppressing progestin levels and spermatogenesis.

Design: Systematic literature review.

Methods: Searches were done in PubMed and Dartmouth library using the terms nestorone, randomized control trial, human, and male. Limits used while searching included published in the last 10 years, randomized control trials, and English.

Results: Using the search criteria the following three studies were found that met the inclusion/exclusion criteria of this study: Ilani et al, Zitzmann et al, and Anawalt et al. All three studies were found on PubMed and reference the Ilani et al study.

Conclusion: Nestorone …

Laparoscopic Assisted Robotic Radical Prostatectomy With Pelvic Lymph Node Dissection Using Viable Cryopreserved Umbilical Tissue To Improve Cavernosal Nerve Function., Joshua Volin, Brett Watson, Lior Kopel, Samantha Kraemer, Jason Hafron

Conference Presentation Abstracts

Radical prostatectomy is the preferred treatment for patients with clinically localized prostate cancer and is typically performed using a robotic approach. Surgical techniques that preserve the neurovascular bundle minimize the risk of incontinence and erectile dysfunction post-operatively. Umbilical cord tissue is a relatively new technique, which has been shown to reduce inflammation and promote regenerative healing. In this video we show a robotic radical prostatectomy with bilateral nerve sparing technique utilizing a cryopreserved umbilical cord allograft nerve wrap.

Strocss 2021: Strengthening The Reporting Of Cohort, Cross-Sectional And Case-Control Studies In Surgery, Ginimol Mathew, Riaz Agha, Strocss Group, Joerg Albrecht, Prabudh Goel, Indraneil Mukherjee, Prathamesh Pai, Anil K. D'Cruz, Ather Enam, Hammad Ather

Section of Neurosurgery

Introduction: Strengthening The Reporting Of Cohort Studies in Surgery (STROCSS) guidelines were developed in 2017 in order to improve the reporting quality of observational studies in surgery and updated in 2019. In order to maintain relevance and continue upholding good reporting quality among observational studies in surgery, we aimed to update STROCSS 2019 guidelines.
Methods: A STROCSS 2021 steering group was formed to come up with proposals to update STROCSS 2019 guidelines. An expert panel of researchers assessed these proposals and judged whether they should become part of STROCSS 2021 guidelines or not, through a Delphi consensus exercise.
Results: 42 …

Post Traumatic Internal Iliac Arteriovenous Fistula Presenting With Persistent Gross Hematuria., Amanda Smart, Michael Wynne, Daniel Stein

Urology Faculty Publications

No abstract provided.

Frequency Of Lower Ureteric Stones And Their Treatment By Tamsulosin, Aden, Ali Ahmed Salem Hatroom

Hadhramout University Journal of Natural & Applied Sciences

The aim of the study is to find out the frequency of lower ureteric stones related to sex, age, and the outcome of using tamsulosin in their treatment This was a retrospective study of all patients who suffer from lower ureteral stone and seen in our Private Urology Clinic from January 2014 to December 2017 in Aden. The total patients were 160. They were 98 (61.3%) males and 62 (38.7%) females) with ratio male to female 1.6 :1. The mean age of patients is (35.2 ± 11.2) years, range (15 to 56) years. The most involved side is left ureter …

Anal Human Papillomavirus Infection Among Men Who Have Sex With Men And Transgender Women Living With And Without Hiv In Pakistan: Findings From A Cross-Sectional Study, Muslima Ejaz, Soren Andersson, Salma Batool, Tazeen Saeed Ali, Anna Mia Ekström

Community Health Sciences

Objectives: The aim of this study was to determine the prevalence of infection, genotypes and risk factors for human papillomavirus (HPV) among men who have sex with men (MSM) and transgender women living with and without HIV in Pakistan. Anal infection with HPV is very common worldwide among MSM, particularly among MSM living with HIV. The high prevalence of HIV among MSM and male-to-female transgendered individuals in Pakistan is a significant health concern since access to screening and health-seeking is often delayed in this stigmatised key population.
Design: This cross-sectional study was conducted between March 2016 and November 2017.
Participants, …

Dysfunctional Voiding: Does A Validated Urine Color Scale Correlate With Dysfunctional Voiding Severity Score?, Katharina Mitchell, Chad Crigger, Tyler Overholt, Tyler Trump, John Barnard, Osama Al-Omar, Hilary Morley

Marshall Journal of Medicine

Introduction

Dysfunctional voiding (DV), defined as abnormal coordination between the urinary sphincter and the detrusor muscle in a neurologically intact individual, affects approximately 40% of patients that populate pediatric urology clinics. Improper hydration affects the specific gravity and concentration of urinary irritants, resulting in symptoms similar to those seen in DV patients.

Methods

Herein, we administered a validated DV survey (the Dysfunctional Voiding Symptom Score [DVSS]) and a validated dehydration severity chart (the Urine Color Chart [UCC]) to toilet trained pediatric patients and compared DV patients to patients presenting with non-urologic concerns. Data was analyzed on an item-for-item basis and …

Androgen Receptor Signaling In Prostate Cancer And Therapeutic Strategies, Aasems Jacob, Rishi Raj, Derek B. Allison, Zin W. Myint

Markey Cancer Center Faculty Publications

Understanding of the molecular mechanisms of prostate cancer has led to development of therapeutic strategies targeting androgen receptor (AR). These androgen-receptor signaling inhibitors (ARSI) include androgen synthesis inhibitor-abiraterone and androgen receptor antagonists-enzalutamide, apalutamide, and darolutamide. Although these medications provide significant improvement in survival among men with prostate cancer, drug resistance develops in nearly all patients with time. This could be through androgen-dependent or androgen-independent mechanisms. Even weaker signals and non-canonical steroid ligands can activate AR in the presence of truncated AR-splice variants, AR overexpression, or activating mutations in AR. AR splice variant, AR-V7 is the most studied among these and …

Parenteral Corticosteroids After Fragility Fracture Increases The Odds Of A Repeat Fracture, Justin David, Marc R. Zucker, Timothy F. Carroll, Ross E. Straughan, Mishra Jaya, Jessie R. Gills, M Westerman

Medical Research Day

Osteoporosis is a skeletal disorder characterized by porous and low-density bones. Patients with osteoporosis have an increased risk of fragility fractures and subsequent repeat fractures. Due to the high morbidity and mortality associated with fractures, medications that cause high risk of falls and decreased bone density should be used with caution to prevent repeat fractures. Some studies have shown that there is no change in fracture-associated medication use before and after a fracture. This study aims to explore the trends of systemic corticosteroid use, which causes a known physiologic decrease in bone density, before and after primary fracture and their …

Multipara With Utero-Vesical Fistula Following Repeat Cesarean Section: A Rare Iatrogenic Complication, Gulnaz Shafqat, Anam Khan, Salma Azam, Rehana Murad

Department of Radiology

Utero-Vesical fistulas are the rarest of all urogenital fistulas, with most cases occurring after cesarean section. Its prevalence is increasing worldwide because of the increasing indications of cesarean section. Patient usually presents with urine leak, amenorrhea and cyclic hematuria. Herein, we present a case of patient presenting with complain of severe urinary tract infection following cesarean section. Review and update of recent literature regarding the diagnostic imaging of this entity are described.

Periaortic Venous Necklace And Renal Right Double Arteries; Case Report, Petru Bordei, Constantin Andrei Rusali, Constantin Ionescu, Dragos Serban, Valeriu Ardeleanu

Journal of Mind and Medical Sciences

The case was found on an organic sample consisting of the two kidneys with the renal pedicles and the corresponding segments of the abdominal aorta and inferior vena cava. From the inferior face of the left renal vein, on the lower side of the aorta, a venous branch with an upward path of 8.02 mm was detached, passing on the anterior face of the aorta, passing before its right side, in order to end on the left side of the inferior vena cava, 13.9 mm above the end of the left renal vein in the inferior vena cava, this branch …

Cystoscopy Scenarios You Should Recognize, Jason P. Gilleran

Conference Presentation Abstracts

No abstract provided.

A Case Of Penile Fracture With Bilateral Corporal Injury And Complete Urethral Disruption, Brett Watson, Samantha Kraemer, Bradley Rosenberg

Conference Presentation Abstracts

Introduction: Penile fracture with bilateral corporal rupture and complete urethral disruption is an uncommon injury, with approximately 60 cases reported in the literature. Case: A 54-year-old man presented with penile pain, ecchymosis, and detumescence, as well as urethral bleeding after blunt trauma sustained during vaginal intercourse. Clinical diagnosis of penile fracture was made and he was taken to the operating room for penile exploration. Complete transection of the urethra and bilateral disruptions of the corpora cavernosa were identified in the proximal penile shaft. The corpora were repaired with 3-0 vicryl. Primary urethroplasty was then performed using 4-0 PDS. Foley catheter …

Robotic Radical Prostatectomy Using Umbilical Tissue To Improve Cavernosal Nerve Function, Joshua Volin, Brett Watson, Lior Kopel, Samantha Kraemer, Jason M. Hafron

Conference Presentation Abstracts

No abstract provided.

Reimbursement Incentive Associated With Decreased Inpatient Opioid Prescribing Following Robotic Radical Prostatectomy, Brett Watson, Ross Touriel, Joshua Volin, Frank Burks

Conference Presentation Abstracts

Introduction: Various strategies have been explored to decrease the quantity of opioids prescribed for post-operative pain. The Michigan Opioid Prescribing Engagement Network, in partnership with BCBS-Michigan, has developed a pain optimization pathway for several surgical procedures, including prostatectomy. Urologists who follow the pain optimization pathway, which includes pre-operative patient education and limiting discharge opioids to 6 tablets of oxycodone 5 mg, can report a modifier for additional reimbursement. We explored the impact of this incentive on inpatient opioid prescribing practices following robotic assisted radical prostatectomy (RARP). Methods: Patients undergoing RARP between January 2017 and August 2019 at a single institution …

A Rare Case Of Pure N4-Acetyl-Sulfaethoxazole Nephrolithiasis Associated With Trimethoprim-Sulfamethoxazole Treatment Of Pulmonary Nocardiosis, Alexander Geisenhoff, Sugandh Shetty

Conference Presentation Abstracts

Introduction: Trimethoprim-sulfamethoxazole is a commonly used antibiotic for treatment of urinary tract infections (UTIs). It is also commonly used to treat nocardia infections. Less common are reports of nephrolithiasis consisting purely of N4-acetyl-sulfamethoxazole, the primary metabolite of trimethoprim-sulfamethoxazole. Case: A 70-year-old male with history of mantle cell lymphoma and T-cell leukemia treated with bone marrow transplant now with nocardia lung infection receiving trimethoprimsulfamethoxazole for the past 6 months who presented to the emergency room with confusion and a fall. He had no prior history of nephrolithiasis, but during hospitalization developed renal colic and was found to have obstructing right proximal …

A Unique Case Of Renal Pelvic Urothelial Carcinoma With Extensive Small Round Cell Sarcoma Differentiation Showing Swsr1 Gene Rearrangement, Zubin Shetty, Mitual Amin, Savitha Balaraman, Sugandh Shetty

Conference Presentation Abstracts

Introduction: Ewings-like sarcoma is a rare subgroup of small round cell sarcoma with immunohistochemistry and morphological similarities to Ewing Sarcoma. We report a rare case of renal pelvis invasive urothelial carcinoma with small round cell sarcoma differentiation showing EWSR1 gene rearrangement. Case: An 84-year-old male presented with 6 months of intermittent painless gross hematuria. Workup revealed a 5.4cm left renal pelvicalyceal mass suspicious for transitional cell carcinoma and a 2.5cm enhancing left renal cortical lesion. The patient underwent an uncomplicated robotic left nephroureterectomy. Pathology revealed small round cell sarcoma composing greater than 80% of the renal pelvis tumor with the …

Is A Preoperative Type And Screen Required In Patients Undergoing Common Urological Procedures? A Cost-Benefit Analysis, Joshua Volin, Patrick Herndon, Aviv Spillinger, Patrick Karabon, James Blumline, Deanna Tran, Craig Fletcher, Jason Hafron

Conference Presentation Abstracts

Introduction: Our objective was to evaluate the cost-effectiveness of obtaining preoperative type and screen (TS) for common urological procedures and to determine patient and hospital factors associated with receiving blood transfusions. Methods: Retrospective database analysis of the 2006-2015 Nationwide Inpatient Sample (NIS) was performed to identify patients undergoing a variety of urological procedures. A total of 4,113,144 cases were identified. Transfusion rates were then determined from NIS data, and multivariate regression analyses was used to identify factors associated with transfusions. A cost-effectiveness analysis was performed to determine the incremental cost-effectiveness ratio (ICER) of obtaining preoperative TS to prevent an emergencyrelease …

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 …

Acute Segmental Testicular Infarction Resulting From Illicit Anabolic Steroid Use, Jacob Stephens, Frank Burks

Conference Presentation Abstracts

Introduction: Segmental testicular infarction (STI) is a rare cause of acute scrotum of unknown etiology. The diagnosis is often made by color Doppler ultrasonography (CDUS) demonstrating absent perfusion in a well-defined testicular region. Previously patients underwent surgical exploration, but currently conservative therapy is recommended. Methods: We report a case of STI related to anabolic steroid use. Results: A 44-year-old male with a history of hypertension presented to the emergency room with acute, severe right testicular pain which was unprovoked and constant. Physical exam was notable only for tenderness at the inferior right testicle. CDUS showed small bilateral hydroceles but preserved …