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Impact of COVID-19 on Urology Resident Case Volume COVID-19对泌尿外科住院病例量的影响

IF 2 3区医学 Q2 UROLOGY & NEPHROLOGY

Urology

Pub Date : 2026-02-01 DOI: 10.1016/j.urology.2025.12.018

Senthooran Kalidoss , David A. Velasquez , Matthew J. Sloan , Richard J. Fantus , Cecilia Chang , Sarah F. Faris

Objective

To assess the impact of the coronavirus disease 2019 (COVID-19) pandemic on urologic surgical training volume.

Methods

Accreditation Council for Graduate Medical Education case volumes for graduating urology residents were queried. Roles analyzed included “All Roles,” “Surgeon,” and “Assistant.” Student t tests compared the mean total case volumes between prepandemic (2015-2019) and COVID-19 pandemic (2020) year. To assess the impact on all residents training during the COVID-19 pandemic (PGY2-5), pre-pandemic (2015-2019) and post-pandemic (2020-2023) case logs were compared.

Results

Total case volumes for graduating residents increased from 2019 to 2023 despite the COVID-19 pandemic (1357 cases in 2019 vs 1394 cases in 2023, P = .06). Urodynamics, percutaneous, and pediatric ureter decreased significantly in volume during the COVID-19 pandemic (2015-2019 vs 2020). Comparing surgical volumes pre-pandemic (2015-2019) and post-pandemic (2020-2023), we found significant decreases in urodynamics, percutaneous, intestinal diversion, retroperitoneal, and pediatric, ranging from an absolute decrease of 2-5 procedures. In contrast, reconstructive surgery, male penis/incontinence, male urethral, and pelvic prostate procedures significantly increased in volume, ranging from an absolute increase in 2-24 procedures logged. There was a significant increase in cases logged in the assistant role.

Conclusion

The COVID-19 pandemic caused significant disruptions to urologic training, but despite concerns, overall surgical case volume for all PGY classes who were training during the pandemic did not change compared to pre-COVID years. The significant increase in cases logged in the assistant role suggests that residents may have double scrubbed surgeries to help counteract the effects of the pandemic on surgical volume.

目的：评估2019冠状病毒病（COVID-19）大流行对泌尿外科培训量的影响。方法：对美国研究生医学教育认证委员会（ACGME）泌尿外科住院医师毕业病例量进行调查。分析的角色包括“所有角色”、“外科医生”和“助理”。学生t检验比较了大流行前（2015-2019）和COVID-19大流行（2020）年的平均总病例量。为了评估COVID-19大流行期间（PGY2-5）对所有住院医师培训的影响，比较了大流行前（2015-2019年）和大流行后（2020-2023年）的病例日志。结果：尽管2019 - 2023年发生了COVID-19大流行，但毕业居民的总病例量从2019年到2023年有所增加（2019年为1357例，2023年为1394例，p = 0.06）。在COVID-19大流行期间，尿动力学、经皮输尿管和儿科输尿管的体积显著下降（2015-2019年与2020年相比）。比较大流行前（2015-2019年）和大流行后（2020-2023年）的手术量，我们发现尿动力学、经皮、肠分流、腹膜后和儿科手术量显著减少，绝对减少2-5例。相比之下，重建手术、男性阴茎/尿失禁、男性尿道和盆腔前列腺手术的数量显著增加，记录的手术数量绝对增加了2-24例。以助理角色记录的案例显著增加。结论：COVID-19大流行对泌尿科培训造成了严重干扰，但尽管存在担忧，与covid前相比，在大流行期间接受培训的所有PGY班级的总手术病例量没有变化。以助理身份登记的病例显著增加，表明住院医生可能会进行两次手术，以帮助抵消大流行对手术量的影响。

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引用次数: 0

Editorial Comment on “Genitourinary Radiation Injury: A Mixed-methods Study Exploring Patient-reported Outcomes and Impact on Quality of Life” 泌尿生殖系统辐射损伤：一项探索患者报告结果和对生活质量影响的混合方法研究（#URL-D-25-01977R1）。

IF 2 3区医学 Q2 UROLOGY & NEPHROLOGY

Urology

Pub Date : 2026-02-01 DOI: 10.1016/j.urology.2025.12.028

Andrew C. Peterson

引用次数: 0

First Use of the FloStent™ for Catheter-dependent Urinary Retention Secondary to Benign Prostatic Hyperplasia: Additional Results From the RAPID I Study 首次使用FloStent治疗BPH继发的导管依赖性尿潴留：来自RAPID I研究的额外结果

IF 2 3区医学 Q2 UROLOGY & NEPHROLOGY

Urology

Pub Date : 2026-02-01 DOI: 10.1016/j.urology.2025.09.018

Bilal Chughtai , Jennifer Polo , Ingrid Perscky , Ruben Urena , Adam Kadlec , Dean Elterman

Objective

To describe the performance of the FloStent™ in men with catheter-dependent urinary retention due benign prostatic hyperplasia (BPH) awaiting transurethral resection of the prostate (TURP). The FloStent™ is a novel device for treatment of BPH, that can be implanted and retrieved with any flexible cystoscope.

Methods

The RAPID I study was a first-in-human clinical trial designed to evaluate the clinical performance of the FloStent™. One arm of the study treated men with lower urinary tract symptoms. In a separate and distinct arm of the study, reported here, 11 men with BPH-related urinary retention and indwelling catheters were enrolled and scheduled for FloStent™ implantation. All underwent outpatient device placement. Follow-up visits occurred at 2, 6, and 12 weeks, after which the device was removed, and subjects underwent TURP as previously indicated.

Results

All 11 participants achieved catheter-free status immediately postprocedure. Baseline characteristics included mean age 69.0 years, prostate size 65.3 mL, prostate-specific antigen 8.3 ng/mL, serum creatinine 1.0 mg/dL, and prostatic urethral length 3.4 cm. At 3 months, 8 of 11 (72.7%) remained catheter-free. Among those, mean International Prostate Symptom Score was 6.4 ± 6.6, Quality of Life score 0.75 ± 1.75, Qmax 9.5 ± 4.8 mL/s, and postvoid residual 105.4 ± 265.1 mL. Pain scores were uniformly 0 across all timepoints. Seven adverse events occurred in five subjects, all nonserious and self-limited.

Conclusion

FloStent™ enabled catheter-free voiding in the majority of subjects, with excellent tolerability. This approach may offer an effective interim solution for patients awaiting TURP.

目的：探讨FloStent在等待经尿道前列腺切除术（TURP）的前列腺增生患者导管依赖性尿潴留中的应用效果。FloStent™是一种用于治疗良性前列腺增生（BPH）的新型设备，可以通过任何柔性膀胱镜植入和取出。方法：RAPID I研究是一项首次人体临床试验，旨在评估FloStent™的临床性能。该研究的一组治疗患有LUTS的男性。在本研究的另一组中，11名患有前列腺肥大相关尿潴留和留置导尿管的男性被纳入研究，并计划进行FloStent植入术。所有患者都接受了门诊装置安置。随访时间分别为2周、6周和12周，之后取出装置，受试者按先前指示进行TURP。结果：所有11名患者术后立即达到无导管状态。基线特征包括平均年龄69.0岁，前列腺大小65.3 mL, PSA 8.3 ng/mL，血清肌酐1.0 mg/dL，前列腺尿道长度3.4 cm。3个月时，11例患者中有8例（72.7%）仍未置管。其中，平均IPSS为6.4±6.6，QOL评分为0.75±1.75，Qmax评分为9.5±4.8 mL/s， PVR评分为105.4±265.1 mL。各时间点疼痛评分均为0。5例受试者发生7例不良事件，均为非严重、自限性不良事件。结论：FloStent™在大多数受试者中实现了无导管排尿，具有良好的耐受性。这种方法可能为等待TURP的患者提供有效的临时解决方案。

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引用次数: 0

Editorial Comment on “The Long Road to Healthcare Quality Standardization and Optimization in Urology” 《泌尿外科医疗质量标准化与优化之路漫漫》社论评论

IF 2 3区医学 Q2 UROLOGY & NEPHROLOGY

Urology

Pub Date : 2026-02-01 DOI: 10.1016/j.urology.2025.12.003

Gillian R. Murray, Kevin Koo

引用次数: 0

Reply to Editorial Comment on “Prescribing Patterns for Beta-3 Agonists and Anticholinergic Medications Used in Treatment of Overactive Bladder” 对“治疗膀胱过度活动的β -3激动剂和抗胆碱能药物的处方模式”社论评论的回复。

IF 2 3区医学 Q2 UROLOGY & NEPHROLOGY

Urology

Pub Date : 2026-02-01 DOI: 10.1016/j.urology.2025.11.255

Grace Khaner , Gregory Vurture , Niharika Malviya , Whitney Clearwater , Melissa Laudano

引用次数: 0

Letter to the Editor on “Chylous Leakage After Retroperitoneal Minimally Invasive Surgery: A Multi-institutional Analysis of Risk Factors, Treatment Course, and Surgical Intervention” 致编辑的信：腹膜后微创手术后乳糜漏：多机构的危险因素、治疗过程和手术干预分析。

IF 2 3区医学 Q2 UROLOGY & NEPHROLOGY

Urology

Pub Date : 2026-02-01 DOI: 10.1016/j.urology.2025.12.020

Maria José Gutiérrez Sierra , Nicolas Guerrero Acosta , Oscar Mauricio Rivero Rapalino , David Fernando Torres Cortes

引用次数: 0

Management of Penile and Pelvic Abscesses Following Corporeal Shunt Placement 阴茎和盆腔脓肿的处理。

IF 2 3区医学 Q2 UROLOGY & NEPHROLOGY

Urology

Pub Date : 2026-02-01 DOI: 10.1016/j.urology.2025.12.013

Isabel Guan, Parth Joshi, Jordan Mendelson, Katharine Hodgen, Maxwell Efros, Joo Lee, Daniel Rittenberg

引用次数: 0

Racial and Demographic Variables Are Associated with Accurate 24-hour Urine Collection Completion and Results 种族和人口变量影响准确的24小时尿液收集完成和结果。

IF 2 3区医学 Q2 UROLOGY & NEPHROLOGY

Urology

Pub Date : 2026-02-01 DOI: 10.1016/j.urology.2025.10.009

Reza Lahiji , Elizabeth Chu , Ernest Allen Morton , Lorenzo Storino Ramacciotti , Rachel Kaufman , Talia Helman , Gabriel Ekene Agu , Matthew Harris , Adam Braunschweig , Samay Patel , Susan Mumford , Pooja Hemige , Braden James , Dattatraya Patil , Mohammad Hajiha , Viraj Master , Kenneth Ogan

Objective

To understand and evaluate demographic predictors of accurate urine collection, as well as to detail key racial differences in lithogenic urine markers.

Methods

We retrospectively reviewed stone-forming patients who underwent 24-hour urine collection between 2010-2022 at a tertiary center. Accuracy was defined by Mayo Clinic creatinine thresholds (13-29 mg/kg for males; 9-26 mg/kg for females). Multivariable logistic regression assessed predictors of accurate collection and racial associations with urinary abnormalities, adjusting for age ≥55, sex, and obesity.

Results

Of 823 patients, 694 (84.3%) collected accurately. Age ≥55 years was associated with double the odds of accuracy (OR 2.18, 95%CI 1.44-3.31, P <.001). Male sex (OR 0.49, 95%CI 0.32-0.76, P = .001) and Black race (OR 0.51, 95%CI 0.32-0.81, P = .005) predicted lower accuracy. Among accurate completers, Black patients had lower odds of hypercalciuria (OR 0.32, P <.001), hyperphosphaturia (OR 0.28, P <.001), and calcium phosphate supersaturation (OR 0.45, P = .022), but higher odds of hypercitraturia (OR 1.69, P = .008).

Conclusion

Younger age, male sex, and Black race were associated with reduced 24-hour urine collection accuracy, highlighting the need for targeted education. Among accurate completers, Black patients demonstrated distinct urinary profiles suggestive of reduced risk for calcium-based stones. These findings highlight the importance of improving adherence and incorporating racial differences into individualized nephrolithiasis risk assessment.

目的：了解和评估准确尿液收集的人口学预测因素，并详细说明主要的种族差异。方法：我们回顾性分析了2010-2022年间在三级中心接受24小时尿液收集的结石形成患者。准确性由梅奥诊所肌酐阈值定义（男性13-29 mg/kg，女性9-26 mg/kg）。多变量logistic回归评估了准确收集和种族与尿异常的关联预测因子，调整了年龄≥55岁、性别和肥胖。结果：823例患者中，694例（84.3%）采集准确。年龄≥55岁与两倍的准确率相关（OR 2.18, 95%CI 1.44-3.31, p < 0.001）。男性（OR 0.49, 95%CI 0.32-0.76, p = 0.001）和黑人（O OR 0.51, 95%CI 0.32-0.81, p = 0.005）预测准确率较低。在准确完成者中，黑人患者高钙尿的几率较低（OR 0.32）。结论：年龄较小、男性和黑人种族预测24小时尿液收集的准确性较低，突出了有针对性教育的必要性。在准确完成者中，黑人患者表现出明显的尿谱，提示钙基结石的风险降低。这些发现强调了提高依从性和将种族差异纳入个体化肾结石风险评估的重要性。

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引用次数: 0

The Long Road to Healthcare Quality Standardization and Optimization in Urology 泌尿外科医疗质量标准化与优化之路漫漫。

IF 2 3区医学 Q2 UROLOGY & NEPHROLOGY

Urology

Pub Date : 2026-02-01 DOI: 10.1016/j.urology.2025.11.236

Franklin D. Gaylis , Kevin Ginsburg , Benjamin Broudy , Hillary Prime , William J. Catalona

Objective

To evaluate a historical perspective of US healthcare quality evolution over the past 100 years, consider pioneers and seminal events that have framed current US healthcare quality in general and specifically in urology.

Methods

A review of influential physicians and organizations who influenced the evolution of quality measurement and improvement was performed. Analysis of urological care examples was performed to identify successes and deficiencies including current Medicare quality measure reporting by urologists.

Results

Dr Ernest Codman laid the groundwork for modern medical quality improvement, Dr Avedis Donabedian defined structure, process, and outcome as being central to quality measurement and improvement providing a foundational framework applicable to all medical specialties including urology, and Dr David Sackett promoted the concept of “evidence-based medicine” (EBM). Grading the quality of scientific evidence, defining clinical practice guidelines and the multidisciplinary field of implementation science have positively impacted healthcare quality. Recent CMS approval of a urology specific Merit-based Incentive Payment System (MIPS) Value Pathway (MVP) is a step toward focused sets of clinical measures and activities that are more meaningful to a clinician’s specialty practice. Analysis of recent MIPS “quality measure” reporting indicates that the majority of urologists report on cross cutting measures (blood pressure, smoking cessation, obesity) rather than more urology relevant quality measures such as active surveillance for low-risk prostate cancer.

Conclusion

Healthcare quality principles have evolved significantly over the last century, with pioneers emphasizing outcome measurement and evidence-based practice. Despite some successes, we have a long road ahead to optimize and standardize evidence-based practice and measures in urology.

目的：评估过去100年美国医疗质量演变的历史视角，考虑先驱和开创性的事件，这些事件已经框定了当前美国医疗质量，特别是泌尿科。方法：回顾影响质量测量和改进发展的有影响力的医生和组织。对泌尿科护理实例进行分析，以确定成功和不足，包括泌尿科医生目前的医疗保险质量测量报告。结果：Ernest Codman博士为现代医疗质量改进奠定了基础，Avedis Donabedian博士将结构、过程和结果定义为质量测量和改进的核心，提供了适用于包括泌尿外科在内的所有医学专业的基础框架，David Sackett博士推广了“循证医学”（EBM）的概念。科学证据的质量分级、确定临床实践指南和实施科学的多学科领域对医疗保健质量产生了积极影响。最近CMS批准了泌尿外科特定的基于绩效的激励支付系统（MIPS）价值途径（MVP），这是朝着对临床医生的专业实践更有意义的临床措施和活动集中的一步。对最近MIPS“质量测量”报告的分析表明，大多数泌尿科医生报告的是交叉测量（血压、戒烟、肥胖），而不是更多泌尿科相关的质量测量，如对低风险前列腺癌的主动监测。结论：医疗质量原则在上个世纪发生了重大变化，先驱者强调结果测量和循证实践。尽管取得了一些成功，但在优化和规范泌尿外科循证实践和措施方面，我们还有很长的路要走。

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Ectopic Seminal Vesicle Masquerading as Thrombosed Varicocele in a Patient With Primary Infertility 原发性不孕症患者的异位精囊伪装成血栓性精索静脉曲张。

IF 2 3区医学 Q2 UROLOGY & NEPHROLOGY

Urology

Pub Date : 2026-02-01 DOI: 10.1016/j.urology.2025.12.027

Rashed Rowaiee , Hamdah Kalantar , Amir Abuhejleh , Omar Almidani , Ammar Al Homsi , Omer Raheem

引用次数: 0

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