Pub Date : 2024-07-01DOI: 10.1097/ju9.0000000000000189
Marissa Clifton, John W. Davis
{"title":"June 2024 JUOP: Celebrating Dr Patrick Walsh’s 50th Year at the Brady Urological Institute","authors":"Marissa Clifton, John W. Davis","doi":"10.1097/ju9.0000000000000189","DOIUrl":"https://doi.org/10.1097/ju9.0000000000000189","url":null,"abstract":"","PeriodicalId":508272,"journal":{"name":"JU Open Plus","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141852897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-01DOI: 10.1097/ju9.0000000000000148
{"title":"Real-World Evidence That a Novel Diagnostic Combining Molecular Testing With Pooled Antibiotic Susceptibility Testing is Associated With Reduced Infection Severity and Lower Cost Compared With Standard Urine Culture in Patients With Complicated or Persistently Recurrent Urinary Tract Infections: Err","authors":"","doi":"10.1097/ju9.0000000000000148","DOIUrl":"https://doi.org/10.1097/ju9.0000000000000148","url":null,"abstract":"","PeriodicalId":508272,"journal":{"name":"JU Open Plus","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141030871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-01DOI: 10.1097/ju9.0000000000000132
Junwei Li, Yanfang Ye, Xiaojing Li, Xinxin Xie, Tao Qin
Age is an important factor for prognostic factor in bladder cancer. However, most clinical studies targeting bladder cancer have limited the upper age limit to 75 years. With the higher age of diagnosis of older patients with bladder cancer, there is a lack of prognostic data for bladder cancer at advanced ages. In this study, we analyzed the prognostic factors of older patients with bladder cancer 75 years or older using Surveillance, Epidemiology, and End Results (SEER) data. Clinical parameters that constitute potential risk factors were analyzed by downloading a total of 13,505 patients with bladder cancer from the SEER database using univariate and multifactorial Cox proportional risk regression. Nomogram was constructed based on parameters significantly associated with overall survival (OS). The consistency index (c-index) and area under the curve were used to evaluate the predictive performance of the model. From the SEER database, we analyzed 13,505 cases and found that the median survival time for the whole cohort was 52 months. However, the median survival was 11 months, 8 months, and 6 months in 75 to 79 years subgroup, 80 to 84 years subgroup, and older than 85 years subgroup, when patients were diagnosed with stage IV. OS was poorer in the high histological grade patients. Furthermore, it was found that patients with lymph node metastasis had a significantly unfavorable prognosis than those with negative lymph nodes. The more advanced stage and distant metastases of patients had the shorter survival. Patients who underwent surgery had better overall survival than nonsurgical patients, and chemotherapy had prolonged survival. Conversely, survival was documented to be shorter with radiotherapy than those without radiotherapy. The overall prognosis of older patients with bladder cancer was poor, especially in patients with lymph node metastasis, high histological grade, and advanced stage, while a combination of surgery and chemotherapy could prolong survival.
{"title":"Development and Validation of Prognostic Nomogram to Predict Overall Survival for Older Patients Who Age 75 Years or Older With Urothelial Carcinoma of Bladder","authors":"Junwei Li, Yanfang Ye, Xiaojing Li, Xinxin Xie, Tao Qin","doi":"10.1097/ju9.0000000000000132","DOIUrl":"https://doi.org/10.1097/ju9.0000000000000132","url":null,"abstract":"\u0000 \u0000 Age is an important factor for prognostic factor in bladder cancer. However, most clinical studies targeting bladder cancer have limited the upper age limit to 75 years. With the higher age of diagnosis of older patients with bladder cancer, there is a lack of prognostic data for bladder cancer at advanced ages. In this study, we analyzed the prognostic factors of older patients with bladder cancer 75 years or older using Surveillance, Epidemiology, and End Results (SEER) data.\u0000 \u0000 \u0000 \u0000 Clinical parameters that constitute potential risk factors were analyzed by downloading a total of 13,505 patients with bladder cancer from the SEER database using univariate and multifactorial Cox proportional risk regression. Nomogram was constructed based on parameters significantly associated with overall survival (OS). The consistency index (c-index) and area under the curve were used to evaluate the predictive performance of the model.\u0000 \u0000 \u0000 \u0000 From the SEER database, we analyzed 13,505 cases and found that the median survival time for the whole cohort was 52 months. However, the median survival was 11 months, 8 months, and 6 months in 75 to 79 years subgroup, 80 to 84 years subgroup, and older than 85 years subgroup, when patients were diagnosed with stage IV. OS was poorer in the high histological grade patients. Furthermore, it was found that patients with lymph node metastasis had a significantly unfavorable prognosis than those with negative lymph nodes. The more advanced stage and distant metastases of patients had the shorter survival. Patients who underwent surgery had better overall survival than nonsurgical patients, and chemotherapy had prolonged survival. Conversely, survival was documented to be shorter with radiotherapy than those without radiotherapy.\u0000 \u0000 \u0000 \u0000 The overall prognosis of older patients with bladder cancer was poor, especially in patients with lymph node metastasis, high histological grade, and advanced stage, while a combination of surgery and chemotherapy could prolong survival.\u0000","PeriodicalId":508272,"journal":{"name":"JU Open Plus","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141034191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-01DOI: 10.1097/ju9.0000000000000150
Bingyuan Yang, Aditi Ray, James Zhang, Ben Turney
Ureteroscopic laser lithotripsy results in the formation of small and numerous stone fragments. These have the potential to act as a nidus for stone recurrence, and the effectiveness of irrigation via the ureteroscope at clearing them is not well understood. Using an in vitro quartz-based model, fragments of known sizes from <63 µm to 2mm are irrigated at rates of 15 mL/min, 30 mL/min and 120 mL/min. Clinically achievable rates of 15-30 mL/min are unable to wash out larger particles >500 µm, and even 120 mL/min irrigation was able to wash out less than half of these larger particles. Complete stone clearance is unlikely to be achievable by intraoperative irrigation alone and requires additional technologies such as suction.
{"title":"How Effective Is Ureteroscopic Irrigation at Evacuating Stone Dust?","authors":"Bingyuan Yang, Aditi Ray, James Zhang, Ben Turney","doi":"10.1097/ju9.0000000000000150","DOIUrl":"https://doi.org/10.1097/ju9.0000000000000150","url":null,"abstract":"Ureteroscopic laser lithotripsy results in the formation of small and numerous stone fragments. These have the potential to act as a nidus for stone recurrence, and the effectiveness of irrigation via the ureteroscope at clearing them is not well understood. Using an in vitro quartz-based model, fragments of known sizes from <63 µm to 2mm are irrigated at rates of 15 mL/min, 30 mL/min and 120 mL/min. Clinically achievable rates of 15-30 mL/min are unable to wash out larger particles >500 µm, and even 120 mL/min irrigation was able to wash out less than half of these larger particles. Complete stone clearance is unlikely to be achievable by intraoperative irrigation alone and requires additional technologies such as suction.","PeriodicalId":508272,"journal":{"name":"JU Open Plus","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141042668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-01DOI: 10.1097/ju9.0000000000000139
L. R. Garabed, Stephanie Wang, Malek Meskawi, N. Bhojani, Daniel Liberman
Urethral strictures and benign prostatic hyperplasia (BPH) are 2 common causes of urinary obstruction and urinary emptying symptoms. While urethroplasty and endoscopic management of BPH have been extensively discussed in the literature when performed on their own, a case of simultaneous urethroplasty and endoscopic management of BPH has not been previously described in the literature. We present the case of a 75-year-old man with significant BPH and concomitant bulbar obliterative urethral stricture. After discussion of treatment options with the patient, we elected to perform both holmium LASER enucleation of the prostate (HoLEP) of a 200cc prostate and buccal graft urethroplasty during the same surgery. The HoLEP was performed through a dorsal urethrotomy in anticipation of urethroplasty. Nontransecting anastomotic repair was then combined with the buccal graft urethroplasty. The patient did not have any acute postoperative complications and had no recurrence. He reported improvements in outcome questionnaire scores and uroflow parameters at the 12-month follow-up. This case presentation is the first to report on simultaneous complex urethroplasty and endoscopic management of BPH, specifically HoLEP. It shows that this approach can lead to positive urinary outcomes without added complications and with lasting outcomes, thereby allowing the use of a combined surgical approach.
{"title":"Complex Buccal Graft Urethroplasty Combined With HoLEP in the Setting of Concomitant Urethral Stricture Disease and Severe Benign Prostatic Hyperplasia: A Case Report","authors":"L. R. Garabed, Stephanie Wang, Malek Meskawi, N. Bhojani, Daniel Liberman","doi":"10.1097/ju9.0000000000000139","DOIUrl":"https://doi.org/10.1097/ju9.0000000000000139","url":null,"abstract":"\u0000 \u0000 Urethral strictures and benign prostatic hyperplasia (BPH) are 2 common causes of urinary obstruction and urinary emptying symptoms. While urethroplasty and endoscopic management of BPH have been extensively discussed in the literature when performed on their own, a case of simultaneous urethroplasty and endoscopic management of BPH has not been previously described in the literature.\u0000 \u0000 \u0000 \u0000 We present the case of a 75-year-old man with significant BPH and concomitant bulbar obliterative urethral stricture. After discussion of treatment options with the patient, we elected to perform both holmium LASER enucleation of the prostate (HoLEP) of a 200cc prostate and buccal graft urethroplasty during the same surgery. The HoLEP was performed through a dorsal urethrotomy in anticipation of urethroplasty. Nontransecting anastomotic repair was then combined with the buccal graft urethroplasty. The patient did not have any acute postoperative complications and had no recurrence. He reported improvements in outcome questionnaire scores and uroflow parameters at the 12-month follow-up.\u0000 \u0000 \u0000 \u0000 This case presentation is the first to report on simultaneous complex urethroplasty and endoscopic management of BPH, specifically HoLEP. It shows that this approach can lead to positive urinary outcomes without added complications and with lasting outcomes, thereby allowing the use of a combined surgical approach.\u0000","PeriodicalId":508272,"journal":{"name":"JU Open Plus","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141053294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-01DOI: 10.1097/ju9.0000000000000146
Lily Kong, N. Coddington, Gary Shahinyan, Janet B. Kukreja, Brian J. Flynn
Massive encrustation is a rare complication of retained foreign bodies in the urinary tract. Large stone size and coexisting artificial material can limit endoscopic options, necessitating surgical removal. We present a case of massive encrustation of a retained ureteral stent treated with robotic-assisted laparoscopic ureterolithotomy.
{"title":"Robotic Ureterolithotomy for Retained Stent With Massive Encrustation: Case Report and Review of the Literature","authors":"Lily Kong, N. Coddington, Gary Shahinyan, Janet B. Kukreja, Brian J. Flynn","doi":"10.1097/ju9.0000000000000146","DOIUrl":"https://doi.org/10.1097/ju9.0000000000000146","url":null,"abstract":"Massive encrustation is a rare complication of retained foreign bodies in the urinary tract. Large stone size and coexisting artificial material can limit endoscopic options, necessitating surgical removal. We present a case of massive encrustation of a retained ureteral stent treated with robotic-assisted laparoscopic ureterolithotomy.","PeriodicalId":508272,"journal":{"name":"JU Open Plus","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141054647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-01DOI: 10.1097/ju9.0000000000000142
{"title":"JUOP Top Reviewers 2023","authors":"","doi":"10.1097/ju9.0000000000000142","DOIUrl":"https://doi.org/10.1097/ju9.0000000000000142","url":null,"abstract":"","PeriodicalId":508272,"journal":{"name":"JU Open Plus","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141055953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-01DOI: 10.1097/ju9.0000000000000147
A. Houjaij, O. Darwish, Jacob Rubin, Raymond Pominville, Pradeep Arora, Mohsin Shiekh, Csaba Gajdos, Nader D. Nader
Partial nephrectomy is the preferred treatment method for certain kidney tumors owing to its nephron-preserving benefit. We aimed to compare the occurrence and importance of complications after radical (RN) or partial (PN) nephrectomy for localized renal cell carcinoma (RCC) and contribution to patient mortality. All RCC cases were extracted from the National Surgical Quality Improvement Program between 2005 and 2017. All-cause mortality was the primary endpoint that defined a failure to rescue (FTR) after the occurrences of complications. Propensity score matching (PSM) was performed to adjust for confounding variables between the 2 groups. The exclusion criteria included patients on dialysis, those with distant metastases, and those with concurrent procedures. Null hypotheses were rejected when P-values were < .05. The database included 24,830 patients, with 22,015 in the RN group and 2815 in the PN. After PSM, 2226 patients after PN were matched 1:1 to an equal number of patients who underwent RN. Overall, postoperative complications occurred in 20.5% after RN, more frequent than 15.9% after PN (P < .001). While the mortality rates were similar, patients were more likely to experience blood transfusion and reintubation, as well as longer hospital stay after RN, while they were likely to have more infectious complications, including abdominal abscess, and more likely to return to the operating room after PN. In both groups, cardiac and respiratory complications were associated with FTR, leading to mortality. Excessive bleeding (requiring transfusion) was also a significant cause of death after RN but not after PN. When planning PN or RN, patients should be counseled on the risks of their selective procedure and the potential increased mortality risk with certain complications. These risks should be weighed against the benefit of those cancer surgeries.
{"title":"Partial Versus Radical Nephrectomy: Comparison of Postoperative Complications and Contribution to Mortality","authors":"A. Houjaij, O. Darwish, Jacob Rubin, Raymond Pominville, Pradeep Arora, Mohsin Shiekh, Csaba Gajdos, Nader D. Nader","doi":"10.1097/ju9.0000000000000147","DOIUrl":"https://doi.org/10.1097/ju9.0000000000000147","url":null,"abstract":"\u0000 \u0000 Partial nephrectomy is the preferred treatment method for certain kidney tumors owing to its nephron-preserving benefit. We aimed to compare the occurrence and importance of complications after radical (RN) or partial (PN) nephrectomy for localized renal cell carcinoma (RCC) and contribution to patient mortality.\u0000 \u0000 \u0000 \u0000 All RCC cases were extracted from the National Surgical Quality Improvement Program between 2005 and 2017. All-cause mortality was the primary endpoint that defined a failure to rescue (FTR) after the occurrences of complications. Propensity score matching (PSM) was performed to adjust for confounding variables between the 2 groups. The exclusion criteria included patients on dialysis, those with distant metastases, and those with concurrent procedures. Null hypotheses were rejected when P-values were < .05.\u0000 \u0000 \u0000 \u0000 The database included 24,830 patients, with 22,015 in the RN group and 2815 in the PN. After PSM, 2226 patients after PN were matched 1:1 to an equal number of patients who underwent RN. Overall, postoperative complications occurred in 20.5% after RN, more frequent than 15.9% after PN (P < .001). While the mortality rates were similar, patients were more likely to experience blood transfusion and reintubation, as well as longer hospital stay after RN, while they were likely to have more infectious complications, including abdominal abscess, and more likely to return to the operating room after PN. In both groups, cardiac and respiratory complications were associated with FTR, leading to mortality. Excessive bleeding (requiring transfusion) was also a significant cause of death after RN but not after PN.\u0000 \u0000 \u0000 \u0000 When planning PN or RN, patients should be counseled on the risks of their selective procedure and the potential increased mortality risk with certain complications. These risks should be weighed against the benefit of those cancer surgeries.\u0000","PeriodicalId":508272,"journal":{"name":"JU Open Plus","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141058274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-01DOI: 10.1097/ju9.0000000000000135
Julio A. Yanes, David A. Velasquez, Mary Rostom, Francis Petrella, P. Saba, Lauren Shepard, A. Ghazi, Ranjith Ramasamy
{"title":"Enhancing Urology Resident Training in Vasectomies Through a 3D Printed Simulation","authors":"Julio A. Yanes, David A. Velasquez, Mary Rostom, Francis Petrella, P. Saba, Lauren Shepard, A. Ghazi, Ranjith Ramasamy","doi":"10.1097/ju9.0000000000000135","DOIUrl":"https://doi.org/10.1097/ju9.0000000000000135","url":null,"abstract":"","PeriodicalId":508272,"journal":{"name":"JU Open Plus","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141035554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-01DOI: 10.1097/ju9.0000000000000154
Akshay Sood
{"title":"Moving the Needle: Integrating Available Risk Stratification Tools for Optimizing Diagnosis of Prostate Cancer","authors":"Akshay Sood","doi":"10.1097/ju9.0000000000000154","DOIUrl":"https://doi.org/10.1097/ju9.0000000000000154","url":null,"abstract":"","PeriodicalId":508272,"journal":{"name":"JU Open Plus","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141030639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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