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Venishetty N, Raheem OA. Commentary on: Frequently asked questions on erectile dysfunction: evaluating artificial intelligence answers with expert mentorship. Int J Impot Res 2024:10.1038/s41443-024-00901-x. [PMID: 38789696 DOI: 10.1038/s41443-024-00901-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Revised: 04/22/2024] [Accepted: 04/26/2024] [Indexed: 05/26/2024]
Affiliation(s)
- Nikit Venishetty
- Paul L. Foster School of Medicine, Texas Tech Health Sciences Center, El Paso, TX, USA
- Department of Surgery, Section of Urology, The University of Chicago, Chicago, IL, USA
| | - Omer A Raheem
- Paul L. Foster School of Medicine, Texas Tech Health Sciences Center, El Paso, TX, USA.
- Department of Surgery, Section of Urology, The University of Chicago, Chicago, IL, USA.
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Şahin MF, Ateş H, Keleş A, Özcan R, Doğan Ç, Akgül M, Yazıcı CM. Responses of Five Different Artificial Intelligence Chatbots to the Top Searched Queries About Erectile Dysfunction: A Comparative Analysis. J Med Syst 2024; 48:38. [PMID: 38568432 PMCID: PMC10990980 DOI: 10.1007/s10916-024-02056-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 03/22/2024] [Indexed: 04/05/2024]
Abstract
The aim of the study is to evaluate and compare the quality and readability of responses generated by five different artificial intelligence (AI) chatbots-ChatGPT, Bard, Bing, Ernie, and Copilot-to the top searched queries of erectile dysfunction (ED). Google Trends was used to identify ED-related relevant phrases. Each AI chatbot received a specific sequence of 25 frequently searched terms as input. Responses were evaluated using DISCERN, Ensuring Quality Information for Patients (EQIP), and Flesch-Kincaid Grade Level (FKGL) and Reading Ease (FKRE) metrics. The top three most frequently searched phrases were "erectile dysfunction cause", "how to erectile dysfunction," and "erectile dysfunction treatment." Zimbabwe, Zambia, and Ghana exhibited the highest level of interest in ED. None of the AI chatbots achieved the necessary degree of readability. However, Bard exhibited significantly higher FKRE and FKGL ratings (p = 0.001), and Copilot achieved better EQIP and DISCERN ratings than the other chatbots (p = 0.001). Bard exhibited the simplest linguistic framework and posed the least challenge in terms of readability and comprehension, and Copilot's text quality on ED was superior to the other chatbots. As new chatbots are introduced, their understandability and text quality increase, providing better guidance to patients.
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Affiliation(s)
- Mehmet Fatih Şahin
- Faculty of Medicine Department of Urology, Tekirdağ Namık Kemal University, Süleymanpaşa, Tekirdağ, 59020, Turkey.
| | - Hüseyin Ateş
- Faculty of Medicine Department of Urology, Tekirdağ Namık Kemal University, Süleymanpaşa, Tekirdağ, 59020, Turkey
| | - Anıl Keleş
- Faculty of Medicine Department of Urology, Tekirdağ Namık Kemal University, Süleymanpaşa, Tekirdağ, 59020, Turkey
| | - Rıdvan Özcan
- Department of Urology, Bursa State Hospital, Nilüfer, Bursa, 16110, Turkey
| | - Çağrı Doğan
- Faculty of Medicine Department of Urology, Tekirdağ Namık Kemal University, Süleymanpaşa, Tekirdağ, 59020, Turkey
| | - Murat Akgül
- Faculty of Medicine Department of Urology, Tekirdağ Namık Kemal University, Süleymanpaşa, Tekirdağ, 59020, Turkey
| | - Cenk Murat Yazıcı
- Faculty of Medicine Department of Urology, Tekirdağ Namık Kemal University, Süleymanpaşa, Tekirdağ, 59020, Turkey
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Conroy DE, Marks J, Cutshaw A, Ram N, Thomaz E, Streeper NM. Promoting fluid intake to increase urine volume for kidney stone prevention: Protocol for a randomized controlled efficacy trial of the sip IT intervention. Contemp Clin Trials 2024; 138:107454. [PMID: 38253254 PMCID: PMC10923155 DOI: 10.1016/j.cct.2024.107454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Revised: 01/11/2024] [Accepted: 01/19/2024] [Indexed: 01/24/2024]
Abstract
BACKGROUND Risk of kidney stone recurrence can be reduced by increasing fluid intake and urine production but most patients fail to adhere to recommended clinical guidelines. Patients have indicated that common barriers to fluid intake include a lack of thirst, forgetting to drink, and not having access to water. We developed the sipIT intervention to support patients' fluid intake with semi-automated tracking (via a mobile app, connected water bottle and a smartwatch clockface that detects drinking gestures) and provision of just-in-time text message reminders to drink when they do not meet the hourly fluid intake goal needed to achieve the recommended volume. This trial evaluates the efficacy of sipIT for increasing urine output in patients at risk for recurrence of kidney stones. METHOD/DESIGN Adults with a history of kidney stones and lab-verified low urine production (<2 L/day) will be randomly assigned to receive either usual care (education and encouragement to meet fluid intake guidelines) or usual care plus the sipIT intervention. The primary outcome is 24-h urine volume; secondary outcomes include urinary supersaturations, past week fluid intake, and experienced automaticity of fluid intake. Outcomes will be assessed at baseline, 1 month, 3 months, and 12 months. CONCLUSIONS The sipIT intervention is the first to prompt periodic fluid intake through integration of just-in-time notifications and semi-automated tracking. If sipIT is more efficacious than usual care, this intervention provides an innovative treatment option for patients needing support in meeting fluid intake guidelines for kidney stone prevention.
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Affiliation(s)
- David E Conroy
- Department of Kinesiology, The Pennsylvania State University, University Park, PA 16802, USA.
| | - James Marks
- Department of Urology, The Pennsylvania State University, Hershey, PA 17033, USA
| | - Alyssa Cutshaw
- Department of Kinesiology, The Pennsylvania State University, University Park, PA 16802, USA
| | - Nilam Ram
- Department of Communication and Psychology, Stanford University, Palo Alto, CA 94305, USA
| | - Edison Thomaz
- Department of Electrical and Computer Engineering, University of Texas, Austin, TX 78712, USA
| | - Necole M Streeper
- Department of Urology, The Pennsylvania State University, Hershey, PA 17033, USA
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Koh HJW, Whitelock-Wainwright E, Gasevic D, Rankin D, Romero L, Frydenberg M, Evans S, Talic S. Quality Indicators in the Clinical Specialty of Urology: A Systematic Review. Eur Urol Focus 2022:S2405-4569(22)00288-7. [PMID: 36577611 DOI: 10.1016/j.euf.2022.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 11/11/2022] [Accepted: 12/06/2022] [Indexed: 12/27/2022]
Abstract
CONTEXT In health care, monitoring of quality indicators (QIs) in general urology remains underdeveloped in comparison to other clinical specialties. OBJECTIVE To identify, synthesise, and appraise QIs that monitor in-hospital care for urology patients. EVIDENCE ACQUISITION This systematic review included peer-reviewed articles identified via Embase, MEDLINE, Web of Science, CINAHL, Global Health, Google Scholar, and grey literature from 2000 to February 19, 2021. The review was carried out under the Preferred Reporting Items of Systematic Reviews and Meta-Analyses (PRISMA) guidelines and used the Appraisal of Indicators through Research and Evaluation (AIRE) tool for quality assessment. EVIDENCE SYNTHESIS A total of 5111 articles and 62 government agencies were screened for QI sets. There were a total of 57 QI sets included for analysis. Most QIs focused on uro-oncology, with prostate, bladder, and testicular cancers the most represented. The most common QIs were surgical QIs in uro-oncology (positive surgical margin, surgical volume), whereas in non-oncology the QIs most frequently reported were for treatment and diagnosis. Out of 61 articles, only four scored a total of ≥50% on the AIRE tool across four domains. Aside from QIs developed in uro-oncology, general urological QIs are underdeveloped and of poor methodological quality and most lack testing for both content validity and reliability. CONCLUSIONS There is an urgent need for the development of methodologically robust QIs in the clinical specialty of general urology for patients to enable standardised quality of care monitoring and to improve patient outcomes. PATIENT SUMMARY We investigated a range of quality indicators (QIs) that provide health care professionals with feedback on the quality of their care for patients with general urological diseases. We found that aside from urological cancers, there is a lack of QIs for general urology. Hence, there is an urgent need for the development of robust and disease-specific QIs in general urology.
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Affiliation(s)
- Harvey Jia Wei Koh
- Faculty of Information Technology, Monash University, Clayton, Australia; Digital Health Cooperative Research Centre, Sydney, Australia
| | - Emma Whitelock-Wainwright
- Faculty of Information Technology, Monash University, Clayton, Australia; Digital Health Cooperative Research Centre, Sydney, Australia
| | - Dragan Gasevic
- Faculty of Information Technology, Monash University, Clayton, Australia; Digital Health Cooperative Research Centre, Sydney, Australia
| | - David Rankin
- Digital Health Cooperative Research Centre, Sydney, Australia; Cabrini Healthcare, Malvern, Australia
| | - Lorena Romero
- Ian Potter Library, Monash University, Melbourne, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Mark Frydenberg
- Department of Surgery, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia; Cabrini Institute, Cabrini Health, Malvern, Australia
| | - Sue Evans
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; Cancer Council Victoria, Melbourne, Australia
| | - Stella Talic
- Digital Health Cooperative Research Centre, Sydney, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
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The application of 3D bioprinting in urological diseases. Mater Today Bio 2022; 16:100388. [PMID: 35967737 PMCID: PMC9364106 DOI: 10.1016/j.mtbio.2022.100388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 07/24/2022] [Accepted: 07/27/2022] [Indexed: 12/02/2022] Open
Abstract
Urologic diseases are commonly diagnosed health problems affecting people around the world. More than 26 million people suffer from urologic diseases and the annual expenditure was more than 11 billion US dollars. The urologic cancers, like bladder cancer, prostate cancer and kidney cancer are always the leading causes of death worldwide, which account for approximately 22% and 10% of the new cancer cases and death, respectively. Organ transplantation is one of the major clinical treatments for urological diseases like end-stage renal disease and urethral stricture, albeit strongly limited by the availability of matching donor organs. Tissue engineering has been recognized as a highly promising strategy to solve the problems of organ donor shortage by the fabrication of artificial organs/tissue. This includes the prospective technology of three-dimensional (3D) bioprinting, which has been adapted to various cell types and biomaterials to replicate the heterogeneity of urological organs for the investigation of organ transplantation and disease progression. This review discusses various types of 3D bioprinting methodologies and commonly used biomaterials for urological diseases. The literature shows that advances in this field toward the development of functional urological organs or disease models have progressively increased. Although numerous challenges still need to be tackled, like the technical difficulties of replicating the heterogeneity of urologic organs and the limited biomaterial choices to recapitulate the complicated extracellular matrix components, it has been proved by numerous studies that 3D bioprinting has the potential to fabricate functional urological organs for clinical transplantation and in vitro disease models. Outline the advantages and characteristics of 3D printing compared with traditional methods for urological diseases. Guide the selection of 3D bioprinting technology and material in urological tissue engineering. Discuss the challenges and future perspectives of 3D bioprinting in urological diseases and clinical translation.
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Bradley ES, Schell B, Ward DV, Bucci V, Zeamer A, Haran JP. The Urinary Microbiome of Older Adults Residing in a Nursing Home Varies With Duration of Residence and Shows Increases in Potential Pathogens. J Gerontol A Biol Sci Med Sci 2022; 77:1313-1320. [PMID: 34791238 PMCID: PMC9653004 DOI: 10.1093/gerona/glab345] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Indexed: 11/13/2022] Open
Abstract
The community of bacteria that colonize the urinary tract, the urinary microbiome, is hypothesized to influence a wide variety of urinary tract conditions. Older adults who reside in nursing homes are frequently diagnosed and treated for urinary tract conditions such as urinary tract infection. We investigated the urinary microbiome of older adults residing in a nursing home to determine if there are features of the urinary microbiome that are associated with specific conditions and exposure in this population. We were also interested in the stability of urinary microbiome over time and in similarities between the urinary and gastrointestinal microbiome. Urine samples were prospectively collected over a period of 10 months from a cohort of 26 older adults (aged >65 years) residing in a single nursing home located in Central Massachusetts. Serial samples were obtained from 6 individuals over 10 months and 5 participants were concurrently enrolled in a study of the gastrointestinal microbiome. Information collected on participants included demographics, medical history, duration of residence in the nursing home, frailty, dementia symptoms, urinary symptoms, antibiotic treatment, urinary catheterization, and hospitalizations over a 10-month period. Clean catch, midstream urine samples were collected and stored at -80°C. DNA was extracted and 16S rRNA gene sequencing was performed. The length of stay in the nursing facility and the Clinical Frailty Scale correlated with significant changes in microbiome composition. An increase in the relative abundance of a putative urinary pathogen, Aerococcus urinae, was the largest factor influencing change that occurred over the duration of residence.
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Affiliation(s)
- Evan S Bradley
- Department of Emergency Medicine, UMass Memorial Medical Center and University of Massachusetts Medical School, Worcester, Massachusetts, USA
- Program in Microbiome Dynamics, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Brent Schell
- Department of Emergency Medicine, UMass Memorial Medical Center and University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Doyle V Ward
- Program in Microbiome Dynamics, University of Massachusetts Medical School, Worcester, Massachusetts, USA
- Department of Microbiology and Physiological Systems, Center for Microbiome Research, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Vanni Bucci
- Program in Microbiome Dynamics, University of Massachusetts Medical School, Worcester, Massachusetts, USA
- Department of Microbiology and Physiological Systems, Center for Microbiome Research, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Abigail Zeamer
- Department of Microbiology and Physiological Systems, Center for Microbiome Research, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - John P Haran
- Department of Emergency Medicine, UMass Memorial Medical Center and University of Massachusetts Medical School, Worcester, Massachusetts, USA
- Program in Microbiome Dynamics, University of Massachusetts Medical School, Worcester, Massachusetts, USA
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Elia M, Monga M, De S. Increased Nephrolithiasis Prevalence in People with Disabilities: A National Health and Nutrition Survey Analysis. Urology 2021; 163:185-189. [PMID: 34619156 DOI: 10.1016/j.urology.2021.07.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 07/06/2021] [Accepted: 07/29/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To estimate the prevalence of nephrolithiasis in people with disabilities (PWD), while accounting for known kidney stone disease risk factors. METHODS We used answers to the disability and kidney disease questionnaires from the 2013-2016 cycles of the National Health and Nutrition Examination Survey (NHANES), a nationally representative cross-sectional survey by the Centers for Disease Control, to calculate nephrolithiasis prevalence by functional disability type. We additionally estimated the total US population of stone formers with disabilities and compared disability prevalence between stone formers and non-stone formers. Multivariate logistic regression models were built using known correlates of nephrolithiasis. RESULTS 34.7% (CI: 30.5-39.1%) of United States stone-formers are PWD. The prevalence of nephrolithiasis in PWD is 16.1% (CI: 14.4-18.0) in comparison to 9.2% (CI: 8.3-10.3) in people without disabilities. PWD have significantly elevated odds of nephrolithiasis (un-adjusted OR: 1.91 CI: 1.55-2.36). Adjusting for age, gender, race, diabetes, hypertension, and obesity, odds of nephrolithiasis remains elevated in PWD overall (adjusted OR: 1.46 95% CI: 1.17-1.83) and in all disability domains. CONCLUSIONS One in 3 people with nephrolithiasis are PWD. Odds of nephrolithiasis are increased in PWD even after adjustment for multiple known risk factors in all disability domains. PWD are known to be a unique population that can face significant health disparities, but there is a dearth of studies that estimate urologic disease prevalence within this group. Future urologic research should incorporate disability status to explore potential disparities.
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Affiliation(s)
- Marlie Elia
- Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH; Present Address: Department of Surgery, University of Washington, Seattle, WA.
| | - Manoj Monga
- Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH; Present Address: Department of Urology, University of California, San Diego, CA
| | - Smita De
- Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH
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Passos PS, Anacleto ST, Versos RS, Alves MC, Mota PO. Reconstruction of the Denonvillier's fascia and posterior ligament of the external urethral sphincter: Assessment of its effect on urinary continence after laparoscopic radical prostatectomy. Arch Ital Urol Androl 2021; 93:274-279. [PMID: 34839631 DOI: 10.4081/aiua.2021.3.274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 07/09/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES Some studies have shown that rhabdosphincter reconstruction provides an earlier return to continence after radical prostatectomy. We aim to study the impact of this procedure in urinary continence along with comparing two specific surgical techniques for posterior reconstruction. MATERIALS AND METHODS We studied a group of patients who were submitted to LRP with No Rhabdosphincter Reconstruction (NRR) and another group with Posterior Reconstruction of the Rhabdosphincter (PRR). The latter was further divided into two groups: "Rocco type stitch" group and "Bollens type stitch" group. We used three questionnaires (IIEF-5, ICIQ-SF and IPSS) to assess urinary continence and erectile function 90 days after surgery. RESULTS Patients of PRR group had a better full continence rate than patients of NRR group at 90 days (96.6% vs 33.3%, p < 0.001). Concerning urinary incontinence (p = 0.116), lower urinary tract symptoms (p = 0.543) and postoperative complication rates (p = 0.738), our results suggested that there were no differences between the techniques studied. CONCLUSIONS Posterior reconstruction of the rhabdosphincter has significant benefits for urinary continence recovery on patients undergoing radical prostatectomy. No differences were observed in continence recovery between the two techniques analyzed. Additionally, reconstruction of the rhabdosphincter appears to be a safe procedure with no increased risk of postoperative complications.
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Affiliation(s)
- Pedro Sousa Passos
- Department of Urology, Hospital de Braga, Portugal; Department of Urology, Hospital de Guimarães.
| | | | | | | | - Paulo Oliveira Mota
- Department of Urology, Hospital de Braga; Institute of Life and Health Sciences, University of Minho.
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Norton JM, Dowling-Castronovo A, Conroy B, Hijaz A, Kim M, Loizou C, Meyer DE, Constantine ML. The Inflection Point Model: a Model to Explore the Hidden Burdens of Non-Cancerous Genitourinary Conditions. Urology 2021; 166:56-65. [PMID: 34390729 DOI: 10.1016/j.urology.2021.07.030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 07/19/2021] [Accepted: 07/29/2021] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To propose a conceptual model to identify points along the condition course where actions or inaction affect downstream burdens of non-cancerous genitourinary conditions (NCGUC). MATERIALS AND METHODS The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) convened an interdisciplinary meeting to comprehensively consider the burdens of NCGUCs. Subsequently, the authors met monthly to conceptualize the model. RESULTS Inflection points (IP) describe time points during a condition course that are sensitive to change. Our proposed Inflection Point Model (IPM) helps conceptualize burden/benefit trade-offs in any related decision and provides a platform to identify the downstream aggregate burden of a NCGUC across multiple socio-ecological levels at a single time point, which may be summed across the condition course to measure cumulative burden. Two personae demonstrate the utility of this model to better understand impacts of two common NCGUCs. CONCLUSIONS The IPM may be applied in multiple contexts: narrowly to explore burden of a single NCGUC at a single IP; or more broadly, to address multiple conditions, multiple IPs, or multiple domains/levels of social ecology. Applying the IPM may entail combining population data describing prevalence of NCGUCs, associated behaviors, and resulting outcome patterns that can be combined with suitable mathematical models to quantify aggregate and cumulative burden. The IPM challenges stakeholders to expand from the individual to include broader levels of social ecology. Application of the IPM will undoubtedly identify data gaps and research needs that must be fulfilled to delineate and address the burden of NCGUCs.
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Affiliation(s)
- Jenna M Norton
- Division of Kidney, Urologic and Hematologic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD.
| | | | - Britt Conroy
- Urology Institute, University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH
| | - Adonis Hijaz
- Urology Institute, University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH
| | - Michelle Kim
- Department of Urology, Massachusetts General Hospital, Harvard Medical School Boston, Boston, MA
| | | | - David E Meyer
- United States Environmental Protection Agency, Office of Research and Development, Center for Environmental Solutions and Emergency Response, Cincinnati, OH
| | - Melissa L Constantine
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN
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Pratsinis M, Babst C, Langenauer J, Schmid HP, Piller A, Neuenschwander A, Betschart P. Qualitative Assessment of Medical Information on YouTube: A Multilingual Comparison of Common Urological Conditions. Urol Int 2021; 105:757-763. [PMID: 34289487 DOI: 10.1159/000517292] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Accepted: 05/03/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Patients nowadays often search video-sharing platforms for online patient education materials. Since previous assessments of urological videos were limited to English, we systematically assessed the quality of videos on treatment of benign prostatic hyperplasia (BPH), prostate cancer (PCa), and urinary stone disease (USD) in 4 different languages on YouTube using validated instruments. METHODS The search for videos on YouTube addressing treatment options of BPH, PCa, and USD was performed in October 2020 in -English, French, German, and Italian. Assessed parameters included basic data (e.g., number of views), grade of misinformation, and reporting of conflicts of interest. Quality of content was analyzed using the validated DISCERN questionnaire. Data were analyzed using descriptive statistics. RESULTS A total of 240 videos (60 videos in each language) were analyzed. Videos on USD in English had the highest number of views (median views 271,878 [65,313-2,513,007]). The median overall quality of videos assessed showed a moderate quality (2.5-3.4 points out of 5 points for DISCERN item 16). Median total DISCERN score of all videos divided by language showed very similar results: English (39.75 points), French (38 points), German (39.5 points), and Italian (39 points). Comparing the different diseases, videos about BPH showed the highest median scores, especially in German language (median score 43.25 points). CONCLUSIONS Videos concerning the treatment of BPH, PCa, and USD have a low to moderate quality of content, with no differences seen between the languages assessed. These findings further support the notion of improved patient information materials on video platforms such as YouTube.
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Affiliation(s)
- Manolis Pratsinis
- Department of Urology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Christa Babst
- Department of Urology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Janine Langenauer
- Department of Urology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Hans-Peter Schmid
- Department of Urology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Alberto Piller
- Department of Urology, Cantonal Hospital Thurgau, Münsterlingen, Switzerland
| | - Anne Neuenschwander
- Department of Urology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Patrick Betschart
- Department of Urology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
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Differences in Healthcare Expenditures, Visits, and Prescriptions by Race for Common Benign Urologic Conditions. Urology 2021; 162:70-76. [PMID: 34242630 DOI: 10.1016/j.urology.2021.06.026] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 06/03/2021] [Accepted: 06/24/2021] [Indexed: 01/10/2023]
Abstract
OBJECTIVE To identify differences in healthcare expenditures and utilization by race in patients treated for common benign urologic conditions. MATERIALS AND METHODS A retrospective secondary data analysis was conducted of patients with common benign urologic conditions using 2016-2018 Medical Expenditure Panel Survey data. Benign conditions included urolithiasis, cystitis, erectile dysfunction (ED), pelvic organ prolapse (POP), urinary incontinence (UI), and benign prostatic hyperplasia (BPH). Generalized linear models were used to evaluate the relationship between total healthcare expenditures and utilization and race for each condition. Adjusted analyses accounted for age, sex, number of chronic conditions, poverty status, self-reported health status, marital status, highest degree of educational attainment, and insurance status. RESULTS The weighted analysis sample consisted of 27,110,416 patients, of whom 80.9% were Non-Hispanic white, 6.9% Non-Hispanic black, and 12.2% other minority races. After adjustment, total healthcare expenditures were significantly lower for Non-Hispanic blacks (incidence rate ratio [IRR] = 0.19, 95% confidence interval [CI]: 0.06-0.61) and other minority races (IRR = 0.30, 95% CI: 0.10-0.88) compared to Non-Hispanic whites treated for ED. Similarly, compared to Non-Hispanic whites, healthcare expenditures were significantly lower for Non-Hispanic blacks treated for UI (IRR = 0.56, 95% CI: 0.35-0.90). CONCLUSION Healthcare expenditures are significantly lower for Non-Hispanic black patients treated for ED and UI in the US Future research is needed to determine if these differences represent an inequality in the delivery of urologic care for patients with these conditions.
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Cruz AP, Skolarus TA, Ambani SN, Hafez K, Kraft KH. Aligning Urology Residency Training With Real-World Workforce Needs. JOURNAL OF SURGICAL EDUCATION 2021; 78:820-827. [PMID: 33046414 PMCID: PMC7546236 DOI: 10.1016/j.jsurg.2020.09.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 08/25/2020] [Accepted: 09/26/2020] [Indexed: 05/09/2023]
Abstract
OBJECTIVE Research suggests recently graduated urology residents do not feel ready for independent practice. We conducted a study to determine if Accreditation Council for Graduate Medical Education (ACGME) minimum case requirements, resident case logs, and graduating resident perceived readiness for practice are aligned with the procedural demand and needs of the current urology workforce. DESIGN Correlative study comparing the association between (1) workforce demand and ACGME case requirements, and (2) workforce demand and perceived resident competency. Three distinct datasets were used; (1) the 2017 Medicare Part B National Summary Data File; (2) the 2017 National Data Report published by the ACGME; and (3) a graduating resident survey from Okhunov et al. SETTING: N/A. PARTICIPANTS N/A. RESULTS In 2017, there were a total of 6,784,696 urologic cases performed through Medicare. We found nonsignificant positive associations between resident case logs (rho = 0.16, p = 0.5784), ACGME minimum procedure requirements (rho = 0.42, p = 0.1255), and Medicare procedural demand. Our 15 index procedures accounted for 21.1% (n = 1,431,775) of all Medicare cases, with a median number of 7706 procedures. Endopyelotomy was the least common procedure (n = 98), while cystoscopy was the most common (n = 980,623). Medicare case volume was positively correlated with graduating residents' procedural confidence (r = 0.86, p < 0.0001). We identified four categories with varied alignment of training and demand: (1) high volume and high confidence, (2) high volume and low confidence, (3) low volume and high confidence, and (4) low volume and low confidence. CONCLUSIONS Optimizing urology residency training is time-sensitive and important. Using national Medicare data coupled with recently graduated urology resident survey results, we provide a guiding framework for improving the alignment of training with workforce demand. Informed by these results, we recommend altering training requirements to reflect these needs.
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Affiliation(s)
| | - Ted A Skolarus
- Department of Urology, University of Michigan, Ann Arbor, Michigan; VA HSR&D Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, Michigan; Dow Division of Health Services Research, University of Michigan, Ann Arbor, Michigan
| | - Sapan N Ambani
- Department of Urology, University of Michigan, Ann Arbor, Michigan
| | - Khaled Hafez
- Department of Urology, University of Michigan, Ann Arbor, Michigan
| | - Kate H Kraft
- Department of Urology, University of Michigan, Ann Arbor, Michigan.
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Abstract
Context: Urological diseases vary from one geographical location to another worldwide. The knowledge of their distribution in each location could determine local workforce and facility needs and as well guide the areas of subspecialization. Aims: The aim of this study is to document the annual frequency and distribution of urological diseases at the Usmanu Danfodiyo University Teaching Hospital, Sokoto. Settings and Design: A cross-sectional retrospective study from January 2016 to December 2016 of all new patients seen at the urology outpatient clinic, emergency department as well as inpatient referrals from other departments of Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria. Materials and Methods: The relevant records were extracted from the patient's case notes and entered into a semistructured questionnaire. Statistical Analysis Used: Data were analyzed using the SPSS software version 20. Results: A total of 607 new patients were seen over the study period. There were 576 (94.9%) males and 31 (5.1%) females, with a male-to-female ratio of 18.6:1. The median age was 45 years, with age range of 1–106 years. Urological emergencies were seen in 35.0% patients. Ninety-one percent of cases were acquired, whereas 8.2% were of congenital etiology. Overall, the most commonly diagnosed urologic diseases among new patients in order of decreasing frequency were benign prostatic enlargement (BPE) (18.6%), bladder tumor (11.8%), upper tract urinary calculi (10.3%), urethral stricture (8.9%), and prostate adenocarcinoma (7.4%). Conclusions: BPE, bladder tumor, upper tract urinary calculi, urethral stricture, and prostate adenocarcinoma are common in our environment. Knowledge of these diseases distribution may guide service expansion and workforce needs, inspire subspecialization as well as direct research and government policy in this community. Nongovernmental organizations wanting to have impact will be suitably directed.
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Affiliation(s)
- Isma'ila Arzika Mungadi
- Department of Surgery, Institute of Urology and Nephrology, Usmanu Danfodiyo University, Sokoto and Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria
| | - Abdullahi Khalid
- Department of Surgery, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria
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Gómez Rivas J, Toribio-Vázquez C, Taratkin M, Marenco JL, Grossmann R. Autonomous robots: a new reality in healthcare? A project by European Association of Urology-Young Academic Urologist group. Curr Opin Urol 2021; 31:155-159. [PMID: 33332877 DOI: 10.1097/mou.0000000000000842] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW Artificial intelligence appears as a potential revolution in the general process of medical training, disease diagnosis and treatment. A novel disruptive technology of the 21st century will be 'learner' robots from artificial intelligence systems able to use all the combination of the available knowledge in medical repositories to give the best standard of care. RECENT FINDINGS The autonomy level of robots depends on three factors: the complexity of the task; the environment in which the robot operates, and the required level of human-robot interaction. Autonomous robots in healthcare may be classified in delivery, nurse, and surgical robots. The increasing capability of robots to perform independent actions and complex tasks raises responsibility and accountability issues in a wide variety of application domains. Ethical analyses of these issues are underway and are mostly oriented toward the development of ethical policies requiring a law frame on robotic autonomous behaviors. SUMMARY Autonomous robots have the potential to improve current medical practice offering a more secure, reliable, and reproducible medicine. Many advancements are required for these new technologies to be fully integrated. Furthermore, the ethical implications of these technologies are yet to be evaluated.
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Affiliation(s)
- Juan Gómez Rivas
- Department of Urology, Clinico San Carlos University Hospital, Madrid, Spain
- Young Academic Urologist-Urotechnology Working Party (ESUT-YAU), European Association of Urology, Arnhem, The Netherlands
| | | | - Mark Taratkin
- Young Academic Urologist-Urotechnology Working Party (ESUT-YAU), European Association of Urology, Arnhem, The Netherlands
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Jose Luis Marenco
- Young Academic Urologist-Urotechnology Working Party (ESUT-YAU), European Association of Urology, Arnhem, The Netherlands
- Department of Urology, Instituto Valenciano De Oncologia, Valencia, Spain
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Zhao H, Anger JT. Accuracy of Urologic Conditions Portrayed on Grey's Anatomy. HEALTH EDUCATION & BEHAVIOR 2021; 49:323-325. [PMID: 33593076 DOI: 10.1177/1090198121990390] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Despite the common prevalence of urologic diseases, studies have demonstrated that the general public often has little knowledge or insight into the field of urology or the role of an urologist. In this study, we investigated the context, frequency, and accuracy of urologic conditions on the television series Grey's Anatomy. We reviewed episodes from the first 15 seasons. Episodes with urologic references were then screened and the urologic conditions, outcomes, and treatments were recorded. We identified a total of only 21 urologic events across 15 seasons and 342 episodes of Grey's Anatomy. A total of 52% (11/21) of the conditions were related to external male genitalia. The portrayal of these conditions and the associated treatments were considered to be medically accurate within reason 62% (13/21) of the time. There is significant room for improvement to increase the portrayal of common urologic conditions and malignancies to improve the public's awareness and perception of our specialty.
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Affiliation(s)
- Hanson Zhao
- Cedars-Sinai Medical Center, Los Angeles, CA, USA
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16
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Xu J, Wang C, Zhang X, Ouyang J, Zhang J. Serum folic acid levels and erectile dysfunction: A meta-analysis and systematic review. Andrologia 2021; 53:e14003. [PMID: 33550658 DOI: 10.1111/and.14003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 01/16/2021] [Accepted: 01/23/2021] [Indexed: 11/27/2022] Open
Abstract
The aim of this study was to assess the relationship between serum folic acid (FA) levels and erectile dysfunction (ED) through a meta-analysis. A research was conducted in MEDLINE via PubMed, Cochrane Library, EMBASE and Web of Science up to 22 November 2020 to identify studies related to FA and ED. Two authors independently screened the literature, evaluated methodological quality and extracted the data. We used RevMan5.3 and STATA 14.0 for meta-analysis. A total of six studies including 1,842 participants were included, and the results showed that the FA levels in the non-ED group were significantly higher than those in the ED group (MD = 3.37, 95% CI 1.49-5.52, p = 0.004). Subgroup analysis indicated that with the increase in ED severity, the difference in FA levels between groups was more obvious (MD: 1.99 vs. 4.63 vs. 5.63). The differences in FA levels between groups seem more significant in the younger group (MD = 4.87, 95% CI 2.58-6.89, p < 0.001) than in the older group (MD = 3.15, 95% CI 2.21-4.08, p < 0.001). In conclusion, FA deficiency is closely related to ED, and the degree of FA deficiency may reflect the severity of ED. In addition, the association seems to be more pronounced in the younger group.
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Affiliation(s)
- Jiangnan Xu
- Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Chao Wang
- Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Xuefeng Zhang
- Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Jun Ouyang
- Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Jianglei Zhang
- Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou, China
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Solano C, Ortiz AMC, Jaimes LMB, Saavedra DXR, Ospino CO, Basto CS. Estado actual de las mujeres en la fuerza laboral en urología. Análisis bibliométrico. Rev Urol 2020. [DOI: 10.1055/s-0040-1721723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
ResumenIntroducción Las mujeres han incursionado y aumentado en todas las áreas médico quirúrgicas y específicamente en la Urología, representando aproximadamente un 10% de esta fuerza laboral.Objetivo Describir el estado actual de las mujeres en la fuerza laboral en Urología a nivel mundial.Métodos Análisis bibliométrico basado en búsqueda retrospectiva de la literatura del año 1969 a 2019, mediante base de datos: MEDLINE, FABUMED y PubReminder®, utilizando términos de búsqueda: (workforce) AND (urology), incluyendo: artículos de revista, artículos originales de investigación, reseñas, ensayos y otros informes científicos. Se obtuvo el factor de impacto (FI) mediante Journal Citation Reports 2017/2018. A través de Scopus se obtuvo el h-index (HI). Las variables analizadas fueron: número total de publicaciones, revistas, autores, instituciones, porcentaje de publicaciones por revista y país, patrón de producción científica a lo largo del período estudiado. Se realizó análisis de mapeo bibliométrico con software VOSviewer®.Resultados Se encontraron un total de 352 revisiones desde el año 1969 hasta 2019. El mayor porcentaje de publicaciones fueron en la última década. Se encontraron en total 131 revistas, de ellas, 28 específicas de urología. La revista con mayor número de publicaciones fue el Journal of Urology. El 90% de los autores provienen de Estados Unidos y del total de artículos solo dos autores principales eran mujeres.Conclusiones El interés por determinar el papel de la mujer en la fuerza laboral urológica es reciente y se correlaciona con el aumento de la representación femenina en esta área.
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Nguyen DD, Marchese M, Ozambela M, Bhojani N, Ortega G, Trinh QD, Friedlander DF. Ambulatory-Based Bladder Outlet Procedures Offer Significant Cost Savings and Comparable 30-Day Outcomes Relative to Inpatient Procedures. J Endourol 2020; 34:1248-1254. [PMID: 32178528 PMCID: PMC7757614 DOI: 10.1089/end.2019.0684] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Introduction and Objectives: Budgetary constraints and novel minimally invasive surgical approaches have resulted in surgical care being increasingly provided at ambulatory centers rather than traditional inpatient settings. Despite increasing use of ambulatory-based procedure for bladder outlet obstruction (BOO) procedures, little is known about the effect of care setting on perioperative outcomes and costs. We sought to compare 30-day readmissions rates and costs of BOO procedure performed in the ambulatory vs inpatient setting. Methods: Using Florida and New York all-payer data from the 2014 Healthcare Cost and Utilization Project State Databases, we identified patients who underwent transurethral resection, thermotherapy, or laser/photovaporization for BOO. Patient demographics, regional data, 30-day readmissions rates, and costs (from converted charges) associated with the index procedure and revisits were analyzed. Predictors of 30-day revisits were also identified by fitting a multivariate logistic regression model with facility-level clustering. Results: Of the 15,094 patients identified, 1444 (9.6%) had a 30-day revisit at a median cost of $4263.43. The 30-day readmission rate for inpatient cases was significantly higher than that of surgeries performed in the ambulatory setting (12.0% vs 8.1%, p < 0.001). Payer status (private vs Medicare: odds ratio [OR] = 0.77, 95% confidence interval [CI] = 0.62-0.95; p = 0.02) and index care setting (ambulatory vs inpatient: OR = 0.48, 95% CI = 0.40-0.57; p < 0.001) predicted 30-day revisits. Conclusions: We identified that index care setting and payer status are independent predictors of 30-day revisit after BOO procedure, with the inpatient setting and Medicare insurance associated with higher odds of revisit. Ambulatory procedures are significantly less costly than procedures performed in the inpatient setting, even after accounting for ambulatory procedures leading to an admission. There is an obvious cost benefit of offering BOO procedure in the ambulatory setting to the appropriate patient. In the context of value-based health care initiatives, our findings have important implications for policymakers seeking to reduce variation in nonclinical sources of perioperative costs and outcomes.
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Affiliation(s)
- David-Dan Nguyen
- Division of Urological Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Center for Surgery and Public Health, Brigham and Women's Hospital and Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Faculty of Medicine, McGill University, Montreal, Canada
| | - Maya Marchese
- Division of Urological Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Manuel Ozambela
- Division of Urological Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Naeem Bhojani
- Division of Urology, University of Montreal Hospital Center, Université de Montréal, Montreal, Canada
| | - Gezzer Ortega
- Center for Surgery and Public Health, Brigham and Women's Hospital and Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Quoc-Dien Trinh
- Division of Urological Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Center for Surgery and Public Health, Brigham and Women's Hospital and Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - David F. Friedlander
- Division of Urological Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Center for Surgery and Public Health, Brigham and Women's Hospital and Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
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Gajdács M. The Importance of Reporting Clinical and Epidemiological Data in Urology: Local Experiences and Insights from the International Literature. MEDICINA (KAUNAS, LITHUANIA) 2020; 56:E581. [PMID: 33143077 PMCID: PMC7693886 DOI: 10.3390/medicina56110581] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 10/24/2020] [Accepted: 10/29/2020] [Indexed: 12/31/2022]
Abstract
Pathologies of the genito-urinary tract are responsible for a considerable disease burden worldwide, leading to significant losses of income, lost working days, increased expenditures for national healthcare systems, and decreased quality of life (QoL) in the affected patients. Among these diseases, infections and malignancies in this anatomical region are some of the most important illnesses in human medicine; nevertheless, benign prostate hyperplasia (BPH), erectile dysfunction, hypospadias, urinary incontinence, and vesicoureteral reflux are also relevant disorders affecting millions. The publication of various microbiological and clinical studies in urology from different geographical regions has important ramifications from the standpoint of epidemiology: on one hand, reported data may influence the development of therapeutic guidelines for urinary tract infections (UTIs) (empiric antibiotic-therapy) and malignancies (including classical cytotoxic drug protocols and next-generation anticancer therapies) both locally and internationally; on the other hand, the relevant stakeholders and government representatives often base their decisions on published evidence. Therefore, novel studies in the field of urology are strongly encouraged to maintain and improve the high standard of patient care internationally and to ensure continuous information supply for international datasets on the causative agents of UTIs and cancer registries. The present Editorial aims to highlight some relevant studies published from the field of urology in Medicina over the last several years.
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Affiliation(s)
- Márió Gajdács
- Department of Pharmacodynamics and Biopharmacy, Faculty of Pharmacy, University of Szeged, 6720 Szeged, Hungary; or ; Tel.: +36-62-341-330
- Institute of Medical Microbiology, Faculty of Medicine, Semmelweis University, 1089 Budapest, Hungary
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20
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Addar AM, Bin Mosa MA, Alothman AS, Alabdulkareem A, Al Jahdali F, Alkhateeb SS. The perception and competency of undergraduates in urology: Is the clinical exposure necessary? Urol Ann 2020; 12:220-224. [PMID: 33100745 PMCID: PMC7546068 DOI: 10.4103/ua.ua_39_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 09/26/2019] [Indexed: 11/18/2022] Open
Abstract
Objective: The objective of this study is to investigate medical students’ perception, choices of future career, and competency in urology. Methods: A cross-sectional survey was distributed among 5th, 6th, and 7th(interns) year medical students at King Saud bin Abdulaziz University for Health Sciences using both hard copies and soft copies. Major outcomes were medical students’ perception, future career decision, and core skills in urology. Results: The overall response rate was 51.3%. A total number of 163 responses (122 were males and 41 females) were collected. Only 8% indicated that they would pursue a surgical career in urology and 42% thought that they had received a good clinical exposure to urology. Of the participants, 67.5% viewed urology as a male-dominated field. Only 17% of the respondents either agreed or strongly agreed that they were considering a future career in urology. Female students were less likely to consider a urological career (P < 0.01). About 32.5% were confident at urethral catheterization. About 66.9% felt that a workshop day to enhance urological skills and knowledge will be beneficial. Females were more confident at assessing a urological case in an acute setting (P < 0.05). Conclusion: Most of the students agreed that their urology exposure was inadequate and their confidence at urethral catheterization was low. As in many different global studies, urology is still regarded as a specialty with a male dominance. This report is consistent with the global decline in formal urological education.
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Affiliation(s)
- Abdulmalik M Addar
- Division of Urology, King Abdullah Internationl Medical Reasearch Center, College of Medicine, King Abdulaziz Medical City, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Manerh A Bin Mosa
- Department of Surgery, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Ali S Alothman
- Division of Urology, King Abdullah Internationl Medical Reasearch Center, College of Medicine, King Abdulaziz Medical City, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | | | - Fares Al Jahdali
- Department of Surgery, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Sultan S Alkhateeb
- Department of Urology, King Faisal Specialist Hospital and Research Centre, Alfaisal University Riyadh, Riyadh, Saudi Arabia
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Kazmi Z, Khan K, Ather MH. The Hidden Work of Urology Residents - A Cross-Sectional Study. Cureus 2020; 12:e10668. [PMID: 33133835 PMCID: PMC7586419 DOI: 10.7759/cureus.10668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: In a tertiary care hospital that caters to all kinds of patients in the clinical and emergency setting, consultation is an important service provided by the urology team. Profiling the spectrum of urologic disease encountered by trainees will assist in the planning of residency curricula and is bound to improve patient outcome for procedural education. Methods: All urologic consultation requests received over a period of three months (November 22, 2019, to February 22, 2020) were identified and recorded in a prospectively maintained consult log. Information collected for each encounter included the time, date, reason for consult, primary service and diagnosis along with the final urologic diagnosis, any urologic intervention, and basic patient demographics (gender and age). Results: Over three months, a total of 568 consult requests were reviewed. Of the patients consulted for, 74% were males; the mean age was 58.45 years (SD+/-19.5 years). The most common service seeking urology consult was the Emergency Room (n=240, 42.25%). The most common reason for consultation was hematuria (n=103, 18.13%) followed by obstructive uropathy (n=98, 17.25%). The majority (n=147, 26%) of the calls were placed between mid-day and 4 pm. Of the total, 26% required immediate attention. Urologic intervention was required in 226 (39.8%). The number of consults seen by junior team members was 478 (84.14%). Conclusion: Hematuria and obstructive uropathy are the most common reasons for urologic consultation requests. Nearly two-thirds of the consults either required immediate attention or intervention. Most of the consults were seen by junior residents, who required elaborate training to address these common issues independently. We believe that our results will be helpful in developing a curriculum for training junior residents.
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Affiliation(s)
- Zehra Kazmi
- Section of Urology, Department of Surgery, Aga Khan University, Karachi, PAK
| | - Kaleem Khan
- Section of Urology, Department of Surgery, Aga Khan University, Karachi, PAK
| | - M Hammad Ather
- Section of Urology, Department of Surgery, Aga Khan University, Karachi, PAK
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Amar A, Afzal A, Hameed A, Ahmad M, Khan AR, Najma H, Abid A, Khaliq S. Osteopontin promoter polymorphisms and risk of urolithiasis: a candidate gene association and meta-analysis study. BMC MEDICAL GENETICS 2020; 21:172. [PMID: 32842990 PMCID: PMC7446165 DOI: 10.1186/s12881-020-01101-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 08/04/2020] [Indexed: 11/10/2022]
Abstract
Background Urolithiasis is a worldwide urological problem with significant contribution of genetic factors. Pakistan, which resides within the Afro-Asian stone belt, has a high reported prevalence (12%) of urolithiasis. Osteopontin (SPP1) is a urinary macromolecule with a suggested critical role in modulating renal stone formation, genetic polymorphisms of which may determine individual risk of developing urolithiasis. However, results of previous studies regarding SPP1 polymorphisms and susceptibility to urolithiasis have apparent inconsistencies with no data available for local population. Methods A total of 235 urolithiasis patients and 243 healthy controls, all of Pakistani ancestry, underwent genotyping for six SPP1 genetic polymorphisms in an effort to investigate potential association with urolithiasis using indigenous candidate gene association study design. Further, a comprehensive meta-analysis following a systematic literature search was also done to ascertain an evidence based account of any existent association regarding SPP1 promoter polymorphisms and risk of developing urolithiasis. Results Three SPP1 promoter polymorphisms, rs2853744:G > T, rs11730582:T > C and rs11439060:delG>G, were found to be significantly associated with risk of urolithiasis in indigenous genetic association study (OR = 3.14; p = 0.006, OR = 1.78; p = 0.006 and OR = 1.60; p = 0.012, respectively). We also observed a 1.68-fold positive association of a tri-allelic haplotype of these SPP1 promoter polymorphisms (G-C-dG) with risk of urolithiasis (OR = 1.68; p = 0.0079). However, no association was evident when data were stratified according to gender, age at first presentation, stone recurrence, stone multiplicity, parental consanguinity and family history of urolithiasis. The overall results from meta-analysis, which included 4 studies, suggested a significant association of SPP1 rs2853744:G > T polymorphism with susceptibility of urolithiasis (OR = 1.37; p = 0.004), but not for other SPP1 polymorphic variants analyzed. Conclusions In conclusion, we report significant association of 3 SPP1 polymorphisms with urolithiasis for the first time from South Asia, however, this association persisted only for SPP1 rs2853744:G > T polymorphism after meta-analysis of pooled studies. Further studies with a larger sample size will be required to validate this association and assess any potential usefulness in diagnosis and prognosis of renal stone disease.
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Affiliation(s)
- Ali Amar
- Department of Human Genetics and Molecular Biology, University of Health Sciences, Khayaban-e-jamia Punjab, Lahore, Punjab, 54600, Pakistan
| | - Ayesha Afzal
- Department of Human Genetics and Molecular Biology, University of Health Sciences, Khayaban-e-jamia Punjab, Lahore, Punjab, 54600, Pakistan
| | - Athar Hameed
- Department of Urology, Fatima Jinnah Medical University, Lahore, Punjab, Pakistan
| | - Mumtaz Ahmad
- Department of Urology, Fatima Jinnah Medical University, Lahore, Punjab, Pakistan
| | - Abdul Rafay Khan
- Centre for Human Genetics and Molecular Medicine, Sindh Institute of Urology and Transplantation, Karachi, Pakistan
| | - Humaira Najma
- Department of Human Genetics and Molecular Biology, University of Health Sciences, Khayaban-e-jamia Punjab, Lahore, Punjab, 54600, Pakistan
| | - Aiysha Abid
- Centre for Human Genetics and Molecular Medicine, Sindh Institute of Urology and Transplantation, Karachi, Pakistan
| | - Shagufta Khaliq
- Department of Human Genetics and Molecular Biology, University of Health Sciences, Khayaban-e-jamia Punjab, Lahore, Punjab, 54600, Pakistan.
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Moynihan MJ, Manganiello MD. A Review of Urologic Conditions in Remote and Austere Environments: Presentation, Evaluation, and Management. Wilderness Environ Med 2020; 31:358-366. [PMID: 32773355 DOI: 10.1016/j.wem.2020.04.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 03/13/2020] [Accepted: 04/27/2020] [Indexed: 02/08/2023]
Abstract
The objective of this review is to provide recommendations on the evaluation and management of urologic conditions in a resource-poor or austere setting from the perspective of the urological literature. The material was synthesized predominantly from urologic society guidelines and journals to bring additional urology-focused insight to the topic to complement the currently available literature, which is largely based on recommendations from nonurologic specialties. We sought to provide a reference guide from a urology-based framework that encourages a collaborative multidisciplinary approach to the development of a resource that serves those in a wilderness, austere, or resource-poor setting.
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Affiliation(s)
- Matthew J Moynihan
- Lahey Hospital & Medical Center, Department of Surgery, Urology Division, Burlington, MA.
| | - Marc D Manganiello
- Lahey Hospital & Medical Center, Department of Surgery, Urology Division, Burlington, MA
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Zhao H, Quach A, Cohen T, Anger JT. Characteristics, Burden, and Necessity of Inpatient Consults for Academic and Private Practice Urologists. Urology 2020; 139:60-63. [PMID: 32109497 DOI: 10.1016/j.urology.2020.02.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 01/27/2020] [Accepted: 02/17/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To compare differences in the characteristics and outcomes of inpatient consults between academic and private practice urologists. MATERIALS AND METHODS We performed a retrospective review of urology consults at a large tertiary-care hospital from June 1st, 2017 to June 30th, 2018. Patient demographics, timing of consult, location of consult, reasons for consult, requesting physicians, and procedures performed were analyzed and compared. RESULTS A total of 613 consults were identified. The most common consults were for a Foley catheter/suprapubic tube (16%), urinary retention (15%), kidney/bladder stones (11%), and hematuria (11%). Seventy-seven percent of the consults were seen in the day time and 79% were seen on the weekdays. One hundred and ten (18%) consults resulted in an operative intervention during the same admission. The others required a Foley catheter placement or suprapubic exchange (17%), bedside procedure (9%), or interventional radiology procedure (4%). The remaining 319 consults (52%) required no intervention and were considered potentially unnecessary. There were no differences in the timing of the consults and the need for intervention between academic and private practice urologists (P = .20). Only 37% of patients followed up as an outpatient. These potentially unnecessary consults resulted an annual loss of 265.8 hours for the urologists and $44,376.09 in excess health care costs. CONCLUSION Over half of inpatient urologic consultations required no urologic intervention and therefore represented potential overuse of urgent inpatient specialty care. This may contribute towards the growing epidemic of burnout in urology. Further work needs to be done to educate other hospital services and nurses to minimize these unnecessary consults.
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Affiliation(s)
- Hanson Zhao
- Division of Urology, Cedars-Sinai Medical Center, Los Angeles, CA
| | - Alan Quach
- University of Colorado School of Medicine, Aurora, CO
| | - Tara Cohen
- Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA
| | - Jennifer T Anger
- Division of Urology, Cedars-Sinai Medical Center, Los Angeles, CA.
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Paraskevopoulou V, Bonis V, Dionellis VS, Paschalidis N, Melissa P, Chavdoula E, Vasilaki E, Pateras IS, Klinakis A. Notch controls urothelial integrity in the mouse bladder. JCI Insight 2020; 5:133232. [PMID: 32051338 DOI: 10.1172/jci.insight.133232] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 12/30/2019] [Indexed: 01/04/2023] Open
Abstract
The Notch signaling pathway mediates cell-cell communication regulating cell differentiation and proliferation and cell fate decisions in various tissues. In the urinary bladder, Notch acts as a tumor suppressor in mice, while mutations in Notch pathway components have been identified in human bladder cancer as well. Here we report that the genetic inactivation of Notch in mice leads to downregulation of cell-cell and cell-ECM interaction components, including proteins previously implicated in interstitial cystitis/bladder pain syndrome (IC/BPS), structural defects and mucosal sloughing, inflammation, and leaky urine-blood barrier. Molecular profiling of ailing mouse bladders showed similarities with IC/BPS patient tissue, which also presented low Notch pathway activity as indicated by reduced expression of canonical Notch targets. Urothelial integrity was reconstituted upon exogenous reactivation of the Notch pathway, implying a direct involvement of Notch. Despite damage and inflammation, urothelial cells failed to proliferate, uncovering a possible role for α4 integrin in urothelial homeostasis. Our data uncover a broad role for Notch in bladder homeostasis involving urothelial cell crosstalk with the microenvironment.
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Affiliation(s)
- Varvara Paraskevopoulou
- Biomedical Research Foundation of the Academy of Athens, Athens, Greece.,Laboratory of Biology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Vangelis Bonis
- Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - Vasilis S Dionellis
- Department of Molecular Biology, University of Geneva, Geneva, Switzerland.,Laboratory of Histology-Embryology, Molecular Carcinogenesis Group, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Pelagia Melissa
- Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | | | - Eleni Vasilaki
- Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - Ioannis S Pateras
- Laboratory of Histology-Embryology, Molecular Carcinogenesis Group, National and Kapodistrian University of Athens, Athens, Greece
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Lokeshwar SD, Benton JZ, King SA, Terris MK, Wallis CJD, Klaassen Z. EDITORIAL COMMENT. Urology 2020; 136:55-56. [PMID: 32033680 DOI: 10.1016/j.urology.2019.10.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 10/15/2019] [Indexed: 11/19/2022]
Affiliation(s)
- Soum D Lokeshwar
- Department of Urology, Miller School of Medicine, University of Miami, Miami, FL
| | | | - Sherita A King
- Division of Urology, Department of Surgery, Medical College of Georgia - Augusta University, Augusta, GA
| | - Martha K Terris
- Division of Urology, Department of Surgery, Medical College of Georgia - Augusta University, Augusta, GA; Georgia Cancer Center, Augusta, GA
| | | | - Zachary Klaassen
- Division of Urology, Department of Surgery, Medical College of Georgia - Augusta University, Augusta, GA; Georgia Cancer Center, Augusta, GA
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Aydin C, Senel E. Impotence literature: Scientometric analysis of erectile dysfunction articles between 1975 and 2018. Andrologia 2020; 52:e13520. [PMID: 31984541 DOI: 10.1111/and.13520] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 12/19/2019] [Accepted: 12/28/2019] [Indexed: 01/30/2023] Open
Abstract
Erectile dysfunction (ED) is portrayed as lasting deficiency to achieve or sustain penile erection in successful vaginal penetration and is a major problem affecting the quality of life in men. The number of ED sufferers worldwide is anticipated to reach 322 million, by 2025. In recent years, many publications and studies have been made in the field of ED. Our aim was to perform a detailed bibliometric analysis of erectile dysfunction literature. In this study, we downloaded the data of the publications from the Web of Science Core Collection. All items indexed in these databases between 1975 and 2018 were included. Documents produced in 2019 were excluded. We searched in WoS databases for the keywords of 'erectile dysfunction' and 'impotence'. Our basic search into WoS databases retrieved a total of 28,266 documents indexed between 1975 and 2018. English dominated impotence literature (92.541%) followed by German, French and Korean (2.136%, 1.920% and 1.180% respectively). The United States has made tremendous improvement in ED studies and is still the effective country. The most prolific author was Montorsi F with 330 articles from Italy, and three-fifth of the authors were from the USA.
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Affiliation(s)
- Cemil Aydin
- Department of Urology, Hitit University School of Medicine, Training and Research Hospital, Corum, Turkey
| | - Engin Senel
- Department of Dermatology, Hitit University School of Medicine, Training and Research Hospital, Corum, Turkey
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Wang X, Guan Y, Wu Y, Meng Q, Dong M. A novel method of bilateral patent processus vaginalis ligation in transumbilical single-site multiport laparoscopic orchiopexy. Int J Med Sci 2020; 17:1043-1047. [PMID: 32410833 PMCID: PMC7211161 DOI: 10.7150/ijms.44682] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 03/31/2020] [Indexed: 11/23/2022] Open
Abstract
Objective: To evaluate safety and efficacy of a novel method of bilateral patent processus vaginalis ligation in transumbilical single-site multiport laparoscopic orchiopexy for children. Methods: A retrospective study was carried out comparing the novel ligation and conventional ligation performed by a single surgeon between July, 2017-July, 2018. The patients were divided into the novel group (42 cases) and the conventional group (59 cases). In the novel group, transumbilical single-site multiport laparoscopic orchiopexy was performed and the bilateral internal rings was stitched with "8" pattern suture. In the conventional group, the conventional TriPort laparoscopic orchiopexy was performed and purse string suture was used to fix the internal rings. The parameters of operative duration time, postoperative hospital stay; postoperative complications were compared between 2 groups. Results: All operations were successful. No Perioperative period complications were found and all patients were discharged within 4-6 days after operation. There is no statistic difference in the surgery time and hospitalization day. However, there is significant difference in the Pain face scale scores after day 2(1.60±0.73 VS 2.02±0.86). And there is no scar and the satisfactory cosmetic could be seen in scrotum and inguinal area in the novel group. Conclusion: The novel ligation was safety and efficacy. It is relatively easy to perform with smaller scar and less pain. We propose the novel ligation as a more viable treatment option for pediatric cryptorchidism with bilateral patent processus vaginalis.
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Affiliation(s)
- Xin Wang
- Department of Pediatric Surgery, Tianjin Children's Hospital, No.238 LongYan Road, Tianjin 300134, PR China
| | - Yong Guan
- Department of Pediatric Surgery, Tianjin Children's Hospital, No.238 LongYan Road, Tianjin 300134, PR China
| | - Yong Wu
- Department of Pediatric Surgery, Tianjin Children's Hospital, No.238 LongYan Road, Tianjin 300134, PR China
| | - QingYa Meng
- Department of Pediatric Surgery, Tianjin Children's Hospital, No.238 LongYan Road, Tianjin 300134, PR China
| | - Ming Dong
- Department of lung cancer surgery, Tianjin medical university general hospital, No.154 Anshan Road, Tianjin 300052, PR China
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Pederzoli F, Joice G, Salonia A, Bivalacqua TJ, Sopko NA. Regenerative and engineered options for urethroplasty. Nat Rev Urol 2019; 16:453-464. [PMID: 31171866 DOI: 10.1038/s41585-019-0198-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/04/2019] [Indexed: 02/07/2023]
Abstract
Surgical correction of urethral strictures by substitution urethroplasty - the use of grafts or flaps to correct the urethral narrowing - remains one of the most challenging procedures in urology and is frequently associated with complications, restenosis and poor quality of life for the affected individual. Tissue engineering using different cell types and tissue scaffolds offers a promising alternative for tissue repair and replacement. The past 30 years of tissue engineering has resulted in the development of several therapies that are now in use in the clinic, especially in treating cutaneous, bone and cartilage defects. Advances in tissue engineering for urethral replacement have resulted in several clinical applications that have shown promise but have not yet become the standard of care.
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Affiliation(s)
- Filippo Pederzoli
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
- Department of Urology, James Buchanan Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, MD, USA
- Università Vita-Salute San Raffaele, Milan, Italy
| | - Gregory Joice
- Department of Urology, James Buchanan Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | - Andrea Salonia
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
- Università Vita-Salute San Raffaele, Milan, Italy
| | - Trinity J Bivalacqua
- Department of Urology, James Buchanan Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | - Nikolai A Sopko
- Department of Urology, James Buchanan Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, MD, USA.
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A simple guidewire and angiocatheter technique for urinary catheter placement. JAAPA 2019; 32:39-42. [DOI: 10.1097/01.jaa.0000569800.52435.71] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Rezaee ME, Ward CE, Brandes ER, Munarriz RM, Gross MS. A Review of Economic Evaluations of Erectile Dysfunction Therapies. Sex Med Rev 2019; 8:497-503. [PMID: 31326359 DOI: 10.1016/j.sxmr.2019.06.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 06/03/2019] [Accepted: 06/11/2019] [Indexed: 02/01/2023]
Abstract
INTRODUCTION Erectile dysfunction (ED) is a common and costly urologic condition with increasing prevalence as men age. Cost-effectiveness of ED therapies and whether cost-effectiveness varies for different populations of men remains underexplored. AIM To review and summarize available published data on the economic evaluation of ED therapies and to identify gaps in the literature that still need to be addressed. METHODS All relevant peer-reviewed publications and conference abstracts were reviewed and incorporated. RESULTS There are a number of medical and surgical treatment options available for ED. The economic evaluation of phosphodiesterase-5 inhibitors, particularly sildenafil, has been well described. However, minimal research has been conducted to assess the cost-effectiveness of intracavernosal injections, intraurethral suppositories, penile prosthesis surgery, vacuum erection devices, and other emerging therapies in men with different causes of ED. CONCLUSION Available economic evaluations of ED therapies are dated, do not reflect present-day physician, pharmaceutical, and device costs, fail to account for patient comorbidities, and may not be generalizable to today's ED patients. Substantial research is needed to evaluate the cost-effectiveness of ED treatments across different patient populations, countries, and reimbursement systems. Rezaee ME, Ward CE, Brandes ER, et al. A Review of Economic Evaluations of Erectile Dysfunction Therapies. Sex Med Rev 2019;8:497-503.
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Affiliation(s)
- Michael E Rezaee
- Section of Urology, Department of Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
| | - Charlotte E Ward
- Center for Healthcare Studies, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA; Center for Health Statistics, University of Chicago, Chicago, IL, USA
| | - Eileen R Brandes
- Section of Urology, Department of Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
| | - Ricardo M Munarriz
- Department of Urology, Boston University Medical Center, Boston, MA, USA
| | - Martin S Gross
- Section of Urology, Department of Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA.
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Okhunov Z, Safiullah S, Patel R, Juncal S, Garland H, Khajeh NR, Martin J, Capretz T, Cottone C, Jordan ML, McDougall E, Clayman RV, Landman J. Evaluation of Urology Residency Training and Perceived Resident Abilities in the United States. JOURNAL OF SURGICAL EDUCATION 2019; 76:936-948. [PMID: 30803721 DOI: 10.1016/j.jsurg.2019.02.002] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 12/17/2018] [Accepted: 02/03/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVE To identify differences and potential deficiencies in urology residency training programs in the United States as they are perceived by residents/recent graduates and program directors. MATERIALS AND METHODS A 45-question and 38-question survey was sent to chief residents/recent graduates and program directors, respectively, at all 120 US urology programs regarding prior medical education, urologic training curricula, and perceived surgical proficiency, among other topics. RESULTS Survey response rate was 58% and 52% for residents and program directors, respectively. Responses regarding program characteristics (e.g., salary, vacation) and research training were similar between program directors and residents. However, their responses regarding skills training and subspecialty training (e.g., robotics and pediatrics) differed substantially. Program directors reported the availability of advanced skills trainers (robot-88%, laparoscopic-86%), whereas fewer residents felt they were available (robot 54% and laparoscopic 72%). The same discrepancies persisted with questions about subspecialty exposure (e.g., program directors reported 48% renal transplant experience vs. 13% reported by residents). Most residents felt comfortable performing essential urology procedures (e.g., cystoscopy/ureteroscopy, open nephrectomy). In contrast, the majority expressed a lack of confidence in performing unsupervised advanced minimally invasive procedures (e.g., laparoscopic and robotic partial nephrectomy, endopyelotomy). Among the responding residents, 72% pursued fellowship training; nearly two-thirds of these residents chose to enter fellowship in order to overcome perceived training deficiencies. CONCLUSIONS Program directors and residents have differing perceptions regarding the education and resources associated with US urology residency training programs. US graduates of urology residency programs express a perceived lack of confidence in several procedures that are commonly encountered in a general urologic practice.
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Affiliation(s)
- Zhamshid Okhunov
- Department of Urology, University of California, Irvine, Orange, California.
| | - Shoaib Safiullah
- Department of Urology, University of California, Irvine, Orange, California
| | - Roshan Patel
- Department of Urology, University of California, Irvine, Orange, California
| | - Samuel Juncal
- Department of Urology, University of California, Irvine, Orange, California
| | - Harwood Garland
- Department of Urology, University of California, Irvine, Orange, California
| | - Nikta R Khajeh
- Department of Urology, University of California, Irvine, Orange, California
| | - Jeremy Martin
- Department of Urology, University of California, Irvine, Orange, California
| | - Taylor Capretz
- Department of Urology, University of California, Irvine, Orange, California
| | - Courtney Cottone
- Department of Urology, University of California, Irvine, Orange, California
| | - Mark L Jordan
- Department of Urology, University of California, Irvine, Orange, California
| | - Elspeth McDougall
- University of British Columbia, Gordon and Leslie Diamond Health Care Centre, Vancouver, British Columbia, Canada
| | - Ralph V Clayman
- Department of Urology, University of California, Irvine, Orange, California
| | - Jaime Landman
- Department of Urology, University of California, Irvine, Orange, California
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Gegenschatz-Schmid K, Verkauskas G, Stadler MB, Hadziselimovic F. Genes located in Y-chromosomal regions important for male fertility show altered transcript levels in cryptorchidism and respond to curative hormone treatment. Basic Clin Androl 2019; 29:8. [PMID: 31171972 PMCID: PMC6545630 DOI: 10.1186/s12610-019-0089-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Accepted: 04/24/2019] [Indexed: 01/27/2023] Open
Abstract
Background Undescended (cryptorchid) testes in patients with defective mini-puberty and low testosterone levels contain gonocytes that fail to differentiate normally, which impairs the development of Ad spermatogonia and ultimately leads to adult infertility. Treatment with the gonadotropin-releasing hormone agonist GnRHa increases luteinizing hormone and testosterone and rescues fertility in the majority of pathological cryptorchid testes. Several Y-chromosomal genes in the male-specific Y region (MSY) are essential for spermatogenesis, testis development and function, and are associated with azoospermia, infertility and cryptorchidism. In this study, we analyzed the expression of MSY genes in testes with Ad spermatogonia (low infertility risk patients) as compared to testes lacking Ad spermatogonia (high infertility risk) before and after curative GnRHa treatment, and in correlation to their location on the Y-chromosome. Results Twenty genes that are up- or down-regulated in the Ad- group are in the X-degenerate or the ampliconic region, respectively. GnRHa treatment increases mRNA levels of 14 genes in the ampliconic region and decreases mRNA levels of 10 genes in the X-degenerate region. Conclusion Our findings implicate Y-chromosomal genes, including USP9Y, UTY, TXLNGY, RBMY1B, RBMY1E, RBMY1J and TSPY4, some of which are known to be important for spermatogenesis, in the curative hormonal treatment of cryptorchidism-induced infertility.
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Affiliation(s)
| | - Gilvydas Verkauskas
- 2Children's Surgery Centre, Faculty of Medicine, Vilnius of University, 01513 Vilnius, Lithuania
| | - Michael B Stadler
- 3Friedrich Miescher Institute for Biomedical Research, Basel, Switzerland.,4Swiss Institute of Bioinformatics, Basel, Switzerland
| | - Faruk Hadziselimovic
- Cryptorchidism Research Institute, Kindermedizinisches Zentrum Liestal, 4410 Liestal, Switzerland
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Han J, Rabley A, Vlasak A, Bozorgmehri S, Bird V, Moy L. Career Expectations and Preferences of Urology Residency Applicants. Urology 2019; 123:44-52. [DOI: 10.1016/j.urology.2018.07.070] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 06/23/2018] [Accepted: 07/23/2018] [Indexed: 10/28/2022]
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Serati M, Andersson KE, Dmochowski R, Agrò EF, Heesakkers J, Iacovelli V, Novara G, Khullar V, Chapple C. Systematic Review of Combination Drug Therapy for Non-neurogenic Lower Urinary Tract Symptoms. Eur Urol 2019; 75:129-168. [PMID: 30293906 DOI: 10.1016/j.eururo.2018.09.029] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 09/14/2018] [Indexed: 01/05/2023]
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Chen Z, Prosperi M, Bird VY. Prevalence of kidney stones in the USA: The National Health and Nutrition Evaluation Survey. JOURNAL OF CLINICAL UROLOGY 2018. [DOI: 10.1177/2051415818813820] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: The National Health and Nutrition Examination Survey (NHANES) has demonstrated an upward trend in prevalence of kidney stones (KSs) in the past 30 years. We aim to report the current prevalence of KSs. Methods: Research was based upon a cross-sectional analysis of response to the 2007–2014 NHANES. The prevalence of self-reported KS history was calculated using weights and design factors reported by NHANES. Four cycles of NHANES data were analyzed separately (2007–2014), and KS-prevalence trends in adult individuals for different age groups were compared. Analysis was performed using SAS ver.9.4. Results: The prevalence of KSs was 10.1% for the last 2013–2014 NHANES cycle. The highest prevalence of KSs was observed in males older than 60 years, at 17.8%, followed by males 40–59 years old at 12.6%. This trend changes in the 20–39-year-old age group, wherein females had a higher prevalence than males—7.5% for females compared to 4.5% in males. Females in the study showed a steady increase in KSs prevalence through the study cycles: 6.6% in 2007 to 9.5% in 2013 ( p < 0.05). The increase in females ages 20 to 39, almost doubled in prevalence: 3.9 to 7.5%, from 2007 to 2013 ( p < 0.05). Females older than 60 years of age have remained stable, with prevalence of 8.9% in 2007 to 9.8% in 2013. Males showed a slight decrease in prevalence from 2007 to 2014, from 12.7% in 2007 to 11.4% in 2014. Prevalence in males and females older than 60 years old were relatively stable. Conclusions: Prevalence of KSs has remained stable in males and has increased in females. Females of child-bearing age showed the most significant increase. For this specific group, there has been a steady increase in the last seven years. Level of evidence: IV
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Affiliation(s)
- Zhaoyi Chen
- Department of Epidemiology, College of Public Health and Health Profession & College of Medicine, University of Florida, USA
| | - Mattia Prosperi
- Department of Epidemiology, College of Public Health and Health Profession & College of Medicine, University of Florida, USA
| | - Victoria Y. Bird
- Department of Urology, College of Medicine, University of Florida, USA
- Department of Biomedical Engineering, College of Engineering, University of Florida, USA
- National Medical Association and Research Group, Gainesville, Florida, USA
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Rezaee ME, Johnson HA, Munarriz RM, Gross MS. Bibliometric Analysis of Erectile Dysfunction Publications in Urology and Sexual Medicine Journals. J Sex Med 2018; 15:1426-1433. [DOI: 10.1016/j.jsxm.2018.08.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 08/06/2018] [Accepted: 08/11/2018] [Indexed: 10/28/2022]
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Kirk PS, Borza T, Dupree JM, Wei JT, Ellimoottil C, Caram MEV, Burkhardt M, Heidelbaugh JJ, Hollenbeck BK, Skolarus TA. Potential Savings in Medicare Part D for Common Urological Conditions. UROLOGY PRACTICE 2018; 5:351-359. [PMID: 30555855 PMCID: PMC6290920 DOI: 10.1016/j.urpr.2017.07.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Millions of patients take prescription medications each year for common urological conditions. Generic and brand-name drugs have widely divergent pricing despite similar therapeutic benefit and side effect profiles. We examined prescribing patterns across provider types for generic and brand-name drugs used to treat 3 common urological conditions, and estimated economic implications for Medicare Part D spending. METHODS We extracted 2014 prescription claims and payments from Medicare Part D and categorized oral medications used to treat 3 urological conditions, namely benign prostatic hyperplasia, erectile dysfunction and overactive bladder. We examined claims and payments for each medication among urologists and nonurologists. Lastly, we estimated potential savings by selecting a low cost or generic drug as a cost comparator for each class. RESULTS There were significant differences in prescribing patterns across these conditions, with urologists prescribing more brand-name and expensive medications (p <0.001). The total potential savings related to prescriptions of more expensive and nongeneric drugs in 2014 was $1 billion (benign prostatic hyperplasia $348,454,910, erectile dysfunction $10,211,914 and overactive bladder $698,130,833). These potential savings comprised 53% of the total spending for these medications in 2014. CONCLUSIONS Within Medicare Part D the potential savings associated with generic substitution for higher cost and nongeneric drugs for 3 common urological conditions surpassed $1 billion, with urologists more likely to prescribe brand-name and more expensive drugs. Increasing low cost and generic drug use where available evidence of efficacy is equivocal represents a promising policy target to optimize prescription drug spending.
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Affiliation(s)
- Peter S. Kirk
- Dow Division of Health Services Research, Department of Urology, VA Ann Arbor Healthcare System, Ann Arbor, Michigan
| | - Tudor Borza
- Dow Division of Health Services Research, Department of Urology, VA Ann Arbor Healthcare System, Ann Arbor, Michigan
| | - James M. Dupree
- Dow Division of Health Services Research, Department of Urology, VA Ann Arbor Healthcare System, Ann Arbor, Michigan
| | - John T. Wei
- Dow Division of Health Services Research, Department of Urology, VA Ann Arbor Healthcare System, Ann Arbor, Michigan
| | - Chad Ellimoottil
- Dow Division of Health Services Research, Department of Urology, VA Ann Arbor Healthcare System, Ann Arbor, Michigan
| | - Megan E. V. Caram
- Division of Hematology & Oncology, Department of Internal Medicine, VA Ann Arbor Healthcare System, Ann Arbor, Michigan
| | - Mary Burkhardt
- University of Michigan Health System, Pharmacy Service, VA Ann Arbor Healthcare System, Ann Arbor, Michigan
| | - Joel J. Heidelbaugh
- Department of Family Medicine, VA Ann Arbor Healthcare System, Ann Arbor, Michigan
| | - Brent K. Hollenbeck
- Dow Division of Health Services Research, Department of Urology, VA Ann Arbor Healthcare System, Ann Arbor, Michigan
| | - Ted A. Skolarus
- Dow Division of Health Services Research, Department of Urology VA Ann Arbor Healthcare System, Ann Arbor, Michigan, VA Health Services Research & Development Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, Michigan
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Chang Y, Chang J, Wang H. Transurethral balloon dilatation of the Prostate and Transurethral Plasmakinetic resection of the Prostate in the treatment of Prostatic Hyperplasia. Pak J Med Sci 2018; 34:736-739. [PMID: 30034449 PMCID: PMC6041535 DOI: 10.12669/pjms.343.14516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background & Objective With the aggravation of global aging, benign prostate hyperplasia tends to have a higher incidence and has been the most common disease in urinary surgery. It is usually treated by surgery. Our objective was to select an effective treatment scheme, the clinical efficacy and relevant indicators of transurethral balloon dilatation of the prostate (TUDP) and transurethral plasmakinetic resection of the prostate (PKRP) in the treatment of benign prostate hyperplasia were emphatically compared. Methods Ninety-eight patients with benign prostate hyperplasia who were admitted to the hospital of between May 2014 and July 2016 were selected and divided into a TUDP group (n=49) and PKRP (n=49) using random number table. The intraoperative blood loss, duration of surgery, international prostate symptom score (IPSS), quality of life (QOL), post-void residual urine (PVR) and complications of the two groups were observed. Results The results demonstrated that the postoperative blood loss and duration of surgery of the patients in the PKRP group were significantly higher than those of the TUDP group (P<0.05); the IPSS, QOL and PVR of the patients in the two groups after surgery were much lower than those before surgery (P<0.05); the IPSS, QOL and PVR of the patients in the PKRP group were significantly lower than those in the TUDP group after surgery (P<0.05). The incidence of postoperative complications of the PKRP group was 38.8%, which was apparently higher than 14.3% in the TUDP group (P<0.05). Conclusion PKRP has better efficacy than TUDP in treating benign prostatic hyperplasia, but QOL was poor and there are many complications. Proper surgical procedure should be selected according to the specific disease condition of patients.
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Affiliation(s)
- Yanhua Chang
- Yanhua Chang, Urology Surgery Department, Binzhou People's Hospital, Shandong, 256610, China
| | - Jingyi Chang
- Jingyi Chang, First School of Clinical Medicine, Anhui Medical University, Anhui, 230032, China
| | - Hui Wang
- Hui Wang, Urology Surgery Department, Binzhou People's Hospital, Shandong, 256610, China
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Use of 5-Phosphodiesterase Inhibitors in Patients with Luts Secondary to Bph: Our Experience and Review of the Literature. Urologia 2018. [DOI: 10.5301/urologia.5000021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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Recurrent Urinary Tract Infections in the Setting of Mesh Implants. CURRENT BLADDER DYSFUNCTION REPORTS 2017. [DOI: 10.1007/s11884-017-0434-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Dangle P, Bansal U, Chaudhry R, Cannon GM, Schneck FX, Ost MC. Trends in Urologic Indications for Pediatric Renal Transplantation Over a 27-Year-period United Network for Organ Sharing (UNOS) Database. Urology 2017; 118:172-176. [PMID: 29154793 DOI: 10.1016/j.urology.2017.10.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 10/17/2017] [Accepted: 10/24/2017] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To elucidate the trends in urologic causes for renal transplant in the pediatric population using a national database. Little is known about the specific pediatric urologic conditions and resultant trends that precede renal transplantation. MATERIAL AND METHODS We reviewed the United Network for Organ Sharing (UNOS) database for pediatric patients (<18 years old) who underwent renal transplantation from January 1988 to September 2015. We included those patients who received a renal transplant because of a urologic condition. RESULTS Over 27 years, 7291 of 20,213 children (36%) underwent renal transplant secondary to a urologic condition. The 2 most common indications were hypoplasia/dysplasia/dysgenesis/agenesis (HDDA, 35.1%) and congenital obstructive uropathy (COU, 25.7%). The incidence of COU has increased from 18% to 30%, and the incidence of Wilms tumor has remained relatively consistent at 1.8% per year. In addition, 68% of all urologic renal transplants were performed in men compared with women. However, a higher percentage of women required transplantation because of Wilms tumor (3.1% vs 1.2%) and chronic pyelonephritis (17.6% vs 7.9%). Overall, the majority of patients (61.5%) who underwent renal transplantation were white, 18.8% Hispanic, and 15.3% black. CONCLUSION HDDA and COU consistently have been the most common urologic indications for renal transplantation. Both are the leading causes in men, whereas HDDA and chronic pyelonephritis are predominant in women. Higher rate of renal transplant during the ages of 11-17 years is suggestive of increased burden on poorly functioning kidneys during times of adolescent growth.
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Affiliation(s)
- Pankaj Dangle
- Division of Pediatric Urology, Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, PA.
| | - Utsav Bansal
- Division of Pediatric Urology, Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Rajeev Chaudhry
- Division of Pediatric Urology, Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Glenn M Cannon
- Division of Pediatric Urology, Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Francis X Schneck
- Division of Pediatric Urology, Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Michael C Ost
- Division of Pediatric Urology, Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, PA
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Kovanecz I, Vernet D, Masouminia M, Gelfand R, Loni L, Aboagye J, Tsao J, Rajfer J, Gonzalez-Cadavid NF. Implanted Muscle-Derived Stem Cells Ameliorate Erectile Dysfunction in a Rat Model of Type 2 Diabetes, but Their Repair Capacity Is Impaired by Their Prior Exposure to the Diabetic Milieu. J Sex Med 2017; 13:786-97. [PMID: 27114192 DOI: 10.1016/j.jsxm.2016.02.168] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2015] [Revised: 02/02/2016] [Accepted: 02/17/2016] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Muscle-derived stem cells (MDSCs) and other SCs implanted into the penile corpora cavernosa ameliorate erectile dysfunction in type 1 diabetic rat models by replenishing lost corporal smooth muscle cells (SMCs) and decreasing fibrosis. However, there are no conclusive data from models of type 2 diabetes (T2D) and obesity. AIM To determine whether MDSCs from obese Zucker (OZ) rats with T2D at an early stage of diabetes (early diabetic SCs isolated and cultured in low-glucose medium [ED-SCs]) counteract corporal veno-occlusive dysfunction and corporal SMC loss or lipo-fibrosis when implanted in OZ rats at a late stage of diabetes and whether MDSCs from these OZ rats with late diabetes (late diabetic SCs isolated and cultured in high-glucose medium [LD-SC]) differ from ED-SCs in gene transcriptional phenotype and repair capacity. METHODS ED-SCs and LD-SCs were compared by DNA microarray assays, and ED-SCs were incubated in vitro under high-glucose conditions (ED-HG-SC). These three MDSC types were injected into the corpora cavernosa of OZ rats with late diabetes (OZ/ED, OZ/LD, and OZ/ED-HG rats, respectively). Untreated OZ and non-diabetic lean Zucker rats functioned as controls. Two months later, rats were subjected to cavernosometry and the penile shaft and corporal tissues were subjected to histopathology and DNA microarray assays. MAIN OUTCOME MEASURES In vivo erectile dysfunction assessment by Dynamic Infusion Cavernosometry followed by histopathology marker analysis of the penile tissues. RESULTS Implanted ED-SCs and ED-HG-SCs improved corporal veno-occlusive dysfunction, counteracted corporal decreases in the ratio of SMCs to collagen and fat infiltration in rats with long-term T2D, and upregulated neuronal and endothelial nitric oxide. LD-SCs acquired an inflammatory, pro-fibrotic, oxidative, and dyslipidemic transcriptional phenotype and failed to repair the corporal tissue. CONCLUSION MDSCs from pre-diabetic rats injected into the corpora cavernosa of rats with long-term T2D improve corporal veno-occlusive dysfunction and the underlying histopathology. In contrast, MDSCs from rats with long-term uncontrolled T2D are imprinted by the hyperglycemic and dyslipidemic milieu with a noxious phenotype associated with an impaired tissue repair capacity. SCs affected by diabetes could lack tissue repair efficacy as autografts and should be reprogrammed in vitro or substituted by SCs from allogenic non-diabetic sources.
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Affiliation(s)
- Istvan Kovanecz
- Division of Urology, Department of Surgery, Harbor-UCLA Medical Center and Los Angeles Biomedical Research Institute, Torrance, CA, USA; Department of Urology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Dolores Vernet
- Division of Urology, Department of Surgery, Harbor-UCLA Medical Center and Los Angeles Biomedical Research Institute, Torrance, CA, USA
| | - Maryam Masouminia
- Division of Urology, Department of Surgery, Harbor-UCLA Medical Center and Los Angeles Biomedical Research Institute, Torrance, CA, USA
| | - Robert Gelfand
- Division of Urology, Department of Surgery, Harbor-UCLA Medical Center and Los Angeles Biomedical Research Institute, Torrance, CA, USA; Department of Medicine, Charles Drew University of Medicine and Science, Los Angeles, CA, USA
| | - Leila Loni
- Division of Urology, Department of Surgery, Harbor-UCLA Medical Center and Los Angeles Biomedical Research Institute, Torrance, CA, USA
| | - James Aboagye
- Department of Medicine, Charles Drew University of Medicine and Science, Los Angeles, CA, USA
| | - James Tsao
- Department of Medicine, Charles Drew University of Medicine and Science, Los Angeles, CA, USA
| | - Jacob Rajfer
- Division of Urology, Department of Surgery, Harbor-UCLA Medical Center and Los Angeles Biomedical Research Institute, Torrance, CA, USA; Department of Urology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Nestor F Gonzalez-Cadavid
- Division of Urology, Department of Surgery, Harbor-UCLA Medical Center and Los Angeles Biomedical Research Institute, Torrance, CA, USA; Department of Urology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA; Department of Medicine, Charles Drew University of Medicine and Science, Los Angeles, CA, USA.
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Efficiency of combined diffusion weighted imaging and conventional MRI in detection of clinically nonpalpable undescended testes. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2017. [DOI: 10.1016/j.ejrnm.2016.09.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Choi SY, Yoon CG. Urologic Diseases in Korean Military Population: a 6-year Epidemiological Review of Medical Records. J Korean Med Sci 2017; 32:135-142. [PMID: 27914143 PMCID: PMC5143286 DOI: 10.3346/jkms.2017.32.1.135] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 09/15/2016] [Indexed: 11/20/2022] Open
Abstract
We sought to describe the incidence rate of the urologic disease in the Korean military by reviewing diagnoses made in active duty soldiers from 2008 to 2013. A total of 72,248 first visits were generated in the Defense Medical Statistics Information System (DMSIS) with its gradually increasing trend over 6 years. A sharp increase of first visit was observed after implementation of the regular health check-up for all conscripted soldiers since 2013. Urolithiasis, prostatitis, epididymoorchitis, urethritis, and varicocele were prevalent. Prostatitis was the highest diagnosis made in the outpatient service, while varicocele was ranked the highest in the inpatient service. The incidence rates of urologic disease varied from 12.3 to 34.2 cases per 1,000 person-years. The urologic disease in conscripted men showed different distribution when we separated the population into conscripted and professional soldiers. Epididymoorchitis was the highest disease followed by urolithiasis, dysuresia, and balanoposthitis in 2013. This study underscores that the urologic disease has spent significant amount of health care resources in the Korean military. This calls for further study to find any significant difference and contributing factors of the urologic disease in the military and the civilian population.
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Affiliation(s)
- Se Young Choi
- Department of Urology, Il-dong Military Hospital, Pocheon, Korea
- Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Chang Gyo Yoon
- Department of Preventive Medicine, The Armed Forces Medical Command, Seongnam, Korea.
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Zhao L. Management of complex urethral stricture: NYU case of the month, february 2017. Rev Urol 2017; 19:52-55. [PMID: 28522932 PMCID: PMC5434838 DOI: 10.3909/riu0752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
- Lee Zhao
- Department of Urology, NYU Langone Medical CenterNew York, NY
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Kan KM, Jayadevan R, Rodriguez N, Weissbart S, Stock JA. The Current State of Urological Education for Medical Students. UROLOGY PRACTICE 2017; 4:71-75. [PMID: 37592605 DOI: 10.1016/j.urpr.2016.03.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Providing medical students with a basic urological education is important as the geriatric population expands and the need for urological care increases. In the last decades there have been considerable changes to medical school curricula and graduation requirements that may impact medical student exposure to urology. We reviewed the literature pertaining to urological education for medical students in the United States. METHODS We searched the PubMed® and Medline® databases to identify articles pertaining to medical student education in urology. We summarized these articles according to 4 themes, including 1) medical student electives in urology, 2) medical student career interest in urology, 3) new interventions in urology education and 4) the urology match. RESULTS We identified 25 articles, which showed that 1) medical student exposure to urology has markedly declined, 2) medical students remain highly interested in pursuing a career in urology, 3) the AUA (American Urological Association) medical student curriculum has provided a key resource for medical school urological education and 4) applying for urology residency may be expensive and challenging. CONCLUSIONS Medical school urological education has changed in the last decades. Although it appears that fewer medical students are required to rotate through urology, new materials are available to educate medical students in urology and many students are highly interested in pursing a career in the field.
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Affiliation(s)
- Kathleen M Kan
- Departments of Urology, Icahn School of Medicine at Mount Sinai and New York University School of Medicine (NR), New York, New York
| | - Rajiv Jayadevan
- Departments of Urology, Icahn School of Medicine at Mount Sinai and New York University School of Medicine (NR), New York, New York
| | - Nermarie Rodriguez
- Departments of Urology, Icahn School of Medicine at Mount Sinai and New York University School of Medicine (NR), New York, New York
| | - Steven Weissbart
- Departments of Urology, Icahn School of Medicine at Mount Sinai and New York University School of Medicine (NR), New York, New York
| | - Jeffrey A Stock
- Departments of Urology, Icahn School of Medicine at Mount Sinai and New York University School of Medicine (NR), New York, New York
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Conroy DE, Dubansky A, Remillard J, Murray R, Pellegrini CA, Phillips SM, Streeper NM. Using Behavior Change Techniques to Guide Selections of Mobile Applications to Promote Fluid Consumption. Urology 2016; 99:33-37. [PMID: 27645525 DOI: 10.1016/j.urology.2016.09.015] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Revised: 09/07/2016] [Accepted: 09/12/2016] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To determine the extent to which validated techniques for behavior change have been infused in commercially available fluid consumption applications (apps). MATERIALS AND METHODS Coders evaluated behavior change techniques represented in online descriptions for 50 fluid consumption apps and the latest version of each app. RESULTS Apps incorporated a limited range of behavior change techniques (<20% of taxonomy). The number of techniques varied by operating system but not as a function of whether apps were free or paid. Limitations include the lack of experimental evidence establishing the efficacy of these apps. CONCLUSION Patients with urolithiasis can choose from many apps to support the recommended increase in fluid intake. Apps for iOS devices incorporate more behavior change techniques compared to apps for the Android operating system. Free apps are likely to expose patients to a similar number of techniques as paid apps. Physicians and patients should screen app descriptions for features to promote self-monitoring and provide feedback on discrepancies between behavior and a fluid consumption goal.
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Affiliation(s)
- David E Conroy
- Department of Kinesiology, The Pennsylvania State University, University Park, PA; Department of Preventive Medicine, Northwestern University, Chicago, IL.
| | - Alexandra Dubansky
- Department of Kinesiology, The Pennsylvania State University, University Park, PA
| | - Joshua Remillard
- Department of Kinesiology, The Pennsylvania State University, University Park, PA
| | | | | | | | - Necole M Streeper
- Department of Urology, The Pennsylvania State University, Hershey, PA
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Hadziselimovic F, Gegenschatz-Schmid K, Verkauskas G, Docampo-Garcia MJ, Demougin P, Bilius V, Malcius D, Dasevicius D, Stadtler MB. Gene Expression Changes Underlying Idiopathic Central Hypogonadism in Cryptorchidism with Defective Mini-Puberty. Sex Dev 2016; 10:136-46. [PMID: 27561106 DOI: 10.1159/000447762] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2016] [Indexed: 11/19/2022] Open
Abstract
The whole genome RNA profiling of testicular biopsies by DNA strand-specific RNA sequencing was examined to determine a potential causative role of isolated congenital cryptorchidism in azoospermia and/or infertility in the context of our previously published GeneChip data. Cryptorchid patients, aged 7 months to 5 years and otherwise healthy, were enrolled in this prospective study. During surgery, testicular tissue biopsies were obtained for histological examination and RNA sequencing. Fifteen patients were selected based on the histological results and were divided into 2 groups. Seven were classified as belonging to the high infertility risk (HIR) and 8 to the low infertility risk (LIR) group. Cryptorchid boys in the HIR group lacked transformation of gonocytes into Ad spermatogonia due to impaired mini-puberty. This group of patients will be infertile despite successful surgery. The new important finding was a decreased PROK2, CHD7, FGFR1, and SPRY4 gene expression in the HIR group. Furthermore, identification of multiple differences in gene expression between HIR and LIR groups underscores the importance of an intact hypothalamic-pituitary-gonadal axis for fertility development. Our RNA profiling data strongly support the theory that in the HIR group of cryptorchid boys insufficient PROK2/CHD7/FGFR1/SPRY4 gene expression induces deficient LH secretion, resulting in impaired mini-puberty and infertility. We therefore recommend hormonal treatment for this cohort of cryptorchid boys with defective mini-puberty following a seemingly successful orchidopexy.
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The Near-future Impact of Retirement on the Urologic Workforce: Results From the American Urological Association Census. Urology 2016; 94:85-9. [DOI: 10.1016/j.urology.2016.04.053] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Revised: 04/06/2016] [Accepted: 04/15/2016] [Indexed: 11/21/2022]
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