Urology

OBJECTIVE: To highlight several advanced surgical techniques for all types of colpocleisis. Pelvic organ prolapse is a common condition that affects up to 40% of the postmenopausal female population.1-2 Particularly for women with advanced pelvic organ prolapse who no longer desire penetrative vaginal intercourse and with multiple medical comorbidities, the obliterative approach is preferred due to decreased anesthetic needs, operative time, and perioperative morbidity.3 Additionally, colpocleisis is associated with a greater than 95% long-term efficacy with low patient regret, high satisfaction, and improved body image...

BACKGROUND: Simple prostatectomy has been established as a management option for lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) with glands larger than 80cc (1). Robotic-assisted simple prostatectomy (RASP) has been established as a safe and effective management option. This has been reported in multiple studies comparing it with the open approach where no statistically significant differences in complication rates have been found (2). The intrafascial approach is intended to add multiple benefits, such as not requiring continuous bladder irrigation and resection of a larger percentage of the adenoma, potentially leading to a lower reoperation rate and diagnosis of prostate cancer in patients in which this was missed preoperatively (3)...

OBJECTIVE: To assess how IsoPSA, a structure-based serum assay which has been prospectively validated in detecting clinically significant prostate cancer (csPCa), can help the biopsy decision process when combined with the Prostate Imaging Reporting and Data Systems (PI-RADS). MATERIALS AND METHODS: This was a single-center retrospective review of prospectively collected data on patients receiving IsoPSA testing for elevated PSA (>4.0ng/mL). Patients were included if they had received an IsoPSA test and prostate MRI within one year of IsoPSA testing, and subsequently underwent prostate biopsy...

No abstract text is available yet for this article.

OBJECTIVE: To compare the efficacy and safety of the sandwich method with GreenLight photoselective vaporization (GLPVP) and bipolar transurethral resection (B-TURP) with those of the enucleation method in patients with BPH and a prostate volume ≥ 80 g. METHODS: Patients with BPH who underwent either the sandwich method with GLPVP and B-TURP or the enucleation method between 2014 and 2021 were included in the analysis. The primary outcome was the comparison of uroflowmetry results between the two groups...

OBJECTIVE: To synthesize existing evidence to evaluate the outcomes of different urinary catheter removal timing (early vs late) after urethroplasty. METHODS: We performed a comprehensive search of PubMed, Embase, the Cochrane Library, and Web of Science from inception to August 7, 2022. Articles were initially screened by title, abstract, and subsequently by a full paper review before being included in the final analysis. All comparative studies that assessed the association between urethral catheterization duration and frequency of extravasation and recurrence rate in patients who underwent urethroplasty were included in the analysis...

OBJECTIVE: To demonstrate a modified approach to the Spence-Duckett procedure for treatment of a distal urethral diverticulum. A urethral diverticulum is an outpouching of urethral mucosa occurring in 2-5% of the population.1 They are thought to commonly arise due to chronic inflammation or infection of the peri-urethral glands.2-3 MATERIALS AND METHODS: : We present a 37-year-old female with vaginal bulge, dyspareunia, and dysuria. On examination, she had a two-centimeter tender mass abutting the distal urethra...

OBJECTIVE: To determine the impacts of COVID-19 pandemic-related changes and program-specific characteristics on the geographic diversity of the 2021 and 2022 urology match classes. METHODS: We gathered publicly available information to compare match outcomes in 2021 and 2022 to the previous 5 application cycles (2016-2020). Variables included residency program class size, program and resident AUA section, and program and resident medical school. Univariate comparisons were made with Fisher's t-tests...

OBJECTIVE: To perform a systematic review of the literature on plant-based and plant-forward diets and the prevention/treatment of the following common men's health conditions: prostate cancer (PCa), erectile dysfunction (ED), and benign prostatic hyperplasia (BPH). METHODS: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses system (PRISMA) criteria were utilized to search PubMed and Medline databases for the following search terms: "Diet [Mesh]" OR "Diet Therapy [Mesh]" AND "Prostatic Hyperplasia [Mesh]" OR "Prostatic Neoplasm [Mesh]" OR "Erectile Dysfunction [Mesh]...

OBJECTIVE: To systematically aggregate and summarize existing data on fistula prevalence among patients with a history of pelvic radiotherapy for prostate cancer. MATERIALS AND METHODS: We queried PubMed, Embase, and Web of Science on October 7, 2020 for peer-reviewed publications pertaining to radiation-induced fistulas in the pelvis. For meta-analysis, we used the random-effects model. We used the I2 statistic to quantify heterogeneity and the Newcastle-Ottawa Scale to assess risk of bias...

Polyorchidism is defined as the presence of two or more testes on the same side. A 7-year-old boy (46 XY) with multiple congenital abnormalities and non-palpable bilateral gonads is presented. He underwent diagnostic laparoscopic surgery at eight months old which revealed duplicated right testes and contralateral presence of persistent left Mullerian duct structures. A successful Fowler-Stephens orchidopexy in two stages was performed on both testicles. Postoperative ultrasonography showed orthotopic right testes of 0...

No abstract text is available yet for this article.

OBJECTIVE: To report the technique and outcomes of tissue expansion (TE) for generating additional penile skin for urethroplasty and/or skin coverage during primary or redo hypospadias repair in penoscrotal transposition (PST) patients with a proximal hypospadias. METHODS: Proximal hypospadias and PST patients with a lack of penile skin, congenitally or after failed repair, who underwent TE assisted reconstruction were reviewed. TE were placed under the penile shaft and expanded skin was used for tubularized incised plate repair...

OBJECTIVES: To improve understanding of co-occurring Obsessive-Compulsive Disorder (OCD) and Bowel and Bladder Dysfunction (BBD) in an outpatient pediatric urology clinic setting. To provide a series of clinical care recommendations to enhance the identification and integrated medical and behavioral health treatment of these disorders. METHODS: Authors participated in a series of discussions to define the patient population and specific aims for the study. Efforts were made to select index patients of diverse background despite limited sample availability...

UNLABELLED: OBJECTİVE: To compare the ability of the obturator nerve block (ONB) and increased plasma ignition distance practice (IPDP) techniques to inhibit obturator nerve reflex (ONR) occurring with bipolar transurethral resection of the bladder. METHODS: Sixty patients who had a tumor placed at the lateral sidewall or had a tumor in another part of the bladder along with the lateral wall were randomly enrolled. Cystoscopic and ultrasonographic examinations and a computerized tomography scanning of the urinary bladder were used to determine the ONB side...

OBJECTIVE: To describe a novel syphon ureteral access sheath (UAS) intended for use during flexible uretero-renoscopy (fURS). We aimed to report on a pilot study as well as intrarenal pressures (IRP) and irrigant flow volumes compared to traditional UAS. METHODS: Patients undergoing routine fURS for single, <2cm intrarenal nephrolithiasis were identified, and written informed consent was obtained. Irrigation via the fURS was instilled through the novel 11/13 Fr UAS without (a proxy for a traditional UAS) and with the novel syphon box attached...

OBJECTIVE: To describe the initial outcomes of a new multidisciplinary gender-affirming surgery (GAS) program comprised of plastic and urologic surgeons. METHODS: We retrospectively examined consecutive patients who underwent gender-affirming vaginoplasty or vulvoplasty between April 2018 and May 2021. We used logistic regression modeling to analyze associations between pre-operative risk factors and post-operative complications. RESULTS: Between April 2018 and May 2021, 77 genital GAS (gender-affirming surgery) procedures were performed at our institution (56 vaginoplasties, 21 vulvoplasties)...

OBJECTIVES: To quantify emergency department (ED) visits and hospital admissions (HA) after common urologic stone procedures including ureteroscopy (URS), shockwave lithotripsy (SWL), and percutaneous nephrolithotomy (PCL) which are a concern of payors, providers, and patients. MATERIALS AND METHODS: This is a retrospective cohort study using claims data from the IBM MarketScan Commercial and Medicare Supplement databases. Adults with a urologic stone diagnosis and no history of stone procedure in prior 12 months who underwent stone procedures between 2012 and 2017 were included...

OBJECTIVE: To determine clinical, surgical and urodynamic attributes associated with earlier AUS reintervention. The artificial urinary sphincter (AUS) is the gold standard treatment for post-prostatectomy stress urinary incontinence (SUI). Factors impacting long-term device survival have not been investigated. MATERIALS AND METHODS: We identified men with post-prostatectomy incontinence who underwent AUS reintervention from 2011-2021 at a single center. Urodynamic study, pad weights and voiding diaries are routinely assessed prior to AUS placement...

OBJECTIVE: To evaluate the clinical value of mixed reality-assisted puncture navigation (MRAPN) in percutaneous nephrolithotripsy (PCNL). METHODS: Two hundred patients undergoing PCN were enrolled, all of whom had kidney stones to be subjected to lithotripsy by PCNL, and grouped according to surgical procedure into the MRAPN (n=100) and non-mixed reality-assisted puncture (non-MRAPN) (n=100) groups. CT data in DICOM format for all patients in the MRAPN group were imported into 3D reconstruction and mixed reality (MR) post-processing workstations, and holographic 3D visualization modelling...