Urology最新文献_第10页

Increasing Diversity, Equity, and Inclusion in Urology Residency Recruitment: Recommendations From the Society of Women in Urology 提高泌尿外科住院医师招聘的多样性、公平性和包容性：泌尿外科妇女协会的建议。

IF 2.1 3区医学

Urology Pub Date : 2024-09-01 DOI: 10.1016/j.urology.2024.04.053

{"title":"Increasing Diversity, Equity, and Inclusion in Urology Residency Recruitment: Recommendations From the Society of Women in Urology","authors":"","doi":"10.1016/j.urology.2024.04.053","DOIUrl":"10.1016/j.urology.2024.04.053","url":null,"abstract":"<div><h3>Objective</h3><p>To provide a framework for diversifying the urologic workforce through residency recruitment by integrating principles of diversity, equity, and inclusion (DEI) into program mission and values, application review, and interview process.</p></div><div><h3>Materials and Methods</h3><p>For this narrative review, the Society of Women in Urology Advancing DEI in Urology Residency Recruitment Task Force identified 4 areas for incorporating DEI into residency recruitment: defining a residency program’s mission and values, holistic application review, an objective interview process, and implementing DEI principles into a program. Using PubMed and Google Scholar, we performed a non-systematic literature search of articles from January 2014 to January 2024. Search terms included combinations of “diversity”, “equity”, “inclusion”, “residency”, “holistic review”, “applications”, “interviews”, and “initiatives”. Additional resources were identified through citations of selected articles. Based on findings from these articles, Task Force members made recommendations for best practices.</p></div><div><h3>Results</h3><p>The diversity of practicing urologists is disproportionate to that of the United States population. Emerging evidence demonstrates that DEI efforts in healthcare are associated with better outcomes and reduction in healthcare inequities. We offer strategies for residency programs to integrate DEI initiatives into their recruitment, application review, and interview process. Furthermore, we address extending DEI principles into a program’s mission and culture to create an inclusive environment conducive to training and supporting individuals from unique backgrounds.</p></div><div><h3>Conclusion</h3><p>It is critical to recruit and retain diverse talent in urology to improve patient care. We urge residency programs and their supporting institutions to adopt DEI principles into their recruitment efforts.</p></div>","PeriodicalId":23415,"journal":{"name":"Urology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140912750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Editorial Comment on “Teaching Hospitals and Textbook Outcomes After Major Urologic Cancer Surgery” 关于 "教学医院与泌尿系统癌症大手术后的教科书成果 "的编辑评论。

IF 2.1 3区医学

Urology Pub Date : 2024-09-01 DOI: 10.1016/j.urology.2024.06.066

引用次数: 0

Intraprostatic Injection of Tranexamic Acid Decrease Blood Loss During Monopolar Transurethral Resection of the Prostate: A Randomized Controlled Clinical Trial 前列腺内注射氨甲环酸可减少单极前列腺切除术中的失血量：一项随机对照临床试验。

IF 2.1 3区医学

Urology Pub Date : 2024-09-01 DOI: 10.1016/j.urology.2024.05.015

{"title":"Intraprostatic Injection of Tranexamic Acid Decrease Blood Loss During Monopolar Transurethral Resection of the Prostate: A Randomized Controlled Clinical Trial","authors":"","doi":"10.1016/j.urology.2024.05.015","DOIUrl":"10.1016/j.urology.2024.05.015","url":null,"abstract":"<div><h3>Objective</h3><p><span>To assess the role of intraprostatic injection of </span>tranexamic acid<span> (TXA) in reducing blood loss<span> during transurethral resection of the prostate (TURP).</span></span></p></div><div><h3>Methods</h3><p><span>We conducted a randomized, controlled, double-blind trial involving 60 patients with benign prostatic hyperplasia aged 50-85</span> <span>years, undergoing monopolar TURP. Patients' prostatic weights ranged from 50 to 80 g. They were divided equally into two groups: group I received an intraprostatic injection of 1 g of TXA (Cyklokapron) dissolved in 50 mL of 0.9 % saline at multiple sites, while group II (control) received a 60 mL saline injection. Comprehensive clinical assessments and standard laboratory tests, including screenings for TXA hypersensitivity, were performed for all patients.</span></p></div><div><h3>Results</h3><p><span><span>Group I exhibited significantly lower intraoperative blood loss and hemoglobin concentration in </span>irrigation fluid immediately postsurgery and at the 6-hour postoperative mark compared to group II (</span><em>P</em><span><span><span> < .05). Coagulation parameters—activated partial thromboplastin time<span>, prothrombin time, </span></span>fibrinogen level, and thrombin clotting time—showed no significant differences between the groups preoperatively or at 6 and 24 hours postoperatively. No </span>thromboembolic events or other complications were reported in either group.</span></p></div><div><h3>Conclusion</h3><p>The intraprostatic injection of TXA during monopolar TURP is safe, with minimal adverse effects, and effectively reduces blood loss.</p></div><div><h3>Registration</h3><p>The study was registered on ClinicalTrials.gov No (ID: NCT05913466).</p></div>","PeriodicalId":23415,"journal":{"name":"Urology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141094344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Predicting Peak Productivity in Urologic Medicare Practice via Work-Relative Value Units 通过工作相对价值单位预测泌尿科医疗保险实践中的峰值生产率。

IF 2.1 3区医学

Urology Pub Date : 2024-09-01 DOI: 10.1016/j.urology.2024.03.037

{"title":"Predicting Peak Productivity in Urologic Medicare Practice via Work-Relative Value Units","authors":"","doi":"10.1016/j.urology.2024.03.037","DOIUrl":"10.1016/j.urology.2024.03.037","url":null,"abstract":"<div><h3>Objective</h3><p>To explore factors associated with productivity in urologic practice. Work-relative value units (wRVUs), the basis for Center for Medicare & Medicaid Services (CMS) and private payer reimbursements, commonly serve to estimate physician productivity. Limited data describes which practice factors predict increased wRVU productivity.</p></div><div><h3>Methods</h3><p>The 2017 and 2018 CMS databases were retrospectively queried for urologic Medicare provider demographics and procedural/service details. Medical school graduation year was used to estimate years in practice and generation (Millennial, Gen X, Baby Boomer, or Post-War). Treated patients’ demographics were obtained. Adjusted and unadjusted linear mixed models were performed to predict wRVU production.</p></div><div><h3>Results</h3><p>Included were 6773 Medicare-participating urologists across the United States. Millennials produced 1115 wRVUs per year, while Gen X and Baby Boomers produced significantly more (1997 and 2104, respectively, <em>P</em> <.01). Post-War urologists produced numerically more (1287, <em>P</em><span> = .88). In adjusted analyses, predictors of Medicare wRVU productivity included female and pelvic medicine and reconstructive surgery (exponentiated beta estimate (β) 1.46, 95% CI 1.32-1.60), men’s health (β 1.22, 95% CI 1.13-1.32), and oncologic subspecialization (β 1.08, 95% CI 1.02-1.14), female gender (β 0.87, 95% CI 0.82-0.92), wRVUs generated from inpatient procedures (β 1.08, 95% CI 1.06-1.09) and office visits (β 0.88, 95% CI 0.87-0.89), and the level of education (β 1.10, 95% CI 1.07-1.14) and percent impoverished patients (β 0.85, 95% CI 0.83-0.88) in provider’s practice zip code.</span></p></div><div><h3>Conclusion</h3><p>Urologic experience, specialization, demographics, practice patterns, and patient demographics are significantly associated with wRVU productivity in Medicare settings. Further work should incorporate quality metrics into wRVUs and ensure patient demographics do not affect reimbursement.</p></div>","PeriodicalId":23415,"journal":{"name":"Urology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140756511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Design and Validation of a Novel 3D-Printed Retrograde Intrarenal Surgery Trainer 设计和验证新型 3d 打印逆行肾内手术训练器。

IF 2.1 3区医学

Urology Pub Date : 2024-09-01 DOI: 10.1016/j.urology.2024.06.061

{"title":"Design and Validation of a Novel 3D-Printed Retrograde Intrarenal Surgery Trainer","authors":"","doi":"10.1016/j.urology.2024.06.061","DOIUrl":"10.1016/j.urology.2024.06.061","url":null,"abstract":"<div><h3>OBJECTIVE</h3><p>To report on the design of a novel 3D-printed retrograde intrarenal surgery (RIRS) benchtop trainer and detail its validation against real-life experiences.</p></div><div><h3>METHODS</h3><p>Digital Imaging and Communications in Medicine (DICOM) files of 2 patients with normal computed tomography of the kidney and bladder were converted into stereolithography files to create 3D triangular mesh models. These images were further refined using Autodesk Meshmixer. These 3D models were fabricated through additive manufacturing, a process commonly known as 3D printing, and assembled in a polypropylene case. After development, the model was validated by 40 experienced urologists and urology residents in their final year of training. They were asked to rate the components of the simulation using a 9-point questionnaire.</p></div><div><h3>RESULTS</h3><p>The model’s value in understanding the principles of RIRS and simulating contextual anatomy had mean scores of 9.43 (standard deviation [SD] = 0.74) and 9.21 (SD = 1.03), respectively. Mean scores for specific steps in RIRS were 8.07 (SD 1.47) for cannulating the ureteric orifice, 8.61 (SD 1.24) for inserting the ureteric access sheath, 9.29 (SD 0.97) for performing a renoscopy and evaluating all the calyces, 9.46 (SD 0.87) for laser lithotripsy, and 9.17 (SD 0.94) for manual stone retrieval. Participants scored the model with a mean score of 9.04 (SD 0.87) regarding realism and a mean score of 9.18 (SD 0.89) when evaluating its ability to enhance a trainee’s confidence in RIRS.</p></div><div><h3>CONCLUSION</h3><p>The model performed well for all components of RIRS. This model allows high fidelity of the simulation and is cost-effective, portable, durable, reusable, and compatible with standard ureteroscopes.</p></div>","PeriodicalId":23415,"journal":{"name":"Urology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0090429524005132/pdfft?md5=591d16a2ae23bfbd982115524cbab74c&pid=1-s2.0-S0090429524005132-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141470994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Editorial Comment on “Eulogy for B&O Suppositories: A Resident’s Remembrance of Rectal Relief” 为 B&O 栓剂讴歌》的社论评论：一位居民对直肠舒缓的回忆"。

IF 2.1 3区医学

Urology Pub Date : 2024-09-01 DOI: 10.1016/j.urology.2024.06.057

引用次数: 0

Systematic Review of the Global Literature on Uncomplicated Recurrent Urinary Tract Infections in Women: Underscoring Major Heterogeneity 关于女性非复杂性复发性尿路感染的全球文献系统性综述：强调主要异质性。

IF 2.1 3区医学

Urology Pub Date : 2024-09-01 DOI: 10.1016/j.urology.2024.06.015

{"title":"Systematic Review of the Global Literature on Uncomplicated Recurrent Urinary Tract Infections in Women: Underscoring Major Heterogeneity","authors":"","doi":"10.1016/j.urology.2024.06.015","DOIUrl":"10.1016/j.urology.2024.06.015","url":null,"abstract":"<div><h3>Objective</h3><p><span>To examine the global literature database on uncomplicated recurrent urinary tract infections (rUTI), this </span>systematic review assesses the availability of rUTI data based on geographic region and elucidates the current state of research and gaps in knowledge.</p></div><div><h3>Methods</h3><p>The databases PubMed, Embase, WHO Global Index Medicus, and SciELO were searched for keywords related to rUTI between 2000 and 2023. Three independent reviewers screened studies restricted to female participants age ≥18 years with uncomplicated rUTIs. Studies were excluded if they did not provide a definition for rUTI or did not cite or report an estimate for rUTI prevalence. The review was registered in PROSPERO and conformed to PRISMA guidelines.</p></div><div><h3>Results</h3><p>The search yielded 2947 studies of which 124 were ultimately included. Convenience samples were used for 91% of studies and sample sizes were 30% n <50, 29% n = 50-99, 22% n = 100-199, 36% n ≥200. Most studies were conducted in Europe (41%) or North America (39%), were prospective (52%), at tertiary centers (49%) and included all ages ≥18 (60%). The most common definition for rUTI was 2 UTI/6 m or 3 UTI/1y (62%). Regardless of study location, most studies cited prevalence estimates for rUTI derived from U.S.-based populations.</p></div><div><h3>Conclusion</h3><p>This study represents the first formal investigation of the global literature base on uncomplicated rUTI. Studies on rUTIs are globally of small scale and definitions used for rUTI are heterogeneous. More studies are needed to ascertain the true prevalence of rUTI outside of North America and Europe.</p></div>","PeriodicalId":23415,"journal":{"name":"Urology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141331895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Editorial Comment on “Increasing Diversity, Equity, and Inclusion in Urology Residency Recruitment: Recommendations From the Society of Women in Urology” 关于 "提高泌尿外科住院医师招聘的多样性、公平性和包容性：泌尿外科妇女协会的建议 "的编辑评论。

IF 2.1 3区医学

Urology Pub Date : 2024-09-01 DOI: 10.1016/j.urology.2024.06.008

引用次数: 0

Editorial Comment on “Incidence and Management of Radiation Cystitis After Pelvic Radiotherapy for Prostate Cancer: Analysis from a National Database” 关于 "前列腺癌盆腔放疗后放射性膀胱炎的发病率和处理方法：来自全国数据库的分析"。

IF 2.1 3区医学

Urology Pub Date : 2024-09-01 DOI: 10.1016/j.urology.2024.05.035

引用次数: 0

Social Vulnerability and Receipt of Neoadjuvant Chemotherapy in Patients Undergoing Radical Cystectomy for Bladder Cancer 膀胱癌根治性切除术患者的社会脆弱性与接受新辅助化疗的情况。

IF 2.1 3区医学

Urology Pub Date : 2024-09-01 DOI: 10.1016/j.urology.2024.05.006

{"title":"Social Vulnerability and Receipt of Neoadjuvant Chemotherapy in Patients Undergoing Radical Cystectomy for Bladder Cancer","authors":"","doi":"10.1016/j.urology.2024.05.006","DOIUrl":"10.1016/j.urology.2024.05.006","url":null,"abstract":"<div><h3>Objective</h3><p>To evaluate the association between a population-level measure of social determinants of health<span><span><span>, the Centers for Disease Control and Prevention Social Vulnerability Index (SVI), and receipt of neoadjuvant chemotherapy in patients with muscle-invasive </span>bladder cancer (MIBC) undergoing </span>radical cystectomy.</span></p></div><div><h3>Methods</h3><p>We queried our institutional database for patients with nonmetastatic MIBC treated with radical cystectomy between 2000 and 2022. Patients were assigned an SVI via ZIP code of residence and grouped into quintiles of SVI (ie, least vulnerable to most vulnerable). Multivariable logistic regression was performed to evaluate the association between SVI and receipt of neoadjuvant chemotherapy, adjusting for age, race, gender, and cancer stage. A sub-analysis was performed to evaluate the association between subthemes of SVI (socioeconomic status, household composition/disability, race/ethnicity/language, and housing/transportation) and receipt of neoadjuvant chemotherapy.</p></div><div><h3>Results</h3><p>Of the 978 patients identified, 490 (50.1%) received neoadjuvant chemotherapy. Patients that received neoadjuvant chemotherapy had a lower SVI, were younger, and had >cT2 stage (all, <em>P</em> <.05). The most vulnerable patients had lower odds of receiving neoadjuvant chemotherapy (OR 0.61, 0.39-0.95) compared to the least vulnerable patients. Analysis of subthemes of SVI demonstrated similar associations by socioeconomic status (OR 0.56, 0.36-0.86) and household composition/disability (OR 0.57, 0.33-0.99).</p></div><div><h3>Conclusion</h3><p>Adverse social determinants of health, or social vulnerability, are associated with suboptimal and disparate utilization of neoadjuvant chemotherapy in patients with MIBC undergoing radical cystectomy. Strategies for identifying vulnerable populations may allow for more targeted interventions that would improve equity in bladder cancer care.</p></div>","PeriodicalId":23415,"journal":{"name":"Urology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141065775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0