Urology最新文献

{"title":"Real-World Economic Burden and Healthcare Resource Utilization of Radical Cystectomy and Trimodal Therapy for Bladder Cancer in the United States.","authors":"Stephen B Williams, Halit O Yapici, Puneet K Singhal, Ian Weimer, Farah Pathan, Hayden W Hyatt, Kunal Lodaya, Haojie Li","doi":"10.1016/j.urology.2025.03.028","DOIUrl":"https://doi.org/10.1016/j.urology.2025.03.028","url":null,"abstract":"<p><strong>Objectives: </strong>To leverage contemporary real-world data to offer a comprehensive and longitudinal assessment of cost and healthcare resource utilization in patients with bladder cancer who underwent radical cystectomy or trimodal therapy.</p><p><strong>Methods: </strong>Claims data between October 01, 2015, and April 24, 2023 were assessed to determine patient characteristics, costs, and healthcare resource utilization. Patients were followed from 90-days up to 5-years of follow-up. Costs and healthcare utilization were further broken down by place of service and specific cost drivers, and subgroups were assessed to explore aspects of treatment recommended guidelines.</p><p><strong>Results: </strong>Of 1,323 patients, 839 underwent radical cystectomy (median age 71 years; 26.2% female) and 484 received trimodal therapy (median age 75, 26.2% female). Median [IQR] per-patient costs were $70,671 [$55,878-$106,812] for the radical cystectomy cohort at 90-days follow-up and rose to $211,671 [$138,597-$346,389] by 5-years post-index. For trimodal therapy, total costs were $34,612 [$16,705-$64,263] at 90-days and increased to $274,462 [$186,337-$421,534] by 5-years. At 90-days, median overall visits (inpatient, outpatient, emergency room, or other) were 26 [16-39] for radical cystectomy and 19 [12-33] for trimodal therapy; overall visits were 163 [119-218] and 186 [144-238] by 5-years, respectively.</p><p><strong>Conclusions: </strong>This analysis reveals that radical cystectomy costs were primarily driven by inpatient services, particularly inpatient facility costs. For trimodal therapy, outpatient costs predominated, driven by drugs administered and outpatient radiology facilities. The considerable costs and utilization associated with these treatments underscore the need for value-based therapeutic approaches aimed at enhancing patient outcomes.</p><p><strong>Data availability statement: </strong>Data for this analysis was made available to the authors through a third-party license from CDM, a commercial data provider in the United States. As such, the authors cannot make these data publicly available due to data use agreement. Other researchers can access the data by purchasing a license through CDM.</p>","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693477","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}

{"title":"Editorial Comment for URL-D-24-01758R1: Simultaneous Bilateral PCNL: Is it Cost-Effective?","authors":"David T Tzou","doi":"10.1016/j.urology.2025.03.030","DOIUrl":"https://doi.org/10.1016/j.urology.2025.03.030","url":null,"abstract":"","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693459","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}

{"title":"Exploring Vacuum Erection Device User Feedback: A GPT-4 Thematic Analysis.","authors":"Hiren V Patel, Behzad Abbasi, Kevin D Li, Marvin Carlisle, Anna Faris, William A Pace, Benjamin N Breyer","doi":"10.1016/j.urology.2025.03.027","DOIUrl":"https://doi.org/10.1016/j.urology.2025.03.027","url":null,"abstract":"<p><strong>Objective: </strong>To explore consumer viewpoints regarding vacuum erection device (VED) use.</p><p><strong>Methods: </strong>We conducted a qualitative analysis of 1,500 Amazon.com reviews for 21 of the most popular VED products. Reviews were analyzed using GPT-4, identifying common themes and subthemes. Electric and manual VEDs were compared, and a multivariable ordinal regression was built to identify factors linked to higher product ratings.</p><p><strong>Results: </strong>The most common themes identified were efficacy (92%) and user experience (78%). Safety and warning mentions appeared in 27% and 6.8% of reviews, respectively. Compared to manual, electric VEDs were more frequently associated with mentions of ease of use (46% vs. 34%), design features (17% vs. 9.3%), and explicit product warnings (7.7% vs. 5.1%). A 5/5 rating was linked to fewer mentions of product deficiency (7.3% vs. 86%), malfunction (1.5% vs. 45%), product warnings (2.8% vs. 24%), and customer service issues (3.9% vs. 21%) compared to a 1/5 rating. Among all reviews, 126 (8.4%) reported using the VED for partner intimacy, while 16 (1.1%) noted its use for masturbation. Within this cohort, 65% used devices with included sex toys, and 35% used standard VEDs. Users seeking partner intimacy reported similar effectiveness (93% vs. 81%), ease of use (59% vs. 54%), satisfaction (91% vs. 95%), and likelihood of recommendation (30% vs. 29%) between VEDs with and without sex toy features.</p><p><strong>Conclusion: </strong>Amazon reviews indicate a generally positive sentiment toward VEDs, with few mentions of malfunction or safety warnings. However, proper patient education remains essential to ensure safe use and minimize the risk of injury.</p>","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693466","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}

{"title":"Validation of a Quantitative Hematuria Scale.","authors":"Sahana Prasanna, Anushka Agrawal, Archit Chabbi, Richard Chan, Robert Heeter, Kevin Li, Sagar Patel, Raymond Yong, Chester Koh","doi":"10.1016/j.urology.2025.03.026","DOIUrl":"https://doi.org/10.1016/j.urology.2025.03.026","url":null,"abstract":"<p><strong>Objective: </strong>To develop a quantitative hematuria scale that assigns specific blood concentration percentages to commonly used descriptors such as \"clear,\" \"mild,\" \"moderate,\" and \"severe,\" in order to standardize hematuria severity assessments during Continuous Bladder Irrigation (CBI) and reduce reliance on subjective visual evaluations.</p><p><strong>Methods: </strong>Samples of bovine blood with concentrations ranging from 0% to 100% were created, photographed, and distributed to a cohort of urologists and healthcare workers in a survey. Respondents were asked to categorize these samples as clear, mild, moderate, or severe. Fleiss' kappa analysis was performed to evaluate inter-rater agreement.</p><p><strong>Results: </strong>Data from 39 respondents were analyzed, and consensus categories for each blood concentration were determined using mode and weighted averages. Overall agreement among respondents was moderate (Kappa=0.53, p < 0.0001). The categories \"clear\" and \"severe\" demonstrated substantial agreement (Kappa=0.63), while \"moderate\" and \"mild\" showed moderate and fair agreement, respectively.</p><p><strong>Conclusions: </strong>This study presents a promising foundation to a novel quantitative scale for hematuria assessment, reducing reliance on subjective visual judgments. The scale would enable clearer and more consistent communication of hematuria severity, which is crucial as urological technologies advance toward quantitative measurements.</p>","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693512","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}

{"title":"Reply to Editorial Comment on \"Genitourinary Fellowship for Family Medicine Physicians\".","authors":"Roger K Khouri, Robert Chang, Jian Yang, Francesco Taormina, Tareq Aro, Lloyd Minsky, Tochi Iroku-Malize, Louis R Kavoussi","doi":"10.1016/j.urology.2025.03.019","DOIUrl":"https://doi.org/10.1016/j.urology.2025.03.019","url":null,"abstract":"","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674561","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}

{"title":"Letter to the Editor on \"The Change of Detrusor Contractility at 5 Years After Transurethral Resection of the Prostate: A Single Center Prospective Observational Study\".","authors":"Yu-Hsiang Lin, Chih-Te Lin, Kuo-Jen Lin","doi":"10.1016/j.urology.2025.03.013","DOIUrl":"https://doi.org/10.1016/j.urology.2025.03.013","url":null,"abstract":"","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674559","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}

{"title":"Editorial Comment Re URL-D-24-02300R1 \"Financial Toxicity in Spina Bifida: Development of a Patient and Caregiver Questionnaire\".","authors":"Emilie K Johnson","doi":"10.1016/j.urology.2025.03.014","DOIUrl":"https://doi.org/10.1016/j.urology.2025.03.014","url":null,"abstract":"","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674556","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}

{"title":"CHILD WITH ACUTE PENILE SWELLING.","authors":"Danelo Estienne du Plessis, Xander Botha, Andre van der Merwe","doi":"10.1016/j.urology.2025.03.018","DOIUrl":"https://doi.org/10.1016/j.urology.2025.03.018","url":null,"abstract":"","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674554","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}

{"title":"Letter to the Editor on \"Rethinking Low Testosterone in Older Men: Association With Obesity Rather Than Aging\".","authors":"Yu-Hsiang Lin, Kuo-Jen Lin, Hsin-Ho Liu","doi":"10.1016/j.urology.2025.03.017","DOIUrl":"https://doi.org/10.1016/j.urology.2025.03.017","url":null,"abstract":"","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674558","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}

{"title":"Reply to Editorial Comment on \"Pregnancy, Fertility Implications, and Parental Leave Policies: Where Does Urology Stand?\"","authors":"Joanna Orzel, Gillian Stearns","doi":"10.1016/j.urology.2025.03.016","DOIUrl":"https://doi.org/10.1016/j.urology.2025.03.016","url":null,"abstract":"","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143670856","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}