IF 2.1 3区医学

Urology Pub Date : 2025-01-01 Epub Date: 2024-10-22 DOI: 10.1016/j.urology.2024.10.030

Suhaib Abdulfattah, Emily Ai, Marina Quairoli, Sahar Eftekharzadeh, Katherine Fischer, Aznive Aghababian, John Weaver, Karl Godlewski, Christopher Long, Dana Weiss, Sameer Mittal, Aseem Shukla, Arun Srinivasan

{"title":"Robot-assisted Laparoscopic Ureteral Reimplantation in Pre-toilet Trained Children With Vesicoureteral Reflux.","authors":"Suhaib Abdulfattah, Emily Ai, Marina Quairoli, Sahar Eftekharzadeh, Katherine Fischer, Aznive Aghababian, John Weaver, Karl Godlewski, Christopher Long, Dana Weiss, Sameer Mittal, Aseem Shukla, Arun Srinivasan","doi":"10.1016/j.urology.2024.10.030","DOIUrl":"10.1016/j.urology.2024.10.030","url":null,"abstract":"Objective: To evaluate the outcomes of pre-toilet trained children undergoing robot-assisted laparoscopic ureteral reimplantation (RALUR) for the treatment of primary VUR at our institution and compare these to an older cohort.Materials and methods: This retrospective study analyzed data from a single institution's registry, comparing outcomes between pre-toilet trained and toilet trained children who underwent RALUR for primary VUR. Preoperative parameters, surgical details, and postoperative outcomes were evaluated.Results: The study included 158 patients, with 24 in the pre-toilet trained group and 134 in the toilet trained group. Both cohorts exhibited similar demographics and preoperative characteristics. Operative times, complication rates, and surgical outcomes were comparable between the groups, despite the pre-toilet trained group presenting with more severe VUR grades. Incidence of febrile urinary tract infection after surgery and need for further intervention did not significantly differ between the cohorts.Conclusion: The current study demonstrates the feasibility, success, and safety of RALUR in pre-toilet trained compared to toilet trained children and thus supports the stance that it is a viable alternative to open surgery.","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":"126-131"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142508920","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 "Variation in Urology Care After Urinary Stone Surgery Among Veterans at High-risk for Recurrence". 关于 "高复发风险退伍军人尿路结石手术后泌尿科护理的差异 "的社论评论。

IF 2.1 3区医学

Urology Pub Date : 2025-01-01 Epub Date: 2024-11-01 DOI: 10.1016/j.urology.2024.10.065

Fuad Elkhoury

引用次数: 0

Editorial Comment on "Living Donor Nephrectomy: Analysis of Trends and Outcomes From a Contemporary National Dataset". 关于 "活体肾脏捐献者肾切除术：当代全国数据集的趋势和结果分析 "的编辑评论。

IF 2.1 3区医学

Urology Pub Date : 2025-01-01 Epub Date: 2024-10-22 DOI: 10.1016/j.urology.2024.10.042

John M Barry

引用次数: 0

Reply to Editorial Comment on "Frailty Among Bladder Augmentation Patients: Healthcare Utilization and Perioperative Outcomes". 回复 "关于膀胱增大术患者体弱的社论评论：医疗保健的使用和围手术期的结果"。

IF 2.1 3区医学

Urology Pub Date : 2025-01-01 Epub Date: 2024-10-22 DOI: 10.1016/j.urology.2024.10.047

Katherine T Anderson

引用次数: 0

Safety and Efficacy of Same Day Discharge for Men Undergoing Contemporary Robotic-assisted Aquablation Prostate Surgery in an Ambulatory Surgery Center Setting-First Global Experience. 在门诊手术中心接受当代机器人辅助水消融前列腺手术的男性当天出院的安全性和有效性--首次全球经验。

IF 2.1 3区医学

Urology Pub Date : 2025-01-01 Epub Date: 2024-08-17 DOI: 10.1016/j.urology.2024.08.006

Kevin C Zorn, Anindyo Chakraborty, Bilal Chughtai, Rahul Mehan, Dean Elterman, David-Dan Nguyen, David Bouhadana, Alexander P Glaser, Shawn Marhamati, Neil Barber, Brian T Helfand

{"title":"Safety and Efficacy of Same Day Discharge for Men Undergoing Contemporary Robotic-assisted Aquablation Prostate Surgery in an Ambulatory Surgery Center Setting-First Global Experience.","authors":"Kevin C Zorn, Anindyo Chakraborty, Bilal Chughtai, Rahul Mehan, Dean Elterman, David-Dan Nguyen, David Bouhadana, Alexander P Glaser, Shawn Marhamati, Neil Barber, Brian T Helfand","doi":"10.1016/j.urology.2024.08.006","DOIUrl":"10.1016/j.urology.2024.08.006","url":null,"abstract":"Objective: To investigate the feasibility, safety, and efficacy of same-day discharge (SDD) after Aquablation specifically in an ambulatory surgery center (ASC).Methods: A prospective cohort of men with significant BPH underwent Aquablation at a single ASC. Comprehensive preoperative assessments were conducted, including uroflowmetry, IPSS, and PVR. Aquablation was performed as morning cases by a single experienced surgeon. Following the procedure, men were assessed for immediate postoperative outcomes, including pain levels, hematuria, and voiding efficiency. Patients meeting discharge criteria were allowed to return home on the same calendar day.Results: A total of 60 consecutive men with a mean prostate size of 115 mL underwent Aquablation, 59 (98%) of whom were discharged the same day. No transfusions or return to the OR occurred. The procedure demonstrated a significant improvement in urinary flow rates and a substantial reduction in IPSS scores at the 1-month post-operative period. Pain scores were found to be minimal, and the incidence of postoperative complications, including hematuria and urinary retention was low and comparable to previously published outcomes. Despite more meticulous focal cautery, no differences in erectile, ejaculatory or adverse outcomes were observed.Conclusion: Aquablation for BPH at an ASC appears to be a safe and effective approach. Morning procedures and attentive cautery and streamlined patient pathways seem essential for SDD. Despite electrosurgical hemostasis, ejaculatory, sexual, and post-operatively pain were not compromised.","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":"132-138"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005362","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

A Multicenter Prospective Sham-controlled Trial Evaluating a Physiologic Closed-loop Wearable Tibial Neuromodulation System for Overactive Bladder. 评估治疗膀胱过度活跃的生理闭环可穿戴胫神经调节系统（REDUCEOAB）的多中心前瞻性假对照试验。

IF 2.1 3区医学

Urology Pub Date : 2025-01-01 Epub Date: 2024-09-17 DOI: 10.1016/j.urology.2024.09.018

Colin Goudelocke, Rohit Dhir, Eve Shapiro, Kevin Cline, Denise Elser Poulos, Parke Hedges

{"title":"A Multicenter Prospective Sham-controlled Trial Evaluating a Physiologic Closed-loop Wearable Tibial Neuromodulation System for Overactive Bladder.","authors":"Colin Goudelocke, Rohit Dhir, Eve Shapiro, Kevin Cline, Denise Elser Poulos, Parke Hedges","doi":"10.1016/j.urology.2024.09.018","DOIUrl":"10.1016/j.urology.2024.09.018","url":null,"abstract":"Objective: To evaluate the effectiveness and safety of a home-based, physiologic closed-loop wearable tibial neuromodulation system in comparison to a sham control for the treatment of overactive bladder (OAB).Methods: This multicenter, prospective, randomized, double-blind, sham-controlled trial included 125 adult subjects with OAB who were randomized 1:1 to receive either active therapy with the Vivally System or sham therapy. Patients were allowed to continue concomitant OAB medications if therapy was stable and the remained on a consistent regimen throughout the study. The primary efficacy endpoint was a responder rate, defined as ≥50% reduction in daily urgency leaks or a ≥30% reduction in daily voids from baseline recorded on an electronic voiding diary. Safety was evaluated through adverse event (AE) reporting and patient satisfaction with the system was recorded.Results: In the modified Intent-to-Treat (mITT) population (n = 107), the responder rate was significantly higher in the active therapy arm (83.6%) compared to the sham arm (57.7%; P = .032). The system demonstrated a favorable safety profile with no serious AE. Patient satisfaction with the device and mobile application was high with 90/92 (97.8%) reporting they were moderately to extremely satisfied and therapy compliance was above 92% for both therapy and sham groups.Conclusion: The Vivally System showed significant improvement in OAB symptoms compared to sham therapy, demonstrating a high responder rate and excellent safety profile. The combination of physiologic closed-loop neuromodulation and a behavior-tracking application may offer an effective and user-friendly option for OAB management.","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":"16-22"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296567","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

Hypospadias Reconstruction Training: Development of an Ex-Vivo Model for Objective Evaluation of Surgical Skills. 尿道下裂重建培训：开发用于客观评估手术技能的体外模型。

IF 2.1 3区医学

Urology Pub Date : 2025-01-01 Epub Date: 2024-09-19 DOI: 10.1016/j.urology.2024.09.013

Tariq Abbas, Sibel Tiryaki, Ali Tekin, Nicolas Fernandez, Mohamed Fawzy, Ibrahim Ulman, Alp Numanoglu, Ahmed Hadidi, Mansour Ali, Iqbal Hassan, Muhammad Chowdhury

{"title":"Hypospadias Reconstruction Training: Development of an Ex-Vivo Model for Objective Evaluation of Surgical Skills.","authors":"Tariq Abbas, Sibel Tiryaki, Ali Tekin, Nicolas Fernandez, Mohamed Fawzy, Ibrahim Ulman, Alp Numanoglu, Ahmed Hadidi, Mansour Ali, Iqbal Hassan, Muhammad Chowdhury","doi":"10.1016/j.urology.2024.09.013","DOIUrl":"10.1016/j.urology.2024.09.013","url":null,"abstract":"Objective: To objectively evaluate technical skill acquisition in hypospadias repair procedures during surgical training using noninvasive wearable sensor technology.Methods: We combined subjective video evaluations with objective electromyography (EMG) measurements in a hands-on hypospadias training course. Surgeons wore wireless EMG and accelerometer sensors on their dominant hand while performing tasks on ex-vivo cadaveric calf penises. The study focused on 4 skills as follows: urethral mobilization, dorsal inlay graft harvest/implantation, meatal-based flap urethroplasty, and dorsal plication. Machine learning techniques analyzed muscle activation patterns and attributes for assessing surgical precision.Results: The course included 18 participants (10 female, 8 males; average age 40.18 ± 8.46 years) categorized as novice (n = 10, <3 years' experience), intermediate (n = 5, 3-5 years), and expert (n = 3, >5 years). Video evaluations did not reveal significant differences due to short-term training. However, EMG measurements showed significant reductions in average EMG power, total time, dominant frequency, and cumulative muscle workload after training. Additionally, the mean power spectral density of the EMG signal decreased notably post-training.Conclusion: This study presents a structured approach for hypospadias training and highlights the effectiveness of wearable sensor technology for objective skill assessment. While video evaluations did not detect significant changes, EMG data provided measurable differences in skill acquisition, suggesting that wearable sensors could enhance objective evaluations of surgical proficiency in residency programs.","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":"112-119"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296583","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

The Epidemiology of Genitourinary Self-inflicted Injuries: Analysis of the National Trauma Databank. 泌尿生殖系统自伤的流行病学：国家创伤数据库分析。

IF 2.1 3区医学

Urology Pub Date : 2025-01-01 Epub Date: 2024-09-30 DOI: 10.1016/j.urology.2024.09.042

Nizar Hakam, Umar Ghaffar, Behzad Abbasi, Kevin D Li, Adrian Fernandez, Hiren V Patel, Joseph Cuschieri, Benjamin N Breyer

{"title":"The Epidemiology of Genitourinary Self-inflicted Injuries: Analysis of the National Trauma Databank.","authors":"Nizar Hakam, Umar Ghaffar, Behzad Abbasi, Kevin D Li, Adrian Fernandez, Hiren V Patel, Joseph Cuschieri, Benjamin N Breyer","doi":"10.1016/j.urology.2024.09.042","DOIUrl":"10.1016/j.urology.2024.09.042","url":null,"abstract":"Objective: To provide insight into the epidemiologic characteristics and trends of genitourinary (GU) self-inflicted injury (SII).Methods: We used data from the National Trauma Databank between 2017 and 2020. We described the characteristics of GU SII cases based on injured organ and then compared male and female injuries.Results: We identified 56,463 patients with SII, of which 1508 (2.7%) had GU involvement. Most cases were male patients (77.3%) and white (70.6%). Median age was 35 years (IQR 26-50). The most commonly injured GU organs were kidney (43.4%), followed by scrotum/testes (22.5%), and penis (18.2%). Most cases (89.9%) represented a single-organ injury whereas 10.1% had 2 or more GU organs injured. Seventy-three of those with kidney injuries (11.2%) underwent nephrectomy. Only 1 patient performing GU SII had a diagnosis code for transsexualism but the majority (82.2%) suffered from pre-existing conditions of which 20.5% had 3 or more comorbidities. More than half the population (54.9%) had preexisting diagnosed mental or personality disorder. A non-GU co-injury was present in most cases (70.8%), most commonly affecting another abdominal organ (44.3%) or fractures (41.3%). A positive drug screen was found in 30.7% of cases. Most patients survived though 15.4% died. Ninety-four percentage of fatal cases had a concomitant non-GU injury.Conclusion: GU injuries account for 2.6% of all SII. These patients are often young white males with known mental or personality disorders. Kidneys were the most common injured and mortality was highest in cases of kidney and bladder injuries with multi-organ trauma involving non-GU organs.","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":"175-181"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142366703","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

Reply to Letter to the Editor on "Hypospadias Reconstruction Training: Development of an Ex-Vivo Model and Objective Evaluation of Surgical Skills". 答复致编辑的信尿道下裂重建培训：体外模型的开发和手术技能的客观评估。

IF 2.1 3区医学

Urology Pub Date : 2025-01-01 Epub Date: 2024-11-05 DOI: 10.1016/j.urology.2024.10.076

Mohamed Fawzy, Sibel Tiryaki, Tariq Abbas, Ahmed Hadidi

引用次数: 0

A Retrospective Analysis of Urethroplasty and Medical Malpractice. 尿道成形术和医疗事故的回顾性分析。

IF 2.1 3区医学

Urology Pub Date : 2025-01-01 Epub Date: 2024-09-24 DOI: 10.1016/j.urology.2024.09.011

Meher Pandher, Imran Khawaja, Zachary Boston, Kunj Jain, Aleksandar Popovic, Rhea Prabu, Amjad Alwaal

{"title":"A Retrospective Analysis of Urethroplasty and Medical Malpractice.","authors":"Meher Pandher, Imran Khawaja, Zachary Boston, Kunj Jain, Aleksandar Popovic, Rhea Prabu, Amjad Alwaal","doi":"10.1016/j.urology.2024.09.011","DOIUrl":"10.1016/j.urology.2024.09.011","url":null,"abstract":"Objective: To review malpractice suits stemming from urethroplasty intervention, which is the standard of care for patients suffering from urethral strictures.Methods: This retrospective study analyzed the LexisNexis and Westlaw databases between 1980 and 2024. Each database was queried with \"urethroplasty\" which yielded 48 cases and 20 jury verdicts/settlements in the LexisNexis database and 46 cases and 14 jury verdicts in the Westlaw database. Selected cases were reviewed variables including chief allegation, litigation location, plaintiff demand, plaintiff award, and verdict. Exclusion criteria included but were not limited to lawsuits regarding non-urologic surgery necessitating urethroplasty and litigation based on traumatic injury necessitating urethroplasty.Results: After manual review of 128 cases in the LexisNexis and Westlaw databases, 12 met inclusion criteria. 5 (42%) cases sued for deformation of the genitalia after urethroplasty, 2 (17%) sued for failure of informed consent, 2 (17%) sued for erectile dysfunction, 1 (8%) sued for a post-operative venous thrombosis, 1 (8%) sued for post-operative infection, and 1 (8%) sued for failure to treat. Six (50%) cases resulted in plaintiff awards; 3 of these were settled before a final verdict. Plaintiff awards varied from $72,500-$810,000. Of the 12 cases, 2 (17%) occurred in California and 2 (17%) occurred in Illinois; the remaining locations were isolated.Conclusion: The most common cause of litigation following urethroplasty was centered on the perceived deformation of the genitalia after urethroplasty, which underscores the significance of urologists setting realistic expectations for patients with thorough pre-operative counseling.","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":"159-165"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142354724","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

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