Urology Practice最新文献

{"title":"Letter: The Impact of American Board of Urology Certification on Postoperative Outcomes for Patients in New York State.","authors":"Franklin D Gaylis, William J Catalona","doi":"10.1097/UPJ.0000000000000833","DOIUrl":"10.1097/UPJ.0000000000000833","url":null,"abstract":"","PeriodicalId":45220,"journal":{"name":"Urology Practice","volume":" ","pages":"492-493"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial Commentary.","authors":"Eric Ballon-Landa, Aaron Baer, Kerri Thurmon","doi":"10.1097/UPJ.0000000000000846","DOIUrl":"https://doi.org/10.1097/UPJ.0000000000000846","url":null,"abstract":"","PeriodicalId":45220,"journal":{"name":"Urology Practice","volume":"12 5","pages":"531-532"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply by Authors.","authors":"Kieran Lewis, Jayant Siva, Angelica Bartholomew, Anne Wong, Carlos Munoz Lopez, Akira Kazama, Nityam Rathi, Eran N Maina, Rebecca A Campbell, Nicholas Heller, Jason M Scovell, Robert Abouassaly, Nima Almassi, Samuel C Haywood, Christopher J Weight, Steven C Campbell","doi":"10.1097/UPJ.0000000000000832","DOIUrl":"https://doi.org/10.1097/UPJ.0000000000000832","url":null,"abstract":"","PeriodicalId":45220,"journal":{"name":"Urology Practice","volume":"12 5","pages":"567"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Telehealth on Treatment Decision-Making in Prostate Cancer.","authors":"Deborah T Glassman, Christina Grindley, John C Wahlstedt, Emily Galen, William Meeks, Kerith Wang, Leonard G Gomella","doi":"10.1097/UPJ.0000000000000825","DOIUrl":"10.1097/UPJ.0000000000000825","url":null,"abstract":"<p><strong>Introduction: </strong>Telehealth utilization has increased since the COVID-19 pandemic. Studies show patient satisfaction with telehealth in managing prostate cancer (CaP); however, data are limited on how telehealth affects treatment decision-making. This study investigates whether appointment type-telehealth vs in person-influences CaP treatment selection, specifically active surveillance (AS) vs definitive therapy.</p><p><strong>Methods: </strong>This was a retrospective analysis of CaP treatment selected by patients at a National Cancer Institute-designated multidisciplinary genitourinary oncology center between March 18, 2020, and December 31, 2022. Telehealth and in-person visits were compared using χ² and <i>t</i> tests. Logistic regression identified variables impacting AS selection.</p><p><strong>Results: </strong>Nine hundred sixty-eight CaP patient visits were evaluated-290 telehealth and 678 in person. In unadjusted analysis, telehealth patients were more likely to be White (68.6% vs 57.1%, <i>P</i> < .001), to live outside Philadelphia (63.1% vs 45.4%, <i>P</i> < .001), to select AS (30.4% vs 19.1%, <i>P</i> < .001), and to be discussing adjuvant (21.4% vs 12.2%) or recurrent treatment (25.9% vs 16.8%, <i>P</i> < .001). Regression analysis demonstrated telehealth did not affect AS selection for initial treatment of Gleason 6 (66.7% vs 62.5%, <i>P</i> = .72; odds ratio = 0.90, <i>P</i> = .86) or 3 + 4 = 7 disease (20% vs 13.3%, <i>P</i> = .26; odds ratio = 2.37, <i>P</i> = .09).</p><p><strong>Conclusions: </strong>Telehealth provides an opportunity to expand access to multidisciplinary CaP care. We demonstrate that appointment type did not significantly affect decision-making for initial treatment of low and low-intermediate risk CaP. Telehealth patients overall were more likely to select AS, likely due to baseline differences and factors unaccounted for by this study (eg, comorbidities and socioeconomics). It is important for physicians using telehealth to consider any associated implications.</p>","PeriodicalId":45220,"journal":{"name":"Urology Practice","volume":" ","pages":"578-585"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144053405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Paraphimosis: An Epidemiological Perspective From a Large Multicenter Research Network.","authors":"Aurora J Grutman, Andrew T Gabrielson","doi":"10.1097/UPJ.0000000000000824","DOIUrl":"10.1097/UPJ.0000000000000824","url":null,"abstract":"","PeriodicalId":45220,"journal":{"name":"Urology Practice","volume":" ","pages":"489-491"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Outcomes of Holmium Laser Enucleation of the Prostate in Patients With Diminished Bladder Contractility.","authors":"Krista N Brackman, Madison T Taychert, Emily C Serrell, Daniel Gralnek, Christopher Manakas, Margaret Knoedler, Ali Antar, Glenn O Allen, Matthew D Grimes","doi":"10.1097/UPJ.0000000000000840","DOIUrl":"10.1097/UPJ.0000000000000840","url":null,"abstract":"<p><strong>Introduction: </strong>Bladder outlet obstruction (BOO) due to benign prostatic hyperplasia (BPH) is common in aging men and can be treated with holmium laser enucleation of the prostate (HoLEP). However, diminished bladder contractility (DC) is also highly prevalent (9%-48%) and can be clinically indistinguishable from BOO without urodynamics (UDS). While HoLEP effectively treats BPH/BOO, clinical outcomes data for patients with DC are limited and mixed. We aim to compare the prevalence and risk factors of catheter dependence among patients with and without DC after HoLEP.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted on 179 patients with preoperative UDS who underwent HoLEP between June 2018 and December 2023. Diminished contractility was defined as Bladder Contractility Index (BCI) < 100. Statistical analyses included univariate and multivariate logistic regression.</p><p><strong>Results: </strong>Among 179 patients, 103 (57.5%) had DC (BCI < 100). After HoLEP, all patients with normal contractility (NC) were voiding while 7.8% of patients with DC were catheter dependent (<i>P</i> = .01) at a mean follow-up of 28 months. Preoperative BCI was associated with post-HoLEP catheter dependence (OR = 0.97, 95% CI 0.95-1.00, <i>P</i> = .046). Postoperative International Prostate Symptom Scores were significantly higher in DC compared with NC groups despite similar preoperative scores.</p><p><strong>Conclusions: </strong>HoLEP rendered 95.5% (171/179) of patients catheter free. However, patients with DC were more likely to require catheterization postoperatively and reported worse urinary symptoms compared with patients with NC. Our results support obtaining UDS when there is clinical concern for DC because this may guide shared decision-making before pursuing HoLEP.</p>","PeriodicalId":45220,"journal":{"name":"Urology Practice","volume":" ","pages":"524-532"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12382733/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A United States Cross-Sectional Analysis of Annual Out-of-Pocket Cost Disparities of Erectile Dysfunction Medications.","authors":"Aaron A Gurayah, Manish Kuchakulla, Robert Fisch, Samantha L Thorogood, Meenakshi Davuluri","doi":"10.1097/UPJ.0000000000000823","DOIUrl":"10.1097/UPJ.0000000000000823","url":null,"abstract":"<p><strong>Introduction: </strong>Our objective was to understand the out-of-pocket (OOP) annual costs of phosphodiesterase 5 inhibitors to treat erectile dysfunction through drug coverage programs in the United States.</p><p><strong>Methods: </strong>We compared the annual OOP costs of the lowest and highest routinely prescribed dosage of medications for sildenafil, tadalafil, and vardenafil across widely used pharmaceutical sources. We examined the cost of phosphodiesterase 5 inhibitors under Medicare Part D at (1) hospital retail pharmacies and (2) 3 commercial retail pharmacies (CVS, Walgreens, and Walmart). These findings were compared with discount platforms GoodRx (through CVS, Walgreens, and Walmart), Mark Cuban Cost Plus, and Amazon Pharmacy.</p><p><strong>Results: </strong>For sildenafil 20 mg, the Part D annual OOP costs including hospitals and retail pharmacies were comparable ranging from $1024 to $1098. The cost at discount platforms was cheaper, ranging from $82 to $275. For sildenafil 100 mg, the hospital-based pharmacies had a median price of $1446, whereas retail pharmacies under Part D ranged from $22,528 to $22,542. Discount platforms were preferred at $89 to $324. For tadalafil 2.5 mg, the Part D groups ranged from $4721 to $4759. The cost of this drug through discount platforms was much lower, ranging from $82 to $312. For tadalafil 20 mg, the cost through Part D ranged from $25,210 to $25,235. The discount platforms were reported to have lower costs ranging from $103 to $496. Vardenafil ranged from $19,015 to $19,039 from Part D groups and $86 to $418 from discount platforms.</p><p><strong>Conclusions: </strong>There are significant cost savings when using discount platforms, which should be discussed to help patients improve accessibility and compliance with erectile dysfunction medications.</p>","PeriodicalId":45220,"journal":{"name":"Urology Practice","volume":" ","pages":"517-523"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144053823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial Commentary.","authors":"Trevor C Hunt, Kamil Malshy, Jathin Bandari","doi":"10.1097/UPJ.0000000000000861","DOIUrl":"https://doi.org/10.1097/UPJ.0000000000000861","url":null,"abstract":"","PeriodicalId":45220,"journal":{"name":"Urology Practice","volume":" ","pages":"101097UPJ0000000000000861"},"PeriodicalIF":1.7,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144859714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urological Procedures and Impact on Advanced Practice Provider Burnout, Job Satisfaction, and Salary: AUA Census Analysis.","authors":"Nathan J Graham, Joshua D Cabral, William D Meeks, Emily Galen, Eric A Singer, Andrew M Harris, Amanda C North, Ted A Skolarus, Susanne Quallich, Parth K Modi","doi":"10.1097/UPJ.0000000000000889","DOIUrl":"10.1097/UPJ.0000000000000889","url":null,"abstract":"<p><strong>Introduction: </strong>More than 25% of advanced practice providers (APPs) in urology suffer from burnout. We hypothesized that procedural independence would be associated with lower burnout, higher job satisfaction, and higher salary for urologic APPs.</p><p><strong>Methods: </strong>The AUA Census data were used to conduct a retrospective cross-sectional study. The Maslach Burnout Inventory and independent procedure data were collected from the 2019 survey. Work-life balance responses were collected from 2022 to 2023. Salary data were collected from 2019 to 2020. Burnout was defined as high levels of emotional exhaustion or depersonalization, while job satisfaction was defined as responses of \"satisfied\" or \"very satisfied.\" We used multiple logistic regression to test the association between performance of procedures and burnout, job satisfaction, and salary, controlling for demographic and job characteristics.</p><p><strong>Results: </strong>Of 116 nurse practitioners and 83 physician assistants in 2019, 120 (60%) routinely performed independent outpatient procedures and 52 (26%) reported burnout. In adjusted analysis, increased work hours (adjusted odds ratio 1.02 per hour, <i>P</i> = .02) was associated with burnout. Independent performance of outpatient procedures was not protective against burnout. Of 365 APPs in 2022 to 2023, 224 (61%) were satisfied with work-life balance and 216 (59%) routinely performed outpatient procedures. Performance of procedures was not associated with satisfaction. Increasing work hours was associated with lower satisfaction (adjusted odds ratio 0.95 per hour, <i>P</i> < .01). Salary was not associated with independent performance of procedures.</p><p><strong>Conclusions: </strong>Independent performance of procedures was not associated with decreased burnout, increased job satisfaction, or higher salary for urology APPs. Work hours were associated with higher burnout and lower satisfaction.</p>","PeriodicalId":45220,"journal":{"name":"Urology Practice","volume":" ","pages":"101097UPJ0000000000000889"},"PeriodicalIF":1.7,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144875829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Penile Fracture Management at Trauma Centers in the United States.","authors":"William Furuyama, Stephen Craig Hill, Li-Ching Huang, Tatsuki Koyama, Niels Johnsen","doi":"10.1097/UPJ.0000000000000888","DOIUrl":"10.1097/UPJ.0000000000000888","url":null,"abstract":"<p><strong>Introduction: </strong>Current AUA urological trauma guidelines recommend prompt surgical intervention for patients presenting with acute penile fracture to minimize potential risks of erectile dysfunction and penile curvature. Given its relatively rare occurrence, there have been few large population-based studies evaluating real-world management of penile fracture. We hypothesized that there is variability in intervention for patients presenting with penile fracture associated with patients' clinical and demographic characteristics and hospital characteristics.</p><p><strong>Methods: </strong>The Trauma Quality Improvement Program database from 2007 to 2017 was analyzed, and patients with diagnosis codes for penile fracture were identified. Patient demographic data and hospital characteristics were analyzed. Multivariable analysis was performed to identify patient and hospital characteristics associated with surgical intervention for penile fracture.</p><p><strong>Results: </strong>We identified 940 patients presenting with penile fracture. The median age was 39 (IQR: 31-47) years. Of the 940 patients, 658 (70%) of patients underwent surgery for penile fracture during the index admission. On multivariable regression analysis, hospital teaching status, type of insurance, and absence of urethral injury diagnosis were significantly associated with the likelihood of intervention.</p><p><strong>Conclusions: </strong>In this large retrospective study, most patients underwent immediate penile fracture repair. However, several patients did not have surgery at the time of their presentation, which was associated with presenting to a nonteaching hospital, having government health insurance, and the presence of urethral injury. Advocating for prompt surgical management remains paramount for improving care for patients with penile fracture.</p>","PeriodicalId":45220,"journal":{"name":"Urology Practice","volume":" ","pages":"101097UPJ0000000000000888"},"PeriodicalIF":1.7,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144838116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}