Urology Practice最新文献

{"title":"The Geographic Mismatch Between Urologic Services and Urologists in the United States.","authors":"Avi Baskin, Max Bowman, Daniel A Barocas, Daniel D Joyce, Kelvin Moses","doi":"10.1097/UPJ.0000000000000868","DOIUrl":"10.1097/UPJ.0000000000000868","url":null,"abstract":"","PeriodicalId":45220,"journal":{"name":"Urology Practice","volume":" ","pages":"101097UPJ0000000000000868"},"PeriodicalIF":0.8,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144601861","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":"Kieran Lewis, Eran Maina, Steven C Campbell","doi":"10.1097/UPJ.0000000000000806","DOIUrl":"10.1097/UPJ.0000000000000806","url":null,"abstract":"","PeriodicalId":45220,"journal":{"name":"Urology Practice","volume":"12 4","pages":"449-450"},"PeriodicalIF":1.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477227","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":"Richard J Boxer","doi":"10.1097/UPJ.0000000000000799","DOIUrl":"10.1097/UPJ.0000000000000799","url":null,"abstract":"","PeriodicalId":45220,"journal":{"name":"Urology Practice","volume":"12 4","pages":"389-390"},"PeriodicalIF":1.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477221","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":"Assessing ChatGPT Responses to Frequently Asked Patient Questions in Reconstructive Urology.","authors":"Mark N Alshak, Johanna Cecelic, Isabella Florissi, Ridwan Alam, Andrew J Cohen","doi":"10.1097/UPJ.0000000000000792","DOIUrl":"10.1097/UPJ.0000000000000792","url":null,"abstract":"<p><strong>Introduction: </strong>Artificial intelligence (such as Chat Generative Pretrained Transformer [ChatGPT]) augments patient education on medical topics, including reconstructive surgery. In this study, we assess the information, misinformation, and readability of ChatGPT responses to reconstructive urology questions. We also evaluate prompt engineering to optimize responses.</p><p><strong>Methods: </strong>One hundred twenty-five questions were presented to ChatGPT (version 4 omni [ChatGPT-4o], OpenAI) and were divided into 6 domains: stress urinary continence, neurogenic bladder, urethral stricture, ureteral stricture, impotence, and Peyronie disease. Quality of health information was assessed using DISCERN (1 [low] to 5 [high]). Understandability and actionability were assessed using Patient Education Materials Assessment Tool for Printable Materials (PEMAT-P; 0% [low] to 100% [high]). Misinformation was scored from 1 (no misinformation) to 5 (high misinformation). Grade and reading level were calculated using the Flesch-Kincaid scale (5 [easy] to 16 [difficult] and 100-90 [fifth grade level] to 10-0 [professional level], respectively).</p><p><strong>Results: </strong>Mean and median DISCERN scores were 3.63 and 5. PEMAT-P understandability was 85.3% but only 37.2% on actionability. There was little misinformation (mean, range: 1.23, 1-4). Responses were at a college graduate reading level. Using prompt engineering in the incontinence domain, scores for DISCERN (3.57-4.75, <i>P</i> = .007), PEMAT-P understandability (89.6% to 96.2%, <i>P</i> < .001), actionability (38.3% to 93.5%, <i>P</i> < .001), and reading level (grade 12.4-5.4, <i>P</i> < .01) all improved significantly while misinformation and word count did not change significantly.</p><p><strong>Conclusions: </strong>ChatGPT-4o's responses are of high quality and understandability with little misinformation. Limitations include actionability and advanced reading level. Using prompt engineering, these deficiencies were addressed without increasing misinformation. ChatGPT-4o can help augment reconstructive urology.</p>","PeriodicalId":45220,"journal":{"name":"Urology Practice","volume":" ","pages":"451-458"},"PeriodicalIF":1.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411211","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 Effect of Preoperative Tamsulosin on Pediatric Ureteroscopic Access: A Multi-Institutional Experience.","authors":"Kayla M Meyer, Kwesi Asantey, Jonathan S Ellison, Aditya Jadcherla, Tori Kostman, Adam Ostergar, Erica J Traxel, Alethea Paradis, Joel Vetter, Douglas W Storm, Linder Wendt, Patrick Ten Eyck, Erik S Davis, Lauren McGee, Kate H Kraft","doi":"10.1097/UPJ.0000000000000793","DOIUrl":"10.1097/UPJ.0000000000000793","url":null,"abstract":"<p><strong>Introduction: </strong>The ability to perform flexible ureteroscopy in children may be limited because of a smaller pediatric ureterovesical junction and ureteral diameter. Tamsulosin has been shown to improve success rates of ureteral instrumentation in adults. To date, the efficacy of this medication to facilitate pediatric ureteral access remains unclear.</p><p><strong>Methods: </strong>We conducted a multi-institutional retrospective review of patients aged 0 to 17 years who underwent ureteroscopy for the treatment of nephrolithiasis from 2013 to 2022. Patients were excluded if they had undergone ureteroscopy or ureteral stent placement within the prior year, underwent semirigid ureteroscopy, or had a known genitourinary abnormality. Study groups included patients prescribed 0.4 mg tamsulosin daily for at least 1 week preoperatively and patients who did not receive tamsulosin.</p><p><strong>Results: </strong>There were 382 patients included, with 126 in the tamsulosin group and 256 in the no-tamsulosin group. Although there were no differences in sex, race, and stone characteristics between the 2 groups, the tamsulosin group was significantly older and had a larger BMI. One week of preoperative tamsulosin was associated with a significantly increased success of flexible ureteroscopic access on first attempt ureteroscopy, with a 24% failure in the no-tamsulosin group vs a 13% failure in the tamsulosin group (<i>P</i> = .010).</p><p><strong>Conclusions: </strong>Our results expand on prior research and suggest that at least 1 week of preoperative tamsulosin facilitates flexible ureteroscopic access in the pediatric population. These results have significant clinical implications, with the potential to reduce multiple procedures and spare children from repeat anesthetic exposures.</p>","PeriodicalId":45220,"journal":{"name":"Urology Practice","volume":" ","pages":"408-414"},"PeriodicalIF":1.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558294","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":"Treatment Delays in the Hispanic Population With Renal Cell Carcinoma: An Analysis of Over 150,000 Patients Using the National Cancer Database.","authors":"Vatsala Mundra, Zachary Melchiode, Jiaqiong Xu, Carlos Riveros Sabogal, Raj Satkunasivam, Christopher J D Wallis, Dharam Kaushik","doi":"10.1097/UPJ.0000000000000801","DOIUrl":"10.1097/UPJ.0000000000000801","url":null,"abstract":"<p><strong>Introduction: </strong>Disparities have been documented in the outcomes of various cancers (eg, lung, colorectal, breast) among the Hispanic population compared with non-Hispanic White (NHW) patients. However, little is known about disparities in renal cell carcinoma (RCC) management despite worse outcomes for those with delays in treatment. The aim of this study was to investigate the disparities in (1) RCC presentation and (2) the time to treatment initiation between Hispanic and NHW patients.</p><p><strong>Methods: </strong>We conducted a comparative analysis using National Cancer Database data from 2004 to 2020 to evaluate disparities in RCC presentation and time to treatment initiation between Hispanic and NHW patients. To minimize inherent differences between the 2 groups, we used 1:1 greedy caliper propensity score matching.</p><p><strong>Results: </strong>After propensity score matching, we analyzed a cohort of 7798 Hispanic and NHW patients. Hispanic patients had an increased likelihood of presenting with clinical T2b RCC relative to NHW patients (odds ratio 1.28; 95% CI, 1.03-1.60) and were more likely to experience delays in surgery (HR, 1.08; 95% CI, 1.01-1.16; <i>P</i> = .017) or any other treatment (HR, 1.08; 95% CI, 1.01-1.16; <i>P</i> = .022). Hispanic patients also received chemotherapy later (HR, 1.49; 95% CI, 1.05-2.12; <i>P</i> = .027).</p><p><strong>Conclusions: </strong>Our data indicate that Hispanic patients often present with more advanced stages of RCC and are likely to experience delays in treatment. This study underscores significant disparities in the presentation and care of RCC between Hispanic and NHW patients, highlighting the need for targeted interventions to address these inequalities.</p>","PeriodicalId":45220,"journal":{"name":"Urology Practice","volume":" ","pages":"371-379"},"PeriodicalIF":1.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626294","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":"Market-Level Features May Influence a Hospital's Decision to Perform Robotic Radical Cystectomy in Florida.","authors":"Neda Qosja, Aaron C Spaulding, Dorin T Colibaseanu, Andrew J Zganjar, Shalmali R Borkar, Ram A Pathak, Timothy D Lyon","doi":"10.1097/UPJ.0000000000000816","DOIUrl":"10.1097/UPJ.0000000000000816","url":null,"abstract":"<p><strong>Introduction: </strong>Adoption of robotic radical cystectomy (RC) occurred before the availability of randomized data supporting oncologic noninferiority of this approach. We hypothesized that market-level features may have influenced a hospital's likelihood of offering robotic RC.</p><p><strong>Methods: </strong>We used the Florida Inpatient Discharge dataset to identify patients who underwent RC for bladder cancer from 2013 to 2020 and compared characteristics between facilities that performed robotic or only open RC. Market features assessed included hospital operating margin, mean per capita income, and the Herfindahl-Hirschman index-a measure of market concentration. Multivariable logistic and negative binomial regression models were fit to evaluate features associated with robotic RC.</p><p><strong>Results: </strong>We identified 4723 patients, of whom 891 (19%) underwent robotic RC. Among the 96 hospitals, 45 (47%) performed at least 1 robotic RC. After multivariable adjustment, features associated with increased odds of offering robotic RC were increasing mean per capita income of the health service area (odds ratio [OR], 1.05, 95% CI: 1.0-1.1, <i>P</i> = .04), a positive hospital operating margin (OR, 6.6, 95% CI: 1.0-43, <i>P</i> = .05), and a higher average annual cystectomy volume (OR, 9.6, 95% CI: 2.1-45, <i>P</i> = .004). Increasing hospital size (incidence rate ratio, 1.12, 95% CI: 1.11-1.13) and mean per capita income (incidence rate ratio 1.05, 95% CI: 1.04-1.07) were significantly associated with a higher number of robotic RCs performed (<i>P</i> < .001).</p><p><strong>Conclusions: </strong>In Florida, local market demand and available financial resources were associated with hospitals offering robotic RC, although market competitiveness was not. These data may be of interest to policymakers investigating adoption patterns of new surgical technology.</p>","PeriodicalId":45220,"journal":{"name":"Urology Practice","volume":" ","pages":"391-400"},"PeriodicalIF":1.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732375","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":"Neda Qosja, Aaron C Spaulding, Dorin T Colibaseanu, Andrew J Zganjar, Shalmali R Borkar, Ram A Pathak, Timothy D Lyon","doi":"10.1097/UPJ.0000000000000821","DOIUrl":"10.1097/UPJ.0000000000000821","url":null,"abstract":"","PeriodicalId":45220,"journal":{"name":"Urology Practice","volume":"12 4","pages":"400"},"PeriodicalIF":1.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477232","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":"Gregory Raster, Parth K Modi","doi":"10.1097/UPJ.0000000000000817","DOIUrl":"10.1097/UPJ.0000000000000817","url":null,"abstract":"","PeriodicalId":45220,"journal":{"name":"Urology Practice","volume":"12 4","pages":"399"},"PeriodicalIF":1.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477231","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":"Reza Ghavamian","doi":"10.1097/UPJ.0000000000000812","DOIUrl":"10.1097/UPJ.0000000000000812","url":null,"abstract":"","PeriodicalId":45220,"journal":{"name":"Urology Practice","volume":"12 4","pages":"379"},"PeriodicalIF":1.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477228","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}