Cuaj-Canadian Urological Association Journal最新文献_第5页

Promoting wellness in urology residency programs: Moving beyond tokenism.

IF 1.9 4区医学

Cuaj-Canadian Urological Association Journal Pub Date : 2025-02-24 DOI: 10.5489/cuaj.9076

Rahim Dhalla, Jason Y Lee, Yonah Krakowsky

引用次数: 0

Using real-world, population-level data to assess the uptake of active surveillance for low-grade prostate cancer before and after the release of clinical guidelines.

IF 1.9 4区医学

Cuaj-Canadian Urological Association Journal Pub Date : 2025-02-24 DOI: 10.5489/cuaj.9019

Douglas C Cheung, Lisa J Martin, Narhari Timilshina, Maria Komisarenko, Patrick O Richard, Shabbir M H Alibhai, Jonathan Sussman, Nicole Mittmann, Antonio Finelli

{"title":"Using real-world, population-level data to assess the uptake of active surveillance for low-grade prostate cancer before and after the release of clinical guidelines.","authors":"Douglas C Cheung, Lisa J Martin, Narhari Timilshina, Maria Komisarenko, Patrick O Richard, Shabbir M H Alibhai, Jonathan Sussman, Nicole Mittmann, Antonio Finelli","doi":"10.5489/cuaj.9019","DOIUrl":"https://doi.org/10.5489/cuaj.9019","url":null,"abstract":"Introduction: Clinical guidelines recommend active surveillance (AS) as the preferred strategy for men with localized grade group (GG) 1 prostate cancer (PCa). We determined if the percentage of GG1 PCa patients in Ontario, Canada, managed by AS changed after the introduction of AS clinical guidelines and assessed adherence to the recommended followup protocol.Methods: Using Ontario administrative databases, we conducted time series analysis (autoregressive integrated moving average [ARIMA] models) in a population-based cohort of men diagnosed with GG1 PCa (2010-2018). Men were classified as managed by AS if they had repeat (confirmatory) biopsy within two years. Sensitivity analyses (treatment classification variation) and secondary analyses (low-risk GG1 and GG2 PCa) were conducted.Results: We identified 12 236 eligible GG1 PCa patients, of which 7749 (63.3%) were initially managed by AS. Percentage AS increased from 44% in 2010 to 82% in 2018. Interrupted time series analysis estimated an immediate step change of 6.2 percentage points (95% confidence interval [CI] 3.0, 9.4) and a difference in slope of -2.3 percentage points (95% CI -6.9, 2.3) per year. Findings were robust to sensitivity analyses and similar for low-risk PCa. Adherence to monitoring and AS uptake in GG2 patients were not associated with guideline publication. Limitations include lack of treatment intent information in administrative data.Conclusions: The use of AS for low-grade PCa patients in Ontario increased from almost one in two patients in 2010 to four in five patients in 2017/2018. Adoption appeared to reflect the growing acceptance of AS prior to the guidelines, as well as an increase in response to the guideline introduction.","PeriodicalId":50613,"journal":{"name":"Cuaj-Canadian Urological Association Journal","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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

Association of absolute amount of pattern 4 disease on prostate biopsy with oncologic outcomes in intermediate-risk prostate cancer: A systematic review. 前列腺活检第 4 型疾病的绝对数量与中危前列腺癌的肿瘤学预后的关系：系统综述。

IF 1.9 4区医学

Cuaj-Canadian Urological Association Journal Pub Date : 2025-02-24 DOI: 10.5489/cuaj.8995

Melissa Sam Soon, Scott C Morgan, Luke T Lavallee, Rodney H Breau, Trevor A Flood, Mark T Corkum

{"title":"Association of absolute amount of pattern 4 disease on prostate biopsy with oncologic outcomes in intermediate-risk prostate cancer: A systematic review.","authors":"Melissa Sam Soon, Scott C Morgan, Luke T Lavallee, Rodney H Breau, Trevor A Flood, Mark T Corkum","doi":"10.5489/cuaj.8995","DOIUrl":"https://doi.org/10.5489/cuaj.8995","url":null,"abstract":"Introduction: Managing intermediate-risk prostate cancer (IRPC) is challenging due to the heterogeneity in patient outcomes within this risk category. Evaluating the absolute amount of Gleason pattern 4 disease (GP4) at biopsy using the total linear length of pattern 4 (GP4-TL) or absolute percentage of pattern 4 (APP4) may enhance risk stratification. This review aimed to determine if these absolute measures predict oncologic outcomes in IRPC and to identify optimal prognostic thresholds.Methods: A systematic review was conducted following PRISMA guidelines. Studies included were those reporting the absolute amount of GP4 on biopsy and related outcomes in IRPC patients undergoing surgery or radiotherapy. Outcomes included biochemical recurrence, androgen deprivation therapy (ADT)-free survival, distant metastasis, prostate cancer-specific mortality, all-cause mortality, and adverse pathology.Results: Seven studies with a total of 2523 patients were included. Analysis revealed that APP4 thresholds were highly predictive of biochemical recurrence, ADT-free survival, and distant metastasis. Both APP4 and GP4-TL were superior to relative %GP4 and Gleason grading (4+3 vs. 3+4) in predicting disease progression and mortality.Conclusions: The absolute amount of GP4 shows consistent associations with important clinical outcomes and offers an accessible and established method to enhance risk stratification. Further research is needed to define optimal thresholds to guide treatment decisions.","PeriodicalId":50613,"journal":{"name":"Cuaj-Canadian Urological Association Journal","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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

Assessing complications from retroperitoneal lymph node dissection for testicular cancer in North America.

IF 1.9 4区医学

Cuaj-Canadian Urological Association Journal Pub Date : 2025-02-24 DOI: 10.5489/cuaj.9042

Mithun Kailavasan, Jesus Cendejas, Melissa J Huynh, Brant A Inman, Nicholas Power

{"title":"Assessing complications from retroperitoneal lymph node dissection for testicular cancer in North America.","authors":"Mithun Kailavasan, Jesus Cendejas, Melissa J Huynh, Brant A Inman, Nicholas Power","doi":"10.5489/cuaj.9042","DOIUrl":"https://doi.org/10.5489/cuaj.9042","url":null,"abstract":"Introduction: Retroperitoneal lymph node dissection (RPLND) is a procedure of significant therapeutic and diagnostic value in the management of testicular cancer. This study aimed to conduct a contemporary review of surgical outcomes following RPLND procedures performed in North America over the last decade.Methods: We queried the National Surgical Quality Improvement Program (NSQIP) database from 2012-2022 (n=9 857 040) to identify patients who underwent RPLND and were diagnosed with testicular cancer. The primary outcome was 30-day morbidity. Secondary outcomes included time-to-complication analysis, rate of additional organ resection, hospital length of stay (LOS), and readmission rates. Binomial logistic regression and a generalized linear model were used to identify risk factors associated with 30-day morbidity and LOS.Results: A total of 513 RPLND procedures met the inclusion criteria. The median age was 30 years (interquartile range [IQR] 24-36.50) with a body mass index of 27.9 kg/m2 (IQR 24.5- 32.0). There were no deaths within 30 days. The overall 30-day morbidity rate was 17% (n=86). Bleeding/transfusion postoperatively (12%), return to the operating room (3%), and superficial surgical site infection (2%) were the three most common complications. Factors associated with increased 30-day morbidity included: history of smoking (odds ratio [OR] 2.5, 95% confidence interval [CI] 1.35-4.68) and concurrent vascular repair/reconstruction (OR 4.1, 95% CI 1.12-15.46). The median LOS was four days (IQR 3- 6) and the 30-day readmission rate was 7.0%.Conclusions: This study underscores that approximately one in six patients experience complications following RPLND in North America. Identifying the timing of and risk factors for these complications can improve physician-patient communication and overall care.","PeriodicalId":50613,"journal":{"name":"Cuaj-Canadian Urological Association Journal","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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

Prostate cancer screening in transgender patients: Why current Canadian screening policies need to be better tailored to our patients.

IF 1.9 4区医学

Cuaj-Canadian Urological Association Journal Pub Date : 2025-02-24 DOI: 10.5489/cuaj.9005

David-Dan Nguyen, Ihtisham Ahmad, Zizo Al-Daqqaq, Laura C Rosella, Amanda Hird, Christopher J D Wallis, Ethan D Grober, Aisha Lofters, Girish S Kulkarni, Alexandra Millman, Yonah Krakowsky

引用次数: 0

Does type of anesthesia during procedural management of suspected renal colic during pregnancy have an impact on preterm birth? 妊娠期疑似肾绞痛手术治疗过程中的麻醉类型对早产有影响吗？

IF 1.9 4区医学

Cuaj-Canadian Urological Association Journal Pub Date : 2025-02-01 DOI: 10.5489/cuaj.8886

Louisa Ho, Madison Lyon, Alec J Sun, Anup B Shah, Natalia C Llarena, Carrie Bennett, James F Bena, Sri Sivalingam, Anna M Zampini, Smita De

{"title":"Does type of anesthesia during procedural management of suspected renal colic during pregnancy have an impact on preterm birth?","authors":"Louisa Ho, Madison Lyon, Alec J Sun, Anup B Shah, Natalia C Llarena, Carrie Bennett, James F Bena, Sri Sivalingam, Anna M Zampini, Smita De","doi":"10.5489/cuaj.8886","DOIUrl":"10.5489/cuaj.8886","url":null,"abstract":"Introduction: Anesthesia choice during the procedural management of suspected renal colic during pregnancy may vary based on available resources and patient or provider preferences, as there are no specific recommendations. Our objective was to evaluate whether preterm birth (<37 weeks) was associated with anesthesia type, anesthesia timing by trimester, or procedure type.Methods: We retrospectively identified pregnant patients who required procedural management with ureteral stent, percutaneous nephrostomy (PCN), or ureteroscopy (URS) for suspected renal colic based on laboratory and imaging findings from 2009-2021 at our center. Analyzed data included anesthesia type (local analgesia only, monitored anesthesia care [MAC], spinal anesthesia, or general anesthesia), trimester of procedure, procedure type, and obstetric outcomes, including preterm birth.Results: The study cohort included 96 patients who underwent 231 total procedures, including primary URS, PCN, and stent, as well as PCN and stent change. The median gestational age was 38.7 weeks (37.1-39.5), and preterm birth rate was 15.8%. The most common anesthetic used across all procedures and trimesters was MAC. PCN was associated with the use of less invasive analgesia or anesthesia, whereas endoscopic procedures were more commonly performed with spinal or general anesthesia. Using multivariable logistic regression, procedure type was associated with preterm birth, but not anesthesia type or timing by trimester.Conclusions: Anesthesia type and timing were not associated with preterm birth, and selection may be influenced by resources, clinical scenario, or patient and provider preferences.","PeriodicalId":50613,"journal":{"name":"Cuaj-Canadian Urological Association Journal","volume":" ","pages":"10-16"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11819859/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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

The impact of informed decision-making on prostate cancer survivorship.

IF 1.9 4区医学

Cuaj-Canadian Urological Association Journal Pub Date : 2025-02-01 DOI: 10.5489/cuaj.9107

David-Dan Nguyen, Christopher J D Wallis

引用次数: 0

Does the cobbler always wear the worst shoes? Sexuality of urologists in training. 泌尿科实习医生的性取向：鞋匠总是穿最差的鞋吗？性 AFUF 研究。

IF 1.9 4区医学

Cuaj-Canadian Urological Association Journal Pub Date : 2025-02-01 DOI: 10.5489/cuaj.8882

Gautier Stempfer, Emilien Seizilles de Mazancourt, Philippe Mollard, Juliette Cotte, Gaelle Margue, Arthur Peyrottes, William Berchiche, Alice Pitout, Pierre-Luc Dequirez, Benoit Mesnard, Guillaume Joussen, Vassily Anastay, Stephan Levy, Claire Deleuze, Anna Goujon, Denis Seguier, Fayek Taha, Georges Mjaess, Kevin Kaulanjan

{"title":"Does the cobbler always wear the worst shoes? Sexuality of urologists in training.","authors":"Gautier Stempfer, Emilien Seizilles de Mazancourt, Philippe Mollard, Juliette Cotte, Gaelle Margue, Arthur Peyrottes, William Berchiche, Alice Pitout, Pierre-Luc Dequirez, Benoit Mesnard, Guillaume Joussen, Vassily Anastay, Stephan Levy, Claire Deleuze, Anna Goujon, Denis Seguier, Fayek Taha, Georges Mjaess, Kevin Kaulanjan","doi":"10.5489/cuaj.8882","DOIUrl":"10.5489/cuaj.8882","url":null,"abstract":"Introduction: Sexuality is an integral part of well-being. Urologists are a population faced with a significant workload and stress that can affect their sexuality. The purpose of this study was to investigate sexuality in this population and assess factors that may impact it.Methods: A cross-sectional study was conducted between May and July 2023 among French urology residents and fellows. Data was collected through an anonymous questionnaire sent by the French Association of Trainee Urologists (AFUF) via email.Results: Out of 445 members of the AFUF, 196 trainee urologists responded. Among them, 130 (66%) respondents were satisfied with their sexual life, and 123 (63%) reported having one or more sexual encounters per week. In univariate analysis, factors significantly impacting the level of sexual satisfaction were gender (p=0.029), level of job satisfaction/well-being (p<0.01), level of professional burnout (p<0.001), and the existence of a romantic relationship.Conclusions: Young urologists are mostly satisfied with their sexual life. Gender, level of job satisfaction/well-being, and level of professional burnout are significant factors impacting the level of sexual satisfaction.","PeriodicalId":50613,"journal":{"name":"Cuaj-Canadian Urological Association Journal","volume":" ","pages":"49-52"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11819853/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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

Patterns of failure with ¹⁸F-DCFPyL PSMA-PET/CT in the post-prostatectomy setting A regional cohort analysis. 前列腺切除术后18F-DCFPyL PSMA-PET/CT的失败模式：地区队列分析。

IF 1.9 4区医学

Cuaj-Canadian Urological Association Journal Pub Date : 2025-02-01 DOI: 10.5489/cuaj.8859

Samantha Sigurdson, Khalid Al Salman, Aruz Mesci, Ian Dayes, Kimmen Quan, Mira Goldberg, Kara Schnarr, Bobby Shayegan, Glenn Bauman, Katherine Zukotynski, Theodoros Tsakiridis, Himu Lukka

{"title":"Patterns of failure with 18F-DCFPyL PSMA-PET/CT in the post-prostatectomy setting A regional cohort analysis.","authors":"Samantha Sigurdson, Khalid Al Salman, Aruz Mesci, Ian Dayes, Kimmen Quan, Mira Goldberg, Kara Schnarr, Bobby Shayegan, Glenn Bauman, Katherine Zukotynski, Theodoros Tsakiridis, Himu Lukka","doi":"10.5489/cuaj.8859","DOIUrl":"10.5489/cuaj.8859","url":null,"abstract":"Introduction: This study aimed to assess the detection rate of prostate cancer recurrence by prostate-specific member antigen-positron emission tomography/computed tomography (PSMA-PET/CT) with 18F-DCFPyL in patients with residual disease or biochemical recurrence (BCR), and its association with surgical pathology and prostate-specific antigen (PSA) kinetics.Methods: Men from South Central Ontario enrolled in the PSMA Registry for Recurrent Prostate cancer (PREP) between April 2019 and December 2021 after radical prostatectomy (RP) and who had 1) pathologic stage N1 or persistent elevated PSA; or 2) BCR (PSA ≥0.10 ng/mL) where initial postoperative PSA was undetectable were included.Results: A total of 169 men (median age 68 years; interquartile range [IQR] 62-71) with complete data met the above criteria. The median PSA was 0.27 ng/mL (IQR 0.16-0.85) prior to PSMA-PET. Overall positivity rate 59%; when PSA was <0.40 ng/mL, overall positivity rate 42% vs. 85% with PSA ≥0.40 ng/mL (p<0.001). Higher pathologic tumor stage increased detection of regional lymph nodes (LNs) (pT2-3a: 32% vs. pT3b: 69%, p<0.001) but not distant metastases (pT2-3a: 12% vs. pT3b: 24%, p=0.15). PSMA-PET detected 18% with prostate bed, 42% with regional LN disease, and 44% with pelvic-only disease. The three most involved LN chains were the internal (21%) and external (20%) iliac, and obturator chains (16%).Conclusions: This prospective study of patients with residual disease or BCR after RP illustrates patterns of failure that could impact diagnosis and postoperative management. Such patients have significant risk of regional LN positivity on PSMA-PET, highlighting a need to include pelvic LNs within salvage radiotherapy volumes.","PeriodicalId":50613,"journal":{"name":"Cuaj-Canadian Urological Association Journal","volume":" ","pages":"17-24"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11819851/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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

Evaluating trends in radical prostatectomy approach and 30-day complication rate in Ontario from 2010-2019. 评估 2010-2019 年安大略省根治性前列腺切除术方法和 30 天并发症发生率的趋势。

IF 1.9 4区医学

Cuaj-Canadian Urological Association Journal Pub Date : 2025-02-01 DOI: 10.5489/cuaj.8636

Nickan Motamedi, Andrew McClure, Nicholas Power, Stephen Pautler, Lilian Gien, Blayne Welk, Jacob McGee

{"title":"Evaluating trends in radical prostatectomy approach and 30-day complication rate in Ontario from 2010-2019.","authors":"Nickan Motamedi, Andrew McClure, Nicholas Power, Stephen Pautler, Lilian Gien, Blayne Welk, Jacob McGee","doi":"10.5489/cuaj.8636","DOIUrl":"10.5489/cuaj.8636","url":null,"abstract":"Introduction: Radical prostatectomy (RP) for prostate cancer has changed over the years with the advent of minimally invasive (MIRP) approaches, which includes robotic-assisted RP (RARP). The MIRP approaches have been shown to reduce complication rate, but there remain barriers to adoption. The objective of this study was to quantitatively describe the trend in the RP approach in Ontario, and to assess the trend in complication rates.Methods: We conducted a population-based, retrospective cohort study including all men who underwent RP for prostate cancer in Ontario from 2010-2019. We used administrative data from Ontario's health databases to gather surgical outcome data. Our primary outcomes were the annualized frequency of RP by surgical approach and annualized 30-day composite complication rate.Results: In total, 22 118 patients were included in the analysis over the study period. There was a trend away from retropubic (RRP) frequency over the study period (80.3% of cases in fiscal year [FY] 2010 to 55.6% in FY 2018) and towards RARP approach (6.8% of cases in FY 2010 and 36.7% in FY 2018). The most common complication was blood transfusion at 6.26%, which saw a downtrend over the study period (7.96% FY 2010, 3.47% FY 2018). The odds ratio for 30-day complication for open RP compared to MIRP was 1.74 (95% confidence interval 1.57-1.92, p<0.001).Conclusions: In Ontario, there has been a steady shift away from RRP and towards RARP. Minimally invasive approaches portend a significantly lower complication rate, likely driven by a lower blood transfusion rate.","PeriodicalId":50613,"journal":{"name":"Cuaj-Canadian Urological Association Journal","volume":" ","pages":"42-48"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11819857/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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