Cuaj-Canadian Urological Association Journal最新文献

{"title":"Impact of travel distance on short-term outcomes in patients receiving treatment for urolithiasis: A population-based study.","authors":"Danielle Jenkins, Greg Hosier, Marlo Whitehead, Darren Beiko, Thomas McGregor, Joseph Nashed, D Robert Siemens","doi":"10.5489/cuaj.8775","DOIUrl":"https://doi.org/10.5489/cuaj.8775","url":null,"abstract":"<p><strong>Introduction: </strong>We aimed to assess the relationship between the distance traveled to receive treatment for urolithiasis and early outcomes.</p><p><strong>Methods: </strong>This is a population-based study of patients who received interventions for urolithiasis in Ontario between 2003 and 2019 using administrative data. Patients were stratified into three groups according to the distance travelled. Descriptive statistics and the Chi-squared test were used to examine differences between these groups based on the urolithiasis treatment of choice. The primary outcomes were reoperation rates and readmission rates. To identify the factors associated with the co-primary outcomes, both univariate and multivariable logistic regression models were employed.</p><p><strong>Results: </strong>A total of 127 195 patients were included in the final analysis, with the majority of patients (n=100 124, 78.7%) having their stone procedure within 30 km from their residence, whereas 9586 patients (7.5%) travelled a distance greater than 90 km. Most of those that travelled >90 km were for extracorporeal shock wave lithotripsy (ESWL) (59%). Type of procedure and region of residence were the only variables that appeared to have a clinically relevant association with greater distance travelled. Unadjusted analysis suggested longer distance travelled was associated with a decrease in the need for a repeat procedure; however, this was likely confounded by an association between distance traveled and procedure type. In adjusted analysis, early post-procedure health resource use did not appear to be dramatically increased with greater distance from care. Indeed, readmission rates at 30 days were marginally lower among those who travelled 30-60 km vs. <30 km (odds ratio [OR] 0.86, 95% confidence interval [CI] 0.80-0.92, and had no detectable difference at >90 km vs. <30 km (OR 0.97, 95% CI 0.88, 1.08). These observations of fewer or no difference in readmissions and emergency visits for those that travelled the greatest distances generally held true in the subgroup analysis for each surgical procedure.</p><p><strong>Conclusions: </strong>This population-based study found no clinically remarkable associations between the distance travelled for urolithiasis treatment and early outcomes. In fact, some marginal decreases in resource use were observed with greater travel distance perhaps reflecting some effect of travel to higher volume referral centers or enhanced processes for those that needed to travel farther for care. This information could be important for clinicians to help appropriate counselling and health systems planning.</p>","PeriodicalId":50613,"journal":{"name":"Cuaj-Canadian Urological Association Journal","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523561","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}

{"title":"Practice patterns and predictors of treatment intensification in patients with metastatic castration-sensitive prostate cancer.","authors":"Geoffrey T Gotto, Steven M Yip, Bobby Shayegan, Dylan E O'Sullivan, Christopher J D Wallis, Naveen S Basappa, Ilias Cagiannos, Robert James Hamilton, Cristiano Ferrario, Ricardo Fernandes, Brita Danielson, Fred Saad, Sebastien J Hotte, Winson Y Cheung, Devon J Boyne, Katherine Chan, Brendan Osborne, Anousheh Zardan, Shawn Malone","doi":"10.5489/cuaj.8691","DOIUrl":"https://doi.org/10.5489/cuaj.8691","url":null,"abstract":"<p><strong>Introduction: </strong>Treatment intensification beyond androgen deprivation therapy (ADT) has shown survival benefit in patients with metastatic castration-sensitive prostate cancer (mCSPC). There is a need to better understand how these novel treatments fit in real-world practice.</p><p><strong>Methods: </strong>Using electronic medical records and administrative data, a population-based, retrospective cohort study of patients newly diagnosed with de novo mCSPC between 2010 and 2020 in Alberta, Canada, and initiated ADT was conducted. Treatment intensification was defined as the receipt of apalutamide, abiraterone acetate, enzalutamide, or chemotherapy (e.g., docetaxel) within 180 days of ADT initiation.</p><p><strong>Results: </strong>A total of 2515 de novo mCSPC were identified, with 2098 (83%) patients initiating ADT post-diagnosis. Of those, 525 (25%) received intensification beyond ADT. The percentage of patients who were intensified was 3% in 2010-2013 and gradually increased to 67% in 2020. From 2014-2017, docetaxel was the most commonly used approach, although it was supplanted by abiraterone acetate, apalutamide and enzalutamide from 2018 onwards. In multivariable logistic regression analyses of patients diagnosed from 2014-2020, significant predictors of intensification were younger age at diagnosis, lower Charlson comorbidity index, greater number of metastatic sites, shorter time to ADT initiation, referral to a medical oncologist, transurethral resection of the prostate or radiation prior to ADT, and more recent year of diagnosis (all p<0.05). Intensification increased for patients living in rural areas and with higher disease burden in 2018+ compared to 2014-2017.</p><p><strong>Conclusions: </strong>There has been a considerable increase in the use of ADT intensification therapies that correspond with the timing of clinical trial data and approvals of novel agents.</p>","PeriodicalId":50613,"journal":{"name":"Cuaj-Canadian Urological Association Journal","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523562","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}

{"title":"Case - Recurrent abscess and vaginal-thigh fistula from a transobturator mesh tape after COVID-19 vaccination.","authors":"Catherine Lu, Dobrochna Globerman, Ken Maslow","doi":"10.5489/cuaj.8847","DOIUrl":"https://doi.org/10.5489/cuaj.8847","url":null,"abstract":"","PeriodicalId":50613,"journal":{"name":"Cuaj-Canadian Urological Association Journal","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523532","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}

{"title":"Evaluating quality, understandability, and actionability of YouTube content for gender affirming surgery: Metoidioplasty.","authors":"Alexandra E Hunter, Reade A Otto-Moudry, Cynthia T Yusuf, Rena D Malik, Rachel A Moses","doi":"10.5489/cuaj.8872","DOIUrl":"https://doi.org/10.5489/cuaj.8872","url":null,"abstract":"<p><strong>Introduction: </strong>The purpose of this study is to evaluate YouTube content about metoidioplasty on completeness of perioperative information, actionability, understandability, degree of misinformation, quality, and presence of commercial bias.</p><p><strong>Methods: </strong>A YouTube search for \"Metoidioplasty\" was conducted and the first 100 video results were watched by five independent reviewers. Videos in English <30 minutes in length were included and videos primarily showing surgical footage were excluded. Videos were evaluated between January 2022 and June 2022. Each video was evaluated for presenter demographics, channel/video statistics, and whether it covered topics including anatomy, treatment options, outcomes, procedure risks, and misinformation, and whether it had a clickbait title. Calculated scores for validated DISCERN and Patient Education Materials Assessment Tool (PEMAT) metrics were the primary outcome variables used to quantify quality, actionability, and understandability. For PEMAT, a cutoff of 75% was used to differentiate between \"poor\" versus \"good/sufficient.\" Multivariate and univariate logistic regressions were performed to assess correlations among primary outcome variables and other variables.</p><p><strong>Results: </strong>Of the 79 videos analyzed, 24% (n=19) were of high quality; 99% (n=78) had poor understandability and 100% (n=79%) had poor actionability. Patients/consumers were the most common publisher type (n=71, 90%).</p><p><strong>Conclusions: </strong>This study demonstrates metoidioplasty content available on YouTube is not comprehensive and is of poor quality, and poor actionability and understandability, demonstrating a clear need for more relevant, accessible, comprehensible, and accurate content.</p>","PeriodicalId":50613,"journal":{"name":"Cuaj-Canadian Urological Association Journal","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523557","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}

{"title":"Case - The conservative management of staghorn stone patients: Evaluation of safety and clinical outcomes.","authors":"Anindyo Chakraborty, Hend Alshamsi, Iman Sadri, Nader Fahmy, Sero Andonian, Fadl A Hamouche","doi":"10.5489/cuaj.8786","DOIUrl":"https://doi.org/10.5489/cuaj.8786","url":null,"abstract":"","PeriodicalId":50613,"journal":{"name":"Cuaj-Canadian Urological Association Journal","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523533","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}

{"title":"Factors associated with the publication and impact of CUA abstracts over the last decade.","authors":"Zizo Al-Daqqaq, Zwetlana Rajesh, Ihtisham Ahmad, Ealia Khosh Kish, Haider Abed, Blayne Welk","doi":"10.5489/cuaj.8843","DOIUrl":"https://doi.org/10.5489/cuaj.8843","url":null,"abstract":"<p><strong>Introduction: </strong>The Canadian Urological Association's (CUA) annual meeting is the largest gathering of Canadian urologists, and many abstracts that are presented go on to be published as peer-reviewed papers. Our objective is to determine the publication rates and impact of these abstracts, and examine predictors associated with their publication.</p><p><strong>Methods: </strong>We identified abstracts presented at the 2010, 2013, 2014, 2015, 2018, 2020, and 2021 CUA meetings, and determined if there were matching manuscripts based on author and title using a comprehensive Medline search. Standardized data was extracted. Medians and interquartile ranges are presented, and regression models were used to determine factors associated with manuscript publication, journal impact factor, and time to publication.</p><p><strong>Results: </strong>There were 1732 CUA abstracts in our years of interest. The overall publication rate was 45.4%. Median journal impact factor was 2.27 for all published abstracts and time to publication was 13.2 months. Type of presentation was significantly associated with publication rate (p<0.001), with 63.7% of podiums, 46.7% of moderated posters, and 39.5% of unmoderated posters published. The median journal impact factor was 3.45 for published podiums, 2.19 for moderated posters, and 2.10 for unmoderated posters.</p><p><strong>Conclusions: </strong>Approximately 45% of CUA annual meeting abstracts are eventually published. The type of presentation correlates well with both publication and impact factor, suggesting the CUA review process and scientific program committee does a good job of judging abstract quality.</p>","PeriodicalId":50613,"journal":{"name":"Cuaj-Canadian Urological Association Journal","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523559","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}

{"title":"Images in urology - Novel reconstruction using a cutaneous transureterostomy diversion during robot-assisted radical cystectomy in a patient with crossed fused renal ectopia.","authors":"Joshua S Jue, Alvin C Goh","doi":"10.5489/cuaj.8815","DOIUrl":"https://doi.org/10.5489/cuaj.8815","url":null,"abstract":"","PeriodicalId":50613,"journal":{"name":"Cuaj-Canadian Urological Association Journal","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523560","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}

{"title":"Graduating resident and fellow readiness for general urologic practice during the COVID-19 pandemic A survey-based assessment of trainees and program directors.","authors":"Kyle Waisanen, Finn Hennig, Ellen Lutnick, Gaganjot Parmar, Daniel Baetzhold, Nathaniel Iskhakov, Kiana Saade, Matthew Peterson, Nader D Nader, Kent Chevli","doi":"10.5489/cuaj8639","DOIUrl":"10.5489/cuaj8639","url":null,"abstract":"<p><strong>Introduction: </strong>Our goal was to compare the perceived readiness of graduating urologic residents and fellows to program directors (PDs) in U.S.-based postgraduate training programs. Additionally, we set out to assess the impact of COVID-19 on postgraduation plans to pursue fellowship training.</p><p><strong>Methods: </strong>Graduating residents, fellows, and PDs of accredited residency/fellowship programs in the U.S. were surveyed. The ranked preparedness of trainees to perform common urologic procedures was measured using a Likert scale from 1 (not comfortable) to 5 (fully proficient). The impact of COVID-19 was measured using a three-point Likert scale. Chi-squared and Kruskal-Wallis analyses were used to compare the groups.</p><p><strong>Results: </strong>From 93 responders, 21 were residents, 19 were fellows, 24 were residency PDs, and 29 were fellowship PDs. The median levels of comfort for trans-urethral resection of the prostate, hydrocelectomy, vasectomy, and urethral sling were at or above (≥3) moderate for both PDs and trainees. PDs were more likely to report underperformance for hypospadias repair (60% vs. 39%), penile prosthesis implantation (39% vs. 26%), and orthotopic neobladder formation (57% vs. 18%) than the trainees. Fifty-three (57.0%) of the surveyors felt that COVID-19 did not impact the trainees' comfort in performing general urologic procedures. COVID-19 influenced trainees' decision to pursue a fellowship or opt to practice as general urologists (p=0.002).</p><p><strong>Conclusions: </strong>Our study suggests there may be a self-reported discrepancy between graduating trainees and their PDs regarding trainees' comfort levels performing general urologic procedures.</p>","PeriodicalId":50613,"journal":{"name":"Cuaj-Canadian Urological Association Journal","volume":"18 7","pages":"E212-E219"},"PeriodicalIF":1.9,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11286195/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141794024","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}

{"title":"Adult patients treated for bladder exstrophy at a young age What are their current demands?","authors":"Amélie Bazinet, Alya Filfilan, Nawel Mokhtari, Louis Lenfant, Alaa Elghoneimi, Emmanuel Chartier-Kastler","doi":"10.5489/cuaj8601","DOIUrl":"10.5489/cuaj8601","url":null,"abstract":"<p><strong>Introduction: </strong>Bladder exstrophy-epispadias complex is a rare condition that necessitates numerous surgical procedures during a patient's youth to achieve adequate urine storage and continence. This study aimed to identify the specific needs and functional challenges faced by adults who underwent pediatric bladder exstrophy reconstructions and assess the management of these issues in an adult population.</p><p><strong>Methods: </strong>A retrospective chart review was conducted for all bladder exstrophy complex patients who underwent surgery at a young age and were subsequently referred to our center between 2005 and 2020. Inclusion criteria included patients with cloacal or classical bladder exstrophy older than 18 years. We recorded the reasons for referral, management of contemporary complaints, types of past and present urinary reconstructions, and their current functional status.</p><p><strong>Results: </strong>The study included 38 patients. The primary reasons for referral were incontinence (39%) and catheterization difficulties (24%). Management typically involved partial or complete surgical revision of their urinary reservoir, occasionally combined with a bladder neck procedure. Ultimately, only three patients continued to experience incontinence, while none reported catheterization issues after undergoing treatment at our center. Long-term exstrophy-related reconstruction complications included urinary tract infections (39%), stones (29%), stenosis (24%), fistulas (13%), chronic renal disease (16%), metabolic abnormalities (3%), and cancer (3%).</p><p><strong>Conclusions: </strong>Adults who have previously undergone bladder exstrophy reconstruction exhibit a wide range of urologic reconstructions. Their needs often revolve around continence and catheterization concerns. Most patients with satisfactory functional outcomes perform self-catheterization through a continent cutaneous channel and have either a continent pouch or an augmented bladder.</p>","PeriodicalId":50613,"journal":{"name":"Cuaj-Canadian Urological Association Journal","volume":"18 7","pages":"E187-E193"},"PeriodicalIF":1.9,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11286191/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141794014","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}

{"title":"Cancer centers of excellence for the multidisciplinary management of urologic cancers The intersection between education, research, and healthcare.","authors":"Daniel Andrés Nieva-Posso, Philippe E Spiess, Herney Andrés García-Perdomo","doi":"10.5489/cuaj8655","DOIUrl":"10.5489/cuaj8655","url":null,"abstract":"<p><p>Urologic cancers are among the leading causes of morbidity and mortality in the world, representing more than 10% of the total number of new cancer cases worldwide. These complex diseases are linked to several issues related to their diagnosis, management, monitoring, and treatment - issues that require multidisciplinary solutions that encompass and manage patients as complex entities. In response to this, the so-called cancer centers of excellence (CCEs) emerged, defined as multidisciplinary institutions specialized in the diagnosis, management, monitoring, and treatment of specific diseases, including cancer. Different institutions, such as the European Association of Urology (EAU), have proposed and encouraged its consolidation, especially for the management of prostate cancer. These institutions must be composed of three areas: healthcare, education, and research, which have complementary interactions and relationships, stimulating research and problem-solving from a multidisciplinary approach and also covering elements of basic science and mental health. The implementation of these CCEs has generated positive results; therefore, it is necessary to stimulate their implementation with a uro-oncologic approach.</p>","PeriodicalId":50613,"journal":{"name":"Cuaj-Canadian Urological Association Journal","volume":"18 7","pages":"E240-E246"},"PeriodicalIF":1.9,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11286193/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141794015","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}