Canadian Urological Association journal = Journal de l'Association des urologues du Canada最新文献

{"title":"A prospective evaluation of patient perspectives and financial considerations during prostate cancer treatment decision-making.","authors":"Karnvir S Rai,&nbsp;Uday Mann,&nbsp;Oksana Harasemiw,&nbsp;Navdeep Tangri,&nbsp;Amanda Eng,&nbsp;Premal Patel,&nbsp;Jasmir G Nayak","doi":"10.5489/cuaj.8228","DOIUrl":"10.5489/cuaj.8228","url":null,"abstract":"<p><strong>Introduction: </strong>In universal healthcare systems, patients may still encounter financial obstacles from cancer treatments, potentially influencing treatment decision-making. We investigated the relationship between socioeconomic status and treatment decision-making as it pertains to patient values, preferences, and perceived barriers to care for localized prostate cancer.</p><p><strong>Methods: </strong>We conducted a prospective study of patients undergoing a prostate biopsy for the initial detection of prostate cancer. Sociodemographic variables were collected, with validated instruments used to determine health literacy levels. Patients were divided into two groups using self-reported income; those with a positive identification of prostate cancer underwent additional surveys to ascertain their knowledge of their diagnosis, treatment-related preferences, and socioeconomic barriers to care. Descriptive statistics were used.</p><p><strong>Results: </strong>Of 160 patients, approximately one-third were classified as having low health literacy. Within the low-income group, education levels were lower (34.6% had less than high school education vs. 10.2% in the high-income group) and unemployment rates higher (75.0% unemployed vs. 38.9% in the high-income group). Low-income patients with prostate cancer placed greater importance on indirect out-of-pocket expenses related to treatment (78.3% vs. 33.3%, p=0.001), higher emphasis on treatment-related travel time (50% vs. 15.1%, p=0.004), and more often had difficulty paying for healthcare services in the past (30.9% vs. 9.1%, p=0.02).</p><p><strong>Conclusions: </strong>Patients with lower household incomes have unique treatment values and decision-making preferences. They may experience additional challenges and barriers to obtaining cancer care, at least partly related to indirect costs. These findings should be considered when framing prostate cancer treatment discussions and designing patient-facing health information.</p>","PeriodicalId":9574,"journal":{"name":"Canadian Urological Association journal = Journal de l'Association des urologues du Canada","volume":" ","pages":"E244-E251"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10544398/pdf/cuaj-9-e244.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9827398","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":"Techniques - 14 Fr super-mini PCNL: How we do it.","authors":"Thomas Fonseka,&nbsp;Alberto Melchionna,&nbsp;Nicolo De Luyk,&nbsp;Vimoshan Arumuham,&nbsp;Simon Choong","doi":"10.5489/cuaj.8308","DOIUrl":"10.5489/cuaj.8308","url":null,"abstract":"","PeriodicalId":9574,"journal":{"name":"Canadian Urological Association journal = Journal de l'Association des urologues du Canada","volume":" ","pages":"E284-E287"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10544406/pdf/cuaj-9-e284.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9827399","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":"Evaluation of Canadian urology residency and fellowship program websites.","authors":"Nicolas Siron,&nbsp;David Bouhadana,&nbsp;Ryan Schwartz,&nbsp;Claudia Deyermendjian,&nbsp;Marie-Lyssa Lafontaine,&nbsp;François Cossette,&nbsp;Mehr Jain,&nbsp;David-Dan Nguyen,&nbsp;Kevin C Zorn,&nbsp;Faisal Khosa,&nbsp;Dean S Elterman,&nbsp;Bilal Chughtai,&nbsp;Naeem Bhojani","doi":"10.5489/cuaj.8292","DOIUrl":"10.5489/cuaj.8292","url":null,"abstract":"INTRODUCTION\u0000There is growing use of online resources in the postgraduate medical education application process to provide applicants program-specific details, thus allowing for informed decision-making. Given the variability and non-standardized electronic training descriptions and objectives, our goal was to assess the availability of program information through program websites for both residency and fellowship urology programs across Canada.\u0000\u0000\u0000METHODS\u0000Using the Canadian Residency Matching Service (CaRMS) and the Canadian Urological Association (CUA) websites, we compiled a list of all Canadian urology residency and fellowship programs. We reviewed all programs' website using a 40-item tool based on seven subcategories, including education, application process, faculty information, trainee/fellow information, research and extra-curricular activities, wellness, and both benefits and career planning. Each website was reviewed by two trained reviewers. Any inter-reviewer discrepancy was resolved by a third-party reviewer.\u0000\u0000\u0000RESULTS\u0000Among 13 Canadian urology residency programs, all had program websites and met 48% of the criteria evaluated. None of the residency program websites reported information on work hours, surgical caseload statistics, or equity diversity and inclusion/community initiatives. Among 37 Canadian urology fellowship programs, 10 programs did not have websites, and the remaining 27 program websites met 28% of the criteria evaluated. Scores were highest for the application process subcategory, while scores were lowest for the wellness and benefits/career planning subcategories among both residency and fellowship programs.\u0000\u0000\u0000CONCLUSION\u0000With growing reliance and dependence on web resources to access residency and fellowship program information, there is a clear need to standardize and improve Canadian training websites for prospective applicants.","PeriodicalId":9574,"journal":{"name":"Canadian Urological Association journal = Journal de l'Association des urologues du Canada","volume":" ","pages":"E291-E296"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10544403/pdf/cuaj-9-e291.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9827400","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":"Holmium laser enucleation of prostate in nonagenarians and octogenarians Impact of age and frailty on surgical outcomes.","authors":"Mohamed Elsaqa,&nbsp;Yu Zhang,&nbsp;Marawan M El Tayeb","doi":"10.5489/cuaj.8211","DOIUrl":"10.5489/cuaj.8211","url":null,"abstract":"<p><strong>Introduction: </strong>Holmium laser enucleation of the prostate (HoLEP) is a well-established technique for management of benign prostatic hyperplasia (BPH). With the growing aging population, a considerable percentage of octogenarians (80-90 years old) and nonagenarians (>90 years old) require surgical management for BPH. We aimed to assess the outcomes of HoLEP in those age groups.</p><p><strong>Methods: </strong>We reviewed a maintained database for HoLEP patients in a tertiary center. Patients were assigned to two groups: above (group A) and below (group B) 80 years old. Perioperative outcome and postoperative followup data were compared between both groups.</p><p><strong>Results: </strong>The study included 1090 patients, 201 and 889 in groups A and B, respectively. Median age was 83 and 70 years in groups A and B, respectively. Group A showed longer operative time, longer catheterization time, and higher 30-day emergency room visits and readmission rates. Hemoglobin drop was comparable, although associated with higher rate of blood transfusion in group A. Overall, 30-day postoperative complications were higher in group A (20.8% vs. 9.3%, p=0.008), although the majority of complications in both groups were grade I and II. The rate of complications over Clavien-Dindo grade II were statistically comparable (3.4% vs. 1.79%, p=0.133). Followup at six weeks, three months, and one year showed comparable functional outcomes in both groups.</p><p><strong>Conclusions: </strong>HoLEP is a safe and effective option in the geriatric population of octogenarians and even nonagenarians. HoLEP is associated with higher overall complication rate in older age groups; however, most complications were minor.</p>","PeriodicalId":9574,"journal":{"name":"Canadian Urological Association journal = Journal de l'Association des urologues du Canada","volume":" ","pages":"E263-E268"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10544397/pdf/cuaj-9-e263.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9882036","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":"Case - Vas deferens injury after herniorrhaphy leading to epididymal blowout in a pediatric patient.","authors":"Joshua White,&nbsp;Wyatt MacNevin,&nbsp;Rodrigo L P Romao,&nbsp;Daniel Keefe","doi":"10.5489/cuaj.8316","DOIUrl":"10.5489/cuaj.8316","url":null,"abstract":"","PeriodicalId":9574,"journal":{"name":"Canadian Urological Association journal = Journal de l'Association des urologues du Canada","volume":" ","pages":"E288-E290"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10544396/pdf/cuaj-9-e288.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9827405","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":"Case series - Liver injury during percutaneous nephrolithotomy.","authors":"Mimi V Nguyen,&nbsp;Jonathan H Berger,&nbsp;Alec R Flores,&nbsp;Tony T Chen,&nbsp;Joseph Yared,&nbsp;Vernon Pais,&nbsp;Benjamin Chew,&nbsp;Mitchell R Humphreys,&nbsp;Karen L Stern,&nbsp;Roger L Sur","doi":"10.5489/cuaj.8291","DOIUrl":"10.5489/cuaj.8291","url":null,"abstract":"","PeriodicalId":9574,"journal":{"name":"Canadian Urological Association journal = Journal de l'Association des urologues du Canada","volume":" ","pages":"E297-E301"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10544404/pdf/cuaj-9-e297.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9826959","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":"The severity of renal colic pain: Can it be predicted?","authors":"Emin Taha Keskin,&nbsp;Muammer Bozkurt,&nbsp;Harun Özdemir,&nbsp;Ramazan Uğur,&nbsp;Metin Savun,&nbsp;Merve Şam Özdemir,&nbsp;Cemal Topal,&nbsp;Halil Lütfi Canat","doi":"10.5489/cuaj.8283","DOIUrl":"10.5489/cuaj.8283","url":null,"abstract":"<p><strong>Introduction: </strong>We aimed to determine whether there was a relationship between the perception of renal colic pain and different psychosocial and physiological factors.</p><p><strong>Methods: </strong>Between May 2021 and July 2022, we prospectively analyzed 320 patients over the age of 18 who were diagnosed with renal colic occurring unilaterally and secondary to a single kidney stone of any size. Body mass index (BMI), education level, hospital anxiety and depression scale (HADS), somatosensory amplification scale (SAS), and the visual analog scale (VAS) features of stone (diameter, Hounsfield value, and localization) and degree of hydronephrosis were analyzed. Correlation analysis of VAS score and these parameters were completed with Spearman's test. The regression analysis was used to determine the predictive factors of severe pain.</p><p><strong>Results: </strong>There was no significant difference found between sex and VAS scores of colic pain (p=0.122). We found a significant correlation between VAS score and localization of kidney stone, degree of hydronephrosis, and anxiety level of patients. High grade of hydronephrosis and high anxiety level were found to be associated with high VAS scores (p<0.001 and p=0.035, respectively). It was shown that SAS and level of depression did not correlate with pain. Only a high degree of hydronephrosis was found to be a predictive factor for severe pain (p<0.01).</p><p><strong>Conclusions: </strong>The patient's high anxiety level and a high degree of hydronephrosis were positively correlated with renal colic pain caused by kidney stones. With this study, the severity of pain in patients with a high degree of hydronephrosis and high anxiety can be predicted and may be a criteria to select suitable treatment to reach faster response.</p>","PeriodicalId":9574,"journal":{"name":"Canadian Urological Association journal = Journal de l'Association des urologues du Canada","volume":" ","pages":"E257-E262"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10544401/pdf/cuaj-9-e257.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9827397","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":"Methods to increase equity, diversity, and inclusion in Canadian urology programs.","authors":"Levi Godard,&nbsp;Julie Wong,&nbsp;Christopher Nguan","doi":"10.5489/cuaj.8224","DOIUrl":"https://doi.org/10.5489/cuaj.8224","url":null,"abstract":"<p><strong>Introduction: </strong>Women and ethnic minorities are underrepresented at all levels of training and practice in urology residency programs. Equity, diversity, and inclusion (EDI) is a growing field of interest in medical research and business literature, especially regarding recruitment. The objective of this review was to evaluate evidence-based strategies to increase EDI to improve urology residency recruitment.</p><p><strong>Methods: </strong>A review was conducted using Ovid Medline to identify publications reporting strategies to increase women and underrepresented minorities (URM ) in healthcare fields. An evaluation of business models was incorporated. Identified strategies were sorted and ranked based on how many papers reported an increased proportion of women or URM in their program following implementation.</p><p><strong>Results: </strong>We assessed 234 publications from 1972-2022. Eleven underwent full review. Six additional pieces of business literature were reviewed and incorporated. The following methods were most often identified to increase diversity: mentorship and holistic application review (six publications), as well as funded internship programs and diverse selection committees (four publications). Diversity statements and application blinding were highlighted by multiple business sources but were each only reviewed in one medical publication.</p><p><strong>Conclusions: </strong>Recommendations identified include mentorship, holistic application review by diverse selection committees with bias training, and development of funded internship programs. Standardized questions and rubrics were also well-studied. Business strategies, such as publishing diversity statements and application blinding, are less studied in medical education literature. This study is unique in its inclusion of both medical and business literature and highlights concrete strategies for urology residency programs to increase EDI during recruitment.</p>","PeriodicalId":9574,"journal":{"name":"Canadian Urological Association journal = Journal de l'Association des urologues du Canada","volume":"17 8","pages":"255-262"},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10426422/pdf/cuaj-8-255.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10387758","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":"More son, less doctor.","authors":"","doi":"10.5489/cuaj.8503","DOIUrl":"https://doi.org/10.5489/cuaj.8503","url":null,"abstract":"","PeriodicalId":9574,"journal":{"name":"Canadian Urological Association journal = Journal de l'Association des urologues du Canada","volume":"17 8","pages":"S170"},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10426423/pdf/cuaj-8-S170.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10012164","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":"CUA azoospermia guideline: An important resource for physicians.","authors":"Matthew Roberts","doi":"10.5489/cuaj.8474","DOIUrl":"https://doi.org/10.5489/cuaj.8474","url":null,"abstract":"","PeriodicalId":9574,"journal":{"name":"Canadian Urological Association journal = Journal de l'Association des urologues du Canada","volume":"17 8","pages":"241"},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10426429/pdf/cuaj-8-241.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10387746","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}