Rural Versus Urban Genitourinary Cancer Incidence and Mortality in Pennsylvania: 1990-2019.

Our aim was to describe the incidence and mortality of genitourinary (GU) cancers in rural and urban Pennsylvania counties. We calculated age-adjusted incidence and mortality rates of GU (prostate, bladder, and kidney) cancers from 1990 to 2019 in the Pennsylvania Cancer Registry. We defined rurality using the Center for Rural Pennsylvania's population density-based definition.

Artificial Intelligence can Facilitate Application of Risk Stratification Algorithms to Bladder Cancer Patient Case Scenarios.

Background: Chat Generative Pre-Trained Transformer (ChatGPT) has previously been shown to accurately predict colon cancer screening intervals when provided with clinical data and context in the form of guidelines. The National Comprehensive Cancer Network (NCCN) guideline on non-muscle invasive bladder cancer (NMIBC) includes criteria for risk stratification into low-, intermediate-, and high-risk groups based on patient and disease characteristics. The aim of this study is to evaluate the ability of ChatGPT to apply the NCCN Guidelines to risk stratify theoretical patient scenarios related to NMIBC.

Prior Negative Biopsy, PSA Density, and Anatomic Location Impact Cancer Detection Rate of MRI-Targeted PI-RADS Index Lesions.

Background: MRI fusion prostate biopsy has improved the detection of clinically significant prostate cancer (CSC). Continued refinements in predicting the pre-biopsy probability of CSC are essential for optimal patient counseling. We investigated potential factors related to improved cancer detection rates (CDR) of CSC in patients with PI-RADS ≥ 3 lesions.

Getting it Across the Finish Line - Publication Rates of Abstracts Presented at a Major Urologic Conference.

Objective: To identify characteristics of published manuscripts following a regional American Urological Association (AUA) meeting and recognize trends of publication rates over a 13-year timeframe.

Methods: Abstract submissions to the Mid-Atlantic AUA (MA-AUA) conference from 2008 to 2020 were collected. Manuscripts were searched using abstract titles and authors in a standard fashion using PubMed, Google Scholar, and Google.

27-year trends in incidence rates for testis cancer across a large statewide registry.

Purpose: To review 27-years of testicular cancer (TC) incidence data (1990-2017) within the state of Pennsylvania to better define incidence, geographic distribution, and trends over time.

Methods: The Pennsylvania Cancer Registry was reviewed for statewide and component county age-adjusted TC incidence rates and stage distribution. We reported annual percent changes (APCs) in age-adjusted rates.

The state of telehealth: 2 years into the COVID-19 pandemic - back to business as usual?

Introduction: Telemedicine (TM) was underutilized prior to the COVID-19 pandemic presumably due to non-standardized reimbursement routes and a perceived lack of need. Early experience with the pandemic necessitated this form of medical care, although durability of consistent delivery remains in question. We quantify the utilization patterns of TM over the past 2 years over multiple waves of the pandemic across various service lines in a large rural health system.

Synchronous melanosis of upper and lower urinary tract.

Urothelial melanosis is an exceptionally rare diagnosis, with less than 25 cases being reported in the literature. Melanosis of the urothelium is characterized by abnormal melanin deposition within tissues, producing a black, velvety appearance to the urothelial mucosa. We present a 67-year-old male undergoing cystoscopy during a routine percutaneous nephrolithotomy (PCNL), who was found to have diffuse bladder melanosis extending up the ureter and into the renal pelvis.

Non-infectious complications following transrectal prostate needle biopsy - Outcomes from over 8000 procedures.

Background: Prostate needle biopsy (PNB) remains the referent standard for diagnosing prostate cancer. Contemporary data highlight an increase in PNB-related infections particularly when performed transrectally. Non-infectious complications, however, may similarly contribute to biopsy-related morbidity.

Incidence and Distribution of New Renal Cell Carcinoma Cases: 27-Year Trends from a Statewide Cancer Registry.

Nationwide databases have implicated an increased incidence of renal cell carcinoma (RCC). The Pennsylvania (PA) Cancer Registry was queried to better define incidence, geographic distribution, and statewide trends of new RCC cases over a 27-year period. JoinPoint Trend Analysis Software modeled average annual percent changes (APCs) in age-adjusted rates (AAR).

Risk of Fatigue and Anemia in Patients With Prostate Cancer Treated With Novel Oral Anti-androgens: A Meta-Analysis of Randomized Controlled Trials.

Novel oral anti-androgens (NOAAs) represent a new class of drugs that are being approved for prostate cancer. However, fatigue and anemia are among the most common treatment-related symptoms. Hence, we conducted a meta-analysis of randomized controlled trials (RCTs) to investigate the relative risks (RRs) of fatigue and anemia associated with NOAAs.

The Optimal Parathyroid Hormone Cut-Off Threshold for Early and Safe Management of Hypocalcemia After Total Thyroidectomy.

Objective: To define optimal intact parathyroid hormone (iPTH) cut-off threshold predictive of hypocalcemia after total thyroidectomy for safe and effective postoperative management.

Methods: This prospective single center study was done in 2 phases. In phase I, predictors of symptomatic hypocalcemia were analyzed and the receiver operating characteristic curve was used to define the optimal iPTH cut-off threshold predictive of hypocalcemia.

Network Analysis of Postoperative Surgical Complications in a Cohort of Children Reported to the National Surgical Quality Improvement Program: Pediatric.

Objective: To understand the temporal relationships of postoperative complications in children and determine if they are related to each other in a predictable manner.

Summary Of Background Data: Children with multiple postoperative complications have increased suffering and higher risk for mortality. Rigorous analysis of the temporal relations between complications, how complications might cluster, and the implications of such clusters for children have not been published.

Pure Bladder Malignant Rhabdoid Tumor Successfully Treated With Partial Cystectomy, Radiation, and Chemotherapy: A Case Report and Review of the Literature.

Background: Extracranial pure malignant rhabdoid tumors (MRT) are aggressive tumors that carry a poor prognosis. Bladder MRTs are very rare and only 8 cases have been reported previously.

Observation: We present a case of a child with bladder MRT.

Nonstented Tubularized Incised Plate Distal Hypospadias Repair: A Single Center 5 Years' Experience.

Objectives: To report our immediate and delayed outcomes of nonstented tubularized incised plate (TIP) distal hypospadias repair.

Methods: We retrospectively reviewed all charts of children who underwent distal hypospadias repair in a single children's hospital from 2013 to 2018. Patients' demographics, hypospadias characteristics, operative technique, and immediate and delayed outcomes were recorded.

Inappropriate imaging for management of cryptorchidism: Has the choosing Wisely® recommendation reduced occurrence?

Introduction: Cryptorchidism is one of the most common referral diagnoses to pediatric urologists. It is well recognized in the urologic community that diagnostic imaging is unnecessary in the work-up of these patients, and the Choosing Wisely® recommendation (CWR) on this subject re-emphasized this in 2013. Many boys, however, still are sent for testing prior to referral.

Alpha-dystroglycan staining pattern and mortality in patients undergoing radical prostatectomy with lymph node positive prostate cancer.

Introduction: Dystroglycan (DG) is a cell surface receptor for extracellular matrix proteins involved in tissue mechanical stability and matrix organization. Initial work has demonstrated that alpha-DG expression is decreased in many types of adenocarcinoma, including prostate, and potentially associated with the development of metastatic disease. However, the consistency between prostate and lymph node alpha-DG staining has not been previously reported.

Circumcision, Buried Penis and Obesity in a Contemporary Cohort of Patients with Penile Cancer.

Introduction: We reviewed patient demographics and body morphology in a contemporary cohort of patients presenting to a tertiary care center for treatment of penile cancer.

Methods: The University of Iowa Oncology Registry was retrospectively reviewed for cases of penile cancer managed between 2006 and 2016. The database was queried for cancer specific details, followed by a chart review for body morphology data and comorbidity status.

Trends in Operating Room Assistance for Major Urologic Surgical Procedures: An Increasing Role for Advanced Practice Providers.

Objective: To characterize changes in surgical assistance patterns over time for commonly performed urologic operations.

Materials And Methods: This study used the Medicare Physician/Supplier Procedure Summary Master File to identify cases performed by urologists from 2003 to 2014. Current Procedural Terminology modifiers were used to identify operations assisted by second surgeons and advanced practice providers (APPs).

The accuracy of multi-detector row computerized tomography in staging rectal cancer compared to endoscopic ultrasound.

Background/aim: Our aim was to evaluate the diagnostic accuracy of multi-detector row computerized tomography (MDCT) in staging of rectal cancer by comparing it to rectal endoscopic ultrasound (EUS).

Materials And Methods: We prospectively included all patients with rectal cancer referred to our gastroenterology unit for staging of rectal cancer from December 2007 until February 2011, 53 patients whose biopsy had proven rectal cancer underwent both MDCT scan of the pelvis and rectal EUS. Both imaging modalities were compared and the agreement between T- and N-staging of the disease was assessed.