Delayed Morbidity Associated With Surgical Management of Urosymphyseal Fistula.

Objective: To characterize and identify factors associated with long-term morbidity of definitive urosymphyseal fistula (USF) treatment.

Methods: Retrospective chart review of a single institution database identified 57 patients who underwent operative treatment of USF between 2009 and 2022 with at least 90 days of follow-up. Delayed complications were considered those occurring ≥90 days following surgery.

Prostate volume on computed tomography correlates well with magnetic resonance imaging measurements and is reproducible across rater training levels.

Background: Data are lacking for the accuracy of computed tomography (CT) in measuring prostate size, which can streamline care and prevent invasive procedures. We evaluate agreement and intra/inter-observer variability in prostate sizing between CT and magnetic resonance imaging (MRI) planimetry for a wide range of gland sizes.

Methods: We retrospectively reviewed 700 patients who underwent MRI fusion biopsy at a single institution and identified 89 patients that had a CT within 2 years of the MRI.

Evaluation of an Opioid-free Pathway for Perineal Reconstructive Surgery: A 1-year Pilot Study.

Objective: To evaluate the impact of a standardized perioperative pain management pathway on postoperative opioid prescribing practices following male perineal reconstructive surgery at our institution.

Methods: Patients undergoing perineal reconstructive surgery (urethroplasty, artificial urinary sphincter, urethral sling) by a single surgeon from July 2022 to June 2023 were prospectively followed. A standardized nonopioid pathway was implemented in the perioperative period.

A novel technique for unilateral dissection of the penile neurovascular bundle to prevent loss of penile sensation during treatment of Peyronie's disease-Initial results of a pilot study.

Background: Plaque incision/excision and grafting are surgical techniques used to treat patients with Peyronie's disease who are refractory to less invasive interventions, have severe penile curvature, or have an hourglass deformity. However, the procedure carries the risk of penile sensory loss because of the need for dissection of the neurovascular bundle (NVB). The aim of this study was to assess the feasibility of a novel technique for unilateral NVB dissection and its ability to preserve penile sensitivity while maintaining adequate correction of the penile curvature.

Prediction of Incontinence after Robot-Assisted Radical Prostatectomy: Development and Validation of a 24-Month Incontinence Nomogram.

Incontinence after robot-assisted radical prostatectomy (RARP) is feared by most patients with prostate cancer. Many risk factors for incontinence after RARP are known, but a paucity of data integrates them. Prospectively acquired data from 680 men who underwent RARP January 2008-December 2015 and met inclusion/exclusion criteria were queried retrospectively and then divided into model development (80%) and validation (20%) cohorts.

Is There a Role for Prone Computed Tomography Before Percutaneous Nephrolithotomy?

The majority of percutaneous nephrolithotomies (PCNLs) are performed prone, whereas most preoperative CT scans are done supine. The purpose of this pilot study is to determine if there is utility of prone CT scans in preoperative planning for prone PCNL by identifying patient populations at risk for organ injury and tract length-related complications. To represent typical preoperative planning using CT, two-dimensional (2D)-axial-prone/supine percutaneous tract measurements were performed by minimizing the distance from the target calix to the posterior-lateral skin in a single axial plane.

Preoperative Modified Spermatic Cord Block Predicts Success in Candidates for Microscopic Spermatic Cord Denervation.

Objective: To examine the utility of a modified spermatic cord block (MSCB) that targets known contributors to refractory chronic scrotal content pain (CSCP) at predicting postoperative pain relief following a microscopic spermatic cord denervation (MSCD).

Methods: A MSCB was performed in all patients with refractory CSCP. This was performed by injecting anesthetic circumferentially around the vas deferens and over the external ring.