Publications by authors named "Chandler D Dora"
Objective: To determine if using spinal anesthesia (SA) for holmium laser enucleation of the prostate (HoLEP) impacted the ability to perform same-day discharge (SDD) compared to a prostate volume-matched cohort undergoing HoLEP under general anesthesia (GA).
Methods: From January 1, 2021 to March 28, 2024, 995 men underwent HoLEP by a single surgeon. Three hundred eleven were identified who had SA and a recorded preoperative prostate volume.
Background Multiparametric MRI can help identify clinically significant prostate cancer (csPCa) (Gleason score ≥7) but is limited by reader experience and interobserver variability. In contrast, deep learning (DL) produces deterministic outputs. Purpose To develop a DL model to predict the presence of csPCa by using patient-level labels without information about tumor location and to compare its performance with that of radiologists.
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- In 2012, the USPSTF classified PSA screening for prostate cancer as "category D," leading to a study on the effects of this change on metastatic prostate cancer (mPCa) diagnoses among different racial, ethnic, and socioeconomic groups.
- The study used data from 2004 to 2017 and found that post-recommendation, there was an increase in mPCa cases at diagnosis, especially among Hispanics and non-Hispanic Blacks.
- Factors like insurance status and household income significantly influenced the likelihood of presenting with mPCa, with uninsured minorities facing higher risks and low-income non-Hispanic Blacks showing increased rates of diagnosis.
Objective: To compare outcomes in males given perioperative tranexamic acid (TXA) during holmium laser enucleation of the prostate (HoLEP) to a historical cohort that did not receive TXA.
Methods: Our cohort included HoLEP patients (N = 1037) from August 2018 through November 2022. Exclusion criteria included history of stroke, transient ischemic attack, or coronary stent placed within 18 months.
Purpose: To determine whether the early apical release (EAR) technique for holmium laser enucleation of the prostate (HOLEP) is associated with improved perioperative outcomes compared to the En-bloc no touch (EBNT) technique.
Methods: Consecutive men treated with HOLEP by a single surgeon from August 2018 to March 2021 were identified. Beginning in June 2021 all procedures were performed using the EAR technique, and these were compared to the preceding cases done with the EBNT technique.
Few series exist in the literature of holmium laser enucleation of the prostate (HoLEP) after prostatic urethral lift (PUL). Even less well known are potential complications seen after a patient undergoes PUL followed by HoLEP. We present our case of a unique clinical finding of a PUL clip and suture found in the urethra of a patient after HoLEP.
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- The study investigates the effectiveness of MRI-guided transurethral ultrasound ablation (TULSA) for treating low- and intermediate-risk prostate cancer, comparing two bladder drainage methods: suprapubic tube (SPT) and indwelling urethral catheter (UC).
- In a retrospective analysis of 45 men, researchers found that while UC patients had fewer days with a catheter, they experienced more lower urinary tract symptoms one month after the procedure, although overall urinary outcomes were similar between both methods after six months.
- The findings indicate that both SPT and UC are viable options for postoperative management, with similar rates of urinary complications, but differences in patient experiences, particularly regarding urinary bother
Objective: To evaluate factors influencing fixed operating room time during holmium laser enucleation of the prostate.
Materials And Methods: A prospective observational study was performed for all holmium laser enucleation of the prostate (HoLEP) cases performed by a single surgeon over a 24-month period. Operating room (OR) time was divided into fixed and variable time.
Objective: To evaluate the impact of coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2, on operating room (OR) efficiency for urologic procedures using the concept of fixed OR times.
Patients And Methods: Over a 24-month period, urology OR data were prospectively collected. Operations were divided into fixed and variable time points.
To analyze operating room (OR) efficiency by evaluating fixed OR times for three common urologic robot-assisted procedures. Over a 24-month period, we prospectively collected intraoperative data for 635 consecutive robot-assisted surgeries. Fixed (nonprocedural) OR times were evaluated for robot-assisted partial nephrectomy (RAPN) ( = 146), robot-assisted radical cystectomy (RARC) ( = 77), and robot-assisted radical prostatectomy (RARP) ( = 412).
View Article and Find Full Text PDFObjective: To determine if transition zone (TZ) volume as measured by magnetic resonance imaging (MRI) correlates closely with specimen weight and postoperative prostate-specific antigen (PSA) and to determine if this correlation improved with increased experience. We hypothesize that information from a preoperative MRI can be leveraged to self-assess competency in holmium laser enucleation of the prostate (HoLEP).
Methods: From August 2018 to June 2021 567 men were identified who underwent HoLEP by a single surgeon and had their data entered into a database.
Purpose: Previously published studies have shown small prostate size, capsular perforation and intraoperative bladder distension are associated with failed trial without a catheter (TWOC) after HoLEP. The study objective was to determine the relationship between MOSES pulse modulation versus standard laser technology and short-term catheter reinsertion following failed TWOC.
Materials And Methods: The study included 487 patients who underwent HoLEP, using standard holmium laser settings (180 patients) or MOSES pulse modulation (255 patients), between August 2018 and February 2021.
Objective: To determine if there is an association between patient body habitus as measured by body mass index (BMI), body surface area (BSA), preoperative prostate volume, postoperative specimen weight, and open conversion with cystotomy or perineal urethrotomy (PU) during holmium laser enucleation of the prostate (HoLEP). We attempt to provide meaningful criteria to assist in preoperative patient counseling.
Materials And Methods: Three hundred consecutive patients underwent HoLEP between August 3, 2018 and February 20, 2020 by a single surgeon.
Objective: To determine if preoperative catheter dependence or specimen weight is associated with failed trial without catheter (TWOC) following holmium laser enucleation of the prostate (HoLEP).
Material And Methods: The study population consisted of 143 consecutive men who underwent HoLEP by a single surgeon over 10 months. Ten were excluded from analysis because they did not have a TWOC on the morning following surgery.
Objective: To demonstrate the surgical considerations for managing retained UroLift implants when performing HOLEP. Prostatic Urethral Lift via the UroLift System has become a common treatment modality to manage symptoms associated with benign prostatic hyperplasia. The UroLift procedure uses nonabsorbable implants to retract obstructing prostate lobes.
View Article and Find Full Text PDFObjectives: To provide pathologic evidence, using six different sling materials, of the findings from rabbit model studies demonstrating loss of tensile strength and stiffness in porcine and cadaveric sling materials.
Methods: Ten rabbits randomized into two survival groups (6 and 12 weeks of age) each had human cadaveric fascia, porcine dermis, porcine small intestine submucosa, polypropylene mesh, and autologous fascia implanted on their anterior rectus fascia. At harvest, hematoxylin-eosin and immunohistochemical staining for CD3, CD20, and MIB-I were performed.
Purpose: We investigated time dependent variations in tensile strength, stiffness, shrinkage and distortion in 6 materials commonly used for transvaginal anti-incontinence surgery.
Materials And Methods: A total of 15 rabbits were randomized into 3 survival groups (2, 6 and 12 weeks, respectively). Each rabbit had human cadaveric fascia, porcine dermis, porcine small intestine submucosa, polypropylene mesh and autologous fascia implanted on the anterior rectus fascia.