Risk Factors for Empiric Treatment Failure in US Female Outpatients with Uncomplicated Urinary Tract Infection: an Observational Study.

Background: Treatment failure (TF) in uncomplicated urinary tract infection (uUTI) increases disease burden and risk of antimicrobial resistance. Identification of risk factors for TF could inform empiric treatment decisions and reduce suboptimal outcomes.

Objective: To evaluate the incidence of TF to empirically prescribed oral antibiotics and identify risk factors for TF in females with uUTI in the United States (US).

Likelihood of Antimicrobial Resistance in Urinary E. coli Isolates Among US Female Patients with Recurrent Versus Non-Recurrent uUTI.

Objective: To assess the relative likelihood of antimicrobial resistance (AMR) and multi-drug resistance (MDR) among E. coli isolates from outpatients with recurrent versus non-recurrent uncomplicated urinary tract infection (uUTI).

Methods: In this retrospective observational US cohort study, female outpatients (≥12 years) with uUTI, positive E.

New avenue of diagnostic stewardship: procedural stewardship for recurrent urinary tract infections in female patients.

Introduction: Societal guidelines offer a weak recommendation to perform cystoscopy for female patients with recurrent urinary tract infections (rUTI) of advanced age and/or with high-risk features. These guidelines lack the support of robust data and are instead based on expert opinion. In this retrospective cohort study, we aim to determine the utility of cystoscopy in patients with and without high-risk features for rUTI.

Female urethral condyloma acuminata mimicking urethral caruncle.

Condyloma acuminata are epidermal lesions caused by the human papillomavirus (HPV) most commonly affecting the anogenital region. Urethral involvement is uncommon, and may mimic other urethral lesions. In this case report, a 62-year-old patient presents with what was believed to be a urethral caruncle and underwent successful resection with the final pathologic diagnosis of urethral condyloma.

Validation of the best practice policy statement on urodynamic antibiotic prophylaxis for the high-risk patient in the era of antibiotic stewardship.

Aims: To validate the recommendations of the Society of Urodynamics, Female Pelvic Medicine, and Urogenital Reconstruction (SUFU) 2017 Best Practice Policy Statement (BPPS) for Urodynamic Antimicrobial Prophylaxis in high-risk patients.

Methods: After institutional review board approval, 489 patients who underwent urodynamics (UDS) in the absence of antibiotic prophylaxis were retrospectively reviewed. Patients were stratified according to the SUFU BPPS risk factors (neurogenic lower urinary tract dysfunction [NLUTD], elevated postvoid residual [PVR], immunosuppression, age over 70, catheter use, and orthopedic implants).

Transvaginal Mesh Placement and the Instructions for Use: A Survey of North American Urologists.

Introduction: Since the issue of the FDA (Food and Drug Administration) Public Health Notification in 2008 regarding complications associated with the use of transvaginal surgical mesh for pelvic organ prolapse and stress urinary incontinence, multimillion dollar litigation has been brought against the companies that have manufactured these products. One component of the litigation has focused on risk information provided in the Instructions for Use document provided with each mesh kit. In this study we evaluated the types of urologists using transvaginal mesh kits and their use of the Instructions for Use provided with each mesh kit.

How I Do It: Techniques to avoid complications in transvaginal mesh surgery.

This article details recommendations on minimizing complications in pelvic floor reconstruction using mesh. It is designed to incorporate real world experience from an expert urologist in female pelvic floor reconstruction with medical literature and prevailing theories.

Transabdominal Robot-Assisted Laparoscopic Urethral Diverticulectomy of a Complex Anterior Horseshoe Diverticulum of the Proximal Urethra.

Complex, proximal, anteriorly located urethral diverticula present the reconstructive urologist with a uniquely challenging task for repair through a conventional transvaginal approach. Herein, we present the first report of urethral diverticulectomy to excise a large, anterior, horseshoe-shaped urethral diverticulum that resulted in bladder outlet obstruction, using a transabdominal robot-assisted laparoscopic approach.

A rare presentation of nephrogenic adenoma: multiple upper tract lesions in a female patient.

Nephrogenic adenomas are rare benign lesions of the urinary tract occurring most frequently in the bladder of male patients. We report the case of a female patient presenting with gross hematuria, which lateralized to the left ureter on cystoscopy. At the time of ureteroscopy, two polypoid lesions were identified in an upper and lower pole calyx, which were found on biopsy to be nephrogenic adenomas.

Female sexual dysfunction in urological patients: findings from a major metropolitan area in the USA.

Objective: To determine the prevalence of and risk factors for female sexual dysfunction (FSD) in a practice focused mainly on female urology.

Patients And Methods: A modified version of the Female Sexual Function Index (FSFI) was used to assess the prevalence of FSD in 587 patients who completed the questionnaire. Logistic regression was used to identify risk factors.

Endoscopic management of vesicoureteral reflux in women presenting with pyelonephritis.

Purpose: Vesicoureteral reflux is not usually considered a major cofactor in acute pyelonephritis in women. However, there is a subset of individuals in whom reflux must be considered in the evaluation of acute pyelonephritis. We sought to evaluate the effectiveness of endoscopic treatment for vesicoureteral reflux in this subset of patients.

Evaluation of the incidentally discovered adrenal mass.

The increased use of abdominal ultrasonography, computed tomography, and magnetic resonance imaging has led to the classification of adrenal lesions termed the incidentally identified adrenal mass or adrenal incidentaloma. Unlike for the large, clinically, or biochemically symptomatic adrenal mass, the evaluation of patients with small, asymptomatic, or nonfunctional adrenal lesions remains controversial. The evaluation of these adrenal incidentalomas presents a challenge to endocrinologists, radiologists, and urologic surgeons alike.

PSA response to finasteride challenge in men with a serum PSA greater than 4 ng/ml and previous negative prostate biopsy: preliminary study.

Objectives: To determine, in a prospective study, the prostate-specific antigen (PSA) response to finasteride challenge in men with a serum PSA greater than 4 ng/mL who had undergone previous biopsy. Patients with a serum PSA level greater than 4 ng/mL who have undergone repeated prostate biopsy with prostate cancer (CaP) that was not detected present a diagnostic dilemma. The magnitude of PSA reduction after administration of finasteride has been well documented.

Simultaneous multiple double pigtail stents for malignant ureteral obstruction.

Ureteral obstruction caused by extrinsic compression from pelvic malignancies often persists after ureteral stent placement. We describe a new technique and present our experience with the simultaneous placement of two ipsilateral ureteral stents after simple stenting has failed.