Rural For-Profit Hospitals Are Associated With Higher Commercial Prices for 3 Common Urological Procedures.

Introduction: Rural patients lack access to urological services, and high local prices may dissuade underinsured patients from surgery. We sought to describe commercially insured prices for 3 urological procedures at rural vs metropolitan and for-profit vs nonprofit hospitals.

Methods: A cross-sectional analysis of commercially insured prices from the Turquoise Health Transparency data set was performed for ureteroscopy with laser lithotripsy, transurethral resection of bladder tumor, and transurethral resection of prostate.

Association of Rural Hospital for-Profit Status With Higher Publicly Reported Prices for the Components of Inpatient Hematuria Evaluation Among Commercially Insured Patients.

Introduction: Rural patients have limited access to urological care and are vulnerable to high local prices. Little is known about price variation for urological conditions. We aimed to compare reported commercial prices for the components of inpatient hematuria evaluation between for-profit vs not-for-profit and rural vs metropolitan hospitals.

The LEGO™ Exercise: An Assessment of Core Competencies in Urology Residency Interviews.

Background: In competitive residency specialties such as Urology, it has become increasingly challenging to differentiate similarly qualified applicants. Residency interviews are utilized to rank applicants, yet they are often biased and do not explicitly address ACGME core competencies.

Objective: We hypothesized a team-based exercise in the urology residency interview centered on building LEGOs assesses core competences.

No-Shows in Adult Urology Outpatient Clinics: Economic and Operational Implications.

Introduction: We analyzed trends and explored implications of no-show rates in adult urology from provider related characteristics at an academic program.

Methods: No-show rates were determined from electronic health records of appointments in adult urology at Duke University Medical Center and affiliated clinics between January 2014 and December 2016. t-Test, Wilcoxon rank sum and ANOVA were employed.

Improving Resident and Nurse Communication Practices: Results of a Collaborative Culture Initiative.

Introduction: Paging is a critical modality for urgent hospital communication. We sought to improve overnight nurse paging practices to reduce noncritical pages, improve resident sleep practices and create a team approach to patient care between residents and overnight nursing staff.

Methods: Residents, overnight urology nurses and a communications liaison met during 2 overnight sessions in October 2014 to develop a training curriculum for overnight paging, which consisted of a paging protocol based on page urgency, and batching nonurgent communication into a cluster page.

Outcomes of Ureteroscopic Stone Treatment in Patients With Spinal Cord Injury.

Objective: To evaluate the association of clinical factors on outcomes in patients with spinal cord injury (SCI) undergoing ureteroscopy. Immobility, recurrent urinary tract infection, and lower urinary tract dysfunction contribute to renal stone formation in patients with SCI. Ureteroscopy is a commonly utilized treatment modality; however, surgical complication rates and outcomes have been poorly defined.

The Urology Applicant: An Analysis of Contemporary Urology Residency Candidates.

Objective: To better understand today's urology applicant.

Methods: All 2016 Urology Residency Match applicants to the study-participating institutions were provided a survey via email inquiring about their paths to urology, their career aspirations, how they evaluate a training program, and how they perceive residency programs evaluate them.

Results: Of a possible 468 applicants registered for the match, 346 applicants completed the survey.

Determining Resident Sleep During and After Call With Commercial Sleep Monitoring Devices.

Objective: To demonstrate that commercial activity monitoring devices (CAMDs) are practical for monitoring resident sleep while on call. Studies that have directly monitored resident sleep are limited, likely owing to both cost and difficulty in study interpretation. The advent of wearable CAMDs that estimate sleep presents the opportunity to more readily evaluate resident sleep in physically active settings and "home call," a coverage arrangement familiar to urology programs.

Definitive Management of Failure After Pyeloplasty.

Introduction: Failure after pyeloplasty is difficult to manage. We report our experience managing pyeloplasty failures.

Methods: We retrospectively reviewed the case log of a single surgeon, from August 1996 to August 2014, to identify all patients undergoing a surgical procedure after failed pyeloplasty.

Duct Diameter and Size of Stones Predict Successful Extracorporeal Shock Wave Lithotripsy and Endoscopic Clearance in Patients With Chronic Pancreatitis and Pancreaticolithiasis.

Objectives: The need for endoscopic therapy before extracorporeal shock wave lithotripsy (SWL) to facilitate pancreatic duct stone removal is unclear. Predictive factors associated with successful fragmentation and subsequent complete duct clearance are variable. We hypothesize pancreatic duct strictures and large stones, but not pre-SWL endotherapy, correlate with successful fragmentation and complete duct clearance.

Experience with 45 Consecutive Patients with Neobladders Undergoing Retrograde Ureteroscopy for Upper Tract Abnormalities.

Introduction: In this study we reviewed the feasibility, technique, complications and outcomes of retrograde ureteroscopy in patients with orthotopic neobladders.

Methods: We retrospectively reviewed our retrograde ureteroscopic experience in patients with orthotopic ileal neobladder diversions. Data were collected and analyzed regarding patient characteristics, indications, technique, success and complications of the procedure.

Contemporary Practice Patterns of Flexible Ureteroscopy for Treating Renal Stones: Results of a Worldwide Survey.

Introduction: Flexible ureteroscopy (fURS) is increasingly used in the treatment of renal stones. However, wide variations exist in technique, use, and indications. To better inform our knowledge about the contemporary state of fURS for treating renal stones, we conducted a survey of endourologists worldwide.

Wire-reinforced ureteral stents to rescue from nephrostomy tube in extrinsic ureteral obstruction.

Introduction: Ureteral obstruction due to extrinsic compression is associated with significant morbidity and mortality. Management options for this condition include renal drainage with percutaneous nephrostomy (PCN) or internal ureteral stent placement. A significant portion of patients will have disease progression leading to internal stent obstruction which is almost uniformly managed with PCN.

Symptomatic subcapsular and perinephric hematoma following ureteroscopic lithotripsy for renal calculi.

Objective: Ureteroscopic lithotripsy (URSL) is believed to be associated with less risk of symptomatic renal hematoma than extracorporeal shockwave lithotripsy (SWL) and percutaneous nephrolithotomy (PCNL). We sought to document the rate of and risk factors for this rare complication following URSL for renal calculi.

Methods: With Institutional Review Board approval, we reviewed 1087 cases of URSL performed between July 2009 and October 2012 for four surgeons.