Safety and efficacy of ultrasound-assisted bedside ureteric stent placement A prospective, single-institution study.

Introduction: Previous studies have demonstrated the feasibility of bedside placement of ureteric stents; however, they have traditionally required two skilled operators and were associated with some stent malposition especially for proximal ureteric obstruction. We sought to investigate the efficacy and safety of a modified technique for ultrasound-assisted bedside ureteric stent insertion without the presence of a skilled assist.

Methods: A single institution prospective study was performed from April-August 2023.

Do you want to be a urologist? Gender differences for medical student perception of urology.

Introduction: Gender inequality has been prevalent in the history of medicine, specifically within surgical specialties. Though there have been advances, urology has remained overwhelmingly male-dominant, with slow growth in female recruitment. This survey study evaluated whether gender-related differences in the perception of urology are present among future applicants that could account for gender disparity seen in recruitment.

Evaluating Patient Tolerability for Urological Procedures Under Conscious Sedation: A Prospective Study.

Objective: To prospectively evaluate patient-reported tolerability and surgical outcomes of urologic procedures with conscious sedation with or without local anesthesia. Administration of general or spinal anesthesia is associated with anesthetic-related complications, long wait times, and high costs. Using intravenous conscious sedation and/or local anesthesia is an emerging alternative for a myriad of urologic procedures.

Ultrasound-Only Percutaneous Nephrolithotomy Is Safe and Effective Compared to Fluoroscopy-Directed Percutaneous Nephrolithotomy.

Outcomes after ultrasound-only percutaneous nephrolithotomy (PCNL), in which no fluoroscopy is used, are not well known. The goal of this study was to compare outcomes of ultrasound-only and fluoroscopy-directed PCNL. Prospectively collected data from the Registry for Stones of the Kidney and Ureter database were reviewed for all patients who underwent PCNL at one academic center from 2015 to 2021.

Maternal family history of urolithiasis is associated with earlier age of onset of stone disease.

Purpose: To evaluate the impact of detailed family history on the severity of disease and age of onset in patients with urolithiasis.

Methods: Prospectively collected data from a single institution between October 2015 and December 2020 were analyzed. Our primary endpoint was the number of patients experiencing at least one recurrent stone during the follow-up period.

Single-Use Ureteroscopes Are Associated with Decreased Risk of Urinary Tract Infection After Ureteroscopy for Urolithiasis Compared to Reusable Ureteroscopes.

Urinary tract infection (UTI) is a common complication after ureteroscopy. Despite sterilization, there is evidence that reusable ureteroscopes can still harbor bacteria. Whether this property is associated with increased risk of UTI is unknown.

Ambulatory percutaneous nephrolithotomy is safe and effective in patients with extended selection criteria.

Introduction: Ambulatory percutaneous nephrolithotomy (PCNL) has been limited to highly selected patients. The objective of our study was to compare complication and stone-free rates after ambulatory PCNL in standard selection criteria vs. extended criteria patients.

Increased risk of new persistent opioid use in pediatric and young adult patients with kidney stones.

Introduction: Adolescents and young adults are a vulnerable patient population for development of substance use disorder. However, the long-term impact of opioid prescribing in young adult patients with renal colic is not known. Our objective was to describe rates of opioid prescription and identify risk factors for persistent opioid use in patients age 25 years or younger with renal colic from kidney stones.

Association of vesicoureteral reflux and gastroesophageal reflux disease in children: A population-based study.

Introduction: Practitioners have anecdotally hinted at a possible association between gastroesophageal reflux disease (GERD) and vesicoureteral reflux (VUR). We sought to identify an association in diagnosis between GERD and VUR using a population-based dataset in a well-defined geographic area covered by a single-payer healthcare system.

Methods: A retrospective review of individuals aged 0-16 years registered in the Nova Scotia Medical Service Insurance database from January 1997 to December 2012 was completed.

Anesthetic technique and oncological outcomes in urology: A clinical practice review.

Introduction: There is increasing awareness that different anesthetic and analgesic techniques may impact outcomes after oncological surgery, generally through modifying effects on the immune system but potentially via other mechanisms including mitigating the surgical stress response. This narrative review aims to summarize the mechanisms underlying the effect of perioperative factors on oncological outcomes, with an emphasis on the available urologic literature.

Methods: Literature on anesthetic technique (i.

Persistent Opioid Use Among Patients with Urolithiasis: A Population based Study.

Background: Urolithiasis can result in acute, short-lived pain for which opioids are often prescribed. The risk of persistent opioid use following an initial presentation for urolithiasis is unknown.

Objective: To describe rates of opioid prescription and identify risk factors for persistent opioid use among patients with urolithiasis.

Evaluation of inter-professional communication and leadership skills among graduating Canadian urology residents.

Introduction: The importance of developing inter-professional communication and leadership skills among residents is well-recognized; however, formal tools to assess these skills are lacking. The goal of our study was to assess the leader and communicator roles in graduating urology residents using a validated self-assessment form developed for business students that focuses on inter-professional skills.

Methods: Chief residents (n=36) were evaluated with surveys of communication and leadership skills.

Growth rates and outcomes of observed large renal masses.

Introduction: The natural history of small renal masses has been well defined, leading to the recommendation of active surveillance in some patients with limited life expectancy. However, this information is less clear for large renal masses (LRM), leading to ambiguity for management in the older, comorbid patient. The objective of this study was to define the natural history, including the growth rate and metastatic risk, of LRM in order to better counsel patients regarding active surveillance.

The X-Y factor: Females and males with urological chronic pelvic pain syndrome present distinct clinical phenotypes.

Introduction: Urological chronic pelvic pain syndrome (UCPPS) in females is often attributed to the bladder (interstitial cystitis/ bladder pain syndrome), while UCPPS in males is often attributed to the prostate (chronic prostatitis/chronic pelvic pain syndrome). However, there is increasing awareness that bladder pain plays a role in both males and females and the degree of overlap of clinical characteristics in males and females with UCPPS is not well known. Our objective was to compare clinical phenotypes of females and males with UCPPS.

Attitudes of graduating Canadian urology residents on the job market: Is it getting better or are we just spinning our wheels?

Introduction: There has been increasing awareness of employment difficulties for physicians, especially surgeons, in Canada over the past few years. Our objective was to elucidate the attitudes and experiences of graduating Canadian urology residents in obtaining employment.

Methods: We surveyed four separate cohorts of graduating urology residents in 2010, 2011, 2016, and 2017.

Spinal Anesthesia is Associated with Lower Recurrence Rates after Resection of Nonmuscle Invasive Bladder Cancer.

Purpose: We sought to determine whether anesthetic type (general vs spinal) would influence cancer recurrence following transurethral resection of bladder tumors.

Materials And Methods: With institutional ethics board approval we examined the electronic medical records of all patients who underwent transurethral bladder tumor resection for nonmuscle invasive urothelial bladder cancer between 2011 and 2013 at a single tertiary care center. Followup information was gathered on all patients in December 2016.

Overactive Bladder and Storage Lower Urinary Tract Symptoms Following Radical Prostatectomy.

Objective: To describe the rate of overactive bladder (OAB) and storage lower urinary tract symptoms following radical prostatectomy (RP) and determine if subsequent radiation increases the risk of OAB.

Methods: We reviewed all patients who underwent open RP at our tertiary care institution from January 2006 to June 2011. Primary outcomes were the proportion of patients with new OAB and time to development of OAB in those treated with RP alone vs RP plus radiation.

Transient ischemic attack: management in the emergency department and impact of an outpatient neurovascular clinic.

Objectives: 1) To evaluate whether transient ischemic attack (TIA) management in emergency departments (EDs) of the Nova Scotia Capital District Health Authority followed Canadian Best Practice Recommendations, and 2) to assess the impact of being followed up in a dedicated outpatient neurovascular clinic.

Methods: Retrospective chart review of all patients discharged from EDs in our district from January 1, 2011 to December 31, 2012 with a diagnosis of TIA. Cox proportional hazards models, Kaplan-Meier survival curve, and propensity matched analyses were used to evaluate 90-day mortality and readmission.

Acquired hemophilia A: A rare cause of gross hematuria.

Acquired hemophilia A is a rare condition caused by spontaneous development of factor VIII inhibitor. This condition most commonly presents with multiple hemorrhagic symptoms and isolated hematuria is exceedingly rare. Early diagnosis is important, as this condition carries a high mortality rate (13-22%).