Simultaneous Bladder Drainage via Suprapubic and Urethral Catheters: Which Drains More Completely and Why?

Background: Reconstructive urologists often place both a urethral and suprapubic catheter intraoperatively to prevent extravasation of undrained urine across anastomosis sutures. As no consensus exists on which catheter drains the bladder more completely, many surgeons leave one catheter to gravity drainage and cap the other postoperatively. We sought to identify differences in catheter urine outflow during dual bladder drainage with suprapubic and urethral catheters in postoperative urology patients.

Robotic bilateral nephrectomy for large polycystic kidney disease.

Objective: This study aims to describe our technique and review our experience with synchronous robotic bilateral nephrectomy for large kidneys in ADPKD with the da Vinci XI and da Vinci Single Port platforms (Intuitive Surgical, Sunnyvale, CA).

Materials And Methods: We performed a retrospective review of all robotic bilateral nephrectomy cases from January 2020 to present at a high-volume robotic single centre. Demographic data and perioperative details including preoperative CT scans, indication for nephrectomy and renal function were collected.

Radium-223 Utilization Patterns and Outcomes in Clinical Practice.

Introduction: Radium-223 was approved for metastatic castration-resistant prostate cancer based on the ALSYMPCA trial. We characterize radium-223 treatment patterns and overall survival (OS) in a large equal access health system.

Methods: We identified all men within the Veterans Affairs (VA) Healthcare System who received radium-223 between January 2013 and September 2017.

Management and Outcomes of Ileal Pouch-Urethral Fistulas.

Objective: To describe a single-center experience with the management of ileal pouch-urethral fistulas (IPUF) following restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA).

Methods: We retrospectively identified patients with documented IPUF managed at our institution from a urethral fistula cohort and analyzed their cases.

Results: Thirteen patients who underwent surgeries for IPUF management from 2005-2022 were identified.

Single-Port, Robot-Assisted Transanal Harvest of Rectal Mucosa Grafts for Substitution Urethroplasty.

Objective: To describe a novel single-port, endorobotic technique for harvesting rectal mucosa grafts (RMGs) for urethral reconstruction.

Methods: A 57-year-old man with prior transurethral procedures developed recurrent obstructive voiding symptoms. Urethrography revealed a panurethral stricture, meatus to the bulbomembranous junction.

Temporal trends in the incidence of severe pelvic fracture urethral injuries in the United States from 1998 to 2014.

Object: To use a contemporary population-based cohort to investigate temporal trends in the national incidence of pelvic fracture urethral injuries (PFUIs) in the United States.

Methods: Using the NIS (National Inpatient Sample), we identified patients with a severe PFUI by a combination of an ICD-9 diagnosis code for pelvic fracture (808.xx) and ICD-9 procedure code for suprapubic tube (57.

Characteristics and Long Term Follow up of Men Who Suffer Ischemic Priapism Secondary to Recreational Use of Intracavernosal Injectable Medications.

Objective: To better understand patient experience, risk factors, culture, and ED outcomes surrounding recreational ICI use that led to ischemic priapism.

Methods: After IRB approval, men presenting for ischemic priapism secondary to recreational ICI use from January 2010 to December 2018 were contacted by mail and then via telephone. Standardized questions were asked of all study participants on the topics of erectile function (IIEF-5), sexual practices, and at-risk behavior at the time of priapism.

Adverse Events Associated With Synthetic Male Slings: An Analysis of the Food and Drug Administration Manufacturer and User Facility Device Experience Database.

Purpose: We sought to describe and analyze the adverse events associated with synthetic male slings reported to the U.S. Food and Drug Administration (FDA) Manufacturer and User Facility Device Experience (MAUDE) database.

Low Rates of Urologic Side Effects Following Coronavirus Disease Vaccination: An Analysis of the Food and Drug Administration Vaccine Adverse Event Reporting System.

Objective: To quantify and describe urologic adverse events and symptoms after vaccination with the Pfizer-BioNTech and Moderna COVID-19 vaccines.

Methods And Materials: We queried the FDA Vaccine Adverse Event Reporting System (VAERS) for all reported symptoms following the Pfizer-BioNTech and Moderna vaccines as of February 12th, 2021. All urologic symptoms were isolated and the reported adverse events associated with each symptom were reviewed.

Safety of concomitant therapy with radium-223 and abiraterone or enzalutamide in a real-world population.

Background: Real-world utilization and outcomes of combination therapy for men with metastatic castrate-resistant prostate cancer (mCRPC) are largely unknown. We evaluated the overall survival (OS) and skeletal-related events (SREs) among men who received radium-223 with or without concomitant abiraterone or enzalutamide in the Veterans Affairs (VA) Health System.

Methods: We reviewed charts of all mCRPC patients who received radium-223 in the VA from January 2013 to September 2017.

Accuracy of Urologic Conditions Portrayed on .

Despite the common prevalence of urologic diseases, studies have demonstrated that the general public often has little knowledge or insight into the field of urology or the role of an urologist. In this study, we investigated the context, frequency, and accuracy of urologic conditions on the television series . We reviewed episodes from the first 15 seasons.

Optimal instrument length for transumbilical laparoendoscopic single site (U-LESS) surgery.

The aim of our study was to recommend a novel method for measuring the distance from the umbilicus to intra-abdominal organs, as well as recommend an instrument length that would accommodate transumbilical laparoendoscopic single-site (U-LESS) surgeries to these areas. From CT scans of 50 men and 50 women, we calculated the distance from the umbilicus to 11 intra-abdominal points of interest using two triangles oriented perpendicular to each other. Using known lengths of the triangles, we used the Pythagorean theorem to calculate distances with and without insufflation.

Risk Factors for Surgical Shunting in a Large Cohort With Ischemic Priapism.

Background: Ischemic priapism is treated with a stepwise algorithm, but some patients may benefit from immediate shunt placement.

Aim: To identify risk factors for surgical shunt placement in a large series of patients with ischemic priapism.

Methods: We identified all patients presenting to our institution with ischemic priapism from January 2010 to December 2018.

Correlation of Online Physician Rating Subscores and Association With Overall Satisfaction: Observational Study of 212,933 Providers.

Background: Online physician rating websites commonly ask consumers to rate providers across multiple physician-based (eg, spending sufficient time, listening) and office-based (eg, appointment scheduling, friendliness) subdimensions of care in addition to overall satisfaction. However, it is unclear if consumers can differentiate between the various rated subdimensions of physicians. It is also unclear how each subdimension is related to overall satisfaction.

Uncoiling of a Cook Resonance Metallic Ureteral Stent.

The Cook Resonance metallic ureteral stent's unique configuration allows adequate urine drainage while providing improved resistance to external ureteral compression. We report a case in which a stent broke and subsequently uncoiled during stent removal under cystoscopy. A 46-year-old woman with a history of cervical carcinoma treated with radiation therapy and chemotherapy and bilateral ureteral strictures presented for cystoscopic removal of bilateral Cook Resonance ureteral stents.

New paradigms in the management of recurrent urinary tract infections.

Purpose Of Review: Recurrent urinary tract infections (rUTIs) represent a large burden on the healthcare system. Recent guidelines from the AUA/CUA/SUFU and advancements in the field reflect a paradigm shift for clinician and patients, steering away from empiric antibiotic therapy towards judicious antibiotic use.

Recent Findings: Antibiotic stewardship, including increasing awareness of the collateral damage of antibiotics and the risks of bacterial resistance are a major focus of the new guidelines.

Catheter Balloon-trauma: Design, Development, and Ex-vivo Studies Using Intact Human Penis Specimens.

Objective: To present a novel urethral catheter design with a pilot balloon to reduce intraurethral retention balloon inflation pressures and to provide a visual alert during catheter placement.

Methods: We manufactured our pilot balloon prototype from both molded and extruded silicone components. Various pilot balloon thicknesses were tested in order to determine the ideal compliance.

Outcomes of Prophylactic Mid-Urethral Sling at the Time of Robotic Sacrocolpopexy.

Objective: To compare outcomes of patients who underwent robotic sacrocolpopexy (RSC) with and without concomitant mid-urethral sling (MUS) placement for prophylaxis or treatment of preoperative stress urinary incontinence (SUI) METHODS: We performed a retrospective review of all patients without prior incontinence procedures who underwent RSC with or without MUS placement by 3 surgeons (JA, LA, KE) at a single institution from 2012 to 2017 for treatment of pelvic organ prolapse. Patients had a MUS placed for either documented SUI or prophylaxis of SUI. We compared patient characteristics, operative details, postoperative outcomes, and complications between the groups.

The Applicant's Perspective on Urology Residency Interviews: A Qualitative Analysis.

Objective: To better understand what urology applicants look for on interview day and what they care about in selecting a residency program through an analysis of anonymous online posts about the urology interview process.

Methods: We collected 3 years (2016-2018) of comments and posts from the Interview Impressions tab of the Urology Match Google Sheet for 133 urology residencies. Qualitative data analysis was performed using grounded theory methodology.

Considerations for Bedside Urologic Procedures in Patients With Severe Acute Respiratory Syndrome Coronavirus-2.

Objective: To provide guidance when performing bedside urologic procedures on severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) positive patients and offer considerations to maximize the safety of the patients and providers, conserve supplies, and provide optimal management of urologic issues.

Methods: Urologic trainees and attending physicians at our institution, who are familiar with existing safety recommendations and guidelines regarding the care of infected patients, were queried regarding their experiences to determine an expert consensus on best practices for bedside procedures for SARS-CoV-2 positive patients.

Results: Our team developed the following general recommendations for urologic interventions on SARS-CoV-2 positive patients: maximize use of telehealth (even for inpatient consults), minimize in-room time, use personal protective equipment appropriately, enlist a colleague to assist, and acquire all supplies that may be needed and maintain them outside the room.

Characteristics, Burden, and Necessity of Inpatient Consults for Academic and Private Practice Urologists.

Objective: To compare differences in the characteristics and outcomes of inpatient consults between academic and private practice urologists.

Materials And Methods: We performed a retrospective review of urology consults at a large tertiary-care hospital from June 1st, 2017 to June 30th, 2018. Patient demographics, timing of consult, location of consult, reasons for consult, requesting physicians, and procedures performed were analyzed and compared.