Detection of clinically significant prostate cancer following initial omission of biopsy in multiparametric MRI era.

Background: Multiparametric prostate MRI (mpMRI) is being increasingly adopted for work-up of prostate cancer. For patients selected to omit biopsy, we identified factors associated with repeat MRI, eventual prostate biopsy, and subsequent detection of clinically significant prostate cancer (csPCa, Grade Group ≥2).

Methods: We identified biopsy-naïve men presenting with PSA 2-20 ng/mL (March 2018-June 2021) undergoing initial mpMRI with PIRADS 1-3 lesions who were not selected for biopsy with ≥6 months follow-up.

Reproductive Urology Consultation Is an Opportunity to Evaluate for Medical Comorbidity: The Prevalence of Elevated Blood Pressure and Obesity at Fertility Evaluation.

Purpose To evaluate the prevalence of elevated blood pressure (EBP), hypertension (HTN), and obesity among men presenting for fertility evaluation. Methods We retrospectively evaluated all men presenting for male infertility consultation at a single institution from 2000 to 2018. Blood pressure (BP) measurements were abstracted from the electronic health record, and EBP/HTN was defined according to American Heart Association/American College of Cardiology guidelines (systolic blood pressure (SBP) ≥ 120 mmHg or diastolic blood pressure (DBP) ≥ 80 mmHg).

Optimizing detection of clinically significant prostate cancer through nomograms incorporating mri, clinical features, and advanced serum biomarkers in biopsy naïve men.

Purpose: To develop nomograms that predict the detection of clinically significant prostate cancer (csPCa, defined as ≥GG2 [Grade Group 2]) at diagnostic biopsy based on multiparametric prostate MRI (mpMRI), serum biomarkers, and patient clinicodemographic features.

Materials And Methods: Nomograms were developed from a cohort of biopsy-naïve men presenting to our 11-hospital system with prostate specific antigen (PSA) of 2-20 ng/mL who underwent pre-biopsy mpMRI from March 2018-June 2021 (n = 1494). The outcomes were the presence of csPCa and high-grade prostate cancer (defined as ≥GG3 prostate cancer).

Utilization of genetic testing in men with advanced prostate cancer.

Background: Genetic evaluation of men with advanced prostate cancer is recognized as imperative both to guide treatment decisions and to trigger cascade genetic testing of family members. Here we investigate utilization patterns of genetic testing among a contemporary cohort of men with advanced prostate cancer at our institution.

Methods: We queried the Northwestern Electronic Data Warehouse from January 2021 to present for all men diagnosed with National Comprehensive Cancer Network high-risk/very high-risk, regional, or metastatic prostate cancer.

The broad reach and inaccuracy of men's health information on social media: analysis of TikTok and Instagram.

Social media (SoMe) offers great potential to expand access to health information, but a significant proportion of users consume its content instead of consulting a physician. We sought to quantify the volume and characterize the accuracy of men's health-related content on TikTok and Instagram. We searched TikTok and Instagram for the terms: testosterone, erectile dysfunction, male infertility, semen retention, Peyronie's disease, and vasectomy.

Characteristics of men who use direct-to-consumer men's health telemedicine services.

The characteristics of men who use direct-to-consumer (DTC) men's health services are not well understood. We conducted an online survey of adult men via ResearchMatch, assessing sociodemographic data, health behaviors, and concern for low testosterone and infertility. Logistic regression estimated the association between participant characteristics and familiarity with and reported use of DTC services such as Hims® and Roman®.

Real-world use of MRI for risk stratification prior to prostate biopsy.

Background: The utilization of MRI to risk stratify elevated PSA prior to prostate biopsy has been inconsistently adopted and varies considerably by practice setting. This study aims to evaluate the usage and performance of MRI as an advanced risk stratification tool of elevated PSA prior to biopsy and identify factors associated with differential utilization of MRI at a large academic setting with ready access to 3T multiparametric MRI of the prostate.

Methods: A retrospective single-center study of 2900 men presenting with elevated PSA 2-20 ng/mL from 2018 through 2021 was conducted.

Perceptions of Infertility and Semen Analysis Testing Among American Men Without Children.

Objective: To determine whether health-conscious men are more likely to be concerned about infertility and self-initiate semen analysis at a laboratory/clinic or through a direct-to-consumer at-home product without a health care provider recommendation.

Methods: Cross-sectional survey conducted online via ResearchMatch.org between November 2019 and January 2020.

Online access to male factor infertility care: the challenge of finding a specialist.

Objective: To investigate internet search results available to couples searching for a male factor infertility specialist.

Design: Cross-sectional.

Setting: Online search engine.

Evaluating Patient-Defined Priorities for Female Patients with Bladder Cancer.

Background: Although bladder cancer is much more common in men than in women, female patients with bladder cancer present with more locally advanced tumors and have worse disease-specific outcomes than male patients, even after controlling for biological differences. There is a paucity of research regarding the optimal approach to caring for female patients with bladder cancer in ways that maximize patient satisfaction, preferences, and values.

Objective: We sought to explore patient-defined priorities and areas in need of improvement for female patients with bladder cancer from the patient perspective.

Examining Online Traffic Patterns to Popular Direct-To-Consumer Websites for Evaluation and Treatment of Erectile Dysfunction.

Background: Direct-to-consumer (DTC) Internet-based prescription and pharmacy platforms offer electronic consultation for evaluation and pharmacologic treatment of erectile dysfunction (ED) without a physical exam or in-person visit, presenting a potentially dramatic shift in care for this condition.

Aim: To characterize the extent to which DTC prescribing sites for ED generate traffic and attract individual users.

Methods: Using SEMRush, a marketing software platform that provides analytics regarding website traffic, we examined online site visits to 6 major DTC prescribing websites offering ED evaluation and treatment from October 2017 through December 2019.

The Impact of Stricter Guidelines on Post-Interview Contact, Restricted Interview Topics and Differences by Gender in the Urology Match.

Introduction: In response to studies showing high rates of program initiated post-interview contact and the use of discriminatory personal questions on topics such as age, intent for children, and religion or political preferences during interviews the Society of Academic Urologists and the American Urological Association published revised guidelines for the 2020 Urology Match. This study assessed the impact of these changes on the applicant experience and prevalence of restricted questions.

Methods: A total of 361 applicants to a single urology residency program were sent an anonymous 20-question survey about post-interview program contact and restricted interview questions.

Anti-TNF agents and potential effects on male fertility: are men being counseled?

Background: Adult men with autoimmune conditions are commonly prescribed anti-tumor necrosis factor (anti-TNF) agents; however, there is a paucity of quality evidence as to their effect on male fertility (e.g. semen parameters and sperm quality).

The association of popular diets and erectile function among men in the United States.

To determine the relationship between popular diets and erectile function we queried the National Health and Nutrition Examination Survey, a cross-sectional dataset, between 2001 and 2004. All men aged 18-85 who answered the prostate and dietary questionnaires were included. Diets were categorized as Mediterranean, low-fat, low-carbohydrate, or nonrestrictive.

Revisiting the penoscrotal approach to artificial urinary sphincter surgery: how does it compare to a perineal incision for initial implantation?

Purpose: Artificial urinary sphincters (AUS) remain the gold standard to treat male stress urinary incontinence. AUS implantation can be performed through a penoscrotal or perineal incision depending on surgeon preference.

Methods: The present study compares initial AUS implantation through two surgical approaches focusing on outcomes of continence and revision.

Sperm retrieval success and testicular histopathology in idiopathic nonobstructive azoospermia.

Prior studies have investigated sperm retrieval rates in men with nonobstructive azoospermia (NOA) secondary to specific etiologies, yet most cases of NOA are idiopathic. We compared sperm retrieval rates and testicular histopathology in idiopathic NOA (iNOA) and nonidiopathic NOA (niNOA). We performed a retrospective review of men with NOA who underwent microdissection testicular sperm extraction (microTESE) between 2000 and 2016.

National Characteristics of Surgeons Performing Vasectomy: Increasing Specialization and a Persistent Gender Gap.

Objective: To describe trends in the characteristics of urologic surgeons performing vasectomy over time.

Methods: We performed a retrospective, cross-sectional study examining surgeon characteristics for case logs from the American Board of Urology between 2004 and 2013. We used generalized estimating equations with a log link and negative binomial distribution to examine demographic differences (gender, rural location, and surgeon volume) in the number of vasectomies surgeons performed over time.

Underutilization of primary medical care among men presenting for fertility evaluation.

Objective: To determine the proportion of men presenting for fertility evaluation who reported having an established primary care physician (PCP).

Design: Retrospective, observational study.

Setting: Academic health center.

Effects of nonsteroidal anti-inflammatory drug (NSAID) use upon male gonadal function: A national, population-based study.

Recent data have suggested that short-term NSAID use induces a state of compensated hypogonadism. Our aim was to investigate the association between chronic, regular NSAID use and compensated hypogonadism in a large, nationally representative cohort, the US National Health and Nutrition Examination Survey (NHANES) database. Men 20-80 years who answered the analgesic use questionnaire and underwent hormonal testing were included.

Success of Prostate and Testicular Cancer Awareness Campaigns Compared to Breast Cancer Awareness Month According to Internet Search Volumes: A Google Trends Analysis.

Objective: To compare the efficacy of men's and women's cancer awareness campaigns using internet relative search volume (RSV) as a surrogate for public interest.

Methods: We utilized Google Trends to determine the RSV for "breast cancer," "prostate cancer," and "testicular cancer" from 2010 to 2017. Baseline annual RSV for each cancer was calculated as the median annual RSV, exclusive of the awareness month period.

Willingness to Participate in Home Screening for Urologic Cancers in the General Population: An Online Survey of Over 1400 Adults.

Objective: To assess willingness of adults to undergo home screening for urologic cancers via urine dipstick and determine the effect of an educational pamphlet on hematuria on screening willingness and knowledge of hematuria.

Materials And Methods: We performed an online survey of adult volunteers throughout the United States from September 25, 2018 to October 15, 2018. The primary outcome was pretest willingness to undergo home screening for hematuria with urine dipstick (4 or 5 out of 5-point Likert).

The Association between Popular Diets and Serum Testosterone among Men in the United States.

Purpose: We examined the relationship of the serum testosterone level to low fat, Mediterranean and low carbohydrate diets in a large, nationally representative patient sample.

Materials And Methods: We queried the NHANES (National Health and Nutrition Examination Survey) from 1999 to 2000, 2003 to 2004 and 2011 to 2012. Men 18 to 80 years old who completed the 2-day dietary history and underwent serum testosterone testing were included in analysis.