The Outcomes of Pelvic Fracture Urethral Injuries Stratified by Urethral Injury Severity: A Prospective Multi-institutional Genitourinary Trauma Study (MiGUTS).

Objective: To determine patient outcomes across a range of pelvic fracture urethral injury (PFUI) severity. PFUI is a devastating consequence of a pelvic fracture. No study has stratified PFUI outcomes based on severity of the urethral distraction injury.

A multicenter prospective cohort study of endoscopic urethral realignment versus suprapubic cystostomy after complete pelvic fracture urethral injury.

Background: Pelvic fracture urethral injury (PFUI) occurs in up to 10% of pelvic fractures. There is mixed evidence supporting early endoscopic urethral realignment (EUR) over suprapubic tube (SPT) placement and delayed urethroplasty. Some studies show decreased urethral obstruction with EUR, while others show few differences.

Urotrauma Guideline 2020: AUA Guideline.

Purpose: The authors of this guideline reviewed the urologic trauma literature to guide clinicians in the appropriate methods of evaluation and management of genitourinary injuries.

Materials And Methods: The Panel amended the Guideline in 2020 to reflect additional literature published through February 2020. When sufficient evidence existed, the Panel assigned the body of evidence a strength rating of A (high), B (moderate), or C (low) for support of Strong, Moderate, or Conditional Recommendations.

Outpatient buccal mucosal graft urethroplasty outcomes are comparable to inpatient procedures.

Background: We sought to compare outcomes between inpatient and outpatient buccal mucosal graft (BMG) urethroplasty among a large tertiary referral center series.

Methods: A retrospective review of consecutive patients who underwent BMG urethroplasty between 2007 and 2018 was performed, including only first stage and one stage graft procedures. Patients were divided into inpatient and outpatient groups.

Age ≤40 is an independent predictor of anastomotic urethroplasty and successful repair of bulbar urethral strictures.

Background: Among men with bulbar strictures, we aimed to analyze stricture characteristics, repair type, and treatment success in younger versus older patient cohorts.

Methods: We retrospectively reviewed our single surgeon database with patients undergoing bulbar urethroplasty from 2007 to 2017. This population was then age-stratified into ≤40 and >40-year-old cohorts.

Synchronous Urethral Repair During Prosthetic Surgery: Safety of Planned and Damage Control Approaches Using Suprapubic Tube Urinary Diversion.

Background: Urethral injury during inflatable penile prosthesis (IPP) or artificial urinary sphincter (AUS) placement is rare, and traditionally most prosthetic surgeons abort prosthetic implantation when urethral repair is necessary.

Aim: To report our experience with synchronous urethroplasty (SU) as a planned or damage control surgery during urologic prosthetic surgery, to evaluate the safety and outcomes of the procedure.

Methods: A retrospective review of our IPP and AUS database was completed to identify patients who underwent an SU between 2007 and 2018.

Versatile algorithmic midline approach to perineal urethrostomy for complex urethral strictures.

Purpose: To present results of an algorithmic approach to perineal urethrostomy (PU) based on a midline perineal incision among men with complex urethral strictures.

Methods: A single surgeon retrospective review of consecutive patients who underwent PU between 2008 and 2017 was performed. Patient demographics and outcomes were collected via medical record review.

Plication for Severe Peyronie's Deformities Has Similar Long-Term Outcomes to Milder Cases.

Introduction: Penile plication (PP) for Peyronie's disease (PD) is an established treatment option for mild to moderate curvature, but scant data exist regarding its utility in severe deformities.

Aim: To evaluate long-term outcomes among men undergoing PP for PD, comparing severe to mild/moderate penile deformities.

Methods: We performed a retrospective review of patients who underwent PP for PD between 2009 and 2017.

Changing Trends in Reconstruction of Complex Anterior Urethral Strictures: From Skin Flap to Perineal Urethrostomy.

Objective: To evaluate procedural trends and outcomes for reconstruction of complex strictures at our tertiary center over the last decade.

Methods: We retrospectively reviewed complex urethral reconstruction comparing 3 techniques: (1) buccal mucosal graft (BMG), (2) penile skin flap, or (3) perineal urethrostomy (PU) at our center (2007-2017) with ≥6 months follow-up. Strictures amenable to anastomotic repair were excluded.

Excision and Primary Anastomosis Reconstruction for Traumatic Strictures of the Pendulous Urethra.

Objectives: To present a multi-institutional experience with functional and patient-reported outcomes among men undergoing excision and primary anastomosis (EPA) urethroplasty for pendulous urethral strictures.

Methods: We describe the technique and present our experience with EPA for focal penile strictures. Patients undergoing urethroplasty (2004-2017) at 2 tertiary referral centers were reviewed, of whom 14 (0.

Erosion rates of 3.5-cm artificial urinary sphincter cuffs are similar to larger cuffs.

Objective: To compare long-term outcomes and erosion rates of 3.5-cm artificial urinary sphincter (AUS) cuffs vs larger cuffs amongst men with stress urinary incontinence (SUI), with and without a history of pelvic radiotherapy (RT).

Patients And Methods: We reviewed the records of all men who underwent AUS placement by a single surgeon between September 2009 and June 2017 at our tertiary urban medical centre.

Prolonged Duration of Incontinence for Men Before Initial Anti-incontinence Surgery: An Opportunity for Improvement.

Objective: To evaluate the duration and severity of male incontinence symptoms before presentation for initial anti-incontinence surgery (AIS) in a large tertiary subspecialty practice. Although male stress urinary incontinence (SUI) is known to profoundly compromise quality of life, many men do not undergo AIS in a timely manner.

Materials And Methods: We retrospectively reviewed our male patients with SUI (2007-2017) and assessed time from SUI onset to initial AIS across various demographics comparing male sling and artificial urinary sphincter (AUS).

Modified Transanosphincteric (York Mason) Repair of Nonradiated Rectourinary Fistulae: Patient-reported Fecal Continence Outcomes.

Objective: To review our experience with the modified York Mason (MYM) procedure in the treatment of rectourinary fistulas (RUFs) and to assess fecal continence using patient-reported measures.

Materials And Methods: A retrospective review was performed of patients who underwent MYM repair of nonradiated RUF with gluteal free fat graft from 2008 to 2016 at a single institution. Success was defined as resolution of the fistula without need for further surgery.

Refined nomogram incorporating standing cough test improves prediction of male transobturator sling success.

Aims: To develop a decision aid in predicting sling success, incorporating the Male Stress Incontinence Grading Scale (MSIGS) into existing treatment algorithms.

Methods: We reviewed men undergoing first-time transobturator sling for stress urinary incontinence (SUI) from 2007 to 2016 at our institution. Patient demographics, reported pads per day (PPD), and Standing Cough Test (SCT) results graded 0-4, according to MSIGS, were assessed.

Low Serum Testosterone is Present in Nearly Half of Men Undergoing Artificial Urinary Sphincter Placement.

Objectives: To report the prevalence of low serum testosterone (LST) in men undergoing artificial urinary sphincter (AUS) placement at a single high-volume institution.

Methods: We retrospectively reviewed all men undergoing AUS procedures by a single surgeon from January 2015 to January 2018 to identify men with pretreatment total serum testosterone levels. LST was defined as less than 280 ng/dL.

Penoscrotal Decompression-Promising New Treatment Paradigm for Refractory Ischemic Priapism.

Background: For prolonged ischemic priapism, outcomes after distal shunt are poor, with only 30% success for priapic episodes lasting longer than 48 hours.

Aim: To present a novel, glans-sparing approach of corporal decompression through a penoscrotal approach for cases of refractory ischemic priapism (RIP) after failed distal shunt procedures.

Methods: We describe the technique and present our initial experience with penoscrotal decompression (PSD) for treatment of RIP after failed distal shunt.

Cord Blood Antiparasite Interleukin 10 as a Risk Marker for Compromised Vaccine Immunogenicity in Early Childhood.

Background: Antenatal exposure to parasites can affect infants' subsequent responses to vaccination. The present study investigated how maternal prenatal infections and newborns' antiparasite cytokine profiles relate to immunoglobulin G (IgG) responses to standard vaccination during infancy.

Methods: A total of 450 Kenyan women were tested for parasitic infections during pregnancy.

Advanced Practice Providers in U.S. Urology: A National Survey of Demographics and Clinical Roles.

Introduction: Projections suggest a significant shortage of urologists coupled with an increasing burden of urological disease due to an aging population. To meet this need, urologists have increasingly partnered with advanced practice providers. However, to this point the advanced practice provider workforce has not been comprehensively evaluated.

Projecting the Urology Workforce Over the Next 20 Years.

Objective: To forecast the size and composition of the urologist and urology advanced care provider (ACP; nurse practitioner, physicians' assistant) workforce over the next 20 years.

Methods: Current urologist workforce was estimated from the American Board of Urology certification data and the 2014 American Urological Association (AUA) Census. Incoming workforce was estimated from the American Board of Urology and AUA residency match data.

Urinary Tract Infection and Neurogenic Bladder.

Urinary tract infections (UTIs) are frequent, recurrent, and lifelong for patients with neurogenic bladder and present challenges in diagnosis and treatment. Patients often present without classic symptoms of UTI but with abdominal or back pain, increased spasticity, and urinary incontinence. Failure to recognize and treat infections can quickly lead to life-threatening autonomic dysreflexia or sepsis, whereas overtreatment contributes to antibiotic resistance, thus limiting future treatment options.

Gender Differences in Compensation, Job Satisfaction and Other Practice Patterns in Urology.

Purpose: The proportion of women in urology has increased from less than 0.5% in 1981 to 10% today. Furthermore, 33% of students matching in urology are now female.

Parasitism in Children Aged Three Years and Under: Relationship between Infection and Growth in Rural Coastal Kenya.

Background: Parasitic infections, which are among the most common infections worldwide, disproportionately affect children; however, little is known about the impact of parasitic disease on growth in very early childhood. Our objective was to document the prevalence of parasitic infections and examine their association with growth during the first three years of life among children in coastal Kenya.

Methodology/principal Findings: Children enrolled in a maternal-child cohort were tested for soil transmitted helminths (STHs: Ascaris, Trichuris, hookworm, Strongyloides), protozoa (malaria, Entamoeba histolytica and Giardia lamblia), filaria, and Schistosoma infection every six months from birth until age three years.

Preoperative imaging for staging bladder cancer.

Accurate preoperative staging of bladder cancer is essential in determining the extent of disease and optimal treatment. The current gold standard of transurethral resection of bladder tumor (TURBT) followed by computed tomography (CT) imaging provides excellent staging specificity, but often understages the disease, leading to pathologic upstaging and adverse outcomes in patients undergoing radical cystectomy. Newer imaging modalities, such as multiparametric magnetic resonance (MR) imaging and positron emission tomography (PET) combined with CT or MR provides promising imaging alternatives which may improve accuracy of staging both local and distant disease.

Evaluation and Management of the Geriatric Urologic Oncology Patient.

The geriatric population presents a unique set of challenges in urologic oncology. In addition to the known natural history of disease, providers must also consider patient factors such as functional and nutritional status, comorbidities and social support when determining the treatment plan. The development of frailty measures and biomarkers to estimate surgical risk shows promise, with several assessment tools predictive of surgical complications.

Effect of antenatal parasitic infections on anti-vaccine IgG levels in children: a prospective birth cohort study in Kenya.

Background: Parasitic infections are prevalent among pregnant women in sub-Saharan Africa. We investigated whether prenatal exposure to malaria and/or helminths affects the pattern of infant immune responses to standard vaccinations against Haemophilus influenzae (Hib), diphtheria (DT), hepatitis B (Hep B) and tetanus toxoid (TT).

Methods And Findings: 450 Kenyan women were tested for malaria, schistosomiasis, lymphatic filariasis (LF), and intestinal helminths during pregnancy.