Publications by authors named "Molly Dewitt-Foy"
Objectives: To characterise the long-term success rate of ventral onlay buccal mucosa graft urethroplasty (vBMG) in the management of bulbar urethral stricture disease (USD), assess patient-reported postoperative satisfaction and decision regret, and delineate clinical factors impacting patient-reported metrics.
Subjects And Methods: Patients with prior vBMG for bulbar USD, performed at Cleveland Clinic between 2003 and 2022, were contacted and brief structured interviews were performed. Stricture recurrence and need for secondary procedures, baseline demographics, and patient-reported outcome surveys were collected.
Introduction: This study assesses the effects of the recent changes to the urology residency match process.
Methods: We emailed an anonymous, multiple-choice survey to each candidate who applied to any of our 3 urology programs for the 2024 Urology Residency Match.
Results: Of the 433 candidates invited, 146 (33.
Introduction: Patient expectations and baseline health are important drivers of outcomes following major genitourinary reconstructive surgery for neurogenic bladder (NGB). Differences in expectations and quality of life (QoL) improvements among different populations with NGB remain insufficiently explored in the literature.
Objective: To compare decisional regret (DR) and urinary-related QoL (UrQoL) in patients undergoing urinary diversion for NGB arising from spinal cord injury of acquired (A-SCI) and congenital (C-SCI) etiologies.
Objective: To evaluate the impact of the recent changes to the urology residency application process on the criteria utilized by residency program directors (PDs) for interview invitations and their perspectives concerning these changes.
Methods: One hundred thirty-seven urology residency PDs were invited to participate in an anonymous survey to explore interview selection criteria and the impact of the increase in preference signals (PS) per applicant.
Results: Fifty-eight PDs (42.
Objective: To assess the impact of posterior urethral stenosis or defect on outcomes following rectourethral fistula (RUF) repair, we present a cohort of 23 men who underwent posterior urethroplasty concurrent with RUF repair.
Methods: We identified 130 men who underwent RUF repair at our institution between 2003 and 2021. Of these, 23 (18%) underwent simultaneous posterior urethroplasty.
Objective: To evaluate urinary outcomes following cystoscopic external urinary sphincter onabotulinumtoxinA (BTX) injections in patients with cerebral palsy (CP). Adults with CP can suffer from bladder outlet obstruction and urinary retention due to a spastic external urethral sphincter ("pseudodysynergia"). We have used BTX injections into the sphincter to relieve the obstruction and allow patients to maintain spontaneous voiding rather than intermittent catheterization.
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- The study aims to analyze the surgical treatment, perioperative outcomes, and the impact of aggressive histologic variants (AHV) in patients with renal cell carcinoma (RCC) and inferior vena cava (IVC) thrombus, noting that AHV indicates a poorer prognosis.* -
- Researchers reviewed data from 403 patients who underwent surgery from 1990 to 2020, finding that 23.3% had AHV and were more likely to show advanced disease stages, but surgery did not lead to worse perioperative outcomes.* -
- Results indicated that while the median survival was similar for patients with and without AHV, sarcomatoid differentiation significantly worsened overall survival, highlighting the need for careful evaluation in surgical
Objective: To examine the effect of virtual care on urine testing, antibiotic prescription patterns, and outcomes of care in urinary tract infection (UTI) management.
Methods: We conducted retrospective analysis of adults treated for UTI in an ambulatory setting across a large health system from March 2020-2021. Outcomes included urine testing, antibiotic prescription, and retreatment or hospitalization, stratified by in-person vs virtual visit.
Background: Schistosomiasis is most notably associated with squamous cell carcinoma of the bladder, and it is estimated that approximately 10% of people infected will develop a urologic complication. Ureteral pathology is rare and has only been described in a handful of case reports. Increasing awareness of this condition is needed given a recent increase in sub-Saharan immigrant population in the United States (US), as prompt recognition is key to providing optimal care.
View Article and Find Full Text PDFObjective: To assess the rationale behind the choice of programs for preference signaling (PS) and subinternships by urology applicants in the 2023 cycle.
Methods: We emailed an anonymous, multiple-choice survey to the 403 prospective candidates who applied to our institution for the 2023 Urology Residency Match.
Results: 121 applicants (30.
Introduction: We aimed to develop and validate a Compound Quality Score (CQS) as a metric for hospital-level quality of surgical care in kidney cancer at the Veterans Affairs National Health System.
Methods: A retrospective review of 8,965 patients with kidney cancer treated at Veterans Affairs (2005-2015) was performed. Two previously validated process quality indicators (QIs) were explored: the proportion of patients with 1) T1a tumors undergoing partial nephrectomy and 2) T1-T2 tumors undergoing minimally invasive radical nephrectomy.
Objective: To evaluate outcomes of inflatable-penile-prosthesis (IPP) implantation after radical-cystectomy compared to other etiologies of erectile dysfunction.
Materials And Methods: All IPPs within the past 20 years in a large regional health system were reviewed, and erectile dysfunction (ED) etiology was determined as radical-cystectomy, radical-prostatectomy, or organic/other ED. Cohorts were generated by 1:3 propensity score match using age, body mass index, and diabetes status.
Article Synopsis
- Bladder diverticula are generally asymptomatic but can increase the risk of bladder cancer, infections, and stones due to urine stagnation.
- A study reviewing 764 patients with bladder diverticula found a bladder cancer diagnosis rate of 13.3%, with 35.3% of those having cancer within the diverticula.
- Male gender and older age were identified as significant risk factors for bladder cancer, while other factors like indwelling catheters and recurrent UTIs did not influence the risk.
Objective: To characterize long-term outcomes for adults with cerebral palsy who have undergone catheterizable channel creation without concurrent bladder augmentation.
Methods: Retrospective review was conducted of patients who underwent catheterizable channel creation without augmentation by the senior author. Variables of interest included development of de novo neurogenic detrusor overactivity, change in continence, escalation in therapy, and upper tract changes.
Objective: To document the incidence, risk factors, and prevalence of sacral insufficiency fractures (SIF) among patients who have undergone total pubectomy for osteomyelitis.
Methods: A retrospective chart review was performed of patients undergoing total pubectomy for osteomyelitis at a single institution from 2016 to 2021. Descriptive statistics and univariate analysis were performed using the Wilcoxon rank-sum test and Fisher exact test as appropriate.
Article Synopsis
- The text discusses a phenotype-based strategy for understanding neurogenic bladder (NGB) in patients with various conditions like spinal cord injury, spina bifida, cerebral palsy, and multiple sclerosis.
- It outlines surgical management options based on whether the main issue is inability to store or empty urine, highlighting techniques such as catheterizable channels and bladder augmentation.
- The importance of addressing complications and considering factors like social support, body type, and limb function is emphasized for better surgical outcomes.
Article Synopsis
- The study investigates the link between kidney stones and the risk of opioid misuse, using data from inpatient and emergency departments across 4 states from 2005 to 2015.
- The analysis found that patients with multiple kidney stone episodes are at a significantly higher risk of developing opioid-related disorders (ORD), particularly among those treated in emergency settings or in Iowa.
- Factors such as younger age, chronic pain diagnosis, and fewer financial resources were associated with increased risk, while higher income and non-white race appeared to lower that risk.
Background: Penile prosthesis surgeons face an ethical dilemma when confronted with a sex offender who seeks surgical management of erectile dysfunction.
Aim: To provide practice guidelines to screen and manage patients with a history of sexual violence prior to surgery.
Methods: Three urologists with expertise in penile prosthesis surgery and 1 medical bioethicist were asked to contribute their opinions and provide recommendations to address this controversial topic.
With the expansion in cross-sectional imaging over the past few decades, there has been an increase in the number of incidentally detected renal masses and an increase in the incidence of renal cell carcinomas (RCCs). The complete characterization of an indeterminate renal mass on CT or MR images is challenging, and the authors provide a critical review of the best imaging methods and essential, important, and optional reporting elements used to describe the indeterminate renal mass. While surgical staging remains the standard of care for RCC, the role of renal mass CT or MRI in staging RCC is reviewed, specifically with reference to areas that may be overlooked at imaging such as detection of invasion through the renal capsule or perirenal (Gerota) fascia.
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