Decision regret and long-term success rates after ventral buccal mucosa graft urethroplasty.

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.

Urology Residency Applicant Selection: Program Directors' New Criteria.

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.

Posterior Urethral Reconstruction at the Time of Rectourethral Fistula Repair: Technique and Outcomes.

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.

Impact of Virtual Care on Outpatient Urinary Tract Infection Management.

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.

Diversity Attracts Diversity: 2023 AUA Match Results.

Objective: 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.

A Novel Metric for Hospital Quality in Kidney Cancer Surgery: A Veterans Affairs National Health System Validation of Concept.

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.

Cancer risk in bladder diverticula: a large institutional analysis of risk and management.

Purpose: Bladder diverticula (BD) are usually asymptomatic, but may increase the risk of infections, stones, or malignancy, likely due to urinary stasis within the BD. We aim to characterize the risk of bladder cancer (BC) within diverticula.

Methods: Retrospective review was conducted of patients diagnosed with BD between 1994 and 2021 at a single institution.

Long-term Follow-up of Patients With Cerebral Palsy Undergoing Catheterizable Channel Creation Without Concurrent Bladder Augmentation.

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.

Neurogenic Bladder:: Assessment and Operative Management.

We present a phenotype-based approach to neurogenic bladder (NGB) by describing prototypical patients with spinal cord injury (SCI), spina bifida (SB), cerebral palsy (CP), and multiple sclerosis (MS). Surgical management is categorized by failure to store and failure to empty, with a focus on catheterizable channels, bladder augmentation, and bladder outlet procedures. Mitigation and management of common complications are reviewed.

Stones and Moans: Higher Number of Nephrolithiasis Related Encounters Increases the Odds of Opioid Misuse.

Objective: To evaluate the association between kidney stones and risk of subsequent opioid misuse.

Methods: The Healthcare Cost and Utilization Project's (HCUP) inpatient, ambulatory, and emergency department databases from 4 states were queried to identify associations with a primary diagnosis code related to kidney stones followed by a diagnosis of opioid abuse, dependence, or overdose between 2005, and 2015. Logistic regression was performed to determine the strength and significance of the relationship between number of primary kidney stone episodes and subsequent diagnosis of opioid misuse.

Role of Imaging in Renal Cell Carcinoma: A Multidisciplinary Perspective.

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.

New Baseline Renal Function after Radical or Partial Nephrectomy: A Simple and Accurate Predictive Model.

Purpose: Preoperative estimation of new baseline glomerular filtration rate after partial nephrectomy or radical nephrectomy for renal cell carcinoma has important clinical implications. However, current predictive models are either complex or lack external validity. We aimed to develop and validate a simple equation to estimate postoperative new baseline glomerular filtration rate.

Race, Decisional Regret and Prostate Cancer Beliefs: Identifying Targets to Reduce Racial Disparities in Prostate Cancer.

Purpose: African American men are more likely to be diagnosed with, die of and experience decisional regret about their prostate cancer than nonAfrican American men. Although some clinical discrepancies may be attributed to genetic risk and/or access to care, explanations for racial discrepancies in decisional regret remain largely speculative. We aim to identify sources of prostate cancer decisional regret with a focus on racial disparities.

Split renal function in patients with renal masses: utility of parenchymal volume analysis vs nuclear renal scans.

Objectives: To evaluate the utility of parenchymal volume analysis (PVA) for estimation of split renal function (SRF) in patients with renal masses. SRF is important for deciding about partial vs radical nephrectomy (PN/RN) and assessing risk for developing severe chronic kidney disease after surgery. For renal donors PVA is routinely used to estimate SRF, but the utility of PVA for the more complex renal mass population remains undefined.

The Association of Urologic Oncology Fellowship Training and Diagnostic Yield of Prostate Biopsy.

Objective: To determine the relationship between urologic oncology fellowship training (UOFT) and diagnostic yield of prostate biopsy.

Methods: Retrospective review was conducted of patients who underwent prostate biopsy across the Cleveland Clinic between 2000 and 2018. Biopsies done by urologists with and without UOFT were detailed via descriptive statistics and appropriate (chi-square, Student t, Wilcoxon rank-sum) tests.

Infiltrative Renal Masses: Clinical Significance and Fidelity of Documentation.

Background: The prevalence of infiltrative renal masses (IRMs) and fidelity of documentation of infiltrative features remain unclear.

Objective: To investigate the prevalence/significance of IRMs and assess whether infiltrative features were documented preoperatively.

Design, Setting, And Participants: A total of 522 patients with renal tumors managed with partial/radical nephrectomy (2012-2014) whose pathology demonstrated locally advanced and/or aggressive histology were analyzed.