Robotic-assisted repair of colovesical anastomosis after Hartmann's reversal procedure.

Purpose: Hartmann's procedure is the resection of the rectosigmoid colon with an end colostomy formation and closure of the anorectal stump (1). Its reversal has a morbidity rate up to 58% (2, 3) with an incidence of fistulae formation of 4.08% (1).

An Evaluation of Peer-Rated Surgical Skill and its Relationship With Detrusor Muscle Sampling in Transurethral Resection of Bladder Tumor.

Objective: To assess the reliability of peer-review of TURBT videos as a means to evaluate surgeon skill and its relationship to detrusor sampling.

Methods: Urologists from an academic health system submitted TURBT videos in 2019. Ten blinded peers evaluated each surgeon's performance using a 10-item scoring instrument to quantify surgeon skill.

It's all in the name: Does nomenclature for indolent prostate cancer impact management and anxiety?

Background: Despite consensus guidelines, many men with low-grade prostate cancer are not managed with active surveillance. Patient perception of the nomenclature used to describe low-grade prostate cancers may partly explain this discrepancy.

Methods: A randomized online survey was administered to men without a history of prostate cancer, presenting a hypothetical clinical scenario in which they are given a new diagnosis of low-grade prostate cancer.

Evaluation of Opioid Prescribing Patterns and Drivers of Variation Following Endoscopic Procedures for Benign Prostatic Hyperplasia Across an Integrated Academic Health System.

Objectives: To evaluate patient, provider, and facility factors associated with variation in opioid prescribing after endoscopic procedures for benign prostatic hyperplasia across a large academic health system to drive improvement efforts.

Methods: Opioids prescribed at discharge for patients who underwent an endoscopic prostate procedure March 2018-November 2019 were analyzed. Multivariable logistic and linear regression were used to evaluate the relationship between patient, provider, and facility factors and the receipt of any opioid prescription and the quantity prescribed.

Surgeon Scorecards Improve Muscle Sampling on Transurethral Resection of Bladder Tumor and Recurrence Outcomes in Patients with Nonmuscle Invasive Bladder Cancer.

Purpose: The presence of detrusor muscle is essential for accurate staging of T1 cancers. Detrusor muscle presence can be a quality indicator of transurethral resection of bladder tumor for nonmuscle invasive bladder cancer. We hypothesized that increasing surgeon awareness of personal and institutional detrusor muscle sampling rates could improve resection quality and long-term oncologic outcomes.

Insurance coverage, stage at diagnosis, and time to treatment following dependent coverage and Medicaid expansion for men with testicular cancer.

Introduction: We sought to assess the impact of Affordable Care Act Dependent Care Expansion (ACA-DCE), which allowed dependent coverage for adults aged 19-25, and Medicaid expansion on outcomes for men with testicular cancer.

Methods: Using a US-based cancer registry, we performed adjusted difference-in-difference (DID) analyses comparing outcomes between men aged 19-25 (n = 8,026) and 26-64 (n = 33,303) pre- (2007-2009) and post-ACA-DCE (2011-2016) and between men in states that expanded Medicaid (n = 2,296) to men in those that did not (n = 2,265)pre- (2011-2013) and post-Medicaid expansion (2015-2016).

Results: In ACA-DCE analysis, rates of uninsurance decreased (DID -5.

Survival following upfront chemotherapy for treatment-naïve metastatic prostate cancer: a real-world retrospective cohort study.

Background: Upfront chemotherapy prolongs overall survival for men with metastatic, hormone-sensitive prostate cancer (mHSPC) based on data from clinical trials. We sought to assess the association between upfront chemotherapy and overall survival in men with mHSPC in a real-world cohort.

Methods: We performed a retrospective cohort study of men with de novo, treatment-naïve metastatic prostate cancer from a large, national cancer database in the United States (2014-2015).

Predictors of use and overall survival for patients undergoing metastasectomy for bladder cancer in a national cohort.

Objectives: To determine the use of surgical resection of metastatic disease in a large national sample and its association with overall survival.

Methods: The National Cancer Database was queried for patients with metastatic bladder cancer (2004-2016). Overall survival was assessed using Kaplan-Meier and multivariable Cox analyses.

Medicaid Expansion Did not Improve Time to Treatment for Young Patients With Metastatic Renal Cell Carcinoma.

Introduction: The absence of health insurance coverage has been associated with worse outcomes for patients with metastatic renal cell carcinoma (mRCC). Medicaid expansion in the United States was an important provision of the Affordable Care Act, which increased the number of low-income individuals eligible for Medicaid starting in January 2014 in several states. The effect of Medicaid expansion on access to healthcare for patients with mRCC is unknown.

National practice patterns for lymph node irradiation in 197,000 men receiving external beam radiotherapy for localized prostate cancer.

Purpose: Controversy surrounds the benefit of pelvic lymph node irradiation (PLN-RT) in localized prostate cancer (CaP). Our objective was to determine the practice patterns and predictors of PLN-RT in a national cohort.

Materials And Methods: The National Cancer Data Base (2005-2015) was leveraged to obtain men diagnosed with nonmetastatic CaP treated with external beam radiotherapy (n = 197,378).

Rates and Predictors of Conversion to Open Surgery During Minimally Invasive Radical Cystectomy.

Objective: To assess the frequency of minimally invasive radical cystectomy (MIRC) conversion to open surgery, what factors influence conversion, whether or not the benefits of MIRC vs open radical cystectomy (ORC) persist after conversion, and compare ORC and MIRC outcomes.

Materials And Methods: We performed a retrospective cohort study from the National Cancer Data Base (2010 to 2013) analyzing patients who underwent completed MIRC (n = 5750), converted MIRC (n = 245), and ORC (n = 12,053) without prior radiotherapy. Multivariable logistic and linear regression analyses were used to assess the association between covariates, open conversion as well as surgical approach, and secondary outcomes such as positive surgical margins (PSMs), use of lymphadenectomy, lymph node yield, hospital length of stay (LOS), and 30-day readmission.

Disparities in Access and Regionalization of Care in Testicular Cancer.

Introduction: Timely mobilization of specialized resources are needed to achieve optimal outcomes in testicular cancer. We used the National Cancer Database to investigate the hospital and demographic features driving disparity.

Patients And Methods: We identified adult men with testicular tumors diagnosed from 2004 to 2013.

Ambicor Two-Piece Inflatable Penile Prosthesis: Background and Contemporary Outcomes.

Introduction: The two-piece inflatable penile prosthesis (IPP; Ambicor) might be a preferred option for men with erectile dysfunction (ED) who have significant retroperitoneal scarring, limited manual dexterity, or other issues. There are reported differences in outcomes and patient and partner satisfaction between three-piece and two-piece IPPs.

Aim: To report contemporary outcomes, patient and partner satisfaction, and mechanical durability data of the two-piece compared with the three-piece IPP.

Robotic-assisted laparoscopic nephrectomy.

The introduction of robot-assisted surgery has helped practitioners implement laparoscopic approached to complex retroperitoneal and renal surgery. Urologists are now more frequently completing surgeries such as radical nephroureterectomy, radical nephrectomy with IVC thrombectomy, and retroperitoneal lymphadentectomy via a laparoscopic approach than ever before. This review discusses the rational of the above surgeries as well as a technical step-by-step description of our robotic nephroureterectomy surgical approach.

Robotic nephroureterectomy: a simplified approach requiring no patient repositioning or robot redocking.

Background: Robotic technology is increasingly adopted in urologic surgery and a variety of techniques has been described for minimally invasive treatment of upper tract urothelial cancer (UTUC).

Objective: To describe a simplified surgical technique of robot-assisted nephroureterectomy (RANU) and to report our single-center surgical outcomes.

Design, Setting, And Participants: Patients with history of UTUC treated with this modality between April 2010 and August 2013 were included in the analysis.

30-day hospital readmission after robotic partial nephrectomy--are we prepared for Medicare readmission reduction program?

Purpose: After CMS introduced the concept of the Hospital Readmissions Reduction Program, hospitals and health care centers became financially penalized for exceeding specific readmission rates.

Materials And Methods: We retrospectively reviewed our institutional review board approved database of patients undergoing robotic partial nephrectomy at our institution and included in our analysis patients who were readmitted to any hospital as an inpatient stay within 30 days from discharge home after robotic partial nephrectomy.

Results: From March 2006 to March 2013 a total of 627 patients underwent robotic partial nephrectomy at our center and 28 (4.