Qualitative Analysis of Program Director Perspectives on Conscientious Objection Policies to Gender-Affirming Care.

Introduction: Emerging reports of objection to gender-affirming care by resident physicians in obstetrics and gynecology (OBGYN), plastic surgery, urology, and pediatric training programs have begun to highlight the rising incidence and ethical complexities of trainee-objection scenarios. This study examines perspective of residency program leadership toward trainee objection to gender-affirming care.

Methods: Program directors from accredited U.

Pain location after ureteroscopy differs based on sex and stone location: results from STENTS.

Objectives: To expand understanding of the patient experience after ureteroscopy with stent placement for ureteric and/or renal stones using a body map to identify pain location and site-specific pain intensity over time, while evaluating the associations of sex and stone location.

Patients And Methods: Participants in a multicentre prospective observational cohort study completed questionnaires at baseline and on postoperative days (PODs) 1, 3 and 5. Pain distribution and intensity were assessed using the Brief Pain Inventory body and genitalia maps, with results stratified by sex and stone location.

Trends in Urology Resident Surgical Autonomy: What Do ACGME Chief Resident Case Logs Indicate?

Objective: To investigate urology resident surgical autonomy trends over time and according to procedure subtype using Accreditation Council for Graduate Medical Education (ACGME) case log data.

Methods: A retrospective review of 364 chief urology resident ACGME case logs collected from 11 institutions spanning 2010-2021 was completed. Resident-defined role in cases as "assistant," "surgeon," or "teaching surgeon" were used as a metric of graded autonomy.

Facilitated Clearance of Small, Asymptomatic Renal Stones With Burst Wave Lithotripsy and Ultrasonic Propulsion.

Purpose: We tested feasibility of burst wave lithotripsy and ultrasonic propulsion to noninvasively fragment and expel small, asymptomatic renal stones in awake participants.

Materials And Methods: Adult patients suspected of having 2- to 7-mm stones were consented and screened for eligibility. Burst wave lithotripsy and ultrasonic propulsion were applied to up to 3 stones in 1 kidney of qualifying participants for a 30-minute total exposure.

Impact of Subsequent Fellowship on Urology Chief Resident Case Log Volumes.

Objective: To characterize the impact of subsequent fellowship on the case log experience of trainees throughout their residency and specifically their chief resident year.

Materials And Methods: Urology resident case logs from 2010 to 2022 were obtained from 13 institutions for total residency and chief years. Five categorized index procedures were included for analysis: General Urology; Endourology; Reconstructive Urology; Urologic Oncology; and Pediatric Urology.

Conscientious Objection to Gender-Affirming Surgery: A Cross-Sectional Analysis of Plastic Surgery and Urology Residency Programs.

Objective: Medical conscientious objection is a federally protected right of physicians to refuse participation in medically indicated services or research activities that are incompatible with their ethical, moral, or religious beliefs. Individual provider objections to gender-affirming surgery have been documented, however the prevalence of such objections is unknown. Our study aimed to characterize physician objections to gender-affirming surgery in plastic surgery and urology residencies and to assess related institutional policies.

Break Wave Lithotripsy for Urolithiasis: Results of the First-in-Human International Multi-Institutional Clinical Trial.

Purpose: This study reports on a prospective, multicenter, single-arm, clinical trial utilizing the SonoMotion (San Mateo, California) Break Wave lithotripsy (BWL) device to fragment urinary stones.

Materials And Methods: Patients with a urinary stone underwent a single treatment of 30 minutes and peak negative pressure of 4.5 to 8 MPa.

Low-fat dietary pattern reduces urinary incontinence in postmenopausal women: post hoc analysis of the Women's Health Initiative Diet Modification Trial.

Background: Urinary incontinence affects >40% of women in the United States, with an annual societal cost of >$12 billion and demonstrated associations with depressive symptoms, social isolation, and loss of work productivity. Weight has been established as an exposure that increases urinary incontinence risk and certain dietary components have been associated with urinary incontinence symptoms. We hypothesized that diet plays a key role in the association between weight and urinary incontinence in US women.

First Series Using Ultrasonic Propulsion and Burst Wave Lithotripsy to Treat Ureteral Stones.

Purpose: Our goal was to test transcutaneous focused ultrasound in the form of ultrasonic propulsion and burst wave lithotripsy to reposition ureteral stones and facilitate passage in awake subjects.

Materials And Methods: Adult subjects with a diagnosed proximal or distal ureteral stone were prospectively recruited. Ultrasonic propulsion alone or with burst wave lithotripsy was administered by a handheld transducer to awake, unanesthetized subjects.

Removal of Small, Asymptomatic Kidney Stones and Incidence of Relapse.

Background: The benefits of removing small (≤6 mm), asymptomatic kidney stones endoscopically is unknown. Current guidelines leave such decisions to the urologist and the patient. A prospective study involving older, nonendoscopic technology and some retrospective studies favor observation.

Multi-Institutional Variation in Performance of Low-Dose Computed Tomography for the Evaluation of Suspected Nephrolithiasis.

Guidelines from the American Urological Association (AUA) and American College of Radiology (ACR) recommend that patients with suspected nephrolithiasis undergo low-dose CT of the kidney, ureter, and bladder (LD CT KUB) as opposed to higher dose conventional imaging. We hypothesized that even at institutions with established LD protocols, higher dose imaging is common. We identified four academic medical centers where LD CT KUB protocols were implemented to yield an effective dose (EDose) consistent with national guidelines.

Evaluation of the Educational Impact of the Urology Collaborative Online Video Didactics Lecture Series.

Objective: To assess the impact of the Urology Collaborative Online Video Didactic (COViD) lecture series series on resident knowledge as a supplement to resident education during the coronavirus disease 2019 pandemic.

Methods: One hundred thirty-nine urology residents were voluntarily recruited from 8 institutions. A 20-question test, based on 5 COViD lectures, was administered before and after watching the lectures.

Fragmentation of Stones by Burst Wave Lithotripsy in the First 19 Humans.

Purpose: We report stone comminution in the first 19 human subjects by burst wave lithotripsy (BWL), which is the transcutaneous application of focused, cyclic ultrasound pulses.

Materials And Methods: This was a prospective multi-institutional feasibility study recruiting subjects undergoing clinical ureteroscopy (URS) for at least 1 stone ≤12 mm as measured on computerized tomography. During the planned URS, either before or after ureteroscope insertion, BWL was administered with a handheld transducer, and any stone fragmentation and tissue injury were observed.

Improving Burst Wave Lithotripsy Effectiveness for Small Stones and Fragments by Increasing Frequency: Theoretical Modeling and Study.

In clinical trial NCT03873259, a 2.6-mm lower pole stone was treated transcutaneously and with 390-kHz burst wave lithotripsy (BWL) for 40 minutes and failed to break. The stone was subsequently fragmented with 650-kHz BWL after a 4-minute exposure.

Virtual Reality Warm-up Before Robot-assisted Surgery: A Randomized Controlled Trial.

Trial Design: This was a randomized controlled trial.

Background: Intraoperative errors correlate with surgeon skill and skill declines with intervals of inactivity. The goals of this research were to identify the optimal virtual reality (VR) warm-up curriculum to prime a surgeon's technical skill and validate benefit in the operating room.

Program Directors' Perspectives of ACGME Requirements and Effectiveness of Training Urology Residents: A National Survey in the Era of the Next Accreditation System.

Objective: To qualitatively assess Urology program directors' perspectives on the effectiveness of training residents after implementation of the Accreditation Council for Graduate Medical Education's (ACGME) 2011 Next Accreditation System, and identify differences in current perspectives and prior surveyed perspectives toward the ACGME Outcome Project.

Methods: A national survey was developed by an ad hoc committee and distributed electronically to 105 Urology program directors. Thirty-four (34) multiple-choice, Likert-scale questions were administered.

National Imaging Trends in Nephrolithiasis-Does Renal Ultrasound in the Emergency Department Pave the Way for Computerized Tomography?

Introduction: Concern regarding radiation exposure has led to increased interest in the use of ultrasound for the initial imaging of suspected renal colic in the emergency department. It is unknown whether such an approach simply defers computerized tomography to outpatient followup. We analyzed national imaging patterns to explore this relationship.