A Comparison of Preoperative Frailty Indices Correlation With Perioperative Risk for Patients Undergoing Sacrocolpopexy.

Objective: To assess whether frailty as defined by the NSQIP mFI-5 or the RAI-rev indices is correlated with 30-day postoperative outcomes for patients undergoing sacrocolpopexy (SCP), and whether one index is more closely correlated than the other.

Methods: SCPs performed between 2006-2020 were identified in the American College of Surgeons National Surgical Quality Improvement Project (ACS-NSQIP) database. Frailty was calculated using two indices: the NSQIP modified frailty index (mFI-5), and the revised surgical Risk Analysis Index (RAI-rev).

Sacrocolpopexy in urology versus gynecology: a contemporary analysis of outcomes and patient profiles.

Introduction: With the aging population, more females will suffer from pelvic organ prolapse. Both urologists and gynecologists perform sacrocolpopexy, but there is no comparative study analyzing differences in provision of care, outcomes, or patient population. We aimed to elucidate potential differences in demographics, outcomes, and minimally invasive surgery utilization for SCP performed by urology and gynecology.

Bowel regimens before radical cystectomy: An analysis of a modern cohort.

Introduction: Bowel regimens (BR) before radical cystectomy (RC) are currently not recommended by Enhanced Recovery After Surgery (ERAS) protocols, as prior studies have shown BRs lead to worsened outcomes. However, many of those studies have used historic literature before recent surgical advancements such as minimally invasive RC and have not investigated the impact BRs have by type of urinary diversion. Our goal is to determine the outcomes of preoperative BR in patients undergoing RC based on diversion type using a modern patient cohort.

Complications and Influential Perioperative Factors Associated with SpaceOAR Hydrogel Placement.

Objective: To examine one academic institution's experiences with SpaceOAR placement, its associated complications, and periprocedural characteristics that affect outcomes for the purpose of quality improvement.

Materials And Methods: We conducted a retrospective review of 233 patients who received SpaceOAR from four surgeons and one radiation oncologist between 2018 and 2021. Variables such as demographics, oncologic parameters, radiation plan, and radiographic assessment of hydrogel placement were recorded.

Stent vs Stentless Ileal Conduits After Radical Cystectomy: Is There a Difference in Early Postoperative Outcomes?

Introduction: Placing ureteral stents at the ureteroileal anastomosis for radical cystectomy with ileal conduit (RCIC) has long been common practice. Recently, some providers have begun omitting stents. We sought to investigate differences in perioperative and 30-day outcomes between patients who underwent RCIC with and without stents placed at the ureteroileal anastomosis.

Peri-operative outcomes following radical prostatectomy in the setting of advanced prostate cancer.

Objective: To compare the peri-operative outcomes of radical prostatectomy (RP) for locally advanced, node-positive, and metastatic prostate cancer (PCa), as determined through pathological staging, using the American College of Surgeons National Surgical Quality Improvement Project.

Methods: We identified RP procedures performed between 2019 and 2021. Patients were stratified by pathological staging to compare the effect of locally advanced disease (T3-4), node positivity (N+) and metastasis (M+) vs localised PCa (T1-2 N0 M0).

Perioperative risk predictors for gender affirming surgery in the NSQIP database.

Introduction: Gender affirming surgeries (GAS), such as phalloplasty (PLPs) and vaginoplasty (VGPs), are important aspects of medical care for transgender patients. Here, we aim to better characterize patient demographics and surgical outcomes for PLPs and VGPs using the National Surgical Quality Improvement Program (NSQIP). We hypothesized that frailty indices would be predictive of perioperative PLP and VGP risk and outcomes for PLPs and VGPs.

A Narrative Review on Robotic Surgery as Treatment for Renal Cell Carcinoma with Inferior Vena Cava Thrombus.

Renal cell carcinoma (RCC) is a common diagnosis, of which a notable portion of patients present with an extension into the venous circulation causing an inferior vena cava (IVC) tumor thrombus. Venous extension has significant implications for staging and subsequent treatment planning, with recommendations for more aggressive surgical removal, although associated surgical morbidity and mortality is relatively increased. The methods for surgical removal of RCC with IVC thrombus remain complex, particularly surrounding the use of robot-assisted surgery.

Racial Disparities in Diagnosis and Treatment of Depression Associated with Androgen Deprivation Therapy for Prostate Cancer.

Objective: To analyze potential racial disparities in the diagnosis and management of depression associated with androgen deprivation therapy.

Methods: TriNetX health record network was queried for prostate cancer patients treated with androgen deprivation therapy from 2003-2023. Differences in rates of depression diagnosis and treatment were compared between White and Black patients.

Perioperative and Complication Related Outcomes for Robotic-Assisted Open Radical Cystectomy: A Comparative National Surgical Quality Improvement Project Analysis.

Radical cystectomy (RC) is standard of care for muscle-invasive bladder cancer, but it comes with significant perioperative risk, with half of the patients experiencing major postoperative complications. Robot-assisted radical cystectomies (RARCs) have aimed to decrease patient morbidity and been increasingly adopted in North America. Currently, both open radical cystectomies (ORCs) and RARCs are frequently performed.

Recurring cystitis cystica and cystitis glandularis masquerading as urothelial carcinoma.

We report a rare case of cystitis cystica and glandularis mimicking low-grade urothelial carcinoma that was found incidentally and treated with resection and fulguration via transurethral resection of bladder tumor (TURBT). When early recurrence was found on surveillance cystoscopy 3 months later, the patient was treated with repeat TURBT and intravesical gemcitabine. Surveillance cystoscopy 4 months later revealed cystitis cystica and cystitis glandularis yet again.

Squamous cell carcinoma of the renal pelvis masquerading as xanthogranulomatous pyelonephritis.

We report a rare case of a 56-year-old male with a history of hypertension who initially presented to the emergency department with abdominal pain and was radiologically diagnosed with left xanthogranulomatous pyelonephritis (XGP) in a non-functioning kidney with a staghorn calculus. Pathological evaluation of his kidney revealed squamous cell carcinoma (SCC) of the renal pelvis with invasion into the renal parenchyma. We highlight the presentation, diagnosis, and management of this rare condition.

The Impact of COVID-19 on the Urology Residency Match and Geographic Proximity of Applicants.

Objective: To determine the impacts of COVID-19 pandemic-related changes and program-specific characteristics on the geographic diversity of the 2021 and 2022 urology match classes.

Methods: We gathered publicly available information to compare match outcomes in 2021 and 2022 to the previous 5 application cycles (2016-2020). Variables included residency program class size, program and resident AUA section, and program and resident medical school.

Association of baseline self-reported fatigue with overall survival after stereotactic body radiation therapy for localized prostate cancer.

Introduction: Stereotactic Body Radiation Therapy (SBRT) has emerged as a definitive therapy for localized prostate cancer (PCa). However, more data is needed to predict patient prognosis to help guide which patients will benefit most from treatment. The FACIT-Fatigue (FACIT-F) is a well validated, widely used survey for assessing fatigue.

Patient Factors Impacting Perioperative Outcomes for T1b-T2 Localized Renal Cell Carcinoma May Guide Decision for Partial versus Radical Nephrectomy.

There remains debate surrounding partial (PN) versus radical nephrectomy (RN) for T1b-T2 renal cell carcinoma (RCC). PN offers nephron-sparing benefits but involves increased perioperative complications. RN putatively maximizes oncologic benefit with complex tumors.

Bladder diverticulum caused by primary bladder neck obstruction.

Here, we report a case of a patient in their mid 30s who presented with an elevated creatinine and was found to have a massive bladder diverticulum. The patient underwent a robotic-assisted diverticulectomy. They were later found to have a primary bladder neck obstruction on video urodynamics, and subsequently, underwent bladder neck incision, leading to significant improvement in urinary symptoms.

Postoperative Rehabilitation of Posterior Cruciate Ligament Surgery: A Systematic Review.

Posterior cruciate ligament (PCL) injuries can be debilitating knee injuries, having involvement in up to 44% of traumatic knee injuries. However, isolated PCL injuries are relatively infrequent. Therefore, effective evidence-based rehabilitation protocols have proven to be elusive.

Mechanism of βAR regulation by an intracellular positive allosteric modulator.

Drugs targeting the orthosteric, primary binding site of G protein-coupled receptors are the most common therapeutics. Allosteric binding sites, elsewhere on the receptors, are less well-defined, and so less exploited clinically. We report the crystal structure of the prototypic β-adrenergic receptor in complex with an orthosteric agonist and compound-6FA, a positive allosteric modulator of this receptor.