UIJ

UIJ

Definition Change and Update of Clinical Guidelines for Interstitial Cystitis and Bladder Pain Syndrome - Beyond the Abstract

The utmost importance of this article is the separation of interstitial cystitis (IC) and bladder pain syndrome (BPS). Clinical management and research should be organized differently for IC and BPS; otherwise, confusion on IC and related conditions will not be dissolved.

Efficacy, Satisfaction, and Compliance: Insights from 15 Years of Botulinum Toxin Use for Female Urgency Urinary Incontinence - Beyond the Abstract

Why look at 15 years of botulinum toxin treatment for female urgency urinary incontinence (UUI)? Well, UUI can seriously disrupt a woman’s quality of life, especially when medical treatments don’t work. Our 15-year study aimed to understand how botulinum toxin has performed as a long-term solution for these patients in real-life conditions, and the results are encouraging. However, some factors do affect its success.

Avoiding "Needless" Nephrectomy: What Is the Role of Small Renal Mass Biopsy in 2024? - Beyond the Abstract

In our recent review article published in Urologic Oncology: Seminars and Original Investigations, "Avoiding Needless Nephrectomy: What is the Role of Small Renal Mass Biopsy in 2024?" we delve into the current management paradigms for small renal masses (SRMs) and propose an important paradigm shift in clinical practice to reduce the rate of "needless" nephrectomies (surgery performed for benign disease).^¹

Identification of Genes That Promote PI3K Pathway Activation and Prostate Tumour Formation - Beyond the Abstract

Prostate cancer continues to be one of the leading causes of cancer mortality in men in the developed world, so there is an urgent need to improve diagnosis and treatment. Our best route to doing this is to identify the pathways that drive prostate cancer and build a clear understanding of the mutations associated with tumours at all stages of the disease.

Our 11 Year Experience with Percutaneous Tibial Nerve Stimulation (PTNS) in Men and Women for the Treatment of Interstitial Cystitis / Bladder Pain Syndrome (IC/BPS) - Beyond the Abstract

Q: What is IC/BPS

A: IC/BPS stands for Interstitial cystitis/bladder pain syndrome (IC/BPS), which is defined as “an unpleasant sensation (pain, pressure, discomfort) perceived to be related to the urinary bladder, associated with lower urinary tract symptoms of more than six weeks duration, in the absence of infection or other identifiable causes”.

Treatment Patterns and Survival Outcomes Before and After Access to Immune Checkpoint Inhibitors for Patients With Metastatic Urothelial Carcinoma: A Single-Center Retrospective Study From 2004 to 2021 - Beyond the Abstract

Treatment options for metastatic urothelial carcinoma (mUC) have been scarce until the development of immune checkpoint inhibitors (ICIs).

Genomic Risk Factors for Urethral Stricture: A Systematic Review and Gene Network Analysis - Beyond the Abstract

In our study titled "Genomic Risk Factors for Urethral Stricture: A Systematic Review and Gene Network Analysis," published in the Urology Journal, we aimed to uncover genetic factors potentially influencing urethral stricture.¹ Our objective was to determine specific genes that might contribute to this condition and compile findings from various studies highlighting the differences in gene expression between individuals with urethral stricture and healthy subjects.

Could a Risk-Adapted Approach Support Shared Decision-making Regarding Eligibility for Adjuvant Pembrolizumab for Patients with Clear Cell Renal Cell Carcinoma at High Risk of Recurrence? A Multicentre Cohort Study - Beyond the Abstract

Adjuvant therapy for renal cell carcinoma (RCC) is a complex field investigated in several randomised clinical trials in recent decades.^¹

Effect of United States Medical Licensing Examination Score Cutoffs on Recruitment of Underrepresented Applicants in the Urology Match

Objective
To determine how the use of United States Medical Licensing Examination (USMLE) score cutoffs during the screening process of the Urology Residency Match Program may affect recruitment of applicants who are underrepresented in medicine (URM).

Materials and Methods
Deidentified data from the Association of American Medical Colleges' (AAMC) Electronic Residency Application Service (ERAS) system was reviewed, representing all applicants to our institution's urology residency program from 2018 to 2022. We analyzed self-reported demographic variables including race/ethnicity, age, sex/gender, as well as USMLE Step 1 and Step 2 scores. Chi-square tests and ANOVA were used to determine the association between race/ethnicity and other sociodemographic factors and academic metrics. Applicants were stratified according to USMLE Step 1 cutoff scores and the distribution of applicants by race/ethnicity was assessed using a Gaussian nonlinear regression fit.

Results
A total of 1258 applicants submitted applications to our program during the 5-year period, including 872 males (69.3%) and 386 females (30.7%). Most applicants were White (43.5%), followed by Asian (28.3%), Hispanic/Latino (11.7%), and Black (7.0%). There was an association between race/ethnicity and USMLE scores. Median USMLE Step 1 scores for White, Asian, Hispanic/Latino, and Black applicants were 242, 242, 237, and 232, respectively (P < .001). As cutoff score increases, percentage of URM applicants decreases.

Conclusion
The use of cutoffs based on USMLE scores disproportionately affects URM applicants. Transitioning from numeric scores to pass/fail may enhance holistic review processes and increase the representation of URM applicants offered interviews at urology residency programs.

Alain Kaldany,¹ Hiren V Patel,² Aditi Gore,¹ Haris Ahmed,¹ Saum Ghodoussipour,³ Ji Hae Park,¹ Danielle Velez Leitner,¹ Thomas L Jang⁴

Division of Urology, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ.
Department of Urology, University of California, San Francisco, San Francisco, CA.
Division of Urology, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ; Section of Urologic Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ.
Division of Urology, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ; Section of Urologic Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ.

Source: Effect of United States Medical Licensing Examination Score Cutoffs on Recruitment of Underrepresented Applicants in the Urology Match

Robotic Simple Cystectomy as a Last Resort for Antibiotic-Recalcitrant Recurrent Urinary Tract Infections in Women - Beyond the Abstract

In advanced stages, recurrent urinary tract infections can claim a patient's life during a urosepsis episode. Our group has built some expertise in dealing with these complex situations for which a bladder removal has to be considered to prevent a septic fatality.

Pulsed Thulium:YAG Laser - What Is the Lithotripsy Ablation Efficiency for Stone Dust from Human Urinary Stones? Results from an in Vitro PEARLS Study - Beyond the Abstract

The novel pulsed Thulium: YAG (p-Tm: YAG) is a promising laser and has been shown to dust all prevailing human urinary stone compositions.¹ However, available in vitro and in vivo studies had not provided efficiency data on its applicability to differing stone composition types. The authors thus sought to investigate the unexplored question of ablation efficiency with the p-Tm: YAG for stone dust from human urinary stones.

Impact of the Extent of Lymph Node Dissection on Survival Outcomes in Clinically Lymph Node-Positive Bladder Cancer - Beyond the Abstract

Radical cystectomy (RC) with bilateral pelvic lymph node dissection (PLND) stands as the established treatment for muscle-invasive bladder cancer (BCa).¹ Despite this, the impact of the extent of PLND on oncologic outcomes remains a topic of debate. Two recent randomized controlled trials (NCT01215071, NCT01224665) failed to demonstrate an advantage in recurrence-free/disease-free survival for performing an extended PLND (ePLND) over standard PLND (sPLND) in patients with clinically node-negative or cT2-T4a N0-2 BCa.^{^2,3}

Application of Artificial Intelligence to Patient-Targeted Health Information on Kidney Stone Disease - Beyond the Abstract

Artificial Intelligence (AI) and its capacity to improve lives has become a contentious topic both within and outside of the medical community. One rapidly evolving application of AI is the development of chat software such as Chat GPT, an open AI chatbot designed to generate written answers to questions in a clear and concise manner. The development of Chat GPT and other AI technologies is particularly significant given the increasing popularity and accessibility of the Internet as a primary source of health information in the United States.¹

Access and Utilization of Health Care by Adults with Spina Bifida

Objective
To contextualize the challenges that persons with congenital genitourinary conditions (CGC) may encounter in adulthood, we examined health care access, readiness for self-management, and health care utilization of adults with spina bifida (SB).

The Deafening Silence of Male Infertility - Beyond the Abstract

While it’s easy to acknowledge that infertility impacts one in six couples, it is challenging to truly grasp the impact beyond the numbers. Due to the sensitive nature and stigma surrounding infertility, many personal experiences are too often internalized rather than openly shared.

Spouses Speak Up: The Impact of Mesh Sling Complications on the Patient's Spouse - A Qualitative Analysis Study

Objective: To examine the perspectives, attitudes, and beliefs of the spouses of women with complications of mesh mid-urethral sling (MUS) surgery with the goal of increasing our understanding of the multidimensional nature of MUS surgery complications.

Methods: After IRB approval, the spouses of patients who underwent surgery for MUS complications at a single tertiary care institution participated in qualitative interviews. Using an interview guide with standardized prompts, semi-structured interviews were conducted. Interviews were transcribed verbatim and reviewed line-by-line by two researchers independently. Inductive content analysis was used to code the transcripts and identify themes, and consensus was achieved by the research team.

Results: Seven male spouses participated in qualitative interviews, and several themes and subthemes were identified. First, spouses expressed feelings of regret. They described that their partner's dyspareunia detracted from their intimate relationship. The participants also reported the negative impact on their lives and their households. Due to the personal nature of the issue, couples would avoid involving friends and family, creating a sense of isolation. Finally, they expressed hope of finding a healthcare team experienced with mesh complications and invested in their spouse's improvement.

Conclusions: Spouses of women who experience MUS complications serve as caregivers and provide support; they are impacted by adverse outcomes. It is important to acknowledge their role in patients' health care experiences and learn from their insights. Our study lays the foundation for future work and ultimately for improving the experiences of patients and their spouses with MUS surgery and potential complications.

Shreeya Popat,¹ Jennifer Chyu,² Una Lee³

Section of Urology and Renal Transplantation, Virginia Mason Franciscan Health, Seattle, WA.
Department of Urology, University of Washington School of Medicine, Seattle, WA.
Section of Urology and Renal Transplantation, Virginia Mason Franciscan Health, Seattle, WA.

Source: Shreeya Popat, Jennifer Chyu, Una Lee; (Sep 27, 2023) Spouses speak up: The impact of mesh sling complications on the patient’s spouse - A qualitative analysis study, Urology.

Copy Number Architectures Define Treatment-Mediated Selection of Lethal Prostate Cancer Clones - Beyond the Abstract

Prostate cancer is still the leading cause of male cancer-related mortality globally. While Androgen Deprivation Therapy (ADT) initially displays promise in patients, metastatic prostate cancer inevitably transforms into a lethal state due to treatment resistance, often within two years. Therefore, deciphering this conundrum is a major medical need.

Pulsed Thulium:YAG Laser-Ready To Dust All Urinary Stone Composition Types? Results From a PEARLS Analysis - Beyond the Abstract

The novel pulsed thulium:yttrium-aluminium-garnet (p-Tm:YAG) laser has only been recently introduced into clinical practice. The authors questioned whether the novel p-Tm:YAG laser is able to dust all known prevailing human urinary stone compositions. Senior urologists would remember the frequency-doubled double-pulse neodymium:YAG (FREDDY) laser which was originally looked at as a potential lithotripsy tool, till it was found ineffective against cystine stones.^{^1,2}

Early Three-Month Report of Amniotic Bladder Therapy in Patients with Interstitial Cystitis/Bladder Pain Syndrome - Beyond the Abstract

In International Urology and Nephrology, we have recently detailed the outcomes of ten consecutive interstitial cystitis/ bladder pain syndrome (IC/BPS) patients unresponsive to current therapies that were subsequently managed with intra-detrusor injection of micronized amniotic membrane (termed Amniotic Bladder Therapy). After treatment, voiding symptoms and bladder pain significantly improved from pre-injection up to 3 months which corresponded to a significant improvement in their overall physical and mental quality of life.

Outcomes of Second-Line Therapies in Patients With Metastatic de Novo and Treatment-Emergent Neuroendocrine Prostate Cancer: A Multi-Institutional Study - Beyond the Abstract

Small cell or neuroendocrine prostate cancer (NEPC) is a rare and aggressive disease characterized by a low serum prostate-specific antigen (PSA) and visceral metastatic disease at diagnosis. NEPC can present as de novo metastatic disease (<1% of prostate cancers) or as treatment-emergent NEPC (T-NEPC), which arises from pre-existing metastatic castrate-resistant prostate cancer (mCRPC) (estimated to occur in 17-30% of mCRPC cases). On a histologic level, NEPC is morphologically similar to the oat cell or intermediate cell appearance of small cell lung cancer (SCLC) with nearly 90% of cases staining positive for a neuroendocrine marker.