Field Of Urology Research Articles

Karakteristik dan Pola Hidup dengan Kejadian Batu Ginjal di Poliklinik Urologi Rumah Sakit Pertamedika Ummi Rosnati Banda Aceh

Background: Kidney stones are one of the 3 most common diseases in the field of urology after urinary tract infections and benign prostate enlargement. This disease usually occurs at the age of 60 – 69 years and occurs 3 – 4 times more in men than women. The procedures that are often performed are non-invasive. Purpose: Knowing the relationship between characteristics and lifestyle with the incidence of kidney stones. Methods: This research is a quantitative research with a cross sectional analytical research design. The sample for this study was 47 kidney stone patients at the Pertamedika Ummi Rosnati Hospital, Banda Aceh. Results: From the results of the Fisher Exact analysis, it was found that the relationship between characteristics and lifestyle with the incidence of kidney stones included age (p=0.003), occupation (0.046), activity status (0.007), diet (0.005) and elimination pattern (0.001). Meanwhile, education (0.560) had no relationship with the incidence of kidney stones. Conclusion: There is a relationship between age, occupation, activity status, diet and elimination patterns with the incidence of kidney stones. Meanwhile, education has no relationship with the incidence of kidney stones.

#829 Renoprotective effects of laxative linaclotide: inhibition of acute kidney injury and fibrosis in a rat model of renal ischemia-reperfusion

Abstract Background and Aims Acute kidney injury caused by renal ischemia/reperfusion (I/R) is a major clinical problem in many aspects of urology fields such as kidney transplantation and partial nephrectomy, but there is no effective treatment. Linaclotide, a guanylate cyclase C agonist clinically approved as a laxative, has recently been shown to be renoprotective in a chronic kidney disease (CKD) model. Therefore, the present study investigated the possibility that the renoprotective effects of linaclotide in renal I/R may extend beyond its gastrointestinal effects. Method The left renal pelvis of adult male Wistar rats was clamped for 45 minutes to induce renal I/R injury. Kidney tissue, colon, and blood were collected 24 hours and 14 days later. Linaclotide was administered for 14 days preoperatively and until postoperative tissue collection. Tissue sections were stained with standard histologic techniques such as HE, Sirius Red, F4/80, etc. As genes associated with I/R, TGF-β and related fibrosis markers α-SMA, MMP2, TIMP1 and inflammatory cytokines TNF, IL-1β and IL-6 were analyzed by quantitative PCR analysis. Results Serum creatinine levels decreased significantly after linaclotide administration, indicating improved renal function. Histologic examination showed less tubular damage and less collagen deposition on Sirius Red staining. Further analysis showed decreased expression of TGF-β and related fibrosis markers α-SMA, MMP2 and TIMP1, suggesting downregulation of the fibrotic TGF-β pathway by linaclotide. Furthermore, 1 day after I/R injury, linaclotide significantly reduced macrophage infiltration and suppressed key proinflammatory cytokines such as TNF, IL-1β, and IL-6. Conclusion These results suggest that linaclotide, with its established safety profile, could extend its benefits beyond gastrointestinal issues and potentially serve as a therapeutic intervention in many aspects of kidney surgeries. In addition, it could provide immediate and practical insights into the selection of laxatives for the management of patients with AKI or CKD, regardless of cause, and for those receiving dialysis or transplant therapy.

Occupational Radiation Exposure During Pregnancy: A Survey of Urologists on Perception, Experience, and Practice Patterns.

Introduction: The field of urology is predominantly male; however, there has been an increasing number of women in the workforce. Peak reproductive years frequently overlap with residency training and early attending career timelines. Exposure to ionizing radiation is a common occupational hazard in many procedural specialties. The use of radiation, for example, in interventional cardiology and interventional radiology, has shown little adjustments in practice patterns, with no adverse outcomes reported among pregnant physicians in their fields in the setting of appropriate radiation safety measures. The impact of radiation exposure during pregnancy for urologists is largely unknown. Our objective was to determine attitudes and practices of urologists related to radiation exposure and to characterize the experience of urologists who have previously been pregnant. Methods: An anonymous online survey was distributed through relevant society membership bases, which included the Endourological Society and the Society for Women in Urology, and social media. Demographics, practice patterns, and changes to practice patterns were recorded for respondents. Statistical analysis was performed in R studio. Results: There were 384 respondents, 255 of whom identified as women. Of these, 164 had been previously pregnant. Female respondents were younger, completed training more recently, and were more likely to have adjusted their caseload due to radiation concerns compared with their male counterparts. Of women who had been pregnant, few had access to policies for who to notify (19%), policies for safety precautions (22%), custom-fitted lead (35%), and maternity lead (20%). Most women (66%) relied on their own research for guidance on radiation safety during pregnancy, while some (41%) also used information from colleagues or mentors. Forty-six percent of women would have taken greater precautions during pregnancy than they did. Conclusions: Access to the appropriate tools to safely navigate pregnancy is inconsistent among practicing urologists. Evidence-based guidelines are needed to better empower pregnant urologists.

Burnout in Urological Education: An In-Depth Study of Residents and Fellows in the 2021 AUA Census.

Our goal was to explore the current trends in burnout, career choice regret, and well-being needs among urology residents and fellows, with specific emphasis on identifying key factors associated with burnout. The AUA Workforce Workgroup collaborated with the AUA Data Team to analyze data from the 2021 AUA Census, comprising a total of 243 residents and fellows. Key demographics, benefits and resources, career choice and debt, and burnout levels were analyzed, focusing on variables like gender, PGY (postgraduate year) level, debt burden, and personal health appointments. Overall, 48% of residents and 33% of fellows met criteria for professional burnout, with a higher incidence among PGY-2 residents (70%). Depersonalization was particularly notable, with 74% of residents reporting medium to high levels. Burnout was significantly associated with difficulty attending personal health appointments (52% vs 34%) and lack of access to on-call rooms (54% vs 36%). In contrast, having children during residency was associated with lower burnout levels (30.8% vs 49.1%). Meal plans were ranked as the most desired benefit (32%), followed by ability to attend health appointments during work hours (17%) and paid family leave (16%). Educational debt over $150,000 was carried by 53% of residents and 48% of fellows. Interestingly, burnout rates showed no statistically significant difference in response rates across genders, relationship status, amount of educational debt, presence of paid maternity or paternity leave, and type of childcare arrangements. Burnout remains a significant issue among urology trainees, with a complex interplay of factors like lack of personal time and provision of call rooms. The alarming rates of depersonalization and exhaustion highlight the urgency of implementing targeted interventions. Enhanced support systems, improved access to health care appointments, provision of call rooms, and debt management programs are recommended to alleviate the growing problem of professional burnout in the field of urology.

Laser Lithotripsy for the Management of Ureteric Calculus

Urinary calculi are important problem in urology field. Ureteral stones can cause obstructive uropathy and subsequent deterioration of renal function. The minimal invasive approaches become the major source of treatment modalities with the development of lithotripsy technology. A prospective cross sectional hospital study was conducted in the Urology Department of a tertiary care hospital in Kathmandu for a period of one year (September 2022 to August 2023). A total of 118 patients attending Urology OPD and undergoing laser lithotripsy were included in the study. Ureteroscopic procedure was done using a 6.5 Fr (Wolf Inc., Germany) semirigid ureteroscope under direct endoscopic vision and once the stone was visible, fragmentation was done using Ho-YAG laser. The mean age of the patients was 35.36 ± 11.65 years with male preponderance (58.5%). The common presenting symptom was flank pain and ureteric calculus was more common in the left side (49.2%). Upper ureteric calculus (60.2%) and single stone (83.9%) were more common. Stone size <10 mm (54.2%) and density more than 1000 HU (87.3%) were more common. Stone retropulsion was seen in 16.1% cases and 78% had no post operative complications. SFR in Xray KUB was 94.9% and in USG was 78.8%. The association of SFR in Xray KUB and USG among different variables - male and female patients, patients with stone size < and ≥ 10 mm, stone density < and ≥ 1000 HU and sites (upper, middle and lower) was statistically not significant. The laser lithotripsy technique was found to be effective and safe for ureteric calculus with high SFR.

Clinicopathological Study of Helicobactor Pylori Infection and Gastric Carcinoma at a Tertiary Care Hospital in Kathmandu

Urinary calculi are important problem in urology field. Ureteral stones can cause obstructive uropathy and subsequent deterioration of renal function. The minimal invasive approaches become the major source of treatment modalities with the development of lithotripsy technology. A prospective cross sectional hospital study was conducted in the Urology Department of a tertiary care hospital in Kathmandu for a period of one year (September 2022 to August 2023). A total of 118 patients attending Urology OPD and undergoing laser lithotripsy were included in the study. Ureteroscopic procedure was done using a 6.5 Fr (Wolf Inc., Germany) semirigid ureteroscope under direct endoscopic vision and once the stone was visible, fragmentation was done using Ho-YAG laser. The mean age of the patients was 35.36 ± 11.65 years with male preponderance (58.5%). The common presenting symptom was flank pain and ureteric calculus was more common in the left side (49.2%). Upper ureteric calculus (60.2%) and single stone (83.9%) were more common. Stone size <10 mm (54.2%) and density more than 1000 HU (87.3%) were more common. Stone retropulsion was seen in 16.1% cases and 78% had no post operative complications. SFR in Xray KUB was 94.9% and in USG was 78.8%. The association of SFR in Xray KUB and USG among different variables - male and female patients, patients with stone size < and ≥ 10 mm, stone density < and ≥ 1000 HU and sites (upper, middle and lower) was statistically not significant. The laser lithotripsy technique was found to be effective and safe for ureteric calculus with high SFR.

Impact of Artificial Intelligence and Machine Learning on Urological Practice

Abstract Artificial intelligence (AI) has revolutionized urology while reshaping clinical practice and research. It excels in predicting treatment outcomes and enhancing disease diagnosis accuracy, particularly in bladder disorders such as interstitial cystitis, bladder cancer, and reproductive urology. AI’s data analysis capabilities enable early detection and prognosis by identifying patterns in vast datasets. It paves the way for more personalized treatments and reshapes disease classification. In the age of “big data,” AI simplifies complex healthcare information while improving decision-making and patient care. In addition, physical AI applications in robot-assisted surgery and nanotechnology enhance drug administration precision, surgical effectiveness, and patient outcomes. This review highlights AI’s pivotal role in identifying and treating urological disorders, aiding surgical guidance, and advancing tissue engineering, showcasing its significant impact and ongoing progress in the field of urology.

Assessment of the Quality of YouTube Educational Videos on Laparoscopic Right Adrenalectomy and Laparoscopic Partial Nephrectomy Surgeries.

Introduction: Despite the considerable studies conducted on the quality of YouTube surgical videos as an educational resource in other surgical fields, there have been no such studies in the field of laparoscopic urology so far. Considering the great sensitivity in these procedures and the necessity of identifying the mistakes in these videos, we aimed to evaluate the quality of YouTube educational videos on laparoscopic right adrenalectomy and laparoscopic partial nephrectomy surgeries. Materials and Methods: In this descriptive cross-sectional study, 131 YouTube educational videos on laparoscopic right adrenalectomy and laparoscopic partial nephrectomy surgeries were reviewed. Two researchers familiar with laparoscopic urological surgery reviewed the videos based on the LAP-VEGaS checklist. A third professor reviewed the videos on which there were disagreements. Results: In the majority of the videos, the title was chosen accordingly and the surgeon was introduced appropriately. Furthermore, in most of the videos, patient anonymity was respected. The mean score of the videos was equal to 74.3 ± 5.4, the maximum score being 17 and the minimum 1. The average score of the partial nephrectomy videos was obtained as 98.3 ± 5.74, whereas the average score for adrenalectomy videos was 47.3 ± 4.5. The overall average score of the studied videos was 74.3 ± 5.40. Conclusion: The results of our study suggest that most of YouTube videos on laparoscopic right adrenalectomy and laparoscopic partial nephrectomy surgeries are used for educational purpose. These YouTube videos are suboptimal in educational aspect and students should be advised to use them with caution.

Intraoperative near-infrared fluorescence visualization of anatomical structures in general surgical and urological practice

Aim: to analyze current literature on the assessment of intraoperative near-infrared fluorescence visualization of anatomical structures in general surgical and urological practice. The experience of using intraoperative near-infrared fluorescence visualization of anatomical structures in general surgical and urological practice is analyzed. The priority areas of the method application are defined, the recent clinical studies in various fields of surgery and urology are reviewed. Conclusions. The method of intraoperative near-infrared fluorescence imaging of anatomical structures with abundant vascularization and for assessing oncological prognosis is the most promising.

Palliative Care for Pediatric Urology

Palliative care in the field of urology has largely been limited to adult oncologic conditions. Although there is a plethora of established literature suggesting the advantageous impact of palliative care, there is limited integration of palliative care in adult urology. This underutilization is further exacerbated in pediatric urology, and palliative care in pediatric urology remains an underexplored area despite the prevalence of several life-limiting conditions in this patient population. This paper highlights the potential need for palliative care intervention in a variety of urologic conditions in the pediatric population, including congenital lower urinary tract obstruction, neurogenic bladder dysfunction, exstrophy-epispadias complex, and congenital bilateral renal agenesis. Each condition poses unique challenges that can be addressed with the inclusion of a palliative care team, including decision-making spanning prenatal-neonatal-pediatric periods, acute and chronic symptom management, family relations, body image issues, risk of recurrent hospitalizations and surgeries, and potentially fatal complications. Alongside standard urologic interventions, palliative care can serve as an additional means of addressing physical and psychosocial symptoms experienced by pediatric urology patients to enhance the quality of life of patients and their families.

Gender inequality in genitourinary malignancies clinical trials leadership.

Over the past 2 decades, there has been a growing interest in the significance of gender roles in healthcare and several efforts and initiatives have focused on increasing female representation in the medical field. Clinical trials play a very important role in shaping medical practice; moreover, the leaders of clinical trials often represent the upper echelon of researchers in any designated field. Presently, there is no data regarding women's representation in urological oncology clinical trials leadership. Therefore, the aim of this study is to examine the extent of female representation in leading urological clinical trials. To thoroughly examine the representation of females as principal investigators (PIs) in urological cancer clinical trials between 2000 and 2020, we conducted a comprehensive search of completed trials focused on kidney, prostate, and bladder cancer on ClinicalTrials.gov. We extracted relevant information regarding the PIs and analyzed the data using univariate analyses to identify any significant differences between male and female PIs. A total of 9145 cancer clinical trials were conducted over the last 2 decades, and 11.3% (n = 1033) of them were urological cancer clinical trials. We were able to obtain detailed information about the principal investigators (PI) in 79.0% (n = 816) of the clinical trials, and we found that 16.8% (n = 137) of them were led by female investigators. Upon evaluating the characteristics of the PIs, female PIs had a significantly lower median age and median total citations as compared to male PIs (55.0 vs 59.0 and 5333 vs 7902; p-value < 0.001 and 0.006, respectively). However, there was no statistically significant difference between the termination rate, publication rate, funding source, cancer type, and the subject of conducting the clinical trials between male and female PIs. Between 2000 and 2020, only 16.8% of urological cancer clinical trials were led by a female PI, perhaps reflective of a low percentage of senior female researchers in the fields of urology, oncology and radiation oncology. Universities, research institutes and funding agencies should work to improve mentorship, representation and opportunities for female investigators to encourage more involvement for female researchers in these clinical trials.

Video-rate endocavity photoacoustic/harmonic ultrasound imaging with miniaturized light delivery.

Endocavity ultrasound (US) imaging is a frequently employed diagnostic technique in gynecology and urology for the assessment of male and female genital diseases that present challenges for conventional transabdominal imaging. The integration of photoacoustic (PA) imaging with clinical US imaging has displayed promising outcomes in clinical research. Nonetheless, its application has been constrained due to size limitations, restricting it to spatially confined locations such as vaginal or rectal canals. This study presents the development of a video-rate (20Hz) endocavity PA/harmonic US imaging (EPAUSI) system. The approach incorporates a commercially available endocavity US probe with a miniaturized laser delivery unit, comprised of a single large-core fiber and a line beamshaping engineered diffuser. The system facilitates real-time image display and subsequent processing, including angular energy density correction and spectral unmixing, in offline mode. The spatial resolutions of the concurrently acquired PA and harmonic US images were measured at and in the radial direction, respectively, and 1.22deg and 1.50deg in the angular direction, respectively. Furthermore, the system demonstrated its capability in multispectral PA imaging by successfully distinguishing two clinical dyes in a tissue-mimicking phantom. Its rapid temporal resolution enabled the capture of kinetic dye perfusion into an ex vivo porcine ovary through the depth of porcine uterine tissue. EPAUSI proved its clinical viability by detecting pulsating hemodynamics in the male rat's prostate in vivo and accurately classifying human blood vessels into arteries and veins based on measurements. Our proposed EPAUSI system holds the potential to unveil previously overlooked indicators of vascular alterations in genital cancers or endometriosis, addressing pressing requirements in the fields of gynecology and urology.

Primary Palliative Care in Urology: Quality Improvement Summit 2021-2022.

The AUA convened a 2021-2022 Quality Improvement Summit to bring together interdisciplinary providers to inform the current state and to discuss potential strategies for integrating primary palliative care into urology practice. We hypothesized that the Summit findings would inform a scalable primary palliative care model for urology. The 3-part summit reached a total of 160 interdisciplinary health care professionals. Webinar 1, "Building a Primary Palliative Care Model for Urology," focused on a urologist's role in palliative care. Webinar 2, "Perspectives on Increasing the Use of Palliative Care in Advanced Urologic Disease," addressed barriers to possible implementation of a primary palliative care model. The in-person Summit, "Laying the Foundation for Primary Palliative Care in Urology," focused on operationalization of primary palliative care, clinical innovations needed, and relevant metrics. Participants agreed that palliative care is needed early in the disease course for patients with advanced disease, including those with benign and malignant conditions. The group agreed about the important domains that should be addressed as well as the interdisciplinary providers who are best suited to address each domain. There was consensus that a primary "quarterback" was needed, encapsulated in a conceptual model-UroPal-with a urologist at the hub of care. The Summit provides the field of urology with a framework and specific steps that can be taken to move urology-palliative care integration forward. Urologists are uniquely positioned to provide primary palliative care for their many patients with serious illness, both in the surgical and chronic care contexts.

(127) Is Artificial Intelligence Ready to Help Urologists?

Abstract Introduction ChatGPT is a language model developed by OpenAI. It's a variant of the GPT (Generative Pretrained Transformer) architecture, a transformer-based neural network used for natural language processing tasks. The model has been trained on a massive corpus of text data and can generate human-like responses to topics and questions. ChatGPT can be used for chatbots, conversation agents, and language translation. The integration of AI into urology has the potential to improve patient outcomes, increase efficiency, and reduce costs, ultimately leading to a better healthcare experience for patients. Objective The objective of this study is to assess the current state of artificial intelligence (AI) when it comes to urologic problems and to determine whether it is sufficiently developed and prepared to provide useful assistance to urologists in their clinical practice. This study aims to assess the accuracy, reliability, and potential benefits of one AI language model (ChatGPT) in efficiently answering common patient questions, providing patients with accurate educational information, minimizing patient harm, and guiding patients towards appropriate management. By exhibiting ChatGPT's capabilities and limitations in the context of urology, the study aims to demonstrate how AI can be helpful in everyday urological practices. Methods ChatGPT (chat.openai.com) was presented with typical clinical scenarios and patient questions. Results AI wrote the introduction answering “What is ChatGPT?” and “How can AI help urologists?”. For the conclusion, AI was prompted with “Is artificial intelligence ready to help urologists?”. Figures summarize the answers to common patient questions given by ChatGPT. Conclusions The use of AI in the field of urology is still in its early stages and more research is needed to determine its full potential. However, there have already been some promising developments and successful applications. For example, AI algorithms have been used to accurately diagnose prostate cancer, predict patient outcomes, and improve surgical planning. While AI has the potential to revolutionize the field of urology, it is important to note that AI is not a substitute for human expertise and judgment. AI algorithms can provide valuable insights and assistance, but the ultimate decision making and treatment planning should still be done by experienced urologists. Additionally, it is important to ensure that AI systems are developed and used in a way that respects patient privacy and data security, and that the outcomes of AI-assisted decision making are transparent and explainable. In summary, AI has the potential to greatly benefit the field of urology. Still, it is important to approach its use with caution and continue evaluating its impact as more research is conducted. Disclosure No.

Sexuality in penile cancer survivors: A rarely discussed problem in uro‐oncology

AbstractSexuality in cancer patients is a complex area. It is estimated that 81% of patients with urological cancer develop problems in their sexual functionality, even from the moment of diagnosis and aggravated during treatment due to direct injury to the genitalia. Currently, there are few avenues of care within the field of urology that address sexual health and quality of sexual life in penile cancer survivors, which causes many of them to lose self‐esteem and have problems with their partners. To review the literature on what are the consequences on the sexual life of penile cancer survivors in terms of their performance, including risk factors associated with penile cancer and what are the alternatives they must recover their sexual life. Most penile cancer survivors develop alterations in sexual performance and functionality, such as loss of sexual interest, dysfunctional ejaculation, and loss of orgasm, increasing the risk of depression and anxiety. Sex therapy is presented as an alternative to improve the quality of life of these patients, proposing sexuality as something more than genitalia and helping to lead a better life. Sex therapy is an alternative and should be contemplated in the therapeutic plan of patients with urological cancer, especially penile cancer, since sexuality is part of an individual's life, and its loss affects the quality of life.

Laser Technology Advancements in the Treatment of Benign Prostatic Hypertrophy.

Lasers have had a significant impact on the treatment of benign prostatic hypertrophy. This article attempts to distill the advancements in laser technology for the treatment of benign prostatic hypertrophy (BPH) into key and understandable points to help make this topic more accessible to urologists. The holmium:yttrium-aluminum-garnet (YAG) laser, one of the most significant lasers in the field of urology, has recently been improved with pulse modulating technology (Moses™ technology). New thulium:YAG technology allows both pulsed and continuous wave modes. The thulium fiber laser is one of the newer lasers to come to market and has been shown to have effective and safe outcomes. GreenLight™ lasers are predominantly used in photovaporization procedures and have also been studied extensively, although less in recent years. The modern urologist is fortunate to have many high-quality lasers and a wide variety of surgical techniques to choose from when treating BPH. Understanding the basic laser principles and applications will help urologists to select the best treatment options for their patients with BPH.

(286) Gender Disparities Exist in the Surgical Management of Peyronie's Disease and Urologic Prosthetics: An Evaluation of American Board of Urology (ABU) Surgical Case Logs

Abstract Introduction Urology has been predominantly male-dominated, although recent trends indicate increased female representation among urology residents, physicians and advanced-practitioner providers. While progress has been made, gender disparities persist due to societal perceptions and biases. The goal of this study was to investigate whether a provider gender gap exists in the field of reconstructive urology using American Board of Urology (ABU) case logs. Objective To examine case volume characteristics for provider gender disparities in Peyronie’s disease and urologic prosthetic surgery. Methods Retrospective review of surgical case log data from 2003 to 2023 of certified urologists was performed for 11 Current Procedural Terminology (CPT) codes for the surgical management of Peyronie’s disease (penile plication CPT 54360, plaque excision/incision with grafting CPT 54111, 54112), male urethral sling or artificial urinary sphincter (CPT 53440, 53445), and placement of penile implant (CPT 54400, 54401, 54405). Inclusion criteria included male patients who were 18 years old or older. Data collected included patient and surgeon demographics, surgical procedure, and surgeon fellowship training status. Cases were analyzed using descriptive statistics and regression testing. Results From 2003 to 2023, a total 2,852 urologists performed 15,171 Peyronie’s disease and urologic prosthetic surgical procedures. Among these procedures, 1,910 (13%) Peyronie’s disease, 8,940 (59%) penile implant, and 4,321 (28%) incontinence procedures were identified. Out of the total practicing urologists, 2,626 were male and 226 were female; the distribution of cases revealed 5 cases performed per male surgeon and 4 cases per female surgeon. Over two decades, there was a significant positive trend in the proportion of cases performed by female surgeons (p &amp;lt; 0.001). 169 (6%) surgeons completed fellowships in Andrology or Male Reconstruction, and performed 2,129 (14%) of total procedures. Across surgeons with Andrology or Male Reconstruction fellowship-training, there were 13 cases performed per male surgeon and 7 cases per female surgeon. Conclusions Our study confirms underrepresentation of female surgeons in the field of Peyronie's disease and prosthetic urology. Although there is a trend of increasing female representation over time, further research can be done to identify barriers to gender equality in the field. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Boston Scientific, Coloplast.

(023) Can Artificial Intelligence Generate a Superior Introduction to a Systematic Review?

Abstract Introduction An iteration of artificial intelligence (AI), large language models (LLMs), such as ChatGPT, have recently gained popularity as a potential educational resource for patients, students, and researchers. LLMs utilize deep learning algorithms to predict the next word in a sequence based on a data library of 300 billion words. Recent studies have shown that while LLMs provide useful information, they are limited due to producing false and nonsensical information. A focus of studies has been on the utility of ChatGPT as an educational resource to patients and learners; however, no study has investigated the utilization of ChatGPT to write a scientific review. AI- generated systematic reviews would be valuable to the dynamic field of urology, especially in terms of research and innovation. Objective Considering the limitations of ChatGPT in performing data analysis, the aim of this project was to assess the utility of AI in constructing introductions of a systematic review on urologic issues and to compare these AI-generated introductions to published introductions written by humans. Methods ChatGPT (4.0), available at www.chat.openai.com, was used to construct three introductions to three different systematic reviews on the following topics: testosterone therapy and cardiovascular events, safety and efficacy of noninvasive therapies for Peyronie’s disease, and erectile dysfunction after radical prostatectomy. Introductions from published systematic reviews in each of the above topics were also obtained. Five different experts in these topics, who were blinded to which introductions were AI generated, reviewed then assessed the introductions for the following parameters: completeness, engagement, accuracy, logic, and clarity of objective. Introductions were assessed for baseline literary differences as well. Results There were no significant differences in the words, characters, number of sentences, and length of sentences between AI-generated introductions compared to those written by humans. There was a statistically significant difference in word length, with AI having a lower average of word length. AI scored significantly higher on average in the categories of completeness and engagement. We did not observe a significant difference between the two groups in the other categories. These observed findings demonstrate that AI can synthesize urologic literature (sexual medicine/men’s health) and generate introductions of a systematic review that are minimally noninferior and possibly superior regarding engagement and completeness. The limitations from this study include a small sample size (5) and the exclusive focus on AI-generated introductions rather than other AI-generated sections of a systematic review. Conclusions Our study reveals that ChatGPT, as an LLM, can provide a noninferior, possibly superior, introduction to a systematic review on topics of urologic sexual medicine and men’s health. As more facets of AI are developed, such as data integration and analysis, AI could be used to generate entire systematic reviews noninferior to those written by humans. Ethical principles of using AI in scientific literature should be examined and discussed prior to the development of more enhanced LLMs. Disclosure No.

(001) Top 50 Most Cited Articles About Female Sexual Dysfunction: A Bibliometric Analysis

Abstract Introduction Female sexual dysfunction (FSD), as recognized by the American Foundation for Urologic Disease, consists of low libido, problems with sexual arousal, inability to achieve orgasm, and dyspareunia. Sexual function is an important aspect of life for many women and is closely correlated with overall well-being. This dysfunction is often underrepresented in the academic space when compared to male sexual disorders, such as erectile dysfunction (ED). As FSD spans the fields of Urology, Gynecology, Psychology, and Endocrinology, bibliometric analyses are an important resource to understand the vast body of knowledge by highlighting landmark papers. Objective The objective of this study was to identify key articles about FSD using citation number and bibliometric analysis to facilitate future scholarly efforts into more research on FSD through a multidisciplinary perspective. Methods We searched for articles in the Web of Science Core Collection between 1900 to 2023 using terms specific to FSD. We identified relevant FSD articles and selected the top 50 most cited (T50). A bibliometric analysis was performed to collect and analyze data about title, authorship, publication year, citation number, journal and impact factor, country and institution, study type, citation index, specialty, and conflict of interest. Citation index was calculated as citations/years since publication to determine citations per year. Results 6,858 results were identified and T50 articles were published between 1997-2014 in 12 countries, across 32 different institutions, and in 20 journals. Most articles were published in 2007 while most citations occurred in articles published in 1999. The most cited article (4020 citations), The Female Sexual Function Index (FSFI): A multidimensional self-report instrument for the assessment of female sexual function by R. Rosen, also had the most citations per year (174.78 citation/year). The USA produced the most articles, specifically through University of Medicine and Dentistry of New Jersey. Journal of Sexual Medicine published the most articles. The mean number of citations per article was 351.64. Observational studies were most common while reviews were least common. Less than half were sponsored. Of all the specialties that FSD spans, most articles were published in Urology &amp; Nephrology, then Psychology, then Obstetrics and Gynecology. Research about FSD has been less impactful and influential than research about male sexual dysfunction, which is evidenced in the lower median citation number (209.00 vs. 364.00 citations, respectively) and total number of articles in WoS (6,858 vs 24,941 articles, respectively) for FSD compared to ED. Since FSD and male sexual dysfunction have about equal prevalence, this disparity may be due to the reluctance of female patients to discuss sexual issues due to shame. Conclusions This is the first bibliometric analysis to identify the characteristics of T50 articles in FSD. This list emphasizes the lack of attention that FSD has had in medical research and underscores the obvious discrepancy between research into FSD and male sexual dysfunction. We hope to provide healthcare professionals with a valuable resource to understand the vast body of knowledge and trajectory of FSD to guide future research and education. Disclosure No.

Re-hospitalization factors and economic characteristics of urinary tract infected patients using machine learning.

Urinary tract infection is one of the most prevalent bacterial infectious diseases in outpatient treatment, and 50-80% of women experience it more than once, with a recurrence rate of 40-50% within a year; consequently, preventing re-hospitalization of patients is critical. However, in the field of urology, no research on the analysis of the re-hospitalization status for urinary tract infections using machine learning algorithms has been reported to date. Therefore, this study uses various machine learning algorithms to analyze the clinical and nonclinical factors related to patients who were re-hospitalized within 30 days of urinary tract infection. Data were collected from 497 patients re-hospitalized for urinary tract infections within 30 days and 496 patients who did not require re-hospitalization. The re-hospitalization factors were analyzed using four machine learning algorithms: gradient boosting classifier, random forest, naive Bayes, and logistic regression. The best-performing gradient boosting classifier identified respiratory rate, days of hospitalization, albumin, diastolic blood pressure, blood urea nitrogen, body mass index, systolic blood pressure, body temperature, total bilirubin, and pulse as the top-10 factors that affect re-hospitalization because of urinary tract infections. The 993 patients whose data were collected were divided into risk groups based on these factors, and the re-hospitalization rate, days of hospitalization, and medical expenses were observed to decrease from the high- to low-risk group. This study showed new possibilities in analyzing the status of urinary tract infection-related re-hospitalization using machine learning. Identifying factors affecting re-hospitalization and incorporating preventable and reinforcement-based treatment programs can aid in reducing the re-hospitalization rate and average number of days of hospitalization, thereby reducing medical expenses.