Urology Medicine Research Articles

A pioneer Turkish urologist-medical historian (Saim Erkun 1901-1949) and his one-century-old review about prostate.

Saim Erkun (1901-1949) was born in Manisa at Aegean region of Anatolia as an Ottoman citizen. While his early life was spent in late Ottoman times at military actions including military prison camp in British colony; India, his active professional productive period was in early Turkish republic period (Est. 1923, centenary). He had a good education period for medicine with the help of his good level of all main World scientific languages such as French, German, and English. Besides his main profession, he was also interested in Ottoman urological medicine around the conquer of Istanbul and allocated them a space in his books in 1930s. He was one of the earliest urology resident (1929-1933, Istanbul) of modern medicine in Turkey. He performed many urological procedures and published the outcomes following modern scientific algorithms, furthermore, there have been urological books including "history" partly referring to antique Ottoman literature among his publications. In this manuscript we focused on the magic word of Urology forever; "Prostate," among his essays. Turkish medicine, particularly urology, renewed itself by some intelligent hard working young clinicians such as Saim Erkun, immediately after the short struggling by means of establishment process of modern Turkiye after World War I by the collapsing of old Ottoman Empire. Furthermore, we think that the stunning special word of urology, "prostate," should especially be mentioned to emphasize the importance of this beginning.

The Impact and Implications of Regenerative Medicine in Urology.

Urology focuses on the treatment of genitourinary disorders through therapies ranging from lifestyle changes to advanced surgeries; the field has recently incorporated robotic and minimally invasive technologies that have improved patient outcomes and reduced hospital stays and complications. However, these methods still have certain limitations. Regenerative medicine, focusing on natural repair abilities, can be an effective and safer alternative. This review aims to examine the impact of regenerative medicine in urology. We adopted a systematic review design by following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. An exhaustive online literature search involving the databases PubMed, theCochrane CentralRegister of Controlled Trials (CENTRAL), and GoogleScholar was conducted spanning the period between January 2010 and October 2023. Data were extracted from studies on regenerative medicine in urology with a special focus on efficacy and safety. Data from 16 studies were analyzed, which showed that cell therapy, biological materials, and tissue engineering are generally used in the field of urinary diseases. The main applications include the regeneration of urinary tissue, the correction of urinary incontinence, the treatment of erectile dysfunction, the reconstruction of ureteric defects, and the formation of bladder tissue. The study findings generally lack definitive conclusions on effectiveness and safety. While our results indicate that regenerative medicine is successful on a subjective level, more clinical trials are needed to establish its effectiveness and safety.

Virtual medicine in urology: Is it here to stay?

Virtual medicine in urology: Is it here to stay?

Factors Influencing Underrepresented in Medicine Urologist Recruitment to Academic Institutions.

We characterize factors associated with recruitment of underrepresented in medicine urology trainees and faculty to academic institutions given the excessive disparity between urology and other fields of medicine. A database of urology faculty and residents in Accreditation Council for Graduate Medical Education programs was created. Demographic data were obtained from departmental websites, Twitter, LinkedIn, and Doximity. Program prestige was defined by U.S. News and World Report rankings. Program location and city size were determined using the U.S. Census data. Multivariable analysis was performed assessing the association of gender, AUA section, city size, and rankings on underrepresented in medicine recruitment. Of urologists in this study 8.7% were underrepresented in medicine status. More women urologists were underrepresented in medicine (31.4%) than non-underrepresented in medicine (21.3%; P < .001). Factors predictive of more underrepresented in medicine urologists were practice in South Central AUA section (OR 2.1, P = .04), and medium metro areas (OR 1.6, P < .01). Among residents, factors predictive of more underrepresented in medicine urologists were female gender (P < .001), living in medium metro areas (P = .03), and training in top 10 programs (P = .001). Underrepresented in medicine faculty were more likely to be women compared to non-underrepresented in medicine faculty (P = .05). Pearson correlation test found no association between the presence of underrepresented in medicine faculty and underrepresented in medicine residents (r = 0.20). Underrepresented in medicine urology residents and faculty were more likely to be women, compared to non-underrepresented in medicine residents and faculty. Underrepresented in medicine residents are more prevalent in medium metro areas and in top 10 programs. More underrepresented in medicine faculty status was not associated with more underrepresented in medicine residents.

Traditional plants that are utilized to treat urinary tract infections: A review

Among the most serious problems affecting public health is urinary tract infection (UTI). There are several parts of the urinary tract affected by this type of inflammation and affects women more frequently than men. As the antibacterial resistance problem is growing in urological medicine, there is a increasing and a continuing requirement to add antimicrobial medication which could be from medicinal herbs in regulatory UTIs. Since the beginning of civilization, medicinal plants have been an integral element of human society in the fight against diseases. For the aim of reducing costs, increasing the effectiveness of treatment and eliminating the side effects of UTI patients, medicinal plants have gained wide popularity and great interest. Medicinal plants have been known as a rich source of therapeutic agents. A number of different plants show promise the ability to treat of a various urologic disorders. As the current review illustrates, a number of traditional medicinal plants are evaluated to prevent or treat UTIs, and modern scientific investigations on these important herbs and some isolated chemical compounds.

Chaperones Utilization in Clinical Practice: Intimate and Sensitive Physical Examination Best Practice Strategies and Concepts in Modern Urological Medicine.

The intention of utilizing chaperones during sensitive physical exams is to show respect to the patient, while simultaneously providing protection to both the patient and the medical provider. Despite clinical practice recommendations to offer chaperones for sensitive urologic exams, there is no data regarding the consistency of chaperone utilization. Our aim was to summarize the patient and provider perspectives on the role of chaperones in urology as well as identify barriers to implement chaperone consistency. In the present investigation, we conducted a systematic review of prospective, case-control, and retrospective studies and followed the PRISMA 2020 guidelines for data reporting. Studies were identified from PubMed, MEDLINE, and PMC using the Medical Subject Headings (MeSH) terms "chaperones, patient", "chaperones, medical", and keywords "chaperones", and "urology". Studies were included if they addressed patient/provider perspectives on chaperone utilization in urology specifically and were excluded if they investigated perspectives on chaperone utilization in other specialties. Preliminary study identification yielded 702 studies, 9 of which were eligible for this review after applying the inclusion and exclusion criteria. Of these, 4 studies focused on the patient perspective and 5 focused on the provider perspective. The percentage of patients that did not have a chaperone present during their urologic exam ranged from 52.9-88.5%. A greater proportion of these patients were male. Patients (59%) prefer a family member compared to a staff member as a chaperone. Physicians (60%) prefer staff member chaperones compared to family members. One study reported that 25.6% of patients did not feel comfortable to ask for a chaperone if they were not offered one. Two studies reported the percentage of patients who believed chaperones should be offered to all urology patients, ranging from 73-88.4%. Three studies reported the use of chaperones in the clinic which ranged from 5-72.5%. Two studies reported chaperone utilization documentation, ranging between 16-21.3%. Two studies reported the likelihood of chaperone utilization depending on gender of the physician, showing that male physicians were more likely to utilize chaperones and were 3x more likely to offer chaperones to their patients compared to female physicians. Research suggests that there are differing perspectives between patients and physicians regarding the specific role and benefits chaperones offer during a sensitive urologic examination, as well as differences in preferences of who should perform the role of the chaperone. While more work needs to be done to bridge the divide between clinical practice and patient/physician preferences, the act of offering chaperones to urologic patients, regardless if they want to utilize a chaperone for their examination is respectful of patient privacy and decision making.

New Frontiers of Extracorporeal Shock Wave Medicine in Urology from Bench to Clinical Studies.

A shock wave (SW), which carries energy and propagates through a medium, is a type of continuous transmitted sonic wave that can achieve rapid energy transformations. SWs have been applied for many fields of medical science in various treatment settings. In urology, high-energy extracorporeal SWs have been used to disintegrate urolithiasis for 30 years. However, at lower energy levels, SWs enhance the expression of vascular endothelial growth factor (VEGF), endothelial nitric oxide synthase (eNOS), proliferating cell nuclear antigen (PCNA), chemoattractant factors, and the recruitment of progenitor cells, and inhibit inflammatory molecules. Low energy extracorporeal shock wave (LESW) therapy has been used in urology for treating chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), interstitial cystitis/bladder pain syndrome (IC/BPS), overactive bladder, stress urinary incontinence, and erectile dysfunction through the mechanisms of anti-inflammation, neovascularization, and tissue regeneration. Additionally, LESW have been proven to temporarily increase tissue permeability and facilitate intravesical botulinum toxin delivery for treating overactive bladders in animal studies and in a human clinical trial. LESW assisted drug delivery was also suggested to have a synergistic effect in combination with cisplatin to improve the anti-cancer effect for treating urothelial cancer in an in vitro and in vivo study. LESW assisted drug delivery in uro-oncology is an interesting suggestion, but no comprehensive clinical trials have been conducted as of yet. Taken together, LESW is a promising method for the treatment of various diseases in urology. However, further investigation with a large scale of clinical studies is necessary to confirm the real role of LESW in clinical use. This article provides information on the basics of SW physics, mechanisms of action on biological systems, and new frontiers of SW medicine in urology.

Stakeholders' Perception of the Introduction of Specialized Hospitals for Urologic Diseases: Qualitative Study

Purpose: The purpose of this study is to seek in-depth perspectives of stakeholders on the necessity and specific criteria for designating a specialized hospital for urologic diseases.Methods: Eight participants experts in urology medicine and specialized hospital system were divided into four groups. Following the semi-structured guidelines, an in-depth interview was conducted twice and a focus group discussion was conducted three times. All the interviews were transcribed verbatim and analyzed. Results: The majority of participants predicted that there would be demand for specialized hospitals for urologic diseases. The criteria of designating a specialized hospital, such as the number of hospital beds and quality of health care, have to be modified in consideration of the specificity of urology. The introduction of a specialized hospital would improve the healthcare delivery system, positively affecting hospitals and patients. Furthermore, government support is essential for the maintenance of specialized hospital systems as urology hospitals experience difficulties in generating profits. Conclusion: This study is expected to be used as base data for introducing and operating a specialized hospital for urologic diseases. In addition, it is expected that the methodology and results of this study would encourage follow-up studies on specialized hospitals and provide guidelines to evaluate the effectiveness of such hospitals in other medical fields.

PD60-04 NEW PATIENT VIDEO VISITS FOR COMMON UROLOGICAL CONDITIONS DO NOT LEAD TO AN INCREASE IN SECONDARY VISITS

You have accessJournal of UrologyHealth Services Research: Practice Patterns, Quality of Life and Shared Decision Making V (PD60)1 Sep 2021PD60-04 NEW PATIENT VIDEO VISITS FOR COMMON UROLOGICAL CONDITIONS DO NOT LEAD TO AN INCREASE IN SECONDARY VISITS Jake Clafin, Juan Andino, Lauren McGee, Chad Ellimoottil, and Emma Bethel Jake ClafinJake Clafin More articles by this author , Juan AndinoJuan Andino More articles by this author , Lauren McGeeLauren McGee More articles by this author , Chad EllimoottilChad Ellimoottil More articles by this author , and Emma BethelEmma Bethel More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002097.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: As policymakers formulate post-COVID-19 pandemic telehealth policies, there is concern that the expansion of video visits will lead to inadequate or unnecessary care which may result in an increase in secondary visits. We investigated whether new patients evaluated through video visits required additional urology visits, procedures, emergency department visits, or hospital admissions compared to an in-person control group. METHODS: We reviewed all new patient video visits performed through Michigan Medicine Urology from March – May 2020 for lower urinary tract symptoms, elevated PSA, nephrolithiasis, and scrotal pain. We performed a 1:1 match of this cohort to a cohort of patients who were evaluated in-person for the same conditions, during the same three month period in 2019. Our primary outcome was the percentage of visits associated with additional urology evaluations within 30 days of the first visit. RESULTS: There were 418 patients who had a new patient video visit during the study period (42% for lower urinary tract symptoms, 32% nephrolithiasis, 18% elevated PSA, 8% scrotal pain). Patients both video visit and in-person cohorts had a similar rate of secondary visits within one (30.9% vs 25.4%, p=0.21) or three months (52.7% vs 48.8%, p=0.43) of the initial evaluation. There were no differences in numbers of procedures completed (33.5% vs 37.3%, p=0.41), ER visits (6.7% vs 5.7%, p=0.69), or hospital admissions (2.4% vs 3.8%, p=0.4). No differences were seen within diagnostic groups. CONCLUSIONS: New patient video visits do not result in an increase in secondary healthcare visits compared to in-person evaluation. This data suggests that new patient video visits can be used as a safe substitute for an in-person evaluation. Source of Funding: 1 K08 HS027632-01 from the Agency for Healthcare Research and Quality © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e1061-e1062 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jake Clafin More articles by this author Juan Andino More articles by this author Lauren McGee More articles by this author Chad Ellimoottil More articles by this author Emma Bethel More articles by this author Expand All Advertisement Loading ...

Applications of neural networks in urology: a systematic review.

Over the last decade, major advancements in artificial intelligence technology have emerged and revolutionized the extent to which physicians are able to personalize treatment modalities and care for their patients. Artificial intelligence technology aimed at mimicking/simulating human mental processes, such as deep learning artificial neural networks (ANNs), are composed of a collection of individual units known as 'artificial neurons'. These 'neurons', when arranged and interconnected in complex architectural layers, are capable of analyzing the most complex patterns. The aim of this systematic review is to give a comprehensive summary of the contemporary applications of deep learning ANNs in urological medicine. Fifty-five articles were included in this systematic review and each article was assigned an 'intermediate' score based on its overall quality. Of these 55 articles, nine studies were prospective, but no nonrandomized control trials were identified. In urological medicine, the application of novel artificial intelligence technologies, particularly ANNs, have been considered to be a promising step in improving physicians' diagnostic capabilities, especially with regards to predicting the aggressiveness and recurrence of various disorders. For benign urological disorders, for example, the use of highly predictive and reliable algorithms could be helpful for the improving diagnoses of male infertility, urinary tract infections, and pediatric malformations. In addition, articles with anecdotal experiences shed light on the potential of artificial intelligence-assisted surgeries, such as with the aid of virtual reality or augmented reality.

FR01-20 HOME GROWN: THE DEVELOPMENT AND STRUCTURE OF UROLOGICAL TRAINING IN THE CARIBBEAN

You have accessJournal of UrologyHistory of Urology Forum I (FR01)1 Apr 2020FR01-20 HOME GROWN: THE DEVELOPMENT AND STRUCTURE OF UROLOGICAL TRAINING IN THE CARIBBEAN Satyendra Persaud*, Belinda Morrison, William AIken, Lawson Douglas, and Lester Goetz Satyendra Persaud*Satyendra Persaud* More articles by this author , Belinda MorrisonBelinda Morrison More articles by this author , William AIkenWilliam AIken More articles by this author , Lawson DouglasLawson Douglas More articles by this author , and Lester GoetzLester Goetz More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000850.020AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Most of the Urologists in the English-speaking Caribbean are graduates of the local training program. Despite the tremendous impact of this training program regionally, there is a lack of awareness of its existence among the wider urological community. This article reviews the history, development and structure of urological training in the English-speaking Caribbean. METHODS: A review of the history and current status of training was documented RESULTS: The University of the West Indies was founded in 1948 with the first campus located in Mona, Jamaica . Surgical training commenced in 1972 at the Mona Campus in Jamaica and was established by Professors Harry Annamunthodo and Errol Walrond. The development of Urology training at UWI in Jamaica followed that of General Surgery. Some years later, training commenced in Trinidad and Tobago mirroring its evolution in Jamaica. Development of urology training The development of urology training in Jamaica was the brainchild of Dr. Lawson Douglas and was borne out of necessity as the high patient to provider ratio in the 1970s was untenable. Several trainees were sent to Canada but only one returned, the rest being lured by lucrative opportunities abroad. Dr Douglas developed a Diploma, a Masters, and then the Doctor in Medicine as it is today. Similar issues led Dr Lester Goetz to develop a training program in Trinidad and Tobago in 2006. The majority of the urologists servicing these two islands are graduates of this local training program. Structure of urology Training. The Doctor of Medicine Program in Urology is divided into two parts – “Part One” consists of core surgical rotations whereas “Part Two” is dedicated urological training. During Part One, residents complete basic surgical rotations. Following successful completion of core training, trainees then complete four years of urological training inclusive of a one or two-year overseas elective period. They are also expected to compile either a casebook of twenty case reports with accompanying commentaries, or ten case reports along with a research project. Following acceptance of the casebook by the university, trainees then sit an exit examination again consisting of written and oral components. Residents are strongly encouraged to participate in research and from 2014 residents undertake the AUA In-Service Examination on a yearly basis. CONCLUSIONS: Since its inception, the Doctor of Medicine in Urology, offered by The University of the West Indies has provided the Caribbean region with the majority of its urologists. Training is structured into parts with exit dependent upon successful completion of an examination. Most have remained in the islands in which they trained. Source of Funding: none © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e291-e291 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Satyendra Persaud* More articles by this author Belinda Morrison More articles by this author William AIken More articles by this author Lawson Douglas More articles by this author Lester Goetz More articles by this author Expand All Advertisement PDF downloadLoading ...

Regenerative medicine in urology: the future of urinary reconstruction

Tissue engineering and regenerative technology are at the cutting edge in reconstructive urology today. However, despite the advances, there are still challenges to be overcome and novel ideas to be investigated.

Enhancing behavioral treatment for women with pelvic floor disorders: Study protocol for a pilot randomized controlled trial

Approximately one in four American women report bothersome urinary symptoms (e.g., urgency, frequency), which greatly impact quality of life, including mental health. Bidirectional relationships have been found between urinary symptoms and anxiety, such that urinary symptoms worsen emotional distress (i.e., anxiety and depression), and in turn anxiety can exacerbate these symptoms. Current methods to treat urinary symptoms, such as physical therapy and medications, do not address their emotional impact. As such, our multidisciplinary team is conducting a randomized control trial (RCT) of cognitive-behavior therapy (CBT) using the Unified Protocol (UP) versus supportive therapy in the context of integrated behavioral treatment in the urogynecology context. Women with bothersome urinary symptoms and anxiety are recruited from the Northwestern Medicine Integrated Pelvic Health Program (IPHP) —a transdisciplinary clinic including urogynecologists, urologists, colorectal surgeons, nurses, and physical therapists— and Northwestern Medicine Urology. Participants are randomized to one of two interventions: UP or supportive therapy. All participants attend therapy once per week for 12 weeks. Assessments of urinary symptoms, anxiety, and other indicators of psychological and physical functioning are completed at baseline, mid-treatment, post-treatment, and at 3- and 6-month follow-ups using patient-reported outcomes. The study has been preregistered on clinicaltrails.gov (ID: NCT03623880) and is currently ongoing.

Biomaterials and Regenerative Medicine in Urology.

Autologous gastrointestinal tissue is the gold standard biomaterial for urinary tract reconstruction despite its long-term neuromechanical and metabolic complications. Regenerative biomaterials have been proposed as alternatives; however many are limited by a poor host derived regenerative response and deficient supportive elements for effective tissue regeneration in vivo. Urological biomaterials are sub-classified into xenogenic extracellular matrices (ECMs) or synthetic polymers. ECMs are decellularised, biocompatible, biodegradable biomaterials derived from animal organs. Synthetic polymers vary in chemical composition but may have the benefit of being reliably reproducible from a manufacturing perspective. Urological biomaterials can be 'seeded' with regenerative stem cells in vitro to create composite biomaterials for grafting in vivo. Mesenchymal stem cells are advantageous for regenerative purposes as they self-renew, have long-term viability and possess multilineage differentiation potential. Currently, tissue-engineered biomaterials are developing rapidly in regenerative urology with many important clinical milestones achieved. To truly translate from bench to bedside, regenerative biomaterials need to provide better clinical outcomes than current urological tissue replacement strategies.

AB016. Application and prospect of traditional Chinese medicine in urology and andrology

This paper reviews the literatures published in the professional journals in the past 20 years, Inductive summarizing the etiology, pathogenesis and syndrome differentiation and typing of chronic prostatitis, prostatic hyperplasia, urinary calculi and erectile dysfunction in TCM, exploring the application of Chinese medicine, such as internal treatment, external treatment and acupuncture, in the treatment of urological Andrology, expounding the research progress of Chinese medicine technology, affirming the multiple advantages of the traditional Chinese medicine technology in the prevention and treatment of urinary Andrology disease, and prospecting the development of Chinese medicine technology in the future.

American Urological Association (AUA) - 112th Annual Meeting (May 12-16, 2017 - Boston, Massachusetts, USA).

The American Urological Association (AUA) stands at the forefront of technology development and urological education for urologists and urological healthcare professionals worldwide. The 112th annual meeting brought together a wide range of researchers in the field of urology to access knowledge, up-to-date clinical guidelines and advances in research. The meeting consisted of plenary and moderated poster, podium and video sessions highlighting the latest research and advances in urological medicine. This report highlights some of the presentations on therapeutic developments for a range of urological conditions.

Early Detection and Diagnosis of Prostate Cancer using Artificial Intelligence Concept

Contemporary research has shown that prostate cancer is the most common cancer amongst older men which can lead to death. However, it has been proven that early detection for most cancers is known to help in making therapeutic decisions in urologic medicine and oncology. Current methods of screening for prostate cancer carried out through blood PSA tests (presence of high Prostate Specific Antigen in the blood) and digital rectal examinations due to their morphological nature lead to a high percentage of False Positive Test Results (FPTR). The occurrence of this FPTR can be reduced by employing Artificial Intelligence (AI) techniques such as Artificial Neural Network (ANN) in evaluating the need for a patient to undergo biopsy. The goal of this research entails the proposition of a model for the early detection of prostate cancer to enhance early detection so as to enable early commencement of intervention to increase the chances of successful treatment and reduction in mortality rates. This research was predicated on the review and analysis of current AI paradigms tailored towards effective detection of prostate cancer. Research findings showed that the PSA test and Digital Rectal Examination (DRE) are not adequate enough to detect prostate cancer but the deployment of assay specific ANN model, which is a machine learning technique reduces the amount of unnecessary biopsies.

Prof. Rajeev Kumar: adrenal masses

The 111th American Urological Association Annual Meeting 2016 (AUA 2016) was held successfully in San Diego Convention Center, San Diego, USA from May 6th to May 10th, 2016. It is the largest scientific meeting to gather together urologists in the world and to provide latest advances in urologic medicine.

Dr. Ryan P. Smith: management of chronic orchialgia

The 111 th American Urological Association Annual Meeting 2016 (AUA 2016) was held successfully in San Diego Convention Center, San Diego, USA from May 6 th to 10 th , 2016. It is the largest scientific meeting to gather together urologists in the world and to provide latest advances in urologic medicine.

American Urological Association (AUA) - 111th Annual Meeting (May 6-10, 2016 - San Diego, California, USA).

The 111(th) Annual Meeting of the American Urological Association (AUA) brought together a wide range of researchers in the field of urology to share knowledge and set standards in urological research. The meeting consisted of plenary, podium and moderated poster sessions, in which the latest research and advances in urologic medicine were presented. This report will highlight some of the presentations on therapeutic developments for a range of urological conditions.