Urological Patients Research Articles

Physical Activity, Alcohol, and Cigarette Use in Urological Cancer Patients over Time since Diagnosis.

Urological cancers represent a substantial global public health concern, exerting far-reaching effects on both individuals and their families. There is an urgent need to comprehensively understand the transformations in patients' lifestyles and behaviors, given their critical role in the treatment process and overall well-being. This study, involving 128 urological cancer patients, aims to investigate changes in physical activity levels, problematic drinking behaviors assessed through the Alcohol Use Disorders Identification Test (AUDIT), and smoking habits assessed using the Fagerström Test for Nicotine Dependence (FTND) over four distinct time intervals over the subsequent three years from the time of diagnosis and among individuals diagnosed more than three years ago. The results reveal a significant decrease in physical activity levels between study intervals (p < 0.0001), declining from 69% to 45% between the first and second post-diagnosis assessments. Furthermore, the highest levels of problematic substance use, indicated by mean scores, were noted in the first year following diagnosis (AUDIT: 4.20, p = 0.01; FTND: 4.83, p = 0.08). Given the significant impact of physical activity on the prospects of recovery, it is imperative to delve more deeply into the factors contributing to this decline and devise targeted interventions for its improvement. In the context of substance use, it is essential to ascertain whether the initially high levels are a result of coping with the cancer diagnosis or represent a turning point at which patients modify their behaviors and cease their addiction. A more thorough understanding of this phenomenon would enhance the effectiveness of precisely focused interventions.

ЭПИДЕМИОЛОГИЯ И ЗАБОЛЕВАЕМОСТЬ МОЧЕКАМЕННОЙ БОЛЕЗНИ В ЧЕЧЕНСКОЙ РЕСПУБЛИКЕ

Urolithiasis still occupies a leading place in a large group of diseases of the genitourinary system in terms of the frequency and level of morbidity of the population. Urolithiasis is characterized by high endemicity, the incidence is increasing, and with it the level of disability, doctors often face serious complications, and in severe cases, the mortality of young, able-bodied people. Currently, it is most urgent to improve the system of providing specialized care to urological patients in rural municipal ar-eas, in each subject, taking into account regional peculiarities. With a comprehensive solution to this problem, it is necessary to study the incidence, features of the epidemiology of urolithiasis and devel-op scientifically based algorithms for prevention, reduction of morbidity, early diagnosis, timely treatment. Consequently, it will be timely to improve the primary link of the rural healthcare segment system.

Возможности улучшения терапевтической активности препаратов бактериофагов.

Introduction. Growth of urological infection caused by antibiotic-resistant pathogens require the search for alternative antimicrobial treatments. Bacteriophage (phage) preparations are currently the only viable alternative to antibiotics. The therapeutic effect of bacteriophages is significantly different from antibiotics, making them active against multidrug-resistant bacteria. Bacteriophage therapy - creation of viral infection in bacteria. However, the effectiveness of treatment depends primarily on the quality of commercial bacteriophage preparations. The collections of bacteriophages is constantly updated in industrial production but in order to increase the lytic activity of bacteriophage preparations to the uropathogens of our clinic, it is necessary to constantly determine the sensitivity of the main pathogens of infection to commercial bacteriophage preparations and regularly update (adapting) commercial phage preparations. Purpose. Improve the lytic activity of commercial bacteriophage preparations; adapt them to the pathogens of a particular hospital. Materials and methods. From 2017 to the present, at the Research Institute of Urology and Interventional Radiology named after N.A. Lopatkin, a branch of the National Medical Research Center of Radiology of the Ministry of Health of Russia (hereinafter referred to as the Research Institute of Urology), regular work has been carried out to update (adapt) commercial bacteriophage preparations to the uropathogens. The most problematic multidrug-resistant microorganisms -pathogens of urological infection- were send for phage production. Wastewater from the clinical building of the Institute of Urology was also send to phage production. Results. Analysis of data on antibiotic- and phage resistance of uropathogens for 2022 indicates multi-resistance of microorganisms in our clinic. Antibiotic resistance phenotypes of pathogens in the urine of outpatients and inpatients have been defined as a whole: extended-spectrum beta-lactamases (ESBLs): 5.3-1.6%, respectively (E.coli-38%; Klebsiella spp. 62%; Proteus mir. 38,5%; P. aeruginosa -61%) methicillin-resistant Staphylococcus aureus (MRSA) 9.9-8.4%; carbapenem-resistant enterobacteria (CRE) 1.7-4.5% (E.coli-1.9%; Klebsiella spp. 29%); Proteus mir. 5%; P. aeruginosa -47.7%) and bacteriophage resistance of uropathogens 4-16.3% . After adaptation of bacteriophage preparations, an increase in their lytic activity to specific microorganisms was obtained by an average of 14% (from 78% to 92%), and an increase in the lytic activity of Sextafag, a polyvalent piobacteriophage containing phagolysate filtrates of Staphylococcus spp., Streptococcus spp., Proteus (P. vulgaris, P. mirabilis), Pseudomonas aeruginosa, Klebsiella pneumonia, E. coli by 16% (48% to 64%) Conclusions. To improve the lytic activity of bacteriophage preparations and improve the effectiveness of urological infection treatment, it is necessary to constantly update the composition of the cocktail of commercial bacteriophage preparations with phages from hospital wastewater and adapt them to freshly isolated microorganisms from urological patients.

Intrarectal Administration of Adelmidrol plus Hyaluronic Acid Gel Ameliorates Experimental Colitis in Mice and Inhibits Pro-Inflammatory Response in Ex Vivo Cultured Biopsies Derived from Ulcerative Colitis-Affected Patients.

Improving clinical outcomes and delaying disease recrudescence in Ulcerative Colitis (UC) patients is crucial for clinicians. In addition to traditional and new pharmacological therapies that utilize biological drugs, the development of medical devices that can ameliorate UC and facilitate the remission phase should not be overlooked. Drug-based therapy requires time to be personalized and to evaluate the benefit/risk ratio. However, the increasing number of diagnosed UC cases worldwide necessitates the exploration of new strategies to enhance clinical outcomes. By incorporating medical devices alongside pharmacological treatments, clinicians can provide additional support to UC patients, potentially improving their condition and slowing down the recurrence of symptoms. Chemically identified as an azelaic acid derivative and palmitoylethanolamide (PEA) analog, adelmidrol is a potent anti-inflammatory and antioxidant compound. In this study, we aimed to evaluate the effect of an intrarectal administration of 2% adelmidrol (Ade) and 0.1% hyaluronic acid (HA) gel formulation in both the acute and resolution phase of a mouse model of colitis induced via DNBS enema. We also investigated its activity in cultured human colon biopsies isolated from UC patients in the remission phase at follow-up when exposed in vitro to a cytomix challenge. Simultaneously, with its capacity to effectively alleviate chronic painful inflammatory cystitis when administered intravesically to urological patients such as Vessilen, the intrarectal administration of Ade/HA gel has shown remarkable potential in improving the course of colitis. This treatment approach has demonstrated a reduction in the histological damage score and an increase in the expression of ZO-1 and occludin tight junctions in both in vivo studies and human specimens. By acting independently on endogenous PEA levels and without any noticeable systemic absorption, the effectiveness of Ade/HA gel is reliant on a local antioxidant mechanism that functions as a "barrier effect" in the inflamed gut. Building on the findings of this preliminary study, we are confident that the Ade/HA gel medical device holds promise as a valuable adjunct in supporting traditional anti-UC therapies.

Comparing Telemedicine and In-Person Clinical Evaluations for Pediatric Urology Concerns

IntroductionTelemedicine may promote equitable health care delivery, particularly in rural and underserved regions. While patient and provider satisfaction with telemedicine appear to be high, it remains unclear if telemedicine accomplishes the same clinical goals as in-person clinic visits. We undertook this study to compare the differences in history-taking, physical examination, and recommended follow-up in new pediatric urology patients seen via telemedicine and in-person. MethodsThis cross-sectional study was performed by retrospectively reviewing the charts of all new patients visiting the general pediatric urology clinic at a single freestanding children's hospital in January and April of three consecutive years (2019, 2020, 2021). Data were abstracted on patient demographics, comprehensiveness of history of present illness, completeness of physical examination, and recommended follow-up. Patients seen by telemedicine and in-person were compared. ResultsOf 1354 patients, 1244 (91.9%) had in-person and 110 (8.1%) telemedicine visits. Telemedicine patients had a median of 4 history of present illness components recorded; in-person patients had 3 (P < 0.0001). Patients seen in-person had a more comprehensive physical examination recorded compared with telemedicine patients (median 12 vs 2 systems, P < 0.0001). Significantly fewer telemedicine patients were discharged from clinic after the initial visit (2.7% vs 16.5%), and significantly more were asked to return for additional evaluation (39.1% vs 23.2, P < 0.0001). ConclusionsInitial pediatric urology telemedicine consultations gathered more historical and fewer physical examination components and were more likely to require an additional clinic visit for evaluation. Goals of care should be considered when selecting a visit modality.

Online health information seeking behavior of Croatian urological patients and liability for the violation of an individual’s right to health by disinformation

The aim of this paper was to explore online health information seeking behavior. The method used in this study was conducting a survey by means of a questionnaire which was distributed to the urological patients of the “Dr. Juraj Navro” National Memorial Hospital in Vukovar in Croatia. The results were analysed by the SPSS statistical package utilising descriptive and inferential statistical methods (Chi-square, Mann Whitney U test). Regarding the online information sources that urological patients consult, as many as 21% of the respondents indicated that they searched for health information on Facebook. The obtained research results point to the conclusion that urological patients have a medium level of trust in online health information and indicate the need to increase the level of health literacy among patients in Croatia through various educational campaigns at the national and international level. The problem of online disinformation raises also numerous legal issues. Therefore, the legal framework of liability due to the violation of an individual’s right to health, by disinformation, was explored.

147. Opportunities for Improving Urine Culturing Practices in U.S. Acute Care Hospitals, 2017-2020

Abstract Background Inappropriate urine cultures (UCs) lead to misdiagnosis and unnecessary antibiotic use and can impact surveillance. The absence of pyuria on a urinalysis (UA) has a high negative predictive value for urinary tract infections (UTIs) in certain settings and can reduce unnecessary UCs. UCs performed without UA or with a negative UA indicate opportunities for diagnostic stewardship. Understanding facility variability and patient characteristics associated with inappropriate UCs can inform improvements in acute care hospitals (ACHs). Methods Using clinical microbiology data from 279 ACHs reporting UC and UA data to the PINC AI Healthcare Database, we assessed appropriateness of the first UC collected during adult hospitalizations, excluding pregnant and urologic procedure patients identified using ICD-10-CM diagnosis codes. Each UC was categorized as follows: (1) UC with at least 1 positive UA (WBC ≥10/HPF, presence of leukocyte esterase or nitrite) 24 hours before/after UC (UA+ UC), (2) UC with negative UA in 24 hours (UA- UC), and (3) UC without UA in 24 hours (no-UA UC). Overall percentages of UC categories were described by year and patient characteristics. Monthly facility-specific percentages of UCs were calculated, and facility-level variability was described by medians, quartiles 1 and 3 (Q1:Q3). Results 1.2 million incident UCs were included. Of those, 65% were UA+, 21% UA-, and 14% no-UA UCs. From 2017 to 2020, UA+ UCs increased from 60.5% to 68.2%, no-UA UCs decreased from 19.3% to 10.5%, and UA- UCs stayed at 21%. UA- and no-UA UCs were more common among male, younger age, and Medicaid patients (Figure 1). No-UA UCs were more commonly obtained on day 4 or later. The median monthly facility-level percentages of UA+, UA-, no-UA UCs were 75 (Q1:Q3, 55.6-86.5), 15 (Q1:Q3, 6.5-28.6), and 5.3 (Q1:Q3, 2.1-10.5), respectively (Figure 2). Overall Percentages of Urine Cultures Variability in Hospital Monthly Percentages of Urine Cultures (UC) in Each Category, 2017-2020, N hospital-months = 9,863 Hospital-level Variability Conclusion During the study period, urine culturing practices improved; however, 35% of incident UCs had no UA or negative UA. The high proportion of these UCs and facility-level variability of the monthly proportions call for diagnostic stewardship to identify and address causes of the potentially suboptimal UC practices. This will support the efforts to decrease UTI overdiagnosis and antibiotic overuse. Disclosures All Authors: No reported disclosures

Comparison of a Valveless Trocar System and Conventional Insufflation in Pediatric Urologic Surgery.

Background: Conventional operative insufflation uses a one-way trocar to handle instruments while maintaining pneumoperitoneum. In 2007, the AirSeal® valveless trocar insufflation system was introduced, which maintains stable pneumoperitoneum while continuously evacuating smoke. Although this device has been validated in adult patients, it has not been extensively validated in the pediatric population. Materials and Methods: A retrospective cohort study of pediatric urology patients aged 0 to 21 who underwent laparoscopic pyeloplasty between March 2016 and October 2021 was performed. Intraoperative physiologic parameters, procedure characteristics, postoperative outcomes, and demographics of each patient in whom either AirSeal insufflation system (AIS) or conventional insufflation system (CIS) was utilized were obtained from hospital records. Data were compared across the AIS and CIS cohorts. The primary outcomes were intraoperative anesthetic and physiologic parameters, including end tidal carbon dioxide, oxygen saturation, body temperature, positive inspiratory pressure, systolic blood pressure, and heart rate. Results: There were no significant differences in the anesthetic and physiologic parameters in the AIS and CIS groups. In addition, no differences in demographics, procedural characteristics, or complication rates were found between the cohorts. Conclusion: The AirSeal valveless trocar insufflation system demonstrates comparable intraoperative anesthetic and physiologic outcomes compared to conventional one-way valve insufflation in pediatric laparoscopic pyeloplasty. Certain surgeon-related qualitative metrics are underappreciated in this study, however, including improved visualization with vigorous suctioning and pressure maintenance with frequent instrument exchanges. Surgeon experience may mask the benefits of these characteristics as it pertains to quantitative surgical outcomes such as estimated blood loss, operative time, and perioperative complications.

Effect of COVID-19 Pandemic on Urology Clinic Attendance: Which Diseases are Important for Patients?

Introduction: We assessed whether there were changes in the characteristics of the patient population attending our urology clinic during the COVID-19 pandemic. &#x0D; Material and Method: Patients attending the general urology clinic of SB-ODU Education and Research Hospital were assessed. Dates from 3 February 2020-10 March 2020 were accepted as before the pandemic, with 11 March 2020-29 May 2020 accepted as after the pandemic. Complaints of patients on attendance were grouped as follows: benign prostate hyperplasia, ureteral diseases, kidney diseases, testis and scrotum diseases, incontinence, bladder diseases, sexually transmitted diseases, penile diseases, emergency urologic problems, sexual problems, urethral diseases, kidney and ureter stones, pediatric diseases and urologic tumors. &#x0D; Results: While 638 patients attended the urology clinic in the 1.5-month period before the pandemic, 398 patients attended in the 2.5-month period after the pandemic. Additionally, 30.9% of patients attending the clinic before the pandemic were women, while this rate fell to 23.6% after the pandemic. After the pandemic, there were statistically significant reductions identified for attendance due to BPH, ureteral diseases, kidney diseases, incontinence, bladder diseases and urethra diseases. There was no significant difference in attendance due to urinary system tumors, pediatric urologic patient group, attendance due to kidney and ureter stones, sexual problems and emergency urology problems. There were increases identified for attendance for testis and scrotum diseases and sexually-transmitted diseases. &#x0D; Conclusion: During the pandemic, the numbers of patients attending the urology clinic significantly reduced. During the pandemic, there were increases identified for attendance at our clinic for testis and scrotum diseases and sexually-transmitted diseases. While attendance reduced for many disease groups, rates of attendance for urologic emergencies, urinary tumors, pediatric patient group, stone disease and sexual problems continued as usual.

The Effect of Preoperative Pain, Fear, and Anxiety on Postoperative Pain in Urological Surgery Patients: A Descriptive and Correlational Study

The study was conducted to determine the effect of preoperative pain, fear, and anxiety on postoperative pain and analgesia use in urology patients. A descriptive and correlational design was used. The population of the study consisted of patients who were hospitalized in the Urology clinic of a university hospital and were planning surgery. The sample consisted of 106 patients who met the inclusion criteria and agreed to participate in the study. The study's data was collected using the Personal Information Form, Analgesia Follow-up Form, Surgical Fear Questionnaire, Surgical Anxiety Questionnaire, and Visual Analog Scale prepared in line with the literature. Descriptive statistics, Pearson correlation coefficient, and linear regression analysis were used to evaluate the data. A positive linear relationship was found between postoperative pain and surgical anxiety, surgical fear, and preoperative pain (P<.05). Regression analysis revealed that preoperative pain (P=.006) affected the level of postoperative pain. In addition, fear of surgery (P=.035) and postoperative pain (P=.000) were found to affect the use of postoperative 24-hour analgesia. The study revealed a relationship between the postoperative pain experienced by the patients and preoperative pain, fear, and anxiety.

Empowering future surgeons: a workshop bridging the gap between graduation and the operating room.

Feedback from foundation trainees in Blackpool highlighted low levels of confidence with the prospect of surgical on-call shifts. Key areas of concern were assessing and managing the acute surgical patient, identifying which patients need an operation and having the technical skills to proficiently assist in theatre. This lack of confidence prevents trainees engaging in what should be an educational and rewarding rotation. The authors designed and facilitated a day of workshops, addressing these key educational needs. Bespoke to the trust's services, lectures were delivered by core surgical trainees on the assessment and management of acute surgical patients in general surgery, urology and trauma and orthopaedics. For the development of technical skills, an afternoon of surgical skills workshops covered suturing, knot tying, laparoscopic principles and theatre etiquette. Small groups of foundation trainees rotated through each workshop, delivered by surgical registrars (ST3+), to ensure high fidelity training. Pre- and post-course questionnaires assessed the efficacy of teaching. Out of a total of 72 foundation trainees, 55 attended the teaching day, of which 45 (81.8%) completed pre- and post-course surveys using a six-point modified Likert scale. Rates for satisfactory confidence levels while on-call improved from 66 to 100% of participants after the course. Suturing skills satisfaction rose from 37.5 to 100%, among other impact markers. All trainees that attended the course displayed a marked improvement. This course is now being incorporated into foundation teaching programmes at a regional level and has scope to be expanded nationally.

SIOG2023-4-P-299 - Geriatric Assessment: Elderly urological cancer patients treatment in a multidisciplinary unit

SIOG2023-4-P-299 - Geriatric Assessment: Elderly urological cancer patients treatment in a multidisciplinary unit

Performance of Perioperative Antibiotic Prophylaxis in Operative Urology

Introduction. Currently, the question of the need for perioperative antibiotic prophylaxis (PAP) during urological operations remains debatable due to the insufficiency of the database that would prove the expediency of mandatory use of PAP to prevent the development of infectious complications in the surgical treatment of urological diseases. The aim of this study was to assess the effect of perioperative antibiotic prophylaxis on the frequency of febrile temperature, leukocytosis, increased serum levels of C-reactive protein, and bacteriuria after various urological interventions. Patients and methods. Method of the study was the analysis of the occurrence of febrile temperature, leukocytosis, increased serum concentration of C-reactive protein, and bacteriuria in the early period after various urological interventions (n=1518) performed in men and women from group 1 (n=753) using perioperative antibiotic prophylaxis (ceftriaxone administered intravenously one hour before the beginning of the intervention (before the incision) at the usual therapeutic dose, equal to 2 g) or without the use of PAP in patients from group 2 (n=765) at the Department of Urology of the St. Petersburg State Budgetary Healthcare Institution St. Luke’s Clinical Hospital. Results. In urological patients treated surgically, the appearance in the early postoperative period of bacteriuria, febrile temperature, leukocytosis, and elevated serum CRP levels was observed only in isolated cases with a frequency of occurrence that did not statistically significantly differ between group 1, where patients were injected intravenously with 2 grams of ceftriaxone 1 hour before the operation, and group 2, the participants of which did not receive PAP. In both groups, the results of the study were not affected by the duration of the intervention and the history of diseases contributing to the development of infectious complications (diabetes mellitus, chronic heart failure, COPD, obesity). Conclusion. Apparently, the question of indications for perioperative antibiotic prophylaxis in the surgical treatment of patients with various diseases of the urological profile remains open, and further research in this direction is relevant.

RESULTS OF CLINICAL AUDITS APPLIED IN UROLOGY PRACTICE: SYSTEMATIC REVIEW FROM 2008 TO 2023

Aim. Identifying and evaluating the possibilities of clinical audit as exemplified by its use in urology.&#x0D; Materials and Methods. The study was performed by analyzing clinical audit reports in urology. Information on clinical audit data was obtained from the electronic databases of clinical audits, such as NHS Digital, HQIP, the online library PubMed and the journal "The Online Journal of Clinical Audits". The methods of the system approach, bibliosemantic, content analysis and structural-logical analysis were used in the study.&#x0D; Results and Discussion. The reports on the results of the clinical audit concerned various aspects of urology: health care management in urology departments; provision of medical care under inpatient conditions; prostate cancer, etc. Clinical audit was conducted in both public and private health care institutions. Based on the results of clinical audits, existing and potential problems and shortcomings were identified, on the basis of which specific recommendations were formulated. During the analyzed period, repeated clinical audits took place, the purpose of which was to monitor the effectiveness of implementations. A key feature that unites the analyzed clinical audit reports is the identification of needs and potential opportunities for improvement.&#x0D; Conclusions. Based on the conducted systematic review, it was established that clinical audit is an effective tool for improving the quality of medical care, in particular, for urological patients. Therefore, it is likely to be applied in other areas of health care for effective management of clinical practice. Its use in private health care institutions will contribute to the improvement of patient care services, and its implementation in the public sector and at the national level of health care will ensure qualitative changes in the medical field.

Efficacy of Biofeedback in Paediatric Urology Patients: A Single Centre Experience

Aim of the Study: Biofeedback assisted pelvic floor muscle training is an underutilised nonpharmacological treatment in paediatric urology. We reviewed all patients who underwent a course of treatment at our centre to evaluate its efficacy. MethodsAll patients who underwent a full cycle of biofeedback in the paediatric urology department from 2016 to 2023 were identified. Demographics and outcomes following treatment were accessed. Results42 patients (28 female) were identified who underwent 8 one-hour sessions on a weekly basis constituted a completed cycle of treatment. Patients were identified for treatment as per local lower urinary tract symptom guidelines and following discussion in a fortnightly urology MDT and including diagnoses of overactive bladder, dysfunctional voiding, and giggle incontinence.Outcomes were measured as successful 29% (continence, normal postvoid residuals, clean intermittent catherization discontinued), partially successful 19% (reduced wetting, abnormal post void residuals, ongoing CIC) and unsuccessful 52% (no change for patient). Age at time of treatment affected likelihood of success: <9 years, 0% success; ≥9 years, 57% [p < 0.05]. There was no significant difference in success for 9–11 years [60%] vs >11 years [56%]. ConclusionsBiofeedback has shown success with improvement in symptoms in 48% of patients (complete or partial), which increases to 57% success in ≥9 years group. We would advocate its use in these difficult to manage patients with LUTS.

First-Year Experience of Managing Urology Patients With Home Uroflowmetry: Descriptive Retrospective Analysis.

Lower urinary tract symptoms affect a large number of people of all ages and sexes. The clinical assessment typically involves a bladder diary and uroflowmetry test. Conventional paper-based diaries are affected by low patient compliance, whereas in-clinic uroflowmetry measurement face challenges such as patient stress and inconvenience factors. Home uroflowmetry and automated bladder diaries are believed to overcome these limitations. In this study, we present our first-year experience of managing urological patients using Minze homeflow, which combines home uroflowmetry and automated bladder diaries. Our objective was 2-fold: first, to provide a description of the reasons for using homeflow and second, to compare the data obtained from homeflow with the data obtained from in-clinic uroflowmetry (hospiflow). A descriptive retrospective analysis was conducted using Minze homeflow between July 2019 and July 2020 at a tertiary university hospital. The device comprises a Bluetooth-connected gravimetric uroflowmeter, a patient smartphone app, and a cloud-based clinician portal. Descriptive statistics, Bland-Altman plots, the McNemar test, and the Wilcoxon signed rank test were used for data analysis. The device was offered to 166 patients, including 91 pediatric and 75 adult patients. In total, 3214 homeflows and 129 hospiflows were recorded. Homeflow proved valuable for diagnosis, particularly in cases where hospiflow was unreliable or unsuccessful, especially in young children. It confirmed or excluded abnormal hospiflow results and provided comprehensive data with multiple measurements taken at various bladder volumes, urge levels, and times of the day. As a result, we found that approximately one-fourth of the patients with abnormal flow curves in the clinic had normal bell-shaped flow curves at home. Furthermore, homeflow offers the advantage of providing an individual's plot of maximum flow rate (Q-max) versus voided volume as well as an average or median result. Our findings revealed that a considerable percentage of patients (22/76, 29% for pediatric patients and 24/50, 48% for adult patients) had a Q-max measurement from hospiflow falling outside the range of homeflow measurements. This discrepancy may be attributed to the unnatural nature of the hospiflow test, resulting in nonrepresentative uroflow curves and an underestimation of Q-max, as confirmed by the Bland-Altman plot analysis. The mean difference for Q-max was -3.1 mL/s (with an upper limit of agreement of 13 mL/s and a lower limit of agreement of -19.2 mL/s), which was statistically significant (Wilcoxon signed rank test: V=2019.5; P<.001). Given its enhanced reliability, homeflow serves as a valuable tool not only for diagnosis but also for follow-up, allowing for the evaluation of treatment effectiveness and home monitoring of postoperative and recurrent interventions. Our first-year experience with Minze homeflow demonstrated its feasibility and usefulness in the diagnosis and follow-up of various patient categories. Homeflow provided more reliable and comprehensive voiding data compared with hospiflow.

Assessing Current Interest, Knowledge, and Inquiries About Vasectomies in Urology Patients and Medical Students.

Background and objective Since the overturning of Roe v. Wade, there has been an increased interest in vasectomy procedures. This study aims to analyze interest, knowledge, and inquiries about the vasectomy procedure among urology patients and osteopathic medical students since this overturn. It also seeks to determine if this data varies between the ages and sexes of participants. It is hoped that the findings will aid in the development of a standardized educational plan that might be provided to urologists for future use with patients and their partners. Methods Surveys consisting of 10 questions regarding interests, knowledge, and inquiries about vasectomy procedures and the changes in interest following the Roe v. Wade decision were distributed to urology patients and osteopathic medical students. Results Female students had an increased interest in their current or future male partner obtaining a vasectomy procedure compared to a year ago, whereas older urology patients and male students did not. Based on the responses to the posed queries, the most important information to include in a standardized educational plan for patients is the overall risks and their likelihood, the likelihood of reversal, and the procedure's recovery time and surgical details. Conclusion Female students' increased interest in the vasectomy procedure may be due to the recent overturn of Roe v. Wade. Therefore, physicians must counsel their male patients' female partners or interested females appropriately regarding vasectomies, as more may now be interested. Additionally, an educational plan based on this study's data may be utilized with future urology patients. Placing emphasis on what patients want to know may help ease patient's associated anxiety with their future procedure and strengthen the relationship between the patient and physician.

Improving the Educational Gap with Implementing of Teaching Scholarship in Virtual Multidisciplinary Tumor Boards

Background: Cancer management has become increasingly challenging due to the emergence of a personalized approach that requires careful assessment, multidisciplinary efforts, and experienced physicians. Objectives: Because of the COVID-19 pandemic’s effect on executing all medical meetings as well as multidisciplinary tumor boards (MTB), we decided to design, perform, and evaluate a teaching scholarship in virtual MTB for urologic cancer patients. Methods: In this prospective study from December 2020 to July 2022, the authors evaluated the designing, implementation, and learning efficacy of a virtual tumor board in the Urology Department of Shahid Beheshti University of Medical Sciences (SBMU). All the faculty members (N = 25) and urology residents (N = 35) were included in this investigation. To make the sessions multidisciplinary, other related departments including pathology, radio-oncology, medical oncology, radiology, and nuclear medicine were also included. Virtual tumor boards were implanted monthly in 20 sessions. Results: A short interview was conducted for the needs assessment. The faculty members' and residents’ statements were divided into high, intermediate, and low importance. After implementation, a satisfaction questionnaire based on the first level of the Kirkpatrick model was recorded and the means were 76% and 71% in faculty members and residents respectively for virtual execution. The results of evaluating the intervention according to the second level of the Kirkpatrick model and through the tests before and after tumor boards were recorded and the mean differences evaluated by paired t test were statistically significant. In the last step for external evaluation, the satisfaction rate of 5 arbitrators was 75% for executing a proper virtual MTB. Conclusions: A virtual board is an effective learning method for the medical education of urology residents. It could help the practitioner to coordinate and discuss with different specialties and lead to the best decision for urologic cancer patients.

Preventing Pediatric Medical Traumatic Stress in a Pediatric Urology Outpatient Setting: Application of the Pediatric Psychosocial Preventative Health Model (PPPHM).

The objectives of this topical review are to (1) increase understanding of pediatric medical traumatic stress (PMTS) in pediatric urology populations through literature review, (2) identify a theoretical model to guide prevention of PMTS in this population, and (3) provide clinical care recommendations based on the model identified. Authors introduce a new term "uropsychology" to describe psychological practice that specializes in the treatment of urology patients. Pediatric uropsychologists from 5 pediatric medical care centers gathered to discuss their experience with treating PMTS in their settings and to review existing literature related to PMTS in pediatric urology, PMTS in other populations, and established models for prevention. Authors provide recommendations based on literature review for preventing PMTS in a pediatric urology population. Gaps in the evidence base for preventing PMTS in this population are identified. Authors provide a series of clinical care recommendations, utilizing clinical experience, and the Pediatric Psychosocial Preventative Health Model (PPPHM) as a framework. While there is limited research on PMTS in pediatric urology populations, urologic interventions can be perceived as invasive, painful, distressing, and traumatic. Application of the PPPHM can guide prevention and intervention efforts. Future research is needed to characterize PMTS in this population, evaluate the efficacy of trauma-informed prevention and intervention practices, and develop screening measures that accurately identify at-risk patients. Authors recommend intradisciplinary collaboration among uropsychologists, urology specialists, and patients and families to create formal standards of care, avenues for other future research, and equitable access to uropsychology care.

Using the DFree device for balanced bladder management

Bladder dysfunctions, regardless of their origin, have significant psychosocial effects. Depending on the existing disorder and bladder functionality, behavioural therapy and supporting tools are the first choice of therapy but the need for medication, intervention and surgery is significant. The DFree ultrasonic sensor enables sonographic measurement of bladder filling and feeds this back to the sensor wearer via an app. The primary outcome of the study was the influence of the DFree on the quality of life of the patients. Secondary endpoints were usefulness and user-friendliness of the DFree device as well as the self-reported degree of autonomy. In the present pilot study, 18 urological patients with various bladder dysfunctions were equipped with the DFree ultrasonic sensor for at least 12 hours daily over a period of three months. The parameters were collected at baseline (T1) and at end of the study (T2) using the Kings Health Questionnaire (KHQ) and the German version of the Client Satisfaction Questionnaire (ZUF-8) (quantitative data) as well as guided interviews (qualitative data). Improvement in bladder dysfunction based on the KHQ could not be statistically confirmed. However, the average value based on the ZUF-8 showed satisfaction with the DFree. In the interviews at T2, the participants gave a positive feedback with specific suggestions for improving user-friendliness. The device was described as helpful and easy to use. The DFree ultrasonic sensor is a new technical tool in the treatment of bladder dysfunctions. Improving specific technical details could increase the user-friendliness as well as the usefulness of the device.