AUA 2018: Panel Discussion: Catheter-Associated UTIs
San Francisco, CA USA (UroToday.com) Brian S. Schwartz, MD (UCSF) moderated the Plenary session on “Catheter-Associated UTIs” with Dr. Tomas Griebling (University of Kansas), Dr. Timothy Averch (University of Pittsburg), and Dr. Ben Chew (University of British Columbia) as the panelists.
Dr. Averch started off the discussion by defining the scope of the problem. The incidence of catheter associated urinary tract infections (CAUTIs) was 9.4 per 1000 catheterizations in 2001. This led to 13,000 attributable deaths/year, excess length of stay and increased costs. In 2008, the Center for Medicare & Medicaid Services made it a never event and no longer provided reimbursement for hospital acquired CAUTIs. Following this the CAUTI rate dropped to 5.3 cases in 2010. Risk factors for CAUTIs are female gender, emergency hospital admission, transfer patients and Medicare patients.
AUA 2018: Distribution of M0 Renal Cell Carcinoma Metastases Stratified by Pathologic Nodal Status
San Francisco, CA USA (UroToday.com) David Y Yang, from the Mayo Clinic, Rochester, MN presented an evaluation of the timing and anatomic distribution of first metastasis in treated RCC patients stratified by nodal status. Yang began by identifying that brain metastases are frequently diagnosed among patients with renal cell carcinoma (RCC) and are associated with a poor prognosis. These patients have historically been excluded from clinical trials and aggressive treatment regimens. There are limited guidelines on screening and surveillance for brain involvement.
AUA 2018: Comparison of Robotic and Open Techniques in Patients Undergoing Radical Nephrectomy and Level II Inferior Vena Cava Thrombectomy
San Francisco, CA USA (UroToday.com) Alp Tuna Beksac from the Icahn School of Medicine at Mount Sinai, New York, NY, presented an evaluation of the safety and feasibility of robot assisted laparoscopic radical nephrectomy for patients with clinical T3 renal masses, level II IVC thrombus. As an introduction to his talk, Beksac stated that inferior vena cava (IVC) thrombectomy is a technically challenging procedure that is a relative indication for open surgery.
AUA 2018: Perioperative Outcomes of Flexible Ureteroscopy for Urolithiasis using the Sheathless Technique: A Comparative Study
Dr. Benjamin Pradere, the Chief of Clinic at Chru Hôpitaux De Tours, presented on the perioperative outcomes using a sheathless method for flexible ureteroscopy (fURS). As a result of advancing capabilities of flexible ureteroscopes, the interest in sheathless and wireless approaches to fURS has increased. The author opened by explaining current literature that correlates ureteral access sheaths (UAS) deployment to a possible increase ureteral damage and ureteral lesions formation during standard fURS.
AUA 2018: Carcinomas Of The Renal Medulla: A Comprehensive Genomic Profiling (Cgp) Study
San Francisco, CA USA (UroToday.com) Stephanie Gleicher, MD, urology resident at the State University of New York Upstate Medical University, presented on the genomic profiling (Cgp) of renal medullar carcinoma (RMC) and collecting duct carcinoma (CDC). The author opened by describing RMC and CDC as being extremely rare but aggressive subtypes of renal cancer, making up less than 1% of renal cancer cases, but also being associate with high probability of metastasis. Current treatment guidelines of both RMC and CDC are primarily chemotherapy, while preforming a debunking nephrectomy in conjunction to chemotherapy has shown to increase survival rates.
AUA 2018: Effect of Ketogenic Diet on the Clear Cell Renal Cell Carcinoma Cell Growth
San Francisco, CA USA (UroToday.com) In recent years, lifestyle intervention via diet and exercise has become an increasingly popular prevention and therapy mechanism for patients suffering from diseases known to be exacerbated by metabolic syndromes. In this regard, clear cell renal cell carcinoma (ccRCC) has been of no exception.
AUA 2018: Somatic Mutation in Mitochrondrial DNA Predicts Postoperative Recurrence in Renal Cell Carcinoma.
San Francisco, CA USA (UroToday.com) While it is well-known that DNA mutations and errors in replication increase risk of cancerous cell growth, it is less-known that mutations in mitochondrial DNA (mtDNA) may be a similarly-important influencer. Even further, given that mtDNA mutations occur at a 10-fold higher rate than nuclear DNA, early detection can pose significant advantage in predicting disease progression and postoperative recurrence of RCC.