AUA 2018: The Feasibility of Discharging Patients Without Opioids After Ureteroscopy
San Francisco, CA USA (UroToday.com) David Sobel, MD, a clinical urologist from the University of Vermont Medical Center, presented on a study that was aimed at determining the feasibility of a non-opioid protocol for post-operative pain and stent symptoms after ureteroscopy (URS). The American opioid epidemic is a healthcare crisis, and urologist may play a role in reducing this problem by minimizing the use of opioids after minor urologic procedures.
AUA 2018: Development and Validation of a Novel Prognostic Model for Predicting Overall Survival in Treatment Naïve Castration-Sensitive Metastatic Prostate Cancer
San Francisco, CA (UroToday.com) The treatment paradigm for the of management castration sensitive prostate cancer (mCSPC) has changed dramatically over the last 5 years with the publication of the CHAARTED, STAMPEDE and LATITUDE trials. These trials have also demonstrated a survival heterogeneity in patients with castrate sensitive metastatic prostate cancer, arguing that some patients may be overtreated by these aggressive regimens. A risk stratification system for patients with mCSPC is currently lacking. Dr. Akamatsu, from Kyoto University Hospital, presents a novel prognostic model aimed to predict overall survival (OS) for patients with mCSPC treated with hormone deprivation therapy.
AUA 2018: Is PSA Density Useful in Predicting Low-Risk Prostate Cancer in African American Men?
San Francisco, CA (UroToday.com) In African-American (AA) men the incidence of prostate cancer is almost 60% higher, and the mortality rate is two- to three-times greater than that of Caucasian men. Over the last 10 years, there has been a significant push to offer active surveillance to patients who are diagnosed with low-risk prostate cancer. PSA density (PSAD) has been one of the main criteria utilized to help differentiate patients at low risk for prostate cancer progression. The current recommendation is that patients with group 1 disease (Gleason 3+3=6) and a PSADT < 0.15 ng/ml/gm have a low potential for prostate cancer progression. However, this value was derived from historical cohorts of mostly Caucasian (CA) men, and the PSAD remains to be validated in an AA cohort. Dr. Babaian, from LSU Shreveport, presents data validating the role of PSAD in identifying men with low-risk prostate cancer.
AUA 2018: The National Resident Matching Program Code of Conduct: What Is The Degree Of Compliance During The Urology Match Process?
San Francisco, CA USA (UroToday.com) Elisabeth Sebesta, MD, a clinical urologist from New York, NY, presented on a study that assessed the frequency and type of violations to NRMP Code of Conduct and Urology Match “guidelines to programs” statement during the Urology Match process in conjunction with the applicants’ perception of these violations.
AUA 2018: Learning Curve With The No-Flip Shangring Circumcision in Kenya
San Francisco, CA USA (UroToday.com) Omar Al Hussein Alawamlh, MD, a clinical urologist from New York, NY, presented on a study looking at the learning curve involved with a male circumcision device. Voluntary medical male circumcision (VMMC) has been shown by three large randomized control trials in Africa to decrease HIV incidence in men by 50-60%. Given this, the UNAIDS and WHO have recommended that VMMC be included as part of their HIV prevention strategies. As a result, 14 sub-Saharan African countries have started to scale up male circumcision services.
AUA 2018: Do Patients Undergoing Primary Ureteroscopy for Ureteral Stones Have a Lower Post-Operative Sepsis Rate Compared to Those Previously Stented?
San Francisco, CA USA (UroToday.com) Nina Mikkilineni, a clinical urologist from the Irving Medical Center at Columbia University, discussed her findings on the rates of sepsis following pre-stenting of patients versus primary ureteroscopy (P-URS). To begin, Dr. Mikkilineni advocated that P-URS is preferred over preoperative stenting due to fewer procedures for the patient, lower short-term costs, shorter duration of irritative stent symptoms, and a possible decreased infection risk.
AUA 2018: Treatment of Non-Obstructive Urolithiasis is Effective in Treatment of Recurrent Urinary Tract Infections
San Francisco, CA USA (UroToday.com) Deepak Agarwal, MD, a clinical urologist from the Mayo Clinic in Rochester Minnesota, presents his research on the treatment of non-obstructive urinary calculi to treat recurrent urinary tract infections (UTIs). Patients who present with these two conditions are particularly challenging patients to treat and are associated with a significant morbidity and cost. According to Dr. Agarwal, there has been growing evidence that the surgical removal of these non-obstructing stones may be beneficial to the treatment of recurrent UTIs. Additionally, it has been shown in previous research that kidney stones can be colonized with bacteria despite appropriate antibiotic administration. Therefore, Dr. Agarwal and his team sought to determine whether or not these procedures are effective.