CUA 2018: Trends and Disparities in the Receipt of Definitive Treatment for Clinically Localized, Muscle-Invasive Urothelial Carcinoma
Halifax, Nova Scotia (UroToday.com) Muscle-invasive bladder cancer (MIBC), which represents about 30% of new bladder cancer diagnosis, is a difficult disease to manage. Metastatic bladder cancer has a poor prognosis, so the opportunity for cure exists – yet treatment options remain quite morbid and have significant impact on quality of life. Yet, to date, the standard of care for MIBC has remained radical cystectomy and urinary diversion (RC) – neoadjuvant chemotherapy (NAC) is recommended, though not always provided.
CUA 2018: Predicting Perioperative Complications in Patients Receiving Radical Cystectomy Using Preoperative Computed Tomography-Measured Adipose Tissue Indices
Halifax, Nova Scotia (UroToday.com) Radical cystectomy (RC) remains the standard of care treatment for muscle-invasive bladder cancer (MIBC), but is also an operation with significant morbidity and peri-operative complications. There have been numerous studies looking at predictors of perioperative complications and outcomes; amongst those, body mass index (BMI) has been assessed, and it has had mixed results as a predictor of outcomes.
CUA 2018: Initial Clinical Testing of Ureteral Access Sheath Force Sensor to Prevent Ureteral Injuries
Halifax, Nova Scotia (UroToday.com) Ureteral injury during ureteroscopy is one major concern during stone ablative surgery. In order to better protect the ureter from damage due to the ureteroscope, a ureteral access sheath (UAS) is typically inserted into the ureter. Though this insertion of this device is meant to prevent injury, the insertion of the UAS, if done incorrectly, can, in fact, damage the ureter due to insertion forces alone. In modern clinical practice, the amount of force that results in patient injury has yet to be defined. Ergo, Dr. Kam Kaler presented his findings on UAS insertion forces using a novel force sensor, shown below.
CUA 2018: Photoselective Vaporization of The Prostate: Evaluation of Conflicts of Interest and Industrial Sponsorship Stratified by Outcome
Halifax, Nova Scotia (UroToday.com) Photoselective vaporization of the prostate (PVP) has been a widely accepted technique for the treatment of non-neurogenic lower urinary tract symptoms secondary to prostate enlargement. However, recently, it has been indicated that conflicts of interest (COIs) and industrial sponsorship (IS) may have some effects on the reporting of outcomes of studies assessing efficacy, safety, or cost parameters of PVP. Marian Wettstein, MD, a clinical urologist from the University of Zurich, thus presented her research on the validity of these claims. She intended to retrospectively evaluate COIs and IS stratified to the outcome of studies involving 80W, 120W, or 180W PVP systems.
CUA 2018: Development of a Patient Decision Aid for Complex, Localized Renal Masses
Halifax, Nova Scotia (UroToday.com) Management of renal cell carcinoma (RCC) has traditionally been a surgically managed disease, and while alternatives have risen for small renal masses (active surveillance, focal therapy), for larger cT1b+ renal masses, the standard of care is still extirpative management. Yet, the decision to proceed with either a nephron-sparing partial nephrectomy (nephron-sparing, albeit with more potential complications) or a laparoscopic radical nephrectomy (not nephron-sparing but usually with fewer complications due to the lack of reconstruction) can be a tough one. Sometimes it is determined by disease factors (ie complexity of the tumor, nephrometry score, etc) or physician factors (preference, comfort). However, sometimes both options are equal and the options are offered to the patient – but it is not an easy decision to make.
CUA 2018: A High-Fidelity Transurethral Resection of Bladder Tumour Simulator: Validation as a Tool for Training
Halifax, Nova Scotia (UroToday.com) In modern clinical practice, the training of future urologists is paramount to delivering quality care. Jonathan Moore, MD, a urologic resident at the Dalhousie University, understood the need for advanced training for urologic students and advocated a novel tumor simulator: the Simbionix TURBT Mentor (Simbionix LTD, Israel).
CUA 2018: Validation of the 2015 Prostate Cancer Gleason Grade Groups for Predicting Cancer Control Outcomes after Radical Prostatectomy
Halifax, Nova Scotia (UroToday.com) In this retrospective analysis, the authors examined the utility of the Gleason grade groups (GGG) (1-5), correlation to Gleason scores of 6, 7(3+4), 7(4+3), 8, and >8, respectively. This was performed on the GGG of radical prostatectomies (RP).