CUA 2018: Urologic Conditions in Nonagenarians
Halifax, Nova Scotia (UroToday.com) The Canadian populations is rapidly aging with centenarians comprising the fast-growing age group nationally. Sparse urological research exists on nonagenarians or centenarians. A study from United Kingdom of nonagenarian urology inpatients found the most common diagnoses to be hematuria and lower urinary tract symptoms (LUTS) and these patients had significantly longer and more complicated hospital stays than their younger counterparts (Pridgeon et al, 2016).
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: What Every Urologist Should Know About Neurogenic Bladder
Halifax, Nova Scotia (UroToday.com) Anne Pelletier-Cameron, MD, provided a State-of-the-Art lecture at CUA 2018, discussing what every urologist should know about neurogenic bladder. Dr. Pelletier-Cameron notes that her top 5 lists for every patient with neurogenic bladder is:
- Keep the patient safe (protect the kidneys) and dry
- Manage their catheters
- Know when not to panic
- Keep the patient infection free
- Know when to “throw in the towel”
CUA 2018: Twenty-Two Year Population-Level Trends in the Surgical Management of Female Stress Urinary Incontinence in Ontario, Canada
Halifax, Nova Scotia (UroToday.com) Stress urinary incontinence (SUI) is one of the more common reasons why women may present to a urologist. Medications have, to date, proven ineffective in treating SUI, thus, surgery has remained the mainstay of management for women with bothersome symptoms. Historically, patients underwent relatively morbid operations requiring prolonged operations and hospital admission. However, in 1999, transvaginal sling (TVS) procedures were introduced in Canada and have since become the gold standard treatment. Complications associated with transvaginal mesh led to warnings from the U.S. Food and Drug Administration (FDA) and Health Canada in 2008 and 2010, respectively.