BACKGROUND:Partial nephrectomy (PN) is the gold-standard treatment for T1 renal-cell carcinoma, which is associated with a significant risk of complications. Tumor ablation (TA) can be implemented in chosen patients with small renal masses. The aim was to evaluate perioperative outcomes and health-care costs of PN and TA. METHODS:Patients aged ≥18 with renal mass diagnosis, who underwent PN/TA in 2007-2021, were identified in the MerativeTM Marketscan® Research Commercial and Medicare databases. Complication rates, probability and time to second surgery, as well as hospital costs (2021 US dollars) of PN and TA were evaluated. The rate of preoperative renal mass biopsies over the years was assessed. Finally, subgroup analyses for types of second surgeries (TA, PN, radical nephrectomy) were performed. RESULTS:Twenty-four thousand forty-five patients with kidney tumors were included. The majority (85.7%) underwent PN. Over the years, preoperative renal biopsies have become more common. TA was associated with a significantly lower risk of complications (adjusted odds ratio [aOR]: 0.56, 95% confidence interval [CI]: 0.50-0.63) and lower costs (aOR: 0.23, 95% CI: 0.20-0.26) than PN. The analysis of specific complications found that only wound-related complications had no significant difference in risk between the procedures (aOR: 0.65, 95%CI: 0.41-1.02). However, TA patients were at higher risk of a second procedure (adjusted hazard ratio: 1.25, 95%CI: 1.05-1.49). CONCLUSIONS:TA is associated with significantly fewer complications and lower costs than PN. However, patients undergoing TA require re-operation more frequently, possibly due to higher recurrence rates. These factors need to be considered when selecting the most appropriate treatment for patients with renal tumors.

You have accessJournal of UrologyBladder Cancer: Invasive I (PD02)1 May 2024PD02-05 THE IMPACT OF VENOUS THROMBOEMBOLISM ON MUSCLE INVASIVE BLADDER CANCER (MIBC) PATIENTS UNDERGOING OPEN OR MINIMALLY-INVASIVE RADICAL CYSTECTOMY IN THE UNITED STATES: PERIOPERATIVE OUTCOMES AND HEALTH-CARE COSTS FROM INSURANCE CLAIMS DATA Francesco Del Giudice, Anas Tresh, Ettore De Berardinis, Vincenzo Asero, Carlo Maria Scornajenghi, Satvir Basran, Federico Belladelli, Gian Maria Busetto, Matteo Ferro, Felice Crocetto, Biagio Barone, Benjamin Pradere, Wojciech Krajewski, Lukasz Nowak, Marco Moschini, Abhay Rane, Ben Challacombe, Rajesh Nair, and Benjamin I. Chung Francesco Del GiudiceFrancesco Del Giudice , Anas TreshAnas Tresh , Ettore De BerardinisEttore De Berardinis , Vincenzo AseroVincenzo Asero , Carlo Maria ScornajenghiCarlo Maria Scornajenghi , Satvir BasranSatvir Basran , Federico BelladelliFederico Belladelli , Gian Maria BusettoGian Maria Busetto , Matteo FerroMatteo Ferro , Felice CrocettoFelice Crocetto , Biagio BaroneBiagio Barone , Benjamin PradereBenjamin Pradere , Wojciech KrajewskiWojciech Krajewski , Lukasz NowakLukasz Nowak , Marco MoschiniMarco Moschini , Abhay RaneAbhay Rane , Ben ChallacombeBen Challacombe , Rajesh NairRajesh Nair , and Benjamin I. ChungBenjamin I. Chung View All Author Informationhttps://doi.org/10.1097/01.JU.0001008836.73392.92.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Interplay between Venous Thromboembolism (VTE) and solid malignancy is established. With rising projected rates of bladder cancer (BCa) and increasing number of patients experiencing BCa and VTE, our aim is to assess the impact of a preoperative VTE diagnosis on perioperative outcomes and health-care costs in MIBC undergoing Radical Cystectomy (RC). METHODS: Patients≥18 y/o with BCa undergoing Open or Minimally Invasive (MIS) RC were identified in the MerativeTM Marketscan® Research Databases between 2007 and 2021. The association of VTE history with 90-day complication rates, postoperative VTE events, rehospitalization, and total hospital costs (2021 US dollars) was determined by multivariable logistic regression modeling adjusted for patient and perioperative confounders. Sensitivity analysis on VTE degree of severity (i.e., pulmonary embolism [PE] and/or peripheral deep [DVT] or superficial venous thrombosis) was examined. RESULTS: Out of n=8,759 RC procedures, n=743 (8.48%) had a previous history for any VTE including n=245 (32.97%) PE, n=339 (45.63%) DVT and n=59 (21.40%) superficial VTE. Overall, history of VTE before RC was strongly associated with almost any worse postoperative outcomes including higher risk for any and apparatus-specific 90-days postoperative complications (Odds Ratio [OR]: 1.23, 95% Confidence Interval [CI], 1.03-1.46). Subsequent incidence of new VTE events (OR: 7.02, 95% CI: 5.93-8.31), rehospitalization (OR: 1.25, 95% CI: 1.06-1.48), other than home/self-care discharge status (OR: 1.53, 95% CI: 1.28-1.82), and higher health-care costs related to the RC procedure (OR: 1.43, 95% CI: 1.22-1.68) were significantly correlated with VTE history. Importantly, the association was maintained regardless the severity of VTE history (i.e., PE, DVT or phlebitis/thrombophlebitis). CONCLUSIONS: Experiencing VTE before RC for MIBC significantly raises the risk of any worse perioperative outcomes regardless the severity of the VTE event. These findings will likely have an impact in BCa counseling on the risks of surgery and will improve our ability to mitigate such risks. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e71 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Francesco Del Giudice More articles by this author Anas Tresh More articles by this author Ettore De Berardinis More articles by this author Vincenzo Asero More articles by this author Carlo Maria Scornajenghi More articles by this author Satvir Basran More articles by this author Federico Belladelli More articles by this author Gian Maria Busetto More articles by this author Matteo Ferro More articles by this author Felice Crocetto More articles by this author Biagio Barone More articles by this author Benjamin Pradere More articles by this author Wojciech Krajewski More articles by this author Lukasz Nowak More articles by this author Marco Moschini More articles by this author Abhay Rane More articles by this author Ben Challacombe More articles by this author Rajesh Nair More articles by this author Benjamin I. Chung More articles by this author Expand All Advertisement PDF downloadLoading ...

BACKGROUND: Using a large population-based dataset, we primarily sought to compare postoperative complications, health-care expenditures, and re-intervention rates between patients diagnosed with ureteropelvic junction obstruction (UPJO) undergoing stented vs. non-stented pyeloplasty. The secondary objective was to investigate factors that influence the timing of DJ stent removal. METHODS: Patients >= 18 years old with UPJO treated with primary open or minimally-invasive pyeloplasty were identified using the MerativeT Marketscan((R)) Databases between 2007-2021. Multivariable modeling was implemented to investigate the association between Double-J (DJ) stent placement and post-pyeloplasty complications, hospital costs, and re-intervention rates and the role of the perioperative predictors on time to DJ stent removal. Subgroup analyses stratified by ureteral stenting duration were additionally performed. RESULTS: Out of 4872 patients who underwent primary pyeloplasty, 4154 (85.3%) had DJ placement. Postoperative complications were rare (N.=218, 4.47%) and not associated with ureteral stenting (odds ratio [OR]: 0.78, 95% confidence interval [CI]: 0.55-1.12). The median cost for in-hospital charges was $21,775, with DJ stent placement independently increasing the median aggregate amount (OR: 1.29, 95% CI: 1.09-1.53). Overall, re-interventions were performed in 21.18% of patients, with DJ stenting found to be protective (OR: 0.79, 95% CI: 0.66-0.96). Higher Charlson Comorbidity Index, longer hospital stay, and open surgical approach were independent predictors for prolonged DJ stenting time to removal. CONCLUSIONS: Our study suggests that patients undergoing stent-less pyeloplasty did have a higher rate of secondary procedures, but not higher complications when compared to those undergoing stented procedures. Concurrently, the non-stented approach is associated with decreased health-care expenditures, despite the increased rates of secondary procedures.

Percutaneous cryoablation (PCA) can be an alternative to partial nephrectomy (PN) in selected patients with stage T1 renal tumours. Existing meta-analyses regarding ablative techniques compared both laparoscopic and PCA with PN. That is why we decided to perform a meta-analysis that focused solely on PCA. The aim of this study was to compare the complications and functional and oncological outcomes between PCA and PN. A systematic literature search was performed in January 2024. Data for dichotomous and continuous variables were expressed as pooled odds ratios (ORs) and mean differences (MDs), both with 95% confidence intervals (CIs). Effect measures for the local recurrence-free survival (LRFS), metastasis-free survival (MFS), cancer-specific survival (CSS) and overall survival (OS) were expressed as pooled hazard ratios with 95% CIs. Among 6487 patients included in the 14 selected papers, 1554 (23.9%) and 4924 (76.1%) underwent PCA and PN, respectively. Compared with the PN group, patients undergoing PCA had significantly lower overall and major postoperative complication rates. There was no difference in renal function between PCA and PN groups. When analysing collective data for cT1 renal carcinoma, PCA was associated with worse LRFS compared with PN. However, subgroup analysis revealed that in the case of PCA, LRFS was not decreased in patients with cT1a tumours. Moreover, patients undergoing robotic-assisted PN had improved LRFS compared with those undergoing PCA. No significant differences were observed between PCA and PN in terms of MFS and CSS. Finally, PCA was associated with worse OS than PN in both collective and subgroup analyses. In conclusion, PCA is associated with favourable postoperative complication rates relative to PN. Regarding LRFS, PCA is not worse than PN in cT1a tumours but has a substantially relevant disadvantage in cT1b tumours. Also, RAPN might be the only surgical modality that provides better LRFS than PCA. In cT1 tumours, PCA shows MFS and CSS comparable to PN. Lastly, PCA is associated with a shorter OS than PN.

BACKGROUND:The relationship between venous thromboembolism (VTE) and solid malignancy has been established over the decades. With rising projected rates of bladder cancer (BCa) worldwide as well as increasing number of patients experiencing BCa and VTE, our aim is to assess the impact of a preoperative VTE diagnosis on perioperative outcomes and health-care costs in BCa cases undergoing radical cystectomy (RC). METHODS:Patients ≥18 years of age with BCa diagnosis and undergoing open or minimally invasive (MIS) RC were identified in the Merative™ Marketscan® Research Databases between 2007 and 2021. The association of previous VTE history with 90-day complication rates, postoperative VTE events, rehospitalization, and total hospital costs (2021 USA dollars) was determined by multivariable logistic regression modeling adjusted for patient and perioperative confounders. Sensitivity analysis on VTE degree of severity (i.e., pulmonary embolism [PE] and/or peripheral deep venous thrombosis [DVT]) was also examined. RESULTS:Out of 8759 RC procedures, 743 (8.48%) had a previous positive history for any VTE including 245 (32.97%) PE, 339 (45.63%) DVT and 159 (21.40%) superficial VTE. Overall, history of VTE before RC was strongly associated with almost any worse postoperative outcomes including higher risk for any and apparatus-specific 90-days postoperative complications (odds ratio [OR]: 1.21, 95% CI, 1.02-1.44). Subsequent incidence of new VTE events (OR: 7.02, 95% CI: 5.93-8.31), rehospitalization (OR: 1.25, 95% CI: 1.06-1.48), other than home/self-care discharge status (OR: 1.53, 95% CI: 1.28-1.82), and higher health-care costs related to the RC procedure (OR: 1.43, 95% CI: 1.22-1.68) were significantly associated with a history of VTE. CONCLUSIONS:Preoperative VTE in patients undergoing RC significantly increases morbidity, post-procedure VTE events, hospital length of stay, rehospitalizations, and increased hospital costs. These findings may help during the BCa counseling on risks of surgery and hopefully improve our ability to mitigate such risks.

The process-of-male reproduction is intricate, and various medical conditions-have the potential to disrupt spermatogenesis. Moreover, infertility in males can serve as an indicator of-potential future health issue. Numerous conditions with systemic implications have been identified, encompassing genetic factors (such as Klinefelter Syndrome), obesity, psychological stress, environmental factors, and others. Consequently, infertility assessment-presents an opportunity for comprehensive health counseling, extending-beyond discussions about reproductive goals. Furthermore, male infertility has been suggested as a harbinger of future health problems, as poor semen quality and a diagnosis of-male infertility are associated with an increased risk of hypogonadism, cardiometabolic disorders, cancer, and even mortality. This review explores the existing-literature on the relationship between systemic illnesses and male fertility, impacting both clinical-outcomes and semen parameters. The majority of the literature analyzed, which compared gonadal function with genetic, chronic, infectious or tumoral diseases, confirm the association between overall male health and infertility.

Background An estimated 10% of male adults have split or dribbled stream leading to poor hygiene, embarrassment, and inconvenience. There is no current metric that measures male stream deviation. Objective To develop a novel method to measure spray in normal and abnormal anatomical conformations. Design, setting, and participants We developed a novel platform to reliably describe spray. We used cadaveric tissues and 3D Printed models to study the impact of meatal shape on the urinary stream. Cadaveric penile tissue and 3D printed models were affixed to a fluid pump and used to simulate micturition. Dye captured on fabric allowed for spray detection. Outcome measurements and statistical analysis Spray pattern area, deviation from normal location, and flowrates were recorded. Computational fluid dynamic models were created to study fluid vorticity. Results and limitations Obstructions at the penile tip worsened spray dynamics and reduced flow. Ventral meatotomy improved flowrate (p<0.05) and reduced spray (p<0.05) compared to tips obstructed ventrally, dorsally or in the fossa navicularis. 3D models do not fully reproduce parameters of their parent cadaver material. The average flowrate from 3D model was 10ml/sec less than that of the penis from which it was derived (p = 0.03). Nonetheless, as in cadavers, increasing obstruction in 3D models leads to the same pattern of reduced flowrate and worse spray. Dynamic modeling revealed increasing distal obstruction was correlated to higher relative vorticity observed at the urethral tip. Conclusions We developed a robust method to measure urine spray in a research setting. Dynamic 3D printed models hold promise as a methodology to study common pathologies in the urethra and corrective surgeries on the urine stream that would not be feasible in patients. These novel methods require further validation, but offer promise as a research and clinical tool.

You have accessJournal of UrologyTrauma/Reconstruction/Diversion: Urethral Reconstruction (including Stricture, Diverticulum) II (MP60)1 Apr 2020MP60-04 PILOT EXPERIMENTAL ANALYSIS OF MEATUS CONFORMATION AND DEVELOPMENT OF NOVEL MEASUREMENTS FOR ABERRANT URINARY STREAM IN 3D PRINTED URETHRAS DERIVED FROM CADAVERIC MODEL Andrew Cohen*, German Patino, Seyed Mirramezani, Sudarshan Srirangapatanam, Anas Tresh, Bhagat Cheema, Jenny Tai, Dylan Romero, Anthony Enriquez, Shawn Shadden, and Benjamin Breyer Andrew Cohen*Andrew Cohen* More articles by this author , German PatinoGerman Patino More articles by this author , Seyed MirramezaniSeyed Mirramezani More articles by this author , Sudarshan SrirangapatanamSudarshan Srirangapatanam More articles by this author , Anas TreshAnas Tresh More articles by this author , Bhagat CheemaBhagat Cheema More articles by this author , Jenny TaiJenny Tai More articles by this author , Dylan RomeroDylan Romero More articles by this author , Anthony EnriquezAnthony Enriquez More articles by this author , Shawn ShaddenShawn Shadden More articles by this author , and Benjamin BreyerBenjamin Breyer More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000929.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: An estimated 10% of male adults have split or dribbled stream which can lead to poor hygiene, embarrassment, inconvenience and social distress. There is no metric that measures the degree of stream deviation from normal, nor is there a definition of normal in this context. Our objective is to develop an innovative method to measure spray. We also evaluate the effect of common pathologies in the distal urethra and corrective surgeries on the urine stream. METHODS: We use cadaveric tissues and 3D Printed models to define distal meatus conformations and their impacts on stream characteristics (Figure). We developed a novel platform to reliably measure spray of urinary flow. Silicone was used to cast the lumen of cadaveric urethra, this was subsequently converted to 3D printable model. Cadaveric penile tissue and 3D printed models were affixed to fluid pump and used to simulate micturition events. Dyed fluid captured on fabric allowed for spray detection. Spray pattern area, deviation from normal location, and flowrates were recorded as obstructions were surgically created in cadaveric tissue or modelled using 3D printing. RESULTS: Characteristic voiding scenarios were validated with high precision. Spray patterns of each void were recorded (Figure d). Obstructions at the penile tip worsen spray dynamics and reduce urinary flow. Ventral meatotomy improves flow rate and reduces spray compared to tips obstructed ventrally, dorsally or in the fossa naviculars. 3D printed models to do not fully reproduce parameters of their parent cadaver material. All other variables constant, the flow rate from 3D model is 3 ml/sec less than that of the penis from which it was derived (p=0.03). Nonetheless, increasing obstruction in 3D models leads to the same pattern of reduced flow rate and worse spray. Via dynamic modelling, distal obstruction was experimentally shown to worsen fluid vorticity. CONCLUSIONS: We developed a robust method to measure urine spray in a research setting. Dynamic 3D printed models hold promise as a methodology to study common pathologies in the distal urethra and corrective surgeries on the urine stream. We recapitulate clinical observations that increased meatal obstruction worsen flow and spray whereas meatotomy leads to improvements. These novel methods require further validation, but offer promise as a powerful research and clinical tool. Source of Funding: Alafi Fund © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e890-e890 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Andrew Cohen* More articles by this author German Patino More articles by this author Seyed Mirramezani More articles by this author Sudarshan Srirangapatanam More articles by this author Anas Tresh More articles by this author Bhagat Cheema More articles by this author Jenny Tai More articles by this author Dylan Romero More articles by this author Anthony Enriquez More articles by this author Shawn Shadden More articles by this author Benjamin Breyer More articles by this author Expand All Advertisement PDF downloadLoading ...

INTRODUCTION AND OBJECTIVES:The United States faces an opioid epidemic, and surgeons must take action.However, a onesize fits all approach to opioid prescribing is sub-optimal.Here, we sought to evaluate changes in prescribing patterns after implementing a urologic-surgery specific postoperative opioid prescribing guideline at three tertiary care facilities.METHODS: We convened a urologic surgery opioid task force.Historical prescribing data for all adult patients without a history of chronic opioid use undergoing 21 urologic procedures at three tertiary care centers from 2015-2016 were used to derive an evidence-based, four-tiered guideline for postoperative opioid prescribing.The guideline was implemented into clinical practice on January 1, 2018, and prescribing patterns including quantity of opioids prescribed (oral morphine equivalents [ OME) and refill rates were compared for a cohort of patients undergoing surgery prior to (January 1eApril 30, 2017; n[1,732) and after (January 1eApril 30, 218; n[1376) implementation.The primary outcome was change in median OME prescribed after guideline implementation.Secondary outcomes include changes in refill rates and guideline adherence.Univariable analysis was performed using Wilcoxon Rank-Sum tests for continuous variables and Chi-squared tests for categorical variables.RESULTS: After guideline implementation, the median OME (IQR) prescribed was significantly lower for 2018 compared with 2017 [100 (0;175) versus 150 (60;225); p<.0001].The median OME also significantly decreased for procedures in all guideline tiers with the exception of tier 0 where the median was stable at 0. The median prescribed OME decreased in 14/21 procedures (67%).The refill rates did not significantly change.Guideline adherence rates within the first four months after implementation, based on individual procedures, ranged from 33-95%.CONCLUSIONS: Fewer opioids were prescribed after implementing the first iteration of our evidence-based prescribing guideline without a significant increase in prescription refills.However, further work is necessary including provider education and assessment of patient utilization of prescribed opioids.

Objective: Web-based platforms have revolutionized the ability for researchers to perform global survey research. Methods to incentivize participation have been singularly focused on European and North American participants with varied results. With an ever increasing proportion of biomedical research being performed in non-western countries, assessment of novel methods to improve global survey response is timely and necessary. To that end, we created a three-arm nested randomized control trial (RCT) within a prospective cohort study to assess the impact of incentives on survey responsiveness in a global audience of biomedical researchers. Results: Email invitations were sent to authors and editors involved in online publishing totaling 2426 participants from 111 countries. Overall we observed a 13.0% response rate: 13.3% for the control group, 14.4% for a group entered to win a gift card, and 11.1% for a group whose participation lead to donation to charity (p = 0.17). Year of publication nor country impacted response rate. Within subgroups, editors were significantly less likely to respond to the survey as compared to authors (6.5% vs. 18.9%; p-value < 0.01). With power to detect a 4.8% difference among groups, we could not detect an impact of incentives on global survey response.

BACKGROUND:Predatory journals fail to fulfill the tenets of biomedical publication: peer review, circulation, and access in perpetuity. Despite increasing attention in the lay and scientific press, no studies have directly assessed the perceptions of the authors or editors involved.OBJECTIVE:Our objective was to understand the motivation of authors in sending their work to potentially predatory journals. Moreover, we aimed to understand the perspective of journal editors at journals cited as potentially predatory.METHODS:Potential online predatory journals were randomly selected among 350 publishers and their 2204 biomedical journals. Author and editor email information was valid for 2227 total potential participants. A survey for authors and editors was created in an iterative fashion and distributed. Surveys assessed attitudes and knowledge about predatory publishing. Narrative comments were invited.RESULTS:A total of 249 complete survey responses were analyzed. A total of 40% of editors (17/43) surveyed were not aware that they were listed as an editor for the particular journal in question. A total of 21.8% of authors (45/206) confirmed a lack of peer review. Whereas 77% (33/43) of all surveyed editors were at least somewhat familiar with predatory journals, only 33.0% of authors (68/206) were somewhat familiar with them (P<.001). Only 26.2% of authors (54/206) were aware of Beall's list of predatory journals versus 49% (21/43) of editors (P<.001). A total of 30.1% of authors (62/206) believed their publication was published in a predatory journal. After defining predatory publishing, 87.9% of authors (181/206) surveyed would not publish in the same journal in the future.CONCLUSIONS:Authors publishing in suspected predatory journals are alarmingly uninformed in terms of predatory journal quality and practices. Editors' increased familiarity with predatory publishing did little to prevent their unwitting listing as editors. Some suspected predatory journals did provide services akin to open access publication. Education, research mentorship, and a realignment of research incentives may decrease the impact of predatory publishing.

Guidelines call for routine reimaging of Grade 4–5 renal injuries at 48–72 h. The aim of the current study is to evaluate the clinical utility of computed tomography (CT) reimaging in high-grade renal injuries.

This review discusses current and developing indications for angioembolization (AE) techniques in urology cases, including trauma and non-trauma uses for kidney, prostate, and bladder conditions. AE methods, complications and technical and clinical outcomes are outlined for each indication for the purpose of aiding urologists in selecting ideal candidates for this procedure.

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Epidemiology & Evaluation1 Apr 2018MP04-07 THE ASSOCIATION OF DIETARY SALT INTAKE AND NOCTURIA: DATA FROM THE 2011-2014 NATIONAL HEALTH AND NUTRITION EXAMINATION SURVEY (NHANES) Nima Baradaran, Scott Bauer, Kirkpatrick Fergus, Anas Tresh, Thomas Gaither, and Benjamin Breyer Nima BaradaranNima Baradaran More articles by this author , Scott BauerScott Bauer More articles by this author , Kirkpatrick FergusKirkpatrick Fergus More articles by this author , Anas TreshAnas Tresh More articles by this author , Thomas GaitherThomas Gaither More articles by this author , and Benjamin BreyerBenjamin Breyer More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.157AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Patients are anecdotally advised to decrease dietary sodium intake to improve nocturia. Recent small studies report higher dietary sodium intake is associated with an increased risk of nocturia. We sought to investigate this association using a large, cross-sectional, population-based database. METHODS We used data collected from 2011-2014 via the National Health and Nutrition Examination Survey (NHANES). Demographic characteristics, sodium intake and urinary symptom data were collected via in-person interviews and standardized questionnaires. Sodium intake was assessed via 24-hour recalls collected on two separate dates. Participants were excluded if age <40 years, history of genitourinary/gynecologic malignancy, or missing exposure or outcome data. We used a multivariate logistic regression model using survey sample weights and adjusted for potential confounders to calculate odds ratios and 95% confidence intervals. We assessed for effect modification by gender and diuretic use. RESULTS A total of 5,798 participants were included. Demographic and clinical characteristics of patients with and without nocturia are summarized in table 1. Dietary sodium intake was not independently associated with nocturia (highest versus lowest quintile odds ratio = 1.4; 95% confidence interval 0.8, 2.3; p-trend = 0.22) after adjustment for age, gender, BMI, depression, and household income (table 2). Other potential confounders including race/ethnicity, presence of urge/stress urinary incontinence, daily physical activity, diabetes, hypertension, education level, history of cardiovascular disease, and psychotropic or diuretics use were tested but were not included in the final model as they were found not to impact the results. There was no evidence of effect modification by gender or diuretic use. CONCLUSIONS After adjusting for potential confounders, dietary sodium intake was not significantly associated with prevalence of nocturia in a nationally representative, cross-sectional, population-based study. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e35 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Nima Baradaran More articles by this author Scott Bauer More articles by this author Kirkpatrick Fergus More articles by this author Anas Tresh More articles by this author Thomas Gaither More articles by this author Benjamin Breyer More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

INTRODUCTION AND OBJECTIVES:To describe the epidemiology of genital burns in the U.S. and investigate the underlying etiology. METHODS:The National Electronic Injury Surveillance System database was queried for individuals who sustained genital burns from 2000 to 2016. We collected data on age, gender, injury diagnosis, disposition, and causative agents. Multivariate analysis was performed to determine predictors of hospitalization. RESULTS:We estimate 17,026 (95% CI 16,649-17,404) cases of genital burns presented to emergency departments nationally. Genital burns occurred more in males than females (12,295 vs 4,731). Scalding (57.9%) was the most common mechanism of injury and hot water (35.7%) the most common causative agent. Significant predictors of hospitalization on multivariate analysis were multi-surface (OR 4.4), scalding (OR 11.5) and thermal burns (OR 27.9). Children ages 0-2 had the highest prevalence of genital burns, and children ages 0-12 comprised 37.1% of the study. For children <5years of age, majority of the burns were caused by hot water in the bathroom. In age group 6-12, the most common causes of genital burns were cooking-related scalds due to hot foods and water. CONCLUSIONS:Children sustain genital burns at a higher rate than adults and many appear to have a preventable mechanism. Improved product design for safety and educating caregivers about potential hazardous situations are needed.

Author(s): Murphy, Gregory P; Awad, Mohannad A; Tresh, Anas; Gaither, Thomas W; Osterberg, E Charles; Baradaran, Nima; Breyer, Benjamin N