Purpose: The increasing incidence of nephrolithiasis underscores the need for effective, accessible tools to aid urologists in preventing recurrence. Despite dietary modification's crucial role in prevention, targeted dietary counseling using 24-hour urine collections is underutilized. This study evaluates ChatGPT-4, a multimodal large language model, in analyzing urine collection results and providing custom dietary advice, exploring the potential for artificial intelligence-assisted analysis and counseling. Materials and Methods: Eleven unique prompts with synthesized 24-hour urine collection results were submitted to ChatGPT-4. The model was instructed to provide five dietary recommendations in response to the results. One prompt contained all "normal" values, with subsequent prompts introducing one abnormality each. Generated responses were assessed for accuracy, completeness, and appropriateness by two urologists, a nephrologist, and a clinical dietitian. Results: ChatGPT-4 achieved average scores of 5.2/6 for accuracy, 2.4/3 for completeness, and 2.6/3 for appropriateness. It correctly identified all "normal" values but had difficulty consistently detecting abnormalities and formulating appropriate recommendations. The model performed particularly poorly in response to calcium and citrate abnormalities and failed to address 3/10 abnormalities entirely. Conclusions: ChatGPT-4 exhibits potential in the dietary management of nephrolithiasis but requires further refinement for dependable performance. The model demonstrated the ability to generate personalized recommendations that were often accurate and complete but displayed inconsistencies in identifying and addressing urine abnormalities. Despite these limitations, with precise prompt design, physician oversight, and continued training, ChatGPT-4 can serve as a foundation for personalized medicine while also reducing administrative burden, indicating its promising role in improving the management of conditions such as nephrolithiasis.

Background: With the dramatic rise of telemedicine in the post coronavirus disease 2019 (COVID-19) pandemic, our objective was to develop a totally virtual multidisciplinary kidney stone clinic and assess patient satisfaction of this format. Methods: The virtual multidisciplinary stone clinic began July 2021 and continued monthly. Prior to the beginning of each clinic, providers from the urology, nephrology, and dietitian teams meet virtually to discuss the patients. Patients would then log into WebEx virtual platform and providers would subsequently log into the patient's virtual room, to review radiology, laboratory results, and dietary logs then provide counseling. Patients were then sent a survey via electronic mail regarding their experience. A 5-point Likert scale was used for responses ranging from strongly disagree to strongly agree. Scores were averaged to rank results. Results: A total of 122 patients were sent surveys, and a total of 31 surveys were completed. Sixty-one percent of patients strongly agree and 13% agree that they felt comfortable using the virtual platform. When asked if they prefer using the virtual platform for their visit, 70% of patients agreed or strongly agreed and only 16% of patients disagreed or strongly disagreed. In regards to potential advantages of a virtual visit, the Likert scores were averaged and ranked from most to least important with improved timeliness (3.7) and ease of scheduling into day (3.6) the highest rated advantages. Most patients did not find any concerns using the virtual platform, however the ability to see the provider in-person and connecting personally was of highest concern with an average Likert score of 2.3. Overall, 83% of patients agreed or strongly agreed that the multidisciplinary stone clinic satisfied their kidney stone related questions regarding treatment and prevention. Conclusions: A virtual multidisciplinary kidney stone clinic can be implemented with high patient satisfaction scores and help overcome the limitations of physical clinic space and provider schedule coordination. There are few disadvantages to using the platform.

You have accessJournal of UrologyJU Forums1 Jan 2024Overutilization of Transfer for Testicular Torsion: An Opportunity for Multilevel Policy Intervention Emily K. Clennon, Brian Duty, and Casey Seideman Emily K. ClennonEmily K. Clennon *Corresponding Author: Emily K. Clennon, MD, MPH, Oregon Health & Science University, 3303 S Bond Ave Building 1, 10th Floor, Portland, OR 97239 ( E-mail Address: [email protected] https://orcid.org/0000-0003-0012-0785 Department of Urology, Oregon Health & Science University, Portland, Oregon More articles by this author , Brian DutyBrian Duty Department of Urology, Oregon Health & Science University, Portland, Oregon More articles by this author , and Casey SeidemanCasey Seideman Department of Urology, Oregon Health & Science University, Portland, Oregon More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003750AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail In the management of testicular torsion, there has been a gradual transition away from care within local community hospitals and toward transfer of patients to pediatric specialty centers. A nationwide analysis reported a gradual increase from 23% transfer in 2006 to 38% in 2012.1 Unpublished data from our institution show the proportion of adolescent patients transferred for torsion has increased from 66% in 2018 to 75% in 2023. The risk of testicular loss with surgical delay is widely recognized, and though delay of patient presentation is often the driving factor for orchiectomy, time spent in interhospital transfer predictably worsens outcomes. Each hour of transfer time confers a 13% increase in likelihood of testicular loss and transfer overall confers a 65% greater relative risk of testicular loss for patients presenting within 24 hours of symptom onset.2,3 In other words, this health systems–based decision may be contributing to preventable loss of testicles among adolescent patients. There are myriad potential reasons for the transfer of pediatric torsion patients to specialized centers, though most stem from institutional policy and liability rather than clinical decision-making. Some hospitals and hospital systems that do not have pediatric subspecialists/pediatric wards have policies that prevent their staff from caring for any patient under the age of 18 outside of the emergency department. Though there are rare exceptions, most torsion patients are pubertal, otherwise healthy, easily intubated, and able to be safely discharged home from the postoperative area—unlike many adult patients requiring emergent surgery. Institutional policies can and should be adaptable to allow the provision of safe and reasonable care, particularly in emergent situations. This type of adaptation was one of several recent successes to reduce transfer for torsion in Oregon. Targeting transfers within the metropolitan area, an agreement was reached with local Kaiser Permanente hospitals which previously had a policy requiring transfer of all patients <18 years old in need of emergent surgical care. Recognizing that most of these patients are pubertal and do not require admission, this policy was modified to allow treatment of patients at least 12 years old and without history or anatomy necessitating a higher level of anesthetic or surgical care. In cases where there is no policy preventing it, some local urologists or anesthesiologists choose not to provide care for minor patients given malpractice coverage limitations for this patient population. Testicular torsion is a notoriously litigious diagnosis, however most lawsuits are related to failure or delay in diagnosis with the median time to diagnosis in cases leading to malpractice claims being 3 days.4 The American Board of Urology newsletter in 2013 clarified that any board-certified urologist can perform scrotal exploration and orchiopexy for suspected testicular torsion for pediatric patients. The newsletter states that “The Board does not support the practice of urologists on call deferring routine pediatric care to subspecialty certified colleagues... there are certain conditions that are considered core to urologic training.”5 With this validation and the knowledge that treatment delay increases risk of testicular loss and provides grounds for a malpractice claim, the most logical path to reducing liability is provision of care locally. The availability of on-call urologists is another factor contributing to patient transfer. Many small hospital systems and independent hospitals lack 24/7 urology coverage, and some urologists have raised concerns that small coverage pools cannot reasonably be expected to provide emergent surgical care for all pediatric torsion patients when pediatric urologists are available relatively nearby. Potential solutions for hospitals that do not have urology coverage include utilization of general surgery or pediatric surgery service lines, as well as considering transfer to closer hospital systems with 24/7 coverage rather than a pediatric specialty center if there is a significant distance required. To help cover pediatric torsions in rural Oregon, one pediatric surgery group that does not include pediatric urology began covering testicular torsions. This coverage prevents 2 hours of travel time for patients in central and southern Oregon and alleviates the lack of 24/7 urology coverage for many rural communities. Our institution has also developed a map of all hospitals in the state with their urology coverage (no coverage, daytime only, limited/variable, 24/7). This map will be distributed to rural hospitals to promote efficient interhospital collaboration and minimization of transfer distance. These successes are not sufficient to allow or promote local care of all pediatric testicular torsion in our state, but they are clear demonstrations of what can be achieved with a diverse, multilevel approach to policymaking and collaboration. We have outlined recommendations for a more comprehensive approach to this issue in the Table—including efforts to define the standard of care as local surgical intervention to protect rural providers from malpractice claims—and hope individuals in other states and in relevant leadership positions consider working to improve this area of pediatric urologic care. Table. Examples of Policy Changes or Multi-Institutional Collaborations at Different Levels of the Health System to Promote Local Care of Pediatric Testicular Torsion Patients Health system level Recommended action Individual/individual surgical practice Educational sessions/collaborations with local adult urologists, pediatric surgeons, or general surgeons about surgical care of pediatric testicular torsion and recommendation for local provision of care Hospital/hospital system In systems with policies preventing care of minors, petition relevant leadership to adapt policies for torsion patients State Educational sessions at state urologic and/or general surgery association meetings about surgical care of pediatric testicular torsion and recommendation for local provision of care Creation of publicly available maps outlining urology call coverage at hospitals throughout the state to ease identification of nearby nonpediatric centers that can provide urgent care Request statements from state medical boards affirming urgent care in local community as standard of care for pediatric torsion patients National Request statement from Societies for Pediatric Urology affirming urgent care in local community as standard of care for pediatric torsion patients REFERENCES 1. Factors affecting pediatric patient transfer in testicular torsion. J Surg Res. 2016; 203(1):40-46. Crossref, Medline, Google Scholar 2. . Improving organ salvage in testicular torsion: comparative study of patients undergoing vs not undergoing pre-operative manual detorsion. J Urol. 2017; 197(3):811-817. Link, Google Scholar 3. . Impact of hospital transfer on testicular torsion outcomes: a systematic review of meta-analysis. J Pediatr Urol. 2021; 17(3):293.e1-293.e8. Crossref, Medline, Google Scholar 4. . Testicular torsion is overrepresented among malpractice cases for gonadal torsion. J Pediatr Surg. 2023; 58(4):762-766. Crossref, Medline, Google Scholar 5. . From the desk of Gerald H. Jordan, ABU Executive Secretary. ABU Report, Issue 21. 2013:6. Google Scholar Recusal: Dr Seideman is an AUA publications online content editor and was recused from the editorial and peer review processes. Support: None. Conflict of Interest Disclosures: The Authors have no conflicts of interest to disclose. Ethics Statement: This study was deemed exempt from Institutional Review Board review. © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211 Issue 1 January 2024 Page: 172-173 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.Metrics Author Information Emily K. Clennon Department of Urology, Oregon Health & Science University, Portland, Oregon *Corresponding Author: Emily K. Clennon, MD, MPH, Oregon Health & Science University, 3303 S Bond Ave Building 1, 10th Floor, Portland, OR 97239 ( E-mail Address: [email protected] More articles by this author Brian Duty Department of Urology, Oregon Health & Science University, Portland, Oregon More articles by this author Casey Seideman Department of Urology, Oregon Health & Science University, Portland, Oregon More articles by this author Expand All Recusal: Dr Seideman is an AUA publications online content editor and was recused from the editorial and peer review processes. Support: None. Conflict of Interest Disclosures: The Authors have no conflicts of interest to disclose. Ethics Statement: This study was deemed exempt from Institutional Review Board review. Advertisement Advertisement PDF downloadLoading ...

Kidney stone cultures can be beneficial in identifying bacteria not detected in urine, yet how stone cultures are performed among endourologists, under what conditions, and by what laboratory methods remain largely unknown. Stone cultures are not addressed by current clinical guidelines. A comprehensive REDCap electronic survey sought responses from directed (n = 20) and listserv elicited (n = 108) endourologists specializing in kidney stone disease. Questions included which clinical scenarios prompt a stone culture order, how results influence post-operative antibiotics, and what microbiology lab protocols exist at each institution with respect to processing and resulting stone cultures. Logistic regression statistical analysis determined what factors were associated with performing stone cultures. Of 128 unique responses, 11

You have accessJournal of UrologyCME1 May 2022PD03-08 THE IMPACT OF MEDICAID EXPANSION ON INSURANCE COVERAGE AND METASTATIC DISEASE AT DIAGNOSIS IN PROSTATE CANCER PATIENTS David Schroeder, Solange Bassale, Brian Duty, and Ryan Kopp David SchroederDavid Schroeder More articles by this author , Solange BassaleSolange Bassale More articles by this author , Brian DutyBrian Duty More articles by this author , and Ryan KoppRyan Kopp More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002518.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: In prostate cancer, improved access to preventative and diagnostic services following the Affordable Care Act’s expansion of Medicaid may have profound effects on disease course and outcomes. We hypothesized that states which enacted Medicaid expansion experienced greater Medicaid coverage gains and lower rates of metastatic disease at time of detection. METHODS: We performed a cross-sectional analysis of 754,952 non-elderly patients aged 40-64 diagnosed with prostate cancer from 2004-2017 using the National Cancer Database (NCDB). Descriptive statistics were generated for demographic variables. Patients were divided into four groups based on diagnosis date (pre-expansion years [2004-2013] vs post-expansion years [2014-2017]) and state expansion status (expansion state [ES] vs. non-expansion state [NES]). For each time period, a multivariate logistic regression was performed to determine the impact of expansion status and other demographic variables on Medicaid enrollment. Metastatic disease at diagnosis was analyzed via multivariate logistic regression with Medicaid and expansion status, time period, and demographic variables as covariates. RESULTS: In pre-expansion years, the rates of Medicaid patients in ES vs NES was 3.6% vs 2.6%. In post-expansion years, the ES vs NES rates were 8.6% vs 3.8%. Residence in an expansion state, race, ethnicity, income, education, and degree of comorbidity were significantly associated with being enrolled in Medicaid in both periods. The odds of being enrolled in Medicaid in black vs white patients was 3.10 (95% CI 2.99-3.21) in pre-expansion years. It decreased following expansion to 2.63, 95% CI 2.52-2.74. The odds of metastatic prostate cancer diagnosis in Medicaid patients residing in ES vs Non-Medicaid patients residing in NES were 3.04, 95% CI 2.91 – 3.17, P<.0001; for Medicaid NES vs Non-Medicaid NES OR was 4.20, 95% CI 3.95 – 4.47, P<.0001. CONCLUSIONS: We demonstrated that Medicaid expansion led to measurable coverage gains through Medicaid for prostate cancer patients and that these patients had lower odds of metastatic disease at diagnosis. Source of Funding: No funding © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e44 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information David Schroeder More articles by this author Solange Bassale More articles by this author Brian Duty More articles by this author Ryan Kopp More articles by this author Expand All Advertisement PDF DownloadLoading ...

You have accessJournal of UrologyStone Disease: Epidemiology & Evaluation III (PD35)1 Apr 2020PD35-06 FOOD ACCESS ENVIRONMENTS OF PATIENTS WITH URINARY TRACT STONES Emily Clennon* and Brian Duty Emily Clennon*Emily Clennon* More articles by this author and Brian DutyBrian Duty More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000906.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Obesity, high sodium diet, and regular consumption of sugar-sweetened beverages have all been positively associated with urinary tract stones, and geographic risk factors for stones – such as temperature and sun exposure – are widely recognized. Less attention has been paid to socioeconomic risk factors such as residence in food deserts, which represent the confluence of geography and diet. In this study, we describe food access patterns among patients with urinary tract stones receiving care at an academic medical center compared to the broader statewide population. METHODS: All individuals with encounters for stone disease at our institution in calendar years 2016-2018 were identified. Patient demographics including age, gender, ethnicity, BMI, and address at time of encounter were abstracted from the medical record, and patient data were linked to U.S. census tract data using the U.S. Census Bureau’s Geocoder tool. Economic and food access data per census tract were derived from the U.S. Department of Agriculture’s Food Access Research Atlas. Analysis was limited to stone formers in Oregon whose census tract information was compared to Oregon statewide data via Mann-Whitney U test (α<0.05). RESULTS: A total of 787 Oregonian patients were seen for stone disease in the study period. Mean age of these patients was 54 years (SD 17), 51.5% were women, 91.9% were non-Hispanic, and mean BMI was 30.4 (SD 10.8). These patients represented 418 of 830 census tracts in Oregon. One-third of tracts occupied by stone formers were classified as food deserts with no access to a grocery store within 1 mile of residence in urban settings and 10 miles in rural settings (33%). Less than 10% of stone formers (8.6%) met classifications for low income and low food access. Compared to overall state characteristics, stone formers lived in tracts that were more urban (85.5 vs. 71.9% , p<0.001), higher income ($72k vs. $64k, p<0.001), less impoverished (15.7 vs. 16.8%, p=0.003), and with similar food access at 1 mile (31.5 vs. 29.5% food desert status, p=0.38) and greater access at 10 miles (1.5 vs. 5.9%, p<0.001). CONCLUSIONS: Approximately one-third of patients treated for stone disease lived in food deserts as designated by the USDA, and 8.6% lived in areas that were both low income and food deserts. These patients lived in areas that were more urban, higher income, and had somewhat better access to food than average across the state, which likely reflects their ability to access treatment at a tertiary care center. Further research is necessary to clarify the relationship between food access and stone disease across the population. Source of Funding: None © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e719-e719 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Emily Clennon* More articles by this author Brian Duty More articles by this author Expand All Advertisement PDF downloadLoading ...

You have accessJournal of UrologyStone Disease: Surgical Therapy III (MP15)1 Apr 2020MP15-06 INDICATIONS FOR STENT OMISSION AFTER URETEROSCOPIC LITHOTRIPSY: A PROSPECTIVE TRIAL FROM THE REGISTRY FOR STONES OF THE KIDNEY AND URETER (RESKU) Robert Fisher*, Kaitlan Cobb, David Friedlander, David Bayne, Seth Bechis, Helena Chang, Thomas Chi, Brian Duty, Jonathan Harper, Ian Metzler, Mathew Sorensen, Marshall Stoller, David Tzou, and Roger Sur Robert Fisher*Robert Fisher* More articles by this author , Kaitlan CobbKaitlan Cobb More articles by this author , David FriedlanderDavid Friedlander More articles by this author , David BayneDavid Bayne More articles by this author , Seth BechisSeth Bechis More articles by this author , Helena ChangHelena Chang More articles by this author , Thomas ChiThomas Chi More articles by this author , Brian DutyBrian Duty More articles by this author , Jonathan HarperJonathan Harper More articles by this author , Ian MetzlerIan Metzler More articles by this author , Mathew SorensenMathew Sorensen More articles by this author , Marshall StollerMarshall Stoller More articles by this author , David TzouDavid Tzou More articles by this author , and Roger SurRoger Sur More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000840.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Ureteral stent complications including pain, infection and discomfort are a significant source of emergency room visits in the post-operative period. Per AUA Guidelines, placement of a ureteral stent following ureteroscopy (URS) is at the urologist’s discretion. The risk/benefit calculation for routine use of ureteral stents following uncomplicated URS is controversial. We performed a multi-institutional study to investigate if ureteral stent omission is safe following URS compared to routine stenting. METHODS: From November 2018 to June 2019, a stent omission protocol was instituted at 5 academic centers for patients undergoing URS with laser lithotripsy and/or basketing by 6 fellowship trained endourologists. Inclusion criteria included: age ≥18 years, solitary ureteral stone ≤10 mm, total renal stone burden ≤15 mm with largest stone ≤10cm. Patients were excluded for solitary kidney or if a ureteral access sheath was used without pre-stenting. Data was collected prospectively via ReSKU (The Registry for Stones of the Kidney and Ureter) and was retrospectively reviewed. Analyzed outcomes included event rates of patient phone calls, unplanned emergency department or clinic visits, and unplanned operation. Bivariate differences in categorical and continuous variables between stented and unstented groups were examined using the Pearson's chi-squared and the students t-test, respectively. RESULTS: A total of 344 URS procedures were performed and 134/344 (39.0%) patients met inclusion criteria for ureteral stent omission. Of these candidates, 90 subjects (67%) had their stents omitted, while 44 (33%) deviated from the stent-less protocol. Deviation from the stent protocol did not vary by institution (20% vs. 37.5% vs. 60% vs. 50% vs. 40%; P>0.05). The total event rate (phone call, ED, OR, or clinic) was 19.1% for subjects with a stent versus 20.0% for subjects with a stent omitted (P>0.05); with the majority (30.7%) of these events being phone calls. CONCLUSIONS: In a multi-center prospectively collected study involving 344 individuals undergoing URS for nephrolithiasis, there was a similar proportion of stented and unstented subjects who called, presented to the ED or clinic, or required a return trip to the operating room following uncomplicated ureteroscopy for stone disease. Our findings suggest that ureteral stents can be safely omitted in properly selected adult patients. Source of Funding: National Institutes of Health grant (NIH P20-DK-116193). © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e206-e206 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Robert Fisher* More articles by this author Kaitlan Cobb More articles by this author David Friedlander More articles by this author David Bayne More articles by this author Seth Bechis More articles by this author Helena Chang More articles by this author Thomas Chi More articles by this author Brian Duty More articles by this author Jonathan Harper More articles by this author Ian Metzler More articles by this author Mathew Sorensen More articles by this author Marshall Stoller More articles by this author David Tzou More articles by this author Roger Sur More articles by this author Expand All Advertisement PDF downloadLoading ...

Reporting of physician-industry transactions has not led to a sustained decline in transactions with urologists. Significant differences in industry interaction exist between academic and non-academic urologists, and values transferred to academic urologists varied by gender, chair status, subspecialty, and AUA section.

Abstract Objectives Evaluate the association between urolithiasis during pregnancy and obstetric outcomes outside the context of urological intervention. Methods We conducted a retrospective cohort study of singleton, non-anomalous gestations delivered at 23–42 weeks in California from 2007 to 2011. Maternal outcomes (preterm delivery [early (<32 weeks) and late (<37 weeks)], preeclampsia, gestational diabetes, cesarean deliveries, urinary tract infection [UTI] at delivery, chorioamnionitis, endomyometritis, and maternal sepsis) and newborn outcomes (seizure, respiratory distress syndrome, hypoglycemia, jaundice, and neonatal abstinence syndrome [NAS]) were compared using χ 2-tests and multivariable logistic regression. Results A total of 2,013,767 pregnancies met inclusion criteria, of which 5,734 (0.28%) were complicated by urolithiasis. Stone disease during pregnancy was associated with 30% greater odds of each early (aOR 1.30; 95% CI 1.19–1.43) and late (aOR 1.29; 95% CI 1.18–1.41) preterm delivery. Cesarean delivery, UTI at delivery, gestational hypertension, gestational diabetes, preeclampsia, and sepsis were all significantly positively associated with urolithiasis. Odds of NAS (aOR 2.11; 95% CI 1.27–3.51) and jaundice were significantly greater in the neonates of stone-forming patients (aOR 1.08; 95% CI 1.01–1.16). Conclusions Urolithiasis during pregnancy was associated with 30% greater odds of preterm delivery and increased risk of myriad metabolic, hypertensive, and infectious disorders of gestation. Neonates born to stone-forming patients were more than twice as likely to develop neonatal abstinence syndrome but did not have significantly greater odds of complications of prematurity.

Journal of EndourologyVol. 33, No. S1 AbstractsFree Access37TH WORLD CONGRESS OF ENDOUROLOGY COMMITTEES AND AWARDSPublished Online:11 Oct 2019https://doi.org/10.1089/end.2019.29065.abstracts.fmAboutSectionsPDF/EPUB Permissions & CitationsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail COMMITTEE MEMBERSEXECUTIVE COMMITTEE OF THE ENDOUROLOGICAL SOCIETYJENS RASSWEILER, MDPresidentALI RIZA KURAL, MDPast PresidentGLENN PREMINGER, MDPresident‐ElectMARGARET S. PEARLE, MD, PhDSecretary GeneralCHANDRU P. SUNDARAM, MDTreasurer-ElectADRIAN JOYCE, MDDirector of EducationBRIAN MATLAGA, MDAssociate Director of EducationBEN H. CHEW, MD, MSc, FRCSCResearch ChairMICHELE PAOLIExecutive DirectorBOARD OF DIRECTORSJEFFREY CADEDDU, MD, USADirectorNORBERTO O. BERNARDO, MD, ArgentinaDirectorJORGE GUITERREZ, MD, USAMember-at-LargeJEAN JOSEPH, MD, MBA, FACS, USADirectorJIAN HUANG, MD, PhD, ChinaDirectorASHOK HEMAL, MD, USAMember-at-LargeEVANGELOS LIATSIKOS, MD, PhD, GreeceDirectorHASSAN RAZVI, MD, CanadaDirectorABHAY RANE, MD, United KingdomDirectorANTHONY C.F. NG, MD, Hong KongDirectorTOMONORI HABUCHI, MD, JapanDirectorGUIDO GIUSTI, MD, ItalyDirectorFOUNDING PRESIDENTARTHUR D. SMITH, MDHISTORIANSTEPHEN Y. NAKADA, MD, FACSJOURNAL OF ENDOUROLOGY EDITORSRALPH V. CLAYMAN, MDARTHUR D. SMITH, MDJOHN DENSTEDT, MDSUBGROUP LEADERSBEN CHEW, MDChair, CROES (Clinical Research Office of the Endourology Society)JIHAD KAOUK, MDPresident, SURS (Society of Urological Robotic Surgery)ROBERT SWEET, MDPresident, Engineering & Urology SocietyDIRK LANGE, MDInternational Society for Urological StentsTHOMAS TAILLY, MDYoung EndourologistsJAMES F. BORIN, MDImage Guided Therapy Working GroupWEBSITE COMMITTEEBrian D. Duty, MD, ChairmanKhurshid R. Ghani, MD, MSAthanasios Papatsoris, MDMichael S. Borofsky, MDZhamshid Okhunov, MDChandru Sundaram, TreasurerBrian Matlaga, Associate Director of EducationAWARDS COMMITTEEEduardo Mazzucchi, MD, ChairmanMordechai Duvdevani, MDOliver Wiseman, MD, MA, FRCSBenjamin Lee, MDNicole L. Miller, MDStephen Y. Nakada, MD, FACSAli R. Kural, MDChandru P. Sundaram, MD (Video)FELLOWSHIP COMMITTEELi-Ming Su, MD, ChairmanBen H. Chew, MD, MSc, FRCSCRobert Figenshau, MDTom Chi, MDGuohua Zeng, MDMario Sofer, MDAndreas J. Gross, MDFINANCE COMMITTEEChandru P. Sundaram, MD, ChairBenjamin R. Lee, MDChristopher Netsch, MDBodo E. Knudsen, MD, FRCSCAUA PROGRAM PLANNING COMMITTEEBen Chew, MD, MSc, FRCSC, ChairAdrian Joyce, MDJihad Kaouk, MDBrian Matlaga, MDMargaret S. Pearle, MD, PhDGLOBAL EDUCATION COMMITTEEAdrian D. Joyce, MD, ChairBrian Matlaga, MDJihad Kaouk, MDEvangelos Liatsikos, MDBradley Schwartz, MDBodo Knudsen, MDAndreas Gross, MDZhamid Okhunov, MDWORLD ENDOUROLOGY COMMITTEEGopal Badlani, MD, ChairRaju Thomas, MD, FACS, MHA, MDAli R. Kural, MDRalph V. Clayman, MDMarius Conradie, MDGraham Watson, MDSOCIAL MEDIA COMMITTEEBrian Eisner, MD, ChairFabio Vicentini, MD (Lap/Stones)Fernando Gomez Sancha, MD (BPH)Matthew Bultitude, MD (Stones)Riccardo Autorino, MD (Robotics)John Davis, MD (Robotics)Igor Sorokin, MD (Stones/Robotics)MEMBERSHIP COMMITTEEJaime Landman, MD, ChairAli R. Kural, MDJoseph Wang, MDAbbas Basiri, MDJoel Aldana, MDAlex E. Meller, MDZhamshid H. Okhunov, MDDelegatesDamien Bolton, MDAustraliaEduardo Mazzucchi, MDBrazilAlex MellerBrazilKenneth T. Pace, MD, MSc, FRCSCCanadaGuohua Zeng, MDChinaKunjie Wang, MD, PhDChinaAnthony C.F. Ng, MDChinaThomas Knoll, MD, PhD, MScGermanyJoseph WongHong KongShahikant Mishra, MDIndiaNasser Simforoosh, MDIranMordechai Duvdevani, MDIsraelSalvatore Micali, MDItalyTomonori Habuchi, MDJapanHiroomi Kanayama, MD, PhDJapanSanzkar ShalerenovKazakhstanKoon H. Rha, MDKoreaDaniel Olvera-PosadaMexicoJose Benito Abraham, MDPhilippinesAlexeiy G. Martov, MD, PhDRussiaMohammed AlomarSaudi ArabiaBurak Turna, MDTurkeyÖmer TuncayTurkeySergei Shamraev, MDUkraineYasser FarahatUAEOliver Wiseman, MD, MA, FRCSUnited KingdomJean Joseph, MD, MBA, FACSUnited StatesBodo E. Knudsen, MD, FRCSCUnited StatesNicole L. Miller, MDUnited StatesShukhrat MukhtarovUzbekistan37TH WORLD CONGRESS OF ENDOUROLOGY ORGANIZING COMMITTEEOlivier Traxer, MD - President of WCE 2019Eric Barret, MDAlexandre de la Taille, MDEric Lechevallier, MDChristian Saussine, MDSteeve Doizi, MDAndras Hoznek, MDFranck Bruyère, MDAlaa El Ghoneimi, MDKarim Bensallah, MDBenjamin Pradère, MDMichel Daudon, MDJean-Philippe Haymann, MDMorgan Roupret, MD2019 RECIPIENT OF THE KARL STORZ “LIFETIME ACHIEVEMENT” AWARDJohn D. Denstedt, MD, FRCSC, FACS, FCAHSDr. John Denstedt graduated from medical school in 1982 at The University of Western Ontario in London, Canada. He completed his residency in urology at Western between 1983 and 1987, followed by a fellowship in endourology at Washington University in St. Louis. He returned to London and joined the Division of Urology in the Department of Surgery at Western in 1990.In July 2002 he assumed the role of city‐wide chair and chief of the Department of Surgery at Western University and served in this role for 14 years. Dr. Denstedt is a past chair of the Canadian Association of Surgical Chairs and a past member of the American Urological Association Board of Directors. He completed a 10‐year term as treasurer of the Endourological Society in 2018.While maintaining an active clinical practice, Dr. Denstedt is an internationally renowned scholar in urology with career accomplishments encompassing over 250 published papers and book chapters, more than 300 guest professorships in countries throughout the world, and numerous honors and awards including being the first Canadian to have won the Gold Cystoscope Award from the American Urological Association in 1998. Dr. Denstedt serves on the editorial board of eight major journals in urology and is currently executive editor of the Journal of Endourology. He is currently the secretary elect of the American Urological Association and will assume a 4‐year term as secretary in 2019.2019 RECIPIENT OF THE RALPH CLAYMAN “MENTOR” AWARDStephen Y. Nakada, MD, FACS, FRCS (Glasg)Stephen Y. Nakada, MD, FACS, FRCS (Glasg) is Professor and Chairman of the Department of Urology and the David T. Uehling Chair of Urology at the University of Wisconsin School of Medicine and Public Health in Madison, WI. He received his medical degree from the University of Rochester School of Medicine and Dentistry and completed his residency training at Strong Memorial Hospital in Rochester, NY. Dr. Nakada went on to complete his endourology fellowship at Washington University prior to joining the faculty at the University of Wisconsin in 1995. Dr. Nakada has been the chairman of urology in Madison since 2001.Dr. Nakada's research focuses on urolithiasis and renal aspects of minimally invasive urology. He has authored or co‐authored over 250 scientific articles and 50 book chapters, and he has edited more than 10 textbooks in those areas. In 2004, Dr. Nakada received the Gold Cystoscope Award from the American Urological Association (AUA) and in 2017 the AUA Distinguished Service Award. He is currently an editorial consultant for Urology Times and an assistant editor of the Journal of Endourology.Dr. Nakada has served as president of the R.O.C.K. Society, the Society of Academic Urologists, the Endourological Society, and the American Board of Urology. He has served on the AUA Staghorn Stone and Ureteral Stones Guidelines Committees, the AUA/ABU Examination Committee, and he served as the chair of the AUA Laparoscopy and Robotic Surgery Committee. Currently Dr. Nakada is a member of the Advisory Council in Urology to the American College of Surgeons. Dr. Nakada is an active member of the American Association of Genitourinary Surgeons, and the Clinical Society of Genitourinary Surgeons, among other societies.2019 RECIPIENT OF THE “ARTHUR” AWARDAthanasios (Thanos) PapatsorisProfessor Athanasios (Thanos) Papatsoris graduated from Patras University School of Medicine with an honorary scholarship and obtained a MSc in benign prostatic hyperplasia (BPH). His PhD in bladder cancer was conferred by the Athens School of Medicine. He trained in urology in Athens and London, where he also completed a 2‐year endourology fellowship (SpR level at Barts Hospital) officially recognized by the Endourological Society. He then completed a clinical fellowship in laparoscopy in Le Mans, France, supported by the European University at Saint Petersburg (EUSP). Furthermore, he served one year as an honorary consultant in Urology at Royal London Hospital, Barts Health NHS Trust. He holds honorary contracts at Addenbrooke's Hospital, Cambridge and Imperial London Healthcare NHS Trust. He obtained his FEBU degree in 2007 and since then has been an FEBU examiner, while also serving as vice chairman of the European Board of Urology (EBU) Examination Committee for the last years.Since 2017, Dr. Papatsoris is an associate professor in urology at the Second Department of Urology, School of Medicine, Sismanoglio General Hospital, Athens, Greece. Moreover, he is an associate board member of ESUT (Endourology Section), EULIS, ESOU (Prostate Cancer Committee), SEGUR, and U‐Merge. He is the EBU, UEMS, and SIU National Delegate as well as uCARE SIU Board member (head of the Publication and Communication Committee) and SIU Academy Endourology Board member. For 4 years he served as the secretary (assistant /general) of HUA and the vice chairman of the HUA Section of Endourology – Laparoscopic Surgery and Urotechnology. Furthermore, he is a board member of IMIBE as well as the secretary general of HGUCG and member of the Endourological Society Website Committee.Prof. Papatsoris Hirsch index is 26 and he has more than 170 publications in PubMed indexed journals with more than 2000 citations; 90 endourology‐related as first or senior author (original papers, reviews, points of surgical techniques). He participated in the development of the endoscopic stone treatment step 1 training/assessment curriculum and serves as the principal investigator in several studies. Lastly, Prof. Papatsoris is a member of the editorial board of several journals, and he has been invited as faculty in international congresses, workshops, HOT, intensive courses, mentoring, and live surgeries in endourology.2019 RECIPIENT OF THE ENDOUROLOGY SOCIETY “INDUSTRY” AWARDShayna MartinAs the global brand marketing director for Cook Medical's urology business, Shayna Martin has more than 15 years of experience in healthcare marketing. She started her healthcare marketing career at an Indiana‐based agency where she focused on hospital marketing across a variety medical specialties and healthcare insurance companies throughout the United States. This role laid the groundwork that she continues to build on as she expands her understanding of the global healthcare community.Ms. Martin started her career with Cook Medical as a brand marketing specialist in 2010. After a short stint with Indiana University in 2011, Ms. Martin returned to Cook to serve as the global brand marketing manager for the urology specialty and was later promoted to director in 2016. Ms. Martin is passionate about continuing Cook's long‐standing goal of partnering with physicians to continue to improve healthcare through innovation, collaboration, and education. Her ability to develop, foster, and strengthen relationships has helped her succeed in her role today.Ms. Martin graduated with a Bachelor of Arts in Journalism from Indiana University in Bloomington, Indiana, where she currently resides.FiguresReferencesRelatedDetails Volume 33Issue S1Oct 2019 InformationCopyright 2019, Mary Ann Liebert, Inc., publishersTo cite this article:37TH WORLD CONGRESS OF ENDOUROLOGY COMMITTEES AND AWARDS.Journal of Endourology.Oct 2019.S4-S13.http://doi.org/10.1089/end.2019.29065.abstracts.fmPublished in Volume: 33 Issue S1: October 11, 2019PDF download

Purpose: Kidney stone patients routinely have CT scans during diagnostic work-up before being referred to a tertiary center. How often these patients exceed the recommended dose limits for occupational radiation exposure of >100 mSv for 5 years and >50 mSv in a single year from CT alone remains unknown. This study aimed to quantify radiation doses from CTs received by stone patients before their evaluation at a tertiary care stone clinic. Methods: From November 2015 to March 2017, consecutive new patients enrolled into the Registry for Stones of the Kidney and Ureter (ReSKU™) had the dose-length product of every available CT abdomen/pelvis within 5 years of their initial visit recorded, allowing for an effective dose (EDose) calculation. Multivariate logistic regression analysis identified factors associated with exceeding recommended dose limits. Models were created to test radiation reducing effects of low-dose and phase-reduction CT protocols. Results: Of 343 noncontrast CTs performed, only 29 (8%) were low-dose CTs (calculated EDose <4 mSv). Among 389 total patients, 101 (26%) and 25 (6%) had an EDose >20 mSv and >50 mSv/year, respectively. Increased body mass index, number of scans, and multiphase scans were associated with exceeding exposure thresholds (p < 0.01). The implementation of a low-dose CT protocol decreased the estimated number of scans contributing to overexposure by >50%. Conclusions: Stone patients referred to a tertiary stone center may receive excessive radiation from CT scans alone. Unnecessary phases and underutilization of low-dose CT protocols continue to take place. Enacting new approaches to CT protocols may spare stone patients from exceeding recommended dose limits.

You have accessJournal of UrologyStone Disease: Epidemiology & Evaluation II1 Apr 2018MP50-02 MAXIMIZING COST EFFECTIVENESS OF UROLITHIASIS MANAGEMENT IN PREGNANCY Emily Clennon, Brian Duty, and Aaron Caughey Emily ClennonEmily Clennon More articles by this author , Brian DutyBrian Duty More articles by this author , and Aaron CaugheyAaron Caughey More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.1613AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Urolithiasis complicates an estimated 1/1500 pregnancies and presents a unique challenge for urology and MFM teams. The management options, which include intraureteral stenting, percutaneous nephrostomy (PCN), and ureteroscopy, vary significantly with regard to complication rates, duration of treatment, need for re-treatment postpartum, impact on quality of life and overall costs. This analytic model compares all of these factors between management options to define a dominant strategy based on gestational age at presentation. METHODS A decision analytic model was built using TreeAge software that compared intraureteral stent placement, PCN, and ureteroscopy. Outcomes of each strategy included treatment failure, requirement of re-treatment either intrapartum or postpartum, and complications stratified by severity. Monthly replacement of stent and nephrostomy tube until delivery were assumed. All probabilities, costs, and utilities were derived from the literature. The time horizon was one year with disutilities, used to generate quality adjusted life years (QALYs), limited to length of gestation or estimated recovery time from operative event or complication. Univariate and multivariate sensitivity analyses were performed to evaluate the robustness of the model. RESULTS Across all gestational ages tested, ureteroscopy was the most cost-effective strategy. In a simulated cohort of 1000 pregnant women with urolithiasis, ureteroscopy would yield 960 out of a possible 1000 QALYs, compared to 870 with stenting and 890 with nephrostomy. In both stent and PCN management, over two hundred placements would fail and 510 and 740 secondary treatments would be required, respectively. In this cohort, ureteroscopy would save $33.8 million compared to stenting and $27 million compared to PCN. Incremental cost benefit of ureteroscopy decreases as pregnancy progresses, and stenting becomes more cost-effective than PCN around 28 weeks gestation. CONCLUSIONS Regardless of gestational age, ureteroscopy was the most cost-effective strategy to manage urolithiasis in pregnancy. Procedural costs and requirement of retreatment postpartum drove strategy preferences. Incremental benefit of ureteroscopy compared to stent and PCN decreased with advancing gestational age. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e675 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Emily Clennon More articles by this author Brian Duty More articles by this author Aaron Caughey More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

PURPOSENephrolithiasis is an increasingly common ailment in the United States. Ureteroscopic management has supplanted shockwave lithotripsy as the most common treatment of upper tract stone disease. Ureteral stricture is a rare but serious complication of stone disease and its management. The impact of new technologies and more widespread ureteroscopic management on stricture rates is unknown. We describe our experience in managing strictures incurred following ureteroscopy for upper tract stone disease.MATERIALS AND METHODSRecords for patients managed at four tertiary care centers between December 2006 and October 2015 with the diagnosis of ureteral stricture following ureteroscopy for upper tract stone disease were retrospectively reviewed. Study outcomes included number and type (endoscopic, reconstructive, or nephrectomy) of procedures required to manage stricture.RESULTSThirty-eight patients with 40 ureteral strictures following URS for upper tract stone disease were identified. Thirty-five percent of patients had hydronephrosis or known stone impaction at the time of initial URS, and 20% of cases had known ureteral perforation at the time of initial URS. After stricture diagnosis, the mean number of procedures requiring sedation or general anesthesia performed for stricture management was 3.3 ± 1.8 (range 1-10). Eleven strictures (27.5%) were successfully managed with endoscopic techniques alone, 37.5% underwent reconstruction, 10% had a chronic stent/nephrostomy, and 10 (25%) required nephrectomy.CONCLUSIONSThe surgical morbidity of ureteral strictures incurred following ureteroscopy for stone disease can be severe, with a low success rate of endoscopic management and a high procedural burden that may lead to nephrectomy. Further studies that assess specific technical risk factors for ureteral stricture following URS are needed.

Journal of EndourologyVol. 32, No. S2 AbstractsFree Access36TH WORLD CONGRESS OF ENDOUROLOGY COMMITTEES AND AWARDSPublished Online:12 Sep 2018https://doi.org/10.1089/end.2018.29044.abstracts.fmAboutSectionsPDF/EPUB Permissions & CitationsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail COMMITTEE MEMBERSEXECUTIVE COMMITTEE OF THE ENDOUROLOGICAL SOCIETYALI RIZA KURAL, MDPresidentSTEPHEN NAKADA, MDPast PresidentJENS RASSWEILER, MDPresident-ElectMARGARET S. PEARLE, MD, PhDSecretary GeneralJOHN DENSTEDT, MD, FRCSC, FACS, FCAHSTreasurerCHANDRU P. SUNDARAM, MDTreasurer-ElectADRIAN JOYCE, MDDirector of EducationBRIAN MATLAGA, MDAssociate Director of EducationBEN H. CHEW, MD, MSc, FRCSCResearch ChairMICHELE PAOLIExecutive DirectorBOARD OF DIRECTORSJEFFREY CADEDDU, MD, USADirectorNORBERTO O. BERNARDO, MD, ArgentinaDirectorJORGE GUITERREZ, MD, USADirectorJEAN JOSEPH, MD, MBA, FACS, USADirectorJIAN HUANG, MD, PhD, ChinaDirectorJAIME LANDMAN, MD, USADirectorEVANGELOS LIATSIKOS, MD, PhD, GreeceDirectorHASSAN RAZVI, MD, USADirectorANDREAS GROSS, MD, GermanyDirectorANTHONY C.F. NG, MD, Hong KongMember-at-LargeTOMONORI HABUCHI, MD, JapanMember-at-LargeGUIDO GIUSTI, MD, ItalyDirectorFOUNDING PRESIDENTARTHUR D. SMITH, MDHISTORIANSTEPHEN Y. NAKADA, MD, FACSJOURNAL OF ENDOUROLOGY EDITORSRALPH V. CLAYMAN, MDARTHUR D. SMITH, MDJOHN DENSTEDT, MDSUBGROUP LEADERSJEAN DE LA ROSETTE, MDChair, CROES (Clinical Research Office of the Endourology Society)ASHOK Y. HEMAL, MDPresident, SURS (Society of Urological Robotic Surgery)ALBERTO BREDA, MDPresident, Engineering & Urology SocietyRAVI KULKARNI, MD, FRCSInternational Society for Urological StentsTHOMAS TAILLY, MDYoung EndourologistsJAMES F. BORIN, MDImage Guided Therapy Working GroupABHAY RANE, MDNOTES & LESS Working GroupWEBSITE COMMITTEEBrian D. Duty, MD, ChairmanKhurshid R. Ghani, MD, MSAthanasios Papatsoris, MDMichael S. Borofsky, MDZhamshid Okhunov, MDAWARDS COMMITTEEEduardo Mazzucchi, MD, ChairmanMordechai Duvdevani, MDOliver Wiseman, MD, MA, FRCSJanak D. Desai, MDNicole L. Miller, MDStephen Y. Nakada, MD, FACSChandru P. Sundaram, MD (Video)FELLOWSHIP COMMITTEEChandru P. Sundaram, MD, ChairmanBen H. Chew, MD, MSc, FRCSCLi-Ming Su, MDDuke Herrell, MDNorberto O. Bernardo, MDMario Sofer, MDAndreas J. Gross, MDFINANCE COMMITTEEJohn Denstedt, MD, FRCSC, FACS, FCAHS, ChairBenjamin R. Lee, MDChristopher Netsch, MDBodo E. Knudsen, MD, FRCSCChandru P. Sundaram, MD, Treasurer-ElectAUA PROGRAM PLANNING COMMITTEEMargaret S. Pearle, MD, PhD, ChairAskok Y. Hemal, MDBrian Matlaga, MDBen H. Chew, MD, MSc, FRCSCGLOBAL EDUCATION COMMITTEEAdrian D. Joyce, MD, ChairBrian Matlaga, MDWORLD ENDOUROLOGY COMMITTEERaju Thomas, MD, FACS, MHA, ChairBenjamin R. Lee, MDRalph V. Clayman, MDChristian G. Chaussy, MDTadashi Matsuda, MDGopal Badlani, MDMEMBERSHIP COMMITTEEJaime Landman, MD, ChairAli R. Kural, MDTadashi Matsuda, MDAbbas Basiri, MDJoel Aldana, MDAlex E. Meller, MDZhamshid H. Okhunov, MDDelegatesEduardo Mazzucchi, MDBrazilKenneth T. Pace, MD, MSc, FRCSCCanadaGuohua Zeng, MDChinaKunjie Wang, MD, PhDChinaAnthony C.F. Ng, MDChinaThomas Knoll, MD, PhD, MScGermanyShahikant Mishra, MDIndiaNasser Simforoosh, MDIranMordechai Duvdevani, MDIsraelGuido Giusti, MDItalyTomonori Habuchi, MDJapanHiroomi Kanayama, MD, PhDJapanKoon H. Rha, MDKoreaJose Benito Abraham, MDPhilippinesAlexey G. Martov, MD, PhDRussiaAndre van der Merwe, MDSouth AfricaBurak Turna, MDTurkeySergei Shamraev, MDUkraineOliver Wiseman, MD, MA, FRCSUnited KingdomJean Joseph, MD, MBA, FACSUnited StatesBodo E. Knudsen, MD, FRCSCUnited StatesNicole L. Miller, MDUnited States36TH WORLD CONGRESS OF ENDOUROLOGY ORGANIZING COMMITTEEOlivier Traxer, MD - President of WCE 2018Eric Barret, MDAlexandre de la Taille, MDEric Lechevallier, MDChristian Saussine, MDSteeve Doizi, MDAndras Hoznek, MDFranck Bruyère, MDAlaa El Ghoneimi, MDKarim Bensallah, MDBenjamin Pradère, MDMichel Daudon, MDJean-Philippe Haymann, MDMorgan Roupret, MD2018 RECIPIENT OF THE KARL STORZ LIFETIME ACHIEVEMENT AWARDGlenn M. Preminger, MDGlenn M. Preminger received his MD from New York Medical College in 1977. After completing his urologic training at the University of North Carolina in 1983, he was an American Urological Association (AUA) Scholar (1983–1985) in the Division of Mineral Metabolism at the University of Texas Southwestern Medical Center, concentrating on the medical management of nephrolithiasis. He ultimately spent 10 years on the faculty in Dallas, returning to North Carolina in 1993 as professor of urologic surgery, director of the Comprehensive Kidney Stone Center, and director of the Urology Residency Program at Duke University Medical Center.Dr. Preminger's clinical interests include the minimally invasive management of urinary tract stones including shock wave lithotripsy, percutaneous, and ureteroscopic stone removal. He directs the metabolic evaluation and preventative medical treatment offered at the Duke Comprehensive Kidney Stone Center. He has had extensive experience in the development of endoscopic instrumentation for minimally invasive urologic procedures and holds eight patents in shock wave lithotripsy design. He, along with Pei Zhong, PhD, established the Lithotripsy Laboratory within the Comprehensive Kidney Stone Center to study shock wave physics and tissue effects within the realms of shock wave lithotripsy and intracorporeal lithotripsy devices. Drs. Preminger and Zhong have been awarded over $10 million in research support from the National Institutes of Health.Dr. Preminger has published more than 350 manuscripts, 100 book chapters, and 10 books, as well as 30 videos that review complex endoscopic techniques. He is a member of 15 professional societies and holds editorial positions with Urology and the Journal of Endourology. He has served as co-chairman of VIII International Symposium on Urolithiasis (1996), co-program chairman of the 16th and 25th World Congresses on Endourology (1998 and 2007), and co-chairman of the first and second International Consultations on Stone Disease, (2001 and 2007). He was chairman of the AUA Nephrolithiasis Guidelines Panel, which released four sets of guidelines for the management of staghorn calculi (1994, 2004) and ureteral calculi (1997, 2007). From 2004 to 2007, he was co-chairman of the joint AUA/EAU International Nephrolithiasis Guidelines Panel.Dr. Preminger served 4 years on the American Board of Urology (ABU)–AUA Exam Committee and remains an examiner for the ABU Oral Exams. He was awarded the 2008 AUA Residents Committee Teaching Award, which recognizes outstanding urology educators who have dedicated their career to resident training and advancing urology GME. Dr. Preminger served as the chair of the AUA Office of Education from 2006 to 2009 and currently sits on the AUA Science and Quality Council that oversees the science, quality, and data components of the association's mission. He served as the director of education for the Endourological Society and was secretary of the Southeastern Section of the AUA from 2015 to 2018. He is currently president elect of the SESAUA.In 2011, Dr. Preminger became chief of the Division of Urologic Surgery at Duke and was named as the James F. Glenn Distinguished Professor of Urologic Surgery. He was recognized by the International Urolithiasis Society in 2012 with a Lifetime Achievement Award. In 2013, he was honored by the School of Medicine of the University of Athens with the title of Doctor Honoris Causa, and the British Association of Urological Surgeons presented Dr. Preminger with the 2013 St. Paul's Medal. He was honored with the 2015 AUA Flanigan Education Award for his commitment to urological education and will receive the Endourological Society's Karl Storz Lifetime Achievement Award in September 2018.2018 RECIPIENT OF THE RALPH CLAYMAN MENTOR AWARDManoj Monga, MDDr. Manoj Monga is the director of the Stevan Streem Center for Endourology and Stone Disease at the Glickman Urological and Kidney Institute of the Cleveland Clinic. Prior to this he was the Joseph Sorkness Professor and vice chair of Urology at the University of Minnesota. After graduating from the Chicago Medical School, he completed his residency at Tulane University. He specializes in endourology and stone disease. He was awarded the Endourology Society “Arthur Smith Young Innovators' Award” in 2007 and has over 390 peerreviewed publications. His research has focused on the evaluation and design of medical devices related to endourology.Dr. Monga is the secretary of the American Urological Association and has served on the board of directors of the Endourology Society. He has served on the American Board of Urology Exam Committee and the American Urological Association Quality Improvement and Patient Safety Committee. He is the past president of the Minnesota Urological Society, the past president of the Engineering and Urology Society, and the past treasurer of the Ohio Urological Society. He was elected to the American Association of Genitourinary Surgeons in 2016. He is the President of the ROCK (Research on Calculous Kinetics) Society.2018 RECIPIENT OF THE “ARTHUR” AWARDAmy E. Krambeck, MDDr. Amy E. Krambeck is the Michael O. Koch Professor of Urology at Indiana University (IU) School of Medicine. Her medical school training was completed at the University of Missouri–Columbia School of Medicine, where she received the Janet M. Glascow Award, which honors women who graduate first in their medical school class. Dr. Krambeck went on to complete her urology residency at the Mayo Clinic in Rochester, Minnesota, in 2008, where she earned the Distinguished Fellow Award. She subsequently completed an endourology fellowship at the Methodist Institute for Kidney Stone Research in Indianapolis, Indiana. From 2009 to 2016 she worked as an endourologist in the Mayo Clinic Department of Urology and then joined the staff at IU Health Physicians/Indiana University in July of 2016. Dr. Krambeck specializes in the surgical and medical treatment of stone disease and benign prostatic hyperplasia (BPH).Dr. Krambeck's research focuses on the pathogenesis, treatment, and prevention of stone disease and the treatment of BPH. From 2008 to 2017 Dr. Krambeck received funding from the National Institutes of Health as part of the Mayo Clinic O'Brien Research Center grant to study renal precursor lesions contributing to kidney stone formation. Dr. Krambeck has also published extensively on the management of stone disease during pregnancy and has worked to improve treatment options for such patients. She has also served on the American Urological Association Guidelines Committee to establish current surgical guidelines for the medical treatment of stone disease. In the area of BPH, Dr. Krambeck has a special interest in the treatment of enlarged prostates in the setting of myogenic or weakened bladders. Much of her BPH research focuses on the use of Holmium laser enucleation of the prostate for the treatment of symptomatic lower urinary tract symptoms.2018 RECIPIENT OF THE INDUSTRY AWARDTheodore C. Lamson, PhDTed Lamson, PhD, is co-founder and chief technical officer of NeoTract, Inc., a wholly owned subsidiary of Teleflex, Inc. Dr. Lamson is a primary inventor of the UroLift system for benign prostatic hyperplasia and served as president and chief executive officer of NeoTract for the first 4 years of the company and sat on its board of directors for the company's entire history. He now oversees reimbursement and health policy, clinical affairs, and medical affairs under Teleflex Interventional Urology. Dr. Lamson sits on the board of directors for Eximis Surgical LLC and advises several other small medical device companies. He has over 25 years of experience in the medical device industry in multiple fields and holds more than 70 patents, many of which represent current commercial medical products.Dr. Lamson has played a leadership role in other successful ventures, such as vice president of research and development for TransVascular (sold to Medtronic), co-inventor for Acclarent (sold to J&J), and strategic advisor to the ExploraMed incubator, which has launched several medical device companies including NeoTract, Inc. In addition to his deep start-up experience, Dr. Lamson has served as vice president in the Vascular division of Medtronic and section manager within the prior-owned Schneider division of Pfizer. Dr. Lamson held the position of design engineer for the Artificial Heart Program at Penn State University, where he earned a MS and PhD in Biomedical Engineering. In 2011, he was awarded the Outstanding Engineering Alumnus Award for Penn State, where he now serves on the curriculum advisory committee to the Biomedical Engineering department. He also holds a BS in Chemical Engineering from Rensselaer Polytechnic Institute.FiguresReferencesRelatedDetails Volume 32Issue S2Sep 2018 InformationCopyright 2018, Mary Ann Liebert, Inc., publishersTo cite this article:36TH WORLD CONGRESS OF ENDOUROLOGY COMMITTEES AND AWARDS.Journal of Endourology.Sep 2018.S4-S13.http://doi.org/10.1089/end.2018.29044.abstracts.fmPublished in Volume: 32 Issue S2: September 12, 2018PDF download

OBJECTIVE To compare the measured stone burden recorded between urologists and radiologists, and examine how these differences could potentially impact stone management. As current urologic stone surgery guideline recommendations are based on stone size, accurate stone measurements are crucial to direct appropriate treatment. This study investigated the discrepant interpretation that often exists between urologic surgeons and radiologists' estimation of patient urinary stone burden. MATERIALS AND METHODS From November 2015 through August 2016, new patients prospectively enrolled into the Registry for Stones of the Kidney and Ureter (ReSKU) were included if they had computed tomography images available and an accompanying official radiologic report at the time of their urologist provider visit. Stone number and aggregate stone size were compared between the urologic interpretation and the corresponding radiologic reports. RESULTS Of 219 patients who met the inclusion criteria, concordance between urologic and radiologic assessment of aggregate stone size was higher for single stone sizing (63%) compared with multiple stones (32%). Statistical significance was found in comparing the mean difference in aggregate stone size for single and multiple stones (P < .01). Over 33% of stone-containing renal units had a radiologic report with an unclear size estimation or size discrepancy that could lead to non-guideline-driven surgical management. CONCLUSION Significant variation exists between urologic and radiologic computed tomography interpretations of stone burden. Urologists should personally review patient imaging when considering stone surgical management. A standardized method for measuring and reporting stone parameters is needed among urologists and radiologists. (c) 2017 Elsevier Inc.

Maintenance of flexible ureteroscopes can involve high costs and administrative burden. Instrument fragility necessitates eventual repair, rendering scopes inaccessible during refurbishment. We conducted a multi-institutional prospective cohort study to identify perioperative factors influencing flexible ureteroscope durability. Patients undergoing flexible ureteroscopy (URS) at six United States endourology centers were enrolled between August 2014 and June 2015. Surgeon self-reported concern and satisfaction with scope performance as well as upward and downward angles of deflection for each scope tip were measured before and after each procedure. The need for scope repair was determined by the operating surgeon at the time of the procedure and recorded. 424 URS cases using 74 flexible ureteroscopes were identified. Scope repair was required in 28 cases (6.6%) involving 26 scopes (35.1%). Upon univariate analysis, shorter patient height, absence of guidewire use, presence of a ureteral access sheath (UAS), longer procedure time, larger stone size, lithotrite type, surgeon training level, and self-reported concern were associated with scope repair. Upon multivariate analysis, UAS use (OR = 2.53, p = 0.005) and degree loss of scope upward flexion during a case (OR = 1.02, p = 0.03) increased the odds of a scope needing repair while the use of safety guidewire decreased the odds of a scope repair (OR = 0.50, p = 0.045). Lithotrite use and surgeon concern were associated with degree loss of scope upward flexion. The use of a UAS, absence of a safety guidewire, and the loss of upward ureteroscope flexion should be considered when evaluating means of optimizing reusable ureteroscope durability.

You have accessJournal of UrologyStone Disease: Epidemiology & Evaluation II1 Apr 2017MP95-14 IMPACT OF RACE AND SOCIOECONOMIC STATUS ON STONE CHARACTERISTICS: RESULTS FROM RESKU – THE REGISTRY FOR STONES OF THE KIDNEY AND URETER Manint Usawachintachit, David Tzou, Kazumi Taguchi, Benjamin Sherer, Brian Duty, Jonathan Harper, Mathew Sorensen, Roger Sur, Robert Sweet, Marshall Stoller, and Thomas Chi Manint UsawachintachitManint Usawachintachit More articles by this author , David TzouDavid Tzou More articles by this author , Kazumi TaguchiKazumi Taguchi More articles by this author , Benjamin ShererBenjamin Sherer More articles by this author , Brian DutyBrian Duty More articles by this author , Jonathan HarperJonathan Harper More articles by this author , Mathew SorensenMathew Sorensen More articles by this author , Roger SurRoger Sur More articles by this author , Robert SweetRobert Sweet More articles by this author , Marshall StollerMarshall Stoller More articles by this author , and Thomas ChiThomas Chi More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.3016AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Socioeconomic status reflects a combination of education, income, and occupation for individuals. It is known to significantly impact several health conditions, but the relationship to kidney stones remains unknown. This study aims to examine the association between race, income, and education on urinary stone presentation. METHODS ReSKU - the Registry for Stones of the Kidney and Ureter - is a prospective stone registry centered at the University of California, San Francisco. From November 2015 to October 2016, all new nephrolithiasis patients were enrolled. Patient demographics, presentation, and stone characteristics are automatically extracted from the electronic health record and stored in a secure data warehouse. Gross household income for postal address was obtained from Census Bureau data and divided into quartiles. Patient factors were correlated to stone characteristics using univariate and multivariate models. RESULTS 411 new stone patients were enrolled. The most common race was Caucasian (71.8%), following by Asian and Hispanic/Latino. Most patients reported their highest education level as ″some college or college degree″ (48.2%), following by ″high school or less″ and ″graduate school″, and their mean annual income was $77,944.4±34,841.4. Staghorn stone was present in 10.4%. The overall mean total stone burden at presentation was 19.8±25.5 mm. No association existed between race and the presence of staghorn stone (p = 0.47), or stone burden (p = 0.29). Education level was significantly associated with the presence of staghorn stone (p <0.01). Similarly, mean stone burden was significantly higher in patients with high school education level (p <0.01). Patients with the lowest income quartile presented with staghorn stones five times more often than the highest quartile (16.8% versus 3%, p <0.01), and income status was inversely correlated to total stone burden (p <0.01). Multivariate analysis demonstrated a strong correlation between education level and the presence of staghorn stone and total stone burden. Comparing patients with graduate school education to high school or less levels of education, the odds ratio for having a staghorn stone was 0.13 (p <0.01), and coefficient for total stone burden was a 13.8 mm decrease for every incremental increase in education level (p <0.01). CONCLUSIONS Lower education level and annual household income were strongly associated with higher total stone burden and the presence of staghorn stones, independent of race. Data collection in ReSKU is continuously ongoing to validate these findings. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e1291 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Manint Usawachintachit More articles by this author David Tzou More articles by this author Kazumi Taguchi More articles by this author Benjamin Sherer More articles by this author Brian Duty More articles by this author Jonathan Harper More articles by this author Mathew Sorensen More articles by this author Roger Sur More articles by this author Robert Sweet More articles by this author Marshall Stoller More articles by this author Thomas Chi More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

You have accessJournal of UrologySurgical Technology & Simulation: Instrumentation & Technology II1 Apr 2017PD42-04 URETERAL ACCESS SHEATH USE ASSOCIATED WITH LOSS OF REUSABLE URETEROSCOPE FLEXION AND INCREASED NEED FOR REPAIR: A MULTI-INSTITUTIONAL PROSPECTIVE COHORT STUDY Kazumi Taguchi, Manint Usawachintachit, David T Tzou, Matthew D Sorenson, Jonathan D Harper, Brian D Duty, Roger L Sur, David L Wenzler, Dylan Isaacson, Carissa Chu, Marshall L Stoller, and Thomas Chi Kazumi TaguchiKazumi Taguchi More articles by this author , Manint UsawachintachitManint Usawachintachit More articles by this author , David T TzouDavid T Tzou More articles by this author , Matthew D SorensonMatthew D Sorenson More articles by this author , Jonathan D HarperJonathan D Harper More articles by this author , Brian D DutyBrian D Duty More articles by this author , Roger L SurRoger L Sur More articles by this author , David L WenzlerDavid L Wenzler More articles by this author , Dylan IsaacsonDylan Isaacson More articles by this author , Carissa ChuCarissa Chu More articles by this author , Marshall L StollerMarshall L Stoller More articles by this author , and Thomas ChiThomas Chi More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.1896AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES While technical advances have improved durability and functionality of reusable flexible ureteroscopes, device use and maintenance can involve high costs and administrative burden. The fragility of these instruments necessitates eventual repair and can render the scope inaccessible during refurbishment. We conducted a multi-institutional prospective cohort study to identify perioperative factors influencing flexible ureteroscope durability. METHODS This study was a collaboration of the Western Endourology STone (WEST) research consortium consisting of six United States tertiary care centers. Consecutive patients undergoing flexible ureteroscopy were enrolled, and scope performance parameters as well as patient characteristics and intraoperative data were collected between August 2014 and June 2015. Surgeon self-reported concern and satisfaction with each scope were queried following each procedure. Upward and downward angles of deflection of each scope tip were measured before and after procedures. The need for scope repair was determined by the operating surgeon at the time of the procedure and recorded. RESULTS 386 ureteroscopic procedures using 63 flexible ureteroscopes were identified. 300 cases (77.7%) were performed for stone disease treatment. Scope repair was required in 25 cases (6.5%) and 23 scopes (36.5%). Upon univariate analysis, female gender, shorter patient height, absence of guidewire use, presence of a ureteral access sheath, longer laser time, lithotrite type, surgeon training level, self-reported concern, and degree of scope upward flexion both pre- and postop were associated with need for scope repair. Upon multivariate analysis, access sheath use (OR=3.09, p=0.0127) and decreased degree of upward flexion at the end of the case (OR=0.972, p=0.0171) were associated with need for scope repair (Table 1). Access sheath use, patient height, and surgeon concern were associated with loss of scope upward flexion. CONCLUSIONS The use of a ureteral access sheath is associated with the loss of upward ureteroscope flexion, which may lead to the need for scope repair. These factors should be considered when evaluating means of optimizing reusable ureteroscope durability. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e813 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Kazumi Taguchi More articles by this author Manint Usawachintachit More articles by this author David T Tzou More articles by this author Matthew D Sorenson More articles by this author Jonathan D Harper More articles by this author Brian D Duty More articles by this author Roger L Sur More articles by this author David L Wenzler More articles by this author Dylan Isaacson More articles by this author Carissa Chu More articles by this author Marshall L Stoller More articles by this author Thomas Chi More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...