OBJECTIVE:To compare characteristics between men and women as they seek medical care for their urinary incontinence (UI), examining patients' experience both with primary care (PCP) and UI specialists. METHODS:This is a cross-sectional study utilizing the National Association for Continence (NAFC)-sponsored adult patient-reported survey data from March 2020 to April 2020. Descriptive statistics were calculated as percentages, and comparisons were performed using a chi-squared test for categorical variables. The statistical significance level was set at p < 0.05. RESULTS:Two hundred sixty-six individuals with UI who had sought medical care completed the survey during the study period. One hundred twenty-four (47%) were women (W) and 142 (53%) were men (M). The study population was older, with the majority of respondents either 45-64 (35%) or 65+ (48%). Most participants sought care for their UI within 2 years of UI onset (59%) and first spoke to their PCP about their UI (64.7%). Women were more likely to endorse a severe emotional impact (OR 1.63, CI 1.04-2.56, p = 0.04) and physical impact (OR 1.90, CI 1.19-3.04, p = 0.01) of their UI on their life. In patients who spoke to their PCP about their UI, women were more likely to bring it up at a routine checkup, while men were more likely to make an appointment to discuss their UI. Men were more likely to endorse that their PCP had spoken to them about a wide range of treatment options and were more likely to have been started on a treatment plan. Men were also more likely to be started on a medication for their UI by their PCP compared to women. PCP referral rates to specialty care were higher amongst men. For those who received a referral, there was a high rate of specialist follow-up (94.0% vs. 98.5% p = 0.19). Men were mostly referred to urology (W 47% vs. 94% M, p < 0.01), with women more frequently referred to gynecology (W 15.9% vs. 0% M, p < 0.01) and urogynecology (W 25.0% vs. 0.9% M, p < 0.01). Specialists were more likely to speak about absorbent products with men compared to women (M 52.5% vs. W 30.7%, p = 0.002). CONCLUSIONS:Though women endorsed more severe impact of UI on their life, men were more likely to be counseled on a wide range of treatment options, started on a treatment plan, prescribed medication for their UI, and be referred to specialty care for treatment of their UI. TRIAL REGISTRATION:This study was not registered with clinicaltrials.gov because it used previously collected, deidentified data. CLINICALTRIALS:gov indicates that observational studies should be registered as a Patient Registry for prospective data collection, which does not apply to this study as the patients included in this survey are not followed.

OBJECTIVE To determine how a patient's demographics, including insurance type, race/ethnicity, gender, and age, may impact the choice of medication prescribed for overactive bladder (OAB). METHODS We queried the AUA Quality Registry for adults between 2014 and 2020 with a diagnosis of OAB for > 1 year, excluding neurogenic causes. Variables included age, race/ethnicity, gender, insurance type, medication first prescribed, year of prescription, provider metropolitan status, and provider practice type. Primary outcome was which factors were associated with increased odds of beta-3 prescription as first medication choice. RESULTS We found 1,453,566 patients with OAB, 641,122 (44.1%) with complete data. Of these, 112,021 (17.5%) were prescribed medication. On multivariate analysis, patients with Medicaid, Medicare, and other/self-pay insurance were less likely to receive a beta-3 vs an anticholinergic compared to private or military insurance. Compared to white patients, Asian, Black, and other races were less likely to receive a beta-3, as were patients outside of metropolitan areas. Age > 50, prescriptions after 2014, and nonacademic settings were associated with increased odds of beta-3 prescription. There was no difference between genders. CONCLUSION Many nonclinical factors, including insurance type and race, may affect which medication is first prescribed for OAB. This is useful for practicing urologists and may help lower barriers to beta-3 prescription through policy change and advocacy. UROLOGY 184: 51-57, 2024. (c) 2023 Elsevier Inc. All rights reserved.

Importance Urinary incontinence (UI) is a common and treatable medical condition among women, but only approximately one third of women seek care. Objective The objective of this study was to determine factors associated with care-seeking behavior in women with UI. Study Design This was a cross-sectional study using patient-reported survey data collected by the National Association for Continence from November 2018 to January 2019. This survey included 60 questions and was conducted using SurveyMonkey. Descriptive statistics were used for baseline characteristics, the χ2 test was used for categorical variables, and multivariate logistic regression was used to determine predictors of care-seeking behavior. Results Four hundred eighty-five women completed the survey, 30.7% were not care seeking, and 69.3% were care seeking for UI. Most women were 55 years or older and had UI for more than 4 years. Care-seeking women had more overactive bladder symptoms. Women who sought care were more likely to report feelings of anger, depression, hopelessness, isolation, and report greater social effects from UI than non–care-seeking women. Less than 10% of women who sought care were asked about their UI by a medical professional. In the multivariate logistic regression expenditure of $5 or more on monthly incontinence maintenance, daily UI and older age were associated with seeking care. Conclusions Most women in our study population sought care for UI. Factors associated with seeking care were expenditure greater than $5 per month on incontinence, daily UI, and age. This information demonstrates the need for effective implementation of screening interventions to increase treatment access.

INTRODUCTION:Office administration of intradetrusor onabotulinumtoxinA is commonly used to treat overactive bladder. For preprocedure analgesia, either 50 mL 2% intravesical lidocaine instillation for 20 to 30 minutes or 200 mg oral phenazopyridine can be used. Phenazopyridine is associated with shorter appointment times and is noninferior to lidocaine for pain control in this setting. We performed a cost analysis of phenazopyridine vs lidocaine for analgesia before office intradetrusor onabotulinumtoxinA injection for the treatment of idiopathic overactive bladder. METHODS:A health care sector-perspective cost analysis was performed. The following assumptions were made: (1) similar efficacy of each medication in providing adequate analgesia, (2) similar physician ease of performing the procedure with either analgesic, and (3) similar patient satisfaction with either analgesic. Average cost of medications, adverse reactions, nursing tasks, and office visit time were found in publicly available data. Sensitivity analyses were performed using TreeAge Pro 2021, R1 software. RESULTS:Phenazopyridine is less costly compared to lidocaine per visit for office intradetrusor onabotulinumtoxinA injection ($827 vs $925). A difference of $98 per procedure provides a total annual cost savings of over $24 million if all procedures are performed with phenazopyridine instead of lidocaine. Sensitivity analysis showed that phenazopyridine remained less costly under most circumstances, and threshold analysis provided exact circumstances under which phenazopyridine is no longer cost saving. CONCLUSIONS:Phenazopyridine provides cost savings compared to lidocaine for analgesia before office intradetrusor onabotulinumtoxinA injection for the treatment of idiopathic overactive bladder. If adopted by providers nationwide, phenazopyridine may reduce health care spending and minimize office visit time while maintaining patient pain control and satisfaction.

Introduction: Overactive bladder (OAB) patients who do not achieve satisfactory results with second-line OAB medications should be offered third-line therapies (percutaneous tibial nerve stimulation, sacral neuromodulation, onabotulinumtoxinA bladder injection [BTX-A]). We aimed to determine which clinical factors affect progression from second- to third-line OAB therapy. Methods: Between 2014 and 2020, the AUA Quality Registry was queried for adult patients with idiopathic OAB. For the primary outcome, patient and provider factors associated with increased odds of progression from second- to third-line therapy were assessed. Secondary outcomes included median time for progression to third-line therapy and third-line therapy utilization across subgroups. Results: A total of 641,122 patients met inclusion criteria and were included in analysis. Of these, only 7487 (1.2%) received third-line therapy after receiving second-line therapy. On multivariate analysis, patients aged 65 to 79, women, White race, history of dual anticholinergic and beta 3 agonist therapy, metropolitan area, government insurance, and single specialty practice had the greatest odds of progressing to third-line therapy. Black and Asian race, male gender, and rural setting had lower odds of progressing to third-line therapy. BTX-A was the most common therapy overall (40% BTX-A, 32% sacral neuromodulation, 28% percutaneous tibial nerve stimulation). The median time of progression from second- to third-line therapy was 15.4 months (IQR 5.9, 32.4). Patients < 50 years old and women progressed fastest to third-line therapy. Conclusions: Very few patients received third-line therapies, and the time to progression from second- to third-line therapies is > 1 year. The study findings highlight a potential need to improve third-line therapy implementation.

Lower urinary tract function is governed by a complex neural control mechanism involving the autonomic and central nervous systems. Neuromodulation's precise mechanism of action in treating OAB and NOUR is unknown. SNM is indicated in women with OAB refractory to conservative and pharmacological treatments, as well as in patients with NOUR. SNM has demonstrated its utility in idiopathic nonobstructive retention, as well as retention secondary to deafferentation of the bladder after pelvic surgery and in Fowler syndrome. SNM is a safe surgical procedure, but preoperative counseling on potential adverse events is advised. Regardless of the indications and devices used, SNM patients will require close and continuous follow-up to ensure that the efficacy is sustained, that the device functions properly, and that there are no device-related adverse events. Although SNM originated over 50 years ago, more study is needed to better elucidate its putative mechanism of action. Clinically, it has a meaningful role in the treatment of refractory OAB and NOUR.

You have accessJournal of UrologyCME1 Apr 2023MP19-14 WHO RECEIVES THIRD LINE THERAPIES FOR OVERACTIVE BLADDER? TRENDS FROM DATA IN THE AUA AQUA REGISTRY Katherine Shapiro, Dora Jericevic, Max Bowman, Camille Velez Morell, Rachel Mbassa, Raymond Feng, Michelle van Kuiken, and Benjamin Brucker Katherine ShapiroKatherine Shapiro More articles by this author , Dora JericevicDora Jericevic More articles by this author , Max BowmanMax Bowman More articles by this author , Camille Velez MorellCamille Velez Morell More articles by this author , Rachel MbassaRachel Mbassa More articles by this author , Raymond FengRaymond Feng More articles by this author , Michelle van KuikenMichelle van Kuiken More articles by this author , and Benjamin BruckerBenjamin Brucker More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003244.14AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Third line therapies for Overactive Bladder (OAB) include Percutaneous Tibial Nerve Stimulation (PTNS), Sacral Neuromodulation (SNS) and OnabotulinumtoxinA bladder injections (BTX-A). The American Urologic Association (AUA) and Society for Urodynamics, Female Pelvic Medicine and Reconstructive Surgery (SUFU) have jointly developed a guideline to help manage patients with OAB. Using the AUA Quality (AQUA) registry, we aim to assess access and implementation of third line therapies. METHODS: The AQUA registry collects data from participating urologists across practice settings by direct interface with local electronic health record systems. We queried the registry for patients >18 years with a new diagnosis of OAB, urinary urgency, frequency, and urgency urinary incontinence (UUI) from 2014-2020 using ICD9 and ICD10 codes with >1 year follow up. We evaluated patients who proceeded to third line therapy by insurance type, gender, ethnicity, metropolitan status, age and medication type. We excluded patients with a diagnosis of neurogenic bladder. Multivariable regression was performed to determine the odds ratio of progression to third line therapy. Only patients who first received second line therapy prior to third line therapy were included in the analysis. RESULTS: A total of 1,401,168 patients were diagnosed with OAB during the study period. Complete data was available for 641,122 and analysis was performed specifically for this cohort. 112,021 (17.5%) patients received second line therapy with either an anticholinergic, beta-3 agonist or combination therapy. Of those, 7,487 (1.2%) received at least one third line therapy. BTX-A was the most common therapy overall (40%, 32% SNS, 28% PTNS), while PTNS was the most common third line therapy in men (35%), Asian patients (37%), patients aged >80 (40%) and patients seen in solo practitioner (46%) settings. Black and Asian race, male gender and rural setting had lower odds of progressing to third line therapy. Patients seen by providers in multi-specialty settings, single specialty settings and solo practices were approximately 3 times more likely to receive third line therapy than in an academic medical center (Table 1). CONCLUSIONS: In this study, a small percentage of patients progress from second to third line therapy. Rates varied amongst gender, race, metropolitan status and practice setting. These findings highlight opportunities to improve third line therapy implementation. Source of Funding: AUA Data Committee © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e270 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Katherine Shapiro More articles by this author Dora Jericevic More articles by this author Max Bowman More articles by this author Camille Velez Morell More articles by this author Rachel Mbassa More articles by this author Raymond Feng More articles by this author Michelle van Kuiken More articles by this author Benjamin Brucker More articles by this author Expand All Advertisement PDF downloadLoading ...

Purpose of Review:This review discusses the role and benefits of telemedicine as an integral component of the post-pandemic care paradigm in urological practice and, in particular, as part of the care of patients with overactive bladder (OAB).Recent Findings:The COVID-19 pandemic accelerated the implementation of telemedicine across almost every medical specialty and (at least temporarily) swept away barriers including those regarding reimbursement and licensure. Telemedicine benefits patients and providers alike including savings on transportation costs, access to specialists or tertiary care from geographically remote locations, and minimized exposure to a contagious illness. Integration of telemedicine into clinical practice can reduce costs for office/exam space and staffing overhead, as well as facilitate greater scheduling efficiency. Many, if not most, aspects of care for the uncomplicated OAB patient can be as effectively managed remotely as with in-person encounters, across the treatment algorithm.Summary:Telemedicine will almost certainly remain a key component in the care of OAB, general urology, and throughout all medical specialties.

INTRODUCTION AND OBJECTIVE: Very little is known about the differences between men and women as they seek medical care for their urinary incontinence (UI). The objective of this study was to compare characteristics between men and women as they seek medical care for their UI, examining patients' experience both with primary care (PCP) and UI specialists. METHODS: This is a cross-sectional study utilizing the National Association for Continence (NAFC)-sponsored adult patient-reported survey data from March 2020 to April 2020. NAFC is a leading patient incontinence advocacy organization in the United States. Descriptive statistics, chi-squared test for categorical variables, and ordinal uni- variate logistic regression were used. RESULTS: 266 individuals with UI who had sought medical care completed the survey during the study period. 124 (47%) were women (W) and 142 (53%) were men (M). The study population was older, with the majority of respondents either 45-64 (35%) or 65 þ (48%). Most participants

Purpose of Review The goal of this paper is to provide the reader with an understanding of the definition of bladder outlet obstruction (BOO) in females and guidance on the diagnostic work-up of this condition. Recent Findings Our understanding of female BOO is continuing to evolve. Urodynamics and fluoroscopy can aid in the diagnosis of this condition. Several new definitions of BOO in females have been studied and provide more clarity for female BOO. However, no one definition has proved to be superior. Therefore, there is no replacement for looking at the entire clinical picture including patient history, examination and urodynamic data if available. Summary Recent studies have further contributed to the body of literature on how to define bladder outlet obstruction in women, but no current consensus exists on the best way to define this condition.

PURPOSE To evaluate if question phrasing and patient numeracy impact estimation of urinary frequency. MATERIALS AND METHODS We conducted a prospective study looking at reliability of a patient interview in assessing urinary frequency. Prior to completing a voiding diary, patients estimated daytime, and nighttime frequency in 3 ways: (1) how many times they urinated (2) how many hours they waited in between urinations (3) how many times they urinated over the course of 4 hours. Numeracy was assessed using the Lipkus Numeracy Scale. RESULTS Seventy-one patients completed the study. Correlation of estimates from questions 1, 2, and 3 to the diary were not statistically different. Prediction of nighttime frequency was better than daytime for all questions (correlation coefficients 0.751, 0.754, and 0.670 vs 0.596, 0.575, and 0.460). When compared to the diary, Question 1 underestimated (8.5 vs 9.7, P =.014) while Question 2 overestimated (11.8 vs 9.7, P =.027) recorded voids on a diary. All questions overpredicted nighttime frequency with 2.6, 2.9, and 3.9 predicted versus 1.6 recorded voids (P <.001). Although not statistically significant, for each question, the predicted frequency of numerate patients was more correlated to the diary than those of innumerate patients. CONCLUSION When compared to a voiding diary for daytime urinary frequency, asking patients how many times they urinated underestimated, and asking patients how many hours they waited between urinations overestimated the number recorded voids. Regardless of phrasing, patients overestimated nighttime urination. Patients in our functional urology population have limited numeracy, which may impact accuracy of urinary frequency estimation. (C) 2021 Elsevier Inc.

You have accessJournal of UrologyEducation Research III (MP20)1 Sep 2021MP20-16 COVID-19 IMPACT ON UROLOGY RESIDENT ROTATION CASE VOLUME Dora Jericevic, Jamie Kanofsky, Benjamin Brucker, Herbert Lepor, and William Huang Dora JericevicDora Jericevic , Jamie KanofskyJamie Kanofsky , Benjamin BruckerBenjamin Brucker , Herbert LeporHerbert Lepor , and William HuangWilliam Huang View All Author Informationhttps://doi.org/10.1097/JU.0000000000002005.16AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Like most surgical specialties, the volume of urology was affected by the COVID19 pandemic with the temporary suspension of all elective surgeries in March 2020. Our study's objectives were to describe surgical volume across urologic subspecialties and its impact on graduating chief residents, and to assess for any changes in our patient population during the pandemic. METHODS: A retrospective analysis was conducted using our institution's quality dashboards. The analysis includes all surgery cases at a single site tertiary referral center in NYC across urologic subspecialities. The periods between January 1 and Dec 31 in 2020 and 2019 were chosen. We chose the same period in 2019 as the control to account for seasonal factors affecting surgical volume. RESULTS: There was a significant decline across all subspecialties in 2020 compared to 2019 (-19%; 2,922 vs 2,359). There was no statistically significant difference in the proportion of robotic surgery, elective surgery, and cases by subspecialty. The 2019 and 2020 patient cohorts were comparable (table 1). Controlling for surgeon preference in booking cases, endourology and oncology cases were the least likely to exhibit declines in volume (OR 1.2, 1.1-1.3; p<0.01). After elective surgeries were allowed to resume in May 2020, surgical volume recovered within 4-6 weeks. Overall, no rebound in surgical volume to correct for the suspension period was observed (figure 1). The 2020 graduating chief class logged 17% fewer cases in residency years U4 and U5 compared to the 2019 class (624 vs 753 cases), but minimum ACGME case counts at the time of graduation were met without issue. CONCLUSIONS: The COVID19 pandemic had a marked impact on urology resident rotation surgical volume with no rebound effect observed. A broader analysis across training sites is needed to estimate the full impact on the residency program. The effect of the lockdown measures on outcomes for untreated or underdiagnosed patients has yet to be established. Download PPT Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e343-e343 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.Metrics Author Information Dora Jericevic More articles by this author Jamie Kanofsky More articles by this author Benjamin Brucker More articles by this author Herbert Lepor More articles by this author William Huang More articles by this author Expand All Advertisement PDF downloadLoading ...

You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy III (MP42)1 Sep 2021MP42-06 PREDICTORS OF SURGICAL APPROACH IN THE MANAGEMENT OF LARGE RENAL MASSES: 20-YEAR SINGLE INSTITUTIONAL EXPERIENCE Zachary Feuer, Dora Jericevic, James S. Wysock, Samir S. Taneja, and William C. Huang Zachary FeuerZachary Feuer More articles by this author , Dora JericevicDora Jericevic More articles by this author , James S. WysockJames S. Wysock More articles by this author , Samir S. TanejaSamir S. Taneja More articles by this author , and William C. HuangWilliam C. Huang More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002063.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Large renal masses (LRM) are managed with radical nephrectomy (RN), which can be performed both via a minimally invasive surgical approach (MIS) or an open approach. For small renal masses, the MIS approach has been shown to be associated with superior peri-operative outcomes, without compromising oncologic outcomes. Given the limited data regarding MIS for patients with LRMs, the goal of this study was to identify and assess the predictors of surgical treatment approach for LRM. METHODS: We identified all patients who underwent RN for LRM (defined as ≥pT2a renal mass) performed between 4/2001 and 2/2021 in a prospectively maintained, IRB approved kidney surgery database including 1772 patients. The MIS approach included patients undergoing laparoscopic RN with or without robotics assistance. The cohort of cases managed with open approach included cases that were converted from a MIS approach during surgery. Multivariate logistic regression was performed to calculate odds ratios for use of the open approach. The threshold for significance was p <0.05. RESULTS: 191 patients underwent RN for LRM during the study period. Results are summarized in Table 1. Use of the open approach decreased temporally (OR 0.005 from 2015-present, p=0.004). Higher pre-operative clinical stage was associated with greater likelihood of RN via an open approach (cT3b OR 951.7, p=0.002). Increasing age was associated with lower likelihood of using the open approach (Age 60-70, OR 0.01, p=0.02; age >70, OR 0.085, p=0.019). Other factors including laterality, gender and co-morbid conditions were not significantly associated with the surgical approach. CONCLUSIONS: While the overall use of open RN for LRMs has decreased over time, open RN remains the preferential surgical approach for higher clinical stage LRMs (>T3b). In our series, treatment approach was noted to be independent of tumor laterality, and most pre-operative patient factors. The decreased likelihood of using the open approach with increasing age may be secondary to a perceived benefit in post-op recovery with the MIS approach. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e773-e773 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Zachary Feuer More articles by this author Dora Jericevic More articles by this author James S. Wysock More articles by this author Samir S. Taneja More articles by this author William C. Huang More articles by this author Expand All Advertisement Loading ...

You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy II (PD16)1 Sep 2021PD16-06 NOT ALL FAT WEIGHS THE SAME: VISCERAL FAT AND PARTIAL NEPHRECTOMY PERIOPERATIVE OUTCOMES Dora Jericevic, James Wysock, Samir Taneja, and William Huang Dora JericevicDora Jericevic More articles by this author , James WysockJames Wysock More articles by this author , Samir TanejaSamir Taneja More articles by this author , and William HuangWilliam Huang More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001998.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Visceral fat (VF) and adherent perinephric fat (APF) have been linked to worse perioperative outcomes during robotic partial nephrectomy (RAPN). Since body mass index (BMI) does not distinguish between VF and subcutaneous fat (SF), alternative fat measures such as the Mayo Adhesive Probability (MAP) Score have been developed. With advanced imaging software, some investigators have proposed quantifying the VF encountered during PN. The objectives of this prospective study were to compare fat measures and assess their impact on perioperative outcomes. METHODS: With IRB approval, between August 2018 and March 2020, patients undergoing RAPN were consented for the study. Intraoperatively, the surgeon assessed APF. Independent analysis of preoperative imaging was using to calculate MAP Score and quantify VF and SF using TeraRecon. Our patient population was studied as 2 groups: those with (+) and without (-) APF. We further assessed the relationship between visceral obesity and perioperative outcomes. RESULTS: Of the 139 patients that underwent a RAPN and consented for the study, 47 (34%) had APF (+APF). The +APF patients were predominantly older males with multiple medical comorbidities (table 1). There was no statistically significant difference in BMI between the +APF and -APF groups (29 vs 27 kg/m2), but the +APF group had more VF. All fat measures except for BMI were highly correlated (ρ>0.7). +APF patients had higher EBL and longer operative times (p<0.01), but higher complication and malignancy rates were not observed. On logistic linear regression analysis, only APF and RENAL score remained predictors of prolonged operative time. On ROC analysis, at the optimal threshold of MAP≥4 to predict APF, a sensitivity of 0.81 and specificity of 0.78 was observed in our cohort. CONCLUSIONS: Alternatives to BMI that distinguish SF from VF capture patient-specific fat factors that complicate PN. They are a valuable addition to nephrometry scores centered entirely on tumor-specific factors and should be considered in preoperative counseling and surgical planning. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e280-e281 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Dora Jericevic More articles by this author James Wysock More articles by this author Samir Taneja More articles by this author William Huang More articles by this author Expand All Advertisement PDF downloadLoading ...