You have accessJournal of UrologyCME1 Apr 2023MP13-19 PROSTATE HEALTH INDEX IS ASSOCIATED WITH INCIDENTAL PROSTATE CANCER DETECTION AT TIME OF HOLMIUM LASER ENUCLEATION OF THE PROSTATE Eric Li, Jenny Guo, Nicholas Dean, Mark Assmus, Ruoji Zhou, Ashley Ross, Matthew Lee, and Amy Krambeck Eric LiEric Li More articles by this author , Jenny GuoJenny Guo More articles by this author , Nicholas DeanNicholas Dean More articles by this author , Mark AssmusMark Assmus More articles by this author , Ruoji ZhouRuoji Zhou More articles by this author , Ashley RossAshley Ross More articles by this author , Matthew LeeMatthew Lee More articles by this author , and Amy KrambeckAmy Krambeck More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003233.19AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Holmium laser enucleation of the prostate (HoLEP) is a size-independent treatment option for BPH. Unfortunately, despite an appropriate work up for elevated PSA, incidental prostate cancer (iPCa) is found in up to 20% of men undergoing HoLEP. HoLEP is not a therapeutic surgical treatment for prostate cancer, so we sought to identify risk factors for iPCa at the time of HoLEP for pre-operative risk stratification. METHODS: We retrospectively queried for men undergoing HoLEP from January 2021-July 2022, and obtained clinicopathologic data. Men with prior history of prostate cancer were excluded (n=55). T test, chi-squared, Fisher’s exact test, and multivariable logistic regression were performed. RESULTS: On univariable regression, PHI >55 was a significant predictor of iPCa (OR 7.27, 95% CI 1.97-27.5, p=0.003), which remained significant on multivariable adjustment for age (OR 6.76, 95% CI 1.81-25.7, p=0.004). On univariable regression, preoperative PSA (p=0.15), % Free PSA (p=0.12), MRI prostate volume (p=0.69), PSA density (p=0.62), prior negative biopsy (p=0.31), and MRI PIRADS were not significantly associated with iPCa. Of the 39 patients who had pre-operative PIRADS 4 or 5 lesions, 36 patients had pre-operative negative biopsy, and only one patient was ultimately found to have iPCa. 66% (68/103) of iPCa was Gleason Grade Group 1 with a median of 1% of tissue positive. CONCLUSIONS: PHI>55 is an independent predictor of iPCa at time of HoLEP. To our knowledge, this is the first report of the association of PHI and iPCa. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e180 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Eric Li More articles by this author Jenny Guo More articles by this author Nicholas Dean More articles by this author Mark Assmus More articles by this author Ruoji Zhou More articles by this author Ashley Ross More articles by this author Matthew Lee More articles by this author Amy Krambeck More articles by this author Expand All Advertisement PDF downloadLoading ...

Introduction: Holmium laser enucleation of the prostate (HoLEP) is a size-independent treatment option for the management of benign prostatic hypertrophy. Although advancements in laser technology have led to clinical improvements in the enucleation portion of HoLEP, the morcellation aspect of HoLEP is often the rate-limiting step. We sought to compare efficiency and surgeon satisfaction in four commercial morcellators. Methods: This was an ex vivo study comparing four commercial morcellators: the Wolf Piranha™, the Lumenis VersaCut™, the JenaSurgical MultiCut Solo™, and the Hawk™ Morcellator. Four surgeons with significant experience performing HoLEPs participated. Surgeons tested each device to morcellate two different prostate models (1) morcellating as much microwave-cooked chicken breast in 10 minutes and (2) timed morcellation of bull testicles. Surgeons completed subjective surveys after each morcellator trial. Objective outcomes included the following: morcellation efficiency (g/min morcellated) and aspiration power (time to aspirate 1 L of saline). Means of continuous variables were compared using analysis of variance. Categorical variables were compared using chi-square tests. Statistical analyses were performed using SAS 9.4 (2019). Results: Comparing subjective outcomes, the Piranha™ was chosen as the safest morcellator (p = 0.0058). The least safe morcellator was thought to be the MultiCut by 75% of surgeons (p = 0.046). The Piranha™ was chosen as the most effective morcellator by 75% of surgeons (p = 0.046). Comparing objective parameters between the morcellators, the Piranha™ had the fastest aspiration time (43.50 ± 10.34 seconds, p = 0.0116). There were no significant differences in morcellation efficiency when using chicken breast (p = 0.3096). However, when comparing the morcellation efficiency using bull testicles, the Piranha™ had the highest efficiency at 39.68 ± 3.57 g/min (p = 0.0268). Conclusion: In this ex vivo study comparing four different commercially available morcellators, the Piranha™ had the highest aspiration power. No significant differences were found in morcellation efficiency using microwave-cooked chicken breast. The Piranha™ was felt to be the safest and most effective morcellator.

Biological tubes are essential for animal survival, and their functions are critically dependent on tube shape. Analyzing the contributions of cell shape and organization to the morphogenesis of small tubes has been hampered by the limitations of existing programs in quantifying cell geometry on highly curved tubular surfaces and calculating tube-specific parameters. We therefore developed QuBiT (Quantitative Tool for Biological Tubes) and used it to analyze morphogenesis during embryonic Drosophila tracheal (airway) development. We find that there are previously unknown anterior-to-posterior (A-P) gradients of cell orientation and aspect ratio, and that there is periodicity in the organization of cells in the main tube. Furthermore, cell intercalation during development dampens an A-P gradient of the number of the number of cells per cross-section of the tube, but these intercalation events do not change the patterns of cell connectivity. These unexpected findings demonstrate the importance of a computational tool for analyzing the morphogenesis of small diameter biological tubes.

You have accessJournal of UrologyInfertility: Epidemiology & Evaluation II1 Apr 2018MP19-05 CRYPTOSPERMIA IS ASSOCIATED WITH SIGNIFICANTLY HIGHER SPERM RETRIEVAL RATES WHEN COMPARED TO PATIENTS WITH AZOOSPERMIA James Wren, Matthew Hudnall, Minh Pham, Annie Darves-Bornoz, Nelson Bennett, and Robert Brannigan James WrenJames Wren More articles by this author , Matthew HudnallMatthew Hudnall More articles by this author , Minh PhamMinh Pham More articles by this author , Annie Darves-BornozAnnie Darves-Bornoz More articles by this author , Nelson BennettNelson Bennett More articles by this author , and Robert BranniganRobert Brannigan More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.654AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Cryptospermia reflects a form of testicular failure where small foci of active spermatogenesis persist within the testicles. Our study assessed the rates of successful sperm retrieval (SSR) in patients with cryptospermia and non obstructive azoospermia METHODS Following IRB approval, a retrospective chart analysis assessed microtesticular sperm extraction (mTESE) procedures performed from January 2004 to August 2017. Inclusion criteria involved males >18 years of age with cryptozoospermia and/or azoospermia that underwent a mTESE. Exclusion criteria included those with obstructive azoospermia, oligospermia or <2 semen analyses. Hormonal profile, semen analysis, testicular volumes, pathology and comorbidities were analyzed. Statistical analysis utilized chi-squared and ANOVA to compare categorical and continuous variables, respectively, between successful and unsuccessful mTESE. Univariate and multivariate logistic regression analyses were performed RESULTS We identified 40 cryptospermic and 221 non-obstructive azoospermic patients. Successful mTESE occurred in 85% of cryptospermic and 48% of azoospermic patients. Significant factors for SSR on univariate analysis included cryptospermia, FSH level and histology (hypospermatogenesis, active spermatogenesis, Sertoli cell only). On multivariate analysis, cryptospermia, hypospermatogenesis and Sertoli cell only histology remained significant. Additional factors such as age, comorbidities, hormonal labs and testicular volume were not significantly different between the two groups CONCLUSIONS Limited data exists for counselling patients with cryptospermia on the chances of successful sperm retrieval. This study, the largest to date demonstrates that patients with cryptospermia have a significantly higher chance of successful microsurgical sperm retrieval when compared to patients with non-obstructive azoospermia © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e245-e246 Advertisement Copyright & Permissions© 2018MetricsAuthor Information James Wren More articles by this author Matthew Hudnall More articles by this author Minh Pham More articles by this author Annie Darves-Bornoz More articles by this author Nelson Bennett More articles by this author Robert Brannigan More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...