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Urology

Volume 20, Issue 3 - 2018

Volume 20, Number 3 - 2018

Table of Contents

Management Options for Nocturia at a Large Urology Group Practice
[Rev Urol. 2018;20(3):115–118 doi: 10.3909/riu0820] © 2018 MedReviews®, LLC
Accuracy in 24-hour Urine Collection at a Tertiary Center
There is a paucity of studies addressing the accuracy of 24-hour urine collection for assessing stone risk parameters. Collection accuracy is thought to be essential for assigning optimal therapy for stone prevention. The objective of this study was to determine factors associated with accurate and inaccurate collections. During a 2-year period (2015-2016), 241 stone formers completed 24-hour urine collections. They were divided into accurate collectors (AC), defined as at least one accurate urine collection, and inaccurate collectors (IC). Accuracy was assessed by 24-hour urine creatinine (Cr) excretion indexed to body weight (normal: males, 20-25 mg Cr/kg; females, 15-20 mg Cr/kg). Demographic data analyzed included age, gender, race, insurance status, partner status, income, and education. Statistical analysis methods included the chi-square test, Fisher’s exact test, and the two-group t-test. Average age was 50.7 years at the time of collection; 50.2% were men, 86% were white, and 14% were black. Overall, 51.0% of collections were inaccurate. There was no statistical significance between AC and IC for gender (P = 0.85), race (P = 0.90), insurance status (P = 0.85), recurrence (P = 0.87), stone type (P = 0.57), education (P = 0.35), income (P = 0.42), or poverty (P = 0.35). Older age (P = 0.017) and having a partner (P = 0.022) were significantly associated with AC. The high rate of inaccurate 24-hour urine collections is a concern. The only factors we identified as influencing collection accuracy were age and partner status. These results underscore the importance of developing methods to improve the accuracy of collecting 24-hour urine samples. [Rev Urol. 2018;20(3):119–124 doi: 10.3909/riu0807] © 2018 MedReviews®, LLC
Histologic Changes in Prostate Cancer Detected Subsequent to the 2012 United States Preventive Services Task Force (USPSTF) Prostate Cancer Screening Recommendation
We report changes in the histopathology of prostate cancer diagnosed in a large urology group practice after the final United States Preventive Services Task Force (USPSTF) Grade D recommendation against prostate-specific antigen screening. All prostate biopsies performed from 2011 through 2015 in a large urology group practice were retrospectively reviewed; 2012 was excluded as a transition year. The changes in biopsy data in years following the USPSTF decision (2013-2015) were then compared with baseline (2011). A total of 10,944 biopsies were evaluated during the study period. Positive biopsy rates rose from 39.1% at baseline to 45.2% in 2015 (P < 0.01) with a marked shift toward more aggressive cancer throughout the study period. The absolute number of patients presenting with Gleason Grade Group 4 or 5 increased from 155/year at baseline to 231, 297, and 285 in 2013, 2014, and 2015, respectively (P < 0.05), unrelated to age or racial changes over time. Black men represented 16% of the cohort. Since the USPSTF recommendation against prostate cancer screening, trends toward a substantial upward grade migration and increased volume of cancers were noted in a cohort of nearly 11,000 patients in a real- world clinical practice. Additionally, continuing reductions in cancer detection in the United States may exacerbate these trends. [Rev Urol. 2018;20(3):125–130 doi: 10.3909/riu0815] © 2018 MedReviews®, LLC
LUGPA Celebrates Its 10th Anniversary at Its 2018 Annual Meeting
[Rev Urol. 2018;20(3):131–132 doi: 10.3909/riu0816] © 2018 MedReviews®, LLC
ICD-10 Changes for October 1, 2018
[Rev Urol. 2018;20(3):133–136 doi: 10.3909/riu0817] © 2018 MedReviews®, LLC
Azoospermia With Testosterone Therapy Despite Concomitant Intramuscular Human Chorionic Gonadotropin NYU Case of the Month, July 2018
[Rev Urol. 2018;20(3):137–139 doi: 10.3909/riu0814] © 2018 MedReviews®, LLC
Endoscopic Management of Ureteral Stricture NYU Case of the Month, August 2018
[Rev Urol. 2018;20(3):140–142 doi: 10.3909/riu0819] © 2018 MedReviews, LLC®