2022 PUBLICATION HIGHLIGHTS
Thus far in calendar year 2022, the Division of Urology has published 71 peer-reviewed manuscripts. This was a group effort and major publications came from each section in the division.
RECONSTRUCTIVE UROLOGY
A long-standing controversy in urologic trauma is the role of urethral realignment in the acute management of pelvic fracture urethral injury (PFUI). These injuries are rare and only occur in approximately 5% of open book pelvic fractures. The rarity of PFUI makes study of the acute management challenging because even the busiest trauma centers will only manage a few of these injuries a year. After PFUI patients can either be managed with a suprapubic tube to drain the bladder or undergo urethral realignment with cystoscopes to bring the severed ends of the urethra into alignment over a catheter. In historical studies, realignment reduced the development of urethral obstruction from fibrosis by 50%.
In order to study the role of realignment after PFUI, the University of Utah and Jeremy Myers, MD served as primary investigator of a multi-institutional trial. The trial ultimately enrolled patients from 27 centers in the United States. The results of this study were published this year by Benjamin McCormick, MD, in the Journal of Trauma and Acute Care Surgery and Urology.
‘A Multi-center Prospective Cohort Study of Endoscopic Urethral Realignment Versus Suprapubic Cystostomy after Complete Pelvic Fracture Urethral Injury: Comparison of EUR versus SPT after PFUI’ published in the Journal of Trauma and Acute Care Surgery.
‘The Outcomes of Pelvic Fracture Urethral Injuries Stratified by Urethral Injury Severity: A Prospective Multi-institutional Genitourinary Trauma Study (MiGUTS)’ published in Urology.
ONCOLOGY
Value-based care and the burden of low value care has been a research priority for Dr. Brock O’Neil. In one analysis of low value care in the treatment of prostate cancer, Dr. O’Neil demonstrated that the American Urologic Association’s choosing wisely campaign had only a modest impact in eliminating imaging in low-risk prostate cancer. The authors estimated only a 3% reduction in inappropriate imaging for low-risk prostate cancer using SEER Medicare data. The results of this analysis were published in Urologic Oncology this year.
‘Impact of choosing wisely on imaging in men with newly diagnosed prostate cancer’ published in Urologic Oncology.
MEN'S HEALTH
Peyronie’s disease is associated with other fibrosing disorders such as Dupuytren’s contractures. This observation suggests a common exposure or inheritable factor. Drs. Alexander Pastuszak, MD, PhD and Michael (Ben) Christensen, PhD demonstrated in the Utah Population Database that there was significant familial clustering of Peyronie’s disease. Their results support a genetic inheritability given the prevalence in probands with the disease. This work was published in Andrology.
‘Significant familial clustering of Peyronie's disease in close and distant relatives’ published in Andrology.
James Hotaling, MD and Darshan Patel, MD showed a significant association between hypogonadism and penile prosthesis infection utilizing the IBM MarketScan database. The authors found over 16,000 men undergoing penile prosthesis placement and identified a 25% higher associated risk for device infection and need for explanation in men with a diagnosis of hypogonadism. Further they found that men who were treated with testosterone had no increased risk of infection compared to non-hypogonadal men.
‘Hypogonadism Associated with Higher Rate of Penile Prosthesis Infection: An Analysis of United States Claims Data’ published in Urology.
PEDIATRICS
Senior author Glen Lau, MD and first author Rano Matta, MD, MS (pediatrics / reconstructive fellow) showed that the use of enterocystoplasty was associated with a higher health care burder compared to botulinum toxin injection in patients with neurogenic bladder from myelomenigocele. The authors utilized IBM MarketScan to demonstrate this relationship, they also showed a low utilization of enterocystoplasty in adult patients with myelomengocele. This study was published this year in Urology.
‘National Trends and Outcomes in the Use of Intravesical Botulinum Toxin and Enterocystoplasty Among Patients with Myelomeningocele’ published in Urology.