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Introduction: The Royal College of Physicians and Surgeons of Canada has begun implementing Competence by Design (CBD). However, it is unclear how much urology trainees and faculty know about CBD, their attitudes towards this change, and their willingness to embrace and participate in this new model of training. Methods: This cross-sectional study was conducted through an online survey, which was administered to all trainees and faculty at Canadian urology programs prior to the implementation of CBD. The final survey consisted of eight demographic questions, 17 fivepoint Likert items, one visual analog scale question, 11 multiplechoice questions, and two open-ended questions. Results: A total of 74 participants (38 faculty and 36 trainees) across 12 universities responded, with a completion rate of 82.4%. This corresponded to an overall response rate of 20.5%. Overall, there was a lack of resounding enthusiasm towards this shift to CBD in urology. Although both trainees and faculty had overall positive perceptions of CBD on assessment, teaching, and readiness, most agreed that this transition will be costly and associated with increased requirements for time, funding, and administrative support. Furthermore, there were significant concerns regarding the lack of valid assessment tools and evidence for the validity of entrustable professional activities. Conclusions: While this survey has demonstrated an appreciation for the benefits of CBD, challenges are equally anticipated. CBD in urology will be a fertile research area; this study has identified several important educational questions regarding the model's effectiveness and consequences, thus, providing collaborative opportunities among all Canadian programs. [ABSTRACT FROM AUTHOR]

Introduction: Variability in the success rates for the endoscopic correction of vesicoureteral reflux (VUR) has prompted a debate regarding the use of routine postoperative voiding cystourethrogram (VCUG). This study examines the predictive performance of intraoperative mound morphology (IMM) and the presence of a postoperative ultrasound mound (PUM) on radiologic success, as well as investigates the role of using these two predictive factors as a composite tool to predict VUR resolution after endoscopic treatment. Methods: This retrospective study included children with primary VUR who underwent endoscopic correction with a double hydrodistension-implantation technique (HIT) and dextranomer/hyaluronic acid copolymer. IMM was assessed intraoperatively. The presence of a PUM and VUR resolution were assessed by postoperative ultrasound (US) and VCUG, respectively. Radiologic success was defined as VUR resolution. Results: A total of 70 children (97 ureters) were included in the study. The overall radiologic success rate was 83.5%. There was no statistically significant association between radiologic success and IMM (85.2% with excellent and 87.5% with "other" morphology; p=0.81). The sensitivity and specificity of PUM for radiologic success in this study was 98% and 71%, respectively, while the sensitivity and specificity of the combined prediction model were 81.9% and 85.7%, respectively. Conclusions: We objectively demonstrated that IMM was a poor predictor of radiologic success and should be used with caution. In addition, the performance of a combined prediction model was inferior to the presence of a PUM alone. As such, selective use of postoperative VCUG may be guided solely by the presence of a PUM. [ABSTRACT FROM AUTHOR]

The article presents a clinical practice guideline (CPG) on pediatric neurogenic lower urinary tract dysfunction (NLUTD) developed by the Canadian Urological Association (CUA) and the Pediatric Urologists of Canada (PUC). It focuses on pediatric patients with neurological conditions causing urinary dysfunction. It further emphasizes the importance of diagnosis, conservative management, surgical interventions, and long-term follow-up.

The article provides guidelines for the diagnosis, management, and treatment of pediatric patients with neurogenic lower urinary tract dysfunction (NLUTD), primarily focusing on those with congenital spinal dysraphism, such as spina bifida. It aims to improve care and outcomes in this patient population by emphasizing early detection and prenatal intervention, involving multidisciplinary healthcare teams, and providing recommendations for various aspects of patient care.

Introduction: The Royal College of Physicians and Surgeons of Canada has begun implementing Competence by Design (CBD). However, it is unclear how much urology trainees and faculty know about CBD, their attitudes towards this change, and their willingness to embrace and participate in this new model of training., Methods: This cross-sectional study was conducted through an online survey, which was administered to all trainees and faculty at Canadian urology programs prior to the implementation of CBD. The final survey consisted of eight demographic questions, 17 five-point Likert items, one visual analog scale question, 11 multiple selection questions, and two open-ended questions., Results: A total of 74 participants (38 faculty and 36 trainees) across 12 universities responded, with a completion rate of 82.4%. This corresponded to an overall response rate of 20.5%. Overall, there was a lack of resounding enthusiasm towards this shift to CBD in urology. Although both trainees and faculty had overall positive perceptions of CBD on assessment, teaching, and readiness, most agreed that this transition will be costly and associated with increased requirements for time, funding, and administrative support. Furthermore, there were significant concerns regarding the lack of valid assessment tools and evidence for the validity of entrustable professional activities., Conclusions: While this survey has demonstrated an appreciation for the benefits of CBD, challenges are equally anticipated. CBD in urology will be a fertile research area; this study has identified several important educational questions regarding the model's effectiveness and consequences, thus, providing collaborative opportunities among all Canadian programs.

Introduction: Variability in the success rates for the endoscopic correction of vesicoureteral reflux (VUR) has prompted a debate regarding the use of routine postoperative voiding cystourethrogram (VCUG). This study examines the predictive performance of intraoperative mound morphology (IMM) and the presence of a postoperative ultrasound mound (PUM) on radiologic success, as well as investigates the role of using these two predictive factors as a composite tool to predict VUR resolution after endoscopic treatment., Methods: This retrospective study included children with primary VUR who underwent endoscopic correction with a double hydrodistension-implantation technique (HIT) and dextranomer/hyaluronic acid copolymer. IMM was assessed intraoperatively. The presence of a PUM and VUR resolution were assessed by postoperative ultrasound (US) and VCUG, respectively. Radiologic success was defined as VUR resolution., Results: A total of 70 children (97 ureters) were included in the study. The overall radiologic success rate was 83.5%. There was no statistically significant association between radiologic success and IMM (85.2% with excellent and 87.5% with "other" morphology; p=0.81). The sensitivity and specificity of PUM for radiologic success in this study was 98% and 71%, respectively, while the sensitivity and specificity of the combined prediction model were 81.9% and 85.7%, respectively., Conclusions: We objectively demonstrated that IMM was a poor predictor of radiologic success and should be used with caution. In addition, the performance of a combined prediction model was inferior to the presence of a PUM alone. As such, selective use of postoperative VCUG may be guided solely by the presence of a PUM.

Emphysematous cystitis is an uncommon and often severe infectious condition of the bladder that usually affects women and diabetics. We report a case of a 62-year-old male patient who presented with concomitant emphysematous cystitis and necrotizing fasciitis of the right leg. The patient was initially managed with emergent disarticulation of the right leg. Tissue cultures were positive for Ciprofloxacin-resistant Klebsiella pneumoniae. He was treated with Piperacillin-Tazobactam; however, due to the failure of conservative management of the condition, the patient underwent a cystoprostatectomy with ileal conduit. To our knowledge, this is the first report of concomitant emphysematous cystitis and necrotizing fasciitis requiring aggressive surgical intervention for both diseases.