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Objectives: To determine accuracy of negative urinalysis (UA) for predicting negative urine culture and the absence of urinary tract infection (UTI), and optimal urine culture growth cutoff for UTI diagnosis in men with and without urinary catheters. Subjects and Methods: UAs with urine cultures within 1 week from adult men were identified and evaluated. Predictive values for the absence of UTI (absence of ≥1 of the following criteria: documentation of UTI diagnosis, antibiotic prescription, uropathogen presence on culture) were calculated. Results: In total, 22 883 UAs were included. Negative UA had a high predictive value for negative urine culture (0.95, 95% confidence interval [CI]: 0.94–0.95) and absence of UTI (0.99, CI: 0.99–0.995) in the overall cohort. Negative UA also had a high predictive value for negative urine culture (0.93, CI: 0.90–0.95) and absence of UTI (0.99, CI: 0.98–0.999) in those with indwelling urinary catheters. The traditional threshold of culture growth of 100 000 colony‐forming units (CFU)/mL did not capture 22% of UTIs. Conclusion: UA exhibits high predictive value for negative urine culture and absence of UTI in men, supporting a protocol wherein culture is only performed in the context of abnormal UA. The traditional 100 000 CFU/mL cut‐off may have not captured a subset of UTI in the male population, and warrants further investigation. [ABSTRACT FROM AUTHOR]

Introduction: Patient expectations and baseline health are important drivers of outcomes following major genitourinary reconstructive surgery for neurogenic bladder (NGB). Differences in expectations and quality of life (QoL) improvements among different populations with NGB remain insufficiently explored in the literature. Objective: To compare decisional regret (DR) and urinary‐related QoL (UrQoL) in patients undergoing urinary diversion for NGB arising from spinal cord injury of acquired (A‐SCI) and congenital (C‐SCI) etiologies. We hypothesize that patients with A‐SCI have higher expectations of improvement in QoL following surgery when compared with C‐SCI, which may lead to higher DR and decreased UrQoL, postoperatively. Design: In this cross‐sectional survey study, we compared A‐SCI to C‐SCI in terms of DR, UrQoL, and postoperative changes in self‐reported physical health, mental health, and pain using validated patient‐reported outcome measures. Setting: Participants were enrolled from a quaternary care institution via mail and MyChart. Participants: The A‐SCI group consisted of 17 patients with traumatic spinal cord injury; the C‐SCI group was composed of 20 patients with spina bifida. Interventions: Not applicable. Main Outcome Measures: The Decisional Regret Scale, Short form‐ Qualiveen (SF‐Qualiveen), and Patient‐reported outcomes measurement Information system‐10 (PROMIS‐10) Global Health surveys. Results: The A‐SCI group displayed poorer preoperative physical health than the C‐SCI cohort, but absolute postoperative changes in this score, along with mental health score and pain level, were not significant after adjusting for baseline scores and follow‐up time. SF‐Qualiveen scores revealed significantly worse impact of NGB in UrQoL for A‐SCI than for C‐SCI when adjusted for other factors. No differences in DR were seen between the groups. Conclusions: Patients with A‐SCI demonstrate lower self‐reported baseline physical health compared with patients with C‐SCI, which may have implications in setting patient expectations when undergoing urinary diversion. In this small cohort, we found a milder self‐reported postoperative impact of NGB in UrQoL in patients with C‐SCI. [ABSTRACT FROM AUTHOR]

Aim: To describe the education and employment transition experience of young adults with spina bifida (YASB) and investigate factors associated with employment. Method: We queried education and employment data from the US National Spina Bifida Patient Registry from 2009 to 2019. We applied generalized estimating equations models to analyze sociodemographic and disease‐related factors associated with employment. Results: A total of 1909 participants (850 males, 1059 females) aged 18 to 26 years contributed 4379 annual visits. Nearly 84% had myelomeningocele and, at last visit, the median age was 21 years (mean 21 years 5 months, SD 2 years 10 months). A total of 41.8% had at least some post‐high school education, and 23.9% were employed. In a multivariable regression model, employment was significantly associated with education level, lower extremity functional level, bowel continence, insurance, and history of non‐shunt surgery. This large, national sample of YASB demonstrated low rates of post‐secondary education attainment and employment and several potentially modifiable factors associated with employment. Interpretation: Specific sociodemographic, medical, and functional factors associated with employment are important for clinicians to consider when facilitating transition for YASB into adulthood. Additional research is needed to understand the impact of cognitive functioning and social determinants of health on transition success in YASB. What this paper adds: There were low education attainment and employment rates in a large sample of young adults with spina bifida.Specific sociodemographic, medical, and functional factors are associated with employment.Some employment‐associated factors, such as continence and self‐management skills, are modifiable. [ABSTRACT FROM AUTHOR]