307 results on '"Jeremy B. Myers"'
Search Results
152. PD30-07 PREVALENCE OF POST-VOID DRIBBLING BEFORE AND AFTER ANTERIOR URETHROPLASTY
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Lee C. Zhao, Kevin J. Flynn, Bryan B. Voelzke, Jill C. Buckley, Benjamin N. Breyer, Katherine J. Cotter, Sean P. Elliott, Jeremy B. Myers, Amy E. Hahn, Nejd F. Alsikafi, Alex J. Vanni, Thomas G. Smith, and Bradley A. Erickson
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medicine.medical_specialty ,business.industry ,Urology ,Urethroplasty ,medicine.medical_treatment ,Post-void dribbling ,medicine ,medicine.symptom ,business ,Surgery - Published
- 2018
153. MP07-02 BASELINE BODY MASS INDEX AND ESTRADIOL LEVELS PREDICT COMBINATION THERAPY WITH ANASTROZOLE IN HYPOGONADAL MEN TREATED WITH CLOMIPHENE CITRATE
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Rachel Moses, James M. Hotaling, Jeremy B. Myers, and Sorena Keihani
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medicine.medical_specialty ,030219 obstetrics & reproductive medicine ,Combination therapy ,business.industry ,Urology ,030232 urology & nephrology ,Anastrozole ,03 medical and health sciences ,0302 clinical medicine ,Medicine ,business ,Baseline (configuration management) ,Body mass index ,medicine.drug - Published
- 2018
154. PD43-10 THE EFFECTS OF AUGMENTATION CYSTOPLASTY AND BOTULINUM TOXIN INJECTION ON PATIENT-REPORTED BLADDER FUNCTION AND SATISFACTION AMONG SPINAL CORD INJURY PATIENTS PERFORMING INTERMITTENT CATHETERIZATION
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John T. Stoffel, Angela P. Presson, Sara M. Lenherr, Sean Elliott, Jeremy B. Myers, Blayne Welk, and Chong Zhang
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business.industry ,Urology ,Anesthesia ,Medicine ,Botulinum toxin injection ,Augmentation cystoplasty ,Bladder function ,business ,medicine.disease ,Spinal cord injury - Published
- 2018
155. PD04-06 LEVEL OF INJURY DOES NOT PREDICT URINARY QUALITY OF LIFE IN PATIENTS WITH SPINAL CORD INJURY ON CLEAN INTERMITTENT CATHETERIZATION
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Sean Elliot, Sara M. Lenherr, Iryna Crescenze, Angela P. Presson, Jeremy B. Myers, John T. Stoffel, Blayne Welk, Chong Zhang, and Diana Covalschi
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Quality of life ,business.industry ,Urology ,Urinary system ,Anesthesia ,Medicine ,In patient ,Clean Intermittent Catheterization ,business ,medicine.disease ,Spinal cord injury - Published
- 2018
156. PD63-03 PATENCY AND INCONTINENCE RATES OF ROBOTIC BLADDER NECK RECONSTRUCTION FOR RECALCITRANT BLADDER NECK CONTRACTURES: THE TURNS EXPERIENCE
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Nejd F. Alsikafi, Atreya Dash, Jeremy B. Myers, Bradley A. Erickson, Nima Baradaran, Stephen Summers, Alex J. Vanni, Lee C. Zhao, Michael A. Granieri, Benjamin N. Breyer, Sean Elliott, Aaron Weinberg, Bryan B. Voelzke, and Eric Kirshenbaum
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Neck of urinary bladder ,medicine.medical_specialty ,business.industry ,Urology ,Medicine ,business ,Muscle contracture ,Surgery - Published
- 2018
157. PD30-03 CLINICAL SIGNIFICANCE OF CYSTOSCOPIC RECURRENCE AFTER ANTERIOR URETHROPLASTY. A MULTI-INSTITUTION ANALYSIS FROM TRAUMA AND UROLOGIC RECONSTRUCTIVE NETWORK OF SURGEONS (TURNS)
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Sean Elliott, Bradley A. Erickson, Alex J. Vanni, Jill C. Buckley, Nejd F. Alsikafi, Lee C. Zhao, Jeremy B. Myers, Thomas W. Smith, Thomas W. Gaither, Benjamin N. Breyer, Bryan B. Voelzke, Gregory Murphy, Nima Baradaran, and Kirkpatrick B. Fergus
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medicine.medical_specialty ,business.industry ,Urology ,Urethroplasty ,medicine.medical_treatment ,General surgery ,Institution (computer science) ,medicine ,Clinical significance ,business - Published
- 2018
158. MP49-06 RETROSPECTIVE OUTCOMES OF RIGHT COLON CONTINENT URINARY DIVERSION IN A SINGLE CENTER, IMPROVING THE CHARACTERIZATION OF COMPLICATION AND REOPERATION RISK
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Nathan J. Alder, Christopher Martin, Jason Chandrapal, and Jeremy B. Myers
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medicine.medical_specialty ,business.industry ,Urology ,Medicine ,Complication ,business ,Single Center ,Continent Urinary Diversion ,Surgery - Published
- 2018
159. PD27-04 ERECTILE DYSFUNCTION MANAGEMENT AFTER FAILED PHOSPHODIESTERASE5-INHIBITOR TRIAL: A COST-EFFECTIVENESS ANALYSIS
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James M. Hotaling, Md, Ms, Mph Rachel A. Moses, Sara M. Lenherr, Md, Ms, James R. Craig, Jeremy B. Myers, Sorena Keihani, and William O. Brant
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medicine.medical_specialty ,Erectile dysfunction ,business.industry ,Urology ,Medicine ,Cost-effectiveness analysis ,business ,medicine.disease ,Intensive care medicine - Published
- 2018
160. PD04-08 PATIENT-REPORTED BLADDER FUNCTION AND SATISFACTION AMONG PARAPLEGIC PATIENTS WITH DIFFERENT BLADDER MANAGEMENT STRATEGIES
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Blayne Welk, Chong Zhang, Sara M. Lenherr, Angela P. Presson, John T. Stoffel, Jeremy B. Myers, and Sean Elliott
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medicine.medical_specialty ,business.industry ,Urology ,Bladder management ,medicine ,business ,Bladder function - Published
- 2018
161. PD02-07 OUTCOMES FOLLOWING POSTERIOR URETHROPLASTY FOR PELVIC-FRACTURE URETHRAL INJURIES: A MULTI-INSTITUTIONAL ANALYSIS
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Niels V. Johnsen, Benjamin N. Breyer, Lee C. Zhao, Thomas W. Smith, Jeremy B. Myers, Jill C. Buckley, Nima Baradaran, Garrick M. Greear, Bradley A. Erickson, Alex J. Vanni, Bryan B. Voelzke, Sean Elliott, Nejd F. Alsikafi, and Michael A. Granieri
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medicine.medical_specialty ,business.industry ,Urology ,Urethroplasty ,medicine.medical_treatment ,medicine ,Pelvic fracture ,medicine.disease ,business ,Surgery - Published
- 2018
162. MP25-18 IMAGING FINDINGS ASSOCIATED WITH RENAL BLEEDING INTERVENTIONS AFTER HIGH-GRADE RENAL TRAUMA: RESULTS FROM THE AMERICAN ASSOCIATION FOR SURGERY OF TRAUMA (AAST) GENITO-URINARY TRAUMA STUDY
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Matthew M. Carrick, Richard A. Santucci, James M. Hotaling, Douglas Rogers, Kaushik Mukherjee, Ian Schwartz, Brandi Miller, Erik S. DeSoucy, Sarah Majercik, Nima Baradaran, Brian J. Smith, Jurek F. Kocik, Brenton Sherwood, Scott Zakaluzny, Jeremy B. Myers, Joshua Piotrowski, Rachel Moses, Marta E. Heilbrun, Sean Elliott, Bryn Putbrese, Raminder Nirula, Timothy Hewitt, Angela P. Presson, Sorena Keihani, Bradley A. Erickson, Benjamin N. Breyer, Yizhe Xu, Xian Luo-Owen, Bradley J. Morris, Frank Burks, and Christopher M. Dodgion
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medicine.medical_specialty ,business.industry ,Urology ,Urinary system ,Internal medicine ,Psychological intervention ,Medicine ,business - Published
- 2018
163. Prevalence of Post-Micturition Incontinence before and after Anterior Urethroplasty
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Thomas G. Smith, Bradley A. Erickson, Bryan B. Voelzke, Nejd F. Alsikafi, Kevin J. Flynn, Jill C. Buckley, Sean P. Elliott, Jeremy B. Myers, Benjamin N. Breyer, Amy E. Hahn, Lee C. Zhao, Katherine J. Cotter, and Alex J. Vanni
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Male ,Time Factors ,Databases, Factual ,Urethral stricture ,medicine.medical_treatment ,030232 urology & nephrology ,Urinary incontinence ,Prom ,Cohort Studies ,0302 clinical medicine ,Postoperative Complications ,Surveys and Questionnaires ,Prevalence ,lower urinary tract symptoms ,media_common ,urinary incontinence ,Urology & Nephrology ,Middle Aged ,reconstructive surgical procedures ,030220 oncology & carcinogenesis ,Urologic Surgical Procedures ,urethral stricture ,medicine.symptom ,Urologic Diseases ,Adult ,medicine.medical_specialty ,Urologic Surgical Procedures, Male ,Urology ,Urethroplasty ,media_common.quotation_subject ,Clinical Sciences ,Renal and urogenital ,Urination ,Post-micturition incontinence ,Databases ,03 medical and health sciences ,Urethra ,Clinical Research ,Lower urinary tract symptoms ,medicine ,Humans ,Minimally Invasive Surgical Procedures ,Factual ,Urge ,Aged ,Retrospective Studies ,Urethral Stricture ,business.industry ,Urinary Incontinence, Urge ,medicine.disease ,Surgery ,patient reported outcome measures ,business ,Body mass index ,Follow-Up Studies - Abstract
PurposeIn this study we aimed to define the prevalence of preoperative and postoperative post-micturition incontinence or post-void dribbling after anterior urethroplasty for urethral stricture disease. We also sought to determine risk factors for its presence.Materials and methodsWe retrospectively reviewed a prospectively maintained, multi-institutional urethral stricture database to evaluate post-micturition incontinence using a single question from a validated questionnaire, "How often have you had a slight wetting of your pants a few minutes after you had finished urinating and had dressed yourself?" Possible answers were never-0 to all the time-3. The presence of post-micturition incontinence was defined as any answer greater than 0. Comparisons were made to stricture type and location, repair type and patient medical comorbidities.ResultsPreoperative and postoperative post-micturition incontinence questionnaires were completed by 614 and 331 patients, respectively. Patients without complete data available were excluded from study. Preoperative post-micturition incontinence was present in 73% of patients, of whom 44% stated that this symptom was present most of the time. Overall postoperative post-micturition incontinence was present in 40% of patients and again it was not predicted by stricture location or urethroplasty type. Of the 331 patients with followup questionnaires 60% reported improvement, 32% reported no change and 8% reported worsening symptoms. The overall rate of de novo post-micturition incontinence was low at 6.3%.ConclusionsThe prevalence of preoperative post-micturition incontinence is high and likely under reported. In most patients post-micturition incontinence improves after urethroplasty and the prevalence of de novo post-micturition incontinence is low. The presence of post-micturition incontinence was not predicted by stricture length or location, or urethroplasty repair type.
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- 2018
164. Contemporary management of high-grade renal trauma: Results from the American Association for the Surgery of Trauma Genitourinary Trauma study
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Kaushik Mukherjee, Ian Schwartz, Erik S. DeSoucy, Angela P. Presson, Brandi Miller, Matthew M. Carrick, Sarah Majercik, Bradley A. Erickson, Jeremy B. Myers, Sorena Keihani, Nima Baradaran, Brian P. Smith, Sean P. Elliott, Joshua Piotrowski, Jurek F. Kocik, Scott Zakaluzny, Raminder Nirula, Timothy Hewitt, Benjamin N. Breyer, Yizhe Xu, Reza Askari, Christopher M. Dodgion, Cullen M. Black, Bradley J. Morris, Frank Burks, Peter B. Thomsen, Richard A. Santucci, and James M. Hotaling
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Male ,Time Factors ,Kidney Disease ,medicine.medical_treatment ,030232 urology & nephrology ,Wounds, Penetrating ,Traumatology ,Cardiorespiratory Medicine and Haematology ,Wounds, Nonpenetrating ,Kidney ,urologic and male genital diseases ,Critical Care and Intensive Care Medicine ,Penetrating ,Injury Severity Score ,trauma centers ,0302 clinical medicine ,Trauma Centers ,Renal trauma ,80 and over ,Prospective Studies ,Disease management (health) ,Young adult ,Prospective cohort study ,Societies, Medical ,Aged, 80 and over ,Trauma Severity Indices ,Disease Management ,Middle Aged ,Prognosis ,Nephrectomy ,Genito-Urinary Trauma Study Group ,Wounds ,Female ,Patient Safety ,6.4 Surgery ,Adult ,medicine.medical_specialty ,Physical Injury - Accidents and Adverse Effects ,Adolescent ,Clinical Sciences ,Urogenital System ,wounds and injuries ,Nursing ,Young Adult ,03 medical and health sciences ,Clinical Research ,Medical ,medicine ,Humans ,Nonpenetrating ,Aged ,Genitourinary system ,business.industry ,Prevention ,General surgery ,Evaluation of treatments and therapeutic interventions ,030208 emergency & critical care medicine ,renal injury grading ,Emergency & Critical Care Medicine ,multicenter study ,Surgery ,Observational study ,Societies ,business ,Follow-Up Studies - Abstract
© 2018 Wolters Kluwer Health, Inc. BACKGROUND The rarity of renal trauma limits its study and the strength of evidence-based guidelines. Although management of renal injuries has shifted toward a nonoperative approach, nephrectomy remains the most common intervention for high-grade renal trauma (HGRT). We aimed to describe the contemporary management of HGRT in the United States and also evaluate clinical factors associated with nephrectomy after HGRT. METHODS From 2014 to 2017, data on HGRT (American Association for the Surgery of Trauma grades III-V) were collected from 14 participating Level-1 trauma centers. Data were gathered on demographics, injury characteristics, management, and short-term outcomes. Management was classified into three groups-expectant, conservative/minimally invasive, and open operative. Descriptive statistics were used to report management of renal trauma. Univariate and multivariate logistic mixed effect models with clustering by facility were used to look at associations between proposed risk factors and nephrectomy. RESULTS A total of 431 adult HGRT were recorded; 79% were male, and mechanism of injury was blunt in 71%. Injuries were graded as III, IV, and V in 236 (55%), 142 (33%), and 53 (12%), respectively. Laparotomy was performed in 169 (39%) patients. Overall, 300 (70%) patients were managed expectantly and 47 (11%) underwent conservative/minimally invasive management. Eighty-four (19%) underwent renal-related open operative management with 55 (67%) of them undergoing nephrectomy. Nephrectomy rates were 15% and 62% for grades IV and V, respectively. Penetrating injuries had significantly higher American Association for the Surgery of Trauma grades and higher rates of nephrectomy. In multivariable analysis, only renal injury grade and penetrating mechanism of injury were significantly associated with undergoing nephrectomy. CONCLUSION Expectant and conservative management is currently utilized in 80% of HGRT; however, the rate of nephrectomy remains high. Clinical factors, such as surrogates of hemodynamic instability and metabolic acidosis, are associated with nephrectomy for HGRT; however, higher renal injury grade and penetrating trauma remain the strongest associations. LEVEL OF EVIDENCE Prognostic/epidemiologic study, level III; Therapeutic study, level IV.
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- 2018
165. Patency and Incontinence Rates After Robotic Bladder Neck Reconstruction for Vesicourethral Anastomotic Stenosis and Recalcitrant Bladder Neck Contractures: The Trauma and Urologic Reconstructive Network of Surgeons Experience
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Jeremy B. Myers, Bradley A. Erickson, Jill C. Buckley, Lee C. Zhao, Bryan B. Voelzke, Benjamin N. Breyer, Michael A. Granieri, Sean P. Elliott, Alex J. Vanni, Eric J. Kirshenbaum, Stephen J. Summers, Aaron C. Weinberg, Nejd F. Alsikafi, Atreya Dash, and Nima Baradaran
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Urologic Diseases ,Male ,medicine.medical_specialty ,Anastomosis ,Urology ,Fistula ,medicine.medical_treatment ,Clinical Sciences ,Urinary Bladder ,Renal and urogenital ,030232 urology & nephrology ,Bioengineering ,Constriction, Pathologic ,03 medical and health sciences ,0302 clinical medicine ,Postoperative Complications ,Robotic Surgical Procedures ,Clinical Research ,Surgical ,medicine ,Humans ,Aged ,Pathologic ,Urethral Stricture ,Osteitis pubis ,Urinary continence ,business.industry ,Prostatectomy ,Anastomosis, Surgical ,Evaluation of treatments and therapeutic interventions ,Urology & Nephrology ,Middle Aged ,medicine.disease ,Constriction ,Surgery ,Urinary Bladder Neck Obstruction ,Neck of urinary bladder ,Dissection ,Stenosis ,Urinary Incontinence ,030220 oncology & carcinogenesis ,Urologic Surgical Procedures ,business ,6.4 Surgery - Abstract
Objective To review a robotic approach to recalcitrant bladder neck obstruction and to assess success and incontinence rates. Materials and Methods Patients with a recalcitrant bladder neck contracture or vesicourethral anastomotic stenosis who underwent robotic bladder neck reconstruction (RBNR) were identified. We reviewed patient demographics, medical history, etiology, previous endoscopic management, cystoscopic and symptomatic outcomes, urinary continence, and complications. Stricture success was anatomic and functional based upon atraumatic passage of a 17 Fr flexible cystoscope or uroflowmetry rate >15 ml/s. Incontinence was defined as the use of >1 pad per day or procedures for incontinence. Results Between 2015 and 2017, 12 patients were identified who met study criteria and underwent RBNR. Etiology of obstruction was endoscopic prostate procedure in 7 and radical prostatectomy in 5. The mean operative time was 216 minutes (range 120-390 minutes), with a mean estimated blood loss of 85 cc (range 5-200 cc). Median length of stay was 1 day (range 1-5 days). Three of 12 patients had recurrence of obstruction for a 75% success rate. Additionally, 82% of patients without preoperative incontinence were continent with a median follow-up of 13.5 months (range 5-30 months). There was 1 Clavien IIIb complication of osteitis pubis and pubovesical fistula that required vesicopubic fistula repair with pubic bone debridement. Conclusion RBNR is a viable surgical option with high patency rates and favorable continence outcomes. This is in contrast to perineal reconstruction, which has high incontinence rates. If future incontinence procedures are needed, outcomes may be improved given lack of previous perineal dissection.
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- 2018
166. Semen parameters are unaffected by statin use in men evaluated for infertility
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Sorena Keihani, Angela P. Presson, Jeremy B. Myers, Christopher Martin, James R. Craig, Douglas T. Carrell, Chong Zhang, Ben Emery, James M. Hotaling, and Kenneth I. Aston
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0301 basic medicine ,Infertility ,Adult ,Male ,endocrine system ,medicine.medical_specialty ,Urology ,Hypercholesterolemia ,Semen ,Semen analysis ,urologic and male genital diseases ,Male infertility ,03 medical and health sciences ,fluids and secretions ,0302 clinical medicine ,Endocrinology ,Internal medicine ,medicine ,Humans ,Infertility, Male ,Retrospective Studies ,030219 obstetrics & reproductive medicine ,medicine.diagnostic_test ,Sperm Count ,urogenital system ,business.industry ,Retrospective cohort study ,General Medicine ,Statin treatment ,Middle Aged ,medicine.disease ,Confidence interval ,Fertility clinic ,Semen Analysis ,030104 developmental biology ,Sperm Motility ,Female ,Hydroxymethylglutaryl-CoA Reductase Inhibitors ,business - Abstract
The effects of statin use on conventional semen parameters in humans are largely unknown and have not been previously studied in subfertile men. We retrospectively reviewed data from 10,140 patients seen at our fertility clinic between 2002 and 2013 to assess the effects of statin use on semen parameters. Men who used any statins for >3 months before semen sample collection were included as cases. Data were gathered on patient age, medication use and conventional semen parameters. A total of 118 patients (126 samples) used statins for at least 3 months before semen sample collection. Data from 7698 patients (8,760 samples), who were not using any medications, were used as controls. In age-adjusted regression models, statin use was not associated with statistically significant changes in semen parameters. When used in combination with other nonspermatotoxic medications, it was associated with 0.3 ml decrease in semen volume (95% confidence interval: 0.02 to 0.58 ml, p-value = .04). In conclusion, statin use was not adversely associated with semen parameters other than semen volume in subfertile patients. These findings from our large-scale retrospective study suggest that there are no clinically relevant deleterious effects from statin use on conventional semen parameters.
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- 2018
167. Letter to the Editor: Organ injury scaling 2018 update: Spleen, liver, and kidney
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Jeremy B. Myers, Joel A. Gross, and Sorena Keihani
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Pathology ,medicine.medical_specialty ,Kidney ,Spleen liver ,Letter to the editor ,medicine.anatomical_structure ,business.industry ,Medicine ,Surgery ,Critical Care and Intensive Care Medicine ,business - Published
- 2019
168. Outcomes of revision surgery for difficult to catheterize continent channels in a multi-institutional cohort of adults
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Jeremy B. Myers, Ronak A. Gor, John T. Stoffel, Daniel Liberman, Travis J. Pagliara, Patrik Luzny, and Sean P. Elliott
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Moderate to severe ,medicine.medical_specialty ,business.industry ,Urology ,medicine.medical_treatment ,Urinary diversion ,030232 urology & nephrology ,Fascia ,Stomal stenosis ,Surgery ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,Oncology ,030220 oncology & carcinogenesis ,Cohort ,Clinical endpoint ,Medicine ,business ,Complication ,Communication channel ,Original Research - Abstract
Introduction: We aimed to describe the strategies of surgical revision for catheterizable channel obstruction and their outcomes, including restenosis and new channel incontinence.Methods: We retrospectively queried the charts of adults who underwent catheterizable channel revision or replacement from 2000‒2014 for stomal stenosis, channel obstruction, or difficulty with catheterization at the Universities of Minnesota, Michigan, and Utah. The primary endpoint was channel patency as measured by freedom from repeat surgical intervention. Secondary endpoints included post-revision incontinence and complication rates. Revision surgeries were classified by strategy into “above fascia,” “below fascia,” and “channel replacement” groupings.Results: A total of 51 patients who underwent 68 repairs (age 18‒82 years old; mean 45) were identified who met our inclusion criteria. Channel patency was achieved in 66% at a median 19 months post-revision for all repair types. There was no difference in patency by the type of channel being revised, but there was based on revision technique, with channel replacement and above the fascia repairs being more successful (p=0.046). Channel incontinence occurred in 40% and was moderate to severe in 12%. The type of channel being revised was strongly associated (p=0.003) with any postoperative channel incontinence. Surgical complications occurred in 29% of all revision procedures, although most were low-grade.Conclusions: Surgical revision of continent catheterizable channels for channel obstruction can be performed with acceptable rates of durable patency and incontinence; however, the surgeon needs to have experience in complex urinary diversion and familiarity with a variety of surgical revision strategies.
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- 2017
169. Effect of Urethroplasty on Anxiety and Depression
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Jeremy B. Myers, Benjamin N. Breyer, Jill C. Buckley, Bradley A. Erickson, Turns, Bryan B. Voelzke, Sean P. Elliott, Kristian D. Stensland, Jared Schober, and Alex J. Vanni
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Male ,Urethral stricture ,medicine.medical_treatment ,030232 urology & nephrology ,Anxiety ,0302 clinical medicine ,Surveys and Questionnaires ,Postoperative Period ,Prospective Studies ,Depression (differential diagnoses) ,Reproductive health ,Depression ,Urology & Nephrology ,Middle Aged ,Mental Health ,Treatment Outcome ,030220 oncology & carcinogenesis ,Preoperative Period ,TURNS ,Urologic Surgical Procedures ,medicine.symptom ,Adult ,medicine.medical_specialty ,Urologic Surgical Procedures, Male ,Psychometrics ,Urology ,Urethroplasty ,Clinical Sciences ,03 medical and health sciences ,Urethra ,Clinical Research ,Internal medicine ,Behavioral and Social Science ,medicine ,Humans ,Reconstructive Surgical Procedures ,Aged ,Retrospective Studies ,Urethral Stricture ,business.industry ,Shim (computing) ,Plastic Surgery Procedures ,medicine.disease ,Mental health ,Brain Disorders ,Urodynamics ,Good Health and Well Being ,Sexual function ,business ,Follow-Up Studies - Abstract
PurposeTo our knowledge anxiety and depression in patients with urethral stricture disease and the impact of urethroplasty on mental health has never been explored. We hypothesized that patients with urethral stricture disease would have higher than normal anxiety and depression levels, and urethroplasty would improve mental health.Materials and methodsWe retrospectively reviewed the records of patients in a multi-institutional reconstructive urology database who underwent anterior urethroplasty. Preoperative and postoperative evaluation of anxiety and depression, and overall health was recorded using the validated EQ-5D™-3L Questionnaire. Sexual function was evaluated with the IIEF (International Index of Erectile Function) and the Men's Sexual Health Questionnaire. Stricture recurrence was defined as the need for a subsequent procedure.ResultsMedian followup in the 298 patients who met study inclusion criteria was 4.2 months. Preoperative anxiety and depression was reported by 86 patients (29%). Those with anxiety and depression reported higher rates of marijuana use, a worse preoperative IIEF score (17.5 vs 19.6, p = 0.01) and a lower image of overall health (66 vs 79, p ≤0.001). Improvement or resolution of anxiety and depression was experienced by 56% of patients treated with urethroplasty while de novo postoperative anxiety and depression were reported by 10%. These men reported a decreased flow rate (16 vs 25 ml per second, p = 0.01). Clinical failure in 8 patients (2.7%) had no effect on the development, improvement or resolution of anxiety and depression.ConclusionsOf patients with preoperative anxiety and depression 56% reported improvement or resolution after urethroplasty. Although new onset anxiety and depression was rare, these patients had a significantly lower postoperative maximum flow rate, possibly representing a group with a perceived suboptimal surgical outcome. A urethral stricture disease specific questionnaire is needed to further elucidate the interplay of urethral stricture disease with anxiety and depression.
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- 2017
170. Spermatogenesis: Fertile Ground for Contributing to Recurrent Implantation Failure?
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Sorena Keihani, Jeremy B. Myers, and James M. Hotaling
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Infertility ,Pregnancy ,In vitro fertilisation ,Assisted reproductive technology ,urogenital system ,business.industry ,medicine.medical_treatment ,medicine.disease ,Bioinformatics ,Sperm ,Testicular sperm extraction ,Recurrent miscarriage ,Sperm Retrieval ,medicine ,business - Abstract
Despite a thorough work-up, the underlying cause remains unknown in a large proportion of cases with recurrent implantation failure. Sperm plays an incontrovertible role in initiating and maintaining a successful pregnancy. Thus, male factor evaluation could provide insight into the etiology of unexplained implantation failure. Sperm genetics and epigenetics are burgeoning areas in infertility research, providing new insights into the diagnosis and management of recurrent implantation failure. This chapter reviews the current evidence on sperm chromosomal aneuploidy and sperm DNA damage, with a focus on recurrent pregnancy loss and implantation failure. Potential causes of sperm DNA damage, including oxidative stress, and different diagnostic methods for detection of sperm DNA fragmentation are summarized. Roles of modifiable risk factors such as alcohol, smoking, varicocele, testicular heat stress, medications, and environmental toxins are discussed, and recommendations are made regarding potential therapeutic options and interventions. Finally, alternative and newer methods for sperm retrieval and selection for assisted reproductive technology are discussed, and opportunities for future assessment and treatment of male factors in recurrent implantation failure are covered.
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- 2017
171. The safety and efficacy of clomiphene citrate in hypoandrogenic and subfertile men
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Erica Johnstone, Jeremy B. Myers, Angela P. Presson, William O. Brant, Jessie Dorais, Darshan P. Patel, Kenneth I. Aston, James M. Hotaling, and Douglas T. Carrell
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Adult ,Male ,Infertility ,medicine.medical_specialty ,Adolescent ,Urology ,Body Mass Index ,Clomiphene ,Male infertility ,Young Adult ,Follicle-stimulating hormone ,Internal medicine ,medicine ,Humans ,Testosterone ,Adverse effect ,Infertility, Male ,Retrospective Studies ,Estradiol ,Sperm Count ,business.industry ,Age Factors ,Testosterone (patch) ,Luteinizing Hormone ,medicine.disease ,Sperm ,Cross-Sectional Studies ,Endocrinology ,Sperm Motility ,Regression Analysis ,Follicle Stimulating Hormone ,Luteinizing hormone ,business ,Hormone - Abstract
Our objective was to evaluate the safety and efficacy of clomiphene citrate (CC) in infertile and hypoandrogenic men through a retrospective study between September 2013 and May 2014. We identified 47 men between 18 and 55 years placed on 50 mg CC every other day. We evaluated the effect of CC on testosterone after 2 weeks, rates of adverse effects and predictors of CC response. Mean baseline testosterone, bioavailable testosterone and estradiol were 246.8 ng dl(-1), 125.5 ng dl(-1) and 20.8 pg dl(-1), respectively. At 2 weeks, mean testosterone, bioavailable testosterone and estradiol increased to 527.6 ng dl(-1), 281.8 ng dl(-1) and 32.0 pg dl(-1) (all P
- Published
- 2015
172. Sperm Concentration Is Poorly Associated With Hypoandrogenism in Infertile Men
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Darshan P. Patel, Douglas T. Carrell, James M. Hotaling, Jessie Dorais, Jeremy B. Myers, William O. Brant, Chong Zhang, Kenneth I. Aston, Angela P. Presson, and Erica Johnstone
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Adult ,Male ,Gynecology ,Infertility ,Azoospermia ,medicine.medical_specialty ,Sperm Count ,business.industry ,Urology ,Normal semen analysis ,Oligospermia ,medicine.disease ,Serum testosterone level ,Sperm ,Cross-Sectional Studies ,Primary outcome ,medicine ,Humans ,Referral center ,Testosterone ,business ,Retrospective Studies ,Hormone - Abstract
To evaluate the utility of routine hormone evaluation in all men presenting for infertility by understanding the relationship between sperm concentration and hypoandrogenism.We performed a retrospective cross-sectional study between September 2013 and May 2014 at a tertiary referral center in Utah. Ninety-four men presenting for infertility consecutively between the ages of 18 and 55 years were identified. Our primary outcome was rate of hypoandrogenism among infertile men defined as the baseline total serum testosterone levels300 ng/dL or bioavailable testosterone (BAT) levels155 ng/dL. Secondary outcomes included association of normospermia, oligozoospermia, or azoospermia with biochemical or clinical hypoandrogenism.Thirty-nine men (41%) had a total serum testosterone level of300 ng/dL, and 41 men (43%) had a BAT level155 ng/dL. Biochemical and symptomatic hypoandrogenism was common; 17 men (18%) had a total testosterone level300 ng/dL and ≥ 3 positive Androgen Deficiency in Aging Male (ADAM) responses, and 18 men (19%) had a BAT level of155 ng/dL and ≥ 3 positive ADAM responses. Sperm concentration (normospermia, oligozoospermia, and azoospermia) was not associated with biochemical hypoandrogenism (total testosterone level300 ng/dL or BAT level155 ng/dL), symptomatic hypoandrogenism (≥ 3 positive ADAM responses), or sexual dysfunction (Sexual Health Inventory for Men score21).Hypoandrogenism is common among infertile men, and routine hormonal evaluation may identify hypoandrogenism in many infertile men with otherwise normal semen analysis. Sperm concentration (normospermia, oligozoospermia, and azoospermia) is not well associated with hypoandrogenism in infertile men.
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- 2015
173. Demographic and socio-economic differences between men seeking infertility evaluation and those seeking surgical sterilization: from the National Survey of Family Growth
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Mark R. Cullen, Darshan P. Patel, Michael L. Eisenberg, William O. Brant, Jeremy B. Myers, and James M. Hotaling
- Subjects
Adult ,Male ,Infertility ,medicine.medical_specialty ,Adolescent ,Urology ,Male infertility ,Young Adult ,Surveys and Questionnaires ,Vasectomy ,medicine ,Humans ,Infertility, Male ,Reproductive health ,Gynecology ,business.industry ,Public health ,Middle Aged ,Patient Acceptance of Health Care ,medicine.disease ,Socioeconomic Factors ,National Survey of Family Growth ,Marital status ,business ,Body mass index ,Demography - Abstract
Objective To identify differences in demographic and socio-economic factors between men seeking infertility evaluation and those undergoing vasectomy, to address disparities in access to these services. Patients and Methods Data from Cycle 6 and Cycle 7 (2002 and 2006–2008) of the National Survey of Family Growth (NSFG) were reviewed. The NSFG is a multistage probability survey designed to capture a nationally representative sample of households with men and women aged 15–45 years in the USA. The variables analysed included age, body mass index, self-reported health, alcohol use, race, religious affiliation, marital status, number of offspring, educational attainment, income level, insurance status and metropolitan home designation. Our primary outcome was the correlation of these demographic and socio-economic factors with evaluation for male infertility or vasectomy. Results Of the 11 067 men identified through the NSFG, 466 men (4.2%) sought infertility evaluation, representing 2 187 455 men nationally, and 326 (2.9%) underwent a vasectomy, representing 1 510 386 men nationally. Those seeking infertility evaluation were more likely to be younger and have fewer children (P = 0.001, 0.001) and less likely to be currently married (78 vs 74%; P = 0.010) or ever married (89 vs 97%; P = 0.002). Men undergoing a vasectomy were more likely to be white (86 vs 70%; P = 0.001). Men seeking infertility evaluation were more likely to have a college or graduate degree compared with men undergoing a vasectomy (68 vs 64%; P = 0.015). There was no difference between the two groups for all other variables. Conclusion While differences in demographic characteristics such as age, offspring number and marital status were identified, measures of health, socio-economic status, religion and insurance were similar between men undergoing vasectomy and those seeking infertility services. These factors help characterize the utilization of male reproductive health services in the USA and may help address disparities in access to these services and improve public health strategies.
- Published
- 2015
174. Current and future international patterns of care of neurogenic bladder after spinal cord injury
- Author
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Gary E. Lemack, P. Granitsiotis, J. C. Castano Botero, Jeremy B. Myers, Alex Gomelsky, Roger R. Dmochowski, and Richard K. Lee
- Subjects
medicine.medical_specialty ,Urology ,medicine.medical_treatment ,030232 urology & nephrology ,Specialty ,Developing country ,Urinary catheterization ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,Urinary Bladder, Neurogenic ,Intensive care medicine ,Spinal cord injury ,Socioeconomic status ,Developing Countries ,Spinal Cord Injuries ,business.industry ,Mortality rate ,Developed Countries ,medicine.disease ,Practice Guidelines as Topic ,Professional association ,business ,Urinary Catheterization ,Developed country ,030217 neurology & neurosurgery ,Forecasting - Abstract
We aim to summarize the literature on international patterns of care for patients with neurogenic bladder (NGB) from spinal cord injury (SCI). We performed a PubMed database search, hand review of references, communication with professional societies, and registry evaluations for pertinent data. Established patterns of care, including SCI registries and specialty centers, are available in high-resource countries such as the US and UK. As such, mortality rates from complications of NGB/SCI are lower. Access to intermittent catheterization supplies, among other resources, may be inadequate in many low-income regions. Cultural and religious beliefs may also hinder integration of proper bladder management in SCI patients. While guidelines exist in many parts of the world, it is unclear how rigorously they are disseminated or followed. While there is a paucity of high-level evidence, the differences in patterns of care are closely related to socioeconomic status and resources of the geographic area. Future research efforts should focus on improving access to diagnostic modalities, supplies, and specialists in these areas.
- Published
- 2017
175. The Neurogenic Bladder Symptom Score (NBSS): a secondary assessment of its validity, reliability among people with a spinal cord injury
- Author
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Sara M. Lenherr, Chong Zhang, Sean P. Elliott, Jeremy B. Myers, Angela P. Presson, Blayne Welk, and John T. Stoffel
- Subjects
Adult ,Male ,medicine.medical_specialty ,Cross-sectional study ,Intraclass correlation ,030232 urology & nephrology ,Validity ,Severity of Illness Index ,Cohort Studies ,03 medical and health sciences ,Disability Evaluation ,0302 clinical medicine ,Quality of life ,Cronbach's alpha ,Surveys and Questionnaires ,medicine ,Humans ,Urinary Bladder, Neurogenic ,Spinal cord injury ,Spinal Cord Injuries ,business.industry ,Reproducibility of Results ,General Medicine ,Middle Aged ,medicine.disease ,United States ,Cross-Sectional Studies ,Neurology ,Physical therapy ,Female ,Neurology (clinical) ,Outcomes research ,business ,030217 neurology & neurosurgery ,Cohort study - Abstract
Prospective cross-sectional study. Validate the Neurogenic Bladder Symptom Score (NBSS) for people with spinal cord injury (SCI). United States (recruitment from community/tertiary neurourology clinics). We used data from a prospective observational study of people with a SCI who enrolled during December 2015–September 2016. Participants completed the NBSS and other measurement tools (SF-12 and SCI-QOL Bladder Management Complications tool). Data were used to determine the internal consistency (Cronbach’s alpha), validity (hypothesis testing), and test–re-test reliability (using an intraclass correlation coefficient). 609 people with a SCI had complete data. The median NBSS total score was 22 (IQR 15–30), and median quality of life was “mixed”. The Cronbach’s alpha of the total and the incontinence, storage/voiding, and consequences domains was 0.85, 0.93, 0.76, and 0.49 respectively. All item to domain correlations were ≥0.3, aside from 3/7 of the items from the consequences domain. Appropriate correlations between the NBSS domains and external variables and other questionnaires were observed, such as a moderate correlation between the SCI-QOL Bladder Management complications tool and the NBSS total score. For the reliability assessment, 174 people had 3 month followup data and did not have a significant change to their urologic health. The intraclass correlation coefficients were >0.75 for all subdomains and the overall score. The NBSS demonstrated good validity and reliability in a large cohort of people with a SCI, and is a suitable tool to assess neurogenic bladder symptoms. Patient-Centered Outcomes Research Institute (PCORI) Award CER14092138.
- Published
- 2017
176. How to Measure Quality-of-Life Concerns in Patients with Neurogenic Lower Urinary Tract Dysfunction
- Author
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Darshan P. Patel, Jeremy B. Myers, and Sara M. Lenherr
- Subjects
medicine.medical_specialty ,Urology ,Urinary system ,030232 urology & nephrology ,Urinary incontinence ,03 medical and health sciences ,0302 clinical medicine ,Quality of life (healthcare) ,Lower Urinary Tract Symptoms ,Medicine ,Humans ,In patient ,Patient Reported Outcome Measures ,Urinary Bladder, Neurogenic ,Intensive care medicine ,Health related quality of life ,Urinary bladder ,business.industry ,Patient population ,medicine.anatomical_structure ,Quality of Life ,Self Report ,medicine.symptom ,business ,030217 neurology & neurosurgery - Abstract
There is an evolving role for quality-of-life measures and patient-reported outcomes in the evaluation of neurogenic lower urinary tract dysfunction. We review available health-related quality-of-life instruments and patient-reported outcomes measures used in the assessment of patients with neurogenic bladder. We also discuss considerations for incorporation of these measures into clinical and patient-reported research. Emphasizing patient-reported outcomes in neurogenic bladder research will guide clinicians and other stakeholders to improve quality of life in this patient population.
- Published
- 2017
177. Urinary Diversion With vs Without Bowel Anastomosis in Patients With an Existing Colostomy: A Multi-institutional Study
- Author
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Mary R. Kwaan, Piyush Pathak, Jeremy B. Myers, Yunhua Fan, Ronak A. Gor, Sean P. Elliott, and Katherine J. Cotter
- Subjects
medicine.medical_specialty ,Time Factors ,Urology ,medicine.medical_treatment ,030230 surgery ,Anastomosis ,Urinary Diversion ,03 medical and health sciences ,0302 clinical medicine ,Postoperative Complications ,Colostomy ,medicine ,Bowel anastomosis ,Humans ,In patient ,Digestive System Surgical Procedures ,Aged ,Retrospective Studies ,business.industry ,Urinary diversion ,Anastomosis, Surgical ,Retrospective cohort study ,Middle Aged ,Surgery ,Intestines ,Treatment Outcome ,030220 oncology & carcinogenesis ,Operative time ,business ,Body mass index - Abstract
Objective To describe the short-term outcomes with the bowel anastomosis (BA) approach vs the no-bowel anastomosis (NBA) approach in adult patients undergoing urinary diversion. Methods A chart review was performed of adults undergoing urinary diversion from 2006 to 2015. Patients with a pre-existing colostomy were divided into NBA and BA groups. Postoperative complications were recorded per the Clavien-Dindo system. Variables were compared using the BA group as a control. A 2-tailed t test was used to compare means. Results A total of 43 patients were included: 33 in the BA group and 10 in the NBA. No significant differences were found between the 2 groups for the comorbidity index (P = .16), the body mass index (P = .54), or radiation history (P = .90). In the NBA and BA groups, the median blood loss was 250 and 300 mL (P = .11); the operative time was 550 and 480 minutes (P = .15); and the length of stay was 10 and 25 days (P = .38), respectively. The BA group had a higher rate of intraoperative (P = .04) and early (P = .02) overall complications. No significant difference was found in early bowel (P = .15) or ureteral obstruction (P = .08), in the overall stomal complications (P = .11), or in the rate of Conclusion A lower rate of intraoperative and postoperative complications occurred in patients undergoing conversion of colostomy to a urinary diversion compared with patients with de novo urinary conduit creation. When possible, a BA should be avoided.
- Published
- 2017
178. PD29-02 OUTCOMES OF URETHROPLASTY TO TREAT STRICTURES ARISING FROM ARTIFICIAL URINARY SPHINCTER (AUS) EROSIONS AND RATES OF SUBSEQUENT AUS REIMPLANTATION
- Author
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Jill C. Buckley, Keith Rourke, Thomas G. Smith, William O. Brant, Nejd F. Alsikafi, Jeremy B. Myers, Nathan Chertack, Jason Chandrapal, Lee C. Zhao, Andrew C. Peterson, Joshua A. Broghammer, Sorena Keihani, Sean P. Elliott, and Bryan B. Voelzke
- Subjects
Artificial urinary sphincter ,medicine.medical_specialty ,business.industry ,Urology ,Urethroplasty ,medicine.medical_treatment ,medicine ,business ,Surgery - Published
- 2017
179. PD13-02 IMPACT OF ABSTINENCE TIME ON SEMEN PARAMETERS IN A LARGE POPULATION BASED COHORT OF SUBFERTILE MEN
- Author
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James R. Craig, Sorena Keihani, Chong Zhang, Angela P. Presson, Jeremy B. Myers, William O. Brant, Kenneth I. Aston, Benjamin R. Emery, Timothy G. Jenkins, Douglas T. Carrell, and James M. Hotaling
- Subjects
Urology - Published
- 2017
180. MP36-14 EVALUATION OF GENERIC VERSUS CONDITION-SPECIFIC QUALITY OF LIFE INDICATORS FOR SUCCESSFUL URETHRAL STRICTURE SURGERY
- Author
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Alex J. Vanni, Bryan B. Voelzke, Bradley A. Erickson, Benjamin N. Breyer, Jeremy B. Myers, and Paul H. Chung
- Subjects
medicine.medical_specialty ,Urethral stricture ,business.industry ,Urology ,medicine ,medicine.disease ,business ,Diverticulum ,Surgery - Published
- 2017
181. MP35-06 STATIN USE IS NOT DETRIMENTAL TO SEMEN PARAMETERS IN SUBFERTILE MEN
- Author
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William O. Brant, Jeremy B. Myers, Sorena Keihani, Kenneth I. Aston, James M. Hotaling, James R. Craig, Douglas T. Carrell, Angela P. Presson, Benjamin R. Emery, and Chong Zhang
- Subjects
Andrology ,medicine.medical_specialty ,business.industry ,Urology ,Internal medicine ,Medicine ,Semen ,Statin treatment ,business - Published
- 2017
182. MP79-01 NEPHRECTOMY AFTER HIGH-GRADE RENAL TRAUMA: RESULTS FROM THE AMERICAN ASSOCIATION FOR THE SURGERY OF TRAUMA (AAST) GENITOURINARY TRAUMA STUDY
- Author
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Xian Luo-Owen, Matthew M. Carrick, Barbara A. Shaffer, Bradley J. Morris, Frank Burks, Brandi Miller, Peter B. Thomsen, Erik S. DeSoucy, Bradley A. Erickson, Sarah Majercik, Scott Zakaluzny, Richard A. Santucci, Jeremy B. Myers, Brian P. Smith, Jurek F. Kocik, Patrick M. Reilly, Raminder Nirula, Timothy Hewitt, Sorena Keihani, Kaushik Mukherjee, Gregory Murphy, Benjamin N. Breyer, Yizhe Xu, LaDonna Allen, and Angela P. Presson
- Subjects
medicine.medical_specialty ,business.industry ,Genitourinary system ,Urology ,medicine.medical_treatment ,medicine ,business ,Nephrectomy ,Surgery - Published
- 2017
183. PD64-04 QUALITY OF LIFE ASSOCIATED WITH BLADDER MANAGEMENT STRATEGY AFTER SPINAL CORD INJURY
- Author
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Darshan P. Patel, Angela P. Presson, Blayne Welk, Amitabh Jha, Sara M. Lenherr, Chong Zhang, Shyam Sukumar, Jeffrey Rosenbluth, Sean Elliott, John T. Stoffel, Jeremy B. Myers, and Ronak Gor
- Subjects
medicine.medical_specialty ,Quality of life (healthcare) ,business.industry ,Urology ,Bladder management ,medicine ,Intensive care medicine ,business ,medicine.disease ,Spinal cord injury - Published
- 2017
184. PD34-11 MULTI-INSTITUTIONAL OUTCOMES OF ENDOSCOPIC MANAGEMENT OF STRICTURE RECURRENCE AFTER URETHROPLASTY
- Author
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Sean Elliott, Thomas W. Smith, Alexandra Carolan, Jeremy B. Myers, Shyam Sukumar, Michael Maidaa, Bradley A. Erickson, and Bryan B. Voelzke
- Subjects
medicine.medical_specialty ,business.industry ,Urology ,General surgery ,Urethroplasty ,medicine.medical_treatment ,Medicine ,Endoscopic management ,business - Published
- 2017
185. PD63-02 COMPLIANCE WITH AUA GUIDELINES WITH EXCRETORY PHASE IMAGING FOR EVALUATION OF HIGH-GRADE RENAL TRAUMA: RESULTS FROM THE AMERICAN ASSOCIATION FOR SURGERY OF TRAUMA (AAST) GENITOURINARY TRAUMA STUDY
- Author
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Brandi Miller, Bradley J. Morris, Frank Burks, Patrick M. Reilly, Benjamin N. Breyer, Brian P. Smith, Erik S. DeSoucy, Jurek F. Kocik, Jeremy B. Myers, Raminder Nirula, Timothy Hewitt, Bradley A. Erickson, Scott Zakaluzny, Sarah Majercik, Peter B. Thomsen, Richard A. Santucci, Gregory Murphy, Xian Luo-Owen, Kaushik Mukherjee, LaDonna Allen, and Sorena Keihani
- Subjects
0301 basic medicine ,medicine.medical_specialty ,Genitourinary system ,business.industry ,Urology ,Surgery ,Compliance (physiology) ,03 medical and health sciences ,030104 developmental biology ,0302 clinical medicine ,030220 oncology & carcinogenesis ,medicine ,Excretory phase ,business - Published
- 2017
186. MP46-07 MULTICENTER ANALYSIS OF ARTIFICIAL URINARY SPHINCTER OUTCOMES IN PATIENTS AFTER BOTH RADICAL PROSTATECTOMY AND ANASTOMOTIC URETHROPLASTY
- Author
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Bryan B. Voelzke, Gregory Murphy, Bradley A. Erickson, Jonathan Wingate, Nejd F. Alsikafi, Benjamin N. Breyer, and Jeremy B. Myers
- Subjects
Artificial urinary sphincter ,medicine.medical_specialty ,business.industry ,Prostatectomy ,Urology ,medicine.medical_treatment ,Medicine ,Anastomotic urethroplasty ,In patient ,business - Published
- 2017
187. PD64-01 THE NEUROGENIC BLADDER SYMPTOM SCORE (NBSS): AN ASSESSMENT OF ITS EXTERNAL VALIDITY AND ABILITY TO DETECT CHANGE
- Author
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Sara M. Lenherr, Richard Baverstock, Jeremy B. Myers, Chong Zhang, John T. Stoffel, Sean Elliott, Angela P. Presson, Blayne Welk, and Kevin Carlson
- Subjects
0301 basic medicine ,External validity ,03 medical and health sciences ,medicine.medical_specialty ,030104 developmental biology ,0302 clinical medicine ,business.industry ,030220 oncology & carcinogenesis ,Urology ,Physical therapy ,Medicine ,business ,Symptom score - Published
- 2017
188. PD34-10 VALUE OF EARLY SURVEILLANCE CYSTOURETHROSCOPY AFTER BULBAR URETHROPLASTY ON RECURRENCE RISK: A TURNS STUDY
- Author
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Darshan P. Patel, Sean Elliott, Bryan B. Voelzke, Angela P. Presson, Ragheed Al-Dulaimi, Christopher McClung, Alexander Vanni, Jeremy B. Myers, Bradley A. Erickson, Thomas W. Smith, and Benjamin N. Breyer
- Subjects
medicine.medical_specialty ,business.industry ,Urology ,Urethroplasty ,medicine.medical_treatment ,Medicine ,business ,Value (mathematics) ,Surgery ,Recurrence risk - Published
- 2017
189. MP35-07 PROTON-PUMP INHIBITOR USE AND SEMEN QUALITY IN SUBFERTILE MEN: IS THERE A HARMFUL EFFECT?
- Author
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Sorena Keihani, Benjamin R. Emery, Angela P. Presson, James M. Hotaling, Kenneth I. Aston, Jeremy B. Myers, William O. Brant, Chong Zhang, James R. Craig, and Douglas T. Carrell
- Subjects
Andrology ,Semen quality ,business.industry ,medicine.drug_class ,Urology ,Medicine ,Proton-pump inhibitor ,business - Published
- 2017
190. V1-09 REPAIR OF ADULT BURIED PENIS WITH REMOVAL OF SUPRAPUBIC FAT PAD AND SPLIT THICKNESS SKIN GRAFT: EMPHASIS ON PATIENT BODY HABITUS
- Author
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Sorena Keihani, Jeremy B. Myers, and Bradley A. Erickson
- Subjects
medicine.medical_specialty ,Split thickness skin graft ,business.industry ,Urology ,Buried penis ,medicine ,Anatomy ,medicine.disease ,business ,Fat pad ,Surgery - Published
- 2017
191. MP11-02 URETHRAL LICHEN SCLEROSUS UNDER THE MICROSCOPE
- Author
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Jill C. Buckley, Joshua A. Broghammer, Sean Elliott, Brennan Tesdahl, Lee C. Zhao, William O. Brant, Nejd F. Alsikafi, Christopher McClung, Jeremy B. Myers, Bradley A. Erickson, Thomas W. Smith, Maria Voznesensky, Alex J. Vanni, Benjamin N. Breyer, and Bryan B. Voelzke
- Subjects
medicine.medical_specialty ,Microscope ,business.industry ,law ,Urology ,Medicine ,Lichen sclerosus ,business ,medicine.disease ,Dermatology ,law.invention - Published
- 2017
192. PD13-12 'THE BACK-UP VASECTOMY REVERSAL.' TESTICULAR SPERM EXTRACTION AT THE TIME OF VASECTOMY REVERSAL IN THE COUPLE WITH ADVANCED MATERNAL AGE: A COST-EFFECTIVENESS ANALYSIS
- Author
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Joseph P. Alukal, William O. Brant, Jeremy B. Myers, Sara M. Lenherr, James R. Craig, James M. Hotaling, and Thomas J. Walsh
- Subjects
Andrology ,medicine.medical_specialty ,business.industry ,Obstetrics ,Urology ,Medicine ,Vasectomy reversal ,Cost-effectiveness analysis ,Advanced maternal age ,business ,Testicular sperm extraction - Published
- 2017
193. Non-steroidal anti-inflammatory drug (NSAID) use is not associated with erectile dysfunction risk: results from the Prostate Cancer Prevention Trial
- Author
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Darshan P. Patel, James M. Hotaling, Jeannette M. Schenk, William O. Brant, Jeremy B. Myers, and Amy K. Darke
- Subjects
Male ,medicine.medical_specialty ,Urology ,030232 urology & nephrology ,Placebo ,Article ,03 medical and health sciences ,0302 clinical medicine ,5-alpha Reductase Inhibitors ,Age Distribution ,Erectile Dysfunction ,Risk Factors ,Internal medicine ,medicine ,Humans ,Prostate Cancer Prevention Trial ,Aged ,Gynecology ,Aspirin ,Proportional hazards model ,business.industry ,Hazard ratio ,Anti-Inflammatory Agents, Non-Steroidal ,Finasteride ,Prostatic Neoplasms ,Middle Aged ,medicine.disease ,Erectile dysfunction ,030220 oncology & carcinogenesis ,Cohort ,Headaches ,medicine.symptom ,business ,medicine.drug - Abstract
Objective To evaluate the associations of non-steroidal anti-inflammatory drug (NSAID) use with risk of erectile dysfunction (ED), considering the indications for NSAID use. Patients and Methods We analysed data from 4 726 men in the placebo arm of the Prostate Cancer Prevention Trial (PCPT) without evidence of ED at baseline. Incident ED was defined as mild/moderate (decrease in normal function) or severe (absence of function). Proportional hazards models were used to estimate the covariate-adjusted associations of NSAID-related medical conditions and time-dependent NSAID use with ED risk. Results Arthritis (hazard ratio [HR] 1.56), chronic musculoskeletal pain (HR 1.35), general musculoskeletal complaints (HR 1.36), headaches (HR 1.44), sciatica (HR 1.50) and atherosclerotic disease (HR 1.60) were all significantly associated with an increased risk of mild/moderate ED, while only general musculoskeletal complaints (HR 1.22), headaches (HR 1.47) and atherosclerotic disease (HR 1.60) were associated with an increased risk of severe ED. Non-aspirin NSAID use was associated with an increased risk of mild/moderate ED (HR 1.16; P = 0.02) and aspirin use was associated with an increased risk of severe ED (HR 1.16; P = 0.03, respectively). The associations of NSAID use with ED risk were attenuated after controlling for indications for NSAID use. Conclusions The modest associations of NSAID use with ED risk in the present cohort were probably attributable to confounding indications for NSAID use. NSAID use was not associated with ED risk.
- Published
- 2017
194. Patient reported outcomes measures in neurogenic bladder and bowel: A systematic review of the current literature
- Author
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James M. Hotaling, Sean P. Elliott, Jeremy B. Myers, John T. Stoffel, William O. Brant, and Darshan P. Patel
- Subjects
medicine.medical_specialty ,Spina bifida ,business.industry ,Urology ,030232 urology & nephrology ,MEDLINE ,Bowel management ,Urinary incontinence ,medicine.disease ,03 medical and health sciences ,0302 clinical medicine ,Systematic review ,Neurogenic Bowel ,Quality of life ,medicine ,Physical therapy ,Fecal incontinence ,Neurology (clinical) ,medicine.symptom ,business ,030217 neurology & neurosurgery - Abstract
Aim To describe existing bladder and bowel specific quality of life (QoL) measurement tools, QoL in patients with multiple sclerosis (MS), spinal cord injury (SCI), Parkinson's Disease (PD), stroke, or spina bifida (SB) affected by bladder or bowel dysfunction, and the impact of specific bladder and bowel management on QoL. Methods We performed a systematic review in PubMed/Medline databases in accordance with the PRISMA statement for English publications between January 1, 2000 and January 1, 2014. Articles were first screened based on their abstract and select full-text articles were then reviewed for eligibility. Articles with no QoL or PROM assessing urinary or bowel dysfunction were excluded. Risk of bias assessment included randomization, incomplete outcomes data, selective outcomes reporting, and other biases. All articles were graded using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system as per the Cochrane Handbook for Systematic Reviews of Interventions. Results The most common QoL measurement tool for urinary and bowel dysfunction was the Medical Outcomes Study SF-36. Twelve (24%) studies used only non-validated QoL questionnaires. Only three urinary or bowel specific QoL measures were found: the Qualiveen questionnaire, the FICQoL, and the QoL-BM. Several studies identified instances were clinical and patient-reported outcomes were inconsistent particularly with indwelling urinary catheter usage and reconstructive surgery. Additionally, certain clinical outcomes surrogates commonly used as primary outcomes measures may not correlate with the patient reported outcomes (PRO). Conclusions Current PRO measures (PROM) and QoL assessments are heterogeneous and several inconsistencies in clinical and PRO for various management options exist. Standardized PROM will help identify optimal bladder and bowel management for patients with neurologic conditions. Neurourol. Urodynam. 35:8–14, 2016. © 2014 Wiley Periodicals, Inc.
- Published
- 2014
195. Multi-institutional 1-Year Bulbar Urethroplasty Outcomes Using a Standardized Prospective Cystoscopic Follow-up Protocol
- Author
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Sean P. Elliott, Chris McClung, Nejd F. Alsikafi, Jeremy B. Myers, William O. Brant, Bryan B. Voelzke, Bradley A. Erickson, Thomas G. Smith, and Joshua A. Broghammer
- Subjects
medicine.medical_specialty ,medicine.diagnostic_test ,Urethral stricture ,business.industry ,Urology ,Urethroplasty ,medicine.medical_treatment ,Functional failure ,Gold standard ,Cystoscopy ,medicine.disease ,Secondary procedure ,Surgery ,Urethra ,medicine.anatomical_structure ,medicine ,business ,Prospective cohort study - Abstract
Objective To evaluate multi-institutional outcomes of bulbar urethroplasty utilizing a standardized cystoscopic follow-up protocol. Methods Eight reconstructive surgeons prospectively enrolled urethral stricture patients in a multi-institutional study and performed postoperative cystoscopy at 3 and 12 months. Anatomic failure was defined as the inability to pass a flexible cystoscope without force. Functional failure was defined as the need for a secondary procedure. Men not compliant with the 12-month cystoscopy were called and asked if any interval secondary procedures had been performed. Patients with bothersome voiding complaints at cystoscopy were considered symptomatic. Results Of 213 men in study, 136 underwent excisional urethroplasty (excision and primary anastomosis [EPA]) and 77 underwent repair with buccal grafts. Cystoscopy compliance was 79.8% at 3 months and 54.4% at 12 months. Anatomic success rates were higher at 3 vs 12 months for EPA repairs (97.2% [106 of 109] vs 85.5% [65 of 76; P = .003] but not buccal repairs (85.5% [53 of 62] vs 77.5% [31 of 40]; P = .30). Functional success rates at a year were higher but statistically similar to anatomical success rates (EPA—90.3% [93 of 103]; P = .33; buccal—87% [47 of 54]; P = .22). Of the 20 anatomic recurrences, only 13 (65%) were symptomatic at the time of cystoscopic diagnosis. Conclusion Rates of success are lower when using the anatomic vs traditional definition. Of recurrences found by cystoscopy, only 65% were symptomatic. One-year patient cystoscopy compliance was poor and its ability to be used as the gold standard screening methodology for recurrence is questionable.
- Published
- 2014
196. Short-term Outcomes of Chait Trapdoor for Antegrade Continence Enema in Adults
- Author
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Jeremy B. Myers, Jeffrey D. Redshaw, Sean P. Elliott, Patrick Hovert, Andrew Nguyen, Eric Hu, M. Chad Wallis, Blake D. Hamilton, and William O. Brant
- Subjects
Adult ,Male ,medicine.medical_specialty ,Time Factors ,Urology ,medicine.medical_treatment ,Enema ,Risk Assessment ,Severity of Illness Index ,Cohort Studies ,Prosthesis Implantation ,Postoperative Complications ,Neurogenic Bowel ,medicine ,Humans ,Therapeutic Irrigation ,Device Removal ,Aged ,Retrospective Studies ,Splenic flexure ,Equipment Safety ,medicine.diagnostic_test ,business.industry ,Interventional radiology ,Retrospective cohort study ,Equipment Design ,Middle Aged ,Surgery ,Regimen ,Cecostomy ,Treatment Outcome ,Patient Satisfaction ,Quality of Life ,Defecation ,Female ,Peristalsis ,Complication ,business ,Fecal Incontinence ,Spleen ,Follow-Up Studies - Abstract
Objective To examine our short-term experience of antegrade continence enema (ACE) delivered via a Chait Trapdoor (Cook Medical, Bloomington, IN) in adults with intractable neurogenic bowel. Methods We performed a retrospective review at the Universities of Utah and Minnesota of 15 patients with Chait Trapdoor placed for the purpose of ACE from 2011 to 2013. Our primary outcome was continued utilization of the Chait Trapdoor. Secondary outcomes included volume of ACE used and time to produce a bowel movement. Results All patients had neurogenic bowel refractory to conventional bowel regimen. Mean follow-up was 6 months (range, 1-17 months). Thirteen patients had the Chait Trapdoor placed in the splenic flexure and 2 had it placed in the cecum. Of the 15 patients, 12 (80%) were still using the Chait Trapdoor at last follow-up. A median of 425 mL (range, 120-1000 mL) of fluid was used to produce a bowel movement in 5-120 minutes. Two patients developed postoperative wound infections, requiring return to the operating room (Clavien IIIb). Long-term complications included 5 patients with a dislodged tube requiring replacement by interventional radiology and 2 patients with local cellulitis. Two patients had the Chait Trapdoor moved to a new location to improve efficacy. Conclusion Although the revision, removal, and complication rates were high, 80% of the patients were satisfied with the function and continued to use the Chait Trapdoor. The volume of irrigation required for ACE and the time it takes to produce a bowel movement vary significantly between patients.
- Published
- 2014
197. Climacturia after Definitive Treatment of Prostate Cancer
- Author
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Jeremy B. Myers, Robert A. Stephenson, Angela P. Presson, Jonathan D. Tward, William O. Brant, John R. Gannon, Christopher Dechet, William T. Lowrance, and Brock O'Neil
- Subjects
Male ,medicine.medical_specialty ,Urology ,medicine.medical_treatment ,media_common.quotation_subject ,Orgasm ,Treatment results ,Sexually active ,Prostate cancer ,Internal medicine ,medicine ,Humans ,Aged ,media_common ,Prostatectomy ,Radiotherapy ,business.industry ,Prostatic Neoplasms ,Urination disorder ,Middle Aged ,medicine.disease ,Health Surveys ,Radiation therapy ,Sexual Dysfunction, Physiological ,Urinary Incontinence ,Erectile dysfunction ,business - Abstract
Prostate cancer treatment results in several sexually related side effects beyond the well studied erectile dysfunction. Climacturia (leakage of urine during orgasm) has been reported after prostatectomy but studies have been limited by multiple factors. In this study we examine the prevalence, causes and impact on orgasm function of climacturia after definitive treatment of prostate cancer with surgery or radiation.A total of 906 anonymous surveys were sent to patients with prostate cancer treated with surgery and/or radiation. Respondents were asked about the presence of urinary leakage, climacturia and various elements related to sexual and orgasmic function. We estimated the prevalence of climacturia, evaluated the differences between those with and without climacturia, and assessed the impact of climacturia on orgasmic function.Overall 412 surveys were returned and available for analysis, and of these respondents 75.2% were sexually active or experiencing orgasms. Climacturia was reported by 22.6% of these respondents, and by 28.3%, 5.2% and 28.6% of those treated with surgery, radiation, or both, respectively (p0.001). The use of aides to obtain an erection (OR 2.24, 95% CI 1.08-4.93, p = 0.035) and the presence of urinary incontinence (OR 3.09, 95% CI 1.66-5.88, p0.001) were also associated with climacturia in a multivariate logistic regression model. Climacturia had no significant impact on orgasmic function and satisfaction.Climacturia is experienced by a substantial proportion of men after undergoing definitive treatment of prostate cancer. We found a complex relationship between stress urinary incontinence and climacturia, and noted that the presence of climacturia does not necessarily negatively impact sexual satisfaction.
- Published
- 2014
198. Multicenter Analysis of Urinary Urgency and Urge Incontinence in Patients with Anterior Urethral Stricture Disease before and after Urethroplasty
- Author
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Bryan B. Voelzke, Christopher McClung, Turns, Judith C. Hagedorn, Jeremy B. Myers, Thomas G. Smith, Sean P. Elliott, Lindsay A. Hampson, Benjamin N. Breyer, Bradley A. Erickson, and Alex J. Vanni
- Subjects
Urologic Diseases ,Adult ,Male ,medicine.medical_specialty ,Urinary urgency ,Urologic Surgical Procedures, Male ,Urethral stricture ,Urology ,Urethroplasty ,medicine.medical_treatment ,Clinical Sciences ,Renal and urogenital ,030232 urology & nephrology ,overactive ,Urinary incontinence ,urge ,03 medical and health sciences ,0302 clinical medicine ,Postoperative Complications ,Urethra ,Clinical Research ,Lower urinary tract symptoms ,medicine ,Humans ,lower urinary tract symptoms ,Retrospective Studies ,Urethral Stricture ,Urinary bladder ,urinary incontinence ,business.industry ,Retrospective cohort study ,Urinary Incontinence, Urge ,Urology & Nephrology ,Middle Aged ,medicine.disease ,Surgery ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,TURNS ,Urologic Surgical Procedures ,urethral stricture ,medicine.symptom ,urethra ,business ,urinary bladder - Abstract
PurposeLittle published data exist on the impact of urethral stricture surgery on urinary urgency. We evaluated urinary urgency and urge incontinence before and after anterior urethroplasty.Materials and methodsMale patients who underwent 1-stage anterior urethroplasty were retrospectively identified at 8 centers. Patients with preoperative and 2-month or greater postoperative subjective urinary urgency assessments were included in study. Patients who received anticholinergic medications preoperatively were excluded. Univariate and multivariate analysis was done to analyze the association of patient characteristics with preoperative and postoperative symptoms as well as improvement or worsening of symptoms after surgery.ResultsSymptom and followup data on urgency and urge incontinence were available in in 439 and 305 patients, respectively. Preoperatively 58% of the men reported urgency and 31% reported urge incontinence. Postoperatively this decreased to 40% of men for urgency and 12% for urge incontinence (each p
- Published
- 2016
199. Editorial Comment
- Author
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Sara M, Lenherr and Jeremy B, Myers
- Subjects
Urology ,Urinary Bladder ,Humans ,Spinal Cord Injuries - Published
- 2018
200. AUTHOR REPLY
- Author
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Rachel A. Moses, Sorena Keihani, James R. Craig, Jacob Basilius, James M. Hotaling, Sara M. Lenherr, William O. Brant, and Jeremy B. Myers
- Subjects
Urology - Published
- 2019
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