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Racial disparities in prostate cancer have not been well characterized on a genomic level. Here we show the results of a multi-institutional retrospective analysis of 1,152 patients (596 African-American men (AAM) and 556 European-American men (EAM)) who underwent radical prostatectomy. Comparative analyses between the race groups were conducted at the clinical, genomic, pathway, molecular subtype, and prognostic levels. The EAM group had increased ERG (P, Walter Rayford, Alp Tuna Beksac et al. investigated gene expression alterations in African-American and European-American men who underwent radical prostatectomy for prostate cancer. The observed differences include higher expression of inflammation genes and lower expression of mismatch repair genes in African-American men.

Acquired hydronephrosis following cystectomy and ileal conduit urinary diversion for bladder cancer is most commonly caused by stricture of the ureter or the ureteroenteric anastomosis. Nevertheless, malignant obstruction due to ureteral tumor recurrence must be ruled out. Neuroendocrine tumors of the ureter are extremely rare and an unlikely cause of hydronephrosis in this setting. We present the first reported case of a patient with a history of bladder cancer and an ileal conduit presenting with hydronephrosis secondary to an obstructing carcinoid tumor of the ureter.

Placement of coudé catheters, manual irrigation of urinary catheters, and management of continuous bladder irrigation (CBI) are routine interventions for which nurses often receive little or no formal education. In this study, our aim was to determine factors associated with higher comfort levels for these catheter-care techniques and to assess whether online instructional videos could be used to improve nursing comfort.Three 5-minute videos were created to demonstrate proper technique for coudé catheter placement, manual irrigation of a catheter, and management of CBI. An online module with pre- and post-video surveys was created and administered to all nursing staff at MedStar Georgetown University Hospital.A total of 821 nurses participated in this study and completed the online module with both pre-- and post-video surveys. Using a 10-point Likert scale, pre-video median comfort levels for coudé catheter placement, manual irrigation of a catheter, and management of CBI were 5, 6, and 5, respectively. Post-video median comfort levels increased significantly to 9, 8, and 8, respectively (p0.001). In the linear regression models, prior formal training was significantly associated with higher baseline comfort levels for all three techniques (p0.001).Prior formal training as well as baseline nursing comfort levels for common catheter related techniques tend to be low and the implementation of simple instructional videos via an online platform may be a useful strategy for improving nursing comfort. This study demonstrates a reproducible strategy for disseminating catheter education for nurses on a larger scale.

INTRODUCTION Surgical trainees experience high rates of depression and suicidal ideation (SI). However, there remain a gap in knowledge on the drivers of depression and SI in trainees, especially within the field of urology.We conducted a national study of urology trainees using a 50-item questionnaire in May 2018. The survey included demographic, depression (Patient Health Questionnaire-9 (PHQ-9)), burnout (Maslach Burnout Inventory (MBI)), and quality of life (QoL) questions.Overall, 37 (17.6%) endorsed depression; 24 residents endorsed SI (11%). SI was higher in those with depression (p0.001). Burnout was also higher among depressed residents (97.3% versus 61.8%, p0.001) and those endorsing SI (16.1% versus 1.5%, p0.001). Depression was associated with female gender (29.2% versus 12.4%, p = 0.005), fatigue (29.5% versus 7.8%, p0.001), and lack of structured mentorship (23.7% versus 9.8%, p = 0.010). Access to mental health services was protective (p = 0.016). Older age, low QoL, dissatisfaction with work-life-balance (WLB), and fatigue were associated with SI. On adjusted analysis, gender (OR 3.1 [95%CI 1.4-6.9], p = 0.006), fatigue (OR 3.8[95%CI 1.6-9.0], p = 0.002), and burnout (OR 16.7 [95%CI 2.2-127.5], p = 0.007) increased the odds of depression. On exploratory analysis, self-reported burnout alone was predictive of SI (OR 7.6 [95%CI 2.5-23]), and performed similarly to an adjusted model (AUC Area 0.718 [95%CI 0.634-0.802] versus 0.825 [0.753-0.897]).Urology trainees experience high rates of depression and SI. Female residents have significantly higher risk of depression. A single-item appears useful to screen for SI. Further investigation is needed to understand and promote urology resident wellness.

Objective To examine the impact of obesity on perioperative outcomes and urethral stricture recurrence after anterior urethroplasty. Material and Methods We reviewed our prospectively maintained single-surgeon database to identify men with anterior urethral strictures who had undergone anastomotic or augmentation urethroplasty between October 2012 and March 2018. In all, 210 patients were included for primary analysis of perioperative outcomes, while 193 patients with at least 12 months follow-up were included for secondary analysis of stricture recurrence. Patients grouped by BMI were compared using univariate and multivariate analyses for perioperative outcomes and log rank testing for recurrence-free survival. Results Overall, 41% (n=86) of patients were obese and 58.6% (n=123) had bulbar urethral strictures. Obese patients had significantly longer urethral strictures (mean=6.7cm±4.7) than nonobese patients (p

INTRODUCTION AND OBJECTIVES:Surgical trainees experience a high rate of depression and suicidal ideation. Despite the high rate of burnout previously reported in urologists, no studies have addressed the rates of depression or suicidality in urology trainees.METHODS:We conducted a national REDCap-based survey study of urology trainees using a 50-question questionnaire in May of 2018. The survey included a demographic, depression, burnout, and quality of life questions. Depression and suicidal ideation was assessed using the PHQ-9; burnout was assessed using the Maslach Burnout Inventory.RESULTS:Responses were collected in 210 of 1,011 (20.9%) eligible participants. Overall, 37 (17.6%) met criteria for moderate-severe depression; suicidal ideation was identified in 25 residents (11.9%)-four times higher than the general population (Fig 1). Rates of suicidal thoughts were higher in those with moderate-severe depression (37.8% versus 5.8%, p

BK virus is a polyomavirus, which causes a ubiquitous infection with an asymptomatic course in immunocompetent individuals and is latent in the genitourinary tract. BK virus reactivation can occur with immunosuppression such as in patients after organ transplantation, which might lead to nephropathy, hemorrhagic cystitis, and has been associated with development of malignancy in the genitourinary tract and nervous system. We present a rare case of urothelial carcinoma with a prominent micropapillary component in a patient 8 years after a cardiac transplantation. Micropapillary urothelial carcinoma (MPUC) is a rare variant of bladder cancer with an aggressive course and poor prognosis. Because of its resistance to intravesical immunotherapy, radical cystectomy is the preferred treatment for nonmuscle-invasive MPUC. This case report adds to the growing body of evidence linking BK virus infection in immunosuppressed patients and the development of MPUC. This aggressive tumor should be suspected in this patient population who present with hematuria.