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Yale Urology Research [Q2: April-June 2024]

July 31, 2024

The following is a comprehensive list of Yale Urology publications / presentations for the second quarter of calendar year 2024. The listing is in descending published date order and features primary faculty and trainee work. Each item includes links to the full study or presentation and provides portions of the abstract / summary.

Diaz GM, Webb LT, Rabil MJ, Lokeshwar SD, Choksi AU, Leapman MS, Sprenkle PC. Risk Factors and Contemporary Management Options for Pain and Discomfort Experienced During a Prostate Biopsy. Curr Urol Rep. 2024 Jun 19. doi: 10.1007/s11934-024-01220-w. Epub ahead of print. PMID: 38896314.

To inform clinicians and offer pain relief alternatives to patients, this review delves into the risk factors for increased pain and modern management options to alleviate pain during prostate biopsy.


Demkowicz PC, Buck MB, Nie J, Marks VA, Wheeler SB, Dinan MA, Gross CP, Leapman MS. Changes in Facility Share of Medicaid-insured Patients With Urologic Cancers Following Implementation of the Patient Protection and Affordable Care Act. Urology. 2024 Jun 18:S0090-4295(24)00447-3. doi: 10.1016/j.urology.2024.06.003. Epub ahead of print. PMID: 38901803.

Urologic cancer care for Medicaid-insured Americans remains unevenly distributed across cancer care centers, even in states that expanded coverage. Our findings suggest that this variation may reflect the effort of some facilities to reduce their financial exposure to increased numbers of Medicaid patients in the wake of ACA-supported state expansions.


Lee HM, Muhammad N, Lieu EL, Cai F, Mu J, Ha YS, Cao G, Suchors C, Joves K, Chronis C, Li K, Ducker GS, Olszewski K, Cai L, Allison DB, Bachert SE, Ewing WR, Wong H, Seo H, Kim IY, Faubert B, Kim J, Kim J. Concurrent loss of LKB1 and KEAP1 enhances SHMT-mediated antioxidant defence in KRAS-mutant lung cancer. Nat Metab. 2024 Jul;6(7):1310-1328. doi: 10.1038/s42255-024-01066-z. Epub 2024 Jun 14. PMID: 38877143.

Using RNA-seq and metabolomics data from human NSCLC, we uncovered that LKB1 loss enhanced SGOC metabolism via serine hydroxymethyltransferase (SHMT)


Bar-Chama N., [Honig S.] Reply to editorial comment on “Amateur versus professional users of the YO Home sperm test: An assessment of usability”. Urology (Ridgewood, N.J.). 06/2024. doi: 10.1016/j.urology.2024.06.016.

As stated in the study, the YO home sperm test is not intended to replace a comprehensive semen analysis but serves as a crucial tool for identifying male factor infertility in the home environment. 


Leapman MS, Ho J, Liu Y, Filson CP, Zhao X, Hakansson A, Proudfoot JA, Davicioni E, Martin DT, An Y, Seibert TM, Lin DW, Spratt DE, Cooperberg MR, Ross AE, Sprenkle PC. Development of a Longitudinal Prostate Cancer Transcriptomic and Clinical Data Linkage. JAMA Netw Open. 2024 Jun 3;7(6):e2417274. doi: 10.1001/jamanetworkopen.2024.17274. PMID: 38874922; PMCID: PMC11179136.

This study established a national-scale linkage of transcriptomic and longitudinal clinical data yielding high accuracy for identifying key clinical junctures, including diagnosis, treatment, and early cancer outcome.


Stephan AP, Hauc SC, Marks VA, Bercik R, Rickey L. TikTok misinformation and user engagement in female pelvic floor conditions. Neurourol Urodyn. 2024 Jun 3. doi: 10.1002/nau.25519. Epub ahead of print. PMID: 38828831.

The poor quality and prevalence of misinformation in FPF-related TikTok videos with the highest engagement raise concerns about the propagation of nonevidence-based health information.


Fazekas T, Shim SR, Basile G, Baboudjian M, Kói T, Przydacz M, Abufaraj M, Ploussard G, Kasivisvanathan V, Rivas JG, Gandaglia G, Szarvas T, Schoots IG, van den Bergh RCN, Leapman MS, Nyirády P, Shariat SF, Rajwa P. Magnetic Resonance Imaging in Prostate Cancer Screening: A Systematic Review and Meta-Analysis. JAMA Oncol. 2024 Jun 1;10(6):745-754. doi: 10.1001/jamaoncol.2024.0734. PMID: 38576242; PMCID: PMC10998247.

The results of this systematic review and meta-analysis suggest that integrating MRI in PCa screening pathways is associated with a reduced number of unnecessary biopsies and overdiagnosis of insignificant PCa while maintaining csPCa detection as compared with PSA-only screening.


Cahill E, Islam R, Chua K, Balraj V, Boyle J, Patel H, Kaldany A, Doppalapudi SK, Velez D, Tunuguntla H, Sterling J. Smoking is not associated with wound complications in augmented urethroplasty: a NSQIP analysis. Int Urol Nephrol. 2024 May 30. doi: 10.1007/s11255-024-04085-7. Epub ahead of print. PMID: 38811450.

Smoking and diabetes were associated with increased wound complications for men undergoing EPA, but not in patients undergoing augmented urethroplasty. Patients with comorbidities associated with worse wound healing may be more likely to have a wound complication when undergoing EPA.


Baum LVM, [Leapman M]. Opioid prescribing trends and pain scores among adult patients with cancer in a large health system. Journal of clinical oncology. 06/2024;42(16_suppl):11059-11059. doi: 10.1200/JCO.2024.42.16_suppl.11059.

Overall, and in patients treated with oncological surgeries, our study in a single large US health system suggests a modest, gradual decline in opioid prescribing for patients with cancer over time. On the other hand, among patients with metastatic cancer, opioid prescribing remained stable for those with documented pain and declined steeply for those without documented pain.


Taylor M. [Leapman M.] Personalized risk assessment of new onset depression in long-term cancer survivors. Journal of clinical oncology. 06/2024;42(16_suppl):e13798-e13798. doi: 10.1200/JCO.2024.42.16_suppl.e13798.

Diagnoses of depression increased in cancer patients since 2008 and were associated with prior history of depression, advanced age, census tract poverty, and continued treatment 3 years after diagnosis. Treatment type and disease specific factors were not strong predictors of depression.


Pelzman D, Honig S, Sandlow J. Comparative review of vasectomy guidelines and novel vasal occlusion techniques. Andrology. 2024 May 22. doi: 10.1111/andr.13665. Epub ahead of print. PMID: 38774918.

Here, we perform a comparative review of vasectomy guidelines from six urological societies worldwide.


Panchendrabose K, Bal DS, Sidhom K, Chung D, Pierce A, Lokeshwar S, Patel P. A Systematic Review of Loco-Sedative Anesthesia for Urologic Surgery. Urology. 2024 Jul;189:1-8. doi: 10.1016/j.urology.2024.05.017. Epub 2024 May 20. PMID: 38777190.

Given the high efficacy rates, loco-sedative anesthesia is a promising technique for urologic interventions and should be further investigated to determine whether it may become the standard of care.


Ghali F, Holt SK, Koehne EL, Chen JJ, Weg ES, Liao JJ, Zeng J, Grivas P, Hawley JE, Hsieh AC, Montgomery RB, Wright JL. Patterns of chemotherapy use with primary radiotherapy for localized bladder cancer in patients 65 or older. Front Oncol. 2024 May 15;14:1341655. doi: 10.3389/fonc.2024.1341655. PMID: 38812783; PMCID: PMC11133586.

Concurrent administration of radio-sensitizing chemotherapy and radiation therapy (RT) has been shown to have superior disease control compared with RT alone and can often be administered with modest added toxicity. We sought to describe national patterns of chemotherapy use


We conducted a single-center, retrospective, evaluator-blinded, pilot, and pivotal clinical trial to assess the clinical performance of the mirCaP kit [hsv2-miR-H9/has-miR-3659] in aiding physicians’ decision-making for PCa assessments in patients within this gray zone.


Hoebeke P, Hittelman A, Jenkins B, Geib T, Titanji W, Bogaert G. Results of a study examining the use of onabotulinumtoxinA in pediatric patients with overactive bladder. J Pediatr Urol. 2024 May 4:S1477-5131(24)00256-0. doi: 10.1016/j.jpurol.2024.04.019. Epub ahead of print. PMID: 38906707.

To investigate the efficacy and safety of onabotulinumtoxinA treatment of OAB in children aged 12-17 years who were not adequately managed with anticholinergics.


Sutcliffe S, Falke C, Fok CS, Griffith JW, Harlow BL, Kenton KA, Lewis CE, Low LK, Lowder JL, Lukacz ES, Markland AD, McGwin G, Meister MR, Mueller ER, Newman DK, Pakpahan R, Rickey LM, Rockwood T, Simon MA, Smith AR, Rudser KD, Smith AL. Lower Urinary Tract Symptoms in US Women: Contemporary Prevalence Estimates from the RISE FOR HEALTH Study. J Urol. 2024 Jul;212(1):124-135. doi: 10.1097/JU.0000000000004009. Epub 2024 May 4. PMID: 38703067; PMCID: PMC11166514.

We aimed to estimate the prevalence of a wide range of lower urinary tract symptoms [LUTS] in US women, and explore associations with both and discussion with health care providers, friends, and family.


Bar-Chama N, Rabinovitch L, Honig S. Amateur vs Professional Users of the YO Home Sperm Test: An Assessment of Usability. Urology. 2024 May 3:S0090-4295(24)00257-7. doi: 10.1016/j.urology.2024.04.001. Epub ahead of print. PMID: 38705243.

This multisite study investigated whether amateur users could use the FDA-cleared YO Home Sperm Test to obtain accurate motile sperm concentration (MSC) results when compared to trained laboratory technicians. 


Lokeshwar SD, Ali A, Weiss TR, Reynolds J, Shuch BM, Ferencz T, Kyriakides TC, Mehal WZ, Brito J, Renzulli J, Leapman MS. The effect of a fermented soy beverage among patients with localized prostate cancer prior to radical prostatectomy. BMC Urol. 2024 May 3;24(1):102. doi: 10.1186/s12894-024-01483-y. PMID: 38702664; PMCID: PMC11067086.

We evaluated the effect of a fermented soy beverage (Q-Can®), containing medium-chain triglycerides, ketones and soy isoflavones, among men with localized PCa prior to radical prostatectomy.


Kunst N. [Sprenkle P., Rabil M., Kim IY., Leapman MS.] PD08-10 EFFECTIVENESS OF PROSTATE SPECIFIC MEMBRANE ANTIGEN POSITRON EMISSION TOMOGRAPHY AMONG PATIENTS WITH BIOCHEMICAL RECURRENT PROSTATE CANCER: RESULTS OF DECISION ANALYTIC MODELING. The Journal of urology. 05/2024;211(5s). doi: 10.1097/01.JU.0001008576.33217.96.10.

The results from this model suggest that upfront PSMA-PET imaging for the evaluation of recurrent prostate cancer may be associated with reduced prostate cancer mortality, increased number of life years and QALYs compared with CTBS.


Golos AM. [Leapman MS.] MP24-10 TRENDS IN UROLOGY PRACTICE CONSOLIDATION AND PRIVATE EQUITY INVESTMENT FROM 2011-2023. The Journal of urology. 05/2024;211(5s). doi: 10.1097/01.JU.0001008860.46052.c4.10.

Urology practices in the United States have undergone increasing consolidation in recent years, accelerated by private equity [PE] investment. We sought to describe practice characteristics and geographic trends in this rapidly evolving landscape.


Fu MZ. [Cahill EM.] MP39-17 THE VIRTUAL UROLOGY RESIDENCY INTERVIEW IS HERE TO STAY: A TWO-YEAR COMPARISON OF APPLICANTS’ ATTITUDES AND PERCEPTIONS. The Journal of urology. 05/2024;211(5s). doi: 10.1097/01.JU.0001008644.01945.6c.17.

Though virtual interviews have decreased interview-related costs, they have presented new challenges for applicants in making informed decisions about residencies. We conducted a survey-based study over two years to clarify this trade off.


Olawoyin O. [Press B., Weiss R., Sterling J., Arlen A.] MP55-19 FACTORS ASSOCIATED WITH OUTCOMES AFTER PYELOPLASTY IN THE PEDIATRIC POPULATION. The Journal of urology. 05/2024;211(5s). doi: 10.1097/01.JU.0001008616.01808.0f.19.

Complications after pyeloplasty are rare and most commonly due to UTI. HOP, and low weight at the time of surgery were associated with increased complications after pyeloplasty. Prior steroid use was not associated with wound dehiscence or surgical site infection.


Ghali F. PD34-09 PATTERNS OF CHEMOTHERAPY USE WITH PRIMARY RADIOTHERAPY FOR LOCALIZED BLADDER CANCER. The Journal of urology. 05/2024;211(5s). doi: 10.1097/01.JU.0001008768.36634.79.09.

Over a third of patients >/65 years receiving RT for MIBC don't receive concurrent chemotherapy. Considering the oncologic benefit and low toxicity options with CRT over RT alone, efforts to increase the use of radio-sensitizing chemotherapy are needed.


Leapman MS. [Rabil M. Sprenkle P., Kim IY.] PD45-11 TEMPORAL AND REGIONAL PATTERNS OF PROSTATE CANCER POSITRON EMISSION TOMOGRAPHY IMAGING AMONG COMMERCIAL INSURANCE BENEFICIARIES IN THE UNITED STATES. The Journal of urology. 05/2024;211(5s). doi: 10.1097/01.JU.0001008792.09108.b4.11.

We conducted a dynamic cohort study to evaluate use of PET imaging among insurance beneficiaries aged 40-89 years with a diagnosis of prostate cancer using deidentified administrative claims from Blue Cross Blue Shield Axis. 


Our aim was to understand patient preferences regarding prostate cancer risk communication and identify best practices for patient-facing risk communication tools.


Leapman MS. [Rabil M., Sprenkle P., Kim IY.] PD45-10 PROSTATE-SPECIFIC MEMBRANE ANTIGEN IMAGING FINDINGS AND SUBSEQUENT CLINICAL MANAGEMENT AMONG PATIENTS WITH BIOCHEMICAL RECURRENT PROSTATE CANCER: A RETROSPECTIVE COHORT STUDY. The Journal of urology. 05/2024;211(5s). doi: 10.1097/01.JU.0001008792.09108.b4.10.

The primary objective was to evaluate clinical management in the six-month period following first PSMA-PET scan in relation to imaging findings. 


Cahill EM. [Choksi AU., Reddy SS., Heckscher D., Rotker K., Honig SC.] MP11-15SPERMATOCELECTOMY WITH VERSUS WITHOUT EPIDIDYMECTOMY: A SINGLE INSTITUTION EXPERIENCE. The Journal of urology. 05/2024;211(5s). doi: 10.1097/01.JU.0001008564.85995.11.15.

The core concept of spermatocelectomy is to identify the communication between the epididymis and spermatocele, which can be difficult and may result in residual tissue and spermatocele recurrence. We postulate that a combined spermatocelectomy with epididymectomy will yield a lower rate of recurrence.


Lokeshwar SD. [Choksi AU., Rahman SN., Martin TV., Hesse DG., Leapman MS.] HF01-10 UROLOGIC EDUCATION AT THE TURN OF THE 20TH CENTURY: A STUDENT’S PERSPECTIVE. The Journal of urology. 05/2024;211(5s). doi: 10.1097/01.JU.0001008828.35887.de.10.

The objective of this study is to give a perspective on the medical education of Urology directly from a student’s notes in 1907.


Sutcliffe S, Falke C, Fok CS, Griffith JW, Harlow BL, Kenton KA, Lewis CE, Low LK, Lowder JL, Lukacz ES, Markland AD, McGwin G, Meister MR, Mueller ER, Newman DK, Pakpahan R, Rickey LM, Rockwood T, Simon MA, Smith AR, Rudser KD, Smith AL. Lower Urinary Tract Symptoms in US Women: Contemporary Prevalence Estimates from the RISE FOR HEALTH Study. J Urol. 2024 Jul;212(1):124-135. doi: 10.1097/JU.0000000000004009. Epub 2024 May 4. PMID: 38703067; PMCID: PMC11166514.

To provide contemporary prevalence estimates of a range of lower urinary tract symptoms [LUTS] in the US adult female population.


Diaz GM. [Webb LT., Sprenkle PC.] MP19-09 PREDICTORS OF A POSITIVE BIOPSY FOLLOWING A PIRADS 3 FINDING ON MRI. The Journal of urology. 05/2024;211(5s). doi: 10.1097/01.JU.0001008716.22569.77.09.

The objective of this study is to identify potential predictors of a positive biopsy following a PI-RADS 3 lesion on MRI in order to reduce the number of unnecessary biopsies.


Webb LT. [Diaz GM., Sundaresan V., Leapman MS., Sprenkle PC.] MP19-12 CHARACTERISTICS OF PI-RADS 5 LESIONS WITH A NEGATIVE OR GLEASON GRADE GROUP 1 BIOPSY. The Journal of urology. 05/2024;211(5s). doi: 10.1097/01.JU.0001008716.22569.77.12.

This study aimed to assess the presence of pre-biopsy clinical factors that could be utilized to predict a discrepancy between imaging and histopathology and thus, avoid low-yield biopsies.


When PIRADS category is included in a predictive nomogram with other common patient factors, risk of csPCa can be accurately predicted.


Rabil MJ. [Jalfon M., Heckscher D., Leapman MS., Cavallo JA.] MP02-19 AUTOMATED ABSTRACTION ALGORITHM FOR RADICAL PROSTATECTOMY SURGICAL OUTCOMES. The Journal of urology. 05/2024;211(5s). doi: 10.1097/01.JU.0001008600.97797.3b.19.

We hypothesized that a novel institutional electronic medical record [EMR]-based automated algorithm for surgical outcomes following robot-assisted laparoscopic radical prostatectomy [RALP] would demonstrate>90% sensitivity and specificity and significant inter-rater reliability [IRR] with National Surgical Quality Improvement Program [NSQIP] data abstraction.


Kunst N. [Sprenkle P., Rabil M., Kim IY., Leapman MS.] MP57-08 COST EFFECTIVENESS OF PROSTATE SPECIFIC MEMBRANE ANTIGEN POSITRON EMISSION TOMOGRAPHY (PSMA-PET) FOR THE EVALUATION OF BIOCHEMICAL RECURRENT PROSTATE CANCER IN THE UNITED STATES HEALTHCARE SYSTEM. The Journal of urology. 05/2024;211(5s). doi: 10.1097/01.JU.0001009420.83948.eb.08.

We developed a decision-analytic model consisting of a decision tree and a Markov model to evaluate the cost-effectiveness of three distinct imaging strategies for the evaluation of patients with biochemical recurrence [BCR] following initial treatment with radical prostatectomy or radiation therapy. 


Ghali F. MP15-18 MOLECULAR CHARACTERIZATION OF URETHRAL CANCER AND COMPARISON WITH BLADDER CANCER. The Journal of urology. 05/2024;211(5s). doi: 10.1097/01.JU.0001009500.87761.bf.18.

We sought to perform molecular characterization of paired primary UC, secondary UC, and paired BC tumors.


Yim S. [Rahman SN.] MP75-10 NOCTURIA ACROSS THE HEART FAILURE CONTINUUM: RESULTS FROM AN OUTPATIENT UROLOGY POPULATION. The Journal of urology. 05/2024;211(5s). doi: 10.1097/01.JU.0001008676.21744.5f.10.

We aimed to characterize nocturia across the stages of HF in a clinical urology population.


Lokeshwar SD. [Choksi AU., Brito J., Renzulli J., Leapman MS.] MP58-01 A RANDOMIZED CONTROLLED TRIAL OF A FERMENTED SOY BEVERAGE AMONG PATIENTS WITH LOCALIZED PROSTATE CANCER PRIOR TO RADICAL PROSTATECTOMY. The Journal of urology. 05/2024;211(5s). doi: 10.1097/01.JU.0001008852.83523.41.01.

We evaluated the clinical effect of a fermented soy beverage among men with localized prostate cancer prior to radical prostatectomy.


Webb LT. [Diaz GM., Rahman SN., Sprenkle PC.] MP31-04 HOW DO 5-ALPHA-REDUCTASE INHIBITORS CHANGE PSA DENSITY IN PATIENTS ON ACTIVE SURVEILLANCE?The Journal of urology. 05/2024;211(5s). doi: 10.1097/01.JU.0001008936.35187.0b.04.

This study was to determine how 5ARIs affect PSA Density [PSAD] in patients who progress to GG2+ disease or treatment compared to those who do not progress.


 Li G. [Sterling J.] MP06-03 EFFICACY OF ENDOSCOPIC URETHRAL STRICTURE TREATMENT USING LIGHTED CATHETER: AN ANIMAL PILOT TRIAL. The Journal of urology. 05/2024;211(5s). doi: 10.1097/01.JU.0001009452.79331.fd.03.

We aimed at investigating light therapy in urethral stricture repair.


Koehne EL, Bakaloudi DR, Ghali F, Nyame Y, Schade GR, Grivas P, Yezefski TA, Hawley JE, Yu EY, Hsieh AC, Montgomery RB, Psutka SP, Gore JL, Wright JL. Adjuvant Chemotherapy and Survival After Radical Cystectomy in Histologic Subtype Bladder Cancer. Clin Genitourin Cancer. 2024 Jun;22(3):102100. doi: 10.1016/j.clgc.2024.102100. Epub 2024 Apr 25. PMID: 38763862.

We sought to characterize the use of adjuvant chemotherapy [AC] in HSBC after radical cystectomy [RC] using the National Cancer Database [NCDB].


Cai Z. [Onofrey JA.] ICASSP 2024 - 2024 IEEE international conference on acoustics, speech and signal processing (ICASSP). Symmetric Consistency with Cross-Domain Mixup for Cross-Modality Cardiac Segmentation. 04/2024:1536-1540. doi: 10.1109/ICASSP48485.2024.10447304.

In this work, we propose Symmetric Consistency with Cross-Domain Mixup [SCCDM], integrated with the teacher-student model for cross-modality cardiac segmentation. Specifically, we introduce symmetric consistency across the domains for two mixed data to diversify the data distribution from both the source domain and target domain. 


Sutherland R, Gross CP, Ma X, Jeong F, Seibert TM, Cooperberg MR, Catalona WJ, Ellis SD, Loeb S, Schulman-Green D, Leapman MS. 'It Just Makes Sense to Me': A qualitative study exploring patient decision-making and experiences with prostate MRI during active surveillance for prostate cancer. BJUI Compass. 2024 Apr 2;5(6):593-601. doi: 10.1002/bco2.351. PMID: 38873351; PMCID: PMC11168777.

This work can inform future studies to optimize patient experience, education and counseling during active surveillance for prostate cancer.


Rahman SN, Long JB, Westvold SJ, Leapman MS, Spees LP, Hurwitz ME, McManus HD, Gross CP, Wheeler SB, Dinan MA. Area Vulnerability and Disparities in Therapy for Patients With Metastatic Renal Cell Carcinoma. JAMA Netw Open. 2024 Apr 1;7(4):e248747. doi: 10.1001/jamanetworkopen.2024.8747. PMID: 38687479; PMCID: PMC11061765.

To assess the association between area-level measures of social vulnerability and racial and ethnic disparities in the treatment of US Medicare beneficiaries with mRCC from 2015 through 2019.


Choksi A. [Hayden C., Sterling S.] Single port bilateral ureteral stricture repair with buccal graft. Videourology. 04/2024;38(1):1-2. doi: 10.1089/vid.2024.0017.

In this video, we demonstrate a case of bilateral RIUS following radiation therapy for cervical cancer, treated with bilateral buccal graft onlay ureteroplasty using the daVinci SP robot, which allowed access to both ureters without having to redock or reposition the patient.

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