Yale Urology Research [Q3: July-September 2024]

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

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Dong S, Cai Z, Hangel G, Bogner W, Widhalm G, Huang Y, Liang Q, You C, Kumaragamage C, Fulbright RK, Mahajan A, Karbasi A, Onofrey JA, de Graaf RA, Duncan JS. A Flow-based Truncated Denoising Diffusion Model for super-resolution Magnetic Resonance Spectroscopic Imaging. Med Image Anal. 2024 Sep 27;99:103358. doi: 10.1016/j.media.2024.103358. Epub ahead of print. PMID: 39353335.

In this work, we introduce a novel Flow-based Truncated Denoising Diffusion Model (FTDDM) for super-resolution MRSI.

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Popiel P, Maggi M, Dalal S, Curran M, Rickey LM. Preventing the Next Neglected Pessary: A Quality Improvement Initiative. Urogynecology (Phila). Published online September 26, 2024. doi:10.1097/SPV.0000000000001578

Through the electronic medical record, we implemented a quality improvement initiative focused on creating a workflow where a pessary can be designated as an implant when inserted. A year after implementation, data was gathered.

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Sundaresan V, Lokeshwar S, Sutherland R, Sohoni N, Golos A, Ajjawi I, Leapman M. Sociodemographic disparities in prostate cancer imaging. Abdom Radiol (NY). Published online September 26, 2024. doi:10.1007/s00261-024-04603-2

This review examines the existing evidence regarding clinical and sociodemographic factors associated with disparities in imaging utilization and treatment for PCa. Major areas of disparities identified include healthcare and research access. Sociodemographic disparities are present in screening and diagnosis; Black patients are consistently less likely to receive both prostate multiparametric MRI and timely molecular imaging used to evaluate for biochemical recurrence.

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Zheng S, Brutus N, Rivera A, O'Marr JM, Gardezi M, Grimshaw AA, Malcolm K, Marcellon R, Mason HR, Cavallo JA. First-Generation Low-Income Individuals in Medicine: A Scoping Review. Acad Med. 2024 Sep 16. doi: 10.1097/ACM.0000000000005877. Epub ahead of print. PMID: 39292871.

This comprehensive scoping review of the medical literature on first-generation low-income (FGLI) individuals in medicine aimed to synthesize the highest levels of evidence to inform medical education stakeholders.

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Rickey LM, Mueller ER, Newman DK, Markland AD, Falke C, Rudser K, Smith AL, Mueller MG, Lowder JL, Lukacz ES; Prevention of Lower Urinary Tract Symptoms (PLUS) Research Consortium. Reliability of Uroflowmetry Pattern Interpretation in Adult Women. Neurourol Urodyn. 2024 Nov;43(8):2084-2092. doi: 10.1002/nau.25584. Epub 2024 Sep 12. PMID: 39264028.

Uroflowmetry is often used to assess lower urinary tract symptoms (LUTS). Criteria for characterization of flow patterns are not well established, and subjective interpretation is the most common approach for flow curve classification. We assessed the reliability of uroflowmetry curve interpretation in adult women.

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Zhu J, Wang Y, Chang WY, Malewska A, Napolitano F, Gahan JC, Unni N, Zhao M, Yuan R, Wu F, Yue L, Guo L, Zhao Z, Chen DZ, Hannan R, Zhang S, Xiao G, Mu P, Hanker AB, Strand D, Arteaga CL, Desai N, Wang X, Xie Y, Wang T. Mapping Cellular Interactions from Spatially Resolved Transcriptomics Data. bioRxiv [Preprint]. 2024 Jan 25:2023.09.18.558298. doi: 10.1101/2023.09.18.558298. Update in: Nat Methods. 2024 Oct;21(10):1830-1842. doi: 10.1038/s41592-024-02408-1. PMID: 37781617; PMCID: PMC10541142.

We highlight spacia's power to overcome fundamental limitations of popular analytical tools for inference of CCCs, including losing single-cell resolution, limited to ligand-receptor relationships and prior interaction databases, high false positive rates, and most importantly the lack of consideration of the multiple-sender-to-one-receiver paradigm.

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Rahman S, Kong V, Jalfon M, Hesse D, Kim J, Wright JL, Adeniran A, Humphrey P, Martin DT, Ghali F. Evaluating Treatment Patterns and the Role of Neoadjuvant Chemotherapy in Plasmacytoid Urothelial Carcinoma: Insights from a Combined National and Institutional Series. Cancers (Basel). 2024 Sep 1;16(17):3050. doi: 10.3390/cancers16173050. PMID: 39272908; PMCID: PMC11394101.

Plasmacytoid urothelial carcinoma (PUC) is a rare histologic subtype of urothelial carcinoma of the bladder (BC). Our objective was to characterize treatment patterns and outcomes of PUC in the NCDB and our recent institutional experience.

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Choksi AU, Lokeshwar SD, Gardezi M, Hayden CS, Khan AI, Tran T, Singh D, Motamedinia P, Martin TV. Assessing the safety of ureteral stent placement for obstructive urolithiasis in patients during the COVID-19 pandemic. Transl Androl Urol. 2024 Sep 30;13(9):1814-1822. doi: 10.21037/tau-24-57. Epub 2024 Sep 26. PMID: 39434763; PMCID: PMC11491224.

Patients with an active severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) [coronavirus disease 2019 (COVID-19)] infection are at a higher risk of post-operative mortality. In this retrospective case-control study, we analyzed the post-operative safety of patients undergoing cystoscopy with ureteral stent placement for obstructing ureteral calculi who tested positive for COVID-19.

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Rabil MJ, Leapman MS, Cavallo JA. Reply to Editorial Comment on "Association of Crowd-Sourced Assessment of Technical Skills and Outcomes of Robotic-assisted Radical Prostatectomy". Urology. 2024 Aug 28:S0090-4295(24)00743-X. doi: 10.1016/j.urology.2024.08.054. Epub ahead of print. PMID: 39208938.

This is the first study demonstrating a statistically significant improvement in RALP outcomes after implementation of a surgical skill assessment and local surgical video peer review paradigm for practicing surgeons.

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Taylor JI, Kamat AM, O'Donnell MA, Annapureddy D, Howard J, Tan WS, McElree I, Davaro F, Yim K, Harrington S, Dyer E, Black AJ, Kanabur P, Roumiguié M, Lerner S, Black PC, Raman JD, Preston MA, Steinberg G, Huang W, Li R, Packiam VT, Woldu SL, Lotan Y. Long-term outcomes of bladder-sparing therapy vs radical cystectomy in BCG-unresponsive non-muscle-invasive bladder cancer. BJU Int. 2024 Aug 25. doi: 10.1111/bju.16509. Epub ahead of print. PMID: 39183466.

To quantify the oncological risks of bladder-sparing therapy (BST) in patients with Bacillus Calmette-Guérin (BCG)-unresponsive non-muscle-invasive bladder cancer (NMIBC) compared to upfront radical cystectomy (RC).

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Li R, Hensley PJ, Gupta S, Al-Ahmadie H, Babjuk M, Black PC, Brausi M, Bree KK, Fernández MI, Guo CC, Horowitz A, Lamm DL, Lerner SP, Lotan Y, Mariappan P, McConkey D, Mertens LS, Mir C, Ross JS, O'Donnell M, Palou J, Pohar K, Steinberg G, Soloway M, Spiess PE, Svatek RS, Tan WS, Taoka R, Buckley R, Kamat AM. Bladder-sparing Therapy for Bacillus Calmette-Guérin-unresponsive Non-muscle-invasive Bladder Cancer: International Bladder Cancer Group Recommendations for Optimal Sequencing and Patient Selection. Eur Urol. 2024 Aug 24:S0302-2838(24)02516-8. doi: 10.1016/j.eururo.2024.08.001. Epub ahead of print. PMID: 39183090.

There has been a recent surge in the development of agents for bacillus Calmette-Guérin-unresponsive (BCG-U) non-muscle-invasive bladder cancer (NMIBC). Critical assessment of these agents and practical recommendations for optimal selection of patients and therapies are urgently needed, especially in the absence of randomized trials on bladder-sparing treatment (BST) options.

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Bakaloudi DR, Koehne EL, Diamantopoulos LN, Holt SK, Sekar RR, Ghali F, Vakar-Lopez F, Nyame YA, Psutka SP, Gore JL, de la Calle CM, Lin DW, Schade GR, Liao JJ, Hsieh AC, Yezefski T, Hawley JE, Yu EY, Montgomery RB, Grivas P, Wright JL. Small Cell Bladder Cancer: Treatment Patterns for Local Disease and Associated Outcomes. A Retrospective Cohort Study. Clin Genitourin Cancer. 2024 Aug 22;22(6):102208. doi: 10.1016/j.clgc.2024.102208. Epub ahead of print. PMID: 39265260.

Small cell bladder cancer (SCBC) is a rare histologic subtype with relative paucity of data regarding treatment response and outcomes. We reviewed 2 databases to compare outcomes in patients with localized SCBC treated with cystectomy versus concurrent chemoradiotherapy (CCRT). We hypothesized that survival would be similar with these therapy approaches.

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Forman R, Long JB, Westvold SJ, Agnish K, Mcmanus HD, Leapman MS, Hurwitz ME, Spees LP, Wheeler SB, Gross CP, Dinan MA. Cost trends of metastatic renal cell carcinoma therapy: the impact of oral anticancer agents and immunotherapy. JNCI Cancer Spectr. 2024 Sep 2;8(5):pkae067. doi: 10.1093/jncics/pkae067. PMID: 39133171; PMCID: PMC11376369.

Immunotherapy (IO) and oral anticancer agents (OAA) have improved outcomes for metastatic renal cell carcinoma (mRCC), but there is a need to understand real-world costs from the perspective of payers and patients.

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Matthew-Onabanjo AN, Honig S. Testicular prostheses: a historical and current review of the literature. Sex Med Rev. 2024 Sep 25;12(4):761-769. doi: 10.1093/sxmrev/qeae055. PMID: 39122239.

We review the literature on testicular prosthesis placement with respect to the history, psychological impact, surgical technique, complications, satisfaction, and novel emerging medical implications.

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Mavrantoni I, Borneman R, Hittelman AB, Vash-Margita A. Impact of luteoma during pregnancy on fetal development and its long-term effects into adulthood. BMJ Case Rep. 2024 Aug 7;17(8):e259373. doi: 10.1136/bcr-2023-259373. PMID: 39117365.

Case presentation: Our patient, who is a woman in her 30s, presented at a major tertiary medical centre in the USA at a Multi-Disciplinary Programme for Differences in Sexual Development. Our patient reports that she identifies as female, is heterosexual and attracted to males. Menstrual history revealed menarche at age 13 and regular monthly periods thereafter.

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Leapman MS, Ho J, Liu Y, Filson C, Zhao X, Hakansson A, Proudfoot JA, Davicioni E, Martin DT, An Y, Seibert TM, Lin DW, Spratt DE, Cooperberg MR, Sprenkle PC, Ross AE. Association Between the Decipher Genomic Classifier and Prostate Cancer Outcome in the Real-world Setting. Eur Urol Oncol. 2024 Aug 3:S2588-9311(24)00183-4. doi: 10.1016/j.euo.2024.07.010. Epub ahead of print. PMID: 39098389.

Our objective was to assess the associations between the Decipher GC and risks of metastasis and biochemical recurrence (BCR) following prostate biopsy and radical prostatectomy (RP) among patients tested and treated in the real-world setting.

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Jung DE, Seo MK, Jo JH, Kim K, Kim C, Kang H, Park SB, Lee HS, Kim S, Song SY. PUM1-TRAF3 fusion protein activates non-canonical NF-κB signaling via rescued NIK in biliary tract cancer. NPJ Precis Oncol. 2024 Aug 1;8(1):170. doi: 10.1038/s41698-024-00654-2. PMID: 39090283; PMCID: PMC11294552.

Here, we identified and investigated the clinical impact of a fusion gene, Pumilio1-tumor necrosis factor receptor-associated factor 3 (PUM1-TRAF3), caused by 1;14 chromosomal translocation in BTC.

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Smani S, Sundaresan V, Lokeshwar SD, Choksi AU, Carbonella J, Brito J, Renzulli J, Sprenkle P, Leapman MS. Risk factors for Gleason score upgrade from prostate biopsy to radical prostatectomy. Explor Target Antitumor Ther. 2024;5(4):981-996. doi: 10.37349/etat.2024.00259. Epub 2024 Jul 30. PMID: 39280242; PMCID: PMC11390291.

This review examines the published literature concerning risk factors for GSU from time of biopsy to prostatectomy final pathology.

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Montgomery TA, Nair HR, Phadke M, Morhardt E, Ludvigson A, Motamedinia P, Singh D, Dahl NK. Protein Intake and High Uric Acid Stone Risk. Kidney Med. 2024 Jul 25;6(9):100878. doi: 10.1016/j.xkme.2024.100878. PMID: 39279882; PMCID: PMC11399574.

We evaluated the metabolic differences between pure and impure uric acid stone formers in this retrospective study of uric acid kidney stone formers diagnosed between 1996 and 2021.

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Sundaresan VM, Wang R, Long JB, Sprenkle PC, Seibert TM, Loeb S, Cooperberg MR, Catalona WJ, Ma X, Gross CP, Leapman MS. Associations Between Prostate Magnetic Resonance Imaging, Genomic Testing, and Treatment for Localized Prostate Cancer. Urol Pract. 2024 Nov;11(6):965-973. doi: 10.1097/UPJ.0000000000000679. Epub 2024 Jul 16. PMID: 39196719.

Although prostate MRI and tissue-based gene expression (genomic) tests improve staging and estimates of prostate cancer prognosis, their association with the intensity of treatment patients receive is not well understood.

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Sundaresan VM, Smani S, Rajwa P, Renzulli J, Sprenkle PC, Kim IY, Leapman MS. Prostate-specific antigen screening for prostate cancer: Diagnostic performance, clinical thresholds, and strategies for refinement. Urol Oncol. 2024 Jul 16:S1078-1439(24)00505-2. doi: 10.1016/j.urolonc.2024.06.003. Epub ahead of print. PMID: 39019723.

In this review, we focus on the clinical role of PSA as a screening biomarker with a particular emphasis on its test characteristics, clinically actionable thresholds, and strategies to refine its clinical interpretation.

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Rabil MJ, Jalfon M, Heckscher D, Song Z, Li F, Martin T, Sprenkle PC, Hesse D, Kim IY, Leapman MS, Cavallo JA. Association of Crowd-Sourced Assessment of Technical Skills and Outcomes of Robotic-assisted Radical Prostatectomy. Urology. 2024 Jul 15:S0090-4295(24)00568-5. doi: 10.1016/j.urology.2024.07.014. Epub ahead of print. PMID: 39019332.

To investigate if use of the Crowd-Sourced Assessment of Technical Skills (CSATS) platform and video peer review with constructive feedback is associated with improvement in technical skill and patient outcomes for robotic-assisted laparoscopic prostatectomy (RALP).

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Lokeshwar SD, Choksi AU, Smani S, Ip KL, Javier-DesLoges JF, Rahman SN, Leapman MS, Martin TV, Hesse DG. Classification and Risk Factors for Surgical Site Infections in Radical Cystectomy: A 16-Year Analysis. Surg Infect (Larchmt). 2024 Oct;25(8):580-585. doi: 10.1089/sur.2024.107. Epub 2024 Jul 3. PMID: 38959160.

The purpose of this study was to identify the risk factors of SSI after RC and to classify and characterize treatment of SSIs.

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Press B [Jalfon M, Hittelman AB] Clinical and environmental considerations for neonatal, office-based circumcisions compared with operative circumcisions. Frontiers in Urology. 07/2024;4. doi: 10.3389/fruro.2024.1380154.

The intention of this paper is not to promote or justify circumcision for all patients, but rather to compare the clinical and environmental impact of neonatal versus operative circumcisions.

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Wen P, Lei H, Deng H, Deng S, Rodriguez Tirado C, Wang M, Mu P, Zheng Y, Pan D. Hyd/UBR5 defines a tumor suppressor pathway that links Polycomb repressive complex to regulated protein degradation in tissue growth control and tumorigenesis. Genes Dev. 2024 Aug 20;38(13-14):675-691. doi: 10.1101/gad.351856.124. PMID: 39137945; PMCID: PMC11368183.

Here we show that hyperplastic disc (Hyd), one of the first tumor suppressors isolated genetically in Drosophila and encoding an E3 ubiquitin ligase with hitherto unknown substrates, and Lines (Lin), best known for its role in embryonic segmentation, define an obligatory tumor suppressor protein complex (Hyd-Lin) that targets the zinc finger-containing oncoprotein Bowl for ubiquitin-mediated degradation, with Lin functioning as a substrate adaptor to recruit Bowl to Hyd for ubiquitination.