Urologic Surgery

Benjamin N. Breyer, MD, is a urologic surgeon who is internationally known for performing complex urethral and penile reconstruction for urethra stricture and cosmetic disfigurement, male incontinence, male fistula, and surgery for erectile dysfunction.

University Hospitals Urology Institute is excited to announce that this coming fall, the department is hosting 2 educational courses in cutting-edge urologic specialties: female sexual health and gender care.

"The thing that's unique about this course, in my opinion, is that we are combining the vaginoplasty and phalloplasty discussions," says Kirtishri Mishra, MD.

"Extra support from trusted peers can help make navigating complex health care systems easier for transgender patients, who often have to wait years before receiving gender-affirming genital surgery—while also managing the stress and trauma associated with being part of a society that often doesn’t accept non-conforming gender expression,” says Geolani Dy, MD, FACS

“This study truly changes the paradigm of infections and suggests we need to work smarter, not harder, to prevent infections,” said urologist Scott Lundy, MD, PhD.

"I think there's a lot of interest now on intraoperative navigation," says Jihad Kaouk, MD.

"A couple [of] times recently, I’ve done 6 in 1 day. A couple weeks ago, I did 4, the week before that, 5. So I would say I’ve seen an uptick," says urologist Bradford Black, MD.

Study finds a 35% increase in vasectomy consultation requests.

“People and patients are so much more informed now, and they're so engaged in their health. It's fantastic,” says Raevti Bole, MD.

“That's not something we're going to know potentially for many years, but I do think all of us are wondering, are we going to see much more interest in vasectomy reversals down the line?” says Sarah Vij, MD.

“We found a significant increase in men under 30 getting vasectomies,” says Raevti Bole, MD.

“There's a lot of talk about Roe v. Wade affecting the reproductive health of women. This implies that it's also affecting reproductive health decisions for men,” says Sarah Vij, MD.

“I would ask the practicing urologist to keep an open mind and not be dogmatic about how they've practiced in the past, and to consider the multiple lines of both indirect and direct evidence that exist,” says Surena F. Matin, MD.

“There are a couple of nomograms that are good for predicting either T2 or higher disease at time of surgery, so on final pathology, or T3 or higher,” says Suzanne Lange, MD.

“We highlighted that there is building evidence suggesting clinical benefits for lymph node dissection, such as a clear benefit of staging, which allows us to perform better prognostication for patients,” says Suzanne Lange, MD.

"Major bladder reconstructive surgeries have the most room for improvement, particularly surgeries involving a bowel anastomosis; also our major oncologic surgeries—Wilm's tumor resections, those types of surgeries," says Sarah Hecht, MD.

“These are add-on codes that need to be added on to the evaluation and management service that's done on that patient on that day,” says Jonathan Rubenstein, MD.

Dr. Butler discusses 2022 milestones from her practice in gender-affirming care and looks ahead to what might be on the horizon for the field in the coming year.

There are several elements of ERAS with strong evidence of benefit in urogynecological surgery.

“We wanted to compare outcomes between nursing home residents and community-dwelling older adults undergoing surgery for bladder and bowel dysfunction,” explains Anne M. Suskind, MD.

The researchers stress the need for improved patient education prior to surgery.

Kidney transplant surgeon Alvin Wee, MD, MBA, presented findings at the 2022 AUA Annual Meeting

Urology entrepreneurs Neal Patel, MD, and Philip Zhao, MD, proudly tout their handheld, wireless endoscopic camera as a device “designed by urologists for urologists."

"The global shortage of ICM has necessitated rapid adaptation of workflows and clinical pathways, which are particularly important for practicing urologists who are evaluating patients for hematuria," write Yair Lotan, MD, and colleagues.

A 54-year-old transgender woman presented at Cleveland Clinic with vaginal stenosis. She was seeking surgical revision after complications from gender affirmation surgeries performed at other care centers failed to establish a functional neovagina.

“We know that, in general, cystectomy in women can disrupt pelvic floor support and innervation, as well as hormonal and sexual function, but there are no good prospective data to help us fully understand pelvic floor complications following the procedure,” said Jacqueline Zillioux, MD.

Patients achieving RC-pentafecta had less blood loss, shorter hospital stays, and lower perioperative mortality.

"Open ureteral reimplantation for ureteral obstruction in ileal-conduit has excellent early outcomes, though a 1/3 experienced high grade complications during follow up," wrote the study's authors, led by Zhina Sadeghi, MD, of the University of Michigan in Ann Arbor.

“I think that the most important thing to take home is that we all have implicit biases towards people who are underrepresented, whether it's women or minorities,” says Rena D. Malik, MD.

“In children and youth, there really [hasn’t] been an examination of the impact of gender-affirming care on mental health care use patterns," said Elizabeth Hisle-Gorman, MSW, PhD.