Browsing by Author "Gauhar, Vineet"

Now showing 1 - 2 of 2
  • Thumbnail Image
    Item
    Defining minimal invasive surgical therapy for benign prostatic obstruction surgery: Perspectives from a global knowledge, attitude, and practice survey
    (Elsevier, 2024) Kwun-Chung Cheng, Bryan; Kar-Kei Yuen, Steffi; Castellani, Daniele; Langer Wroclawski, Marcelo; Zhao, Hongda; Chiruvella, Mallikarjuna; Chua, Wei-Jin; Tiong, Ho-Yee; Tanidir, Yiloren; de la Rosette, Jean; Rijo, Enrique; Misrai, Vincent; Krambeck, Amy; Elterman, Dean S.; Somani, Bhaskar K.; Yuen-Chun Teoh, Jeremy; Gauhar, Vineet; Urology, School of Medicine
    Objective: To scrutinize the definitions of minimal invasive surgical therapy (MIST) and to investigate urologists' knowledge, attitudes, and practices for benign prostatic obstruction surgeries. Methods: A 36-item survey was developed with a Delphi method. Questions on definitions of MIST and attitudes and practices of benign prostatic obstruction surgeries were included. Urologists were invited globally to complete the online survey. Consensus was achieved when more than or equal to 70% responses were "agree or strongly agree" and less than or equal to 15% responses were "disagree or strongly disagree" (consensus agree), or when more than or equal to 70% responses were "disagree or strongly disagree" and less than or equal to 15% responses were "agree or strongly agree" (consensus disagree). Results: The top three qualities for defining MIST were minimal blood loss (n=466, 80.3%), fast post-operative recovery (n=431, 74.3%), and short hospital stay (n=425, 73.3%). The top three surgeries that were regarded as MIST were Urolift® (n=361, 62.2%), Rezum® (n=351, 60.5%), and endoscopic enucleation of the prostate (EEP) (n=332, 57.2%). Consensus in the knowledge section was achieved for the superiority of Urolift®, Rezum®, and iTIND® over transurethral resection of the prostate with regard to blood loss, recovery, day surgery feasibility, and post-operative continence. Consensus in the attitudes section was achieved for the superiority of Urolift®, Rezum®, and iTIND® over transurethral resection of the prostate with regard to blood loss, recovery, and day surgery feasibility. Consensus on both sections was achieved for EEP as the option with the better symptoms and flow improvement, lower retreatment rate, and better suitable for prostate more than 80 mL. Conclusion: Minimal blood loss, fast post-operative recovery, and short hospital stay were the most important qualities for defining MIST. Urolift®, Rezum®, and EEP were regarded as MIST by most urologists.
  • Thumbnail Image
    Item
    Management of Kidney Stones in Pregnancy: A Worldwide Survey of Practice Patterns
    (Liebert, 2024-10) Juliebø-Jones, Patrick; Semins, Michelle J.; Seitz, Christian; Krambeck, Amy; Keller, Etienne Xavier; Davis, Niall F.; Tselves, Lazaros; Geraghty, Robert; Beisland, Christian; Ulvik, Øyvind; Sørstrand Æsøy, Mathias; Bres-Niewada, Ewa; Hameed, B. M. Zeeshan; Gauhar, Vineet; Contreras, Pablos; Skolarikos, Andreas; Somani, Bhaskar K.; Urology, School of Medicine
    Introduction: Kidney stones in pregnant is not a common emergency, but it is one that is extremely challenging to manage. There exists no previous survey, which maps the different practice patterns adopted. Our aim was to deliver a survey to evaluate the current status of practice patterns across different parts of the world regarding the management of stone disease in pregnancy. Methods: Through an iterative process, 19-item survey was devised. This contained the following five sections: (1) Demographics, (2) General items, (3) Diagnosis and Imaging, (4) Initial management, (5) Surgery. It was disseminated via social media and email chains. Results: A total of 355 responses were collected, and the majority (66.2%) reported no established hospital protocol for stones in pregnancy. Ultrasound was the most popular first line imaging choice (89.9%) but 8% would choose non-contrast CT. The latter was also chosen as second line choicer in 34.6% as opposed to magnetic resonance imaging. A large proportion (42.5%) had requested CT in pregnancy previously. With equivocal ultra sound results, only 19.4% would proceed to ureteroscopy (URS) but 40.9% would opt for CT. Twenty-four–48 hours were the most popular (37.6%) time period to observe before surgical intervention. Ureteral stent and nephrostomy were regarded as equally effective, and 6 weeks was most popular frequency for an exchange. Most do not use fetal heart rate monitoring intraoperatively. A total of 3.94% had previously performed percutaneous nephrolithotomy during pregnancy. Conclusion: Practice patterns vary widely for suspected kidney stones in pregnancy and use of CT appears increasingly popular. This includes when faced with equivocal ultrasound results and instead of proceeding to ureteroscopy. Most hospitals lack an established management protocol for this scenario.