Search

Background: Reduced clinical exposure to urology at the undergraduate or internship level is the main explanation for the marked decrease in applicants to urology residencies. This manuscript was to access the application rate for urology specialty compared with that of other specialties and to investigate the relationship between the decreasing trend in urology applications and social interest using internet trend tests., Methods: We reviewed data collected by the Korean Hospital Association from 2007 to 2014. We assessed internet trends using Naver Trend for domestic social interest and Google Trends for international social interest (2007 to 2014). Trend tests and Spearman correlations were used for statistical analyses., Results: Among the all specialties, the application rates to obstetrics and gynecology, emergency medicine, and occupational medicine are significantly increasing (p = 0.015, 0.012, and 0.048, respectively). Application to other specialties is mostly decreasing. The decreasing trend is highest for urology (beta = - 12.21 and p < 0.001). The application rate and domestic social interest revealed by Naver trends were significantly correlated (r = 0.786 and p = 0.021). No correlation was found between Naver trends and Google trends (r = - 0.19 and p = 0.651)., Conclusions: The rate of application to urology specialty is decreasing the fastest, and this trend is related to domestic social interest. An attempt should be made to increase the number of urologic applicants.

Introduction and Hypothesis: Randomized controlled trials (RCTs) provide the best quality clinical evidence. The aim of this study was to assess the quality of RCTs published by the International Urogynecology Journal (IUJ) in 2007-2016., Methods: RCTs in original articles were extracted from PubMed and IUJ homepage. Change in RCT quality over time was assessed with Jadad and van Tulder scales and Cochrane Collaboration's risk of bias tool (CCRBT). Jadad scores of 3-5 or van Tulder scores of >5 indicated high-quality RCTs. The effect on RCT quality of including funding source and institutional review board (IRB) approval statements and describing the intervention was assessed. In addition, changes in RCT topics over time were assessed., Results: Annual RCT frequencies did not change significantly (6.7-15.7%): 36.1% and 25.7% described blinding and allocation concealment, respectively. Both tended to increase between 2013 and 2016, particularly 2013 and 2014. Funding statement inclusion (39.1% overall) and intervention description (78.2% overall) tended to increase steadily. IRB statement inclusion (60.4% overall) increased significantly (p < 0.01). Jadad scores and van Tulder rose significantly until 2014 (p < 0.01). Frequencies of high-quality RCTs tended to rise. CCRBT indicated that RCTs with a low risk of bias tended to increase until 2014. However, from 2015, Jadad scores, van Tulder, and CCRBT the low risk tended to decreased. RCTs with funding and IRB approval statements had higher Jadad and van Tulder scores than unfunded RCTs (p < 0.01 and p < 0.01, respectively). Intervention description did not associate with better quality., Conclusions: RCT quality improved over time, but a dip in quality was observed in 2015-2016 because of decreased blinding and allocation concealment.

Aims: To assess the quality of randomized controlled trials (RCTs) published in Neurourology and Urodynamics (NAU) by using three types of analytical tools., Methods: MEDLINE was used to extract RCTs from original articles published in the NAU from 1993 to 2012. The relationship between the number of articles and RCTs with time and that between various factors and the quality of RCTs were analyzed. To analyze the quality of the RCTs, the time period was divided into four sections and three tools were applied (e.g., the Jadad scale, van Tulder scale, and Cochrane Collaboration Risk of Bias Tool [CCRBT])., Results: Among the 1,957 original articles, 93 (4.75%) were RCTs. The ratio between the number of NAU and RCTs over time increased. The Jadad score for years 1993-1997 was 3.25 ± 1.71, 1998-2002 was 2.10 ± 0.74, 2003-2007 was 2.09 ± 1.12, and 2008-2012 was 2.80 ± 1.09 (P = 0.014). The van Tulder scales were 6.25 ± 3.10, 4.40 ± 1.65, 4.97 ± 1.99, and 5.93 ± 1.98, respectively (P = 0.055). The CCRBT identified a low risk of bias in 1 (25%), 0 (0%), 1 (2.86%), and 5 (11.36%) articles, respectively. Trials with allocation concealment, Institutional review board (IRB) approval, and blinded studies had significantly higher quality than others., Conclusions: The quantitative increase of RCT presented in NAU over time was observed but there was no definite qualitative improvement. Effort is required to improve the quality of RCTs published in NAU from the design step., (© 2013 Wiley Periodicals, Inc.)

Objectives: Randomized controlled trials are one of the most reliable resources for assessing the effectiveness and safety of medical treatments. Low quality randomized controlled trials carry a large bias that can ultimately impair the reliability of their conclusions. The present study aimed to evaluate the quality of randomized controlled trials published in International Journal of Urology by using multiple quality assessment tools., Methods: Randomized controlled trials articles published in International Journal of Urology were found using the PubMed MEDLINE database, and qualitative analysis was carried out with three distinct assessment tools: the Jadad scale, the van Tulder scale and the Cochrane Collaboration Risk of Bias Tool. The quality of randomized controlled trials was analyzed by publication year, type of subjects, intervention, presence of funding and whether an institutional review board reviewed the study., Results: A total of 68 randomized controlled trial articles were published among a total of 1399 original articles in International Journal of Urology. Among these randomized controlled trials, 10 (2.70%) were from 1994 to 1999, 23 (4.10%) were from 2000 to 2005 and 35 (4.00%) were from 2006 to 2011 (P = 0.494). On the assessment with the Jadad and van Tulder scale, the numbers and percentage of high quality randomized controlled trials increased over time. The studies that had institutional review board reviews, funding resources or that were carried out in multiple institutions had an increased percentage of high quality articles., Conclusions: The numbers and percentage of high-quality randomized controlled trials published in International Journal of Urology have increased over time. Furthermore, randomized controlled trials with funding resources, institutional review board reviews or carried out in multiple institutions have been found to be of higher quality compared with others not presenting these features., (© 2013 The Japanese Urological Association.)

Purpose: To analyze the quality of studies reporting randomized clinical trials (RCTs) in the field of endourology., Materials and Methods: RCTs published in the Journal of Endourology from 1993 until 2011 were identified. The Jadad scale, van Tulder scale, and Cochrane Collaboration Risk of Bias Tool (CCRBT) were used to assess the quality of the studies. The review period was divided into early (1993-1999), mid (2000-2005), and late (2006-2011) terms. Studies were categorized by country of origin, subject matter, single- vs multicenter setting, Institutional Review Board (IRB) approval and funding support, and blinding vs nonblinding., Results: In total, 3339 articles had been published during the defined review period, of which 165 articles were reporting a RCT. There was a significant increase in the number of RCTs published over time, with 18 (2.81%), 43 (4.88%), and 104 (5.72%) studies identified in the early, mid, and late term, respectively (P=0.009). Nevertheless, there was no difference in terms of quality of reporting, as assessed with the Jadad scale, van Tulder scale, or CCRBT, between the three study terms. On the other hand, significant differences were found in both the number of high qualitative RCTs that used blinding methodology and those that had IRB review, when comparing the early, mid, and late terms., Conclusion: There has been a growing number of Journal of Endourology publications reporting on RTC over the last two decades. The quality of reporting for these studies remains suboptimal, however. Researchers should focus on a more appropriate description of key features of any given RCT, such as randomization and allocation methods, as well as disclosure of IRB review and financial support.

Background: Laparoendoscopic single-site surgery (LESS) has gained popularity in urology over the last few years., Objective: To report a large multi-institutional worldwide series of LESS in urology., Design, Setting, and Participants: Consecutive cases of LESS done between August 2007 and November 2010 at 18 participating institutions were included in this retrospective analysis., Intervention: Each group performed a variety of LESS procedures according to its own protocols, entry criteria, and techniques., Measurements: Demographic data, main perioperative outcome parameters, and information related to the surgical technique were gathered and analyzed. Conversions to reduced-port laparoscopy, conventional laparoscopy, or open surgery were evaluated, as were intraoperative and postoperative complications., Results and Limitations: Overall, 1076 patients were included in the analysis. The most common procedures were extirpative or ablative operations in the upper urinary tract. The da Vinci robot was used to operate on 143 patients (13%). A single-port technique was most commonly used and the umbilicus represented the most common access site. Overall, operative time was 160±93 min and estimated blood loss was 148±234 ml. Skin incision length at closure was 3.5±1.5 cm. Mean hospital stay was 3.6±2.7 d with a visual analog pain score at discharge of 1.5±1.4. An additional port was used in 23% of cases. The overall conversion rate was 20.8%; 15.8% of patients were converted to reduced-port laparoscopy, 4% to conventional laparoscopy/robotic surgery, and 1% to open surgery. The intraoperative complication rate was 3.3%. Postoperative complications, mostly low grade, were encountered in 9.5% of cases., Conclusions: This study provides a global view of the evolution of LESS in the field of minimally invasive urologic surgery. A broad range of procedures have been effectively performed, primarily in the academic setting, within diverse health care systems around the world. Since LESS is performed by experienced laparoscopic surgeons, the risk of complications remains low when stringent patient-selection criteria are applied., (Copyright © 2011 European Association of Urology. Published by Elsevier B.V. All rights reserved.)

Purpose: To evaluate the clinical characteristics of patients with maximal urine flow rate ( Qmax) ≥ 25 ml/s complaining of lower urinary tract symptoms (LUTS), using propensity score-matching analysis to compare with the control group. Methods: Medical records from a prospectively maintained database for first visit male patients with LUTS/benign prostatic hyperplasia between 2010 and 2012 were used to select 818 patients. Of these patients, 68 men with Qmax ≥ 25 ml/s were defined as the supervoider group, and 68 patients were selected for the control group using propensity scores, which were calculated for each patient using multivariable logistic regression model based on the following covariates: age, prostate volume, voided urine volume, and post-voided residual volume. International Prostate Symptom Score (IPSS), quality of life score, and Overactive Bladder Symptom Score (OABSS) were also analyzed. Results: Mean Qmax was 30.82 ± 5.13 in supervoiders and 15.95 ± 4.88 ml/s in controls ( p < 0.001). There were statistical differences in IPSS between supervoiders and controls (12.63 ± 5.81 vs. 16.13 ± 6.90; p = 0.002). Although the IPSS voiding symptom sub-score in supervoiders was lower than controls (5.09 ± 3.35 vs. 7.40 ± 4.00; p < 0.001), there were no significant differences in storage symptom and post-micturitional symptom sub-scores. In OABSS and subdomain scores for frequency, nocturia, and urgency, there were no significant differences between the groups. However, the urge incontinence subdomain score was significantly higher in supervoiders versus controls (0.69 ± 1.26 vs. 0.18 ± 0.52; p = 0.003). Conclusions: Supervoiders experience comparable levels of storage and post-micturition symptoms, but display more severe urge incontinence despite milder voiding symptoms and better uroflowmetric measurements than propensity score-matched controls. [ABSTRACT FROM AUTHOR]

Objective: To compare patient-reported outcomes (PROs) with objective outcomes after shock wave lithotripsy (SWL) and ureteroscopic surgery (URS) for ureteral calculi (UC). Methods: We prospectively evaluated 160 consecutive patients who underwent SWL ( n = 65) or URS ( n = 95) for a single radiopaque UC ranging from 4 to 15 mm. For patients who underwent URS, a 6-Fr double-J stent was routinely placed for 2 weeks after surgery. To examine PRO, we used a self-administered nonvalidated questionnaire evaluating overall satisfaction and PRO in four domains (pain, hematuria, voiding symptom, and time to return to routine activity) and willingness to undergo the treatment procedure again. Propensity-score matching analysis was performed to adjust for potential confounding by discrepancy of pretreatment parameters between groups. Stone-free rates (SFRs) and complications were also compared. Results: SFRs after the first, second, and third sessions of SWL were 61.5, 81.0, and 93.5 %, respectively. SFR after URS was 100 %, which was significantly better than SFRs for third-session SWL ( p = 0.023). Complications were comparable. By propensity-score matching analysis, overall satisfaction was similar between groups, whereas PRO for voiding symptom and time to return to routine activity were significantly better in the SWL group (all p < 0.05). The two groups were not different in willingness to undergo the same procedure again. Conclusions: Despite significantly higher SFR after URS for UC, overall patient satisfaction was comparable after SWL and URS, meanwhile PRO of the SWL group was better than URS for voiding symptom and time to return to routine activity. In addition of objective treatment outcomes, PROs should be considered in counseling treatment methods for UC. [ABSTRACT FROM AUTHOR]