During a 4-year interval from earlier to longer-term phases of PC treatment survivorship, sexual, urinary, and bowel dysfunction remain significant concerns among early-stage PC treatment survivors, compared with control men. Although postprostatectomy HRQOL remains relatively stable during this interval, disease-specific HRQOL continues to evolve among men treated with BT and 3-D CRT.

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Introduction: Ureteral stents are commonly placed after ureteroscopy (URS). Though studies indicate that stents are associated with patient discomfort, their impact on downstream health services use is unclear. We examined patterns of stent utilization in Michigan and their association with unplanned healthcare encounters.Methods: We used the Michigan Urologic Surgery Improvement Collaborative's Reducing Operative Complications from Kidney Stones (MUSIC ROCKS) clinical registry to identify URS cases between 2016 and 2019. Factors associated with stent placement were examined using bivariate and multivariable statistics. Using multivariable logistic regression, we evaluated whether stent placement was associated with emergency department (ED) visits and hospitalizations within 30 days. Results:We identified 9662 URS and a stent was placed in 7025 (73%) of these. Frequency of stent use across the 137 urologists varied (11-100%, p<0.001), and was not associated with total case volume. Factors associated with stent use included age and stone size. Pre-stented cases and renal stones had a decreased odds of stent placement. On multivariable analysis after adjusting for risk factors, stent placement was associated with a 1.25 higher odds of ED visit (OR 1.25; 95%CI 1.01-1.54 p=0.043) but not hospitalization (OR 1.28; 95%CI 0.94-1.76 p=0.12). In a single high-volume practice, 0.5% of cases that omit a stent required urgent stenting postoperatively. Conclusion:There is substantial variation in the use of stents in Michigan, irrespective of case volume. Stent placement significantly increased the odds of an ED visit after surgery. Importantly, stent omission rarely required subsequent urgent stent placement.

Erectile dysfunction is a prevalent disorder that not only affects men with the disorder but also their partners. Significant improvements in the sexual health of these couples have been achieved with the introduction of phosphodiesterase 5 (PDE5) inhibitors. Currently PDE5 inhibitors are used on an on-demand basis. New evidence regarding the effects of PDE5 inhibitors on the underlying pathophysiologic processes that cause erectile dysfunction have sparked interest in the continuous dosing of these medications. We will discuss the biological background and the available clinical evidence for the continuous use of phosphodiesterase inhibitors in erectile dysfunction. Lastly, we will discuss the emerging clinical data for the use of daily PDE5 inhibitors in men with lower urinary tract symptoms.