Background Reverse shoulder arthroplasty (RSA) is commonly used in the treatment of rotator cuff arthropathy. Indications for RSA have expanded to include complex proximal humerus fractures. Studies directly comparing outcomes between traumatic and traditional elective indications are limited. The purpose of this study was to compare early active range of motion (aROM) within the first two years postoperatively between traumatic and non-traumatic primary RSA, as well as compare ASES scores, and patient satisfaction at final follow-up. Methods A retrospective analysis was conducted of all RSA performed by a single surgeon between January 2000 and December 2018. Patients were grouped by indication into traumatic and non-traumatic elective groups. Demographics, surgical data, and routine aROM data were collected. aROM was compared at 3, 6, 12, and 24 months. American Shoulder and Elbow Surgeons (ASES) score and patient satisfaction were determined at the time of this investigation. Results 367 RSA procedures were performed by the senior author during the study period, 88 for fracture (24%), and 279 for non-traumatic elective indications (76%). Forward elevation and external rotation were inferior in the fracture group at all time points in the first two years. Internal rotation was equivalent throughout the first two years. Final ASES scores were 77.6 versus 83.5 in the fracture and non-fracture groups, respectively ( p = .33). Conclusion Patients undergoing RSA for fracture had statistically significant inferior aROM in forward elevation and external rotation throughout the first two years. Despite having inferior aROM, ASES scores and patient satisfaction at final follow-up were statistically equivalent. Level of Evidence Level III; Retrospective Cohort Comparision; Prognosis Study
goals and progression towards them. Overall program ranking was 6/7 on likert scale, "very satisfied". Students identified program selection and ERAS application assistance as their main goals, with mentors described as "inspirational", "accessible", and "supportive".CONCLUSIONS: #UroStream101 was a successful pilot program providing mentorship for students. This was desperately needed during an atypical application cycle and provided knowledge that will be invaluable in further developing the program going forward.
Intradetrusor onabotuli-numtoxinA (BTX-A) is a common third-line therapy for treatment of refractory overactive bladder (OAB), however several gaps exist in pre-and post-procedural standard of care. Prior studies have demonstrated BTX-A efficacy at 2-3 weeks, but there are limited data documenting when patients should begin to note symptom improvement. We performed a prospective study evaluating several factors involved in the BTX-A patient care pathway. The primary aim of this abstract was to determine patient-reported temporal improvement in symptoms following initial BTX-A therapy.METHODS: A prospective, non-randomized study of patients with non-neurogenic, refractory urgency-frequency syndrome and urgency urinary incontinence undergoing first-time BTX-A injection under local anesthesia was performed. Intradetrusor injection of 100 units BTX-A was performed by one of 3 FPMRS-trained providers using a standard 20-site template. Patients were required to discontinue their OAB medication(s) at the time of BTX-A injection for 3 weeks and complete a daily Patient Global Impression of Improvement (PGI-I) diary during this time. Data were collected at 1 month, including final satisfaction score and adverse outcomes. Descriptive analysis was performed in R programming.RESULTS: 25 patients were included (24 female, 1 male). Median age was 75 years and BMI was 34.3. Figure 1 shows a jitter plot with loess smoothed fit of patient-reported PGI-I over time following BTX-A injection. 24 patients (96%) reported symptom improvement (PGI <4) by 3 weeks, with 19 patients (76%) documenting at least "much better" (PGI >2). Median time to first improvement (PGI <4) was 1 day, at least "much better" was 4 days, and median time to maximum patient improvement was 6 days. Median final satisfaction score was PGI 2 ("much better"). Adverse outcomes included UTI in 2 patients (8%) and incomplete emptying requiring transient intermittent catheterization in 1 patient (4%).CONCLUSIONS: Patients with refractory OAB undergoing firsttime 100 units BTX-A injection reported median time to first improvement (PGI <4) at 1 day, at least "much better" at 4 days, and median time to maximum patient improvement at 6 days. These data may help further counsel patient expectations following initial BTX-A therapy.
METHODS: A list of academic urologists was generated using AUA-accredited residency program websites as of July 2021. Gender, subspecialty, AUA section, and academic rank were recorded. Scopus was queried to identify h-indices. Descriptive statistics were performed for the entire group and within subspecialties (oncology, endourology, pediatrics, FPMRS, andrology, reconstruction, general urology). Univariable and multivariable linear regression models were created to characterize the relationship between h-index and gender.RESULTS: A total of 1694 academic urologists from 137 AUAaccredited institutions were included, of whom 308 were women (18.2%). Oncology was the most common subspecialty; however, it contained the smallest proportion of women (5.6%, 28/513). Subspecialties with the highest proportion of women included FPMRS (49%, 87/716) and pediatric urology (30%, 87/291). Overall, mean h-index for women was lower than for men (adjusted mean difference -10.1, 95% CI -12.2 to -8.0, p<0.001) Men had significantly higher h-indices across all academic ranks except instructor, all subspecialties except reconstruction and general urology, and across all AUA sections except Northeast section (Table 1). After adjusting for MD/PhD status, subspecialty, year since first publication, and AUA section, h-index was significantly lower for women by an average of 2.2 points (p[0.03).CONCLUSIONS: Male urologists have significantly higher hindices than women even after adjusting for academic rank, subspecialty, and geographic region. The use of gender-and subspecialtyspecific h-index metrics to guide academic advancement decisions may be a useful strategy to promote gender equity in academic urology.
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