Well-differentiated papillary mesothelioma (WDPM) is a rare mesothelial tumour occurring in the tunica vaginalis of the testicle. The pathological classification of paratesticular mesothelial tumours is controversial and continues to evolve in the literature. Diagnostic criteria of one subtype, WDPM, are histological and include the following: 1) papillary or tubular-papillary architecture; 2) bland nuclear cytology; 3) low mitotic activity; 4) lined by a single row of cuboidal cells; and 5) absence of stromal invasion.1,2 This report presents issues of diagnosis of this rare pathology with imaging from an example case.

Introduction: The number of female medical students and physicians entering the workforce is increasing. Despite this trend, some surgical specialties are still considered male-dominant. Urology has a significant male predominance in both residency and independent practice. This male predominance could have an impact on the physician work force, mentorship opportunities for females pursuing surgery, and on medical student attraction to urology as a specialty. Research conducted in the U.S. has shown that although fewer females enter the field of urology, acceptance rates between the two genders are similar. This study aims to identify if a trend towards gender-specific acceptance into urology residency exists within Canada. We also seek to identify if gender trends in acceptance to urology differ from other surgical specialties in Canada and assess the current workforce trends in Canadian urological practice. Methods: Canadian Residency Matching Services (CARMS) data from the previous 10 years was analyzed. This data was accessed from the CARMS website.1 Logistic regression analyses were used to assess if any significant difference exists between the rates of female and male applicant acceptance into urology. These rates were then compared to the rates of female and male acceptance into surgical residency as a whole and to specific surgical specialties, such as general surgery, orthopedics, and otolaryngology. Results: Within urology applicants, there is no evidence that the success rate over time between males and females differs (p=0.47). Within surgical residency applicants, there is no evidence that the success rate over time differs between male and female applicants (p=0.84). In comparing these two rates, there is also no significant difference between rates of acceptance to urology vs. surgery in general for female applicants (p=0.45). General surgery has a higher growth of females entering into the specialty compared to urology (p=0.026). Conversely, otolaryngology (p=0.123) and orthopedics (p=0.163) did not show a significant difference in the rates of female acceptance as compared to males over time. Our small sample size of 451 applicants over the 10-year time span (122 female, 329 male) could represent a limitation, however, we did ensure to analyze a 10-year sample to attempt to get an accurate representation of any trends. Conclusions: Our data identifies that there is no significant trend toward male acceptance into urology over female applicants. There is no significant difference related to female acceptance specifically into urology or any difference between rates of females accepted into urology as compared to all other surgical subspecialties combined.

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Introduction: This quality improvement study examined if a video-based resource could reduce delayed discharges after robotic prostatectomy while maintaining high levels of patient satisfaction. Methods: From April 2018 to February 2020, all patients undergoing robotic-assisted radical prostatectomy (RARP) were asked to complete an anonymous survey evaluating their perioperative experience. The quality improvement (QI) intervention started in March 2019 with a series of six educational videos being shown to all patients. The videos were used to supplement postoperative instruction. The discharge times of all patients were obtained from The Ottawa Hospital Data Repositories. A run chart analysis was used to detect change in discharge time (outcome measure). Patient satisfaction (balancing measure) was analyzed using Chi-squared analysis and descriptive statistics. Results: A total of 425 robotic prostatectomies (199 pre-intervention, 226 post-intervention) were available. Analysis of the run chart revealed non-random change favoring earlier discharge in the intervention group (p<0.05), with a pre-intervention late discharge rate of 64% and a post-intervention late discharge rate of 55%. A total of 140 surveys (59 pre-intervention, 81 post-intervention) assessing patient satisfaction were completed, corresponding with a response rate of 29.6% and 35.8%, respectively. Median score on a 10-point scale for overall satisfaction was equal between the intervention and non-intervention groups (9 [interquartile range (IQR 8–10) vs. 10 [IQR 8-10], p=0.92). Conclusions: Patient satisfaction with care and education was high for all patients and was not negatively impacted by this intervention. Video education tools may be one method to help improve the discharge process following RARP.