Mp02-08 are Urologists Used Differently in Private Versus Academic Hospitals? A Comparison of Urologic Consultations in the Transition From a Nonteaching to Teaching Hospital

Pomajzl, AJ; Delto, Joan C.; Siref, Larry E.; Tesdahl, Brennan

doi:10.1097/ju.0000000000000816.08

Cited by 3 publications

(5 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Continuous bladder volume monitoring is helpful to diagnose incontinence or urine retention and to reduce the need for indwelling urinary catheter 9 . For instance, post-operative urinary retention (POUR) is defined as the inability to urinate after a surgical procedure despite having a full bladder and affects up to 70% of surgery patients 10 . It may be accompanied by discomfort, bladder spasms, and urine leakage; it may further progress to renal obstruction, acute and chronic kidney injury, and ultimately renal failure.…”

Section: Introduction Wearable Ultrasound Devices For Continuous Moni...mentioning

confidence: 99%

“…POUR can be easily managed and reversed via intermittent or indwelling urinary catheterization once diagnosed. However, in about 60% of patients, symptoms can be masked and go unnoticed due to anesthesia, analgesia, or insensitivity related to chronicity of obstruction, leading to poor post-operative outcomes, urinary tract infections, prolonged bladder overdistension, and increased length of hospital stay 10 . With continuous bladder monitoring, POUR can be diagnosed in its early stage and prevent future complications.…”

Section: Introduction Wearable Ultrasound Devices For Continuous Moni...mentioning

confidence: 99%

See 1 more Smart Citation

Memory-efficient low-compute segmentation algorithms for edge ultrasound devices: continuous bladder monitoring

Song

Asiedu

Wang

et al. 2023

Preprint

View full text Add to dashboard Cite

Post-operative urinary retention is a medical condition where patients cannot urinate despite having a full bladder. Ultrasound imaging of the bladder is intermittently used to estimate urine volume for early diagnosis and management of urine retention. Moreover, the use of bladder ultrasound can reduce the need for an indwelling urinary catheter and the risk of catheter-associated urinary tract infection. Wearable ultrasound devices combined with machine-learning based bladder volume estimation algorithms reduce the burdens of nurses in hospital settings and improve outpatient care. However, existing algorithms are memory and computation intensive, thereby demanding the use of expensive GPUs. In this paper, we develop and validate a low-compute memory-efficient deep learning model for accurate bladder region segmentation and urine volume calculation. B-mode ultrasound bladder images of 360 patients were divided into training and validation sets; another 74 patients were used as the test dataset. Our 1-bit quantized models with 4-bits and 6-bits skip connections achieved an accuracy within 3.8% and 2.6%, respectively, of a full precision state-of-the-art neural network (NN) without any floating-point operations and with an 11.5× and 9.0× reduction in memory requirements to fit under 150 kB. The means and standard deviations of the volume estimation errors, relative to estimates from ground-truth clinician annotations, were 5.0±33 ml and 6.8±29 ml, respectively. This lightweight NN can be easily integrated on the wearable ultrasound device for automated and continuous monitoring of urine volume. Our approach can potentially be extended to other clinical applications such as monitoring blood pressure and fetal heart rate.

show abstract

Section: Introduction Wearable Ultrasound Devices For Continuous Moni...mentioning

confidence: 99%

Section: Introduction Wearable Ultrasound Devices For Continuous Moni...mentioning

confidence: 99%

Memory-efficient low-compute segmentation algorithms for edge ultrasound devices: continuous bladder monitoring

Song

Asiedu

Wang

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…A recent study found that lower body mass index (BMI), longer operative time, and perioperative use of nonsteroidal anti-inflammatory drugs (NSAIDs) and glycopyrrolate may be risk factors for POUR following total knee arthroplasty (TKA) 8 . Other authors have identified that TJA itself was a risk factor for POUR, with rates 20-times greater than in the general surgery population 2-4 . In a recent retrospective cohort study at our institution, we found that the incidence of POUR was 35% in an adult TJA population with no history of urinary problems 9 .…”

mentioning

confidence: 99%

“…Postoperative urinary retention (POUR) is defined as the inability to void in the presence of a full bladder, leading to catheterization. In the context of total joint arthroplasty (TJA), POUR presents a notable problem, as the etiology is not well understood 1 and the incidence has been reported between 5% and 70% 2,3 . This variability can be attributed to the lack of a consensus on the optimal bladder volume at which catheterization should occur, with suggested cutoffs ranging from 300 to 1,000 mL.…”

mentioning

confidence: 99%

Preoperative Bladder Scanning Can Predict Postoperative Urinary Retention Following Total Joint Arthroplasty

Magaldi,

Strecker,

Nissen

et al. 2024

Journal of Bone and Joint Surgery

View full text Add to dashboard Cite

Background: As total joint arthroplasty (TJA) moves to the outpatient setting, it is becoming clear that postoperative urinary retention (POUR) is a potential impediment to same-day discharge. Although risk factors for POUR have been widely studied, the lack of their clinical utility warrants investigation of specific preoperative factors that can assist in surgical planning and patient optimization. The purpose of the current study was to determine whether preoperative symptom surveys and bladder scanning are useful tools in identifying POUR risk. Methods: We performed a prospective analysis of patients undergoing total hip arthroplasty (THA) and total knee arthroplasty (TKA) at a high-volume orthopaedic hospital between December 1, 2020, and September 30, 2021. A total of 507 patients (324 female and 183 male) undergoing TJA completed the American Urological Association (AUA) symptom index preoperatively and then again at 14 and 64 days postoperatively. Post-void bladder scans were obtained in the immediate preoperative setting. POUR was defined as a bladder volume of >500 mL that required catheterization. Chi-square and quintile analysis were used to compare bladder scanning volumes, and Student t tests were used to compare AUA scores. Results: The rate of POUR was 37% (66 female and 34 male) and 23% (37 female and 19 male) in the TKA and THA groups, respectively. Increasing post-void residual volume (PVRV) measured on preoperative bladder scanning was found to be predictive of POUR. Among the TKA cohort, younger age and lower body mass index were also associated with increased catheterization, although age was not statistically significant. The AUA symptom survey was not found to correlate with POUR in either population. Conclusions: There was a predictable and exponential increase in the rate of catheterization as preoperative PVRV increased from 50 to 200 mL. The AUA symptom score showed no utility in predicting POUR in our study population. We propose that preoperative bladder ultrasonography become standard practice in TJA, especially among patients scheduled for same-day discharge. Level of Evidence: Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.

show abstract

“…POUR is defined as impaired voiding following surgery, despite a full bladder, that results in elevated postvoid residual volumes 12 . In addition to delaying discharge, POUR has been associated with urinary tract infections (UTIs) and permanent bladder injury secondary to overdistension 12 . Patient, anesthetic, and perioperative factors may influence the development of POUR.…”

mentioning

confidence: 99%

Short-Term Indwelling Foley Catheters Do Not Reduce the Risk of Postoperative Urinary Retention in Uncomplicated Primary THA and TKA

Weintraub

Yang

Nam

et al. 2022

Journal of Bone and Joint Surgery

View full text Add to dashboard Cite

Background: The purpose of this randomized controlled trial was to determine whether a short-term Foley catheter (inserted in the operating room and removed upon arrival to the orthopaedic floor) would reduce the risk of postoperative urinary retention (POUR) in patients undergoing primary total hip (THA) and total knee arthroplasty (TKA).Methods: Three hundred and eighty-eight patients undergoing inpatient primary TKA (n = 228) or THA (n = 160) with spinal anesthesia were randomized to receive a short-term Foley catheter (n = 194) or no Foley (n = 194). There were 143 male and 245 female patients. The primary outcome was POUR, defined as requiring ‡2 straight catheterizations or the placement of an indwelling urinary catheter when indicated by retention of ‡450 mL on bladder scans. Secondary outcomes included urinary tract infections (UTIs) within 3 weeks and the need for ‡1 straight catheterization. A power analysis determined that 194 patients per group were required to detect a 7% minimal clinically important difference in POUR rates at 80% power and alpha of 0.05. Intention-to-treat and as-treated analyses were performed (2 patients received the non-allocated treatment). Outcomes were compared between the groups using univariate and multivariate analyses, with alpha < 0.05.Results: Nine patients developed POUR: 4 in the short-term Foley group and 5 in the control group (2.1% versus 2.6%; p = 1.00). Of those who developed POUR, 8 were male and 1 was female (88.9% versus 11.1%; p = 0.002). Twenty-four patients required ‡1 straight catheterization: 10 in the Foley group and 14 in the control group (5.2% versus 7.2%; p = 0.40). Four patients developed UTIs: 3 in the Foley group and 1 in the control group (1.5% versus 0.5%; p = 0.62) on intention-to-treat analysis, and 4 in the Foley group and none in the control group (2.1% versus 0.0%; p = 0.12) on as-treated analysis. Conclusions:The use of a short-term Foley catheter inserted in the operating room and removed on arrival to the orthopaedic floor does not decrease the rate of POUR.

show abstract

Mp02-08 are Urologists Used Differently in Private Versus Academic Hospitals? A Comparison of Urologic Consultations in the Transition From a Nonteaching to Teaching Hospital

Cited by 3 publications

References 0 publications

Memory-efficient low-compute segmentation algorithms for edge ultrasound devices: continuous bladder monitoring

Memory-efficient low-compute segmentation algorithms for edge ultrasound devices: continuous bladder monitoring

Preoperative Bladder Scanning Can Predict Postoperative Urinary Retention Following Total Joint Arthroplasty

Short-Term Indwelling Foley Catheters Do Not Reduce the Risk of Postoperative Urinary Retention in Uncomplicated Primary THA and TKA

Contact Info

Product

Resources

About