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Salvage Cryoablation and Robotic Seminal Vesiculectomy: A Novel Salvage Treatment for Locally Recurrent Prostate Cancer

Smigelski, Michael B; Wysock, James; Taneja, Samir S; Lepor, Herbert
PMID: 37300480
ISSN: 1557-900x
CID: 5594642

Incidence of Benign Renal Masses in a Contemporary Cohort of Patients Receiving Partial Nephrectomy for Presumed Renal Cell Carcinoma

Vijay, Varun; Vokshi, Fjolla Hyseni; Smigelski, Michael; Nagpal, Shavy; Huang, William C
INTRODUCTION/BACKGROUND:Over the past decade and a half, advances in diagnostic imaging as well as an increased utilization of active surveillance (AS) and renal mass biopsy (RMB) have led to an improved ability to identify benign lesions prior to partial nephrectomy (PN). We seek to examine the incidence of benign pathology at the time of PN in a contemporary cohort of patients undergoing PN for presumed renal cell carcinoma (RCC). PATIENTS AND METHODS/METHODS:We performed a chart review on a prospectively maintained database on a series of patients who underwent PN between January 1, 2006 and December 31, 2021 for solid renal masses concerning for RCC. RESULTS:One thousand two hundred twenty-nine patients were included in the analysis, with 240 patients (19.2%) identified to have benign disease on final pathology. Of patients with benign disease, (23%) of patients had angiomyolipoma (AML) and 64% had oncocytoma. Between 2006 and 2021, there was a significant increase in the incidence of benign pathology after PN. When examining 3-year rolling averages over this same time period, the incidence of oncocytoma appeared to increase while the incidence of AML decreased. CONCLUSION/CONCLUSIONS:Despite improvements in diagnostic tools and increased utilization of active surveillance, the overall incidence of benign pathology, particularly oncocytoma, did not decrease over time in this contemporary cohort of patients undergoing PN.
PMID: 36535809
ISSN: 1938-0682
CID: 5394592

The Optimal Prostate Biopsy in the Era of Multiparametric Magnetic Resonance Imaging [Editorial]

Smigelski, Michael; Taneja, Samir S
PMID: 36336612
ISSN: 2588-9311
CID: 5356942

Promoting Organizational Change: A Urology Department-wide Wellness Program to Reduce Burnout

Margolin, Ezra J; Kosber, Rashed L; Smigelski, Michael B; Rawjani, Saba; Deleon, Sanny; Velji, Salimah; Melendez, Edwin; Anderson, Christopher B; McKiernan, James M; Badalato, Gina M
INTRODUCTION/BACKGROUND:We developed a comprehensive wellness initiative to address burnout with specific interventions targeted at faculty, residents, nurses, administrators, coordinators, and other departmental personnel. METHODS:A department-wide wellness initiative was implemented in October 2020. General interventions included monthly holiday-themed lunches, weekly pizza lunches, employee recognition events, and initiation of a virtual networking board. Urology residents received financial education workshops, weekly lunches, peer support sessions, and exercise equipment. Faculty were offered personal wellness days to use at their discretion at no penalty to their calculated productivity. Administrative and clinical staff were given weekly lunches and professional development sessions. Pre- and post-intervention surveys included a validated single-item burnout instrument and the Stanford Professional Fulfillment Index. Outcomes were compared using Wilcoxon rank-sum tests and multivariable ordinal logistic regression. RESULTS:< .001). The highest-rated components were monthly gatherings (64%), sponsored lunches (58%), and employee of the month (53%). CONCLUSIONS:A department-wide wellness initiative with group-specific interventions can help reduce burnout and may improve professional fulfillment and workplace community.
PMID: 37145807
ISSN: 2352-0787
CID: 5542272

Differences in Use of Aggressive Therapy for Localized Prostate Cancer in New York City

Smigelski, Michael; Wallace, Brendan K; Lu, Jun; Li, Gen; Anderson, Christopher B
BACKGROUND:Socioeconomic factors may impact how a patient is treated for prostate cancer (CaP). Our objective was to determine if county of residence or neighborhood socioeconomic characteristics were associated with treatment for CaP in New York City (NYC). MATERIALS AND METHODS:We used the NYSPACED database to identify men aged 40 to 80 years with localized CaP in NYC between 2004 and 2016. We categorized patients into receiving either aggressive local therapy (ALT) or non-aggressive treatment (NT). We identified borough of residence through NYSPACED and used Public Use Microdata Area (PUMA) designation to define neighborhood characteristics using United States Census data. We hypothesized that differences exist in use of ALT according to county of residence and neighborhood characteristics. We used multivariable logistic regression to test the association between county of residence and ALT as well as between ALT and PUMA characteristics. RESULTS:Our cohort included 40,668 patients. Overall, 80% had ALT, and 21% had NT. NT use increased over time from 16% in 2004 to 32% in 2016 (P < .001). On multivariable logistic regression, patients in Manhattan were less likely to receive ALT compared with those in other boroughs (P < .001). PUMAs with lower education attainment, larger foreign-born populations, lower crime rate, and higher median income were significantly associated with receipt of ALT (P < .05). CONCLUSIONS:We observed significant differences in use of treatment for men with newly diagnosed CaP in NYC. The ability to receive this treatment was associated with borough of residence as well as neighborhood socioeconomic characteristics. Additional research is required to identify barriers in access to NT within NYC.
PMID: 32891565
ISSN: 1938-0682
CID: 5122062

Implementation of a Hospital-Wide Protocol Reduces Time to Decompression and Length of Stay in Patients with Stone-Related Obstructive Pyelonephritis with Sepsis

Haas, Christopher R; Smigelski, Michael; Sebesta, Elisabeth M; Mobley, David; Shah, Ojas
PMID: 32668984
ISSN: 1557-900x
CID: 5122052

Urology Virtual Education Programs During the COVID-19 Pandemic

Smigelski, Michael; Movassaghi, Miyad; Small, Alexander
PURPOSE OF REVIEW/OBJECTIVE:This article aims to describe the impact of the COVID-19 pandemic on American urology trainees, with a focus on virtual learning initiatives. RECENT FINDINGS/RESULTS:Urological education was forced to rapidly adapt to the COVID-19 pandemic in 2020. Significant challenges included quarantines, redeployment of residents and faculty, and suspension of regularly scheduled conferences. In response, urologists across the country adopted web-based platforms to develop virtual lecture series to fill the gap. Popular programs for residents included UCSF's COViD (Collaborative Online Video Didactics) series and the New York Section of the American Urological Association's EMPIRE (Educational Multi-institutional Program for Instructing REsidents) series. Virtual education programs have enabled urology trainees to pursue their education during the pandemic. While the long-term impact of the pandemic on urology training remains unknown, some good may be found in the innovative solutions that have arisen in urology education.
PMCID:7578438
PMID: 33090272
ISSN: 1534-6285
CID: 5122072

A Urology Department's Experience at the Epicenter of the COVID-19 Pandemic [Editorial]

Pak, Jamie S; Sayegh, Christopher I; Smigelski, Michael B; McKiernan, James M; Cooper, Kimberly L
PMCID:7326405
PMID: 32619601
ISSN: 1527-9995
CID: 5122042