Program Book

Southeastern Section of the AUA | 80th Annual Meeting | March 17-20, 2016 PROGRAM BOOK

80th SESAUA Annual Meeting March 17-20, 2016 Omni Nashville Hotel Nashville, Tennessee

Sponsored by the American Urological Association Education and Research, Inc. Jon S. Demos, MD 2015 – 2016 President Southeastern Section of the AUA, Inc. Table of Contents

Program Schedule at a Glance ...... 2 Mission Statement ...... 6 Educational Needs & Objectives ...... 6 Accreditation Statement ...... 7 Contact Information ...... 9 Officers, Board of Directors, and Special & Standing Committees ...... 10 Numerical Membership of the SESAUA ...... 15 General Meeting Information ...... 16 Evening Functions ...... 17 Child Care Information ...... 17 Optional Events ...... 18 Industry Satellite Symposium Events ...... 21 Technical Exhibits ...... 22 Industry Partners ...... 23 Named Lectures and Contests ...... 24 Full Scientific Program ...... 27 WEDNESDAY, MARCH 16, 2016 ...... 27 THURSDAY, MARCH 17, 2016 ...... 27 FRIDAY, MARCH 18, 2016 ...... 46 SATURDAY, MARCH 19, 2016 ...... 66 SUNDAY, MARCH 20, 2016 ...... 72 Alphabetical Index of Authors ...... 93 Podiums ...... 99 Posters ...... 143 Annual Business Meeting Agenda ...... 304 Minutes of the 79th Annual Business Meeting ...... 305 Proposed Bylaws Changes ...... 310 Bylaws ...... 311 Necrology Report ...... 330 Preliminary Treasurer’s Report ...... 331 Membership Candidates and Transfers ...... 332 Report of the SESAUA Representative to the AUA Board of Directors ...... 334 Roster of the State Societies and Officers ...... 336 Previous Officers and Annual Meeting Sites ...... 337 Future SESAUA Meetings ...... 346

Program Schedule at a Glance

All sessions located in Broadway Ballroom A-D unless otherwise noted.

THURSDAY, MARCH 17, 2016 THURSDAY, MARCH 17, 2016 5:30 a.m. Registration/Information Desk Open 5:305:00 a.m.p.m. Registration/InformationBroadway Ballroom EF Pre-Function Desk Open 5:00 p.m. Broadway Ballroom EF Pre-Function 9:00 a.m. Exhibit Hall Open 9:004:00 a.m.p.m. BroadwayExhibit HallBallroom Open EF 4:006:00 p.m.a.m. SpeakerBroadway Ready Ballroom Room EFHours 5:00 p.m. Mockingbird 1 6:00 a.m. Speaker Ready Room Hours 5:007:30 p.m.a.m. Spouse/GuestMo Hospitalityckingbird 1 Suite Open 10:30 a.m. Bass Room 7:306:30 a.m.p.m. Spouse/GuestOpening Hospitality Celebration Suite Open 10:30 a.m. Bass Room 9:30 p.m. Country Music Hall of Fame 6:30 p.m. Prostate Cancer 1 Opening Celebration Penis Cancer Poster Session 9:306:30 p.m.a.m. Poster SessionCountry Music Hall of Fame Cumberland 4 Cumberland 3 Prostate Cancer 1 Penis Cancer Poster Session 6:30 a.m. Poster SessionGee-Dineen Health Policy Forum 1 Cumberland 4 8:00 a.m. CumberlandAmbrose-Reed 3 Lecture: Urology Practice: Navigating the Paradigm Shift 8:45 a.m. OpeningGee-Dineen Remarks Health - SESAUA Policy Forum President 1 8:00 a.m. Ambrose-Reed Lecture: Urology Practice: NavigatingBreak -the Visit Paradigm Exhibits Shift 9:00 a.m. Broadway EF 8:459:30 a.m. BestOpening Video ViewingRemarks and - SESAUA Award PresentationPresident

9:40 a.m. ProstateBreak - Visit Cancer Exhibits Panel 9:00 a.m. 10:20 a.m. Prostate CancerBroadway Podium EF Session

11:459:30 a.m. a.m. Best VideoSurvivorship Viewing andPanel Award Discussion Presentation Industry Sponsored Lunch Industry Sponsored Lunch 12:159:40 a.m. p.m. Symposium Prostate Cancer Panel Symposium Broadway Ballroom JK Broadway Ballroom GH 10:20 a.m. 1:30 - 5:00 Prostate1:30 - 5:00 Cancer Podium3:45 Session - 5:00 3:45 - 5:00

Pediatric Endourology Robotic Surgery Prostate 11:45 a.m. Survivorship Panel Discussion 1:30 p.m. Sub-Plenary Sub-Plenary Poster Session Cancer 2 Poster 5:00 p.m. Session Session Cumberland 3 Session CumberlandIndustry 1/2 Sponsored Broadway Lunch Industry SponsoredCumberland Lunch 4 12:15 p.m. & SymposiumBallroom A-D Symposium CumberlandBroadway 3 Ballroom JK Music Row 5

1:30 - 5:00 1:30 - 5:00 3:45 - 5:00 3:45 - 5:00

Pediatric Endourology Robotic Surgery Prostate Cancer 1:30 p.m. Sub-Plenary Sub-Plenary Poster Session 2 Poster 5:00 p.m. Session Session Cumberland 3 Session Cumberland 1/2 Broadway Cumberland 4 & Ballroom A-D Cumberland 3

2 SCHEDULE AT A GLANCE

D - A -

5:30

1/2 1/2

ew Era

Sub- Sub

Plenary

Plenary Pediatric

Pediatric Session 2 Session 2 7:30 3:45 - 5:30 3:45

Cumberland Cumberland

Ballroom Session Session

7:00 - 7:30 7:00 Row 5

Dysfunction Podium

Dysfunction Podium Incontinence/Voiding Incontinence/Voiding

Incontinence/Voiding Broadway Ballroom A-D

Broadway

Ballroom

Symposium

Symposium Music -

A-D A

Targeted Biopsy: A N Broadway Ballroom GH Function Outcomes/

Outcomes/ - -

EF EF

Health Service/ Industry Sponsored Lunch

Industry Sponsored Lunch Lunch Sponsored Industry HealthService/

Podium Session Socioeconomics Podium Session Socioeconomics

Broadway Ballroom Broadway

unless noted. otherwise Refractory OAB EF Pre

- Art Lecture: Art Lecture:

- - Ballroom Ballroom

Visit Exhibits

the the Session - Session - - Bass Room Bass Room AUA Update AUA AUA Update of of Mockingbird 1 Cumberland 4 Mockingbird 1 Cumberland 4 - - Ballroom Wildhorse Saloon Wildhorse Wildhorse Saloon Exhibit Hall Open Exhibit Hall Exhibit Hall Open

roadway Residents' Night Out Break - Visit Exhibits Break - Visit

Residents' Night Out Break Broadway Ballroom EF Broadway Ballroom Broadway Ballroom EF Broadway B : Basic Principles for Urologic Practice Nephrolithiasis Poster 3 Nephrolithiasis Poster Session Session State-of-the-Art Lecture: State-of-the-Art Lecture: State State FRIDAY, MARCH 18, 2016 MARCH 18, FRIDAY, Outcomes/ Ballroom Ballroom FRIDAY, MARCH 18, 2016 Outcomes/ Cumberland 4 Cumberland 4

Speaker Ready Room Hours Speaker Ready Cumberland 4 Cumberland 4 Speaker Ready Room Hours Miscellaneous Miscellaneous Health Service/ Poster Session Renal Cancer Podium Session Health Service/ Poster Session RenalCancer Podium Session Montague Boyd Essay Contest Reconstruction/ Montague Boyd Essay Contest AUA Course of Choice Lecture: AUA Reconstruction/ Diversion Poster AUA Course of Choice Lecture: Diversion Poster T. Leon Howard Imaging Session Leon Howard Imaging T. T. Leon Howard Imaging Session Broadway Ballroom EF Pre-Function EF Broadway Ballroom Broadway Panel Discussion - Refractory OAB Panel Discussion - Refractory Panel Discussion Registration/Information Desk Open Registration/Information Registration/Information Desk Open Spouse/Guest Hospitality Suite Open Spouse/Guest Hospitality The Impact of MRI and MRI and MRI of Impact The Spouse/Guest Hospitality Suite Open Suite Hospitality Spouse/Guest

Musings on ED after Radical Prostatectomy Musings on ED after RadicalProstatectomy

Broadway Broadway

Symposium Symposium Surgical Approaches for Robotic Partial Nephrectomy Approaches for Robotic Surgical Surgical Approaches for Robotic Partial Nephrectomy Geriatric Urology: Basic Principles for Urologic Practice Geriatric Urology: Basic Geriatric Urology Presidential Lecture: Active Surveillance: Lessons Learned Presidential Lecture: Presidential Lecture: Active Surveillance: Lessons Learned Programat a Schedule Glance Erectile ter Session Broadway Ballroom JK Session in Prostate Cancer Diagnosis, Risk Assessment, and Therapy Assessment, in Prostate Cancer Diagnosis, Risk Broadway Ballroom JK in Prostatein Cancer Diagnosis,Risk Assessment, and Therapy Kidney/ Kidney/ Session Cumberland 3 cer 1 Poster Session Industry Sponsored Lunch Cumberland 3 Industry Sponsored Lunch Lunch Sponsored Industry Pos Andrology Poster Cumberland 3 Cumberland 3 Cumberland 3 Cumberland 3 Poster Session Kidney/Adrenal Poster Session Kidney/Adrenal Erectile Dysfunction/ Cancer 1 Poster Can Ballenger Lecture: The Impact of MRI and MRI-Targeted Biopsy: A New Era A Biopsy: Ballenger Lecture: The Impact of MRI and MRI-Targeted Adrenal Cancer 2 Ballenger Lecture: Adrenal Cancer 2 Dysfunction/Andrology

All sessions located in in located All sessions

9:30 a.m. 8:40 a.m. 8:00 a.m. 6:30 a.m. 1:30 p.m. 1:40 p.m. 2:20 p.m. 2:45 p.m. 3:45 p.m. 4:45 p.m. 5:45 p.m. 9:30 a.m. 8:00 a.m. 8:40 a.m. 6:30 a.m. 5:45 p.m. 4:45 p.m. 3:45 p.m. 2:20 p.m. 2:45 p.m. 1:30 p.m. 1:40 p.m. 6:00 a.m. 5:45 p.m. 10:00 a.m. 4:00 p.m. 6:00 a.m. 5:45 p.m. 7:30 a.m. 10:30 a.m. 7:00 p.m. 10:30 p.m. 10:30 a.m. 7:00 p.m. 10:30 p.m. 6:00 a.m. 5:45 p.m. 7:30 a.m. 6:00 a.m. 5:45 p.m. 10:00 a.m. 4:00 p.m. 11:00 a.m. 11:00 a.m. 11:30 10:30 a.m. 12:00 p.m. 12:30 p.m. 11:00 a.m. 11:30 a.m. 10:30 a.m. 12:00 p.m. 12:30 p.m. 2 Program Schedule at a Glance

All sessions located in Broadway Ballroom A-D unless otherwise noted.

SATURDAY, MARCH 19, 2016 SUNDAY, MARCH 20, 2016 6:00 a.m. Registration/Information Desk Open 12:306:00 a.m. p.m. Registration/InformationBroadway Ballroom EF Pre-Function Desk Open 12:15 p.m. Broadway Ballroom EF Pre-Function 7:00 a.m. Exhibit Hall Open 11:006:00 a.m. a.m. SpeakerBroadway Ready Ballroom Room HoursEF 6:0012:15 a.m. p.m. SpeakerMockingbird Ready Room 1 Hours 12:30 p.m. Mockingbird 1 7:30 a.m. Spouse/Guest Hospitality Suite Open 7:3010:30 a.m. a.m. Spouse/GuestBass Hospitality Room Suite Open 10:30 a.m. Bass Room Bladder 6:30 p.m. 2016 SESAUA Annual Reception & Banquet Erectile Voiding Cancer/ 11:00 p.m. Inflammation/Broadway Ballroom EF Dysfunction/ Video Dysfunction Diversion Infection Andrology Session II 2 Poster Podium 7:00 a.m. 6:30 a.m. Simulators/TrainingPoster Voiding Dysfunction 1 Podium Cumberland Session Session 6:30 a.m. Poster SessionSession Poster Session Session 1/2 Cumberland BroadwayVideo Session I CumberlandCumberland 3 3 Cumberland 4 Broadway 4 BallroomCumberland 1/2 Ballroom A-D 8:00 a.m. History of Urology in Kentucky and TennesseeG/H

7:308:30 a.m.a.m. PanelAUA GuidelinesDiscussion Presentation- Men's Health Gee-Dineen Health Policy Forum 2 9:30 a.m. 8:00 a.m. State-of-the-Art Lecture:Gee-Dineen The PolicyEvolution Forum of Healthcare 3 Markets Break - Visit Exhibits 10:30 a.m. Broadway Ballroom EF 9:30 - 10:15

11:00 a.m. Socioeconomics/ Annual Business Meeting Bladder Cancer Basic Statistical Methods 9:30 a.m. Poster Session Science/Imaging/ 11:45 a.m. Poster Session Resident Quiz Bowl Cumberland 4 Miscellaneous Cumberland 3 Industry Sponsored Lunch Symposium 12:30 p.m. Podium Session Broadway Ballroom GH Broadway Ballroom A-D Journal of Urology Peer Review Seminar 1:00 p.m. Prostate Cancer 3 Poster SessionCumberland Bladder 1/2 Cancer 2 Poster Session 10:304:00 p.m.a.m. Cumberland 3 *Not CME Accredited Cumberland 4

11:30 a.m. Report by the IVUmed Participants

12:00 p.m. SESAUA Urology Care Foundation Scholar Report

12:10 p.m. Remarks from Incoming SESAUA President 12:15 p.m.

4 SCHEDULE AT A GLANCE

D D - -

A A

Erectile Erectile Podium Podium Session Session Broadway Broadway 10:15

Andrology Andrology

- Ballroom A-D Ballroom Ballroom Dysfunction/ Dysfunction/ Ballroom

Basic Imaging/

9:30 9:30 - 10:15

Miscellaneous Miscellaneous Basic Science/ Podium Session Podium Session Science/Imaging/

Broadway Broadway Ballroom A-D adway adway

G/H

Cumberland 4 Cumberland 4

Cancer/ Podium Podium Cancer/ Bladder Bladder Session Session Ballroom Ballroom Bro Broadway Diversion Diversion Ballroom GH

icipants Function

Bladder Cancer 2 Poster Session Bladder Cancer Poster 2 Session unless noted. otherwise lance EF Pre D

- 4 4 A

Voiding Voiding Voiding Session Session 2 Poster 2 Poster Cumberland Cumberland Bass Room Bass Room Dysfunction Dysfunction oster Session Cumberland 4 Cumberland 4 Mockingbird 1 Mockingbird 1 Mockingbird Ballroom P Poster Session Bladder Cancer Bladder Cancer DineenPolicy Forum 3

Ballroom Ballroom SUNDAY, MARCH 20, 2016 MARCH SUNDAY,

SUNDAY, MARCH 20, 2016 Gee Gee-Dineen Policy Forum 3 Gee-Dineen Policy Forum Speaker Ready Room Hours Speaker Ready Room Hours Speaker Ready AUA Guidelines Presentation AUA AUA Guidelines Presentation

Broadway Ballroom EF Pre-Function EF Broadway Ballroom Broadway Report by the IVUmed Participants Report by the IVUmed Part Registration/Information Desk Open Registration/Information Desk Open Registration/Information Spouse/Guest Hospitality Suite Open Suite Hospitality Spouse/Guest Spouse/Guest Hospitality Suite Open Spouse/Guest Hospitality

Poster Poster Session Session

Infection Infection Remarks from Incoming SESAUA President Remarks from Incoming SESAUA Remarks from Incoming SESAUA President Cumberland 3 Cumberland 3 Inflammation/ Inflammation/ Broadway Broadway SESAUA Urology Care Foundation Scholar Report Urology SESAUA SESAUA Urology Care Foundation Scholar Report Cumberland 3 Cumberland 3

Programat a Schedule G

Cumberland 3 Cumberland 3 1/2 1/2 Poster Session Poster Session Video Video Video Socioeconomics/ Socioeconomics/ Statistical Methods Statistical Methods Prostate Cancer 3 Poster Session Prostate Cancer 3 Poster Session Poster 3 Cancer Prostate Session II Session II Cumberland Cumberland

All sessions located in in located All sessions p.m.

0 :30 a.m. 6:00 a.m. 12:15 p.m. 7 10:30 a.m. 6:00 a.m. 12:15 p.m. 7:30 a.m. 10:30 a.m. 6:00 a.m. 12:15 p.m. 6:00 a.m. 12:15 p.m. 7:30 a.m. 8:00 a.m. 9:30 a.m. 6:30 a.m. 9:30 a.m. 7:30 a.m. 8:00 a.m. 6:30 a.m. 11:30 a.m. 11:30 10:30 a.m. 11:30 a.m. 10:30 a.m. 12:00 p.m. 12:1 12:15 p.m. 12:00 p.m. 12:10 p.m. 12:15 p.m.

4 Mission Statement

To be the professional organization in the southeastern United States that fosters the highest standards of urologic care through education, research and socioeconomic awareness. The Southeastern Section of the American Urological Association goals: • Support excellence in urologic care of patients • Education of urologists • Encourage research • Forum for presentation of: . Clinical interest . Clinical and basic research . Support the AUA in healthcare policy and share ideas with the AUA, Inc.

Scientific Program SESAUA Secretary, Glenn M. Preminger, MD, has planned a dynamic program that is certain to provide practicing urologists cutting-edge information. Detailed information about the scientific program begins on page 28.

Educational Needs & Objectives

Educational Needs The Secretary of the SESAUA (Glenn M. Preminger, MD) consulted with other members of the Committee on Education and Science and the Executive Committee members including SESAUA Past President, Jack Amie, MD; President, Jon Demos, MD; Chair, Committee on Education and Science, S. Duke Herrell III, MD; and Chair, Office of Education of the AUA, Victor Nitti MD, regarding the needs we are attempting to fulfill through our annual scientific program. It was agreed by the above committee members, Section Officers and Chair, Office of Education of the AUA that there continues to be significant educational needs for our annual meeting and scientific program. Urologic abnormalities can present with a myriad of clinical symptoms and signs. Accurate differential diagnosis and disease management, which meets current standards of care, requires ongoing review of the presentations of various urologic abnormalities as well as the appropriate use of safe and cost-effective imaging modalities and various pharmacologic, minimally invasive, and operative management options. In addition, advancements in medical science and progress in management of various urologic diseases require basic and clinical research. Presentation and discussion of such peer- reviewed and Abstract Reviewer-selected summaries and results of investigations provide “cutting edge” updates for practicing clinicians and essential feedback to researchers on the practical applications and translation of their investigations to clinical practice. There is a need to increase communication among urologic oncology and Endourological researchers and forge a strong relationship between the National Cancer Institute and the Society of Urologic Oncology, as well as the Society’s members and others interested in Kidney, Bladder, and Prostate, Cancers. In addition, many urologists treat patients with a myriad of non-malignant conditions such as urinary incontinence, stone disease, benign prostatic hypertrophy, obstructive uropathy, spinal cord injuries, infertility, erectile dysfunction and congenital (pediatric) diseases among the most common. Improving relationships with these subspecialties, and appropriate governmental funding sources (such as National Institute of Diabetes and Digestive and Kidney diseases – NIDDK/NIH) will provide a community of urologists with the most up-to-date research that will provide optimal patient care.

6 NEEDS & OBJECTIVES ACCREDITATION

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e managementoptimal of various common dilemmas in pediatric urology. The American Urological Association (AUA) is accredited by the the by accredited is (AUA) Association Urological American The 28.00 28.00 egrate new and modified and egrate new testing optimal and medical treatment selection for on of Identified Conflict of Interest: Interest: of Conflict Identified of on Learners: Describechangesimportantsocioeconomics recent in impacting patients and urologic care. Describe the state Apply Evidencespecifically urologic Based (EBM)Medicine practice in incorporating AUA Guidelines into daily practice. Analyze th Describe the recent for innovations evaluationmanagement and ofpatients undergoing urologic surgery. Demonstratemanagement. of a better understanding cancer prostate detection and Int preventionstone of outcomes. and optimal disease Identify optimizedmanagement pathways and for noninvasive and invasive prostate, bladder and testiscancer a focus with on the p femal in problems formodalities. the treatment various Peer review forPeer valid, review evidence educationalthe course/program activity by director, editor, Education and/or Content Committeesubgroup. Review its or Limitto content no recommendations with evidence

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MDs or DOs.MDs or However, the will issue AUA documentation of participation thatstatesthat the certified activity was for Evidence Based Content: of commercial free and rigorous, scientifically balanced, fair, is valid, activity thisin CME bias. Policy: Disclosure AUA activity (i.e., activity planners, presenters,authors) participatingan educational in activity theprovided by AUA toto relevant provider disclose any required are the financial a with relationships relationshipsmay influence the educationalcontent and resolve conflicts any of interest prior to the commencement educationalthe of activity.this The intent of is disclosure to not prev provide learners judgments. information theywhich make own their can with Themeeting disclosure registrationmayforfound your packet. report this in be Resoluti Accreditation: Accreditation: C Accreditation Councilfor Continuing Medical Education to provide continuing (ACCME) medicalfor education physicians. At the conclusionAtthe the of 80 Educational Objectives Educational commensurate theparticipation with their extent of activity. the in Others program/course directors editors or for identification of conflicts of interest. Peer reviewers, working thewith program directors and/or editors,mechanism(s the will document management resolution and conflict the of interest of final of and the approval activity will be documented prior can/will to implementation. mechanisms usedbe the Any below of to resolve conflictinterest: of maximum of of maximum 6 • Introduction of a debate format with an unbiased moderator (point-counterpoint) • Inclusion of moderated panel discussion • Publication of a parallel or rebuttal article for an article that is felt to be biased • Limit equipment representatives to providing logistics and operation support only in procedural demonstrations • Divestiture of the relationship by faculty

Off-label or Unapproved Use of Drugs or Devices: It is the policy of the AUA to require the disclosure of all references to off-label or unapproved uses of drugs or devices prior to the presentation of educational content. The audience is advised that this continuing medical education activity may contain reference(s) to off-label or unapproved uses of drugs or devices. Please consult the prescribing information for full disclosure of approved uses.

Disclaimer: The opinions and recommendations expressed by faculty, authors and other experts whose input is included in this program are their own and do not necessarily represent the viewpoint of the AUA.

Audio, Video and Photographic Equipment: The use of audio, video and other photographic recording equipment is prohibited by attendees inside AUA meeting rooms.

Consent to Use of Photographic Images: Attendance at or participation in AUA meetings and other activities constitutes an agreement by the registrant to AUA's use and distribution (both now and in the future) of the attendee's image or voice in photographs and electronic reproductions of such meetings and activities.

Reproduction Permission: Reproduction of written materials developed for this AUA course is prohibited without the written permission from individual authors and the American Urological Association.

Special Assistance/Dietary Needs: The American Urological Association complies with the Americans with Disabilities Act §12112(a). If any participant is in need of special assistance or has any dietary restrictions, please see the registration desk.

Disclaimer Statement Statements, opinions and results of studies contained in the program and abstracts are those of the presenters/authors and do not reflect the policy or position of the SESAUA, nor does the SESAUA provide any warranty as to their accuracy or reliability.

Every effort has been made to faithfully reproduce the abstracts as submitted. However, no responsibility is assumed by the SESAUA for any injury and/or damage to persons or property from any cause including negligence or otherwise, or from any use or operation of any methods, products, instruments or ideas contained in the material herein.

Copyright Notice Individuals may print out single copies of abstracts or slides contained in this publication for personal, non-commercial use without obtaining permission from the author or the SESAUA. Permission from both the SESAUA and the author must be obtained when making multiple copies for personal or educational use, for reproduction for advertising or promotional purposes, for creating new collective works, for resale or for all other uses.

Filming/Photography Statement No attendee/visitor at the SESAUA 80th Annual Meeting may record, film, tape, photograph, interview or use any other such media during any presentation, display or exhibit without the express, advance approval of the SESAUA Executive Director. This policy applies to all SESAUA members, non-members, guests and exhibitors, as well as members of the print, online or broadcast media.

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SESAUA

Inc., SESAUA T 88 Officers, Board of Directors, and Special & Standing Committees

2015 – 2016

OFFICERS TERM EXPIRES President Jon S. Demos, MD; Lexington, KY 2016

President-Elect Dean G. Assimos, MD; Birmingham, AL 2016

Secretary Glenn M. Preminger, MD; Durham, NC 2018

Treasurer Scott B. Sellinger, MD; Tallahasse, FL 2017

Past President Jack M. Amie, MD; Brunswick, GA 2016

Historian Jerry E. Jackson, MD; Sumter, SC 2017

Member at Large David M. Kraebber, MD; Wilmington, NC 2017

Chair, Committee on Education and Science S. Duke Herrell III, MD; Nashville, TN 2018

2016 Planning Committee Glenn M. Preminger, MD (Program Chair) 2016 Jack M. Amie, MD; Brunswick, GA 2016 Dean G. Assimos, MD; Birmingham, AL 2016 Jon S. Demos, MD; Lexington, KY 2016 S. Duke Herrell III, MD; Nashville, TN 2016 David M. Kraebber, MD; Wilmington, NC 2016 Scott B. Sellinger, MD; Tallahassee, FL 2016

REGIONAL REPRESENTATIVES

Alabama Representatives Peter N. Kolettis, MD; Birmingham, AL 2018 Merle L. Wade Jr., MD; Gadsden, AL 2018

Alabama Alternate Representatives Jared M. Cox, MD; Birmingham, AL 2018 Tracey S. Wilson, MD, FACS; Birmingham, AL 2018

Florida Representatives Michael A. Dennis Jr., MD, FACS; Gainesville, FL 2018 Alan M. Nieder, MD; Miami Beach, FL 2016 Sijo J. Parekattil, MD; Clermont, FL 2017 Rolando Rivera, MD; Naples, FL 2017 Paul R. Young, MD; Jacksonville, FL 2018

OFFICERS, BOARD OF DIRECTORS, AND SPECIAL & STANDING COMMITTEES

018 2018 2018 2018 2017 2018 2017 2017 2018 2018 2018 2017 2017 2018 2018 2017 2018 2017 2018 2018 2016 2017 2 2018 2017 2018 2018 2016 2018 2018

Celebration, FL Celebration,

Brayfield,PR Caguas, MD; - Dong Lee, MD; Winter FL Haven, MD; Lee, Dong - biiAugusta, Madi, GA MD; ssissippi Representative Puerto Representative Rico Marcos Perez R. RepresentativePuerto Rico Alternate Eduardo I. Canto, SanMD; Juan, PR North Representatives Carolina Alternate Brian Hillsborough, MD; NC S. Cope, Aaron Lentz, Raleigh, NC MD; Matthew E.Matthew Chapel Hill, MS; MD, Nielsen, NC Panama Representative Angel A. Alvarado, M RepresentativePanama Alternate MD Alston, Celeste Joshua A. Perkel, MD; Macon, GA JoshuaA. GA Perkel, Macon, MD; Chad W.M. Atlanta,Chad Ritenour, GA MD; Cary N.Cary Robertson, NC Durham, FACS; MD, Georgia Alternate RepresentativesGeorgia Alternate Ra Mathew C. Raynor, Chapel MD; Hill,Mathew NC Georgia Representatives Jr., N. GA Henry Goodwin Evans, MD; Mississippi Representative Alternate ChristopherBean, Jackson, MD; MS M. Kenneth Ogan, MD; Atlanta,Kenneth GA MD; Ogan, Savannah,Shook,Thomas GA E. MPH; MD, Representatives Carolina North F.Gregory Greenville, FACS; MD, Murphy, NC ChadwickP. Huckabay, MD Christopher R. Williams, MD; Jacksonville, FL FL Jacksonville, Williams, MD; R. Christopher Mi Louisiana Representatives Alternate JonathanShreveport, Henderson, MD; LA Vipul R. Patel, MD, FACS; MD, Patel, R. Vipul BatonAnna Smither, LA R. MD; Rouge, Louisiana Representatives Louisiana Wayne J. G. Hellstrom, MD, FACS; New Orleans, LA Orleans, New FACS; MD, Hellstrom, G. J. Wayne Kentucky Kentucky RepresentativeAlternate Murali K.Ankem, Louisville, MBBS; KY Orleans,FACS;Benjamin LA R. New MD, Lee, Kevin Ki Kevin Katie Nicole Ballert, Lexington, MD; KY Kentucky RepresentativeKentucky Florida Representatives Alternate Adam J. Ball, MD; Port St. Lucie, FL Port St. J. Adam MD; Lucie, Ball, Lawrence S. Hakim, MD, FACS; Weston,Lawrence S. FL FACS; MD, Hakim, 10 South Carolina Representatives T. Brian Willard, MD, FACS; West Columbia, SC 2017 Richard W. Young, MD; Myrtle Beach, SC 2017

South Carolina Alternate Representatives Ross A. Rames, MD; Charleston, SC 2017 Alexander W. Ramsay, MD; Charleston, SC 2017

Tennessee Representatives Peter E. Clark, MD, Nashville, TN 2017 Donald T. McKnight Jr., MD; Jackson, TN 2016

Tennessee Alternate Representatives Sam S. Chang, MD, MBA; Nashville, TN 2016 Melissa R. Kaufman, MD, PhD; Nashville TN 2017

REPRESENTATIVE TO AUA BOARD OF DIRECTORS

Representative to AUA Board of Directors Thomas F. Stringer, MD; Gainesville, FL 2017

RESIDENT REPRESENTATIVES

Resident Representatives Juan Chipollini, MD; Miami, FL 2016 Albert J. Duboy, MD; Tampa, FL 2016 James Bradley Mason, MD; Gainesville, FL 2016 Robert D. Williams, MD; Jacksonville, FL 2016

STANDING COMMITTEES

Bylaws Committee Lee N. Hammontree, MD; Homewood, AL (Committee Chair) 2018 (T2) Timothy K. Duffin, MD; Clarksville, TN 2018 (T2) Jonathan Henderson, MD; Shreveport, LA 2016 (T1) Nicole L. Miller, MD; Nashville, TN 2016 (T1) Glenn M. Preminger, MD; Durham, NC (Secretary) 2018 (T1) Michael J. Wehle, MD; Jacksonville, FL 2017 (T1)

Committee on Education and Science Christopher S. Gomez, MD; Miami, FL (Young Urologists Representative) 2016 (T1) Benjamin R. Lee, MD, FACS; New Orleans, LA (Committee Member - Videos) 2016 (T2) David F. Penson, MD, MPH; Nashville, TN (Committee Member - Montague Boyd Essay) 2018 (T1) Chad W.M. Ritenour, MD; Atlanta, GA (Committee Member - Imaging) 2018 (T2) Stephen J. Savage, MD; Charleston, SC (Committee Member - Residents) 2017 (T1) S. Duke Herrell III, MD; Nashville, TN (Chair) 2018 (T2) Raj S. Pruthi, MD; Chapel Hill, NC (Member at Large) 2018 (T1) Johannes W.G. Vieweg, MD; Gainesville, FL (Member at Large) 2016 (T2)

Finance Committee Gerard D. Henry, MD; Shreveport, LA (Committee Chair) 2017 Brant Inman, MD, MS; Durham, NC 2016 Donald T. McKnight Jr., MD; Jackson, TN 2017 Felix Mendoza-Rosa, MD; Cayey, PR 2018 John F. Pirani, MD; Gadsden, AL 2016 Scott B. Sellinger, MD; Tallahassee, FL (Treasurer) 2017

OFFICERS, BOARD OF DIRECTORS, AND SPECIAL & STANDING COMMITTEES

2016 2018 2017 2017 2018 2016 2016 2017 2017 2017 2018 2018 2016 2018 2016 2018 2016 2018 2016 2016 2016 2016 2016 2016 2016 2016 2016 2016 2016 2016 2016 2016 2016 2016 2016 2016 2018 2018 2018

rnate Representative)rnate

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13 (Puerto AlteRico

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; MD Ortiz, - Deya, MD; Ponce, (PuertoDeya, PR MD; Representative) Rico ssan, MD; Franklin,ssan,TN (Tennessee MD; Alternate Representative) lissa R. Kaufman, MD, PhD; Nashville, TN (Committee Chair) (Committee TN Nashville, PhD; MD, Kaufman, lissa R. Glenn M. Preminger,Glenn NC Durham, M. MD; FL Tallahassee, MD; Sellinger, B. Scott W. (Committee Chair) Terry Stallings, AL Daphne, FACS; MD, Site Selection Committee RaymondJ. Leveillee, City, Cooper FL MD; (Past President) Jack M. Amie, MD; St. SimonsIsland,St.President)Jack Amie, MD; (Immediate GA Past M. Gregory F.Gregory Greenville, at FACS; MD, (Member Murphy, NC Large) Martha K. Terris, MD, FACS; MD, Terris, K. Martha W. (Committee Chair) Terry Stallings, AL Daphne, FACS; MD, Nominating Committee Nominating James K. O'Kelly, MD; Florence, SC Florence, MD; O'Kelly, K. James Thomas J. Polascik, MD; Durham, NC Durham, MD; Polascik, J. Thomas C. Taub,Harvey FL Ocala, MD; Scott W.Scott Lisson; Cary, NC TN Nashville, MD; Miller, L. Nicole Chad W.M. Atlanta,Chad (Committee Ritenour, GA Chair) MD; Membership Committee Membership John M. Patterson,JohnKY M. (Kentucky Frankfort, MD; Alternate Representative) Vise,Richard Meridian, M. (Mississippi MS MD; Representative) Me Thomas Hogeman Phillips,Thomas Hogeman Carolina Matthews, MD; Representative) (North NC Woolums,Charles Proctorville, (Kentucky Representative) S. MD; OH MartinK. Daytona Dineen,FLBeach, (Consultant) MD; Committee Local Arrangements John F. Pirani,ALJohn (Alabama Gadsden, MD; F. Representa Steve J. Hodges, MD; WinstonSteveJ. Hodges, MD; Edward W.Edward KillorinJr., MD; Columbus, GA (Georgia Representative) Ricardo Sanchez Charles Hattiesburg, Moore, MD; R. William B. Gilbert, MD; Rome, GA (GeorgiaWilliamAlternate B. GA Gilbert, Representative) Rome, MD; John M. Ha W.BradleySteele, Charleston, (South Carolina MD; SC Alternate Representative) DonaldA.Shreveport, Elmajian, (Louisiana MD; LA Alternate Representative) Brian E. Richardson, Montgomer MD; - Ruiz Gilberto John W. Nashville,TNJohn (Tennessee III, Brock MD; Representative) (FloridaPalm FL Terrence Coast, Representative) MD; C. Regan, Ross A. Rames, MD; Mt. Pleasant, (South Carolina Representative) SC Ross Mt. MD; A. Rames, JonathanShreveport, Chair) Henderson,(Vice MD; LA (AlternateSumter,JerrySC E. Chair) Jackson, MD; Alternat FL (Florida Bird, MD; Gainesville, Vincent G.

Lester J. Prats, MD; New Orleans, LA Orleans, Lester (LouisianaJ. Representative) Prats, New MD; Lorie G. Fleck, MD; Mobile, AL (Chair) AL Mobile, MD; Fleck, G. Lorie Health Policy Council Policy Health 12 REPRESENTATIVES TO AUA COMMITTEES

AUA Board of Directors Raymond J. Leveillee, MD; Cooper City, FL (Alternate Representative) 2017 Thomas F. Stringer, MD; Gainesville, FL (Representative) 2017

AUA Bylaws Committee Lee N. Hammontree, MD; Homewood, AL 2017 (T2) Gerard D. Henry, MD; Shreveport, LA 2017 (T3) Gregory F. Murphy, MD, FACS; Greenville, NC 2017 (T2)

AUA Editorial Board Committee Wayne J.G. Hellstrom, MD, FACS; New Orleans, LA 2017 Nicole L. Miller, MD; Nashville, TN 2016 Ramakrishna Venkatesh, MD, MS, FRCS; St. Louis, MO 2018

AUA Health Policy Council Lorie G. Fleck, MD; Mobile, AL 2019 Andrew Charles Peterson, MD, FACS; Durham, NC 2017 Terrence Christopher Regan, MD; Palm Coast, FL 2017

AUA History Committee Jerry E. Jackson, MD; Sumter, SC 2017

AUA Judicial & Ethics Council Peter Earl Clark, MD; Nashville, TN 2016 Gregory F. Murphy, MD, FACS; Greenville, NC 2017 Stephen Edward Strup, MD, FACS; Lexington, KY 2019

AUA Nominating Committee Charles R. Pound, MD; Jackson, MS (Representative) 2017 Raju Thomas, MD, FACS, MHA; New Orleans, LA (Alternate Representative) 2017

AUA Practice Management Committee David M. Kraebber, MD; Wilmington, NC 2017

AUA Resident's Committee Julia M. Willingham, MD; Shreveport, LA (Representative) 2016

AUA Young Urologist Committee Christopher S. Gomez, MD; Miami, FL (Representative) 2017

14 NUMERICAL MEMBERSHIP

3 2

87 76 633 1443 2310

Numerical Membership of the SESAUA Active Affiliate Allied Associate Honorary Senior Membership of Grand Total

1414 General Meeting Information

Registration/Information Desk Hours Location: Broadway Ballroom EF Pre-Function, Level Two Wednesday, March 16, 2016 2:00 p.m. – 5:00 p.m. Thursday, March 17, 2016 5:30 a.m. – 5:00 p.m. Friday, March 18, 2016 6:00 a.m. – 5:45 p.m. Saturday, March 19, 2016 6:00 a.m. – 12:30 p.m. Sunday, March 20, 2016 6:00 a.m. – 12:15 p.m.

Exhibit Hall Hours Location: Broadway Ballroom EF, Level Two Thursday, March 17, 2016 9:00 a.m. – 4:00 p.m. Friday, March 18, 2016 10:00 a.m. – 4:00 p.m. Saturday, March 19, 2016 7:00 a.m. – 11:00 a.m.

Speaker Ready Room Hours Location: Mockingbird 1, Level Three Thursday, March 17, 2016 6:00 a.m. – 5:00 p.m. Friday, March 18, 2016 6:00 a.m. – 5:45 p.m. Saturday, March 19, 2016 6:00 a.m. – 12:30 p.m. Sunday, March 20, 2016 6:00 a.m. – 12:15 p.m.

Spouse / Guest Hospitality Suite Hours Location: Bass Room, Level Four Thursday, March 17, 2016 7:30 a.m. – 10:30 a.m. Friday, March 18, 2016 7:30 a.m. – 10:30 a.m. Saturday, March 19, 2016 7:30 a.m. – 10:30 a.m. Sunday, March 20, 2016 7:30 a.m. – 10:30 a.m.

Board of Director and Committee Meetings

Executive Committee Meeting: Wednesday, March 16, 2016 8:00 a.m. – 12:00 p.m. Location: Gibson Boardroom

Board of Directors Meetings: Wednesday, March 16, 2016 Board of Directors Lunch 12:00 p.m. – 1:00 p.m. Location: Cumberland 2

Board of Directors Meeting 1:00 p.m. – 5:00 p.m. Location: Cumberland 5/6

Committee Meetings: Thursday, March 17, 2016 Health Policy Council Meeting 5:00 p.m. - 5:30 p.m. Location: Cumberland 6

Friday, March 18, 2016 Nominating Committee Meeting 4:45 p.m. - 5:45 p.m. Location: Cumberland 5

Residents Committee Meeting 5:00 p.m. - 6:00 p.m. Location: Cumberland 6

16 GENERAL MEETING INFORMATION tive . All D -

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17 Dinner and Entertainment

Cocktails d’oeuvres and Hors

Evening Functions Omni Nashville Hotel in Broadway Broadway in Hotel Nashville Omni

Child Care Information

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7:30 p.m. 7:30 11:00 p.m. 11:00 9:30 p.m. 9:30

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eception Banquet and ess Meetingess 11:45 a.m. at the the 11:45 at a.m. Omni Nashville Hotel, Broadway Ballroom Denim and Dazzle registratio in included is ticket (1) One The closingsocial eventthe of 80 Country Music Fame of Hall Denim, Boots & Buckles (Casual) 6:30 p.m. One ticket (1) is included inregistration, addit adults and complimentarychildren. for Welcome to Nashville! Come enjoy a glass of wine, local cuisine, and and cuisine, local wine, glass a of enjoy Come to Nashville! Welcome entertainmentcolleagues catching with while and exhibitors. up 7:30 p.m. 6:30 p.m. please an expertly with menu,musical crafted everyone entertainment and dancing.

–

Location: Location: Attire: Cost: Website: 19, MARCH 2016 SATURDAY, 2016 R Annual Time: Description: Attire: Cost: Description: Email: Disclaimer: SESAUA is to happy provide this information, butdirectly is not associatedwith the sitting service. Phone: Location:

Sitting Service: One ticket to each functionincludedOne ticketto in registration each is your fee. Individual tickets be pu may THURSDAY, MARCH 17, 2016 Celebration Opening Time: Annual Busin Annual The SESAUA Annual MeetingBusiness heldwill be Saturday, on March 19, 2016, from 11:00 a.m. meeting attendees welcome are and encouraged to attend. Please note that only Ac and Senior membersmay vote. Members need not be registered for the scientific portion of the conference to attend the Business Meeting. 16 Optional Events

(Availability of tours is subject to change)

Optional events are not included in the registration fee, except for the Presentation on the Foundation for Hospital Art “PaintFest.”

All optional tours depart from the main lobby of the Omni Nashville Hotel unless otherwise noted. Please arrive 15 minutes prior to the scheduled time.

THURSDAY, MARCH 17, 2016

Presentation on the Foundation for Hospital Art “PaintFest” 9:30 a.m. - 9:50 a.m. The Hospital Art “Paintfest” will be open during all Spouse/Guest Hospitality Suite Open Hours in the Bass Room at the Omni Nashville Hotel – Spouse/Guest Hospitality Room. The traditional hospital setting is exemplified by white, sterile walls and ceilings. Examining rooms, waiting rooms, corridors – areas where health professionals and other caregivers work, where families and patients wait – are too often colorless, lifeless and certainly not inviting. The Foundation for Hospital Art was officially established in 1984, and is dedicated to involving patients and volunteers worldwide to create colorful, soothing artwork donated to hospitals to help soften the often stressful hospital experience. Information above, along with other information, can be found at www.hospitalart.com. Cost: Complimentary

Discover Historic Franklin Tour (Boutique Shopping) 11:00 a.m. – 3:15 p.m. Participants are required to meet in the lobby of the Omni Nashville Hotel at 10:45 a.m. The tour includes transportation and a tour guide. Franklin is a unique blend of history and progress. Since its beginning in 1799, it’s grown from a tiny, agricultural community into a strong blend of residential, commercial and corporate citizens. Downtown Franklin, comprised of a beautiful historic district, offers true Southern hospitality with a great American Main Street, and 200 years of rich history. Visitors will find commemorative brick sidewalks, beautiful landscaping, lovely Victorian architecture, and stunning renovated historic buildings – all located in the heart of Franklin. Downtown Franklin offers elegant shopping, restaurants, antique shops, a variety of clothing stores, art galleries, professional services, and more. Cost: $50.00 per person

18 OPTIONAL EVENTS lle

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al al events make this museum worth visiting. 4:00 p.m. 4:30 p.m.4:30 3:45 p.m.3:45

– – – 00 per person 00 per ation, a docent tour, 45 Tour Culinary Plantation Kitchen Meade Belle 1:00 p.m. 18, 2016 MARCH FRIDAY, 1:00 p.m. Music and Memories Tour Memories and Music the winery. Tostageset for thesouthernculinary this adventure, will tour we one ofSouth’s the great mansions,Belle Plantation. Meade The tour begins infullythe re mansion, completed in whose1853, grounds include a large house, carriage stable,log cabin,Weseveral other and the original buildings.spendin original thenPlantation will time kitchen the where southern cooks will let partici you classics like biscuitscountry smoked plantation with home pie, or ham, pecan Hotel at 12:45 p.m. The tour includes transportation, entrance to the Belle Meade Plant smoked. The final stop will be a sampling of five in wines the winery, a tradition started on the plantation 1820. in Cost: $114.00 person per Lesson Mixology 2:00 p.m. Nashville andcocktails,Themixology eventHotel. in includes light lesson snacks. a Hotel at 12:45The tour p.m. includes transportation, intoJohnnyentrance and the Cash Museum, Musicians Museum. and Hall Fame and of music peoplemake come and inevitably Music for placewhere is to known the City memoriesmade are as well. Take an i and preserves. The tour also explores the kitchen’s cellar, root garden, herb and the largest antebellum smokehouse inthe South offriendssocialenvy gatherings all the knowing ever to you your Have at wanted be by to mix tohow the thi cocktail? perfect Sneak away Hotel to become the always you’ve to bartender wanted be. During the lesson will you taught a trained by mixologist to make on how several of popularmost craft the cocktails currentlymore than there. There’s out ju additionmix to trendy to your cocktail, learning how be given will an introduction you on the Tennessee for,several known the whiskeys Nashville of specialty and is ingredientslike bitters too. Cost: $80. opened in2013, museum the features themost largestcomprehensive and collection of Johnny Cashmemorabilia artifacts and Statein world. the iconic artists,explore theJohnnythat only museum Cash, and world honorsthe the in talentedmusiciansplayed on the greatest who time. recordings The all tour of a begins with stop at the Johnny Cash M Cost: $83.00 per The finalstopMusicianstourthe the is at of Hall and Museum Fame in Of reopened which 2013 inthe bottom level of the historic Municipal Auditoriuma three year after absence. The museum somethinghas of inter HotRed Chili Peppers, and from toMotown Southern Rock. likeSome Jimi are Hendrix known. Otherswell session such as L.A. Hal Blaine drummer not as known, but are well played have on hundreds of hit ThePapas, Mamas and The and The BeachBoys. The Musicians Hall Fame of and Museum has on exhibit the very instruments that thesemusicians used to record many of these classic hits. store, speciand 1818 SATURDAY, MARCH 19, 2016

Artistic Side of Nashville Tour 10:00 a.m. – 2:00 p.m. Participants are required to meet in the lobby of the Omni Nashville Hotel at 9:45 a.m. The tour includes transportation and admission to the Frist Center for the Visual Arts. Spend the day enjoying the artistic side of Nashville! Nashville’s largest art museum is the Frist Center for the Visual Arts, a 125,000 square-foot exhibition facility in downtown Nashville. The Frist does not collect art, but displays a revolving collection of the finest international, national and local art that is changed every six to eight weeks. After the Frist, set out to discover some of Nashville’s best art galleries located on the 5th Avenue of the Arts. Nashville’s burgeoning art scene is gaining quite the following especially with the First Saturday Art Crawl, an evening of hundreds of Nashvillians enjoying wine and art while floating from gallery to gallery. Cost: $67.00 per person

Golf 1:00 p.m. – 5:30 p.m. at Richland Country Club. Transportation departs from the Omni Nashville Hotel at 12:30 p.m. The event price includes green and tournament fees, cart, and box lunch.

Nestled on 170 acres of rolling hills with breathtaking views, Richland Country Club is steeped in the history, elegance and grace of Tennessee. It is the tradition of friendliness and of premier club facilities, blended together in a beautiful setting and surrounded by our Jack Nicklaus signature golf course. For many, Richland is their home away from home – a place to connect, relax and enjoy the simple pleasures of life. Cost: $123.00 per person

Hector Henry 5K Run/Walk 2:30 p.m. Participants are required to meet in the lobby of the Omni Nashville Hotel at 2:15 p.m. Started in 2014 at the 78th Annual Meeting in Florida, the Hector Henry 5K Run/Walk honors our past president and historian. Take part in honoring the late Hector Henry in the Third Annual Hector Henry 5K Run/Walk. The route will begin at the Omni Nashville Hotel lobby. All participants will receive a commemorative shirt. In addition, you have the opportunity to donate to the event with the tax deductible proceeds going to the Nashville chapter of the Leukemia and Lymphoma Society. Please contact the registration/information desk for more information or to submit a donation. Cost: $25.00 per person

20 INDUSTRY

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of Prostate Cancer” MD Klein, Eric Glickman Urological Institute and Kidney Taussig Institute atCancer Clinic Cleveland Ohio Cleveland, Industry Satellite Symposium Lunch Symposium Satellite Industry Location: DX “Oncotype TreatmentDecisions for Cancer Patients” Vahan S. Kassabian, MD PA Urology, Georgia GA Atlanta, Lunch Symposium Satellite Industry Location: GH Broadway Ballroom “Rationalof Genomic Testin Use Jenkins/Pokempner Director Complementary of and Alternative Medicine Department Urology,of of University Michigan, Ann Arbor, Michigan Lunch Symposium Satellite Industry Location: JK Broadway Ballroom That mCRPC With Patients for Clinical Findings “Key Therapy” Deprivation on Androgen Progressed Has MD, FACS S. Raoul Concepcion, Urology TN Nashville, MD, W. Moul, Judd FACS Duke University Medical Center Durham, NC “Continuing Care for Your Patients With Metastatic Metastatic With Patients Your for Care “Continuing CRPC” MD, FACS Morris, David Urology Associates, PC Hendersonville, TN Lunch Symposium Satellite Industry Location: “Promoting Wellness in Save 2016: Time Reviewing Worthless” What WorksIs What and MD, MPH Moyad, Mark Industry Satellite Symposium Lunch Symposium Satellite Industry Location: Broadway

Industry Satellite Events Symposium Industry

1:30 p.m. 1:30 p.m. 1:45 1:30 p.m. 1:30 1:30 p.m. 1:30 1:30 p.m. 1:30

– – – – – MARCH 18, 2016 MARCH

19, MARCH 2016 SATURDAY, 12:30 p.m.

12:30 p.m.

FRIDAY, 12:30 p.m.

12:15 p.m.

THURSDAY, MARCH17, 2016 12:15 p.m. 2020 Technical Exhibits

Alphabetical as of 3/1/16

AbbVie KARL STORZ Allergan, Inc. Koelis American HIFU/Southern Litho Lumenis, Inc. American Urological Association, Inc. Marley Drug, Inc Astellas Pharma US, Inc. MDxHealth ASTORA Woman's Health Medivation/Astellas Bard Medical MiMedx Group Bayer HealthCare Mission Pharmacal Company Bayer Multi Vendor Service Myriad Genetic Laboratories, Inc. Boston Scientific Corporation NeoTract, Inc. Cogentix Medical Nurse Rosie Products Coloplast NuTech Biomarkers LTD LLC Cook Medical Olympus America, Inc. Dendreon Corporation Owensboro Health Regional Hospital Dornier MedTech Pacific Edge Diagnostics USA Ltd. EDAP Technomed, Inc. Palmetto Health Endo Pharmaceuticals Prometheus Laboratories Inc. Ferring Pharmaceuticals Retrophin GenomeDx Biosciences Inc. Richard Wolf Medical Instruments, Corp. Genomic Health Rush Health Systems GenPath Siemens Medical Solutions USA, Inc. HealthTronics, Inc. Signostics HIFU Solution, LLC TOLMAR Pharmaceuticals Hitachi-Aloka Medical United Medical Systems Janssen Biotech, Inc.

22 INDUSTRY

Contributors

23 AbbVie Coloplast Industry Partners Industry en Biotech, Inc.

Gold Level Level Gold Silver Level Cook Medical KARL STORZ KARL Platinum Level Level Platinum Genomic Health Marley Drug,Marley Inc Medivation/Astellas ology Foundation Care Industry Partners Industry Janss Nurse Products Rosie Dendreon CorporationDendreon Astellas Pharma US, Inc. Ur GenomeDx Biosciences Inc. Biosciences GenomeDx Our 2016Our Myriad GeneticMyriad Laboratories,Inc. Thank 2016to Our You The SESAUA Wishes Thank andThe to Recognize SESAUA

22 Named Lectures and Contests

The Ballenger Memorial Lecture

Dr. Edgar Ballenger was the Southeastern Section president in 1935 and president of the AUA in 1939. The Annual Ballenger Memorial Lectureship was established after his death in 1946 and serves as our major scientific presentation.

Samir S. Taneja, MD is the James M. and Janet Riha Neissa Professor of Urologic Oncology, Professor of Urology and Radiology, and director of the division of urologic oncology at the NYU Langone Medical Center. He received his undergraduate and medical education at Northwestern University Medical School. He completed his surgical and urologic training at the University of California at Los Angeles, and joined the NYU faculty in 1996. Dr Taneja is nationally renowned as a leader in the treatment and research of urologic cancers. His clinical practice has focused upon radical prostatectomy, partial nephrectomy, and complex tumor resection, by open and minimally invasive techniques. His laboratory research has focused in androgen receptor transcriptional activation and the relationship of AR to prostate cancer growth. He has previously overseen a research laboratory in androgen receptor biology, and has received funding through the National Institutes of Health, Department of Defense, and the Prostate Cancer Foundation. In recent years, his clinical research interest has been in prostate cancer diagnostics, with particular focus on the use of imaging in the detection, risk stratification, and therapy of prostate cancer. He is internationally renowned as an expert in prostate cancer imaging, MRI-targeted prostate biopsy, and integration of MRI into clinical practice paradigms. He has lectured throughout the world on the use of prostate MRI in detection and therapy. He has served as Oncology Task Force Member and Chair, and Oncology Knowledge Assessment Test Co-Chair, for the American Board of Urology Exam Committee, Program Chair and Executive Committee Member for the Society of Urologic Oncology, and, most recently, Secretary General of the Urologic Research Society. He has authored over 150 articles, 25 book chapters, and five textbooks and periodicals on urologic cancer and urologic surgery. He is the consulting editor of the Urologic Clinics of North America, and serves on the editorial board of European Urology. He is the previous Urology Surveys Upper Tract Oncology Editor, and the current Urology Surveys Prostate Cancer Editor for the Journal of Urology. He is editor of the 3rd, 4th, and upcoming 5th, editions of Taneja's Complications of Urologic Surgery: Prevention and Diagnosis, one of the most widely read textbooks in American urology.

The Montague Boyd Prize Essay Contest

Dr. Montague Boyd was the founder of the Southeastern Section, and he served as president in 1933 and 1934. The prize was established in 1967 and is given to a resident, fellow, or urologist in private practice less than 10 years.

24 NAMED LECTURES AND CONTESTS 25 Dr. Samuel Ambrose was the Southeastern Southeastern was the Ambrose Section Samuel Dr. president in 1975, and in 1981 became the first chairman Public Relations to be Committee, later called AUA of the Mason who served as the Socioeconomic Committee. Dr. president this committee, which formed later became the Josiah Reed Southeastern was the Health Council. Policy Dr. The Ambrose-Reed Ambrose-Reed The Lecture The T. Leon Howard Imaging Conference The T. Dr. Deepak A. Kapoor, President, Advanced Urology Centers of New York, York, Urology Centers of New Advanced President, A. Kapoor, Deepak Dr. is one of the youngest physicians to have headquartered in Melville, NY, been certified by the American Board of Urology over 20 years of clinical and business expertise. His medical background and comes to IMP with is diverse with both laboratory and clinical experience, both in the academic Kapoor’s expertise includes basic science research and private sectors. Dr. and extensive experience in oncologic in molecular well as biologyas reconstructive surgery. Dr. T. Leon Howard was president of the South Central Section in 1932. He Leon Howard was president of T. Dr. AUA American Board of Urology in 1934 and was a founding trustee of the president in 1941. He became an honorary member of the Southeastern Section in 1947. Dr. Kapoor’s organization, Advanced Urology Centers of New York (AUCNY), has become York Advanced Urology Centers of New Kapoor’s organization, Dr. the largest comprehensive urology group in the United States, and is regarded practice as compliance and the areas of quality management, utilization a national leader in the review, development of coordinated clinical pathways. Associate Professor of Urology, Kapoor is Clinical Dr. AUCNY, In addition to his duties with at the Icahn School of Medicine at Mount Sinai, Chairman of Health Policy and Immediate (representing nearly 25% of all practicing urologists in the United Past President of LUGPA malpractice medical specific urology national only (the RRG SCRUBS of Chairman is States), (the national political action of UROPAC carrier), has served on the Board of Directors York committee representing the interests of the specialty of urology), founder of the New Association (representing urology group practices the business interests of Trade Urology Access to Integrated Cancer Care (an informal past Chairman of York), in the State of New advocacy group representing the rights of patients to access integrated services of the Allied Urological Services, (the of Directors of highest quality), is a member of the Board Chairman where he also functions as , States largest lithotripsy partnership in the United and Past-President of the Integrated Medical of the Finance Committee) and is Founder Executives. American College of Physician Kapoor is a Fellow of the Foundation. Dr. Kapoor has published lectured extensively and on both clinical and business medical Dr. York medical advisory boards, includingon a number of the New issues, and serves He is the 2014 recipient of the Russell Advisory Panel. State Governor´s Prostate Cancer American Section of the York from the New Award Lavengood Distinguished Service W. from Award Ambrose-Reed Socioeconomic Essay Association as well as the 2011 Urological clinical Kapoor continues to enjoy an active practice Association. Dr. American Urological the along with his administrative duties. Section president in 1992, and chairman of the AUA Socioeconomic Committee in 1986. This Socioeconomic Committee in 1986. AUA of the in 1992, and chairman Section president pioneers in the field of health policy. award honors these two 24 The Gee-Dineen Health Policy Forum

The Gee-Dineen Health Policy Forum will examine the impact of Government health policy, physician payment reform and the interaction between quality patient care and the pressures of trying to practice medicine amid ever increasing government regulation. These sessions serve to honor Drs. William Gee and Martin Dineen, past presidents of the Section, for the major contributions they have made to the socioeconomic issues at both the sectional and national levels.

2016 Presidential Lecture: Laurence H. Klotz, MD, FRCSC

Dr. Laurence Klotz is currently Professor of Surgery at the University of Toronto and Past Chief, Division of Urology, Sunnybrook Health Sciences Center. He is a graduate of the University Toronto Faculty of Medicine, and the Gallie program in urology at the University of Toronto. He was a fellow in Urologic Oncology at Memorial Sloan Kettering Cancer Centre. He is the current chairman of the Canadian Urology Research Consortium and the World Urologic Oncology Federation (WUOF). He is a member of the American Association of Genito-Urinary Surgeons, Past-President of the Urological Research Society and the Canadian Urological Association, and honorary member of the American, Chinese, and Chilean Urological Associations. Professor Klotz’s research interests include molecular and metabolic effects of androgens and androgen deprivation therapy (ADT), active surveillance, focal therapy for low risk disease using HIFU, and prostate cancer prevention. He has been the national or international principal investigator for multicentre clinical trials of ADT, active surveillance and biomarkers for prostate cancer, among numerous others. Professor Klotz is the associate editor of the Journal of Urology responsible for prostate cancer, the editor emeritus of the Canadian Urology Association Journal, and is an honorary director of Prostate Cancer Canada. During his career, he has authored approximately 350 peer-reviewed scientific publications and five books. He founded ‘The Void,’ an all-urology contemporary rock band. He was awarded the Queen’s Jubilee Medal for meritorious public service in 2013, the Lister Prize and the Society of Urologic Oncology Medal in 2014, and the Order of Canada and the Canadian Cancer Society Harold Warwick Prize in 2015.

26 Full Scientific Program

th 80 Annual Meeting of the Southeastern Section of the AUA WEDNESDAY

March 16 - 20, 2016 Omni Nashville Hotel

All sessions will be located in Broadway Ballroom A-D unless otherwise noted Speakers and times are subject to change

WEDNESDAY, MARCH 16, 2016

OVERVIEW THURSDAY

8:00 a.m. - 12:00 p.m. SESAUA Executive Committee Meeting Location: Gibson Boardroom 12:00 p.m. - 1:00 p.m. SESAUA Board of Directors Luncheon Location: Cumberland 2 1:00 p.m. - 5:00 p.m. SESAUA Board of Directors Meeting Location: Cumberland 5/6 2:00 p.m. - 5:00 p.m. Registration/ Information Desk Open Location: Broadway Ballroom EF Pre-Function

THURSDAY, MARCH 17, 2016

OVERVIEW

5:30 a.m. - 5:00 p.m. Registration/Information Desk Open Location: Broadway Ballroom EF Pre-Function 6:00 a.m. - 5:00 p.m. Speaker Ready Room Hours Location: Mockingbird 1 7:30 a.m. - 10:30 a.m. Spouse/Guest Hospitality Suite Open Location: Bass Room 9:00 a.m. - 4:00 p.m. Exhibit Hall Open Location: Broadway Ballroom EF 9:30 a.m. - 9:50 a.m. Presentation on the Foundation for Hospital Art "Paintfest" Location: Bass Room 11:00 a.m. - 3:15 p.m. Discover Historic Franklin Tour (Boutique Shopping) Location: Meet in the lobby of the Omni at 10:45 a.m. 1:00 p.m. - 3:45 p.m. Music and Memory Tour Location: Meet in the lobby of the Omni at 12:45 p.m. 6:30 p.m. - 9:30 p.m. Opening Celebration Location: Country Music Hall of Fame

26 27 Concurrent Sessions Begin

Concurrent Session 1 of 2

6:30 a.m. - 8:00 a.m. Prostate Cancer 1 Poster Session Location: Cumberland 3 Moderators: Raju Thomas, MD, FACS, MHA New Orleans, LA Wesley M. White, MD Knoxville, TN Poster #1 CAN PSA DENSITY AND FREE-TO-TOTAL PSA RATIO IMPROVE OUR ABILITY TO PREDICT PROSTATE CANCER ON BIOPSY? RESULTS FROM A PROSPECTIVE, MULTI-INSTITUTIONAL, AND CONTEMPORARY COHORT Samarpit Rai¹, Nachiketh Soodana Prakash², Nicola Pavan³, Bruno Nahar², Amil Patel², Yan Dong4, Ramgopal Satyanarayana², Dipen J. Parekh² and Sanoj Punnen² ¹Department of Urology, University of Miami Miller School of Medicine, Miami, FL; ²Department of Urology, University of Miami Leonard M. Miller School of Medicine, Miami, FL; ³Department of Urology, University of Miami Leonard M. Miller School of Medicine, Miami, FL and Urology Clinic, Department of Medical, Surgical and Health Science, University of Trieste, Italy; 4OPKO Diagnostics, LLC, Nashville, TN Presented By: Samarpit Rai, MD Poster #2 AMONG MEN WITH LOW-GRADE PROSTATE CANCER ON PROSTATE BIOPSY, THE 4KSCORE PREDICTS MORE AGGRESSIVE PROSTATE CANCER AT PROSTATECTOMY Sanoj Punnen¹, Vivek Venkatramani², Bruno Nahar1, Stephen Zappala2, Daniel Sjoberg3 and Dipen Parekh¹ ¹Department of Urology - University of Miami Miller School of Medicine, Miami FL; 2Andover Urology, Andover, MA; 3Memorial Sloan Kettering Cancer, New York City, NY Presented By: Vivek Venkatramani, MD Poster #3 MULTIPLEX RNA SEQUENCING OF PROSTATE CANCER-ASSOCIATED TRANSCRIPTS IN EXTRACELLULAR VESICLES FROM POST-DRE URINE Kathryn Pellegrini¹, Kristen Douglas², Kathryn Wehrmeyer¹, Dattatraya Patil¹, Nicole Pulley¹, Anna Bausam¹, Mersiha Torlak¹, Martin Sanda¹ and Carlos Moreno¹ ¹Emory; ²Emory University, Atlanta, GA Presented By: Kristen Douglas, BA Poster #4 MICRORNA-301A EXPRESSION ACT AS A DISPARITY MARKER FOR PROSTATE CANCER Angelena Edwards¹, Trinath P. Das², Arokya PapuJohn², Suman Suman², Targhee J. Morris², Erin N. Floyd³, Akhila Ankem², Jamie C. Messer², Houda Alatassi³, Murali K. Ankem² and Chendil Damodaran² ¹University of Louisville School of Medicine, Louisville, Kentucky; ²Department of Urology, University of Louisville School of Medicine, Louisville, Kentucky; ³Department of Pathology, University of Louisville School of Medicine, Louisville, Kentucky Presented By: Angelena B. Edwards, MD

28 THURSDAY

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, Robert Coleman , Robert , Vidhush Yarlagadda , Vidhush ¹ 8 ¹ 29 , Jeffrey Nix Jeffrey , , Thomas Polascik , Thomas ³ ¹ , Karin Staudacher , Karin

4 223 DICHLORIDE (RA Statisticon AB, Uppsala, Sweden; Sweden; Uppsala, AB, Statisticon - , Houda Alatassi , Houda 6 ¹ and Oliver Sartor Oliver and Guthrie

n Jones n 7 , Robert Given Robert , Tulane Cancer Center, New Orleans, LA Orleans, New Center, Cancer Tulane 4 Department of Pathology and Laboratory Medicine, Tufts Tufts Medicine, Laboratory and Pathology of Department 8 4 MARY CRYOTHERAPYMARY FOR HIGH

YEAR FOLLOW YEAR - Al Kasr Al Aini Hospital, Cairo University, Giza, Egypt; Egypt; Giza, University, Cairo Hospital, Aini Al Al Kasr GU Research Network, LLC, Omaha, NE; NE; Omaha, LLC, Network, Research GU DukeUniversity, Durham, NC; Department of Urology, University of Alabama at Birmingham, Birmingham, at Alabama of University Urology, of Department Department of Urology, University of Louisville School of of School Louisville of University Urology, of Department Stephe School of Medicine, Baltimore, MD; MD; Baltimore, Medicine, of School OH MMed(Surg) MBBS, Tay, Jack Kae By: Presented State University School of Medicine, Detroit, MI; MI; Detroit, Medicine, of School University State Parker Medical School, Norfolk, VA; VA; Norfolk, School, Medical ¹ UK; Sheffield, Sheffield, of University Hospital, University Hospital, Stockholm, Sweden; Sweden; Stockholm, Hospital, University and Soroush Rais and Soroush PRI CANCER: PROSTATE LOCALIZED CLINICALLY THE FROM OUTCOMES FUNCTIONAL AND ONCOLOGIC COLD REGISTRY Tay Kae Jack Mosehly PROSTATE ON DISPARITIES RACIAL OF EVALUATION FUSION MRI/US ON DETECTION CANCER Patrick Cher RESISTANT PROSTATE CANCER (CRPC) Damodaran Chendil 3 Nordquist Luke BIOPSIES PROSTATE TARGETING INDEPENDENTAR MOLECULAR TREATMENT THE FOR SIGNALING John Thomas John Cancer Centers of Nevada, Las Vegas, NV; NV; Vegas, Las Nevada, of Centers Cancer rust and Institute of Cancer Research, Sutton, Sutton, Research, Cancer of Institute and Trust Foundation NHS UK; Norway; Medical Center, Boston, MA Boston, Center, Medical Guthrie J. Patrick By: Presented ¹ ³ Presented By: Luke Nordquist, MD, FACP MD, Nordquist, Luke By: Presented Alabama at Birmingham, Birmingham, AL; AL; Birmingham, Birmingham, at Alabama ¹ AL; Birmingham, Birmingham, Birmingham, at Alabama of University Radiology, AL; ¹ Kentucky; Louisville, Medicine, Vogelzang RADIUM University of Louisville School of Medicine, Louisville, Kentucky Louisville, Medicine, of School Louisville of University Presented By: Chendil Damodaran, PhD Damodaran, Chendil By: Presented RESISTANT PROSTATE CANCER (CRPC) PATIENT METASTASES BONE SYMPTOMATIC WITH (PTS) ALSYMPCA FROM (METS)

Poster #8 Poster Poster #7 Poster Poster #6 Poster Poster #5 Poster

28 Poster #9 SIGNIFICANT REDUCTION IN THERAPEUTIC BURDEN FROM USE OF CCP TEST IN TREATMENT DECISIONS AMONG NEWLY DIAGNOSED PROSTATE CANCER PATIENTS IN A LARGE PROSPECTIVE REGISTRY Brian Willard¹, Todd Cohen¹, Neal Shore², Judd Boczko³, Naveen Kella4, Brian J Moran5, Fernando J Bianco6, E David Crawford7, Rajesh Kaldate8, Michael K Brawer8 and Mark L Gonzalgo9 ¹Carolina Urology Partners, West Columbia, SC; ²Carolina Urologic Research Center, Myrtle Beach, SC; ³WESTMED Medical Group, Woodmere, NY; 4The Urology and Prostate Institute, San Antonio, TX; 5Prostate Cancer Foundation of Chicago, Westmont, IL; 6Urological Research Network, Miami Lakes, FL; 7University of Colorado at Denver, Aurora, CO; 8Myriad Genetic Laboratories, Inc., Salt Lake City, UT; 9University of Miami Miller School of Medicine, Miami, FL Presented By: T. Brian Willard, MD, FACS Poster #10 ROBOTIC TRAINING WITH PORCINE MODELS INDUCES LESS WORKLOAD THAN VIRTUAL REALITY ROBOTIC SIMULATORS FOR UROLOGY RESIDENT TRAINEES Vladimir Mouraviev, Martina Klein, Eric Schommer, Srinivas Samavedis, David Thiel, Gabriel Ogaya-Pinies, Hariharan Ganapathi, Anup Kumar, Raymond Leveillee, Raju Thomas, Julio Pow Sang, Li-Ming Su, Engy Mui, Roger Smith and Vipul R. Patel Global Robotic Institute, Celebration, FL Presented By: Gabriel Ogaya-Pinies, MD Poster #11 EVALUATION OF OUTCOMES OF SALVAGE ROBOTIC PROSTATECTOMY: SINGLE INSTITUTION EXPERIENCE Christopher Chew, Jamil Syed, Gabriel Ogaya-Pinies, Hariharan Ganapathi, Vladimir Mouraviev, Anup Kumar, Srinivas Samavedi, Rafael Coelho, Bernardo Rocco, Tracey Woodlief, Janice Doss, Cathy Jenson, Travis Rogers, Kevin Boener, John Andrich and Vipul R. Patel Global Robotic Institute, Celebration, FL Presented By: Gabriel Ogaya-Pinies, MD Poster #12 PROSTATE CANCER WITH RARE METASTATIC LYTIC BONE LESIONS: POSITIVE BONE SCAN POST DOXETAXEL CHEMOTHERAPY IN THE SETTING OF CLINICALLY SUCCESSFUL TREATMENT M. Paula Domino¹, Raymond Sutowski² and Victoria Y. Bird³ ¹Department of Urology, University of Florida, Gainesville, Florida; ²Department of Radiology, University of Florida; ³Department of Urology, University of Florida Presented By: Maria Paula Domino, MD

30 THURSDAY

¹ ¹

, Pranav Pranav , , Kamran Kamran , ² Shoshtari, Shoshtari, ¹ - , Pranav , Pranav ² FRACS

Department of of Department , Anthony M. , ³ 4 D P16INK4A

Sharma ity, Boca Raton Florida Raton Boca ity, MD

, and Philippe Spiess and Philippe and Philippe Spiess and Philippe

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¹ ¹

4 , Anna Giuliano Anna , ¹ , Anders E. Berglund E. , Anders

-Shoshtari itourinary Oncology, Moffitt Cancer Center, Center, Cancer Moffitt Oncology, itourinary , Peter Johnstone , Peter Department of Biomedical Informatics, H. Lee Lee H. Informatics, Biomedical of Department Department of Radiation Oncology, Moffitt Moffitt Oncology, Radiation of Department Florida Atlantic Univers Atlantic Florida ¹ ² ² ² Kelvin A. Moses, MD, PhDKelvin MD, A. Moses, TN Nashville, Michael E. Woods, MD Chapel Hill, NC

, Andrew Leone , Andrew , Andrew Leone , Andrew ¹ -Shoshtari 31 RECURRENCE IN PATIENTS WITH PENILE ¹ ¹

, Jasreman Dhillon Jasreman ,

4 , Julio M. Powsang M. Julio , , Kamran Zargar Kamran , ¹ ¹ -Shoshtari Center for Infection Research in Cancer, Lee Moffitt Cancer Cancer Moffitt Lee Cancer, in Research Infection for Center Department Gen of Department Department of Genitourinary Oncology, Moffitt Cancer Center, Center, Cancer Moffitt Oncology, Genitourinary of Department Department of Genitourinary Oncology, Moffitt Cancer Center, Center, Cancer Moffitt Oncology, Genitourinary of Department ¹ Florida; Tampa, FL; Tampa, Institute, Research and Center Cancer Moffitt ³ Center andResearch Institute, T Magliocco Sharma AND SYSTEMIC OF PATTERNS PRACTICE NATIONAL RADIATION INTHERAPY THE TREATMENTPENILE OF CANCER: ANALYSIS OF THE CANCERNATIONAL DATABASE Diorio Gregory RACIAL ECONOMICAND DISPARITIES IN THE CELL SQUAMOUS PENILE OF TREATMENT CARCINOMA: RESULTS FR DATABASE Zargar Kamran Ashouri, Kenan Sharma, Pranav EFFECT NO HAS SURGERY SPARING PENILE OF TYPE ON TIME TO CANCER Diorio Gregory ¹ Florida; Tampa, Florida Tampa, Center, Cancer Dio Joseph Gregory By: Presented CLINICAL SIGNIFICANCE OF P53 AN OF P53 SIGNIFICANCE CLINICAL Zargar Kamran Penis Cancer Poster Session Poster Penis Cancer Location: 4 Cumberland Moderators: CONTEMPORARYSTATUS IN NORTH A AMERICAN PENILE COHORT CARCINOMA Pathology, H. Lee Moffitt Cancer Center and Research Institute, Institute, Research and Center Cancer Moffitt Lee H. Pathology, Tampa, FL, Presented By: Kamran Zargar, MBChB Zargar, Kamran By: Presented ¹ Florida; Tampa, Moffitt Cancer Center, Tampa, FL Tampa, Center, Cancer Moffitt MD Sharma, Pranav By: Presented DO Diorio, Joseph Gregory By: Presented Adam Luchey and Philippe Spiess Philippe and Luchey Adam Sharma Zargar

8:00 a.m.

- Poster #13 Poster #16 Poster #15 Poster #14

6:30 a.m. Concurrent 2 Session 2 of 30 Poster #17 COMPARISON OF SURVIVAL OUTCOMES FOR AFRICAN-AMERICAN AND CAUCASIAN MEN WITH ADVANCED PENILE CANCER IN FLORIDA Chad R. Ritch¹, Nicola Pavan², Samarpit Rai¹, Nachiketh Soodana-Prakash¹, Raymond R. Balise³, Dipen J. Parekh¹ and Mark L. Gonzalgo¹ ¹Department of Urology, University of Miami Leonard M. Miller School of Medicine, Miami, FL; ²Department of Urology, University of Miami Leonard M. Miller School of Medicine, Miami, FL and Urology Clinic, Department of Medical, Surgical and Health Science, University of Trieste, Italy; ³Division of Biostatistics, Department of Public Health Sciences, University of Miami Leonard M. Miller School of Medicine, Miami, FL Presented By: Chad R. Ritch, MD, MBA Poster #18 LYMPHADENECTOMY FOR SQUAMOUS CELL CARCINOMA OF THE PENIS: FROZEN TO FINAL Neil Manimala¹, Shohreh Dickinsen², Jasreman Dhillon², Wade Sexton², Phillippe Spiess², Scott Gilbert², Julio Pow-Sang² and Michael Poch² ¹USF Dept of Urology, Tampa, FL; ²Moffitt Cancer Center, Tampa, FL Presented By: Neil J. Manimala, BS Poster #19 THE ETIOLOGIC ROLE OF HUMAN PAPILLOMAVIRUS IN PENILE CANCER: PUERTO RICO HEALTH SCIENCES STUDY Carlos M. Pérez-Ruiz¹,²,³, Vivian Colón-López², María Sánchez- Vázquez², Carola T. Sánchez², Mario Quintero-Anguilo4,³, María J. Marcos-Martínez4,³, Curtis Pettaway5, Joel Palefsky6, Antonio Puras-Báez¹,³ and Magaly Martínez-Ferrer² ¹University of Puerto Rico, School Of Medicine, Urology Section, San Juan, PR; ²University of Puerto Rico Comprehensive Cancer Center, San Juan, PR; ³Puerto Rico Medical Services Administration, San Juan, PR; 4University of Puerto Rico, Department of Pathology and Laboratory Medicine, San Juan, PR; 5University of Texas, MD Anderson Cancer Center, Houston, TX; 6University of California - San Francisco, San Francisco, CA Presented By: Carlos M. Perez-Ruiz, MD Poster #20 CONTEMPORARY SURVIVAL TRENDS IN PENILE CANCER James Ferguson¹, Allison Deal², Angela Smith³, Matthew Nielsen³ and Michael Woods³ ¹University of North Carolina Department of Urology; ²Lineberger Cancer Center, University of North Carolina; ³Department of Urology, University of North Carolina Presented By: James E. Ferguson III, MD, PhD Poster #21 CONTEMPORARY MANAGEMENT AND OUTCOMES OF GENITOURINARY MELANOMA: THE MOFFITT CANCER CENTER EXPERIENCE Barrett McCormick¹, Julio Pow-Sang², Wade Sexton², Poch Michael² and Philippe Spiess² ¹University of South Florida College of Medicine, Tampa, FL; ²Moffitt Cancer Center, Tampa, FL Presented By: Barrett Zachary McCormick, MD

Concurrent Sessions End

32 THURSDAY , ¹

¹ Urologic Urologic

Vanderbilt Vanderbilt ³

, David Penson , David

and Daniel Barocas and Daniel

, WangLucy

ak A. Kapoor,ak A. MD

Vanderbilt University Medical Center, Center, Medical University Vanderbilt

² and Award Presentation and Award SESAUA President SESAUA

Melville, NY Melville, Deep

ham, NC Ming Su, MD - , Jeremy Warner , Jeremy ¹

New York, NY Seattle, WA JeffreyW. Nix, MD New Orleans, LA Orleans, New Martin G. Sanda, MD GA Atlanta, MD Taneja, S. Samir MD Polascik, J. Thomas Dur James R. Porter, MD AL Birmingham, Li Jon S.Jon MD Demos, Lexington, KY FACSBenjamin R. MD, Lee, Lorie G.Lorie Fleck, MD AL Mobile, MD Jackson, E. Jerry Sumter, SC

Gainesville, FL Gainesville,

for Prostate Cancer Risk Assessment , Maximilian Lang Maximilian ,

¹ Reed Lecture: Urology Practice: Navigating Navigating Practice: Urology Lecture: Reed

Broadway Ballroom EFBroadway Ballroom - Ingram Cancer Center, Nashville, TN; TN; Nashville, Center, Cancer -Ingram

Visit Exhibits

- Dineen Health Policy Forum 1 Forum Policy Health Dineen - Vanderbilt University Medical Center, Department of Department Center, Medical University Vanderbilt

Surgery, Nashville, TN; TN; Nashville, Surgery, Vanderbilt Matthew Resnick Matthew ¹ Presented By: Raj Kurpad, MD Kurpad, Raj By: Presented Prostatectomy Robotic on Update Prostate Cancer Podium Session Moderators: TO PROCESSING LANGUAGE NATURAL OF USE THE DETERMINE CANCER PROSTATE RISK CLINICAL STRATA Gregg Justin the Paradigm Shift the Paradigm Woods Raj Michael and Kurpad NC Hill, Chapel Carolina North of University Panel Cancer Prostate Moderator: Biomarkers Panelist: Therapy Focal Panelist: Panelist: Ambrose Guest Speaker: Remarks Opening President: Break Location: Viewing Video Best Moderator: NODE LYMPH RETROPERITONEAL ASSISTED ROBOT DISSECTION Nashville, Medicine, of Department Center, Medical University TN MD Gregg, Justin By: Presented Gee Moderators:

1 11:45 a.m. 11:45

9:30 a.m. 8:45 a.m. 10:20 a.m. 10:20 9:00 a.m. 9:40 a.m. -

- - - - - 0 a.m. 10:20 a.m. # a.m. 10:20 Video #1 Video

10:20 a.m. 9:00 a.m.

8:00 a.m. 9:4 8:45 a.m.

9:30 a.m. 32 10:27 a.m. #2 APPLICATION OF ACTIVE SURVEILLANCE THRESHOLD TO SERIES OF SAMPLES SUBMITTED FOR COMMERCIAL TESTING Thomas E. Keane¹, Peter T. Scardino², Jack M. Cuzick³, Steve Stone4, Brent Evans4, Matthew R. Jorgensen4, James A. Eastham², John W. Davis5, Daniel W. Lin6, Judd W. Moul7, Michael K. Brawer4 and E. David Crawford8 ¹The Medical University of South Carolina, Charleston, SC; ²Memorial Sloan Kettering Cancer Center New York, NY; ³Wolfson Institute of Preventive Medicine, London; 4Myriad Genetics, Inc., Salt Lake City, UT; 5The University of Texas MD Anderson Cancer Center, Houston, TX; 6University of Washington, Seattle, WA; 7Duke Cancer Institute, Durham, NC; 8University of Colorado Health Science Center Aurora, CO Presented By: Thomas Edward Keane, MD, ChB, FRCSI, FACS 10:34 a.m. #3 ACCURACY OF STAGING MRI IN PATIENTS UNDERGOING ROBOTIC-ASSISTED LAPAROSCOPIC PROSTATECTOMY Timothy Brock¹, Wesley White², Ryan Pickens² and Eric Heidel² ¹University of Tennessee Medical Center, Knoxville, TN; ²Department of Surgery, University of Tennessee Medical Center, Knoxville, TN Presented By: Timothy C. Brock, MD 10:41 a.m. #4 PREDICTORS OF EXTRAPROSTATIC EXTENSION AFTER RADICAL PROSTATECTOMY IN A CONTEMPORARY COHORT OF MEN BIOPSIED WITH AN EXTENDED BIOPSY SCHEME Wilson Rovira¹, Juan Serrano-Olmo² and Ricardo Sánchez-Ortiz³ ¹University of Puerto Rico School of Medicine, San Juan, PR; ²San Pablo Pathology Group, Bayamón, PR; ³Robotic Urology & Oncology Institute and University of Puerto Rico School of Medicine, San Juan, PR Presented By: Wilson Rovira-Pena, MD 10:48 a.m. #5 NOVEL IN VIVO MODEL FOR COMBINATORIAL FLUORESCENCE LABELING IN MOUSE PROSTATE Xiaolan Fang¹, Michael B. Rothberg², Kenneth Gyabaah³, Bita Nickkholgh³, J. Mark Cline4 and K.C. Balaji² ¹Department of Cancer Biology, Wake Forest Comprehensive Cancer Center, Winston-Salem, NC; ²Department of Urology, Wake Forest School of Medicine, Winston-Salem, NC; ³Wake Forest Institute for Regenerative Medicine, Winston-Salem, NC; 4Department of Pathology, Wake Forest School of Medicine, Winston-Salem, NC Presented By: Michael B. Rothberg 10:55 a.m. #6 THE 4KSCORE PREDICTS THE GRADE AND STAGE OF PROSTATE CANCER IN THE RADICAL PROSTATECTOMY SPECIMEN; RESULTS FROM A MULTI-INSTITUTIONAL PROSPECTIVE TRIAL Sanoj Punnen¹, Vivek Venkatramani², Bruno Nahar¹, Daniel Sjoberg², Stephen Zappala³ and Dipen Parekh¹ ¹Department of Urology - University of Miami Miller School of Medicine, Miami FL; ²Memorial Sloan Kettering Cancer, New York City, NY; ³Andover Urology, Andover, MA Presented By: Sanoj Punnen, MD

34 THURSDAY

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¹ kh, Murugesan Manoharan Manoharan Murugesan kh, ZED READ INZED READ Prakash, MD, MS MD, -Prakash, University of North Carolina, Carolina, North of University BBS, MMed(Surg)) BBS, ²

am Blot , Bruno Nahar Bruno , , Alison Brown , Alison , Felipe Munera , Felipe ¹ , Yuqi Bi Yuqi , ¹ ¹ ¹

, Mark ,Gonzalgo Mark ¹ CAPSULAR EXTENSION OF OF EXTENSION CAPSULAR

and Willi and ¹

Department of Radiology University of of University Radiology of Department ¹ ²

, Murugesan Manoharan , Murugesan ³

35 ¹ Punnen anoj , Rajan Gupta , Rajan , Zhiguo Zhao , Zhiguo , Samarpit Rai Samarpit , ¹ ¹ ¹

, Jay Fowke , Jay and S

² ¹ RISK PROSTATE CANCER PROSTATE RISK

DukeUniversity, Durham, NC; Department of Urology, University of Miami Miller School of of Miller School Miami of University of Urology, Department Vanderbilt University Medical Center, Nashville, TN; TN; Nashville, Center, Medical University Vanderbilt PROSTATE CANCER NC Hill, Chapel M Tay, Jack Kae By: Presented PREDICTING EXTRA Tay Kae Jack Polascik and Thomas ¹ INCOME LOW AMONG SCREENING PSA OF PATTERNS AFRICAN WHITEAMERICAN AND MEN: FROM DATA THE SOUTHERN COMMUNITY COHORT STUDY Moses Kelvin ¹ FL; Miami Medicine FL; Miami Medicine of School Miller Miami OF ABILITY THE OF ANALYSIS COMPARATIVE ACTIVE AND NOMOGRAMS PATHOLOGICAL SURVEILLANCE CRITERIA TO SELECTWITH PATIENTS LOW Pare J Dipen Iremashvili, Viacheslav Punnen and Sanoj University of Miami, Miami, FL PhD MD, Iremashvili, Viacheslav By: Presented DEFININGINCREMENTAL THE UTILITY OFPROSTATE MULTIPARAMETRIC MAGNETIC RESONANCE IMAGING STANDARD SPECIALIAT AND CANCER DETECTION BETWEEN PERIPHERAL ZONE ZONE PERIPHERAL BETWEEN DETECTION CANCER BIOPSIES? TARGETED ZONE TRANSITIONAL AND PROSPECTIVE A FROM RESULTS PRELIMINARY MENCOHORT OF UNDERGOINGMRI Prakash Soodana Nachiketh Pavan Nicola Miami Medicine of Miller School Miami of University Biostatistics, FL Soodana Nachiketh By: Presented Holmes EVALUATING THE TIMING OF SURGICAL OF SURGICAL THE TIMING EVALUATING PROSTATECTOMY FOLLOWING COMPLICATIONS Eric Deal, Allison Sukhu, Troy Macey, Matthew Lomboy, Jason Matthe Pruthi, Woods, Raj Michael Wallen, Smith NC Hill, Chapel MD Lomboy, R. Jason By: Presented BIOPSY ¹ Ramgopal Satyanarayana Ramgopal Parekh Raymond Balise Raymond Medical College, Nashville, TN Nashville, College, Medical PhD MD, Moses, A. Kelvin By: Presented

11:30 a.m. #11 a.m. 11:30 11:23 a.m. #10 a.m. 11:23 11:16 a.m. #9 a.m. 11:16 11:09 a.m. #8 a.m. 11:09 11:02 a.m. #7 a.m. 11:02

34 11:37 a.m. #12 PATHOLOGIC UPGRADING ON CONFIRMATORY BIOPSY IN A RACIALLY DIVERSE GROUP OF MEN ON ACTIVE SURVEILLANCE FOR PROSTATE CANCER Allison H. Feibus¹, Nora M. Haney¹, John Boxberger¹, Justin Levy¹, Elisa Ledet¹, Robert S. Libby¹, Jordan J. Kramer¹, Ian R. McCaslin¹, Krishnaro Moparty², Brian Lewis¹, Raju Thomas¹, Oliver Sartor¹ and Jonathan L. Silberstein¹ ¹Tulane University School of Medicine - New Orleans, LA; ²Southeast Louisiana Veterans Health Care Services, New Orleans, LA Presented By: Allison Feibus, BS, MS 11:45 a.m. - 12:15 p.m. Survivorship Panel Discussion Moderator: Andrew C. Peterson, MD, FACS Durham, NC Management of Lower Urinary Complications After Treatment for Prostate Disease: Stricture, Bladder Neck Contracture, Fistula and the Devastated Outlet Panelist: Richard A. Santucci, MD Detroit, MI The Potential for Neuromodulatory Strategies in the Radical Pelvic Surgery Patient Panelist: John P. Mulhall, MD New York, NY

12:15 p.m. - 1:30 p.m. Industry Sponsored Lunch Symposium Location: Broadway Ballroom JK

12:15 p.m. - 1:30 p.m. Industry Sponsored Lunch Symposium Location: Broadway Ballroom GH

Concurrent Sessions Begin

Concurrent Session 1 of 4

1:30 p.m. - 5:00 p.m. Pediatric Sub-Plenary Session Location: Cumberland 1/2 1:30 p.m. - 3:15 p.m. Pediatric Poster Session Location: Cumberland 3 Moderators: Jonathan Routh, MD MPH Durham, NC Stacy T. Tanaka, MD Nashville, TN Poster #22 PROGNOSTIC VALUE OF BIOCHEMICAL MARKERS IN WILM’S TUMOR: A SYSTEMATIC REVIEW Eugene B. Cone¹, Stewart S. Dalton², Megan Van Noord³, Henry E. Rice4 and Jonathan C. Routh5 ¹Duke University, Duke Clinical Research Institute and Division of Urology, Durham NC; ²University of Florida School of Medicine, Gainesville, FL; ³Duke University Medical Library, Durham, NC; 4Division of Pediatric Surgery, Dept of Surgery, Duke University Medical Center, Durham, NC; 5Division of Urologic Surgery, Dept of Surgery, Duke University Medical Center, Durham, NC Presented By: Eugene B. Cone, MD

36 THURSDAY

s ’ ² , , ¹ ¹ and and

, Sean , Sean ² Children UCSD University ³ 6 ² Facultad de de Facultad ela Gupta ela 4

, Sean , Sean

University of of University ³ ³ , Ang , ³ UCSD Department 4 , Derrick Johnston , Derrick

6 , Miguel Castellan , Miguel 4 Mount Sinai Medical Medical Sinai Mount

, Larisa Kovacevic 5

, Gina Cambareri Gina , ¹ ¹

Braun - isa Kovacevic

iversity, Portland, OR; OR; Portland, iversity, University of Virginia Medical Medical of Virginia University Roig, Zhi Geng, Bruce Bruce Geng, Zhi Roig, 4 -

;

, Lar , ² , George Wayne , George UCSD Department of Urology, Rady Rady Urology, of Department UCSD ² 5 Huang, MD Huang, Florida International University University International Florida

. ³ , Gina ,Cambareri Gina , Bayne , Aaron e of Medicine, Miami, FL; 5 4 HYPOSPADIAS e Health Science Center, Memphis, TN; TN; Memphis, Center, Science Health e

. s Hospital, Miami, FL; ’ , Dana Giel , Dana

¹ , Elizabeth Tourville Elizabeth , ¹ ¹ , Ruben Blachman , Ruben and Rafael Gosalbez Rafael and ¹

¹ 37 Derrick L. Johnston, MD Johnston, L. Derrick Joan Delto, MD Delto, Joan INE IN PEDIATRIC STONE PATIENTS: PATIENTS: STONE PEDIATRIC IN INE , Joan C. Joan Delto C. , ¹

¹ s Hospital of Michigan, Detroit, MI Detroit, Michigan, of Hospital s ’ , George Chiang George , , George Chiang , George ³ 4

Oregon Health & Science Un & Science Health Oregon 5 Children UCSD Department of Urology, San Diego, CA; CA; Diego, San Urology, of Department UCSD Nicklaus Children Nicklaus Oregon Health & Science University, Portland, OR; OR; Portland, University, Science & Health Oregon University of Tennesse of University ¹ Corbett Ciencias de la Salud, Universidad Anahuac Mexico Norte, Norte, Mexico Anahuac Universidad Salud, la de Ciencias Mexico By: Presented Center, Miami Beach, FL; FL; Beach, Miami Center, Andrew Labbie Andrew and Aaron Bayne and Aaron ¹ Presented By: Derrick L. Johnston, MD Johnston, L. Derrick By: Presented Children's Specialists of San Diego, San Diego, CA; CA; Diego, San Diego, San of Specialists Children's Georgia Regents University Augusta, GA Augusta, University Regents Georgia MD Kabaria, Reena By: Presented OUTCOMESSACRAL NEUROMODULATION OF IN CHILDREN WITH DYSFUNCTIONAL ELIMINATION SYNDROME NEUROGENIC BLADDER AND Klaassen Zachary Wilson, Shenelle Fox, Patrick Kabaria, Reena Jr Neal and Durwood GLANS WIDTH URETHRALAND PLATE WIDTH: WITH POSTOPERATIVE CORRELATION IN COMPLICATIONS Garcia Michael Huang, Jonathan H Jonathan By: Presented 6 ORCHIOPEXY LAPAROSCOPIC STAGE SINGLE DOES INCREASE OFTESTICULAR THE RATE ATROPHY? Alam Alireza Scherz, Hal Kirsch, Andrew Cerwinka, Wolfgang Broecker, Elmore James and Smith Edwin GA Atlanta, Medicine, of School University Emory 24 HOUR UR PREDICT HISTORY FAMILY POSITIVE DOES A ABNORMALITIES? METABOLIC Johnston Derrick THE ROLE OF MEDICAL MANAGEMENT IN PEDIATRIC PEDIATRIC IN MANAGEMENT MEDICAL OF ROLE THE NEPHROLITHIASIS VanDlac Amanda Department of Urology, San Diego, CA Diego, San Urology, of Department By: Presented of Urology, Rady Children's Specialists of San Diego, San Diego, Diego, San Diego, San of Specialists Children's Rady Urology, of CA; ¹ ² Dana Giel Dana VA; Charlottesville, Center, Medical Virginia Center, Charlottesville, VA; VA; Charlottesville, Center, Herbert Wertheim Wertheim Herbert Colleg of Tennessee Health Science Center, Memphis, TN; TN; Memphis, Center, Science Health Tennessee of MI Detroit, Michigan, of Hospital Corbett Mariarita Salvitti Mariarita

Poster #27 Poster #26 Poster #25 Poster #24 Poster #23

36 Poster #28 UPDATE ON CONTINENT CATHETERIZABLE CHANNELS AND THE TIMING OF THEIR COMPLICATIONS Deborah Jacobson¹, Cyrus Adams¹, John Thomas², Stacy Tanaka², Douglass Clayton², John Pope IV², John Brock III² and Mark Adams² ¹Vanderbilt University Department of Urology, Nashville, TN; ²Division of Pediatric Urology, Vanderbilt University, Nashville, TN Presented By: Deborah L. Jacobson, MD Poster #29 USE OF AN EXTRACTION STRING FOR URETERAL STENT REMOVAL FOLLOWING PEDIATRIC UROLOGIC SURGERY Abby Taylor¹, Mark Barazza², Erica Mercer² and Michael Erhard² ¹Mayo Clinic Florida, Jacksonville, FL; ²Nemours Children's Health System, Jacksonville, FL Presented By: Abby S. Taylor, MD Poster #30 CRYPTORCHIDISM: PATTERNS OF DELAYED REFERRAL AND INAPPROPRIATE IMAGING Derrick Johnston, Elleson Schurtz and Dana Giel University of Tennessee Health Science Center, Memphis, TN Presented By: Derrick L. Johnston, MD Poster #31 INJECTION PRESSURE PROFILOMETRY DURING ENDOSCOPIC CORRECTION OF VESICOURETERAL REFLUX (VUR): CAN TECHNIQUE BE STANDARDIZED? Michael Garcia-Roig, Blake Marshall, Wolfgang Cerwinka, Edwin Smith, Bruce Broecker, Hal Scherz, James Elmore and Andrew Kirsch Emory University Department of Pediatric Urology/ Childrens Healthcare of Atlanta, Atlanta, GA Presented By: Michael L. Garcia-Roig, MD Poster #32 CONTEMPORARY DEMOGRAPHIC AND TREATMENT PATTERNS FOR NEWBORNS DIAGNOSED WITH DISORDERS OF SEX DEVELOPMENT Rohit Tejwani¹, Deanna Adkins², Brian Young¹, Muhammad Alkazemi¹, Steven Wolf³, John Wiener¹, J. Todd Purves¹ and Jonathan Routh¹ ¹Division of Urologic Surgery, Duke University, Durham, NC; ²Division of Pediatric Endocrinology, Duke University, Durham, NC; ³Department of Biostatistics, Duke University, Durham, NC Presented By: Rohit V. Tejwani, MS Poster #33 OPEN VS. MINIMALLY INVASIVE SURGICAL APPROACHES: ASSOCIATED POST-OPERATIVE COMPLICATIONS OF PEDIATRIC UROLOGIC SURGERY IN THE UNITED STATES Rohit Tejwani¹, Brian Young1, Hsin-Hsiao Wang1, Steven Wolf2, John Wiener1 and Jonathan Routh1 ¹Division of Urologic Surgery, Duke University, Durham, NC; ²Department of Biostatistics, Duke University, Durham, NC Presented By: Rohit V. Tejwani, MS

38 THURSDAY OCTYL OCTYL Marchan Marchan - - ary ary , Steven ¹

, Zach ²

, Rohit Tejwani

, Patrick Fox

² -

² Negron, MD -Negron, , Durham, NC

TN N

Georgia Regents University, Augusta, Augusta, University, Regents Georgia ²

and Jonathan C. Routh C. Jonathan and

¹ Ballroom EFBallroom Hsiao Wang S. -Hsiao Plenary SessionPlenary - -Brayfield , Brandon Wilson , Brandon Atlanta, GA Atlanta, MelissaKaufman, PhD MD, R. MD Miller, L. Nicole John S. Wiener,John S. MD Andrew J. Kirsch, Richard Rink, C. MD Indianapolis, IN Nashville, TN Nashville, B.Pickens,Ryan MD Durham, NC Durham, TN Knoxville, ¹

, Hsin 39 ¹ Negron, Karina Escudero, Marcos Perez Marcos Escudero, Karina -Negron, and Durwood Neal Durwood and Broadway Ballroom A Broadway Ballroom Broadway

Visit Exhibits

ty of Puerto Rico School of Medicine of School Rico Puerto of ty - Duke University School of Medicine, Department of of Department Medicine, of School University Duke , WienerJohn S. ² ²

Duke University Medical Center, Division of Urology, Durham, Durham, Urology, of Division Center, Medical University Duke Department of Surgery, Section of Urology, Georgia Regents Regents Georgia Urology, of Section Surgery, of Department Wolf

¹ NC; Bioinformatics & Biostatistics Channels Catheterizable in Outcomes Patient: Bifida Spina the for Care Transitional Adult Pregnancy and Function Sexual Panelist: Sub Endourology Location: Podium Session Endourology Moderators: and Marcos Perez and Marcos Wilson Shenelle Break Location: Panel Spina Discussion Bifida Location: 1/2 Cumberland Moderator: Institution Single A Cystoplasty: Augmentation Pediatric Experience Contemporary Panelist: Panelist: Brian J. Young J. Brian MODIFIED CIRCUMCISION TECHNIQUE2 USING Guzman Juan CHARACTERIZATION OFPEDIATRIC EMERGENCY LACERATION, GENITAL FOR EVALUATION ROOM ABRASION, CONTUSION AND INJURIES ASSESSING THE UTILIZATION OF MINIMALLY MINIMALLY OF UTILIZATION THE ASSESSING INVASIVE SURGICAL TECHNIQUES IN THE PEDIATRIC UROLOGYPOPULATIO CYANOACRYLATE(DERMABOND) IN THE POPULATION ADOLESCENT Presented By: Brian J. Young, MD Young, J. Brian By: Presented GA MD Wilson, Shenelle By: Presented Universi Guzman Juan By: Presented ¹ GA; Augusta, University, ² Klaassen

2:30 p.m. 2:30

- 5:00 p.m. 5:00 3:45 p.m. 3:45 5:00 p.m. 5:00

- - - Poster #36 Poster #35 Poster #34 1:30 p.m. Concurrent 4 Session 2 of 1:30 p.m.

3:15 p.m.

3:45 p.m. 38 1:30 p.m. #13 EVALUATION OF CONTACT ELECTROPULSE LITHOTRIPSY: IN VITRO ASSESMENT OF CAVITATION AND STONE FRAGMENTATION Adam Kaplan¹, Gerogy Sankin², Morgan Gautho², Chen Yang², Glenn Preminger¹, Michael Lipkin¹ and Pei Zhong² ¹Division of Urologic Surgery, Duke University Medical Center, Durham, NC; ²Department of Mechanical Engineering and Materials Science, Duke University, Durham, NC Presented By: Adam G. Kaplan, MD 1:37 p.m. #14 THE EFFECT OF CONTINUED ASPIRIN THERAPY IN PATIENTS UNDERGOING PERCUTANEOUS NEPHROLITHOTOMY (PCNL) Brandon Otto, Forat Lufti and Vincent Bird University of Florida, Gainesville, FL Presented By: Brandon J. Otto, MD 1:44 p.m. #15 HUMAN MONOCYTES ENHANCE MACROPHAGE CLEARANCE OF CALCIUM OXALATE KIDNEY STONES Paul Dominguez, Sergei Kusmartsev, Benjamin Canales, Johannes Vieweg and Saeed Khan University of Florida, Gainesville, FL Presented By: Paul Dominguez-Gutierrez, PhD 1:51 p.m. #16 THE PREDICTIVE VALUE OF URINALYSIS FOR THE DETECTION OF URINARY TRACT INFECTIONS IN ACUTE NEPHROLITHIASIS Matthew D. Lyons, Jason R. Lomboy, Christina W. Zhou, Gary G. Koch, Alan Kerr, Peter H. Gilligan and Davis P. Viprakasit Chapel Hill, NC Presented By: Matthew Lyons, MD 1:58 p.m. #17 THE ROLE OF ROBOTIC SURGERY IN THE TREATMENT OF COMPLEX KIDNEY STONES – A SINGLE CENTER EXPERIENCE. Erika Ibarra, Zachary Klaassen, Martha Terris and Rabii Madi Georgia Regents University, Augusta, Georgia Presented By: Rabii Madi, MD 2:05 p.m. #18 ACCURACY OF DUAL ENERGY COMPUTED TOMOGRAPHY IN THE CHARACTERIZATION OF KIDNEY STONE COMPOSITION Charles Stoneburner, William Haley, Maria Jepperson, David Thiel, Colleen Thomas and Joseph Cernigliaro Mayo Clinic Jacksonville, Florida Presented By: Charles Stoneburner, MD 2:12 p.m. #19 FACTORS AFFECTING URETERAL STENT SYMPTOMS Lindsey Hartsell¹, Paul Murphy², Glen Lau², Rowena Desouza², Robert Wake² and Anthony L. Patterson² ¹UTHSC Memphis, TN; ²UTHSC, Memphis, TN Presented By: Lindsey M. Hartsell, MD

40 THURSDAY

Swedish Swedish 4

¹ HAMSTER HAMSTER , James

- ² Mayo Clinic Clinic Mayo ²

Muhsin -

Deya, MD

and Woods and Michael

uiz INSTITUTIONAL SERIES INSTITUTIONAL -

, Haidar Abdul , Haidar ²

logy, Birmingham, AL Birmingham, logy,

erland 3 Ponce, PR Birmingham, AL Birmingham, Davis P. Viprakasit, MD Viprakasit, P. Davis Chapel Hill, NC James R. Porter, MD Seattle, WA Amar Singh, MD Stephen E. Strup, FACS MD, Nashville, TN Nashville, FL Gainesville, R Gilberto Chattanooga, TN Lexington, KY Dean G. Assimos, G.Dean MD MD Miller, L. Nicole MD Bird, G. Vincent Michael Ferrandino, MD Durham, NC Durham,

41 Naval Medical Center San Diego, CA; CA; San Diego, Center Medical Naval

³ , James Porter , Erik Castle , Erik ³ ¹ Broadway Ballroom EFBroadway Ballroom Visit Exhibits :

University of North Carolina Chapel Hill, NC; NC; Hill, Chapel Carolina North of University

Presented By: Mary E. Killian, MD Killian, E. Mary By: Presented Urology Group Seattle, WA Group Urology Seattle, Presented By: Raj Kurpad, MD Kurpad, Raj By: Presented Panelist: Panelist: Q&A Poster Session Surgery Robotic Location: Cumb Moderators: NODE LYMPH RETROPERITONEAL ASSISTED ROBOT DISSECTION: MULTI A Kurpad Raj Stone Pelvic Renal the of Treatment Percutaneous Break Location: Oncology Endourologic TCC Tract Upper of Management Endourologic Panelist Robotics of Age in the Laparoscopy for Role Still a Panelist: Cancer Testicular for RPLND Robotic Mary Killian, Sonia Fargue, Ross Holmes, John Knight and Dean Dean and Knight John Holmes, Ross Fargue, Sonia Killian, Mary Assimos Uro of Department UAB Renal CM 1.5 the of Management Discussion: Panel Pelvis Stone Moderator: SWL Panelist: URS Panelist: THE EFFECT OF VIABILITY ON CELL ALANINE AND OXALATEPRODUCTION HYPEROXALURIAPRIMARY IN TYPE 1 USINGTRANSFORMEDCHINESE ¹ AZ; Phoenix, Lesperance OVARY CELLS OVARY

4:45 p.m. 4:45 5:00 p.m. 5:00 4:25 p.m. 4:25 4:05 p.m. 4:05

:00 p.m. - - - - 3:45 p.m. 3:45 5:00 p.m. 5:00 3:15 p.m. 3:15 5

- - - - 2:19 p.m.2:19 #20 Poster #37 4:25 p.m. 4:45 p.m. 4:05 p.m. 3:45 p.m.

3:15 p.m.

3:45 p.m. Concurrent Session 4 3 of

2:30 p.m.

3:45 p.m. 40 Poster #38 REAL-TIME NERVE MONITORING TO FACILITATE NEUROVASCULAR BUNDLE RESECTION DURING ROBOTIC PROSTATECTOMY Scott Miller Georgia Urology Presented By: Scott D. Miller, MD Poster #39 MEN WITH LOW RISK PROSTATE CANCER: WERE THEY WISE TO OPT FOR ROBOT ASSISTED RADICAL PROSTATECTOMY? Hariharan Palayapalayam Ganapathi, Gabriel Ogaya, Vladimir Mouriev and Vipul Patel Global Robotics Institute, Florida Hospital, Celebration, FL Presented By: Hariharan Palayapalayam Ganapathi, MD Poster #40 ROBOTIC SALVAGE PARTIAL NEPHRECTOMY: A VIABLE APPROACH FOR THE MANAGEMENT OF LOCAL TUMOR RECURRENCE FOLLOWING FAILED NEPHRON SPARING SURGERY. Erika Ibarra, Zachary Klaassen, Martha Terris and Rabii Madi Georgia Regents University, Augusta, Georgia Presented By: Rabii Madi, MD Poster #41 ROBOTIC-ASSISTED PARTIAL NEPHRECTOMY FOR COMPLEX AND HILAR RENAL TUMORS Juan Guzman-Negron¹, Hector Lopez-Huertas², Ricardo Sanchez-Ortiz² and Ronald Cadillo-Chavez² ¹University of Puerto Rico School of Medicine; ²Robotic Urology and Oncology Institute Presented By: Juan Guzman-Negron, MD Poster #42 LONG-TERM RESULTS USING NOVEL NO-CLIP ROBOTIC PROSTATECTOMY TECHNIQUE TO FACILITATE NERVE PRESERVATION Scott Miller Georgia Urology Presented By: Scott D. Miller, MD Poster #43 ASSESSMENT OF PATIENT FACTORS ASSOCIATED WITH PROLONGED HOSPITALIZATION OR PROLONGED URETHRAL CATHETERIZATION FOLLOWING ROBOT ASSISTED RADICAL PROSTATECTOMY (RARP) Eric Schommer¹, Kolbi Tonkovich², Zhuo Li² and David Thiel² ¹Mayo Clinic Jacksonville, Jacksonville, FL; ²Mayo Clinic Florida, Jacksonville, FL Presented By: Eric Andrew Schommer, MD Poster #44 ARE MODELS OF OPERATIVE COMPLEXITY ASSOCIATED WITH SURGICAL APPROACH FOR NEPHRON SPARING SURGERY? Pranav Sharma, Barrett McCormick, Kamran Zargar-Shoshtari and Wade Sexton Moffitt Cancer Center, Tampa, FL Presented By: Pranav Sharma, MD Poster #45 WITHDRAWN

42 THURSDAY

and and

³ , ² TO

University ² STEP STEP - Pinies, -Pinies,

BY -

- , Juan , Juan Class

Department of Internal Internal of Department , Michael Seeds Michael , ³ ²

Department of Physiology and and Physiology of Department

4 ² TS: STEP A

Pinies, MD Pinies,

, Amanda Carter , Amanda

, Susan Sergeant Susan , ¹

Department of Biochemistry, Wake Forest Biochemistry, of Department

² University, Augusta, Georgia Augusta, University, and Amar Singh Amar and

Dipen J. MD Parekh, FL Miami, Atlanta, GA Atlanta, ChristopherFilson, MS P. MD, ²

43 - Ogaya Gabriel Rabii Madi, MD Madi, Rabii

4 , Nathan Jung f TN College of Medicine Chattanooga; Chattanooga; Medicine of College f TN ¹

Cumberland 4 Cumberland Section on Molecular Medicine, Wake Forest School WakeSchool Forest Medicine, on Molecular Section

Austin Hester , ¹ ed By:ed

Medical Student at the University of TN College Health Science Science Health College TN of University the at Student Medical Department of Urology, Wake Forest School of Medicine, Medicine, of School Forest Wake Urology, of Department University o University

PREDICT BIOCHEMICAL FAILUREWITH PATIENTS IN POST CANCER PROSTATE LOCALIZED PROSTATECTOMY

¹ Winston Salem, NC; NC; Winston Salem, Medicine, of School THE ASSESSMENT OF A GENOMIC CLASSIFIER GENOMIC OF A ASSESSMENT THE Ogaya Gabriel Ramharack, Ritu Woodlief, Tracey Louisiana Orleans, New University, Tulane MPH MD, Wang, Julie C. By: Presented Session Poster 2 Cancer Prostate Location: ARACHIDONIC METABOLISMACID IN PROSTATE CANCER IS WITH GENETICASSOCIATED AND EPIGENETICWITHIN VARIATIONS CLUSTER. THE FADS Cui Tao Patel R Vipul and Mouraviev Vladimir Ganapathi, Hariharan FL Celebration, Institute, Robotic Global ROBOTIC ASSISTED LAPAROSCOPIC URETERONEOCYSTOSTOMY: SINGLE A CENTER EXPERIENCE Smith Hugh SYMPTOMATIC RENAL CYS Thomas Raju and Powers Mary Wang, Julie Moderators: Present EARLY EXPERIENCEEARLY WITH RETZIUS SPARING PROSTATECTOMY. RADICAL ROBOTIC Rabii and Terris Martha Klaassen, Zachary Ibarra, Erika Al Ray, Madi Regents Georgia By: Presented Pharmacology, Wake Forest School of Medicine, Winston Medicine, of School Forest Wake Pharmacology, NC Salem, MD Cui, Tao By: Presented Medicine, Medicine, of Medicine, Winston Salem, NC; NC; Salem, Winston Medicine, of Chistopher Keel Chistopher Floyd Chilton Floyd ROBOTIC MANAGEMENT APPROACH ¹ of TN College of Medicine Chattanooga, Chattanooga, TN; TN; Chattanooga, Chattanooga, Medicine of College TN of ³ TN Memphis, Center, Presented By: Hugh Smith, MD Smith, Hugh By: Presented

5:00 p.m. 5:00

- Poster #49 Poster #50 Poster #48 Poster #47 Poster #46

Concurrent Session 4 4 of 3:45 p.m.

42 Poster #51 COMPARISON OF CONCORDANCE RATES BETWEEN COGNITIVE AND MRI FUSION BIOPSY OF THE PROSTATE Ram Pathak¹, Candice Bolan², Mellena Bridges², Monica Moore², Zhuo Li² and Todd Igel² ¹Mayo Clinic Jacksonville, Florida; ²Mayo Clinic, Jacksonville FL Presented By: Ram Pathak, MD Poster #52 INNOVATIVE APPLICATION OF INSTANT TOGGLING OF ENDOSCOPE IN MORBID OBESITY DURING ROBOT ASSISTED RADICAL PROSTATECTOMY USING XI DA VINCI ROBOTIC SURGICAL SYSTEM Gabriel Ogaya-Pinies, Hariharan Ganapathi, Anup Kumar, Vladimir Mouraviev, Srinivas Samavedi, Rafael Coelho, Bernado Rocco, Tracey Woodlief, Travis Rogers and Vipul R Patel Global Robotic Institute, Celebration, FL Presented By: Gabriel Ogaya-Pinies, MD Poster #53 GAPS IN TREATMENT AMONGST METASTATIC CASTRATION RESISTANT PROSTATE CANCER (MCRPC) PATIENTS TAKING ABIRATERONE ACETATE OR ENZALUTAMIDE Ajay S. Behl¹, Lorie A. Ellis¹, Dominic Pilon², Yongling Xiao², Patrick Lefebvre² and Nancy A. Dawson³ ¹Janssen Scientific Affairs, LLC; ²Groupe d’analyse, Ltée, Montréal, QC; ³Georgetown University, Washington DC Presented By: Ajay S. Behl, PhD Poster #54 THE EFFECT OF MRI FUSION BIOPSY ON PATIENT- REPORTED VISUAL ANALOG SCALE (VAS) PAIN SCORES: A COMPARISON OF MRI FUSION, COGNITIVE FUSION, AND STANDARD SYSTEMATIC BIOPSY OF THE PROSTATE Ram Pathak, Monica Moore, Zhuo Li and Todd Igel Mayo Clinic Jacksonville, Florida Presented By: Ram Pathak, MD Poster #55 THE ASSOCIATION BETWEEN PREOPERATIVE LEUKOCYTOSIS AND POSTOPERATIVE OUTCOMES FOLLOWING PROSTATECTOMY FOR PROSTATE CANCER Matthew Macey, Troy Sukhu, Jason Lomboy, Allison Deal, Eric Wallen, Michael Woods, Raj Pruthi, Matthew Nielsen and Angela Smith Chapel Hill, NC Presented By: Matthew R. Macey, MD Poster #56 PREDICTIVE VALUE OF C-REACTIVE PROTEIN FOR DIAGNOSING PROSTATE CANCER IN PATIENTS UNDERGOING INITIAL PROSTATE BIOPSY Robert Gerhard, Christopher Filson, Datta Patil, Viraj Master and Muta Issa Emory University, Atlanta GA Presented By: Robert S. Gerhard, MD

44 THURSDAY

, 7 4 , G. ¹ al, QC al, and é

- ³ Private Private OPERATIVE OPERATIVE ² - Oncology Oncology ³ Janssen , Ellet Justin , Ellet ² ³ e, Montr e, é ology, MUSC, MUSC, ology, , H. Ganapathi , H. ¹

and Keane Thomas Keane and Urology resident, MUSC, MUSC, resident, Urology

6 , Dominic Pilon , Dominic 5 ³

rsham, PA; PA; rsham, ¹

analyse, Lt

VARIABLE, POST PGY ’ - 4

Pinies, MD Pinies,

- , Sarkissian Hagop Sarkissian , ² , R. Ramharack, R. aya Professor of Onc ² , Lilly Michael , Lilly 6 5

Groupe d Groupe and V. Patel ³

, Yongling Xiao , Yongling ¹ ² Chairman of Urology, MUSC, Charleston, SC Charleston, MUSC, Urology, of Chairman Professor of Biostatics and Epidemiology, Epidemiology, and Biostatics of Professor

, Alter J. 5 7 esident, MUSC, Charleston, SC; SC; Charleston, MUSC, esident, ³ ¹

45 Pinies, Hariharan Ganapathi, Vladimir Mouraviev, Mouraviev, Vladimir Ganapathi, Hariharan -Pinies, , Shah Jaimin , Shah ¹

, Ajay Behl Ajay , ¹ Mayer Elizabeth Mayer OPERATIVE METASTATIC RISK FOR PROSTATE PROSTATE FOR RISK METASTATIC OPERATIVE , V. Mouraviev - ¹ GenomeDx (San Diego, Ca) Diego, (San GenomeDx - ²

PGY3 Urology r Urology PGY3 GR Janssen Scientific Affairs, LLC, Ho LLC, Affairs, Scientific Janssen Charleston, SC; SC; Charleston, Garrett MUSC, Charleston, SC; SC; Charleston, MUSC, Presented By: Tracy J. Tipton J. Tracy By: Presented Urologist, Florida Urology Partners, Tampa, FL; FL; Tampa, Partners, Urology Florida Urologist, SC; Charleston, MUSC, Fellow, ¹ PERINEAL PROSTATECTOMY NOMOGRAM NOMOGRAM PROSTATECTOMY PERINEAL PREDICTIVE OF RFS Celebration Opening Location: Fame Country of Music Hall ¹ Ogaya Gabriel R Vipul and Harvey Tadzia Rogers, Travis Woodlief, Tracey Patel FL Celebration, Institute, Robotic Global FOUR OF A INTRODUCTION Tracy Tipton Tracey Woodlief Tracey PREVALENCE GLUCOCORTICOID OF IN USE PROSTATE CANCER PATIENTS Ellis Lorie Lefebvre Patrick DEHYDRATED HUMAN AMNION/CHORION MEMBRANE ALLOGRAFT NERVE WRAP THE PROSTATIC AROUND NEUROVASCULAR BUNDLE DOES INCREASE NOT THE RISK RECURRENCE BIOCHEMICAL OF FOLLOWING PROSTATECTOMY RADICAL Og Gabriel By: Presented THE ROLE OF GENOMIC CLASSIFIER TO ASSESS ASSESS TO CLASSIFIER GENOMIC OF ROLE THE POST Charleston, SC; SC; Charleston, Presented By: Tracey Woodlief, PhD Woodlief, Tracey By: Presented ¹ Ogaya CANCERWITH PATIENTS ADVERSE POST Presented By: Lorie Ellis, PhD Ellis, Lorie By: Presented Scientific Affairs, LLC; LLC; Affairs, Scientific PATHOLOGY

9:30 p.m. 9:30

- Poster #60 Poster #59 Poster #58 Poster #57

Concurrent Sessions End Sessions Concurrent 6:30 p.m.

4444 FRIDAY, MARCH 18, 2016

OVERVIEW

6:00 a.m. - 5:45 p.m. Registration/ Information Desk Open Location: Broadway Ballroom EF Pre-Function 6:00 a.m. - 5:45 p.m. Speaker Ready Room Hours Location: Mockingbird 1 7:30 a.m. - 10:30 a.m. Spouse/Guest Hospitality Suite Open Location: Bass Room 10:00 a.m. - 4:00 p.m. Exhibit Hall Open Location: Broadway Ballroom EF 1:00 p.m. - 4:30 p.m. Belle Meade Plantation Kitchen Culinary Tour Location: Meet in the lobby of the Omni at 12:45 p.m. 2:00 p.m. - 4:00 p.m. Mixology Lesson Location: Bass Room 7:00 p.m. - 10:30 p.m. Residents' Night Out Location: Wildhorse Saloon

Concurrent Sessions Begin

Concurrent Session 1 of 3

6:30 a.m. - 8:00 a.m. Erectile Dysfunction/Andrology Poster Session Location: Cumberland 3 Moderators: Wayne J. G. Hellstrom, MD, FACS New Orleans, LA Douglas F. Milam, MD Nashville, TN Poster #61 SYNCHRONOUS DUAL AUS/IPP INSERTION THROUGH A SINGLE PENOSCROTAL INCISION Gregory Mitchell¹, Faysal Yafi², Taylor Peak³, Premsant Sangkum4 and Wayne Hellstrom¹ ¹Tulane University School of Medicine, New Orleans, LA; ²Tulane University School of Medicine; ³Tulane University school of Medicine, New Orleans, LA; 4Mahidol University, Bangkok, Thailand Presented By: Gregory C. Mitchell, MD, MS Poster #62 THE UBIQUITOUS AVAILABILITY AND EASY ACQUISITION OF ILLICIT ANABOLIC ANDROGENIC STEROIDS AND TESTOSTERONE PREPARATIONS ON THE INTERNET J. Abram McBride, Jason Lomboy, Culley C. Carson and R. Matt Coward Department of Urology, UNC Chapel Hill NC Presented By: J. Abram McBride, MD

46 FRIDAY Tulane Tulane ²

and and

¹ neering, neering, Temple Temple , James James , ² ¹ ERECTILE

IMPROVED

IRRIGATION IRRIGATION ¹

Mayo Clinic, Clinic, Mayo 6 ” , Mark Mark , ² , Premsant , Premsant

¹ SPECIFIC CUTOFFS , Suresh Sikka , Suresh -

University, Bangkok, Florida Urology Partners, Partners, Urology Florida

, John Jackson , John

³ ²

CONTAINED rrie Stewart rrie

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Tulane University school of of school University Tulane ³ , Michael Metro Michael , and Rafael Carrion Rafael and ¹

Mahidol

, Ca 4 4 ² INJECTIONS UNRELATED TO LAYER ALGINATE -

® , Justin Saul Justin , ¹ , Landon Trost Landon , 5

and Emmanuel Opara Emmanuel and

¹ S CORPORA CAVERNOSALS CORPORA INJURY John Beilan, John S. Fisher, Justin B. Emtage, Emtage, B. Justin Fisher, S. John Beilan, John Jersey Urology Group Urology Jersey 4 , Faysal Yafi Faysal , , Justin Parker Justin , ¹

¹ 47 John D. Jackson, PhD Jackson, D. John , Steixner , Brian S DISEASE Department of Chemical and Paper Engi Paper and Chemical of Department ’ ³ ²

Akdeniz University, Antalya, Turkey; Turkey; Antalya, University, Akdeniz , Erhan Ates 5 4 ENGINEERING ENDOCRINE OVARIAN OF - TERM SECRETIONSHORMONE VITRO IN - , Anthony Atala Anthony , ¹ versity Urology, Philadelphia PA; PA; Philadelphia Urology, versity Florida Beach, Miami Center, Medical Sinai unt Tulane University School of Medicine, New Orleans, LA; LA; Orleans, New Medicine, of School University Tulane University of South Florida Urology, Tampa Florida; Florida; Tampa Urology, Florida South of University Wake Forest Institute for Regenerative Medicine, Winston Winston Medicine, for Regenerative Institute Wake Forest Wayne Hellstrom Wayne ¹ LA; Orleans, New Medicine, University School of Medicine; Medicine; of School University Thailand; Thailand; Presented By: Michael Bickell, DO Bickell, Michael By: Presented ¹ Uni DYSFUNCTION:THERE AGE ARE AND ASPIRATION OF PRIAPISM (CAIP) PRIAPISM OF ASPIRATION AND MD Wallen, J. Jared By: Presented MD Pathak, Ram By: Presented SOFT GLANS SYNDROME: INTRAURETHRAL GELS AS GELS AS INTRAURETHRAL SYNDROME: GLANS SOFT GLANS FOR MUSE TO AN ALTERNATIVE ENGORGEMENT. Jared Wallen, J. Carrion Rafael and Martinez Daniel Bickell, Mike FL Tampa, Florida South of University COLOR DOPPLER DUPLEX (CDDU) ULTRASOUND PARAMETERS MENOF WITHOUT ORGANIC and Effriong Isaac Li, Zhuo Davidiuk, Andrew Pathak, Ram Broderick Gregory Florida Jacksonville, Clinic Mayo A NOVEL TECHNIQUE FOR FOR NOVEL TECHNIQUE A Akshay Caso, Jorge Sidhu, Ajaydeep Delto, Joan Yanes, Rafael Nieder Alan and Bhandari Mo MD Yanes, E. Rafael By: Presented PENILE DAILY OF DURATION OF EFFECT THE TRACTION IN UNDERGOING PATIENTS FOR THERAPY INJECTION INTRALESIONAL PEYRONIE Pinsky Michael Michael Bickell Michael TISSUE CELLS MULTI USING A Sivanandane Sittadjody SPONTANEOU XIAFLEX FOLLOWING ACTIVITY SEXUAL LONG Salem, NC; Yoo ¹ Rochester, MN Rochester, MD Pinsky, R. Michael By: Presented Tampa Florida; Florida; Tampa Swierzewski Sangkum Miami University, Oxford, OH Oxford, University, Miami By: Presented THAT DEFINETHAT NORMALCY? MICROCAPSULE STRUCTURE RESULTSIN

Poster #68 Poster #67 Poster #66 Poster #65 Poster #64 Poster #63

46 Poster #69 USE AND EFFECTIVENESS OF PHARMACOLOGIC AND NON-PHARMACOLOGIC ERECTILE DYSFUNCTION AIDS AMONG PROSTATE CANCER SURVIVORS FOLLOWING RADICAL PROSTATECTOMY FROM THE PROST-QA COHORT Ilan Safir¹, Martin Sanda¹, Peter Chang², Dattatraya Patil¹, Catrina Crociani², Jill Hardy³, Larry Hembroff³, John Wei4 and Akanksha Mehta¹ ¹Emory University School of Medicine, Atlanta, GA; ²Beth Israel Deaconess Medical Center, Boston, MA; ³Michigan State University, East Lansing, MI; 4University of Michigan, Ann Arbor, MI Presented By: Ilan J. Safir, MD Poster #70 PROSPECTIVE EVALUATION OF POSTOPERATIVE PENILE REHABILITATION: PENILE MORPHOLOGY AND PATIENT SATISFACTION 2 YEARS FOLLOWING COLOPLAST TITAN INFLATABLE PENILE PROSTHESIS Michael Pryor¹, Rafael Carrion², Run Wang³ and Gerard Henry4 ¹Regional Urology Sreveport, LA; ²University of South Florida, Tampa, FL; ³University of Texas School of Medicine at Houston and MD Anderson Cancer Center, Houston, TX; 4Reginal Urology, Shreveport, LA Presented By: Michael B. Pryor, MD Poster #71 END DIASTOLIC VELOCITY VERSUS RESISTIVE INDICES IN PREDICTING BETTER CLINICAL RESPONSE USING PENILE DOPPLER ULTRASOUND FOR PATIENTS WITH ERECTILE DYSFUNCTION Casey McCraw, Zachary Klaassen, Reena Kabaria, Roger Chen and Ronald Lewis Georgia Regents University, Augusta, GA Presented By: Casey O. McCraw, BS, MD Poster #72 WITHDRAWN

Concurrent Session 2 of 3

6:30 a.m. - 8:00 a.m. Nephrolithiasis Poster Session Location: Cumberland 4 Moderators: Kenneth Ogan, MD Atlanta, GA Charles D. Scales Jr., MD, MSHS Durham, NC Poster #73 OXALATE CONCENTRATIONS IN HUMAN GASTROINTESTINAL FLUID Thanmaya Reddy¹, John Knight¹, Ross Holmes¹, Lisa Harvey¹, April Mitchem¹, Charles Wilcox², Klaus Monkemuller² and Dean Assimos¹ ¹Department of Urology, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama; ²Division of Gastroenterology and Hepatology, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama Presented By: Thanmaya Reddy, MD

48 FRIDAY

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, Tony Chen Tony , , Georgy Sankin Georgy , ¹ ² , Glenn Preminger Glenn , 49 ² Department of Mechanical Engineering and and Engineering Mechanical of Department , Tony Chen ² ¹ , Adam Kaplan , Adam ¹ , Preminger , Glenn ¹

rials Science, Duke University, Durham, NC Durham, University, Duke Science, rials Department of Mechanical Engineering and Material Science, Science, Material and Engineering Mechanical of Department Division of Urologic Surgery, Duke University Medical Center, Center, Medical University Duke Surgery, Urologic of Division Division of Urologic Surgery, Duke University, Durham, NC; NC; Durham, University, Duke Surgery, Urologic of Division Daniela Radvak Daniela Vanderbilt University Medical Center, Nashville, TN Nashville, Center, Medical University Vanderbilt UNDERSTANDINGTHE BURDEN INPATIENT OF CARE FORWITH PATIENTS URINARY STONE DISEASE Scales D. Charles and Cone B. Eugene Duke University, DukeClinical ResearchInstitute andDivision of NC Durham Urology, MD Cone, B. Eugene By: Presented WORKIN - VARIATION HYPERPARATHYROIDISMINKIDNEY STONE FORMERS ENDOUROLOGISTSBY Miller Nicole and Herrell Duke S. Marien, Tracy Seltz, Lara MD Seltz, M. Lara By: Presented Neal Simmons Neal BMI, GENDERAGE, 24 HOUR PREDICT URINE AND PARAMETERS RECURRENT IN IDIOPATHIC CALCIUM FORMERS STONE OXALATE Jenn Bozorgmehri, Shahab Canales, Benjamin Otto, Brandon Muna Canales and Bird Kuo, Vincent FL Gainesville, Florida, of University MD Otto, J. Brandon By: Presented IMPROVEDWITH CONTROL PAIN LOCAL ANESTHETIC PERCUTANEOUSAFTER NEPHROSTOLITHOTOMY: A ANALYSIS PROSPECTIVE Mo Rishi Mason, James FLEXIBLE USE SINGLE NOVEL OF A EVALUATION URETEROSCOPE Dale Joanne COMPARISON ELECTRIC OF PULSE LITHOTRIPTERAN FRAGMENTATION STONE LASER: HOLMIUM THE TO EFFICIENCY IMPACT ON FLEXIBLE AND FLOW AND DEFLECTION URETEROSCOPE Kaplan Adam ¹ Durham, NC; Mate Florida Gainesville, Urology, of Department Florida of University THE EFFECTVARIABLE OF PULSE DURAT Shin Yang, Chen Kaplan, Adam Chen, Tony Ackerman, Anika Glenn Preminger Scales, Charles Simmons, William Richard, Michael and Lipkin Duke UniversityMedical Center B James By: Presented STONECOMMINUTION, TIP FIBER DEGRADATION, AND MODEL "DUSTING" IN A RETROPULSION STONE ¹ ² Durha University, Duke MD Dale, Joanne By: Presented Anika Ackerman Anika Ferrandino Presented By: Adam G. Kaplan, MD Kaplan, G. Adam By: Presented Presented By: Anika J. Ackerman, MD Ackerman, J. Anika By: Presented

Poster #80 Poster #79 Poster #78 Poster #77 Poster #76 Poster #75 Poster #74

48 Poster #81 DEVELOPMENT OF A NOVEL CURRICULUM IN MEDICAL KIDNEY STONE PREVENTION Troy A. Sukhu, Jason R. Lomboy, Matthew R. Macey and Davis P. Viprakasit Chapel Hill, NC Presented By: Troy A. Sukhu, MD Poster #82 URETERAL STONE DIAMETER ON COMPUTERIZED TOMOGRAPHY CORONAL RECONSTRUCTIONS IS CLINICALLY IMPORTANT AND UNDER-REPORTED Tracy Marien and Nicole Miller Vanderbilt, Nashville, TN Presented By: Tracy Marien, MD Poster #83 ACCURATE DETERMINATION OF 24-HOUR URINE CREATININE IN PATIENTS WITH NEPHROLITHIASIS: EFFECTS OF GENDER, AGE, BMI AND PROTEIN CATABOLIC RATE Jeremy Bergamo¹, Julia Han², Rupam Ruchi³, Xuerong Wen³, Vincent Bird² and Victoria Bird² ¹College of Medicine, University of Florida, Gainesville, Florida; ²Department of Urology, University of Florida, Gainesville, Florida; ³Division of Nephrology, Department of Medicine, University of Florida, Gainesville, Florida Presented By: Julia Han, MD Poster #84 IMPACT OF AUA RECOMMENDATIONS ON IMAGING TRENDS IN THE FOLLOW-UP OF URETERAL CALCULI Anika Ackerman, Tony T. Chen, Laura Ding, Glenn Preminger, Charles Scales and Michael Lipkin Duke University Medical Center, Durham, NC Presented By: Anika J. Ackerman, MD Poster #85 DIGITAL TOMOSYNTHESIS: A VIABLE ALTERNATIVE TO NON-CONTRASTED COMPUTED TOMOGRAPHY FOR THE FOLLOW UP OF NEPHROLITHIASIS? Adam Kaplan¹, Fernando Cabrera¹, Ramy Youssef², Matvey Tsivian¹, Richard Shin¹, Charles Scales, Jr.¹, Glenn Preminger¹ and Michael Lipkin¹ ¹Division of Urologic Surgery, Duke University Medical Center, Durham, NC; ²Department of Urology, University of California, Irvine, Orange, CA Presented By: Adam G. Kaplan, MD

50 FRIDAY -

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University University 6 Western ²

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TERM WITH Institute for - ²

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4 , Thaddeus S. Brink S. , Thaddeus 4

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edical Center, Durham, NC; NC; Durham, Center, edical - -

pital Raymond Poincar Raymond pital Broadway Ballroom A Broadway Ballroom ô and Michael Kennelly Michael and

H 8 5 , Pierre Denys , Pierre 4 ation: ation: Hospital Universitario de C de Universitario Hospital NJ; Bridgewater, Inc., Allergan, Division of Urology, Duke University and Durham VA Medical Medical VA Durham and University Duke Urology, of Division Erasmus Medical Center, Rotterdam, The Netherlands; Netherlands; The Rotterdam, Center, Medical Erasmus

Vanderbilt University Medical Center, Nashville, TN; TN; Nashville, Center, Medical University Vanderbilt Duke University Medical School, Durham, NC; NC; Durham, School, Medical University Duke of Manitoba, Winnipeg, MB, Canada; Canada; MB, Winnipeg, Manitoba, of Neuromodulation Research, Medtronic Inc., Minneapolis, MN; MN; Minneapolis, Inc., Medtronic Research, Neuromodulation Magyar Spain; Spain; Centers, Institute for Medical Research, Durham, NC Durham, Research, Medical for Institute Centers, BS Potts, A. Bradley By: Presented Charlotte, NC Charlotte, R Roger By: Presented Presented By: James E. Pilkington, MD Pilkington, E. James By: Presented LSU Health Health LSU ARE THE WOMEN WITH PERSISTENT STRESS STRESS PERSISTENT WITH WOMEN THE ARE URINARY INCONTINENCE MIDURETHRALAFTER SLING WITH THOSE FROM DIFFERENT SURGERY RECURRENT SUI? Gomelsky Alex and II Frilot F. Clifton Liang, Jessie Health LSU MD Liang, Jessie By: Presented LOSS OR AFTER GAIN WEIGHT OF IMPACT THE MIDURETHRAL SLINGSURGERY ON SUCCESS OR COHORT ANALYSIS LONGITUDINAL A FAILURE: Gomelsk Alex and II Frilot F. Clifton Pilkington, E. James POSITIVE OUTCOMES AFTER FIRST TREATMENTWITH LONG PERSIST ONABOTULINUMTOXINA REPEAT TREATMENTS IN PATIENTSWITH NEUROGENIC DETRUSOR OVERACTIVITY Dmochowski Roger 4 8 LATE INTERMITTENTLATE SACRAL NEUROSTIMULATION SIGNIFICANTLY INCREASES CAPACITY BLADDER Potts A. Bradley Peterson C. Andrew 5 Incontinence/Voiding Dysfunction Podium Session Podium Dysfunction Incontinence/Voiding Loc ¹ NY; Cheektowaga, LLC, Associates, Urology York New ³ and Matthew O. Fraser Matthew and ¹ Medical Research, Durham, NC; NC; Durham, Research, Medical University M Diaz Moderators:

#22

7:30 a.m.

- 7:30 a.m. #21 a.m. 7:30 7:51 a.m. #24 a.m. 7:51 7:44 a.m. #23 a.m. 7:44 7:37 a.m.

Concurrent Sessions End Sessions Concurrent

7:00 a.m. Concurrent 3 Session 3 of 50 8:00 a.m. - 8:40 a.m. Panel Discussion - Refractory OAB Moderator: Alexander Gomelsky, MD Shreveport, LA Medicalization of Refractory OAB Panelist: Deborah J. Lightner, MD Rochester, MN Neuromodulation Panelist: Katie N. Ballert, MD Lexington, KY Botulinum Toxin Panelist: Tracey S. Wilson, MD, FACS Birmingham, AL 8:40 a.m. - 9:30 a.m. AUA Course of Choice Lecture: Geriatric Urology: Basic Principles for Urologic Practice AUA Course of Choice Guest Speaker: Tomas L. Griebling, MD, MPH Kansas City, KS 9:30 a.m. - 10:30 a.m. T. Leon Howard Imaging Session Moderator: Chad W. Ritenour, MD Atlanta, GA Case #1 A MAN WITH SCROTAL SWELLING AND DIFFICULTY WITH AMBULATION Jeffrey Pearl, MD, Usama Al-Qassab, MD and Muta Issa MD, MBA Emory University Department of Urology, Atlanta, GA Presented By: Jeffrey Pearl, MD Case #2 AN ELDERLY FEMALE WITH ACUTE RENAL FAILURE Thanmaya Reddy, MD¹, Dustin Gayheart, MD² and Dean Assimos, MD¹ ¹Department of Urology, University of Alabama at Birmingham School of Medicine, Birmingham, AL; ²Pikeville Medical Center, Pikeville, KY Presented By: Thanmaya Reddy, MD Case #3 INCIDENTAL FINDING IN A MALE WITH UROLITHIASIS Natalia Ballesteros, MD, Paul Davis, Medical Student, and Dennis N. Smith, MD, Gratis Faculty University of Louisville, Louisville, KY Presented By: Natalia Ballesteros, MD Case #4 A YOUNG MAN WITH RECURRENT TESTICULAR PAIN Deborah Jacobson, MD and Duke Herrell, MD Vanderbilt University Presented By: Deborah L. Jacobson, MD Case #5 EMT DISPATCHER: "HER KIDNEY EXPLODED!" Melissa Mendez, MD and Adam Kaplan, MD Division of Urologic Surgery, Duke University Medical Center, Durham, NC Presented By: Melissa Mendez, MD

52 FRIDAY

Targeted -

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MD MS

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The Impact of MRI and MRI MRI and of Impact The Toronto, ON Laurence H. Klotz, FRCSCMD, New York, NY Lexington, KY Lexington, KY Jon S.Jon MD Demos, James R. Porter, MD John P. Mulhall, MD New York, NY Seattle, WA Samir S. Taneja, MD Taneja, S. Samir Lexington, KY

w Orleans, LA w Orleans, red Symposium Lunch red

MD Thiel, D. David Jacksonville, FL Jacksonville, N

Ilan J. J. Ilan Safir, MD GA Atlanta, FACS PhD, A. MD, Viraj Master, GA Atlanta,

Nashville, TN Nashville, MD Ark, Jacob TN Nashville, Feib Allison DavidF.Penson, MPH MD,

53 Art Lecture: Surgical Surgical Approac Lecture: Art Art Lecture: Musings on ED after Radical Radical after ED on Musings Lecture: Art

- -

Broadway Ballroom EFBroadway Ballroom Broadway Ballroom GH Broadway Ballroom the the

- - Visit Exhibits

- Speaker: Speaker: of of

- -

residential Lecture: Active Surveillance: Lessons Lessons Surveillance: Active Lecture: residential Univ of MS Medical Center Medical MS of Univ

Speaker: Presidential Guest Guest Presidential

Moderators: AUA Update AUA MD Gee, William F. President: AUA P Learned Introducer: State Guest Speaker: Session Podium Renal Cancer Finalists: Jon S. Demos, Introducer: State Guest Sponso Industry Symposium Lunch Sponsored Industry Break Location: Contest Essay Boyd Montague Moderator: Lecture: Ballenger Guest A MECONIUM STREAK ALONG THE PENILE SHAFT IN A IN A SHAFT PENILE THE ALONG STREAK MECONIUM A NEWBORN Bean, MD, Christopher and Harmon, Edwin MD, Hurtt, Robbie MD ¹ Hur Robbie By: Presented Location: JK Broadway Ballroom Location: Robotic Partial Nephrectomy Partial Robotic Prostatectomy Biposy: A New Era in Prostate Cancer Diagnosis, Risk Risk Diagnosis, Cancer Prostate in New Era A Biposy: Assessment, Therapy and

12:30 p.m. 12:30 1:30 p.m. 1:30 p.m. 12:00 p.m.12:00 11:00 a.m. 11:00 11:30 a.m. 11:30

2:45 p.m. 2:45 2:20 p.m. 2:20 3:20 p.m. 3:20 1:40 p.m. 1:40 - - -

- - -

- - - - Case #6 Case 2:20 p.m. 12:00 p.m. 11:30 a.m. 1:40 p.m. 12:30 p.m. 2:45 p.m. 1:30 p.m. 12:30 p.m. 10:30 a.m.

11:00 a.m. 52 2:45 p.m. #25 THE EFFECT OF SURGEON EXPERIENCE, NEPHROMETRY SCORE, AND BODY MASS INDEX ON PERIOPERATIVE OUTCOMES FOLLOWING ROBOT ASSISTED LAPAROSCOPIC PARTIAL NEPHRECTOMY Russell Terry¹, James Mason¹, Matthew Sorensen² and Li-Ming Su¹ ¹University of Florida Department of Urology, Gainesville, Florida; ²University of Tennessee Division of Urologic Surgery, Knoxville, Tennessee Presented By: Russell Terry, MD 2:52 p.m. #26 URINE LEAK RATES IN HIGH-RISK PATIENTS UNDERGOING MINIMALLY INVASIVE PARTIAL NEPHRECTOMY WITHOUT COLLECTING SYSTEM CLOSURE Adam Berneking, Seth Broster, Stephen Strup and Jason Bylund University of Kentucky Department of Urology, Lexington KY Presented By: Adam Berneking, MD 2:59 p.m. #27 RANDOMIZED DOUBLE BLINDED PLACEBO CONTROLLED TRIAL OF SILDENAFIL FOR RENOPROTECTION PRIOR TO HILAR CLAMPING IN PATIENTS UNDERGOING ROBOTIC ASSISTED LAPAROSCOPIC PARTIAL NEPHRECTOMY Louis S. Krane¹, Charles Peyton² and Ashok K. Hemal² ¹National Cancer Institute, Bethesda, MD; ²Wake Forest Baptist Health, Winston Salem, NC Presented By: Charles C. Peyton, MD 3:06 p.m. #28 PREDICTORS OF OVERALL SURVIVAL IN PATIENTS WITH STAGE I RENAL CELL CARCINOMA Jason Lomboy¹, Allison Deal², Angela Smith¹, Michael Woods¹, Eric Wallen¹, Matthew Nielsen¹ and Mathew Raynor¹ ¹The University of North Carolina School of Medicine Chapel Hill, NC; ²The University of North Carolina Lineberger Comprehensive Cancer Center Chapel Hill, NC Presented By: Jason R. Lomboy, MD 3:13 p.m. #29 MAYO ADHESIVE PROBABILITY (MAP) SCORE IS ASSOCIATED WITH LOCALIZED RENAL CELL CARCINOMA PROGRESSION FREE SURVIVAL David Thiel¹, Davidiuk Andrew², Camille Meschia¹, Daniel Serie³, Kaitlynn Custer³, Steven Petrou¹ and Alexander Parker³ ¹Department of Urology, Mayo Clinic Florida, Jacksonville, FL; ²Mayo Clinic Florida; ³Department of Health Sciences Research, Mayo Clinic Florida, Jacksonville, FL Presented By: Andrew J. Davidiuk, MD 3:20 p.m. - 3:45 p.m. Break - Visit Exhibits Location: Broadway Ballroom EF

Concurrent Sessions Begin

Concurrent Session 1 of 6

3:45 p.m. - 5:30 p.m. Pediatric Sub-Plenary Session 2 Location: Cumberland 1/2

54 FRIDAY , ³ and and

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Shostari, Pranav Pranav Shostari, and Phillippe and Phillippe -

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, Yoram Baum , Yoram ¹ , Kenneth Ogan , Kenneth 4

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the , Wayne Wayne , Harris

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of -

Leone, MD Leone,

, Christopher Filson , Christopher Indianapolis, IN

4 CLEAR CELL HISTOLOGIES CELL CLEAR - erland 3

Durham, NC Durham, Stacy T. Tanaka, MD Tanaka, T. Stacy TN Nashville, JonathanRouth, MD MD Elmajian, A. Donald Shreveport, LA Kenneth MD Ogan, GA Atlanta, : Richard C. Rink, MD Richard Rink, C. : , Omer Kucuk

² 55 , Pranav Sharma , Pranav ¹ Emory University School of Medicine, Department Department Medicine, of School University Emory Emory University School of Medicine, Department Department Medicine, of School University Emory Department of Interventional Cardiology, Florida Florida Cardiology, Interventional of Department

² 4 Emory University School of Medic of School University Emory ³ , Dattatraya Patil , Dattatraya 4 ³ ¹

² artment of Genitourinary Oncology, Moffitt Cancer Center, Center, Cancer Moffitt Oncology, Genitourinary of artment anagement of DSD of anagement Dep Emory University School of Medicine, Department of Urology, Urology, of Department Medicine, of School University Emory Department of Urology, University of South Florida, Tampa, FL; FL; Tampa, Florida, South of University Urology, of Department

¹ GA; Atlanta, Urology; of Viraj Master Viraj OPERATIVE TUMOR DEBULKING THROMBUS PRIOR TO RADICAL NEPHRECTOMY WITH INFERIOR VENA THROMBECTOMYCAVA NOVEL USE THE OF ANG Emtage Justin Andrew Leone, Gregory Diorio, Kamran Zargar Kamran Diorio, Gregory Leone, Andrew Powsang, M. Julio Gilbert, M. Scott Dhillon, Jasreman Sharma, Spiess Philippe and A. Poch Michael Sexton, J. Wade FL Tampa Center, Cancer Moffitt R Andrew By: Presented CARCINOMA CELL RENAL THE OF EVALUATION INFLAMMATORY SCOREINWITH PATIENTS CLEAR NONCELL AND Sekar Rishi Difficult Discussion Cases Moderators: Session Poster 1 Cancer Kidney/Adrenal Location: Cumb Moderators: HISTOLOGIC OF AGGRESSIVE SIGNIFICANCE VARIANTS OFRCC: COMPARISON OFRHABDOID RENAL CELL (RRCC), CARCINOMA SARCOMATOID RENAL(SRCC CELL CARCINOMA Pediatric Urology State Urology Pediatric Guest Speaker 4GRADE RCC of Urology, Winship Cancer Institute, Atlanta, GA Atlanta, Institute, Cancer Winship Urology, of Presented By: Rishi Sekar, BA Sekar, Rishi By: Presented Hematology and Medical Oncology, Winship Cancer Institute, Institute, Cancer Winship Oncology, Medical and Hematology GA; Atlanta, Mersiha Torlak Mersiha ¹ ² Spiess M Presented By: Justin B. Emtage, MD B. Emtage, Justin By: Presented Mehrdad Alemozaffar Mehrdad Tampa, FL; USA FL, Tampa, Hospital,

5:30 p.m. 5:30 4:30 p.m. 4:30

- - 4:45 p.m. 4:45

- Poster #86 Poster #88 Poster #87 4:30 p.m. 3:45 p.m. Concurrent 6 Session 2 of

3:45 p.m.

54 Poster #89 ROBOT-ASSISTED NEPHROURETERECTOMY FOR TREATMENT OF UPPER TRACT UROTHELIAL CELL CARCINOMA Maxim McKibben¹, Matthew Nielsen², Raj Pruthi², Mathew Raynor², Angela Smith² and Michael Woods² ¹Durham; ²UNC - Chapel Hill, NC Presented By: Maxim J. McKibben, MD Poster #90 CONTRALATERAL ADRENAL METASTASES OF RENAL CELL CARCINOMA INDICATE BENEFIT TO ADRENAL- SPARING RADICAL NEPHRECTOMIES Rachel Locke¹, J. Ryan Mark², Chamath Chandrasekera³, Ciara Huntington³, Kent Kercher³ and Chris Teigland¹ ¹McKay Urology, Levine Cancer Institute, Carolinas Healthcare System, Charlotte, NC; ²Levine Cancer Institute, Carolinas HealthCare System, Charlotte, NC; ³CMC Dept of General Surgery, Division of Minimally Invasive Surgery , Carolinas Healthcare System, Charlotte, NC Presented By: J. Ryan Mark, MD Poster #91 BIOENGINEERED PORCINE KIDNEY CONSTRUCTS SEEDED WITH AUTOLOGOUS CELLS FOR LONG-TERM SURVIVAL IN VIVO Joao Paulo Zambon, In Kap Ko, Ick-Hee Kim, Charesa Smith, John Jackson, Anthony Atala and James Yoo Wake Forest Institute for Regenerative Medicine, Winston Salem, NC Presented By: John D. Jackson, PhD Poster #92 ROLE OF NON-NEOPLASTIC RENAL PARENCHYMA ABNORMALITIES IN THE POPULATION WITH AND WITHOUT PREOPERATIVE CKD Nicola Pavan¹, Carmen M. Mir², Nachiketh Soodana-Prakash², Raymond R. Balise³, Vivek Venkatramani², Sam Shabtaie4, Varun Channagiri4, Alessia Fornoni5, David B. Thomas6 and Dipen J. Parekh² ¹Department of Urology, University of Miami Leonard M. Miller School of Medicine, Miami, FL and Urology Clinic, Department of Medical, Surgical and Health Science, University of Trieste, Italy; ²Department of Urology, University of Miami Leonard M. Miller School of Medicine, Miami, FL; ³Division of Biostatistics, Department of Public Health Sciences, University of Miami Leonard M. Miller School of Medicine, Miami, FL; 4University of Miami Miller School of Medicine, Miami, FL; 5Katz Family Drug Discovery Center and Division of Nephrology and Hypertension, University of Miami, Miller School of Medicine, Miami, FL; 6Department of Pathology, University of Miami Miller School of Medicine, Miami, FL Presented By: Nicola Pavan, MD Poster #93 HAS SLIDING CLIP RENORRHAPHY ELIMINATED THE NEED FOR COLLECTING SYSTEM (CS) REPAIR DURING ROBOTIC ASSISTED PARTIAL NEPHRECTOMY (RAPN)? Robert Williams and Dave Thiel Mayo Clinic - Jacksonville, FL Presented By: Robert D. Williams, MD

56 FRIDAY - , ¹

, Uwais Zaid , Uwais

and Shubham and Shubham

Cleveland Clinic, Clinic, Cleveland

² ²

² AND DRUG AND

ARIATIONS FOR FOR ARIATIONS , Gargae Lavien Gargae , ¹

, Sudhir Isharwal , Sudhir Cone ² Salem, NC Salem,

J. Kennelly, MD - Birmingham Department of Public Public of Department Birmingham

and Aaron Lentz Aaron and

¹ and Lee Hammontree Lee and , Eugene

¹ Charlotte, NC MD Terlecki, P. Ryan Winston Michael University of Nebraska, Omaha Nebraska Omaha Nebraska, of University ¹

³ 57 Lee N. Hammontree, MD Hammontree, N. Lee Duke Urology of Raleigh, Raleigh, NC Raleigh, Raleigh, of Urology Duke , John Lacy, John ¹ ²

AL Birmingham, Alabama, of Centers Urology ²

¹ ented By: Garjae D. Lavien, MD Lavien, D. Garjae By: ented University Alabama, of University University of Kentucky, Lexington KY; KY; Lexington Kentucky, of University Division of Urologic Surgery, Duke University Medical Center, Center, Medical University Duke Surgery, Urologic of Division Pres Division of Urology, Genitourinary Cancer Survivorship Program, Program, Survivorship Cancer Genitourinary Urology, of Division NC Durham, Center, Medical University Duke Daniel Beilan, Jonathan Baumgarten, Adam McCormick, Barrett Hernandez David and Patel Trushar Ordorica, Raul Martinez, FL Tampa, Medicine, of College Florida South of University MD McCormick, Z. Barrett By: Presented PROFILE MICROBIOLOGICAL Peterson Andrew and Zaid Uwais Lavien, Garjae Health; Health; By: Presented Mendez Melissa PRACTICE PATTERNS V AND URETHRAL STRICTURE DISEASE MANAGEMENT AMONG RECONSTRUCTIVE SURGEONS Johnson Sara INKINDIA INJECTION (TATTOOING) OFTHE URETERIC SYMPHYSIS PUBIC OF PATTERNS SUSCEPTIBILITY OSTEOMYELITIS CANCER PROSTATE IN THE SURVIVOR A. Scott TullyJr ¹ Session Poster Reconstruction/Diversion Location: 4 Cumberland Moderators: FOLLOWING SENSATION GLANS OF RECOVERY COMBINED WITH VENTRAL ONLAY DORSAL AND A GLANS SPLITTINGTECHNIQUE STRICTURES FOR OF NAVICULARISTHE FOSSA DIVERSIONS: URINARY IN ANASTOMOSIS INTESTINAL SIMPLEA EFFECTIVE AND IN TECHNIQUE TO AID SUBSEQUENT RECOGNITION RETROGRADEIN MANIPULATIONS RESULTSPARTIAL ROBOTIC OF NEPHRECTOMY (RBP) TO COMPARISON WITH LESS OR 4CMS TUMORS IN (LRC) CRYOABLATION RENAL LAPAROSCOPIC RESULTS Presented By: Sara E. Johnson, BS, Medical Student Medical BS, Johnson, E. Sara By: Presented Andrew Peterson Andrew MD Mendez, Melissa By: Presented ¹ OH; Cleveland ¹ Durham, NC; Gupta

4:45 p.m. 4:45

- Poster #95 Poster #98 Poster #97 Poster #96 Poster #94

3:45 p.m. Concurrent 6 Session 3 of

56 Poster #99 AMBULATORY OUTPATIENT URETHROPLASTY IS SAFE AND PRODUCES GOOD OUTCOMES Uwais Zaid, Garjae Lavien, Michael Granieri and Andrew Peterson Duke University, Durham NC Presented By: Uwais Zaid, MD Poster #100 CHARACTERIZATION OF GENITAL FOREIGN BODY INJURY RELATED HOSPITAL VISITS: A POPULATION- BASED ANALYSIS Shenelle Wilson¹, Zachary Klaassen¹, Erika Ibarra² and Durwood Neal¹ ¹Department of Surgery, Section of Urology, Georgia Regents University, Augusta, GA; ²Georgia Regents University, Augusta, GA Presented By: Shenelle Wilson, MD Poster #101 URINARY OUTCOMES AFTER ANTERIOR EXENTERATION AND NEOBLADDER URINARY DIVERSION IN WOMEN Justin Gregg¹, Johnson Wong², Curran Emeruwa², Matthew Resnick³, Daniel Barocas³, MIchael Cookson4, Sam Chang³, David Penson³, Joseph Smith³, Kristen Scarpato³ and Kelvin Moses³ ¹Vanderbilt University Medical Center, Department of Urologic Surgery, Nashville, TN; ²Meharry Medical College, Nashville, TN; ³Vanderbilt University Medical Center, Department of Urologic Surgery, Nashville, TN; 4University of Oklahoma College of Medicine, Department of Urology, Oklahoma City, OK Presented By: Justin Gregg, MD Poster #102 ETIOLOGY AND CHARACTERIZATION OF GENITAL LACERATION, CONTUSION, AND ABRASION INJURIES Shenelle Wilson¹, Brandon Wilson², Reena Kabaria², Zachary Klaassen² and Durwood Neal² ¹Department of Surgery, Section of Urology, Georgia Regents University, Augusta, GA; ²Georgia Regents University, Augusta, GA Presented By: Shenelle Wilson, MD Poster #103 POST-OPERATIVE COMPLICATIONS AFTER LAPAROTOMY IN ADULT PATIENTS WITH SPINA BIFIDA David C. Moore, Joshua A. Cohn and Mellissa R. Kaufman Vanderbilt University, Department of Urologic Surgery, Nashville, TN Presented By: David C. Moore, MD Poster #104 URETERAL REIMPLANTATION BY BLADDER ELONGATION AND PSOAS HITCH (BEPH) THROUGH A GIBSON INCISION IS SAFE, EFFECTIVE, AND HAS LOW MORBIDITY IN THE TREATMENT OF DISTAL URETERAL STRICTURES. Bryce Allio, Garjae Levien, Uwais Zaid and Andrew C. Peterson Division of Urology, Duke University Medical Center, Durham, North Carolina Presented By: Bryce A. Allio, MD

58 FRIDAY

³ , ¹ , ² Veterans Veterans ² , Dipen J. muel David muel ³ , Christopher Christopher , , , Wallston Ken

y of Miami , Samarpit Rai Samarpit ,

, Sa ² ¹ inic, Department of of Department inic,

Vanderbilt University University Vanderbilt ²

MD n Jackson, Anthony Atala, Atala, Anthony Jackson, n

UROLOGY PROGRAM PROGRAM UROLOGY - ² Kirillova , Irina D ¹ -

, Salil ,Gabale Salil Division of Biostatistics, Biostatistics, of Division Vanderbilt University School of of School University Vanderbilt ² ³

² , ChadR. Ritch

² , Wilkins Consuelo

, Raymond R. Balise R. , Raymond ¹ ²

Safir, MD Safir, ¹

-Prakash DAY POSTOPERATIVE POSTOPERATIVE DAY

- 2 , Steven Gerhard , Steven ¹ Andrew C. James,Andrew Lexington, KY J.Matthew MPH MD, Resnick, TN Nashville,

59 John D. Jackson, PhD Jackson, D. John , Lisa Sherden Lisa , ¹ , Carmen C. Mir, Carmen C. ¹ nter, Nashville, TN;

Broadway Ballroom A Broadway Ballroom , James Baumgardner , James

¹ and Mark Gonzalgo L. Mark and

and Muta Issa Muta and ²

¹ E FLOW QUESTIONNAIRE: DEVELOPING A NOVEL NOVEL A DEVELOPING QUESTIONNAIRE: E FLOW Department of Urology, University of Miami Leonard M. Miller Miller M. Leonard Miami of University Urology, of Department Emory University School of Medicine, Atlanta, GA; GA; Atlanta, Medicine, of School University Emory Department of Urology, University of Miami Leonard M. Miller Miller M. Leonard Miami of University of Urology, Department Meharry Medical College, Nashville, TN; TN; Nashville, College, Medical Meharry GA Atlanta, Center, Medical Affairs J Ilan By: Presented TH INSTRUMENTEVALUATE LOWER TO TRACT URINARY MEN IN SYMPTOMS Heslop Daniel Outcomes/Health Service/Socioeconomics Podium Session Location: TELE OF A IMPLEMENTATION FOR HEMATURIA OUTPATIENT REFERRALS: INITIAL RESULTS PATIENT SATISFACTION AND Safir Ilan Huang Jonathan ¹ NUTRITIONAL STATUS AND MAJOR ABDOMINAL NUTRITIONALSTATUS AND 30 SURGERIES: COMPLICATIONS Pavan Nicola Filson IN VIVO EVALUATION OF FUNCTIONALIZED MUSCLE MUSCLE FUNCTIONALIZED OF EVALUATION VIVO IN RECONSTRUCTION FOR SCAFFOLDS Joh Ju, Min Young Shapiro, Lindsey Lee Jin Sang and Yoo James Winston Medicine, for Regenerative Institute Forest Wake NC Salem, By: Presented ¹ Medical Ce Medical Nachiketh Soodana Nachiketh Moses and Kelvin TN Nashville, Nursing, BS Heslop, Daniel By: Presented Moderators: ¹ Cl Urology and FL Miami, Medicine, of School Italy; Trieste, of University Science, Health and Surgical Medical, ² FL; Miami, Medicine, of School Universit Sciences, Health Public of Department FL Miami, Medicine, of School Miller M. Leonard Parekh MD Pavan, Nicola By: Presented

4:45 p.m. 4:45

- 3:52 p.m.3:52 #31 3:45 p.m.3:45 #30 Poster #106 Poster #105

Concurrent Session 6 4 of 3:45 p.m.

58 3:59 p.m. #32 THE PRIMARY CARE BURDEN OF URINARY STONE DISEASE IN THE UNITED STATES Melissa Mendez¹, Ebony Boulware², Sharon Hull³, John Ragsdale III³, Michael Lipkin¹, Glenn Preminger¹ and Charles Scales4 ¹Division of Urologic Surgery, Duke University Medical Center, Durham, NC; ²Department of Medicine, Duke University Medical Center, Durham, NC; ³Department of Community and Family Medicine, Duke University Medical Center, Durham, NC; 4Division of Urologic Surgery, Duke University Medical Center and Duke Clinical Research Institute, Durham, NC Presented By: Melissa Mendez, MD 4:06 p.m. #33 THE RELATIONSHIP BETWEEN TRAVEL DISTANCE TO CYSTECTOMY AND LIKELIHOOD OF READMISSION Jason Lomboy, Matthew Macey, Troy Sukhu, Anne-Marie Meyer, Ke Meng, Matthew Nielsen, Raj Pruthi, Eric Wallen, Michael Woods and Angela Smith Chapel Hill, NC Presented By: Jason R. Lomboy, MD 4:13 p.m. #34 IMPACT OF HEALTH LITERACY ON SURGICAL OUTCOMES FOLLOWING RADICAL CYSTECTOMY Kristen R. Scarpato¹, Stephen F. Kappa¹, Kathryn M. Goggins², Sam S. Chang¹, Joseph A. Smith, Jr.¹, Peter E. Clark¹, David F. Penson¹, Matthew J. Resnick¹, Daniel A. Barocas¹, Sunil Kripalani² and Kelvin A. Moses¹ ¹Vanderbilt University Medical Center, Department of Urologic Surgery, Nashville, TN; ²Vanderbilt University Medical Center, Institute for Medicine and Public Health, Nashville, TN Presented By: Kristen R. Scarpato, MD, MPH 4:20 p.m. #35 IMPACT OF MINIMALLY INVASIVE BENIGN PROSTATIC HYPERPLASIA (BPH) THERAPIES ON 30- AND 90-DAY POSTOPERATIVE OFFICE ENCOUNTERS Ram Pathak, Mike Heckman, Nancy Diehl, Emily Brennan, Kandarp Shah, Gregory Broderick, Todd Igel, Steven Petrou, Michael Wehle, Paul Young and Dave Thiel Mayo Clinic Jacksonville, Florida Presented By: Ram Pathak, MD 4:27 p.m. #36 HIGH VALUE HEMATURIA CARE: IDENTIFYING COSTS OF A NOVEL CARE PATHWAY Tony Chen¹, Wendy Webster², Christopher Samples³, Mohammad Shahsahebi4, Michael Lipkin5, Glenn Preminger5, Sharon Hull4 and Charles Scales, Jr.5,6 ¹Duke University School of Medicine, Durham, NC; ²Surgery Clinical Operations, Duke University Medical Center, Durham, NC; ³Hospital Ambulatory Care Operations, Duke University Medical Center, Durham, NC; 4Department of Community & Family Medicine, Duke University Medical Center, Durham, NC; 5Division of Urology, Department of Surgery, Duke University Medical Center, Durham, NC; 6Duke Clinical Research Institute, Durham, NC Presented By: Tony T. Chen, BS

60 FRIDAY

, ³ , ¹

and and

, ¹ ¹ MA

and Peter Peter and

¹ ³

, Bradley Carthon Bradley , ³ , Michael Woods , Michael ¹ , Yoram Baum , Yoram

: ANALYSIS OF OF : ANALYSIS ¹ , Kenneth Ogan , Kenneth URINARY URINARY 4 -

na Lineberger Lineberger na roy Sukhu, Allison Deal, Deal, Allison Sukhu, roy

, Mark Lockhart E. Mark , ² and Mathew Raynor Mathew and

¹ , Wayne Wayne , Harris , Jeffrey Pearl Jeffrey , , Angela Smith Angela , ¹ ³ ² Lai, MD Lai,

enburg , Christopher Filson , Christopher 4

JeffreyW. Nix, MD Birmingham, AL Birmingham, Stephen MD Riggs, Charlotte, NC

, Allison Deal , Allison , Omer Kucuk 61 ¹ ² , James Ell Emory University School of Medicine, Department Department Medicine, of School University Emory Emory University School of Medicine, Department Department Medicine, of School University Emory ¹

² 4 Emory University School of Medicine, Department of of Department Medicine, of School University Emory , Dattatraya Patil , Dattatraya 4 , Matthew Nielsen Matthew , ³ ¹ ¹

¹ GA; The University of North Caroli North of University The ² University of Alabama at Birmingham School of Medicine; Medicine; of School Birmingham at Alabama of University Birmingham at Alabama of University Radiology, of Department Emory University School of Medicine, Department of Urology, Urology, of Department Medicine, of School University Emory The University of North Carolina School of Medicine Chapel Hill, Hill, Chapel Medicine of School Carolina North of University The Department of Urology, University of Alabama at Birmingham; Birmingham; at Alabama of University Urology, of Department ¹ GA; Atlanta, Urology; of Institute, Cancer Winship Oncology, Medical and Hematology Atlanta, Viraj Master Viraj THE NATIONAL CANCER DATA BASE Lomboy Jason PREOPERATIVE BETWEEN THE ASSOCIATION OUTCOMES POSTOPERATIVE AND LEUKOCYTOSIS FOLLOWINGNEPHRECTOMY KIDNEY FOR CANCER T Macey, Matthew Lomboy, Jason Pruthi, Raj Woods, Michael Wallen, Eric Raynor, Mathew Smith Angela and Nielsen Matthew NC Hill, Chapel MD Lomboy, R. Jason By: Presented Rishi Sekar Rishi CLINICAL PREDICTORS RADICAL OR OF PARTIAL CELL RENAL I STAGE FOR NEPHRECTOMY PATIENTS YOUNGER IN CARCINOMA ¹ NC; Win Shun Lai Shun Win Session Poster 2 Cancer Kidney/Adrenal Location: 3 Cumberland Moderators: EVALUATION OFTHE RENAL CELL CARCINO ASSESSING THE COSTS OF EXTRA OF COSTS THE ASSESSING INFLAMMATORY SCOREINWITH PATIENTS CLEAR HISTOLOGY CELL FINDINGS UROGRAM THE POTENTIAL CT OF AND OF EVALUATION THE IN ULTRASOUND OF ROLE ASYMPTOMATIC MICROSCOPIC HEMATURIA of Urology, Winship Cancer Institute, Atlanta, GA Atlanta, Institute, Cancer Winship Urology, of BA Sekar, Rishi By: Presented Anna Bausum Anna N. Kolettis N. ¹ ² ³ Wallen Eric NC Hill, Chapel Center Cancer Comprehensive MD Lomboy, R. Jason By: Presented Presented By: Win Shun V. V. Win Shun By: Presented Mehrdad Alemozaffar Mehrdad

5:45 p.m. 5:45

- 4:34 p.m.4:34 #37 Poster #107 Poster #109 Poster #108

Concurrent Session 6 5 of 4:45 p.m.

60 Poster #110 NEPHRON SPARING SURGERY FOR LARGER RENAL TUMORS: OUTCOME AND INITIAL EXPERIENCE Nathan Jung¹, Hugh Smith², Amanda Carter³, Juan Class4, Christopher Keel4 and Amar Singh4 ¹University of TN College of Medicine Chattanooga; ²Univeristy of TN College of Medicine Chattanooga, Chattanooga, TN; ³Medical Student at the University of TN Health Sciences Center, Memphis, TN; 4University of TN College of Medicine Chattanooga, Chattanooga, TN Presented By: Nathan L. Jung, MD Poster #111 RISK FACTORS THAT AFFECT SURVIVAL IN PATIENTS WITH RENAL CELL CARCINOMA INVADING THE VENA CAVA Marissa Kent, Drew Palmer and John Libertino Lahey Hospital & Medical Center, Burlington, MA Presented By: Marissa Kent, MD Poster #112 RENAL CELL CARCINOMA WITH AND WITHOUT END STAGE RENAL DISEASE: A SURVIVAL ANALYSIS AT A SINGLE RURAL MEDICAL CENTER Matthew Gay¹, David Barham¹, Stephen Bracewell², Jonathan Taylor³ and Swapnil Kachare4 ¹Brody School of Medicine, East Carolina University, Greenville, NC; ²Department of Urology, Thomas Jefferson University, Philadelphia, PA; ³Division of Urology, Department of Surgery, Brody School of Medicine, East Carolina University, Greenville, NC; 4Department of Surgery, Brody School of Medicine, East Carolina University, Greenville, NC Presented By: Matthew R. Gay, BS Poster #113 PROGNOSTIC VALUE OF PD-1 EXPRESSION IN LOCALIZED CLEAR CELL RENAL CELL CARCINOMA Rishi Sekar¹, Michelle DiMarco², Dattatraya Patil¹, Adebooye Osunkoya³, Gabriel Sica², Brian Pollack4 and Viraj Master¹ ¹Emory University School of Medicine, Department of Urology, Atlanta, GA; ²Emory University School of Medicine, Department of Pathology, Atlanta, GA; ³Emory University School of Medicine, Department of Pathology, Department of Urology, Atlanta VA Medical Center, Atlanta, GA; 4Emory University School of Medicine, Department of Dermatology, Atlanta VA Medical Center, Atlanta, GA Presented By: Rishi Sekar, BA Poster #114 BODY MASS INDEX PREDICTS PATHOLOGICALLY FAVORABLE RENAL CELL CARCINOMA IN CT1 RENAL CELL CARCINOMA Kae Jack Tay, Matvey Tsivian, Efrat Tsivian and Thomas Polascik Duke University, Durham, NC Presented By: Kae Jack Tay, MBBS, MMed(Surg) Poster #115 INTERMEDIATE-TERM FOLLOW UP COMPARISON OF RENAL FUNCTION AND SURVIVAL IN ELDERLY PATIENTS UNDERGOING RADICAL NEPHRECTOMY Charles Peyton, Matthew Heavner, Michael Rothberg and Ashok Hemal Wake Forest Baptist Medical Center, Winston Salem, NC Presented By: Charles C. Peyton, MD

62 FRIDAY

, ¹

and and

Shoshtari,

- , Michael Woods , Michael ¹

TS YOUNGER THAN SIX THAN YOUNGER TS

OBESE PATIENTS OBESE

, Jonathan C. Routh C. Jonathan , ² and Mathew Raynor Mathew and

¹ er, Division of Urology, Durham, Durham, Urology, of Division er,

, Angela Smith Angela , LL CARCINOMA: ANALYSIS ²

North Carolina Lineberger Lineberger Carolina North AND NON- AND

² S. John Tejwani, Rohit Wang, S. -Hsiao Daniel A. Barocas, MPH,FACS MD, TN Nashville, Muta M. Issa, MD, MBA Decatur, GA

, Lisa M. Einhorn M. Lisa ,

, Allison Deal , Allison 63 ¹ ¹ , Matthew Nielsen Matthew , ¹

The University of Duke University Medical Center, Division of Pediatric Pediatric of Division Center, Medical University Duke ² ² comes/Health Service/Miscellaneous Poster Session The University of North Carolina School of Medicine Chapel Hill, Hill, Chapel Medicine of School Carolina North of University The Duke University Medical Center, Division of Urology, Durham, Durham, Urology, of Division Center, Medical University Duke NC MD Young, J. Brian By: Presented Brian J. Young J. Brian Greene H. Nathaniel BIFIDA SPINA OF IMPACT ECONOMIC THE ESTIMATING IN THESTATES UNITED Hsin Young, J. Brian Routh C. Jonathan and Wiener Cent Medical University Duke ¹ NC; NC Hill, Chapel Center Cancer Comprehensive MD Lomboy, R. Jason By: Presented Stephen and Clarke S. Harry Prasad, Sandip Sarkissian, Hagop J. Savage Carolina, South of University Medical Urology, of Department SC Charleston, MD Sarkissian, Hagop By: Presented Out Location: 4 Cumberland Moderators: ESTIMATION AND ANALYSIS UNNECESSARILY OF PROCEDURESEARLY INFAN IN TRENDS IN DIAGNOSIS, MANAGEMENT, AND OVERALL OVERALL AND MANAGEMENT, DIAGNOSIS, IN TRENDS CE SURVIVAL OFRENAL CANCER OFTHE BASE NATIONAL DATA Lomboy Jason OF OUTCOMES PERIOPERATIVE OF COMPARISON PURE LAPAROSCOPIC RETROPERITONEAL AND TRANSPERITONEAL NEPHRECTOMY TUMORS =T1B IN OBESE BETWEEN STATES UNITED THE IN OF AGE MONTHS BILATERAL BENIGN ONCOCYTOMAS RENAL AND REVIEW INSTUTION BIOPSY: SINGLE ROLE RENAL OF Zargar Kamran Diorio, Gregory Leone, Andrew Wade J. M. Powsang, Julio Gilbert, M. Scott Sharma, Pranav Spiess E. Philippe and Poch A. Michael Sexton, FL Tampa, Center, Cancer Moffitt MD Leone, R. Andrew By: Presented ¹ NC; NC Durham, Anesthesia, MD Young, J. Brian By: Presented Eric Wallen Eric

5:45 p.m. 5:45

- Poster #119 Poster #120 Poster #118 Poster #117 Poster #116

Concurrent Session 6 6 of 4:45 p.m.

62 Poster #121 DETERMINING PROSTATE CANCER RISK STRATA USING ONLY GLEASON SCORE AND PSA Justin Gregg¹, Maximilian Lang², Sam Chang², Peter Clark², Michael Cookson³, S. Duke Herrell², David Penson², Matthew Resnick², Joseph Smith² and Daniel Barocas² ¹Vanderbilt University Medical Center, Department of Urologic Surgery, Nashville, TN; ²Vanderbilt University Medical Center, Department of Urologic Surgery, Nashville, TN; ³University of Oklahoma College of Medicine, Department of Urology, Oklahoma City, OK Presented By: Justin Gregg, MD Poster #122 EVALUATING THE TIMING OF SURGICAL COMPLICATIONS FOLLOWING CYSTECTOMY Troy Sukhu, Jason Lomboy, Matthew Macey, Allison Deal, Eric Wallen, Michael Woods, Raj Pruthi, Matthew Nielsen and Angela Smith Chapel Hill, NC Presented By: Troy A. Sukhu, MD Poster #123 IMPACT OF HEALTH LITERACY ON DISCHARGE DISPOSITION FOLLOWING RADICAL CYSTECTOMY Stephen F. Kappa¹, Kristen R. Scarpato¹, Kathryn M. Goggins², Sam S. Chang¹, Joseph A. Smith, Jr.¹, Peter E. Clark¹, David F. Penson¹, Matthew J. Resnick¹, Daniel A. Barocas¹, Sunil Kripalani² and Kelvin A. Moses¹ ¹Vanderbilt University Medical Center, Department of Urologic Surgery, Nashville, TN; ²Vanderbilt University Medical Center, Institute for Medicine and Public Health, Nashville, TN Presented By: Stephen F. Kappa, MD, MBA Poster #124 PERIOPERATIVE COMPLICATIONS AFTER MALE INCONTINENCE SURGERY: EFFECT OF LENGTH OF STAY ON OUTCOMES Allen Simms¹, Daniel Davenport¹, Sudhir Isharwal², Sara Johnson¹, Stephen Strup¹ and Shubham Gupta¹ ¹University of Kentucky, Lexington KY; ²University of Nebraska, Omaha Nebraska Presented By: Allen J. Simms, BS Poster #125 UROLOGIST USE OF CYSTOSCOPY FOR PATIENTS PRESENTING WITH HEMATURIA Samuel David, Datta Patil, Mehrdad Alemozaffar, Muta Issa, Viraj Master and Christopher Filson Emory University School of Medicine, Atlanta, GA Presented By: Samuel A. David, MD Poster #126 DISCREPANT INCREASE IN RADICAL CYSTECTOMIES FAVORING ACADEMIC VS. COMMUNITY HOSPITALS SINCE THE IMPLEMENTATION OF THE ACGME 80- HOUR WORK RESTRICTION Brian J. Young, Daniel F. Zapata, Hsin-Hsiao S. Wang, Jonathan C. Routh and Edward N. Rampersaud Duke University Medical Center, Division of Urology, Durham, NC Presented By: Brian J. Young, MD

64 FRIDAY egents egents , Durwood E. E. , Durwood ²

, John M. ² Georgia R Georgia

- ²

, Rita P. Jen P. , Rita

Georgia Regents University, University, Regents Georgia

- y Klaassen, Rita P. Jen, Grace Grace Jen, P. Rita Klaassen, y - , Jigarkumar R. Parikh R. Jigarkumar , and Rabii Madi Rabii and

² Klaassen ary BASED ANALYSIS BASED - 65 Medical College of Georgia Georgia of College Medical ²

, Zach

, Lael Reinstatler Lael , ts' Night Out Night ts' ² , Martha K. Terris K. Martha , ²

Medical College of Georgia Georgia of College Medical DiBianco and Terris K. Martha DiBianco, M. John Everett, Ross Yaguchi, Madi Rabii Georgia of College Medical GA Augusta, BS Harper, Ben By: Presented Residen Location: Wildhorse Saloon Chairs/DirectorsProgram Residents Only and Leslie Peard Leslie UROTHELIALUPPER CARCINOMA TRACT LOCATED IN CLINICAL WORSE HAS PELVIS RENAL THE OUTCOMES THE TO URETER: COMPARED A POPULATION Zachar Harper, T. Benjamin PATIENTS =80 UNDERGOING YEARS OF AGE RADICAL CYSTECTOMY FORBLADDER UROTHELIAL T2 IMPROVED SIGNIFICANTLY HAVE CARCINOMA SURVIVAL SPECIFIC DISEASE AND OVERALL OUTCOMES Neal, Jr Neal, ¹ GA; Augusta, University Cancer Center, Augusta, GA Augusta, Center, Cancer University Presented By: Leslie Peard Leslie By: Presented

10:30 p.m. 10:30

- Poster #128 Poster #127 7:00 p.m. Concurrent Sessions End Sessions Concurrent

64 SATURDAY, MARCH 19, 2016

OVERVIEW

6:00 a.m. - 12:30 p.m. Registration/ Information Desk Open Location: Broadway Ballroom EF Pre-Function 6:00 a.m. - 12:30 p.m. Speaker Ready Room Hours Location: Mockingbird 1 7:30 a.m. - 10:30 a.m. Spouse/Guest Hospitality Suite Open Location: Bass Room 7:00 a.m. - 11:00 a.m. Exhibit Hall Open Location: Broadway Ballroom EF 10:00 a.m. - 2:00 p.m. Artistic Side of Nashville Tour Location: Meet in the lobby of the Omni at 9:45 a.m. 1:00 p.m. - 5:30 p.m. Golf Location: Meet in the lobby of the Omni at 12:30 p.m. 2:30 p.m. 3rd Annual Hector Henry 5K Run/Walk Location: Meet in the lobby of the Omni at 2:15 p.m. 6:30 p.m. - 7:30 p.m. 2016 SESAUA Annual Reception Location: Broadway Ballroom EF 7:30 p.m. - 11:00 p.m. 2016 SESAUA Annual Banquet Location: Broadway Ballroom EF

Concurrent Sessions Begin

Concurrent Session 1 of 3

6:30 a.m. - 8:00 a.m. Simulators/Training Poster Session Location: Cumberland 3 Moderators: Michael Ferrandino, MD Durham, NC Paul R. Young, MD Jacksonville, FL Poster #129 DIFFUSION OF ROBOTIC TECHNOLOGY INTO UROLOGIC PRACTICE HAS LED TO IMPROVED BASELINE RESIDENT PHYSICIAN ROBOTIC SKILLS IN THE SOUTHEASTERN SECTION OF THE AMERICAN UROLOGICAL ASSOCIATION (SESAUA) Eric Schommer¹, Vipul Patel², Vladimir Mouraviev², Colleen Thomas¹ and David Thiel¹ ¹Mayo Clinic Jacksonville, Jacksonville, FL; ²Global Robotics Institute, Celebration, FL Presented By: Eric A. Schommer, MD

66 SATURDAY

6 -

hael hael ² , Li ²

, Mic ¹

inic Florida, Florida, inic , Jason Lee Jason , Rochester, Rochester, 5 4

odd Igel odd d Michael d Michael

Mayo Cl and David Thiel David and ²

, Bryan Comstock

, Zhou Li² , Zhou Gainesville, FL; FL; Gainesville, ² , Aaron Boonjindasup Aaron , ³

Robert Williams, Dave Thiel and and Thiel Dave Williams, Robert -Gil, MD, MPH

, Chandru Sundaram Chandru , 4 Toronto, Toronto, Canada Toronto, Toronto, 6 ¹ Maddox , Michael ¹ Eric M. Wallen and Davis Viprakasit P. Wallenand Davis M. Eric

Seattle, WA; WA; Seattle, ²

, Kolbi Tonkovich Kolbi , ¹

il, Akshay Bhandari, Jorge Caso, Rafael Rafael Caso, Jorge Bhandari, Akshay -Gil, 67

, Thomas Lendvay , Thomas ¹

, Matthew Gettman Matthew , ³ , Philip Dorsey Philip , ¹ Indianapolis, IN; IN; Indianapolis, 5 New Orleans, LA; LA; Orleans, New Mayo Clinic Jacksonville, Jacksonville, FL; FL; Jacksonville, Jacksonville, Clinic Mayo esented By: Mary K. Powers, MD Powers, K. Mary By: Presented SIMULATION OF MRI FUSION BIOPSY: CREATION OF A OF A CREATION BIOPSY: MRI FUSION OF SIMULATION STANDARDIZED CURRICULUM TO ENSURE EDUCATION RESIDENT SATISFACTORY Schommer, Eric Pathak, Ram COSTS TRAININGUROLOGY OF RESIDENTS IN ROBOTIC VS. CYSTECTOMY, OPEN DUPLICATION OF PERSONNEL IN ACADEMIC SETTINGAN Garcia Maurilio Nieder M. Alan and Sidhu Ajaydeep Delto, C. Joan Yanes, Pinsky VASECTOMY SIMULATION TRAINER WITHENHANCED CONSTRUCTFACE VALIDITYAND Amy Rosa, La Delaney Moore, Monica Thiel, Dave Pathak, Ram T and Broderick Gregory Frank, Ryan Lannen, MD Pathak, Ram By: Presented FACILITATE TO TOOL EDUCATION OF USE AN IMMEDIATE DIRECTED SURGICALAND SKILLS INFEEDBACK UROLOGY Sukhu, A. Troy Macey, R. Matthew Lomboy, R. Jason Connolly, AnnaMarie NC Hill, Chapel MD Lomboy, R. Jason By: Presented FUNDAMENTALS OFENDOUROLOGY: THE RESIDENT PERSPECTIVE Glenn T Chen, Tony Mendez, Melissa Ackerman, Anika an Scales Charles Lipkin, Michael Preminger, Ferrandino NC Durham, Center, Medical University Duke Igel Todd Florida Jacksonville, Clinic Mayo MD Pathak, Ram By: Presented Miami Urology, of Department Center Medical Sinai Mount FL Beach, Garcia Maurilio By: Presented Mary Powers Mary ON INVOLVEMENT TRAINEE RESIDENT OF IMPACT ROBOT ASSISTED PROSTATECTOMY RADICAL (RARP) OUTCOMES Schommer Eric Florida Jacksonville, Clinic Mayo MD Ackerman, J. Anika By: Presented CROWDSOURCING OFASSESSMENT SURGEON DISSECTION VEIN RENAL ARTERY OF AND DURING ROBOTIC PARTIAL NEPHRECTOMY: NOVEL A OF ASSESSMENT QUANTITATIVE FOR APPROACH SURGICAL PERFORMANCE and Benjamin Lee and Benjamin ¹ MN; Ming Su ¹ FL Jacksonville, MD Schommer, A. Eric By: Presented

Poster #136 Poster #135 Poster #134 Poster #133 Poster #132 Poster #131 Poster #130

66 Poster #137 COMMUNICATION SKILLS ASSESSMENT USING HUMAN AVATARS: PILOTING A VIRTUAL WORLD OBJECTIVE STRUCTURED CLINICAL EXAMINATION (OSCE) Bruce Kava¹, Allen Andrade², Robert Marcovich¹, Thaer Idress³ and Jorge Ruiz³ ¹University of Miami Miller School of Medicine Miami, Florida; ²James J. Peters VA Medical Center, Bronx, NY; ³Bruce W. Carter VA Medical Center, Miami, FL Presented By: Bruce R. Kava, MD

Concurrent Session 2 of 3

6:30 a.m. - 8:00 a.m. Voiding Dysfunction 1 Poster Session Location: Cumberland 4 Moderators: Yvonne K. Koch, MD Miami, FL L. Keith Lloyd Jr., MD Birmingham, AL Poster #138 COMPARISON OF ONABOTULINUMTOXINA INTRADETRUSOR INJECTION NEEDLE PERFORMANCE WITH MODERN FLEXIBLE CYSTOSCOPES Robert Williams, Jesse Dove, Steven Petrou and David Thiel Mayo Clinic - Jacksonville, FL Presented By: Robert D. Williams, MD Poster #139 UTILITY OF ROUTINE CYSTOGRAPHY FOLLOWING THE MANAGEMENT OF TRAUMATIC BLADDER RUPTURES Niels Johnsen¹, Jason Young², Elizabeth T Brown¹, Oscar Guillamondegui² and Roger Dmochowski¹ ¹Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, TN; ²Division of Trauma and Surgical Critical Care, Vanderbilt University Medical Center, Nashville, TN Presented By: Niels V. Johnsen, MD Poster #140 INITIAL PHARMACOTHERAPY FOR OVERACTIVE BLADDER SYMPTOMS AMONG MEDICARE BENEFICIARIES Charles Scales Jr.¹, Melissa Greiner¹, Bradley Hammill¹, Andrew Peterson², Lesley Curtis¹ and Kenneth Schmader³ ¹Duke Clinical Research Institute, Durham, NC; ²Division of Urologic Surgery, Duke University, Durham, NC; ³Division of Geriatrics, Duke University, Durham, NC Presented By: Charles D. Scales Jr., MD, MSHS Poster #141 IN DIABETIC PATIENTS WITH URODYNAMICALLY- CONFIRMED DETRUSOR UNDERACTIVITY, CONCURRENT PERIPHERAL NEUROPATHY CORRELATES TO NEITHER BLADDER SENSATION NOR TO THE DEGREE OR TYPE OF IMPAIRED CONTRACTILITY Bradley Potts, Michael Belsante and Ngoc-Bich Le Durham, NC Presented By: Bradley A. Potts, BS

68 SATURDAY

and and

³ YING

DINDO -

Advanced Urology Urology Advanced ² Bich Le Bich REPORTED REPORTED

- -

, Ronald Tutrone , Ronald Pond, Allison Boemer and and Boemer Allison Pond, ² -

ll, MD

Chesapeake Urology Associates, Associates, Urology Chesapeake

³ M

CONFIRMED DETRUSOR Rose, MD -

, Anthony Cantwell , Anthony

¹ 4 69 Wake Forest Baptist Medical Center, Winston Winston Center, Medical Baptist Forest Wake 4 Shreveport, Shreveport, LA Shreveport, Shreveport, Shreveport, Shreveport, LA Shreveport, Shreveport,

y: Kyle M. - - TIVITYWITHOUT BLADDER OUTLET

kstalis Charleston, SC Charleston, - olaco, Erin Kelly, Karen Pfotenhauer and Majid Majid and Pfotenhauer Karen Kelly, Erin olaco, Atlantic Urology Clinics, Myrtle Beach, SC; SC; Beach, Myrtle Clinics, Urology Atlantic TREATMENT OFTHE ISOLATED CYSTOCELE: PRACTICE PATTERNS IN THE SOUTHEASTERN AUA THE OF SECTION Pettibone Amanda Hartsell, Lindsey CROSSOVER STUDY OF THE PROSTATIC URETHRAL LIFT (PUL) PROCEDURE THE TREATMENT FOR OF LOWER SYMPTOMSTRACT URINARY BENIGN TO DUE OUTCOMES YEAR 2 HYPERPLASIA: PROSTATIC Bogache William MUSC Rabley Andrew By: Presented MUSCLE FLOOR PELVIC PREOPERATIVE OF IMPACT TRAINING STORAGEON EMPT URINARY AND Alex and II Frilot F. Clifton Islam, Tameem Gamble, Laura Gomelsky Health LSU PATIENT OF ROLE THE ASSESSING Gomelsky Alex and Karaman R. Umar Rose, M. Kyle BLADDER OUTLET PROCEDURES EFFECTIVE AN ARE TREATMENT OPTION FOR PATIENTS WITH URODYNAMICALLY Ngoc and Belsante Michael Potts, Bradley Durham, NC BS Potts, A. Bradley By: Presented MESH PELVIC OF COMPLICATIONS OF ANALYSIS CLAVIEN THE USING SURGERY REVISION SYSTE CLASSIFICATION Leah Rac, Goran Freilich, Drew Tipton, Tracy Rabley, Andrew Rovner Eric and Cox Lindsey Rames, Ross Chiles, SYMPTOMS WOMENIN WITH MIXED INCONTINENCE UNDERGOING SLING SURGERY MD Gamble, Laura By: Presented OF EVALUATION THE IN QUESTIONNAIRES OUTCOME FOR SURGERY SLING AFTER LIFE OF QUALITY FEMALE STRESS INCONTINENCE: URINARY REVIEW A OF THE LITERATURE Health LSU B Presented COMPLICATIONS OF BOTOX INJECTIONS IN IN INJECTIONS OF BOTOX COMPLICATIONS POPULATIONS PATIENT DIFFERENT Marc C Mirzazadeh Health Baptist Forest Wake MBA MD, Colaco, Marc By: Presented Salem, NC Salem, FACS MD, Bogache, K. William By: Presented ¹ Institute, Daytona Beach, FL; FL; Beach, Daytona Institute, MD; Towson, Rowena Desouza Rowena UTHSC Memphis, TN Hartse M. Lindsey By: Presented Daniel Ru Daniel OBSTRUCTION UNDERAC

Poster #148 Poster #147 Poster #146 Poster #145 Poster #144 Poster #143 Poster #142

68 Poster #149 GROWTH HORMONE-RELEASING HORMONE ANTAGONISTS DECREASE INFLAMMATION AND TGF?2-INDUCED PROLIFERATION OF HUMAN BPH-1 CELLS - A NOVEL LINK BETWEEN PROSTATIC INFLAMMATION AND AUTOCRINE/PARACRINE GHRH Petra Popovics¹, Andrew V. Schally², Roberto Perez², Norman L. Block³ and Ferenc G. Rick² ¹University of Miami Miller School of Medicine, Division of Endocrinology, Diabetes and Metabolism, Miami, FL; ²Miami VA Medical Center, Miami, FL; ³University of Miami Presented By: Petra Popovics, PhD

Concurrent Session 3 of 3

7:00 a.m. - 8:00 a.m. Video Session I Location: Cumberland 1/2 Moderator: Christopher E. Keel, DO Chattanooga, TN Video #1 ROBOT ASSISTED RETROPERITONEAL LYMPH NODE DISSECTION Raj Kurpad and Michael Woods University of North Carolina Chapel Hill, NC Presented By: Raj Kurpad, MD Video #2 ROBOTIC VESICOVAGINAL FISTULA REPAIR WITH VASCULAR FLAP INTERPOSITION Joan C. Delto, Rafael Yanes, Maurilio Garcia-Gil, Ajaydeep S. Sidhu, Yvonne Koch and Akshay Bhandari Mount Sinai Medical Center, Miami Beach, FL Presented By: Joan Delto, MD Video #3 ROBOTIC ADRENALECTOMY FOR METASTATIC MELANOMA Micahel Jennings, Kyle Basham, Ryan Owen, Christopher Winter, Johnathon Angelle, Bedford Waters and Wesley White University of Tennessee Medical Center Knoxville, TN Presented By: Michael O. Jennings, MD Video #4 COMPLEX ROBOT-ASSISTED LAPAROSCOPIC EXTRAVESICAL URETERAL REIMPLANTATION (RALUR) FOLLOWING ENDOSCOPIC INJECTION OF DEXTRONAMER/HYALURONIC ACID FOR VESICOURETERAL REFLUX Michael Garcia-Roig, Jonathan H. Huang and Andrew J Kirsch Emory University Department of Pediatric Urology/ Children’s Healthcare of Atlanta, Atlanta, GA Presented By: Michael L. Garcia-Roig, MD Video #5 DORSAL LUMBOTOMY APPROACH TO INFANT PYELOPLASTY: A USEFUL TOOL FOR THE PEDIATRIC UROLOGIST Michael Garcia-Roig, Anthony J. Tracey and Andrew J. Kirsch Emory University Department of Pediatric Urology/ Children’s Healthcare of Atlanta, Atlanta, GA Presented By: Michael L. Garcia-Roig, MD

70 SATURDAY

O'Bryan, MD -O'Bryan,

ment of the low PatientT

OURETERECTOMY IN A Knoxville, TN Knoxville,

Men's Health

. Lawrence Van Horn, PhD, MPH, MBA .PhD, Van MPH, Lawrence Horn, TN ashville, - R N NEPHR

- Detroit, MI McComb, MS Raj S. Pruthi, MD Ronald W.Ronald FACS MD, Lewis, Augusta, GA W.Ronald FACS MD, Lewis, Augusta, GA G.Lorie Fleck, MD AL Mobile, MD Jackson, E. Jerry Sumter, SC Chapel Hill, NC StephenJ. Savage, MD Michael E.MD Moran, RichardSantucci, A. MD Charleston, SC New York, NY John P. Mulhall, MD

71 Art Lecture: The Evolution of Healthcare Healthcare of Evolution The Lecture: Art - ASSISTED RADICAL CYSTECTOMY WITH WITH CYSTECTOMY RADICAL ASSISTED

Broadway Ballroom EFBroadway Ballroom the

- Visit Exhibits

- of - Dineen Health Policy Forum 2 Forum Policy Health Dineen -

State Break Location: Meeting Business Annual Bowl Quiz Resident Moderators: University of Louisville Dept. of Urology, Louisville, KY Louisville, Urology, of Dept. Louisville of University Moderator: in Manage Challenges the Dysfunction Erectile Panelist: Problem Growing A Penis: Buried Adult Gee Moderators: COMPLETELY RENAL DUPLICATED UNIT ROBOTIC INTRACORPOREAL CONTINENT CATHETERIZABLE RESERVOIR POUCH) (INDIANA Messer Jamie and O'Bryan Brittany Ewing E. Brittany By: Presented Tennessee and in Kentucky Urology of History Speaker: Discussion Panel Panelist: ROBOTIC HEMI Winter, White, Wesley Owen, Kyle Christopher Ryan Basham, Waters Bedford and Angelle Jonathon Jennings, Michael Tennessee of University Presented By: Kyle Basham, MD Basham, Kyle By: Presented Markets Guest Speaker:

Panelist: Panelist: nd

12:30 p.m.12:30 11:45 a.m. 11:45 11:00 a.m. 11:00

10:30 a.m. 10:30 9:30 a.m. 8:30 a.m. - - -

- - - Video #7 Video Video #6 Video 9:30 a.m. 8:30 a.m.

11:45 a.m.

8:00 a.m. Concurrent Sessions E Sessions Concurrent

11:00 a.m. 10:30 a.m. 70 12:30 p.m. - 1:45 p.m. Industry Sponsored Lunch Symposium Location: Broadway Ballroom GH

1:00 p.m. - 4:00 p.m. Journal of Urology Peer Review Seminar Location: Cumberland 1/2 *Not CME Accredited 6:30 p.m. - 7:30 p.m. 2016 SESAUA Annual Reception Location: Broadway Ballroom EF 7:30 p.m. - 11:00 p.m. 2016 SESAUA Annual Banquet Location: Broadway Ballroom EF

SUNDAY, MARCH 20, 2016

OVERVIEW

6:00 a.m. - 12:15 p.m. Registration/Information Desk Open Location: Broadway Ballroom EF Pre-Function 6:00 a.m. - 12:15 p.m. Speaker Ready Room Hours Location: Mockingbird 1 7:30 a.m. - 10:30 a.m. Spouse/Guest Hospitality Suite Open Location: Bass Room

Concurrent Sessions Begin

Concurrent Session 1 of 5

6:30 a.m. - 7:30 a.m. Video Session II Location: Cumberland 1/2 Moderator: Christopher E. Keel, DO Chattanooga, TN Video #8 ROBOTIC ASSISTED LAPAROSCOPIC DIVERTICULECTOMY FOR SYMPTOMATIC CALYCEAL DIVERTICULUM: TECHNIQUE AND INITIAL EXPERIENCE (DVD IS TITLED: ROBOTIC-ASSISTED LAPAROSCOPIC CALYCEAL DIVERTICULECTOMY) Anand Shridharani, Juan Class, Argil Wheelock, Norman Galen, Colin Goudelocke, Paul Zmaj, Sarah Hunt and Amar Singh University of TN College of Medicine Chattanooga Presented By: Anand Shridharani, MD Video #9 ROBOTIC PARTIAL NEPHRECTOMY ON MULTIPLE KIDNEY TUMORS. A SAFE ALTERNATIVE TO RADICAL NEPHRECTOMY Erika Ibarra and Rabii Madi Georgia Regents University, Augusta, GA Presented By: Rabii Madi, MD Video #10 ROBOTIC RESECTION OF LOCALLY RECURRENT RENAL CELL CARCINOMA Weil Lai, Michael M. Maddox, Gregory Mitchell and Benjamin R. Lee New Orleans, LA Presented By: Weil Lai, MD

72 SUNDAY ; and and

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Lexington VA VA Lexington ³ , Beau Toskich ¹

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¹ Matthew Lane Matthew

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lege of Medicine, Department of of Department Medicine, of lege ASSOCIATED URINARY TRACT - Belaunde, Juan M. Guzman M. Juan -Belaunde, Belaunde, MD -Belaunde, Saavedra

Tampa General Hospital, Tampa, FL; FL; Tampa, Hospital, General Tampa . ²

, Tracey Lund , Tracey ¹ ez BALLOON URINARY CATHETERS CATHETERS URINARY BALLOON y New Orleans, LA Orleans, New y Shubham Gupta, MD Lexington E.Durwood Neal Augusta, GA -

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Antonio Saavedra Antonio

é Kaiser Permanente Riverside Medical Center, Riverside, CA Riverside, Center, Medical Riverside Permanente Kaiser Lexington VA Medical Center, Lexington, KY; KY; Lexington, Center, Medical VA Lexington University of Florida Department of Radiology, Gainesville, Gainesville, Radiology, of Department Florida of University USF Health Morsani Col Morsani Health USF University of Kentucky, College of Medicine, Lexington, KY; KY; Lexington, Medicine, of College Kentucky, of University University of Florida Department of Urology, Gainesville, Florida Gainesville, Urology, of Department Florida of University GANGRENE: THE EXPERIENCE AT THE UNIVERSITY OF OF UNIVERSITY THE AT EXPERIENCE THE GANGRENE: PUERTO RICO MEDICAL CENTER Antonio Puras Antonio Universi Presented By: Jose A Jose By: Presented ¹ FL; Tampa, Urology, ³ MD Beilan, Jonathan By: Presented RISK IN BACTERIA RESISTANT OF FECAL SWABS IS CORRELATED WITH PREVIOUS ANTIBIOTIC POPULATION VETERAN A IN EXPOSURE Li¹ Dillon NOVEL DUAL A. Beilan Jonathan Inflammation/Infection Poster Session Location: 3 Cumberland Moderators: DELAYED PRIMARY CLOSUREOFFOURNIER Jos ¹ ² ROBOTIC PYELOLITHOTOMY IN A HORSESHOE HORSESHOE IN A PYELOLITHOTOMY ROBOTIC KIDNEY Herrell Duke S. and Marien Tracy Kappa, F. Stephen Urologic of Department Center, Medical University Vanderbilt TN Nashville, Surgery, Presen PERCUTANEOUS TRANSHEPATIC ENDOSCOPIC CHOLEDOCHOLITHOTOMYLASER Terry Russell Preston David ROBOTIC FLAP: BOARI TECHNICAL MODIFICATIONS ENHANCETO SUCCESS and Thomas Raju Shaw J. Eric McCaslin, Ian Wang, R. Julie Universit Tulane Presented By: Julie C. Wang, MD, MPH MD, Wang, Julie C. By: Presented ³ Ordorica Medical Center, Lexington, KY, Department of Urology, Urology, of Department KY, Lexington, Center, Medical KY Lexington, Kentucky, of University MPH BS, Li, Dillon By: Presented Vincent Bird Vincent ¹ ² Florida MD Terry, Russell By: Presented REDUCE CATHETER INFECTIONS

7:30 a.m.

- Poster #150 Poster #152 Poster #151 Video #13 Video Video #12 Video Video #11 Video

6:30 a.m. Concurrent Session 5 2 of

72 Poster #153 TRANSRECTAL SATURATION PROSTATE BIOPSY IS NOT ASSOCIATED WITH GREATER COMPLICATION RATES COMPARED WITH A STANDARD EXTENDED BIOPSY STRATEGY Jorge Rivera-Mirabal¹, Ronald Cadillo-Chávez², Héctor López- Huertas² and Ricardo Sánchez-Ortiz² ¹University of Puerto Rico School of Medicine, San Juan PR; ²Robotic Urology & Oncology Institute and University of Puerto Rico School of Medicine, San Juan, PR Presented By: Jorge Rivera-Mirabal, BSc Poster #154 EPIDEMIOLOGICAL DISTRIBUTION OF PATHOGENS IN NECROTIZING SOFT TISSUE INFECTION Benjamin Angel, Patrick Hensley, Jonathan Walker, Raevti Bole and Jason Bylund Department of Urology, University of Kentucky Medical Center Presented By: J. Benjamin Angel, MD Poster #155 ALEXIS WOUND PROTECTOR/RETRACTOR REDUCES WOUND INFECTION DURING RADICAL CYSTECTOMY AND URINARY DIVERSION Ajaydeep S. Sidhu¹, Elizabeth T. Nagoda², Rafael E. Yanes¹, Joan C. Delto¹, Akshay Bhandari¹, Jorge R. Caso¹ and Alan M. Nieder¹ ¹Mount Sinai Medical Center Department of Urology, Miami Beach, FL; ²FIU Herbert Wertheim College of Medicine, Miami, FL Presented By: Ajaydeep S. Sidhu, MD Poster #156 PROLYL HYDROXYLASE ENZYME INHIBITION PROTECTS THE BLADDER FROM INFLAMMATORY INJURY Douglass Clayton¹, Matthew D. Mason², Magdalena Grabowska¹, Anne G. Dudley¹, Daniel P. Casella¹, Robert J. Matusik¹, Peter E. Clark¹, Stacy T. Tanaka¹, John C. Thomas¹, John C. Pope¹, Mark C. Adams¹, John W. Brock¹, Pinelopi Kapitsinou³, Hanako Kobayshi¹, Qingdu Liu¹, Olena Davidoff¹ and Volker H. Haase¹ ¹Vanderbilt University School of Medicine, Nashville, TN; ²SUNY Upstate Medical Center, Syracuse, NY; ³University of Kansas Medical Center, Kansas City, KS Presented By: Douglass B. Clayton, MD Poster #157 DIAGNOSIS OF BLADDER OUTLET OBSTRUCTION IN MEN WITH DETRUSOR UNDERACTIVITY BASED ON VOIDING WITH THE SPANNERTM TEMPORARY PROSTATE STENT Douglas Swartz¹ and Sagar Shah² ¹Jacksonville, FL; ²McIver Urological Clinic Presented By: Douglas A. Swartz, MD Poster #158 MULTISPECIALTY RETROSPECTIVE REVIEW OF THE CLINICAL UTILITY OF PELVIC MRI IN THE SETTING OF PELVIC PAIN John Moore, Ram Pathak, Gregory Broderick, Candice Bolan, Mellena Bridges and Caroline Snowden Mayo Clinic Florida, Jacksonville, FL Presented By: John R. Moore, MD

74 SUNDAY

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, Sara , Sara ²

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University of Nebraska, Nebraska, of University

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Margaret Kent, MD Kent, Margaret , Jonathan Walker , Jonathan

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75 Allen J. Simms, BS Gupta

Shreveport, Shrevep Shreveport, , Daniel Davenport Daniel ,

¹ -

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ented By: Juan Guzman Juan By: ented vez á Robotic Urology & Oncology Institute and University of Puerto Puerto of University and Institute Oncology & Urology Robotic Glickman Urological and Kidney Institute, Cleveland Clinic, Clinic, Cleveland Institute, Kidney and Urological Glickman University of Puerto Rico School of Medicine, San Juan, PR; PR; Juan, San Medicine, of School Rico Puerto of University University of Kentucky, Lexington Kentucky, of University University of Kentucky and VA Medical Center, Lexington, KY; KY; Lexington, Center, Medical VA and Kentucky of University

Presented By: By: Presented Ch ¹ ² PR Juan, San Medicine, of School Rico Carolina North MD Allio, A. Bryce By: Presented Pres ¹ Omaha Health LSU NATIONALLY VALIDATED MULTI CENTER COHORT PROSPECTIVE Simms Allen DOES PUNCTURE TROCAR THE BLADDER OF DURING RETROPUBIC MIDURETHRAL SLING IMPACT VOIDING AND STORAGE URINARY POSTOPERATIVE SYMPTOMS? Gomelsky Alex and II Frilot F. Clifton Kent, Margaret J. J By: Presented ASSOCIATED WITH IMPROVED CONTINENCEEARLY ROBOTICAFTER RADICAL PROSTATECTOMY Peterson C. Andrew and Ajay Divya Allio, A. Bryce Duke Urology, of Division PATTERNS OFMALE INCONTINENCE PROCEDURES IN POPULATION (VA) AFFAIRS VETERANS THE Belknap Samuel MALE AFTER COMPLICATIONS PERIOPERATIVE INCONTINENCE SURGERY: R DOUBLE Juan POST MANAGING TO APPROACH AN ALGORITHMIC SLING RETENTION URINARY MALE IN PATIENT THE PREVENTCAN UNNECESSARY SURGICAL INTERVENTION Voiding Dysfunction 2 Poster Session Poster 2 Dysfunction Voiding Locat Moderators: and Shubham and Shubham ¹ ² OH Cleveland, MD Belknap, Samuel By: Presented Johnson

7:30 a.m.

- Poster #159 Poster #163 Poster #162 Poster #161 Poster #160

6:30 a.m. Concurrent 5 Session 3 of 74 Poster #164 PROSTATIC URETHRAL LIFT: BPH TREATMENT FOR THE SEXUALLY INCLINED Jonathan A. Beilan, Jared J. Wallen, Bhavik B. Shah, Michael Bickell, Daniel R. Martinez, Justin Parker, David J. Hernandez and Rafael E. Carrion USF Health Morsani College of Medicine, Department of Urology, Tampa, FL Presented By: Jonathan Beilan, MD Poster #165 PRACTICE LEVEL IMPACT OF THE ENDOSCOPIC MANAGEMENT OF BENIGN PROSTATIC HYPERTROPHY (BPH): ARE WE IMPROVING QUALITY OF CARE? Ram Pathak, Mike Heckman, Nancy Diehl, Emily Brennan, Kandarp Shah, Gregory Broderick, Todd Igel, Steven Petrou, Michael Wehle, Paul Young and Dave Thiel Mayo Clinic Jacksonville, Florida Presented By: Ram Pathak, MD Poster #166 REOPERATION FOR SEVERE COMPLICATIONS AFTER 180-W XPS GREENLIGHT® LASER VAPORIZATION OF THE PROSTATE David C. Moore, Joshua A. Cohn and Mellissa R. Kaufman Vanderbilt University, Department of Urologic Surgery, Nashville, TN Presented By: David C. Moore, MD

Concurrent Session 4 of 5

6:30 a.m. - 7:30 a.m. Bladder Cancer/Diversion Podium Session Location: Broadway Ballroom G/H Moderators: Jamie Messer, MD Louisville, KY Michael E. Woods, MD Chapel Hill, NC 6:30 a.m. #38 UNDERSTANDING THE TRAJECTORY OF SYMPTOMS AND FUNCTIONING IN THE 90-DAY CYSTECTOMY PERIOD Matthew Macey, Troy Sukhu, Jason Lomboy, Sarah Stanley, Allison Deal, Dana Mueller, Matthew Nielsen, Raj Pruthi, Eric Wallen, Michael Woods and Angela Smith Chapel Hill, NC Presented By: Matthew R. Macey, MD 6:37 a.m. #39 EFFECTIVE TREATMENT OF URINARY BLADDER CANCERS BY GROWTH HORMONE-RELEASING HORMONE ANTAGONISTS: A PRECLINICAL REPORT Ferenc Rick¹, Petra Popovics², Norman L. Block², Karoly Szepeshazi¹ and Andrew V. Schally¹ ¹Miami VA Medical Center; ²University of Miami Miller School of Medicine Presented By: Ferenc Rick, MD, PhD 6:44 a.m. #40 ASSOCIATIONS BETWEEN PHYSICAL ACTIVITY AND HEALTH-RELATED QUALITY OF LIFE IN BLADDER CANCER SURVIVORS: A CROSS-SECTIONAL STUDY Ajay Gopalakrishna, Joseph Fantony, Thomas Longo and Brant Inman Duke University Medical Center, Durham, NC Presented By: Ajay Gopalakrishna, BS, BA

76 SUNDAY

³ ¹ DAL

and Kelvin Kelvin and , Matthew , Matthew

² ³ , Hong Pu Hong , ²

RISK PATIENTS

, Sam Chang , Sam

- 4

TY FOR A HOSPITAL HOSPITAL FOR A TY

D -

, Wong Johnson

-Shoshtari, Michael Poch, Julio O'Bryan, MD -O'Bryan, ² , Craig Horbinski Craig , , Kristen Scarpato Kristen , ³

r¹

, Michael Cookson , Michael ³ University of Oklahoma College of of College Oklahoma of University Meharry Medical College, Nashville, TN; TN; Nashville, College, Medical Meharry 4 ²

TN;

WITH EX VIVO URINARY DIVERSION URINARY VIVO EX WITH , Daniel Zette Robert M. Coward, MD Robert M. Coward, Chapel Hill, NC MD Kolettis, N. Peter AL Birmingham, ¹ and Natasha Kyprianou Natasha and

77 , Joseph Smith , Joseph ¹ ³ Jacksonville, FL , Curran Emeruwa Curran , ¹ - ASSISTED LAPAROSCOPICASSISTED OPEN AND

- Broadway Ballroom A Broadway Ballroom , Daniel Barocas , Daniel ³

³ Sang, Wade Sexton, Philippe Spiess and Scott Gilbert Scott and Spiess Philippe Sexton, Wade -Sang, in Gregg in Vanderbilt University Medical Center, Department of Urologic Urologic of Department Center, Medical University Vanderbilt Department of Pathology, University of Kentucky Medical Medical Kentucky of University Pathology, of Department Vanderbilt University Medical Center, Department of Urologic Urologic of Department Center, Medical University Vanderbilt Department of Urology, University of Kentucky Medical Center; Center; Medical Kentucky of University Urology, of Department Robert Williams, Caroline Snowden and Gregory Broderick and Gregory Snowden Caroline Williams, Robert MD Williams, D. Robert By: Presented Patrick Hensley Patrick Session Podium Dysfunction/Andrology Erectile Location: PREDICTINGERYTHROCYTOSIS HYPOGONA IN PELLETS TESTOSTERONE RECEIVING MALES Clinic Mayo RADICAL CYSTECTOMY AMONG HIGH AMONG CYSTECTOMY RADICAL SINGLEA CENTER COMPARISONINITIAL OF RADICAL ASSISTED ROBOTIC OF EXPERIENCE CYSTECTOMY WITH INTRACORPOREAL URINARY RADICAL ASSISTED ROBOTIC TO DIVERSION CYSTECTOMY Messer Jamie and O'Bryan Brittany KY Louisville, Urology, of Dept. Louisville of University ROBOTIC ASSISTED CYSTECTOMY: RADICAL FEASIBILITY PROFITABILI AND AND PRIVATE PRACTICE Shah Nikhil and Sand Matt Laungani, Rajesh GA Atlanta, FACS MD, Laungani, G. Rajesh By: Presented EPITHELIAL MESENCHYMAL TRANSITION IN BLADDER CANCER PROGRESSION Just AFTER OUTCOMES PATHOLOGIC AND SURGICAL ROBOTIC Zargar Kamran Sharma, Pranav Pow FL Tampa, Center, Cancer Moffitt MD Sharma, Pranav By: Presented Ewing E. Brittany By: Presented ONCOLOGIC OUTCOMES AFTER ANTERIOR ANTERIOR AFTER OUTCOMES ONCOLOGIC BLADDER INVASIVE MUSCLE FOR EXENTERATION CANCER IN WOMEN Medicine, Department of Urology, Oklahoma City, OK City, Oklahoma Urology, of Department Medicine, MD Gregg, Justin By: Presented David Penson David Moderators:

¹ Nashville, Surgery, ³ TN; Nashville, Surgery, Moses Stephen Strup Stephen ¹ ² Center MD Hensley, Patrick By: Presented Resnick

7:30 a.m.

- 58 a.m. #42 58 a.m. 7:19 a.m. #45 a.m. 7:19 7:12 a.m. #44 a.m. 7:12 7:05 a.m. #43 a.m. 7:05 6: 6:51 a.m. #41 a.m. 6:51 6:30 a.m. #46 a.m. 6:30 Concurrent Session 5 5 of 6:30 a.m.

76 6:37 a.m. #47 COMPARATIVE ANALYSIS OF SURGERY VS. INTRALESIONAL INJECTION THERAPY FOR VENTRAL PEYRONIE’S DISEASE Faysal Yafi¹, Georgios Hatzichristodoulou², Christopher Knoedler³, Landon Trost4 and Wayne Hellstrom¹ ¹Tulane University School of Medicine, New Orleans, LA; ²Technical University of Munich, Germany; ³Tulane University school of Medicine, New Orleans, LA; 4Mayo Clinic, Rochester, MN Presented By: Faysal A. Yafi, MD, FRCSC 6:44 a.m. #48 IN VITRO AND IN VIVO ASSESSMENT OF MIRABEGRON-MEDIATED RELAXATION IN RAT AND HUMAN CORPORA CAVERNOSA Taylor Peak¹, Serap Gur², Faysal Yafi1, Philip Kadowitz1, Suresh Sikka¹ and Wayne Hellstrom1 ¹Tulane University School of Medicine, New Orleans, LA; ²Ankara Univerity, Turkey Presented By: Taylor Peak, BA 6:51 a.m. #49 IN CONTRAST TO PRIOR STUDY, NEW DATA SHOWS BACTERIA FOUND AT REVISION IPP SURGERY DIFFERS FROM PREVIOUSLY IDENTIFIED BIOFILM Martin Gross¹, Culley Carson III², Steven Wilson³, John Delk II4, Craig Donatucci5 and Gerard Henry6 ¹LSU-Shreveport Department of Urology; ²UNC Department of Urology, Chapel Hill, NC; ³Institute for Urologic Excellence, Indio, CA; 4UAMS Department of Urology, Little Rock, AR; 5Eli Lilly and Company, Indianapolis, IN; 6Regional Urology, Shreveport, LA Presented By: Martin Gross, MD 6:58 a.m. #50 NON-INDUSTRY SPONSORED SAFETY ANALYSIS FOLLOWING COLLAGENASE CLOSTRIDIUM HISTOLYTICUM (XIAFLEX®) INJECTION IN MEN WITH PEYRONIE’S DISEASE Ryan Owen, Christopher Winter, Jonathan Angelle, Michael Jennings, Wesley White and Edward Kim University of Tennessee Graduate School of Medicine, Knoxville, TN Presented By: Ryan C. Owen, MD 7:05 a.m. #51 IS THE GOLD STANDARD SHIFTING? NATIONAL TRENDS IN ANTI-INCONTINENCE SURGERY FOR MEN BASED ON THE NATIONAL INPATIENT SAMPLE Marc Colaco, Susan MacDonald and Ryan Terlecki Wake Forest Baptist Health, Winston-Salem NC Presented By: Marc Colaco, MD, MBA 7:12 a.m. #52 COST OF STUTTERING PRIAPISM VERSUS PLACEMENT OF INFLATABLE PENILE PROSTHESIS John Burns and Chad Huckabay University of Mississippi Medical Center, Division of Urology, Jackson, MS Presented By: John F. Burns, MD 7:19 a.m. #53 NOVEL TREATMENT ALGORITHM FOR CAVERNOUS VENOUS OCCLUSIVE DISEASE (CVOD) BASED ON SEVERITY AS MEASURED BY RESISTIVE INDEX Ram Pathak, Issac Effriong, Zhuo Li and Gregory Broderick Mayo Clinic Jacksonville, FL Presented By: Ram Pathak, MD

78 SUNDAY

BIOPRINTER BIOPRINTER

D -

Salem, NC Salem, - Rochester, MN Toronto, ON Laurence H. Klotz, FRCSCMD, Deborah J.Deborah Lightner, MD

Mobile, AL Mobile, MD Jackson, E. Jerry Sumter, SC

Winston J.Christian Winters, MD, FACS Winters, MD, J.Christian PeterE.Clark, MD G.Lorie Fleck, LA Orleans, New Nashville, TN Nashville, Louisville, KY MD Gopal Badlani, H. Murali K. Ankem, MBBS Ankem, K. Murali

79 John D. Jackson, PhD Jackson, D. John

Broadway Ballroom A Broadway Ballroom Wook Kang, Sang Jin Lee, John Jackson, James Yoo and and Yoo James Jackson, John Jin Lee, Sang Wook Kang, Dineen Policy Forum 3 Policy Dineen - - ics in in ics Urology

FOR SURGICAL RECONSTRUCTIONFOR SURGICAL BUILDINGVIABLE 3 TISSUES USING A Hyun ABU Update: Current Status MOC of Status Update: Current ABU Speaker: Basic Science/Imaging/Miscellaneous Podium Session Location: AUA Presentation Guidelines AUA Speaker: Gee Moderators: for Radiation and Surgery of Effectiveness Comparative Evidence? is the What Cancer: Prostate Guest Speaker: Eth Guest Speaker:

Anthony Atala Anthony Winston Medicine, for Regenerative Institute Forest Wake NC Salem, By: Presented

Moderators:

9:30 a.m. 8:30 a.m. 9:00 a.m.

- - - 10:15 a.m. 10:15 9:30 a.m. 8:00 a.m.

- - - a.m. 9:30 a.m. #54 a.m. 9:30 9:00 a.m. 8:00 a.m. 8:30 a.m.

Concurrent Sessions Begin Sessions Concurrent

8:00 a.m.

9:30 Concurrent Session 5 1 of 7:30 a.m. Concurrent Sessions End Sessions Concurrent 78 9:37 a.m. #55 PERIOPERATIVE OUTCOMES OF OPEN AND MINIMALLY INVASIVE NEPHROURETERECTOMY AND PRE-OPERATIVE PREDICTORS OF COMPLICATIONS: AN ANALYSIS USING THE NATIONAL SURGICAL QUALITY IMPROVEMENT PROGRAM DATABASE Nachiketh Soodana Prakash¹, Nicola Pavan², Raymond R Balise³, Bruno Nahar¹, Samarpit Rai¹, Chad R. Ritch¹, Sanoj Punnen¹, Ramgopal Satyanarayana¹, Dipen J. Parekh¹ and Mark L. Gonzalgo¹ ¹Department of Urology, University of Miami Miller School of Medicine Miami FL; ²Department of Urology, University of Miami Leonard M. Miller School of Medicine, Miami, FL and Urology Clinic, Department of Medical, Surgical and Health Science, University of Trieste, Italy; ³Division of Biostatistics, Department of Public Health Sciences, University of Miami Leonard M. Miller School of Medicine, Miami, FL Presented By: Nachiketh Soodana-Prakash, MD, MS 9:44 a.m. #56 FIBER-OPTIC CONFOCAL LASER ENDOMICROSCOPY OF SMALL RENAL MASSES: TOWARDS REAL-TIME OPTICAL DIAGNOSTIC BIOPSY Li-Ming Su¹, Jennifer Kuo¹, Robert Allan², Joseph Liao³, Kellie Ritari¹, Patrick Tomeny¹ and Christopher Carter² ¹Department of Urology, University of Florida College of Medicine, Gainesville, FL; ²Department of Surgical Pathology, University of Florida College of Medicine, Gainesville, FL; ³Department of Urology, Stanford University School of Medicine, Stanford, CA Presented By: Jennifer Kuo, BS 9:51 a.m. #57 SYSTEMATIC REVIEW OF OUTCOMES OF THE TRANSOBTURATOR SLING IN MEN WITH INCONTINENCE SECONDARY TO RADICAL PROSTATECTOMY AND RADIOTHERAPY FOR PROSTATE CANCER Divya Ajay¹, Bradley Potts², Cynthia Feltner³ and Andrew Peterson¹ ¹Duke University Medical Center, Durham, NC; ²Duke University Medical School, Durham, NC; ³University of North Carolina, Chapel Hill, NC Presented By: Divya Ajay, MD, MPH 9:58 a.m. #58 INPATIENT UROLOGIC CONSULTATIONS – WHERE DO WE STAND? Dunia Khaled¹, Amanda Saltzman¹, Danica May¹, Jeremy Konheim¹, Raunak Patel¹, Samantha Prats², Ashley Richman¹, Allison Feibus², William Chastant², Joseph Fougerousse², Brian Baksa¹ and Melissa Montgomery¹ ¹Ochsner Clinic Foundation, New Orleans, LA; ²Louisiana State University Health Sciences Centers School of Medicine, New Orleans, LA Presented By: Dunia T. Khaled, MD, MS

80 SUNDAY

, Paul Paul , ,

¹ ² , Gregory J. J. , Gregory ¹ , Jason , Jason ¹

¹ ITY AND , E. Will Kirby E. , Regional Urology Regional ² , Francesca Enneking , Francesca ² ² , Carl Henriksen Carl ,

and Ramakrishna Ramakrishna and

roy Sukhu, Jason Lomboy, Lomboy, Jason Sukhu, roy ² University of Florida, Florida, of University d Raj Pruthi , Troy Sukhu Troy , ² ¹ an , Adaixa Padron , Adaixa

n, MD , Clark McCall , Venetia Orcutt , Venetia ¹ Leone, MD Leone, ¹

Langston, MD Langston,

. . , Michael Poch , Michael ¹ N PATIENT REPORTED HEALTH AND Dallas, TX , Daniel Davenport , Daniel

, Heather Schultz Heather , ¹ ¹ ² , Angela Smith Angela , ¹ ¹ PaulCrispen, L. MD FL Gainesville,

, Olivia C. OBrian C. Olivia ,

81 RamakrishnaVenkatesh, MS,MD, FRCS Anja M. Zan , Anja Zann Anja , ¹ and Gerard Henry Gerard and ¹

and Scott M. Gilbert M. Scott and

¹ ALSIS AND INTRAPELVICALSIS IN PRESSUREAND IN AN , Matthew Macey Matthew , ¹ , Wade , J. Sexton Shreveport Department of Urology; Urology; of Department Shreveport -

Department of Surgery, University of Kentucky, Lexington, KY Lexington, Kentucky, of University Surgery, of Department University of Florida Department of Anesthesiology, Gainesville, Gainesville, Anesthesiology, of Department Florida of University Chapel Hill, NC; Department of Urology, University of Kentucky, Lexington, KY; KY; Lexington, Kentucky, of University Urology, of Department LSU University of Florida Department of Urology, Gainesville, FL; FL; Gainesville, Urology, of Department Florida of University Moffitt Cancer Center, Tampa, FL; ¹ Matthew Nielsen Matthew Presented By: Joshua P. Langston, MD Langston, P. Joshua By: Presented Lomboy Allison Deal, E. Will Kirby, Davis Viprakasit, Matthew Nielsen, Nielsen, Matthew Viprakasit, Davis Will Kirby, E. Deal, Allison Smith Angela and Pruthi Raj REGARDINGEMERGING TRENDS DATA SURGICALIN EDUCATION RESEARCH FINANCIALAND RELATIONSHIPS BETWEENMANUFACTURERS DEVICE PROSTHETICAND UROLOGISTS Martin Gross ADVANCED PRACTICE PROVIDERSIN U.S. UROLOGY Langston Joshua SURGICAL EQUIPMENT COST AWARENESS AMONG AWARENESS AMONG COST EQUIPMENT SURGICAL SURGEONS UROLOGICAL T Macey, Matthew Langston, Joshua NC Hill, Chapel P Joshua By: Presented DEFECTS PERIOPERATIVE OF ANALYSIS ACTIVE QUAL ROOM OPERATING IMPROVES EFFICIENCY. James Mason Lewis J. Johnson J. Lewis ¹ Venkatesh ¹ ² By: Presented Session Poster Methods Socioeconomics/Statistical Location: 3 Cumberland Moderator: DIFFERENCES I INITIAL CYSTECTOMY: TO PRIOR LIFE OF QUALITY RESULTSFROM BLADDER CANCER OUTCOMES AND IMPACT (BCOIS) STUDY Leone Andrew EFFECTS OF ALPHA BLOCKADE ON URETERAL URETERAL ON BLOCKADE ALPHA OF EFFECTS PERIST MODEL PORCINE STENTED VIVO FL Gainesville, R Andrew By: Presented ¹ ¹ LA Shreveport, MD Gross, Martin By: Presented Presented By: By: Presented ¹ ² FL ¹ Diorio Crispen and Paul Jacobson

10:30 a.m. 10:30

- 10:05 a.m. #59 a.m. 10:05 Poster #167 Poster #171 Poster #170 Poster #169 Poster #168

9:30 a.m. Concurrent 5 Session 2 of

80 Poster #172 THE EFFECT OF DISTANCE TO A HIGH-VOLUME CENTER ON RECEIPT OF TREATMENT FOR INVASIVE BLADDER CANCER Troy Sukhu Troy Sukhu, Jason Lomboy, Matthew Macey, Anne- Marie Meyer, Ke Meng, Matthew Nielsen, Raj Pruthi, Eric Wallen, Michael Woods and Angela Smith Chapel Hill, NC Presented By: Troy A. Sukhu, MD Poster #173 CRITICAL ANALYSIS OF PSA TESTING IN THE INPATIENT SETTING Lindsey Hartsell¹, Paul Murphy1, Timothy Boswell2, Matthew Davis1, Christopher Ledbetter1, Anthony L. Patterson1 and Robert Wake1 ¹UTHSC Memphis, TN; 2Grove City College, Grove City, PA Presented By: Lindsey M. Hartsell, MD Poster #174 WOMEN UROLOGISTS: WORK-LIFE BALANCE IN 2014 Kristi Hebert, Amanda Saltzman¹, Samantha Prats¹, Ashley Richman², Joanna Togami², Leslie Rickey³,4 and Melissa Montgomery² ¹Ochsner Clinic Foundation/Louisiana State University, Department of Urology, New Orleans, LA; ²Ochsner Clinic Foundation, Department of Urology, New Orleans, LA; ³Yale University School of Medicine, Department of Urology; 4Department of Obstetrics, Gynecology & Reproductive Sciences, New Haven, CT Presented By: Kristi L. Hebert, MD Poster #175 ASSESSING THE ACUITY OF AFTER-HOURS OUTPATIENT PHONE CALLS TO THE UROLOGIST Matthew R. Macey, Troy A. Sukhu, Jason R. Lomboy and Davis P. Viprakasit Chapel Hill, NC Presented By: Matthew R. Macey, MD Poster #176 STATISTICAL METHODS IN RANDOMIZED CONTROLLED TRIALS IN THE UROLOGIC LITERATURE: TWO DECADES OF IMPROVEMENT Eugene B. Cone¹, Vikram Narayan², Daniel Smith², Philipp Dahm³ and Charles D. Scales¹ ¹Duke University, Duke Clinical Research Institute and Division of Urology, Durham NC; ²University of Minnesota, Department of Urology; ³Minneapolis Veterans Healthcare System and University of Minnesota, Department of Urology Presented By: Eugene B. Cone, MD Poster #177 OUR RELATIONSHIP WITH CONSULTING PROVIDERS - KNOWING IS HALF THE BATTLE Dunia Khaled¹, Amanda Saltzman¹, Danica May¹, Jeremy Konheim¹, Raunak Patel¹, Samantha Prats¹, Ashley Richman¹, Allison Feibus², William Chastant², Joseph Fougerousse², Brian Baksa¹ and Melissa Montgomery¹ ¹Ochsner Clinic Foundation, New Orleans, LA; ²Louisiana State University Health Sciences Center, School of Medicine, New Orleans, LA Presented By: Dunia T. Khaled, MD, MS

82 SUNDAY

, Mark and and , 5

6 H AN H AN e, Miami, Miami, e, and Michael Michael and

² Yate , Travis ester Comprehensive Comprehensive ester ² , Ahmed Saeed Saeed , Ahmed ² , Raymond Balise , Raymond

iami Miller School of of Miller School iami

, Richmond Owusu , Richmond Urologic Oncology Fellow, Fellow, Oncology Urologic ¹ ²

emphis, TN , Brant Inman Brant ,

¹ Urology of Virginia, Virginia Virginia Virginia, of Urology

, Luis Lopez , Luis ² ² -Prakash

-De La Rosa, MD and Murugesan Manoharan Murugesan and Urologic Oncology Fellow, Fellow, Oncology Urologic

7 , Matthew Acker Matthew , Fantony, MD partment of Urology, University of Miami Miami of University Urology, of partment ¹

. ITY OFSHA8K, A HYAL1 -Chi Foo Research Associate Department of Urology, of Department Chairman, 4 7

² , Wen , Ajay Gopalakrishna , Ajay ² Tampa, FL Tampa, Durham, NC Durham, Michael A. Poch, MD BrantInman, MS MD, ¹

, Andre Jordan , Andre 83 ¹ -De la Rosa University of Illinois, Chicago, IL Chicago, Illinois, of University ³ Department of Cell Biology, Sylv Biology, Cell of Department

, Dipen Parekh Dipen , ² 6

Assistant Professor Departments of Biostatistics and and Biostatistics of Departments Professor Assistant , Nachiketh Soodana , Nachiketh 5 ³

OPERATIVE PERIOD. OPERATIVE OPERATIVE VTE PROPHYLAXIS VTE OPERATIVE

- - TUMOR ACTIV - Professor of Urology, University of Miami Miller School of School Miller Miami of University of Urology, Professor 6 DukeUniversity, Durham,NC; Research Associate, De Department of Urology, University of Miami Miller School of of Miller School Miami of University of Urology, Department Urology, University of Miami Miller School of Medicin of School Miller Miami of University Urology, FL; Medicine, Miami, FL; FL; Miami, Medicine, Gonzalgo Presented By: Alfredo Harb Alfredo By: Presented Urology, University of Miami Miller School of Medicine, Miami, Miami, Medicine, of Miller School Miami of University Urology, Florida; FL Miami, Medicine, of Miller School Miami of University INCREASED RISK DEPRESSION OF THE EARLY IN POST THE IMPROVE ASSAY METHYLATION GENE A CAN OF CYTOLOGY? PERFORMANCE Fantony Joseph WIT IS ASSOCIATED CYSTECTOMY RADICAL Harb Alfredo Bladder Cancer Poster Session Poster Cancer Bladder Location: 4 Cumberland Moderators: ANTI Chipollini Juan REGIONAL PRACTICE PATTERNS IN THE USE OF OF USE THE IN PATTERNS PRACTICE REGIONAL POST Rowena and Earl Joshua Black, Welser,Ryan Joseph Lau, Glen DeSouza M HSC, Tennessee of University Lance Raymond Abern³ ¹ ¹ FL; Miami, Medcine, of School Miller Goolam Cancer Center, University of Miami Miller School Medicine of School Miller Miami of University Center, Cancer MD Juan Chipollini, By: Presented Presented By: Glen A. Lau, MD Lau, A. Glen By: Presented VA; Beach, J Joseph By: Presented Vinata Lokeshwar Vinata ¹ Medicine; HYALURONIDASE INHIBITOR, BLADDER CANCERIN CELLS Department of Urology, University of M of University Urology, of Department FL; Miami, Medicine, Department of Urology, University of Miami Miller School of of School Miller Miami of University Urology, of Department Florida; Miami, Medicine,

10:30 a.m. 10:30

- Poster #179 Poster #181 Poster #180 Poster #178

Concurrent 5 Session 3 of 9:30 a.m.

82 Poster #182 ADDITIONAL ADJUVANT CONVENTIONAL CHEMOTHERAPY IN PATIENTS PREVIOUSLY TREATED WITH NEOADJUVANT CHEMOTHERAPY AND RADICAL CYSTECTOMY Kamran Zargar-Shoshtari, Michael Kongnyuy, Pranav Sharma, Mayer N Fishman, Scott M. Gilbert, Michael A. Poch, Julio M. Powsang, Philippe E. Spiess, Jingsong Zhang and Wade J. Sexton Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, Florida Presented By: Kamran Zargar-Shoshtari, MBChB, MD, FRACS Poster #183 SHOULD DIET MODIFICATION BE A COMPONENT OF BLADDER CANCER SURVIVORSHIP? A CROSS- SECTIONAL STUDY OF DIETARY HABITS IN BLADDER CANCER PATIENTS. Joseph Fantony, Ajay Gopalakrishna, Thomas Longo and Brant Inman Duke University, Durham, NC Presented By: Joseph J. Fantony, MD Poster #184 LONG-TERM OUTCOMES OF BALLOON DILATION FOR BENIGN URETEROILEAL ANASTOMOTIC STRICTURES IN PATIENTS WHO UNDERWENT RADICAL CYSTECTOMY AND URINARY DIVERSION Alfredo Harb-De la Rosa¹, Ahmed Saeed Goolam², Matthew Acker³, Govindarajan Narayanan4, Dipen Parekh5 and Murugesan Manoharan6 ¹Research Associate, Department of Urology, University of Miami Miller School of Medicine, Miami, FL; ²Urologic Oncology Fellow, University of Miami Miller School of Medicine; ³Urologic Oncology Fellow, Department of Urology, University of Miami Miller School of Medicine, Miami, FL; 4Interventional Radiology, , University of Miami Miller School of Medicine, Miami, FL; 5Chairman, Department of Urology, University of Miami Miller School of Medicine, Miami, FL; 6Professor of Urology, , University of Miami Miller School of Medicine, Miami, FL Presented By: Ahmed Saeed Goolam, MD, BSc, MBBS, FRACS Poster #185 DEFINING AND ANTICIPATORY POSITIVE TEST USING URINE BLADDER CANCER TESTS Thomas Longo¹, Ajay Gopalakrishna¹, Joseph Fantony¹, Richmond Owusu², Wen-Chi Foo¹, Rajesh Dash¹ and Brant Inman¹ ¹Duke University, Durham, NC; ²University of California San Diego, San Diego, CA Presented By: Thomas A. Longo, MD

84 SUNDAY

Emory Emory , 4 4

Emory Emory ³

ODEL , Philippe Philippe , , JoAnn JoAnn , Vanderbilt Vanderbilt ³

, Mehrdad Mehrdad , ³

, Dipen Parekh , Dipen 5

² Sexton Wade ,

² Columbia University Medical Medical University Columbia

5 , TatsukiKoyama , Shipra Arya Shipra , ² ² BASED BLADDER - and Kenneth Ogan Kenneth and

4 ² Vanderbilt University Medical Center, Center, Medical University Vanderbilt tt Gilbert tt ²

, Miami,; Sukhu, MD Sukhu, , Michael ,Cookson Michael

² . , Sco ¹

University of Miami Miller School of Medicine, Medicine, of School Miller Miami of University

and Christopher Anderson Christopher and 85 4

² , Daniel Barocas Daniel , , Dattatraya Patil , Dattatraya , Viraj Master , Viraj ¹ ¹ 4 SSISTED OPEN RADICAL AND CYSTECTOMY

A hu, Jason Lomboy, Matthew Macey, Allison Deal, Eric Eric Deal, Allison Macey, Matthew Lomboy, Jason hu, - , Sam Chang , Sam and Michael Poch Michael and , Nashville,TN;

³ ²

effrey Pearl effrey Moffitt Cancer Center, Tampa, FL Tampa, Center, Cancer Moffitt Emory University Department of Urology, Atlanta, GA; GA; Atlanta, Urology, of Department University Emory Vanderbilt University Medical Center, Department of Urologic Urologic of Department Center, Medical University Vanderbilt University of South Florida College of Medicine, Tampa, FL; FL; Tampa, Medicine, of College Florida South of University Emory University Department of Urology, Atlanta, Georgia; Georgia; Atlanta, Urology, of Department University Emory University Department of Urology of Department University MD Pearl, Jeffrey By: Presented ¹ Surgery TN; Nashville, Surgery, Urologic of Department Urology of Department UniversityMedical Center, Departments of Biostatistics, Nashville, TN; ¹ ² Spiess FAILURE OF RADIATION FAILURE McCormick Barrett Wallen, Michael Woods, Raj Pruthi, Matthew Nielsen and Angela Angela and Nielsen Matthew Pruthi, Raj Woods, Michael Wallen, Smith NC Hill, Chapel A Troy By: Presented RADICAL FOLLOWING OUTCOMES EXAMINING CYSTECTOMY M CARE IN DRIVEN ACP AN M. Myra Drury, Nick B. Merwarth, Mark, Caroline R. James Riggs B. Stephen and Gaston E. Kris Robinson, Institute Cancer Levine Presented By: James R. Mark, MD BE TO LIKELY LESS ARE PATIENTS FRAIL DISCHARGED TO HOME CYSTECTOMYAFTER J PATIENT AND FACTORS PRESERVATION: CHARACTERISTICS SINGLE FROM INSTITUTION A EXPERIENCE Justin Gregg Justin Alvarez PREOPERATIVE BETWEEN THE ASSOCIATION OUTCOMES POSTOPERATIVE AND LEUKOCYTOSIS FOLLOWINGCYSTECTOMY BLADDER CANCER FOR Suk Troy A PROSPECTIVE COMPARISON OF FUNCTIONAL AND AND FUNCTIONAL OF COMPARISON PROSPECTIVE A LAPAROSCOPIC AFTER OUTCOMES NUTRITIONAL ROBOT Surgery, Atlanta, GA; GA; Atlanta, Surgery, Vascular of Department University ¹ ² Joseph Smith Joseph Center, Department of Urology, New York, NY York, New Urology, of Department Center, Presented By: Justin Gregg, MD Gregg, Justin By: Presented Presented By: Barrett Z. McCormick, MD McCormick, Z. Barrett By: Presented Alemozaffar

Poster #190 Poster #189 Poster #188 Poster #187 Poster #186

84 Concurrent Session 4 of 5

10:30 a.m. - 11:30 a.m. Bladder Cancer 2 Poster Session Location: Cumberland 4 Moderator: Mehrdad Alemozaffar, MD Atlanta, GA Poster #191 INITIAL EXPERIENCE WITH ROBOTIC CYSTECTOMY AND INTRA-CORPOREAL URINARY DIVERSION Anna Bausum, Dattatraya Patil, Eunice Goetz, Viraj Master, Martin Sanda, John Pattaras, Kenneth Ogan and Mehrdad Alemozaffar Emory University Presented By: Anna Bausum, BS Poster #192 ASSESSMENT OF PATIENT ATTITUDES TOWARDS BOTHERSOME ISSUES WITH URINARY DIVERSIONS IN THE PREOPERATIVE SETTING USING THE URINARY DIVERSION DECISION AID (UDDA): RESULTS OF A PILOT STUDY Justin Emtage¹ and Michael Poch² ¹Department of Urology, University of South Florida, Tampa, FL; ²Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, FL Presented By: Justin B. Emtage, MD Poster #193 SURVIVAL ANALYSIS OF GENDER DISPARITIES IN PATIENTS WITH BLADDER CANCER IN FLORIDA: RESULTS FROM A POPULATION-BASED CANCER REGISTRY Nicola Pavan¹, Tulay Koru-Sengul², Samarpit Rai³, Feng Miao², Taghrid Asfar², Chad R Ritch4, Dipen J Parekh4 and Mark L Gonzalgo4 ¹Department of Urology, University of Miami Leonard M. Miller School of Medicine, Miami, FL and Urology Clinic, Department of Medical, Surgical and Health Science, University of Trieste, Italy; ²Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida, USA and Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida, USA; ³Department of Urology, University of Miami Miller School of Medicine, Miami, Florida, USA; 4Department of Urology, University of Miami Miller School of Medicine, Miami, Florida, USA and Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida, USA Presented By: Nicola Pavan, MD Poster #194 TREATMENT OF ATYPICAL/SUSPICIOUS CYTOLOGY EFFECTS TEST PERFORMANCE Thomas Longo, Ajay Gopalakrishna, Joseph Fantony and Brant Inman Duke University, Durham, NC Presented By: Thomas A. Longo, MD

86 SUNDAY

, ¹ and and

, ³ , Akshay ¹ ¹ University ³

-Gil , Hariharan , Hariharan ² ² and Brant Brant and

University of ¹ BASED BASED ² -

¹ , Chad Ritch partment of Urology, Urology, of partment 4 Y AFFECT AFFECT Y

, Rafael E. Yanes E. , Rafael ²

Mayo Clinic Florida, Florida, Clinic Mayo

, Thomas Longo , Thomas ¹ -De la Rosa

and Mark Gonzalgo Mark and

, Maurilio Garcia , Maurilio ² , Rajesh Dash Rajesh , ¹ and Paul Young Paul and ¹

m College of Medicine, Miami, Miami, Medicine, of m College

² INVASIVE BLADDER - , Sanjaya Swain , Sanjaya ³ and Alan M. Nieder M. Alan and

¹ Chi Foo -Chi

, Alfredo Harb Alfredo , 5 Robotics Institute, Florida Hospital, Hospital, Florida Institute, Robotics ¹

, Joseph Fantony Joseph , ¹ , Elizabeth T. Nagoda T. Elizabeth , , Joan C. Delto C. Joan , , Wen ¹ DAY MORTALITY RATES IN IN RATES MORTALITY DAY Urologic Oncology Fellow, Department of of Department Fellow, Oncology Urologic ² ² - , Marissa Rice 4 ¹

, Raymond Balise Raymond , ¹ 87 FRACS MBBS, BSc, MD, Goolam, Saeed Ahmed : FIU Herbert Werthei ²FIU Herbert Department of Public Health Sciences, Division of of Division Sciences, Health Public of Department Research Associate, Department of Urology, Urology, of Department Associate, Research

² ² , Jorge R. Caso linic Florida, Jacksonville, FL; FL; Jacksonville, Florida, linic

¹ Professor of Urology, University of Miami Miller School of School Miller Miami of University of Urology, Professor 5 DAY AND 90

Clinical Fellow Global Fellow Clinical University of Miami School of Medicine, De Medicine, of School Miami of University Duke University Medical Center, Durham, NC; NC; Durham, Center, Medical University Duke Urologic Oncology Fellow, University of Miami Miller School of of School Miller Miami of University Fellow, Oncology Urologic Mount Sinai Medical Center Department of Urology, Miami Miami Urology, of Department Center Medical Sinai Mount Mayo C Mayo Presented By Presented Medicine, Miami, FL Miami, Medicine, ¹ FL; Beach, FL MD Sidhu, S. Ajaydeep By: Presented Miami FL; ¹ Bhandari Medicine; of School Miami of University Biostatistics, George Wayne George F. EN BLOC META RESECTION BLADDER TUMORS: OF A Ahdoot Michael ¹ Richmond Owusu Richmond RETROSPECTIVE EVALUATION OF TREATMENT WITH RATES NEOADJUVANT CHEMOTHERAPY IN PATIENTS WITH MUSCLE Davidiuk Andrew ILEUS POSTOPERATIVE REDUCED FOR ALVIMOPAN LENGTH OFAND STAY CYSTECTOMY:AFTER THE EXPERIENCE SINAI MOUNT Sidhu S. Ajaydeep OUTCOMES ONCOLOGIC OF ANALYSIS Ajay Gopalakrishna Ajay 30- OCTOGENARIANS UNDERGOING RADICAL CYSTECTOMY Goolam Saeed Ahmed SPECTRUM EFFECTS DRAMATICALL DIAGNOSTIC PERFORMANCE OFURINE Inman ¹ CA Diego, San Diego, San California BA BS, Gopalakrishna, Ajay By: Presented Murugesan Manoharan Murugesan Urology, University of Miami Miller School of Medicine, Miami, Miami, Medicine, of Miller School Miami of University Urology, FL; University of Miami Miller School of Medicine, Miami, FL; FL; Miami, Medicine, of Miller School Miami of University ³ ¹ Medicine; of Miami School of Medicine, dDepartment of Urology, Miami FL Miami Urology, of dDepartment Medicine, of School Miami of MD Ahdoot, Michael By: Presented Palayapalayam Ganapathi Palayapalayam ¹ CANCER STRATIFIED YEAR BY DIAGNOSTIC TESTS FOR BLADDER CANCER Celebration, FL.; FL.; Celebration, Department of Urology, Jacksonville, FL Jacksonville, Urology, of Department MD Davidiuk, J. Andrew By: Presented

Poster #199 Poster #198 Poster #197 Poster #196 Poster #195

86 Poster #200 IMPACT OF SMOKING ON SURVIVAL OUTCOMES IN PATIENTS DIAGNOSED WITH BLADDER CANCER: RESULTS FROM A POPULATION-BASED CANCER REGISTRY (1981-2009) Samarpit Rai¹, Tulay Koru-Sengul², Nicola Pavan³, Feng Miao², Taghrid Asfar², Chad R. Ritch4, Dipen J. Parekh4 and Mark L. Gonzalgo4 ¹Department of Urology, University of Miami Miller School of Medicine, Miami, FL; ²Department of Public Health Sciences and Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL; ³Department of Urology, University of Miami Miller School of Medicine, Miami, FL and Urology Clinic, Department of Medical, Surgical and Health Science, University of Trieste, Triesta, Italy; 4Department of Urology and Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL Presented By: Samarpit Rai, MD Poster #201 LENGTH OF HOSPITAL STAY AND READMISSION RATES AFTER RADICAL CYSTECTOMY IN OCTOGENARIANS COMPARED TO YOUNGER PATIENTS Alfredo Harb-De la Rosa¹, Ahmed Saeed Goolam², Hariharan Palayapalayam-Ganapathi³, Dipen Parekh4 and Murugesan Manoharan5 ¹Research Associate Department of Urology, University of Miami Miller School of Medicine, Miami, FL; ²Urologic Oncology Fellow, University of Miami Miller School of Medicine; ³Clinical Fellow Global Robotics Institute, Florida Hospital, Celebration, FL; 4Chairman, Department of Urology, UNiversity of Miami Miller School of Medicine, Miami, FL.; 5Professor of Urology, University of Miami Miller School of Medicine, Miami, FL Presented By: Ahmed Saeed Goolam, MD, BSc, MBBS, FRACS Poster #202 FEASIBILITY OF STRUCTURED TELEPHONE CALLS FOR SYMPTOM MANAGEMENT FOLLOWING CYSTECTOMY Jason Lomboy, Matthew Macey, Troy Sukhu, Sarah Stanley, Allison Deal, Dana Mueller, Matthew Nielsen, Raj Pruthi, Eric Wallen, Michael Woods and Angela Smith Chapel Hill, NC Presented By: Jason R. Lomboy, MD

88 SUNDAY , ³ , Dipen J. , Michael , Michael ³ ² , Benjamin ¹

and Ricardo Ricardo and

ANTIGEN ANTIGEN Robotic Urology & & Urology Robotic ³ New Orleans, LA; LA; Orleans, New - erstein -Olmo

New Orleans, LA; LA; Orleans, New , Justin Levy

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SPECIFIC Belaunde, MD Belaunde, -

OPKO Diagnostics, LLC, LLC, Diagnostics, OPKO , Krishnarao Moparty , Krishnarao

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, Nachiketh Soodana Prakash Soodana Nachiketh , ²

, Elisa Ledet , Elisa School of Medicine, San Juan, PR; PR; Juan, San Medicine, of School , Juan Serrano Juan , , Ramgopal Satyanarayana Ramgopal ,

³ ¹ 4

- Saavedra

University of Miami Leonard M. Miller Miller M. Leonard Miami of University . ² ong and Jonathan L. Silb L. Jonathan and

¹ 3 TMPRSS2:ERGAND URINARY INSTITUTIONAL, PROSPECTIVE, AND OPTIMAL PSA RANGE FOR THE THE FOR RANGE PSA OPTIMAL - , Oliver Sartor , Oliver ¹ Bruce R. Kava,Bruce MD R. F Miami, Ricardo F. Sanchez Hato Rey, PR

-Belaunde 89

³ , Nicola Pavan Nicola , , Yan D Yan ,

¹ ³ By: Viacheslav Iremashvili, MD, PhD MD, Iremashvili, Viacheslav By:

, Kevin Chagin Kevin , ³ -Ortiz and Sanoj Punnen Sanoj and

³ al, Surgical and Health Science, University of Trieste, Italy; Italy; Trieste, of University Science, Health and Surgical al, Saavedra

, Raju Thomas ¹ é nchez San Pablo Pathology Group, Bayam Group, Pathology San Pablo Department of Urology, University of Miami Leonard M. Miller Miller M. Leonard Miami of University Urology, of Department Southeast Veterans Health Care Services Services Care Health Veterans Southeast Cleveland Cancer Foundation, Cleveland, OH Cleveland, Foundation, Cancer Cleveland University of Puerto Rico Puerto of University Department of Urology, University of Miami Miller School of of Miller School Miami of University of Urology, Department Tulane University School of Medicine Medicine of School University Tulane ² A Jose By: Presented Sá ¹ of School Rico Puerto of University the and Institute Oncology PR Juan, San Medicine, Parekh Allison H. Feibus H. Allison PROSTATE PREDIAGNOSTIC Murugesan Kava, Bruce J Parekh, Dipen Iremashvili, Viacheslav Punnen Sanoj and Manoharan Samarpit Rai Samarpit OF PCA UTILITY BIOMARKERS IN AFRICAN AMERICAN MEN UNDERGOING PROSTATE BIOPSY University of Miami, Miami, FL Presented PROGRESSIVEINCREASE IN PROSTATE CANCER IN DECADE LAST THE OVER AGGRESSIVENESS PUERTOMEN RICAN Jos DEFINING THE MAXIMAL PREDICTIVE DENSITY EFFICACY OF TO PSA DETECT PROSTATE CANCER ON BIOPSY: RESULTS MULTI FROM A Nahar Bruno Prostate Cancer 3 Poster Session Poster 3 Cancer Prostate Location: 3 Cumberland Moderators:

Nashville, TN Nashville, Presented By: Samarpit Rai, MD Rai, Samarpit By: Presented ¹ FL; Miami, Medicine, of Department Clinic, Urology and FL Miami, Medicine, of School Medic ³ FL; Miami, Medicine, of School ² ¹ W. Kattan W. CONTEMPORARY COHORT CONTEMPORARY KINETICS NOT ASSOCIATED WITHARE THE RISK OF PATIENTS CANCER PROSTATE IN PROGRESSION MANAGED WITH ACTIVE SURVEILLANCE Presented By: Allison Feibus, BS, MS BS, Feibus, Allison By: Presented ³ Lee

11:30 a.m. 11:30

- Poster #203 Poster #206 Poster #205 Poster #204

10:30 a.m. Concurrent 5 Session 5 of 88 Poster #207 ABNORMAL SERUM LIPIDS AND ELEVATED BODY- MASS INDEX ASSOCIATED WITH PROSTATE CANCER AGGRESSIVENESS IN PUERTO RICAN MEN Raúl Fernández-Crespo¹, Jeannette Salgado-Montilla², Margarita Irizarry-Ramirez³ and Ricardo Sánchez-Ortiz4 ¹University of Puerto Rico School of Medicine, San Juan PR; ²UPR-MD Anderson Partnership in Cancer Research, University of Puerto Rico, San Juan, PR; ³School of Health Professions, University of Puerto Rico, San Juan, PR; 4Robotic Urology & Oncology Institute and University of Puerto Rico, San Juan, PR Presented By: Raul Fernandez-Crespo, MD Poster #208 IMPACT OF PELVIC LYMPH NODE DISSECTION DURING RADICAL PROSTATECTOMY ON 30-DAY POST OPERATIVE COMPLICATIONS: RESULTS FROM A LARGE NATIONAL DATABASE Nicola Pavan¹, Samarpit Rai², Nachiketh Soodana-Prakash², Raymond R. Balise³, Carmen M. Mir², Bruno Nahar², Fernando Marsicano², Chad R. Ritch², Dipen J. Parekh² and Mark L. Gonzalgo² ¹Department of Urology, University of Miami Leonard M. Miller School of Medicine, Miami, FL and Urology Clinic, Department of Medical, Surgical and Health Science, University of Trieste, Italy; ²Department of Urology, University of Miami Leonard M. Miller School of Medicine, Miami, FL; ³Division of Biostatistics, Department of Public Health Sciences, University of Miami Leonard M. Miller School of Medicine, Miami, FL Presented By: Nicola Pavan, MD Poster #209 RACIAL VARIATION IN THE OUTCOME OF SUBSEQUENT PROSTATE BIOPSIES IN MEN WITH AN INITIAL DIAGNOSIS OF ATYPICAL SMALL ACINAR PROLIFERATION (ASAP) Robert Scott Libby¹, Jordan J. Kramer¹, Allison H. Feibus¹, Nora M. Haney¹, Ian R. McCaslin¹, Krishnarao Moparty², Oliver Sartor¹, Raju Thomas¹ and Jonathan L. Silberstein¹ ¹Tulane University School of Medicine - New Orleans, LA; ²Southeast Louisiana Veterans Healthcare Services - New Orleans, LA Presented By: Robert S. Libby, MS Poster #210 THE ASSOCIATION OF FATTY ACID LEVELS AND GLEASON GRADE AMONG MEN UNDERGOING RADICAL PROSTATECTOMY Lael Reinstatler¹, Zachary Klaassen¹, Yi Xu², Xiaoyu Yang², Rabii Madi¹, Martha K. Terris¹, Steven Y. Qian², Uddhav Kelavkar³ and Kelvin A. Moses4 ¹Medical College of Georgia - Georgia Regents University Cancer Center, Augusta, GA; ²North Dakota State University, Fargo, ND; ³Nutechbiomarkers, Savannah, GA; 4Vanderbilt University Medical Center, Nashville, TN Presented By: Zachary Klaassen, MD Poster #211 EMT SIGNATURE AS PREDICTOR OF PROSTATE CANCER RESISTANCE TO RADIOTHERAPY Tim Stark, Patrick Hensley, Hong Pu, Stephen Strup and Natasha Kyprianou Department of Urology, University of Kentucky Medical Center Presented By: Tim Stark

90 SUNDAY

and and

² , ¹ , David University of

² ² e, Celebration, Celebration, e, Pinies³, Hariharan Hariharan -Pinies³, Department of , Philippe E. Spiess E. Philippe ,

³ ²

Lucas Wiegand Lucas , MD

, Jennifer Gordetsky , Jennifer Pinies, MD Pinies, ESAUA President ESAUA ²

, Raul Ordorica Raul ,

² Salem, NC Salem, am, AL Global Robotic Institut Robotic Global - ³

er Department of Genitourinary Genitourinary of Department er

³ , Fisher ¹

Department of Pathology, University of of University Pathology, of Department ² Mary E.Mary Killian,MD AL Birmingham, Birmingh Jon S.Jon MD Demos, Assimos, G.Dean MD Martin K. Dineen, MD Dineen, K. Martin GA Atlanta, Petra Popovics, PhD Lexington, KY Daytona Beach, FL Nima Baradaran Charleston, SC Jonathan Huang, H. MD RishiA. MBA Modh, MD, FL Gainesville, Charles Peyton, C. MD FL Miami, Winston

, , Jared WallenJ. 91 - Ogaya Gabriel ¹

, Jessica Tracht

-Bahrami ¹ of Urology, University of Alabama at Birmingham, Birmingham, at Alabama of University Urology, of

, Trushar Patel ², Trushar University of South Florida Department of Urology Tampa, Tampa, Urology of Department Florida South of University Moffitt Cancer Cent ² ³

University of Central Florida School of Medicine; Medicine; of School Florida Central of University Department University of South Florida Morsani College of Medicine Tampa, Tampa, Medicine of College Morsani Florida South of University

Introducer: Introducer: Introducer: Report Scholar Foundation Care Urology SESAUA Presenter: S Incoming from Remarks Speaker: Ganapathi³, Cathy Jenson³, Janice Doss³, Vladimir Mouraviev³ Mouraviev³ Vladimir Doss³, Janice Jenson³, Cathy Ganapathi³, Patel³ R and Vipul ¹ IDENTIFYING LYMPH INADDITIONAL NODES RADICAL SPECIMENS NODE LYMPH PELVIC PROSTATECTOMY Lai Shun Win Participants IVUmed the by Report Presenters: John S. Fisher S. John TO BIOGRAFTS TISSUE SCAFFOLDING OF USE THE BOLSTERVESICOURETHRAL THE ANASTOMOSIS PROSTATECTOMY ROBOTIC SALVAGE DURING REDUCES CATHETER RATES LEAK TIMES. AND Ogaya Gabriel Syed², Jamil Kadakia¹, Yash LONG TERM ARRAY OF DEVASTATING OF DEVASTATING TERM ARRAY LONG IN SEEDS BRACHYTHERAPY OF COMPLICATIONS PROSTATE CANCER College; Medical Florida Alabama at Birmingham, Birmingham, AL; AL; Birmingham, Birmingham, at Alabama ¹ AL; Birmingham, Hernandez Rais Soroush Birmingham, Birmingham, at Alabama of University Radiology, AL MD Lai, V. Win Shun By: Presented FL By: Presented and Jorge Lockhart and Jorge ¹ FL; FL; Oncology Tampa, FL Tampa, Oncology S John By: Presented

12:10 p.m. 12:10 p.m. 12:15 12:00 p.m.12:00

- - - Poster #214 Poster #213 Poster #212 12:00 p.m. 12:10 p.m. 11:30 a.m. Concurrent Sessions End Sessions Concurrent

90 Disclaimer Statement Statements, opinions, and results of studies contained in the program are those of the presenters/authors and do not reflect the policy or position of the SESAUA nor does the SESAUA provide any warranty as to their accuracy or reliability.

92 ALPHABETICAL INDEX OF AUTHORS

51 29 22 15

Poster #179 Poster #156 Poster #142 AB # Poster #22 Poster #79 Poster #176 Poster #49 Poster #78 Poster #5 Poster #125 AB # Poster #197 Video #2 Poster #25 Poster #15 Poster #16 AB # AB # Poster #12 Poster #3

ass Brooks ass

Gutierrez, Paul Gutierrez, -

9:30 a.m. 6:30 a.m. 6:30 a.m. 7:05 a.m. 1:30 p.m. 6:30 a.m. 9:30 a.m. 3:45 p.m. 6:30 a.m. 6:30 a.m. 4:45 p.m. 3:13 p.m. 10:30 a.m. 7:00 a.m. 1:30 p.m. 6:30 a.m. 6:30 a.m. 7:37 a.m. 1:44 p.m. 6:30 a.m. 6:30 a.m.

as, Kristenas, Joanne

complete text.

Chipollini, Juan Chipollini, 3/20/16 3/20/16 3/19/16 Clayton, Dougl Clayton, Colaco, Marc 3/20/16 Cone, Eugene B. Eugene Cone, 3/17/16 3/18/16 Cui, Tao 3/17/16 3/20/16 3/18/16 Dale, 3/17/16 Damodaran, Chendil Damodaran, David, Samuel Samuel David, Adam 3/18/16 J. Andrew Davidiuk, 3/18/16 3/20/16 Delto, Joan 3/19/16 3/17/16 Diorio, Gregory Joseph Gregory Diorio, 3/17/16 3/17/16 3/18/16 Dmochowski, Roger Roman Roger Dmochowski, Dominguez 3/17/16 Domino, Maria Paula Maria Domino, 3/17/16 Dougl 3/17/16 93

ter, Date, Time, and AbstractPlacement ter, and Date, Time,

57 26 3 52 36 Alphabetical of Index Authors See Abstracts section for

Poster #74 Poster #84 Poster #134 Poster #199 AB # Poster #104 Poster #160 Poster #154 Case #3 Video #6 Poster #191 Poster #53 Poster #152 Poster #164 Poster #161 AB # Poster #63 Poster #148 AB # AB # AB #

Author/Presen

30 a.m. 0:30 a.m.

6:30 a.m. 6:30 a.m. 6:30 a.m. 10:30 a.m. 9:51 a.m. 3:45 p.m. 6:30 a.m. 6:30 a.m. 9:30 a.m. 7:00 a.m. 1 3:45 p.m. 6:30 a.m. 6:30 a.m. 6:30 a.m. 2:52 p.m. 6: 6:30 a.m. 10:34 a.m. 7:12 a.m. 4:27 p.m.

6 J. Ackerman, Anika 3/18/16 3/18/16 3/19/16 Ahdoot, Michael Ahdoot, Divya Ajay, 3/20/16 3/20/1 3/18/16 Allio, Bryce A. Bryce Allio, 3/20/16 Angel, Benjamin James 3/20/16 Ballesteros, Natalia 3/18/16 Basham, Kyle 3/19/16 Bausum, Anna Bausum, 3/20/16 Behl, Ajay S. 3/17/16 Beilan, Jonathan Beilan, 3/20/16 3/20/16 Belknap, Samuel Belknap, 3/20/16 Berneking, Adam Berneking, 3/18/16 Bogache, William William K. Bogache, 3/19/16 Bickell, Michael 3/18/16 Brock, Timothy Craig Timothy Brock, 3/17/16 Burns, John F. John Burns, 3/20/16 Chen, Tony T. Tony Chen, 3/18/16 9292 Edwards, Angelena B. Gregg, Justin 3/17/16 6:30 a.m. Poster #4 3/17/16 11:09 a.m. AB #1 3/18/16 3:45 p.m. Poster #101 Ellis, Lorie 3/18/16 4:45 p.m. Poster #121 3/17/16 3:45 p.m. Poster #58 3/20/16 9:30 a.m. Poster #186 3/20/16 6:51 a.m. AB #41 Emtage, Justin B. 3/18/16 3:45 p.m. Poster #88 Gross, Martin 3/20/16 10:30 a.m. Poster #192 3/20/16 6:51 a.m. AB #49 3/20/16 9:30 a.m. Poster #170 Ewing-O'Bryan, Brittany E. 3/19/16 7:00 a.m. Video #7 Guthrie, Patrick J. 3/20/16 7:05 a.m. AB #43 3/17/16 6:30 a.m. Poster #7 Fantony, Joseph James 3/20/16 9:30 a.m. Poster #180 Guzman-Negron, Juan 3/20/16 9:30 a.m. Poster #183 3/17/16 1:30 p.m. Poster #35 3/17/16 3:45 p.m. Poster #41 Feibus, Allison 3/20/16 6:30 a.m. Poster #159 3/17/16 11:37 a.m. AB #12 3/20/16 10:30 a.m. Poster #205 Hammontree, Lee N. 3/18/16 3:45 p.m. Poster #94 Ferguson III, James E. Han, Julia 3/17/16 6:30 a.m. Poster #20 3/18/16 6:30 a.m. Poster #83

Fernandez-Crespo, Raul Harb-De La Rosa, Alfredo 3/20/16 10:30 a.m. Poster #207 3/20/16 9:30 a.m. Poster #181

Fisher, John Samuel Harper, Ben 3/20/16 10:30 a.m. Poster #212 3/18/16 4:45 p.m. Poster #128

Gamble, Laura Hartsell, Lindsey M. 3/19/16 6:30 a.m. Poster #145 3/17/16 2:12 p.m. AB #19 3/19/16 6:30 a.m. Poster #147 Garcia-Gil, Maurilio 3/20/16 9:30 a.m. Poster #173 3/19/16 6:30 a.m. Poster #136 Hebert, Kristi Lynn Garcia-Roig, Michael Louis 3/20/16 9:30 a.m. Poster #174 3/17/16 1:30 p.m. Poster #31 3/19/16 7:00 a.m. Video #4 Hensley, Patrick 3/19/16 7:00 a.m. Video #5 3/20/16 7:19 a.m. AB #45

Gay, Matthew Ryan Heslop, Daniel 3/18/16 4:45 p.m. Poster #112 3/18/16 3:52 p.m. AB #31

Gerhard, Robert Steven Huang, Jonathan Hwaien 3/17/16 3:45 p.m. Poster #56 3/17/16 1:30 p.m. Poster #27

Goolam, Ahmed Saeed Hurtt, Robbie 3/20/16 9:30 a.m. Poster #184 3/18/16 9:30 a.m. Case #6 3/20/16 10:30 a.m. Poster #196 3/20/16 10:30 a.m. Poster #201 Iremashvili, Viacheslav 3/17/16 11:16 a.m. AB #9 Gopalakrishna, Ajay 3/20/16 10:30 a.m. Poster #206 3/20/16 10:30 a.m. Poster #195 3/20/16 6:44 a.m. AB #40 Jackson, John D. 3/18/16 6:30 a.m. Poster #64 3/18/16 3:45 p.m. Poster #91 3/18/16 3:45 p.m. Poster #105 3/20/16 9:30 a.m. AB #54

94 ALPHABETICAL INDEX OF AUTHORS

38 37 44 23 7 28 33 16

AB # Poster #175 Poster #37 Video #1 Video #10 AB # Poster #214 Poster #168 Poster #171 Poster #178 AB # Poster #98 Poster #86 Poster #116 AB # Poster #167 Poster #151 Poster #2 AB # AB # AB # Poster #108 Poster #202 Poster #109 Poster #117 Poster #133 Poster #185 Poster #194 AB # Poster #55

5 p.m.

mas Andrew mas 9:30 a.m. 3:45 p.m. 7:00 a.m. 6:30 a.m. 4:34 p.m. 10:30a.m. 9:30 a.m. 9:30 a.m. 9:30 a.m. 7:12 a.m. 3:4 3:45 p.m. 4:45 p.m. 7:44 a.m. 9:30 a.m. 6:30 a.m. 10:30 a.m. 11:02 a.m. 3:06 p.m. 4:06 p.m. 4:45 p.m. 4:45 p.m. 4:45 p.m. 6:30 a.m. 10:30 a.m. 9:30 a.m. 10:30 a.m. 1:51 p.m. 3:45 p.m. 6:30 a.m.

8/16 3/20/16 Kurpad, Raj Kurpad, 3/17/16 3/19/16 Lai, Weil Lai, 3/20/16 Lai, Win Shun Vincent Win Shun Lai, 3/1 3/20/16 Langston, Joshua Paul Joshua Langston, 3/20/16 3/20/16 Lau, Glen A. 3/20/16 Gobind Rajesh Laungani, 3/20/16 Lavien, Garjae D. Garjae Lavien, 3/18/16 Leone, Andrew Robert Leone, Andrew 3/18/16 3/18/16 3/18/16 3/20/16 Li, Dillon 3/20/16 Liang, Jessie Libby, Robert Scott Robert Libby, 3/20/16 R. Jason Lomboy, 3/17/16 3/18/16 3/18/16 3/18/16 3/18/16 3/18/16 3/19/16 3/20/16 Tho Longo, 3/20/16 3/20/16 Matthew Lyons, 3/17/16 Macey, MatthewMacey, Ryan 3/17/16 3/20/16 95

13 2 58 20 56

Poster #28 Case #4 Video #3 Poster #139 Poster #96 Poster #30 Poster #23 Poster #110 Poster #24 Poster #26 AB # Poster #75 Poster #85 Poster #123 Video #12 Poster #137 AB # Poster #163 Poster #111 Poster #177 AB # AB # Poster #210 AB #

R. 1:30 p.m. 9:30 a.m. 7:00 a.m. 6:30 a.m. 3:45 p.m. 1:30 p.m. 1:30 p.m. 4:45 p.m. 1:30 p.m. 1:30 p.m. 1:30 p.m. 6:30 a.m. 6:30 a.m. 4:45 p.m. 6:30 a.m. 6:30 a.m. 10:27 a.m. 6:30 a.m. 4:45 p.m. 9:30 a.m. 9:58 a.m. 2:19 p.m. 10:30 a.m. 9:44 a.m.

6 n, Mary E. 16 Jacobson, Deborah L. Deborah Jacobson, 3/17/16 3/18/16 Jennings, Michael Olen Michael Jennings, 3/19/1 Johnsen, Niels V. Niels Johnsen, 3/19/16 Johnson, Sara Eileen Sara Johnson, 3/18/16 Johnston, Derrick L. Derrick Johnston, 3/17/16 3/17/16 3/17/16 Kabaria, Reena 3/17/16 3/18/ Jung, Nathan Longstreet Nathan Jung, Kaplan, Adam G. Adam Kaplan, 3/17/16 3/18/16 3/18/16 Kappa, Stephen F. Stephen Kappa, 3/18/16 3/20/16 Kava, Bruce 3/19/16 Keane, Thomas Edward Thomas Keane, 3/17/16 Kent, Jennifer Margaret 3/20/16 Kent, Marissa 3/18/16 3/20/16 Khaled, Dunia T. Dunia Khaled, 3/20/16 3/17/16 Killia Kuo, Jennifer 3/20/16 Klaassen, Zachary 3/20/16 94 Madi, Rabii Ogaya-Pinies, Gabriel 3/17/16 1:58 p.m. AB #17 3/17/16 6:30 a.m. Poster #10 3/17/16 3:45 p.m. Poster #40 3/17/16 6:30 a.m. Poster #11 3/17/16 3:45 p.m. Poster #46 3/17/16 3:45 p.m. Poster #50 3/20/16 6:30 a.m. Video #9 3/17/16 3:45 p.m. Poster #52 3/17/16 3:45 p.m. Poster #59 Manimala, Neil J. 3/20/16 10:30 a.m. Poster #213 3/17/16 6:30 a.m. Poster #18 Otto, Brandon J. Marien, Tracy 3/17/16 1:37 p.m. AB #14 3/18/16 6:30 a.m. Poster #82 3/18/16 6:30 a.m. Poster #76

Mark, James Ryan Owen, Ryan C. 3/18/16 3:45 p.m. Poster #90 3/20/16 6:58 a.m. AB #50 3/20/16 9:30 a.m. Poster #188 Palayapalayam Ganapathi, Mason, James Bradley 3/17/16 3:45 p.m. Poster #39 3/18/16 6:30 a.m. Poster #77 Pathak, Ram McBride, James Abram 3/17/16 3:45 p.m. Poster #51 3/18/16 6:30 a.m. Poster #62 3/17/16 3:45 p.m. Poster #54 3/19/16 6:30 a.m. Poster #132 McCormick, Barrett Zachary 3/19/16 6:30 a.m. Poster #135 3/17/16 6:30 a.m. Poster #21 3/18/16 6:30 a.m. Poster #68 3/18/16 3:45 p.m. Poster #97 3/18/16 4:20 p.m. AB #35 3/20/16 9:30 a.m. Poster #190 3/20/16 6:30 a.m. Poster #165 3/20/16 7:19 a.m. AB #53 McCraw, Casey O. 3/18/16 6:30 a.m. Poster #71 Pavan, Nicola 3/18/16 3:45 p.m. Poster #92 McKibben, Maxim J. 3/18/16 3:45 p.m. Poster #106 3/18/16 3:45 p.m. Poster #89 3/20/16 10:30 a.m. Poster #193 Mendez, Melissa 3/20/16 10:30 a.m. Poster #208 3/18/16 9:30 a.m. Case #5 3/18/16 3:45 p.m. Poster #95 Peak, Taylor 3/18/16 3:59 p.m. AB #32 3/20/16 6:44 a.m. AB #48

Miller, Scott David Peard, Leslie 3/17/16 3:45 p.m. Poster #38 3/18/16 4:45 p.m. Poster #127 3/17/16 3:45 p.m. Poster #42 Pearl, Jeffrey 3/18/16 9:30 a.m. Case #1 Mitchell, Gregory C. 3/20/16 9:30 a.m. Poster #189 3/18/16 6:30 a.m. Poster #61 Perez-Ruiz, Carlos M. Moore, David C. 3/17/16 6:30 a.m. Poster #19 3/18/16 3:45 p.m. Poster #103 3/20/16 6:30 a.m. Poster #166 Peyton, Charles C. 3/18/16 2:59 p.m. AB #27 Moore, John R. 3/18/16 4:45 p.m. Poster #115 3/20/16 6:30 a.m. Poster #158 Pilkington, James E. Moses, Kelvin A. 3/18/16 7:51 a.m. AB #24 3/17/16 11:30 a.m. AB #11 Pinsky, Michael R. Nordquist, Luke 3/18/16 6:30 a.m. Poster #66 3/17/16 6:30 a.m. Poster #6 Popovics, Petra 3/19/16 6:30 a.m. Poster #149

96 ALPHABETICAL INDEX OF AUTHORS

42 8 55 18 10

Poster #29 Poster #43 Poster #129 Poster #131 Poster #87 Poster #107 Poster #80 Poster #113 Poster #14 Poster #44 AB # Video #8 Poster #155 Poster #198 Poster #124 Poster #162 Poster #47 AB # AB # Poster #211 AB # Poster #81 Poster #122 Poster #172 Poster #187 Poster #157 Poster #8 AB # Poster #114

1:30 p.m. 3:45 p.m. 6:30 a.m. 6:30 a.m. 3:45 p.m. 4:45 p.m. 6:30 a.m. 4:45 p.m. 6:30 a.m. 3:45 p.m. 6:58 a.m. 6:30 a.m. 6:30 a.m. 10:30 a.m. 4:45 p.m. 6:30 a.m. 3:45 p.m. 10:20 a.m. 9:37 a.m. 10:30 a.m. 2:05 p.m. 6:30 a.m. 4:45 p.m. 9:30 a.m. 9:30 a.m. 6:30 a.m. 6:30 a.m. 11:23 a.m. 4:45 p.m.

Prakash, Nachiketh -

Tim 6 Taylor, Abby S. Abby Taylor, 3/17/16 3/17/16 Schommer, Eric Eric Schommer, Andrew 3/19/16 3/19/16 Sekar, Rishi 3/18/16 3/18/16 3/18/16 3/18/16 Seltz, Lara M. Sharma, Pranav Sharma, 3/17/16 3/17/16 3/20/16 Shridharani, Anand Shridharani, 3/20/16 3/20/1 Sidhu, Ajaydeep S. Sidhu, Ajaydeep 3/20/16 J. Allen Simms, 3/18/16 3/20/16 Hugh Smith, 3/17/16 Soodana 3/17/16 3/20/16 Stark, 3/20/16 Stoneburner, Charles Stoneburner, 3/17/16 Sukhu, Troy Anthony Troy Sukhu, 3/18/16 3/18/16 3/20/16 3/20/16 A. Douglas Swartz, 3/20/16 Jack Kae Tay, 3/17/16 3/17/16 3/18/16 97

21 39 5 4 30 34 se #2

AB # Poster #141 Poster #143 Poster #130 Poster #70 Poster #144 Poster #1 Poster #200 Poster #204 Poster #73 Ca AB # Poster #17 Poster #153 AB # Poster #146 AB # Poster #150 Poster #203 Poster #69 AB # Poster #118 Poster #140 AB #

arles D.

7:30 a.m. 6:30 a.m. 6:30 a.m. 6:30 a.m. 6:30 a.m. 6:30 a.m. 6:30 a.m. 10:30 a.m. 10:30 a.m. 6:30 a.m. 9:30 a.m. 6:37 a.m. 6:30 a.m. 6:30 a.m. 6:30 a.m. 10:48 a.m. 10:41 a.m. Jose Antonio Belaunde, 6:30 a.m. 10:30 a.m. 6:30 a.m. 3:45 p.m. 4:45 p.m. 6:30 a.m. 4:13 p.m.

- Pena, Wilso Mirabal, Jorge Mirabal,

- - , Michael B. , Michael 3/18/16 Potts, Bradley A. 3/19/16 3/19/16 Powers, Mary Katie 3/19/16 Pryor 3/18/16 Rabley, Andrew Rabley, 3/19/16 Rai, Samarpit 3/17/16 3/20/16 3/20/16 Thanmaya Reddy, 3/18/16 3/18/16 Rick, Ferenc 3/20/16 Ritch, Chad R. 3/17/16 3/20/16 Rivera Rose, Kyle Matthew Kyle Rose, 3/19/16 3/17/16 Rothberg, Michael Michael Bryan Rothberg, 3/20/16 3/17/16 Rovira Saavedra 3/20/16 Joseph Ilan Safir, 3/18/16 3/18/16 Sarkissian, Hagop 3/18/16 Scales Ch Jr., 3/19/16 Scarpato, Kristen R. 3/18/16 96 Tejwani, Rohit Vikram Wilson, Shenelle 3/17/16 1:30 p.m. Poster #32 3/17/16 1:30 p.m. Poster #36 3/17/16 1:30 p.m. Poster #33 3/18/16 3:45 p.m. Poster #100 3/18/16 3:45 p.m. Poster #102 Terry, Russell 3/18/16 2:45 p.m. AB #25 Woodlief, Tracey 3/20/16 6:30 a.m. Video #13 3/17/16 3:45 p.m. Poster #57

Tipton, Tracy J. Yafi, Faysal A. 3/17/16 3:45 p.m. Poster #60 3/20/16 6:37 a.m. AB #47

Venkatesh, Ramakrishna Yanes, Rafael E. 3/20/16 10:05 a.m. AB #59 3/18/16 6:30 a.m. Poster #65

Venkatramani, Vivek Young, Brian J. 3/17/16 6:30 a.m. Poster #2 3/17/16 1:30 p.m. Poster #34 3/17/16 10:55 a.m. AB #6 3/18/16 4:45 p.m. Poster #119 3/18/16 4:45 p.m. Poster #120 Wallen, Jared J. 3/18/16 4:45 p.m. Poster #126 3/18/16 6:30 a.m. Poster #67 Zaid, Uwais Wang, Julie C. 3/18/16 3:45 p.m. Poster #99 3/17/16 3:45 p.m. Poster #48 3/20/16 6:30 a.m. Video #11 Zann, Anja M. 3/20/16 9:30 a.m. Poster #169 Willard, T. Brian Zargar, Kamran 3/17/16 6:30 a.m. Poster #9 3/17/16 6:30 a.m. Poster #13 3/20/16 9:30 a.m. Poster #182 Williams, Robert D. 3/18/16 3:45 p.m. Poster #93 3/19/16 6:30 a.m. Poster #138 3/20/16 6:30 a.m. AB #46

98 PODIUMS

. cancer. cancer. automate the

acy. Automating acy. Automating R), manual data data usingthedata weighted

support tools. While the time decisionsupport tools - - ts. driven quality incentives and -

Ingram CancerIngram Center, Nashville, TN; - 99

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stratum - led quality improvement, and decision - Justin MD Gregg, In the clinical setting,risk stratification informs prognostication and treatment

NLP can achieve greater than 90% accuracy on D’Amico risk stratification of

Manually collectedclinical stage, biopsy Gleason score, and preoperative PSA t t with manual risk stratification (Κ=0.78, SE = 0.02) (Table). The Κ for clinical T

Of theOf 2353 patients treated from 2015, 2010 to NLP identified 3 elementsin all

¹Vanderbilt University Cente Medical Justin Gregg¹, Maximilian Lang¹, Lucy Wang²,Justin Resnick¹,Penson¹, MaximilianJeremy Gregg¹, Matthew David Lucy Lang¹, Warner³Barocas¹ and Daniel ²Vanderbilt University Center, Medical Vanderbilt THE USE OF NATURAL LANGUAGE PROCESSING TO DETERMINE PROSTATE PROSTATE DETERMINE TO PROCESSING LANGUAGE NATURAL OF USE THE CANCER CLINICAL RISK STRATA Podium#1 Introductio decisions.system It also underlies

³Vanderbilt University Center, Medical Department Medicine, of Nashville, TN Presented By: risk as such care, cancer penalties, physician Thus, determining risk stratum is a prerequisite for payor elementsstratummedical risk availablein electronicare (EM of the record collection is resource intensive, limiting the scalability of these activities. Therefore, we we Therefore, activities. these of scalability the limiting intensive, resource is collection investigated the of accuracy automated an datamethod, extraction natural language processing extraction for (NLP), D’Amico stratum of risk elemen Kappa statistic standard(Κ); (SE) error is reported. Results: 1945 (recallAmongpatients =82.7%). all with 3 elements, had a 91.9% raw NLP agreemen stage, Gleasonscore, 0.89, NLP by extraction 0.87,and was and PSA 0.89, respectively. manually within83.3%1.0 values collected PSA ng/mL levelsof extracted PSA were of Methods: values from prospective our institutional prostatectomy usedcategorize to database were patientsintermediate low, as high or Conclusion: extraction of the same datafrom points the EMR, and risk stratum calculated was on based NLP. The ability ofto NLP identify the elements risk of stratum calculated, (recall)was and the tomanually accuracy the compared NLPcollected of was the collection of characteristics risk couldbe used real to power measurementscaleand tocancerup quality care. in localizedcancer, prostate recall with ofthanThesefigures greater comparable 80%. are to othertasks tradeoff NLPknown and illustrate the recall and accur between 9898 Podium #2 APPLICATION OF ACTIVE SURVEILLANCE THRESHOLD TO SERIES OF SAMPLES SUBMITTED FOR COMMERCIAL TESTING Thomas E. Keane¹, Peter T. Scardino², Jack M. Cuzick³, Steve Stone4, Brent Evans4, Matthew R. Jorgensen4, James A. Eastham², John W. Davis5, Daniel W. Lin6, Judd W. Moul7, Michael K. Brawer4 and E. David Crawford8 ¹The Medical University of South Carolina, Charleston, SC; ²Memorial Sloan Kettering Cancer Center New York, NY; ³Wolfson Institute of Preventive Medicine, London; 4Myriad Genetics, Inc., Salt Lake City, UT; 5The University of Texas MD Anderson Cancer Center, Houston, TX; 6University of Washington, Seattle, WA; 7Duke Cancer Institute, Durham, NC; 8University of Colorado Health Science Center Aurora, CO Presented By: Thomas Edward Keane, MD, ChB, FRCSI, FACS Introduction: Active surveillance (AS) is an increasingly popular treatment modality for men with localized prostate cancer. Recently, we developed a method to select men for AS based on a score that combines cell cycle progression (CCP) with CAPRA (combined clinical CCP risk (CCR) score). Here, we apply our validated AS threshold to a series of samples submitted for commercial testing. Methods: Formalin-fixed prostate biopsy samples from 7881 patients were submitted by their physicians to Myriad Genetic Laboratories for CCP analysis. Patient clinicopathological data was obtained from the test request form. The CCP score was calculated based on RNA expression of 31 CCP genes normalized to 15 housekeeping genes, and combined with CAPRA to generate the CCR score. The clinicopathological data of patients with a CCR score meeting the AS threshold were analyzed focusing on their PSA, % positive cores, Gleason, stage, AUA risk classification, and CAPRA score. Results: Of the 7881 patients included in the analysis, 4758 (60.4%) qualified for AS based on their CCR score. A substantial number of these patients, 2213 (46.5%), would not have qualified for AS based on their clinical characteristics alone. A summary of the patients’ clinicopathological characteristics is shown below. Conclusion: This analysis showed that 60.4% of commercially tested patients qualified for AS, nearly half of which would not have qualified for AS based on their clinicopathological characteristics. For patients considering deferred treatment, the CCR score provides significant prognostic information at disease diagnosis.

100 PODIUMS

or erved in in erved

statistically statistically rogeneity and ASSISTED ASSISTED -

iopsy to surgical assisted laparoscopic - went contrast went enhanced uvant therapy, 524 were

e of extraprostatic extension

Ortiz³ - stage upgrading from to biopsy - lume, PSA, and PSA density. lume, PSA, and PSA density. f tumor staging based on MRI of the stagingtumorf based the of on MRI on score.

101

stage and Gleas -

Olmo² and Ricardo Sánchez and RicardoOlmo² Pena, MD agnosis ofagnosis made.cancer prostate has been At institution, our - dical Center,dical Knoxville, ²Department Surgery, TN; of University

2015. Aftermen excluding neoadj with - ano- nformation usefulfor counseling patients and developing more lson Rovira MRI of the pelvis hasthe clinical become pelvisfor populara adjunct staging of MRI and Timothy C. Brock, MD Brock, C. Timothy Wi When performing radical a prostatectomy (RP), issurgeon the conflicted by tests were performed to evaluate for any statistically significant (p ≤ 0.05)

Our study suggests that staging pelvic for MRI prostate cancer is a po

Weto investigate concordance aim the o

Wechart performed34 patients under of reviews who From our IRB−approved database, 791 men were identified treated with open or

The overall tumor stage concordance between andMRI surgical specimen was

MRI ofMRI the pelvisto undergoing prior RALP faculty either by two 2012 ofsurgeons between and 2015. T predictors discordance T of based on Introduction: robotic 2007 RP between Results: ¹UniversityPabloJuan,ofPR; ²SanSan SchoolPuerto Rico Medicine, of Pathology Group, Bayamón,PR; ³Robotic OncologyInstitute & Urology UniversitySchool of Puerto and Rico of Medicine, San Juan, PR 50% (17/34). 63% (12/19) of patients with (cT2) MRI’s were ultimately demonstrating upgraded organ to ≥ confined pT3a. disease Downgrading of tumor stage was obs Presented By: pelvissurgical in specimen staging with patients undergoing robotic Methods: 33% (5/15) patients patients of (2 from3 patients T2c;T3a downgraded to downgraded from T3b to T3a). In to regard potential predictors of discordance, none of the variables (age, biopsy Gleasonscore, prostate volume,PSA,PSA density) or were significant. no significant There were predictors T of surgicalspecimen, tumor however, volume as a percentage of the surgical specimen a was significant predictor of = (p 0.003) Gleason score upstaging b from specimen. percentage Mean involvement comparedin to of as those 49% upstaged was (7/34). downgraded same (21/34)24% those the were that or remained in Conclusion: predictor of tumor stage. Our study also reaffirmsthe inherent inaccuracies of prostate biopsy. ofSix an increase 34 patientsscore saw surgicalspecimen in Gleason 7 on while of 34 saw a decrease. These findings likely are reflective of tumor hete multifocality,inconsistent as well as pathologicinterpretation. Podium #4 PREDICTORS OF EXTRAPROSTATIC EXTENSION AFTER RADICAL RADICAL AFTER EXTENSION EXTRAPROSTATIC OF PREDICTORS WITH AN MEN OF BIOPSIED COHORT CONTEMPORARY A IN PROSTATECTOMY SCHEME BIOPSY EXTENDED WilsonSerr Juan Rovira¹, prostatectomy (RALP). We consideredprostatectomy possible also any (RALP). discordance predictors of including age, biopsy Gleason score, prostate vo Secondarily, predictors consideredmeasures whether were of any same we the of discordancescore surgicalspecimen needle Gleason score. Gleason biopsy between and (EPE) in a contemporary cohort of men biopsy contemporary(EPE) cohort extended of in diagnosed with schemes.a Methods: the concurrent but antagonizing goals ofcancer prostate (CaP) control bundle and nerve preservation.We preoperative reviewed variables predictiv Introduction: treatmentplanning once a di we now routinely now we obtain ofMRI the pelvisin place of staging CT for of high and intermediateWecandidates feel riskthat consider we patients radical prostatectomy. for offersMRI valuablei accurate expectations in toregard neurovascular bundlepreservation, the need for pelvic lymph dissection node and possible adjuvant therapy. Objectives: ¹UniversityTennessee of Me ofKnoxville, Tennessee TN Center, Medical Presented By: Podium#3 ACCURACY OFMRI STAGING PATIENTS IN UNDERGOING ROBOTIC LAPAROSCOPIC PROSTATECTOMY LAPAROSCOPIC WesleyWhite²,TimothyEric Pickens²Brock¹, Heidel² and Ryan 100 identified with unilateral disease and 241 with bilateral disease on biopsy, for a total of 1,006 prostate sides for evaluation. A single pathologist reviewed all biopsy slides with a mean number of 11.5 cores (median: 12). The presence of EPE was correlated with preoperative variables. Statistical analysis was performed with SPSS. Results: Sixteen percent (161/1006) of prostate sides exhibited EPE. There were statistically significant differences between patients with EPE and those without regarding serum PSA (8.7 vs. 5.9 ng/ml), PSA density (0.22 vs. 0.13), longest positive core (7.7 vs. 3.8 mm), total sum of cancer per side (17.9 vs. 6.3 mm), perineural invasion (30.2% vs. 9.3%), percent positive biopsies (42.9% vs. 29.8%), positive biopsy at the base (21% vs. 8.2%), abnormal rectal exam (28.9% vs. 10%), and prostate size (42.8 vs. 46.9 g) (all p<0.02). In multivariate analysis, the strongest independent predictors of EPE included core length ≥7mm (OR: 2.71, 95% 1.66 to 4.40), sum of cancer per side ≥ 20 mm (OR: 2.15, 95% CI, 1.2 to 3.84), PSA density≥0.2 (OR: 2.14, 95%CI: 1.29 to 3.54), primary Gleason grade 4 (OR: 2.03, 95% CI: 1.32 to 3.12), perineural invasion (OR: 1.93, 95% CI: 1.66 to 4.40), and a positive core at the base (OR: 1.50, 95% CI: 1.01 to 2.36). Independent of Gleason score, patients with any core ≥ 7mm and any core with PNI exhibited a higher risk of EPE (50.0% vs. 11%, p<0.001), which increased to 67.7% with a PSA density ≥0.2, and to 72% with a positive biopsy at the base. There was no increased risk of EPE with regards to mean BMI, age, history of DM or smoking, positive biopsy at apex, or a positive laterally directed biopsy. Conclusion: In this contemporary cohort of men with CaP treated with RP, men with any cancer core ≥ 7mm and any core with PNI exhibited a 50% risk of EPE which increased to 67.7% with a PSA density≥ 0.2, and to 72% with a positive biopsy at the base. Funding: none

Podium #5 NOVEL IN VIVO MODEL FOR COMBINATORIAL FLUORESCENCE LABELING IN MOUSE PROSTATE Xiaolan Fang¹, Michael B. Rothberg², Kenneth Gyabaah³, Bita Nickkholgh³, J. Mark Cline4 and K.C. Balaji² ¹Department of Cancer Biology, Wake Forest Comprehensive Cancer Center, Winston- Salem, NC; ²Department of Urology, Wake Forest School of Medicine, Winston-Salem, NC; ³Wake Forest Institute for Regenerative Medicine, Winston-Salem, NC; 4Department of Pathology, Wake Forest School of Medicine, Winston-Salem, NC Presented By: Michael B. Rothberg, MD Introduction: Currently, few animal models exist to study the cellular origin of normal or neoplastic development in the prostate by tracing multiple cell lineages in vivo. We previously described a mouse model that expresses fluorescent proteins (XFPs) for normal tissue, benign hyperplasia, and primary neoplasia in the prostate. We have since developed this model to demonstrate more advanced forms of prostate cancer to facilitate the treatment of heterogeneous prostate diseases by targeting individual cell lineages. Methods: Using an in vivo stochastic fluorescent protein combinatorial strategy, XFP signals were expressed specifically in the prostate of: (1) Protein Kinase D1 (PKD1) knock- out, K-Ras G12D knock-in, (2) Phosphatase and tensin homolog (PTEN) knock-out, K-Ras G12D knock-in, and (3) K-Ras G12D knock-in, PTEN PKD1 knock-out triple mutant mice under the control of the prostate-specific Probasin (PB) promoter. Results: In vivo XFP signals were observed in the prostate of (1) PKD1 knock-out, K-Ras G12D knock-in, (2) PTEN knock-out, K-Ras G12D knock-in, and (3) K-Ras G12D knock-in, PTEN PKD1 knock-out triple mutant mice, which developed prostate cancer sporadically invading the urethra and micro-metastasis to the lung, in situ carcinoma aggressively invading the urethra (see Figure), and a highly aggressive prostate cancer resulting in early animal death, respectively. The unique expression pattern of XFPs in neoplastic tissue indicated the clonal origin of cancer cells in the prostate. Conclusion: This transgenic mouse model demonstrates combinatorial fluorescent protein expression in locally aggressive and metastatic cancerous prostatic tissues. This novel prostate-specific fluorescent-labeled mouse model, which we named Prorainbow, could be

102 PODIUMS

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igated the association association the igated

0709 to0709 K. C. Balaji NIH and by grant the prostate.the - 1 confined significantly cancerwas higher - 10- - 103

Bruno Nahar¹, Daniel Sjoberg², DanielBruno Nahar¹, Stephen Zappala³ IMEN; RESULTS FROM A MULTI A FROM RESULTS IMEN;

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University of MillerFL; of Miami Miami School Medicine,

ostate cancer occurred cancer ostate at 26 sites throughout the United States from er and underwent radical er a significant saw Weprostatectomy. re was 7% (4, 12), 25% (12, 38), and 47% (24, 66) (p<0.0001). (24, 47% 66) 38), 12), (12, and (4, 25% 7% was re

Vivek Venkatramani²,

A recent prospectivevalidation study confirmed 4Kscore the accurately Vivek Venkatramani²,

an Kettering Cancer, New YorkKettering Urology,an City, Cancer, Andover, New NY; ³Andover MA In a subsetmen underwent ofwho radical prostatectomy, the 4Kscore was

rates a panel of 4 Kallikreins (totalPSA, free PSA, intactPSA and human

Prospective enrollment of 1312 men who were referred Prospectivemen were offor enrollment prostate 1312 who for biopsy n:

radical prostatectomy. Among the 1312 men who enrolled inmenthiswho Amongthe 1312 found to validation 144 were study, 2) in2) digitaladdition age, to We examination, rectal biopsy and prior status.

- Introduction: predicted aggressive prostate cancer on prostate biopsy.We invest 4Kscore test results compared were for those and with without non organ assessedconcordancethe the between 4Kscore prior to of and grade biopsy prostate cancer at between thebetween 4Kscore and pathologic and stage grade radical at the prostatectomy, where entiresampled. prostate is gland October 2013 toWe Aprilselectedmen 2014. found to were who positive have prostate cancer biopsies radicalto and elected undergo prostatectomy. 4KscoreThe is an algorithm that incorpo kallikrein clinicalsuspicion of pr Methods: This is work supportedW81XWH grant DOD by usefulmalignantstudying in pathology and benign of Podium #6 THE 4KSCOREPREDICTS STAGE CANCERGRADE OF INPROSTATE THE AND THE SPEC PROSTATECTOMY RADICAL and Dipen Parekh¹ ¹DepartmentUrology of Presented By: at surgery usingWilcoxon the rank Results: have prostate canc association the between 4Kscore and grade at surgery higherwith scores relating to worse surgicalspecimenthethe higher cancers in7, and 8 or men grade. Gleason 6, with For 4Ksco (IQR) median ²Memorial Slo ²Memorial CA079448Fang. to X. PROSPECTIVE TRIAL PROSPECTIVE Sanoj Punnen¹, The medianmen non organ with among 4Kscore Conclusio significantly associated pathological with extracapsular and grade extension inthe surgical specimen, higher with scores linked being to higher grade more and aggressive histology. then menthen confined cancers with theto prostate ([36% vs.[19% (IQR 19,58)] 9, (IQR 35)], p=0.002). The test can be beneficialaid toin treatment decision making for men are who contemplating observation theirof cancer versus immediate treatment 102 Podium #7 EVALUATING THE TIMING OF SURGICAL COMPLICATIONS FOLLOWING PROSTATECTOMY Jason Lomboy, Matthew Macey, Troy Sukhu, Allison Deal, Eric Wallen, Michael Woods, Raj Pruthi, Matthew Nielsen and Angela Smith Chapel Hill, NC Presented By: Jason R. Lomboy, MD Introduction: While complication rates following prostatectomy are well described, the timing with which each occurs is unclear. Our objective was to evaluate the median time-to- event for common 30-day postoperative complications following prostatectomy to better define early and late complications. Methods: Using the American College of Surgeons - National Surgical Quality Improvement Program (NSQIP) database, we performed a retrospective review of patients undergoing prostatectomy from 2005-2013. NSQIP collects prospective data on >135 variables, including perioperative data, 30-day post-operative complications and mortality on major surgical procedures at over 450 participating academic and private institutions. We investigated 19 complications occurring after prostatectomy and assessed days from operation to complication to better define early complications (those occurring during the first half of 30 days) and late complications (those occurring during the latter half of 30 days). Results: Overall, 23,157 patients underwent prostatectomy. Overall, 8.4% experienced a complication within 30 days, with 1.6% of patients experiencing two or more complications. The majority of complications occurred within 15 days (82%). Complications such as infection (wound, urinary tract, sepsis) were most likely to occur between 12-15 days post- procedure. Similarly, postoperative DVT and pulmonary embolism were likely to occur at a median of 11 days post-procedure. Cardiovascular, pulmonary, and neurologic complications, while rare, occurred a median of 2-8 days following prostatectomy. The table below reveals that all complications are most likely to occur early (within the 1st 15 days following surgery), although if later complications occur, these are most likely to be wound or thrombosis-related. Conclusion: The majority of 30-day complications following prostatectomy occur within the first 15 days, with cardiovascular, pulmonary, and neurologic complications occurring early and wound and thrombosis-related complications occurring several weeks later. Knowledge regarding timing of postoperative complications may better inform quality improvement measures for postoperative follow-up.

104 PODIUMS - - PI US

R 1.0 CI 95% iami FL iami RISK

- RADS score.RADS - ad Gleason ≤3+3 and Sanoj and Sanoj 7.31, p<0.011), in whereas RADS score and grouped score and grouped RADS

- – RADS scores (O scores RADS - 2), indeterminate probably or (3) risk cancer.prostate - -

US fusionand compared biopsy cancer

- fold increase in the odds of detecting cancer fold detectingthe cancer of in odds increase - variable clinical course. Multiple instruments instruments Multiple course. clinical variable

ad to unnecessaryad to men biopsies undergoing in 105 . Each targeted lesion in the PZ and TZ was targeted was . TZ PZ Each the lesion and in risk patients including active surveillance (AS) criteria criteria (AS) surveillance active including risk patients - Prakash, MD, MS rekh, Murugesan Manoharan and Sanojrekh, Punnen and Murugesan Manoharan - rom targetedcores categorized cancer, were as no non ns in the PZ and 82 lesions in the and 82 lesions inPZ in TZ.the Among lesions found ns seen in the peripheral zone (PZ) and the TZ. in peripheral theseen (PZ)the zone and US FUSION BIOPSY FUSION US

ents with pathologically with ents low

- RADS <4 (OR 3.08;RADS CI 1.29 95% -

rly in the hyperplasticrly in transitional (TZ), where zone changes that are . With. significantstatistically respect to see did cancer,not a although we 6.10% compared p=0.12) to TZ. Furthermore, lesions inthe PZ a with Nachiketh Soodana Viacheslav Iremashvili, MD, PhD MD, Iremashvili, Viacheslav Risk stratification is essential for safe and efficientmanagement of patients Multiparametric has as MRI modality emerged a popular imaging localize to

To our knowledge this is the this knowledge our first study concern is To to address a regarding an

5). Histopathology f : vs. -

133 men133 elevated with PSA positive or digital rectal exam MRI underwent Thisstudy included 402 radical prostatectomy patients h who

We identified 143 lesio 143 We identified

4.84, p<1.0).

– Introduction: Presented By: NachikethSoodana Nahar¹, Prakash¹,Pavan¹, Tara Bruno Abboud¹, Nicola Samarpit Rai¹, Felipe Rosa Munera², Raymond Castillo², Balise³, Murugesan Bruce Manoharan¹, Kava¹, Ramgopal Satyanarayana¹, Mark Gonzalgo¹, Ritch¹, Chad Parekh¹ Dipen Podium#8 ZONE TRANSITIONAL AND ZONE PERIPHERAL BETWEEN DETECTION CANCER COHORT PROSPECTIVE A FROM RESULTS PRELIMINARY BIOPSIES? TARGETED MRI OF MEN UNDERGOING Punnen¹ ¹Department Urology, of UniversitySchool of Miami Medicine Miller of Miami FL; ²Department Radiology of UniversitySchool of Miami Medicine Miller of Miami FL; ³Department Biostatistics, of UniversitySchool Medicine Miller of Miami of M prostatecancer. Nevertheless, interpretation subjective, of is concerns MRI with for false positives, particula commonWethismay confused tosuspicion region cancer. for be a analyzed of prospectivecohortmen of undergoing MRI detection lesions rate between Methods: fusion averagewith biopsy of 2 cores taken target per for the detection of cancer prostate October 2015 July between 2014 and PI MRI the to according radiologists by classified previously accordingto level their assuspicion of probably benign (1 malignant (4 significant cancer (Gleason 6) and significant canceron PI lesions lesions, between TZ and PZ detection based rates in cancer (Gleason ≥ 7). We Results: compared the inthe TZ, 57. 3% reported were as probably malignant,compared 44.7% to of lesions seen inthe PZ. diagnosed Cancer was in23% of the lesionsinthe compared PZ, to only in9.7% in the TZ (p<0.01) significant difference,there a trend was towards higher detectionsignificant of cancer in the PZ (13.29% Methods: prostate cancer detected on a biopsy at with least 10 cores.We compared the ability of two nomograms,Kattan those ofal. et (predictsthe risk pathologically of indolent prostate have been developedhave to select low and nomograms. compared this abilityAScriteriaseveral In the of analysis we and prognosticidentify to tools pati with prostate highlywith with diseasecancer, a RADS score > 4 were associated a three were with scoreRADS > 4 Introduction thethere no increased cancer higher TZ with was of PI risk compared to PI lesions with FL Miami, Miami, of University Presented By: increased likelihood of false positives reporting when the presence and aggressiveness of cancer in the TZ versus the PZ. This may le 0.20 Conclusion: the ofMRI prostate. Podium #9 COMPARATIVE ANALYSIS OF THE ABILITY OF PATHOLOGICAL NOMOGRAMS AND AND NOMOGRAMS PATHOLOGICAL OF ABILITY THE OF ANALYSIS COMPARATIVE ACTIVE SURVEILLANCE CRITERIA TO SELECT PATIENTS WITH LOW PROSTATE CANCER Pa J Dipen Iremashvili, Viacheslav 104 cancer) and Truong et al. (predicts the risk of pathologically low-grade prostate cancer) to select patients with pathological Gleason 6 organ-confined prostate cancer to that of three AS criteria – those of John Hopkins (JH) and University of California at San Francisco (UCSF) medical centers, and Prostate Cancer International Research International: Active surveillance (PRIAS) study. The performance of each tool was evaluated with respect to discrimination and predictive accuracy. Results: The nomograms demonstrated slightly higher discrimination. However there was considerable overlap between the areas under the curve of different instruments with the exception of UCSF protocol that was clearly inferior to the nomograms. Up to 16% more patients with the same prevalence of organ-confined Gleason 6 cancer would have been selected by the nomograms compared to JH and UCSF protocols (Figure 1). The size of the subgroup selected by the PRIAS protocol was essentially the same as that of the nomograms when the cut-off points of predicted risk with the same positive predictive value were applied. Conclusion: PRIAS criteria demonstrate optimal balance between sensitivity and specificity and are not inferior to the available pathological nomograms in selecting patients with low-grade organ-confined prostate cancer. At the same time, the nomograms may be able to select more patients with the same risk of non-organ confined and/or high-grade disease when compared to JH and UCSF protocols.

Podium #10 DEFINING THE INCREMENTAL UTILITY OF PROSTATE MULTIPARAMETRIC MAGNETIC RESONANCE IMAGING AT STANDARD AND SPECIALIZED READ IN PREDICTING EXTRA-CAPSULAR EXTENSION OF PROSTATE CANCER Kae Jack Tay¹, Rajan Gupta¹, Alison Brown¹, Rachel Silverman² and Thomas Polascik¹ ¹Duke University, Durham, NC; ²University of North Carolina, Chapel Hill, NC Presented By: Kae Jack Tay, MBBS, MMed(Surg) Introduction: Multi-parametric MRI (mpMRI) is increasingly used in staging early prostate cancer but remains heavily reader-dependent. We aim to define the incremental utility of mpMRI over clinical parameters in determining pathological extra-capsular extension (pECE) of prostate cancer interpreted in a standard radiological setting and when further over-read by a specialized reader. Methods: Men with clinically-localized prostate cancer undergoing mpMRI and radical prostatectomy at our institution between 2011 and 2013 were retrospectively reviewed. Radiological prediction of pECE was obtained from standard radiological reports (standard- read) and by a specialized reader blinded to clinical/pathological findings (specialized- read). Performance metrics for standard read and dedicated over-read were determined. The incremental benefit of standard read and specialized-read were determined by sequential addition to a baseline clinical parameters-only logistic regression model predicting pECE. Results: Of 120 men, pECE was present in 46.7%. Standard-read mpMRI had an accuracy of 59%, sensitivity 77% and specificity 44% while specialized-read had an accuracy of 83%, sensitivity 86% and specificity 81%. The positive likelihood ratio was 2.1

106 PODIUMS - - test -

seful when

more aggressive prostate read influencedread post

nd >=2 comorbiditiesnd >=2 (both - income AA and White men - status, insurance status, and 2009. Men were 2009. Men queriedwere as to - ) AA). AAmen younger ) than were e a potential source of survivale a potential source of disparity,

25%, on multivariate p<0.001). However

read mayread particularly be u - vs. 107

¹, Joseph and Fowke¹ Acquaye², Jay Holmes², Arturo ¹, only model,only addingstandard 3.5 8.8 and read adding -

read. - foldhigher mortality,Whitecompared tomen. Although the - sparing approaches. - cialized American (AA) menAmerican diagnosed are (AA) with specific antigen (PSA) screening is controversial, variation in the the in variation is controversial, (PSA) screening antigen specific 53y, p<0.001), household and also reported53y, a lower income, less - - capsularmodestlympMRI extensiononly specialized negative at while or glandor -

vs. -

African Kelvin A. Moses, MD, PhD MD, Kelvin A. Moses, PositivempMRI at standard and specialized PSA screening practices strongly are associated socioeconomic with strata,

revious year (recent). Odds ratios generated (OR) were to determine odds of read. The negative likelihood ratio 0.4 was at baseline,0.5 adding standard Men age 40 and older completed age 40 and older a baselineMen the questionnaire as part of -

Analyses included men 31,755 (22,167 (69.8%

ods:

nclusion: particularlyWe populations. the among examine underserved sought impact to of socioeconomic trendsscreening PSA lowstatus among on enrolled in Southern CommunityStudy.the Cohort Meth utilization of prostate receiptscreening PSA postulated of has been to b Introduction: cancer (PCa), a 2.3 and have in the baseline clinical parameters whether they received ever had whether PSA testing (never/ever),theytesting and if had PSA within the p receipt of PSA testing adjusted age, for household income, status, insurance marital status, educational level and comorbidity. Results: prospective Southern Community Cohort Study from 2002 Kelvin Moses¹, Zhiguo Zhao¹, Yuqi Bi Yuqi Zhao¹, Zhiguo Moses¹, Kelvin Blot¹ William ¹Vanderbilt University Center, Medical Medical College, Nashville, ²Meharry TN; Nashville, TN Presented By: PATTERNS SCREENINGPSA OF INCOME LOW AMONG AMERICAN AFRICAN AND FROMWHITEMEN: SOUTHERN DATA THE COMMUNITY STUDY COHORT Podium #11 specialized White men (50y read and 0.2 and speread adding suggesting that racial differences PCa screening in relate to access healthcare rather than culturalpersonal factorsor to related race. analysis, controlling for differences inincome, educational comorbidity, race no longer significantly was associated PSA with screening. Across both race groups,screening PSA similarly associated increasing with income, educational status,status, insurance and comorbidity status. Co attained education, unmarried status, no insurance and Whitecompared to men (all White>=30menp<0.001). a BMIA higher percentage had of p<0.001). On univariate analysis,a higher percentage of AAmen had never received PSA screeningcompared White to men (75% Conclusion: probability of extra

read influencedread moderately. it Specialized considering nerve 106 Podium #12 PATHOLOGIC UPGRADING ON CONFIRMATORY BIOPSY IN A RACIALLY DIVERSE GROUP OF MEN ON ACTIVE SURVEILLANCE FOR PROSTATE CANCER Allison H. Feibus¹, Nora M. Haney¹, John Boxberger¹, Justin Levy¹, Elisa Ledet¹, Robert S. Libby¹, Jordan J. Kramer¹, Ian R. McCaslin¹, Krishnaro Moparty², Brian Lewis¹, Raju Thomas¹, Oliver Sartor¹ and Jonathan L. Silberstein¹ ¹Tulane University School of Medicine - New Orleans, LA; ²Southeast Louisiana Veterans Health Care Services, New Orleans, LA Presented By: Allison Feibus, BS, MS Introduction: To evaluate the clinical variables associated with upgrading at confirmatory biopsy among a racially-diverse group of men with prostate cancer (PCa) who elect Active Surveillance (AS). Methods: Following IRB approval, of the more than 260 men from our multi-institutional prospective AS database we identified 140 that had undergone at least 1 confirmatory biopsy since their initial diagnosis. Patients whose diagnosis was made on TURP, had any Gleason 4 on their initial biopsy or whose initial and confirmatory biopsy were more than 2 years apart were excluded. The analysis cohort included 121 men who had Gleason Score ≤ 6, clinical stage ≤ T2a and PSA ≤ 20 ng/mL. Disease upgrading on confirmatory biopsy was Gleason score ≥ 7. Multiple variables were examined as univariate and MV predictors of upgrading. Results: We identified 121 men who fit inclusion criteria, 55 (45%) African Americans (AA) and 66 non-AA (55%) with a median follow-up of 22 months. The median age was 66, median number of biopsy cores taken at diagnostic biopsy was 12 and median time interval between diagnostic and confirmatory biopsy was 12 months. On confirmatory biopsy, no evidence of disease was noted for 51 (42%) men (26 AA, 25 non-AA), 48 (40%) men (18, AA, 30 non-AA) had findings consistent with their initial biopsy and 22 men (11 AA, 11 non- AA) experienced upgrading at repeat biopsy. Of the 22 (18%) men who were upgraded, 18 (8 AA, 10 non-AA) upgraded to a Gleason score of 7, 3 (2 AA, 1 non-AA) were upgraded to a Gleason score of 8 and 1 (AA) had a Gleason score of 9. In univariate analysis AA race was associated with a greater number of positive cores (p = 0.04) and greater total prostate volume (p = 0.03) at confirmatory biopsy. Multivariate analysis was performed and none of the clinical variables examined (race, age, BMI, PSA, volume, PSAD, number of positive cores, total number of cores, percentage of positive cores, time between biopsies) were associated with upgrading on repeat biopsy. Conclusion: Our findings suggest that race is not associated with an increased risk of upgrading at confirmatory biopsy. AA with low-risk PCa are reasonable candidates for inclusion in most AS protocols and should not be excluded based on race alone.

108 PODIUMS

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The maxim The

voltage, nanosecond duration electric pulses. -

randon Otto,Foratrandon and Vincent Lufti Bird Podium #13 LITHOTR ELECTROPULSE CONTACT OF EVALUATION OF CAVITATION AND STONE FRAGMENTATION STONE AND CAVITATION OF AdamKaplan¹, Gautho²,Yang², Sankin²,Gerogy Preminger¹, Chen Glenn Michael Morgan Lipkin¹ and Pei Zhong² ¹Division University Urologic Surgery, of Center, Durham, Medical Duke ²Department NC; ofEngineering Mechanical Materials and Science, University,Durham, Duke NC Presented By: Introduction: of high Methods: coaxial probe that fits into the channel working of a rigid flexible or ureteroscope. We microfractureevaluated and cavitation formation treatmentthis activitystone with during developednewly lithotripter. evaluated sizes 3 probe with (2.4Fr, 3.6Fr, and 4.5Fr) at stand varying the target begostone (5:2ratio), ranging frommm. 0 to 8 Lithotripter settings 1J/5Hz. were Bubbleshape atmaximumthe captured was expansion a high with (Phantom v7.3, Vision USA). Research, Resultant damage to begostone the after 10 micropulses a with analyzed was Results: consistent standtested.for during 200 pulses probe the At each a volume at a stand 6mm, size, at decreased probe Req with than a distance greater 6mm, however Req increased th with Februarybetween 2012 and August 2015 at a tertiary careWe center. evaluated both ASA. their continuing patients in PCNL of complications and outcomes Results: Introduction: leads to increased cardiovascular and thromboembolic Since events. have 2012 we continuedASA inall patients undergoingWe PCNL. sought to review our experience to date. Methods: increased surgical bleeding. There is increasing evide is increasing There bleeding. surgical increased THE EFFECT OFCONTINUED IN PATIENTS UNDERGOING THERAPY ASPIRIN PERCUTANEOUS NEPHROLITHOTOMY (PCNL) (0.78±0.06mm3 vs. 0.42±0.14mm3, p=0.027).The same also probe demonstrated a significant decrease (Req=5.28±0.23mm versus Req=5.415±0.17mm, p=0.002). Conclusion: mechanisms inaddition associated to those elect with and cavitationwave In erosion). fact,more the importantmethod stone of fragmentation is likely nanosecond that of inside dielectric breakdown the stone.These resultsthat suggest the optimal use of the device isw Podium #14 B patientscontinued mg, ASA9 (11%) 81 continued ASAmg and 3 325 (4%) continued cardiovascular including demographics, for 1 Table (See perioperatively. clopidogrel history)mean mm. 37 (16) stone Them was timemediansize (SD) The OR 129 was a medianwith blood loss of 25 cc. 81 (96%) patients had a singleaccess site. Tract dilation performedwas balloon with dilation, Amplatz dilatorscombination of a or both in61 (73%), 8 (10%) and 14 (17%) of patientsrespectively. median The lengt configurationcrater demonstrated thecavitationleast largest the with damage effect. University of Florida, Gainesville, FL Gainesville, Florida, of University Presented By: medianchange in hemoglobin, hematocrit and creatinine 0.7 g/dL, were 2.1 g/dL, and 0.06 108 mg/dL respectively. 39 (46%) patients underwent a second procedure to clear residual stone. At the completion of all procedures, 79 (100%) patients were stone free. (See Table 1 for surgical details). The overall 30-day readmission rate was 10%. 21 (26.5%) patients experienced complications within 30 days: two grade I, thirteen grade II, three grade III and three grade IV. The major complications (≥ Clavien III) were: 2 episodes of sepsis, 3 pleural effusions requiring drainage and 1 displaced nephrostomy tube. There was 1 (1.3%) blood transfusion. No patients experienced a thromboembolic event. (See table 1 for complication data) Conclusion: PCNL appears both effective and safe in patients continuing ASA perioperatively. Postoperative hemorrhage was uncommon and this concern should not dissuade urologists from offering PCNL with perioperative ASA use to this patient population.

Podium #15 HUMAN MONOCYTES ENHANCE MACROPHAGE CLEARANCE OF CALCIUM OXALATE KIDNEY STONES Paul Dominguez, Sergei Kusmartsev, Benjamin Canales, Johannes Vieweg and Saeed Khan University of Florida, Gainesville, FL Presented By: Paul Dominguez-Gutierrez, PhD Introduction: We have reported that healing (M2) macrophages phagocytize and destroy of CaOx crystals in vitro. Furthermore, we have demonstrated that monocytes respond to specifically to CaOx by producing cytokines in a time- and dose-dependent manner. Based on these observations, we hypothesize that monocytes provide key stimulatory factors to facilitate macrophage clearing of renal CaOx crystals thereby preventing kidney stone formation in humans. Methods: Human primary monocytes were collected from healthy donors and seeded in 8- chamer glass slides with 200ul of complete media. For macrophage differentiation assays, monocytes were treated with 250 nmols of CaOx, potassium oxalate (K2Ox), and zinc oxalate (ZnOx), 20ug/ml of M-CSF (positive control), PBS (negative control). Differentiation was monitored at day 3 and 6 by staining for macrophage morphology. For phagocytosis assay, macrophages were pre-exposed to monocytes’ supernatant treated with 250nmols of CaOx, hydroxyapatite (HA) and PBS (controls). After 8h, macrophages were exposed to 250nmol of Qdot 525-labeled CaOx. Phagocytic changes were observed in an x200 field with a fluorescence microscope. Results: Primary human monocytes were exposed to CaOx, HA, and PBS. The

110 PODIUMS xposure of xposure

esting is most the esting

CSF still retainedmonocyte their -

saving. Urinalysis t Urinalysis saving. - y y macrophages comparable to that of the 111 CSF treatedmonocytes displayed complete -

aOx crystalsaOx monocytes induced primary human display to labeled CaOx labeledwithin1h of CaOx exposure compared to24h for HA and - thew Lyons,thew MD these transferredmonocytes were macrophages to 8h prior to adding

Concurrent urinary tractinfectionscan (UTI) be present inpatients with Mat

Although they cannot clear deposits alone, humanmonocytes capable are

labeled CaOx, resulting in the CaOx supernatantlabeled resultingthe CaOx, in CaOx stimulatingmacrophage -

ith of a history antibiotic use, indwelling/ stents catheters diversions, / or We consecutive retrospectively reviewed clinic a stone to patients presenting

Of 200 patientsOf presenting acute with nephrolithiasis, (15.5%) a UTI, 31 had

ds: PREDICTIVE OF VALUE URINALYSIS THE DETECTION FOR OFURINARY its/mL on urine culture. Factors that significantly were associated culturewith positivity Conclusion: cause differentiatemonocytesmonocytes to CaOx intomacrophages to aiding the in We clearanceclearance.speculatethatmonocytes play CaOx a crucial role and in prevention of kidney stone formation. enhancing macrophage uptake of crystals; CaOx furthermore, prolong e macrophagemorphology like M and K2Ox, ZnOx, while morphology. 6, At day and M CaOx morphology.macrophage K2Ox displayed ver untreated, displayedmacrophageZnOx no differentiation. and quantum dot uptake of quantum dot WithinPBS. days, 3 C supernatants of THE Presented By: Podium #16 INFECTIONSTRACT NEPHROLITHIASISIN ACUTE W.Koch, D. Christina Kerr, Peter Alan H. Lomboy, Matthew Lyons,Jason G. Zhou, Gary R. Viprakasit P. Davis and Gilligan Chapel Hill, NC Introduction: with a ureteralwith obstructingor stoneconfirmed renal tomography computed by and a corresponding urinalysis culture February 2013 and urine and August between 2015. w Patients commonly used screening tool for the presence ofUTI a until a confirmatory urine culture is available.Wesought to determine the performancecharacteristics of urinalysis for detecting nephrolithiasis. in UTIs patients acute with Metho immunosuppression excluded were fromthe analysis. Pertinent clinical and laboratory data medical obtainedwere records. the from Appropriate statistical made comparisons were basedculture on urine positivity and correlating urinalysischaracteristics. Results: on univariate analysis female gender, included nitrite positivity, leukocyte esterase defined as growth of a singleuropathogen at greater than or equal to 10^4 colony forming un symptomatic nephrolithiasis.Prompt identification of often an infection dictates acute management inthese patientsand canbe life 110 positivity, increasing bacteriuria, pyuria, number of squamous cells and decreasing urine clarity. 75% of positive cultures within the cohort were nitrite negative, including 58% of UTIs with gram-negative organisms. Pyuria greater than or equal to 11 WBC/hpf was seen in 84% of patients with positive cultures and 30% of patients with negative cultures. On multivariate analysis, however, only leukocyte esterase positivity, increasing bacteriuria and decreasing urine clarity remained significant. Using these variables, logistic regression identified ranges of predicted probabilities which correctly predicted 75% of positive cultures and 95% of negative cultures. Conclusion: In our cohort, 15.5% of patients presenting with acute nephrolithiasis have concurrent UTIs. An association between different characteristics within the urinalysis, specifically leukocyte esterase positivity, increasing bacteriuria and decreasing urine clarity, may potentially be used to more reliably predict the urine culture outcome in symptomatic stone patients. Further study with larger sample sizes is needed to verify these findings and determine the clinical benefit in the acute setting.

Podium #17 THE ROLE OF ROBOTIC SURGERY IN THE TREATMENT OF COMPLEX KIDNEY STONES – A SINGLE CENTER EXPERIENCE Erika Ibarra, Zachary Klaassen, Martha Terris and Rabii Madi Georgia Regents University, Augusta, Georgia Presented By: Rabii Madi, MD Introduction: The use of robotic-assisted treatment modalities for complex staghorn kidney stones has recently been reported in the literature. We report our initial experience and outcomes with robotic anatrophic nephrolithotomy (RAN) and robotic pyelolithotomy (RP) for the treatment of complex kidney stones. Methods: Between October 2012 and August 2014, 13 patients underwent 14 robotic surgeries for complex kidney stones (RAN n=8; RP n=6). One patient underwent bilateral RP in a single setting for bilateral renal pelvic stones. RAN was mostly performed in patients with full staghorn stones, and RP was offered to patients with large stones located in an extra renal pelvis. Most patients failed previous endoscopic intervention or had an anatomic variation that precluded such intervention. Variables of interest included demographic (age, gender, body mass index (BMI))and perioperative (pre, post-op day 1 and most recent) creatinine (Cr), warm ischemia time (WIT), robotic time, operative time, estimated blood loss (EBL), length of stay (LOS)) outcomes. Stone free rates and median follow-up are reported. Results: Among 13 patients undergoing robotic procedures, the median age was 54 (IQR 41-57) years, BMI was 31.2 (IQR 25.1-33.2) kg/m2 and preoperative Cr was 0.87 (IQR 0.81-1.25) mg/dL. Operatively, median WIT was 36 (IQR 31-42) min (for RAN patients only), robotic time was 158 (IQR 150-210) min, operative time was 195 (IQR 185-255) min, and EBL was 100 (IQR 75-100) mL. Median LOS was 2 (IQR 1-4) days, post-op day 1 Cr was 1.28 (IQR 0.84-1.51) mg/dL, and most recent follow-up Cr was 1.13 (IQR 0.81-1.41) mg/dL. All patients undergoing RP were completely stone free, while 50% of patients undergoing RAN were completely stone free. There were no perioperative complications. Three of five patients undergoing RP had known kidney anomalies (ectopic pelvic kidney, back-to-back pelvic fused kidneys, and ureteral pelvic junction obstruction). Median follow- up time was 2.0 (IQR 0.7-9.6) months. Conclusion: Robotic-assisted surgery of complex kidney stones is an emerging minimally invasive modality. Our RAN experience is encouraging, however early results suggest subsequent procedures may be necessary to achieve complete stone free rates in complex cases. Patients undergoing RP for renal pelvic stones have excellent stone free rates. Specifically, this approach may be indicated in patients with anatomic renal anomalies that are not amenable to traditional endoscopic options.

112 PODIUMS %)

UA, and UA, and ssified 1 1 ssified

UA stones,UA and 20 (5.3 -

UA calculi. Of the 3 categories, -

UA stones, misclassified 1 was a as lank pain, suprapubic pain, irritable - d the symptomatologyd the of patients with UA) and uric acid(UA) calculi. However, -

113 singlemineral laboratory compared and was to

98.3%). The sensitivities The corresponding98.3%). and 95%

uric (non -

- f non f

UA and UA calculi been less has investigated.thoroughly - Florida ECT, compared toECT, stone spectroscopy infrared analysis by (IR). imaging is reliableforcharacterization the ofmixed UA and UAAmong (10.0%). the non 343 - of a procedure to a procedure remove replace or theirof stents. Patient demographics

Since theirintroduction 1967, ureteral in the of use stents has been achieved theachieved sensitivity. highest UA stones.accurately DECT classified 365 (96.8%)of the stones analyzed UA) by D CharlesStoneburner, MD Lindsey Hartsell, MD M. DECT Dual energy CTDual (DECT),energy imaging a new modality, different uses two energy - -

We identified patientsmaterial stone with operativefrom removal or A previouslyureteral symptoms validatedstent distributed questionnaire was to

377 totalkidney stonesunderwent both stone analysis and DECT scan. Stone

s, pain, and othersince issues stent. having theThe into grouped responses were UA calculi - mixed UA/nonmixed Introduction: mixed UA/nonmixed of the 14 UA stones as a mixed stone (7.1%) and 2 of the 20 mixed stones were as non misclassified CIs range from 90.0% to 97.4% for theCIsfrom for to differentstone 97.4% types 90.0% miscla range (Table). DECT Methods: DECT. by characterization composition Results: spontaneous prior had undergone DECT scanning. passage,stone and who Kidney pathologic at performed was a analysis confidence(95% interval 94.5% (CI): analysis IR by identified (3.7%) 14 UA stones, 343 (91.0%) non Presented By: beamsto determine composition of substances, including urinary calculi. has DECT proven reliable in the characterization o non mixed stone (0.3%) and 8 were not characterized not stone (2.3%). mixed were DECT by (0.3%) and 8 Conclusion: composition calculi.Thisincharacterizationthe study confirms of degree accuracy a high of kidney stones DECT by including UA, UA mixed and non characterizationmixed of non thisThe aimthe assessstone study is to characterization accuracy of of (UA, non Podium #18 ENERGYACCURACY OF COMPUTEDDUAL IN THE TOMOGRAPHY COMPOSITION STONE KIDNEY OF CHARACTERIZATION Charles Stoneburner, WilliamCharlesStoneburner, Jepperson, Maria Haley, DavidThiel, Thomas and Colleen Joseph Cernigliaro Mayo Clinic Jacksonville, FACTORS AFFECTING URETERAL STENT SYMPTOMS STENT URETERAL AFFECTING FACTORS Podium #19 LindseyWake² Desouza², Hartsell¹,Paul Lau², Robert and Anthony Glen Rowena Murphy², L. Patterson² ¹UTHSC Memphis, TN; ²UTHSC,Memphis, TN Presented By: Introduction: commonplaceformalignant obstruction relief of for ureteral benign etiologies. and Symptoms greatly.the to related vary stentcan F voiding, and hematuria are common, though some experience no symptoms at all. voiding, no symptomssome all. experience common, though at and hematuria are Objectives: Our objectivedeterminemalignant toobstruction was causes if of opposed as to benign causes stricture, (stone, etc) influence ureteral stents.Age and gender alsowere for analyzed differences symptoms in related to ureteral stents. patientsthe at time and detailspertaining to theirstent collected were and paired thewith responses on the stent questionnaire. Questions on the survey detailed urinary symptoms, general health question SymptomsUrinary and GeneralIndex Health reflecting Index symptoms the their of respective category. for analyzed were Responses correlation regression with analysis and Methods: 112 Student’s t-test. Values were assigned to the questions to generate an index score with higher values indicating worse symptoms. The Urinary Symptoms Index score ranged from 11 to 50 and General Health Index score from 6 to 30. Results: There were 70 questionnaires used in the analysis. Reason for stent placement (malignancy versus stone disease) when correlated with Urinary Symptom Index was significant (p=0.026) with scores higher by 4.4 ± 1.9 for those with stones compared to those with malignancy. Female gender showed a higher Urinary Symptoms Index score of 3.9±1.9 (p=0.048). Comparison of age to Urinary Symptoms Index and General Health Index did not show a significant correlation. Reason for stent placement compared to General Health Index was also not significantly correlated. Conclusion: Those with malignancy and males tended to tolerate ureteral stents better than those with stents placed for stone disease and females, respectively. As opposed to ureterolithiasis, malignant obstruction tends to have a more insidious onset. This information may be useful in counseling patients about their potential experience with a ureteral stent. We are continuing to accrue data and hope to further demonstrate relationships between patient characteristics and their symptoms.

Podium #20 THE EFFECT OF ALANINE ON CELL VIABILITY AND OXALATE PRODUCTION IN PRIMARY HYPEROXALURIA TYPE 1 USING TRANSFORMED CHINESE-HAMSTER OVARY CELLS Mary Killian, Sonia Fargue, Ross Holmes, John Knight and Dean Assimos UAB Department of Urology, Birmingham, AL Presented By: Mary E. Killian, MD Introduction: Primary hyperoxaluria is a spectrum of autosomal recessive disorders that are caused by a defect in glyoxylate metabolism resulting in excessive oxalate synthesis and urinary oxalate excretion. These disorders may lead to kidney stones, nephrocalcinosis and oxalosis. Those afflicted are at high risk for CKD and ESRD. Primary hyperoxaluria type 1 (PH 1), the disorder which has the most profoundly negative impact on renal function, is due to a deficiency of the hepatic peroxisomal enzyme alanine: glyoxylate aminotransferase (AGT). AGT catalyzes the transamination of glyoxylate to glycine. Glycolate is the immediate precursor of glyoxylate. The latter is formed by the oxidation of glycolate catalyzed by glycolate oxidase (GO). Glyoxylate may be oxidized to oxalate catalyzed by lactate dehydrogenase (LDH). Absent, mistargeted or defective AGT results in increased generation of glyoxylate resulting in increased oxalate production. In addition to catalyzing the transamination of glyoxylate to glycine, AGT it is also an integral part of the alanine to pyruvate reaction. The goal of this study was to characterize the effects of supplemental alanine on the activity of various types of AGT in Chinese-hamster ovary cells (CHO). Methods: CHO cells transformed with glycolate oxidase (GO) and normal or mutant human AGT cDNA were initially incubated without and with various concentrations of supplemental alanine and subsequently exposed to differing amounts of glycolate. Viability assays were performed and the oxalate concentration of the media was measured by ion chromatography. Results: Supplemental alanine improved viability in cell lines expressing GO and the following types of AGT cDNA: AGT major allele, AGT minor allele, AGT Gly170Arg, AGT Gly41Arg, AGT Ile244Thr, AGT Phe152Ile. The latter 4 are known mutations found in patients afflicted with PH1. In addition, with supplemental alanine, oxalate concentration in the media was decreased for the cell lines transformed with GO and AGT major allele, minor allele as well as the Gly170Ar, Ile244Thr and Phe152Ile mutants. Conclusion: These findings demonstrate that supplemental alanine reduces the generation of oxalate in this model system and improves cell viability. This suggests that the administration of supplemental alanine could prove to be a future method of reducing endogenous oxalate synthesis in certain patients with PH1 and perhaps those not afflicted with this disorder.

114 PODIUMS

tain frequency

Global 4 cycle, or immediately immediately cycle, or -

ue Bladder Capacity (TBC) anesthetized (s.c. 1.2 g/kg) - Division of Urology, Duke 5 Friedman Test and Dunn’s Multiple Friedman Test Multiple and Dunn’s

5 l series two, SNS was appliedwas series during thel two, SNS void, timed to mid to timed void, -

115 , Institute,for Research, Medical NC Durham,

fillcystometrograms. In experimental series we one, - urham,for NC; Research, ²Institute Medical Durham,

venous catheter and transvesical catheter. bladder The L6/S1 and Matthew O.Matthew Fraserand

Dawley ratsDawley urethane (n=24) were - 4

n TBC only occurred during the fourth 25% and second 50% periods

ed suture.with se data indicate that therapy timed to coincide with the final 25% of the coincidese indicatethe thatto final therapy data of timed 25% the with Sacral Neurostimulation (SNS) is an FDA treatment approved for urge BradleyA. Potts, BS

The

Female Sprague eclinicalstudies clinical common and that suggest use discontinuousmay use

In theIn first series,significant a only SNS increaseTBC observed in was was when

, ThaddeusS. Brink 4 INTERMITTENT SACRAL NEUROSTIMULATION SIGNIFICANTLY INCREASES

SNS baseline control values did not change in any systematic fashionseries. either systematicchange any SNSnot in control in values did baseline - Presented By: incontinence. The therapy has been most commonly used as a continuous treatment but several pr also be efficacious. the Using rat modelfor SNS, investigated we whether continuous SNS is required for increasing bladder capacity if or intermittent application targeted to cer phases of a filling cycle(e.g. immediately post Introduction: precedingcan voids) similar effects. produce Methods: University CentersVA Medical and Durham ¹Duke UniversitySchool,D Medical NC; ³DIvision Urology, University of Duke NC; Center, Durham, Medical Podium #21 LATE BLADDER CAPACITY Bradley C.Brooks²,Jillene A. Peterson³, Potts¹, E. DanielleAndrew J. Dwight M. Degoski², Nelson NeuromodulationInc., Research, Minneapolis,Medtronic MN; applied SNS at the onset of bladder filling for 25%, 50%, 75%, and 100% of the previous controlfilling cycleduration In (n=10). experimenta first,second,first third, second of and the fourth and 25% control and times fill 50% in random pseudorandom (all or randomized,followed 50% by 25% randomized) order. using analyzed Control the were TBC and test Comparisons Test. Results: applied for 75% 100% or cycleduration and 35%, (30 resp., p<0.05). In the secondseries, i increases significant and 43%,(32 resp., p<0.001). differences No inrandomization found. approaches were Pre Conclusion: and implanted a jugular with trunksnerve isolated were bilaterally and two electrodes placed were on each exposed nerve. Stimulating electrodes electrically were insulated parafilm with mineral and oil. The clos were wounds Animals mounted were Ballman in cages to ensuremovement of free the bladder catheter, connected was which to infusiontransducers. After pumpscontinuous and pressure control cystometry (0.1 ml/min), and before every stimulation period, Tr demonstratedwas single stable with of reoperation for battery replacement. The result also suggests important physiological differences different bladder the filling of that among should phases be explored. Funding Source: Medtronic Inc., Minnesota Minneapolis, to MOF bladder fill cycleis critical SNSeffects for for increasing bladder capacity.clinicalAstrategy taking advantage this of may principle battery improve life inpatients and reduce 114 Podium #22 POSITIVE OUTCOMES AFTER FIRST TREATMENT WITH ONABOTULINUMTOXINA PERSIST LONG-TERM WITH REPEAT TREATMENTS IN PATIENTS WITH NEUROGENIC DETRUSOR OVERACTIVITY Roger Dmochowski¹, Philip Aliotta², Bertil Blok³, David Castro-Diaz4, Pierre Denys5, Karen Ethans6, Manher Joshi7, Andrew Magyar8 and Michael Kennelly9 ¹Vanderbilt University Medical Center, Nashville, TN; ²Western New York Urology Associates, LLC, Cheektowaga, NY; ³Erasmus Medical Center, Rotterdam, The Netherlands; 4Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain; 5Hôpital Raymond Poincaré, Garches, France; 6University of Manitoba, Winnipeg, MB, Canada; 7Allergan, Inc., Irvine, CA; 8Allergan, Inc., Bridgewater, NJ; 9Carolinas Rehabilitation, Charlotte, NC Presented By: Roger Roman Dmochowski, MD, MMHC, FACS Introduction: A post-hoc analysis examined whether response to long-term onabotulinumtoxinA treatment is consistent with response to the first onabotulinumtoxinA treatment. Methods: Patients in a 3-year extension study (following a 52-week phase 3 study) received onabotulinumtoxinA ‘as needed’ based on their request/fulfillment of prespecified criteria. This analysis includes patients who received only the approved 200U dose during the 4-year study; patients were grouped by % UI reduction after first treatment: <25% (n=23), 25-49% (n=10), 50-74% (n=23), 75-99% (n=55), and 100% (n=84). Assessments included mean % UI reduction, change from baseline in Incontinence-Quality of life (I-QOL) total score, and AEs through 6 treatments. Results: 43% of patients (84/195) experienced 100% UI reduction, and 83% of patients (162/195) experienced ≥50% UI reduction after onabotulinumtoxinA treatment 1. Baseline characteristics were largely comparable across subgroups. For subgroups with mean UI reduction ≥50% after treatment 1, all subsequent treatments resulted in similar mean % UI reductions (64-93%) and consistent I-QOL improvements that were 2-3X the minimally important difference (≥11 points). Interestingly, in the 33 patients with <50% UI reduction after treatment 1, ~1/3 of these patients experienced ≥50% UI reduction with all subsequent treatments. Overall AE rates were similar across all subgroups and consistent across repeat treatments; UTI was the most common AE. Conclusion: NDO patients with ≥50% UI reduction after their first onabotulinumtoxinA treatment experience consistent improvements in UI and QOL over 4 years of repeat treatments. A <50% UI reduction after first treatment does not necessarily predict low response with subsequent treatments. Funded by Allergan, Inc.

Podium #23 ARE THE WOMEN WITH PERSISTENT STRESS URINARY INCONTINENCE AFTER MIDURETHRAL SLING SURGERY DIFFERENT FROM THOSE WITH RECURRENT SUI? Jessie Liang, Clifton F. Frilot II and Alex Gomelsky LSU Health - Shreveport, Shreveport, LA Presented By: Jessie Liang, MD Introduction: Midurethral slings (MUS) are an effective treatment for female stress urinary incontinence (SUI). However, women who fail sling surgery have not been typically separated into those who have persistent SUI (onset <6 weeks after MUS) and those with recurrent SUI (≥6 weeks). We hypothesize that there are specific characteristics in the cohort of women who have early or persistent SUI after MUS that may allow for prediction of recurrence in women who are initially continent. Methods: We performed an IRB-approved, retrospective chart review of women who underwent top-down RP and outside-in TO MUS at our institution with a minimum of 6 weeks of follow-up. Women who underwent previous anti-incontinence surgery were included. Pre- and postoperative assessment included pelvic examination, subjective SEAPI classification (Stress incontinence, Emptying, Anatomy (anterior vaginal wall descent), Protection (pad use), Inhibition (urge incontinence)), and quality of life (QoL)

116 PODIUMS - - obese obese age at -

tionships were were tionships groups for each increase in BMI in BMI increase -

se in BMI in those se in those in BMI

incontinence surgery or - surgical factors and their obese subobese - - obese counterparts. While non -

incontinencesurgery. Since the impact of -

0.2) in those cured and an - 117 0.5 obese) and a mean increa - WalkerWomen persistent with grades. prolapse - SS AFTER MIDURETHRALSS SLING SURGERYAFTER

in TO MUS at our institution. Inclusion criteria criteria Inclusion institution. at our MUS TO in -

approved, retrospectivechart ofreview women who - obese, mass index than the cured group (31.2mass thancured vs. 29.7, the p<0.05) group index - - women fit who the inclusion RP, (689 criteria TO). 373 Of skfor factor developing stress urinary incontinence and (SUI) up length vs. persistent cureSUI or vs. (36.7 and 19.3 15.4 0.1 non up of 12 months.up of 12 Pelvic of exam life and quality assessment was - - obese, +0.3 obese; both p<0.001). However, the changes in BMI in obese, in BMI changes p<0.001). obese; in However, the +0.3 both - essure, and Badenessure, and weight lossweight to been shown have has a salutary effect on SUI, obese follow

ically better SEAPIscores postoperative and QoL than either with group down RPdown and outside - James E. Pilkington, MD Pilkington, E. James mass index (BMI)mass calculationindex preoperative at assessment and at last follow Obesity is a ri Over 10% of MUS failuresmay first of withinthethe 10% Over of MUS occur 6 weeks

Shreveport, Shreveport, LA

- we aimwe to assesseffects the of longitudinal, postoperative changeweight SUI We performed an IRB

cantlyhigher preoperativepad use than(2.6 thosecured 2.3 and vs. 1.6,

We identified 1062 Out of 1371 women, 584 met ofOut 584 inclusion 1371 women, 221 TO). criteria RP, Mean (363 body

g concomitantsurgery with included. were MUS was Cure defined as absence of ecurrent SUI. Delayed recurrencemay be associated lower with QoL scores when but not the recurrent SUI (30.5).Women group inthe persistent recurrent and SUI groups had signifi p<0.01). Preoperative notscores SEAPI indices QoL and were statistically different thebetween persistentWomenrecurrent and SUI groups. recurrent with SUI had longer significantly indices.subjective defined was absence Cure of as SUI objective or no additional and procedures abstracted SUI. for hospital Demographicsclinic were the from charts. and Statistical conducted. evaluation was Results: these, cured 801 (75.4%) were of SUI, 116 (10.9%) while and 145 (13.7%) had persistent and recurrent SUI, statistically The respectively. 3 groups were similar inage, parity, valsalva leak point pr SUI statistically had a higher body Introduction: obese women significantly have higher rates of SUI after both retropubic (RP) and transobturatormidurethral (TO)slings than (MUS) theirnon surgical bariatricor women SUI with remaineligible curativefor anti Conclusion: postoperative SUI. postoperative period. These women to appear similar be demographically to those with r compared early recurrence. with Further researchinto non months, p<0.001).Of interest, women persistent with SUI had statistically better As scorespostoperative expected,SUI cured the the QoL than SEAPI recurrent group. and had statistgroup THE IMPACT OF WEIGHT GAIN OR LO OR GAIN WEIGHT OF IMPACT THE possible association recurrence with is ongoing. Podium #24 ANALYSIS COHORT LONGITUDINAL A FAILURE: OR SUCCESS ON E.James Pilkington, Gomelsky Alex II and Frilot F. Clifton LSU Health Presented By: weight lossweight sustainedcontinence stress gain or on after definitive sling been not has evaluated, underwent top cure. Methods: up and a minimumfollow - Women underwentconducted at who visit. previous each anti Results: havin subjective objective or SUI and no additional procedures forStatistical SUI. analysis was conducted. included included surgery 51±13 yearswas and mean follow up was 33±23 months. Of the entire cohort, 417 (72%) achieved cure of SUI. entire For the group, there a meanwas reduction inBMI from 29.8 preoperatively to 29.6 postoperatively ( from 30.8 to 31.3 inthose not cured (+0.5; p<0.001).When stratified into non (BMI<30, n=321) and obese groups (BMI≥30, n=263), there was a mean reduction in BMI inthose curedwere who ( who were not (+0.5were non who either direction too small were make to a clinicalWhen the difference. analysis was similarrepeatedthe forgroups, MUS in RP the rela and TO women observed forcohort, as the obese well as the entire and non 116 MUS procedure. Conclusion: Weight loss may be associated with cure and weight gain may be associated with persistent or recurrent SUI after either RP or TO MUS surgery. In this study, the amount of weight lost or gained in either the obese or non-obese groups were likely too small to make a clinical difference in either the RP or TO MUS groups. Patients should be counseled that weight loss or weight maintenance after sling surgery may confer a beneficial effect on postoperative stress continence.

Podium #25 THE EFFECT OF SURGEON EXPERIENCE, NEPHROMETRY SCORE, AND BODY MASS INDEX ON PERIOPERATIVE OUTCOMES FOLLOWING ROBOT ASSISTED LAPAROSCOPIC PARTIAL NEPHRECTOMY Russell Terry¹, James Mason¹, Matthew Sorensen² and Li-Ming Su¹ ¹University of Florida Department of Urology, Gainesville, Florida; ²University of Tennessee Division of Urologic Surgery, Knoxville, Tennessee Presented By: Russell Terry, MD Introduction: Case complexity can be influenced by many factors, some related to the surgeon and others related to the patient. We sought to assess the effects of surgeon experience, R.E.N.A.L. Nephrometry Scoring (NS), and patient body mass index (BMI) on perioperative and renal function outcomes following robotic assisted partial nephrectomy (RAPN). Methods: We retrospectively reviewed 227 consecutive RAPNs performed by a single surgeon at a tertiary care academic hospital over a 6 year period. To examine the effect of surgical experience, cases were divided into three equally divided eras between 2008- 2014. To examine the effect of NS, cases were divided into three groups based upon NS complexity: low (4−6), medium (7−9) and high (10−12). To examine the effect of BMI, patients were divided into four groups based upon BMI: normal (18−24.9), overweight (25−29.9), obese (30−34.9), morbidly obese (>35). Parameters compared included patient age, BMI, NS, OR time (ORT), warm ischemia time (WIT), EBL, length of stay (LOS), pathologic tumor size (TS), positive surgical margin (PSM) rate, postop change in eGFR at one month (∆GFR), ASA score, and perioperative complication rate (Comp%). Statistical analyses were performed using ANOVA, Chi−square, and student’s T-test with a p value of <0.05 indicating statistical significance. Results: With increasing surgeon experience, significant increases were observed in NS (p<0.001), TS (p=0.015), and ASA score (p=0.002) whereas BMI, ORT, WIT, WBL, LOS, PSM, ∆GFR, and Comp% were unchanged. Higher NS complexity was associated with higher BMI (p=0.05), longer ORT (p=0.046) and WIT (p<0.001), and increased Comp% (p=0.03). No differences were observed in the other variables. With increasing BMI, significant increases in ORT (p=0.03) and ASA (p<0.001) were observed. No differences were observed in the other variables. Conclusion: Our analysis indicates that as surgeon experience increases, patient and tumor complexity also increases without compromising perioperative or renal function outcomes. As NS increases, longer ORT and WIT are seen with elevated Comp%, which may be useful for patient counseling. Finally, while increasing patient BMI was shown to correlate with increased ORT and ASA, it ultimately had no effect on complication rates or renal function outcomes, suggesting RAPN to be a safe and effective technique regardless of patient BMI status.

Podium #26 URINE LEAK RATES IN HIGH-RISK PATIENTS UNDERGOING MINIMALLY INVASIVE PARTIAL NEPHRECTOMY WITHOUT COLLECTING SYSTEM CLOSURE Adam Berneking, Seth Broster, Stephen Strup and Jason Bylund University of Kentucky Department of Urology, Lexington KY Presented By: Adam Berneking, MD Introduction: Minimally invasive partial nephrectomy (MIPN) has become the gold

118 PODIUMS

vs. risk

- ,

assisted -

9%, p=0.77) − bilization the of vs.

assist, robot and - nephrectomy shows superior

stem is entered during resection the of poreal suturingWe ischemia during time.

, 1.7% overall, to, compared reported rates Hemal²

. 10%, p=0.53), 2 days (−9% − on of urine leakon of formation. urine 119

13%. Our UL rates for low risk13%. rates Our UL for (NS low <7; n=70), stratified rates of 1.3, 7.4,and 13.6%. Based on vs. -

extrarenal (ER) RPS,extrarenal patients our IR an with pelvis

MD; ²Wake Forest Baptist Health, WinstonBaptist ForestSalem ²Wake MD; Health, 0mg oral dose sildenafil of immediately prior RAPN

, vs. nd Ashok K

ve outcomes including warm ischemia time (median 15 (median time ischemia warm including outcomes ve 1.7% for IR and ER scores,ERfor respectively. IR patients No and with 1.7% vs. atment of the small renal mass. dictatesthat Tradition formal smallrenal atment the of gible consecutive 9/2013gible between and patients undergoing RPN 9; high n=92), risk 1.4%, and (NS n=10) patients >9; were and 2.2%, 23.6% - Hilar occlusion at time of robot−assisted laparoscopic partial nephrectomy Charles Peyton,C. MD k factors for after MIPN, UL to none have knowledge our reported leak rates Our technique for minimally invasive partial

th secondary endpoints assessing post−operative renal functional outcomes

Of 40 eliOf We identified 172 patients met who all inclusion at criteria institution our from We performed an institutional board approved,review placebo controlled, double

Urineleak occurred in patients3/172

Krane¹, Peyton²Charles a

. riskformal patients collectingclosure withoutsystem. undergoing the MIPN of -

y 2006 to 2006 y February 2015. Urine leak defined was as persistentdrain output requiring NC Presented By: Introduction: qualitiesmodels inanimal We of reperfusion. ischemia a randomized conducted control humans.trial to effect this assess in (RCT) Methods: (Trial Registry: NCT01950923). Primary end point accrual, was participation and retention of patients wi criteriaand safety. Exclusionincluded coronary history artery disease, solitary of kidney, suspected benign intolerance pathology,females. PDE5i pregnant or min,16.5 similar. p=0.29) ineGFR were demonstrated similar Change decrease between sildenafil versus placebo at 1 day (−8% (RAPN) provides a bloodless fieldit for tumor excision, may cause however ischemia renal reperfusionwith injury. Phosphodiesterase 5 inhibitors (PDE5i)demonstrate renoprotective blinded RCT evaluating a single 10 Results: 12/2014, randomized 30 (75%) were to treatmentthere 100% was participation and and retention.matched well The groups were formeasured all comorbities and RENAL nephrometry score. Intraoperati ¹National Cancer Institute, Bethesda in high closure of the collectingclosuremorbiditytothe necessary preventof system potential is associated with postoperative urine leakthe from (UL) renal remnant. Although several studies have established ris standard surgicaltre for RANDOMIZED DOUBLE BLINDED PLACEBO CONTROLLED TRIAL OF SILDENAFIL SILDENAFIL OF TRIAL CONTROLLED PLACEBO BLINDED DOUBLE RANDOMIZED FOR RENOPROTECTION CLAMPING PRIORHILAR TO IN UNDERGOING PATIENTS ROBOTIC ASSISTED LAPAROSCOPIC PARTIAL NEPHRECTOMY Podium #27 Louis S laparoscopicThese procedures.challenge results thatformal collecting dogma accepted preventisystemclosurethe for is necessary outcomes respect with to urine compared leak when to traditionaltechniques that include formalclosure collecting the of technique system. Our reliable proven has in high preoperative renal impairment<60; n=25) developed (eGFR a leak. One of patients six a UL.(16.7%) mass developed renal with >7cm Conclusion: patients and eliminatesthe extra intracor need for successfullyhave applied approach our to lap, pure hand from other large series ranging from 3 Methods: kidney. After resectionmass,the of a fibringlue patchis placedthe surgical within defect and securedmadeclose collectingsutures. bolstering to with attempt the No is system nor ureteralare catheters the placed when collectingsy Wetumor.stratified on RENAL patients nephrometry based score Renal (NS), Pelvis Score (RPS), other perioperativefactors and risk to for previously shown increase UL. Results: any interventionany (i.e. persistent percutaneousstenting, drainage, ureteralsurgical Our etc). technique involves routine hilar control after isolation of the tumor and mo Ma (n=135) had a UL rate of 2.2% and those with an ER pelvis (n=36) had no leaks, comparedhad no leaks,ER pelvis (n=36) those an with and rate 2.2% (n=135) had a UL of to literature rates of 0%, respectively,compared to reported moderate risk 7 (NS the classification intrarenal of (IR) 118 and 1 month (−4% vs. −6%, p=0.31) following RAPN. Intermediate follow up (median 183 days) demonstrated similar results (−8% vs. −1%, p=0.16) between the two cohorts. Safety profiles were not different between the two cohorts without any adverse reactions to the sildenafil. Conclusion: In this placebo controlled double blinded randomized trial, sildenafil does not appear to have a significant renoprotective role prior to renal hilar clamping in robotic partial nephrectomy.

Podium #28 PREDICTORS OF OVERALL SURVIVAL IN PATIENTS WITH STAGE I RENAL CELL CARCINOMA Jason Lomboy¹, Allison Deal², Angela Smith¹, Michael Woods¹, Eric Wallen¹, Matthew Nielsen¹ and Mathew Raynor¹ ¹The University of North Carolina School of Medicine Chapel Hill, NC; ²The University of North Carolina Lineberger Comprehensive Cancer Center Chapel Hill, NC Presented By: Jason R. Lomboy, MD Introduction: There has been a continued increase in the incidence of renal cell carcinoma, largely driven by the rise in early stage RCC. This stage migration is thought to be due to increased detection of incidental small renal masses. Historically, the majority of small renal masses have limited metastatic potential and harbor more indolent pathologic features. With this stage migration, there has been increased utilization of nephron-sparing procedures. Prior studies have shown overall survival advantages of nephron-sparing intervention. We sought to identify predictors of overall survival in patients with Stage I RCC. Methods: Using the National Cancer Data Base, we identified all patients with Stage I RCC between 1998 and 2008. Cases were censored through 2008 to allow for full 5-year follow- up for survival analysis. Univariable and multivariable analyses were performed to identify predictors of overall survival. Results: Between 1998 and 2008, a total of 97,132 cases of Stage I RCC were identified. Mean age at diagnosis was 60.24 with a slight male predominance (57.8% vs. 42.2% female). Intervention included nephrectomy, partial nephrectomy, ablation, none, and other in 67.8%, 24.5%, 3.4%, 3.2%, and 1.1%, respectively. On multivariable analysis, multiple demographic factors were predictive of lower overall survival (male sex, age, year of diagnosis, African American race, lower income, Medicaid/Medicare/uninsured, and facility type). Partial nephrectomy was strongly associated with improved overall survival (HR=0.706, p<0.0001). Multiple pathologic factors were also independently predictive of

120 PODIUMS

5 group 5 group are also are -

S in patients S in patients lorida; lorida; operative MAP - H LOCALIZED LOCALIZED H

Meier (KM) curveswere -

culated pre culated th risk of progression, with

umber of hematuria evaluations. We evaluations. hematuria of umber linic Florida, Jacksonville, FL Jacksonville, Florida, linic ents of perinephric fat thickness and outcomes.We assessed the association variate proportional cox hazards models - 5) were more were 5) likely be male, to older, have - 4.52], p=0.032). Of interest, the association - 121 3) yields a hazard ratio of 2.16theof yields ratio 3) for 4 a hazard -

operative imaging. Kaplan 5) 5) associatedare decreased with PF - urology pathway for managingurology pathway for hematuria consults, - -

4.06, p=0.017). Adjustment BMI for didnot alter the

- UROLOGY PROGRAM FOR OUTPATIENT OUTPATIENT FOR PROGRAM UROLOGY - E

size (allsize p <0.01). notscoresare High MAP associated with grade (gradegrade and 4) 3 and marginstatus predictive (positive) were

sectional imaging measurem imaging sectional - scores and follow up datascores tofollow scores PFS. Dichotomizing assess MAP and 5) and low (MAP and low 5) 0

- adjusted =2.20 HR [1.07 11.24], p=0.039). - - The Mayo Adhesive ProbabilityAdhesive The Mayo scoresystem is a validated scoring (MAP) Recent guideline changes have relaxed the changes definition relaxed have Recent guideline microscopic of High MAP scores (4 Andrew J. Davidiuk,Andrew MD Ilan Joseph Safir, MD Partialprovides nephrectomy a significant overall survival advantage in

ersity School of Medicine, Atlanta, GA; ²Veterans Affairs Medical Center, We identified 456 patients from a prospective registry surgically treated for

5) for each patient with pre for5) patient each with

3 group (95%3 group CI: 1.15 - Patients with high MAP scores (4 scores MAP high with Patients 3). aggressiveness These findingsmay perinephric be associated with indicatefat RCC - Introduction: patients Stage with I histology, RCC. Tumor tumor grade, and marginstatus of overall survival. worse Conclusion: survival. Chromophobe histologyassociated was improved with overall survival (HR=0.788, p<0.0001). Higher tumor WIT IS ASSOCIATED SCORE (MAP) PROBABILITY ADHESIVE MAYO independently predictive of survival. Multiple demographic and social factors also are care. of disparities potential highlighting further survival, with associated significantly Podium #29 RENAL CELL PROGRESSION CARCINOMA SURVIVAL FREE Steven Custer³, Kaitlynn Serie³, Daniel Camille Meschia¹, Andrew², Thiel¹, David Davidiuk Parker³Petrou¹Alexander and ¹DepartmentFlorida, Clinic Urology, of Jacksonville, Mayo Clinic F ²Mayo FL; ³Department Sciences Research, C Health of Mayo - (0 scores Methods: localized 2002 and between 2014. RCC single cal A reviewer Presented By: stranding used to predict adherent perinephric fat. Given previously studied links between inflammation tumorigenesis, and RCC hypothesized we that higher MAP scores are associated renal poor with cell carcinoma (RCC) score progression survivalof free patients RCC. (PFS) and with MAP in derived from cross utilized to estimate PFS. Univariate and multi usedwere to estimate the association ofscore MAP wi adjustmentcovariates for such age, (BMI), mass body index as and SSIGN (Size, Stage, Grade, Necrosis) scores. Results: nodal status (p=0.28), necrosis tumor (p=0.37), sarcomatoiddifferentiation (p=0.33), type or of surgery ((nephrectomy vs. partial nephrectomy) p=0.71). total our Of cohort, 405 patients had MAP 4 (MAP high into higher BMI, and larger tumor versus 0 Introduction: association (BMI association report on results from a new telereport on results new from a hematuriamayand significantly have increased the n Atlanta, GA Atlanta, Presented By: IlanSafir¹,Salil Baumgardner², James Gabale¹,SamuelJonathan David¹, Huang¹, Steven Gerhard¹, Irina Kirillova²,Issa¹ Filson¹ Christopher and Muta ¹Emory Univ HEMATURIA REFERRALS: INITIAL RESULTS PATIENT SATISFACTION AND thickness and stranding. TEL OF A IMPLEMENTATION surgically treated for clinically localized compared RCC to patients lowerwith MAP scores (0 Podium #30 Conclusion: with MAPwith and PFSconsistent remains among pathologic stage patients RCC T1 (n=287 (HR = 3.46 [1.06 120 including a survey of patient attitudes and satisfaction with such a program. Methods: Patients referred to the Atlanta Veterans Administration Medical Center with hematuria were scheduled for a tele-urology clinic encounter utilizing a telephone call to obtain hematuria-related clinical information via a standardized algorithm. At subsequent cystoscopy, patients were evaluated with a 29-question survey regarding overall acceptance and satisfaction of the clinic (8 questions) and impact factors (21 questions). Results: 150 veterans participated in the survey. Median time from consult request to appointment was 12 days and thereafter to cystoscopy was 16 days. Patients reported high acceptance and overall satisfaction with telephone evaluation; mean scores exceeded 9 out of 10 for overall satisfaction, efficiency, convenience, friendliness, care quality, understandability, privacy, and professionalism. When presented with a choice, nearly all patients (98%) preferred telephone-based visits to face-to-face clinic appointments. Underlying negative factors responsible for patients’ preferences included transportation- related issues (97%) and logistical clinic issues (64%). 97% of patients reported a high quality evaluation. Conclusion: Patients report high acceptance and satisfaction with telephone clinics as a mechanism for expedited hematuria evaluation, primarily due to avoiding barriers related to transportation and clinical operations, as well as a perceived high quality of evaluation. Telephone appointments have potential to positively impact healthcare access and productivity.

Podium #31 THE FLOW QUESTIONNAIRE: DEVELOPING A NOVEL INSTRUMENT TO EVALUATE LOWER URINARY TRACT SYMPTOMS IN MEN Daniel Heslop¹, Lisa Sherden¹, Consuelo Wilkins², Ken Wallston³ and Kelvin Moses2 ¹Meharry Medical College, Nashville, TN; ²Vanderbilt University Medical Center, Nashville, TN; ³Vanderbilt University School of Nursing, Nashville, TN Presented By: Daniel Heslop, BS Introduction: The American Urological Association Symptom Score (AUA-SS) is the gold standard instrument used to assess lower urinary tract symptoms (LUTS) commonly associated with benign prostatic hyperplasia (BPH). However, completion of the AUA-SS may be difficult, as it requires adequate literacy and numeracy skills. This study aims to determine community levels of literacy and numeracy and to pilot a novel method of assessing LUTS in men. Methods: A trained researcher recruited 64 men from clinics at Nashville General Hospital, a safety net county hospital in Nashville, TN. Exclusion criteria included age <40 years or >75 years, blindness, non-English speaking, and untreated psychiatric disease. We obtained demographic data and assessed literacy and numeracy using validated tools including: the revised Rapid Estimate of Adult Literacy in Medicine (REALM- R), the Schwartz-Woloshin numeracy instrument and the Subjective Numeracy Scale (SNS). Patients were then administered a 4-item questionnaire to assess LUTS covering the following domains; Frequency, Incontinence (Leakage), Nocturia (Overnight voiding), and Weak stream (FLOW). Time to complete the FLOW questionnaire was measured. Results: Thirty-seven men (57.8%) had a reading level below the 6th grade. Twenty-two men (34.4%) had low to no numeracy (SNS score < 2). The median time to complete the FLOW questionnaire was 18.0 seconds (IQR 15.8-21.0). The mean number of positive responses to the FLOW instrument was 1.7. Sixteen men (25%) reported zero symptoms, while the number of men who reported one, two, three, and four positive responses was sixteen (25%), eleven (17%), twelve (19%), and nine (14%), respectively. A subset of 28 patients was re-administered the FLOW questionnaire two weeks later and there was no significant difference in the mean number of positive responses (1.6). Test-retest reliability was 0.91. Cronbach’s alpha, a measure of internal consistency, for the FLOW was 0.67. Conclusion: The majority of men recruited from clinics at a safety net hospital had low literacy and numeracy scores, yet were able to complete the FLOW instrument with no difficulty. Using the novel FLOW instrument in this pilot group to measure urinary function is rapid and consistent, and represents a promising avenue for further research in assessing

122 PODIUMS - - Scott - primary primary vs.

based outpatient based - stitute, Durham, erall costcare of for , NC; ²Department, NC; he Nationalhe Centerfor hospital Division of Urologic Urologic of Division - 4 rvey ofrvey non

ed care during 34% of visits.Patients seen

123

4 rvices and physician specialty. Visits were identified identified were Visits specialty. physician and rvices versus urology by patient or sex metropolitan location.

sectional ambulatory visits analysis of for patients with

- uneven workforceuneven distribution reducestocare access urologic in 11%, p = 0.007) than those seen in urology. There were no =0.007) in those There seen were urology. than p 11%,

sts represented presentationstone new (p<0.001 a of structure of the NAMCS.structure of vs.

Urinary stoneUrinary is disease a highly prevalent condition inthe United States, Melissa MD Mendez, A substantialA of portion ambulatory visits for patients kidney stones with

CM diagnosticCM codes. National estimates compared were using the Rao

- h urinary stones in the Unitedtheh urinary stones States. in We cross performed a 9

- During the study period, an estimatedmillion 10.6 ambulatory visitsfor patients

RIMARY CARE BURDENRIMARY OF STONEURINARY DISEASE THE UNITED IN

ne. Further research is to gain required a better understanding of utilization, variation, Introduction: affecting nearly 1 in11 persons in their lifetime. stones Many pass without requiring surgical intervention, and Surgery, DukeCenter In and Duke University Clinical Research Medical NC Presented By: many areas. Patients may be initially evaluated or managed by primary care physicians. Patientsmayinitiallymanagedmany care be primary physicians. evaluated by areas. or Given thiscontext, sought characterize we to the utilizationprimary of care visits for wit patients tractupper stones 2008 and 2010 using between the National Ambulatory Survey Care (NAMCS). NAMCS ismultistage a probability su Methods: visits inthe States.It United specifically is designedto provide nationally representative patient regarding includes information survey The utilization. of healthcare estimates demographics, health conditions, se using ICD Results: with upper tract upper with Urologists stones occurred. providedmore carethan at half just these of visits (56%), and primary care physicians provid inprimary care were younger (49.4 vs. 53.1 years, p =0.01) and more likely to be of non ethnicitywhite (26% third of urologi to visit care). Conclusion: occursthe in primarysetting. of care thesesymptomatic Many onset for are a visits new of sto and outcomescare of for these patients. For patients not surgical requiring intervention, treatmentmayina primary setting care provide a lever to reduce the ov kidneythe stones States. in United differences invisits to primary care Most visits (61%) to for primary a care were stone new presentation, a smaller with proportioncontrast,stone forInchronic a recurrence one of only about (16%). disease THE P AdvancingTranslational Sciences,Vanderbilt Institute for Clinical and Translational Research VR11947 (KM), U.S. and the Services Resources Health and Administration (HRSA),Faulkner, Marquetta D34HP16299 (Dr. PI) Podium #32 STATES MelissaEbonyJohn Boulware², Sharon III³, Ragsdale Hull³, Mendez¹, Michael Lipkin¹, Glenn Preminger¹ CharlesScales and LUTS, even in men with limited literacy. men limitedLUTS, literacy. with in even Funding: No. Supported UL1TR000445 from CTSA by award t ¹Division University Urologic Surgery, of Center, Medical Duke Durham of Medicine, University Medical Duke ³Department NC; Center, Durham, Community of and FamilyMedical Medicine, University Center, Durham, Duke NC; chi square test univariate or regression, linear as appropriate.Allanalyses accounted for sampling complex the 122 Podium #33 THE RELATIONSHIP BETWEEN TRAVEL DISTANCE TO CYSTECTOMY AND LIKELIHOOD OF READMISSION Jason Lomboy, Matthew Macey, Troy Sukhu, Anne-Marie Meyer, Ke Meng, Matthew Nielsen, Raj Pruthi, Eric Wallen, Michael Woods and Angela Smith Chapel Hill, NC Presented By: Jason R. Lomboy, MD Introduction: Population-based estimates of readmissions following cystectomy range from 25-43%. Recent studies have investigated the relationship between complications and other patient- and hospital-level factors; however, the relationship between distance traveled for surgery and risk of readmission remains unclear. We hypothesized that larger distances would increase the risk of readmission following surgery. Methods: Using a linked data resource combining NC Central Cancer Registry with administrative claims data from Medicare, Medicaid, and private insurance plans, we included adult patients undergoing radical cystectomy for bladder cancer from 2003-2008. Complications were carefully coded and grouped based on previously published standards: genitourinary, gastrointestinal, wound, infection, venous thromboembolism, and others. Travel distances were calculated by using straight-line distances between zip codes of the patient and cystectomy provider. Bivariable analyses were performed, and multivariable logistic regression was used to evaluate the association of travel distance to cystectomy with likelihood of readmission within 30 and 31-90 days. Results: Of 735 patients who underwent cystectomy, 171 (23%) were readmitted within 30 days, and n=156 (21%) were readmitted between 31-90 days. Mean age was higher among those readmitted, but was statistically non-significant. No significant differences were noted based on race, stage, comorbidity status, or complication type. However, on bivariable analysis, distance to the cystectomy provider > 30 miles was associated with a higher likelihood of readmission (p=0.0009). On multivariable analysis, the only predictor of 30-day readmission was a longer travel distance to the cystectomy provider (table 1). Results were also analyzed for 31-90 day readmissions, but no significant predictors were identified. Conclusion: Longer travel distance to a cystectomy provider is associated with higher 30- day readmission rates, suggesting that complications occurring during this time period may benefit from closer follow-up.

124 PODIUMS

R=1.035, 95% R=1.035, 95% nt difference was difference was nt and actmedical on

f complications after radical radical after complications f operative complicationsoperative were - 15, range 3 to 15). Lower BHLS BHLS 3 to range Lower 15, 15). - 0.986 respectively). Similarly, an

–

llslog interaction and to any each with day postday - 0.995).

- 125 day postoperative period (commonly referred to operative complications. - d database and identified d database and 368 patients who - over a 3 month a 3 period.over

Dindo classification.We performed bivariate and - verall”, “major” III, (grade and “minor” IV), I, (grade II)

and 90

er, Department of Urologic Surgery,er, Department Urologic Nashville, of TN; -

DAY POSTOPERATIVE OFFICE ENCOUNTERS OFFICE POSTOPERATIVE DAY - VASIVE BENIGN PROSTATIC HYPERPLASIA (BPH) (BPH) HYPERPLASIA PROSTATIC BENIGN VASIVE

alth literacy is an increased associated with likelihood having of AND 90 AND

Vaporization Prostate the of Laser (GLS), and Holmium Enucleationthe of

Health literacyHealththe ability is to comprehend obtain, Kristen R. Scarpato, MD, MPH MD, Scarpato, R. Kristen Ram Pathak, MD At institution, our main three surgical options (>30 cases/year) exist for BPH

Lower he Lower

period) for procedure. each period)

We performed a retrospective of all review patients underwent TURP, who GLS, Since November 2010, all patients admittedto Vanderbilt University Medical 1.070 and OR =0.907, 95% CI: 0.834

The overall complication rate 42.7%,was 8.4% with categorized as major and - A total of patients 291 consecutive underwent who TURP (N=199, mean age 71,

approved, prospectively manage - operatively (OR = 0.915, 95% CI: 0.841 CI: 0.915, 0.841 operatively 95% = (OR -

Introduction: KristenA. Kappa¹, Joseph Scarpato¹, S. Sam Stephen R. Chang¹, M. Goggins², F. Kathryn DanielSmith,F.Penson¹,PeterE. A. J. Jr.¹, Clark¹, Barocas¹, Resnick¹, Matthew David A. Kelvin Moses¹ and Kripalani² Sunil ²Vanderbilt University Center, Medical Institutefor Public Medicine Nashville, Health, and TN Presented By: Podium #34 RADICAL FOLLOWING OUTCOMES SURGICAL ON LITERACY HEALTH OF IMPACT CYSTECTOMY ¹Vanderbilt University Cent Medical 34.2%minor. literacy health Median 13 (IQR score was 10 analyzed and grouped and analyzed according to “o Clavien to the according complication logistic regression analyses to evaluate the relationship literacybetween and riskmajor of and minor complications. Results: information, and is an independent predictor health of patients outcomes in chronic with health conditions. There few are data regarding its relationshipsurgicalWeto outcomes. hypothesized that health low literacy increasesthe risk o cystectomy (RC). Methods: underwent and had available RC health literacy data.Patienttumorcharacteristics, and as aswell operativedetails recorded. were All 30 Center administered are the validated Brief HealthWe Literacy Screen (BHLS). analyzed an IRB score was significantly associated with developing a minor complication (O minor a complication developing with associated significantly was score CI: 1.002 increasing associated score BHLS was a decreased with odds of having any complication post Conclusion: Conclusion: complications among patients undergoing RC and shouldbe considered caring when for these decreasein post to an effort patients - 30 ON THERAPIES IMPACT OF MINIMALLY IN MINIMALLY OF IMPACT Podium #35 Shah,RamBrennan, Diehl,KandarpPathak, Heckman, Emily Mike Nancy Gregory Wehle,Broderick, ThielPetrou,StevenTodd Dave Igel, Young Michael Paul and Florida Clinic Jacksonville, Mayo Presented By: Introduction: as the global failingmedical therapy: Transurethral Monopolar Resection of Prostate the (TURP), Greenlight Laser Prostate (HoLEP). The primary aim of the to study was compare the frequency of postoperative encounters inthe 30 Methods: Decemberfrom Januaryand HoLEP2012 through this 2014. Currently, institution’s it is practice protocolto record all ca phone postoperative patient inthe ElectronicRecord Medical (EMR). Therefore, all postoperative encounters suchcalls patient as questions, or catheter exchanges removals, or and hospital based readmissions recorded visits ED were or Results: meanBMI 28.5), HoLEP (N=60, meanmean age 68,BMI 28.1), GLS or mean (N=32, age 72, mean BMI 29.3) for BPH were included. statisticalNo significa 124 observed for age, BMI, pre-operative AUA symptom score or pre-operative maximum flow velocity (Qmax). 30 day postoperative encounters differed significantly between the three surgery types (P<0.001). Specifically, there were fewer encounters within 30 days of TURP compared to both HoLEP (≥1 encounter, TURP: 48.7%, HoLEP 66.7%, P=0.006) and GLS (≥1 encounter, TURP: 48.7%, Greenlight: 93.7%, P<0.001). The number of encounters within 30 days of discharge was less for HoLEP compared to GLS (P=0.021). When considering the number of encounters within 90 days postoperatively, these were also significantly lower for TURP patients (P<0.001) compared to both HoLEP and GLS, while no differences between the latter two surgery groups were observed. 51.3% of TURP patients had 0 encounters in the 30 day postoperative period while 33.3% and 6.3% of HoLEP and GLS patients had 0 encounters in the same time period, respectively. Hospital readmission rates were not significantly different between the three groups (P=0.71). Conclusion: TURP results in fewer postoperative encounters in both the 30- and 90-day postoperative period compared to HoLEP and GLS. More than half of TURP patients had zero encounters within the 30 day postoperative period while less than 1/3 of HoLEP and less than 1/15 of GLS patients had zero encounters within this same time frame. The impact on office staff must be factored into transitioning from TURP to GLS or HoLEP.

Podium #36 HIGH VALUE HEMATURIA CARE: IDENTIFYING COSTS OF A NOVEL CARE PATHWAY Tony Chen¹, Wendy Webster², Christopher Samples³, Mohammad Shahsahebi4, Michael Lipkin5, Glenn Preminger5, Sharon Hull4 and Charles Scales, Jr.5,6 ¹Duke University School of Medicine, Durham, NC; ²Surgery Clinical Operations, Duke University Medical Center, Durham, NC; ³Hospital Ambulatory Care Operations, Duke University Medical Center, Durham, NC; 4Department of Community & Family Medicine, Duke University Medical Center, Durham, NC; 5Division of Urology, Department of Surgery, Duke University Medical Center, Durham, NC; 6Duke Clinical Research Institute, Durham, NC Presented By: Tony T. Chen, BS Introduction: Asymptomatic microhematuria (AMH) is a common incidental finding. Evaluation often involves two patient encounters (consultation and subsequent procedure), which increases time from referral to workup conclusion, is burdensome to patients and may increase costs of care. Using the health system perspective, we compared costs of our traditional two-visit evaluation process with those of a novel single encounter process. Methods: We created a cost identification model to compare overall costs of the traditional and single-encounter pathways. First, a multidisciplinary team of primary care and urology providers and administrative leaders developed care process maps of the delivery value chain for microhematuria. Using the novel strategy of time-driven activity-based costing (TDABC), we then estimated indirect costs; direct costs were based on Medicare fees for the appropriate encounters. The team captured variables such as operational costs and process times in both evaluation pathway models to calculate personnel capacity costs. These calculations were applied to the evaluation pathway models to determine total cycle costs. Results: In the traditional evaluation cycle, the average total costs were $400; 75% were direct costs and 25% were indirect costs. By comparison, the single episode-based encounter reduced total costs by 15%. The majority of the savings accrued from lower indirect costs involved in the second visit of the traditional pathway. A number of modifiable personnel factors influence indirect costs. Assistance of resident physicians in the evaluation & management visit reduced indirect costs by 18%. Use of certified medical assistants in patient care reduced indirect costs incurred by registered nurses by 65%. From the patient perspective, projected time savings are substantial, including elimination of at least one office visit and the associated travel and opportunity costs. Conclusion: Using the novel costing approach of TDABC, we estimate that the cost of hematuria evaluation may be reduced by 15% through an innovative care delivery pathway. The new pathway may also improve value by freeing up additional return appointment

126 PODIUMS -

pletion time, time, pletion urinary findings findings urinary

ng to additional imaging, imaging, additional to ng urinary findings $75122 or was - ldbe substituted for CTU inthis

127 up up to 2015May reviewedwas to determine if

URINARY FINDINGS OF UROGRAM CT AND urinary findings, leadi urinary - - Use of RUS inplace ofscreen CTU to the tracts upper

urinary findings detected on CTU can lead to expensive l followl -

Lai, MD nal masses or stones, could then go on tocouldthen stones, CTU. go on masses or nal

rinaryfindings found in were 150 (74.3%) patients, requiring . u 2014. All genitourinary2014. and incidental (GU) extra - - two patientstwo evaluated CTU formalignancy with AMH. were GU urinary findings on CTU in patients with asymptomatic microscopic microscopic asymptomatic with patients in CTU on findings urinary - Win Shun V CT urography CT urography (CTU) is currently recommended to evaluate the urinary upper

The incidental extra incidental The

By: A retrospective performed review was to identify all performed CTUs for at AMH Lai¹, James Ellenburg²,James Kolettis¹Mark E. Peter Lockhart³ N. Lai¹, and

Two hundred hundred Two

expense ofexpense $41608.totalcost The related to extra ur costur identification identifies strategy multiple opportunities to improve healthcare

Introduction: tract for patients asymptomaticwith microhematuria (AMH). However the use of CTU also commonly reveals incidental extra setting. Methods: our institutionour from 2012 hematuriaand also to determine if renal ultrasound cou proceduresand referrals. The purpose of this to study was assess the costs associated extra incidental with valueincrease and patientsatisfaction streamlining by healthcare delivery. Asthenew ispathway implemented,futurestudies costs, actual assess will to referral com Win Shun slots.O EXTRA OF COSTS THE ASSESSING patient satisfaction and clinical outcomes. Source Funding: None of Podium #37 THE POTENTIAL ROLE INULTRASOUND OF THE EVALUATION OF ASYMPTOMATIC HEMATURIA MICROSCOPIC ¹Department Urology, of University Birmingham;Alabama at ofAlabama ²University of at Birmingham School Medicine; of Radiology, ³Department Alabama of at of University Birmingham documented.were Further clinica Presented

any additionalany referrals, tests, and/or procedures imaging ordered were based on the initial CTU. determined usingthe Costreimbursement estimates Medicare were physician rate. Results: adjusted was documentedwas in2 patients (0.99%), masses both renal suspicious for renal cell carcinomaSixty patients (RCC). found to kidney were have stones,of 26 had stones which ≥ 5mm. Incidental extra further imaging costs of $85.35 or $17242 patient per screened. patients Twelve required a $13898.57,cost of totalinpatient proceduresfor a hospital in resulting a 28 days 20 and of $371.89 initial per table).screened patient (See Conclusion: inpatients could AMH with avoid costs morbidity and these associated with incidental findings, still while adequately evaluating the urinary upper tract. Those positive with findingssuch on RUS, as re and invasive testing and treatment.

126 Podium #38 UNDERSTANDING THE TRAJECTORY OF SYMPTOMS AND FUNCTIONING IN THE 90-DAY CYSTECTOMY PERIOD Matthew Macey, Troy Sukhu, Jason Lomboy, Sarah Stanley, Allison Deal, Dana Mueller, Matthew Nielsen, Raj Pruthi, Eric Wallen, Michael Woods and Angela Smith Chapel Hill, NC Presented By: Matthew R. Macey, MD Introduction: Post-operative cystectomy recovery can be challenging for patients, and understanding how these symptoms change over time has not been well studied. We aimed to assess the trajectory of symptoms, emotional and social functioning following cystectomy through weekly and bi-weekly telephone calls. Methods: We administered a post-cystectomy telephone symptom survey to all cystectomy patients presenting between 9/2014 and 4/2015; weekly for the first 30 days, and bi-weekly from 31-90 days. Three question categories were included: symptom, emotional/social, and global functioning assessment for a total of 18 questions. Patients were asked if they were experiencing each symptom and if so, whether they would rate this as mild, moderate, or severe. Each symptom was evaluated at each time point, and general trends were assessed. Results: A total of 27 patients participated in post-cystectomy interviews, and completed a median number of 7 calls (out of a possible 9) for a total of 182 calls. Pain was present throughout week 12, but most severe at week 2 (29%). General gastrointestinal symptoms were also evaluated: nausea was worst at day 2, weeks 4 and 10 (23%, 32%, 25%). However, vomiting was much less likely and only reported on day 2, and weeks 8 and 10 (7-14%). Diarrhea appeared to be most severe and common in the first 2 weeks following surgery (up to 36%), but improved afterward. Constipation, on the other hand, was experienced by 6-35% throughout all 12 weeks. Appetite and bloating improved dramatically with time, with the majority (64%, 71%) reporting poor appetite and bloating within the first week but decreasing by week 12 (6%, 18%). With respect to emotional/social functioning, sleep was impacted throughout the entire 12 weeks, most severe in the first week (41%), but still present in 40% by week 12. Feelings of depression and anxiety were also common throughout the postoperative period, but most common in the first month (ranging from 14-36%). Difficulties with social functioning and walking were also most common in the first 2 weeks. Conclusion: Symptoms vary dramatically throughout the 90-day post-cystectomy period. While some issues such as diarrhea, poor appetite, bloating and mood disturbances occur most commonly in the first month, other symptoms such as constipation, nausea, pain, and sleep disturbances can persist up to 12-weeks following surgery.

Podium #39 EFFECTIVE TREATMENT OF URINARY BLADDER CANCERS BY GROWTH HORMONE-RELEASING HORMONE ANTAGONISTS: A PRECLINICAL REPORT Ferenc Rick¹, Petra Popovics², Norman L. Block², Karoly Szepeshazi¹ and Andrew V. Schally¹ ¹Miami VA Medical Center; ²University of Miami Miller School of Medicine Presented By: Ferenc Rick, MD, PhD Introduction: Urinary bladder cancer is the fifth most frequent cancer diagnosed and among the most expensive cancers to treat in the United States. The management of muscle-invasive tumors presents a clinical challenge because of the toxicity and limitations in efficacy and durability of current therapeutic modalities. Novel therapeutic strategies for this disease are of paramount importance. Growth hormone-releasing hormone (GHRH) receptors and its splice variant were detected in a series of urothelial malignancies and GHRH has been shown to influence the growth of these tumors. Herein we evaluated the effect of GHRH antagonists on the growth of various experimental human urinary bladder cancers in vitro and in vivo in nude mice. Methods: We investigated the effects of several GHRH antagonists MIA 602, MIA 606 and MIA 690 on growth of urothelial HT-1376, J82, and RT-4 tumors xenografted into nude

128 PODIUMS - -

related related

n of growth of of growth n of n tumor weights weights tumor n

71% in treated the gonists noted. was -

L). s and how theses and how are CTSA Grant Number - - man urothelial primary RELATED QUALITY QUALITY RELATED - 1376 tumors, the GHRH tumors,the GHRH 1376 - (PWB, P <0.001), emotional eastern United States. SECTIONAL STUDY SECTIONAL 70% decrease70% i aire (IPAQ - - Western blotting.

sitting time was negatively correlated (P < (P correlated negatively was time sitting

66% decrease in tumorin66% weights decrease (p<0.05). - 129

BS, BA 606 resulted in a similar marked inhibitio marked similar a in resulted 606 - 60%involume reduction and 52 - treatment settingsurvivorstreatment bladder cancer in warranted. are - 602 and MIA - studies investigatingcausalthe physical relationship between activity BETWEEN PHYSICAL ACTIVITY HEALTH AND 02. Its solelyare contents the responsibility authorsthe of and do not - Physical activity has to been shown significantly improve health Ajay Gopalakrishna, Gopalakrishna, Ajay Physical activity is positively associated in HRQOL with bladder cancer

Sciences,Institutesthrough National Duke Health, of We efficacy demonstrated antagoniststheirthe GHRH of of lack potent and Bl (PBl <0.001), FACT general (P <0.001), and trial (TOI, outcome index < P

Bladder cancer survivors identified through an institutional database mailed were

Thefor receptorsmain their and GHRH splice detected SV1, variant, were in A totalA 466 subjects of response (49% completed rate) survey.mean the The age

Bl) and the International and the Bl) Physical Activity Questionn g: This project a grant supported by was from the Foundation Urology Care - 4 cancers; tumor volume and weights were reduced about4 cancers; by weights 51 tumor were and volume - mice. receptors GHRH presence validated by of was The cancerthemodels.In HT bladder samplestumor 3 human all of Results: antagonistscaused a 30 (p<0.05). All three antagonistsstrongly inhibited a 62 by shown ofcancers growth J82 as 75%and 54 reduction tumor volume in Treatment MIA with RT Introduction: a survey that included the Functional Bladder Assessment Cancer of Therapy Cancer (FACT Results: was 73 years, male,was 80%White. were and 88% were Linear regression indicated a positive association physical between activity and physical being well well beingwell (EWB,functional P <0.001), and being (FWB,well P subscales, <0.001) as well as the FACT OF SURVIVORS: CROSSLIFE BLADDER CANCER IN A ASSOCIATIONS ASSOCIATIONS Conclusion: toxicity ininhibiting ofthe experimental growth models cancer of bladder in vivo. The expression of receptors GHRH detected was inmodelsall 3 hu of bladder carcinomas.findings Our warrant further development antagonistsGHRH of for clinical therapy of bladder cancer alone in or combination current with chemotherapeutic agents Explorationtheirmechanism of and action. of Fundin Research Scholars Program,the American Urological Association Southeastern Section the the Affairsand by Veterans Research Medical Service Department. of Podium #40 Ajay Gopalakrishna,Brant InmanFantony, Thomas Josephand Longo Duke University Medical NC Center, Durham, Presented By: groups (p<0.05).miceThe tolerated this therapy and organ well; body not weights were significantly changed by the treatments. toxicityNo from the antaGHRH quality of life and survivorship (HRQOL) in a variety of cancer patients. little However, is aboutknown the physical activity patterns bladder cancer of survivor related to in HRQOL the United States. Our objective to was describe HRQOL and self reported physical activityand examine patterns the association thesemeasures between in survivorsa large livingSouth bladder cohortthe of cancer in Methods: 0.001) composite scores. Conversely, total daily 0.01) all with of the aforementioned indices. Adjusting for demographic factors didnot alter findings. the Conclusion: survivors. Further theand HRQOL in post Acknowledgements: This publication supported was Advancing Center the by for National Translational 5TL1TR001116

necessarily of official NIH. represent the the views 128 Podium #41 ONCOLOGIC OUTCOMES AFTER ANTERIOR EXENTERATION FOR MUSCLE INVASIVE BLADDER CANCER IN WOMEN Justin Gregg¹, Curran Emeruwa², Johnson Wong², Matthew Resnick³, Daniel Barocas³, Michael Cookson4, Sam Chang³, David Penson³, Joseph Smith³, Kristen Scarpato³ and Kelvin Moses³ ¹Vanderbilt University Medical Center, Department of Urologic Surgery, Nashville, TN; ²Meharry Medical College, Nashville, TN; ³Vanderbilt University Medical Center, Department of Urologic Surgery, Nashville, TN; 4University of Oklahoma College of Medicine, Department of Urology, Oklahoma City, OK Presented By: Justin Gregg, MD Introduction: Female patients with muscle invasive bladder cancer (MIBC) traditionally undergo anterior pelvic exenteration. However, female genitourinary (GU) organ involvement is rare and removal can potentially affect urinary and sexual function. Our study aimed to identify tumor characteristics associated with female GU organ involvement. We hypothesized that a lack of trigonal or bladder floor tumor, intraoperative palpable posterior mass, and clinical lymphadenopathy is associated with a lack of GU organ involvement. Methods: We retrospectively reviewed charts of female patients who underwent radical cystectomy at our institution from 1999 - 2014. Patient and operative characteristics were extracted from the electronic medical record. Women who had a prior hysterectomy were excluded. We examined patient and operative characteristics as well as presence of hysterectomy for association with disease recurrence. Statistical analysis utilized chi squared and Student’s t-test. We evaluated if the three characteristics in our hypothesis were associated with lack of GU organ involvement in patients who underwent hysterectomy. Results: Out of 322 eligible patients, 164 (51.0%) did not have a hysterectomy prior to cystectomy. Of these, 143 (87.2%) underwent intraoperative hysterectomy. Mean follow-up time was 2.0 years (SD 2.7). Twenty patients (12.2%) recurred during follow-up. No patient or surgical factor other than use of adjuvant chemotherapy or radiation (p<0.01) was associated with recurrence. Thirty four out of 143 patients who underwent exenteration (23.8%) had female GU organ involvement. Thirty out of 102 patients (29.4%) who had a trigone or bladder floor tumor, palpable posterior mass or suspicious LN on preoperative scan had female GU organ involvement. Four out of 41 (9.8%) patients who did not meet this criteria had GU organ involvement (p=0.01). Two of the women who did not undergo anterior extenteration had a documented recurrence, neither of which involved the female GU organs. Conclusion: Rates of female GU organ involvement found during anterior exenteration for MIBC are higher than previously reported. Lack of trigonal/bladder floor tumor, palpable posterior mass and adenopathy on imaging may be associated with absence of GU organ involvement. Individualized risk assessment, patient preferences, and intraoperative findings should be used to guide surgical planning.

Podium #42 SURGICAL AND PATHOLOGIC OUTCOMES AFTER ROBOTIC-ASSISTED LAPAROSCOPIC AND OPEN RADICAL CYSTECTOMY AMONG HIGH-RISK PATIENTS Pranav Sharma, Kamran Zargar-Shoshtari, Michael Poch, Julio Pow-Sang, Wade Sexton, Philippe Spiess and Scott Gilbert Moffitt Cancer Center, Tampa, FL Presented By: Pranav Sharma, MD Introduction: Although many surgeons have extended robotic−assisted surgery to bladder cancer, the benefit of robotic−assisted laparoscopic cystectomy compared to open radical cystectomy is still unclear, and few have focused on high risk groups (e.g. advanced stage disease). We sought to evaluate postoperative and pathological outcomes of robotic−assisted laparoscopic and open radical cystectomy, focusing on high−risk patients. Methods: We retrospectively identified patients who underwent robotic assisted

130 PODIUMS 7,

- ancer ancer

n was used to to used n was w comparisons comparisons w 12) which was the the was which 12) - 373, p<0.001). There - September 2014. Clinical and

6) and ECUD 5 days 5 (IQR and ECUD 6) een January 2014 to June 2015. -

– 12, p=0.299). Days NPO alsowere -

operative data including length ofstay - KY

, focuscritically robotic areas where on

d pathologic outcomes not were significantly 131

CTOMY WITH EX VIVO URINARY DIVERSION URINARY VIVO EX WITH CTOMY e of high complications grade (>Clavien III) grade in

tectomies performed, were 36 of RARC. which Awere

D median days 5 (IQR 6 D O'Bryan, MD - formed ICUD 13 RARC with including 2 ileal conduits 4 (IC), ECUD 7, p=0.292), postoperative complications and final of Urology, Louisville Urology, of

. vs.

the ICUD (2/13) cohort though this was not significant (p=0.08). the ICUD (2/13) cohort though this not was significant (p=0.08). p of 18 patientsEach ECUD IC, (9 5 NB, 4 IP). with similar was group 487) compared487) to ECUD median (IQR 328 251 vs. -

er chance blooder of transfusions receiving intraoperatively (10.9 vs. 54.0%, Brittany E. E. Ewing Brittany Robotic assisted laparoscopic radicalcystectomy (RARC) for bladder c Short−term postoperative an

cystectomy radical open or cystectomy and ilealconduit urinary diversion for

ic cystectomy and 300 (84.5%) underwent open radical cystectomy. A total of A retrospective review comparing initial our experience RARC with ICUDwith During the study period,During the robotic (15.5%) 55 patients assisted underwent

To date we have per have Todate we

ession analysis, a robotic surgical approach not was independently associated with comes were compared surgicalcomes between were regressio Logisticapproaches. nd lower disease stage (p=0.009), less and were likely receive to neoadjuvant bladder cancer at institution our fromJanuary 2010 laparoscopic demographic factors,disease characteristics, postoperative complications pathological and out identify predictors of 30−day complications, prolonged length of soft−tissuesurgical margins (STSMs) in high−risk patients. stay (LOS), and positive Results: chemotherapy (18.2 vs. p=0.005) 38.0%, comparedto patients open treated with cystectomy.associated cystectomy Roboticwas lessloss with blood vs. (350 cc, 800 p<0.01), and low 176 (49.6%) classified caseswere as high risk disease.cystectomy Robotic patients were more likely to be male(96.4 vs. p<0.01), 71.0%, higher have performance status (p=0.002) a p<0.01). roboticmargin Surgicalrates between similar and open cystectomy were across the entire cohort and among the high−risk subgroup (29.2 vs. 27.0%, p=0.82). On adjusted regr postoperative 30−day complications (p=0.82), prolonged LOS (p=0.18), or positive surgical margins high patientsrisk among (p=0.32). Conclusion: laparoscop total of 13 patients had ICUD compared to 18 ECUD.with We Open excluded cystectomy patients,multiplesurgeries patients as with prior well as prior or pelvic radiotherapy. has been reported potentialwith for improvement inperioperative morbidity compared to the open approach. Predominantly extracorporeal urinary diversion (ECUD), initialwith experiences intracorporeal with urinary diversion (ICUD) being reported. Fe exist. the between ICUD and ECUD Methods: In thistime period a total of 47 cys Results: comparedset to ECUD patients RARC a betw with of with Presented By: Introduction: different robotic between assisted laparoscopicopen radical and cystectomy groups. Futureshould term studiesinsurvival) longer outcomeshighexamine cases (e.g. risk amonglarger groups of patients, and also A SINGLE CENTER COMPARISON OF INITIAL EXPERIENCE OF ROBOTIC ASSISTED ASSISTED ROBOTIC OF EXPERIENCE INITIAL OF COMPARISON CENTER SINGLE A RADICAL CYSTECTOMY WITH INTRACORPOREAL URINARY DIVERSION TO ROBOTIC ASSISTED CYSTE RADICAL cystectomy could improve patient outcomes. Podium #43 Brittany O'Bryan and Jamie Messer University Louisville of Dept Indiana Pouch (IP), and 7 Neobladders (NB). Peri (LOS)and days NPOas as well surgical oncologic and functional efficacy efficacy was compared a grou with to regard with age, gender, race,mass performance ECOG status, index, body comorbidities, surgeries, previous estimated transfusion, blood neoadjuvant of loss, use chemotherapy (ICUD 5 9 pathological (IQR forLOS 10 days median ICUDwas The stage. similar ICU with for groups both same compared to ECUD medianLOS 11 days (IQR 9 p=0.475).significant Our onlymedian in difference ICUDoperative was with time 444 minutes (IQR 414 was a trendwas towards a higher incidenc the ECUD (6/18) 130 Functional outcomes including continence for IP and NB as well as ureteral stricture were similar among the groups. Conclusion: Robotic assisted ICUD can be safely performed by surgeons familiar with robotic cystectomy, with comparable outcomes to ECUD. Operative time is significantly longer but this does not appear to affect patient outcomes, and may trend towards fewer high grade complications. The main limitation of our current analysis is the retrospective nature of the study.

Podium #44 ROBOTIC ASSISTED RADICAL CYSTECTOMY: FEASIBILITY AND PROFITABILITY FOR A HOSPITAL AND PRIVATE PRACTICE Rajesh Laungani, Matt Sand and Nikhil Shah Atlanta, GA Presented By: Rajesh G. Laungani, MD, FACS Introduction: Robotic surgery has been widely used for treatment of localized prostate cancer, but more recently has been gaining ground in regards to radical cystectomy and treatment for bladder cancer. Challenges that many urologists face when it comes to radical cystectomy are those of long operative times, long inpatient stays, increased complication rate and decreased re-imbursements. This has led many urologists to refer advanced bladder cancer that may require surgical intervention to larger centers of excellence and/or academic centers. Using the Da Vinci Robotic Surgical System we have found that robotic radical cystectomy can be successfully accomplished in a community hospital and private practice setting with low complication rate, decreased hospital stay, decreased operative times and profitability for both the hospital and urologist. Methods: We evaluated the experience of a single fellowship trained Robotic Urologic Oncologist over a span of 3 years, from August 2012 – August 2015. Total number of robotic assisted radical cystectomies were evaluated in regards to operative times, length of stay and re-admission rates along with costs and contribution margins associated with procedure. Results: A total of 35 robotic assisted radical cystectomies were completed. Mean operative time was 4.2 hours. In all procedures an ileal conduit was performed as the urinary diversion of choice. Bilateral pelvic lymph node dissection was also completed in each case. Average length of stay was 5.0 days. 30 day re-admission rate was 5.7 percent. Average contribution margin was $4,768. Taken into account was cost associated with performing the procedure with robotic assistance with a hurdle expense of $1,250 per case. This is assuming that a single robotic system in a hospital performs approximately 250 – 400 cases per system per year. This resulted in a final contribution margin of $3,518. Conclusion: The addition of robotic assistance in the hands of a fellowship trained robotic urologic oncologist allows for radical cystectomy to be a feasible and profitable option even in a private practice and community hospital setting. Factors that are important for success include; decreased OR time, decreased length of stay, appropriate coding and billing on the part of the surgeon and hospital as well as a high volume robotics program so as to cover fixed costs associated with the robot, ie instruments, depreciation and service contracts.

Podium #45 EPITHELIAL MESENCHYMAL TRANSITION IN BLADDER CANCER PROGRESSION Patrick Hensley¹, Daniel Zetter¹, Craig Horbinski², Hong Pu¹, Stephen Strup¹ and Natasha Kyprianou¹ ¹Department of Urology, University of Kentucky Medical Center; ²Department of Pathology, University of Kentucky Medical Center Presented By: Patrick Hensley, MD Introduction: Tumor epithelial cells undergo a morphological shift through the process of epithelial mesenchymal transition (EMT) with characteristic loss of cell polarity conferring invasive and metastatic properties during cancer progression. The role of EMT in bladder

132 PODIUMS - cadherin. - carcinoma carcinoma

ofilin relative relative ofilin number was 7.3. 7.3. number was

way ANNOVA was inHct from baseline modeling in a series -

cadherin and gain in N - ive to hightumors grade —defined as a hematocrit n inhuman bladder cancer tests used were to evaluate

- cadherin and E -

tailed T - cadherin relat - identified. Sections were subjected to to subjected were Sections identified. - ause for the increased risk. The primary aim of 133

e tumor cells. Two blindedcells.e tumor reviewersTwo independently

sections de and invasive tumors (Ta and Tis) showed markedlyinvasive showed (Ta tumors and Tis) decreased

cadherinand lower N - as as as recorded on therapy. well levelsmain all The while adjacent high fields powered section. per One - localization of the cytoskeleton regulator cofilin is significantly associated associated significantly is cofilin regulator cytoskeleton the of localization sent included. were The procedure included implantation of 10 pellets - cadherin theirrelative to invasive counterparts. - The FDA added a recently warning label to testosterone replacement Robert D. Williams, Robert MD D. These data demonstrateEMT induction bladder in tumorshuman is

Jacksonville, FL Jacksonville,

- —has been theorized to be the c A retrospective analysis histopathological of sections from 48 patientswho All patientstestosterone had who pellets procedures Clinic at Mayo Florida since

59 patients met patients inclusion/exclusion the 59 criteria. therapy prior was to Hct Mean With increasing tumor stage there a parallel was increase incofilin expression

icantly associated cancer bladder with progression invasive high to grade, disease. esults: Immunoreactivity determined using was the Quick Score calculated multiplying by staining intensity percentage of by positiv reviewed threereviewed non of human bladder cancer specimens.of cancer human bladder Methods: N cofilin, against antibodies using immunostaining underwent radicalurothelial cystectomyfor carcinoma conducted. was Tissue blocks were sectioned into 5μM tissue cancer progression to advanced disease is poorly understood.In conducted study this we a retrospective analysislandscape the of EMT and actincytoskeleton re used to differences analyze tumorbetween stage. Two to low grade tumors grade to low a significant (p<0.0001).There was loss E of R (p<0.0001). Increasing stage was associated increased with sublocalization nuclear of cofilin(p<0.0001). High tumors grade expressed significantly levels higher c of differences tumor grade. between cadherinexpression increased with tumor stage (p<0.0001; p=0.0256). Similarly, grade low tumors exhibited higher E expression N of (p=0.2144; p<0.0001). Non to after treatment +3.6 3 was (p<0.05), baseline to after treatment +2.0,was and baseline 6 to aftertreatment +3.3. After 9 was consecutive of 1 year treatment, 42 (11.9%) 5 of Conclusion: Mean changeMean inHct from baseline months to within6 therapy was of +0.9 (p<0.05), baseline tomonths to 6 12 +1.8 was (p<0.05), baseline to +2.2 1 to was (p<0.05), 2 years and baseline to greater than 2 years +2.9 was (p<0.05). changeMean 0.426. length Mean of treatment 26.1 was months. total Mean treatment Results: outcomechange Hct. evaluated in was 2010 to the pre subcutaneously,mg.Patients 75 each that than total had less three procedures were excluded. Patients average who interval between treatments >180 was days were excluded. Baseline w Hct signif sub nuclear The Introduction: therapy (TRT) inearly addressing 2015 concerns for risk increased cardiovascular, of cerebrovascular, and venous thrombolic events. Erythrocytosis (Hct) > 0.50 this to study was describe the change inhematocrit after TRT specifically testosterone with pellets. Methods: with bladderwith cancer progression. The expression profilecofilin of inin situ Robert Williams,Robert Snowden Broderick and Gregory Caroline Presented By: PREDICTINGERYTHROCYTOSIS MALES HYPOGONADAL IN RECEIVING PELLETS TESTOSTERONE specimenssuggestingstage earlytumors role of paralleledthat an and grade advanced of cofilin inEMT. This study is firstthe to establish the significance of the EMT landscape contextual to actincytoskeleton dynamics controlled as cofili by progression to advanced disease. These findings of are potentially high clinical and therapeutic significance inestablishing the phenotypic conversionsof EMT as a biomarker chemotherapeutics. targetfor of advanced and a disease Podium #46 ClinicMayo 132 patients had at least one episode of erythrocytosis. After 2 years of treatment 12 of 29 (41.3%) patients had at least one episode of erythrocytosis. No statistically significant associations were identified using univariate analysis. Conclusion: Hct increases by a predictable amount after TRT with testosterone pellets. The data shows the increase is more time-dependent than treatment dependent. More research needs to be done to identify subjects that will be more sensitive to erythrocytosis.

Podium #47 COMPARATIVE ANALYSIS OF SURGERY VS. INTRALESIONAL INJECTION THERAPY FOR VENTRAL PEYRONIE’S DISEASE Faysal Yafi¹, Georgios Hatzichristodoulou², Christopher Knoedler³, Landon Trost4 and Wayne Hellstrom¹ ¹Tulane University School of Medicine, New Orleans, LA; ²Technical University of Munich, Germany; ³Tulane University school of Medicine, New Orleans, LA; 4Mayo Clinic, Rochester, MN Presented By: Faysal A. Yafi, MD, FRCSC Introduction: Less than 10% of all Peyronie’s disease (PD) patients exhibit ventral curvatures and, as such, there is a paucity of data regarding the optimal approach to these patients. We sought to compare the outcomes of surgery (tunical plication [TP]) and intralesional injection (ILI) therapy (interferon-α2b) in this cohort of patients. Methods: Retrospective data was collected from 2 centers: Tulane University (ILI) and Technical University of Munich (TP). Collected variables included patient demographics and pre- and post-treatment sexual function, penile measurements such as curvature and length, penile vascular findings, and post-treatment outcomes. Results: A total of 35 patients with ventral PD (21 ILI and 14 TP) were included in the study. There were no significant differences between the 2 groups prior to the interventions. There was a significantly better improvement in mean curvature with TP (46.4 degrees) as compared to ILI (9.3), p<0.0001. TP was associated with a significantly higher rate of ≥20% improvement in curvature as compared to ILI (100% vs. 67%, p=0.027). There was no significant difference in change in SHIM scores between the groups, however, 36% of the ILI patients noted an improved SHIM score as compared to none in the TP group. Finally, erect penile length was preserved or improved in 67% of the ILI group vs. 14% of the TP group, p=0.005. Conclusion: TP confers a better overall improvement in penile curvature as compared to ILI in patients with ventral Peyronie’s plaques. Preserved or improved erect penile length and SHIM scores may be observed in patients undergoing ILI.

Podium #48 IN VITRO AND IN VIVO ASSESSMENT OF MIRABEGRON-MEDIATED RELAXATION IN RAT AND HUMAN CORPORA CAVERNOSA Taylor Peak¹, Serap Gur², Faysal Yafi1, Philip Kadowitz1, Suresh Sikka¹ and Wayne Hellstrom1 ¹Tulane University School of Medicine, New Orleans, LA; ²Ankara Univerity, Turkey Presented By: Taylor Peak, BA Introduction: The β3-adrenergic receptor (AR) subtype of the sympathetic nervous system has been well characterized at the structural and molecular levels. Stimulation of β3-ARs localized on smooth muscle cells may play a physiological role in mediating penile erection. Mirabegron, a selective β3-AR agonist, has been recently developed for the treatment of overactive bladder, and may offer an alternative pharmacological option for the treatment of erectile dysfunction (ED). We sought to examine the effects and mechanism of action of mirabegron in rat and human erectile tissues. Methods: Human corpus cavenosum (CC) specimens were obtained from 17 patients with ED undergoing penile prosthesis implantation. Mirabegron-elicited relaxation responses (10-8-10-3 M) on phenylephrine (Phe)-induced contraction were performed using human and rat CC strips in the organ bath. The effects of inhibitors [NG-nitro-L-arginine methyl

134 PODIUMS

- – e at ently ently linked ROCK - -

kinase in - and

5 emoval and

kinase - ARs independ dependent manner - - AR and Rho 10one (ODQ, 30µM), (ODQ,10one 30µM), - - cement negative, were and , Craig Donatucci, Craig 4 I a] quinoxalin - was identified as s. warneri. All IPPs All IPPs as warneri. s. identified was

[4,3 - induced contractions inhuman and rat CC - e 1 week to 30 months). toe 1 week 30 total organisms Ten Regional Urology, Shreveport, LA

UAMS Department of Urology, Little Department Urology, of UAMS Rock, 6 4 induced relaxations CC. human and rat in 135 ; - ARfasudil blocker, µM), and (Rho 1 - oxadiazolole induced relaxation responsesevaluated. were The kinase Thesemaysupport resultsfor pathway. provide evoked contractions CC in dose a - - - - fasudil. KCl ARs localized mostly to smooth muscle cells of human human of cells muscle smooth to mostly ARs localized -

β3 infectious reasons subsequently were responsible for those

- [1,2,4] - itional cultures drawn. were Complications leading to revision

istochemistry was employed to localize β3 81 years). eleven patients the diabetics. Four were of to Time up data. - - ), SR59230A (β3 gonized mirabegron 5 inhibitorsthefor treatment ED. of ision surgery for: infection (7), autoinflation (2), bladder laceration (1), (1), laceration bladder (2), autoinflation (7), infection for: surgery ision - NAME and ODQ as well as methylene blue did not affectmirabegronmethylenethe as did well not as blue NAME and ODQ Martin Gross, MD Inintroduced 1995, et Licht al. the idea that organisms found at removal and

Mirabegron Mirabegron markedly relaxes isolated CC by activating β3 6

ARsthe RhoA/Rho and - We identified four our 304 patients at institutionsthat revisionundergone had of cGMP pathway. There pathway. cGMP is also evidencethe of existence functional a close of link

Mirabegron inhibitedMirabegron Phe later IPPinfection occurred. if it In Licht’s study, three of the culture positive Eight cultures taken at time the of removal and repla -

NAME, 100µM), 1H

- Shreveport Department Department ²UNC Chapel Hill, Urology; Urology, of NC; of Eli Lilly Indianapolis, and Company, IN - 5 an IPP June between and December 2001 2012. Eleven later underwent another IPP revision surgery add where surgery includedmechanical failure (6), autoinflation glans floppy (1), (1), hematoma formation (1), loss of fluid (1), and retained components (1). patients These then later underwent IPPrev and erosionWe (1). extensively patients’ reviewed charts compile to appropriate perioperative and follow Results: had been inplace for an average of 4.4 years 1 month (range years). to patient Mean 12 54 69 (range age was patients later higher colony became infected and countssameorganism found the of were at timeof explantation;meanwhile, none ofIPP the patients a negative with cultur reoperation developeda subsequent prosthetic infection. onlyIPPthe This study is to our thatknowledge cultures compares removal at culturesand replacement with later at Wesurgery. reviewed our series of similar surgical IPP patients r undergoing truereplacement today.if thissee to remains Methods: ofsix these replacement prostheses subsequently became infected. In contrast, three IPPs had positivecultures s. (two s. epidermidis, one lugdunensis) and replacement. removal at Only one becameinfected, causativethe agent and Gerard Henry ¹LSU ³InstituteExcellence, for Urologic Indio, CA; ester (L Presented By: Introduction: replacement of an IPP for non found at infection approximately was months 6.2 (rang AR; methylene blue (20µM inhibitor,0.1 mirabegronµM)] on mirabegron responses compared responseswith were to isoprenaline and nebivolol. After exposure,drug immunoh CC smoothCC muscle cells and cGMP levelsmeasured were enzymeby immunosorbent assay. Results: and SR59230A anta Inhibitors L of induced relaxation responses. responsesMirabegron (between 0.1and 10µM) were enhanced the by ROCK inhibitor, minormg/kg)the alone comparedto1 vehicle on in effect administered had a vivo procedure, it decreased MAP. and ratCC. The inhibitory effectsmirabegron of on contractileindependent activity were of changes in tissue cGMP. Conclusion: of the NO between between β3 were partiallywere inhibited bymirabegron. Although intracavernosalmirabegron (doses of 0.1 further clinicalstudies combinations mirabegron using ROCK with and of phosphodiesterase Martin Gross¹, Culley Carson III², Steven Wilson³,MartinGross¹, Steven III², Delk I Culley John Carson IN SHOWSPRIOR FOUND TO CONTRAST STUDY, NEW DATA BACTERIA AT BIOFILM IDENTIFIED PREVIOUSLY FROM DIFFERS SURGERY IPP REVISION Podium #49 134 were identified in these eleven cases with the following frequency: s. epidermidis (3), e. faecalis (2), candida (1), citrobacter (1), e.coli (1), MRSA (1) and s. warneri (1). Conclusion: In contrast to the findings of Licht et al., our series shows that bacteria (or lack thereof) found at revision surgery are not the same bacteria as those found in subsequent revision, explantation, or salvage. These findings may be due to both infection retardant coatings and antimicrobial washout, which has become the standard of care in IPP revisions. This is the first study to our knowledge that directly refutes the conventional wisdom established by Licht’s study.

Podium #50 NON-INDUSTRY SPONSORED SAFETY ANALYSIS FOLLOWING COLLAGENASE CLOSTRIDIUM HISTOLYTICUM (XIAFLEX®) INJECTION IN MEN WITH PEYRONIE’S DISEASE Ryan Owen, Christopher Winter, Jonathan Angelle, Michael Jennings, Wesley White and Edward Kim University of Tennessee Graduate School of Medicine, Knoxville, TN Presented By: Ryan C. Owen, MD Introduction: Peyronie's disease is a collagen deposition disorder of the penile shaft causing penile curvature, pain and emotional distress related to patient and partner dissatisfaction. Medical and surgical treatment options have largely been experimental, empiric, and/or compromised penile length and function. In 2013, the FDA approved collagenase clostridium histolyticum (CCH) (Xiaflex®) for use in men with Peyronie's disease who demonstrate a palpable penile plaque and penile curvature of >30°. Currently, there is limited data on the clinical outcomes since approval of this medication. Given this gap in knowledge, we have conducted a review of all patient visits for CCH administration with the aim of reporting on real world clinical outcomes and adverse effects. Methods: After IRB approval, a prospective study was conducted to assess patient outcomes and complications associated with CCH injection. Eligible study candidates included those with documented penile curvature of between 30° and 90° and a palpable penile plaque. The risk evaluation and mitigation strategy (REMS) protocol was followed as described in the CCH prescribing information. Adverse events and treatment response were documented after each patient encounter. Results: Thirty-eight men received 222 plaque injections with CCH from April 2014 thru August 2015. Plaque softening was observed in 34 (89.4%) men while 28 (73.6%) reported improvement in curvature. Out of the 38 men identified, 24 (63.2%) experienced penile, suprapubic or scrotal ecchymosis with 1 or more injections. Additional adverse effects included post injection penile pain (11/38 = 28.9%), penile edema (7/38 = 18.4%), hematoma formation (4/38 = 10.5%), penile erythema (3/38 = 7.9%), penile blister (3/38 = 7.9%) and penile hemorrhage (1/38 = 2.6%). Importantly, there has not been a corporal rupture after any injection. Conclusion: CCH is a safe and effective treatment option for men with Peyronie’s disease. Minor adverse effects may be anticipated but are typically short lived. Additionally, the majority of men report improvement in penile curvature and plaque composition.

136 PODIUMS t 9 - NIS - eons are year periodyear -

ational rates for

cell priapism were INCONTINENCE

- year period were relatedperiod year were -

term erectiledysfunction. In some - ively reviewed ively a two reviewed over 2012. Of these cases, 2012. 20,790 Of were -

re increasinglyre slingprocedures rather than ingqueried incontinence the procedures we

137 esis.

Salem NC - ueried thecases database for radical of prostatectomy tatectomy is improving.

MBA

, ON THE NATIONAL INPATIENT SAMPLE

, Winston ng trend inthe amount of total incontinence procedures done year periodyear from 2000 - tually saw a significanttually saw increase (F(1,11)=12.95, p<0.01). There 2, 416 men underwent incontinence underwent men theHCUP in 416 2, procedures

9 codes for priapism retrospectwere eight percent of priapism encounters the over two Sickle cellSickle stuttering related priapismissignificant a cost to burden the Marc Colaco, MD John F. Burns, MD F. Burns, John - Incontinencemajor factor is a inquality oflife after radical prostatectomytha

- The rate of incontinence procedures is throughoutdecreasing the United

, Susan MacDonald and Ryan Terlecki Ryan Susan MacDonald, and

A retrospective cross sectional analysis performed was using data collected in ICD

A totalA of 3 Sixty

uction: 9 code 60.5) for comparison.All data collected was for the time period from January - iapism episodes, hospital encounters, and cost. A cost performed was analysis to Introduction: may lead to restriction of physical activityemotional and distress.In to order combat incontinence urologists developed have multiple treatments including synthetic implants for refractory cases. the However, with advent ofsurgical new technology surg reportingbetter surgical for incontinence the incontinence outcomes need procedures and may be less common.Thus, the purpose of thisstudy isto the analyze national trends of surgical incontinence procedures and to correlate these trends n with radical prostatectomy. Methods: procedure codes. of For identify the purpose codes (implantation 589.3 artificial of urinary sphincter59.4[AUS]), (suprapubic sling operation), 59.5 (retropubic suspension), urethral and 59.6 suspension) (paraurethral for incontinenceWe q procedures. also (ICD to2000 throughData weighted a national December was using average 2012. NIS guidelines. Results: the National Inpatient Survey (NIS) database.identified Cases were their by ICD Podium #51 IS GOLDSTANDARD SHIFTING? THE TRENDSNATIONAL IN ANTI Introd Marc Colaco Wake Baptist Forest Health Presented By: databasethe 13 during COST OF STUTTERING PRIAPISM VERSUS PLACEMENT OF INFLATABLE PENILE PENILE INFLATABLE OF PLACEMENT VERSUS PRIAPISM STUTTERING OF COST PROSTHESIS Huckabay John Burns and Chad SURGERY FOR MEN BASED MEN FOR SURGERY Conclusion: Podium #52 University Mississippi of Center, Medical Jackson, Division Urology, MS of (F(1,11)=6.15, p=0.03). stratifying when However, the data type by of incontinence procedure,significant only sphincter a procedures saw decrease (F(1,11)=21.70, p<0.01) and sling procedures ac no significantwas trendthe of in rate radical prostatectomy. patient and healthsystemand leads care to long sphincter slingwere procedures and 11,625study procedures.thethere time During period awas significant decreasi Presented By: AUS procedures. trend This downward exists despitethe fact that therate of radical prostatectomies remained has stable. Takentogether thesefindssuggest that the national incontinence after radical rate pros States,performed and those cases that are a patients,measures prophylactic not are effectivemore leads to which intolerable or pr evaluate at what point itmore becomes cost effective to performa penile prosthesis in stuttering priapism. patients with Methods: Results: at University our Hospital.Totalcost encounter per for the room emergency and/or visit admission reviewed. were Costs reviewed were a similar over of time period for patients undergoing placementprosth a penile of tocell sickle disease. Fifteen patients accountedfor 59 encounters to relatedcell sickle priapism.median Averagecost and encounter per sickle to related 136 $4,215 and $2,486 respectively. Average and median cost per hospital encounter for inflatable penile prosthesis were $21,075 and $21,066 respectively. Twenty-seven percent of patients had five or more encounters during this two-year period alone with maximum number of encounters in one patient reaching seventeen. Conclusion: Cost of average penile prosthesis placement is equal to the average of six encounters related to sickle cell stuttering priapism. Placement of penile prosthesis should be considered in patients with sickle cell stuttering priapism who cannot be managed by more conservative measures. Consideration should be given to fund placement of prosthesis in these patients by insurance companies and Medicaid.

Podium #53 NOVEL TREATMENT ALGORITHM FOR CAVERNOUS VENOUS OCCLUSIVE DISEASE (CVOD) BASED ON SEVERITY AS MEASURED BY RESISTIVE INDEX Ram Pathak, Issac Effriong, Zhuo Li and Gregory Broderick Mayo Clinic Jacksonville, FL Presented By: Ram Pathak, MD Introduction: Cavernous venous occlusive disease (CVOD) is defined as a failure to maintain adequate erections despite appropriate arterial inflows and can be non-invasively diagnosed with Color Duplex Doppler Ultrasound (CDDU). Treatment for CVOD is usually step-wise and includes phosphodiesterase type-V inhibitors (PDE-5i), constriction ring, Intracavernosal injection (ICI), or implantable penile prosthesis (IPP). The primary aim of our study was to construct a novel treatment algorithm based on CVOD severity as measured by Resistive Index. Methods: A retrospective review was conducted on patients who underwent analysis by CDDU from January 2010 to June 2013. Resistive Indices (RI) were calculated using Peak Systolic Velocity (PSV) and End Diastolic Velocity (EDV) values by the following formula: RI=(PSV–EDV)/PSV. Patients were included if they satisfied the following CDDU parameters: Right and Left post-visual stimulation PSV ≥ 35cm/s and unilateral RI <0.9. At 2 years follow-up, treatments that were deemed satisfactory by patients were recorded. The association between satisfactory treatment and the severity of CVOD was assessed using Spearman rank order test. Results: 75 patients with a mean age of 60 (19-83) and mean BMI of 26.3 (19-39.3) satisfied the inclusion criteria. 10 patients were lost to follow-up and were not included in the final analysis. When sub-stratifying the pure group into tertiles, the following RI cutoffs were discovered: mild (81.6-94.0), moderate (72.6-81.5) and severe (59.5-72.5). Of note, the presence of Peyronie’s Disease (PD) was not statistically different between the severity groups (p=0.726). With these three group’s comparison, co-variates such as post-PSV right (p = 0.032), post- PSV left (p= 0.003), average post-PSV (p = 0.002), SHIM score categories (SHIM scores: 1-10 vs. 11- 20, P = 0.030), and Phosphodiesterase type-5 (PDE- 5) inhibitor failure rate (p=0.017) were statistically significantly different. Treatment modalities, in increasing invasiveness, consisted of PDE-5i, PDE-5i plus constriction ring, ICI, and IPP. As RI decreases (i.e. CVOD becomes more severe), the proportion of patients satisfied with more aggressive treatments also increases (p=0.04). Conclusion: These findings further substantiate our claim of categorization of CVOD into mild, moderate and severe classifications. Patients with more severe CVOD as characterized by lower RI should bypass conservative therapies and proceed directly to more invasive options such as ICI or IPP.

Podium #54 BUILDING VIABLE TISSUES USING A 3-D BIOPRINTER FOR SURGICAL RECONSTRUCTION Hyun-Wook Kang, Sang Jin Lee, John Jackson, James Yoo and Anthony Atala Wake Forest Institute for Regenerative Medicine, Winston Salem, NC Presented By: John D. Jackson, PhD Introduction: 3-D Bioprinting technology is evolving into a viable method to building tissue

138 PODIUMS D - amarpit re performed Univariate and and Univariate

ystemis able to very very modules that can l of Medicine, Miami, Miami, Medicine, l of 127 mixture,127 gelatin,and - D tissueD structures. Live/dead - ts were identifiedtswere inthe National

, FL

cells/Pluronic F 139

OPERATIVE PREDICTORS OF PREDICTORS OPERATIVE - e two methodse two to be similar. hasWeshown been Prakash, MD, MS Open nephroureterectomy associated was a higher with -

D organ organ D structures with precision. This s - fully delivered through the bioprinter nozzles, placed and into NU comparedtoNU open nephroureterectomy. no There were

OMES OF OPEN AND MINIMALLY INVASIVE INVASIVE MINIMALLY OPEN AND OF OMES We investigated the feasibility of delivering viable cells while cells while viable of delivering feasibility the We investigated

Nachiketh Soodana Minimallynephroureterectomy invasive isalternative (MINU) an approach to

We successfully have designed and constructed an integrated organ printing

Between 2005 and 2013, a total of 1,027 patien The integrated printing organ system consistedfour of deli A totalA 669 (65%) of and 359 (35%) patients and MINU underwent open rmed withina single printed structure the with use of 2 different colored dyes (red

Cells success were

caprolactone) (PCL) were delivered to construct 3 - (ε

processmultiple materials, types of synthetic including polymers a cell/gel and mixture. The materials precisely are dispensed theby control of airpressure. A heating unit used was to obtaindispensable synthetic polymers. 3T3 NIH fabricatingsyntheticsimultaneously durablescaffolds structures create durable to tissue for reconstructive procedures. and organs for surgicalWe reconstruction. developed a novel organ printing system that canmultiple deliver cells, gel polymers, and rigid and biomolecules manufacturing for tissue constructs.and organ Methods: Methods: NEPHROURETERECTOMY PRE AND Conclusion: Conclusion: OUTC PERIOPERATIVE poly staining and MTS performed assays were tocell evaluate viability withinthe 3 configuration. the desired position approximately with cell 80% viability. Cells morphologically appeared normalevidence and showed of proliferation after 1 day printing. differentTwo cell types confiwere and green). systemthatto is able print 3 deliver and place viablecells the in desired positionmanner. in a precise This system majorprovides printing organ thetechnology, of leap a advancement in could which be used surgical for reconstruction. Podium #55 Results: COMPLICATIONS: AN ANALYSIS USING THE NATIONAL SURGICAL QUALITY QUALITY SURGICAL NATIONAL THE USING ANALYSIS AN COMPLICATIONS: IMPROVEMENT PROGRAM DATABASE NachikethSoodana Prakash¹, Nicola Balise³, Nahar¹,Pavan², S Bruno Raymond R Rai¹, Ritch¹,Satyanarayana¹,SanojPunnen¹, Ramgopal J. R. Chad Parekh¹ and Dipen Mark L. Gonzalgo¹ ¹DepartmentUrology, of UniversitySchool of Miami Medicine Miller of Miami FL; ²DepartmentUrology, of UniversitySchoo of M. Leonard Miller Miami FLand Clinic, Urology DepartmentScience, of Surgical Medical, University and Health of of University Sciences, Health Public of Department Biostatistics, of ³Division Italy; Trieste, MiamiSchool Medicine, M. Miller Leonard of Miami Introduction: Presented By: Methods: open nephroureterectomymanagement for tract upper of urothelial carcinoma (UTUC). Oncological outcomesth between analyzed theanalyzed to NSQIP determine databasethere a significantif was difference in perioperative complications and open nephroureterectomy. MINU between Surgical Quality Program Improvement Database (NSQIP) that underwent nephrouretectomy for UTUC. Pre−operative covariates were analyzed to predict the rates of severe multivariate (Clavien−Dindo models logistic regression (controlling for demographic and comorbid grade ≥ conditions) built were to predict complications severe analyses and exploratory done were 3) perioperative to predict 18 common complications. Further, comparisonsmeans of we complications. using unpaired t−test or Wilcoxon adjustedtomaintain an experiment−wise p .05. < rank−sum tests where appropriate. Results: P−values were rate of severe complications (OR 1.87, CI 1.02−3.4, p = 0.04). Post−operative occurrence of pneumonia (OR 4.5, CI 1.7−3.4, p < 0.001) and lower for MI 0.0001) were transfusions (OR 2.5, CI 1.7−3.6, p < nephroureterectomy, respectively. 138 significant differences between the two surgical methods with respect to incidence of other complications. MINU took longer on average than open nephroureterectomy (median 219 mins vs. 200 mins, p < 0.001). Time to discharge was longer for open nephroureterectomy compared to MINU (median 6.25 days vs. 5 days, p < 0.0001). Conclusion: Post−operative pneumonia and occurrence of severe complications (Clavien−Dindo grade ≥ 3) were higher for the open nephroureterectomy group compared to MINU. These data suggest that MINU is an acceptable surgical approach for management of UTUC that is associated with lower morbidity compared to open nephroureterectomy.

Podium #56 FIBER-OPTIC CONFOCAL LASER ENDOMICROSCOPY OF SMALL RENAL MASSES: TOWARDS REAL-TIME OPTICAL DIAGNOSTIC BIOPSY Li-Ming Su¹, Jennifer Kuo¹, Robert Allan², Joseph Liao³, Kellie Ritari¹, Patrick Tomeny¹ and Christopher Carter² ¹Department of Urology, University of Florida College of Medicine, Gainesville, FL; ²Department of Surgical Pathology, University of Florida College of Medicine, Gainesville, FL; ³Department of Urology, Stanford University School of Medicine, Stanford, CA Presented By: Jennifer Kuo, BS Introduction: The incidental detection of small renal masses is on the rise. However, not all require aggressive treatments as up to 20% are benign and the majority of malignant tumors harbor indolent features. Improved preoperative diagnostics are needed to differentiate tumors requiring aggressive treatment from those more suitable for surveillance. We evaluated and compared confocal laser endomicroscopy (CLE) with standard histopathology in ex vivo human kidney tumors as a proof-of-principle towards diagnostic optical biopsy. Methods: Patients with solitary small renal masses scheduled for partial or radical nephrectomy were enrolled in the study. Two kidneys were infused with fluorescein via intraoperative intravenous injection, and 18 tumors were bathed ex vivo in dilute fluorescein prior to confocal imaging. A 2.6 mm CLE probe was used to image tumors and surrounding parenchyma from external and en face surfaces after specimen bisection. CLE images were compared to standard H&E analysis of corresponding areas. Results: Ex vivo CLE imaging revealed normal renal structures that correlated well with histology. Tumor tissue was readily distinguishable from normal parenchyma, demonstrating features unique to benign and malignant tumor subtypes. Topical fluorescein administration provided more consistent CLE imaging than the intravenous route. Additionally, en face tumor imaging was superior to external imaging. Conclusion: We report the first feasibility study using CLE to evaluate small renal masses ex vivo and provide a preliminary atlas of images from various renal neoplasms with corresponding histology. These findings serve as an initial and promising step towards real- time, diagnostic optical biopsy of small renal masses.

140 PODIUMS

1 pads per

free, 0 - eriod. Intraoperative outcome data were outcome were data Analyses (PRISMA) (PRISMA) Analyses - focusing on iatrogenic

year p operative outcomes from 8 - -

up ranged from 12 to 24 months.to fromup ranged 24 12

- in the United States. the in United

Jeremy Konheim¹, Raunak Patel¹,

WHERE DO WE STAND?

– udies have are inconsistent udies are have and the with data 141 operative success (e.g.pad - 55 percent included across all studies. About half -

examine patientcontinence reported outcomes, e slinge is a minimally invasive treatment option for

operativeand urethral acute urinary retention injuries. -

operative satisfactionthe procedure.commonly Most with - tions oftions post operative measure of urinary continence, patient reported post - operative patientsatisfaction a significant and number report - prostatectomystress urinary continence. is There evidence that - ed seriesed transobturatorsling of men incontinence with in placements events post with ey Potts², Peterson¹ Feltner³Andrew Cynthia ey and The transobturator mal Urologistssurgical as subspecialists the have responsibility of consultation Divya Ajay, MD, MPH Dunia T. Khaled, MS MD, Dunia T. Men with urinary incontinence with Men secondary to radical prostatectomy when

After obtaining Institutional Board approval, Review all adult urologic A systematicA searchdatabase conducted was usingkeywords, according to eport post

satisfactionsurgery. events the from adverse and 1600 inpatientconsultations received the over 2 were There were 126There patients were availablefor analysis of post

s School of Medicine, New Orleans,Schools Medicine, LA of New Podium #57 MEN IN SLING TRANSOBTURATOR THE OF OUTCOMES OF REVIEW SYSTEMATIC WITH INCONTINENCE SECONDARY TO RADICAL PROSTATECTOMY AND RADIOTHERAPY FOR PROSTATE CANCER Divya Ajay¹,Divya Bradl ¹Duke UniversityDurham, University NC; Center, School, Medical Medical ²Duke Durham, NC; ³University Carolina,Chapel Hill, North of NC Presented By: Introduction: patients post with Preferred Reporting SystematicItems for and Meta Reviews continence outcomes worse are inmen radiotherapy with in addition to a radical prostatectomy. these many st However, of Methods: often is insufficientto data support these conclusions. The of objective thisstudy to was conduct of a systematic review male the transobturator slingplacement after radical prostatectomy and radiotherapy to satisfaction and adverseevents. Results: consultations excluded. were The patient cohort a meanwith male 66% was age of 61 consultations January between 2013 and January 2015 identifiedwere and retrospectively reviewed. Demographic, clinical, interventional,subsequent and abstracted. The data based analyzed was on patient demographics, referring department, reason for consultation, frequency of consultation, and subsequent intervention. operative Results: studiessample to sizesfrom Follow 30. ranging with 5 guidelines. Publish retrieved.after were The treatment three for cancer key prostate questions examined were: patient reported post Authors differing used defini Methods: complications including retention acute urinary erosion. and urethral INPATIENT UROLOGIC CONSULTATIONS Conclusion: Conclusion: combined radiotherapy with have successpoor rates the with transobturator sling. Only 50 percent r Podium #58 DuniaKhaled¹, Saltzman¹,Amanda May¹, Danica efficiency and ultimately provide quality patient care, must we understand full our scope of Whilepractice.the pattern of inpatientconsultations been reported has inother surgical subspecialties, data regarding urologic consultations is limited, most observed adverse of patients the post reported Samantha Prats²,William Ashley Allison Richman¹, Feibus²,Joseph Chastant², MelissaFougerousse², Baksa¹ Brian Montgomery¹ and ¹Ochsner Orleans, Foundation, Clinic LA; ²Louisiana University New State Sciences Health Center Introduction: Whileservices.common they practice, typically are unplanned and overlooked. Toimprove catheter injuries. A singleinstitution inIreland has published an overall experience with adult urology consultations. To knowledge,our there has been no report on a similar pattern adult urology consultation of at institution any day, etc.).from 0 Success rates ranged Presented By: 140 years. 59% of referrals were from medical subspecialties, 26% emergency medicine, and 15% surgical subspecialties. Gross hematuria related issues resulted in 17% of consultations, upper tract hydronephrosis in 17%, infectious etiologies in 17%, lower urinary tract/benign prostate related issues resulting in 16%, catheter-related issues in 11%, and genitourinary malignancy in 7%, with remaining reasons for consultation summing to less than 5% each. Iatrogenic gross hematuria alone resulted in 8% of ordered consultations. 11% of patients were seen on multiple admissions. Only 29% of consultations resulted in any type of urologic intervention (procedural or operative); of these only 30% were operative. Conclusion: Inpatient consults constitute a significant workload at our institution. We report the epidemiology of consultations at a high volume tertiary care academic center to shed light on an otherwise poorly studied, albeit large portion, of routine urologic practice. The analysis of this data provides an improved understanding of our patient population and allows for the identification of current and prediction of future trends for our urology department. The knowledge gained may be applied to other high volume tertiary academic centers allowing for creation and implementation of strategies to maximize efficiency and efficacy. Funding: None The authors declare no conflicts of interest.

Podium #59 EFFECTS OF ALPHA BLOCKADE ON URETERAL PERISTALSIS AND INTRAPELVIC PRESSURE IN AN IN VIVO STENTED PORCINE MODEL Lewis J. Johnson¹, Daniel Davenport² and Ramakrishna Venkatesh¹ ¹Department of Urology, University of Kentucky, Lexington, KY; ²Department of Surgery, University of Kentucky, Lexington, KY Presented By: Ramakrishna Venkatesh, MD, MS, FRCS Introduction: Many clinical studies have shown beneficial role of oral alpha-blockers for ureteral stent related morbidity. However, the in vivo effects of oral alpha-blockers on a stented ureter are unclear. We evaluated the effects of alpha blockade on ureteral dynamics in a stented porcine ureter. Methods: Twenty-seven female pigs were utilized in this study. Fourteen pigs received oral alpha-blocker medication (silodosin, 8 mg daily) and 13 pigs received no medication. Under cystoscopic guidance a 5F ureteral catheter was positioned in the renal pelvis and attached to a pressure monitor. A Foley catheter was placed in the bladder along with a bladder pressure transducer. A lumbotomy was performed and ureter was identified. A magnetic sensor was placed on the extra-luminal surface of the ureter to monitor ureteral peristalsis. We measured renal pelvic and bladder pressures, urine output and ureteral peristalsis every hour for 10 minutes for a total of 5 hours. The pigs were then euthanized. Results: The mean weight was 42.5 kg in the drug group and 45.9 kg in the non-drug group (p=0.008). Mean hourly urine output was 140 ml in the drug group and 144 ml in the no-drug group (p=0.76). Mean baseline renal pressure was 13.2 mmHg and 13.8 mmHg (p=0.69) in the drug and non-drug group, respectively. Mean peristaltic renal pelvic pressure was 19.1 mmHg in the drug group and 19.2 mmHg in the no-drug group (p=0.97). Mean number of peristalsis was 11/10min and 14/10min (p=0.03) in the drug and non-drug group, respectively. Conclusion: Alpha blockade in an in vivo stented porcine ureter resulted in no significant effect on renal pelvic pressure but a significant decrease in the number of ureteral peristalsis. Further investigation of alpha-blocker on ureteral dynamics is required to better understand its effects on stent related symptoms.

142 POSTERS

4 ,

sity (PSAD)

state biopsy (PB) to to (PB) biopsy state

143 Posters

Bruno Nahar², StephenBrunoSjoberg Zappala³, Daniel Nahar², TOTAL PSA RATIO IMPROVE OUR ABILITY TO TO OUR ABILITY IMPROVE RATIO PSA TOTAL - TO -

OPKO Diagnostics, LLC, Nashville, TN Nashville, LLC, Diagnostics, OPKO GRADE PROSTATE CANCER ON PROSTATE BIOPSY, THE THE BIOPSY, PROSTATE ON CANCER PROSTATE GRADE - 4 University of MillerFL; of Miami Miami School Medicine, University of MillerFL; ³Andover of Miami Miami School Medicine,

- - Memorial Sloan Kettering Cancer, New YorkSloan City,Memorial NY Kettering Cancer, New 4

se modelsefor diagnosing PCa any (AUC 0.76 versus 0.70, P <0.0001) , P < 0.0001) and significant 0.0001)PCa

vek Venkatramani, MD Vivek Venkatramani², 0.70 Several studies reported an increased have value of PSA den Samarpit Rai, MD Rai, Samarpit Vi PSAD and f/tPSA add substantial predictive to power the diagnostic

was performedwas to according the established practice at each study site. The

ological centers the nation. within A performed phlebotomy was immediately 17 ng/mL/cc, respectively (P <0.0001). The median PSA f/t men in no with vs.

, Ramgopal Satyanarayana², Dipen J. Parekh² and Sanoj Punnen² , Parekh²Sanoj Satyanarayana², Dipen Ramgopal J. and 1,370 prospectively 1,370 suspicion patientsPCa PBfor referred enrolled of for a were

PROSTATE CANCER ON BIOPSY? RESULTS FROM A PROSPECTIVE, PROSPECTIVE, A FROM RESULTS BIOPSY? ON CANCER PROSTATE Of themenOf 1,290 in finalthe cohort, 301 (23%) and 284 (22%) men were

INSTITUTIONAL, AND CONTEMPORARY COHORT CONTEMPORARY AND INSTITUTIONAL, - tment Urology of med.

, prior biopsy status, and DRE for the prediction of any PCa and significantforPCa. the, PCa any and prediction prior of status, biopsy and DRE onclusion: prior to PBfor PSAmeasurement. PSA and f/tcalculated PSAD was using the prostate volume obtained during the trans−rectal examination ultrasound (TRUS) guided PB. Histopathologic the under area receiver operatingcharacteristic to curve used (AUC) the assess was added discriminative value of PSADf/t added toPSA a base and when model consisting of PSA, age across 26 ur Results: determinePSAD if PSA and f/t the enhanced predictionPCa and/or of significant any PCa (Gleasonscore ≥ compared 7) toPSA alone. Methods: and free−to−total PSA ratio (f/t PSA) over PSA alone in predicting prostate However, both thesecancer derivatives to appear be underutilized incurrent clinical (PCa). practice. This study a contemporary analyzed men cohort for pro of referred diagnosed with low−grade PCa (Gleason score = 6) and significant PCa respectively. The median PSAD values in men with no PCa, low−grade PCa, and significant PCa were 0.09, 0.11, and 0. and significantmodelSimilarly,P 0.82f/t < PCa0.0001). a versus 0.77, (AUC PSA with superiorshowed predictive value compared to the base model diagnosing for PCa any (AUC 0.73 PCa, low−grade PCa, and significant 0.0001). The AUC for a model incorporating PCa PSAD superior showed predictive value was 0.21, 0.17, and compared to the ba 0.12 respectively (P < Introduction: armamentariumfor PCa any and significantPCa.calculation Their may aidin the early detection aggressive of reducingthe of biopsies PCa, while unnecessary being number perfor #2 Poster WhilePSAD superior showed predictive f/t value over forPSA predicting PCa any (AUC 0.76 versus no differenceP was =0.0062), 0.73, there their indiscrimination significant of PCa. C LOW WITH MEN AMONG 4KSCORE PREDICTS MORE AGGRESSIVE PROSTATE CANCER AT AT CANCER PROSTATE MORE AGGRESSIVE PREDICTS 4KSCORE PROSTATECTOMY Sanoj Punnen¹, Presented By: Presented By: and Dipen Parekh¹ ¹Depar ²Department Urology of Urology, Andover MA; ¹Department Urology, of UniversitySchool of Medicine, Miller of Miami Miami, FL; ²Department Urology, of UniversitySchool ofMedicine, M. Miller Leonard of Miami Miami, FL;School ³Department Urology, M. Leonard Miller of of Miami University of Medicine Miami, and Urology Clinic, Department FL Surgical Medical, Science, of and Health University Trieste, of Italy; Poster #1 Poster PSA DENSITYCAN FREEAND Samarpit Prakash²,Nahar², NicolaPatel², Rai¹,Soodana AmilBruno Pavan³, Nachiketh Yan Dong MULTI PREDICT 142142 Introduction: Most men diagnosed with prostate cancer in the United States are found to have low-grade tumors. While many of these men are good candidates for active surveillance, a proportion will have a bad outcome due to the presence of a more aggressive prostate cancer that was missed on initial biopsy. A recent prospective study confirmed the 4Kscore accurately predicts the likelihood of aggressive cancer on prostate biopsy. We wanted to see if the 4Kscore could predict the presence of more significant cancer in a population of men with low-grade tumors on the diagnostic biopsy. Methods: A recent multi-institutional prospective validation of the 4Kscore was conducted at 26 sites throughout the United States. We selected men who were found to have low- grade (Gleason 6) cancer on biopsy for this analysis. The 4Kscore calculates the risk of aggressive prostate cancer on prostate biopsy by a blood test that measures levels of four kallikrein biomarkers (total PSA, free PSA, intact PSA, and human kallikrein-2) plus age, DRE findings, and prior biopsy status. We investigated whether the 4Kscore was associated with more significant cancer among men found to have Gleason 6 cancer on prostate biopsy. We also looked at a subset of these men who underwent radical prostatectomy to see if the 4Kscore was associated with prostate cancer being upgraded in the surgical specimen. Results: Among the 1312 men enrolled in this trial, 306 men were found to have Gleason 6 cancer on prostate biopsy. The 4Kscore was significantly associated with the number of positive cores (p=0.001) and the millimeters of cancer seen (p=0.0002), with higher 4Kscores relating to more extensive cancer present on biopsy. In the subpopulation of 51 men who underwent radical prostatectomy, the median 4Kscore was significantly higher among men who had an upgrade to Gleason 7 or higher [15% (8,25)] compared to men who did not experience an upgrade [7% {4,14)] (p=0.032) in their final pathology. Conclusion: Among men with Gleason 6 prostate cancer on biopsy, we found the 4Kscore was associated with the prostate cancer being upgraded in the surgical specimen at radical prostatectomy. The 4Kscore test may facilitate the selection of men who can be observed versus those who should undergo immediate treatment.

Poster #3 MULTIPLEX RNA SEQUENCING OF PROSTATE CANCER-ASSOCIATED TRANSCRIPTS IN EXTRACELLULAR VESICLES FROM POST-DRE URINE Kathryn Pellegrini¹, Kristen Douglas², Kathryn Wehrmeyer¹, Dattatraya Patil¹, Nicole Pulley¹, Anna Bausam¹, Mersiha Torlak¹, Martin Sanda¹ and Carlos Moreno¹ ¹Emory; ²Emory University, Atlanta, GA Presented By: Kristen Douglas, BA Introduction: There is an opportunity for prostate cancer-associated biomarkers to improve diagnosis and classification of prostate cancers. Extracellular vesicles (EVs) containing RNA and proteins from their cell of origin are released and can be detected in biofluids such as urine, making them a rational target biomarker. Methods: We have established a protocol for the isolation of RNA from urinary EVs, and have used the Precise Assay targeted RNA sequencing method to analyze the expression of over 300 prostate cancer-associated genes in EVs collected from the post-DRE urine. Results: We prepared RNA from the EVs recovered from 30 mL of post-DRE urine and obtained RNA yields ranging from 0.3 – 581 ng (average: 70.2 ± 81.4 ng, n = 234 patients). The majority of the specimens, n = 205 (88%), had sufficiently concentrated RNA for our gene expression studies. Of the >300 genes assessed, approximately 25% were not detected in the urinary EVs of any patients. Analysis of the remaining genes demonstrated that there are distinct gene expression profiles in the urinary EVs of men with aggressive prostate cancer (n = 26) as compared to men with no evidence of disease (n = 12). Conclusion: Urinary EVs represent a novel source for biomarker discovery in prostate cancer. Our pilot study has demonstrated the ability to stratify patients based on their urinary EV RNA expression profile. Further investigation and refinement of urinary EV gene expression signatures may offer an approach to discover informative molecular information about prostate tumors prior to diagnostic biopsy, or serve as an alternative means of assessing patients on active surveillance

144 POSTERS - hing controls, 4 301a in prostate prostate 301a in 301a expression - survival signaling - -

1. -

y, apoptotic,y, real timePCR and 301a expression during diagnosis - isville, Kentucky isville, 301a coulda potentialbe metastaticmarker - 301a coulda disparitybe marker as as well - prostate cancer patients during the diagnosis 145 prostate cancerprostate patients. MiR

interacting protein), to binding untranslated its – -

301a induced mediated Rho pro - prostate cancerprostate patients exhibitedmiR a significant -

small noncoding RNA molecules present inall cell types 301a activates signaling Rho inhibitingpathway by a tumor -

ed to that of CA that of ed to e found that AA

elude and wait watch timelinesmorbiditymortality and prevent and of C

AfricanAmericanmen (AA) more having aggressivephenotypes suffer from Angelena B. Edwards, MD AngelenaB. Edwards, 301a restored TXNIP regulated function down which signaling, Rho thus

Our results suggest that miR -

ancer. MiR with prostatewith cancer and also to augment a novel biomarker that could 301A EXPRESSION ACT AS A DISPARITY MARKER FOR PROSTATE PROSTATE FOR MARKER DISPARITY A AS ACT EXPRESSION 301A

A total of 75 formalin fixed paraffinAfixed total 75 formalin of matcembedded (FFPE) with

miR We found a significant differential expression (p=0.013) of miR

and Chendil Damodaran²

increased motilityincreased epithelial incells, prostate normal RWPE

was correlatedclinicalwas with theStudies from our (metastasis)aggressiveness disease. of laboratory and others have reported that miR in prostate c (GleasonSimilar 6). pronounced observed expressions in the were men serum AA of compar(p=0.001) when Introduction: metastaticpairedclinicaltheircases) fresh tissues BPH (13 tumor with tumors, 6 and diagnosis selected were forstudy. this Prostate cancercell normal lines and cellprostate lines obtained from were subjectedATCC and to cell viabilit western blot analysis. Results: higher incidence/mortalitycancer prostate compared of Caucasian with when American (CA). MicroRNAs (miRNAs) are and theirexpression correlated patterns are many cancer types including with prostate cancer. The goal of the study is to the identify genetic factors may which influence the disparity in AA patients distinguishmalignantfrom cancer benign prostatic hyperplasia the early during(BPH) diagnosis the of disease. Methods: suppressor protein, (thioredoxin TXNIP region, and resulting ininvasion/migration of prostate cancer cells. On the contrary, silencing cancer specimens compared to as benign prostatic hyperplasia and adjacent(BPH) benign w Interestingly, tissue. 301a expression (p=0.008) than the CA MICRORNA ¹UniversityMedicine, of Louisville School of Louisville, Kentucky; ²Department Urology, of University Louisville of Medicine, ofSchool Louisville, Kentucky; ³DepartmentPathology, of University Louisville of Medicine, ofSchool Lou #4 Poster CANCER Angelena Edwards¹, Trinath P. Das², Arokya PapuJohn², Suman²,Suman Targhee J. Morris²,Floyd³,Akhila Messer²,Jamie Erin Alatassi³, Houda C. Ankem², N. Murali K. Ankem² Presented By: inhibiting colony forming ability, adhesion, invasion and migration of prostate cancer P P cancer of prostate migration and invasion adhesion, ability, forming colony inhibiting miR of expression over cells. Similarly, and (Gleason 6/7) will prostate cancer patients. Conclusion: potential marker for metastasis and detecting its miR 144 Poster #5 TARGETING AR INDEPENDENT MOLECULAR SIGNALING FOR THE TREATMENT OF CASTRATION RESISTANT PROSTATE CANCER (CRPC) Chendil Damodaran¹, Suman Suman¹, Trinath P. Das¹, Jim Mosehly¹, Houda Alatassi² and Murali K. Ankem¹ ¹Department of Urology, University of Louisville School of Medicine, Louisville, Kentucky; ²Department of Pathology, University of Louisville School of Medicine, Louisville, Kentucky Presented By: Chendil Damodaran, PhD Introduction: Androgen ablation therapy is the mainstay for prostate cancer (CaP), which is initially effective in de-bulking the tumor volume, however, around 30% of patients eventually develop castration-resistant prostate cancer (CRPC), which is resistant to most chemotherapeutic agents. This is a key challenge for clinicians trying to palliate an incurable disease and extend life. Hence, there is an immediate need for identification of novel targets to eradicate CRPC effectively. Hence, the goal of the study is to identify novel therapeutic target for CRPC. Methods and Results: To identify the molecular targets, we utilized human CaP tissues and immunohistochemistry revealed high expression of active AKT (pAKT) is a key event, in advanced stage patients as compared to hyperplastic tissues. Next, we have screened for molecules inhibit AKT activation; molecular docking studies suggested that Withaferin A (WA) binds to active site of AKT and inhibits its activation. Treatment of WA inhibits the growth of CRPC cells by inhibiting AKT mediated pro-survival signaling and concomitantly induced apoptosis. we have utilized three different in vivo models.(i) Stably AKT overexpressing CRPC cells induced aggressive tumor growth in Xenograft models, and oral administration of WA (4mg/kg-4 weeks) significantly inhibited AKT induced tumor growth. (ii) Secondly, to establish the AKT inhibitory mechanism of WA, we utilized the PTEN knockout mice model; vehicle and WA (5mg/kg) were orally gavage up to 45 weeks. Gross pathological studies suggested a significant growth inhibition and micro metastasis in WA-treated tumors as compared to the vehicle treated tumors. (iii) Finally, to determine the chemopreventive effect of WA we employed TRAMP mice with same treatment strategies up to 40 weeks and histopathological examination revealed that control groups showed metastasis to lungs, liver or kidneys (58.3%). However, in the treatment group 16.6% mice showed metastasis. Immunohistochemistry of tumor sections revealed high expression of AKT, pAKT, down regulation of nuclear FOXO3a and Par-4 in AKT overexpressed tumor sections/TRAMP controls. On the contrary, inhibition of AKT signaling and activation FOXO3a-Par-4 induced cell death was seen in WA-treated mice including AKT- overexpressed Xenograft tumors. Conclusion: Overall, these results provide important scientific evidence in support of targeting AKT signaling will inhibit CRPC as well as metastatic CRPC. Acknowledgements: This work was supported by the R01CA140605 and R01CA138797

Poster #6 3-YEAR FOLLOW-UP OF CHEMOTHERAPY FOLLOWING RADIUM-223 DICHLORIDE (RA-223) IN CASTRATION-RESISTANT PROSTATE CANCER (CRPC) PATIENTS (PTS) WITH SYMPTOMATIC BONE METASTASES (METS) FROM ALSYMPCA Luke Nordquist¹, Robert Coleman², Sten Nilsson³, Nicholas Vogelzang4, Karin Staudacher5, Marcus Thuresson6, Christopher Parker7 and Oliver Sartor8 ¹GU Research Network, LLC, Omaha, NE; ²Weston Park Hospital, University of Sheffield, Sheffield, UK; ³Karolinska University Hospital, Stockholm, Sweden; 4Comprehensive Cancer Centers of Nevada, Las Vegas, NV; 5Bayer AS , Oslo Norway; 6Statisticon AB, Uppsala, Sweden; 7The Royal Marsden NHS Foundation Trust and Institute of Cancer Research, Sutton, UK; 8Tulane Cancer Center, New Orleans, LA Presented By: Luke Nordquist, MD, FACP Introduction: Ra-223 is approved for pts with CRPC, symptomatic bone mets, and no visceral mets based on ALSYMPCA results. Ra-223 prolongs overall survival (OS), whether administered with prior or no prior docetaxel treatment (tx) (Hoskin Lancet Oncol 2014). Chemotherapy (chemo) after Ra-223 tx was safe and well tolerated (Sartor ESMO

146 POSTERS - - or 223 -

223 and 223 (141 - - core biopsy 223 (93 mg)223 (93 - - up data. -

rican (AA) and non and rican (AA)

1/48 (2%)1/48 for neutrophils; 223, 46 [72%] pbo) and 223, and pbo) [72%] 46 year followyear - -

tion. tion. vs.

, John Thomas³, Jeffrey Nix¹, 223 pts (41/142 [29%]) and pbo pts pts [29%])223 pts (41/142 and pbo pbo pts with grade 3/4 grade hemepbo pts values with - Bahrami¹,³ -

vs. ve analysisve 3 of as analyzed, and hematologic (heme) safety 223 - 147 223 and 20/21(95%) pbo pts. -

223 and 10 pbo pts223 and 10 time from analysisof preliminary in 2012. - 223 and 64/307 (21%) pbo pts had chemo following study chemo following 223 and 64/307 pts tx, had (21%) pbo - 223, [20%] 13 pbo). timechemo Median to 35 days longer was rofilessimilar tochemo up to those with for 3 years of after pbo - pbo (80 pbo (80 d). chemo Median duration longer was Ra with 0/49for (0%) platelets. measurements Heme lab time over are vs. 2/49 (4%) for (4%) hemoglobin;2/49 11/114(10%)

vs. GUIDED PROSTATE BIOPSIES vs. -

, Williamand Soroush, Grizzle² Rais 4 Patrick J. J. Guthrie Patrick Significant racial African disparities exist Ame between

This post hoc analysis that showed pts couldreceive chemo Ra following pbo (127 d).pbo (127 total Median dosedaily lower Ra with docetaxel was

The analysis includes ALSYMPCA pts chemo had who following study tx (Ra Between January 2014 and August 2015, 177 patients underwent who mpMRI nt of Radiology, University of Alabama at Birmingham, Birmingham, AL; AL; Birmingham, Birmingham, at Alabama of University Radiology, of nt

142/614 (23%) Ra (23%) 142/614

223 (115d) - related in37/41(90%) Ra death, [33%])died during and 30 days aftermost cause chemo;common prostatewas ommon chemo agents were docetaxel [69%](100 chemoagentsommon were Ra – up. - 1/116 (1%)

Department Medicine, Pathology of Boston, and Laboratory Tufts Center, Medical MA Introduction: Presented By: African American men inGleason Grade at the time of prostate cancer (PCa) diagnosis. To better characterize used multiparametric this we disparity magnetic resonance imaging detec (mpMRI)targeteda toolto PCa assist in and biopsies as #7 Poster ON DETECTION CANCER PROSTATE ON DISPARITIES RACIAL OF EVALUATION FUSION MRI/US 4 2012). These currentanalyses postchemo hoc evaluated after ALSYMPCAstudy tx, moreincludinga extensi additional and 62 pts an ¹DepartmentUrology, of UniversityAlabama Birmingham, of at AL; Birmingham, ²DepartmentPathology, of Birmingham, University Alabama Birmingham, of at AL; ³Departme Methods: and MRI/ultrasound (US) fusion guided prostate biopsy and concurrent 12 Patrick Guthrie¹,Yarlagadda¹, Vidhush Jennifer Gordetsky¹,² Sandra Gaston 223 or placebo223 or [pbo]). identified, Chemo agents were and time last from to study tx start of chemo and its duration calculated. were OS w based values on lab reviewed. Results: Methods: Methods: were reviewed.were stratified They were race by butentry criteria: also protocol pri (1) negative prostate surveillance biopsy, active (2) primary protocol, (3) or evaluation biopsy Most c mitoxantrone [16%] (23 Ra including an additional 52 Ra 52 additional an including after Ra d) thand) with 9/116were (8%) Conclusion: Conclusion: OSwith and hemesafety p follow (21/64 cancer than with pbo (120 mg).than Percentages pbo (120 Ra with of and months15.8 followingSimilar proportions pbo. Ra of presented (Table). OS Median startfrom of 16 months chemowas following Ra

146 for abnormal DRE or elevated PSA. MRI studies with T2-weighted, diffusion weighed, and dynamic contrast enhancement sequences were evaluated and areas of suspicion were identified. Patients underwent MRI/US fusion biopsies of targets and concurrent standard 12-core biopsy. The number of targets with PCa, number of standard biopsies with PCa, grade identified, and distribution of tumors was calculated. Results: In our study, 38 AA males and 139 non-AA males underwent MRI/US fusion biopsies. PSA, age, and cancer detection on standard biopsy were not significantly different between groups. AA and non-AA men had a mean of 2.58 and 2.74 targets identified, respectively(p=N.S). The efficacy of targeted biopsy vs. standard biopsy in detection of PCa and higher grade disease was equivalent between AA and non-AA males(p=N.S.). When both targeted cores and standard cores found PCa, standard cores in AA males showed higher grade PCa than targeted cores (p<0.001). Conclusion: African American males have been shown to have higher risk of PCa and higher grade disease, but in our patient cohort undergoing MRI/US fusion-guided biopsy, cancer detection stratified by grade was equivalent. In patients with PCa found on both standard and targeted biopsy techniques, AA patients had higher grade disease on standard biopsy cores, likely a result of the distribution of AA patients referred with already diagnosed PCa on AS, suggesting a selection bias favoring the posterior peripheral zone location of their tumors.

Poster #8 PRIMARY CRYOTHERAPY FOR HIGH-GRADE CLINICALLY LOCALIZED PROSTATE CANCER: ONCOLOGIC AND FUNCTIONAL OUTCOMES FROM THE COLD REGISTRY Kae Jack Tay¹, Thomas Polascik¹, Ahmed Elshafei²,³, Michael Cher4, Robert Given5, Vladimir Mouraviev6, Ashley Ross7 and J. Stephen Jones8 ¹Duke University, Durham, NC; ²Cleveland Clinc, Cleveland, OH; ³Al Kasr Al Aini Hospital, Cairo University, Giza, Egypt; 4Wayne State University School of Medicine, Detroit, MI; 5East Virginia Medical School, Norfolk, VA; 6Orlando, FL; 7Johns Hopkins School of Medicine, Baltimore, MD; 8Cleveland Clinic, Cleveland, OH Presented By: Kae Jack Tay, MBBS, MMed(Surg) Introduction: To evaluate the oncological and functional outcomes of primary cryotherapy in men with clinically localized, high-grade prostate cancer. Methods: We included all men with biopsy Gleason score ≥ 8, localized (cT1-2) disease with a serum PSA ≤50 ng/ml from the Cryo On-Line Data (COLD) registry. The primary outcome was biochemical progression free survival (BPFS) as defined by the Phoenix criteria (nadir PSA +2 ng/ml). Secondary outcomes of continence (defined as strictly no leak) and potency (able to have intercourse) were patient-reported. Factors influencing BPFS were evaluated individually using Kaplan Meier and in a multivariate model using Cox regression. Results: Altogether, 300 men were included for analysis. The median follow-up was 18.2 months (mean 28.4) and median BPFS was 69.8 months. Based on Kaplan-Meier analysis, the estimated 2 and 5 year BPFS rate was 77.2% and 59.1% respectively. Neo-adjuvant

148 POSTERS

. , 5 urethral urethral - treatment -

and Mark L

, Brian Moran J

4 ) and a ) post cidenceof recto The Urology and Prostate The 4 University of Miami Miller Miller of Miami University 9 , KMichael Brawer up. The in The up. 8 -

University of Colorado at Denver,University Aurora, Colorado of 7 149 month follow

- , Rajesh Kaldate , Rajesh 7 et analysiset of 119 patients at Urologic Carolina Research

cancer−specific disease progression and mortality when

Prostate Cancer FoundationProstate CancerWestmont, Chicago, of IL; 5 value <0.0001),mean treatment of with number per options callyterm.cancer prostate short localized the in - hen¹, Neal Shore²,Judd Kella Neal Boczko³, Naveen hen¹,

, E David Crawford 6 tic Laboratories, Inc., Lake UT; Salt City, luation (p luation grade, clini The cellcycleThemolecular progression is test a validated that (CCP) assay T. Brian Willard, MD, FACS Willard, MD, Brian T. - SC; ³WESTMED Medical Group, Woodmere, Medical NY; SC; ³WESTMED Group, Primary cryotherapyPrimary appearscommunity tothe and safe be effective in

Untreated patients with newly diagnosed (≤6 months), clinically localized

There was a significantThere was treatment recorded reductionthe at in burden each

CP) recordedwas on the first questionnaire. thenwas test conducted The CCP on Myriad Gene Myriad nistered. Changes in treatments between the pre−CCP and post−CCP questionnaires 8 Urological Research Network, Lakes, FL; Miami demonstrated the impact of CCP testing on treatment decisions at each stage.testingdemonstrated on treatment decisions CCP impact of each the at prostate adenocarcinoma were enrolled. The physician’s (pre−C initial therapy recommendation prostate biopsy tissue. Three post−CCP questionnaires recorded treatment recommendation, physician/patient treatment the and actual decision, treatment physician’s revised admi Results: patient decreasing from 2.66 pre−CCP test to 1.19 in actual administration. From pre−CCP Introduction: successive eva assesses risk of prostate of risk assesses Center presented. are Methods: combined with standard clinicopathologic (n=1206) prospective registry to evaluate CCP test impact on personalizing prostate cancer parameters. PROCEDE−1000 is treatment. Results of a subs the largest Gonzalgo Fernando J Bianco School of Miami, FL Medicine, Presented By: 6 hormonal administeredtherapy was men tothis 41% to tended men occur and of with in larger prostates,technical likelyconsideration a as downsizing prior to for cryosurgery. At multivariate analysis,the presence of Gleason score 1.9 10 (HR 9 or ¹Carolina Urology Partners, West¹Carolina Partners, Urology Columbia, ResearchSC; ²Carolina Urologic Center, Myrtle Beach, Institute, San Antonio, TX; #9 Poster SIGNIFICANT REDUCTION IN THERAPEUTIC BURDEN FROM USEIN OF TEST CCP TREATMENT DECISIONS NEWLY PROSTATEAMONG CANCER DIAGNOSED LARGEPATIENTS IN PROSPECTIVE A REGISTRY Co Willard¹, Todd Brian CO; setting for for setting high Conclusion: PSA nadir of ≥ 0.4 biochemical regression. progression using Cox notedcontinence was ng/ml in Complete90.5% (HR 5.7) were the of men and potency in17% of men at 12 only significant variables associated with fistulae urinary and retention intervention requiring catheterization temporary beyond was 1.3% and 3.3% respectively.

148 therapy recommendation, the CCP risk score caused a change in actual treatment administered in 70% of patients; of these changes, 81% were reductions in treatment. These reductions occurred in radical prostatectomy (56.7%, N=67 to N=29), radiation therapy (71.4% primary, N=49 to N=14; 50% adjuvant, N=8 to N=4), brachytherapy (32.4% interstitial, N=34 to N=23; 93.3% HDR, N=15 to N=1). A considerably high percentage of patients (31.1%; 37/119) were recommended for conservative management post−CCP testing. The subset analysis of patients from Carolina Urologic Partners supports and mirrors the data obtained from the entire patient set. Conclusion: The CCP risk assessment score has a significant impact in helping physicians and patients reach consensus on an appropriate personalized treatment decision, often with major reductions in interventional treatment burden.

Poster #10 ROBOTIC TRAINING WITH PORCINE MODELS INDUCES LESS WORKLOAD THAN VIRTUAL REALITY ROBOTIC SIMULATORS FOR UROLOGY RESIDENT TRAINEES Vladimir Mouraviev, Martina Klein, Eric Schommer, Srinivas Samavedis, David Thiel, Gabriel Ogaya-Pinies, Hariharan Ganapathi, Anup Kumar, Raymond Leveillee, Raju Thomas, Julio Pow Sang, Li-Ming Su, Engy Mui, Roger Smith and Vipul R Patel Global Robotic Institute. Celebration, FL Presented By: Gabriel Ogaya-Pinies, MD Introduction: In pursuit of improving the quality of residents’ education, the Southeastern Section of the American Urological Association (SES AUA) hosts an annual robotic training course for its residents. The aim of this study is to evaluate robotic simulation workload and stress levels on urology resident trainees utilizing porcine models and virtual reality robotic simulators during this workshop. Methods: Twenty−one residents from 14 programs in the SES AUA participated in this 2015 course. The first day residents have been taught with didactic lectures by faculty. On the second day trainees were divided into two groups. Half were asked to perform skill tasks on the Mimic da Vinci−Trainer (MdVT, Mimic Technologies, Inc., Seattle, WA, U.S.A) for four hours while the other half performed set tasks in a live nephrectomy on porcine model using the da Vinci Xi robot (Intuitive Surgical Inc., Sunnyvale, CA). After the four hours the groups changed places for another 4−hour session. All trainees were asked to complete the NASA TLX 1−page questionnaire following both the MdVT simulation and live animal model sessions. Results: The analysis of the interface by TLX interaction was analyzed to determine whether the scores of each of the six TLX scales varied across the two interfaces. The means of the TLX scores observed at the two interfaces were similar. The only significance was observed for frustration, which was significantly higher at the simulation than the animal model, t(20) = 4.12, p = 0.001). This could be due to the trainees’ familiarity with alive anatomical structures over skill set simulations which remains a real challenge to novice surgeons. The other reason is that the simulators have a metrics to provide a score for specific performance traits, as well as combining all of these into a single composite score of performance for entire exercise Conclusion: Novice trainees experienced significant mental overload while performing tasks on both the simulator and the live animal model during the robotics course. NASA TLX scoring demonstrates that live animal models provide the same proficiency performance with less frustration. On contrary, the simulation part of course remains more challenging task for trainees with more frustration and repetitive exercises to achieve the passing score.

150 POSTERS e e op - 85) -

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Pinies, Hariharan Ganapathi, Vladimir Vladimir Ganapathi, Hariharan Pinies, - t of Urology, University of Florida University Urology, t of 151

Pinies, MD Pinies,

MDP bone scan MDP demonstratedmultifocal lytic lesions with - inal vesicle invasion. Positive surgical margins were found in 11 in found were margins surgical Positive invasion. vesicle inal up will be necessary indetermining full the extent of sRARP in ETAXEL CHEMOTHERAPY IN THE SETTING OF CLINICALLY CLINICALLY OF SETTING THE IN CHEMOTHERAPY ETAXEL - Celebration, FL

, surgical therapy. primary Salvage robot assisted radical prostatectomy - Toreport radiographic outcomes treatment of of prostatecancer rare with Gabriel Ogaya Gabriel Maria Paula Domino, MD Domino, Paula Maria There is a significantThere is a number experience of patients who recurre

This large case series further validates sRARP as a suitableseries largesRARP case further validatesThis a as treatment option

a biochemical failureaftermedian a follow up of (IQR) 14.5 (8

A 70 year old maleA old 70 year presented PSA with 586; a baseline with PSA of a year 3.7 We retrospectively reviewed our database of more than patients 8,500 have who

The medianThe interval from (IQR) 26 sRARP therapy 48 (range to primary was

atients (36.8%) retained potency after the salvage procedure with nerve sparingsalvagepotency nerve with theatients procedure (36.8%) after retained r #11 er data in this field. this in data er oodlief, Janice Doss, Cathy Jenson, Travis Rogers, Kevin Boener, John Andrich Jenson,TravisBoener, Janice JohnKevin and Cathy Doss, oodlief, Rogers, Poste robotundergone assisted radicalprostatectomy. a period Over of8 years (2008 Presented By: Introduction: determine predictors biochemical of recurrence. Results: patients had ChristopherSyed, Jamil Chew, Ogaya Gabriel Mouraviev,Kumar,Samavedi, Anup Srinivas Tracey Rocco, Bernardo Coelho, Rafael W Patel Vipul R. Global Robotic Institute cancer after non singlesurgeon. a performed sRARP caseto of series by date Methods: identified had 65 patients have sRARP who performed after a failure of primary ablative Whentreatment. evaluating outcomes, biochemical recurrence sRARP after defined was as two postoperative PSA measurements of ≥ 0.2 ng/mL. Continence was defineduse of 0 pads after surgery. defined was Potency as the ability achieve to and maintainas th satisfactory erections firm forenough intercourse. sexual Kaplan The used to estimate survival.Both univariate and multivariate regression analysis months.median The (IQR) age of patients undergoing sRARP 69 (65 was (26.2%) patientssem had (16.7%) no patients.There were cases of rectal injury intraoperative any or complications. Anastomotic found in (27.7%)18 were leaks cases at 10 EVALUATION OF OUTCOMES OF SALVAGE ROBOTIC PROSTATECTOMY: SINGLE SINGLE PROSTATECTOMY: ROBOTIC SALVAGE OF OUTCOMES OF EVALUATION INSTITUTION EXPERIENCE (sRARP) represents a feasible treatment optionin these cases. purpose of The the study is to report the outcome (biochemicalcontinence, recurrence, potenc the 11th riband left ilium, soft tissuemass effect inthe bladder, and pelvic lymphadenopathy. 99mTc 65 patients continent were to salvage prior continence and 53.8% RARP reported after surgery. considered potent 19 patients were salvage 7 of through before RARP. going these p techniquedone bilaterally inmajorityabsolute cases. of Seminal invasion,vesicle pre Introduction: Methods: earlier. Biopsy and staging demonstrated T4G4+3 prostate cancer perineural with invasion.Stagingscancontrast demonstrated CT lytic lesions with lyticmetastasis bone after treatment Docetaxel with chemotherapyand report the need for furth Gleason surgicalmargins and positive predictive >7, were recurrence. biochemical of Conclusion: Presented By: modalities. follow Longer for patients have experienced who localized recurrence of cancer. prostate Our outcomes for biochemicalcontinence comparable recurrence,to s and other potency, are Poster #12 Bird³ Y. Victoria and Sutowski² Raymond Domino¹, Paula M. of ²Department Florida; Gainesville, Florida, of University Urology, of ¹Department Radiology, University Florida; of ³Departmen PROSTATE CANCER WITH RARE METASTATIC LYTIC BONE LESIONS: POSITIVE POSITIVE LESIONS: BONE LYTIC METASTATIC RARE WITH CANCER PROSTATE DOX POST SCAN BONE providing adequateand quality cancer control life of issues. SUCCESSFUL TREATMENT 150 increased blood pool/intense hyperemia activity at 5 minutes and again at 2 hours after hydration, consistent with aggressive appearing lytic metastatic disease. A biopsy of the 11th rib was consistent with metastatic carcinoma of the prostate. The patient underwent immediate ADT and 6 cycles of Docetaxel per CHAARTED and STAMPEDE trials, and radiation to pelvis for pain palliation associated with large metastasis. Results: Post chemotherapy, 1 month follow up bone scan showed multiple areas with uptake concerning for active disease however staging contrast enhanced CT scan done at the same time showed sclerotic lesions and minimal evidence of active metastatic disease. PSA after Docetaxel chemotherapy was 0.67; clinically the patient had overall improvement. Conclusion: There are no current publications recommending timing of bone scan for evaluation of successful chemotherapy treatment for metastatic prostate cancer with lytic lesions.This case report demonstrates clinically successful treatment of metastatic prostate cancer with rare lytic lesions after Docetaxel chemotherapy per PSA and enhanced CT determination, however bone scan remained positive. There is no current determination of when a bone scan would become negative after chemotherapy with Docetaxel for metastatic prostate cancer with lytic lesions. We wish to add this finding to the body of literature that exists for this evolving therapy for prostate cancer and recommend further investigation to aid in determination of appropriate clinical endpoints in related treatment.

Poster #13 CLINICAL SIGNIFICANCE OF P53 AND P16INK4A STATUS IN A CONTEMPORARY NORTH AMERICAN PENILE CARCINOMA COHORT Kamran Zargar-Shoshtari¹, Anders E. Berglund², Pranav Sharma¹, Julio M. Powsang¹, Anna Giuliano³, Anthony M. Magliocco4, Jasreman Dhillon4 and Philippe E. Spiess¹ ¹Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, Florida; ²Department of Biomedical Informatics, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; ³Center for Infection Research in Cancer, Lee Moffitt Cancer Center and Research Institute, Tampa, FL; 4Department of Pathology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, Presented By: Kamran Zargar, MBChB, MD, FRACS Introduction: Due to the low incidence of penile carcinoma (PC), the value of p16ink4a, p53 and HPV infection status in clinical practice remains unclear. Herein, we report our experience with potential clinical utility of these markers in men with PC treated at our institution. Methods: Tissue microarrays (TMA) of 57 cases of invasive penile squamous cell carcinomas were immunohistochemically stained for p16 and p53. HPV In-Situ- Hybridization (ISH) for high-risk subtypes was also performed. Association between marker status, nodal disease, cancer specific (CSS) and overall (OS) were evaluated. Survival was assessed with Kaplan-Meier and Cox regression analyses and predictors of nodal disease were analysed in a logistic regression model. Results: p16 and HPV ISH were positive in 23 (40%) and 24 (42%) of the cohort,

152 POSTERS vs. vs. ent ent

2012 2012

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Meier analysis,Meier the - 76). Estimated median median 76). Estimated

– basaloid tumor subtypes - 14.5%, p=0.02, respectively) and 93.7 months, p<0.01). Patients with 0.97; and median p=0.022) income vs.

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04- Shoshtari, LucheyAdam and Philippe - or pathologicalor nodal statusadjuvant and diagnosed of penile SCC penile fromdiagnosed of 1998

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– not reached) at median follow−up of 44.7 months (IQR:

vs.

– 1.58; p<0.01) independentlywas associated with OS, worse

– 15.4%, p<0.0115.4%, and 12.5 vs.

We evaluated sociodemographic and economic differences inoverall Pranav Sharma, MD Center, Tampa, FL Incurrent this cohort, p53 and p16 status demonstrated clinical utility in

Racial and economic disparities insurvivalthe of cancer penile patients exist.

0). Blackstage patients a higher (pT3/T4: disease with 0). of presented 17.4 We identified 5,720 patients a with

Median age was 66 years (interquartile age was Median [IQR]: range 55

81.

e (pT3/T4: 11.8 (pT3/T4: e – 0.99]). The worst CSS was seen inpatientspN+ doublewith negative p16 and p53 - clusion: idence interval [CI]: 1.21 etter OS. respectively. Theproportion of basaloidwarty, or were significantlywere higher inthe positive p16 patients (48% vs. 3%, p<0.01). p53 expression negativewas cases. in (54%)31 In patients, negative p16 status p53 positive was associated 4.4disease pN+ with [95%CI (OR 1. unadjusted estimated OS insignificantly was longer inp16 positive patients (median OS 75 vs. 27,median p=0.27) and not was CSS reachedmultivariable (p=0.16).In a Cox proportional hazard model, controllingwhen f chemotherapy, p16 status significant a was predictor for CSS improved (HR: 0.36,[95%CI 0.13 expression (8 vs. 34 months,expression 34 p=0.01). vs. (8 Con Methods: survival (OS) of penile SCC patients using the National Cancer Data Base (NCDB).survival using the Data SCC (OS) penile patients National Cancer of Presented By: Introduction: with with clinically non−metastatic disease and available pathologic OS was estimated tumorusing the Kaplan−Meier method, and differences were determined and using nodal staging. the log−rank test. independent predictors OS. of Cox proportional Results: haz private insurancemedianhigher and income presented a lower stage with >$63,000 of diseas privatewhile insurance (HR: 0.78, 95% CI: 0.63 had a bettermedian OS (163.2 >$63,000 (HR: 0.84,95% CI: 0.74 follow up. Pranav Sharma, KenanAshouri, Kamran Zargar Spiess Moffitt Cancer Poster #14 RACIAL ECONOMICAND DISPARITIES TREATMENT INPENILE OF THE SQUAMOUS CELL RESULTS CARCINOMA: CANCER FROM THE NATIONAL DATABASE predicting nodal disease as well as survival. The markers maypredicting potentialmarkershave survival. as The disease well nodal utility as in selecting high risk patients may who benefit from adjuvant therapies more or string OS 91.9 was months (IQR: 25.8 17.2 13.7%,median and had a worse p=0.039) OS (68.6 p=0.001,multivariate respectively). On analysis, black ratio (hazard race [HR]: 1.39, 95% conf b An understandingminimizecare. these help differences will of treatment cancer in gaps Conclusion: 152 Poster #15 TYPE OF PENILE SPARING SURGERY HAS NO EFFECT ON TIME TO RECURRENCE IN PATIENTS WITH PENILE CANCER Gregory Diorio¹, Andrew Leone¹, Keenan Ashouri², Pranav Sharma¹, Kamran Zargar- Shoshtari¹ and Philippe Spiess¹ ¹Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, Florida; ²Florida Atlantic University, Boca Raton Florida Presented By: Gregory Joseph Diorio, DO Introduction: Squamous Cell Carcinoma of the Penis (PSCC) is a rare but has significant effect on urinary, sexual and psychological health. Traditionally, management of PSCC has included wide excision with a 2 cm margin and partial or total amputation. Recent treatment paradigms have demonstrated that penile sparing surgery (PSS) can have excellent oncologic control while preserving function and cosmesis. The purpose of this study is to evaluate the effect of laser ablation (LA) and wide local excision (WLE) on recurrence rates in patients with penile cancer. Methods: We retrospectively reviewed or penile cancer database from 1994-2013 for penile cancer patients treated with LA or WLE. Clinical and demographic characteristics were compared using the Mann-Whitney U test to compare medians and the chi-squared test for proportions. Recurrence-free survival (RFS) was examined using the Kaplan-Meir method and comparisons carried out with the log rank test. Multivariate Cox-regression analysis was used to test the association of PSS with disease recurrence. Results: 37 patients were identified who underwent PSS at our institution. There was no difference between the two groups in terms of age, pTstage, margin status, HPV status, recurrence, or follow up. Median follow up was 62.6 months for LA and 28.7 months for LWE (p=0.81). On Kaplan-Meir analysis median time to recurrence was 3.9 months (SE 1.24 95% CI: 1.45-6.34) for LA vs. 12.1 months (SE 5.1 95% CI: 2.1-22.1) for LWE (p=0.25). Of those who recurred, 4 patients (36.4%) in the LWE group were managed with partial penectomy, the remainder in both groups were managed with further PSS. On multivariate analysis RFS was not significantly associated with the type of PSS (odds ratio 0.43 95% CI: 0.113-1.67 p=0.22). Histologic grade was an independent predictor of RFS (odds ratio 8.03 95% CI: 1.66-38.85 p=0.01). Conclusion: Type of PSS has no association with RFS in patients with penile cancer though histologic grade may be an adverse predictor of time to recurrence. Further prospective studies are needed to examine the oncologic treatment paradigm in patients with penile cancer while optimizing function and cosmesis.

Poster #16 NATIONAL PRACTICE PATTERNS OF SYSTEMIC AND RADIATION THERAPY IN THE TREATMENT OF PENILE CANCER: ANALYSIS OF THE NATIONAL CANCER DATABASE Gregory Diorio¹, Andrew Leone¹, Pranav Sharma¹, Kamran Zargar-Shoshtari¹, Peter Johnstone² and Philippe Spiess¹ ¹Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, Florida; ²Department of Radiation Oncology, Moffitt Cancer Center, Tampa, Florida Presented By: Gregory Joseph Diorio, DO Introduction: Squamous Cell Carcinoma of the penis (SCC) is a rare disease that poses many treatment challenges in advanced stages. We sought to analyze the national practice patterns of systemic and radiation therapy (XRT) in the treatment of penile cancer among community and academic urologists using the National Cancer Database. Methods: We retrospectively reviewed the National Cancer Database for all patients with penile cancer from 1998-2012. Patients were divided into two groups : Those treated in the community setting and those treated in academic centers. Treatment patterns of systemic chemotherapy and radiation therapy were compared. A sub analysis of the two groups was then performed stratified by year of diagnosis ( 1998-2002, 2003-2007, 2008-2012), clinical node status (cN1, cN2, cN3) and pathologic node status (pN1&2 and pN3). Statistical analysis was performed using the chi-squared test for proportions using SPSS software

154 POSTERS

n his 2012 for for 2012 For AAM AAM For - 43.5% in the

vs. operatively, XRT

astatic disease, we

Prakash¹, Raymond R. -

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mographic variables including: age,

R AFRICAN

nard M. Miller School Medicine, M.nard Miller of Miami, 155 statistics,Sciences,Public Department Health of

ancer moreare likely to receive systemic chemotherapy 2007(p=0.01) and 2008 - s there was no difference in the use of XRT for those treated at an for thosean there treated at s XRT wasthe of no difference use in 38.1% in academic centers) . centers) in academic 38.1% C where disease mortality disease is highest. where C men (AAM) compared to Caucasian men with comparedtomen cell squamous (AAM) Caucasian penile (CM) istrationsystemicchemotherapy of for patients nodal with disease vs. pathologicfrom data 14,395 available patients was from 1998

- Studies suggest that there may be disparity inclinical outcomes for Chad Ritch, R. MD, MBA

Patientsc penile with Mortality rates frompenile SCC remainhigh incontemporary series.

Using the Florida Data Cancer System, identified we men diagnosed penile with

Clinico Of the 653 mentheOf 653 penile with SCC, 198 [38 (19%) and 160 (81%) AAM had CM] espectively). Forthe entire cohort patients more to were likely receive systemic

y advancedy and/or metastatic disease. follow Median up for the entire cohort 12.5 was cN status no difference inuse chemotherapy or XRT of was seen community between and academiccenters.Patients more pN1&N2likely receive with nodes to adjuvant were XRT inthe community setting (p=0.001). difference No inchemotherapy use seen was betwee analysis. For all patient all For analysis. academiccommunitystratifiedsetting.When there no difference or year by was the in use for patientsof XRT treated academiccommunity at centers and across groups all (p=0.2, 0.6, 0.5 r academic and community stratified centerswhen pathologic status by node the with majority receiving adjuvant rather than neoadjuvant chemotherapy (3.2% therapy inan academic setting (p=0.01). Chemotherapy use significantly was higher in academic centers for years 2003 and significant considered were differences if p<0.05. Results: community; 4.6% Conclusion: inacademiccenters, more likely to and it is be delivered adjuvantly. Post ismore frequentlycommunity deliveredsetting.the patients forcurrent in pN1&N2 Despite guidelines, admin remains to be uniformly adopted. Further studies needed to are delineate optimal multimodalitythistherapyto in difficult treat population. Poster #17 CAUCASIAN MENWITH IN PENILEADVANCED FLORIDA CANCER R.Chad Ritch¹, Nicola SamarpitPavan², Nachiketh Rai¹, Soodana COMPARISON OF SURVIVAL OUTCOMES FO OUTCOMES SURVIVAL OF COMPARISON Balise³,Parekh¹J. Gonzalgo¹ and Mark L. Dipen ¹DepartmentUrology, of University of Leo Miami FL;School ²Department Urology, M. Miller Leonard of of Miami University of Medicine, Miami, and Urology Clinic, Department FL Surgical Medical, Science, of and Health Bio of ³Division Italy; Trieste, of University University Miller Miami School of Medicine, M. Leonard of Miami, FL Presented By: Introduction: Methods: follow−up, stage, race Treatment categorizedtype was as surgery alone surgery or plus additionaltherapy and treatment type (chemotherapy and/or radiation).met For locally advanced and were compared between compared treatmenttype and overall survivalmultivariable A CM. (OS) AAM between and AAM and CM. model developed significant to was determine OS. predictors of Results: SCC, from 2004 toWe 2014. men excluded diagnosedwere who on autopsy at or the time of death <6 months and with of follow up. De African−American Wecarcinomasought (SCC). determine to there whether a survivalwas difference for Africanmen, American versus Caucasian particularlymetastatic inlocally and advanced cases SC penile of locall mos. Forstages, all demonstrated AAM a significantlycompareddecreased OSmedian to vs. (26 mos,CM 37 p=0.03).For locally metastatic advanced and disease, there a was persistent, but non−significant, trend toward disparity in median OS between AAM and CM vs.mos,(17 AAMsurgery received p=0.06). compared to plus 23 Fewer CM additional therapy for locally advancedmetastatic and/orvs. t [8 but 42 (26%)], disease (21%) difference statistically not was significant. After adjustingforstage, and treatment age,type, AAM likelihood 1.63,SCC p=0.015). penile had increased (HR from death of Conclusion: inFlorida, stage advanced treatment presentation, with disparity, at may along partially 154 explain decreased survival rates. Further studies are needed to determine the additional socioeconomic, as well as potential biologic, factors that may predict the relatively poor outcome observed in AA men with penile SCC.

Poster #18 LYMPHADENECTOMY FOR SQUAMOUS CELL CARCINOMA OF THE PENIS: FROZEN TO FINAL Neil Manimala¹, Shohreh Dickinsen², Jasreman Dhillon², Wade Sexton², Phillippe Spiess², Scott Gilbert², Julio Pow-Sang² and Michael Poch² ¹USF Dept of Urology, Tampa, FL; ²Moffitt Cancer Center, Tampa, FL Presented By: Neil J. Manimala, BS Introduction: Appropriately staging lymph node status of patients with squamous cell carcinoma (SCC) of the penis is essential for both prognosis and treatment. Surgical management of lymph nodes is a significant component to treatment algorithms, and the extent of lymph node dissection (standard, +/− pelvic) is often determined intraoperatively by frozen section. The ability for frozen section to reliably detect nodal metastasis is thereby critical. Methods: Using an IRB approved database of Moffitt Cancer Center patients undergoing ILND for cN0−cN2 disease were collected retrospectively from 2001 to 2014. Discordance rates between intraoperative frozen section and final pathology of lymph node status and number were analyzed. Changes in pathology were categorized by major and minor changes. Major changes were considered to be that which would modify the intraoperative plan from standard ILND to addition of pelvic nodes (increase of nodal count from ≤2 or >2) or vice versa. Minor changes consisted of additional positive nodes identified that would have no effect on intraoperative plan. Results: A total of 50 patient s of met inclusion criteria (median age 63 years, IQR 44 −82 years). Mean node count on frozen section was 6.7 with average number of positive lymph nodes 1.2. The average node count on final pathology was 13 with average positive lymph node count of 3. Four out of 50 patients (8%) had a change in pathologic nodal status from negative to positive and one patient had a change from positive to negative. Major change occurred in 9 cases (18%) and minor change in 3 cases (6%). Additionally, within the cN0 subset of patients 3 of 14 (21%) patients had frozen sections that failed to detect nodal metastasis present in final pathology. Conclusion: These findings indicate that intraoperative frozen section diagnosis is an accurate means of determining patients’ nodal metastasis status, thus guiding intraoperative decision making. Caveats may be warranted regarding patients’ clinical node status as it relates to planned ILND aggressiveness. Furthermore, factors that increase patient risk for pelvic lymph node dissection will be considered on further investigation.

156 POSTERS

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6 Introduction: ¹UniversityOfSchoolPuerto Medicine, Rico, Juan, of PR; ²University San Section, Urology ofCancer Comprehensive Puerto Rico C Services Administration, San Juan, PR; Cancer Center, TX; Houston, PathologyPR; and Laboratory Medicine, Juan, San Carlos M. Pérez Poster #19 THE ETIOLOGIC PAPILLOMAVIRUSROLE HUMAN OF PENILE INPUERTO CANCER: RICO SCIENCESHEALTH STUDY Presented By: related to infection human with papillomavirus (HPV). Population the prepuce.studies Recent implicatecancer penile multifactorial, etiology asspecif studies reported have cancer that incidence penile mortality Puerto and in is Rico higher than most developed countries. There is limited about knowledge the epid genotype distribution of HPV infection inpenile cancer patients inPuerto Rico. Introduction: Palefsky Sánchez², QuinteMario with penilewith cancerto period during of the 2014. 2004 Methods: relation sociodemographic between clinicalinfection factors amon and HPV with intervenedWe cases. revie penile cancer and the paraffinblocks analyzed. were A total of twenty embeddedand twenty blocks diagnosed patients entered interviewed.study in the were Following DNA Extraction, HPV genotyping was performe distributions and descriptive statistics used to were characterize sample. the Bivariate and logistic regression analysis used was to determine the demographic, relationbetween histological, a Results: these, resulted high 26.3% in and 1.7% genotypes observed inthis sample proportion of HPV infection observed(11.1%) in was cancerpenile cases poorly differentiated compared when HPV to A studies. higher systematic review to previous is comparable which HPV infection, for proportion of HPV infection statistically was significant for age, younger location, and tumor Wegrading. observed a higher incidence of HPV genotypes patie in differentiated carcinoma 11.1 % compared with HPV negative cases (3.6 %,p=0.0075). Fourteen percent of penile cancer patients demonstrated genotypes that not are covered HPV databy futurestudiessecondary for vaccine, in establishing new Conclusion: regression analysis revealed that patients dia timesmore likely to in be HPV positive comparedsamplestumor when thosewith older (OR=3.2;95%CIthan 0.96 55 years age of Introduction: examiningsurvivaltrendsin time. theover The National Ca Poster #20 JamesAllison Ferguson¹,Woods³ AngelaSmith³, Nielsen³ Deal², Michael Matthew and ¹University of Carolina of ²LinebergerDepartment Cancer North Urology; Center, University of North Ca cell the thesquamous of carcinoma ofcases penis between used years summarize to of 1998 to 2012. The NCDB, jointlysponsored the by American of College Surgeons and the CONTEMPORARY SURVIVAL TRENDSIN PENILE CANCER Presented By: 156 American Cancer Society, is a clinical oncology database sourced from hospital registry data that are collected in more than 1,500 Commission on Cancer-accredited facilities. Methods: The Kaplan-Meier method was used to estimate overall survival (OS), and Cox regression modeling was used to adjust for age, stage, and race in multivariable models to evaluate risk of mortality over time. Time periods 1998-2001, 2002-2005, and 2006-2009 were compared. Results: Overall, 10407 newly diagnosed adult patients with squamous cell carcinoma of the penis were identified over this time and 9268 had complete stage information. Stage distribution changed slightly over time. In 1998, the distribution was 0: 33%, I: 36%, II: 16%, III: 9% IV: 6%, and in 2012 it was 0: 27%, I: 26%, II: 29%, III: 9% IV: 9%. American Joint Committee on Cancer definitions did not change over this time. Five-year OS remained similar between time periods: 1998-2001 - 62.8%, 2002-2005 – 62.6%, 2006-2009 – 60.8%. In a multivariable analysis for all stages combined, age, stage, and race were independent predictors of mortality, but year of diagnosis group was not. Interestingly, when we evaluated each stage individually, stage II patients diagnosed between 2006- 2009 had higher 5-year survival rates than earlier years (58.1% vs. 51.8% (2002-2005) and 50.7% (1998-2001)). These differences remained statistically significant in multivariable analysis with a p-value of 0.0099. Year of diagnosis group was not statistically significantly different for other stages. Conclusion: Overall survival of penile cancer patients as a whole has remained stable between 1998 and 2009. However, stage II patients showed improved survival between 2006 and 2009. This may reflect an improvement in the surgical management of these patients.

Poster #21 CONTEMPORARY MANAGEMENT AND OUTCOMES OF GENITOURINARY MELANOMA: THE MOFFITT CANCER CENTER EXPERIENCE Barrett McCormick¹, Julio Pow-Sang², Wade Sexton², Poch Michael² and Philippe Spiess² ¹University of South Florida College of Medicine, Tampa, FL; ²Moffitt Cancer Center, Tampa, FL Presented By: Barrett Zachary McCormick, MD Introduction: Genitourinary (GU) tract melanomas are rare. Few studies analyze large cohorts. We present an institutional experience of GU melanoma cases over a 20-year time period. Methods: We reviewed the records of patients presenting to our institution between 1994 and the present. Data was collected via retrospective chart review and included patient and disease characteristics, follow-up, and survival. Results: A total of 13 patients were identified. Three were excluded due to incomplete data. A summary table is included. 8 had primary GU malignancies. The mean Breslow depth among all patients was 5.1 mm. All female patients had urethral primaries. Two were treated via transurethral resection and one via total urethrectomy. Two presented with T4 disease and recurred at distant sites at 6 and 14 months, respectively. The other had disease at multiple sites at presentation. Among males, malignancy was observed in the glans (N=3, 42.8%), shaft (N=2, 28.6%), and scrotum (N=2, 28.6%). Penile cases were treated with both wide local excision (WLE) and partial penectomy. Patients in both approaches demonstrated recurrences. WLE was performed in all scrotal cases. Some differences were appreciated between the sexes; males tended to present with a range of pathological staging; T1 (N=1, 14.3%), T2 (N=2, 28.6%,), T3 (N=1, 14.3%), and T4 (N=2, 28.6%) was observed. Additionally, while our female patients all recurred distantly and within 14 months, the males recurred between a range of 4-55 months and at both distant and local sites. Conclusion: The present study highlights that female patients presenting with GU melanoma in our series presented with more consistent recurrence patterns than our male patients. Additionally, female patients all recurred to or presented with disease at distant sites. Male patients, especially those with glans or shaft involvement, were more likely to recur locally. Whether these findings translate to changes in treatment paradigms remains

158 POSTERS 2015 -

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5 duction: performedchildren on old, <18 years prognostic with data. The protocol prospectively was registered and conducted as PRISMA per reviewers guidelines. Two abstracted data using a standardized evaluation referee. Descriptivestatistics performedthe were aggregated on calculation data, with of relative possible. risks when Results: Medical Center, Durham, NC Intro Methods: Conclusion: fourthmost common childhood cancer. tumor Many biomarkers been have studied individually but as ofthere has yet been no comprehensiveWesummary the of data. systematicall marker.the presence prognostic implications a given of the of Presented By: WebScience of electronic dat favorablehistology and 10.2% displaying anaplasia. Nine biomarkers in appeared multiple studies, enabling calculation of relative the risk of (RR) overall survival and/or the ofRR recurrence of (Table disease The strongest1). heterozygosity on 11p15, (LOH) of a RR with recurrence of 5.00, LOH although on 1p and alsostrongly linkedgainfunctionto of 1q were 2.86). recurrence (2.93 on and stronglyincreased associated risk risk overall an recurrence a decreased with or of of survival. These data suggest several leading targets for future study and development of diagnostictests additionto in potentia patientsWT.Studies with had a median 61 patients of 24 biomarker with positive patients studyper and a medianfollow - 3, 4, and 5 28.5%,were 26.4%, 14.1%, 24.5%, and 1.7%, 8 with Routh to be seen.to be Two unpredictablenature and supportthe need for ever ¹Duke University, ClinicalInstitute Duke Division Urology,Research of Durham NC; and Univer ³Duke FL; Gainesville, Medicine, of School Florida of ²University Durham, NC; Poster #22 Rice VanEugeneStewart E. Megan Noord³, B. Henry S. Cone¹, Dalton², PROGNOSTIC VALUE OF BIOCHEMICAL MARKERS IN WILM’S TUMOR: A REV SYSTEMATIC Center, NC; Durham, strategies. 158 Funding Source: Grant K08-DK100534 from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).

Poster #23 THE ROLE OF MEDICAL MANAGEMENT IN PEDIATRIC NEPHROLITHIASIS Amanda VanDlac¹, Dana Giel², Larisa Kovacevic³, Sean Corbett4, George Chiang5, Gina Cambareri6, Derrick Johnston² and Aaron Bayne¹ ¹Oregon Health & Science University, Portland, OR; ²University of Tennessee Health Science Center, Memphis, TN; ³Children’s Hospital of Michigan, Detroit, MI; 4University of Virginia Medical Center, Charlottesville, VA; 5UCSD Department of Urology, Rady Children's Specialists of San Diego, San Diego, CA; 6UCSD Department of Urology, San Diego, CA Presented By: Derrick L. Johnston, MD Introduction: The incidence of nephrolithiasis in children has increased significantly over the last three decades with up to a 10% increase annually (Sas, et al., 2010). Guidelines recommend children should undergo a complete metabolic evaluation with a first stone occurrence because up to 70% of children with nephrolithiasis will have a urine abnormality that increases their risk of stone formation (Tasian, 2014). While medical management has been extensively studied in adults, there is limited evidence supporting medical management in children. Medical management of pediatric stones is based largely on extrapolation of studies performed in adult populations. The objective of this study is to determine if dietary modifications, potassium citrate and/or hydrochlorathiazide (HCTZ) are associated with improvement in Litholink parameters in pediatric stone formers. Methods: Using a multi-institutional pediatric nephrolithiasis stone consortium database we retrospectively compared the pre and post treatment Litholink results for pediatric patients with normal anatomy and a history of nephrolithiasis who underwent treatment with dietary modifications, HCTZ or citrate between 1999-2013. Results: There were 44 subjects included in the analysis. 39 (88.64%), 2 (4.55%) and 3 (6.82%) patients were treated with dietary changes, HCTZ and citrate respectively, as an isolated intervention. With dietary changes we found a significant improvements in 24 hour volume (p<0.05), decrease in supersaturation of calcium oxalate (p<0.0001) and a significant decrease in 24 hour calcium/creatinine ratio (p<0.0001). We had insufficient patient numbers to show any significant findings for HCTZ and citrate supplementation but the limited numbers available showed substantial changes in the calcium and citrate respectively. Conclusion: Dietary changes correlated with a significant improvement in 24 hour volume, supersaturation of calcium oxalate and 24 hour calcium/creatinine ratio. This suggests that dietary management can lead to meaningful changes in the relative risk of stone formation in children with pediatric nephrolithiasis.

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, La Miguel Castellan¹, Andrew hour urinehour analyses. 4 - hour urinehour abnormalities inchildren a history with of urolithiasis or whether - Derrick L. Johnston,Derrick L. MD Pediatric urolithiasis is a complex disease wit disease is complex a urolithiasis Pediatric Joan Delto,Joan MD Laparoscopic orchiopexy isstandardtreatmentLaparoscopic the orchiopexy intra for

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216 childrenmet216 inclusion criteria.120 (56%) family had a positive history of iuria/hyperoxaluria, hypocitraturia/hyperoxaluria. or Afterstratifying for BMI (a

Stephens (SFS) procedure.We - Whitneycontinuousfor for Fisher’s performed Test Exact test was U variables and - hour calcium,hour oxala - normalities.creatininetrend towards greaterchildren excretion a 24 hour There in was Facultad Universidad Salud, de Ciencias de la Anahuac Mex Introduction: institutional evaluate study, influence the we familymetabolic of history on abnormalities via standardized 24 Methods: social, and environmental factors. A family positive history of urolithiasis long has been considered factor a risk stoneformation for some and practitionersmay their alter workup based upon the presence absence or of a fa seen at five institutions 2000 from ¹UniversityTennessee of Department Science Health Center, of Memphis, ²UCSD TN; VA; Charlottesville, Center, Medical Virginia of ³University CA; Diego, San Urology, Aaron Bayne Introduction: Itcan be performed single as staged a laparoscopic (SSLO) orchiopexy a staged or Fowler testicular atrophy and positioning for both techniques.We also aim to identify patient factors that may influence outcomes. Presented By: Urineparameters analyzed respectwith were family to historyof disease. stone Statistical analysis performed was inaggregate and also stratified BMI by Mann variables. categorical Results: common abnormalities being supersaturationcalcium of phosphate patients) (145 and low urine24 hour volume patients) (123 . no correlation There was between family history and 24 stone disease. 204 (94%) had at l stone at 204 (94%) had disease. There was no correlationThere was family between urine of following and any parameter the history hypercalciuria/hypocitraturia, hyperoxaluria/hypercalciuria/hypocitraturia, combinations: hypercalc riskknown factor for 24 ¹Nicklaus Children’sFL; FL; ²Mount SinaiBeach, Hospital, Center, Miami Medical Miami, ³Florida InternationalWertheim UniversityCollege Medicine, Herbert of Miami, FL; 4 Poster #24 24 HOUR URINEPEDIATRIC IN STONE POSITIVE PATIENTS: FAMILY DOES A HISTORY PREDICT METABOLIC ABNORMALITIES? DerrickJohnston¹, Elizabeth Tourville¹, Cambareri²,Sean Gina Corbett³, Health Science University,Portland, & OR; Department Urolog of Presented By: high rate of 24 Poster #25 DOES SINGLELAPAROSCOPIC STAGE ORCHIOPEXY INCREASE OF THE RATE ATROPHY? TESTICULAR Alireza Alam¹, Joan C. Delto², George Wayne³,Alireza Angela Alam¹, Joan Delto², George C. Salvitti¹, Gupta¹, Mariarita Ruben - Blachman ab a positivewith family historythis but didmeetstatistical not significance (p=0.145). Patient statisticallystone did correlate diseaseage atnot onset also of with Conclusion: stonestone disease and incidence inchildren, there is no statistical correlation between family 24 and history there was still no correlation familybetween history and 24 not they a positive have family history.of The presence family absence or history should notto influencethe perf decision 160 Methods: After IRB approval was obtained, a retrospective chart review was performed to identify patients with undescended testicles undergoing SSLO or SFS between November 2006 to 2014. Baseline characteristics were obtained. Testicular atrophy was assessed at follow-up by palpation and comparison with an orchidometer. Positioning was interpreted as abnormal (inguinal or high scrotum) or secure (mid or low scrotum). Odd ratios for atrophy and positioning were calculated using risk-analysis and binary logistic regression. Results: We analyzed 94 testes (82 patients). SFS was performed in 37 cases (39.4%) and SSLO in 57 (60.6%). Baseline characteristics were comparable (Table 1). Mean follow- up was 21.9 and 11.9 months for SFS and SSLO cases, respectively. Of those undergoing SFS, 10.8% were atrophic at follow-up, similar to that for SSLO (7%). With respect to positioning on follow-up, none of the testes undergoing SFS were abnormally positioned whereas in the SSLO group, 19.3% were high in the scrotum. Patient age, side of undescended testicle, intra-abdominal location (high or low), and associated anomalies were not predictive of atrophy rate. However, possible predictors were unilateral non-descent and small pre-operative testes. In terms of positioning, SFS significantly reduced the odds of abnormal positioning in those with high intra-abdominal testes (0.05, 95% CI: 0.01-0.43). No other variables were predictive of abnormal positioning for either high or low abdominal testes. Conclusion: We report comparable atrophy outcomes for both SFS and SSLO, though a slightly lower odds of abnormal position after SFS. Thus, both techniques may be safely used to correct abdominal testes. Prospective, randomized studies with long-term follow-up are needed to better compare these two methods. No disclosures.

Poster #26 OUTCOMES OF SACRAL NEUROMODULATION IN CHILDREN WITH DYSFUNCTIONAL ELIMINATION SYNDROME AND NEUROGENIC BLADDER Reena Kabaria, Patrick Fox, Shenelle Wilson, Zachary Klaassen and Durwood Neal Jr Georgia Regents University Augusta, GA Presented By: Reena Kabaria, MD Introduction: Sacral neuromodulation delivered by the InterStim System has been used to treat urge incontinence, urgency-frequency, and nonobstructive urinary retention for the past 15 years in the adult population. Safety and efficacy have not yet been established for patients under the age of 18. There is limited data regarding the success of sacral neuromodulation for treatment of dysfunctional elimination syndrome and neurogenic bladder in pediatric patients. The aim of this study is to report our experience of sacral neuromodulation in the pediatric population. Methods: Between January 2001 and May 2015, 22 patients underwent a two-staged operative procedure. The first stage was a test stimulation phase with temporary percutaneous lead placement near the sacral nerves at S3 and/or S4. The device was kept in place for a week and symptoms were evaluated with a detailed voiding diary. If the symptoms improved by at least 50%, the InterStim device was permanently implanted. All

162 POSTERS

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stage hypospadias obtained were Measurements repair. a with operative baseline asses - - 7.5 years). There were no reported were infections,7.5 There years).

- al Scherz, Edwin Scherz, Elmore and James Smith al six percentsix of patients off are all bl Multiple componentsthecomplex, of hypospadiasMultiple including glans width - Jonathan Hwaien Huang, MD Jonathan Hwaien Sacral neuromodulation isminimally a invasive,effective treatment in ding symptoms childrending in dysfunctional with syndrome elimination and

for patients complications, with stratified based on the GW and UPW fficacy of sacralfficacy neuromodulationchildren. of in Between November 2012 and December 2014, GW and UPW were Between NovemberGW UPW were 2012 and December and 2014,

e widest the urethral aspect of the dorsal glans e and of plate. Multiplephysicians (interquartile (IQR): range 10.0 Median followMedian up 2.9was months (0.5 Amongthe 22 patients,100% reported overall improvementsymp invoiding n 12/50 (24.0%), compared ton 12/50 6/75 compared (24.0%), (8.0%) in patients GW> with 13.5mm = (p

ments. Classification and regression tree used (CART)was analysis to identify the ications for GW ≤ 13.5mm and > 13.5mm were 3.00 and 3.17, respectively. The W ≤ 3.75mm was significantly associated with complications. Of the patients with UPW 4.0) and 4.0mm (IQR: 3.0 patientspre underwent urodynamicevaluation. They were initiallymanaged conservatively behavioralwith therapy and pharmacotherapy, failed. ultimately which Results: with thewith teststimulation therefore, phase, and all permanent underwent implantation the of InterStimII Neurostimulator Model mean3058. The 11.9 was age years 3 (range while thewhile others had neurogenic bladder secondaryto cerebral palsy (n=3), spina bifida (n=3), and anorectal malformation(n=2). The mean duration up of follow 3.6was years 7 months(range migration, device or devices removed, problems. Two for were lack efficacyone of and one due to complete resolution of symptoms after three years. Three patients required battery changes. Eight Conclusion: 50% were male. The majority male.The50% patients the were of had dysfunctional elimination the result. The remaining 3 patients reportat least improvement 50% insymptoms, but are unsatisfied the with results. managing voi neurogenic do bladder notwho respond to pharmaco optimal dichotomizationand UPW ofthat GW best predictedcomplications following surgery. The average meatalscore of the GMS grading system for hypospadias was determined thresholds. reviewed thereviewed measurement to provide a consensus. Patients followed after were surgery and a thresholdcomplicationsfor calculated was intraoperative based on penile measure Results: Introduction: particular,Sarhan et al. recently reported an increased risk of complications urethral with plate <8mm. width We to aim determine the glans and urethral width plate width where inc significantly rate complication Methods: 13.0) undergoing single ruler at th (GW) and urethral (UPW),plate width b have prospectivelymeasured preoperatively inmonths,125 boys (median age 8.0 6.0 range adverse reported, effects long however were Poster #27 JonathanGarcia Michael Huang, of 125 boys (14%). The median GWfor patients and with without complications was 13.0mm GLANS WIDTH URETHRALGLANS WIDTH:AND PLATE CORRELATION WITH HYPOSPADIAS IN COMPLICATIONS POSTOPERATIVE Andrew Kirsch,Andrew H Emory University School Medicine, of Atlanta, GA Presented By: safety and e ≤ 3.75mm, complications were present patients UPW with =0.006). >3.75mm (p The average meatal scores for patients with in 12/47 (25.5%), compared compl to 6/78 (7.7%) in UP respectively (p = 0.025). CART analyses showed a GW ≤ 13.5mm was an optimal predict split patients with to complications. Of the patients with GW ≤ 13.5mm, complications were present i 0.013).median The for patients UPW and without with complications 3.3mm was (IQR: 3.0 – 162 average meatal scores for patients with complications for UPW ≤ 3.75mm and > 3.75mm were 3.33 and 3.67, respectively. Conclusion: GW and UPW appear to affect outcomes after hypospadias repair. GW ≤ 13.5mm and UPW ≤ 3.75mm are associated with a higher complication rate in patients undergoing hypospadias repair. However, GW and UPW may be only two of multiple variables, including meatal location, that comprise the hypospadias complex and affect the post-operative complications.

Poster #28 UPDATE ON CONTINENT CATHETERIZABLE CHANNELS AND THE TIMING OF THEIR COMPLICATIONS Deborah Jacobson¹, Cyrus Adams¹, John Thomas², Stacy Tanaka², Douglass Clayton², John Pope IV², John Brock III² and Mark Adams² ¹Vanderbilt University Department of Urology, Nashville, TN; ²Division of Pediatric Urology, Vanderbilt University, Nashville, TN Presented By: Deborah L. Jacobson, MD Introduction: Continent catheterizable channels can improve the quality of life in patients undergoing lower urinary tract reconstruction. We previously reported our outcomes of these channels and concluded that most complications occurred in the first year after surgery and then decreased in incidence over time. In the previous cohort of patients, our follow-up was short and this left us with the question of whether or not channel related events continue to accumulate with longer follow-up. Methods: We have previously presented our database of post-operative demographics and outcomes in patients undergoing lower tract reconstruction. All complications were graded by a modified Clavien-Dindo system. This retrospective database included children who underwent construction of either a Malone antegrade continence enema (MACE) or Mitrofanoff procedure between January 2002 and January 2014. A review was performed of the outcomes of patients with continent catheterizable channels created in association with complex reconstructive procedures from 2003 - 2014. We performed 117 procedures on 81 patients resulting in 75 channel related events. 43 were MACE and 74 were catheterizable channels. Results: Follow-up was an average of 81.1 months. There were 75 total channel related events noted in 45 patients (56.3%), with a mean of 0.9 events per patient. 45.3% were Clavien Grade 1, 2.7% were Grade 3A, and 52% Grade 3B. The mean time to first event was 27.4 months. 46 difficult catheterization events were noted in 27 patients (33.8%) at an average of 40.7 months after surgery. 17 of these (37%) required surgical intervention. 7 cases of stomal incontinence were noted in 5 patients (6.2%) at an average of 23 months after surgery; all were surgically repaired. 2 incidences of fistula formation were noted in 2 patients (2.5%) at an average of 28 months after surgery; both were surgically repaired. 18 cases of stomal stenosis were noted in 13 patients (16.3%) at an average of 21 months after surgery. 13/18 of these (72%) ultimately required surgical intervention. 2 instances of stomal prolapse were noted in 2 patients (2.5%) at an average of 16.9 months after surgery; both were surgically repaired. Conclusion: As compared to our previous cohort of patients with similar volume but shorter follow-up, our assumption that these catheter associated events leveled was incorrect. Based on the current and more detailed series, they can continue to occur, albeit at a similar rate. This is important information that may allow for better informed consent and more realistic parental expectations following these complex procedures.

164 POSTERS - - arly (12.1%)

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t the of use imaging inevaluating patients undescended with t, which has known risksknown hasthepopulation. pediatric in t, which aim The of the Urology service at institution our from 2000 to 2010. term stent ureteral placementstandard is of for care many pediatric - V) was 6.4% (14) with major complications (Clavien score III or higher) higher) III score or (Clavien major complications with 6.4% (14) was V) - The American Urological Association’s (AUA) Choosing Wisely campaign Wisely campaign Choosing (AUA) Association’s Urological American The Short Abby S. Taylor, MD Taylor, S. Abby Derrick L. Johnston,Derrick L. MD The use of extraction string offor use extraction doubleThe rates of inappropriaterates of imaging practice our in referred boys to and who

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lusion: ery.

AGING Introduction: urologic surgeries.retrieval Cystoscopic of an indwelling double Poster #29 FOLLOWING REMOVAL STENT URETERAL FOR STRING EXTRACTION OF USE AN PEDIATRIC UROLOGIC SURGERY Abby Taylor¹,Barazza²,and MichaelErhard² Mercer² Erica Mark ¹Mayo Clinic Florida, Jacksonville, FL; ²Nemours Children's Health Sys Health Children's FL; ²Nemours Jacksonville, Clinic Florida, ¹Mayo FL Presented By: additional anesthetic even thisstudy is tothe evaluate efficacy, safety tolerance and an extraction of stringfor removal of a double Introduction: testis (UDT). The guidelines AUA alsohave clearly advocated for early referral to a surgical specialist for boys UDT that with does not descendWe spontaneously. evaluated referral patterns and underwent correlate surgeryfindingssocioeconomic for the UDT and factors.with Methods: has recommended agains correction for UDT by Demographic collected data including were patient referral,race, age at status, insurance and the type of imaging any performed previously to evaluate for undescended testis. Chi outpatient setting is a safe, reliableoption for pediatric patients undergoing urologic surgery need forwith short term ureteral stenting a low with overall risk of accidenta low risk of urinary tract infections, and very low risk of long termadverse outcomes, all avoidingwhile a secondthe anesthetic in pediatric event population. surg concomitantstent ureteral placement planned and outpatient viaextraction removal string from January 1, 31, 2005 to performed 2014 December three by pediatricfe Poster #30 UniversityScience Tennessee of Health TN Center, Memphis, CRYPTORCHIDISM: PATTERNS OF REFERRAL INAPPROPRIATEDELAYED AND IM DerrickJohnston, Gieland Dana Elleson Schurtz Methods: urologist retrospectively were Age reviewed. (0 Presented By: Dindo surgicalcomplications analyzed. were Results: documented infections,compared to 5 (3.2%) inchildren over the age of 2 (p=0.008). All four surgicalsubgroups comparable were in terms of rates stent of unplanned removal, postoperativecalls, ED phone visits, and postoperative co UTIs. Overall I score (Clavien observed in2 cases (1%), both requiring cystoscopic stent removal anesthesiaunder for broken extractionstring attempted planned during removal. Conc removalscheduledto priorstent appointment for extraction. removalthe Early stent of occurred in12 (5%) cases, and this more was common inthe 0 performed robotic (85 assisted pyeloplasty, 30 open pyeloplasty, 97 Ureteroscopy, and 8 other), stent duration, stent location, removal postopera emergency department visits postoperative (ED), urinary tract infections (UTI), and Clavien (10.6%)compared as in to children 5 (3.2%) the over age of 2 (p=0.047). 7 (8.6%) e removals occurred infemalescompared tomales,although 5 (3.8%) in this not was statistically significant (p=0.13). of None the unplanned stent removals required repeat stent insertion. Postoperative UTIs more were common inthe 0 164 squared and Fisher’s exact test were used for categorical variables where appropriate. Multivariate analysis was performed using stepwise binary logistic regression. Results: 999 patients were identified. Only 100 patients (10%) were referred and evaluated before 6 months of age. Median age at surgical correction was 4.95 years (SD = 4.1). 225 patients (23.4%) had previously undergone imaging with 220 having undergone ultrasound and 5 having undergone axial imaging. Chi-squared tests showed that patients with public insurance were more likely to undergo inappropriate imaging (p<.0001), were less likely to have timely referral before 6 months of age (p=.001), and were less likely to have surgery before 18 months of age (p<.0001). Non-white patients were similarly more likely to have undergone inappropriate imaging (p=.012), though differences in referral and surgery patterns did not reach statistical significance. Stepwise binary logistic regression identified insurance status as having a significant independent statistical correlation with inappropriate imaging (p=.0001) and referral timing (p=.007). Public insurance was associated with increased utilization of inappropriate imaging with an odds ratio of 1.98 (95%CI = 1.391-2.835). Public insurance was also predictive of delayed referral to the urology service with an odds ratio of 2.034 (95%CI =1.213-3.412) compared to private insurance. Conclusion: There is a high rate of delayed referrals and inappropriate imaging by non- urologist providers in evaluation of UDT in our region. Patients with public insurance are more likely to receive inappropriate imaging and delayed referrals. Race also shows association with inappropriate imaging utilization. Continued efforts are warranted to educate non-urologist providers on appropriate management of UDT including timely referral and use of imaging.

Poster #31 INJECTION PRESSURE PROFILOMETRY DURING ENDOSCOPIC CORRECTION OF VESICOURETERAL REFLUX (VUR): CAN TECHNIQUE BE STANDARDIZED? Michael Garcia-Roig, Blake Marshall, Wolfgang Cerwinka, Edwin Smith, Bruce Broecker, Hal Scherz, James Elmore and Andrew Kirsch Emory University Department of Pediatric Urology/ Childrens Healthcare of Atlanta, Atlanta, GA Presented By: Michael Louis Garcia-Roig, MD Introduction: Endoscopic correction of VUR is a reliable treatment when performed by experienced injectors. The Double HIT(DHIT) technique & loss of ureteral hydrodistension(HD) are reliable injection endpoints. However, reported success varies at 50-93%. We aim to document variables in DHIT technique among experienced surgeons using IPP. Methods: IPP’s were assessed during endoscopic correction of VUR with Deflux(Salix Pharmaceutical, NC) by 5 attending physicians. Demographics, VUR & HD grades were assessed. Injections were standardized to DHIT method with an injection endpoint of volume injected & HD elimination. An arterial blood pressure transducer (Argotrans Argon Medical Devices, Plano, TX) placed between syringe/injector was interfaced with an Arduino UNO(Arduino Turin, Italy), sampling pressure every 250ms. Pressure was obtained as sensor voltage difference(SVD) & converted to atmospheres of pressure with a conversion formula by comparing SVD to a calibrated manual pressure gauge. Injection sites, duration, pressure, syringe depressions, & volume injected were recorded. Pressure variability was calculated overall & per-patient. Total variability was decomposed by variation source (physician, injection site/side, syringe depressions number) & reported as the percentage of total variation per source. Results: IPPs were recorded in 19 children: mean age 5.6±3.9 yrs, VUR 2.5±1.0, HD 2.4±0.8. Sensors gave consistent results during calibration(R2=0.99). Postop voiding cystourethrograms were obtained in 13 patients with a success rate of 92%/patient, 95%/ureter. VUR & HD grade did not correlate with IPP. Average pressure across injection side & site was consistent & accounted for <5% of variation. Pressure variation was attributed to the number of syringe depressions (27%), inter-physician variation (17%), with the remaining 44% unaccounted for by measured variables. Figure 1 illustrates physician &

166 POSTERS - 9 - ICD

2012) to2012) - %), p<0.001). 8,229 (74.9%); 13.2d) and mean - ed to home (8,510,

performed at age 3.5 3.6) -

). Our objective to was describe 9 codes.We performed descriptive 79,013). - - ssful endoscopicinjection using the DHIT

167

with DSD via ICD OF SEX OF SEX DEVELOPMENT

ersity, Durham, ³DepartmentBiostatistics, of NC; Duke

4.0d). Mean length 12.14.0d). 11.1 Mean stay was days of CI (95% -

Currently, little is known ofknown initialCurrently, little infants is treatment patterns newborn for MS Tejwani, Vikram Rohit Neonates DSD most with are diagnosed assigned commonly female as

Endoscopic correction of VUR canbe monitored We IPP. by demonstrated

We the retrospectively Nationwide InpatientSample reviewed (2006

We identified infants total weighted a of newborn 10,983 Specific DSD. with

and are disproportionately likely to be in a lower socioeconomic disproportionatelyand are lower group. likely in of Most toa be Introduction: patient pressure variability. Conclusion: Conclusion: the of range variables needed to achieve succe method.measurements Future alternate with injection define endpointsmay unaccounted IPP. ideal & an variation University,Durham, NC Presented By: diagnosed Disorders with of Sex Development (DSD Poster #32 RohitWolf³, Tejwani¹, Young¹,Brian Adkins²,Deanna Alkazemi¹,John Muhammad Steven Wiener¹, Jonathan Purves¹ Routh¹ J. Todd and ¹Division Urologic of Surgery, University, Duke Durham, NC; ²DivisionPediatric of Endocrinology, Univ Duke national treatment patterns for using these newborns a representative, all nationwide, database.payer Methods: identify infants newborn diagnosed statistics using standard weighting algorithms the by Agency for recommended as HealthcareQuality Research and (AHRQ). Results: diagnoses cervical/female were genital anomaly in6,389 (58.2%), adrenogenital disorders in2,947 (26.8%), indeterminate sex/ambiguous genitaliain (16.3%), 1,794 androgen insensitivity (partial total) or in 66 (0.6%). Female gender assignedwas to 2,478 assigned (22.6%)missingmale; and 277 (2.5%) were assignment. gender were any DSD neonates disproportionatelymore were likelyin tothe income be lowest quartile (3,484 (32.5%), p<0.001) and to be self/publically insured (6,268 (57.1 mostNeonates were commonly (3,867, white 35.2%), black (2,019, 18.4%), Hispanic or (2,277, no significantThere 20.7%). was change in time over annual (1,530 rate birth in 2006 v. 1,465 in trend).2012, for p=0.71 neonates discharg Most were 83.1%); an additional 1,501 transferred (13.7%) were to another facility, and 346 (3.1%) died inthe Surgery was hospital. 843 (7.7%) performed neonates; on those requiring surgery underwent an average of 3.3procedures (95% CI 3.1 CONTEMPORARY DEMOGRAPHIC TREATMENT PATTERNSAND NEWBORNS FOR DIAGNOSED WITH DISORDERS days (95% 2.9 CI Conclusion: gender, totalinpatientcharges $70,607 (95% $62,202 were CI 166 these patients are managed without immediate surgery and are discharged to home from their birth hospital. However, DSD neonates account for >$111 million in hospital charges annually in the United States.

Poster #33 OPEN VS. MINIMALLY INVASIVE SURGICAL APPROACHES: ASSOCIATED POST- OPERATIVE COMPLICATIONS OF PEDIATRIC UROLOGIC SURGERY IN THE UNITED STATES Rohit Tejwani¹, Brian Young², Hsin-Hsiao Wang², Steven Wolf³, John Wiener² and Jonathan Routh² ¹Division of Urologic Surgery, Duke University, Durham, NC; ²Division of Urologic Surgery, Duke University Medical Center, Durham, NC; ³Department of Biostatistics, Duke University, Durham, NC Presented By: Rohit Vikram Tejwani, MS Introduction: Advances in laparoscopic and robotic technology and a paradigm shift amongst providers and families favoring preferential use of less-invasive surgical approaches in children have resulted in a marked rise in the availability and use of minimally invasive surgery (MIS) in pediatric urology. Despite substantial differences in invasiveness, cost, and intra/post-operative characteristics, studies directly comparing MIS to open approaches in children are lacking, and the equivocality of outcomes between these modalities is unknown. We sought to compare post-operative complication rates between a subset of MIS and open pediatric urologic procedures using a validated nationwide dataset. Methods: We retrospectively reviewed the Nationwide Inpatient Sample (1998-2012) for pediatric (≤18 years) admissions for MIS/open ureteral reimplant, ureterureterostomy, pyeloplasty, radical/partial nephrectomy, appendicovesicostomy, enterocystoplasty, and sling, as identified via ICD-9-CM codes. Admissions from centers performing ≤5 MIS procedures during the 14 year period queried were excluded to reduce bias and ensure subject comparability. Admission-associated in-hospital post-operative complications as defined by the National Surgical Quality Improvement Program (NSQIP) were identified. Missing demographic values were replaced using multiple imputation. Wald chi-square test and ANOVA were used to compare discrete and continuous variables respectively, and Propensity Scores were used to match patients by surgery type. Results: A total of 14,631 encounters from 59 qualifying centers were identified. Patients undergoing MIS were more likely to be older (7.81 vs. 4.67; p<0.0001), male (52% vs. 43%; p = 0.0026) and seen in an urban non-teaching setting (3.9% vs. 2.7%; p=0.02). MIS encounters were less likely to result in NSQIP-defined post-operative complications (7% vs. 9.1%; p=0.005). Adjusting for other covariates, patients who received MIS were 0.73 times as likely to experience a post-operative complication compared to open surgery (p=0.0302). A decrease in complication rates over time as hospitals became specialized (i.e. performed ≥ 5 MIS) was noted, though was not statistically significant (p=0.49). Conclusion: Over a 14 year period, MIS was associated with a lower NSQIP-defined postoperative complication rate at centers that had performed ≥5 pediatric urologic MIS procedures, which may be reflective of improvements in technology and surgeon proficiency as MIS has become more common nationwide. Further investigation of these factors is warranted as pediatric urologic practice guidelines evolve.

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9 - 15 to 15 to

ding on the procedure

Marchan and Marcos PerezMarchan and Marcos - Steven Wolf², John S. Wiener¹ and OCTYL CYANOACRYLATE -

169 USING 2

MIS based on the procedure performed (Figure 1). The

2012 Nationwide InpatientWe Sample (NIS).used ICD OCA; Dermabond) is a synthetictissue that adhesive has - -

Negron, MD - nterocystoplasty,sling and surgery. Our primary endpoint the was Hsiao S. Wang¹, Rohit Tejwani¹, Tejwani¹, Rohit Wang¹, S. Hsiao - % in% 2012).

OCA when OCA comparedwhen to the standard circumcision technique in mcisionmost remains thecommon surgical in theprocedure United -

patients (<18 years old) undergoing proceduresthat could performed be Circu Juan Guzman Juan Negron, Karina Escudero, Marcos Perez Brian J. Young, J.Brian MD The advent of minimallyThe advent invasive of surgery (MIS) techniques subsequent with

Asthere expected,States is steadily MIS the of increasing in United use -

We the retrospectively charts review consecutive of patients 50 from ages We the analyzed 1998 on: followed by morefollowed diffusion by widespread Our objective of to MIS. the was assess

In identified total, 34,131 were patients as having an eligible procedure. There

ty, functionaland cosmetic outcome appearanceof a modified circumcision

Poster #35 (DERMABOND) IN THE ADOLESCENT POPULATION Juan Guzman MODIFIED CIRCUMCISION TECHNIQUE Poster #34 TECHNIQUES SURGICAL INVASIVE MINIMALLY OF UTILIZATION THE ASSESSING IN THE PEDIATRIC UROLOGYPOPULATION BrianYoung¹, J. Hsin Introducti technique using 2 Brayfield University School Puerto Rico Medicine of of Presented By: Introduction: utilityproven inthe closure of minor surgical incisions. The aim this of study is to assess the safe adolescent patients. Methods: States. 2 Octyl Cyanoacrylate (2 Jonathan Routh¹C. ¹Duke UniversityDivision Center, ²Duke Medical Urology, University of NC; Durham, School of DepartmentBioinformatics, Biostatistics Medicine, of & NC Durham, Presented By: technological advancements equipment in has in ofera a new ushered surgical management of disease.Previous studies consistently have initial found an period of “early adopters” trends utilization MIS in pediatric procedures across various in urology. Methods: Results: of uptake the in variation wide was greatestincrease inseen techniquespercent utilization MIS in of pyeloplasties was (0.6% in1998 vs. 23.1% inEnterocystoplasty2012). associated was the with least MIS uptake of (0.0% 1998 vs. 2.1 in Conclusion: is initial period an there adults, in findings to previous Similar population. urology pediatric growthof followed more by rapid slow diffusion use. Depen of percenttime for utilization procedure of each queried. over MIS open or usingopen or minimally invasive techniques. Proceduresincluded ureteralwere reimplant, ureteroureterostomy, pyeloplasty, nephrectomy, partial/heminephrectomy, appendicovesicostomy, e codes to identify performed, varying there widely are rates utilization. of In clear lightthis of trend, additional against weigh the associatedresearchcosts to increased outcomes MIS. is with needed in 168 21 who underwent circumcision performed by a single surgeon from 2007 to 2015. All patients in our study were Tanner stage V. 52% of patients (26/50) underwent circumcision using 2-OCA and 48% of patients (24/50) were performed with the standard circumcision. Acute and late complications were recorded and compared between the groups using the clavien classification. Database review included type of surgery, complications, pain meds requirements and parental satisfaction. Statistical analysis was performed using the chi- square test. Results: During follow-up, the 2-OCA circumcision group complications were Clavien I complications in all patients including redundant foreskin in 2 patients (7.6%) and wound dehiscence in 1 patient (3.8%). No hemorrhage, granuloma formation and allergic reactions were reported in this group. In the standard circumcision group, complications were Clavien I in 4 patients and Clavien IIIb in 1 patient. Complications in this group included granuloma formation in 2 patients (8.3%), penile swelling in 1 patient (4.2%), wound dehiscence in 1 patient (4.2%) and hematoma in 1 patient (4.2%). The patient who developed a hematoma required subsequent surgical intervention for penile exploration and blood clot evacuation. There was no statistically significant relationship between circumcision technique and the presence of complications. Patients in the 2-OCA circumcision group required less pain medications postoperatively (11.5%) when compared to the suture circumcision group (29.1%) although not statistically significant. There was no statistically significant relationship between the use of pain medications and the presence of complications. Parental satisfaction with the procedure was excellent in both groups. Conclusion: 2-OCA modified circumcision technique is a safe and cosmetically appealing alternative to standard suture circumcision in the adolescent population with comparable complication rates. The risk of wound dehiscence in the 2-OCA group was not increased when compared to the standard suture group. Further studies in the adolescent population and a larger sample size will be needed to confirm these findings. Funding: None

Poster #36 CHARACTERIZATION OF PEDIATRIC EMERGENCY ROOM EVALUATION FOR GENITAL LACERATION, ABRASION, AND CONTUSION INJURIES Shenelle Wilson¹, Brandon Wilson², Patrick Fox², Zachary Klaassen² and Durwood Neal² ¹Department of Surgery, Section of Urology, Georgia Regents University, Augusta, GA; ²Georgia Regents University, Augusta, GA Presented By: Shenelle Wilson, MD Introduction: Genital lacerations, abrasions, and contusions represent a significant subset of pubic injuries that may require pediatric emergency room (ER) consultation and evaluation. The objective of the study was to characterize the demographics, injury etiology, and outcomes of pediatric patients suffering from these injuries. Methods: There were 7,392 patients ≤18 years of age in the Consumer Product Safe Commission’s (CPSC) National Electronic Injury Surveillance System (NEISS) database who were diagnosed with ‘pubic region’ trauma during ER visits from 2009-2014. Amongst these patients, there were 2421 (33%) patients with ‘laceration’ and ‘contusions, abrasions’ injuries who subsequently comprised the study cohort. Descriptive statistics were used to compare admission rates between demographic groups. Results: There were 1260 females (52%) and 1161 males (48%) who presented to the ER with genital lacerations, abrasions and/or contusions. Of those patients, the age breakdown was: infants/babies (0-12mos, 0.7%), toddlers (13mos-3yr, 22%), preschoolers (4-5yrs, 24%), school age (6-12yrs, 40%), and teenagers (13-18yrs, 14%). The most common race was Caucasian (n=959, 53%) followed by Black (n=457, 25%). The most common overall injury was related to recreational activities and electronics (n=927, 38%) with school age children representing 52% (n=486) of those patients. There were 40 patients admitted (2%) to the hospital and school age children represented 40% (n=16) of these patients, most commonly secondary to recreational activities and electronics (n=6, 38%). Toddlers accounted for 60% (n=185) of grooming/hygiene/bathroom related injuries and teens accounted for 55% (n=141) of sports related injuries. There was no difference between

170 POSTERS

- - ic robot and ulation

4 - RPLND between - retrospective faction.

aged childrenaged represented the

- chemotherapy RA -

ttle, WA ttle, sparing surgery, antegrade ejac - d as an alternative to the open approach institutionalcohort. - 171 LND is feasible,LND reproducible, and oncologically

Muhsin²,James Porter James Lesperance³, - based analysis. School large multi - sparing surgery was attempted in68 (66%) patients. Lymph other) regarding likelihoodother) (bothadmission p>0.05). of - 42.7). 6/103 (5.8%) patients required conversion from a - vs.

ceration, abrasion, and contusionceration, abrasion, and injuries represented 1/3of Swedish Urology Group SeaSwedish 4 chemotherapy RARPLND. A bilateral performed template was RPLND in -

Raj Kurpad, MD The goldstandards for the treatmentmetastatic of testicular cancer include Genital la Genital

To knowledge,our presentwe the largest series of outcomes data inpatients

need for parental and teacher awareness when encountering teacher awareness when for genital and parental trauma need Patients underwent who a primary post or

A total of 103 patients were includedtotalA of were 67/103 in 103 patients analysis. our (65%) patients

ated clinicalated stage disease, I (25%) 26/103 patients demonstratedclinical stage II

STITUTIONAL SERIES with potentialwith benefits ofmorbidity reduced and quicker recovery. purpose of The study our is to the examine intraoperative,perioperative, postoperative,oncologic and outcomes of patientsa in undergoing RARPLND both chemotherapy and retroperitoneal lymph node dissection (RPLND). In recent years, robot assisted RPLND (RARPLND) has emerge Introduction: Michael Woods¹ ¹University Clinic Phoenix,Hill, ²Mayo AZ; Carolina of NC; Medical ³Naval Chapel North Center San CA; Diego, Methods: Presented By: largestcohort patients and admitted evaluated of their forgenital injuries.Thesefindings suggest a injuries, consideringthe frequency of these the injuries necessity potential and hospital of admission. Poster #37 MULTI A DISSECTION: NODE LYMPH RETROPERITONEAL ASSISTED ROBOT gender or age (schoolor gender age Conclusion: pediatric ER visits inthis population IN Raj Kurpad¹, Erik Castle², Haidar Abdul Standard descriptive statistical measures used to were detail demographic, clinical, perioperative, postoperative,oncologic and outcomes. Results: March 2008 and June 2015 includedwere in analysis.our data Outcomes from four reputabletertiary academicmedical centers reviewed was ina was preserved inwas patients. 56/68 of (83%) Conclusion: undergoing a RARPLND in the managementmetastatic of testicular cancer. Our preliminary study demonstrates that RARP sound.In hands experienced the of potential surgeons, the has to RARPLND reduce morbiditythe recovery comparedto and enhance open procedure. disease, and 10/103 (10%) patients demonstrated clinicalstage disease. III 33/103 (32%) underwent a post demonstr 65 (63%) patients and a nerve node yield 25.3 was (±13.8) nodes. documented lymph median at deaths No follow were a up ofmonths 25.3 6.9 (IQR assisted to surgery. an open operative Mean time 342 minutes was mean (±108), estimated blood loss 244.6 was ml (±483), and mean postoperative length of stay was 2.1 days (±1.5).complication The overall (21%) 22/103 experiencing with a rate 27% was 1 complication,grade 5/103 experiencing (5%) a grade 2 complication, and 1/103 (1%) experiencing a grade 3 complication.With regards to oncologic outcomes, 54/103 (52%) patients demonstratedstage pathologic (40%) 1 disease, 41/103 demonstrated patholog stagedemonstrated 2 disease, and 8/103 pathologic (8%) disease. stage 3 9 patients with administered IIC)pathologic were 1 IIA, postoperative IIB, and stage (4 2 disease 4 chemotherapy. Of those patients had a who nerve 170 Poster #38 REAL-TIME NERVE MONITORING TO FACILITATE NEUROVASCULAR BUNDLE RESECTION DURING ROBOTIC PROSTATECTOMY Scott Miller Georgia Urology Presented By: Scott D. Miller, MD Introduction: During robotic prostatectomy, nerve preservation focuses on the autonomic nerves present in the neurovascular bundles. Somatic nerves that play a role in urinary continence and the second phase of tumescence often travel in close proximity to these bundles. Our objective is to examine the feasibility of real-time nerve monitoring software and hardware to consistently and safely distinguish these two types of nerve tissues. Methods: A laparoscopic version of the same hardware and software used for spine and neurosurgery was used intraoperatively to map the somatic nerves during robotic prostatectomy in 17 patients in whom one (n=14) or both (n=3) neurovascular bundles were intentionally sacrificed for oncologic control. Results: Somatic nerves on both sides of all patients (100%) were identified and preserved, as evidenced by good waveforms during nerve stimulation at the end of the procedure. These 34 somatic nerves were highly variable in location. Of the 20 nerves present on the same side as neurovascular bundle resection, 9 were adjacent to and visually indistinguishable from the neurovascular bundle. Margins were negative in association with all 20 wide resections, 6 of which had extracapsular extension. Two patients had positive margins in other locations. Conclusion: Real-time nerve monitoring can reliably identify the variability of somatic nerve anatomy during robotic prostatectomy. This tool is particularly useful when sacrificing a neurovascular bundle for oncologic control. Arbitrary wide resection is often unnecessary and can be harmful to surrounding structures that play a role in functional outcomes.

Poster #39 MEN WITH LOW RISK PROSTATE CANCER: WERE THEY WISE TO OPT FOR ROBOT ASSISTED RADICAL PROSTATECTOMY? Hariharan Palayapalayam Ganapathi¹, Gabriel Ogaya², Vladimir Mouriev² and Vipul Patel² ¹Global Robotics Institute; ²Global Robotics Institute, Florida Hospital, Celebration, FL Presented By: Hariharan Palayapalayam Ganapathi, MD Introduction: Several treatment options are available for low risk prostate cancer (LRPCa) patients including active surveillance, radiation and radical prostatectomy. It is interesting to know the outcomes when these LRPCa patients opt for Robot Assisted Radical Prostatectomy (RARP). Methods: Between Feb 2008 to Aug 2014, 5502 patients undergone RARP in a single high volume center; of them 2445 (44.4%) patients were diagnosed with low risk prostate cancer clinically (Biopsy Gleason Score ≤ 6, PSA < 10 ng/ml, ≤ cT2a - NCCN low Risk). All patients had minimum 12 core prostate biopsy, performed or reviewed in the same institute. All patients were operated by a single highly experienced surgeon. We retrospectively analyzed the perioperative, histology and follow up data. Results: Perioperative events Overall complications rate was less than 5% (All Clavien grades 4.9%). Complications of Clavien grade I (Ileus, wound infection, Urinary retention), grade II (Blood transfusion, Pneumonia, Urine leak) grade IIIa (persistent Ileus, DVT, MI) and grade IIIb (pelvic hematoma, pelvic abscess, re-operation for bleed) were observed in 1.8%, 2.6%, 0.2% and 0.2% respectively. Surgical pathology outcome In prostatectomy specimens of these low risk (Biopsy Gleason 3+3) patients, upgraded Gleason (48.2%) pattern to secondary 4 (3+4), primary 4 (4+3) and secondary 5 (3+5) were seen in 41%, 6% and 0.7% respectively. In contrary to clinical staging, prostate cancer was not organ confined in more than 12% (pT3a-0.9%, pT3b-1.0%, pT4-0.3%). Positive surgical margin was observed in 9.5% and seminal vesicles were infiltrated in 1%. Trifecta Outcome 97.6% of them maintained BCR free status at 5 years follow up. Continence and potency rate were 63,81,89,93,95% and 33,44,53,65,70% respectively at 6 weeks, 3 &6 months, 1&2 years. Potency recovered better in patients younger than 55 years (85% at 1 year).

172 POSTERS

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of false enal masses robotic time of specimens (positive

assisted laparoscopic - Ortiz² and Ronald and Ortiz² -

botic Urology and Oncologybotic Urology and Institute

173

Huertas², Ricardo Sanchez up time was 12.2 ± 10.8 months. up time 10.8 ± 12.2 was - -

Negron, MD - tion. this In preliminary present report, we experience our with assistedpartial nephrectomy (RAPN) has acceptance gained as a

- r).

obotic partial suspiciousnephrectomy for kidney tumor a a single by University, Augusta, Georgia

Local Local tumor recurrence after sparingsurgery nephron (NSS)managing for Rabii MD Madi, Negron¹, Hector Lopez Juan Guzman Juan As robotic

In our single our singlecenter, In surgeon experience, robotic partial nephrec

Men with LRPCa who chose half to RARP, LRPCa them undergo (48.1%) with who of nearly Men

Between August 2006 and May 2013, patients 138 consecutive May and Between August 2006 underwent ASSISTED PARTIAL PARTIAL ASSISTED NEPHRECTOMY HILAR COMPLEX FOR RENAL AND hrectomy (n=1), (n=1), cryotherapy radiofrequency ablationand robotic (n=1) In 2012, a prospective database was developed for all men r with In developed for a prospective database was 2012, all -

All surgeries were performedAll surgeries were the robotic via a mean approach with

Chavez² -

anded to tumorsWe ofcomplexity. greater report experience our using for RAPN Presented By: renal cell carcinoma is (RCC) usually managed radical by nephrectomy, a strategy that compromises renal preserva roboticthe of partial use the nephrectomy in setting recurrentsuspected of following RCC NSS. Methods: laparoscopic r or surgeon Among (RM). them, patients four had robotic partial nephrectomy for recurrent enhancing previously treated tumors. kidney Patients were hand with Introduction: 175 ± 77 min. The postoperative course uneventful was and all patients discharged were majorhome second postoperative on the day. No perioperativecomplications occurred. resected 4 the of 3 in tumor malignant viable showed pathology Final frozen sections judged one specimen negative was of for malignancy after complete pathologic examination). follow Mean Similarly patients preoperative had morewho SHIMbetter than had 20 erectile function recovery (80% 1 yea at Conclusion: Conclusion: Gleasonhad upgraded pattern infinal With pathology. gaining experiencesafe RARP is and perioperative complication rateswell were withinacceptable limits. spite In of upgrading (48%)upstaging and (12%),cancercontrol excellentthis was in group. Continence rate and potency rate steadily improvedtime over to reach 95% and 70 % at 2 years. These information certainly are helpful for informed decision makingmen by wit diagnosednewly LRPCa. Poster #40 ROBOTIC SALVAGE PARTIAL NEPHRECTOMY: VIABLE FOR THE APPROACH A MANAGEMENT TUMOR OF RECURRENCELOCAL FOLLOWING FAILED NEPHRON SPARING SURGERY ErikaKlaassen, Ibarra,Zachary Martha Terris and Rabii Madi Georgia Regents partial nephrectomy diagnosis the (n=1) with confirmed of recurrence radiographically and/or biopsy. by Results: partial nep Conclusion: foundfeasiblewas to alternative be a and safe radical to formanagement nephrectomy the of suspected recurrent initially RCC managed NSS by ablation. or Patientselection is crucialminimize and preoperativetomay biopsy necessarythe incidence be positive results. Juan Guzman Poster #41 ROBOTIC TUMORS Cadillo ¹Universityof SchoolPuerto Rico Medicine; of ²Ro Presented By: Introduction: minimally invasive alternative inthe management small of renal tumors, its indication has exp completely endophytic tumors,hilar tumors, and those of high complexity (RENAL nephrometry score >10). Methods: who underwent surgeon managed single (RCC).who Fifty tumors RAPN were renal a with by 172 RAPN between 10/2012 and 12/2014. Fifteen masses were endophytic, hilar, and/or exhibited a RENAL nephrometry score >10. Perioperative and oncological outcomes were evaluated. Complications were recorded using the Clavien-Dindo classification. Results: Mean age was 60.6 years (Range from 37 to 77), body mass index (BMI) was 29.1 kg/m2 (Range from 21.8 to 40.1) and ASA Score was 2.6 (Range from 1 to 3). Mean tumor diameter was 3.7 (Range from 1.6 to 7.2). Tumor complexity was divided on severity of R.E.N.A.L nephrometry score (>10), endophytic and hilar location. 6/15 patients met more than one complexity criteria. 5 patients (33.3%) had a nephrometry score >10, 4 patients (26.6%) had a completely endophytic tumor and 12 patients (80%) had a hilar tumor. Of the 12 hilar tumors: 4 (33.3%) also met the criteria for renal nephrometry score >10 and 1 (8.3%) for endophytic tumor. Mean operative time was 161 min (Range from 130 to 256), warm ischemia time was 33.3 min (Range from 22 to 45), estimated blood loss was 106.3 ml (Range from 15 to 250) and length of stay was 1.8 days (Range from 1 to 4). Pathology revealed renal cell carcinoma: 12 (80%), benign cyst: 3 (20%). Pathology stage was: pT1a: 10 (66.6%), pT1b: 5 (33.4%). There were no positive surgical margins. There were no conversions to open surgery. There were no intraoperative complications and no transfusions. One patient required a selective angioembolization (Clavien-Dindo grade III). No patients progressed to dialysis postoperatively and there were no significant difference between preoperative and postoperative serum creatinine or estimated glomerular filtration rate using the Modification of Diet in Renal Disease equation (MDRD). There were no recurrences after a median follow up of 13.3 months. Of 15 patients, 46.7% had at least a follow-up of ≥1 year and 26.7% had a follow-up of ≤6 months. Conclusion: Robotic partial nephrectomy is a technically challenging, but safe and feasible approach for select patients with complex renal tumors: high nephrometry score, hilar location, or completely endophytic location. Funding Source: None

Poster #42 LONG-TERM RESULTS USING NOVEL NO-CLIP ROBOTIC PROSTATECTOMY TECHNIQUE TO FACILITATE NERVE PRESERVATION Scott Miller Georgia Urology Presented By: Scott D. Miller, MD Introduction: Pedicle control during robotic prostatectomy has been performed in a variety of ways. Prior series have used clips, bipolar electrocautery, or temporary bulldog clamping with subsequent over-sewing. Clip usage – the most common technique – has the potential disadvantages of migration into the anastamosis, lack of surgeon control, dislodgment with subsequent bleeding, and inadvertent ligation of neural tissue. We present the long-term results of a novel no-clip technique developed in 2004. Methods: Over a seven-year period, nine hundred and eighty-six patients with normal erectile function (SHIM>22) who were candidates for bilateral nerve sparing underwent robotic prostatectomy. A figure-of-eight absorbable suture ligature is placed into the proximal portion of the pedicle just posterior to the prostate prior to partial transection. This suture and attached needle are temporarily left in situ. Care is taken to sequentially ligate (using the same suture in a continuous manner) and divide portions of the pedicle without incorporating the neurovascular bundle. The neurovascular bundles are sharply dissected along the prostatic capsule. Holding the suture on slight tension during the dissection avoids direct traction of the bundle. Results: Excellent hemostasis and visualization were achieved in all patients. Five patients required post-operative transfusion. No other complications associated with this technique were observed. The positive margin rate at this location was less than 2%. Successful intercourse (SEP-3) was reported by 296 (30%), 503 (51%), and 897 (91%) of patients in this selected group at 6 weeks, 4 months, and one year, respectively.

174 POSTERS rethral ion was was ion

e compared in 10. The association association The 10.

- e, OR time, median lobe, lobe, median time, OR e,

on (n=10, 2.7%, <0.0001) were RP) =0.004), blood estimated loss (306

21 days). catheter Median time 9 was Shoshtari and Wade Sexton square test. Logistic regress - - - (P=0.001) associated were >14 UC with assisted transperitoneal PN (RATPN), or -

4 - 175

plication associated was prolonged with hospital LOS

September 2014 by a singlesurgeon. Clinicodemographic erwent RARP a single by fellowship trained surgeon were

Dindo grade 1 grade Dindo – - way way ANOVA and chi - tive, postoperative and patient prolonged with LOS defined >3 as rgical approach. and LOS > 3 days. >3 and LOS

Prolonged length of hospital prolonged stay u (LOS)and Wemarkers determinedcomplexity if operative of inpartial nephrectomy four resected tumors were (45%) viaOPN, 40 (34%) viaRATPN, and 25 Eric Andrew Schommer,Andrew Eric MD Pranav Sharma, MD 37 days). 16 (4.3%) patients had LOS >3 days. 56 (15.3%) patients had UC

- Surgical experience/learning curve didnot affect time UC LOS or following

- line renal functionmoresolitary (p=0.003), kidneys (p=0.001),more and

We retrospectively identifiedmasses suspected removed for 119 cell renal 372 patients und who

Fifty Median hospitalMedian stay was 2 days 1 (range

assisted retroperitoneal (RARPN). PN Differencesmeans in and proportions were -

ffitt Center,Tampa, FL Cancer Introduction: days and prolonged UC defined as >14 days were reviewed.multivariate Univariateaswere days and >14 days and prolonged defined UC logistic models regressionused were associated to identify were factors risk that with >14having days UC of preoperative, intraopera Poster #43 PROLONGED WITH ASSOCIATED FACTORS PATIENT OF ASSESSMENT FOLLOWING CATHETERIZATION URETHRAL PROLONGED OR HOSPITALIZATION (RA PROSTATECTOMY RADICAL ASSISTED ROBOT Eric Schommer¹, Kolbi Tonkovich², Zhuo Li² and David Thiel² David and Li² Zhuo Tonkovich², Kolbi Schommer¹, Eric FL Jacksonville, Florida, Clinic ²Mayo FL; Jacksonville, Clinic Jacksonville, ¹Mayo Presented By: catheterization following (UC) RARP associated are decreased with patient satisfaction and possibly long term functional outcomes.study This aims to identifypatient factorsthatmay time.impact and UC prolonged LOS Methods: retrospectively reviewed. All patients on a postoperative were pathway to be discharged on postoperative removed UC have 1 and (POD) 7 day on POD number Results: days 3 (range >14 days. Age, BMI, Gleason PSA, preoperative scor score,ASA nerve sparing,nerve pelvic node dissection lymph blood loss, (PLND),specimen estimated weight, after or caseassociation 200 had no LOS with >3 days.Patients receiving a blood transfusion (n=7, 1.9%, P<0.0001) having or any complicati associated LOS>3 with days.Age, PSA, Gleason preop score, score,ASAmedian lobe, sparing,nerve transfusion, any PLND, aftercase 200 had no association prolonged or with UC. BMI ≥30 (P=0.02), OR time (198.2 vs. 215.7 min, P vs.mL,P=0.004), 336.4 complication any (P=0.0001), (51.4 and specimen weight vs. 58.6 g, P=0.03) were associated with prolonged UC. On multivariate analysis BMI ≥ 30 (P=0.02) complicationand any Clavien (PN) patients,such as Adhesive nephrometry RENAL Probability and Mayo score, (MAP) associatedwere su with Introduction: Presented By: Mo RARP. BMI ≥ 30 or any complication was associated with prolonged UC. Blood transfusion requirement postoperative any or com days. Conclusion: following RARP. Poster #44 Pranav Sharma, Barrett Zargar Kamran McCormick, ARE MODELS OF OPERATIVE COMPLEXITY ASSOCIATED WITH SURGICAL SURGICAL WITH ASSOCIATED COMPLEXITY OPERATIVE OF MODELS ARE APPROACH FOR NEPHRONSURGERY? SPARING Methods: carcinomafrom January 2012 determined using the one robotic tumorsmanaged PN open with (OPN), robotic performedidentify to independentpredictors open surgical resection. of characteristics, pathological features, and postoperative outcomes wer Results: (21%) viaRARPN. OPN performedwas inpatients more with comorbidities (p=0.021), base lower multifocal (p=0.001). Patientsdisease undergoing mean OPNhad a higher nephrometry 174 score compared to RATPN and RARPN groups (7.8 vs. 7.1 vs. 6.9, respectively; p=0.039). Mean MAP scores were no different among all three groups (p=0.34). On multivariate analysis, higher nephrometry score (odds ratio [OR]: 1.41, 95% confidence interval [CI]: 1.10 – 1.81; p=0.007) was associated with open surgical technique. Nephrometry score was a strong predictor of open PN (area under curve [AUC]=0.64, p=0.01) with a score of 6.5 having the highest sensitivity and specificity (76% and 42%, respectively). Conclusion: RENAL nephrometry score is associated with surgical approach intuitively chosen by a surgeon, but presence of adherent perinephric fat is less likely to influence decision-making.

Poster #45 WITHDRAWN

Poster #46 EARLY EXPERIENCE WITH RETZIUS SPARING ROBOTIC RADICAL PROSTATECTOMY Al Ray, Erika Ibarra, Zachary Klaassen, Martha Terris and Rabii Madi Georgia Regents University, Augusta, Georgia Presented By: Rabii Madi, MD Introduction: Retzius sparing robotic radical prostatectomy (RSRRP) has been previously reported in Europe but not in USA. We are reporting our first experience and impression with this technique after performing 50 consecutive cases. Methods: 50 consecutive RSRPP were performed at our institution by a single surgeon (RM). Peri-operative outcomes were compared with the last 50 robotic radical prostatectomy cases performed in the regular fashion. Technique of that procedure will be outlined in the abstract. Results: Patients who underwent RSRPP did not differ from the standard group in terms of clinical stage, Age, PSA, and Gleason Score. RSRPP was successfully performed in all cases except for initial 2 cases . Peril-operative outcomes were comparable between groups. At a median follow up of 4 months, Patients who underwent RSRRP appear to have earlier recovery of continence with 30% of patients not needing to wear any urinary pads. RSRPP appear particularly tempting in patients with large median lobe. On the other hand, This technique has a steep learning curve and could be particularly difficult in large prostate. Conclusion: Our initial experience with Retzius Sparing Robotic Radical Prostatectomy is encouraging. Early analysis of outcome suggests earlier recovery on continence with no added morbidity. This technique has a steep learning curve and could be particularly difficult in large prostate.

Poster #47 ROBOTIC ASSISTED LAPAROSCOPIC URETERONEOCYSTOSTOMY: A SINGLE CENTER EXPERIENCE Hugh Smith¹, Nathan Jung², Amanda Carter³, Juan Class², Chistopher Keel² and Amar Singh² ¹University of TN College of Medicine Chattanooga; ²University of TN College of Medicine Chattanooga, Chattanooga, TN; ³Medical Student at the University of TN College Health Science Center, Memphis, TN Presented By: Hugh Smith, MD Introduction: Robot-assisted laparoscopic ureteroneocystostomy is becoming popular and has been described previously by other centers with an acceptable outcome to traditional open approach. We present our experience with robot-assisted laparoscopic ureteroneocystostomy versus open repair. Methods: We retrospectively evaluated the records of adult patients who underwent ureteroneocystostomy at our institution from 2007 to 2014. Patient demographics, operative

176 POSTERS - 0 not

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- 69). Average patient -

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assist - 26.9 in the open group. Mean ORopen group.26.9the Mean in 315) compared to at open compared 315) 158.66 - vs.

assisted 2.35 was (1 - assisted 44 (27 was - STEP ROBOTIC MANAGEMENT MANAGEMENT STEP ROBOTIC -

177 BY -

step approachmanaging in renal cysts, the with

by - 10.1).the In roboticcase group, a of - Thomas oldpatient a large with left 19×13×11 cm renal cyst operative myocardial infarctionthat ended inmortality. 89) and robot 89) - - - year - assisted group was 28.5assisted was group - 1.7). minimal, Complication rateswere however - tomatic renal cystsmanagedobjective are the with ofreducing 23 roboticallywere assisted. Three casesconverted were to open from r placement,r cyst the initially was viaa transmesenteric approached Symptomatictreating the challenge renal cysts for present a urologist. Julie C. Wang, MPH MD, Julie C. Symp

Long term outcomes roboticLong of assistedlaparoscopic ureteroneocystostomy

similar, the robot

The case is a 42

This procedure was safely performed. The patient had minimal blood loss, and There were 33 patients who underwent 33 patientswho ureteroneocystostomy There were tofrom 2014: 2007

: to be equivalent to open repair. Hospital LOS and blood loss significantly are lower 14). Preoperative creatinine ofthe robotic a median was group of 0.8 (0.6 - assistedto excessive due scarring. adhesions and Patient demographicsincluded a 260). Median EBL significantly was for lower robotic at 25 (10 - - data, analyzed. perioperativemorbidity term were long outcomes and ten open were and Results: robot mean open repairage of 46.5 (23 BMI’s were timeslightly robotic longer (mins) for was 183.21 at (81 (120 4000) ml4000) for open. Lengthstay (LOS) ofof robot cases complicated was a post by One open case required transfusion and a combinedcase vascular with surgery and GYN that resulted insignificant blood loss. Long term robotic ATNshort developed that discharge required average term dialysisthe and increased creatinine.thethe In open group, preoperative creatinine 0.9 (0.7 was discharge 0.85 it was (0.6 4.7 (2 creatinine discharge 0.7 at was (0.6 one patient recurrent with urinary tract infections, and another patient chronic with pelvic painand recurrent tract infections. urinary Conclusion: appear infor for seriesour than repair. robotic open assisted Poster #48 Introduction: exc or agents of sclerosing instillation and aspiration include ofOptions treatment the cyst. This video presents step our SYMPTOMATIC RENAL CYSTS: A STEP A CYSTS: RENAL SYMPTOMATIC be fulguratedproximityclose its because of major to collecting vessels and the The system. perinephricmobilized vascular fat as was pedicle into and anchored grafts to cyst the prevent appositioncysttothe of prevent walls and recurrence. Conclusion: approximately 1500ccsclear of renal cyst fluid evacuated. was The patient sent was home morning recurrence.the without of evidence done well any next and has symptomssuch pain as and early satiety, the and with goal of preventing recurrences. This concerns.video addresses these of both APPROACH Wang,Julie Powers and Raju Mary Louisiana Orleans, New University, Tulane Presented By: keypreventing goal of recurrences. any Methods: Results causing flank , satiety and subsequent flank causing pain, She loss. weight elected,early the after appropriate consenting process,elective undergo to cyst robotic decortication. assisted The patient positioned was inthe lateral decubitus position. After achieving peritoneum and the appropriate troca approach.marsupializing After cyst,cystthe theto fluid aspirated prevent was spillage any into peritonealcavity the prior just tothethe cyst excising cyst. dome The lining could of 176 Poster #49 ARACHIDONIC ACID METABOLISM IN PROSTATE CANCER IS ASSOCIATED WITH GENETIC AND EPIGENETIC VARIATIONS WITHIN THE FADS CLUSTER. Tao Cui¹, Austin Hester¹, Susan Sergeant², Michael Seeds³ and Floyd Chilton4 ¹Department of Urology, Wake Forest School of Medicine, Winston Salem, NC; ²Department of Biochemistry, Wake Forest School of Medicine, Winston Salem, NC; ³Department of Internal Medicine, Section on Molecular Medicine, Wake Forest School of Medicine, Winston Salem, NC; 4Department of Physiology and Pharmacology, Wake Forest School of Medicine, Winston Salem, NC Presented By: Tao Cui, MD Introduction: The incidence of prostate cancer (PCA), the most common non-cutaneous neoplasm affecting men worldwide, varies dramatically based on diet and human ancestry. The dietary omega-6 fatty acid, linoleic acid (LA) is implicated as a major contributor to PCA development and progression due to its ability to be metabolized to pro-inflammatory substrates such as arachidonic acid (AA) and mediators such as prostaglandin E2. The rate limiting steps in the enzymatic conversion of LA to AA are mediated by the fatty acid desaturase enzymes, FADS1 and FADS2. Experimental evidence supports the role of dietary LA in PCA incidence and progression; however, epidemiological studies have not been able to show any association. We have identified genetic and epigenetic variation within the FADS cluster that increases the efficiency of LA to AA metabolism and have shown the frequency of high-converting variants to be much greater in African ancestry populations. We hypothesize that gene-diet interactions, not captured by epidemiological studies, are masking the effect of increased dietary omega-6 fatty acids. This study examines associations between genetic and epigenetic variations and the fatty acid composition of PCA tissue. Methods: Flash frozen PCA tissues from radical prostatectomies were obtained from the Wake Forest tissue bank. Putative relationships between the FADS SNP, rs174537, methylation status of the FADS CpG site cg27386326, and fatty acid composition were examined. Results: Individuals homozygous for the major allele at rs174537 had significantly higher AA concentration (p<0.001), higher FADS1 (p=0.011) and FADS2 (p<0.001) activity, and lower methylation at cg27386326 (p=0.002). In addition, the methylation status at cg27386326 was independently associated with AA concentration (p<0.001) and FADS1 and FADS2 activities (p=0.007). Conclusion: Genetic and epigenetic variations in the FADS cluster have significant effects on intraprostatic conversion of dietary LA to AA and potentially the development and progression of PCA. Figure Legend: Genetic variation at rs174537 influences metabolism of dietary omega-6 fatty acids to AA. GG = homozygous major allele, TT = homozygous minor allele. *=p<0.05, **=p<0.01

178 POSTERS - - - - n up and - e, data of 0.077) (9 0.077) (9

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were cancerwere free, 6 while up time in this study. These findings suggest that GC score alone may -

radical prostatectomy the (RP).clinical However, application and validity - Institute, Celebration, FL Gabriel Ogaya Gabriel

GC scores predictive are of BCR at 9

ier follow ier ancer: cancer: ((no (6

From 2013 to 2015, GC was calculated was From 2013 toGC from 2015, 105 patients underwent robot who 0.072)) (cancer:0.072)) ((6 Instudy, thissubset patients available of a for were follow 0.093)). In patients BCR, with GC scores significantly were higher in patients at 9 – – d radicalall prostatectomyInstitute.the in categories risk Robotics Global Each at pment post ASSESSMENT OF A GENOMIC CLASSIFIER TO PREDICT BIOCHEMICAL BIOCHEMICAL PREDICT TO CLASSIFIER GENOMIC OF A ASSESSMENT hs versus those patients who were cancer versus 0.011) 0.10 ± were free ± 0.072 versushs those (0.19 patients who

95% of the patients - 3% biochemical with failure. Decipher scores not significantly were different atfollow any - Poster #50 THE FAILURE INWITH PATIENTS LOCALIZED CANCER PROSTATE POST PROSTATECTOMY Woodlief,Tracey Gabriel Ramharack, Ritu Ogaya

Methods: Methods: assiste months post 9 ,66 weeks,patient and up atthen 3 followed was demonstrated to be highly prognostic for the risk of biochemical failure and metastasis develo toclinical predict (BCR) biochemical and determined. to recurrence remains be Presented By: Introduction: Genomic Classifier (GC) (Decipher (GC) Classifier Genomic Global Robotic Mouraviev Vipul and Patel R cancerstatus. A representative formalin from prostate the index cancer lesion the with highestpathologic Gleason from grade each RP specimen. extracted was and amplified, RNA labeled and hybridized for analysis and generation ofsignature scores. searched we Then a correlation GC scor between PSA monitoring and clinical outcomes. Results: months,71 and 62 patients respectively.weeks, and 9 at 6 available Approximately 3, 6 90 up time point patients between cancerwere who free versus presented those who with persistent c 1 months mont Decipher(p=0.025), notmonths. was significantly however 6 different 3 or at months Conclusion: BCR at earl not be the best predictorof early BCR to initiate an advanced imaging work possible adjuvant therapy. 178 Poster #51 COMPARISON OF CONCORDANCE RATES BETWEEN COGNITIVE AND MRI FUSION BIOPSY OF THE PROSTATE Ram Pathak¹, Candice Bolan², Mellena Bridges², Monica Moore², Zhuo Li² and Todd Igel² ¹Mayo Clinic Jacksonville, Florida; ²Mayo Clinic, Jacksonville FL Presented By: Ram Pathak, MD Introduction: MRI fusion biopsy of the prostate has been demonstrated to show excellent detection rates, especially with clinically significant adenocarcinoma. The primary objective of our study was to determine the concordance rate between true MRI fusion and cognitive fusion via an intra-patient comparison. Methods: Indications for MRI fusion biopsy include patients with persistently elevated PSA and negative prior transrectal ultrasound-guided prostate biopsy (TRUS-bx). Fusion biopsy was achieved using the UroNav® Fusion Prostate Biopsy System (Invivo® Gainesville, Florida) in an in-office setting under local injectable lidocaine anesthetic. 2 Radiologists interpreted each MRI, providing both PIRADs and Likert scores. Cognitive biopsies were performed without fusion assistance. Standard systematic biopsies were variably obtained (physician and patient directed). Intra-patient comparison was achieved by comparing rates of detection of adenocarcinoma (Gleason < 7) and clinically significant adenocarcinoma (Gleason >= 7). The agreement between MRI Fusion and cognitive results was evaluated by concordance rate, Kappa coefficient and McNemar’s test. Results: 26 consecutive patients with a mean age of 67.1 and BMI of 26.9, who underwent MRI fusion biopsy of the prostate, were included in the analysis. Mean prostate volume was 37.4 (18.0-80.6) with an average PSA of 9.9 (2.3-61.5). A mean number 14.9 (6-20) biopsies were obtained per patient. PIRADs and Likert score correlated well with both detection of adenocarcinoma and clinically significant adenocarcinoma for both radiologists: Reader 1 (detection of all adenocarcinoma: PIRADs P=0.002, Likert P=0.072; detection of clinically significant adenocarcinoma: PIRADs P=0.002, Likert P=0.005) and Reader 2 (detection of all adenocarcinoma: PIRADs P=0.003, Likert P=0.015; detection of clinically significant adenocarcinoma: PIRADs 0.002, Likert 0.002). Of the 26 MRI fusion biopsies, 16 (61.54%) were positive with 81% demonstrating clinically significant adenocarcinoma. Of the 19 cognitive biopsies obtained, 12 (63.16%) were positive with 75% demonstrating clinically significant adenocarcinoma. Concordance rate between MRI fusion and cognitive was 73.6% (Kappa P=0.48, McNemar P=0.66). Conclusion: Our intra-patient comparison between MRI fusion and cognitive fusion yielded similar rates of detection.

Poster #52 INNOVATIVE APPLICATION OF INSTANT TOGGLING OF ENDOSCOPE IN MORBID OBESITY DURING ROBOT ASSISTED RADICAL PROSTATECTOMY USING XI DA VINCI ROBOTIC SURGICAL SYSTEM Gabriel Ogaya-Pinies, Hariharan Ganapathi, Anup Kumar, Vladimir Mouraviev, Srinivas Samavedi, Rafael Coelho, Bernado Rocco, Tracey Woodlief, Travis Rogers and Vipul R Patel Global Robotic Institute. Celebration, FL Presented By: Gabriel Ogaya-Pinies, MD Introduction: To demonstrate the innovative role of instant endoscope toggling in key steps of nerve sparing (NS), modified posterior reconstruction and vesicourethral anastomosis (VUA) in the presence of morbid obesity during robot assisted radical prostatectomy using Xi da Vinci Robotic Surgical System. Past, techniques for nerve sparing have focused on encompassing preventative injury techniques such as an athermal approach, early retrograde release and minimization of tension via utilization of the 30 down scope. However, in our clinic we have highlighted the role of instant toggling of the endoscope (from 30 down to up) within the Xi da−Vinci robotic surgical system during bilateral complete NS in challenging scenarios (such as obesity) in order to further minimize local and long-lasting preventative surgical injuries. Methods: From January to May 2105, twenty morbidly obese patients (BMI≥40) were

180 POSTERS ng

ccessed and reportedccessed due to and the drug interactionsdrug and intolerance or - resistant cancer prostate (mCRPC) - ed that the use of toggling use thatinstant the ed of

d on ABI or ENZ (index date) between (index ENZ ABI or d on ion Meier (KM) survival (KM) Meier curves used were to - Research Databases were usedconduct to were Research a Databases

181 ® onstruction and VUA inchallenging scenario(s), providers reducing the dosage. drug study This aims

eded to understand the reasons for gaps intreatment in bility. Kaplan

.05) inthe than standardRARP procedure.The modified posterior

fairs, LLC; d’analyse,²Groupe Montréal,Ltée, QC; ³Georgetown

Ajay S. Behl, PhD S. Behl, Ajay Abiraterone (ABI) acetate and enzalutamide novelare oral therapies (ENZ) In the current study, demonstratwe

Significantly higher rates of refill gaps ≥30 days and ≥ 60 days observedwere

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The table summarizesbelow the KM probabilities of having a refill gap amo With instantthe of toggling, use significantly wasformean the time NS less (12.3

up, or end of data availa - S IN TREATMENT AMONGST METASTATIC CASTRATION RESISTANT RESISTANT CASTRATION METASTATIC AMONGST S TREATMENT IN offering survival benefit to metastatic castrat Introduction: included inthis study utilizing instant toggling of the endoscope the with daVinci Xi robotic system. sparing Nerve technique and challenges a were known challenges known presented surgical by scenariossuch narrowdeep as pelvis a in morbidly obese patients. Results: min versusmin, 18.1 p<0 reconstruction and vesicourethralanastomosis completed was efficiently inall cases.There no intraoperative/postoperativewere complications. Conclusion: endoscope using Xi da−Vinci robotic surgical system during RARP is not improves visualization both of anatomical Also,landmarks and qualityonly instant of NS. safe, but it toggling facilitatesmodified rec posterior such morbid with as obesity. long term However, randomized trials controlled required are to evaluatefunctional benefits in outcomes longer time over period and potential of negative events. Poster #53 PROSTATE CANCER (MCRPC)PATIENTS TAKING ABIRATERONE OR ACETATE ENZALUTAMIDE AjayBehl¹,Ellis¹, Lorie S.Pilon²,A. Dominic PatrickLefebvre² Yongling and Nancy Xiao², A.Dawson³ ¹Janssen Scientific Af University,Washington DC patients. The efficacycancertreatments of rely on patientconsistency and adherence to recommended dosage regimens.Factors such as drug totreatment describeENZ. patterns discontinuation for and observed ABI Methods: GAP Presented By: retrospective patientsmCRPC initiate analysis of 10/01/2012 to 12/31/2014 with ≥6 months of continuous eligibility prior to index date and a PC diagnosiscontinuous during the period eligibility. of Patients observed were until to loss follow compare the rates of having a refill gap (i.e., ≥14 days, ≥30 days, or ≥60 days) ABI ENZ. on initiated inor patients Results: ENZ. or ABI on initiated patients Conclusion: initial this in of observation months 6 after to ABI compared as ENZ initiating patients for analysis. Additional research is ne patientstreated mCRPC with therapies. This research funded Janssen was by Scientific LLC Affairs, toxicitiescan result inpatients their or 180 Poster #54 THE EFFECT OF MRI FUSION BIOPSY ON PATIENT-REPORTED VISUAL ANALOG SCALE (VAS) PAIN SCORES: A COMPARISON OF MRI FUSION, COGNITIVE FUSION, AND STANDARD SYSTEMATIC BIOPSY OF THE PROSTATE Ram Pathak, Monica Moore, Zhuo Li and Todd Igel Mayo Clinic Jacksonville, Florida Presented By: Ram Pathak, MD Introduction: MRI fusion biopsy of the prostate can be performed as an in-office procedure under local anesthetic. We evaluated visual analog scale (VAS) pain scores (0-10) in patients undergoing MRI fusion biopsy of the prostate. Methods: Indications for MRI fusion biopsy included prior negative transrectal ultrasound- guided prostate biopsy (TRUS-bx) with persistently elevated PSA and MRI with a suspicious lesion defined as PIRADS > 3. Fusion biopsies were attained using the UroNav® Fusion Biopsy System (Invivo® Gainesville, Florida). In addition, cognitive fusion (visually- registered) and standard systematic biopsies were obtained for each patient. VAS scores were recorded for MRI fusion, cognitive fusion (visually-registered), and standard systematic biopsies. Results: 13 patients with a mean age of 70.8 and mean BMI of 26.5 underwent MRI fusion biopsy of the prostate. No patients were diagnosed with a history of chronic prostatitis, chronic pelvic pain, irritable bowel syndrome, fibromyalgia, current prescription narcotic pain medication, or active anorectal disease. Mean PSA was 7.85 with an average prostatic volume of 31.79. 8 patients (61%) had MRI lesions located in the apex, while 4 (31%) and 1 (8%) patients possessed lesions in the mid and base of the prostate, respectively. The mean VAS scores for fusion, visually-registered or cognitive, and systematic biopsies were 3.2, 2.1, and 1.8, respectively, reaching statistical significance (P=0.042) Conclusion: The dentate line serves as an anatomic landmark, where innervation below the dentate line is supplied by branches of the inferior rectal nerve and innervation above the dentate line is supplied by branches of the inferior hypogastric plexus. Standard TRUS- bx avoids needle passes below the dentate line using a sweeping maneuver, thus limiting painful apical biopsies. Unfortunately, MRI fusion software prohibits this maneuver as it interferes with the proper alignment of the electromagnetic tracker and probe adaptor to the field generator, resulting in heightened pain for more anterior and apical lesions.

Poster #55 THE ASSOCIATION BETWEEN PREOPERATIVE LEUKOCYTOSIS AND POSTOPERATIVE OUTCOMES FOLLOWING PROSTATECTOMY FOR PROSTATE CANCER Matthew Macey, Troy Sukhu, Jason Lomboy, Allison Deal, Eric Wallen, Michael Woods, Raj Pruthi, Matthew Nielsen and Angela Smith Chapel Hill, NC Presented By: Matthew Ryan Macey, MD Introduction: Preoperative leukocytosis has been linked with decreased overall survival in lung and gynecologic malignancies and post-operative complications following colorectal cancer. However, leukocytosis has not been evaluated as a predictor of postoperative complication or mortality among patients with prostate cancer. The objective of this study is to evaluate whether leukocytosis is associated with postoperative complications and mortality following prostatectomy for prostate cancer. Methods: Using the American College of Surgeons - National Surgical Quality Improvement Program (NSQIP) database, we performed a retrospective review of patients undergoing radical prostatectomy and a primary diagnosis of prostate cancer from 2005- 2013. NSQIP collects prospective data on >135 variables, including perioperative data, 30- day post-operative complications and mortality on major surgical procedures at over 450 participating academic and private institutions. Bivariable and multivariable analyses were performed on this multicenter, prospective data set using pre-operative NSQIP variable of leukocytosis (defined as WBC>11) for likelihood of postoperative mortality and complications.

182 POSTERS - – vs.

day day - 55% 1 vs.

diverse cohort of -

y predicty the presence

2015). We2015). men excluded significant otherwise), or

- – ificant predictorificant 30 of day mortalityday rare was (<1%), -

. American men (p=0.19). - based of biomarker inflammation that -

parametric bivariate testingassessed the - 3 mg/L, >3 mg/L). Primary outcome of interest of interest outcome Primary mg/L). mg/L, 3 >3 183

– American men - white race white (0.003), and lower preoperative hematocrit -

diverse cohortdiverse Veterans of presenting for initial prostate - re re of interest CRP levels, was continuous as variableand 3

REACTIVE PROTEIN FOR DIAGNOSING PROSTATE PROSTATE FOR DIAGNOSING PROTEIN REACTIVE - ven Gerhard, MD Gerhard, ven American (n=853, 62%). bivariate On analysis, not CRP was - score ≥ 7). Other covariates of interest included age at biopsy, race, reactive protein (CRP) is a serum reactive(CRP) protein is a s to estimate relationship the between CRP and presence of underlying - white race and lower preoperative racewhite hematocrit and lower strong were predictors of C ,762 patients who underwent,762 prostatectomy patientswho for cancer, prostate 86.5% were Preoperative leukocytosissign a not was (p=0.47), controlling when for preoperative hematocrit, creatinine, ASA, age, Robert Ste

In a large racially large In a

e analysis, those leukocytosis 6.6% with of a complication experienced within We retrospectively reviewed an institutional mendatabase of 1402 who

59% >3 mg/L, a continuous or mg/L p=0.40) 2.3 >3 59% if no PCa variable (median

Characteristicspatients of 1373 in cohortour presented are inTable 1. PCa was Of 19 1) were significant 1) were predictors of complications. 30

vs.

hort Africanwas

an 2.5 mg/L 2.5 PCa, p=0.54). with Similaran negative noted findings for presence were of sy, serum CRP did not predict prostate cancersy, prostateserum (clinically did predict not CRP oster #56 Results: white, 12.2% smokers, were and median 62age was years. Overall, 2.6% had (n=516) preoperative leukocytosis, median a with of lab 9 days between drawand operation date. bivariabl On race, BMI,smoking status, presenceand of diabetes.Amongthese variables, ASA (p=0.004), higher BMI (p=0.03), non 30 dayscompared to 7.3%those of without leukocytosis (p=0.53). On multivariable analysis, leukocytosis significant a not was predictor complications of following prostatectomy (p<0.000 Conclusion: subsequentmultivariable complications analysis. on and after adjustingfor comorbidities, preoperative leukocytosisnot was a significant predictor outcomethis of (p=0.6). complicationsmortality prostatectomy or following cancer. for higher prostate However, - BMI, non ASA, P Robert Gerhard, ChristopherPatil, Filson,Viraj Issa Datta Muta and Master Emory University,Atlanta GA Introduction: PSA>100with (n=29). Exposu PREDICTIVE VALUE OF C VALUE PREDICTIVE CANCERPATIENTS IN UNDERGOING INITIAL PROSTATE BIOPSY Presented By: was presencewas of outcome PCa. Secondary presence was clinically of significant PCa (csPCa) (i.e., Gleason PSA, among others. Parametric and non underwent theirfirst the (2011 at biopsy Atlanta prostate VAMC level categoricalmg/L, variable 1 (i.e., <1 PCa. Results: has to been shown be elevated inmalignancies. a large, Using racially of underlyingcancer prostate (PCa). Methods: association exposure between andoutcomes ofWe interest.then fit multivariate logistic regression model men, we assessedmen, we elevated whether CRP levels couldindependentl found in775 (56%)men, of 617 (80% men of where PCa) with had csPCa.majorityA of the co 3 mg/L associatedeithercategorical PCa, as presence with of a variablemg/L(56% <1 medi thecsPCa subgroup p>0.05) African (all of and among which was also observed among African also among was which observed biop Conclusion: 182 Poster #57 THE ROLE OF GENOMIC CLASSIFIER TO ASSESS POST-OPERATIVE METASTATIC RISK FOR PROSTATE CANCER PATIENTS WITH ADVERSE POST-OPERATIVE PATHOLOGY Tracey Woodlief¹, J. Alter², R. Ramharack¹, H. Ganapathi¹, G. Ogaya¹, V. Mouraviev¹ and V. Patel¹ ¹GRI; ²GenomeDx (San Diego, Ca) Presented By: Tracey Woodlief, PhD Introduction: Genomic Classifier (GC) (Decipher®), a novel 22-RNA biomarker profile, has been demonstrated to be highly prognostic for the risk of metastasis and biochemical reoccurrence post-radical prostatectomy. However, the association between the final adverse pathology characteristics that can lead to early post-RARP biochemical and clinical failure and GC remains unknown. Methods: GC were calculated from 105 patients, who underwent a RARP at our Institution between 2013 and 2015. The underlying features used to select patients were postoperative prostate pathologies, including primary and secondary Gleason score, tumor volume and size, pathological state T and D’Amico classification. Results: In this analysis, the Decipher results were subdivided into quartiles in order to further analyze the Decipher’s ability to assess final prostatectomy specimen pathology. A representative formalin-fixed paraffin-embedded (FFPE) block was taken from the index prostate cancer lesion with the highest pathologic Gleason grade from each RP specimen. RNA was extracted and amplified, labeled and hybridized to Human Exon 1.0 ST microarrays (Affymetrix, Santa Clara, CA, USA) for analysis and generation of signature scores. In the quartile analysis, the GC quartiles were as follows (Q1: 0.0175 ± 0.0008; Q2: 0.0403 ± 0.0012; Q3: 0.076 ± 0.0048; Q4: 0.2761 ± 0.0267), which was significantly different as by design. Within the quartiles, tumor volume was significantly different between Q4 and each of the lower groups (Q1, Q2, Q3)(p<0.01), with overall percent difference in tumor volume between Q1 and Q4 being a 42.4% increase. While, tumor dimension was significantly increased in Q4, with an overall percent difference in tumor dimension between Q1 and Q4 being 46.8%. Next, within the quartiles, the primary pathological Gleason score was significantly higher in Q4 versus Q1, Q2 and Q3 (p<0.03). While, D’Amico class was also significantly higher in Q4 versus Q3 (p<0.04), with a trend for differences in the other quartiles. Also in this study, the GC score was significantly correlated to both increased tumor volume and size (p<0.0003) (Tumor dimensions: R2=0.1182; Tumor volume:R2=0.1223). Conclusion: In our study GC score was significantly correlated with tumor volume and size, primary Gleason grade, total Gleason score and D’Amico class. These findings suggest value of biomarker to predict increased metastasis risk.

184 POSTERS -

index, forindex, treated - INCREASE THE

d a mean CCI of 1.8. treated mg patients and 10 - one enzalutamide)and had ified. these, 223,953 Of (70%) tumorigenesis.

Charlson comorbidity (CCI) index -

ic obstructive and inflammatory pulmonary

t reported.study been widely Thisto aimed 185 graft groups, interms biochemical of recurrence -

androgen, chemotherapy, oral mCRPC therapy,

- FL

July 2015, 151 patients underwent full partial or NS RARP,

Pinies, MD Pinies,

- hed graft and no Celebration, , matc - Affairs, Scientific ²Janssen PA; LLC,Affairs, Horsham, ³Groupe LLC; up informationin145 patients. Postoperative analyzed outcomes were - Cancer progression and dissemination progression Cancer is excessive associated with Pinies,Ganapathi,Woodlief,Vladimir Hariharan Tracey Mouraviev, Travis The prevalence glucocorticoidThe of increases use(GC) age consistent with Gabriel Ogaya Gabriel Lorie Ellis, PhD - databases. The index date for the treated cohort (i.e., patients receiving

GC use is common in patients with PC, including in those not receiving PC PC receiving not those in including PC, with patients in common is use GC st, adrenal blocker, anti

Toascertain the oncological safety of dehydrated HumanAmnion/Chorion ® ditiesmade should to which known PC physicians.be Source of Funding: This

By: Patients with ≥ 2 PC diagnoses or ≥1 claim for a PC therapy and ≥ 12 months From August 2013 to

acquired diseases as such chron A total 321,113 of eligible ident PC patients were -

assisted radical prostatectomy (RARP). - he mosthe recent PC diagnosis date. GC use summarized, was post (BCR). Five variables taken were into accountcreate to homogenous groups: patient age, between propensitybetween Rogers, PatelR and Vipul Tadzia Harvey surgery or radiation) definedwas as the date ofmost the recent treatment. PC The index date for the untreatedcohort (i.e., PC with diagnosis but without PC treatment) defined was as t RISK RECURRENCE BIOCHEMICAL OF FOLLOWING PROSTATECTOMY.RADICAL Ogaya Gabriel Global Robotic Institute LHRH agoni LHRH Introduction: Methods: angiogenesis. It is therefore,that clinicians occasionally inquire to amniotic as whether factors,mightcausemembrane, growth numerous its with Presented Objective: Membrane the around (dHACM) neurovascular bundle(NVB) following sparing nerve (NS) robot performed a single by surgeon, with bilateral placement dHACM the around We NVB. were able to get follow Poster #58 PREVALENCE GLUCOCORTICOID OF PROSTATE IN CANCER USE PATIENTS LorieEllis¹, Behl², Ajay Yongling Xiao³,Pilon³ Patrick Dominic Lefebvre³ and ¹Janssen Scientific d’analyse, Ltée, QC Montréal, Presented By: with age with Introduction: conditions for GCs which indicated. are GCs commonly are alone in used or combination otherwith therapies for prostate cancer (PC), but studies of GC treatment patterns in treated and untreatedPC patients no have PC. indescribe theGC use of prevalence Methods: continuous eligibility 1/2005 between and 7/2014 identified were inTruven Health MarketScan and untreated PC patients descriptive using statistics.Baseline demographics and comorbidities also reported.were untreatedwere and 97,160 (30%) patients treated were awith PC therapy. Untreated patientsmeanmean had a and a age of Quan 68 years of 1.7 and treated patients had a mean age of 71 years an Approximately of 30% treated untreated patients of and 40% patients received during GCs the observation Among period. treated patients, patients of 70% receiving chemotherapy and 88% of patients receiving oral mCRPC therapies (abirater evidence of GC use. daily Median GC dose was 24 mg inuntreated and 20 mg intreated chemotherapyPC 14mg patients. in was dose daily Median GC Results: inmCRPCpatients therapies. treated oral with Conclusion: PC comorbi Scientificresearch Janssen by Affairs, funded LLC was Poster #59 therapies. daily Median in GC dosagesto patients tended be lower PC treated with therapies than inthose without PC therapies. GC usePC patients inmay be related to non DEHYDRATED HUMAN AMNION/CHORIONMEMBRANE NERVE WRAPALLOGRAFT AROUND THE PROSTATIC NEUROVASCULAR BUNDLENOT DOES 184 final pathology Gleason score, positives surgical margins (PSM), pT stage and follow-up time. Survival analyses was performed using Kaplan-Meier method with log-rank test. Results: The mean follow up was 16.5 months. 8 patients presented BCR in the dHACM group versus 11 patients in the no-dHACM group (p= 0.322). Two subanalysis were performed comparing BCR between these two groups, one in patients with PSM in the dHACM group (21 patients) versus those with PSM in the no-dHACM group (21 patients) showing no differences (p= 0.59), and a second subanalysis comparing patients with extraprostatic disease (≥T3) in the dHACM group (11 patients) versus the no-dHACM group (17 patients; p= 0.23) Conclusion: Our results indicate that dHACM placement does not increase the risk of biochemical recurrence after RARP.

Poster #60 INTRODUCTION OF A FOUR-VARIABLE, POST-PERINEAL PROSTATECTOMY NOMOGRAM PREDICTIVE OF RFS Tracy Tipton¹, Shah Jaimin², Sarkissian Hagop³, Ellet Justin4, Garrett-Mayer Elizabeth5, Lilly Michael6 and Keane Thomas7 ¹PGY3 Urology resident, MUSC, Charleston, SC; ²Private Urologist, Florida Urology Partners, Tampa, FL; ³Oncology Fellow, MUSC, Charleston, SC; 4PGY5 Urology resident, MUSC, Charleston, SC; 5Professor of Biostatics and Epidemiology, MUSC, Charleston, SC; 6Professor of Oncology, MUSC, Charleston, SC; 7Chairman of Urology, MUSC, Charleston, SC Presented By: Tracy J. Tipton Introduction: Post-prostatectomy nomograms are useful for predicting patient outcomes and are consequently used widely for both clinical decision making and patient counseling. Few studies have reported nomogram data in the post-perineal prostatectomy setting. Our primary objective was to develop and evaluate a post-perineal prostatectomy nomogram based on established risk factors. Methods: Data were obtained from a prospectively maintained database of 298 patients who underwent radical perineal prostatectomy at the Medical University of South Carolina from January 1997 through December 2012. Median follow up was 863 days. Patients who underwent hormone therapy, radiotherapy or cryotherapy prior to RPP were excluded (n=79). Recurrence was defined as PSA exceeding a threshold of 0.2ng/mL and recurrence-free survival (RFS) as the time from surgery until recurrence or death. Seven baseline variables were considered for inclusion in the nomogram: age, race, year of surgery, Gleason grade, PSA, margin status, and pathologic “T” score. Data was randomly assigned to a training set (n=149) and an internal validation set (n=70) with the constraint

186 POSTERS - - - 5 -

year, ce of - partner partner surgical

- f AUS cuff cuff f AUS 5, 12% had -

morbidites included included morbidites - piece in70% and 2 AUS). We sought to - perineal prostatectomy Mahidol University, University, Mahidol - 4 and Wayneand Hellstrom¹

4 79). Co - ision between 2009 and 2014. ision between variable nomogram for predicting

- 92), median SHIM score improved - operative LogPSA, first Gleason 4 - PSA,first Gleason component, race, interest similar across were groups. -

ed. study. age of Mean patients inthe database

, , Premsant Sangkum 187

prostatectomy radiotherapy.Distribution o - dex for the model from the training set was 0.78. A the forA modeldex the training 0.78. from set was

in up of 19 months (1 - -

Mitchell, MD, MS

indices and parsimony, the finalmodel applied was to the validation set

- year RFS.year applicationmodel Thethe the set of to validation C yielded a - morbidities previous and/or radiotherapy. American vs. not and positivemargin status all were significant predictors Current gold standardsCurrent gold offor care patients significant with post - - Gregory C.Gregory

This study that suggests preoperative

Dual synchronousAUS/IPP insertion through a single penoscrotal incision is

We retrospectively collected on 33 patients had synchronous data who dual index calculated.index

The medianThe age of cohort the 64 (range was 51

219 patients included were inthis - on:

3, African - year and five - FS inthe post perineal prostatectomysetting that has high predictive ability which was ¹Tulane Orleans, UniversitySchool Medicine, ²Tulane of New of University LA; School LA; Orleans, New of Medicine, school University ³Tulane Medicine; Introduction: prostatectomy erectile (ED) dysfunction and stress urinary incontinence the are (SUI) inflatablepenile prosthesis (IPP) and the artificial urinary sphincter ( report experience our dual with synchronousAUS/IPPinsertion through a single penoscrotal incision. Methods: insertion singleAUS/IPP penoscrotal through a of inc Collected data included various patient,clinical, and surgical parameters. Post Bangkok, Thailand Presented By: that the proportion of patients recurrence with in the training and validation the sets were proportionalsame.model prognostic assess hazards Cox significanto used was baseline variables a multivariable and model developed. was After determining optimal an model C on based and the C outcomes including erectile function, of degree incontinence,complications, and patient and partner satisfaction also collect were rates Results: hypertension (67%), dyslipidemia (52%), coronary arterydisease (30%), diabetes (24%), 21%with of the patients receivingpost sizes 3.5cm was (33%), 4.0cm (64%), and 4.5cm (3%).IPPs3 were Results: 58 was years; 32% African were American, 20% had primary gleason of 4 positive margins patientscancer PSA of had prostate 6.3. average and 27% was recurrences. Distributions baseline of variables of Based final on our multivariableregression model, pre vs. 2 of biochemical recurrence. The C nomogram created was based on thismodel, predictingmedian as RFS as well one two of 0.82.index Conclusion: piece in30%. Atmedian a follow and marginstatus significantly are associated RFS with inthe post satisfaction rates 9/10 were and 10/10, respectively. Complications included 3 infections, 2 cuffAUS leaks, 1 IPP erosions 2 AUS distal and erosion, morecommonly and occurred in patients cowith from 5 to 25 and median decreased day from 25 and to 5 to per from patient Median pads 1. 6 and setting. findings These led todevelopment the of a four R validated in an independent sample. Poster #61 SYNCHRONOUS DUAL AUS/IPP SINGLE INSERTIONPENOSCROTAL THROUGH A INCISION Peak³ Taylor Yafi², Faysal Mitchell¹, Gregory Conclusi can excellenta safe procedure yield results. which mellitus Diabetes history and previous of radiotherapyAUS erosion. infection device convey a higher of and risk 186 Poster #62 THE UBIQUITOUS AVAILABILITY AND EASY ACQUISITION OF ILLICIT ANABOLIC ANDROGENIC STEROIDS AND TESTOSTERONE PREPARATIONS ON THE INTERNET J. Abram McBride, Jason Lomboy, Culley C. Carson and R. Matt Coward Department of Urology, UNC Chapel Hill NC Presented By: James Abram McBride, MD Introduction: To determine the availability and ease of purchase of anabolic androgenic steroids (AAS), testosterone (T), and anabolic supplements on the Internet. Methods: A Google search was performed using “buy steroids.” The top 10 ranked sites were evaluated for content. Discussion forums and YouTube links were excluded. The availability of agents per site was stratified by AAS, T, anabolic supplements (naturally occurring extracts), and post-cycle recovery and erectile dysfunction medications. Purchase was simulated up to payment entry. Ease of purchase was evaluated by need for prescription, pharmacy location, and payment and delivery options. Supportive information and instruction was stratified by cycle recommendations, recovery information, and non- steroid alternatives. Results: 8 sites remained after exclusion. The most commonly available synthetic AAS were Dianabol, Deca-Durabolin, Anadrol, Masteron, and Winstrol respectively, on 87% of sites, with 62% offering additional agents. Injectable T preparations including enanthate, cypionate, propionate, and T blends were available on 87% of sites. Only 12.5% offered anabolic supplements or alternatives. Recovery agents available included clomiphene citrate offered by 75% of sites, 62% offered tamoxifen and anastrozole, and 50% offered hCG and letrozole. PDE5 inhibitors were offered by 62% of sites, and one offered intracavernosal alprostadil. For ease of purchase, no site required a prescription, 71% accepted credit card/Paypal, 37% accepted Bitcoin, and all sites were supplied by international pharmacies shipping directly to home addresses with disclaimers that consumers are liable to local laws. For supportive information, 75% of sites had cycle recommendations, 62% provided post-cycle recovery information, and only one site provided non-steroid alternatives. Conclusion: AAS and T are readily available and remarkably easy to purchase on the Internet without a prescription. It is of paramount importance that clinicians are aware of this considerable problem given the known significant detrimental effects these agents have on long-term fertility and sexual function.

Poster #63 SPONTANEOUS CORPORA CAVERNOSAL INJURY FOLLOWING XIAFLEX® INJECTIONS UNRELATED TO SEXUAL ACTIVITY Michael Bickell¹, Justin Parker¹, Michael Metro², Mark Swierzewski³, Brian Steixner4 and Rafael Carrion¹ ¹University of South Florida Urology, Tampa Florida; ²Temple University Urology, Philadelphia PA; ³Florida Urology Partners, Tampa Florida; 4Jersey Urology Group Presented By: Michael Bickell, DO Introduction: Xiaflex®, is a purified clostridal collangenase that results in enzymatic disruption of the collagen found in a Peyronie’s plaque and is indicated for the treatment of men with Peyronie’s disease (PD) that have at least a 30 degree penile curvature. In clinical studies Xiaflex® has been shown to have a 34% improvement in penile curvature and is a minimally invasive treatment option for PD. Treatment related adverse events occurred in 84% of men treated with Xiaflex®, although most of these events were mild to moderate and the majority resolved in 2 weeks without intervention. However, serious events did occur in the clinical trials following Xiaflex® injections and include penile fracture in 0.5% of patients and severe penile hematoma in 3.7% of patients. In clinical trials all penile fractures occurred during intercourse. Objective: Highlight previously unreported spontaneous corporal injury following Xiaflex® Methods: Retrospective review of two patients that developed spontaneous, serious adverse events following Xiaflex® injections unrelated to intercourse.

188 POSTERS - lation lation permeable permeable - LAYER TERM - - estradiol (E2) -

injectionsPD presented for to

layered microcapsule, the where

- stimulating hormone and 50 (FSH) - elling, and bruising occurred which ported but followingnormal, a nocturnal following an injection after a rigid nocturnal 189 based hormone therapy using cell encapsu - fold) FSH concentrations response to in and E2 of for the treatment of PD. Bothforevents treatment occurred the PD. of term culture. Cell viability and 17 β - -

® ee dimensionalsupports. natural The architecture of

graftin patient 2. number

membrane from an outer alginate layer containing thecacells. The

RING OF OVARIAN ENDOCRINE OVARIAN RING OF MULTI CELLS USING A

cells inmultilayer encapsulated capsules the resembling natural follicular

John D. Jackson, D. PhD John Although hormone replacementcompensate forto therapy is the able of loss InstituteWinstonfor Regenerative Medicine,Salem, ²Department of NC;

Our study highlightsthe potential for unanticipated adverse events of corporal

Ovaries were excisedOvaries were from old day 21 rats cells and endocrine (granulosa and

Histologically, encapsulated sustainedcells the showed viability long during the Two patients activelyTwo treated that were Xiaflex with

ENGINEE injections;patient single a one received injection patient and received two two -

ornithine (PLO) ® - L - ml luteinizing hormone (LH) in long in (LH) hormone ml luteinizing Conclusion: Conclusion: Xiaflex of injection following rupture injections. Bothevents occurred the night erection.Patientobserved number 1 was and treated conservatively patient and number 2 takenwas for the separate exploration.to OR Two tears in tunica the albuginea were identified and repaired patch a with unexpectedly without intercourseas previously re erection the night after injection. Physicians should thatbe aware ruptures may occur spontaneously a decreased and have thresholdfor surgical evaluation in an atypical presentation. Poster #64 TISSUE the ER complaints with penilesevere pain, of sw spontaneously a nocturnalfollowing erection. Both patients inthe first were cycle of Xiaflex Results: ALGINATE MICROCAPSULE STRUCTURE RESULTS IMPROVED IN LONG Introduction: technology hormones.sex deliver to Methods: the nativeusedmodelconstruct follicles themulti to was a ovarian hormone production, hormone delivery through pharmacologicalmeans results in consistently highconcentrations, serum cause which clinical various complications. The purpose of study our isto develop a cell theca isolated. cells) were Granulosa and theca cells then were encapsulated inalginate hydrogel microcapsulesto provide thr HORMONE SECRETIONS IN VITRO IN SECRETIONS HORMONE Sittadjody Sivanandane¹,JustinAnthonyJamesSaul², Jackson¹, Yoo¹,John Atala¹ and Emmanuel Opara¹ ¹Wake Forest ChemicalEngineering, and PaperMiami University, Oxford, OH Presented By: granulosa cells positioned were inan inner alginate core separated by a semi poly encapsulated incubated cells 50 ng/ml with follicle were ng/ secretionmediaculturefor assessed the were 30 days. in Results: term culture. The structuresecreted significantly (4 higher 188 LH than was observed in two other control encapsulation schemes (p<0.05, n=6). Conclusion: We believe that the juxtaposition of granulosa and theca cells in a spatial orientation that mimics the natural physiology results in better cellular function. We conclude that our multilayered ovarian tissue construct has a gonadotropins-responsive secretion of sex hormones thus, demonstrating for the first time that the endocrine unit of ovaries could be recapitulated ex vivo.

Poster #65 A NOVEL TECHNIQUE FOR “CONTAINED” IRRIGATION AND ASPIRATION OF PRIAPISM (CAIP) Rafael Yanes, Joan Delto, Ajaydeep Sidhu, Jorge Caso, Akshay Bhandari and Alan Nieder Mount Sinai Medical Center, Miami Beach, Florida Presented By: Rafael E. Yanes, MD Introduction: Ischemic priapism is a compartment syndrome of the penis that requires emergent treatment. The usual management algorithm calls for saline irrigation, aspiration of intracorporal blood, and injection of phenylephrine. This is usually performed in less than ideal conditions, at the bedside in the emergency department (ED). When conventional measures are used, there is commonly copious spillage of blood with significant occupational exposure to the urologist and ED staff. Our patient population is unique in that around 36% of the patients are HIV positive. Given this, a method of irrigation and injection that minimizes exposure to blood is particularly valuable. Methods: An 18G metal needle is inserted transversely into the lateral aspect of the corpora in the standard fashion. A three-way stopcock is then attached to the needle. A closed system is created by attaching a Beckman Dickinson Vacutainer® to one end of the stopcock and a syringe with saline or phenylephrine to the other end. Red-top blood draw vials are attached to the vacutainer for aspiration. To optimize the vacuum capability, no IV plastic tubing or butterfly needles are used in the suction component, decreasing dead space and eliminating vacuum collapse of a connector wall (Figure 1). Results: A total of 18 patients were treated using this technique. The mean time to presentation was 12 hours. The etiology in all patients was recreational intracavernosal drug abuse. In all cases, the vacuum tubes provided enough negative pressure to evacuate the blood safely and without spillage, allowing for proper disposal and cognizance and accurate measurement of the amount of aspirated blood. Priapisms were completely resolved in all 18 patients without requiring further intervention. Conclusion: Our novel technique for irrigation and aspiration in the treatment of priapism promotes a safer environment for the urologist and hospital staff while allowing us to keep track of the amount of aspirated blood, and facilitates safe and proper disposal.

190 POSTERS

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, Landon , 11 months) 5 - etween 2001 f PT. PT was was PT f PT. ost prosthesis

tralesional injection of of injection tralesional Mahidol University, University, Mahidol 4 , Erhan, Ates 4 rvature, if used for at least rvature, for least if used at

in15/18 (83%) patients. The Mayo Clinic, Rochester, MN Mayo

6 PY FOR PEYRONIE’S DISEASE PEYRONIE’S FOR PY

treatmentstretched penile length (SPL),

- ects.

191 urethral injectiontrimix/bimix gel ofand all their penile duplex penile duplex Doppler studies performed. was - -

and post 9.9 degrees [SD 11.8], p=0.49), change or in SPL (PT -

on Akdeniz University,Turkey; Antalya, 5 significantly greater SPLcomparedthose to PT not (4.4mm using [SD 0.5] urethral gels as a treatmenturethralfor these a gels patients. as 2b (IFN) has been previously described.We present an update on our phics, initial vascular status,pre vascular initial phics,

- - ne University school of Medicine, New Orleans, University of New school Medicine, LA; ne The concomitantuseThe of traction penile PT in with Michael Pinsky,R. MD This study servesperform to of a review a subset of penile our prosthesis Jared J. Wallen, MD hundred and twelve patients underwent a median IFN patientsand twelve hundred a injections (range 12 underwent of

Daily use of PT during intralesional therapy for PD may provide a small but - Softis glans syndrome a patient continued with reported phenomena flaccid

esis. review we Here 18 patients whom had underwent implantation of a either

A retrospective review of patients underwent IFN who therapy b Of the 19 patients initially evaluated 1 of them excluded was from the review

Of theOf 18 patientsincluded inthe cohort,satisfactory results measured as were One

ed on how to mix to and perform ed on how intra , , Suresh Sikka¹Wayne Hellstrom¹and 6 mm[SD 6.5] vs. +2.1mm no PT [SD 7.4], in p=0.45), change curvature (PT reported glanular engorgement and were reportedreported glanular engorgement and were - 24). Daily use of PT reported 31% by was of patients. no differences There were in mix/trimix intra mix/trimix - Bangkok, Thailand; Presented By: Introduction: interferon alpha and 2012 completedwith pre Poster #66 THE EFFECT OFDURATION OFDAILY PENILE TRACTION INPATIENTS UNDERGOINGINTRALESIONAL INJECTION THERA Michael Yafi²,Pinsky¹, Faysal CarrieStewart³, Premsant Sangkum Trost ¹Tulane Orleans, UniversitySchool Medicine, ²Tulane of New of University LA; School ³Tula Medicine; Charts were reviewedCharts and were collectedwere regarding various patientdemographics, vascular parameters, penile objective measurements length and curvature and use o further stratified of duration use. to daily according Results: 6 clinical assess the durationtraction. to experience benefit daily of and Methods: patient demogra Introduction: Methods: cohort due to true floppy glans syndrome and recommendation for revision and upsizing of penile prosth malleable inflatableor penile and had continuing implant complaints soft of glans with physicianconfirmed sizing of adequate the prosthetic device.All 18 patients were instruct patients whom requiremedications adjunctivesoftsyndrome, the for glans efficacy and of bi erectcircumference penile betweencurvature patients a PT and regimen followed who and those didnot. who PT Overall of use impactdid changenot in circumference penile (PT +3.2 questions answered. were Results: self remainingthree patients all injecting were solution trimix and eventually discontinued therapy due to pain. The average length of treatment to months date is 6 (2 degrees [SD 16.0] vs. no PT continuedwith furthersatisfaction side eff and no Conclusion: glans in the face armamentarium for treating soft glans syndrome issomewhat limited inthe p of a properly positioned and functioning prosthetic. The urologist’s subjectively meaningful improvement in SPL, without affecting cu affecting without SPL, in improvement meaningful subjectively 3 hours a day. Poster #67 Wallen, Bickell,Emtage, S. Mike Fisher, JustinJaredJohn DanielBeilan,B.John J. Martinez and Rafael Carri FL Tampa, Florida South of University Presented By: SOFT SYNDROME: GLANS INTRAURETHRAL GELSMUSE ALTERNATIVE AN TO AS ENGORGEMENT GLANS FOR Conclusion: vs. 1.3mm [SD 0.8], p=0.04). p=0.04). 0.8], [SD 1.3mm vs. +2.4mm [SD 0.9] vs. no PT +1.3mm [SD 0.8], p=0.56). however, gained Men who used PT ≥3 hours/day, 190 setting due to the technical aspects intracavernosal injections and vacuum erection devices and the risks they pose to the implant. The Goldstein group has previously reported an incidence of soft glans syndrome in as high as 61% in the post prosthesis setting with 59% of those patients having a good response to MUSE. One of the biggest documented patient complaints with MUSE therapy in the literature to date is pain with administration, upwards of 39%, which is why the interest in bimix and various trimix intra-urethral gels is warranted in this patient cohort. The incidence of pain with injection that ultimately required discontinuation of therapy in our cohort was 3/18 (16.7%). Given the high patient satisfaction and low pain incidence we recommend further careful evaluation of injectable gels for soft glans syndrome.

Poster #68 COLOR DOPPLER DUPLEX ULTRASOUND (CDDU) PARAMETERS OF MEN WITHOUT ORGANIC ERECTILE DYSFUNCTION: ARE THERE AGE-SPECIFIC CUTOFFS THAT DEFINE NORMALCY? Ram Pathak, Andrew Davidiuk, Zhuo Li, Isaac Effriong and Gregory Broderick Mayo Clinic Jacksonville, Florida Presented By: Ram Pathak, MD Introduction: Erectile Dysfunction (ED) can be non-invasively diagnosed by Color Duplex Doppler Ultrasound (CDDU). The primary aim of the study was to identify age-specific CDDU parameters for patients without organic erectile dysfunction. Methods: A retrospective review was conducted to identify patients without organic ED who underwent in-office testing with intracavernous pharmacologic erection augmented by visual sexual stimulation and CDDU over a 5 year period. Patients were characterized by demographic information and CDDU parameters. CDDU parameters included pre- and post-visual stimulation peak systolic velocities (PSV) and the resistive index (RI). Non- organic ED was defined as post-visual stimulation PSV >= 35cm/s and RI >= 0.9 and included in the analysis. Pearson correlation test was used to evaluate the association between ordinal age groups with PSV and RI measurements. Results: In our cohort, 220 patients were identified with non-organic ED (PSV>=35cm/s, RI>=.90). The mean age of our cohort was 53.7 years old with a mean BMI of 27.2. For the entire cohort, average post-visual stimulation PSV was 55.0 (35.0-115.5) and average RI was 0.99 (.9-1.0). Medical co-morbidities were limited in our population, with only 29%, 7%, and 11% reporting hypertension, Diabetes, and heart disease, respectively. Priapism, as defined as a sustained erection requiring an injectable reversible agent, occurred in 93% of patients. The patients were then stratified by age (<30, 30-39, 40-49, 50-59, 60-69, and >70) and Doppler parameters were analyzed, yielding a negative correlation coefficient for pre-visual stimulation PSV (-0.14, P=0.04), post-visual stimulation PSV (-0.20, P=0.003) and RI (-0.06, P=.350) (Table1). Conclusion: No patients were diagnosed with arterial insufficiency or cavernous venous occlusive disease. There appears to be an age-related decline in pre- and post-visual stimulation PSV. Characterization of Doppler parameters in patients without organic ED can be used to construct cutoffs to further define age-specific normalcy.

192 POSTERS - - 5 - nd urgery. RP use - 26 and -

sparing s - ated quality of life pharmacologic aids - rel - 4.3) and ICI 2.0, (OR - up was assessedup was with University Michigan, of - QA COHORT QA 4 - PHARMACOLOGIC -

oupled a dailywith post operative period.

- 4 aintenance of function sexual

ment.

STATE CANCER SURVIVORS SURVIVORS CANCER STATE up. Primarymeasures self outcome were - QA) usingQA) the validated EPIC - the use erectile of aids patients by undergoing 193

RP sexual bother sexual symptoms,RP and post - , Atlanta, GA; ²Beth Israel Deaconess Medical

year followyear pharmacologic erectile functionaids following radical - -

ction, post and Akanksha Mehta¹

ealthcare providerstheealthcare in early post 4

with two

ssessment; PROST

fael Carrion², Run Wang³ Gerard Henry fael Carrion², and Run One of the most common patient complaints after IPP (inflatable penile penile IPP (inflatable after complaints patient common most of the One Erectiledysfunction (ED) ismost the common health MichaelB. MD Pryor, Ilan Joseph Safir, MD

There is universal interest in y: 31.8, p<0.001) adjusted for age, baseline PSA, and nerve 3.9) were statistically3.9) were significantly associated an increased with risk sexual of - -

Baseline sexual fun 589 menmen RP.589 CaP with underwent reported 150 ED (34%) at baseline.At2 sults: Reginal Urology, Shreveport, LA Introduction: Presented B Introduction: supplemental questionnaires. Erectile function aids phosphodiesterase offered were and effectiveness assessed erectilewere of a prospective, aids in longitudinal,multicenter cohortmencancer prostatestudy with Satisfaction Outcomes (Prostate of Cancer and with Treatment Quality A inhibitorsintraurethral (PDE5i), alprostadil (IA), intracavernosal injection (ICI), and vacuum erection devices (VED) reported bother sexual and quality erections.multivariate of Univariate and logistic regression used was for analysis.to Randomness lost follow of prostatectomy (RP). Methods: Ann Arbor, MI Presented By: complaint prostate following cancer (CaP)A treatment. better understanding regarding effectivenessacceptability and of these aids is warranted inorder to appropriately counsel patients and theirpartners regarding the recovery and m following CaP treatment. The objective ofstudy this to was assess and effectiveness use of various pharmacologic and non ¹Emory UniversitySchool Medicine of Center, University,East State Boston, ³Michigan MA; MI; Lansing, 4 Poster #69 EFFECTIVENESS USEPHARMACOLOGIC AND OF NON AND ¹Regional Sreveport,Urology LA; South ²University ³University Florida, FL; of of Tampa, SchoolTexas Anderson Cancer of TX; Houston Center, Houston, and MD at Medicine operative protocol rehab maximuminflation IPP,with the to of evaluate objective morphologicchangesmeasurements in aspenile well as satisfaction to patient assess in Coloplasttheir years to after penile Titan place 2 up length prosthesis)surgery is reported loss ofWe penile length. employed have a method of using lengthnew measuring technique (NLMT) intraoperatively, c sensitivity analysis. Re years, 334 subjectstried at had ED least aid: subjects of 22%, one and 21% 98%, 28%, had tried a PDE5i, VED, ICI, IA, and respectively. Multivariablelogistic regression fou that reported subjects who PDE5i to effective be an treatmentmodality 15.5 were times more likely to report erections firm enough for intercourseyears two after RP (OR 15.5, 95%CI: 7.5 ERECTILE DYSFUNCTION AIDS AMONG PROERECTILEDYSFUNCTION AMONG AIDS PROST THE FROM PROSTATECTOMY RADICAL FOLLOWING IlanSafir¹, Dattatraya Martin Patil¹,Sanda¹, Peter Chang², Jill Crociani², Catrina Hardy³, Larry Hembroff³, John Wei 95%CI: 1.1 95%CI: RP.PDE5iisthe Oral best of predictor satisfaction sexual years after two to RP high owing satisfaction and less its with bother use. Both pharmacologic and non bother years after RP. two Conclusion: While adjusting for samefactors, use of IA(OR 2.3, 95%CI: 1.2 should h by be encouraged Poster #70 Michael Pryor¹, RA PROSPECTIVE EVALUATION OF POSTOPERATIVE PENILE REHABILITATION: REHABILITATION: PENILE OF POSTOPERATIVE EVALUATION PROSPECTIVE FOLLOWING YEARS 2 SATISFACTION PATIENT AND MORPHOLOGY PENILE PROSTHESIS PENILE INFLATABLE TITAN COLOPLAST 192 Methods: A prospective, three-center, study of 40 patients who underwent IPP placement, with NLMT for erectile dysfunction with the Coloplast Titan IPP. Patient instructions were to inflate daily for 6 months and then inflate maximally for 1-2 hours daily for 6-24 months. Fifteen penile measurements were taken before and immediately after surgery and at follow-up visits. Results: All 15 penile measurements were improved at 1 and 2 years from pre-implant status, and there was a statistically significant improvement in the objective measurements at year 2 compared to year 1.There was also statistically significant improvement in satisfaction of penile morphology at both year 1 and year 2 compared to pre-operative physical perception. At 2 years post-op, 67.8% of subjects were satisfied with their length and 77% had perceived penile length that was longer (30.8%) or the same (46.2%) as prior to the surgery. These 2 year values were an improvement from 1 year. Patient satisfaction profiles regarding penile size, use of IPP, and sexual performance with the IPP were all improved at 2 years compared to 1. At year 2, 96.4% of the patients reported being very satisfied or extremely satisfied in regards with the surgery fulfilling their expectations, versus 83.3% for the first year. Conclusion: This study suggests using the Coloplast Titan with aggressive cylinder sizing and a post-operative penile rehabilitation inflation protocol may optimize patient satisfaction and erectile penile measurements, and provide sustained improvement with longer follow- up. Financial funding: Coloplast Corporation

Poster #71 END DIASTOLIC VELOCITY VERSUS RESISTIVE INDICES IN PREDICTING BETTER CLINICAL RESPONSE USING PENILE DOPPLER ULTRASOUND FOR PATIENTS WITH ERECTILE DYSFUNCTION Casey McCraw, Zachary Klaassen, Reena Kabaria, Roger Chen and Ronald Lewis Georgia Regents University, Augusta, GA Presented By: Casey O. McCraw, BS, MD Introduction: Erectile dysfunction (ED) is a common disorder affecting millions of men worldwide. Penile Doppler (PD) is a useful modality to assess the functional underlying cause of the ED. PD can be used for evaluating different parameters of an erection including peak systolic velocity (PSV), End diastolic velocity (EDV), Resistive Indices (RI) and cavernosal artery diameter (CAD). These measurements can aid the physician in diagnoses and treatment. The objective of this study was to determine whether RI or EDV better predicts clinical response on PD for erectile dysfunction evaluation. Methods: Between July 2008 and February 2013, 472 consecutive patients were evaluated for ED with a PD ultrasound of which 465 patients had complete data. This cohort was then divided into three groups based on clinical response: 1) Clinical response 0 degrees (n=112, 24%), 2) Clinical response 0-45 degrees (n=226, 49%), 3) Clinical response greater than 45 degrees (n=127, 27%). Interquartile Range (IQR), Mean, median and Standard Deviation (SD) were then calculated for certain demographic data and PD parameters including EDV and RI (calculated (PSV-EDV)/PSV). Both parameters were calculated by best response regardless of cavernosal side. Demographic and PD ultrasound parameters between the groups were compared using descriptive statistics. Results: The median age for Group 1 was 58 (IQR 20) years, 59 (IQR 16) years for Group 2 and 55 (IQR 18) years for Group 3 (p=0.06). Caucasians showed a significantly better clinical response when compared to other races (p= 0.03). There was no significant difference between the groups for marital status (p=0.67). Patients in Group 3 had significantly improved EDV (0 ± 0 vs. Group 1, 0.1 ± 3.2 vs. Group 2, 0.9 ± 0.1) and RI (1.02 ± 0.16 vs. Group 1, 0.99 ± 0.17 vs. Group 2, 0.95 ± 0.19) values compared to the Group 1 and 2 (both p<0.0001). Conclusion: EDV and RI can both be used to accurately predict clinical response of PD. However, using RI may be superior to EDV when reporting results, as it more accurately depicts overall vascular flow. This is likely secondary to RI considering both venous and arterial data, compared to EDV which only assesses the venous system.

194 POSTERS renal

molar of - immons,

amples. In In amples.

ated ated in a subset 3 of 52x greater52x than the - powered laserpowered at low -

powered lasersmay also Alabama

195 molar and insolubleoxalate detected from ranged powered laser using a dustingWemodel. also - -

ing theing of pulse width low- intestine (insoluble or soluble), cations in the intestinal intestinal the in cations soluble), or intestine (insoluble

molar. A determination of the soluble and insoluble insoluble soluble and of the A molar. determination - in the majority thein of do not individuals end stage have who individual variability of the mechanisms responsible for for responsible mechanisms of the variability individual tion has been demonstratedthere humans but is limited in -

nimum of 8 hours.nimum Aspirates from fluid and material withinthese e was made centrifugatione was by subsequent sample the and of

intestine undergoing adults gastrointestinal of endoscopy.

molar. Ratio of insoluble to soluble oxalate was calcul was oxalate soluble to of insoluble Ratio molar. - Stone dusting is typically performed using a high Multiplefactors influence the delivery of from oxalate the intestine the into Thanmaya Reddy, MD Anika J. Ackerman, MD

These results demonstrate that there ismeasurable no oxalate secretion in

oxalate inoxalate the intestine there is of range oxalate a wide concentrations reported

Eleven adults undergoing endoscopystomach both thestomach of the or and Only one of four gastric samples had detectablemicrooxalate, 4.9 ox², Klaus Monkemuller² and Dean Assimos¹Dean Klaus Monkemuller²ox², and components oxalat of acidification resultant pellet. the of solubleoxalate. no insoluble There was detectedoxalate gastricthe in s oxalate soluble oxalate, contained samples intestinal small of eleven eight contrast, detected from ranged 1.7to 191 micro Results: 56 to 3243 micro56 to 3243 lumen, themicrobiome, fecal intestinal and and renal transport processes.models Animal shownhave that oxalate isboth absorbed and secretedwithinthe intestine. Gastrointestinal absorp oxalate obtained.areasmeasured were Oxalate was ion by chromatography. The limit detection of microof technique this is 1.5 Poster #72 WITHDRAWN Poster #73 ThanmayaKnight¹,Ross John April Harvey¹, Holmes¹,Mitchem¹, Reddy¹, Lisa Charles Wilc Introduction: bloodstream and finally into the urine including the amountof in oxalate a food, the conformation of oxalate withinthe data regardingconformation secretionthe within alimentary oxalate the and of tract. human The objectivemeasure ofstudy this to conformation was the amount and in oxalate the of stomach and small Methods: the small participated bowel inthis study. of None the patients end had stage renal disease. Allfastedmi for a OXALATE CONCENTRATIONS IN GASTROINTESTINAL HUMAN FLUID ¹Department Urology, of UniversityAlabama BirminghamSchool of at Medicine, of Birmingham,Alabama; ²Division Gastroenterology of and Hepatology, University of AlabamaBirminghamSchool Medicine, of Birmingham, at Presented By: smallintestinal samples and insoluble oxalate notedwas to be 36 the stomach in the fasted state Conclusion: Conclusion: renal disease. Alternativelysmallthe intestine, in there issome of degree activity oxalate in majoritythe subjects of end stage state. renalin fasted those without disease with the In measurable transportoxalate processes. studies Further including warranted are inpatients with suggesting that there is inter amount solubleof oxalate. dysfunction. Funding: Departmental Poster #74 WilliamYang, Richard, Shin Anika S Kaplan, Adam Ackerman, Tony Chen, Chen Charlesand Lipkin Scales, Preminger Glenn Michael Duke University Medical NC Center, Durham, Presented By: Introduction: THE EFFECTVARIABLE OF PULSE ON STONE DURATION COMMINUTION, FIBER MODEL "DUSTING" A IN STONE RETROPULSION AND DEGRADATION, TIP energy and highenergy frequency. Adjust produce a stone effect.We dusting fragmentation determined efficiency long of pulse versus short pulse duration ina low 194 compared fiber-tip degradation and retropulsion at different pulse lengths. Methods: Experiments were conducted using a new variable pulse laser (Swiss Laserclast Ho:YAG-EMS) with adjustable pulse duration(300-1500μs). To assess comminution and fiber-tip degradation, a dusting model was employed by delivering 4kJ of energy to a BegoStone over a constant surface area controlled by a 3D positioning system. Laser settings were 1J/10Hz and 2J/5Hz in both long and short pulse mode. Comminution efficiency was measured as loss of stone mass and fiber-tip degradation was measured simultaneously. The same laser and fiber were used in a pendulum model to measure stone retropulsion with a high-speed resolution camera. A BegoStone was attached to a silk suture and immersed in water. The laser was applied to the stone and retropulsion was considered displacement from the origin after a single fire. Results: Comminution was significantly greater at higher energy (2J/5Hz) compared to lower energy (1J/10Hz) on both long and short pulse (p< .0001, p=0.0002). Long pulse improved comminution significantly at higher energy (0.420g vs. 0.310g), but not lower energy(0.163g vs. 0.247g)(p=0.0022, p=0.1419). At higher energy tip degradation was 1.308mm on short pulse and 0.335mm on long pulse, which was significant(p=0.0009). Tip degradation was also greater on short pulse at lower energy than long pulse (0.230mm vs. 0.038mm), but this was not significant(p=0.7247). The results of the pendulum test showed that at higher energy, short pulse caused more retropulsion than long pulse (p<0.0001). At lower energy short pulse also caused more retropulsion, but this was not significant(p=0.6071). Conclusion: Increasing pulse duration may allow for better stone dusting with increased fragmentation efficiency, decreased tip degradation, and less retropulsion when using higher energies with a low-power laser.

Poster #75 COMPARISON OF AN ELECTRIC PULSE LITHOTRIPTER TO THE HOLMIUM LASER: STONE FRAGMENTATION EFFICIENCY AND IMPACT ON FLEXIBLE URETEROSCOPE DEFLECTION AND FLOW Adam Kaplan¹, Tony Chen¹, Richard Shin¹, Anika Ackerman¹, Daniela Radvak², Georgy Sankin², Pei Zhong², Charles Scales¹, Neal Simmons², Glenn Preminger¹ and Michael Lipkin¹ ¹Division of Urologic Surgery, Duke University Medical Center, Durham, NC; ²Department of Mechanical Engineering and Materials Science, Duke University, Durham, NC Presented By: Adam G. Kaplan, MD Introduction: A new intracorporeal lithotriptor uses a nanosecond duration electrical discharge through a flexible coaxial probe to endoscopically fragment urinary stones. This device was compared to a holmium laser with regards to stone fragmentation efficiency and their impact on flexible ureteroscope deflection and flow of irrigation. Methods: Using a custom bench model, stone fragmentation efficiency of the Nano-electric Pulse Lithotriptor (NPL, Lithotech Group, Israel) was evaluated with a begostone (mixture 5:2) confined under 0.9% normal saline atop sequential mesh sieves. Two NPL probe sizes (2.0 and 3.6F) and two holmium laser fibers (200 μm and 365 μm) were evaluated using 6mm begostones. Time to first break, time to complete break (all fragments <3mm), and overall fragment sizes were measured. Ureteroscope deflection was tested in 5 new 4th generation flexible ureteroscopes, with an empty channel followed by placement of a 2.0F NPL probe, a 2.4F NPL probe, a 200 μm laser fiber, and a 1.9F wire basket. Ureteroscope irrigation flow was measured using normal saline at 100 cm, with an empty channel and then with a 2.0F NEP probe, a 200 μm laser fiber, and a 1.9F wire basket. Results: The 2.0F NPL showed improved stone fragmentation efficiency compared to the

196 POSTERS 2014

– 29y, p=0.001). -

2 mm fragments, while -

URINEPARAMETERS RECURRENT IN

197 49y, p=0.03;citrate nadired at 18 -

icantly impacted urinary calcium, oxalate, citrate, pH,

linear association noted was between age and urinary

- ctric pulse lithotripter produces improved stone fragmentation sectional study 392 consecutive of 2007 patients between morbid conditionsurinemorbid parameters.to 24h detect abnormal - - ele - in recurrentstone formersin unwilling are unablecomplete or to who more dust (<1 mm fragments); the difference morewas pronounced ompared to the 5.25° with laser and 2.75° thewith basket).Irrigation flow

Routine urine (h) hour 24 testing inrecurrent formers stone costly can be Brandon J. Otto, MD Brandon

The Nano

tus (DM) 20%;tus (DM) and hypertension 43%. (HTN) Older age was associated with In cohort. our age signif

This is a cross a is This

Mean Mean age was 51±16y; 54% male; 87% Caucasian; 42% had BMI≥30 kg/m2;

ion and ROC curve analysis to assess the predictive the of assess curve gender, ability to age, analysis body ion and ROC um or citrateum or (calcium at 40 peaked normalities recurrentstone formers. in Introduction: and cumbersome.Instead,might keycharacteristics providers use patient a surrogate as metabolicfor testing,it but characteristics is unclear which predict best 24h stone risk ab University of Florida, Gainesville, FL Gainesville, Florida, of University IDIOPATHIC CALCIUM OXALATE STONE FORMERS STONE OXALATE CALCIUM IDIOPATHIC Brandon Otto,BenjaminShahab Canales, Bozorgmehri, Jennifer Kuo, Vincent and Bird Canales Muna Presented By: Methods:

Conclusion: Conclusion: efficiencycomparedthe the to holmium as 2.0F laser. and 2.4F However NPLlimit probes and theflow limits ureteroscopeprobe 2.4F deflection. Poster #76 AGE, BMI, GENDERAGE, 24 HOUR PREDICT AND the laser created thebetween larger NPL laser and probes. ureteroscopes the In 5 tested,ureteroscope deflection reducedaverage an was by of 3.75° thewith 2.0 NPL 22.25° and probe the with 2.4F NLP (c probe through the ureteroscopeml/min 36.5 was toml/min reduced on average, 18.3 and was with the μm 200 laser fiber, and to 6.3ml/min the with 2.0F probe. NEP 200 μm laser (86 mg/min vs. 52 mg/min, p = 0.014) aslaser mg/min (173 mg/min,vs. 80 p=0.05). The NPL createdmoredid 1 the 3.6F NPL vs. the 365 μm calci diabetes melli greater urinary oxalate trend<0.001), (p urinary lower uric acid trend=0.007),(p and lower urinary pH trend<0.001). (p A non with with ≥2 lifetime stone episodes, >70% CaOx mineral analysis, and at We logisticWe used collection.24h urine in valuescomparedleastmeandecades. age by one 24h urine regress mass (BMI), co index and Results: toage alone and BMI gender shows with predict or analysis ROC Table 24h urine 1 of results.significantly.improve not AUC HTN did Conclusion: and volume.Along and gender with BMI, age can predictkey 24h urine stone risk results. This data the lays foundationfor a risk predictionmay toolused aswhich be a surrogate for 24h urine results metabolic testing. 196 Poster #77 IMPROVED PAIN CONTROL WITH LOCAL ANESTHETIC AFTER PERCUTANEOUS NEPHROSTOLITHOTOMY: A PROSPECTIVE ANALYSIS James Mason, Rishi Modh, Akira Yamamoto and Vincent Bird University of Florida Department of Urology, Gainesville, Florida Presented By: James Bradley Mason, MD Introduction: Postoperative pain control after percutaneous nephrostolithotomy (PCNL) can be challenging. Injection of local anesthetic at the percutaneous tract has been tried in the past with varying results. Using objective and subjective measures, we aimed to determine if pain control after PCNL was improved with injection of local anesthetic at the time of the procedure. Since pain control is a limiting factor in discharge timing after PCNL, we also wanted to establish the effect of potentially improved pain control on length of admission. Methods: This prospective quality improvement study compared two cohorts, with a total enrolment of 44 patients. The first 22 patients were assigned to Cohort 1, which served as a control group. The next 22 patients were assigned to cohort 2 and received 30mL injection of 0.25% bupivacaine surrounding the percutaneous tract. Exclusion criteria included patients who were verbally non-communicative, paraplegic, had pre-existing percutaneous access, or undergoing a bilateral procedure. Pain scores were monitored using the Defense and Veterans Pain Rating Scale (DVPRS). Narcotic usage was measured in morphine equivalents. Data was collected for final analysis from the electronic medical record after patient discharge. Results: Analysis of data demonstrated an equal distribution in patient age, sex, ASA score, and stone free rate. Patient reported pain levels in cohort 2 measured at 1, 6, and 12 hours post-op were significantly improved as compared to cohort 1. Total narcotic usage for the first 8 hours post op was also significantly decreased in cohort 2. Total cumulative narcotic usage for the admission was 30.5% less in cohort 2 as compared to cohort 1 (120.1 vs. 172.6). There was no significant difference in cumulative narcotic use at 24 hours or for the admission. Average length of admission was 2.55 and 2.05 respectively for cohort 1 and cohort 2, demonstrating a 20% decrease in length of admission. Conclusion: Patients receiving injection of bupivacaine surrounding the percutaneous tract at the time of PCNL reported improved pain scores and registered lower total narcotic requirement as compared to those receiving no local pain control. In addition, length of admission is also improved with pain control involving local anesthetic. Due to its low cost, low side effect profile and great efficacy in pain control we advocate the use of bupivacaine in all patients after percutaneous nephrostolithotomy.

Poster #78 EVALUATION OF A NOVEL SINGLE USE FLEXIBLE URETEROSCOPE Joanne Dale¹, Adam Kaplan¹, Daniela Radvak², Richard Shin¹, Anika Ackerman¹, Tony Chen¹, Charles Scales¹, Michael Ferrandino¹, Glenn Preminger¹ and Michael Lipkin¹ ¹Division of Urologic Surgery, Duke University, Durham, NC; ²Department of Mechanical Engineering and Material Science, Duke University, Durham, NC Presented By: Joanne Dale, MD Introduction: A novel single-use flexible ureteroscope, promises the optical characteristics and maneuverability of a non-disposable 4th generation flexible ureteroscope. In this study, the single-use flexible ureteroscope was directly compared to contemporary flexible ureteroscopes, with regards to optics, ureteroscope deflection and irrigation flow. Methods: Three flexible ureteroscopes including the LithoVue (Single-Use, Boston Scientific, USA), Flex-Xc (Karl Storz, Germany) and Cobra (Richard Wolf, Germany) were assessed in vitro for image resolution, distortion, color representation, grayscale imaging, field of view and depth of field. Ureteroscope deflection was tested with an empty channel followed by placement of a 200μm laser fiber, a 1.9F wire basket, a 2.0F Nanoelectric pulse lithotripsy (NPL) probe and a 2.4F NPL probe. Ureteroscope irrigation flow was measured using normal saline at 100cm, with an empty channel followed by a 200μm laser fiber, a 1.9F wire basket and a 2.0F NPL probe.

198 POSTERS

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1.18) or 1.18) or ease is ease is - ischarged ischarged discharge discharge - tiple logistic tiple logistic

esolution, image image esolution, illion of a fullwhich Cobra showedCobra loss of XC (p=0.003) XC and the

channel channel than the Flex disposable 4th generation

- ears, and 53% female; were f care patientsf for urinary with Xc and Xc -

was 3.1 days, 3.1was 25% with staying 4). Older patients (≥ 65 years) - utilizationof inpatient care health

female CI 95% 1.10 (OR 1.14,

12.66) - 2.64), with a much2.64), likelihood a higher with of SNF - 199

ternativeto standardnon

Clinical ResearchInstitute Division Urology, of Durham NC and

2011 a diagnosticwith code consistent urinary with stone disease. National Eugene B. Cone,Eugene MD Urinary stoneUrinary disease imposes a significanton burden U.S. patients, a with Utilization inpatient of for care patients urinary stone with dis The LithoVue singleTheuse LithoVue ureteroscopesuperb has optical capabilities, –

We the analyzed Nationwide Inpatient Sample(NIS), stratified a 20% sample of An estimatedmillion 1.85 stone patient during discharges the study occurred The optical functionaland characteristics of the three ureteroscopes in shown are

Presented By: Introduction: Poster #79 47% is attributed to inpatientcare. In spitethe of high spending on inpatientcare for patients urinary stone with disease, littleabout is known these hospitalizations and outcomes to care.was Our objective describe of o patterns stones discharged from inpatient care in the States.United Methods: hospitalThethe study discharges population in US. all included patients d 2007 between regression contribution assess to of performed characteristicscare was patient to received. Results: the 2.1medianstay was overall days 1 length (IQR of representedsubstantially nearly 1 in those discharged.3 of Hospital use was resource higher among these older patients:median length stay of 5.9over days. Similarly, to discharge home healthskilled (14%)nursing and facilities (21%) commonwas among those 65 years over of age.Patients more were likely to be dischargedskilledtofacility a nursing if they were older than 65 years old(OR 2.75, CI 2.89 UNDERSTANDINGTHE BURDEN INPATIENT OF FOR CARE PATIENTSWITH URINARY STONE DISEASE estimatescomparisons and utilization generated of were using and patient outcomes standard weights, accountingthe for complex survey design of the NIS. Mul period. In this cohort, the age average 54.1was (SEM0.13) y Eugene B. Cone and Charles D. ScalesEugene D. B. and Charles Cone prevalence of 8.8% and growing. Total annual costs likely $10 exceed b Duke University, Duke Results: Table1. The the LithoVue showed largest fieldof excellent with view, r al viable a it making flow, and deflection distortiondepth and substantial field.No of demonstrateddifference color in was reproducibilityor grayscale discernment ureteroscopes.between LithoVueThe maintained full deflection ability all with instruments, though the Flex deflection ranging fromto 2° 27° depending on the instrumentWithplaced. an empty channel,the rate a flow LithoVue greater showed thanthe Flex (p<0.001).Cobra It maintained better flow instrumentswith inthe The has Cobra a separate instrument 3.3F channel, rates keepingflow the same with insertion. instrument Conclusion: placement if older than 85 (OR 11.90, CI 11.24placement 11.90, CI than 85 (OR if older flexible digitalfiberoptic and ureteroscopes. Conclusion: substantial. In particular, femalesand older adults disproportionately receive inpatient care. Older adults high hospital at risk are longer stays of and requiring additional post care. Further research is required to understand detailed resources,and inpatientcaresuch intensive as surgical procedures. 198 Poster #80 VARIATION IN WORK-UP OF PRIMARY HYPERPARATHYROIDISM IN KIDNEY STONE FORMERS BY ENDOUROLOGISTS Lara Seltz, Tracy Marien, S. Duke Herrell and Nicole Miller Vanderbilt University Medical Center, Nashville, TN Presented By: Lara M. Seltz, MD Introduction: Nephrolithiasis occurs in 15-20% of patients with primary hyperparathyroidism (PHPT) and 5% with nephrolithiasis have PHPT. AUA guidelines recommend obtaining a parathyroid hormone (PTH) level if PHPT is suspected. While many likely suspect PHPT in the setting of hypercalcemia, some may not be realize that normocalcemic PHPT exists or that a high normal PTH in the setting of hypercalcemia is abnormal and warrants further evaluation. The aim of this survey is to determine the practice patterns for the workup of PHPT in stone formers (SFs) by Urologists. Methods: An online six question survey was sent to members of the Endourological Society via e-mail. These Endourologists were queried on their approach to the work-up of PHPT in their stone patients. Results: The 232 Endourologists who responded to this survey had been in practice for an average of 15 years (1-45 years). 94% work-up their SFs for PHPT when they felt this was indicated. 12% report sending PTH on all SFs, 43% for recurrent nephrolithiasis, 37% for hypercalciuria, and 69% for hypercalcemia. 71% refer to an Endocrinologist for elevated PTH and 60% will refer for further PHPT work-up for a high normal PTH in the setting of hypercalcemia. If serum calcium level is normal, 16% never check PTH, 22% check PTH regardless of serum calcium, 40% check if serum calcium is in the upper limits of normal, 34% check for hypercalciuria, and 22% check for worsening hypercalciuria on a thiazide diuretic. In terms of repeating PTH, 18% said they never recheck, 46% will for persistent hypercalcemia, 53% for recurrent stone episodes and hypercalcemia, 11% for hypercalciuria, and 25% check for worsening hypercalciuria after starting a thiazide diuretic. Conclusion: PHPT is not always an easy diagnosis to make, and therefore requires a high index of suspicion. This survey demonstrates high variability in the work-up of PHPT in SFs conducted by Endourologists. Recognizing that PTH should be checked for hypercalcemia and that a high normal PTH in the setting of hypercalcemia is abnormal is necessary to diagnose PHPT. Significant variation in practice patterns on checking PTH in the setting of normal serum calcium and re-checking a PTH after a prior was normal is likely secondary to the lack of data available to guide practitioners. Further studies are needed to ascertain when to test for PHPT in these challenging cases and more sophisticated guidelines will improve the work-up of PHPT in SFs by Urologists.

Poster #81 DEVELOPMENT OF A NOVEL CURRICULUM IN MEDICAL KIDNEY STONE PREVENTION Troy A. Sukhu, Jason R. Lomboy, Matthew R. Macey and Davis P. Viprakasit Chapel Hill, NC Presented By: Troy Anthony Sukhu, MD Introduction: Currently, many at-risk kidney stone patients do not undergo appropriate metabolic evaluations. Under-utilization of guideline recommended testing may be partially due to decreased physician confidence with test result interpretation. We sought to evaluate the creation and implementation of a novel asynchronous learning medical stone prevention curriculum within a urology residency program to address this knowledge skill. Methods: An education guide was created based on current guideline recommendations, relevant published data and actual patient examples to detail the rationale and individual steps for test interpretation. Participants were presented with an introductory didactic lecture and a reference electronic guide. Monthly self-study cases and questions were administered online. The formal interpretation of the cases with explanations to all responses were immediately provided to the learner. Pre and post-study surveys were used to evaluate the efficacy, utility and satisfaction of the curriculum. Results: Over a 12-month academic period, all 14 residents (PGY1-5) within a urology

200 POSTERS th istory As stone

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reported. - e including whether whether including e REPORTED - ncy varied with seniority seniority with varied ncy ion will determine the use use the determine will ion

five spontaneously passed - on monthlyon questions 6 was

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interpret metabolicinterpret stone evaluations. Interest continued in

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assessment, skill developmentlearners obtained by time was over - assessment questions. time Mean spent - Tracy MD Marien, It that known is well spontaneous passage ureteral of stones is dependent CTIONS IS IMPORTANT CLINICALLY UNDER AND

Evaluation asynchronous of a novel curriculum learning suggests improved

Coronal diameter ureteral of stonessignificantly is under

A retrospective chart review retrospectiveA chartwas performed review on patients seenclinic in between

One patients hundred qualified for this study. Forty

s: minutes 25 seconds (range minutes).to 21 The percentage of residentscomfortreporting intheir ability to interpret test results increased from to 50% 78%. Proficiency ininterpreting actual test cases43%from increased to 71 reported likelihood of the learner for ordering metabolic evaluationsinthe future increased fromto 79% 100%.All participantsthat felt that the beneficial curriculumwas to their understanding and abilityto Conclusion: repeated interval self resident confidence base and knowledge metabolicwith test interpretat participation 100%. was the program in includingthree learners no formal with treating experience stone patients. Thirteen residents reportedof referencecompleting use the guide education and greater 75% than of the monthly self residency completed the curriculum. Prior to implementation, residents received training in in training received residents to implementation, Prior curriculum. the completed residency Initial proficie rotations. clinical relevant during testing metabolic nephrology fellowshipprogram institution.our at Further applicat of the program for potential addressing gapsknowledge and possibly increasing utilizationwidespread metabolic testing in of appropriate patients. Poster #82 URETERAL STONE DIAMETER ON COMPUTERIZED TOMOGRAPHY CORONAL CORONAL TOMOGRAPHY COMPUTERIZED ON DIAMETER STONE URETERAL RECONSTRU with a minimal time commitment. Monthly testing is on is testing Monthly commitment. time minimal a with frequently reported inthe axial plane only. The aim of thisstudy isto compare the coronal maximumstone diameter and to the determine axial clinical thesignificance ofcoronal the diameter. Method February 2014 and February 2015 to identify those history with of stones. ureteral Patients includedwere if of they had a history ureteral stone noted on CT scan performed wi coronal reconstructions.Patients excludedwere if theyrequired urgent intervention with decompression,stone treatment withinseven days ofsymptoms of the had or onset multiple stones. ureteral Management the of stone ureteralmedical and pertinent h related tostone their disease stone including and diameter on axial coronal CT imaging, gender, age, BMI, height, creatinine, stone location withinthe ureter, stone composition, usemedical of expulsive therapy, and history related to stone diseas Introduction: on stone size.stone Ureteral they a recurrentwere stone former, had history of prior stone passage, and if they had ever had a stent placedside on thetheir of ureteral stone.A statistical analysis performed was associatedto factors stone which assess with were Results: stones and 55 required surgery. In 70% of casesthe coronal largerdiameter than was the diameteraxial of average an by mm.1.6 Coronal diameter reported was univariate analysis stone passage associated was axial with diameter (P <0.0001), coronal diameterstone (P <0.0001), location withinthe ureter patient (P =0.0003), = age (P 0.010),medical expul and 0.009). On multivariate analysis axial diameter, coronal diameter and stone location remained significant factors spontaneousstone associated with passage. Conclusion: Tracy Marien and Nicole Miller Nicole and Marien Tracy Vanderbilt, Nashville, TN Presented By: size is a significant predictorstone passage of and an important factor in determining managementstone,the offailure to report the and coronal axial diameterscould to lead inappropriateWe treatment.strongly recommend obtainingcoronal recon 200 CT is performed for suspected ureteral stone to guide management decisions.

Poster #83 ACCURATE DETERMINATION OF 24-HOUR URINE CREATININE IN PATIENTS WITH NEPHROLITHIASIS: EFFECTS OF GENDER, AGE, BMI AND PROTEIN CATABOLIC RATE Jeremy Bergamo¹, Julia Han², Rupam Ruchi³, Xuerong Wen³, Vincent Bird² and Victoria Bird² ¹College of Medicine, University of Florida, Gainesville, Florida; ²Department of Urology, University of Florida, Gainesville, Florida; ³Division of Nephrology, Department of Medicine, University of Florida, Gainesville, Florida Presented By: Julia Han, MD Introduction: Adequacy of 24-hour(hr) urine collections for metabolic evaluation in patients with urolithiasis is determined by 24-hr urine creatinine (Cr). We investigate adequacy of this parameter and how gender, age, body mass index (BMI) and protein catabolic rate (PCR) correlate with 24-hour urine studies. Methods: We queried our institutional database of stone formers undergoing evaluation for demographics and 24-hr urine results. Primary analysis included all samples and assessment of adequacy of collection (under-collection, over-collection, or adequate) using 24-hr urine Cr laboratory standards. Analysis was performed on patients with two consecutive 24-hour urine collections to assess for concordance (both urine samples with same classification -under/over/adequate collection). Subgroup analysis based on gender, age, BMI, and PCR were performed. Continuous variables were compared using independent t-test, and categorical variables were examined using chi-squared or fisher exact test, using SAS 9.4 (Cary, NC). Results: A total of 510 patients collected 986- 24-hr urine samples; 58% were deemed inadequately collected by laboratory standards, 64.2% and 35.8% were under-collected and over-collected respectively. Patients with only one urine collection were excluded from further analysis. We identified 401 patients with two consecutive 24-hr urine collections of which 269 had two concordant 24-hr urine collections; with 38% considered adequate collection, and 62% considered under or over-collected. Subsequent analysis focused on comparison between patients that under-collected and over-collected, and had two concordant 24-hour urine studies. Those who under-collected were 55% female and those who over-collected were 50% female; P=0.55. Mean age was 60.5 +-SD 13.5 versus (vs) 36.9+-SD 13.7 years old, P<0.001, in the under and over-collector groups respectively. The under-collected group consisted of 1.7% BMI <17, 10.2% BMI <24 and 88.1% BMI >25. The over-collected group had 2% BMI<17, 48% BMI <24 and 50% BMI >25, P<0.001. Mean 24-hour urine creatinine of the under-collected group was 12.6+-SD 3.1 mg/kg/24-hrs vs. 26.2+-SD 4.5 mg/Kg/24-hrs in the over-collected group; P<0.001. Mean PCR for the under-collectors was 0.7+- SD 0.2 vs. 1.2+-SD 0.3 in the over-collectors; P<0.001. Conclusion: A large number of 24-hr urine collections for evaluation of patients with nephrolithiasis are deemed inadequate when considered by 24-hr urine Cr laboratory standard. However, a significant pattern exists among the under and over-collected groups when age, BMI and PCR are considered, suggesting that further studies of these populations should be done to determine if the collections are truly inadequate.

Poster #84 IMPACT OF AUA RECOMMENDATIONS ON IMAGING TRENDS IN THE FOLLOW-UP OF URETERAL CALCULI Anika Ackerman, Tony T Chen, Laura Ding, Glenn Preminger, Charles Scales and Michael Lipkin Duke University Medical Center, Durham, NC Presented By: Anika J. Ackerman, MD Introduction: Patients with symptomatic ureteral calculi often undergo imaging studies; associated costs and radiation doses can be substantial. To address these concerns for

202 POSTERS as emergent -

rays (KUB), and - o presented to the y departmenty were recently published an

CONTRASTED - observer agreementobserver w - endourology department has

d radiation exposure. Statistical exposure. d radiation reductioncost in and radiation

up of observed ureteral stones up CT, found we similar rates of - - ray based, imagingtechnique that -

up urolog our with

- up. - up CT scan before and 12% after protocol - 203 w these differences not were significant (p=0.0788 contrasted and to (NCCT) computed tomography - square test, Wilcoxonsquarerank test, sumtest, and logistic - up imaging after a period ofmanagement conservative

- up imaging, includingKUB, CT, and US, decreased a by - 10mm and >10mm. Potential variables affecting stone - ease. Logisticfailed regressiontosignificant identify any class correlation coefficient (ICC). coefficient correlation class - re re ≤3mm in size. Mean stone count per renal unit was 4.46 and tomosynthesis (DT) isX a new

role for up of therole patients follow nephrolithiasis with ina non up imaging obtained, effective radiation dose from imaging, clinical and - Digital Adam Adam Kaplan,G. MD

Since the released AUA the 2013 ClinicalEffectiveness Protocol for imaging

A of retrospective patients review nephrolithiasis with at institution our that Weconducted of a retrospective patients chart review wh Data from 117 medical charts117 from protocol, protocol,Data (before after were 59; 58) Of theOf 79 renal unitsassessed, 41 exhibited exact stone counts on DT and

was further largestclassifiedthe was stone for the into renal per unit detected NCCT by

harles and Michael Scales, Jr.¹, Preminger¹ Lipkin¹ Glenn hat randomly treatment did undergo blinded stone or not passage two were to assigned patients ureteral with stones, American The Urological Association imaging clinical effectivenessWe protocol. assessed the impact these recommendations of on utilization, for patientscost, radiation and institution. our exposure at Methods: emergency department the period before stone one year a ureteral time with and during after the protocol AUA released. was underwent Patients a who CT scanconfirming the presenceof a ureteral stone had follow and who included.Wecollected demographics, dataregarding stone history,stone and size follow location, outcomes. Primary outcome thewas numberX scans, of abdominal CT regression. Results: included. 27% patients of follo underwent ultrasounds (US) obtained for follow before after and the release of 2013 AUA the protocol. outcomesSecondary included cost billedof fees institution imaging our determined the at by an analysisChi using performed was release (p=0.0406). Cost follow of Poster #85 NON TO VIABLE ALTERNATIVE A TOMOSYNTHESIS: DIGITAL withoutnegative a impactpatient on care serious or adverse outcome. Continued adherencethe to significant protocol lead to likely will a exposure. AdamKaplan¹,Youssef²,Fernando Cabrera¹, Tsivian¹, Ramy Matvey Shin¹, Richard C ¹Division University Urologic Surgery, of Center, Duke Medical Durham, ²Department NC; of Urology, University California, of Irvine, Orange, CA Presented By: Introduction: mean of $1,030 and effective radiation dose from all imaging decreased a mean by of 2.88mSv after protocol release, however and p=0.0592). did the Of not patients a follow have who clinical outcomes, including surgicalmanagement, stonepassage, and loss up, to follow beforeand after protocol rel predictorsfollow obtaining scan of on CT repeat Conclusion: inmanagementthe ureteral of calculous disease, our significantly decreased utilization offor CT followscan NEPHROLITHIASIS? OF UP FOLLOW THE FOR TOMOGRAPHY COMPUTED allows image enhancement minimalwith increase in radiation The exposure. purpose of this tostudy was compare non DT with evaluate its potential underwent and NCCT DT from2012 to July September 2013 was performed. Renal units t recordedreaders, who stone count, (mm2), area size maximumstone length (mm) and location, differences Mean for DT and NCCT. both compared. renal per were unit Stone size setting. Methods: 5 categories: <5mm, following detection rate including, evaluated. stone and BMI size were Inter determined intra using the Results: NCCT. At total detectedstones ofNCCT, 352 and 337 were respectively, on DT and of morewhich than 50% we 202 4.27 for DT and NCCT respectively. The mean difference in stone area was 16.5mm2 (- 4.6-38.5), p=0.121. Stratification by stone size showed minimal difference in stone count and size, especially for smaller stones <5mm. Correlation between BMI and stone detection rates was 0.06 and 0.05 for stone count and stone area (mm2), respectively. ICC for stone size was 0.89 and 0.86 for DT and NCCT, indicating strong correlation between readers and adequate reproducibility Conclusion: We found DT to be a comparable imaging modality to NCCT for the detection of intra-renal stones, without a significant effect from stone size and BMI and adequate reproducibility between multiple readers. DT appears to be an ideal alternative for following patients with nephrolithiasis due to its acceptable stone detection rates, low radiation exposure and decreased cost as compared to NCCT.

Poster #86 SIGNIFICANCE OF AGGRESSIVE HISTOLOGIC VARIANTS OF RCC: COMPARISON OF RHABDOID RENAL CELL CARCINOMA (RRCC), SARCOMATOID RENAL CELL CARCINOMA (SRCC) AND FUHRMAN GRADE 4 RCC Andrew Leone, Gregory Diorio, Kamran Zargar-Shostari, Pranav Sharma, Jasreman Dhillon, Scott M. Gilbert, Julio M. Powsang, Wade J. Sexton, Michael A. Poch and Philippe Spiess Moffitt Cancer Center, Tampa FL Presented By: Andrew Robert Leone, MD Introduction: Renal cell carcinoma (RCC) with rhabdoid (rRCC) and sarcomatoid (sRCC) features, an example of dedifferentiation, portends poorer prognoses compared to conventional, clear cell RCC. Studies have suggested a poorer prognosis for sarcomatoid compared to rhabdoid. We sought to compare clinical outcomes of rRCC and sRCC using grade 4 RCC as a control. Methods: A retrospective chart review was performed identifying all patients with rRCC and sRCC and grade 4 RCC diagnosed from 1998 to 2015 at a high-volume cancer center. Pathology was re-reviewed by a dedicated genitourinary pathologist according to 2013 ISUP guidelines. Primary end point was overall survival assessed via death registry. Clinical endpoints were compared using Fisher exact or Mann-Whitney tests. Kaplan-Meir analysis was used for unadjusted survival curves and cox regression was used for multivariate analysis. Results: 165 patients were identified 12 rRCC, 60 sRCC, and 89 grade 4 RCC with a minimum follow up of 12 months or death. 4 patients were excluded with both rRCC and sRCC. No significant differences were identified amongst the three cohorts when comparing clinical and pathologic parameters including age, presence of clinical metastases, path N stage, path T stage, tumor size and percentage necrosis. Mean follow up was statistically different in sRCC (sRCC 38.8 months vs. 11 months (0.009)) vs. 22.3 months reflecting longer follow up interval for sarcomatoid patients. Overall Survival for sarcomatoid vs. grade 4 RCC was significantly worse (p=0.002) and not different for rhabdoid vs. grade 4 RCC (p=0.105) However, on multivariate cox regression model controlling for clinical confounders (LVI, clinical metastases, T stage, N stage), presence of sRCC or rRCC were not statistically significant predictors of OS. Conclusion: In this single institution cohort, presence of sarcomatoid or rhabdoid features were not independent negative risk factors for overall survival at in patients with RCC on multivariate analysis after controlling for clinical confounders . However, overall survival was significantly worse for patients with sRCC compared to grade 4 RCC. As per ISUP consensus, we conclude systematic pathological review remains important in identification and reporting of variant pathology in nephrectomy specimens. Further multicenter trials are needed to corroborate this finding.

204 POSTERS -

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, Christopher Filson 4

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HISTOLOGIES CELL CLEAR 1.49, p<0.001). 205 - - off analysis. Score determination based was a on - e prognostic ability of to RISK SSIGN and UISS. one patients includedthe were in study. Area under - , ErythrocyteSedimentation (ESR), corrected Rate cell predictive with RCC accuracy on par UISSwith and and UISS 0.7829, 0.8133, was 0.7760, and respectively.

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Our data show that RISK is an independent thatsignificant show Our data and predictor overall of Emory University ofWinshipEmory School Medicine, of Department Urology, 4

Patients that nephrectomy underwent for

Three , GA; , GA; square analysis revealed AUCs no statistically of significant RISK, difference between - ¹Emory UniversitySchool Medicine, Atlanta,of Department Urology, of GA; ²Emory University School Medicine,School of Department Urology; of Universityof ³Emory Medicine,Winship Medical and Oncology, Department Cancer Hematology of Institute, Atlanta Rishi Sekar¹, Dattatraya Patil¹, Jeffrey Pearl¹, Yoram Baum¹, Mersiha Torlak², Omer Omer Torlak², Mersiha Baum¹, Yoram Pearl¹, Jeffrey Patil¹, Dattatraya Sekar¹, Rishi WayneKucuk³, AlemozaffarBradley Mehrdad Harris³, Carthon³, Poster #87 SCORE INFLAMMATORY CARCINOMA CELL RENAL THE OF EVALUATION PATIENTS WITHPATIENTS NON CELLAND CLEAR GA Atlanta, Institute, Cancer Presented By: Introduction: prognostic in biomarkers renal cell carcinoma reports (RCC), few their analyzed have prognosticWethat value combination inaggregate. of hypothesize a preoperative C Reactive Protein albumin (CRP), Methods: factor intumor progression. Altho calcium, and AST/ALT Inflammatory into a RCC ratio could Score (RISK) serve a as powerful prognostic tool in patients clearwith cell non and KennethViraj Maste Ogan¹ and queried fromnephrectomy our database. Thethreshold individual optimalfor biomarkers determinedwas methodology,search using grid operating receiver characteristic (ROC) analysis,sensitivity and value of 0, 1, or 2 for each biomarker determined established by thresholds. The final score, sum ofchi the RISK, points from was and ROC biomarker. accrued each Chi SSIGN, and UISS (p=0.820, and p =0.317, respectively).multivariate On analysis, after adjusting for confoun increasemortalityin (HR=1.32, 1.17 95%CI Conclusion: Conclusion: survival inclear cell and non analysis performed was th to compare proportionalImpact usingcox overall survival hazard analyzed models. on regression was Results: the curve (AUC) for RISK,SSIGN,

SSIGN. Notably, RISK iscomposed of standardized preoperative laboratory markers, allowing crucial prognosticinformation tomedical be integrated decisionmaking into prior to surgery. 204 Poster #88 NOVEL USE OF THE ANGIOVAC SYSTEM FOR PRE-OPERATIVE TUMOR THROMBUS DEBULKING PRIOR TO RADICAL NEPHRECTOMY WITH INFERIOR VENA CAVA THROMBECTOMY Justin Emtage¹, Pranav Sharma², Asad Sawar³ and Phillippe Spiess² ¹Department of Urology, University of South Florida, Tampa, FL; ²Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, FL; ³Department of Interventional Cardiology, Florida Hospital, Tampa, FL, USA Presented By: Justin B. Emtage, MD Introduction: Surgical excision is the standard of care for renal cell carcinoma (RCC) presenting with tumor extension into the renal vein and inferior vena cava, but this can be technically challenging, especially in high-level cases. As such, it follows that decreasing the thrombus level prior to extirpative surgery could make the operation easier and decrease complications. The AngioVac system has previously been used to decrease embolic phenomenon intra-op. We present the first reported case of AngioVac system use for pre-operative tumor thrombus debulking. Methods: A 62-year old male presented with severe dyspnea. Work up included a magnetic resonance imaging (MRI) of the abdomen that revealed a 12 cm right renal mass with associated level III-IV IVC thrombus and retroperitoneal lymphadenopathy. Interventional Cardiology was consulted who used the AngioVac system to de-bulk the IVC tumor thrombus. The patient was then taken for right radical nephrectomy, IVC thrombectomy, and retroperitoneal lymph node dissection. Results: The AngioVac procedure was carried out with a significant amount of tumor thrombus removed. Post-procedurally MR venogram showed that the thrombus had regressed slightly, with evidence of improved blood flow around the tumor indicating absence of caval wall invasion. The nephrectomy was then carried out uneventfully. The thrombus was completely removed but there was clear IVC wall invasion and given the significant extent of this, infrarenal IVC resection and ligation was completed. Final pathology showed a pT3cN1Mx clear cell RCC, Fuhrman grade 3 with 6/6 lymph nodes positive for malignancy. Conclusion: The AngioVac system successfully debulked the tumor thrombus, but did not significantly decrease the thrombus level, nor impact the surgical outcome. This is likely due to the significant volume and adherence of the caval wall. Further studies are clearly indicated to clarify the utility, if any, of the AngioVac system for pre-operative downstaging in cases of RCC with tumor thrombus extension. This will likely be best suited for level I and II tumor thrombi without IVC wall invasion and in patients where a conventional surgical approach is deemed potentially too morbid.

206 POSTERS ing ing

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pective of patients chart review the at Carolinas Medical erectomyis an increasingly treatment modality utilized for

2011 and February 2015, consecutive 37 RANUs were requires further investigation. further requires

Until recently,Untilthis performed fashion. an open was in w Nielsen²,Raynor²,Pruthi², Raj w Mathew Angela Smith² and

lateral adrenals been have removed at nephrectomy; however, 9 codes for RCC. for 9 codes -

up period (median 12.5 months),seven patients bladder experienced - Chapel Hill, NC

an lymph node count of 9.7 2 (range Nephroureterectomy is the goldstandard treatment for tract upper urothelial Maxim J. McKibben, MD J. McKibben, Maxim mL), and median length of stay 2.0 was days (range 1 J. Ryan Mark, MD J. Mark, Ryan Renal cell carcinoma (RCC) is the most common renal cancer with 61,560 cancer 61,560 commoncarcinoma with most renal is cell the (RCC) Renal

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Ten performed adrenalectomies were series in nephrectomy our 5 with Mean operativeMean minutes time 252 was 167 (range - ASSISTED NEPHROURETERECTOMY FOR TREATMENT OF UPPER TRACT TRACT UPPER OF TREATMENT FOR NEPHROURETERECTOMY ASSISTED

s Teigland¹ - (8%), and pT3in 14 (38%). Diffuse B Methods: Introduction: moreLaparoscopic,robotic being to recently, utilized, aim approaches and now are and we robot of series case institution single our review performed single atinstitutionsingle and robot a for Both re UTUC. docking cell carcinoma cell(UTUC). carcinoma UROTHELIALCELL CARCINOMA Maxim McKibben¹, Matthe Presented By: Poster #89 ROBOT Michael Woods² ¹Durham; ²UNC techniques used. were Results: (range 25 (range underwent neoadjuvant chemotherapy gemcitabine/cisplatin.with Singlerobot docking (59%). performedtechnique was cases Lymphadenectomy in in9 patients used 22 was (25%), me with inthree cases.margins Surgical positive were cases intwo (distal ureteral margin and renal vascularmargin). pTisPathologywas in3 (8%), (24%), pTa pT1 inin 9 7 (19%), pT2 in 3 requiring exploratory laparotomy and 11 units of pRBCs, and post specimen (history of UTUC). 26 specimenshigh were grade (72%). complications Six were reported, including bladder leaks,aspiration two pneumonia failure,bleed respiratory with During the follow recurrences,fivemetastatic developed and disease. Conclusion: regarding oncologic outcomes upper tractupper urothelialcellcarcinoma, a shortened with length of stay compared to laparoscopic nephroureterectomy. Though initial encouraging, are data long Poster #90 Rachel Chandrasekera³, Chamath Locke¹, J. Mark², Ciara Huntington³, Ryan Kent Kercher³ and Chri ¹McKay Urology,Institute, Levine CancerSystem, Carolinas Healthcare Charlotte, NC; ²Levine Cancer Institute, Carolinas Dept HealthCare of System, ³CMC Charlotte, NC; General Surgery, Division Minimally of Invasive Carolinas Surgery , Healthca Charlotte, NC Presented By: Introduction: Methods: JanuaryCenter 1999 between and had CPT March 2015 codeswho for nephrectomy and adrenalectomy and ICD Results: metastatic benign5 cases with and lesions. RCC Metastatic disease found1 was in ipsilateralcontralateral and 4 adrenal metastasesgland.contralateral All were metachronousmetastasis and the ipsilateral synchronous. was Cancer staging for the metastases andpatients T3aNXM1, the T3bNXM0, to adrenal gland RCC with were T1bN0M0. The cancerstaging the patients for RCC benign with adrenal lesions were CONTRALATERAL ADRENAL METASTASES OF RENAL CELL CARCINOMA CARCINOMA CELL RENAL OF METASTASES ADRENAL CONTRALATERAL INDICATE BENEFIT TO ADRENAL new casesnew expected in2015 and approximately of 25% metastatic patients presenting with disease. Historically, ipsi adrenal encouraged. Wesparing now technique data is characterizing present our experience institution.our adrenal in with lesionspatientsfound treated for at RCC 206 T1aNXM0, T3aNXM0, T1aNXM0 and T2bNXM0. All recurrences were diagnosed within 5 years except 2 patients who presented with adrenal metastasis at 80 months and 316 months. The pathology for these two cases was PT1b and PT3a respectively. Conclusion: Adrenal metastases in our series were more likely to occur in the contralateral adrenal gland, indicating a benefit to adrenal sparing technique during radical nephrectomy. Our data also demonstrates the need for long term follow-up after nephrectomy because we observed recurrences beyond 5 years.

Poster #91 BIOENGINEERED PORCINE KIDNEY CONSTRUCTS SEEDED WITH AUTOLOGOUS CELLS FOR LONG-TERM SURVIVAL IN VIVO Joao Paulo Zambon, In Kap Ko, Ick-Hee Kim, Charesa Smith, John Jackson, Anthony Atala and James Yoo Wake Forest Institute for Regenerative Medicine, Winston Salem, NC Presented By: John D. Jackson, PhD Introduction: Kidney transplantation is the only definitive treatment for end stage renal disease (ESRD). However, the availability of transplantable kidneys is limited. Recent advances in the field of bioengineering whole kidney constructs have provided a promising solution to address the shortage. Previously, we have developed decellularization and recellularization methods that allowed efficient recellularizaiton including re-endothelia- lization of vasculatures and repopulation with renal cells using acellular porcine kidney scaffolds, followed by promising outcomes from short-term implantation [1]. Methods: To make this technology amenable for clinical translation, this study aimed to evaluate vascular patency of bioengineered porcine kidney constructs seeded with autologous cell sources in a heterotopic implantation pig model. To provide anti- thrombogenic capability, the decellularized kidney scaffold from native porcine kidneys was re-endothelialized following conjugation of heparin and CD31 antibody. For renal function, the re-endothelialized kidney scaffold was seeded with the renal cells, followed by bioreactor culture before implantation. The engineered kidney construct was implanted at the iliac site of pigs. During implantation, blood perfusion through the kidney implant was examined by CT scan and at 1 week implantation, the harvested implant was processed for histological analysis. Results: Results of CT scan demonstrated evidences of partial blood perfusion within the implant. The histological and immunochemical analysis confirmed the vascular patency and viability of the seeded renal cells with maintenance of renal phenotype during the implantation. Conclusion: These results demonstrate that long-term implantation of engineered porcine kidney constructs is possible and this approach will lead to the development of an alternative treatment method for patients with ESRD.

208 POSTERS and and

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NEOPLASTIC RENAL RENAL PARENCHYMANEOPLASTIC ABNORMALITIES THE IN - Renal cancer is associated with chronic kidney cancer chronic is associated with disease.studiesRenal Several Classic renorrhaphy duringconsists RAPN renorrhaphy toClassic CS prevent of repair urine Robert D. Williams, Robert MD D. Nicola Pavan, MD

DM DM end with NNA assessment from assessmentsurgical from speci NNA

Jacksonville, FL Jacksonville,

We retrospectively 201 patients reviewed underwent who nephrectomy between We 90 consecutive reviewed single underwent RAPNsurgeon patients a who by

inthe such analysisas demographic characteristics (age, sex, BMI) and CKD stageCKD III patients older were (68 vs. 56 years, .004) Pand presented < a van¹, Carmen M. Mir², Nachiketh Soodana Mir²,van¹, Nachiketh Carmen M.

dities,most the GAs diabetic relevant were glomerulosclerosis (OR 7.32; p=0.01),

ivariatemultivariate and logisticregression used determine the to analyses were Department Pathology,School of Medicine, Millerof Miami University Miami, of FL Introduction: leakage a second by ofsutures followed cortical layer to bleeding. prevent renal Omission ofmayWe decrease CS warm ischemia repairthe assessed time outcomes (WIT). of corticalRAPNthatsingle patients layer without had CSrenorrhaphy repairfollowing CS entry. Methods: Poster #93 HAS SLIDINGHAS CLIP RENORRHAPHY ELIMINATED THE NEED COLLECTING FOR SYSTEM DURING REPAIR ROBOTIC (CS) ASSISTEDPARTIAL NEPHRECTOMY (RAPN)? Robert WilliamsRobert Thiel and Dave Presented By: Mayo ClinicMayo University Miller Miami School of Medicine, M. Leonard of Miami, FL; Dipen J. Parekh² ¹Department Urology, of UniversitySchool of Medi M. Miller Leonard of Miami FLand Clinic, Urology DepartmentScience, of Surgical Medical, University Health and of Trieste,Italy; ²Department Urology, of UniversitySchool M. Miller Leonard of Miami of Pub of Department Biostatistics, of FL; ³Division Miami, Medicine, CKD present several with abnormalities related to inflammationhealing withinthe and three areas.nephron The furtherinvestigation these of might a role abnormalities have in the evaluation of deteri ultimate renal acute interstitial inflammation 12.47; (OR p=0.02) significantly were associated with decreased Hyperplastic eGFR. arteriolosclerosis an independent was (OR 2.30; p=0.025) predictor <60. baseline of eGFR Conclusion: and without CKD showed similarshowed and without CKDdemographics. GA, patients Overall, of showed 56% 86% IAshowed and 98% patients of presentedIn VA.multivariate with the analysis for adjusted comorbi segmentalsclerosis (OR 4.54; p=0.0006) and glomerular adhesion 2.80; (OR p=0.04). In the IAinterstitial group, 7.36; fibrosis (OR p<0.001),tubular atrophy 2.75; (OR p=0.02 Presented By: Introduction: nephrectomy. non The suggestedsurrogates as term for longrenal Wefailure. to describe endeavored have the most relevantfeatures t within associationsstage presence NNA III. of and the between preoperative CKD Results: higher rate of comorbidities (hypertension, diabetes, Charlson comorbidity index). Pathological features groupedwere as follows: glomerular (GA), interstitial (IA) vascular or abnormalities (VA). Un preoperative CKD. Methods: 2012 and 2014 availablewith histological Additional ofassessment NNA. factors were included Miller School of Medicine, Miami, FL; Miami, Medicine, of School Miller 6 Poster #92 NON OF ROLE Nephrology and Hypertension, University Miami, Miller of have shownhave a 20% rate of POPULATION WITH WITHOUTAND PREOPERATIVE CKD PaNicola Shabtaie Sam Venkatramani², 208 that had CS entry. Patients were subdivided into two groups—those with CS repair and those without CS repair. All patients underwent sliding clip cortical renorrhaphy with absorbable suture. All patients had a surgical drain placed intra-operatively and drain/serum creatinine ratios were collected on post-operative day number one. The primary outcome was a comparison of margin, ischemia, and complication score (MIC) among the two groups. Secondary outcomes compared were hospital stay, estimated blood loss (EBL), total operative time, drain/serum creatinine ratio (D/S ratio), and drain time. Fisher’s exact test was used for analysis of categorical variables. Unpaired t test was used for analysis of continuous variables. Results: 60 patients had CS repair and 26 had no CS repair. Mean age was 62.1 vs. 58.5 (p=0.22), mean tumor size 3.42 cm vs. 3.27 (p=0.57), and mean R.E.N.A.L nephrometry score 8.48 vs. 8.04 (p=0.18) for the CS repair and no CS repair groups, respectively. Negative margin status was obtained in all cases. Positive MIC score was obtained in 38 (60.3%) in the CS repair group and 18 (69.2%) in the no CS repair group (p=0.48). Mean WIT was 19.3 and 17.3 min (p=0.037) for the CS repair group and no CS repair group, respectively. Grade III or higher complications were seen in 4.6 % of CS repair group and 7.6% of the no CS repair group (p=0.62). There was no difference in mean hospital stay [2.98 vs. 2.85 days (p=0.62)], mean EBL [611vs. 505 mL (p=0.51)], mean operative time [222 vs. 211 min (p=0.18)], mean D/S ratio [1.14 vs. 1.05 (p=0.42)], and mean drain time [2.86 and 2.68 days (p=0.64) for the CS repair and no CS repair groups, respectively . 2 CS repair patients went home with a drain while 1 no CS repair patient went home with a drain (p=0.99). Conclusion: Omitting CS repair during RAPN with single layer sliding clip cortical renorrhaphy decreases WIT without altering MIC scores, complications, hospital stay, or drain time.

Poster #94 RESULTS OF ROBOTIC PARTIAL NEPHRECTOMY (RBP) IN TUMORS 4CMS OR LESS WITH COMPARISON TO LAPAROSCOPIC RENAL CRYOABLATION (LRC) RESULTS A. Scott Tully Jr¹ and Lee Hammontree² ¹University of Alabama, Birmingham Department of Public Health; ²Urology Centers of Alabama, Birmingham, AL Presented By: Lee N. Hammontree, MD Methods: We reviewed office and hospital records of patients who underwent RPN (LH, TH, MB) from June 2010 until August of 2015. Age, tumor size, path reports, OR time, EBL, LOS and complications were reviewed. We also compared these results with previous report of laparoscopic renal cryoablation of renal masses of similar size. Results: Mean age for RPN was 58.23(N=180 range 18-84) and for LRC was 62.31 (N269 range 27-87). BMI for RPN group mean was 39.62 (N=123 range 20.36-43.95 and for LRC group was 28.42 (N 191 range 20.34-48.75. ASA (anesthesia risk) for the RPN group was mean 2.60 (N=160 range 1-5) and for the LRC group was 2.71 (N=265 range 1-4) ( T- value: 3.5761 p-value: 0.0006). Tumor size in RPN group was mean 2.73cm (N = 180 range 1.1-4.0) and for LRC group was 2.48 (N 268 range 1.6-4.0) (T-test: -5.705 p-value: <.0001). Length of stay (LOS) for RPN group was mean 2.26 days (N 156 range 1-18) and for LRC group was mean of 1.94 days (N264 1-17) (T-test: -2.721 p-value: 0.0035). Estimated blood loss (EBL) for RPN group was mean of 235.49cc (N = 144 range 10- 1400cc) and for the LRC group had a mean of 74 cc (N = 259 range 5-1500cc) (T-test: - 15.063 p-value: <.0001). Complication overall rate for RPN was 14.7% (N=163) and for LRC the overall rate was 7.8 and the grade levels will be compared. Time in OR was mean 136.98min for RPN (N 113 range 67-290min) and for the LRC group was 110min (N 263 48-230min) p <.0001 Conclusion: Robotic partial nephrectomy has become a standard for management of renal mass removal in properly selected patients. Experience has led to broadening indications. For renal masses 4cm or less which are exophytic, Laparoscopic Renal Cryoablation is an alternative which may have less LOS, Blood loss, time in OR and fewer complications.

210 POSTERS of es

for

rson¹ and

rpora mightrpora affect glans afts with a glans splitting technique for 211 ts reported normal glans shaft and sensation and

tcomes glans preservationsensation with of and

procedure. In brief, the procedure entails splitting the glans, excising Melissa MD Mendez, Combined dorsal and ventral onlay grafts with a glans splitting ventral a glansonlay technique grafts with and dorsal Combined Using dorsalUsing onlay gr and ventral

Three patients recalcitrantstrictures with navicularis the of fossa meatus and

Postoperatively, all patien three

Introduction: Strongconsideration should givencryoablation to renal be small mass for renal appropriately selected. Poster #95 Aaron Lentz² ¹Division University Urologic Surgery, of Urology Center, Medical Durham, Duke ²Duke NC; of Raleigh, Raleigh, NC Presented By: the glans(Figure 1). As part of routine and postop pre care, patients interviewed were to describetheircurrent shaft glans sensation, and ejaculatory status,length, penile and quality glans engorgement. of Conclusion: RECOVERY OF GLANS SENSATION FOLLOWING COMBINED DORSAL AND AND DORSAL COMBINED FOLLOWING SENSATION GLANS OF RECOVERY WITHVENTRAL GLANS ONLAY SPLITTINGTECHNIQUE A STRICTURES FOR OF NAVICULARISTHE FOSSA Melissa Mendez¹, Eugene Cone¹, Gargae Lavien¹, Uwais Zaid¹, Andrew PeteMelissaGargaeEugene Lavien¹, Cone¹, Zaid¹, Uwais Andrew Mendez¹, Results: sensation and sexual function. this, Given sought we to describe the physiologic outcomes afterthis utilizing technique. underwent the above the dysplastic urethral plate, preforming a dorsal onlay buccalwith graft, a ventral onlay reapproximation lastly, and flap, skin pedicled circumferential or island transverse a with denied having symptomscoldglans of paresthesia. or changes inglans No engorgement ejaculatoryor loss length.function penile found, and there of no was were Methods: strictures of the fossa navicularis is a novel technique that creates a functional urethral channel maintaining while a cosmetically appealing glans penis. There is concern however that aggressivemobilization of the glans off wings the tips of the co

strictures of the fossa navicularisutilizes a combination of several different reconstructive techniques thatcollectively not have been previously described. Our three patients had excellent physiologic sexual ou engorgement,mobilizationfunction, ejaculatory length. and penile Aggressive glans the of doeswings not to appear glanssensation affect function sexual or and allows for an excellent cosmetic reconstructio FigureSplit 1: (A)the glans, dysplastic excise urethral (B)plate onlay buccal Dorsal with graftcircumferentialtransverse Ventral island (C) pedicled onlay a or with skin flap, (D) Reapproximationthe glans of

210 Poster #96 PRACTICE PATTERNS AND VARIATIONS FOR URETHRAL STRICTURE DISEASE MANAGEMENT AMONG RECONSTRUCTIVE SURGEONS Sara Johnson¹, John Lacy², Sudhir Isharwal³ and Shubham Gupta¹ ¹University of Kentucky, Lexington KY; ²Cleveland Clinic, Cleveland OH; ³University of Nebraska, Omaha Nebraska Presented By: Sara E. Johnson, BS, Medical Student Introduction: To define the patterns of urethral stricture management amongst genitourinary reconstructive surgeons. Methods: A survey was sent to 273 members of the Society of Genitourinary Reconstructive Surgeons (GURS) with working e-mails. The survey was designed to ascertain practice type, volume, and surgeons’ preferences for management for six index cases. These cases were 1) A 35 yoM with a 1.5 cm bulbar stricture; 2) A 65 yoM with the same 1.5 cm stricture; 3) A 35 yoM with a 2.5 cm bulbar stricture; 4) A 65 yoM with the same 2.5 cm stricture; 5) A 35 yoM with a 4.0 cm bulbar stricture; and 6) A 65 yoM with the same 4.0 cm stricture. Results: Our survey had 94 respondents, of whom 91 treated men with urethral strictures regularly. 71.9% practiced in USA, and 52% had been in practice for more than 10 years. 86% performed 13 or more urethroplasties a year, and 46% performed more than 50 urethroplasties in a year. 90% harvested their own buccal grafts. 36% respondents closed the harvest site, 46% left it open, and 18% had variable preferences. 33% preferred a dorsal onlay of buccal grafts for bulbar strictures, 19% preferred ventral, while the remaining used both approaches. Surgeons’ preferences for six index patients are depicted in Figure 1. Overall, excision and primary anastomosis (EPA) was preferred in older men with shorter strictures. Commonly preferred operations were EPA, buccal mucosal graft urethroplasty (BMGU), and augmented anastomotic urethroplasty (AAU). Flap based urethroplasty was preferred <2% of the times, incision/dilation was never preferred, and non-transecting urethroplasty was mentioned in up to 5% of cases. Conclusion: We illuminate the practice patterns of surgeons specializing in the management of urethral strictures. There is considerable variability among this group with regards to treatment strategies for bulbar strictures, buccal graft harvest site closure, and siting of buccal graft within the bulbar urethra. For longer strictures (4 cm), augmentation urethroplasty with buccal graft was widely preferred; however, for shorter strictures (1.5 cm, or 2.5 cm), wide variance in the use of excision and primary anastomosis and buccal graft augmentation was noted.

212 POSTERS

up - w patient up flexible flexible up operatively - - ally in three

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uent identification during term efficacy. This procedure - INTESTINAL ANASTOMOSIS - operatively and had follo

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t disease, hydronephrosis or post 213

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d and Andrew Peterson and Andrew d McCormick, MD

fficulta retrograde approach. via Often,these interventions require .

Urinary diversionUrinary requiring uretero Barrett Z Garjae D. Lavien, MD Lavien, D. Garjae Pubic symphysis osteomyelitisseen prior undergone have in is patients who intestinal anastomosis and facilitate access to the upper tracts.facilitateintestinalto upper and the anastomosis access

- IndiatattooingInk attimecystectomy the ofsimple, is a quick, and effective

After IRB approval, performed we prospective a study to determine the safety We from ofJanuaryAugustconducted 2011 to an IRB approved 2015 a review py to mark topy site the concerning of lesions) for easycan which identificationallow

A total of patients 5 undergoing radical cystectomy IC with due to bladder cancer,

fficacy applying of Ink India tattoos ureteric at iation other or ablative therapy for treatment of theirprostate cancer and presents up to the altered anatomydifficulty and localizing theanastomoses withina bowel segment, tractupper surveillance forcarcinomas urothelial as well thesetreatment as of complicationscan be di Wepercutaneousmanagement.describe technique a new anastomotic tattooing of using IndiaInk inert, (an colloidal suspension of carbon particlessafely usedfor decades during colonosco of ureteric the complicated anastomoti by Introduction: Methods: and e cystectomy.constructionAfter the of ilealconduitcreation of (IC) enterotomy and for the ureteral reimplantation, 0.5 cc aliquots of IndiaInk injected were submucos areas approximately 1 cmfrom the enterotomy createtriangulation to a the around anastomosis. The remainder of anastomosis the and procedurecompleted was the per surgeon’smethod. usual monitored Patients were post Trushar DavidHernandez Patel and University of SouthTampa, Florida College of Medicine, FL Presented By: IN DIVERSIONS: URINARY SIMPLE EFFECTIVE A IN TECHNIQUEAND TO AID SUBSEQUENT RECOGNITION RETROGRADEIN MANIPULATIONS Barrett AdamMcCormick, Baumgarten, Jonathan Beilan, Daniel Martin 7 #9 Poster INKINDIA INJECTION (TATTOOING) OFTHE URETERIC flexible cystoscopysettingthe in outpatientfor evaluate efficacy. to Results: neurogenic bladderrefractoryor interstitialenrolledthe cystitis study. in One were was excludedwas follow from - cystoscopy demonstrated has site. thecontinued around dye anastomotic the presence of Conclusion: safe methodto mark the anastomosis facilitating its subseq retrograde manipulation. follow Further experienced adverse any events related to the tattooing, including anaphylactic reaction, abscessformation the at conduit, anastomotic or leak breakdown. or F may increase the urologist’s to ability access the tracts upper endoscopicallymanage and patients stricture, with urolithiasis, recurren Division Urology, of Genitourinary Cancer SurvivorshipProgram, Duke University Medical Center, NC Durham, Presented By: Introduction: 7 to 10 years later pelvicwith pain. In this sought review we to delineate the microbiological features and antibiotic susceptibility patterns of pubic symphysis os rad prostate cancer survivor. Methods: diagnosis pubicsymphysis of osteomyelitis established was magnetic with resonance imaging and confirmed tissue by culture of pubic symphysectomyspecimens at the time of resection. Antimicrobial suscep database identify to cancer prostate survivors underwent multidisciplinary who treatmentfor pubicsymphysis osteomyelitis. Dem without having to approaches. rely on percutaneous Poster #98 Zai Uwais Lavien, Garjae MICROBIOLOGICAL PROFILE DRUGSUSCEPTIBILITY AND OF PATTERNS PUBIC SURVIVOR CANCER PROSTATE THE IN OSTEOMYELITIS SYMPHYSIS 212 Laboratory Standards Institute criteria. Results: We identified 17 patients with a median age of 71 years of age (range 64-84). Surgical debridement is pending in 4. Thirteen have undergone pubic symphysectomy with or without pubic rami debridement, along with concomitant urinary and/or fecal diversion. All patients received a course of parenteral antibiotics for 6 weeks or longer prior to surgical management which was stopped 2 weeks prior to surgery. We identified 26 cultured isolates from 13 tissue specimens. Positive isolates were cultured in 92% of patients, with polymicrobial infections noted in 62%. Enterococcus was the most predominant isolate identified representing 27% of all cultured organisms, followed by Escherichia coli at 19%. The antibiotic resistance rates are noted in Table 1. The most commonly used classes of antibiotics that were administered based on these cultures included carbapenems (35%) and glycopeptides (16%). Conclusion: Upon resection, the majority of prostate cancer survivors with pubic symphysis osteomyelitis will have a dominant organism identified. Enterococcus and Escherichia coli account for the majority of the offending pathogens. Clinicians should consider the empiric use of carbapenems and glycopeptides in patients prior to definitive surgical management. Financial funding: None

Poster #99 AMBULATORY OUTPATIENT URETHROPLASTY IS SAFE AND PRODUCES GOOD OUTCOMES Uwais Zaid, Garjae Lavien, Michael Granieri and Andrew Peterson Duke University, Durham NC Presented By: Uwais Zaid, MD Introduction: Urethroplasty is considered a durable and definitive treatment for urethral strictures. In many facilities, patients are admitted for 1-2 days following open urethral reconstruction. In our practice, anterior urethroplasties are performed as an outpatient procedure with patients being sent home the day of surgery. We report our experience from a large academic practice. Methods: A retrospective chart review from 1/2010 to 12/2014 of an IRB approved database was performed identifying all patients who underwent anterior urethroplasty. These patients were discharged on the day of surgery, unless limited by medical comorbidities, on a standardized regimen including stool softeners, pain medications (oxycodone 5mg, 21 tablets) and no antibiotics. We excluded posterior urethroplasties. Patient demographics, stricture characteristics, patient outcomes and complications were reviewed along with patient phone calls, emergency room visits, readmissions, and urinary catheter complaints. Results: We reviewed 167 anterior urethroplasties, of which 154 (92.2%) were discharged on the day of surgery and 13 (7.8%) were admitted. Median patient age was 52 years (±16) in the ambulatory group and 56 (±19) in the admitted group. The 13 admissions (median 1 day) were for ESRD (3), atrial fibrillation (1), hypoxia (1), pediatric patient (1), and unknown (7). With regards to patient calls via telehealth triage, there were 32 (20.8%) at a median of

214 POSTERS

ma (1), 50) was50) - need for need for

(n=73, 15%), se who were haracteristics of ian (n=195, 41%) ian 41%) (n=195, s 19 (age 50) was massage was 50) - ome (n=185, 39%).

2014. Amongst these - ed were morewere ed likely to be those who were not admitted. were those who vs.

ot differ between patients who were admitted differ patientsot between were who 215

based analysisbased of genital injuries, foreign body there is a -

50 years of age, and 54 (11%) patients ≥51 years of age. The 22 days) inthe ambulatory and 2 group (15.4%) at a median of - - BASED ANALYSIS - ry etiology, and outcomes etiology,sufferingry patients of a genital foreign body N OF GENITAL FOREIGN BODY INJURY RELATED HOSPITAL HOSPITAL RELATED INJURY BODY FOREIGN GENITAL OF N s populations 32 days) inadmittedthe 7 (4.5%) group. There readmissions were inthe University, Augusta, GA -

41 days) inthe ambulatory and 4 (30.7%) group at a median of 6 days - Shenelle Wilson, MD Genital foreign injuries body is an uncommon urological problem may which

In experience, our rates of ER visits, readmission,catheter problems, and In thi

There were 10,663There were patients inthe Consumer Product Safe Commission’s nge 0

There were 266 females (56%) and 209 males (44%) who presented to the ER presentedmales to ER 266 females (44%) the and 209 who There (56%) were 13 days) inthe admitted group. Reviewing ER visits, there 12 (7.8%)were at a

- ays 20 (range irinjury. Althoughthe incidence of foreign genital body injuries an uncommon represents 7 days (ra (range 4 (range median of 12 days 0 (range Introduction: 26 d Methods: (CPSC) National Electronic Surveillance Injury System (NEISS) databa Conclusion: Conclusion: require emergency room (ER) evaluation. The objective of the study towas characterize the demographics, inju visit. ER necessitating injury related need for additionalmedications pain didn CHARACTERIZATIO reoperation,oral complications casesin of buccal harvest, phone callsand requesting medications. additional pain after urethroplastyon the discharged or surgery. day that This indicates data ambulatory urethroplastysafeand appropriate is forand without urethroplasty anterior grafting. with Poster #100 POPULATION VISITS: A Presented By: diagnosed ‘pubic with trauma region’ visits during from 2009 ER patients, 475 there (4.5%) were patients ‘foreign with body’ injuries subsequently who comprised the study cohort. Descriptive statistics used to were comparec subsequentlypatients were hospital the admitted to who Results: genitalwith foreignmost injuries. body Caucascommon The was race followed by African American (n=82, 17%). There were age, 217 (46%) 204 patients 19 (43%) patients ≤18 years of wound infectionwound (1), intractable and nausea (1). There 12were (7.8%)complaints due to admittedthe the a and 2 (15.3%) urinarygroup catheter at in group the in ambulatory median days daysno patient of16.5 and respectively. 8 There were deaths, ambulatorythe and 1 (7.7%) group in admitted for group. readmission Reasons included MI (1), PE/DVT CHF exacerbation perineal (1),(1), mentalaltered hemato status (2), most common the location injury occurredwhere the was patient’s h Shenelle Wilson¹,Shenelle Neal¹ Klaassen¹, Zachary Ibarra² Erika and Durwood ¹DepartmentSection Surgery, of Urology, University, of GeorgiaRegents Augusta, GA; ²Georgia Regents mostThecommon type related of was to injury clothing and accessories (n=94, 20%) followed miscellaneous by suchcoins 19%),items (n=91, bottles and as recreation and electronic equipment (n=79, 17%), personalsupplies hygiene/grooming massage devices/vibrators 13%), (n=63, supplieskitchen office 12%)supplies (n=58, and etiology(n=17,commonmost 4%). of The for injury females 19 (age clothing and accessorieschildren and for recreation (<18) was and electronic equipment. There 55 were (12%) patients admitted were that to the hospitalthe from ER. Compared to patients dischargedwere who home, patients that admitt were male(represented 58% of admissions,more p=0.03) and likely to had a have miscellaneous,kitchen office suppliesor supplies injury. foreign no There body was difference the groups between two (p=0.56). inage Conclusion: devices/vibrators and personal hygiene/grooming supplies, for adult male range ofrange injury mechanisms necessitating ER visits. Clothing accessory injuries the were males morethecommon likelymost admittedto injury, hospitalfor cause to of were be and the mechanism ofER visits, urologic these increased findingsfor support educational the need effortsinterventions and in thesepreventing injuries. 214 Poster #101 URINARY OUTCOMES AFTER ANTERIOR EXENTERATION AND NEOBLADDER URINARY DIVERSION IN WOMEN Justin Gregg¹, Johnson Wong², Curran Emeruwa², Matthew Resnick³, Daniel Barocas³, MIchael Cookson4, Sam Chang³, David Penson³, Joseph Smith³, Kristen Scarpato³ and Kelvin Moses³ ¹Vanderbilt University Medical Center, Department of Urologic Surgery, Nashville, TN; ²Meharry Medical College, Nashville, TN; ³Vanderbilt University Medical Center, Department of Urologic Surgery, Nashville, TN; 4University of Oklahoma College of Medicine, Department of Urology, Oklahoma City, OK Presented By: Justin Gregg, MD Introduction: Female patients with muscle invasive bladder cancer (MIBC) traditionally undergo anterior pelvic exenteration. However, female genitourinary (GU) organ involvement is rare and removal can potentially affect urinary and sexual function. Our study aimed to examine if GU organ sparing was associated with improved urinary function in women who underwent orthotopic neobladder (NB) urinary diversion. We hypothesized that women in whom pelvic organs were spared would have lower instances of nighttime wetting and need for catheterization. Methods: We retrospectively reviewed charts of female patients who underwent radical cystectomy at our institution from 1999 - 2014. All patients who underwent NB diversion were included. We examined these characteristics, and the presence of hysterectomy (either pre- or intra-operative), for association with nighttime wetting and catheter use. We compared patients who did and did not ever undergo hysterectomy for urinary outcomes using chi squared tests. Results: Out of 322 eligible patients, 40 (12.4%) underwent NB diversion. Thirty-three (82.5%) women had data available on post-operative urinary function, 14 of whom (42.4%) did not undergo anterior exenteration and did not have a previous hysterectomy. Mean follow-up time was 4.1 years (SD 3.8). Average age was 60.9 years (SD 11.1). Three out of 14 (21.4%) and 6/12 (50%) women who did not undergo hysterectomy and 4/18 (22.2%) and 4/17 (23.5%) with prior hysterectomy were dry at night when seen at their second and third post-operative visits, respectively (p=0.96 and 0.14). One out of 14 (7.1%) and 6/30 (20%) without hysterectomy and 5/19 (26.3%) and 3/17 (17.7%) with prior hysterectomy were catheterizing at their second and third post-op visits, respectively (p=0.16 and 0.71). Conclusion: Rates of nighttime wetting and catheterization are common in women after neobladder placement. Anterior exenteration or prior hysterectomy does not appear to affect urinary outcomes; however, our study is likely underpowered to detect a difference. Large studies that include patient-reported urinary outcomes are needed to further investigate characteristics associated with urinary symptoms after neobladder diversion.

Poster #102 ETIOLOGY AND CHARACTERIZATION OF GENITAL LACERATION, CONTUSION, AND ABRASION INJURIES Shenelle Wilson¹, Brandon Wilson², Reena Kabaria², Zachary Klaassen² and Durwood Neal² ¹Department of Surgery, Section of Urology, Georgia Regents University, Augusta, GA; ²Georgia Regents University, Augusta, GA Presented By: Shenelle Wilson, MD Introduction: Genital lacerations, abrasions, and contusions represent a significant subset of pubic injuries that may require emergency room (ER) consultation and evaluation. The objective of the study was to characterize the demographics, injury etiology, and outcomes of patients suffering a genital laceration, abrasion and/or contusion necessitating ER visit. Methods: There were 10,663 patients in the Consumer Product Safe Commission’s (CPSC) National Electronic Injury Surveillance System (NEISS) database who were diagnosed with ‘pubic region’ trauma during ER visits from 2009-2014. Amongst these patients, there were 3207 (30.1%) patients with ‘laceration’ and ‘contusions, abrasions’ injuries who subsequently comprised the study cohort.

216 POSTERS

- - - 50 -

18 was related to sports. to related 18 was - 50 years of age,and 154 (5%)

- , 18 of whom (78%) male. were At the Kaufman

. up were classified according to the Clavien to the classified according up were patients (91%) had experienced at least one -

217 83.8), 21 -

based analysis of genital lacerations, abrasions, and -

nd 3 (13%) patients,nd respectively. patientsTwelve (52%) urologists to participate incare.their Patients and urologists Cohn and Mellissa R Cohn y and frequentlyy undergo complex abdominal reconstructive

. y demonstratesy challenges the associated perioperative with aneous items, such writing supplies items, bottles, as aneous (n=295, and 9%), 10 recreationwas electronic and equipment.most The common -

is population oshua A oshua three patients met inclusion criteria met inclusion patients three - David C. Moore, MD Moore, DavidC. Children spina with bifida resultant with neurogenic bladder require regular This stud This In th In

onal status.Perioperative outcomes associated complexwith urologic

me (n=1253, 39%). mostcommon The type of injury was related to recreation (n=1290,40%) followed African by American (n=585,18%). 2421 There were We identified all patients >18 years of age spinawith bifida that underwent recreational activities and electronics were most common. Since the incidence of of incidence the Since common. most were electronics and activities recreational Twenty There were 1503 females 1503 There were (47%) 1704 males and presented(53%) who to theER Moore, J

. OPERATIVE COMPLICATIONS AFTER LAPAROTOMY INADULT PATIENTS up of 44.2 months 16.1 (IQR - - operative complication, 3.0 an average with ± 2.2 complications patient. per At least - parotomy for urologic disease. Results: genitalwith lacerations, common was contusions.most race and/or The abrasions Caucasian (75%) patients ≤18 years of age, 632 (20%) patients 19 Vanderbiltof University, Department Urologic Surgery, Nashville, TN Presented By: Introduction: urologic care from infanc surgery at age. a young Aspatients these transition to adulthood, present they a significant operative challenge becausefrequent comorbid of disease, habitus, body prior surgery and limited functi reconstruction inadult patients spina with bifida received have limited study.We therefore sought to characterize perioperative outcomes inadult patients spina with bifida following la Methods: Methods: follow months >3 with patients Only institution. at our intervention urologic for laparotomy up were included. Complications at last follow Complications included. up were of differing complications multiple When Complications. of Surgical Classification Dindo consideredgradessame patient,the separately. occurred in was each Results: kg/m2 28.4 8.1 ± mass index 11.2meantimelaparotomy, was ± years, of body 36.0 age and ASA class 2.9 ± 0.41. length Mean of hospitalization 8.0 was ± 2.4 days. At a median follow management spinawith adult patients bifida of undergoing laparotomy for urologic intervention. Because life increased of expectancy inthis patient population, there is heightened need for adult should ofbe aware the risks to proceeding prior major with urologic surgery. Further patients ≥51 years of age. The most common location where thepatient’s ho injury occurred was the clothing/accessories (n=278, 9%), baby/toddler specific items (n=58, 2%), and kitchen items (n=41,most 1%).The common etiology of injury for females and males ages 19 and electronic equipment (n=1145, 36%, devices), incl.sexual followed by grooming/hygiene/bathroom specific items (n=431, 13%), furniture (n=416, 13%), sports (n=331, 10%), miscell and children ages 3 experienced a complication of III grade higher. or There no deaths. were mostThe frequent complications surgicalsite were ileus infection and prolonged (39%) (48%), UTI (26%). one grade I,one grade II, IIIa, IIIb,IVa, and IVb complication experienced was 17 (74%), by 10 (43%), 6 (26%), 3 (13%), 2 (9%), a post Conclusion: genital lacerations, abrasions, contusions and represent a relatively commoncause of urologic ER visits; these findings supportfor the increased need educational efforts and POST etiology of injury for children 2 and under relatedwas to grooming, hygiene, and bathroom related items. The most common etiology for children ages 11 Conclusion: contusions,there is are of range mechanisms identified. injury wide that were Children ages represented 18 and under 75% of persons seen the by these ER for injuries. Injuries related to interventions in preventing these injuries. These findings also support the need forfurther characterization pediatricspecific of injuries. Poster #103 WITH SPINA BIFIDA SPINA WITH C David 216 studies will focus on identifying risk factors for a complicated postoperative course and developing patient care pathways aimed at minimizing morbidity.

Poster #104 URETERAL REIMPLANTATION BY BLADDER ELONGATION AND PSOAS HITCH (BEPH) THROUGH A GIBSON INCISION IS SAFE, EFFECTIVE, AND HAS LOW MORBIDITY IN THE TREATMENT OF DISTAL URETERAL STRICTURES. Bryce Allio, Garjae Levien, Uwais Zaid and Andrew C. Peterson Division of Urology, Duke University Medical Center, Durham, North Carolina Presented By: Bryce A. Allio, MD Introduction: Multiple approaches exist for the reimplantation of the distal ureter. Our institution has favored bladder elongation in conjunction with the psoas hitch (BEPH) via the Gibson incision. The BEPH may reach similarly proximal strictures as the Boari flap however avoiding issues with flap integrity and tissue ischemia with less manipulation of the bladder tissue. We present our results using this technique in a series of patients undergoing surgery for obstruction of the distal ureter from various causes. Methods: We conducted a retrospective chart review of all patients undergoing ureteral reconstructive procedures from 2011 to 2015 at our institution. Patients undergoing ileal ureter, sacral hitch, planned midline procedures, robotic reimplant, and pediatric patients were excluded from the current analysis. Patient demographic data, etiology, adjunct procedures, and perioperative outcomes were reviewed. The procedure performed was limited to the BEPH through a Gibson incision. Postoperative follow up, imaging and any re-interventions were also captured. Failure was defined as recurrent stricture and/or continued need of a nephrostomy tube or repeat intervention. Results: A total of 14 patients underwent BEPH for strictures of the distal ureter. Of these patients, 3 underwent additional hernia repair in the same surgical setting. All cases were successfully completed with no alteration in surgical approach and no intraoperative complications. The median operating room time was 227 minutes for BEPH only. Median blood loss was 237 ml with no intraoperative transfusions. For patients that underwent only BEPH the average hospital stay was 2.4 days versus 3.1 days who underwent associated procedures. At two weeks of follow-up, all 14 patients had cystograms that were negative for leak. In all cases, follow-up nephrostograms revealed no strictures. The median follow up with imaging was 309 days. There were three minor complications (Clavien I/II) including ileus, and two UTIs (21%) and one serious complication (Clavien III) requiring IR drainage of a psoas abscess (7.1%). All reimplantations were successful without long term changes in urination symptoms or wound problems. Conclusion: Ureteral reimplantation of the distal ureter by BEPH through a Gibson incision is a safe effective procedure with good outcomes and limited morbidity as found at a single institution with good long term follow-up.

218 POSTERS - 1 - - hrough thehrough

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th primary musclecells implantation. To evaluate the cell cell the evaluate To implantation. - d M. Miller School of Medicine, Miami, Miami, Medicine, of School Miller M. d greatest cell count. Fiber 219 e cells, accelerating resulted which e in muscle ABDOMINAL SURGERIES: 30 SURGERIES: ABDOMINAL tistics, Department of Publictistics, DepartmentSciences, Health of

1 prior to implantation. To theevaluate effectthe of scaffolds implantedcreated were a into defectsite in the ative Medicine, Winstonative Medicine,Salem, NC -

operative complications.Patients better nutritional with status prior to jected IGF with specificscaffolding to system. were evaluate The study objectives this the of John D. Jackson, PhD D.John Nicola Pavan, MD Patient nutritionalstatus inthe preoperative setting been associated has with It been demonstrated tissuethat has contains almost body every the in some -

Our data suggest abilityOur data an stem of hostcells to into recruit scaffolds the with machinery that is responsible formaintenance daily and repairof injured

Decellularized porcine The NSQIP Database was queried usingwas codesThe Database CPT to NSQIP a cohort of build patients

Functional testing showed an increase in muscleFunctional an increasetesting functionalityshowed in 4 by in groups all ,364) underwentwho colectomy, cystectomy, and hysterectomy from 2009 to

n of the scaffolds, the muscle and scaffold were removedscaffold muscle scaffolds, and characterized were and the then of by IP) database to determine whether preoperativeIP) databasewhether to determine factors assuch nutritional status ostand replacement response towards repairtissue may of defects.achieved be This

tibialismuscle anterior of rats. experimental Three tested groups were (along two with control groups); those empty with scaffolds,scaffolds seeded with muscleprogenitor cells, and scaffolds in Introduction: specificstemcells and progenitorsuggests may that potential there be a opportunity to bias the h maneuveringby host stem cells and progenitor using targetspecific scaffolds. this In study, aimedwe to regenerate musclefunctionality following volumetricmuscle loss t use a target of type of stemprogenitor or cells. cells These believed are to be part of underlying regenerative functionalized decellularized tissue scaffolds on the hostmuscle cell migration and muscle function recovery invivo. tissue. regenerative The an underlying mechanism presence of informthe tissue of Methods: Poster #105 FOR SCAFFOLDS MUSCLE FUNCTIONALIZED OF EVALUATION VIVO IN RECONSTRUCTION Lindsey Shapiro, Young Min Ju, John Jackson, Anthony Atala, James Yoo and Sang Jin Jackson,LindseyJohn SangAtala, Anthony YooJames Ju, Shapiro, Min and Young Lee Wake Institute Forest for Regener Presented By: scaffolds,force a transducer was utilizedmeasure to isometric force produced the by tibialismuscle anterior at 4 2 or either weeks post infiltratio Masson’s Trichrome.H&E and Results: weeks relative group.the Scaffolds to only defect seeded wi recovered 53% of 4, functionalityweek a 21% increasedefect by the over group. The only retrieved implants progressive showed cellinfiltration scaffolds the time. of over IGF The and seeded progenitor cellscaffolds yielded the infiltratedcells 2.scaffoldthe week early as as could withinbe seen =(N 162 Conclusion: NUTRITIONAL STATUS MAJOR AND Poster #106 COMPLICATIONS POSTOPERATIVE Nicola R.Pavan¹, Ritch², Samarpit Rai², Soodana Mir², Carmen Chad C. Nachiketh Balise³,Prakash², J. Gonzalgo² Parekh² and Mark L. Raymond R. Dipen ¹DepartmentUrology, of University of Leonar Miami FLand Clinic, Urology DepartmentScience, of Surgical Medical, University and Health of Trieste,Italy; ²Department Urology, of UniversitySchool M. Miller Leonard of Miami of Biosta FL; of ³Division Medicine, Miami, University Miller Miami School of Medicine, M. Leonard of Miami, FL Methods: regeneration in situ.Thisstudyhopes to provide a platformfordevelopment the tissue of engineering and regenerative medicine in regards to volumetric muscle loss. Presented By: Introduction: surgery been have to shown have perioperative fewer complications compared to patients nutritional poor with status.We the utilized National Surgery Quality Improvement Program (NSQ couldcomplicationsthepredict incidencemajor of following surgery. abdominal the rate of post the capability differentiatingmuscl of to 218 2013. Exclusion criteria included ascites, disseminated cancer, chronic use of steroids, blood transfusion before serum albumin test, ventilator dependence, ASA 5, emergency procedures, and sepsis before surgery. Postoperative complications were classified according to Clavien−Dindo criteria. Multivariate analysis was performed to predict factors associated with major 30−day postoperative complications (Clavien−Dindo grade ≥ 3). Results: The distribution of abdominal surgeries was: open colectomy (28.7%), MIS colectomy (33.4%), open cystectomy (2.3%), MIS cystectomy (0.10%), open hysterectomy (15.7%) and MIS hysterectomy (19.9%). After adjusting for age, sex, smoking, and surgical approach, patients with >10% weight loss 6 months prior to surgery had a higher chance of developing major postoperative complications (OR 1.14, p < 0.053). Patients with below normal BMI also had a higher chance of developing major postoperative complications compared to patients with normal BMI (OR 1.36, p < 0.0003). Increased risk of major complications was observed in patients with moderate (OR 1.18, p < 0.01) or severe (OR 1.93, p < 0.0001) hypoalbuminemia, and for patients who were smokers (OR 1.38, p < 0.0001). Conclusion: Lower nutritional status significantly increases the risk of 30−day postoperative morbidity following abdominal surgery (colectomy, cystectomy, hysterectomy). Using a standardized predictive algorithm to identify, treat, and optimize nutritional status preoperatively may help to reduce the incidence of postoperative complications in patients undergoing abdominal surgery.

Poster #107 EVALUATION OF THE RENAL CELL CARCINOMA INFLAMMATORY SCORE IN PATIENTS WITH CLEAR CELL HISTOLOGY Rishi Sekar¹, Dattatraya Patil¹, Jeffrey Pearl¹, Yoram Baum¹, Anna Bausum², Omer Kucuk³, Wayne Harris³, Bradley Carthon³, Mehrdad Alemozaffar4, Christopher Filson4, Kenneth Ogan¹ and Viraj Master4 ¹Emory University School of Medicine, Department of Urology, Atlanta, GA; ²Emory University School of Medicine, Department of Urology; ³Emory University School of Medicine, Department of Hematology and Medical Oncology, Winship Cancer Institute, Atlanta, GA; 4Emory University School of Medicine, Department of Urology, Winship Cancer Institute, Atlanta, GA Presented By: Rishi Sekar, BA Introduction: With recent advancements in the understanding of cancer pathogenesis, the host inflammatory response has been well established as an integral factor in disease progression. Although numerous inflammatory markers have been studied as prognostic biomarkers in renal cell carcinoma (RCC), few studies have analyzed their prognostic value in aggregate to achieve greater predictive accuracy. We hypothesize that a combination of C-Reactive Protein (CRP), albumin, Erythrocyte Sedimentation Rate (ESR), corrected calcium, and AST/ALT ratio into a RCC Inflammatory Score (RISK) could serve as a powerful prognostic tool in patients with clear cell RCC. Methods: Patients that underwent nephrectomy for clear cell RCC were queried from our nephrectomy database. The optimal threshold for individual biomarkers was determined using grid search methodology, receiver operating characteristic (ROC) analysis, and sensitivity-specificity trade-off analysis. Score determination was based on a value of 0, 1, or 2 for each biomarker as dictated by established thresholds. The final score, RISK, was the sum of all points accrued from each biomarker. ROC and chi-square analysis was performed to compare the prognostic ability of RISK to SSIGN and UISS. Impact on overall survival was analyzed using cox proportional hazard regression models. Results: Two-hundred-and eighty patients were included in the study. Area under the curve (AUC) for RISK, SSIGN and UISS was 0.7744, 0.7755, and 0.8090, respectively. Chi-square analysis of AUCs revealed no statistically significant difference between RISK, SSIGN, and UISS (p= 0.975 and p =0.299, respectively). On multivariate analysis, after adjusting for confounding variables, each unit increase in RISK was associated with a 31% increase in mortality (HR=1.31, 95%CI 1.13-1.50, p<0.001).

220 POSTERS

he University of effectively obtained -

rgical intervention with s patients of receiving radical or rkers easily and cost rkers easily and

t of choice, technically when feasible. Prior 221

d with undergoing with radicald versus partial nephrectomyfor

on of partial nephrectomy partial this on of from in increased group in1998 14.1%

ion, lower income, educationion, lower lower level, and insurance status (Medicaid, CARCINOMA IN YOUNGER PATIENTS: ANALYSIS OF THE NATIONAL NATIONAL THE OF ANALYSIS PATIENTS: YOUNGER IN CARCINOMA Surgicalintervention for earlystage cellcarcinoma renal the remains gold Jason R. Lomboy, MD Lomboy, Jason R.

Our data show that RISK is an independent thatsignificant show Our data and predictor overall of

Using the National Cancer Data Base, identified we all patients less than 60

A total of patients the under 71,498 age of surgical 60 underwent intervention for

Methods: years of stagecell age with I underwent carcinoma renal su who stage I renal cell carcinoma patients.stage younger cellI in renal Introduction: standard. Partial nephrectomythe treatmen is studies demonstrated have an increase chronic innew kidney disease and a decrease in overall survival in radicalWepatients partial undergoing sought to versus nephrectomy. associate factors clinical identify radical 1998 and 2012. Multiple partialor clinical nephrectomy between variables were assessedto evaluate the impact of undergoing surgical intervention. Univariableand multivariableanalyses performedto were identify predictor partial nephrectomy. Results: North Carolina Lineberger Comprehensive Chapel CancerHill, Center NC Presented By: multivariable to 2012. 59.4% in On analysis, increasing age, (Hispanic, race African American), earlier of year surgery, larger tumor size, hospital (community type cancer program), locat stagecell Icarcinoma renal 1998 and 2012. between Of these, partial 38.9% underwent nephrectomy. Utilizati Medicare, all uninsured) independently were predictive undergoing of radical versus partial CLINICAL PREDICTORS OF RADICAL OR PARTIAL NEPHRECTOMY FOR STAGE I STAGE FOR NEPHRECTOMY PARTIAL OR RADICAL OF PREDICTORS CLINICAL CELL RENAL Poster #108 CANCER DATA BASE Woods¹,JasonAllison Lomboy¹, Smith¹, Angela Deal², Wallen¹, Michael Eric Matthew Nielsen¹ Raynor¹ and Mathew ¹TheSchool University ²T Carolina of NC; North Chapel Medicine Hill, of survival inclear predictive cell with RCC accuracy and UISS. SSIGN with on par Notably, composedRISK standardizedma of laboratory is Conclusion: Conclusion:

preoperatively, crucial allowing prognosticmedical integrated information into to be decision making prior to surgery. 220 nephrectomy. Conclusion: In patients younger than 60, utilization of partial nephrectomy for stage I renal cell carcinoma increased significantly between 1998 and 2012, with more than half of patients undergoing surgical intervention receiving nephron-sparing surgery in more recent years. Multiple clinical factors were predictive of undergoing radical versus partial nephrectomy, including increasing age, larger tumor size, and receiving care at community cancer centers (versus academic or comprehensive cancer centers). Additional patient- specific factors were also predictive of radical nephrectomy (location, income, education level, insurance status), highlighting broader access to specialty care issues.

Poster #109 THE ASSOCIATION BETWEEN PREOPERATIVE LEUKOCYTOSIS AND POSTOPERATIVE OUTCOMES FOLLOWING NEPHRECTOMY FOR KIDNEY CANCER Jason Lomboy, Matthew Macey, Troy Sukhu, Allison Deal, Mathew Raynor, Eric Wallen, Michael Woods, Raj Pruthi, Matthew Nielsen and Angela Smith Chapel Hill, NC Presented By: Jason R. Lomboy, MD Introduction: Preoperative leukocytosis has been linked with decreased overall survival in lung and gynecologic malignancies and post-operative complications following colorectal cancer. However, leukocytosis has not been evaluated as a predictor of postoperative complication or mortality among patients with kidney cancer. The objective of this study is to evaluate whether leukocytosis is associated with postoperative complications and mortality following nephrectomy for kidney cancer. Methods: Using the American College of Surgeons - National Surgical Quality Improvement Program (NSQIP) database, we performed a retrospective review of patients undergoing nephrectomy and a primary diagnosis of kidney cancer from 2005-2013. NSQIP collects prospective data on >135 variables, including perioperative data, 30-day post-operative complications and mortality on major surgical procedures at over 450 participating academic and private institutions. Bivariable and multivariable analyses were performed on this multicenter, prospective data set using pre-operative NSQIP variable of leukocytosis (defined as WBC>11) for likelihood of postoperative mortality and complications. Results: Of 9,250 patients who underwent nephrectomy for kidney cancer, 22.1% underwent open radical, 18.1% open partial, 25.9% laparoscopic partial, and 33.9% laparoscopic radical nephrectomy. 63% of patients were male, 87.6% white, and median age was 62 years. Overall, 7% (n=643) had preoperative leukocytosis, with a median of 8 days between lab draw and operation date. On bivariable analysis, 19.8% of those with leukocytosis experienced a complication compared to 16.1% of those without leukocytosis (p=0.017). However, on multivariable analysis, leukocytosis did not remain a significant predictor of complications following nephrectomy (p=0.28), when controlling for preoperative hematocrit, creatinine, ASA, age, race, gender, BMI, smoking status, and presence of diabetes. Among these variables, advanced age, male gender, and lower preoperative hematocrit were significant predictors of complications (all p<0.001). 30-day mortality was rare (<1%), and after adjusting for complications, preoperative leukocytosis had a borderline significant association with mortality (p=0.05). Conclusion: Preoperative leukocytosis was a significant predictor of 30-day complications following nephrectomy on bivariable analysis but not when controlling for other variables such as advanced age, male gender and low preoperative hematocrit, which were strong predictors of subsequent complications.

222 POSTERS - - is thologic thologic , 28.9%) , 28.9%) Our mean

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alyzed. op AKI patientand one (7.2%), developed a - up. - Nephron sparing surgery sparingNephron for tumor size than greater 4 cm (T1b) To determine which nine partial nephrectomies MIS/robotic, (29 40 open) and preformedwere at Nathan Longstreet Jung,Nathan Longstreet MD Marissa Kent, MD -

Minimally invasive open partial or nephrectomy is efficacious for stageT1b

Patients who underwentPatients who open partial T1b nephrectomy greateror for RCC A review retrospective performed chartwas underwentall on patients who

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4 14 cases of pT3, and 4 case of pT4 renal cell carcinoma. renal of cell case pT4 scorescases Nephrometry and 4 pT3, 14 of were term follow term

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Results: our institutionour The age and average 2007 and 2014 for T1b between greater or disease. tumor size for the cohort 61.0 was (range 34 average operativeaverage time 145 minutes was 47 (range increasingly present surgicalmanystandardcenters. the as we our Here used at being operative, perioperative, and surgical outcomes for patients undergoing partial singlecarcinomanephrectomy institution. renal cellfor a greater or at stage T1b Met between 2007 and 2014 at institutionbetween our retrospectively were evaluated. Patient demographics, operative, perioperative,surgical complications, and and oncologic outcomes an were patients with T3b or T3c renal cell carcinoma. cell renal T3c or T3b with patients Methods: nephrectomy at& Hospital Lahey Medical Center from 1971 Introduction: operative and 3 month follow fluid or hematoma perinephric (2.9%), infarction myocardial included complications collection (5.8%),distress and respiratory (4.3%). The distribution of pathology among the patients included 49 cases of pT1b, 4 cases of pT2, nephrometry scoreto from was The available average 11. 5 cases and ranged for the 51 of 7.51. Tumor locationsanterior, included 15 11 posterior,24 “neither”. 1 hilar, and follow up inthis cohortmonths is 35.4 0 (range TN Presented By: Introduction: performed hilar without clamping.cases with hilar the clamping, Of 45 warm average ischemiatime minutes (n=26, 26.5 37.5%) was cold and average ischemia (n=20 timeminutes. 21.4 was median The length of stay for the groups 3 days two (range:1 was for18) minimally the 5 days invasive (range:2 and Singh Poster #110 RENAL FOR LARGER SURGERY SPARING NEPHRON INITIAL EXPERIENCE INITIAL NathanAmanda Carter³, Jung¹, Smith², Class Hugh Juan ¹UniversityTNCollege of Medicine Chattanooga; of ²Univeristy College Medicine of TN of Chattanooga,TN; Chattanooga, ³Medica Center, Memphis, TN; disease of (8.6%). the Two patients 2.8% or had local have recurrence of renal cell carcinoma and four patients 5.7% or had distant recurrence, one with to examined Proportional using and analyzed Cox Survival Hazard models.Additional factors #111 Poster renal cellmorbiditysize carcinoma cm) acceptable with >4.0 (tumor and recurrence in risk - long RISK THAT SURVIVAL FACTORS INAFFECT WITH PATIENTS RENAL CELL CARCINOMA INVADING CAVATHE VENA reporting a mean of 1.11 and 1.06, 1.14 respectively. The open approach creatinine levels 1.56,were 1.68 and 1.56 respectively. There awere total of 12 complications (16.9%). Five patients had post and one to multiple sites. Conclusion: Palmer LibertinoJohn MarissaKent, and Drew HospitalLahey Burlington,& Center, Medical MA Presented By: Twenty carcinoma. cell renal T3c or T3b of diagnosis 222 examined in this cohort included rate of complications, tumor recurrence, intra-operative death rate, and 30-day mortality rate. Results: One-hundred eighty-two patients with stage T3b or T3c renal cell carcinoma met inclusion criteria with a median follow-up of 18.5 months. Of these, 124 (68%) were stage T3b and 58 (32%) were stage T3c. One-hundred and six (58%) patients experienced a complication from surgery. The intra-operative death rate was 1.1% (2 patients) and the 30- day mortality rate was 7.1% (13 patients). Seventy-one (39%) patients had disease recurrence at a median of 7 months (range 1-232 months). The 5-year disease-specific survival was 40% and the 5-year overall survival was 32%. Of the 21 risk factors analyzed; non-clear cell histology, positive lymph nodes, and perinephric fat involvement were all significantly associated with decreased overall survival at p < 0.05 using unadjusted modeling. On multivariable analysis, fully adjusting for all three significant variables, only positive lymph nodes and peri-nephric fat involvement remained significant. Conclusion: In patients with T3b or T3c renal cell carcinoma, lymph node positivity and peri-nephric fat involvement are associated with decreased overall survival. This shows that the tumor biology is the primary factor determining survival, not the extent of the tumor thrombus.

Poster #112 RENAL CELL CARCINOMA WITH AND WITHOUT END STAGE RENAL DISEASE: A SURVIVAL ANALYSIS AT A SINGLE RURAL MEDICAL CENTER Matthew Gay¹, David Barham¹, Stephen Bracewell², Jonathan Taylor³ and Swapnil Kachare4 ¹Brody School of Medicine, East Carolina University, Greenville, NC; ²Department of Urology, Thomas Jefferson University, Philadelphia, PA; ³Division of Urology, Department of Surgery, Brody School of Medicine, East Carolina University, Greenville, NC; 4Department of Surgery, Brody School of Medicine, East Carolina University, Greenville, NC Presented By: Matthew R. Gay, BS Introduction: End stage renal disease (ESRD) has been isolated as a risk factor for renal cell carcinoma (RCC), however the pathogenesis of RCC in ESRD remains unclear. Limited data exists comparing clinical outcomes among RCC patients with ESRD to the general population. The purpose of this study was to compare clinical and overall survival differences in RCC patients with and without ESRD in a rural population in the southeastern United States. Methods: All patients who underwent nephrectomy for RCC at Vidant Medical Center from 2003-2013 were identified. Patient characteristics, tumor related factors and survival data were obtained. Student’s t-test and Chi-squared analysis was used for comparative analysis. Univariate and multivariate survival analyses were performed. Results: A total of 386 patients were identified and divided into those with ESRD (n=45) and those without ESRD (n=341). The mean age of patients with ESRD (56.3 ± 10.6) was significantly younger than patients without ESRD (60.2 ± 11.0), p=0.02. ESRD patients were more likely to be African American (80% vs. 32.6%, p<0.001). ESRD patients were more likely to have papillary RCC tumors (42.2% vs. 15.5%, p<0.0001), bilateral disease (22.2% vs. 5.0%, p=0.0003), and smaller tumors (3.22 vs. 5.63cm, p<0.0001). There was a greater representation of T1 disease in the ESRD population, p<0.0001. There was no significant difference in tumor grade or multifocal disease. Patients with papillary RCC tumors had a greater 5-year overall survival (88.7%) as compared to patients with clear cell RCC (76.8%) and other RCC (66.3%), p=0.0003. Patients with T1 tumors (84.5%) had the greatest survival, p<0.001. There was no statistical difference in 5-year overall survival in ESRD vs. non-ESRD population. In multivariate analysis, ESRD was independently associated with increased overall mortality. Conclusion: ESRD patients had an increased likelihood of having smaller, papillary tumors. However, the decreased overall survival is likely related to shorter life expectancy in patients with ESRD.

224 POSTERS - - 1 1 - - PD free - -

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1) have1) shown efficacy inadvanced renal - - - freeKaplan survival using the evaluated was - 225 ya Patil¹,Adebooye Gabriel Osunkoya³, ya Sica², ry tumorry PD

1 was performed on tumor specimens performed1 was on tumor using anti - 1 expression and its prognostic value inpatients with - 1 positivity correlate stage and FNG. not TNM does with -

1 EXPRESSION IN LOCALIZED CLEAR CELL RENAL RENAL CELL CLEAR LOCALIZED IN EXPRESSION 1 -

nt nt advancements inmedical therapies, immune checkpoint nt methodologyfor nt PD

1 positivity, stage TNM and FNG (chi - e tumor PD Emory UniversityEmory School Medicine, of Department Dermatology, of

e and stage the are most important prognosticators of disease up were queriedup were from nephrectomy our database. Tissue blo - free survival inpatients renal with cellWith carcinoma. the wide With rece three patients included were inthe study. The distribution of PD - - Kae Jack Tay, MBBS, Jack Tay, Kae MMed(Surg) RishiSekar, BA Grad and Viraj Master¹

Our data that show prima 4

1 positivity does not have a significanthave 1 positivity does not impact and recurrence on overall

- 4 >1% expressiongraded and in10% increments. The relationship PDbetween Patients that underwent nephrectomy for localized clear cell (T1 RCC Fifty Medicine, Department Pathology,Medicine, of Department Urology, of Atlanta VA Medical

sectional imaging, the majority of renal masses are now diagnosedmassessectional incidentally.majority now are renalthe of imaging, - 1 positivity on overall and recurrence - ir method. Center, Atlanta, GA; GA; Atlanta, Center, ¹Emory UniversitySchool Medicine, Atlanta,of Department Urology, of GA; ²Emory UniversityPathology, School Medicine, of Department Atlanta, of University GA; ³Emory School of CELL CARCINOMA RishiSekar¹,Michelle DiMarco², Dattatra Pollack Brian Poster #113 OF PD VALUE PROGNOSTIC Poster #11 Polascik Thomas and Efrat Tsivian Tsivian, Jack Tay, Kae Matvey Duke University, NC Durham, Presented By: BODY MASS INDEX PREDICTS PATHOLOGICALLY FAVORABLE RENAL CELL CELL RENAL FAVORABLE PATHOLOGICALLY PREDICTS INDEX MASS BODY CARCINOMA IN RENAL CELL CT1 CARCINOMA Introduction: AtlantaAtlanta, GA Center, VA Medical Presented By: Introduction: cell carcinoma (RCC). However, the utility of tumor PD inhibitors targeting programmedcell death 1 (PD and recurrence this evaluat study, we of cross >4 years of follow localized clear cell RCC. cell clear localized RCC. Methods: tumor and adjacent renal parenchyma benign selected were for analysis. Immunohistochemical staining for PD 1 clone NAT105 (Abcam). Focusing on immune cellexpression, PD defined as positivity, stage wasTNM Pearson’s evaluatedchi and FNG, using of PD Me Results: expression in 10% increments can be seen in Table 1. No statistically significant correlation correlation significant statistically 1. No Table in seen be can increments 10% in expression foundwas between PD respectively). statistically No significant differences inoverall recurrence or survival. Using a differe previous studies, suggesting that further researchPD of into the role Further,PD with clearwith thatPD cell RCC, but methodscase/tissue ofas block as well PD selection and were foundwere between positive and negative PD p=0.43, respectively). Conclusion: 224 Several patient characteristics have been correlated with adverse pathological features and increased risk of recurrence in renal cell carcinoma (RCC). We aim to investigate the associations between body mass index (BMI) and adverse pathological features in solid cT1 renal masses. Methods: We evaluated all patients with a sporadic solid cT1 renal mass from the Duke Renal Cancer Database who underwent resection (radical or partial nephrectomy) between 2000 and 2011. All resections were performed at the Duke University Medical Center with central pathological review by a team of dedicated genitourinary pathologists. The main outcome measure was adverse pathology, defined as any combination of Fuhrman grade 3-4, extracapsular extension, fat or vascular invasion. Multivariable regression models were used to assess the associations between BMI and adverse pathology while adjusting for tumor size, age, gender and race. Results: A total 731 patients were identified. Seven patients with non-RCC malignancies were excluded from further analysis. The mean age was 59.6 years ± 11.9, mean BMI 30.4 ± 6.5 and mean radiological tumor size 3.6 cm ± 1.5. A total of 608 lesions were proven to be RCC and 116 benign. On multivariable analyses, BMI was not associated with malignant histology. Among those with RCC, 143 had adverse pathology. At multivariate analysis, lower BMI (OR 0.96), larger radiological diameter (OR 1.59) and male gender (OR 1.56) predicted adverse pathology. Conclusion: Our data support the practice of deferred intervention in patients with smaller renal tumors. Obesity does not appear to be a contraindication to active surveillance in small renal masses.

Poster #115 INTERMEDIATE-TERM FOLLOW UP COMPARISON OF RENAL FUNCTION AND SURVIVAL IN ELDERLY PATIENTS UNDERGOING RADICAL NEPHRECTOMY Charles Peyton, Matthew Heavner, Michael Rothberg and Ashok Hemal Wake Forest Baptist Medical Center, Winston Salem, NC Presented By: Charles C. Peyton, MD Introduction: To evaluate the patient characteristic, changes in renal function and overall survival of elderly patients undergoing radical nephrectomy with intermediate-term follow up. Methods: We reviewed our database of 332 patients undergoing radical nephrectomy from January 2008 through July 2012. Patients were divided into elderly (n = 96) or non-elderly (n = 236), defined as ≥ 70 or < 70 years old at the time of nephrectomy. The two groups were compared for perioperative characteristics, renal functional outcomes and overall survival. Standard student t-test were used for continuous variables and Fischer-exact tests for categorical comparisons. Kaplan-Meier estimates models for survival were compared using log-rank tests. Results: Elderly patients were more likely to have hypertension (81 vs. 72%, p = 0.019) and hyperlipidemia (57 vs. 39%, p = 0.003). Preoperative estimated GFR based on MDRD

226 POSTERS re 53

d for vs.

ration (FNA). Spiess

72, p =0.01, . vs.

53 mL/min/1.73m2, p

77). The median size of - vs.

term follow up.However, the - Poch and PhilippePoch E and Bx) or fine or Bx) needleaspi

- .

5.5cm). of size contralateral Median the -

Shoshtari, Pranav Sharma, Scott M. - 227 We sought to assess the natural history and

h bilateral renal Patient characteristicsoncocytoma.

Sexton, A Michael

, ) of) the contralateralmass afterPN followed by active 6cm). 4 patients6cm). bilateral underwent staged PN and one patient - Leone, MD 8

. Powsang, Wade J Bx/FNA (5/5

guided percutaneous core biopsy (CT - . - Andrew R Andrew Renal oncocytomas benign are yet radiologically are indistinguishable from have significantlyhave diminished dischargeGFR at (43 Elderly patients radical undergo who nephrectomy to tended worse have

thecohort younger and quite similar to discharge results (42

IRB approved renal mass 2005 and renal IRB approved reviewe 2013 was database between 12 patients identified wit 12 were vs.

to favor the younger cohort, but this was not significantcohort,test,favor thisto the not p = but 0.079). (log was younger rank s 445 days.most significantly GFR recentfollow on up was diminished inelderly Introduction: malignant small renal masses (SRMs). management of patients pathologically with bilateral proven (synchronous) oncocytoma after undergoing initial partial nephrectomy (PN). Methods: Presented By: patients bilateral with oncocytomas. All patients either underwent robotic/laparoscopic or open partial nephrectomy two by surgeons. Final pathology determined was surgical by CT or excision Moffitt Center,Tampa Cancer tumor(s)cm 2.15 (0. was Patienttumor demographics, characteristics (pathologic data, location, size) type of surgery, pre/post eGFR surgical and complications recorded. were Follow up was determined surgeons’per discretion. Results: listedare Tableat in1. the age Median 68 (46 time surgery of was the primary (0.4 tumor(s) 2.1cm resected was underwent simultaneous partial bilateral nephrectomy (horseshoe kidney). 2 patients underwent RFAbiopsythethe at time of contralateral of mass afterPN. 7 patients underwent CT surveillance. One intraoperative complication reported was with thermal injury to the proximal ureter requiring pyleoplasty. Thereno biopsy/FNA were related complications. No equation was significantly lower in elderly patients (median 61 (median patients elderly in lower significantly was equation respectively). no differentgroups.stagesize was theTumor between and Elderly patients notedwere to BILATERAL BENIGN RENAL ONCOCYTOMAS AND ROLE OF RENAL BIOPSY: BIOPSY: RENAL OF ROLE AND ONCOCYTOMAS RENAL BENIGN BILATERAL SINGLE INSTUTION REVIEW Poster #116 Leone, Diorio, Gregory Andrew Zargar Kamran Gilbert, Julio M Julio Gilbert, =0.025). atHowever, discharge there no differencewas inrisk acute of kidney injury as defined> 25% by change in followGFR. Median up for most recentrenal function testing wa patients mL/min/1.73m2,= p 0.035). survival Overall curvesdid not define mediansurvival and tended Conclusion: renal functional outcomes at and discharge at intermediate did not appear to be a difference in overall difference survival.in didtonot be a appear 226 patients required repeat intervention for suspected malignancy with a mean follow up of 34 months. There was no significant change in delta median creatinine. One patient was lost to follow up and one patient died of unknown causes 5 years post operatively. Conclusion: Patients with bilateral renal masses and pathologically proven renal oncocytoma can be safely managed with observation after biopsy confirmation of the contralateral mass. Patients should undergo imaging surveillance as further research is needed to determine the probability of malignancy in this rare patient population.

Poster #117 TRENDS IN DIAGNOSIS, MANAGEMENT, AND OVERALL SURVIVAL OF RENAL CELL CARCINOMA: ANALYSIS OF THE NATIONAL CANCER DATA BASE Jason Lomboy¹, Allison Deal², Angela Smith¹, Michael Woods¹, Eric Wallen¹, Matthew Nielsen¹ and Mathew Raynor¹ ¹The University of North Carolina School of Medicine Chapel Hill, NC; ²The University of North Carolina Lineberger Comprehensive Cancer Center Chapel Hill, NC Presented By: Jason R. Lomboy, MD Introduction: The incidence of renal cell carcinoma continues to rise. Prior studies have demonstrated a significant stage migration in RCC with an increasing proportion of small renal masses being diagnosed. The objective of the current study was to investigate recent trends in diagnosis and management of RCC nationwide. Methods: We utilized the National Cancer Data Base, representing approximately 70% of all newly diagnosed cancers nationwide. We identified all patients greater than 18 years of age diagnosed with renal cell carcinoma between 1998 and 2012. Trends in stage at diagnosis, treatment interventions (none, ablation, surgery), and overall survival were analyzed. Results: Between 1998 and 2012, the proportion of stage I tumors at diagnosis has continued to increase, representing nearly two-thirds of all diagnoses of RCC in recent years. Subsequently, the proportion of advanced stage RCC has decreased over this time period. When evaluated by age group, similar trends in stage distribution and migration were found. Between 2009 and 2012, no significant difference in stage distribution was found. Additionally, mean age at diagnosis has decreased over time (61.9 years in 1998, 60.9 years in 2012), driven largely by the younger age at diagnosis of stage I tumors. With the increase in proportion of stage I tumors at diagnosis, there has been interval increase in utilization of nephron sparing surgery and decreasing use of radical nephrectomy across all age groups. Statistically significant improvements in overall survival were seen across most

228 POSTERS

ative time or

1B TUMORS

invasive surgery at renal a tertiary -

229 dvanced more is stage likely RCC a reflection of

oneal group, 12 had a BMI<30 (low BMI [LBMI]) and 14 test forcontinuouscategorical for and X2 variables and - ere were no significant were ere in differencesbaseline factors with OBESE PATIENTS OBESE - es obesity as BMI≥30 with more than 1/3 of the current U.S. operative outcomes:EBL, operative time, size tumor and -

on that examines perioperative outcomes in laparoscopicpure ization has significantlyization time. has increased been an There over has

the LBMI and HBMI cohorts. The only in conversionsthe were

Hagop Hagop Sarkissian, MD The CDC defin There continues be significantmigrationto increasing an stage with

analyzed peri analyzed Laparoscopic retroperitoneal radicalpotential nephrectomy has advantages in

cutive patients underwent minimally who A retrospective analysis of a prospectively collectedsingle institution database of

Of the 26 inthe retroperit

262 conse academic referral center between August 2009 and June A 2015. total of 26 patients underwent retroperitoneal and 37 tumors. We transperitoneal laparoscopic nephrectomy with ≥T1b mediansinterquartile outliers. EBL due to for with ranges Results: complications, usingt the paired Introduction: population fitting that description. demonstrated Although studies previous have the feasibility of transperitoneal laparoscopic nephrectomy inobese sought patients, we to provide novel informati retroperitoneal and transperitoneal nephrectomy oflarger tumorsin (≥T1b) obese patients. Methods: Conclusion: stages and age groups.stages and age meansizetumor in cohort based each operative on BMI. Mean times similar within were the retroperitoneal and transperitoneal groups respectively. Complications EBL and were not different between with with a BMI≥30 (high BMI [HMBI]). Of the 37 in the transperitoneal group 24 had a BMI<30 and 13 with a BMI≥30 . th note, 2. Of Table in outcomes Demographic data are presented in Table 1 and perioperative COMPARISON OF PERIOPERATIVE OUTCOMES OF PURE LAPAROSCOPIC LAPAROSCOPIC PURE OF OUTCOMES PERIOPERATIVE OF COMPARISON RETROPERITONEAL TRANSPERITONEALAND NEPHRECTOMY IN =T Poster #118 BETWEEN NON OBESE AND Sarkissian,Savage Hagop S. Stephen J. Harry Prasad, Sandip and Clarke Department Urology, of South University Medical Carolina, Charleston, of SC Presented By: proportion of stage I tumors diagnosed over time with a decrease in the overall age at theproportion overall intumorsstage age at timeI of diagnosed a decrease over with diagnosis. The decreased of proportion a of significantin increaseoverall number early stagesignificantI of diagnoses. The RCC stagemigration mitigated has the latter over 4 years. In line current recommendations, with partial nephrectomy util increase in overallsurvival acrossmost stages and groups.age

retroperitoneal LBMI group. a previously operated field and amongst patients. obese difference No inoper Conclusion: complications noted, was which may be a function of the reproducibility of the operative approach and anatomy. Given increasing obesity, retroperitoneal rates of laparoscopic 228 nephrectomy is a safe, cost effective and attractive approach with larger renal tumors. Thus it may be safely utilized along with its counterpart, the transperitoneal approach.

Poster #119 ESTIMATION AND ANALYSIS OF UNNECESSARILY EARLY PROCEDURES IN INFANTS YOUNGER THAN SIX MONTHS OF AGE IN THE UNITED STATES Brian J. Young¹, Lisa M. Einhorn², Jonathan C. Routh¹ and Nathaniel H. Greene² ¹Duke University Medical Center, Division of Urology, Durham, NC; ²Duke University Medical Center, Division of Pediatric Anesthesia, Durham, NC Presented By: Brian J. Young, MD Introduction: In 2007, the United States Food and Drug Administration Anesthetic and Life Support Drugs Advisory Committee released a recommendation that elective procedures in infants be delayed until 6 months of age for concerns of neurotoxicity. Since then, there have been no reports in the medical literature examining how often elective procedures are performed in infants less than 6 months old in the U.S. This study uses publicly available data to estimate the number of elective procedures still occurring in this population. Methods: The State Ambulatory Surgery Database (SASD) of the Healthcare Cost and Utilization Project (HCUP), sponsored by the Agency for Healthcare Research and Quality (AHRQ), provides data for a given state on all ambulatory procedures performed in a given year. All patients less than 6 months of age who had a primary surgical Current Procedural Terminology (CPT) code associated with an ambulatory encounter were identified in the states of California (CA), North Carolina (NC), New York (NY), and Utah (UT) from 2007- 2010. CPT codes that represented elective procedures that could reasonably be postponed until 6 months of age (hernia repairs, skin cosmetic procedures, and hypospadias repair) were identified. Using population estimates from the Centers for Disease Control Wide- ranging Online Data for Epidemiologic Research (WONDER) database, rates of early procedures were estimated for each state and extrapolated for the entire United States. ANOVA was used to detect a significant difference between reported rates. A multivariable logistic regression model was used to estimate the impact of insurance status and state on the probability that the procedure was unnecessarily early. Results: The rates of elective procedures performed before 6 months of age in CA, NC, NY, and UT were 3.3, 25.1, 13.4, and 15.2 per 10,000 person years (p<0.001), respectively. Using all medical procedures in infants less than 6 months of age as a denominator, the proportions in CA, NC, NY, and UT were 27%, 29%, 41%, and 29%,

230 POSTERS

estimate of -

y early (OR based tumor based tumor - D STATES D 2010; the total =0.003) ER and

2010 trend analysis - ical procedures still are CM CM codes to identify SB -

9 -

da (SB) are survivingda (SB) are beyond gic Surgery, Nashville,gic TN; Clark², Michael Cookson³, Clark², S. Duke Michael

231 2010 Nationwide Emergency Department Sample unts for neitherunts outpatientmanagement SB (such as

cation typically incorporates digital rectal exam (DRE) Hsiao S. Wang,Wiener John and Jonathan Tejwani, Rohit C. S. S. Hsiao - alyzed thealyzed 2006 SD) of 29.2 and (±1.2) 28.4 (±1.2) years respectively. Most patients had Risk stratificationRisk formsthemultiple basis of cancer prostate quality Brian J. Young, J.Brian MD Justin MD Gregg, An increasing of children number spina with bifi

Based inpatientfrom on dataER sources, and theSB economic impact of

A substantial number of likely unnecessarily early surg

We an e difficult to obtainfrom We electronictherefore notes. aimed to investigate the

In total, 37,584 inpatient admissions (33.5%males) identified were from NIS and

Vanderbilt University Center, Medical Surgery, Department Urologic Nashville, of TN; infancy as a resultmodernof advances medical insurgical and care. little However, data exists regarding the economic implicationsmodern of SBWe care. examined thecharge data provide nationwide estimates. to Methods: We(NEDS)ICD and Nationwide Inpatient Sample (NIS). used Introduction: patients.We abstracted demographic and charge data. estimated The charges were by imputation. multiple Results: BrianYoung, Hsin J. Routh Duke University Medical DivisionCenter, Urology, NC of Durham, Presented By: 49,200 ER encounters(27.1% males) from NEDS, 17,699 (36.0%) of whom were subsequently 66.5%,majority admitted. adults of The 72.9%) NEDS (NIS patients were meanwith age (± publicmost theNEDScommonwas insurance the 65.9%), NIS ( 64.3%, South and geographic 36.6%). region NEDS 39.5%, (NIS respectively (p<0.001). Private insurancewas a risk factor for an early procedure (OR 1.16, tocompared 95% [1.10,procedurea public CI in 1.24]) insurance. was when NC Having associated an increased with probability of procedure a being unnecessaril 1.10, 95% CI [1.02, 1.19]) as as well inNY 2.02, (OR 95% CI [1.86, 2.19]). Based on this electivedata,thethe procedures early States estimatedin United of is 7,712. number Conclusion: medianThecharge captured in admission per $24,684 NIS was by estimated inpatientcharges $1.670 were billion/year. ER charges Mean captured NEDS by were $1,555/encounter for a total of $120 million/year. A 2006 ESTIMATINGTHE BIFIDA ECONOMIC OFIMPACT SPINA IN THE UNITE performedininfants less months than ofstatus 6 Insurance may age. and geography be independent predictorssurgery unnecessarily being of performed. early Poster #120 demonstrated an increasingcharge inpatient per admission (RR=1.05, p visit (RR=1.09, p<0.001). Conclusion: atwas least billion $1.79 2010 alone. in This figuresignificant is likely a under Introduction: the true economic burden, it as acco outpatient visits,surgeries)medications,societal and costs. nor Herrell²,Resnick²,Smith² DavidPenson², Barocas² Joseph Daniel and Matthew ¹ ²Vanderbilt University Center, Medical Department Urolo of OK City, Oklahoma Urology, of Department Medicine, of College Oklahoma of ³University Presented By: Justin MaximilianPeterGregg¹, Sam Chang², Lang², DETERMINING PROSTATE CANCER RISK STRATA USING ONLY GLEASON SCORE SCORE GLEASON ONLY USING STRATA RISK CANCER PROSTATE DETERMINING AND PSA stratifi Risk indicators. Poster #121 stage,PSA.score,Whilestrataenable Gleason automated and these would extraction of more efficientcalculationmeasurement, patient facilitate of groups risk and DRE quality ar findings predictive accuracy of Gleasonscore and PSA, alone, at stratifying prostate cancer risk comparedwhen to completeclinical data populatedmanually a prospective in clinical 230 database. Methods: Patients who underwent radical prostatectomy between 2010 and 2015 were eligible for inclusion in the current study. Preoperative clinical T stage, Gleason score, and PSA were prospectively gathered in an electronic database and served as the reference for risk stratification. Patients were then placed into low, intermediate and high risk groups based on D’Amico risk criteria and modified criteria, which assumed that all tumor staging was cT1c. Accuracy of modified risk criteria was compared to the prospective reference using the weighted Kappa statistic (Κ). Results: Of the 2,353 eligible patients, 2,344 (99.6%) had complete data available for analysis. 925 (39.5%), 1,016 (43.3) and 403 (17.2) patients had low, intermediate and high risk disease based on D’Amico risk criteria. Modified risk criteria had a 98.0% raw agreement with risk stratification (Κ=0.95, SE = 0.02) (Table). Modified risk criteria had 100%, 95.7% and 90.6% agreement with true risk stratification of low, intermediate and high risk disease, respectively. Conclusion: The combination of Gleason score and PSA value provides an accurate risk assessment of patients with prostate cancer. Validation of these findings would enable providers and organizations to easily extract risk stratification data from raw medical records, enabling streamlined measurement of quality indicators and performance feedback.

Poster #122 EVALUATING THE TIMING OF SURGICAL COMPLICATIONS FOLLOWING CYSTECTOMY Troy Sukhu, Jason Lomboy, Matthew Macey, Allison Deal, Eric Wallen, Michael Woods, Raj Pruthi, Matthew Nielsen and Angela Smith Chapel Hill, NC Presented By: Troy Anthony Sukhu, MD Introduction: While complication rates following cystectomy are well described, the timing with which each occurs is unclear. Our objective was to evaluate the median time-to-event for common 30-day postoperative complications following cystectomy to better define early and late complications. Methods: Using the American College of Surgeons-National Surgical Quality Improvement Program (NSQIP) database, we performed a retrospective review of patients undergoing cystectomy from 2005-2013. NSQIP collects prospective data on >135 variables, including perioperative data, 30-day post-operative complications and mortality on surgical procedures at over 450 participating academic and private institutions. We investigated 19 common complications occurring after cystectomy and assessed days from operation to complication to better define early complications (those occurring during the first half of 30 days) and late complications (those occurring during the latter half). Results: Overall, 4,121 patients underwent cystectomy with 70% undergoing an incontinent diversion, 16% continent diversion, and 15% unspecified. 56.7% of patients experienced a complication within 30 days, with 22% of patients experiencing two or more complications. Of patients who had at least 1 complication, most (91%) had their first within 15 days. Complications such as infection (wound, urinary, sepsis) were most likely to occur between 10-14 days post-procedure. Similarly, postoperative DVT and embolism were likely to occur between 13-14 days post-procedure. Cardiovascular, pulmonary, and neurologic complications occurred a median of 3-8 days following cystectomy. The table below reveals that most complications occur early, although when wound or thrombosis-

232 POSTERS

- health Charlson Charlson ccur within the surgery. -

discharge services. - an ileal conduit an ileal (OR

orm quality improvement

discharge services (OR =0.9, CI: - 1.1, p<0.001) and higher1.1, p<0.001) – Medicine and PublicMedicine Nashville, and Health, operative period. -

233 discharge servicesdischarge after RC. - 1.2, p<0.05) associated were thewith use of post –

up. day complicationsday following cystectomy o - - discharge services than patients with - related complicationsseveralrelated occur weeks later. Knowledge -

discharge servicesmultivariatedischarge (55.6% vs. p<0.05). 45.6%, On analysis, - Health literacyHealththe ability is tocomprehend and actmedical obtain, on Stephen Kappa,F. MD, MBA

The majority of 30 The

disposition (home, homecare, health skilled nursing facility, other or Since November 2010, all patients admittedto Vanderbilt University Medical More thanMore half all of patients undergoing required RC post

¹, Peter E. Clark¹, David F. Penson¹, Matthew J. Resnick¹, DanielF.Penson¹,PeterE. J. A. Clark¹, Barocas¹, Resnick¹, Matthew David ¹, re administeredre the validated Brief HealthWe Literacy Screen (BHLS). analyzed approved, prospectively managedapproved,identified prospectively database and 504 patients who - 1.0, p=0.09). Older age (OR =1.1,1.0, CI: 1.0 age (OR p=0.09). Older –

ikelyto utilize post Introduction: Methods: information, and is an independent predictor health of patients outcomes in chronic with Center a an IRB underwent and RC had available health literacy data. Patient characteristics as well as discharge rehabilitation recorded. resources)We were performed bivariateand logistic regression analysisclinical for adjusted characteristics and demographic to determine if health literacy associatedwas theof with utilization post health conditions. data There few regarding are health literacy and its relationshipto dischargeWe hypothesizedthatdisposition. needs discharge patient after radical cystectomy are (RC) affected health by literacy status, and that patients lower with literacy morelikely to home were care, utilize skilled health nursing facility, other or rehabilitation immediate post the in resources Results: 0.8 Compared patients to high with literacy, health health more patients lower with literacy were l health literacy not was associated the with use of post IMPACT OF HEALTH LITERACY ON DISCHARGE DISPOSITION FOLLOWING FOLLOWING DISPOSITION DISCHARGE ON LITERACY HEALTH OF IMPACT RADICAL CYSTECTOMY Poster #123 A.S.Scarpato¹,StephenKappa¹, Kristen Joseph Sam M. Chang¹, F. Goggins², Kathryn R. Smith, Jr. A. Kelvin Moses¹ and Kripalani² Sunil ¹Vanderbilt University Center, Medical Surgery, Department Urologic Nashville, of TN; ²Vanderbilt University Center, Medical Institutefor TN Presented By: dischargeservices, patients continent with while (neobladder, diversions Indiana pouch) lesswere to likely require post Comorbidity Index (OR =1.1, CI: 1.0 related spread out complications the post over were 30 days they occurred, Conclusion: measures for follow postoperative first 15 days, cardiovascular, with pulmonary, neurologic and complications occurring early and thrombosis while wound regarding timing postoperative complications of may better inf 232 0.4, CI: 0.2–0.8, p<0.01). Conclusion: Older age, comorbidities, and incontinent urinary diversions are associated with increased utilization of post-discharge services after RC. Lower health literacy may affect patient discharge disposition, but was not significant on multivariate analysis. This finding may reflect an unmet need for patients with lower health literacy given the complex self-care required of patients after cystectomy. Further studies are needed to determine the associations between health literacy, discharge disposition, and other surgical outcomes.

Poster #124 PERIOPERATIVE COMPLICATIONS AFTER MALE INCONTINENCE SURGERY: EFFECT OF LENGTH OF STAY ON OUTCOMES Allen Simms¹, Daniel Davenport¹, Sudhir Isharwal², Sara Johnson¹, Stephen Strup¹ and Shubham Gupta¹ ¹University of Kentucky, Lexington KY; ²University of Nebraska, Omaha Nebraska Presented By: Allen J. Simms, BS Introduction: To identify predictors of perioperative complications after the treatment of male urinary incontinence using a nationally validated outcomes-based program. Methods: This is an analysis of data prospectively obtained from multiple centers through the American College of Surgeons National Surgery Quality Improvement Program (ACS- NSQIP). Patients who underwent male urethral sling (CPT 53440) or artificial urinary sphincter (AUS- CPT 53445) placement from 2011 – 2013 were included. The primary outcome was a composite 30–day major morbidity measure that included unplanned readmission related to the procedure, unplanned return to the operating room related to the procedure, infection, treated deep venous thrombosis or pulmonary embolism, pneumonia, or acute renal failure. Chi-square, student’s t or analysis of variance tests were performed as appropriate. Forward stepwise multivariable logistic regression (p for entry < .05, for exit > .10) was performed to identify predictors of morbidity. Significance was set at p < 0.01 due to multiple comparisons. Results: 789 male patients underwent surgery during the study period: 370 slings, and 419 AUS. There were no perioperative deaths, and no cerebrovascular or cardiovascular complications occurred. The most common morbidities were related unplanned readmissions and related unplanned return to the operating room. Major morbidity was higher in AUS group than sling group (5.5% vs. 2.4%, p=.031). Patients who stayed overnight in the hospital did better than patients who were discharged the same day. After combining the procedures and adjusting for procedure type, overnight stay was associated with a decrease in major morbidity (odds ratio 0.40, 95% C.I. 0.17 to 0.94, p = .036). Conclusion: In this unique multicenter cohort of men who underwent incontinence surgery, major morbidity was infrequent, and was slightly higher after AUS placement as compared to sling placement. Patients who stayed overnight after surgery appeared to have fewer complications compared to patients discharged the day of surgery. Corroborative and cost effectiveness studies are needed to further illuminate this interesting finding.

234 POSTERS - level level -

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agnosiscodes 599.70,599.71, 599.72. or After 235 congruent evaluation of a patient presenting with level restricted were select to populations (e.g., - -

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DM di 1.29) and current smokers (50.9% - – 9 - 3.50) (Figure). Use of cystoscopy3.50) based (Figure). did vary on of not Use – 10.1 million) 10.1 resulting ina hematuria diagnosis (inabsence – third of patients diagnosed hematuria with urologistsby - 2010, 2012), identified we visits to urologiststhat resulted ina – t a population ere performedere to evaluate the available relationshipbetween patient Samuel AdamSamuel MD David, Ina diagnosis to order rule cancer,cystoscopy ofout bladder performance of

Despite guidelinesthecystoscopy emphasizing importance in workup of the

a, just one over Using the Center for Disease and Preventionfor the Control NationalAmbulatory Center Using

eligible patients) or individual institutions. We population a institutions. used individual or patients) eligible Among million an estimated 121 patient visits to urologists, identified we >8.6 -

ts with hematuria in the United States. thets hematuria with United in rs, OR 2.00, 95% CI 1.15 2.00, CI 95% rs, OR

Methods: Medical Survey Care (2006 hematuria.studies Prior a Medicare Presented By: Introduction: survey to evaluate factors use associated with cystoscopy of patients among presenting to urologis is integral an componentof guideline any hematuriadiagnosis, on ICD based Emory University School Medicine, of At Poster #125 WITH PRESENTING PATIENTS FOR CYSTOSCOPY OF USE UROLOGIST HEMATURIA SamuelPatil, Datta Alemozaffar, David, Mehrdad Christopher Viraj Muta Issa, Master and Filson excluding visits a urinary tractwith infection generated diagnosis, (UTI) we population

visits. Use of cystoscopy was morevisits. commoncystoscopy among (odds older Use was patients ratio of 1.15 (OR) 10 yearsper of 1.03 age, CI 95% of UTI). performed Cystoscopy was after ordered or 35.9%CI (95% 31.6 million encounters (95% CI 7.2 estimatescystoscopy of useacrossthe United States. Bivariate statisticsmultivariable and w logistic regression (e.g.,sex, tobacco age, use), (e.g.,specialty, provider type of degree), and practice setting factorscystoscopy. region) (e.g., and use considered of reliable Results were if on based ≥30 observationsraw if or standard errors< were 30% of point estimates. Results: smoke Conclusion: of hematuri patient (39.9% 0.89 male,femalesex CI vs. OR 1.40, 33.4% 95% undergo thisundergo procedure. Although increaseduse of cystoscopysmokers for and older patients is encouraging,should increasingfocus efforts contemporary to on adherence guidelines 234 Poster #126 DISCREPANT INCREASE IN RADICAL CYSTECTOMIES FAVORING ACADEMIC VS. COMMUNITY HOSPITALS SINCE THE IMPLEMENTATION OF THE ACGME 80-HOUR WORK RESTRICTION Brian J. Young, Daniel F. Zapata, Hsin-Hsiao S. Wang, Jonathan C. Routh and Edward N. Rampersaud Duke University Medical Center, Division of Urology, Durham, NC Presented By: Brian J. Young, MD Introduction: Radical cystectomy (RC) to treat invasive bladder cancer is a complex procedure associated with high rates of morbidity and mortality. Mortality rates are known to be inversely proportional to the number of cases performed annually by surgeons and hospitals. We questioned whether RC utilization rates in different hospital settings have changed since the introduction of the ACGME 80-hour work rule in 2003. Methods: We queried the 1998-2011 Nationwide Inpatient Sample (NIS) database for inpatient admissions for bladder cancer (ICD-9 code 188) and radical cystectomy (CPT 57.71) among adults (age>17 years). Our principal outcome was use of RC over time, particularly after 2003; our secondary outcomes were in-hospital mortality, length of stay (LOS), and hospital charges. As per NIS guidelines, the sample was weighted to provide a national estimate. Weighted multivariable regression models were used to correct for confounding. Results: We identified 1,093,522 bladder cancer admissions over the study period, of which 104,569 were for RC. Mean age was 73.7 years; 68.3% were white; 19.0% were privately insured. Overall, there was a significant increase in the use of RC over the study period with 6,668 (8.5%) in 1998 and 9,238 (11.1%) in 2011 (p=0.01). Among RC admissions, there was a decrease in in-hospital mortality (2.1% in 1998 and 1.5% in 2011, p=0.03) and increase in hospital charges ($45,035 in 1998 v. $114,838 in 2011, p<0.001) over the study period, even after adjusting for confounding. LOS was not significantly changed (8.4d in 1998 v. 8.3d in 2011, p=0.2). After stratifying RC admissions before and after year 2003 there was a 10 fold difference in the increase of RC utilization among teaching hospitals vs. non-teaching hospitals (61% vs. 6.3% increase respectively; p<0.001). Conclusion: Utilization of RC has significantly increased over time. While LOS and mortality have decreased over time, admissions still prove to be more expensive. After the 2003 implementation of ACGME 80-hour work week, RC utilization has increased at a 10- fold greater rate at teaching institutions. This phenomenon is likely multifactorial, however it warrants further investigation to discern whether training restrictions have had a significant impact on confidence or ability to perform complex operations in community settings.

Poster #127 PATIENTS =80 YEARS OF AGE UNDERGOING RADICAL CYSTECTOMY FOR T2 BLADDER UROTHELIAL CARCINOMA HAVE SIGNIFICANTLY IMPROVED OVERALL AND DISEASE SPECIFIC SURVIVAL OUTCOMES Leslie Peard¹, Zachary Klaassen², Rita P. Jen², John M. DiBianco², Lael Reinstatler², Jigarkumar R. Parikh², Durwood E. Neal, Jr², Martha K. Terris² and Rabii Madi² ¹Medical College of Georgia - Georgia Regents University, Augusta, GA; ²Medical College of Georgia - Georgia Regents University Cancer Center, Augusta, GA Presented By: Leslie Peard Introduction: Given the morbidity associated with radical cystectomy (RC), the ideal management of muscle invasive bladder cancer (MIBC) in elderly patients may be a less aggressive approach. Using a population-based cohort we compared treatment modalities of T2 bladder urothelial carcinoma and specific outcomes in this high-risk population. Methods: Patients ≥80 years of age diagnosed with AJCC stage T2 bladder urothelial carcinoma were identified in the SEER database (2004-2010; n=5,174). These patients were categorized as those that underwent RC, radiation, or supportive therapy. Supportive therapy was defined as individuals who did not undergo radiation or RC. Overall survival (OS) and disease specific survival (DSS) for each group were compared using log-rank test

236 POSTERS

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went RC, 1,217 patients RC, 1,217 thatwent (23.5%) – ng radiation or supportive therapy. ng radiation or The metastatic at disease diagnosis. Patients - grade diseasegrade 95%CI 1.29, (OR 1.07, 1.57; 001). Factors receipt001). with of associated RC 2, 95%CI 1.54 - specific comparedsurvival were (DSS) for - OR 0.82, 95%CI 0.79 237

grade diseasegrade (III - -

ive therapy (vs RC: HR 1.43, 95%CI 1.43,ive therapy HR 1.17 (vs RC: more than doublesurvival time compared to patients 2.33). older age (continuous Predictors were DSM of

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- term outcomes of patients UTUC location tumor by and identify - 1.71).Predictors older age (continuous of were OM -

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6.2%, p=0.03) compared to those renal with pelvis UTUC. Patients with metastatic at disease diagnosis usinglog - vs. nal pelvistumors.The purpose of thisstudy to was use a population The prognostic impact urothelial tract upper tumor of carcinoma (UTUC)

Ben Harper, BS Ben

Appropriatelyselected elderly patients T2 with bladder urothelial carcinoma

1.05), radiationRC: 1.8 HR (vs 74 (IQR 16) years, p=0.001),male (61.3

I: HR 1.62, 95%CI 1.12 95%CI 1.62, HR I: - Patients diagnosed with UTUC were identifiedPatients database were UTUC from diagnosedthe 2004 in SEER with There were 5,444 (61.8%)There were patients 3,361 renal (38.2%) with pelvis and with

There were 403 patients 403 thatThere were (7.8%) under metastatic morelikely at older be ureteral to (median diagnosis were UTUC 75 vs.

- vs.

ation. grade disease, had however - and Kaplan analysis.Meier Descriptive statisticsmultivariable and logistic regress models performed were to generate odds ratios to (OR) identify factors associated with receipt of ratios RC.Hazard for (HR) overall mortality and (OM) disease specificmortality calculated. were (DSM) Results: underwent radiation, and 3,554 patients had (68.7%) supportive who therapy. Patients who (p<0.001), younger underwent were RC married more often (p<0.001), and had high disease (p=0.001)those compared to undergoi medianforOS theand supportive RC, radiation therapy groups wasmonths, 21, 11 and 7 respectively (p<0.001). The median DSS for RC, radiation and supportive therapy groups months, respectively 12, (p<0. was 9 and 5 youngerwere age (>80 years, continuous (OR 1.31, 95%CI 1.00 95%CI 1.03 2.29; IV RC: 2.54, HR 95%CI 2.17 1.03,HR 1.02 95%CI analysis. Multivariablemodels perf logistic regression selection were backward with metastasisfactorsto distant for associated with generate ratios odds diagnosis. (OR) at Results: WORSE CLINICAL OUTCOMES COMPARED TO THE URETER: A POPULATION A URETER: THE TO COMPARED OUTCOMES CLINICAL WORSE BASED ANALYSIS BenjaminRoss Everett,P.John T. Harper, Klaassen, Jen, Yaguchi, Zachary Grace M. Rita DiBianco,K. Madi Terris and Rabii Martha Medical College Georgia of Presented By: UPPER TRACT UROTHELIALUPPER CARCINOMA TRACT LOCATED IN T Poster #128 Introduction: locationis defined, most well not studiessuggest however tumors ureteral inferior have outcomes to re Conclusion: Patientson age alone.shouldsignificantly treated be denied based not had RC RC with higher had supportivewho therapy. Furthermore, patients an adequate with support may group improvedhave outcomes compared to counterparts. unmarried 2011 (n=8,805). Descriptive statistics used to were compare demographic and clinicopathologic variables between patients non with UTUC. Overall disease survival and (OS) patients non with 3,124 (92.9%) that ureteral with UTUC had non non with no difference inOS (p=0.72), patients however renal with pelvis had UTUC worse DSS (p=0.01). Factors associated distantmetastasisfor with at renal diagnosispelvis UTUC included black race (vs OR white 1.74, 95%CI 1.14, 2.65; ureteral UTUC. Among these patients, 4,745 (87.2%) there were renal with pel (IQR 14) datasetcompare to long racewhite (7.7 (OR 1.42, 95%CI 1.25, 1.62; p<0.001). High demographicclinicopathologic and factors distant associated with metastasis at disease present Methods: ureteral UTUC morewere likelyto AJCC have Stage I disease and less likely to have StageIII (Stage I disease 236 p=0.009) was the only factor associated with distant metastasis at diagnosis for patients with ureteral UTUC. Conclusion: Contrary to previous studies, patients with non-metastatic UTUC at diagnosis have inferior DSS if the tumor is in the renal pelvis compared to the ureter, suggesting the renal pelvis may not be protective from aggressive tumor behavior. Furthermore, grade of disease is an independent factor associated with metastatic disease at diagnosis for both patients with renal pelvis and ureteral UTUC.

Poster #129 DIFFUSION OF ROBOTIC TECHNOLOGY INTO UROLOGIC PRACTICE HAS LED TO IMPROVED BASELINE RESIDENT PHYSICIAN ROBOTIC SKILLS IN THE SOUTHEASTERN SECTION OF THE AMERICAN UROLOGICAL ASSOCIATION (SESAUA) Eric Schommer¹, Vipul Patel², Vladimir Mouraviev², Colleen Thomas¹ and David Thiel¹ ¹Mayo Clinic Jacksonville, Jacksonville, FL; ²Global Robotics Institute, Celebration, FL Presented By: Eric A. Schommer, MD Introduction: We hypothesized that propagation of robotic technology into urologic practice and familiarity with robotic surgery has improved baseline resident trainee robotic skills. Methods: Resident trainees from 17 programs in the SESAUA participate in an annual 2- day robotic training course consisting of didactic lessons and console simulation training. Baseline resident trainee scores on the Mimic robotic simulator (Mimic Technologies, Inc. , Seattle, WA, USA) from 2012 were compared to 2015 scores on four standard Mimic exercises: Camera Targeting 2, Energy Dissection 1, Needle Targeting, and Peg Board 1. Wilcoxon rank sum tests were used to compare the four exercises between 2012 and 2015 trainees. Access to a robotic simulator and robotic console time during actual cases were also assessed in the 2015 group to see if they affected results. P-values of 0.05 or less were considered statistically significant. Results: 27 trainees in 2012 and 34 trainees in 2015 completed the exercises on the Mimic robotic simulator. Overall score, economy of motion score, and time to complete exercise were all significantly better in the 2015 trainee group compared to the 2012 trainee group (p<0.001) in the Peg Board 1, Camera Targeting 2, and Energy Dissection exercises. Overall scores for the Needle Targeting exercise were improved between 2015 and 2012 trainees (p = 0.04). Trainee access to a simulator was not associated with overall score on any of the 4 exercises in the 2015 group. In the 2015 group, actual robotic console time was associated with better overall scores in Camera Targeting 2 (p =0.02) and Peg Board 1 ( p = 0.04). Conclusion: Baseline resident trainee performance on basic robotic simulator exercises has improved over the last 3 years irrespective of robotic simulator access or console time.

Poster #130 CROWDSOURCING ASSESSMENT OF SURGEON DISSECTION OF RENAL ARTERY AND VEIN DURING ROBOTIC PARTIAL NEPHRECTOMY: A NOVEL APPROACH FOR QUANTITATIVE ASSESSMENT OF SURGICAL PERFORMANCE Mary Powers¹, Thomas Lendvay², Aaron Boonjindasup¹, Michael Pinsky¹, Philip Dorsey¹, Michael Maddox¹, Bryan Comstock², Li-Ming Su³, Matthew Gettman4, Chandru Sundaram5, Jason Lee6 and Benjamin Lee¹ ¹New Orleans, LA; ²Seattle, WA; ³Gainesville, FL; 4Rochester, MN; 5Indianapolis, IN; 6Toronto, Toronto, Canada Presented By: Mary K. Powers, MD Introduction: We sought to describe a methodology of crowdsourcing for obtaining quantitative performance ratings of surgeons performing renal artery and vein dissection of robotic partial nephrectomy (RPN). We sought to compare assessment of technical performance obtained from the crowd sourcers to those of surgical content experts (CE). Our hypothesis is that the crowd can score performances of renal hilar dissection

238 POSTERS - - - eri CE for

involved cases. -

10 11.3%), ASA score -

only and resident sident (P status <0.0001) and pre 7 88.7%, 8 - - level (R=0.82, p<0.001) surgeon and - . OR time Mean (ORT) less was for the 232 of 372 cases (62.4%). Preoperative

239

operative associationand their outcomes RARP of -

consistency across videos of CE GEARS ratings remained remained consistency ratings across videos of GEARS CE

- Schommer, MD

. ric A d with CEd with ratingsat both the video Weconclude that crowdsourced assessmentof quantitative performance E ved 548 GEARS 548 ved ratingscrowdworkers. from Even though CE exposed were This study examines peri

1 RARP was divided was into 7 steps:RARP (BTD), bladder takedown endopelvic fascia, A group of group attendingA resident and surgeons submitted robotic total (n=5) of a 14

Residents performed on the consolefor Within received13 days ratings we all on from videos 3 CE the and within 11.5 assessment question. adder neckadder seminal (BN), vesicle/vas sparing, deferens (sv/vas), and pedicle/nerve apex, test or Wilcoxon rank sum test.test or omparably to surgical CE using the omparablysurgical Evaluative Global Skills to using Assessment Robotic CE of - operative variables compared were surgeon between Introduction: residentwith trainee differentsteps involvement in RARP. of Methods: bl anastomosis. a single by 372 RARP performed surgeon fromJuly 2007 to February 2015 analyzed.were Residenttimesteps console recorded.keyP the was during of 7 each Poster #13 Thiel² David and Li² Zhou Tonkovich², Kolbi Schommer¹, Eric FL Jacksonville, Florida, Clinic ²Mayo FL; Jacksonville, Clinic Jacksonville, ¹Mayo Presented By: Vital outcomes trainee of performance compared on thesteps key using were sample two t Results: BMI (mean 28.4), PSA (mean 6.7), Gleason score (6 IMPACT OF RESIDENT TRAINEE INVOLVEMENT ON ROBOT ASSISTED RADICAL RADICAL ASSISTED ROBOT ON INVOLVEMENT TRAINEE RESIDENT OF IMPACT OUTCOMES (RARP) PROSTATECTOMY video clips of RPN during hilar. These videos ratedwere by both crowd and c (GEARS). Methods: technical skills GEARS.performance minimum using ACE and 30 Amazonof 3 MechanicalTurkcrowdworkersscale. evaluatedGEARS video the with each Results: hours receiwe to a training module, internal (mean 2.4), score AUA and SHIM (mean 8.9) similar score were (mean 15.9) between surgeon only and resident involved cases. re 2nd year operative associated (P=0.0093) PSA no resident > with 10 were console time. Estimated blood loss (P=0.09), transfusion (P=0.11), and complications (P=.33) nowere different surgeonbetween only and resident involved cases low (ICC=0.38).low Despite this, found we that GEARS crowdworker ratings of videos were correlate highly level (R=0.84, p<0.001). Similarly, ratings crowdworker of the renal artery dissection were highly correlated expert with assessmentsfor (R=0.83, p<0.001) the unique surgery specific specific Conclusions: Conclusions: ratingsmay be a suitablealternative to surgical experts ratings and would provide a rapid, skills. technical to triage solution scalable 238 surgeon only cases (190.4 vs. 206.4 min, P=0.003). There was no difference in positive margins (P=0.79), length of stay (LOS) (P=0.30), catheter days (P=0.17), readmission (P=0.33), reoperation (P=0.73), home with drain (P=0.88), or undetectable 6 month PSA (P=0.07) when comparing surgeon only to trainee cases. Residents performing BN step had no effect on BN margins (P=0.73), prolonged catheterization (P=0.62), home with drain (P=0.4121), or 6 month undetectable PSA (P=0.1070). ORT was not affected by resident performing anastomosis (P=0.08) or sv/vas (P=0.82), but was significantly prolonged if BTD performed by trainee (233.0 vs. 191.7min, P <0.0001). Residents performing anastomosis had no effect on prolonged catheter time (P=0.62), home with drain (P=0.41), or LOS (P=0.20). Residents were more likely to be involved in at least one portion of the case (74.0% vs. 56.6%, P=0.0012), in BN (63.4% vs. 30.6% P <0.0001), and anastomosis (48.0% vs. 15.3%, P <0.0001) following purchase of Mimic simulator (Mimic Technologies, Inc., Seattle, WA, USA) in January 2012. Conclusion: Supervised resident console involvement in RARP does not negatively affect peri-operative patient outcomes although it prolongs ORT compared to surgeon-only cases with the BTD step adding the most operative time. The acquisition of a robotic simulator appears to have increased trainee console exposure in various steps of RARP.

Poster #132 VASECTOMY SIMULATION TRAINER WITH ENHANCED FACE AND CONSTRUCT VALIDITY Ram Pathak, Dave Thiel, Monica Moore, Delaney La Rosa, Amy Lannen, Ryan Frank, Gregory Broderick and Todd Igel Mayo Clinic Jacksonville, Florida Presented By: Ram Pathak, MD Introduction: We assessed the face and construct validity of a newly created Vasectomy Simulation Module. Methods: All current resident physicians at our institution were asked to participate in the new vasectomy simulation module. The module consisted of a didactic power point presentation, an audio-visual component, and a hands-on vasectomy simulator. The module was completed in the presence of a single attending physician. Pre- and post- simulation surveys quantifying simulation effectiveness, impact on confidence level, and critiques of the overall design were obtained from each resident. Face and construct validity were ascertained via questionnaires and resident performance as graded by an attending physician in a blinded manner using video tape recordings and gloved hands Results obtained: A total of 8 residents were included in the analysis (2 Pre-urology, 2 Uro- 1, 2 Uro-2, and 2 Uro-3). All residents reported “agree” or “strongly agree” when asked if the model was effective for vasectomy training. Furthermore, simulation increased the confidence to perform a vasectomy independently on average of 1.58 points based on pre- and post-questionnaire analysis. (95% CI 1.09—2.89, p=0.02). Residents were then graded on a 20 objective checklist (with each objective scored as un-mastered, partially mastered, or completely mastered) and overall Likert score by a single attending physician in a blinded fashion. Training year has a significantly positive association (overall p-value<0.01) with number of objectives completed and scores. In comparison to pre-Urology residents, Uro-3s had on average 13.5 (95% CI 8.3—18.6, p-value=<0.01) more scores of “completely mastered”. In comparison to Uro-1s, Uro-3s had on average 13.0 (95% CI 7.8—18.2, p-value=<0.01) more scores of “completely mastered”. Finally, in comparison to Uro-2s, Uro-3s had an average 6.0 (95% CI 0.8—11.2, p-value=0.02) more scores of “completely mastered”. When examining year as a predictor of Likert score using linear regression, year has a significantly positive association with Likert score (overall p- value<0.01). In comparison to Pre-urology residents, Uro-1s had a mean Likert score of 0.5 higher (95% CI -0.7—1.7, p-value=0.041), Uro-2s had a mean Likert score of 2.0 higher (95% CI 0.8—3.2, p-value<0.01), and Uro-3s had a mean Likert score of 3.5 higher (95% CI 2.3—4.7, p-value<0.01). Conclusion: Our enhanced vasectomy simulation module demonstrated excellent face and construct validity.

240 POSTERS - - -

to - ions ions in daily in daily

implementation implementation

time. Pre and posttime.Pre and -

241 numbers. Withnumbers. increasing restrictions regarding

cey, Troy A. Sukhu, AnnaMarie Connolly, Eric M. Wallencey,A. AnnaMarie Sukhu, EricConnolly, Troy M. stage urology residents’ of perception learning needs surgical steps immediately following urologic procedures. -

undation for Exxcellence in Women’s IncExxcellenceundationfor Care in Health cal NC Durham, Center, monththe feedback gradually program period, introducedwas the into - s are included in theincluded Milestones. Urology sin ACGME In are addition expert to individual key steps and overall procedure ability level. Next, faculty a 6

Acquisitionsurgicalof skills for specific has traditionally procedures been Jason R. Lomboy, MD Lomboy, Jason R. Anika J. Ackerman, MD The endoscopicmanagement urologic of disease medical iscore knowledge

Usesurgical of a skills tool feedback facilitatesmore timely objective and

on, both residents and faculty bothon, residents and reported their discussions using informal as

knowledge and skillsknowledge endourology isfor lacking. The objectivestudy the of was of surgicalof training feedback. 89% of residents reported a better appreciation for We junior anonymously urology surveyed residents their regarding percept In collaboration the with OB/GYN Department,skills a surgical tool modified was

Over

k. A commonly noted limitation of the program both by residents and faculty ical feedbackresident importantto development only 46%with reporting being to outlinekey the steps of 19 urologic procedures. Postoperatively, completed learners self of assessments performed a similarperformed a the review with resident inreal Introduction: trainingmandates and ACGME documentto clinical competency, better definedmethods for evaluatingWe surgicalskills necessary. are structured evaluated program a face of measured repetition by case log and facefeedback performance of on Methods: used evaluatesurveys efficacy, to the were satisfactionthe utility and tool. of Results: Poster #133 EDUCATIONUSE TOOLOFFACILITATE TO IMMEDIATEAN DIRECTEDAND SURGICAL SKILLS IN FEEDBACK UROLOGY Presented By: Jason R. R. Matthew Ma Lomboy, and Davis P. Viprakasit Chapel Hill, NC FUNDAMENTALS OFENDOUROLOGY: THE RESIDENTPERSPECTIVE implementation, residents facultyboth and noted improvements the in frequency, quality and timing Conclusion: ing oflearn specific steps withinurologic procedures. Residents reported increased satisfaction surgical with feedback received, ability to structure preparation, and comfort approachingwith faculty. efforts Continued to improve of incorporation tool the with constraintsworkflow paramount are to improve utilization. Further application determine will the usesurgicalfor the augmenting of program skill development in urology and to potentiallyskillsmeans of assessment.serve a as Sponsored Fo The by Poster #134 AnikaMichael Ackerman, Preminger, MelissaGlenn Tony Mendez, T Lipkin, Chen, Charles ScalesFerrandino Michael and Duke University Medi their currentown surgical abilities and an improved means structure to theircase preparation.notedcomfort 78% a greater residentsfor faculty approaching of with feedbac routine clinical rotation for procedures.of increasing types of total 57 procedures A were evaluatedparticipation with 100% of by residents of and 77% faculty. to Prior implementati primarymeans feedback. constraints of Time and difficulty initiating conversation the were commonlymostcited limitations for feedbackfaculty considered the of 92% process. surg satisfied the with feedback amount of training. receivedduring own their Post remained the difficulties incorporating the tool into the standard clinical workflow. around keyaround Methods: tothelearner describe perspectives of range skills core endourology regarding and concepts. Presented By: Introduction: input, curricular development shouldalso informed be the by perspective of the learners. Published regarding early data and surgicalskillfor urology residents. recognition these In fundamental this key of role, concepts skill and of the mostWeof important related the endourology surgicalskills knowledge. analyzed and 240 survey responses using a standard multistage, cutting-and-sorting technique to qualitatively assess and categorize the data. The Institutional Review Board of Duke University determined that this research was exempt from the review requirement. Results: 21 junior urology residents from 6 residency programs in the southeastern US completed the survey. 60% of the residents were PGY2, 30% were PGY3, and 1 participant was PGY1. The survey responses were sorted into 13 categories. Ninety-five percent of the participants had responses that fell into the “indications” category, defined as selection of an intervention from various surgical options, including criteria and decision-making process for that selection. Sixty-seven percent of the residents had answers that were categorized as “basic access skill”, defined as gaining antegrade access or retrograde access to the upper urinary tract. Forty-eight percent of participants responded with answers that described “complications”, defined as management or avoidance of complications that may arise from endourologic procedures. Other categories that emerged based on resident survey responses included basic and complex endoscopic skill, developing endoscopic experience, complex access skill, equipment handling and safety, anatomy, imaging, management of infected stones, and non-surgical management. Conclusion: A substantial majority of junior urology residents surveyed believe that it is important to learn indications for endourologic procedures. Avoiding and managing complications of endourologic procedures, in addition to gaining access to the urologic system, are other areas that these residents feel are particularly critical. Focusing on these specific themes in educating junior urology residents may increase confidence and ability in performing endourologic procedures.

Poster #135 SIMULATION OF MRI FUSION BIOPSY: CREATION OF A STANDARDIZED CURRICULUM TO ENSURE SATISFACTORY RESIDENT EDUCATION Ram Pathak, Eric Schommer, Robert Williams, Dave Thiel and Todd Igel Mayo Clinic Jacksonville, Florida Presented By: Ram Pathak, MD Introduction: To combat concerns over surgical cases, duty-hour restrictions, and ethical obligations of the patient-physician alliance, simulation has evolved as a necessary adjunct in residency education. Given the novelty of MRI Fusion Biopsy, we created a standardized curriculum to educate residents on performing MRI fusion biopsy equipped with a didactic power-point presentation and audio-visual component, as well as, skills training on a MRI fusion simulator in the presence of an attending physician. The primary aim of the study was to determine the impact of the MRI fusion biopsy simulation on resident education via questionnaires. Methods: At our institution, the UroNav® Fusion Biopsy System (Gainesville, Florida) was implemented in 2014. Current residents were asked to participate in a MRI Fusion Biopsy Simulation module, consisting of a didactic portion outlying the procedural steps of MRI fusion biopsy utilizing the UroNav® Fusion Biopsy System and supervised skills demonstration using a “phantom” model provided by Invivo®. Residents were then asked to perform the appropriate steps including preparation of the room and software, patient positioning, outlying regions of interest, sweep and segmentation, and, ultimately, the biopsy procedure. A checklist was constructed to ensure competency. Questionnaires were utilized to gauge face validity. Results obtained: Only residents (n=4) without any clinical MRI fusion biopsy experience were included in the analysis. When asked if this model allowed for realistic application of performing a MRI fusion biopsy, 75‰ of residents stated they ‘strongly agree’, while 1 resident ‘agreed’ with the aforementioned statement. The model provided excellent visual and haptic feedback for probe placement and obtaining biopsy (100% ‘strongly agree’). Moreover, all residents agreed that this simulation model realistically simulates the anatomic landmarks and overall haptic experience of executing a MRI fusion biopsy. Conclusion: Our MRI Fusion Biopsy Simulation Module received overwhelmingly positive feedback with excellent face validity.

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decisionmaking and PSA screening, delivering a diagnosis of prostate cancer,

- Poster #136 RESID UROLOGY TRAINING OF COSTS DUPLICATION OF PERSONNEL IN ACADEMICAN SETTING Maurilio Garcia Maurilio Mount Sinai Urology, Be of Center Medical Miami Department Presented By: Introduction: conduit (IC) has been less evaluated. Sidhu and Alan M. Nieder M. Alan and Sidhu paidto thecosts of performing all manner of robotic vs. open surgeries. The differential cost of performing reside institution retrospective review of operative reports for patients undergoing Methods: performing a resident teaching case for a robotic vs. open RC IC,with especially with toregard duplic Surgical Assistants (PASA). without robotic assistance.of Series 9 robotic compared RC/ IC to were 9 most our recent open RC/ IC.t Paired Medicare and Medicaid Medicare(CMS) ClaimsProcessing Manua values institution. our at Results: period fromto 2/2010 performed 6/2015,were 9 robotically from 10/2011 performed open from 5/2015 longer for robotic (309 group vs. min, 237 p=0.001). 9/9 of both had residents groups as first assistants. had a PASA 0/9 open cases incystectomies. vs. of 8/9 robotic PASA are reimbursed 13.6% at CMS by Methods: Introduction: insurers.A PASA can be reimbursed up to $1,000 for an out of network case at our institution,to $8,000 additional up or in coststhe system tofor care health resident operative training r the at Conclusion: designates communicationscoreskillsas competencyfor a residency training; skills which difficultare teach evaluate. and objectively to Objective assessment providing informedconsent surgery and disclosing for medic a BruceAllenKava¹,Andrade²,Jorge Marcovich¹, Ruiz³ Thaer and Robert Idress³ Medical VA Peters J. ²James Florida; Miami, of Medicine School Miller of Miami ¹University Center, Bronx Presented By: patients expensive, (SP) are used and rarely theWein surgical specialties. the evaluate practice that enables avatars digital using simulation world virtual of a feasibility learningcommunication and assessmentsk resident of virtualdesign.settings Two world developed,were allowing for interaction house between staff and an avatar tutorial on communication skills, participants participated in4 virtual world encounters: shared instruments and semi not reimburse for the cost a resident of surgical assistant. For robotic cases in teachingour hospital, a PASA isthe added to surgical team to allow COMMUNICATION SKILLS USING HUMAN ASSESSMENT AVATARS: PILOTING A WORLDVIRTUAL OBJECTIVE STRUCTURED CLINICAL EXAMINATION console, a cost of teaching robotic RC/ IC not incurred for open RC/ IC. IC for incurred console, teaching not cost of open RC/ RC/ robotic a None Funding: Poster #137 faculty members evaluated the archived virtual world OSCE for each resident resident each for OSCE world virtual archived the evaluated members faculty 242 Results: Twelve Urology housestaff participated. More than half had no prior training in these communication skills. The virtual world encounter was realistic, immersive, and easy to use. High acceptance to the platform was expressed. Presence (suspension of reality) and co-presence (feeling as if were interacting with a live person) correlated with educational satisfaction (Spearman rho= 0.72,p=0.007). Debriefing interviews identified problems with 1) limited non-verbal feedback, 2) too much information presented, and 3) lack of immediate feedback. Intra-class correlation (ICC) for the faculty assessments was 0.538 (95% CI: 0.369- 0.699) for single measures, and 0.777 (95% CI: 0.637-0 869) for average measures. Conclusion: A virtual world OSCE is a feasible, acceptable and applicable method of communication skills assessment. Improving non-verbal cues, focusing on a single skill set, and providing immediate feedback should be incorporated into future studies of this platform.

Poster #138 COMPARISON OF ONABOTULINUMTOXINA INTRADETRUSOR INJECTION NEEDLE PERFORMANCE WITH MODERN FLEXIBLE CYSTOSCOPES Robert Williams, Jesse Dove, Steven Petrou and David Thiel Mayo Clinic - Jacksonville, FL Presented By: Robert D. Williams, MD Introduction: Intradetrusor injection of onabotulinumtoxinA (BTX-A) can be performed with rigid or flexible cystoscopy. The primary aim of this study was to analyze irrigant flow rate and total angle of deflection for the intradetrusor injection needles used for flexible cystoscopic injection of BTX-A to see if any needle provided a technical advantage. Methods: Three commercially available intradetrusor injection needles were evaluated using two modern flexible cystourethroscopes. The three needles analyzed were the NBI070 (Coloplast, Minneapolis, MN), DIS200 (Laborie, Williston, VT), and NM-101C- 0427/MAJ-565/MAJ-655 (Olympus, Center Valley, PA). Angles of deflection and irrigant flow rates were calculated with an empty working channel and each injection needle in the working channel of the two flexible cystoscopes. Results: With the working channel empty, the Karl Storz 11272CU1 (KS) and Olympus CYF-V2 (O) cystoscopes had a total range of deflection of 341° and 281°, respectively. Total range of deflection with KS cystoscope was reduced to 275°, 250°, and 311° for the Coloplast NBI070, Laborie DIS200, and Olympus NM-101C-0427 needles, respectively. Total range of deflection with O cystoscope was reduced to 195°, 157°, and 257° for Coloplast NBI070, Laborie DIS200, and Olympus NM-101C-0427 needles, respectively. Average flow rates with an empty working channel were 5.7 mL/s and 5.5 mL/s for the KS and O cystoscopes, respectively. Mean flow rate with KS cystoscope was reduced to 1.0 mL/s, 0.1 mL/s, and 0.7 mL/s for Coloplast NBI070, Laborie DIS200, and Olympus NM- 101C-0427 needles, respectively. Mean flow rate with O scope was reduced to 0.5 mL/s, 0.1 mL/s, and 0.4 mL/s for Coloplast NBI070, Laborie DIS200, and Olympus NM-101C-

244 POSTERS - ethral, ethral,

up without repeat -

zed were incidence were zed of A injection needles, the the A injection needles, -

up of patients traumaticwith bladder - associated bladder ruptures. For patients with 245 -

nd do not undergo cystorrhaphy after blunt trauma

for thegreatest total ofrange deflection and has the P ruptures underwentP who cystorrhaphy, 28 (45%) had no

up cystography does not to appear affect clinicalmanagement IQR15, 7 patients 33). (13%) had persistentcontrast extravasation at - 0427 allows0427 - y 16).y This patient’scatheter removed was infollow The value of in cystography follow Niels V. Johnsen, MD up cystogramcystogram.time negative to and Follow 101C Among commercially availableintradetrusor BTX ¹, Jason Young²,Elizabeth OscarBrown¹, Guillamondegui² T¹, and Roger

s 14 days 10 to (range only 1/86 with 20) (1.2%) with positive imaging. No Retrospective review ofRetrospective institutional our review registry trauma identified patients all with 154 consecutive patientsmet inclusion criteria. had EP 85 (55%) ruptures, 57 operative da trauma 2000 and 2014. Patients bladder ruptures between concomitant with ur - - hville, TN hville, cystograms prior to a negative study. negativecystograms to a prior eath prior to6 IP patients,EP/IP).EP/IP interventionAll patients EP, IP (5 and 1 with or Olympus NM Olympus 0427 needles,0427 respectively. Conclusion: Introduction: Presented By: UTILITY OF ROUTINE CYSTOGRAPHY FOLLOWING THE MANAGEMENT OF MANAGEMENT THE FOLLOWING CYSTOGRAPHY ROUTINE OF UTILITY TRAUMATIC BLADDER RUPTURES ¹DepartmentUrologic Vanderbilt of Surgery, University Center, Medical Nashville, TN; ²Division and SurgicalCritical Trauma Vanderbilt of Care, Medical University Center, Nas Poster #139 Niels Johnsen Dmochowski¹

greatest elasticity flexibility. and rate. Coloplast the flow NBI070 allows for best Conclusion: Conclusion: following the repairof simpleblunt trauma Of the 62 patients IP with EP/I or imaging performed removal.catheter prior to had initialcystograms 34 (55%) median at a of 12.5 days 9, (IQR after 16) cystorrhaphy only 1 patientwith having a persistent (3%) leak (post injuries 56 EP patients cystorrhaphy, 24 EP The were patients. underwent remaining did as managedcatheter drainage alone. with (37%) IP ruptures combined and 12 (8%) EP/IP rupture. 12 patients excluded with were d bladder neck, ureteral or excluded. injuries Bladder were injuries categorized either were as intraperitoneal (IP) extraperitoneal or (EP)management and primary strategyconsisted of either cystorrhaphy catheter or Primary drainage. analy outcomes positive follow Results: Methods: Methods: blunt rupturesWe is unknown.sought to evaluate routine whether cystography alters clinical management inpatients both do a who associated bladder ruptures. 49/56 (87%)managed catheter with EP patients initial drainage had negative cystograms at a median of 19 days ( median these patients 3 of a (IQR developed 29). urinary tract 15 days 14, of fistulae, while themean remaindermedian of 67), at had negative 38 days a 26, with of a (IQR imaging 2.8 patient urinary complications experienced following catheter removal. imaging.cystorrhaphyAll EP patients initialcystograms had negative median 20 of a at days (IQRmedian 14, The overall 30). time to cystogram negative forcystorrhaphy all patients wa 244 EP injuries managed with catheter drainage, cystography alters management in at least 13% of patients. Though the vast majority (87%) of conservatively managed EP patients are healed by 19 days, the optimal timing of cystography in this setting remains unknown.

Poster #140 INITIAL PHARMACOTHERAPY FOR OVERACTIVE BLADDER SYMPTOMS AMONG MEDICARE BENEFICIARIES Charles Scales Jr.¹, Melissa Greiner¹, Bradley Hammill¹, Andrew Peterson², Lesley Curtis¹ and Kenneth Schmader³ ¹Duke Clinical Research Institute, Durham, NC; ²Division of Urologic Surgery, Duke University, Durham, NC; ³Division of Geriatrics, Duke University, Durham, NC Presented By: Charles D. Scales Jr., MD, MSHS Introduction: Overactive bladder (OAB) affects up to 40–50% of older men and women. OAB diminishes quality of life through its impact on daily living and emotional well-being, even in the absence of urine loss. The economic costs of treating patients with OAB are projected to exceed $80 billion annually by 2020, more than half incurred by Medicare beneficiaries. Despite this burden of disease, no prior study has examined Medicare Part D medication claims. Our objective was to describe variation in initial drug treatment of OAB symptoms among Medicare Part D beneficiaries. Methods: We performed a retrospective cohort study of beneficiaries using the Medicare 5% sample. Between 2007–2013, we identified beneficiaries with an outpatient encounter consistent with OAB symptoms and a drug claim for a first generation (pre-2000 FDA approval: oxybutynin, tolterodine) or a second generation (post-2000 FDA approval: darifenacin, fesoterodine, mirabegron, solifenacin, trospium) agent. Subjects with recent urinary tract infection, neurogenic bladder, and prostate cancer diagnoses were excluded. No subject had a prior OAB drug claim. We used a multivariable log-binomial regression model to estimate the relative probability of receipt of an initial 2nd generation agent, controlling for beneficiary demographics, comorbidity, provider specialty, and geographic variation. Results: During the study period, 17,944 beneficiaries had an initial drug claim. The average beneficiary was aged 78 ± 7.5 years, 80% were female, and 89% were white. Beneficiaries dually eligible for Medicaid constituted 26% of the cohort. In multivariable models, black beneficiaries and dual-eligibles were slightly less likely to receive 2nd generation agents (black: RR 0.91, p=0.015; Medicaid: RR 0.95, p=0.012). Urologists and gynecologists were substantially more likely than generalists to prescribe 2nd generation drugs (urology: RR 1.49, p<0.001; gynecology: RR 1.30, p<0.001). Subjects with dementia were 13% more likely to receive a 2nd generation agent. Within 6 months, 15% of beneficiaries filled a prescription for an alternative OAB agent. Conclusion: Medicare beneficiaries initially treated by specialists are substantially more likely to receive 2nd generation OAB agents. While side effect profiles may differ, particularly with extended-release formulations, current guidelines do not support substantial efficacy differences among these agents. Further investigation is required to understand differences in outcomes and costs associated with these disparate prescribing patterns. Funding: NIH/NIA GEMSSTAR program (R03AG048130) and American Geriatric Society Dennis W. Jahnigen Career Development Award (Scales).

246 POSTERS , ho

was

diagnoses of genital/degenerative ic indications. ic indications.

ection: overactive bladder

heral neuropathy. We heral neuropathy. the used r to degree or type or impaired degree of to r CONFIRMEDDETRUSOR -

confirmeda diagnosis and of DU Of DM. confirmed DU, the presenceconfirmedthe peripheral DU, of - - IN DIFFERENT PATIENT POPULATIONS

247 Bich Le -

flow urodynamicflow study (UDS) at institutionour from 1996 to 2014. - ael Belsante Ngoc ael and

Diabetes mellitus isDiabetes (DM) implicated metabolicmajor the as disease Botox isBotox neurotoxic proteinthat isseeing increased usage for a variety of BradleyA. Potts, BS Marc Colaco,MBA MD, In and UDS patients DM with

We performed retrospective an IRB approved of all review patients w Data was retrospectively was collectedData from patients all undergoing injections Botox

We identified 58 patients with UDS with patients 58 We identified ed as both neurogenic, to due the degeneration of neurons secondary to oxidative iated with DM and DU, we set out to investigatepresence to setthe out peripheral and DU, of we if DM iated with ent indications.entAlthough these treatments improveto patient been found have quality nsation reported intact was 19 of in 24 patients patients (2 without sensation with info) UNDERACTIVITY, CONCURRENT PERIPHERAL NEUROPATHY CORRELATES TO NEITHER SENSATION BLADDER NORTHE DEGREEIMPAIRED TO OF OR TYPE CONTRACTILITY Bradley Potts, Mich Poster #141 IN PATIENTS DIABETIC WITH URODYNAMICALLY Durham, NC Methods: Presented By: associated detrusor with underactivity (DU). The pathogenesis of in DU patients DM with is describ stressmicrovascular and myogenic, damage, and the due to direct stress oxidative of hyperglycemiamuscle.morethe to order about on bladder neurogenic In learn effects assoc neuropathy relates to bladdersensation, to or thetypeor degree of impaired detrusor contractility. Introduction: underwent pressure inclusion isolated were DU, detrusor hyperactivity impaired with contractility (DHIC), and acontractileWe bladder (AB). the excluded following causes known ofDU: concomitant pelvic UDS, other radiation,BOO neuropathologycon on and (stroke, disease, and brain/spinal/peripheral trauma/surgery). nerve After identifyingsample of our patients used Fisher’s we DM, with Exactto Test compare bladder sensation the and types patients patientsof between DU perip and with without mean group. each compare to BCI in TestWilcoxon Rank Sum Inclusion criteria included males age >18 years with diabetes, emptying symptoms, bladder bladder symptoms, emptying diabetes, with years >18 males age included criteria Inclusion contractility index (BCI) <100, and bladder outlet obstruction <40.index UDS Results: these, 26 (48%) had documented peripheral neuropathy and 28 (52%) didnot. Bladder se neuropathy (79%) and in 25 of 28 patients without neuropathy (89%), no showing significantthose difference included in DU neuropathy of with Types (P=0.47). DHIC (12 46%), isolated 35%), and AB (9, those DU 19%). Types in (5, DU of without neuropathy included DHIC (16, 57%), isolated (10, DU 36%), and AB (2, 7%). no significant There was difference the in groupstypesproportions between two (P=0.42). BCI of Mean DU 53.0 inpatients neuropathy with and 67.1 inpatients without neuropathy, no showing significant difference (P=0.11). Conclusion: COMPLICATIONS INJECTIONS OF BOTOX COMPLICATIONS neuropathy correlates bladdersensation to no neither contractility.We the will continue relationship explore to as and DU we DM between investigate findings pertinent previously to proposed and novel pathophysiologic mechanisms. Poster #142 (OAB), neurogenic interstitialcystitis or then bladder (NGB), analyzed Cohorts were (IC). Introduction: Methods: ina single outpatientacademic institution period.clinic Subjects a 3 year over were separated into differentbased cohorts indication upon inj for differ of life, they significant do have potentialcomplications. for purpose Thus the ofstudy this is compare injectionto complicationof the rates Botox for different urolog Presented By: Wake Baptist Forest Health Marc Colaco,Karen Kelly, and Majid Erin Pfotenhauer Mirzazadeh 246 for rates post treatment urinary tract infection as defined by positive cultures within one month, and clinical retention defined as a need for catheterization after treatment, and volumetric retention defined as a post void residual greater than 200mL. Results: A total of 240 subjects were included in this analysis. 181 patients had urine culture data and of these 30 (16.7%) developed post treatment UTI. Patients with OAB had significantly higher rates of UTI than any other group (23% versus 12%, p=0.041). Regarding retention, OAB patients had a higher rate of retention than IC patients with a difference that was near significant (10.1% versus 3.2%, p=0.055). NGB patients were not included in this analysis as many were doing self-catheterization prior to Botox. 77 subjects had recorded post void residuals. Of them 19.73% of patients demonstrated post void residuals greater than 200 after treatment. There was no significant difference between groups on rate of retention (p=0.7). Conclusion: In this cohort study patients with OAB who underwent Botox treatment had a significantly higher rate of post treatment infection and a near significant higher rate of retention. This suggests that Botox may not be an equally safe for the treatment for all bladder pathology.

Poster #143 BLADDER OUTLET PROCEDURES ARE AN EFFECTIVE TREATMENT OPTION FOR PATIENTS WITH URODYNAMICALLY-CONFIRMED DETRUSOR UNDERACTIVITY WITHOUT BLADDER OUTLET OBSTRUCTION Bradley Potts, Michael Belsante and Ngoc-Bich Le Durham, NC Presented By: Bradley A. Potts, BS Introduction: Detrusor underactivity (DU) is an important cause of bladder emptying dysfunction, and it is only distinguished from bladder outlet obstruction (BOO) with pressure-flow urodynamic studies (UDS). There is sparse information in the literature regarding the management of DU patients without associated BOO. We set out to investigate the surgical procedures that have been used for such patients and their associated outcomes. Methods: We performed an IRB approved retrospective review of all patients who underwent UDS at our institution from 1996 to 2014. Inclusion criteria included males age >18 years with complaint of emptying symptoms, bladder contractility index <100, and BOO index <40. Diagnoses of inclusion were isolated DU, detrusor hyperactivity with impaired contractility (DHIC), and acontractile bladder (AB). We excluded the following known causes of DU: concomitant BOO on UDS, diabetes, pelvic radiation, and neuropathology (stroke, congenital/degenerative disease, and brain/spinal/peripheral nerve trauma/surgery). Other extracted data included demographics, comorbidities, previous therapies, and need for further interventions. Success was defined as no future retention or symptoms requiring urinary catheterization or subsequent operations. Results: We identified 139 patients with median follow-up (FU) of 10 mos. (IQR = 1 – 36) after UDS diagnosis. Most patients were managed with either medication alone (37%) or urinary catheterization +/- medication (30%). Only 21 patients (15%) received bladder outlet surgery (14 TURPs, 6 KTPLAPs, and 1 bladder-neck incision). Types of DU in this group included DHIC (10, 48%), isolated DU (6, 29%), and AB (5, 24%). Success was achieved in 18 (86%) of patients undergoing bladder outlet procedures with postoperative FU of 6 mos. (IQR = 1 – 18). Failure occurred in 3 cases: 1) an isolated DU patient with UTI and retention 10 days postop; 2) an AB patient with UTI and retention 15 days postop; and 3) an isolated DU patient with fecal impaction and retention 3 mos. postoperatively. In the latter 2 cases, patients resumed volitional voiding without further difficulty. Using the same methods, we also identified 5 patients with DU who then had radical prostatectomy for prostate cancer. In this group, success was achieved in all 5 (100%) cases with FU 45 mos. (IQR = 6 – 81). Conclusion: Though infrequently attempted, bladder outlet procedures are an effective treatment option for patients with UDS-diagnosed DU without BOO. We recommend considering the procedure in all patients with medication-refractory DU. Our post-

248 POSTERS - D - and and - novo novo (16.7%) . Thirty requiring

operative - th prostate tion without Dindo classification classification Dindo -

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nt for stress urinary incontinence (SUI), and been D) classificationD) system.Patients noted to have were ty ofmesh revision surgery most of the peri -

eveport, LA

Dindo (C D criteria for classification as a surgical complication surgical as a classification for criteria D - line treatme - -

up. Patients with Clavien with Patients up. - To describe complications in patients undergoing vaginal mesh revision mesh revision vaginal undergoing patients in complications describe To The presence preoperative of urgency urinary incontinence (UUI) is a risk Andrew Rabley Andrew Laura Gamble,Laura MD Despite the complexi

Shreveport, Shr

and Eric Rovner

- operative (occurring prior to discharge from initialsurgery) post or We retrospectiveapproved conducted an IRB of 243 patients chart review who DINDO CLASSIFICATION SYSTEM -

- One and eleven hundred of 243 patients found (45.7%) were to at have least 1

Charleston, SC

- lts: ods: sion and 41/243 (16.9%) underwent combined procedures. Surgical complications were ster #145 Introduction: surgery,categorize and to complications their according the to Clavien Presented By: system. Meth prostatectomymay results be considered discussingwhen treatment options wi THE USING SURGERY MESH REVISION PELVIC OF COMPLICATIONS OF ANALYSIS CLAVIEN cancer DU. also have patients who Poster #144 Freilich, Rabley, TracyAndrew Tipton,Goran Rac, RossLeah Chiles, Rames, Drew Lindsey Cox MUSC underwent vaginal meshunderwentsingle vaginal 2007 and 2014 atinstitution. extraction between a 55/243 (22.6%) patients underwent POP mesh revision, 147/243 (60.1%)underwent sling mesh revi Clavien the using stratified five/132 (26.5%)complications classified were as deviation Grade 1 (any from normal postoperative course), 59 (44.7%) as Grade 2 (deviation requiring pharmacological intervention), 9 (6.8%) (radiologic, as Grade 3a surgical endoscopicor interven anesthesia), and 29 (21.9%) as Grade 3b (radiologic, surgical endoscopicor intervention anesthesia).with no There Grade 5 complications. 4 or were The most common 3a complications de novo were or persistent stress urinary incontinence (SUI) cystoscopic examination.most Thecommon 3b complications persistent were SUI and anterior POP requiring another surgical repair. Four/132 (3.0%) complications de were urinary urge novo incontinence,1 (0.8%) SUI de novo was de and 5 (3.8%) were pelvic prolapse. organ Eight/132complications peri were Resu surgicalcomplication, 18/111 with patients (16.2%) suffering multiple complications. A total of 132 eventsmet the C either peri (within90 days of the initial operation) complications. Timeto resolutionmedical and comorbidities also investigated. were Chi squared and T prognosticsignificancesmokingstatus. BMI, and diabetes age, of Grade 3b. Eighty four/132 (63.6%) complications resolved 90 days, by 10 (7.6%) were stable, still (6.1%) 8 (6.1%) had improved, 8 and 22 were pendingoutcome, an were lostwere follow to factor for outcomes poorer after midurethral sling surgery. (MUS) Pelvicmusclefloor is first a (PFMT) training Conclusion: Introduction: without complicationsBMI respect to with (p=0.99), age (p=0.32), smoking status (p=0.19) and diabetes series. (p=0.30) our in postoperative complicationsminor. are Using the C most common in largeour series. Age, BMI, smokingstatus and diabetes didnot increase complications. of risk the Po Gomelsky Alex and II Frilot F. Clifton Islam, Tameem Gamble, Laura LSU Health Presented By: IMPACT OF PREOPERATIVE PELVIC FLOOR MUSCLE TRAINING ON URINARY URINARY ON TRAINING MUSCLE FLOOR PELVIC PREOPERATIVE OF IMPACT INCONTINENCE MIXED WITH WOMEN IN SYMPTOMS EMPTYING AND STORAGE UNDERGOING SLING SURGERY 248 shown to be efficacious for other urinary storage and emptying symptoms; however, the role of PFMT prior to MUS surgery is not well defined. We investigate the impact of preoperative PFMT on urinary storage and emptying symptoms in women with mixed UI (MUI) prior to undergoing MUS. Methods: This is an IRB-approved, retrospective chart review of women with stress- predominant MUI undergoing a retropubic MUS. We identified 54 women that elected for PFMT initially and eventually underwent retropubic, top-down MUS (PFMT group). These were matched by age with 54 women who underwent MUS only (MUS group). Pre- and postoperative assessments included subjective SEAPI classification [Stress incontinence, Emptying, Anatomy, Protection (pad use), Inhibition (UUI)], and quality of life (QoL) indices. Cure was defined as absence of subjective or objective SUI and no additional procedures for SUI. Demographics were abstracted from the hospital and clinic charts. Results: Mean age was 49.7±12.2 years and mean follow-up was 20.2 and 22.8 months in the PFMT and MUS groups, respectively. Mean body-mass index and parity were not statistically different between groups. After completing therapy, 22.2%, 31.5%, and 18.5% of women in the PFMT group had subjective improvement in baseline SUI, emptying, and UUI scores on SEAPI, respectively. SUI cure rates after MUS were 85.2% vs. 70.4% in the PFMT and MUS groups, respectively (p<0.05). In terms of postoperative emptying, 79.6% and 90.7% of women in the PFMT and MUS groups, respectively, had no subjective complaints. In the PFMT group, 8 women (14.8%) reported worse subjective emptying, but only one underwent sling incision. Three women (5.6%) in the MUS group reported worse subjective emptying and none had a sling incision. Resolution of preoperative UUI was observed in 61% and 46% of women in the PFMT and MUS groups, respectively. Postoperative QoL indices were statistically improved in both groups, with no significant difference between groups. Conclusion: In this pilot study, PFMT performed prior to MUS surgery was of benefit in improving not just SUI, but also other subjective emptying and storage symptoms. While small, our analysis suggests a potential effective treatment strategy in women with preoperative MUI and should be confirmed with larger, randomized studies.

Poster #146 ASSESSING THE ROLE OF PATIENT-REPORTED OUTCOME QUESTIONNAIRES IN THE EVALUATION OF QUALITY OF LIFE AFTER SLING SURGERY FOR FEMALE STRESS URINARY INCONTINENCE: A REVIEW OF THE LITERATURE Kyle M. Rose, Umar R. Karaman and Alex Gomelsky LSU Health - Shreveport, Shreveport, LA Presented By: Kyle Matthew Rose, MD Introduction: Patient-reported outcome questionnaires, such as short forms of the Urinary Distress Inventory (UDI-6) and Incontinence Impact Questionnaire (IIQ-7), have been uniformly adopted as clinical tools to assess magnitude and bother of symptoms before and after sling surgery for female stress urinary incontinence (SUI). However, the ability of questionnaires to provide decision-making information for physicians and patients remains unknown. We aim to assess the outcomes of these questionnaires in the literature and to determine the impact of questionnaire data on clinical management of SUI. Methods: A PubMed database literature search was performed for English language studies using the following terms: SUI, UDI-6, and IIQ-7. Studies evaluating midurethral (MUS) or bladder-neck pubovaginal sling (PVS) procedures were included. Studies evaluating colposuspensions, bulking agents, and mini-slings were excluded. Studies that only had a postoperative index value or did not compare ≥2 techniques or variables were excluded. Abstracted data included objective/subjective outcomes and questionnaire results. Results: An initial PubMed search yielded 775 studies, of which 43 met inclusion criteria. An additional 14 studies were identified from hand review of references, for a total of 57 unique studies. Studies analyzed the efficacy of retropubic MUS (21), transobturator MUS (12), PVS (4), and 20 trials compared different sling approaches or materials. Although age, BMI, prior and concomitant surgeries, and presence of mixed incontinence were

250 POSTERS - item - actice

less of orted a orted a in mean in mean

patients. In

controlled studies - bother. As neither 6 total scores, the es. -

o better understandthe 7or UDI -

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improvement. Randomized

251

Pond, Desouza Boemer Allison and Rowena -

50, and >50 repairs per year, respectively.significant A -

significant postoperative significantsco improvement in - - al Association. al question developed to survey was inquireisolated treatment of about - 6, or both, is observed after both, or is observed 6, sling any regardless procedure, baseline of - ix Based upon currentBased guidelines upon concrete literature,there offered to no are Lindsey Hartsell, MD M.

Our review confirmsOursignificant review that a post Based preliminary on our results,majoritythe of respondents the from the

A s There a total were of 45 responses. of 18% respondents certifiedwere infemale 7, UDI 7, . We. found have that is there variation inpractice patterns inthe gynecology erceptions patients among community inour often are media. the influenced by For these identified as variables impacting questionnaire outcomes, no single study found a a found study single no outcomes, questionnaire impacting variables as identified non or worsening operatively. Several studies examined the change (Δ) in IIQ outcomes individual of questions,and subsets these questionnaires, of study no and found a worsening non or comparing sling two revealed essentially procedures no significant difference between groups either inimprovement questionnaire. on Conclusion: IIQ- total patientcharacteristics, approach, operative definitionsuccess. or At of these present, questionnaires provide a quantification only symptom severity and of provides guidance insling choice facilitates or management other decisions,future research shouldbe devoted to other patient reported outcomes such as single questionnairesminimum or important differenceinquestionnaire outcom TREATMENT OFTHE ISOLATED CYSTOCELE:PRACTICE PATTERNS IN THE SOUTHEASTERN SECTIONTHE AUA OF Poster #147 Pettibone Amanda Hartsell, Lindsey UTHSC Memphis, TN Presented By: Introduction: patternssoutheastern in greaterour community. reasons, to wanted be ableto offer we and postmenopausal pre our patientsmore concrete data as to if they augment should an have tissue native or based upon pr repair Urologists an isolatedcystocelemesh biologic to on whether augment repair graft. or with Furthermore,there no recommendations are made menopausal particular upon in based status community as as well in local own our urologiccommunity. Recent FDA statements have cautionedagainst the use synthetic of mesh inthe vaginal compartment, and current social p practice patterns South SectionEastern of (SES) urologists inregards to treatment of isolated anterior and postmenopausal prolapse in women.pre Methods: Results: pelvicmedicine and reconstructive surgery (FPMRS). 40% of respondents perform repair thewith patient’s tissues native inboth and postmenopausal pre premenopausal patients 9% biologic used graft, and 7% reported usingmesh. The slightlynumbers were higher inpostmenopausal patients 13% with using biologic graft and 9% usingmesh. those Of usingmesh mesh kit. for repair, a use 59%28% rep change intheir practice patterns after the statement. FDA 88%, 10%, and 2% of respondents perform <20, 20 percentage and postmenopausal referred both outtreatment. of patients pre for were cystoceles, including differences any treatment between inpre and postmenopausal women. sent Thissoutheasternsurvey was members onlinethe to of out sectionthe of American Urologic SES were not perform certified.SES FPMRS repairs, were isolated those anterior majority Of who the uses the patient’s tissue native rather than a biologic graft or mesh regard Conclusion: Conclusion: menopausalstatus. responses More characterize needed to are better practice patterns and to helpdevelop future guidelines for treatment of isolated prolapse. anterior There was no fundingfor this project. 250 Poster #148 CROSSOVER STUDY OF THE PROSTATIC URETHRAL LIFT (PUL) PROCEDURE FOR THE TREATMENT OF LOWER URINARY TRACT SYMPTOMS DUE TO BENIGN PROSTATIC HYPERPLASIA: 2 YEAR OUTCOMES William Bogache¹, Anthony Cantwell², Ronald Tutrone³ and Daniel Rukstalis4 ¹Atlantic Urology Clinics, Myrtle Beach, SC; ²Advanced Urology Institute, Daytona Beach, FL; ³Chesapeake Urology Associates, Towson, MD; 4Wake Forest Baptist Medical Center, Winston Salem, NC Presented By: William K. Bogache, MD, FACS Introduction: Treatment options for men suffering from lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH) include watchful waiting, medications, ablative surgeries, and the new Prostatic Urethral Lift (PUL) procedure. Understanding the balance of risk and benefit facilitates the selection of the most appropriate therapy for each patient. We sought to evaluate the 2 year effectiveness of the Prostatic Urethral Lift procedure through a crossover study design in order to more fully characterize PUL performance. Methods: Fifty-three patients with LUTS underwent sham procedure as part of a blinded, randomized study at 19 centers in the USA, Canada and Australia. After becoming unblinded at 3 months, these men then elected to participate in this crossover study and were followed for 2 years. The crossover PUL procedure involved placement of small permanent implants (UroLift® System, NeoTract, Inc., Pleasanton, CA) into the lateral lobes of the prostate to relieve obstruction. Assessments included LUTS relief, quality of life, peak urinary flow rate, sexual function and adverse events. Results: At 2 years after crossover PUL, International Prostate Symptom Score (IPSS), quality of life (QoL), and peak flow rate (Qmax) improved 36%, 40%, and 77% from baseline, respectively. Symptom response in this same cohort after sham procedure indicated initial dilatory improvement at 1 month with significant decay by 3 months post- procedure. Adverse events associated with the procedure were typically mild to moderate and patients returned rapidly to normal activity. Four patients (8%) required intervention with transurethral resection of the prostate and 1 patient required additional PUL implants within the first two years. There were no reported instances of new onset, sustained erectile or ejaculatory dysfunction. Conclusion: In this study, the PUL procedure was found to be associated with stable and significant average symptom relief over two years of follow up. The moderate improvement seen after sham procedure diminished rapidly. PUL procedure improved quality of life while maintaining sexual function. This crossover study was sponsored by NeoTract, Inc.

252 POSTERS - r

- to fold -

ial-

ntagonist spectrum - β1 did not Báez d conditioned 1 CELLS CELLS 1 - - - and a 2 embedded 3D embedded 3D -

releasing hormone - conditioned medium; whereas -

Negron and Antonio Puras and Antonio Negron fold (p<0.001), while mRNA levels for - - cadherin and Snail(p<0.01) . (p<0.001) - 1 macrophage - 253 AUA and Miami VA Medical Center VA Medical AUA and Miami Belaunde, MD defined spherical structures matrigel in matrix and

- by GHRH antagonist GHRH by decreased inflammation and - induced proliferation determined was utilizing by the -

releasing hormone (LHRH),receptors and their also are - INDUCED PROLIFERATION BPH OFHUMAN -

1 cells THPwith - 1 prostatic cell to linematrigel used generate was Belaunde, Guzman Juan M. - RELEASING HORMONE DECREASEANTAGONISTS - - induced sphere diametersinducedsphere 64% by (P<0.01).However, degarelix did ico School of Medicine, San Juan, PR - FL; ²Miami VA Medical Center, Miami, FL; ³University of Miami of FL; ³University Miami, Center, Medical VA FL; ²Miami

BETWEEN PROSTATIC INFLAMMATION AND PCR (qPCR). Symptoms prostatic of benign hyperplasia frequently(BPH) include 1 cells developed well - Petra Popovics, PhD Jose Antonio Saavedra Fournier's (FG) gangrene has been a dreadful entity since first described in -

Chronic prostatic inflammationmay contributethe to development of BPH

Human BPH

BPH

nd GHRH in inflammation in GHRH nd induced proliferation. These findings highlight the importance further of s, in sphere average which diameters evaluated. were Chronic inflammation was tative RT

Poster #149 HORMONE GROWTH INFLAMMATION AND TGF?2 AND INFLAMMATION Presented By: Introduction: histologicalsignschronic of inflammation. suggests Much evidence that epithel mesenchymal transition (EMT) and inflammatory cytokines major are factors in the pathogenesisBPH. of Hypothalamic neurohormones, hormone growth AUTOCRINE/PARACRINE GHRH A NOVELA LINK PetraPopovics¹, V.Schally², Roberto Block³Andrew and Ferenc G. L. Perez², Norman Rick² ¹UniversityofSchool of Medicine, Miller Miami Division Endocrinology, Diabetes of and Metabolism, Miami, (GHRH) and luteinizing(GHRH) hormone expressed inmodelsexperimental of in BPH, thesewhich neurohormone antagonists have been shown to reduce prostatic volume, suppress the levels of proinflammatory cytokines and alterfindingssuggestEMT.the foto related expression genes These a role of receptorLHRH/LHRH and GHRH/GHRH receptor inthe axes development chronic of inflammationthe thisin been investigated prostate, not to has and EMT however, date. Methods: culture induced treating by BPH EMT EMT specifically was initiated by the utilization of TGFβ1 or TGFβ2. The role LHRH a of secreted LHRH antagonist,LHRH antagonist degarelix, and a GHRH lab. developed in Theour presence of confirmedculturesreceptors in was 3D immunocytochemistryfor by and LHRH GHRH and quanti Results: expressed cellmembrane receptors for and GHRH. LHRH Macrophage medium induced a 26% (P<0.001) increase inthe mean diameter of cells elevationmarkersEMT inthethe N expression of The expression also of increased was GHRH 2.7 LHRH LHRH slightlywere reduced (ns). Blockade of feedback GHRH a GHRH a by inflammation reduced DELAYED PRIMARY CLOSUREOFFOURNIER’S GANGRENE: THE EXPERIENCE AT THE UNIVERSITY OF PUERTO RICO MEDICAL CENTER significantlysphere affect diameter. Conclusion: partly triggering by EMT; an important factor inmightthis process be the locally secreted GHRH. Blockade GHRH of effects TGFβ2- investigations on the ability antagonists of GHRH to reduce prostatic inflammation and EMT. SES Foundation, Care Urology Funding: Poster #150 José Antonio Saavedra not cause any significant changes. TGFβ2increased average sphere diameter by 32%, this antagonistGHRH contrast,Ineffect (P<0.001). by 67% by TGF reduced was Introduction: University Puerto R of Presented By: late 19th century. Initialmanagement includes hemodynamic stabilization, broa antibiotics, and aggressive surgical debridement. Moreover, posterior managementwound and closure, requiring multiple surgical procedures and prolonged hospitalization, have 252 always been challenging, as described in recent series. We want to report our experience, involving delayed non-surgical primary closure (DNSPC) of FG, using Prolene mattresses and a non-slip knot technique, for sequential bedside tissue approximation, which aims to reduce patient's admission time and necessity for multiple operations. Methods: We review the outcomes of 16 patients who underwent surgical management for FG between 2013 and 2015. All patients underwent wide local debridement and DNSPC, using the same technique, involving placement of interrupted Prolene mattresses along wound edges and leaving wounds partially open. Then, aggressive wound local care and sequential re-approximation, by tightening the sutures, were started on post-operative day 1. Once wounds were closed, sutures were secured using surgeon's knots. Patients were analyzed in respect to age, comorbidities, total area and volume of resection, hospitalization time, and WBC at the time of admission. Results: Of the 16 patients, the median patient age was 59 years (range 45-82). The median resected area and resection volume were 63 cm2 (range 12-156 cm2) and 140 cm3 (range 18-597 cm3), respectively. Median hospitalization time was 6.5 days (range 2- 19 days). Median WBC count at time of admission was 14.1 thousand cells/mcL (range 6.6- 26.1). Of the comorbidities present, diabetes mellitus was the most prevalent (62.5%), followed by hypertension (50%). Other comorbidities included alcohol dependence, obesity, and peripheral vascular disease. Three patients required a secondary procedure, one due to revision of suture placement, one due to an extensive primary debridement, and other due to revision required by different surgeons. Only three patients received supplementary hyperbaric therapy during admission. All patients were followed, at least once, within 2 weeks after discharge, and none required further surgical management or re-admission. Conclusion: Our data show that patients with FG can be safely managed with delayed non-surgical primary wound closure. Also, the necessity for expensive supportive therapies and reoperation is decreased. This may translate into improved wound healing, cosmesis, and shorter hospitalization time. Moreover, this method may become an option for well- selected patients with defects not requiring tissue grafting. Funding source: None

Poster #151 RISK OF RESISTANT BACTERIA IN FECAL SWABS IS CORRELATED WITH PREVIOUS ANTIBIOTIC EXPOSURE IN A VETERAN POPULATION Dillon Li¹, Shilpa Sachdeva¹, Matthew Lane², Jon Demos³ and David Preston³ ¹University of Kentucky, College of Medicine, Lexington, KY; ²Lexington VA Medical Center, Lexington, KY; ³Lexington VA Medical Center, Lexington, KY, Department of Urology, University of Kentucky, Lexington, KY Presented By: Dillon Li, BS, MPH Introduction: Infectious complications following transrectal ultrasound and prostate biopsy (TRUSBx) have been increasing. Emergence of fluoroquinolone (FQL)resistant bacteria is believed to be a related risk factor. Previous antibiotic exposure and presence of diabetes may also be related to FQL resistant bacteria in the fecal flora. We studied the relationship of ciprofloxacin (CIP) resistant organisms on rectal swab (CIPROORS) to previous antibiotic exposure (FQL and other antibiotics) and the presence of diabetes in a Veteran population. Methods: In May 2012, the Lexington VAMC Urology service began testing all patients considered for TRUSBx with rectal swabs to identify CIP resistant organisms. A retrospective analysis of this group revealed 91 of 511 samples with CIPROORS. VA pharmacy and medical records of these subjects were examined for antibiotic prescriptions (from 6/1/2009-present) and the presence of diabetes, respectively. Odds ratios were calculated to study these risk factors in relation to the presence of CIPROORS. Results: Subjects with CIPROORS had significantly more prescriptions of any antibiotic than subjects without CIPROORS (2.58 vs. 1.69, p=0.0026, Mann-Whitney U test). Subgroup analysis showed 2 or more antibiotic prescriptions increased the risk of developing CIPROORS significantly (OR=1.6, 95 CI 1.01-2.53). The relationship between FQL prescriptions and CIPROORS was analyzed. Subjects with CIPROORS had more

254 POSTERS

- te™ 5.11. 5.11. - d and d and >3 months, and clinicians clinicians and AUTI in these AUTI in these

care personnel care personnel ASSOCIATED ASSOCIATED - vs. -

chanical irritation irritation chanical

methodscare of for

0.42, p=0.0013, Mann vs.

associated infections in the the in infections associated - days.Of note, the Duet - tivariableregression analysis was ant when 2 or moreor 2 FQL prescriptionswhen ant .60; within3 months 1 >30 days, OR=2.15, 95% CI 0.91 - balloon urinary catheter.balloon

- vs.

ETERS REDUCE CATHETER ters, opposedtraditional as to Foley catheters, 255 type urinary catheter relatively remained has - 1.27). A mul - associated urinary tract infections (CAUTIs), which which (CAUTIs), infections tract urinary associated - 3.79). The time interval from antibiotic prescription to to prescription antibiotic from time interval The 3.79). -

month timeframe, 162 patients Duette™ had catheters -

days. There were six CAUTIs six thein traditionaldays.There were Foley group; balloon cathetersstandard practice in of as to an effort - - ile insertion techniques,maintenance daily care protocols, and

, FL; ³Kaiser, Permanente Center, Riverside Medical Riverside, CA 2.08; within30 days -

BALLOON URINARY CATH URINARY BALLOON The design of the Foley the of design The Jonathan Beilan, MD - days).

CIPROORS correlated previous was with prescription of antibiotic any inour Use of cathe Duette™ urinary -

>6 months,>6 OR=0.95, 95% CI 0.57

UTI rates, one of National the PatientSafety Goals identified the by Joint Patients included instudythis had a Duette™ catheterurinary inserte During the study’s 11

vs. loon catheters,onlycalculated one loggedthe CAUTI; infection there was rate was

bal - tudy and the group risk greatest was more 2 or with prior FQL prescriptions. The presence FQL prescriptionscomparedto those without (0.78 CIPROORS have have struggled manageto catheter rectal testsignificantswab not was a for factor risk developing CIPROORS:6 within months Whitney U test). The risk of CIPROORS was signific was CIPROORS of risk The test). U Whitney foundwere (OR=1.98, 95% CI 1.04 Introduction: therefore catheter 1.1 1000 per OR=1.17, 95% CI 0.66 Finally, the diabetes this presence of in population didnot the increase risk for developing CIPROORS 0.45 (OR=0.75, 95%CI unchanged sinceconception its 1937. the in Over last 75 years,hospitals becomehave one of the most common types of healthcare placed, and 223 patientsBard™ catheters had placed in Thisthe accounted NSICU. a for total 870 Duette™ catheterof catheter days, and 1090 Bard™ the days. Of patients with dual medicalfield. Traditional Foley catheters to been shown cause have me these catheters. new Patient demographics,includingcatheter insertion/removal date and collectedCAUTI to analyzed were infectionassess diagnosis, and rate. Results: and trauma tomucosal the lining of the bladder, increasing the risk of C patients. The purpose of is this study to and present analyze the infection rate of a new type bladderDuette™ drainagethe system: dual cared for inTampa General Hospital’s neuroscience intensive care unit (NSICU). Data was collected catheters on placed fromJuly 2015. 2014 through May All patient received the appropriate training regarding the insertion technique and thiscohort demonstrated 5.5 infections 1000 catheter per NOVEL DUAL performed and confirmed thatprevious exposure to multipleFQL prescriptions is a significant for CIPROORS. factor risk developing Conclusion: s of diabetes the nor timing of antibiotic prescription (FQL other any or antibiotic)contributed CIPROORS. of risk the to Poster #152 URINARY INFECTIONS TRACT JonathanA. Beilan¹, Lund², Tracey Kristen Ordorica³ and DavidJ. Beane², Raul C. Hernandez¹ ¹USF Morsani DepartmentHealth Urology,College Medicine, of Tampa, of ²Tampa FL; General Hospital, Tampa Presented By: Methods: infection than rateBard™ than average the lower is is the also not rate, lower but rate only generally reported inthe currentliterature for traditional catheters Foley infections (4.4 per 1000 catheter Conclusion: infectioushas a lower riskthose requiring for indwelling bladder drainage. Utilizing an improved catheter designmucosal will reduce trauma and residual volumes, urine in which conjunction ster proper with facilities inpatient and Hospitals of CAUTIs. risk the reduce will time indwelling minimized dual initiating consider should reduce CA Commission.

254 Poster #153 TRANSRECTAL SATURATION PROSTATE BIOPSY IS NOT ASSOCIATED WITH GREATER COMPLICATION RATES COMPARED WITH A STANDARD EXTENDED BIOPSY STRATEGY Jorge Rivera-Mirabal¹, Ronald Cadillo-Chávez², Héctor López-Huertas² and Ricardo Sánchez-Ortiz² ¹University of Puerto Rico School of Medicine, San Juan PR; ²Robotic Urology & Oncology Institute and University of Puerto Rico School of Medicine, San Juan, PR Presented By: Jorge Rivera-Mirabal, BSc Introduction: While an extended prostate biopsy (bx) strategy with 10−14 transrectal cores remains the standard for an initial bx, a saturation bx remains a useful tool in select men with a prior negative bx. Although a transrectal saturation bx may have a greater theoretical risk of bleeding or infectious complications, there is little evidence to support this claim. We sought to compare our complication rates in men undergoing a transrectal extended versus saturation bx strategy. Methods: We performed an IRB−approved review of the records of 324 men who underwent 334 consecutive prostate bx at our institution between 10/2006 and 3/2015. All bx were performed under light sedation. Culled variables included age, prostate size, diabetes mellitus status, prior history of prostatitis, number of cores, antibiotics used, serum PSA, and history of a prior bx. All received oral levofloxacin (ampicillin/sulbactam or TMP/SMX with allergy or prior quinolone exposure), and a Fleet enema with diluted neomycin. Men with a history of prostatitis or a prior bx also received garamycin intravenously. Complication rates were compared between patients with a saturation versus extended bx. Statistical analysis was performed with SPSS. Results: Of 334 bx, 302 were performed as a standard extended bx with ≤19 cores (mean:13.9; median:14) and 32 as a saturation bx of ≥20 cores (mean:27; median:28). Patients in the saturation group were more likely to have had a prior bx (100% vs. 52.6%, p<0.001), have a higher serum PSA (9.5 vs. 5.7 ng/ml, p<0.01), or receive i.v. garamycin in addition to the standard preparation (100% vs. 67.5%, p<0.001). There were no statistically significant differences between groups with regards to mean age (59.7 yrs.), prostate size (47.8 cc), history of diabetes (16.8%), prior history of prostatitis (6.3%), overall complication rate (3.1% vs. 2.3% extended), febrile urinary tract infection (0% vs. 1%), bleeding requiring rectal vault compression with a Foley balloon (0 vs. 1%), urinary retention (3.1% vs. 0.3%), or bx results (positive: 28.1% vs. 31.1%; ASAP or PIN: 6.2% vs. 12.9%.) Conclusion: Our data show that with oral levofloxacin, a neomycin enema, and garamycin, a transrectal saturation bx scheme (28−core) was not associated with greater complication rates compared with an extended strategy (14−cores). Theoretical concerns about greater complication rates with a transrectal saturation bx are unfounded and should not preclude its use in select patients with an indication. Funding: none

Poster #154 EPIDEMIOLOGICAL DISTRIBUTION OF PATHOGENS IN NECROTIZING SOFT TISSUE INFECTION Benjamin Angel, Patrick Hensley, Jonathan Walker, Raevti Bole and Jason Bylund Department of Urology, University of Kentucky Medical Center Presented By: James Benjamin Angel, MD Introduction: Fournier’s gangrene (FG) and necrotizing soft tissue infections (NSTI) of the genitalia and perineum are characterized by a life threatening polymicrobial fasciitis with mortality rates in modern series upwards of 10%. Empiric antimicrobial coverage in combination with early surgical debridement comprise the standard of care. The description of causative pathogens and corresponding sensitivities has been limited. The objective of this study was to describe microbiological data from FG/NSTI in a large, single center series to improve empiric antimicrobial selection tailored to NSTI in both men and women. Methods: A retrospective chart review of patients who underwent surgical debridement for FG/NSTI between 01/2005 to 07/2015 was performed. Abscess, tissue and blood culture

256 POSTERS

or (Appliedor Medical)is a useful sentation didnot differ between I is essentialfor optimal clinical ties, if available. Clinical data was

, and potentially reduced incidence of g resistant organisms (MDR) didnot

early antibiotictherapy likely to pathogens. 257 microbial infections present were infor 60% both

d obese (BMI >30) patients.We present institution’s our ring protector/retract wound - Ajaydeep S. Sidhu, MD The Alexis dual Alexis The

Empiric antimicrobial selection for FG/NST for selection antimicrobial Empiric

147 patients underwent debridement 147 patients underwent available for FG/NSTI. Culturesfor were 145

ari¹, Jorge R. Caso¹ and Alan M.Alan Nieder¹ Jorgeari¹, and R. Caso¹ Introduction: ¹Mount Sinai ofBeach, CenterMedical Miami Herbert Department Urology, ²FIU FL; FL Miami, of Medicine, College Wertheim Presented By: tool for open surgery including radical cystectomy (RC) with urinary diversion. The The diversion. urinary with (RC) cystectomy including radical surgery open for tool advantagesthis of particular retractor using includeand atraumatic adequate wound retraction, protectionfrom contents bowel and spillage surgicalsite infectionWe (SSI). routinely use the Alexis retractor at institution, our and in experience,our during and pelvic it provides RC exposure node dissection adequate lymph ineven overweight (BMI > an 25) outcomes including perioperative factors and incidence of SSI the utilization during of the

ALEXIS WOUND PROTECTOR/RETRACTOR REDUCES WOUND INFECTION DURING RADICAL CYSTECTOMY URINARY DIVERSION AND Poster #155 Ajaydeep S. Sidhu¹, ElizabethT. Nagoda², Rafael E. Yanes¹, Joan C. Delto¹, Akshay Bhand Conclusion: outcomes. Thisfirststudy is the investigate to causativeand their pathogenssensitivities in relation to patient sex.data These may aide inunderstanding the etiology and pathogenesistailoring as well females in as results recorded were inaddition to antimicrobialsensitivi obtainedseveritycalculate (FGSI) Fournier’s to the score. gangrene index Results: patients, 47 females and 98 males.Average age at pre males and females (51.9 years, vs. respectively; 51.6 FGSI p=.913). Average score was lower on presentationmales for (5.1 vs. 7.1, p=.001). The presence of polymicrobial, anaerobic, gram positive,multidru gram or negative significantlystatistically associateda organisms women. with were the in affect MDR FGSI causative of incidence The p=.001). 5.11, vs. males (5.65 in FGSI in increase significant pathogens listed are inthe table.Poly colicommonsexes.mostspp. and Bacteroides isolatedmales pathogen E. The in was while in females the most isolated organism thewas Prevotella spp. 256 Alexis wound retractor for RC. Methods: After IRB approval was obtained, we retrospectively reviewed patients at our institution that underwent an open RC with urinary diversion from February 2010 to July 2015, and included those cases where an Alexis wound retractor was used for the entirety of the case (based on operative note). We also identified a cohort of 30 recent, consecutive cystectomy cases where a traditional Bookwalter retractor was used. We examined patient demographics, operative time, blood loss (EBL), intraoperative complication rate, length of stay (LOS), and postoperative SSI rate at follow up within 30 days.

Results: We identified 22 cases where the Alexis retractor was used for the entirety of the case. See attached table for patient demographics and perioperative outcomes between the two groups. In the Alexis group, 12 patients (54.5%) had a BMI ≥ 25 (25.1-35.0), and 3 patients (13.6%) had a BMI ≥ 30 (30.0-35.0). There were no reported intraoperative complications in the two cohorts. There were 5 (22.7%) SSI’s in the Alexis group, and 10 (33.3%) SSI’s in the Bookwalter group. Conclusion: The Alexis retractor is a useful tool for retraction and wound protection during open RC, and can be safely used in overweight and obese patients up to a BMI of 35. The Alexis retractor also may reduce wound complications and expedite operative time. We suggest prospective studies be performed to elucidate the retractor’s utility further. Funding: None

Poster #156 PROLYL HYDROXYLASE ENZYME INHIBITION PROTECTS THE BLADDER FROM INFLAMMATORY INJURY Douglass Clayton¹, Matthew D. Mason², Magdalena Grabowska¹, Anne G. Dudley¹, Daniel P. Casella¹, Robert J. Matusik¹, Peter E. Clark¹, Stacy T. Tanaka¹, John C. Thomas¹, John C. Pope¹, Mark C. Adams¹, John W. Brock¹, Pinelopi Kapitsinou³, Hanako Kobayshi¹, Qingdu Liu¹, Olena Davidoff¹ and Volker H. Haase¹ ¹Vanderbilt University School of Medicine, Nashville, TN; ²SUNY Upstate Medical Center, Syracuse, NY; ³University of Kansas Medical Center, Kansas City, KS Presented By: Douglass Brooks Clayton, MD Introduction: A family of oxygen-dependent enzymes called prolyl hydroxylases (PHD) regulates stability of hypoxia inducible factor (HIF) proteins. When PHDs are inhibited, HIF proteins are active. During periods of stress, HIF activity is critical for cell adaptation and survival. Other animal models of inflammation show that inhibiting PHD activity using an inhibitor called dimethyloxalylglycine (DMOG) reduces inflammation and protects against injury. Inflammatory injury is a key component of many urologic diseases. We hypothesized that inhibition of PHD enzyme activity with DMOG would protect the bladder from inflammatory injury through the stabilization of HIF proteins. Methods: All experiments presented were approved by our institutional animal care and use committee (M11/217). This work is funded by a career development award from the National Institutes of Health (K08 DK106472-01). Male and female C57BL/6 mice were used to establish experimental cystitis with intraperitoneal (i.p.) cyclophosphamide (CYP) at varying doses (75 - 300 mg/kg). Injection of CYP alone produced rapid inflammatory injury within 48 hours hallmarked by hemorrhage, edema, urothelial loss, and influx of leukocytes. To test the impact of DMOG treatment on this injury model, experimental mice received a

258 POSTERS DU and DU

patients with (one

dministration. Histologic Histologic dministration. the stent subsequent with O and DU voided DU theOwith and

lysisof inflammatory key genes

saline vehicle) immediately priorto CYP

259

qPCR, and histologic hematoxylinanalysis with and specificmechanisms underpinning the effects of DMOG

- ts, inhibition of PHD activity with DMOG prevents CYP CYP prevents DMOG with activity of PHD inhibition ts, channel channel patientsurodynamics. additional An 4 urinary with - not have urodynamics similarly were tested thewith stent. The blockingmedication. All detrusor 8 patients had low pressures and

intermittentcatheterization made was after the patient voided the with stent Douglas A. Swartz, MD Douglas A. Bladder outletBladder obstruction (BOO) BPH with and detrusor underactivity (DU) vidence of tested were DU inserting by a temporary prostate stent In experimen our

The intraurethral prostate stentfacilitated the with BOO diagnosis of

To determine if the temporary determine if the stent (SpannerTM) prostate To couldfacilitate the

Eight patients BOO diagnosed with from benignhyperplasia prostate (BPH) with

Six ofSix the patients urodynamic with diagnosed BO Based upon gross evaluation and bladder weight, strikingdifferences seen were

ction: singlemg16 doseof i.p. (dissolved DMOG in administration. Mice receiving saline treatment prior toCYP served as controls. Readouts of inflammatory injury included gross appearance of the bladder, vivo ex bladder weight, inflammatory gene expression using eosinstaining bromodeoxyuridine as well staining as (BrdU). Results: Results: retention and an Underactive (UAB)Bladder history by diabetic (one long and 3 with standing did BOO) who prostatestent placed was local with anesthesia removedand were after 2 to 30 days. The bladder PVR determined was a B&K with transabdominal ultrasound. A decision to proceed surgerywith or and basedwas on PVRml). (<90 Successfulsurgical outcome a PVRwas ml of < 90 and resolution score). (bother LUTS of BOO determined by multi by BOO determined Introdu Objective: and predictdiagnosis patientsDU surgical in outcome. BOO of with Methods: (SpannerTM). Three patients presented urinary retention with and five had severe Lower ml on 250 > (PVR) Volume Residual void Post a with (LUTS) Tract Symptoms Urinary maximum tolerate alpha prostate stent a low with PVR and subsequentlywere successfully treated with Transurethral ResectionProstate theAll patientssix of (TURP). treated TURP with had subsequent resolution urineTwo high volumes of residual and LUTS. retention high and one with did PVR)not the void with stent subsequently and were treated intermittentwith catheterization. Of the patients presenting retention with and history of UAB without urodynamics, low 3 voided with PVR using successful and resolution TURP the of urinary retention. One patient that void did with not the spanner on intermittent remained catheterization. Conclusion: urodynamic e oftencoexist and present a difficult treatmentAn decision. test objective tosurgical predict avoidunnecessary empiricoutcome is needed to TURP with invasive treatments. analysis reduction showed inhemorrhage (doublearrows and asterisks), urothelial edema, cell heads), hyperplasia neutrophil and (arrow migration in treatedDMOG animals (arrow) (Figure A) compared to controls (Figure B). qPCR ana (IL1b, IL6, significantly Vegfa) showed higher expressionlevels saline in treated CYP controls. Urothelial measuredproliferationas BrdU decreased by stainingshowed cell turnover in controls. Conclusion: between between andDMOG saline treated animals CYP following a DouglasShah² and Sagar Swartz¹ DIAGNOSIS OUTLET BLADDER OF OBSTRUCTION DETRUSORMEN INWITH UNDERACTIVITY BASED ON VOIDINGWITH THE SPANNERTM TEMPORARY STENT PROSTATE treatment. Poster #157 Clinic Urological FL; ²McIver ¹Jacksonville, Presented By: cystitis.mediated The effects seenbe to appear activation. acute pathway by HIF Further iswork needed to dissect the HIF predictedbe successful would TURP inthese patients severe or LUTS retention with with PVR. high financial external No study.thisfunding for received was 258

Poster #158 MULTISPECIALTY RETROSPECTIVE REVIEW OF THE CLINICAL UTILITY OF PELVIC MRI IN THE SETTING OF PELVIC PAIN John Moore, Ram Pathak, Gregory Broderick, Candice Bolan, Mellena Bridges and Caroline Snowden Mayo Clinic Florida, Jacksonville, FL Presented By: John R. Moore, MD Introduction: We sought to evaluate the utility of MRI in the assessment of male pelvic pain (MPP). MRI has become the gold standard radiology test for pelvic anatomy. MRI’s are commonly ordered to evaluate pelvic pain. There are very few studies detailing the efficacy of pelvic MRI in delineating the anatomic origin of MPP. The primary aim of our study was to evaluate the clinical utility of pelvic MRI as defined by a congenital or acquired anatomic abnormality. Methods: IRB approval (15-004216) for a minimal risk protocol was obtained. The retrospective analysis included all male pelvic MRI’s from 2010 – 2014, at our institution. These were further categorized by ordering providers’ specialty (Urology, Pain Management, Oncology, Internal Medicine Specialties, Colorectal Surgery/Gastroenterology, and Orthopedics/Neurology) and urology specific diagnosis codes (male pelvic pain, prostatitis, groin pain, scrotal pain, testicular pain, orchitis, and penile pain). Clinical utility was defined as pathologic findings on MRI. Sub-analysis was performed on the co-diagnosis of cancer. Results: Of the 2,643 non-musculoskeletal male pelvis MRIs performed at our institution over a 5 year period, 597 (22%) were ordered for MPP. Diagnosis codes included: hip pain, rectal pain, joint pain, penile pain, scrotal pain, male pelvic pain, and orchitis. Results by specialty are listed in the table below. Congenital or acquired abnormalities were identified in 205 of 597 cases (34%). Only 5% of MRI’s for MPP were ordered in the setting of malignancy; not surprisingly the majority of those patients were followed by Oncologists. For urologic specific diagnosis codes, clinical utility proved to be 23%. Conclusion: We were surprised to find a large number of both specialists and generalists to be invested in the evaluation of MPP. MPP is difficult to treat, often occurring in a setting of generalized pain. With increasing availability of MRI technology and its specificity for identifying anatomic abnormalities, it might be presumed that MRI is a likely test to define a clinically significant anatomic reason for pain. Our study suggests that pelvic MRI identifies the etiology of MPP in one-third of cases.

260 POSTERS 0 -

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0 V - mass (28.2), index catheter time (mean 8.4 days), en 2007 and 2015 were identified.en 2007 and 2015 were the first For 571 - Huertas², Ronald Cadillo - ferences groups regards between with to late early or operative complications extracted by and outcomes were up, 89.2% free were -

- e began adding another stitch end tothe reapproximate at layer (SL) running vesicourethrallayer anastomosis using Quill - Negron, MD -

stimated bloodstimated loss (87.3 cc), length of stay (1.04 days), history approved prospectiveapproved database, 639 consecutivecancer prostate - h 2.2% (10/454) ofh 2.2% (10/454) patients artificial opting for or a sling urinary operative urinary retention (POUR) has been reported in3 operative defined TOS success was as the use of 1 security 0 or - - 571). SPSS was used forSPSS statistical was571). used analysis. phic data, post - Despite modificationsDespite intechnique, urinary incontinence after radical Post

Juan GuzmanJuan Negrón¹, Héctor López Bryce A. Allio, MD Allio, A. Bryce Performinglayer vesicourethral a double anastomosis did not prolong

s defined as being free of padsmonthsat 2 4 months or postoperatively. The s 518

0 Using our IRB We retrospectively men reviewed undergoing a TOS at institution our from 2006 LAYER VESICOURETHRAL ANASTOMOSIS ASSOCIATED WITH WITH ASSOCIATED ANASTOMOSIS VESICOURETHRAL LAYER

Patients higher likelihoodofcontinent anastomosis a DL with had a being at 2 - Ortiz²

- o’clock to the 9 o’clock position with 3 with position o’clock 9 the o’clock to - Poster #159 DOUBLE IMPROVED CONTINENCE EARLY ROBOTIC RADICAL PROSTATECTOMYAFTER Juan Guzmán Introduction: prostatectomy (RP) remains a challenging problem insomepatients, particularly in our Hispanic population a high with rate of obesity and diabete ¹UniversityJuan,ofPR; ²RoboticSan SchoolPuerto Oncology Rico Medicine, of Urology & InstituteRicoSchool Medicine, Juan, of PR and University San Puerto of Sánchez Presented By experience early urinary continence with after double adopting a anastomosis. Methods: cases,theanastomosis performed was a Rocco with posterior reconstruction using 3 Monocryl a singlefollowed by patients treated robotic betwe with RP suture.Afterthe 572nd case, w the anterior detrusorto the striated horseshoe sphincterveinrunning it and dorsal fromthe 3 of diabetes (18.3%), (27.9%). obesity or note, Of managed inpatients a SL with anastomosis follow >1 year with operative time min), (165 e probability ofthose early continencetime the groupbetween compared DL at was points (n=52) and the52 immediate consecutive patients underwent who a SL anastomosis (n=52) (case endpoint, wa Results: monthsp<0.02) compared (55.7%months vs. and 4 34.6%, p<0.02) (53.8% with vs. 28.8% the SL group. no dif There were complications,meatalstrictures (1%), early urinary retentionmean (2.9%), age (57.5 years), prostate (48.5 weight g), body operative associated a greater time with was and prob ofmonths, 24.9 wit sphincter procedure due to more severe incontinence. Conclusion: months afterWhether prostatectomy. robotic long thistechniqueSLcompared anastomosis longer a with studiedwhen follow will be to 2012. Demogra chart Post review. becomes available. Funding: none Poster #16 PREVENTMALEIN PATIENT CAN THE UNNECESSARY SURGICAL INTERVENTION C. PetersonBryceA. Allio,Andrew Ajay Divya and Division Urology, University of Medical Duke Caroli North Durham, Center, Presented By: AN ALGORITHMIC APPROACH TO MANAGING POST MANAGING TO APPROACH AN ALGORITHMIC Introduction: patientsmale undergoing a transobturator sling for (TOS) post Methods: incontinence (PPSUI). Our objective towas e undergoing TOS, interventions to used address and resolution it rates to an propose algorithm for management. pads/day, negative stress exam test on pad or lessweight than 8 g/day. POUR was 260 defined as patient reported inability to void requiring urological intervention. Results: 290 men with PPSUI that underwent a TOS were identified. POUR was reported in 11.7% (34/290). 33 of these patients had a radical prostatectomy and 1 had a radical cystoprostatectomy with an orthotopic neobladder. Clean intermittent catheterization (CIC) was taught to 67.6% (23/34) patients, 29% (10/34) had an indwelling foley placed. The patient with the neobladder decided he no longer wanted to CIC and underwent sling lysis. All remaining patients resolved spontaneously with 85% (29/33) experiencing retention for 1-7 days and 12% (4/33) for 7-30 days. Conclusion: Post-operative urinary retention is distressing however resolves in most cases spontaneously and with only conservative management. We propose the following algorithm outlined in Figure 1. for the management of POUR. Sling removal should be reserved only for POUR lasting greater than 30 days.

Poster #161 PATTERNS OF MALE INCONTINENCE PROCEDURES IN THE VETERANS AFFAIRS (VA) POPULATION Samuel Belknap¹, Jonathan Walker¹, John Lacy², David Preston¹ and Shubham Gupta¹ ¹University of Kentucky and VA Medical Center, Lexington, KY; ²Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH Presented By: Samuel Belknap, MD Introduction: We sought to evaluate the surgical management of male incontinence procedures in the VA population. We also sought to identify whether medical comorbidities or race were factors in the decision for placement of a male sling versus an artificial urinary sphincter (AUS) in the VA and clinical outcomes for these procedures. Methods: A retrospective chart review was performed using the VA Informatics and Computing Infrastructure (VINCI) database to access the Corporate Data Warehouse (CDW). Current Procedural Technology (CPT) codes were used to define a cohort of any male who underwent placement, revision, or removal of a male sling or AUS between 1/2000 and 12/2013. Data were then grouped and analyzed based on age, race, comorbid conditions, and CPT code and subsequent procedures. Results: A total of 2,907 male incontinence procedures were performed in 1,301 patients whose first procedure was either a sling (n=407, 31.3% of cohort) or an AUS (n=894, 68.7% of cohort) in the VA system. AUS placement was associated with a higher need for reoperation compared to sling (41.6% vs. 24.6%, P<.001). 100/407 (24.6%) of patients whose first procedure was a sling underwent a second procedure during the time period compared to 390/894 (41.5%) of patients whose first procedure was an AUS. Men who had

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- - –

day major major day –

ined,risk adjusted and nationally incontinencesurgery during the study period: - 263 CPT placement53445) withinthe years 2011

- Meier freedomMeier fromreoperation for sphincter was -

NSQIP). underwentPatients who maleurethral sling (CPT -

year Kaplan s anti underwent - related unplanned readmissions unplanned and related return to based program. and 10 -

ram(ACS - re thatre included unplanned readmission related to the procedure,

ated unplanned return to the operating room (1.7% vs. 0.0%, p=.016). 0.0%, to operating ated(1.7% the vs. unplanned room return Totheevaluate complications perioperative treatment after the male of Allen J. Simms, BS Simms, J. Allen nificant (p = .118).nificant = (p

We present cohort a large male of incontinence proceduressingle inthe

In a multicenter prospectivelymaintained cohortmen underwent of who anti

gs in other populations. in gs This is an analysis of prospectively data obtained from academic and community 789 male patient

mericanmen less were likely to AUS undergo placementcompared to ion: A - Introduction: validated outcomes Methods: medicalcenters through American the College Surgeons of National Surgery Quality Improvement Prog urinary incontinence using a prospectively mainta PERIOPERATIVE COMPLICATIONSMALE INCONTINENCE AFTER SURGERY: PROSPECTIVE CENTER MULTI VALIDATED NATIONALLY A FROM RESULTS COHORT Poster #162 Allen Simms¹, Daniel Davenport¹, Sudhir Isharwal², Sara Johnson¹, Stephen Strup¹ and Shubham Gupta¹ Presented By: or53440) artificial urinary sphincter (AUS ¹UniversityKentucky, of KY; Lexington NE Omaha ²University Nebraska, of an AUS placed were lessan AUS placed were likelyAfricanbe to more American (P<.001) and were likely to be obese (P<.001). 5 2013 comprisedthe study population. Theprimary outcome a composite was 30 morbidity measu Results: unplannedreturn the tothe room operating torelated procedure, infection, treated deep venous thrombosis pulmonary or failure. pneumonia, embolism, acute or renal Conclus 62% and 58%, respectively.62%58%, and VApayer system. placement AUS occurred at a higher rate than maleslings in the VA highersystem than previously AUS were and revision ratesfor reported civilian data. African 370 slings, and 419 AUS. no There perioperativewere deaths, no patients required transfusion,cerebrovascular cardiovascular and no or complications most The occurred. common morbidities were morbiditythe thangroup Table). operating sling(see group AUS room higher Major in was (5.5% p=.031), vs. higher 2.4%, including related unplanned readmissions (3.8% vs. 1.4%, p=.044) and rel

Caucasians. underwentPatientsmaleless sling who require were repeat tosurgical likely interventionthose had AUS thanFurther placement. warranted who to studies confirm are these findin Octogenarians comprised 9.5% of patients (75/789) and had more than twice the majorOctogenarians twicemore comprised than the patients 9.5% of (75/789) and had morbiditythan rate less elderly (8.0%) patients (3.8%), this not but difference was sig statistically Conclusion: 262 incontinence surgery, major morbidity was infrequent, and was slightly higher after AUS placement as compared to sling placement. Despite a numerically higher complication rate as compared to younger patients, octogenarians’ overall complication rate was low, with no mortality or severe cardiovascular morbidity. Male slings and AUS are safe operations with low peri-operative complications, even in elderly patients.

Poster #163 DOES TROCAR PUNCTURE OF THE BLADDER DURING RETROPUBIC MIDURETHRAL SLING IMPACT POSTOPERATIVE URINARY STORAGE AND VOIDING SYMPTOMS? J. Margaret Kent, Clifton F. Frilot II and Alex Gomelsky LSU Health - Shreveport, Shreveport, LA Presented By: Jennifer Margaret Kent, MD Introduction: Trocar-mediated bladder puncture complicates 2-24% of retropubic (RP) midurethral slings (MUS) and is typically treated with trocar repositioning and extended continuous bladder drainage. It is unknown whether trocar puncture leads to development of future storage or voiding sequelae, prolonged catheterization, urinary tract infections, or decreased patient satisfaction with surgery. We aim to further characterize risk factors for bladder puncture and examine long-term patient outcomes following RP MUS placement. Methods: We performed an IRB-approved, retrospective chart review of women who underwent top-down RP MUS at our institution. Voiding trial was performed per protocol on day of discharge. Those failing to void efficiently were discharged with an indwelling urethral catheter and repeated the trial as outpatient. Pre- and postoperative assessment included pelvic exam and quality of life (QoL) indices. Cure was defined as no subjective or objective SUI and no additional procedures for SUI. Demographics and perioperative details were abstracted from the patient charts. Results: We identified 683 women who underwent a retropubic MUS with a mean follow- up of 18.1 ± 17.2 months. Thirty-one women (4.5%) had a bladder puncture [right (21), left (10)]. One of these was missed on intraoperative cystoscopy and underwent partial excision the next day. Women in the puncture group had statistically lower body mass index (26.2 vs. 30.2) and lower valsalva leak point pressure (79 vs. 89 cm H2O) vs. the non-puncture group. Other demographic variables and QoL index scores were not statistically different between groups. Median day of discharge (1 for both) and day of successful voiding (1 for both) were not statistically different between the puncture and non-puncture groups. Subjective postoperative emptying and prevalence of de novo storage symptoms was not significantly different between the 2 groups. There were no associations between laterality of puncture and postoperative storage and voiding symptoms. No patient suffered an intraoperative urethral injury and cystoscopy performed during follow-up period in 12 women in the puncture group and revealed no erosion. Postoperative QoL indices were significantly improved regardless of bladder puncture. Conclusion: Bladder puncture during retropubic MUS surgery does not seem to be associated with additional urinary storage or voiding sequelae. Median time to successful

264 POSTERS - he and

- related

operatively. All - refractory LUTS -

operative outcomes of - operative cystoscopy. A -

operative AUASS SHIM and scores - bladder punctureis not associated with delayed voidingtrial mayconsidered be in and post -

gnificant patient’s impactthe on erectile or - 265 retrospectivemanner. of surgery performed Choice

s preserving while ability. sexual their

16). The median16). The number of PUL 2 implants 4 (range was

- men significant reported their improvement in urinary function.

the prostate (TURP), Greenlight laser vaporization of the prostate

vation, When care, choosing of surgery. pharmacotherapy, a plan and operative hematuriarequiring continuous approximately hours of 24 operative AUASS (15.7,moderate) significantly was improved compared (CBI), while another case was complicated by a retained needle of the retainedcomplicated needle a by caseof was (CBI), another while - - nign prostatic hyperplasia(BPH) iscommon one ofmostconditions the ulatory function; was there no significant change the pre in average ral Lift is(PUL) procedure gaining popularity as itminimally offers a invasive Be Jonathan Beilan, MD Ram Pathak, MD The primary aim this of study was to investigate peri PULsafe offers and viableoption a inthe treatment of bladder outlet eilan, Jared J. Wallen,J.B. Shah, Jared Bickell, Michael Bhavik eilan, Daniel Martinez, R.

dependent. Informationcollected demographics, included patient operative

test was usedtest was to analyze the pre operative (24.2, values severe, p=0.01). reported patient No a decline inhis All patients underwent who TURP, PVP, and HoLEP from January 2012 to The first 15 patients PUL treated with from men’s two health sexual clinics in - -

The age of cohort average the 63.3 was years. followed for Patients a were

BPH, and prioritized maintaining theirbaseline sexual function post operative SHIM scores two adverse (p>0.05). There were events: one patient - roderick, Todd Igel, Steven Petrou, Michael Wehle,roderick, ThielStevenPetrou,Todd Dave Igel, Young Paul Michael and Introduction: managedmen’s in healthcare centers. The need for intervention to improve BPH due to voiding is similar inthe both groups. Likewise, PROSTATIC URETHRAL LIFT:BPH TREATMENT INCLINEDSEXUALLY FOR THE delayed sling erosionthe into Non bladder. women sustaining a bladder puncture. Poster #164 JonathanA. B JustinJ.Parker, HernandezE. and Rafael David Carrion USF of Morsani DepartmentHealth Urology,College Medicine, of Tampa, FL Presented By: urinarylower tractsymptoms (LUTS) increases age; with treatment options include conservative obser themust patient considersuch efficacyand his urologist as numerous variables and duration of treatment, invasiveness, dysfunction.suchsexual and adverse effects as The Ureth Prostatic maximalmaintainmen function. desired tosexual PUL procedure who in Methods: treatmentmodality to little shown have that has been effect the patient’s on sexual performance.This study report serves to initial our surgical and experience outcomes t of Tampa, FL includedwere inthis study. Selected patients had medication student’s t patients demonstrated bilobar prostatic hypertrophy on pre in function, to sexual order voiding assess respectively. and Results: 6).the Of 15 patients, 11 medianmonths 4 of 0.5 (range erectile ejac or The post average to the pre experienced post post irrigation bladder Urolift required which subsequent endoscopic device, removal. Conclusion: obstructionsecondary to no siwith BPH, allow will PUL to include armamentarium urologic the Expanding function. ejaculatory men’scenters counsel effectively to health patients treatmentBPHmodalities on with that will improve their voiding symptom PRACTICE LEVEL IMPACT OF THE ENDOSCOPIC MANAGEMENT OF BENIGN BENIGN OF MANAGEMENT ENDOSCOPIC THE OF IMPACT LEVEL PRACTICE CARE? OF QUALITY WEIMPROVING (BPH): ARE HYPERTROPHY PROSTATIC Poster #165 Shah,RamBrennan, Diehl,KandarpPathak, Heckman, Emily Mike Nancy Gregory B Mayo Clinic Jacksonville, Florida Clinic Jacksonville, Mayo (PVP),single enucleation institution a and Holmium surgeons).at (HoLEP) (6 Methods: December 2014 were examinedDecember 2014 were ina Presented By: Introduction: surgeonwas transurethral resection of 264 characteristics, post-operative outcomes, and intra/post-operative complications. Results: 291 consecutive patients who underwent TURP (N=199), HoLEP (N=60), or PVP (N=32) for BPH were included in our analysis. Regarding demographic and disease information, characteristics were similar between the three surgery groups with the exceptions of pre-operative PSA (P=0.001), likely secondary to the fact that HoLEP was more often reserved for larger glands. Differences were evident regarding pre/postoperative change in Qavg (P=0.018), pre/post-operative change in PVR (P=0.020), pre/post-operative change in hemoglobin (P=0.004), length of hospital stay (P<0.001), and duration of catheterization (P<0.001) (see Table 1). There was no difference in 90 day change of AUA system score or Qmax between the 3 groups. Conclusion: TURP appears to have favorable outcomes in terms of urodynamic parameters including Qavg and PVR, while PVP tends to have less duration of hospitalization and blood loss, though significantly greater length of catheterization. The three treatment modalities were similar in terms of rates of 90 day symptom improvement, transfusions, post-operative episodes of urinary or clot retention, and hospital readmission.

Poster #166 REOPERATION FOR SEVERE COMPLICATIONS AFTER 180-W XPS GREENLIGHT® LASER VAPORIZATION OF THE PROSTATE David C. Moore, Joshua A. Cohn and Mellissa R. Kaufman Vanderbilt University, Department of Urologic Surgery, Nashville, TN Presented By: David C. Moore, MD Introduction: 180-W XPS GreenLight® laser (GL) vaporization of the prostate has become widely adopted secondary to its comparable functional results to transurethral resection of the prostate as well as shorter operative and catheterization times. The procedure is thought to be safe, with hematuria and urinary retention being the most frequent complications necessitating reoperation. Though uncommon, we sought to characterize patients with new onset debilitating lower urinary tract symptoms with incontinence following GL and describe management of this challenging clinical presentation. Methods: We retrospectively evaluated all patients referred to our institution for severe LUTS and incontinence following GL. In all patients, initial clinical evaluation included urodynamics (UDS), cystourethroscopy, and AUA symptom score (AUASS). Following initial evaluation, all patients were managed according to clinician judgment and patient preference with stepwise escalation of treatment invasiveness as required. Results: Six patients met inclusion criteria. Mean age was 59.2 ± 2.6 years at the time of GL. Mean AUASS at tertiary presentation was 23.5 ± 2.3. All patients reported incontinence. On UDS, 5 patients (83%) had detrusor overactivity, 3 with leak. Mean Abdominal Leak Point Pressure was 37.2 ± 10.7 cmH20. Mean detrusor pressure at maximum flow was 19.9 ± 7.5 cmH20 corresponding to a mean maximum flow rate of 9.6 ± 3.1 ml/s. In all patients, post void residuals were less than 50 mL. Findings on cystourethroscopy included: prostatic regrowth (2), bladder neck contracture (1), necrotic bladder neck (1), and non-coapting external sphincter (3). One patient forewent further surgery after diagnosis of advanced lung cancer. The remaining 5 patients underwent an average of 4.6 ± 1.7 additional procedures with the first procedure occurring 202 ± 40.2 days after GL. These procedures included: procedures for urethral stricture disease (7), Botox® injections under anesthesia (5), artificial urinary sphincter placement and revisions (3), InterStim® (3), penile prosthesis (1), suprapubic tube (1), second GL (1) and simple

266 POSTERS

36 (general 36 (general Sexton¹, -

ect patients. ect . s. 6.4, p=0.08, 8 (distress and reported health - -

operative discussion -

l and understudied life Diorio¹, Wade J

. tictrigone bladder neck bilateralwith and and women from different socioeconomic

ealth questionnaires, including SF including questionnaires, ealth 267

outcomes according vary to demographic,social and

demographicstratato identify differences and trendsin FL; ²University of Florida, Gainesville, FL Gainesville, Florida, of ²University FL; needed to shedneeded to additionalto understudied light this area.

re (SAS, Cary, NC). Preparing surgery for is cancer stressfu complex, a Andrew Robert Leone,Andrew MD

Patient reported health This smallseriesThis highlightscase but rare sequelae debilitatingthe of GL and

One hundred sixty eight patients from two centers were enrolled centers sixty hundred eight patients intwo froma prospecti One were Mean age was 67.8 years. . Women preparing. for 67.8 cystectomy age was years. Mean lower reported esent patient poor selection, improperoperative technique, operative underreported or Introduction: event. Todate, littleexaminedresearch has patients’ reporttheirhealth of and quality of life prior to radical cystectomy,as a result and little aboutisknown the level of stress they experience if or health states inmen vary backgrounds. Toaddress this sought we to gap, better quantify patient statestocystectomy. leading radical up Methods: Michael Gilbert¹ Carl Henriksen², ScottPoch¹, Jacobson¹Paul M. and ¹Moffitt Cancer Center, Tampa Presented By: observational cohort study between to 2013 2015, of complete 94 had which baseline data availablefor analysis. this Baseline demographic,clinical and socioeconomic information collected was at registration. Patients completed battery of validated h a cystectomy inone patient found a necro have to grade Vgrade vesicoureteral reflux. Conclusion: exceptional clinical challenge these casesIt if represent. these is unclear outcomes repr complications GL. with associated Thesesupport data a thorough pre of the risks of this procedure and may suggest a role for UDS prior to GL in sel GL prior in for to may UDS role suggestof procedure risks this and the of a Andrew Leone¹, OliviaAndrew Padron¹,C. Adaixa OBrian¹, J Gregory DIFFERENCESIN PATIENT REPORTED QUALITY HEALTH OFAND LIFE PRIOR TO CYSTECTOMY:INITIAL RESULTS CANCER FROM OUTCOMES BLADDER AND IMPACT (BCOIS) STUDY Poster #167 health and wellbeing),PHQ BCI/BIS and physical (functional outcomes), depression),the Coping Strategies and (copingIndex style) prior to cystectomy. Survey results compared acrosssocio were physical,mental functionaland health before surgery. Patient reported outcomes were compared using t tests for binary groups and ANOVA for three or more categories using standard statistical softwa

Results: sexual scoressexual and higher depressionsymptoms men, than although differences in questionnaire not scores statistically were significant (PHQ8 scores 8.9 v >10major cutofffor and depression). incomes more Men women low with were likely to indicate avoidancecoping as than a strategy patients inhigher income groups. Complete results shown are in the Table. Conclusion: economic factors, suggestingthatimportant differences exist regards with patients to how cope the with stress a bladder associated with cancer diagnosis and preparing for cystectomy. studies Larger are 266 Poster #168 SURGICAL EQUIPMENT COST AWARENESS AMONG UROLOGICAL SURGEONS Joshua Langston, Matthew Macey, Troy Sukhu, Jason Lomboy, Allison Deal, E. Will Kirby, Davis Viprakasit, Matthew Nielsen, Raj Pruthi and Angela Smith Chapel Hill, NC Presented By: Joshua Paul Langston, MD Introduction: A growing focus on cost containment in healthcare is leading to increased scrutiny of all phases of care. Surgeons use a wide variety of disposable surgical tools, which account for a substantial portion of outpatient surgical costs. Our objective was to determine individual surgeons’ awareness of disposable cystoscopic equipment costs, determine whether practice characteristics could account for this, and assess the value placed on cost containment in surgical decision making. Methods: Qualtrics software was used to administer a 34-question survey to Urological surgeons (residents and attendings) at The University of North Carolina. Focusing on commonly used disposable supplies in the cystoscopy suite, each item included a photograph for identification and solicited a free text response estimating the items’ actual cost to the hospital and how often the respondent used it. Results: 23 of 24 (96%) of surveys were returned. 84% (16/19) felt that cost was "Important" or "Very Important" in the selection of equipment, while 48% (9/19) reported that they attempted to minimize costs "often" or "all the time." 68% (13/19) underestimated aggregate true costs. 20% (4/19) estimated within 33% of aggregate true costs. Basic cystoscopic equipment costs were underestimated by a mean of $3,965. There was no correlation between accuracy and number of cases performed using this equipment or ‘years in urologic practice,’ with R=-0.14 and R=-0.13 respectively. In addition, there was no significant association between self-rated knowledge of equipment costs or degree of consideration of costs in surgical decision making, p=0.6509 and p=0.6244 respectively. The Double-J stent showed the highest mean variance in this category, being underestimated in cost by 40%. Trans-urethral resection and catheter-related costs were overestimated by $487 and $151 respectively. Similarly, there were no correlations of cost accuracy with years in practice, self-rated knowledge or consideration of costs. Catheter- related items had the highest number of uses per month and also the highest percentage variance from true cost, 217%. Conclusion: Surgeons show a high degree in inaccuracy in estimating the cost of equipment used in cystoscopic surgery. Neither experience nor consciousness about cost leads to accuracy in estimating costs. The vast majority believe cost should be considered when selecting equipment. Informing physicians of true costs is essential in controlling unnecessary disposable equipment expenses.

Poster #169 ACTIVE ANALYSIS OF PERIOPERATIVE DEFECTS IMPROVES OPERATING ROOM QUALITY AND EFFICIENCY James Mason¹, Anja Zann¹, Clark McCall², Francesca Enneking² and Paul Crispen¹ ¹University of Florida Department of Urology, Gainesville, FL; ²University of Florida Department of Anesthesiology, Gainesville, FL Presented By: Anja M. Zann, MD Introduction: Operating room inefficiency has been linked to patient dissatisfaction and increased cost of care. There are many defects related to operating room inefficiency with some heavily influencing turnover delays. There are multiple avenues for defects to arise and sabotage the efficiency and quality of a high volume operative center. We sought to improve operating room quality and efficiency through identifying and tracking perioperative defects on the day of surgery. By actively monitoring for delays and establishing personnel and process accountability we aimed to reduce perioperative delays and decrease turnover time. Methods: Operating room times and delays for urologic surgeries were tracked for 9 months. Known defects were tracked and newly identified causes of delay were added to the existing defect list. Identification of existing and new defects as the cause of delay were

268 POSTERS

ts intostandard a ificto payments for surgical heavy distributionheavy of payments - y y to 19 men’s health surgeons. aid Services (CMS) website. WeServicesaid website. (CMS) ments, with $167,163 towards men’s

related clinical trials, while Coloplast funding is is funding Coloplast while trials, clinical related - 269 for 2014 allows for a transparent examination of

ments (mean $184,194). The top five men’s health e manufacturers. primarilye Surgeons who implant cient data for analysis. Perioperative defects affected

inflatablepenile prostheses,male slings, and artificial

related clinical trials. The top five men’s health surgeons for - se found was to be related to local extended anesthetic blocks, es and malees continence devices but than the AMS, data that show

from 47 to 37 minutes. perioperative delay tracking Adherence to 37 from 47 to was

The Affordable ActCare mandatesmanufacturer reporting of financial Incorporating identification perioperative of defec Martin Gross, MD

CMS OpenCMS Payments data

By: A review of the CMS Open Payments performed. was Payment of Open information data A the review CMS

Atotal of tracked urologic 713 cases operativemonths. were 9 those, over Of volume implanters of

AMS distributed top approximatelythe 25 to general payments $2,588,908 in

antly towards maleantly slingtrials. There is also a top -

related clinicaltrials. Coloplast distributed $246,278 inresearch payments, with - Shreveport Department ²Regional Urology; Urology, of Shreveport, LA - RGING DATA REGARDINGRGING TRENDS DATA SURGICAL INEDUCATION AND was separatedwas into general paymentsand research payments. top 25 surgeons The were devic compiledthe two from each of femaledevices removed from were the listthere as other are device manufacturers in the market who provide these products. We then selected the men’s health urologic surgeons (i.e. high voiced involved standard by inductionstafftime operating prior to out during a process of anesthesia. Results: 610 cases found tohave were suffi 420 (68.9%) cases. Turnover time> 45 minutes related was to 146 defects the with most tardycommon turnovercases anesthesiawith operative being of consents. Inor 50% over time > 45 minutes the cau incorrect equipment,posting incorrect procedure tardiness.Percentage and patientcase of delays >45 minutes decreased were fromto 40% 26% 9 months. over Average turnover time decreased was inverselyturnover related time roomthus effect. demonstrating to a Hawthorne Conclusion: EME pre−induction time out improves operating room time. This efficiency process also the has potential to improve operating room quality reducing by by decreasing room turnover preoperative mistakes avoiding confusion. and Poster #170 RESEARCH FINANCIAL RELATIONSHIPSMANUFACTURERS DEVICE BETWEEN PROSTHETICAND UROLOGISTS MartinGross¹ Gerard Henry² and ¹LSU Presented Introduction: education research. and Methods: Results: Coloplast distributed approximately $2,702,278 in general paymentsthe to top 25 prosthetic urologists on its list, with $1,988,184 specifically AMS distributedto a total of in $333,371 research pay 16 men’s health surgeons. health prosthetic urologists on its list, $1,852,715 with specificall relationshipshospitals. physicians with first and The of regarding year Open data Payments for 2014 is available for Medicarevia the and Medic Center urinary sphincters)for further detailed analysis. explored the financial relationships the between primary prosthetic urology device manufacturers, American Medical Systems and Coloplast, and the surgeonswhom with they financial have relationships spec men’s health urologic $18,787 towards men’s health totalAMS $920,974 pay of accrued in a surgeonsfor Coloplast a total $1,522,302 (meanin of accrued payments $304,460). Four formanufacturers, ten both.top for the surgeons in top both one in with the 25 were Conclusion: predomin Coloplast,by the with first five surgeons receiving substantiallymore funding on average forthan AMS. those the financial relationships between men’s health prosthetic urologists and industry thatsignificantlyfirst Coloplasttime. known ismarket well smaller a has It share in for the inflatable penile prosthes they distributemoneytomore urologists prosthetic surgical AMS for research education. funding appears to be directed towards IPP 268 Poster #171 ADVANCED PRACTICE PROVIDERS IN U.S. UROLOGY Joshua Langston¹, Heather Schultz¹, Troy Sukhu¹, Jason Lomboy¹, Matthew Macey¹, Venetia Orcutt², E. Will Kirby¹, Matthew Nielsen¹, Angela Smith¹ and Raj Pruthi¹ ¹Chapel Hill, NC; ²Dallas, TX Presented By: Joshua P. Langston, MD Introduction: As healthcare models evolve and provider shortages grow, the role of Advanced Practice Providers (APPs) in Urology continues to expand. To date, little is known about the practice characteristics and developing trends within this group. Our goal was to conduct a role delineation study of Urology APPs in the United States examining demographics and practice characteristics. Methods: An anonymous, 29 item, Qualtrics web-based survey was sent to APPs identified by membership in the American Urology Association (AUA), the Urology Association of Physician Assistants (UAPA) and the Society of Urologic Nurses and Associates (SUNA). Data were analyzed via SAS 9.4. Results: Of a possible 1347 respondents, 296 completed surveys for a response rate of 22%. Advanced practice nurses (APNs) represented 62% of respondents, while Physicians Assistants (PAs) comprised the remainder. The majority of respondents were female (80.8%) with a median age of 46 years. While 41% had been in urology practice 5 years of less, 16% had over 15 years in this specialty. The majority had no post-graduate specialty training in urology (76%). Practice setting was divided between medium-sized Private Practice (2-9 physicians) (25%), Academic/University (18%), Hospital-employed (18%), and large Private Practice (>10 physicians) 16%. Most APPs are employed in settings which include multiple APPs, with a median of 2 PAs and 2 APNs in the group. Practice focus was overwhelmingly ‘General Urology’ (73%), with ‘Stone Disease’ (28%), ‘Female/Neurourology’ (23%), and ‘Oncology’ (21%) as additional areas of focus. Respondents were evenly distributed over AUA geographic sections with 52.9% practicing in urban settings. The majority of care was provided in the ambulatory setting (74.9%) with visits conducted predominantly independently (74.9%). Procedures performed by APPs varied widely, but most commonly were bladder instillations of chemotherapy, intracavernosal injections for ED, urodynamics testing, neuromodulation for incontinence, and implant insertion (LHRH Antagonist, Testosterone, etc) Conclusion: The increasing burden of urologic disease in America coupled with a decrease in the supply of urologists will continue to impact access to care. Continued characterization of urologic care provided by APPs is required as workforce researchers investigate innovative models of care and the potential for expanded scopes of practice. These results enhance our understanding of advanced practice providers currently employed in urology practice.

Poster #172 THE EFFECT OF DISTANCE TO A HIGH-VOLUME CENTER ON RECEIPT OF TREATMENT FOR INVASIVE BLADDER CANCER Troy Sukhu, Jason Lomboy, Matthew Macey, Anne-Marie Meyer, Ke Meng, Matthew Nielsen, Raj Pruthi, Eric Wallen, Michael Woods and Angela Smith Chapel Hill, NC Presented By: Troy A. Sukhu, MD Introduction: Regionalization of major surgery such as cystectomy has spurred interest in the association of high-volume centers (HVC) and improved post-operative outcomes. However, concerns have been raised regarding access to care, with increasing travel distances playing a role in treatment selection. Our objective was to evaluate the effect of distance to closest HVC on treatment selection for muscle-invasive bladder cancer (MIBC). Methods: Using a linked data resource combining NC Cancer Registry with administrative claims data from Medicare, Medicaid, & private insurance plans, we included adult patients diagnosed with Stage 2 bladder cancer from 2003-2008. We created 2 mutually exclusive treatment groups (standard: cystectomy or chemo-radiation; non-standard: other or no treatment). HVCs were identified as those performing >15 cystectomies during the study

270 POSTERS , 1

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standard therapy had - standard therapy, even , Christopher, Ledbetter - 1

NT SETTING line zip distancecode between of -

, Davis Matthew 2 es & multivariable logistic regression were 271

, Timothy Boswell 1 dard treatment.dard standard age of the Mean patients in group standard (p<0.001). group Groupsalso differed race by and - 0 miles) (p<0.004). On multivariable analysis, distance>30 miles stan - Grove City College, City PAGrove City, Grove 2 and Robert Wake

1 d treatment). no significant However, noted difference was for tionsProstate forSpecificAntigen testing controversial, are (PSA) and

nce to HVC is notincreased with associated is to likelihood HVC receiptnce of of Lindsey Hartsell, MD M. Indica Dista

standar -

provides guidelinesfor PSA screening for the there Urologist. clearly are Though 274 patients with confirmed MIBC were identified,patients confirmed with were 274 MIBC n=123 undergoing with

tely ordered, examine which confounding clinicalfactorsmay been present, have appropriate uses for PSA in the inpatient setting, manyappropriatesetting, inpatientin the PSA uses confoundingmay potential for factors exist such as presence of an indwelling Foley catheter concurrent or urinary tract Inappropriate use of inpatient PSA testing increases the cost of hospitalization and can a negativehave psychological patient. impact on the Thisusestudy inpatient intends of testing, to PSA to examine differentiate tests which are appropria ¹UTHSC Memphis, TN; CRITICAL ANALYSIS OF PSA TESTING IN THE INPATIE THE IN TESTING PSA OF ANALYSIS CRITICAL Poster #173 Lindsey Hartsell¹, Paul Murphy was 73.1was vs.the 77.7 non in period.calculated Nearest using straight by distance was standard and n=151 non the patientclosest Bivariable and HVC. analys used to evaluate the effect of nearest distance to a HVC receipt on of non treatment MIBC. for Results: Anthony Patterson L. Presented By: Introduction: recommendations to for prostate screen among how on cancer vary organizations. The American Urological Association’s (AUA) publication in toregard PSA testing published in April 2013 insurance type (minority patientsand those Medicaid with or Medicare more were likely to receive non comorbidity, non education. underwent Patients gender, or who shorter distances to a distance have a HVC (73% miles) of <30 vs. received those who standard therapy (56%, <3 to associated a HVC was lowerlikelihood with to non undergo controllingwhen comorbidity, for factors gender, age, race, insurance (table). and other

Conclusion: Conclusion: standard therapy for MIBC. Regionalization ofmay care not significantly impact access to care previously as hypothesized. 270 and determine the cost of such inappropriate testing. Methods: After obtaining Internal Review Board approval, a list of inpatient PSA charges were generated from the Electronic Medical Record (EMR) at one hospital over a one-year period in Memphis, Tennessee. Retrospective chart review was used to compile patient demographics, a summary of the patient’s hospital course, and if there were potential clinical events that may have altered the PSA value (i.e. if the patient had an indwelling catheter, an active urinary tract infection, etc.). Two senior Urology residents independently reviewed the data and determined if ordering PSA was appropriate based on the clinical scenario. The billed value assigned to each PSA test was gleaned from the financial records. Results: Retrospective chart review during a one-year period in one hospital system found 192 PSA tests ordered, of which 102 were inappropriate (53%), and 89 were appropriate (47%). Inappropriately ordered PSA tests amounted to a total cost of $25,936 and resulted in 20 Urology consults adding an additional $6,000 in charges. Rectal exam to correlate with PSA was documented in 37 of 192 (19%). Foley catheter was present at the time the PSA was collected in 55 of the 192 (29%), and a urinary tract infection was present in 28 of 192 (14%). Conclusion: The majority of inpatient PSA testing was determined to be inappropriate. Significant cost savings could be seen in even one hospital, simply by eliminating a fraction of inappropriate PSA testing through education of ordering providers. The importance of reducing unnecessary PSA testing is underscored because of the scrutiny PSA testing receives in both the Urologic and general medical communities.

Poster #174 WOMEN UROLOGISTS: WORK-LIFE BALANCE IN 2014 Kristi Hebert, Amanda Saltzman¹, Samantha Prats¹, Ashley Richman², Joanna Togami², Leslie Rickey³,4 and Melissa Montgomery² ¹Ochsner Clinic Foundation/Louisiana State University, Department of Urology, New Orleans, LA; ²Ochsner Clinic Foundation, Department of Urology, New Orleans, LA; ³Yale University School of Medicine, Department of Urology; 4Department of Obstetrics, Gynecology & Reproductive Sciences, New Haven, CT Presented By: Kristi Lynn Hebert, MD Introduction: The goal of this study is to characterize the work-life balance of women urologists in the United States in 2014. Methods: An anonymous electronic survey was distributed to 1563 women urologists in January 2015, eliciting demographic data and information on work-life balance. Descriptive data are presented as percentages, medians and means. Results: Of 1563 surveys, 365 were completed for a 23% response rate. Forty percent were trainees, while 60% were practicing women urologists. The mean age was 39 years (25-73). Of practicing women urologists, 78% identify as working full time. The mean number of hours worked was 50-59 per week, consistent with AUA 2014 census data for all urologists. Of the 22% who identify as part time, over half work at least 40 hours per week. Fifty-three percent of practicing women urologists have never changed jobs. The number of job changes was 1 in 26%, 2 in 10%, 3 in 8%, 4 in 2%, and 5+ in 1%. Major factors determining where practicing women urologists live include geographic location (26%), proximity to family (23%), and their or their spouse’s job opportunities (49%). Fifty percent live >100 miles away from family, and slightly over 40% live <50 miles away from family. Nineteen percent were single, 72% were married, and 4% were divorced. Of those married, marriage occurred before residency in 35%, during training in 45%, and after training in 20%. Forty-nine percent had no children, with 66% of these being trainees. Sixteen percent of all participants had 1 child, 26% had 2 children, and 9% had 3 or more children. Of the 182 with children, the mean number per participant was 1.9. The majority of childbirths (51%) occurred after training, while 44% and 5% occurred during and before training, respectively.

272 POSTERS - tes the

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HOURS OUTPATIENT PHONE CALLS TO THE THE TO CALLS PHONE OUTPATIENT HOURS -

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Matthew Ryan Macey, Ryan MD Matthew After The majorityThe of American women married urologists were in2014 with

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NG THE ACUITY OF AFTER ACUITY THE NG

nine percentchildren women someone elseurologists for of daytime with rely on - 151) days151) between calls. half Over of the betweencalls 4:30 were - More thanMore ¾ remaintheirin first second or job. those practicing of Half miles >100 live majority fromtheaway family, and rely on non years). Ninety childcare. Twenty 11% spouses providing have family daytimefilling childcare,another member have and 4% role. this Conclusion: children,mostmarriages with d occurring afterWomen training. havingare children urologists later inlife American than women overall. The number of hours worked by women urologists is consistentAmerican with urologists overall, and most wome Women older (30 urologists were Introduction: ASSESSI Poster #175 Presented By: UROLOGIST Chapel Hill, NC Matthew R. Macey, Troy A. Sukhu, Jason R. Lomboy and Davis P. Viprakasit R. P.A.Jason and Davis Sukhu,Matthew Macey, R. Lomboy Troy may addressingpatient from range concerns acute to providing postoperative reassurance. The unclearcalls can acuity the of contribute to however, patient both added and anxiety physicianWe workload.sought characterize to cohort was male.cohort Pediatric calls. patients madecalls was 30 comprised by of were 22% Repeat patients a mean with of 1.5 1 (range 0 hourscoveringthe callsto urologist April 7 an between included: gender, age, nature patient of concern,call, and time day intervention of provided and disposition. Calls resulting ina recommendation for emergency room (ER) evaluation consideredwere high acuity. Demograph using appropriate statistical measures. Results: patientsto the urology service. patient 48 years Mean age was (range 0.4 calls to the urology service at a tertiarycallstourology service a the referral at state institution. Methods: calls were overnightcalls 10pm were between Sunday. The call average duration 5 over was minutes in63% calls, of including 50% of overnight calls. Postoperative concerns accounted patient for 56% of c reassurance predominant education or the was interventioncalls. inmost of65% The common issues involved catheters / nephrostomytubes urinary (15%), lower tract symptoms (15%) and hematuriacomplaints mean (13%). A of duration 10 over minu required inwas 20% theserequired An calls. a medication of additional patients of 16% prescription. consideredcalls of Only 14% were high acuity. a higher percentage However, of thesecalls occurred overnight and on weekends.most Thecommon patient necessitatingERincluded referral feverssignificant (29%), (26%) and urinary pain difficulties (21%). Conclusion:

anxiety as asanxiety well reduction physician in workload. not highWhile acuity. postoperative patients co concerns successfully were addressed simple with patient education. or reassurance Better peri complaints patient most common the of discussion and identification help decrease after 272 Poster #176 STATISTICAL METHODS IN RANDOMIZED CONTROLLED TRIALS IN THE UROLOGIC LITERATURE: TWO DECADES OF IMPROVEMENT Eugene B. Cone¹, Vikram Narayan², Daniel Smith², Philipp Dahm³ and Charles D. Scales¹ ¹Duke University, Duke Clinical Research Institute and Division of Urology, Durham NC; ²University of Minnesota, Department of Urology; ³Minneapolis Veterans Healthcare System and University of Minnesota, Department of Urology Presented By: Eugene B. Cone, MD Introduction: Given that randomized controlled trials (RCTs) provide the highest level of clinical evidence it is critical that their statistical methodology be sound and clearly reported. We performed a systematic review of reported statistical methods of RCTs published in 2013 as compared to RCTs in 2004 and 1996 with the objective of quantifying any improvement in statistical reporting. Methods: All RCTs involving human subjects published in 4 leading urology journals in 2013 were identified for formal review, and compared to a prior analysis of studies from 1996 and 2004 using the same inclusion criteria. Two independent reviewers abstracted data using a standardized evaluation form. Disagreements were settled by consensus and third party referee. Chi-square, student’s T, and ANOVA were used to analyze the results. Results: A total of 82 RCTs published in 2013 met inclusion criteria and were compared to 65 and 87 RCTs from 1996 and 2004, respectively. Similar to earlier years, the majority of RCTs used two−arm (84.1%), parallel group designs (91.5%). The median sample size (IQR) per arm increased from 32 (19, 94) in 1996 to 45.5 (25, 116) in 2004 and 61 (39, 131) in 2013 (p<0.001). Many important statistical criteria are now reported by the majority of trials, including sample size justification (68.3% in 2013, vs. 47.0% and 19.0% in 2004 and 1996 respectively), which statistical tests were used (95.1% vs. 94% vs. 82%) and effect size estimates for primary outcomes (67.1% vs. 13% and 5%). Importantly, reports of other key aspects of the statistical methodology such as multiplicity adjustment, test sidedness, and statistical software used continue to be low. The most common statistical tests used in 2013 continue to be chi square (42.7%) and T tests (45.1%), while regression analysis is becoming increasingly common. Conclusion: The quality of statistical reporting in the urological literature has improved over the last 2 decades. However, considerable opportunities remain and should be addressed by educational efforts in applied statistics for authors, reviewers and journal editors.

Poster #177 OUR RELATIONSHIP WITH CONSULTING PROVIDERS - KNOWING IS HALF THE BATTLE Dunia Khaled¹, Amanda Saltzman¹, Danica May¹, Jeremy Konheim¹, Raunak Patel¹, Samantha Prats¹, Ashley Richman¹, Allison Feibus², William Chastant², Joseph Fougerousse², Brian Baksa¹ and Melissa Montgomery¹ ¹Ochsner Clinic Foundation, New Orleans, LA; ²Louisiana State University Health Sciences Center, School of Medicine, New Orleans, LA Presented By: Dunia T. Khaled, MD, MS Introduction: Urologic consultations often do not require inpatient intervention. Argument by urologists exists for outpatient evaluation. In an increasingly multidisciplinary patient

274 POSTERS

not . , and , and operative operative - department,

59 (28.6%) of cialty, with the the with cialty, 00, 12%), and

OPERATIVE VTE VTE OPERATIVE

ect to their use of VTE of prophylaxis ecttheir to use nsultants. t practice statement 75% with those of laxis, 42% while used mechanical only and including length of time in practice, practice practice practice, in time of length including

275

Fisher quantitativelytest to used was for exact test

, MD year periodyear at a high volume, tertiary care, academic institution, - based electronic developed and sent survey was to allmembers active of -

Toevaluate awareness of and adherence to the AUA best practice

Glen A. Lau

Over a two Over

operative admission After obtaining Institutional Board approval, Review all adult inpatient, non - s declare no conflicts of interest. declare conflictss no of A web

A total of 1600 consultationsmetcriteria for than inclusion. halfMore (n=907, based manner specific to consultant subgroups. Of theOf to 101 respondentssurvey, the 26% heldan academic position, the while - ion:

discharge prophylaxis. The - Methods: care environment,of knowledge consultants’ our concerns increasingly is relevant, Wehowever. analysis2 full report of yearsconsultation inpatient an of dataa and establish effortsbaselinetofrom own our co as improve which intraoperative urologic consultations January and 2013 between January 2015 were identified and retrospectively Data reviewed. analyzed was based on referring reasonconsultation,intervention a subsequent forperformed. whether and was Results: majority (n=776, 86%) internists/hospitalists. by ordered commonmost Thefor reasons consultationmedicalfromspecialty a gross were hematuria 27%),(n=163, infection (n=158, 20%),urinary retention/BPH (n=126, 16%), catheter issues (n=1 iatrogenic(25.5%) (n=65,the injury from 7%). department. 408 received emergency were Of thesemost the frequent consultations as follows: were 102 (25%) upper tract obstruction, infection,37 (9%)63 (15%) 80 (20%) post gross hematuria, and issues.urologicthe 269 (16.8%) of received consultations were surgical from subspecialties,most thefor with common consultation reasons urinary retention/BPH being (n=67, 25%),tract obstruction upper 16%), catheter (n=43, (n=32, issues 12%) genitourinary related pain(n=24, 9%).commonmostsurgicalsubspecialties The ordering urologic general consultations were surgery 132 (8% with of consults, total) followed by obstetrics and gynecology (n=47, 3%) and transplant surgery (n=25, 2%). 4 consults received required subsequent intervention. Of these,61% emergency were department consults,medical 33% consults,surgical and 38% consults. Interventions were equallylikely proceduralto acrossspecialties. operative or be Conclus 56.7%) of the56.7%)consultations total frommedical urologic of spea were received Results: differencescharacteristicsin resp respondents with of we have identifiedwe commonmost theconsulting frequentmost departments, reasons for consultations,likelihood as well as of inpatient intervention.consultations Most have required intervention. Having established may begin a baseline, we now to target resources and improve the approach to patientmanagement prior even to consultation inan evidence Introduction: statement on VTE prophylaxis and to evaluate regional practice patterns inthe Southeast prophylaxis VTE to regard with (SESAUA) Association Urologic American the of Section during post Methods: remainder either hospital were (12%) employed in or solo privateor practice group (62%). Eighty of aware percent the AUA were bes respondentsstating that it had influenced theirVTE of prophylaxis.use All the one of but majorityVTErespondents form of prophylaxis, the with some using used (54%) (99%) combinationmechanical chemical and prophy the after Southeast AUA obtaining the Section institutionalapproval. of Key IRB variables respondentof interest characteristics were setting, to the operative awareness also of volume. regard Questions with and posed were AUA best practice statement on VTE prophylaxis, type of VTE prophylaxis used and use of post PROPHYLAXIS Glen Lau, Joseph Welser, DeSouzaBlack,JoshuaGlen and Rowena Joseph Earl Lau, Ryan The author POST OF USE THE IN PATTERNS PRACTICE REGIONAL Funding: None Poster #178 University Tennessee TN of Memphis, HSC, Presented By: 274 3% used chemical only. Of those who used combination VTE prophylaxis, there was a significantly higher number who stated that they were influenced by the AUA best practice statement (p=0.003). Those practicing for greater than 10 years were significantly less likely (p=0.008) to use combination VTE prophylaxis (48%) than those practicing for less than or equal to 10 years (83%.) There were no other statistically significant differences in demographics between those who used mechanical DVT prophylaxis alone versus those who used a combination or chemical only. Of the respondents who prescribed post- discharge chemical prophylaxis, 92% used combination prophylaxis during admission. Conclusion: Overall, there was no significant difference in the use of VTE prophylaxis between urologic surgeons with differing practice type or surgical volume. Although our sample size was limited, we did show a large percentage of self-reported awareness of the AUA best practice statement and adherence to its recommendations, with 99% of respondents using some form of VTE prophylaxis. Those who used combination mechanical and chemical prophylaxis were more likely to report the AUA best practice statement to have influenced their practice and were more likely to have been in practice less than 10 years.

Poster #179 ANTI-TUMOR ACTIVITY OF SHA8K, A HYAL1 HYALURONIDASE INHIBITOR, IN BLADDER CANCER CELLS Juan Chipollini¹, Andre Jordan², Luis Lopez², Travis Yate² and Vinata Lokeshwar² ¹Department of Urology, University of Miami Miller School of Medicine; ²Department of Cell Biology, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine Presented By: Juan Chipollini, MD Introduction: Tumor cell-derived hyaluronidase HYAL1, which degrades hyaluronic acid (HA) into angiogenic fragments, promotes tumor growth and metastasis. HYAL-1 is an independent prognostic marker for predicting metastasis. Small molecular mass sulfated hyaluronic acid (sHA) derivatives (sHA8k) inhibit HYAL1 activity through a mixed inhibition mechanism. Antitumor activity of sHA8k and mechanism of action was evaluated in BCa models. . Methods: Effect of sHA8k (0–40 ug/ml) on cell proliferation and apoptosis was examined in BCa cells (253J-Lung, HT1376, UMUC-3, T24, RT4) by cell counting and Cell Death ELISA kit. Matrigel invasion and Boyden chamber assays were used to test the effect of sHA8k on invasive activity. Effect of sHA on signaling, apoptosis cascade, HA receptor (CD44, RHAMM), EMT markers (B-catenin, E-cadherin, Snail, Twist) levels, was evaluated by Q- pCR and immunoblotting assays. Angiogenic fragment addition and mAkt transfection were performed to elucidate mechanism of action. Athymic mice bearing 253J-Lung xenografts were treated with sHA (25 and 50 mg/kg) by i.p. injection. Results: sHA8k inhibited proliferation, motility and invasion in BCa cells that expressed HYAL-1. At IC50 for HAase activity inhibition (~ 20-ug/ml), sHA induced > 3-fold apoptosis and inhibited invasive activity of BCa cells. sHA8k induced caspase-3, -8, -9 activation, up- regulation of Fas, Fas-L, FADD, DR4, DR5 and E-cadherin. sHA8k downregulated CD44, RHAMM, bcl-2, phospho(p)-Akt, pGSK3B, pBcatenin(ser552), snail and Twist expression. Effect of sHA8k were attenuated by angiogenic HA fragments or overexpression of m-Akt and downregulation of CD44 and RHAMM mimicked sHA8k effects. sHA significantly inhibited 253J-Lung xenograft growth. The majority of the animals did not form palpable tumors at 50-mg/kg dose. No weight loss or serum and organ toxicity was observed in sHA treated animals. Biochemical analysis of tumors also showed the same alterations in Akt and EMT pathways as observed cell culture. Conclusion: This is the first study that shows sHA8k, a small molecular mass HYAL-1 inhibitor has potent antitumor activity. Support: R01 CA 72821-14 (VBL)

276 POSTERS

6 - Chi - s and has has and s f urothelial

r Schoolr of Assistant 5

; based TWIST/NID2 - week postoperatively. The - IST1 and NID2 methylation and NID2 IST1 and Murugesan Manoharan

7 e constructed for cytology alone, Research Associate Department diversion is a complex surgical surgical is complex a diversion 4 en the equivocalen the cytologies were ; FL d several subgroups. iversity Miami School of Medcine, Miller of

, Dipen Parekh 6 277

ool of Medicine, Miami, Florida Miami, Medicine, of ool

OPERATIVE PERIOD OPERATIVE opulation. Using a validated questionnaire, the Beck - edicine, Miami, Miami, edicine,

; ³Urologic Oncology Fellow, Department of Urology, of Urology, Department Fellow, Oncology ; ³Urologic r of Urology, University of Miami Miller School of Medicine, Medicine, of School Miller of Miami University Urology, of r De La Rosa,De MD , , Mark Gonzalgo - 5 ven toven patients preoperatively and 6

Professo iami, Florida iami, 6 ;

L In study our of the TWIST1and NID2 methylation assay, the reported Radical cystectomy (RC) with urinary urinary with (RC) cystectomy Radical Aberrant gene methylationAberrantmalignancieseverallinked gene has to been specificity were thewell originally below reported values of 90% and 93%. Joseph James Fantony, MD Alfredo Harb

De la Rosa¹, Matthew Acker², Goolam³, Saeed Ahmed NachikethSoodana laDe Rosa¹, Matthew -

Chairman, Department Urology, of University Miami School of Miller of 7 BDIs were gi BDIs were

The TWIST1/NID2methylation testconducted was using patient urine samples.

; ; ²Urologic Oncology Fellow, Department of Urology, University of Miami Miller Miller Miami of University Urology, of Department Fellow, Oncology ; ²Urologic A total of 172 patients analyzedwere (37% for hematuria and 63% surveillance , Raymond Balise 4 ant Inman¹ and Michael Abern³ Inman¹ and Michael ant FL FL

Introduction: Miami, Miami, University of Miami Miller School of M of School Miller Miami of University ¹Research Associate,of Department Urology, Un Miami, School of M Medicine, assay were overallassay sensitivity specificity respectively. were AUC and 72% for 57% and of The cytology alone equivocal with cytologies positive 0.704, was to and improved 0.773 the with additionmethylationthe ofWh DNA assay (p<0.01). considered negative the AUC for cytology improved from 0.558 to 0.697 thewith addition of methylation the DNA assay (p<0.01). Conclusion: Poster #180 OF PERFORMANCE THE IMPROVE ASSAY METHYLATION GENE A CAN CYTOLOGY? JosephFantony¹,AjayWen Gopalakrishna¹, Lance², Richmond Owusu¹, Raymond Methods: shown promiseshown cancer. inbladder Its reported specificitymatches that of cytology, and far exceeds the sensitivity.We examine the performance of the urine carcinoma. All patients cystoscopy,methylation underwent a cytology. assay, Cystoscopy and the was goldstandard. Receiver operator characteristiccurves wer the methylation assay alone,combined and a model. Areas the under curve (AUC) were compared using likelihood ratiotests. Standard diagnosticmetrics of cytology and the methylationcohort calculatedthe for assay an were Results: for institutions. BCa) majoritytwo from male The currentsmokers former or were (72%) and (57%). performance characteristicscombined The a for TW ¹Duke University, Durham,NC; ²Urology of Virginia, Virginia Beach, VA; ³University of of ³University VA; Beach, Virginia of Virginia, ²Urology Durham,NC; University, ¹Duke IL Chicago, Illinois, Presented By: o detection the in cytology of urine addition the with assay methylation Foo¹, Br Foo¹, of Urology, University Miami Sch of Miller Professor Biostatistics Departments of University and Urology, Mille Miami of FL Medicine, Miami, Presented By: Medicine, Miami, F Medicine, Miami, Introduction: procedure potential with significant formorbidity. studies Many examined have quality life of after radicalcystectomy and urinary diversion; however, only few prospective studies have ratesanalyzed of depressioninthis p Depression Inventory prospectively (BDI), we studiedthe rates of depression among patients undergoing radicalcystectomy, the with hope of early identification of patients at risk. Methods: scores correlated obtained were into categories of normal,mild,moderate and severe for DEPRESSION IN THE EARLY POST Alfredo Harb RADICAL CYSTECTOMYWITH IS INCREASEDASSOCIATED RISKAN OF However, the addition of a TWIST1/NID2 based DNA methylationHowever, the diagnostic addition a TWIST1/NID2assayadds of DNA based cytology. to urine value Poster #181 sensitivity and Prakash 276 both periods. Each patient’s numeric values obtained from the BDI assessments were compared from the preoperative and postoperative stages. Any increase in depression category was deemed clinically significant. We used the Signed Rank Test to compare absolute scores and the paired t-test to compare the mean depression scores. We considered a p-value of <0.05 as significant. Results: 57 patients were included in our study during the selected time period. Of these, 5 patients passed away and were excluded. The incidence of depression is demonstrated in Table 1. A clinically significant increase in the depression symptoms was noted in nearly 35% of patients. More than 50% of patients remained stable in their scores and categories in the preoperative and postoperative comparison. A decrease in scores was seen in approximately 8% of responders (p<0.001). Overall, 50% of patients were considered normal in both stages. An increase in the mean BDI scores from 7 in the preoperative to 11 in the postoperative phases was noted (95% CI, range 2.5–6.2, p-value <0.01). This is shown in Table 2. Conclusion: In this study, a statistical and clinically significant increase in depressive symptoms was noted when comparing patients undergoing RC in their preoperative and postoperative stages. In acknowledging the small numbers involved with this pilot study, we continue to accrue patients. It is hoped that a multivariate analysis be performed. We will also look at the role of SSRIs in the perioperative setting.

Poster #182 ADDITIONAL ADJUVANT CONVENTIONAL CHEMOTHERAPY IN PATIENTS PREVIOUSLY TREATED WITH NEOADJUVANT CHEMOTHERAPY AND RADICAL CYSTECTOMY Kamran Zargar-Shoshtari, Michael Kongnyuy, Pranav Sharma, Mayer N Fishman, Scott M. Gilbert, Michael A. Poch, Julio M. Powsang, Philippe E. Spiess, Jingsong Zhang and Wade J. Sexton Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, Florida Presented By: Kamran Zargar, MBChB, MD, FRACS Introduction: In bladder cancer, neoadjuvant chemotherapy (NAC) can downstage the primary tumor prior to radical cystectomy (RC), and may impact eventual overall survival. However, the optimal management in patients with persistent non-organ confined disease (pT3-4 and/or pN+) following RC is unknown. The aim of this study was to describe use and outcomes of adjuvant chemotherapy (ACT) in patients with residual non-organ confined cancer following NAC and RC. Methods: Using single institution data, pT3-4 and/or pN+ patients who received NAC and RC were identified. ACT was defined as systemic therapy administered post operatively to patients who were clinically disease free. Recurrence-free (RFS) and cancer specific-free survival (CSS) were assessed with Kaplan-Meier analysis. Cox regression was used in multivariate models for survival. Results: From 2001-2013, 161 patients received NAC and RC. Eighty pT3-4 and/or pN+

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SECTIONAL STUDY OF DIETARY HABITS IN BLADDER

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- opalakrishna, Thomas Longo and Brant Inman Thomasopalakrishna, Longo sectional usedsurvey the results II DHQ the from to asses - ied. NAC was cisplatin was NAC ied. platin pN and marginpN status (HR: 0.89, 95%CI: 0.48

chemotherapy inboth neoadjuvant adjuvant and settingsmedian had RFS

Diet has been shown to affect cancer recurrence, shown progression, and overall been has Diet Joseph James Fantony, MD Bladder cancer survivors exhibit poor adherenceto standard dietary

ACTthis in cohort retrospective of pT3

Afterinstitutional IRB approval, an identifyto used large database cohort was a Out of 962 subjects, completed 73,the 962 age was of survey 80% (48%).Out 461 Mean ACT (p=0.78).group ACT remained an insignificant predictor for RFS after based - - nine (36%) receivedmedian ACT; the cycles number ofACT (IQR: 4 of was 3 - patients identif were Twenty with medianwith timeto from ACT discharge of 50 days (IQR: 40 Introduction: survival. In bladder cancer patients, intake high of veget associatedmortality, a reduction with inoverall little butknown aboutis the roleof other macronutrients. Furthermore,macronutrientsof the role bladder cancer in survivors they as movethe treatment period beyond is unknown. Methods: of bladder cancer patients. mailed They were a survey that the included Diet History Questionnaire IIII). (DHQ This validated instrument is the by Ame recommended Cancer Society and National Cancer Institute. It involves 151 questions covering portion size 134 over food items and 8 supplements, and takes a patient roughly an hour to complete. Our cross compliancethe DietaryAmericans. US Guidelinesfor with Results: male,were and 87%white. were The recommended proteinintake met was exceeded or 98% of respondents and 66.8% we recommendations. Similarly,met 62.9% carbohydrate recommendations. Unfortunately, only 44.5%met fat recommendations,grainmetthe recommendations. whole and 0.9% 62% by suRecommended of exceeded sodium intake was containingmonthsregimens RFSmedian 17.5 (5). was Themonths the and 13.7 in ACT in the non adjusting for pT, for adjusting patients carbo was monthsinthe respective (p=0.65) groups and remained insignificant after adjusting for pathologicconfounders [95%CI: 0.34 (HR: 0.67, cisplatin Presented By: Conclusion: Conclusion: recommendations, but they representmetabolic a unique state. It what is unknown constitutes healthy cancer dietinsurvivor, a a bladder butdiet a healthy has potent a component of survivorshipintervention and not merely sustenance. Cancer survivors are an important target populationhealth for promotion efforts plan and we further investigation oflifesty impact life other diet on quality and its of amongst

bettermedian RFS. the However, choice of ACT regimens, and incorporation of drugs neoadjuvant in adjuvantboth contexts and further requiresstudy. SHOULDMODIFICATION DIET COMPONENT BE OF BLADDER CANCER A CROSS A SURVIVORSHIP? Poster #183 CANCER PATIENTS JosephFantony, Ajay G Duke University, Durham, of months.23.2 Conclusion: 278 Poster #184 LONG-TERM OUTCOMES OF BALLOON DILATION FOR BENIGN URETEROILEAL ANASTOMOTIC STRICTURES IN PATIENTS WHO UNDERWENT RADICAL CYSTECTOMY AND URINARY DIVERSION Alfredo Harb-De la Rosa¹, Ahmed Saeed Goolam², Matthew Acker³, Govindarajan Narayanan4, Dipen Parekh5 and Murugesan Manoharan6 ¹Research Associate, Department of Urology, University of Miami Miller School of Medicine, Miami, FL; ²Urologic Oncology Fellow, University of Miami Miller School of Medicine; ³Urologic Oncology Fellow, Department of Urology, University of Miami Miller School of Medicine, Miami, FL; 4Interventional Radiology, , University of Miami Miller School of Medicine, Miami, FL; 5Chairman, Department of Urology, University of Miami Miller School of Medicine, Miami, FL; 6Professor of Urology, , University of Miami Miller School of Medicine, Miami, FL Presented By: Ahmed Saeed Goolam, MD, BSc, MBBS, FRACS Introduction: Ureteroileal anastomotic strictures after radical cystectomy and urinary diversion pose a complex management issue. Balloon dilation has been advocated as a means to avoid the morbidity of complex reconstructive procedures. The success rate of this procedure is difficult to assess. Methods: We retrospectively reviewed our cystectomy database from 2008−2012 and identified patients who underwent balloon dilation for confirmed benign ureteroileal anastomotic strictures. 13 patients who underwent balloon dilations and who had a minimum of 2 years of follow−up after diagnosis were included for analysis. Success of balloon dilation was defined as being free of stent, nephrostomy, or surgical intervention. Results: 2 of 13 patients underwent neobladder and 11 underwent ileal conduit urinary diversion. Median time to stricture was 7 months. Mode of presentation was radiologic in 9 of 13 patients, reduction in eGFR in 2 and symptoms in 2. Strictures were left sided in 10 patients, right sided in 5, and bilateral in 2, for a total of 15 renal units. All 15 obstructed renal units underwent at least one attempted balloon dilation of the stricture. 1 stricture was completely obstructing open reconstruction was undertaken. Of the 14 renal units that underwent balloon dilation, 10 required at least 2 procedures. The success rate after primary treatment was 7.1%. The overall success rate after a second balloon dilation remained unchanged, for an overall failure rate of 92.9%. 9 of 14 renal units (64.3%) that underwent balloon dilation required permanent ureteric stent, nephroureteral stent or nephrostomy. 5 of 14 renal units (35.7%) underwent surgical revision, which consisted of reconstruction/reimplant in 4 patients and nephrectomy for a non–functioning renal unit in 1 patient. Conclusion: Ureteroileal anastomotic strictures after urinary diversion pose a complex problem. Minimally invasive treatments have been advocated, including balloon dilation and endoscopic incision, but overall success rates are poor. Our single institution series showed the long–term failure rate of balloon dilation is 93%. Attempts at serial balloon dilations are unlikely to yield further success, and if the patient's condition permits, reconstruction.

Poster #185 DEFINING AND ANTICIPATORY POSITIVE TEST USING URINE BLADDER CANCER TESTS Thomas Longo¹, Ajay Gopalakrishna¹, Joseph Fantony¹, Richmond Owusu², Wen-Chi Foo¹, Rajesh Dash¹ and Brant Inman¹ ¹Duke University, Durham, NC; ²University of California San Diego, San Diego, CA Presented By: Thomas Andrew Longo, MD Introduction: A urine test that detects the presence of a bladder tumor prior to it being identifiable by cystoscopy is termed an “anticipatory positive” test. Such a test results in earlier detection and treatment of tumors. Our objective was to establish criteria for determining what constitutes an anticipatory positive test, and then to assess these criteria using urine cytology and the UroVysion assay. Methods: We included all subjects who had urine cytology and cystoscopy, or UroVysion

280 POSTERS - 80-

assisted to future -

Columbia Columbia 5 do not predict do not predict

day of cystoscopywindow

atios calculated were using 67%] and 41% [95% CI: 39 67%] and 41% - 44%] 84% [95% and CI: - ) ) morewere likely than those with 44%]. Those a suspicious/atypical with - rtment of Urologic Surgery,rtment UrologicNashville, of TN; 281 ine, Department of Urology, Miami,; Miami,; Urology, of Department ine, all white.were There no were differences inbaseline ASSISTED AND OPEN RADICAL OPENCYSTECTOMYASSISTED RADICAL AND

- nd with their with function. physicalrecovery of nd Robot

2012 and used2012 models generalizedmixed linear for toaccount - asured by a hand dynamometer) measured weight and body by asured were , Joseph Smith²Joseph and Christopher, Anderson 4 between ORC and RARC. We ORCcomparetheseto between and RARC. quantify and aimed withinWesubjects. propose thatanticipatory testingif occurs 4 criteria

to compare differences in patient characteristics, change in handgrip

three patients enrolled, ORC. were 21 (64%) whom Average underwent of - Following open radicalFollowing cystectomy (ORC), patientsfacechallenges can Justin MD Gregg,

The sensitivityspecificityThe cytology and UroVysion of tests improve do not and

tests - We prospectively enrolled and evaluated patients RARC and ORC. having

Thirty A total of 4,733 pairsurine of cytologies and cystoscopies from 990 subjects were

69%] and a specificity of 41% [95% CI: 39 - onclusion: onclusion: Universityof MiamiSchool of Medic Miller Vanderbilt University Center,Medical Depa radical cystectomy introduced (RARC) was inattempt to reducemorbidity the and enhance the recovery of ORC. It is if currently unknown there are differences infunctional and nutritional recovery outcomeschanges examining by inpatient strength after hand grip weight and ORC and RARC. Methods: Handgrip strength me(as preoperatively and at 6 weeks, 3 monthsmonths and 6 postoperatively. In casesmissing of data, and handgrip interpolated. weight body strength We were chisquared used tests and Student’s t Introduction: maintaining nutrition adequate a Results: strength, weightchange and RARC body ORC patients. between in and University Center, Medical York, Department Urology, NY of New Presented By: 4 and cystoscopy 2003 from repeated measures time points. FISH performance assessed was initially withina 30 ¹ age 69.2was years (SD 10.2) and characteristics, pathology complications or ORC between and RARC. Average estimated blood loss operative higher (p=0.05) was shorter time and was ORC. with (p<0.01) Average baseline handgripstrength was (11.2) 35.9 kilogramsforce in ofthe (kgf) and group ORC 35.6 (7.8) kgf inthe RARC group (p=0.9). Average weight 181.5was (32.7) pounds before and 176.7ORC (31.7) before RARC (p=0.7). Changes inhandgrip strength at and weight are met:are the (1) testnew is prior positive tothe goldstandard test, the specificity (2) (3) and the sensitivity of test the new increase the when goldstandard is allowed to lag frailty proportional hazards models to account for correlated subjects. Results: analyzed. Initial sensitivityspecificity [95%CI: 63% 62 and was (standardalso to cystoscopies (lagged later that allowed time) we a year but up occurred time) to be credited to an initially positive FISH test. r Hazard ²Vanderbilt University Center, Medical Surgery, Department Urologic Nashville, of TN; ³Vanderbilt University Center, Medical Biostatistics, DepartmentsNashville, of TN; 44%]. These values were almost unchanged at 390 days with a sensitivity almostunchanged [95%CI:44%]. 66% a at with of were These values 390 days 62 (hazard (hazard ratio1.27) positive or cytology (hazard ratio1.80 a negativecystoscopy. a positive subsequently have cytology to combinedWe2040 UroVysioncystoscopies a also analyzed assays and from 1022 subjects. Sensitivity and specificity 37%were [95% CI: 30 87%], respectively. These measures did not improve over time (up to 1 year later). When 87%],to later).improve 1 year timemeasures not over respectively. (up did These compared to subjects negative a with UroVysion, those a positive with UroVysion a had year. 45%chance recurrent fortumor higherthe having a bladder next within C JustinBarocas²,Koyama³, DanielTatsukiJoAnnGregg¹, Alvarez³, Sam Michael Chang², Cookson², Dipen Parekh A PROSPECTIVE COMPARISON OF FUNCTIONAL AND NUTRITIONAL OUTCOMES OUTCOMES NUTRITIONAL AND FUNCTIONAL OF COMPARISON PROSPECTIVE A LAPAROSCOPICAFTER ROBOT futuremodest bladder cancer. offers Our data positive for evidence anticipatory testing, and suggests clinicianscases. closer up in should consider these follow Poster #186 over time.over Subjects UroVysion a positive with increased have risk of having a positive cystoscopytime at laggedbutmajority thepoints, positive of UroVysion tests 280 the specified time points are shown in the Table. There were no significant differences between ORC and RARC (all P>0.05). Conclusion: Radical cystectomy results in decreased physical function and changes in nutritional status. We did not identify any differences in these outcomes between ORC and RARC. Limitations include non-randomized design, and a small patient cohort, which limited our power to identify differences between groups. An on-going multi-institutional randomized trial (RAZOR) may help address this question.

Poster #187 THE ASSOCIATION BETWEEN PREOPERATIVE LEUKOCYTOSIS AND POSTOPERATIVE OUTCOMES FOLLOWING CYSTECTOMY FOR BLADDER CANCER Troy Sukhu, Jason Lomboy, Matthew Macey, Allison Deal, Eric Wallen, Michael Woods, Raj Pruthi, Matthew Nielsen and Angela Smith Chapel Hill, NC Presented By: Troy Anthony Sukhu, MD Introduction: Preoperative leukocytosis has been linked to decreased overall survival in lung & gynecologic malignancies and post-operative complications following colorectal cancer. However, leukocytosis has not been evaluated as a predictor of postoperative complications or mortality among patients with bladder cancer. The objective of this study was to evaluate whether leukocytosis is associated with postoperative complications and mortality following radical cystectomy for bladder cancer. Methods: Using the American College of Surgeons-National Surgical Quality Improvement Program (NSQIP) database, we performed a retrospective review of patients undergoing radical cystectomy for bladder cancer from 2005-2013. NSQIP collects prospective data on >135 variables, including perioperative data, 30-day postoperative complications and mortality on major surgical procedures at over 450 participating academic and private institutions. Bivariable and multivariable analyses were performed on this multicenter, prospective data set using leukocytosis (defined as preoperative WBC >11) for likelihood of 30-day postoperative complications and mortality. Patients undergoing steroid treatment were excluded. Results: Of 3,043 patients who underwent radical cystectomy, 70% received an incontinent diversion and 17.6% received a continent diversion (13% were unspecified). 9.9% of patients (n=300) had preoperative leukocytosis, with a median 7 days between lab draw and operation date. 76% of patients were male, 94.6% Caucasian, with a median age of 70 years. On bivariable analysis, 65.3% of those with leukocytosis experienced a complication compared to 55.3% of those without (p=0.0009). On multivariable analysis, preoperative leukocytosis remained a significant predictor of post-operative complications (p=0.02) when controlling for preoperative hematocrit, creatinine, ASA, age, race, gender, body mass index (BMI), smoking status, and diagnosis of diabetes. Male gender, ASA class 4, BMI, and pre-operative hematocrit were also found to be significant independent predictors of complications (p<0.05). Mortality at 30 days was uncommon (2.2%). After adjusting for complications, preoperative leukocytosis was not shown to be a predictor of 30-day mortality on multivariable analysis. Conclusion: Preoperative leukocytosis was a significant predictor of 30-day postoperative complications but not mortality in patients undergoing radical cystectomy for bladder

282 POSTERS - two -

assistant in - Gaston and Gaston

. six patients (14.7%) were - rom 1/2010 to 7/2015 was Robinson, E Kris

. f 4.1 underwentmajority RC. The of related variables of patients at our - ived neoadjuvant chemotherapy. Eighty

Drury, Myra M Drury, Myra 283

cystectomy (RC) have historically have cystectomy (RC) reported been .

re prevalent in robotic cases prevalentfor 84.6% in accountingre robotic

r otherr perioperativecharacteristics. Additional research volume necessitated has training ACPs to first

ay was 9.3was ± 8.2 (open: days ay 9.9 days, robotic: days). 8.5 II). and day 90 day 30 mortality rates 1.1% were and 4.1% - OLLOWING RADICAL CYSTECTOMYOLLOWING RADICAL CARE IN ACP AN Mark, MD

R. killed nursing facility rehabilitation. or 137 patients at had least one nine patients (33.3%)rece -

James James Outcomes following radical up, 36.8% were readmittedup, 36.8% were within90 days. Twenty

Our patient outcomes suggest that RC can be performed patient suggestcan acceptable outcomes with be Our that RC

Riggs

A retrospective review of patients undergoing f RC . Mark, CarolineMark, Merwarth, B Nick

A totalA 177 patientsmen of (134 a median and 43 women) with age of (22 66.2

. lusion: Introduction: by largeby teaching institutions a full with complement resident of We physicians. perform RC using carecomposed teams of advanced care providers (ACPs) the direction under of an attending surgeon. Increasing Levine Cancer Institute Presented By: addition to theirperioperative responsibilities.We report the experienceand outcomes of model patients care. RC our of novel this in Methods: conductedsummarize to experience and outcome 84) years84) and a meanComorbidity o Charlson Index urinary diversions ileal were conduits totaling 153 patients Indiana (86.4%). pouches and orthotopic ileal neobladders constructed were for 11 (6.2%) 12 (6.8%) and patients, respectively. Fifty Stephen B institution. Results: radicalcystectomiesACP performed bedside as acting robotically (45.8%)were an with assistantcases. in robotic40.2% of Overall, 23.7% of cases included recorded as an ACP firstmoinvolvement assistant. ACP was of ACP operative experience. A total of 143 patients negative (80.8%) were for lymph node tumor involvement, which included 105 ≤pT2 (73.4%), 29 pT3 (20.3%), and 9 pT4 (6.3%). Average hospitalst oflength 26.0% of patients readmitted were within30 days, and of171 patients had at who least 90 days of follow discharged to a s Clavien complication, grade complicationswhom 116 (85%) only had that were of I minor (Clavien considered results inan ACP care driven modelserve and can as a benchmarkfor surgeons model.attempting care to this practice in new respectively. Conc investigating the underlying cause of leukocytosis associated and managementmay contribute reducingthe subsequentcomplications to of risk following cystectomy. cancer, controlling when even fo EXAMINING OUTCOMES F Poster #188 MODEL DRIVEN James R 282 Poster #189 FRAIL PATIENTS ARE LESS LIKELY TO BE DISCHARGED TO HOME AFTER CYSTECTOMY Jeffrey Pearl¹, Dattatraya Patil², Shipra Arya³, Mehrdad Alemozaffar4, Viraj Master4 and Kenneth Ogan4 ¹Emory University Department of Urology, Atlanta, Georgia; ²Emory University Department of Urology, Atlanta, GA; ³Emory University Department of Vascular Surgery, Atlanta, GA; 4Emory University Department of Urology Presented By: Jeffrey Pearl, MD Introduction: Cystectomy for bladder cancer is associated with a high complication rate and morbidity. The postoperative course may be prolonged and frequently results in discharge to a location other than home. Being discharged to a location other than home has been associated with worse outcomes, patient satisfaction, and quality of life. Frailty is a syndrome of decreasing physiologic reserve. Institutional studies have shown that increasing frailty predicts postoperative complications and mortality in cystectomy patients. However, recent larger database studies have questioned this relationship. Objective: To retrospectively evaluate the modified frailty index (mFI) as a predictor of discharge disposition after cystectomy using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database. Methods: Using data from the ACS-NSQIP we identified patients undergoing cystectomy from 2011 to 2013. Frailty was measured using the modified frailty index a validated 11- point scale based on the Canadian Study of Health and Aging Frailty Index (CSHA-FI). Discharge disposition variables included: home, skilled nursing facility, rehabilitation facility, and expiration. A univariate and multivariate logistic regression analysis was performed to identify the relationship between frailty and discharge disposition to a location other than home. Results: We identified 3,999 patients who underwent cystectomy. 616 patients (15.4%) were discharged to a location other than home (Figure 1). Patients with two or more points on the mFI had a statistically significant increased risk of being discharged to a location other than home when compared to non-frail patients (OR 1.54 [CI 1.17 – 2.04, p = .002]). Multivariate regression controlled for age, body mass index, gender, race, anesthetic technique, wound classification, American Society of Anesthesiologists Risk Classification, work relative value unit, and length of hospital stay. Conclusion: Frailty as measured by the mFI is an independent and significant predictor of discharge disposition to a location other than home following cystectomy. This could assist providers and patients while setting expectations for postoperative outcomes.

284 POSTERS er ell 8).

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s 26.4, 24 (70%) s had a history 26.4, IUD). - pure SCC may be consideredmay SCCpure poor

²,Spiess² PhilippePoch² Michael and performed on all patients at institution our from 285

our cohortour of cases9/2014from

IUD. Of these, 28 (84%) males, were mean age

- es were definedes late. as were Complication rates were

mozaffar IUD and are the subjects of thissubjectsIUD the and are analysis. of - BASEDPRESERVATION: BLADDER FACTORS AND - McCormick, MD

Z. corporeal urinary diversioncorporeal urinary (RARC - (cystectomy lymph and node dissection), is however, stillthe in early

Anna Bausum, BS Barrett There is an increasing trend of robotic assistedradical cystectomy (RARC) Radical cystectomy plays a predominant rolein the management of bladd

Our series reviewed patients failed who BP for bladderWhile cancer. limited

We retrospectively reviewed

A retrospective chartwas review

34 patients underwent RARC 30 patients were evaluated. The average age at the time of BP was 67 (33−8

as 23.3%.most The common complication infection type was wound (13.3%). year Two Introduction: identified RARC 34 underwent stages forWe urinary diversion. present experience our completewith robotic radical cystectomy and intra Methods: Results: Introduction: as an alternative to radical open cystectomy. This has been particularly applicableto the extirpative portions was 63 ± 17.8 years at the time of surgery, mediansurgery,BMI time 63 ± years wa of the 17.8 at was condition, comorbid 6 (17.6%) received smoking, least of had at one and 25 (73%) Poster #190 RADIATION OF FAILURE Presented By: cancer, bladder preservation but (BP) ispossible inselect patients. A subset will fail and require salvage cystectomy.We evaluated patients cohortfailed our who of radiation−basedBP over a 13−year period. Methods: Emory University Poster #191 INITIAL EXPERIENCE WITH ROBOTIC CYSTECTOMY AND INTRA 2002−2015 who failed BP occurring at before or 4 monthsafter BPcompletion, typical upon our based timeline for and underwent cystectomy. repeat cystoscopy. All other recurrenc Early recurrences were those evaluated using the readmission, considered grade. were high Clavien−Dindo Classification. Results: Class III−V, or those requiring notedwas onfinal pathological evaluation. In patients pure with SCC, survival no was longer than 12 months and all experienced early failures. Patients considering BP should be made of the potential aware risks those while with candidates. 28 patients combined underwent chemoradiation. 2 patients radiation received only. Pre BP, 86.7% patients of had clinical CIS, T1 T2or urothelial carcinoma (N=26). (UC) 4 patients squamous with had UC differentiation and 2 patients squamous pure had c carcinoma (SCC).mean The radiation dose53 Gray. was The timeaverage from BP completion to salvage cystectomy was 13.5 early months failures. (2−43). The 7 overall patients complication were rate considered was w 60%. The high−grade complication rate overall survival 43.3%.final was pathologicstaging, At patients found all 63.3% of to were T3have or greater disease, including 8 patients T4 with disease. histologi Final was consistent with pre−BP findings; 80% of patients squamous differentiation, SCC. had pure and 7% Patients SCC pure had all with early had pure UC, 13.3% had UC with recurrences survival with no longer than 12 months.SCC patients noted were pathological progression from cystectomy. T2 disease pre−BP to T3/T4 disease by the sample size, foundwe an overall two−yearlow survival rate at the time of Conclusion: ¹UniversitySouth Florida ofCancer of Tampa, College Center, ²Moffitt Medicine, FL; Tampa, FL Presented By: PATIENT CHARACTERISTICS SINGLE FROM INSTITUTION A EXPERIENCE BarrettWadeGilbert², Scott McCormick¹, Sexton URINARY DIVERSION Anna Bausum, Dattatraya Patil, Eunice Goetz, Viraj Master, Sanda,Martin John Pattaras, AleKenneth Mehrdad Ogan and 284 neoadjuvant chemotherapy. In regards to urinary diversion type (73.5%) underwent ileal conduit and 9 (26.5%) received a neobladder urinary diversion. Mean total operating room time was 7hours and 26mins for ileal conduit and 10hours and 27mins for neobladders. There was a significant learning curve, particularly for neobladders, as depicted in Figure 1. Mean estimated blood loss was 550 ± 450mL. On pathology, TNM stage distribution was as follows: T stage (T0:5, T1:14, T2:3, T3: 10, T4:2), N Stage (N0: 24, N1:5), M stage (M1:1). Positive surgical margins were found in 3 (8.9%) of patients; 2 of these patients had pT4 disease and the other was a ureteral margin with CIS. The median number of lymph nodes removed was 34. Median length of stay was 5 days. There were 5 major complications including sepsis (1), bowel anastomotic leak (1), wound dehiscence (1), and pulmonary embolism (1). Conclusion: The potential for decreased surgical blood loss, quicker return to the activities of daily living, and better pain management following robotic surgery has lead to increased adoption of RARC as an accepted surgical alternative to open cystectomy. These benefits are more likely to be realized with complete RARC-IUD as opposed to RARC and opening for the urinary diversion. Appropriately powered studies are required for understanding cost, patient selection, learning curve, and post-operative outcomes for RARC-IUD.

Poster #192 ASSESSMENT OF PATIENT ATTITUDES TOWARDS BOTHERSOME ISSUES WITH URINARY DIVERSIONS IN THE PREOPERATIVE SETTING USING THE URINARY DIVERSION DECISION AID (UDDA): RESULTS OF A PILOT STUDY Justin Emtage¹ and Michael Poch² ¹Department of Urology, University of South Florida, Tampa, FL; ²Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, FL Presented By: Justin B. Emtage, MD Introduction: Extirpative surgery for bladder cancer can be a life-changing event and one of the main reasons is the introduction of a urinary diversion. Surgeon inclination plays a large role in determining the type of urinary diversion used but patient preference is the single most important driving factor. We developed a questionnaire focusing on bothersome symptoms in both functional urinary and bowel domains to assist patients in determining the type of diversion that would suit them best (Figure 1a). We report the pilot results in the initial cohort of patients questioned. Methods: An IRB-reviewed prospective database was collected of all patients undergoing radical cystectomy and urinary diversion. Patients eligible for all forms of urinary diversion were asked to fill out the UDDA at their pre-operative consultations spanning from August 2014 to December 2014. Men and women were included. Demographic data was collected and respondent answers were entered into our database. Results: A total of 13 patients filled out the UDDA (Figure 1b). This included 12 men and 1 woman. The average age in the cohort was 66.5 years. Of the questions asked, respondents felt they would be most bothered by having loose stools, and needing to catheterize frequently as greater than 75% of patients either agreed or strongly agreed with those statements. A significant, but lower portion, felt strongly that the need for pads or an

286 POSTERS

- on- sity

significant significant hichurinary ², TaghridAsfar², R Chad BASED REGISTRY CANCER -

Department Urology, of 4 outcome an important variations is objective

4 a for Florida residents ≥18 years of age at the 287 red between FPs and MPs with BC. A multivariable BC.Awith FPs and MPs between red

Sengul², Samarpit Rai³, Feng Miao Feng Rai³, Samarpit Sengul², - and Mark L Gonzalgo Mark and

4 Nicola Pavan, MD Studiessuggest incidencemayclinical a disparity thatthe there in and be

There a are number of limitations, including small our samplesize and n

FCDS linked with US census linked US FCDS with dat

, Italy;, ²Department Public of Sciences, Health University MiamiSchool of Miller of , , Dipen J Parekh a, USA 4 operative thatshow sequelae. frequent They also voiding is not a of - ¹DepartmentUrology, of UniversitySchool of Medicine, M. Leonard Miller of Miami Miami, FLand Clinic, Urology DepartmentScience, of SurgicalMedical, University and Health of Trieste Medicine, SylvesterFlorida, Center, Comprehensive and Miami, University of Cancer USA Univer of Urology, ³Department USA; Florida, Miami, of Medicine, School Miller Miami USA; Florida, Miami, Medicine, of School Miller of Miami external bag wouldbe bothersome. Less than half of the patients felt they would be morebothered by frequent urination. Conclusion: SURVIVAL ANALYSIS GENDER OF DISPARITIES PATIENTS IN WITH BLADDER POPULATION A FROM RESULTS FLORIDA: IN CANCER Poster #193 University of Miami Miller School of Medicine, Miami, Florida, USA and Sylvester Sylvester and USA Florida, Miami, Medicine, of School Miller Miami of University ComprehensiveMedicine, Cancer Miller Center, University Miami School of of Miami, Florid Presented By: Introduction: outcome for femalepatients compared (FP) to malepatients bladder with (MP) cancer (BC). Understanding demographic and clinical validated questionnaire.pilot our However, thatshow presence results the do of watery stools and the need for routine catheterization viewed as are the most bothersome possible post concern.maymake This the concept of a continent urinary diversion somewhat less appealing to some workFurther patients. is needed to reasons elucidatethe behind these decidingto use opinions, assist patientstools w in the refine we to and diversionfit them. best for is the Nicola Pavan¹, Koru Pavan¹, Tulay Nicola of disparities gender We the analyzed research. Florida Cancer Data System to (FCDS) determine disparities survival gender patients impact of BC. the diagnosed with in on Methods: includedtime 1981BC diagnosis and 2009 were in study. of between the Demographic and clinical variables including BC age at diagnosis,stage, race, smoking status,socio and economicstatus compa (SES) were Ritch 286 Cox regression model was fitted to determine predictors of overall survival defined as elapsed time from BC diagnosis to death or last follow-up for alive patients. Results: Of 77,811 patients diagnosed with BC, 25% were FPs. The majority of FP were non- Hispanic (93%), living in an urban area (95%), and middle-high/high SES (70%). Among FPs, there were 38% never, 20% former, and 20% current smokers. There were more Black FPs (6%) than Black MPs (3%). Localized cancer was almost equally distributed between MPs (71%) and FPs (70%), but FPs were more likely to present with advanced cancer compared to MPs (5% vs. 3%). Median survival was 3.0 years for FPs versus 3.6 years for MPs. The 5-year survival rate was 38% and 41% for FPs and MPs, respectively. FPs had better overall survival compared to MPs (AHR 0.92; 95%CI 0.90- 0.95) in multivariate analysis adjusting for socio-demographics and clinical and treatment characteristics. Conclusion: This study confirms that gender disparities exist and influence BC overall survival. Female gender is associated with improved overall survival compared to males in Florida after adjusting for clinical and socio-demographic factors. Additional studies are needed to further define potential biologic and environmental variables that may affect gender disparities and BC survival outcomes.

Poster #194 TREATMENT OF ATYPICAL/SUSPICIOUS CYTOLOGY EFFECTS TEST PERFORMANCE Thomas Longo, Ajay Gopalakrishna, Joseph Fantony and Brant Inman Duke University, Durham, NC Presented By: Thomas Andrew Longo, MD Introduction: Urine cytology has been reported as a highly specific but poorly sensitive test. Cytology is reported as positive, negative, atypical, or suspicious. Atypical/suspicious cytologies account for roughly a quarter of the results and present a clinical dilemma. Physicians’ risk aversion means they are typically treated as positive and result in clinical action. We test the effects of this assumption on sensitivity and specificity. Methods: After IRB approval, we queried clinical and pathology databases to identify all subjects at Duke University Medical Center who had undergone both a urine cytology and a cystoscopy from 1/2003 to 1/2012. Diagnostic test performance metrics were calculated using logistic models: (a) a generalized estimating equation (GEE) and (b) a generalized linear mixed model (GLMM). These take into account clustered/correlated test results that occur due to repeated testing within subjects. Results: A total of 990 unique subjects were identified that provided 4,733 pairs of cytology and cystoscopy for analysis. Our cohort was 61% male, 75% Caucasian, and had 54% current or former smokers. Of cytologies, 1898 (40%) were negative, 423 (9%) positive, and 2408 (51%) suspicious or atypical. When suspicious/atypical cytology results using the GEE model were classified as positive, the sensitivity was 59% [95%CI: 56-63%] and the specificity was 43% [95% CI: 40-45%]. When these results were re-classified as negative, this had the effect of a large increase in specificity 97% [95%CI: 96-98%] with a consequent decrease in sensitivity 8% [95%CI: 6- 11%]. Results using the GLMM model were similar. Conclusion: In our study, the performance of urine cytology depended heavily on how the equivocal (atypical/suspicious) results were classified. Our sensitivity was maximized when equivocal cytologies were considered positive, but at significant detriment of the specificity. Meanwhile, our specificity improved greatly when the equivocal results were considered negative, but at the expense of a poor sensitivity. Furthermore, the diagnosis of an atypical/suspicious cytology was higher at our medical center than reported in the literature, and therefore significantly overestimated the performance of the urine cytology test. Acknowledgements: This publication was supported by the National Center for Advancing Translational Sciences, National Institutes of Health, through Duke-CTSA Grant Number 5TL1TR001116-02. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH.

288 POSTERS

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- day and 90 day rmance widely usedtwo of diagnostic for tests bladder - related factorsmustfactor into clinicians’ interpretation of -

making. and Murugesan Manoharan -

5 year period from 2003 toWhite 2012. light cystoscopy served as

ll subjects underwentll cystoscopy, cytology, who and FISH testing - 01, cytology:01, p <0.001), and history smoking p < of (FISH: 0.001, DAY MORTALITYDAY IN RATES OCTOGENARIANS UNDERGOING - , Ritch Chad Spectrum effectsoccur diag when Radical cystectomy isRadical curativetreatment an effective for invasive bladder 4 Ahmed Saeed Goolam, MD, BSc, MBBS, FRACSBSc, Goolam, MBBS, Ahmed Saeed MD, Ajay Gopalakrishna, BS, BA BS, Gopalakrishna, Ajay

The diagnostic perfo

enarians were foundenarians were to a 30 have :

nd their their decision nd

Professor of Urology, University of Miami Miller School of Medicine, Miami, Miami, Medicine, of School Miller Miami of University Urology, of Professor 5 Accessing thepatients NCDB, undergoing for RC urothelial the cancer between We a assessed

; In both FISH a previousand cytology, diagnosis cancer of bladder (FISH: p < During the study period, 33,939 patients identified were having as undergone RC

were calculated tomixedwere linear account models using generalized for (GLMM) BASED DIAGNOSTICBASED TESTS BLADDER CANCER FOR FL

- ods: ods: DAY AND 90 ; ³Clinical Fellow Global Robotics Institute, Florida Hospital, Celebration, Celebration, Hospital, Florida Institute, Robotics Global Fellow ; ³Clinical - ndergoing RC a higher will have post ancer surveillance),ancer race,smoking gender, status. age, and Oncology Fellow, Department of Urology, University of Miami Miller School of Medicine, Medicine, of School Miller Miami of University Urology, of Department Fellow, Oncology Miami, Introduction: Poster #195 OF PERFORMANCE DIAGNOSTIC AFFECT DRAMATICALLY EFFECTS SPECTRUM URINE subgroups of a population. Whensubgroups spectrum a population. effects of diagnostic occur during testing for cancer, difficultmisdiagnoses patient can occur. to Our objective evaluate was the effects of test indication, age, gender, race, an of commonly two used urinary tests, urine cytology and the UroVysion fluorescence insitu hybridization cohortlarge cancer (FISH) contemporary for patients.in of bladder a assay, Methods: Results: 0.001,cytology:<0.05), increasingcytology: male p p < age (FISH: 0.001, p < 0.001), (FISH:gender <0.0 p at institution our a over 10 cytology: associated p <0.01) were increased with sensitivity and decreased specificity. thesignificantRace performance test. either impact had no of on the goldstandard diagnostictest bladder cancer. for Standard diagnostic test performance metrics clustered/repeatedmeasures withinWesubjects. calculated test performancefor the overall cohort as as well key by patient variables: test indication (hematuriaversus bladder c Conclusion: cancer, FISH significantly and urinevary cytology, accordingpatient the to demographic in theywhich tested. were Patient ¹Urologic Oncology Fellow, University of Miami Miller School of Medicine; ²Research ²Research Medicine; of School Miller Miami of University Fellow, Oncology ¹Urologic Associate,of UniversitySchool Department Urology, Medicine, Miller of Miami Miami, of FL cancer. This procedure imposes significant physiological stress on candidates and is often associated significantwith morbidity and mortality. It is expected that octogenarians u Presented By: Introduction Welimited. theto aim 30 review Rajesh and Brant Inman¹ Dash¹ ¹Duke UniversityDurham, NC; Center, Medical ²University CaliforniaSan of San Diego, Diego, CA Presented By: Ajay Gopalakrishna¹, Tho Joseph Fantony¹, 30 test results a Poster #196 forthese, bladder cancer. 80 or patients aged aged <80 and 4309 were 29,630 Of were above. Octog Results: Meth years 2003 and 2012 identified.were We then stratified this cohort into age groups of <80 and ≥80. The mortality rates in each group were analyzed. We further regardscomorbiditywith (CCI) to and tumorstage. Charlson index examined the d underwent RC for bladder cancerunderwent forutilizing RC bladder large National Cancer a Database (NCDB). 2.2%in patientsyounger The (P<0.0002). 90 Sanjaya Swain RADICAL CYSTECTOMY Ahmed Saeed Goolam¹, Alfredo Harb 288 15.5% compared to 6.1% in the younger group (P<0.0002). There was no difference in mortality rates when stratified according to T-stage or CCI. Conclusion: The 30-day mortality rates following RC are almost three times higher in the octogenarian population compared to younger patients. This trend persists during the 90- day periods. Of interest, there was no correlation between the Charlson scores and the mortality rates over the 30 and 90-day periods. Furthermore, higher tumour stage was not found to be associated with increased mortality rate.

Poster #197 RETROSPECTIVE EVALUATION OF TREATMENT RATES WITH NEOADJUVANT CHEMOTHERAPY IN PATIENTS WITH MUSCLE-INVASIVE BLADDER CANCER STRATIFIED BY YEAR Andrew Davidiuk¹, Marissa Rice² and Paul Young² ¹Mayo Clinic Florida, Jacksonville, FL; ²Mayo Clinic Florida, Department of Urology, Jacksonville, FL Presented By: Andrew J. Davidiuk, MD Introduction: Neoadjuvant chemotherapy prior to radical cystectomy is the standard of treatment for muscle invasive bladder cancer since but adherence of these guidelines has remained poor for numerous reasons. We present our treatment and response rates of neoadjuvant chemotherapy prior to radical cystectomy in patients with muscle-invasive bladder cancer. Methods: We reviewed all patients who underwent radical cystectomy for muscle-invasive bladder cancer by a single surgeon from September 1, 2009 through January 31, 2015 at our institution and retrospectively analyzed treatment and response rates of neoadjuvant chemotherapy. Our primary analysis focused on comparing treatment rates for neoadjuvant chemotherapy stratified by year of treatment. We also reviewed final surgical pathology and compared rates of pathologic stage T0 and pathologic downgrading in patients who did and did not receive neoadjuvant chemotherapy. Results: One hundred and thirteen (113) patients underwent radical cystectomy for muscle invasive bladder cancer. Overall, 57 (50.4%) received neoadjuvant chemotherapy prior to radical cystectomy, but when stratified by year, treatment rates increased from initial rates of 33% (2/6) of patients in 2009 and 25% (7/28) in 2010, to increased rates of 63% (12/19) in 2011, 38.4% (5/13) in 2012, 81.8% (18/22) in 2013, 52.2% (12/23) in 2014, and 50% (1/2) in 2015. Overall our pathologic stage T0N0M0 (P0) and pathologic downgrading rates were 14.2% (16/113) and 30.1% (34/113). When stratified by whether patients received neoadjuvant chemotherapy, rates of P0 and pathologic downgrading were higher in the treatment group, 24.6% (14/57) and 43.9 % (25/57) as compared to no treatment, 3.8% (2/56) and 16.1% (9/56). When reviewing all P0 patients, 1/16 patient recurred at last follow up. Conclusion: Treatment rates of neoadjuvant chemotherapy in the treatment of muscle invasive bladder cancer increased over time from 2009 to 2015, and with treatment, improved pathologic outcomes were noted at time of final surgery.

290 POSTERS

opioid opioid - perative perative

s bowel or ve review from review ve

randomized series, the of use - and UD with bowel reconstruction bowel with and UD is

continue using alvimopan routinely in all

291 nction (RBF), decrease incidence of postoperative

(RC) with urinary diversion with (RC) is (UD) an extensive cystectomycare. In non our

- Gil¹, Akshay Bhandari¹,Alan M. Nieder¹ JorgeCaso¹ Gil¹, and R. Akshay - Garcia Radical cystectomy cystectomy Radical

Ajaydeep S. Sidhu, MD

The of use after alvimopan cystectomy

After IRB approval was obtained, we performedAfter obtained, a retrospecti IRB approval was we and controland groups1). (Table The alvimopan started was group on an oral diet

122 patients underwent attempted completed or cystectomy UD. with 59 patients operation postoperative requiring complex alvimopan,care.The of use a Mu Introduction: antagonist, anastomosis after primary bowel and concurrent narcotic administration has toshown accelerate return fu of bowel ileus (POI), and reduce length of hospitalstay (LOS). This study evaluates the efficacy of alvimopan in and reducing LOS. expediting RBF Methods: Poster #198 STAY OF LENGTH AND ILEUS POSTOPERATIVE REDUCED FOR ALVIMOPAN EXPERIENCE SINAI MOUNT THE CYSTECTOMY: AFTER Ajaydeep S. Sidhu¹, Elizabeth T. Nagoda², Rafael E. Yanes¹, George F. Wayne²,JoanAjaydeep Nagoda²,Elizabeth F. C. Rafael S.Yanes¹, Sidhu¹,T. E. George Delto¹, Maurilio ¹Mount Sinai ofBeach, Center Medical Miami Herbert Department Urology, ²FIU FL; FL Miami, of Medicine, College Wertheim Presented By:

There were fewer casesThere were the POI in of alvimopan median p = (5% group 0.04). The vs. 19%, did fornot LOS days those patients who received 5 days for versus was 6 alvimopan who receive alvimopan 0.01). < (p Conclusion: Results: received alvimopan versus did 63 who not. Baseline characteristics similar were for alvimopan before the control (3.0group vs. 4.4 days, p <0.01). The alvimopan experienced group earlier passage of flatus BM (3.4 and vs. 4.4 days, p <0.01; 4.5 vs. 5.5 days, p =0.01). February 2010 to July patients 2015 of We undergoing attempted completed or cystectomy. included underwent simple patients radical who or through cystectomy UD with both open and roboticWe obtained approaches. patient demographics and perio characteristics.We identified two cohorts: a contemporary group receivedwho alvimopan and an earlier did group not (control).who Patientsthecohort in alvimopan received standardWe dosing. compared time to start of oral diet, passage of flatu the groups.movement between two POI, and LOS presence of (BM), an important adjunct to post cystectomiescontraindications reconstruction no for bowel if is anticipated UD exist. and

alvimopan associated incidence was a low with of POI, function, earlier of return bowel and reduced hospital stay. Based on this, we Funding: None. 290 Poster #199 EN BLOC RESECTION OF BLADDER TUMORS: A META-ANALYSIS OF ONCOLOGIC OUTCOMES Michael Ahdoot¹, Raymond Balise² and Mark Gonzalgo³ ¹University of Miami School of Medicine, Department of Urology, Miami FL; ²Department of Public Health Sciences, Division of Biostatistics, University of Miami School of Medicine; ³University of Miami School of Medicine, dDepartment of Urology, Miami FL Presented By: Michael Ahdoot, MD Introduction: En bloc resection of bladder tumors (ERBT) maintains closer adherence to oncologic principles than traditional Transurethral Resection of Bladder Tumors (TURBT). Several small studies have failed to demonstrate a statistically significant recurrence free survival (RFS) benefit with the use of ERBT vs. TURBT. The objective of this study was to determine if a pooled meta-analysis of ERBT vs. TURBT yielded a RFS difference between the 2 surgical modalities. Methods: A Pubmed search for “en-bloc TURBT” and permutations of this search term was used to identify relevant journal articles. Inclusion criteria was limited to articles published in English with at least 1 year or greater follow-up, disease recurrence data, and the presence of a traditional TURBT control group. ERBT included both laser and electrical energy sources for resection. Recurrence was defined as visual identification of bladder tumor on surveillance cystoscopy in all studies. Only studies treating transitional cell carcinoma were included. Data were pooled and assessed for differences in recurrence free survival at 12, 18, and 24 months. A clinically significant difference in recurrence rate of greater than or equal to 5% was defined prior to the study. Results: 5 studies met inclusion criteria. Data was available for 296 ERBT and 259 TURBT patients at 12 months with fewer data available at 18 and 24 months. The overall recurrence rate at one year for ERBT was 14% vs. 20% for TURBT (p=0.025). Use of ERBT was associated with a 35% relative risk reduction for recurrence at 1 year (RR 0.65, 95CI 0.44-0.95). The Breslow-Day test for homogeneity of the odds ratios was 0.52 suggesting consistent homogeneity among the data included within the meta-analysis. At 18 and 24 months there was a relative risk reduction for tumor recurrence of 38% (RR .62, 95 CI .24-.96) and 23% (RR .23, 95 .77-1.06) when comparing ERBT to TURBT. This difference, however, was not statistically significant. Conclusion: There is limited data assessing the impact of en-bloc resection of bladder tumors on oncologic outcomes. This meta-analysis demonstrates that there may be a clinically and statistically significant recurrence risk reduction with the use of ERBT vs. TURBT at one year. Randomized controlled trials comparing ERBT and TURBT are needed to validate the benefits associated with ERBT observed in this meta-analysis.

Poster #200 IMPACT OF SMOKING ON SURVIVAL OUTCOMES IN PATIENTS DIAGNOSED WITH BLADDER CANCER: RESULTS FROM A POPULATION-BASED CANCER REGISTRY (1981-2009) Samarpit Rai¹, Tulay Koru-Sengul², Nicola Pavan³, Feng Miao², Taghrid Asfar², Chad R. Ritch4, Dipen J. Parekh4 and Mark L. Gonzalgo4 ¹Department of Urology, University of Miami Miller School of Medicine, Miami, FL; ²Department of Public Health Sciences and Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL; ³Department of Urology, University of Miami Miller School of Medicine, Miami, FL and Urology Clinic, Department of Medical, Surgical and Health Science, University of Trieste, Triesta, Italy; 4Department of Urology and Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL Presented By: Samarpit Rai, MD Introduction: Smoking is a well established risk factor for bladder cancer (BC), accounting for nearly half of all diagnosed cases. However, little is known about its effect on survival across race, ethnicity, and socio-economic status (SES) in Florida. We used a population- based Florida cancer registry to report demographic and survival trends for patients

292 POSTERS .001]

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patients diagnosed with

year survival ratesfor the the younger patients, younger the 43% -

groups. 40.4), respectively. overall Median - . 25883 (86.8%) were were 25883 (86.8%) . high/highest SES (57%). The majority of of majority The (57%). SES high/highest 43.8), respectively.Former smokers ([HR] - -

293

5 younger) and analyses performedyounger) were LOS, examining ystectomy between 2003 and 2012. between ystectomy divided Patients were vs. vs.

39.1), and 42.9% (42.0 atients BC, diagnosed with former, smoked, never 31% were 27% - ted significant with morbidity. studies Many examined have the length d BC (71%). Median overallMedian survival d BC (71%). and 5 year survivalyear ratesfor never, former, 40.4% and current smokers were 1.17, p<0.001) and current smokers ([1.21]; 95% CIand currentsmokers1.17 ([1.21]; 1.17, 95% p<0.001) - ted ratios hazard (AHR) along 95%with confidence intervals (95% CI) for and Murugesan Manoharan and Radical cystectomy urinary with diversion is surgicalcomplex a procedure Ahmed Saeed Goolam, MD, BSc, MBBS, FRACSBSc, Goolam, MBBS, Ahmed Saeed MD,

ients ients residing in Florida ≥18 years with BC between 1981 and 2009. Median ine the difference inLOS and readmission rates 30 days among within these

There many are disparitiessurvival inBC across different races, ethnicities, Wefound a statistically significant differencemean the LOS the in between 4 De la Rosa¹, Ahmed Saeed Goolam², Ahmed Hariharan Palayapalayam laDe Rosa¹,

The Florida Cancer Data System linked (FCDS) was US to census data to We the analyzed NCDB and identified patients urothelial with carcinoma the of

; ²Urologic Oncology Fellow, University of Miami Miller School of Medicine; of Medicine; School Miller of Miami University Fellow, Oncology ; ²Urologic 29804 patients met the inclusionmet the criteria29804 patients Of the p Of 77,811

ively. The 5- The ively. FL year overallyear survival compared rateswere people never between smoked, who - 41.2), 38.3% (37.5 - YSTECTOMY IN OCTOGENARIANS COMPARED TO YOUNGER PATIENTS YOUNGER TO COMPARED OCTOGENARIANS IN YSTECTOMY Professor Urology, Miller of Miami, University Miami School of Medicine, of Presented By: Introduction: Results: that remains associa of hospitalstay (LOS)and readmission rates after radical cystectomy. However, very few studies compared have these octogenarians between outcomes patients. and younger We aim to determ 30 days readmission (CCI). rates Comorbidity and Charlson Index two groups,two large utilizing National Cancer a Database (NCDB). Methods: underwentbladder who radical c into groups two (octogenarians 5 diagnosed stratifiedsmokingBC status. with by Methods: and 5 and 22% current were smokers. majority The of patients malesWhites were (75%), (96%), and livingmiddle in (95%) area an urban with patients had localize identify pat all (39.7 Department Urology, of UNiversitySchool of Medicine, Miller of Miami ¹Research Associateof Department Urology, University Miami School of Miller o Miami, Miami, ³Clinical Fellow Global Robotics Institute, Florida Hospital, Celebration, Celebration, Hospital, Florida Institute, Robotics Global Fellow ³Clinical compared to octogenarian patients. Contrary to expectations, no significant difference was Conclusion: groups;may ittwo significant however, notclinical be thecontext. in also It was that noted morethe patients of younger dischargedwere withinthe first pos had a LOS ≤ 7 days compared to patients.octogenarians Table younger comparedto of 1 14% stayed 2 weeks longer than 32% of octogenarians (p < 0.0002). Close illustrates similartwo was the results. above among the CCI to 21% of and 3921 (13.2%) were ≥ 80 years. Mean LOS was 11 days for patients < 80 years and 12 days for octogenarians < (p 0.02). 2364 (9.1%) patients readmittedwere <80 years within ofcompared octogenarians30 days 344 (8.8%) = 0.46).Of to (p former smokers,currentmultivariable and smokers. A regressionCox model to used was determine adjus mortality after adjusting for age at diagnosis,sex, race, ethnicity, SES,maritalstatus, regional lymphBC. node positivity,treatment, stage and of grade, Results: entire 3.5 cohort years and 39.9% were CI: (95% 39.5 survival for never, former, and current smokers 3.6 years, were 3.3 years, and 3.9 years, respect 1.14; 1.11 CI 95% LENGTH OF STAY HOSPITAL READMISSIONAND RADICAL RATES AFTER C had a higher riskmortality smoked never comparedto of multivariate people who on analysis. Conclusion: and SES. a higherSmokingwith riskmortality is associated of in BC. These data highlightimportance the smoking of cessation for BC patients and underscore patient need for smoking. educationthethe of dangers regarding Poster #201 Alfredo Harb Dipen Parekh 292 found in the rates of readmission between the two groups. CCI does not predict length of hospital stay or readmission likelihood.

Poster #202 FEASIBILITY OF STRUCTURED TELEPHONE CALLS FOR SYMPTOM MANAGEMENT FOLLOWING CYSTECTOMY Jason Lomboy, Matthew Macey, Troy Sukhu, Sarah Stanley, Allison Deal, Dana Mueller, Matthew Nielsen, Raj Pruthi, Eric Wallen, Michael Woods and Angela Smith Chapel Hill, NC Presented By: Jason R. Lomboy, MD Introduction: Increasing attention has been placed on the improvement of post-operative complications and readmissions following radical cystectomy (RC). We aimed to assess the feasibility of a post-cystectomy telephone survey by assessing timing of calls, referrals to clinic or emergency room, readmissions, and patient satisfaction. Methods: Our objective was to develop a post-cystectomy telephone symptom survey which would be administered to patients by an advanced practice professional at various time intervals within 90 days. All patients undergoing RC for bladder cancer between 9/2014 and 4/2015 participated. Three question categories included symptom, emotional/social, and global functioning assessments for a total of 18 questions. The time for each call was recorded as well as whether the patient was referred to the clinic or emergency room (ER) for further evaluation, or readmitted. Patient satisfaction was assessed via an exit survey. Results: 27 patients participated in post-cystectomy calls, completing a median of 7 calls (out of a possible 9), for a total of 182 calls. Of these patients, median age was 72 years, and 30% were female. 74% had <=pT2 disease and 26% had pT3-T4 or node positive disease. 44% received neoadjuvant chemotherapy. 41% of patients completed 8-9 calls, and 89% completed at least 5 calls. The median time to complete each call was 9 minutes. Only 16 patients (59%) reported follow-up with their PCP during the 12-week postoperative period, whereas n=6 (22%) had at least 1 ER/urgent care visit, and n= 6 (22%) were readmitted (compared to historical 90-day readmission rates of 33-43%). 8 patients were referred for further care (for a total of 11 referrals). In two cases, referrals were made to the ER, and the remainder were referred for a urologic clinic visit. Referrals were evenly disbursed throughout the 12-week period. 78% participated in the satisfaction survey. Overall, 76% and 86% felt that the number of calls and questions, respectively, were “just right.” 81%, 95%, and 71% of patients agreed that the calls were “useful,” “easy to understand,” and “improved discussion” with their provider, respectively. Conclusion: Instituting post-cystectomy calls in the postoperative period is feasible, although does require added time from staff. Patients are highly satisfied with post- cystectomy calls, which initiated several referrals for further evaluation, and appeared to reduce readmissions compared to institutional averages.

294 POSTERS fic , 4

Ortiz³ -

P<0.02), clinical stage >T1cB: T1c, (A:16% 295

Olmo²Sánchez and Ricardo - lobe (A: 5.2 mm, B: 8.4 mm, C: 9.6 mm, p<0.001), p<0.001), mm, 9.6 C: mm, 8.4 B: mm, 5.2 (A: lobe Belaunde, MD

- 2.5%, B: 33.1%, C: 32.6%, p < 0.01), RP specimen GS≥

PROSTATE CANCER ON BIOPSY: RESULTS FROM A A FROM RESULTS BIOPSY: ON CANCER PROSTATE

2013−2015 group had a higher likelihood of GS≥ 7(3+4) on

redictiveaccuracy of PSADon the varied based of range PSA or stage on RP specimenstage on RP (A: B: 23.5%, C: 20.1%, mean 18.4%), age (57.4 rology, UniversitySchool of Medicine, M. Miller Leonard of Miami Miami, INCREASE IN PROSTATE CANCER AGGRESSIVENESS OVER THE THE OVER AGGRESSIVENESS CANCER PROSTATE IN INCREASE Belaunde¹, Juan Serrano ³Robotic OncologyInstitutePuerto & Urology the University Rico of and - Jose Antonio Saavedra Samarpit Rai, MD Rai, Samarpit PSA density (PSAD) is an important predictor of prostate cancerWe (PCa). Given recent data showing less recentGiven showing data specific prostate (PSA) antigen utilization by

f Urology, University of Miami Miller School of Medicine, Miami, FL; FL; Miami, Medicine, of School Miller of Miami University Urology, f

Between 2007 and 2015, CaP patientsmanaged with RP inPuerto Rico have n=323), and C: 2013−2015 (N=277) to compare clinical and pathological

Using our IRB−approved database, 719 consecutive men with CaP were

There was statisticallyThere was significant trend time over for increasingmean serum PSA care physicians (19.3% (PCPs) to 8.2%)the since publication USPSTF of

INSTITUTIONAL, PROSPECTIVE, AND CONTEMPORARY COHORT CONTEMPORARY AND PROSPECTIVE, INSTITUTIONAL, - usion:

OPKO Diagnostics,OPKO Nashville, LLC, TN 4 Introduction: Presented By: SchoolJuan, of PR San Medicine, primary statement in 2012, we setstatement characteristics ifCaP changed evaluate in time we out over 2012, in had a prostatectomymencohort radical treated with (RP). of Methods: Results: identified managed were who 2007 RPwith between and 2015. One pathologistcentrally reviewed all slides. Patients were divided into three time groups: A: 2007−2009 (n=119), B: 2010−2012 ( statisticalvariables. for used SPSS analysis. was Introduction: ¹Department o ²University and Urology Clinic, School FL Medicine, of M. Leonard Miller of Miami, Miami DepartmentScience, HealthSurgical Medical, Trieste, University of and of Italy; ³Department U of FL; Ramgopal Satyanarayana³, Dipen J. Parekh³ Punnen³ and Sanoj Poster #203 PROGRESSIVE DECADELAST MENPUERTO IN RICAN José Saavedra SamarpitNahar³,Prakash³, Rai¹, Pavan², YanBruno Soodana Dong Nicola Nachiketh DEFINING THE OPTIMAL PSA RANGE FOR THE MAXIMAL PREDICTIVE EFFICACY EFFICACY PREDICTIVE MAXIMAL THE FOR RANGE PSA OPTIMAL THE DEFINING OFPSA DENSITY TODETECT ¹UniversityPabloJuan,ofPR; ²SanSan SchoolPuerto Rico Medicine, of Pathology Group, Bayamón, PR; 26.6%, 36.5%, C: p<0.001), percent positive biopsies28.1%, (A: 23.9%, p<0.05), 29.6%, largestmillimeters (A:coretumor positive lobe per 3.6 mm,mm,B: 4.4 (mm), 4.9 C: p<0.01), totalsumcancer of cores per risk of Gleason score (GS) ≥ 7(3+4) on biopsy (A: 37%, B: 52%, C: 65.7%, P<0.01), risk of 20.2%, primary p<0.04), of risk (A: B: on biopsy 12.6%, C: 13.0%, Gleason 4 grade 1 (A: biopsy on invasion perineural 7(3+4) (A: 38.7%, B:47.1%, C: 65.3%, p<0.001), and greater use of robotic RP (A: 51.3%, B:multivariate C: 93.2%, 100%, p<0.001). In analysis,serumPSA independent of and clinical stage, patients inthe biopsy (odds ratio: 2.58, 95%confidence intervals (CI): 1.61 to 1.15) and GS≥ 7(3+4) in the no differences groups1.45 RPThere 2.34, CI were to specimen 95% (OR: between 3.80). regardswith to T3 years), prostate weight (46.2 g), mean body−mass diabetesmellitus, smoking, hypertension,mean or timelag from biopsy to surgery (3.54 index (28.1), history of dyslipidemia, mo.). Concl a progressive,shown statistically significant increaseserumPSA in levels, greater tumor volume, and higher Gleasonscores.Whether these differences are todue practice−speci referral patterns,changing pathological trends in a reflection or review, PSA lower of utilization deserves further PCPs study. by Funding: none Poster #204 MULTI (A: 5.2 ng/ml, B: 5.9 ng/ml, C:ng/ml, 6.57 assessed the whether p thewhether patient negative a previous biopsy. had Presented By: 294 Methods: We assessed a contemporary and prospective cohort of men who were referred for biopsy of the prostate for suspicion of PCa at 26 different sites across the United States. The area under the receiver operating characteristic curve (AUC) was used to assess the added predictive accuracy of PSAD versus PSA across 3 different PSA ranges (<4, 4 – 10, >10 ng/mL) and in men with or without a prior negative biopsy for the detection of any and significant (Gleason > 7) PCa. Results: Of the 1,290 patients in the final cohort, 585 (45%) men were diagnosed with PCa and 284 (22%) men were diagnosed with significant PCa. PSAD was significantly more predictive than PSA for detecting any PCa in the PSA ranges of 4 – 10 (AUC 0.70 vs. 0.53, P<0.00001) and >10 (AUC 0.84 vs. 0.65, P<0.00001) ng/mL. Similarly, for significant PCa, PSAD was more predictive than PSA in the PSA ranges of 4 – 10 (AUC 0.72 vs. 0.57, P<0.00001) and >10 (AUC 0.82 vs. 0.68, P = 0.0001) ng/mL. Furthermore, PSAD was significantly more predictive than PSA in detecting PCa in men that had a prior negative prostate biopsy (AUC 0.69 vs. 0.56, P = 0.0001 for any PCa and AUC 0.81 vs. 0.70, P = 0.0042 for significant PCa), and those that didn’t (AUC 0.72 vs. 0.67, P = 0.0001 for any PCa and AUC 0.77 vs. 0.73, P = 0.0026 for significant PCa). However the difference between the AUC of PSAD and PSA (ΔAUC) was a lot more pronounced in men that had a prior negative prostate biopsy (ΔAUC = 0.13 for any PCa and ΔAUC = 0.11 for significant PCa) as opposed to those that didn’t (ΔAUC = 0.05 for any PCa and ΔAUC = 0.04 for significant PCa), suggesting that PSAD is a much better predictor than PSA alone in men who have undergone a previous biopsy. Conclusion: As PSA increases, the predictive accuracy of PSAD over PSA appears to improve for the detection of any PCa and significant PCa. Additionally, PSAD has a more pronounced predictive value over PSA in detecting any and significant PCa in men who have undergone a prior negative biopsy. We support the use of PSAD testing to avoid unnecessary biopsies in men who have elevated PSA secondary to an enlarged prostate.

Poster #205 UTILITY OF PCA3 AND TMPRSS2:ERG URINARY BIOMARKERS IN AFRICAN AMERICAN MEN UNDERGOING PROSTATE BIOPSY Allison H. Feibus¹, Oliver Sartor¹, Krishnarao Moparty², Michael W. Kattan³, Kevin Chagin³, Elisa Ledet¹, Justin Levy¹, Benjamin Lee¹, Raju Thomas¹ and Jonathan L. Silberstein¹ ¹Tulane University School of Medicine - New Orleans, LA; ²Southeast Veterans Health Care Services - New Orleans, LA; ³Cleveland Cancer Foundation, Cleveland, OH Presented By: Allison Feibus, BS, MS Introduction: To determine the performance characteristics of urinary PCA3 and TMPRSS2:ERG (T2:ERG) in a racially diverse group of men. Methods: Following IRB approval, from 2013-2015, post digital rectal exam (DRE) urine was prospectively collected in patients without known prostate cancer (PCa), prior to biopsy. PCA3 and T2:ERG RNA copies were quantified and normalized to PSA mRNA copies using Progensa assay (Hologic, San Diego, CA). Prediction models for PCa and high-grade PCa were created using standard of care (SOC) variables (age, race, family history of PCa, prior prostate biopsy and abnormal DRE) plus PSA. Decision Curve Analysis was performed to compare the net benefit of using SOC, plus PSA, with the addition of PCA3 and T2:ERG. Results: Of 304 patients, 182 (60%) were AA; 139 (46%) were diagnosed with PCa (69% AA). PCA3 and T2:ERG scores were greater in men with PCa, ≥3 cores, ≥33.3% cores, >50% involvement of greatest biopsy core and Epstein significant PCa (p-values < 0.04). PCA3 added to the SOC plus PSA model for the detection of any PCa in the overall cohort (0.747 vs. 0.677; p<0.0001), in AA only (0.711 vs. 0.638; p=0.0002) and non-AA (0.781 vs. 0.732; p=0.0016). PCA3 added to the model for the prediction of high-grade PCa for the overall cohort (0.804 vs. 0.78; p=0.0002) and AA only (0.759 vs. 0.717; p=0.0003) but not non-AA. Decision curve analysis demonstrated significant net benefit with the addition of PCA3 compared with SOC plus PSA. For AA, T2:ERG did not improve concordance statistics for the detection any or high-grade PCa. Conclusion: For AA, urinary PCA3 improves the ability to predict the presence of any and

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SPECIFIC ANTIGEN KINETICS ARE NOT ASSOCIATED ASSOCIATED NOT ARE KINETICS SPECIFIC ANTIGEN

diagnostic PSA (i.e. values availableat the time of diagnosis) - up of 3.2 years 1). (Figure Pre Viacheslav Iremashvili, MD, PhD MD, Iremashvili, Viacheslav To analyze the association pre To the analyze between -

Weevidence findsuggestnot to patients did any that in low diagnosed with E SURVEILLANCE

program.This study included 137 active surveillance patients twowith more or

usingonly the pre We offer AS to patients with biopsy Gleason sum ≤7, ≤2 positive biopsy cores,

Of 137 patients included inpatients 137 theOf included analysis 37 (27.0%) progression had biopsy a over

grade PCa. grade for thisHowever population,T2 - diagnosticmonths. sets levels period a PSA measured over of3 leastTwo of at - Introduction: (PSA)kineticsthe risk progression and biopsy of inactive our surveillance cohort (AS) and also study the to pre effect adding of predictivePSA do and PSA velocity performance (PSAV) of Methods: ≤20% tumor present in any core, PSA<15 ng/ml and clinical stage T1 analyses performed. looked were at we First, the PSA associationbetween kinetics calculated pre high PROSTATE PREDIAGNOSTIC significantlystratificationand risk standard detection to tools. Poster #206

Presented By: and the risk of biopsy progression. Second, inthe same ofgroup patients analyzed we the predictivekineticsPSAcalculated value of using only post WITHPROGRESSIONOF THE RISK CANCER PATIENTS PROSTATE IN MANAGED WITH ACTIV ViacheslavIremashvili, and Sanoj Bruce Kava, Murugesan Manoharan Parekh, J Dipen Punnen FL Miami, Miami, of University 1994 through December 2013,366 men cancer prostateenrolled with in activeour surveillance it to that of PSA kinetics based on both pre kinetics PSAitto on that based of Results: median follow Conclusion: ng/ml/year statistically was significantly associated the with risk future of biopsy progression, afterfor adjustment however baseline density PSA these associations were no longer significant.kinetics combinedPSA tested pre the on of None based diagnostic statisticallyPSA values were significantly thewith risk biopsy associated of progressionstudied the group in riskcancer prostate historical pre

296 Poster #207 ABNORMAL SERUM LIPIDS AND ELEVATED BODY-MASS INDEX ASSOCIATED WITH PROSTATE CANCER AGGRESSIVENESS IN PUERTO RICAN MEN Raúl Fernández-Crespo¹, Jeannette Salgado-Montilla², Margarita Irizarry-Ramirez³ and Ricardo Sánchez-Ortiz4 ¹University of Puerto Rico School of Medicine, San Juan PR; ²UPR-MD Anderson Partnership in Cancer Research, University of Puerto Rico, San Juan, PR; ³School of Health Professions, University of Puerto Rico, San Juan, PR; 4Robotic Urology & Oncology Institute and University of Puerto Rico, San Juan, PR Presented By: Raul Fernandez-Crespo, MD Introduction: Puerto Rico Cancer Registry data suggest that prostate cancer (CaP) mortality in the island is higher than that of mainland Caucasians. Given the association between nutritional factors and CaP aggressiveness, we sought to evaluate the relationship between metabolic factors and CaP phenotype in a cohort of men treated with radical prostatectomy (RP). Methods: Using our IRB−approved database, we identified 781 men with CaP treated with RP between 2004 and 2015. Metabolic variables such as body−mass index (BMI) and a reported history of diabetes mellitus (DM) or dyslipidemia were correlated with prostate cancer phenotype and adjusted for confounding variables. SPSS was used for multivariate analysis. Results: Mean age of the cohort was 57.5 years, mean serum prostate specific antigen (PSA) 6.14 ng/ml, T1c clinical stage: 72.5%, and biopsy Gleason scores were 6 (3+3): 48.1%, 7(3+4): 36.5%, 7(4+3): 10.6%, and ≥ 8(4+4): 4.8%. DM was present in 16.1% (127/791), history of dyslipidemia in 25% (198/781), and obesity (BMI≥30) in 31.2% (247/781). In univariate analysis, the only factors predictive of biopsy Gleason score ≥ 7(3+4) (GS≥7) were a history of dyslipidemia (60.6% GS≥7 vs. 39.4%; odds ratio:1.60, 95% confidence intervals: 1.15 to 2.22), BMI ≥30 (57.3% GS≥7 vs. 49.4%, OR: 1.37, 95% CI: 1.01 to 1.86), age (OR 1.02, 95% CI: 1.02 to 1.06), serum PSA (1.14, 95% CI: 1.09 to 1.19), and clinical stage >T1c (77.9% GS≥7 vs. 42.1%, OR:4.84, 95% CI: 3.37 to 6.94). These associations remained statistically significant after adjusting for each other in multivariate analysis. There was a trend for an increased risk of extraprostatic extension in the RP specimen in men with dyslipidemia (22.2% vs. 18.5%) or DM (25% vs. 18.4%) but this was not statistically significant. Conclusion: Independent of serum PSA levels and rectal exam findings, Puerto Rican men with CaP and abnormal serum lipids or obesity exhibited a higher likelihood of being diagnosed with GS≥7(3+4) on prostate biopsy. Additional studies are warranted to compare the types of dyslipidemia and the impact of lipid lowering drugs on prostate cancer phenotype. Funding: none

Poster #208 IMPACT OF PELVIC LYMPH NODE DISSECTION DURING RADICAL PROSTATECTOMY ON 30-DAY POST OPERATIVE COMPLICATIONS: RESULTS FROM A LARGE NATIONAL DATABASE Nicola Pavan¹, Samarpit Rai², Nachiketh Soodana-Prakash², Raymond R. Balise³, Carmen M. Mir², Bruno Nahar², Fernando Marsicano², Chad R. Ritch², Dipen J. Parekh² and Mark L. Gonzalgo² ¹Department of Urology, University of Miami Leonard M. Miller School of Medicine, Miami, FL and Urology Clinic, Department of Medical, Surgical and Health Science, University of Trieste, Italy; ²Department of Urology, University of Miami Leonard M. Miller School of Medicine, Miami, FL; ³Division of Biostatistics, Department of Public Health Sciences, University of Miami Leonard M. Miller School of Medicine, Miami, FL Presented By: Nicola Pavan, MD Introduction: Pelvic lymph node dissection (PLND) during radical prostatectomy (RP) is the most effective method for detecting lymph node metastases in patients with prostate cancer. The association between PLND during RP and morbidity, especially

298 POSTERS -

(OR

d to MIS−RP. to d AA. On multivariateAA. On analysis, - istically different between AA non and

year interval from the initial were excluded. initial from were the interval year 3 (10%) non -

. 299 AA. Of the 42 patients with PCa, 25 (24%) met the OfAA. 42 patients PCa, 25 (24%) with - New Orleans, Louisiana LA; Veterans ²Southeast New

icant disease, although racial without variation; 18 - nsity significant were cancer predictors on repeat of

(AA) are known to moreknown have are (AA) aggressive cancer prostate

AA. OnlyAA. 10 (9%) patients, againwithout racial variation, had 12 (39%) non 12 (39%) -

. party², Oliver Sartor¹, Raju Thomas¹ and Jonathan L. Silberstein¹JonathanOliverparty², Sartor¹, L. RajuThomas¹ and Libby, MS Libby, s, presented who ASAP with on initial prostate and biopsy AA).AAhad higher PSA, PSA velocity, PSA and density (all

- d to assess the PLND to impact forprimary of assess predicting two d endpoints New Orleans, LA New S.

al small acinar proliferation (ASAP) on initial prostate biopsy. prostate initial on (ASAP) proliferation acinar small al - of 21,895 menof undergoing 21,895 RP between 2006 and classified 2013 were

ce, age, mass body (BMI), index transrectal ultrasound (TRUS) volume, specific(PSA),PSA velocity, antigentime PSA density, and elapsed MIS−RP and 21.0% for ORP). PLND was not associated with a higher risk - ients with an initial finding of ASAP. ASAP. of finding initial an with ients RP and ORP was RP performed in17,354 (79.3%) 4,541 and (20.7%) patients, Robert African Americans 7 (23%) Non 7

PLNDissignificantly associated during RP a with increased certain of risk

AA ASAP diagnosed with on initial not biopsy prostate increased have do risk

−

Upon receivingUpon a retrospective IRB approval, analysismen performed was on A total

MIS Of the 106 men theOf 106 inthe cohort, analysis AAand 31 (29%) not 75 (71%) were were

#209

infection=0.02), and perioperative (OR 1.77; p transfusion (OR 1.32; 0.002) p = identified ra identified - omboembolic adverse events (AEs),We remains unclear. the assessed effect PLND of on 30−day postoperative AEs in patients undergoing Surgeons’ SurgicalNational ImprovementQuality Program (NSQIP).database RP using the American College of thr Methods: Results: into two groups according to surgical approach (MIS−RP vs. ORP) and whether PLND was performed. Multivariate logisticregression adjusting for approachand demographic features performe was (overall complications and major complications defined as Clavien−Dindo ≥ 3) typescomplications. of P−values were adjusted tomaintain and an experiment−wise p 0.05. < for 17 Healthcare Services We(PCa) determine and a greater soughtPCa. predictors to probability death of of from subsequent detection and risk stratificationPCa of ina racially diverse of group men who presented atypic with Self Introduction: 4.64, p < 0.0001) and major (OR 1.6, p = 0.0004) AEs compare AEs =major0.0004) 1.6, p and 4.64, <0.0001) (OR p Conclusion: ¹Tulane UniversitySchool Medicine of Methods: subsequently confirmatory received prostate biopsiesSeptemberfrom 2000 through July 2015. Confirmatory biopsy a with greater than 3 respectively. performed PLND was in7,579 (43.7%) and 3,597(79.2%) patients in the MIS−RP and ORP groups, respectively. The overall postoperative 8.7% (5.5% for complication rate was of(OR 1.02; (OR 0.99; DVT 0.98) associated PLND PE was or p= p= 0.91). However, with a higher risk of superficial surgical site infection (OR 1.68; p =0.013), space organ surgical site regardlesssurgical notPLND ofwas associated approach. overall with major or AEs on overall risk of higher significantly a with associated was ORP analysis. multivariable types of AEs within the 30−day post−operative period. significant However, and thromboembolic PLND association AEs. between there appears to be no from the Southeast Louisiana Health Veterans System Care University and Tulane Medical Orlean New in Center RACIAL VARIATION IN THE OUTCOME SUBSEQUENT OF PROSTATE BIOPSIES IN PROLIFERATION SMALL ACINAR ATYPICAL OF DIAGNOSIS INITIAL WITH AN MEN (ASAP) Haney¹,Robert Ian J. ScottJordan Kramer¹, R. Libby¹, Feibus¹, Allison H. M. Nora McCaslin¹, Krishnarao Mo Poster Presented By: serum prostate biopsiesbetween evaluated were to determine if they predictors were of subsequent PCa in pat diagnosis Results: increasingde PSA, age, and PSA not. were cores ASAP with biopsy and number race, of volume BMI, while TRUS African American (non any componentany of(9%) Gleason 4; AA 7 vs P<0.05). Age, BMI, and TRUSvolume not stat were AA.subsequent diagnosed PCa in biopsy was without (40%) significant patients in 42 racial variation; AA vs 30 (40%) for criteria signif Epstein pathological (24%) AA vs Conclusion: 298 of PCa on confirmatory biopsy compared to non-AA. Regardless of race, most cancers were low grade and lower volume, and AA with ASAP should be managed in a similar manner to non-AA with ASAP.

Poster #210 THE ASSOCIATION OF FATTY ACID LEVELS AND GLEASON GRADE AMONG MEN UNDERGOING RADICAL PROSTATECTOMY Lael Reinstatler¹, Zachary Klaassen¹, Yi Xu², Xiaoyu Yang², Rabii Madi¹, Martha K. Terris¹, Steven Y. Qian², Uddhav Kelavkar³ and Kelvin A. Moses4 ¹Medical College of Georgia - Georgia Regents University Cancer Center, Augusta, GA; ²North Dakota State University, Fargo, ND; ³Nutechbiomarkers, Savannah, GA; 4Vanderbilt University Medical Center, Nashville, TN Presented By: Zachary Klaassen, MD Introduction: Polyunsaturated omega−6 (ω−6) fatty acids (FAs) are associated with increased cancer risk, as opposed toω−3 FAs. The ideal ratio of ω−6 toω−3 (ω−6:ω−3) in red blood cell membranes should be 0.25−1, but an imbalanced ratio may be associated to cancer severity. We examined the association of ω−6:ω−3 and individual FA components on pathological results among men with prostate cancer undergoing radical prostatectomy. Methods: Seventy men were included in the study. Components of ω−6 (lineoleic acid (LA), arachidonic acid (AA), and dihomo−Î³−linolenic acid) and ω−3 (docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA)) were analyzed by liquid chromatography/mass selective detector separation. Univariate analysis was performed using the t−test for continuous variables and Chi−square for categorical values. Results: The median ω−6:ω−3 was 12.65 (IQR 6.85−23.25). A higher percentage of men with ω−6:ω−3 >12.65 had Gleason ≥4+3 disease (58.6% vs. 41.4% ω−6:ω−3 <12.65, p=0.18). Median LA was 18.7 (IQR 6.8−33.9), and a higher percentage of men above the median had Gleason ≥4+3=7 disease (61.8% vs. 36.3% LA <18.7, p=0.029). A greater percentage of men with high AA (median 3.7, IQR 1.6−6.3) also had Gleason ≥4+3=7 disease (62.1% vs. 34.3% AA <3.4, p=0.03). Conclusion: Higher levels of individual components of ω−6 FAs and imbalanced ω−6:ω−3 may be associated with higher−grade prostate cancer.

Poster #211 EMT SIGNATURE AS PREDICTOR OF PROSTATE CANCER RESISTANCE TO RADIOTHERAPY Tim Stark, Patrick Hensley, Hong Pu, Stephen Strup and Natasha Kyprianou Department of Urology, University of Kentucky Medical Center Presented By: Tim Stark Introduction: Growing evidence suggests the process of epithelial-mesenchymal transition (EMT) may contribute to prostate cancer progression and radiotherapeutic resistance. Mechanistic insights have identified that radiation-induced EMT and consequential changes to the tumor microenvironment may facilitate metastatic potential and diminish therapeutic response. This study interrogated the EMT profile in human prostate tumors pre- and post- radiation therapy (RT). Methods: A retrospective analysis of pathologic specimens was conducted in a cohort of 41 patients with tissue diagnosed prostate cancer recurrence after radiotherapy. Pre- treatment clinical specimens were available for a subset (n=8) of these patients. Paraffin- embedded tissue sections (5μM) were subjected to immunohistochemical staining with antibodies specific to EMT effectors (E-cadherin, N-cadherin, β-catenin and vimentin), the actin cytoskeleton remodeling regulator Cofilin, and the a DNA repair enzyme PARP-1. Blinded reviewers graded immunoreactivity and cellular distribution of markers using “Quick Score” in three non-adjacent high-powered fields. A two-tailed t-test was used to detect statistical significance, set at p<0.05. Results: Radiotherapy induced EMT in human prostate cancer specimens with a statistically significant decrease in E-cadherin, increase in N-cadherin, and decrease in

300 POSTERS

term safety of - 1 compared to1 untreated invasive treatment option option treatment invasive - -

term complications of seed -

RT specimens1). (Table In responseto - crease inimmunoreactivity for the actin induced DNA breaks.Impairing EMT prior to - 301

term complications including fistulae, bladder neck neck bladder fistulae, including term complications -

onsequences resulting fromonsequences resulting prostate permanent implant

sequelae of prostate brachytherapy be quite can devastating zed prostate cancer. However, longcancer. prostatezed However, term - n remodeling withinthe tumormicroenvironment correlate with e cytotoxic effects of RT of effects cytotoxic e RT specimens relativeto pre

- ases performed and overall complicationases and performed unknown. However, this rates are

d urinary incontinenced theirmanagement. and

John Samuel Fisher Brachytherapy is typically considered a minimally

The long The This study identified thatphenotypic changes associated EMTwith induction

A total of 39 patients presenting to tertiary our referral center from 1999 to 2014 ons included fistulain 19.4% (n=7), bladder cancer in33.3% (n=12), and bladder The meanThe age at presentation 70.7 was (56 to 83) years. time Mean to the 1 expression and nuclear localization implicatesmechanisms thatmay DNA repair - ersion in52.9% (n=18) and colostomy in symptom13.9% (n=5). score AUA was orida Department of Urology Tampa, FL;orida Department Urology Tampa, Center of ³Moffitt Department Cancer of EEDS IN PROSTATE CANCER Introduction: moderateto severe in 93.5% of patients at presentation. consistentscore was SHIM with severe erectilethosedysfunction 77.3% patients of reporting. in diagnosisthe of complication 7.39 was to (2 seed years 18) implantation. after Complicati neckcontracture in69.4% (n=18). Bladder found cancer was to be high in grade 10 patients in grade 2 and low patients. Patients these with complications urinary underwent div therapymanagement. and their Results: with complicationswith of seed brachytherapy implantation identified were and retrospectively Weassessed. describe c the Methods: Methods: Conclusion: for many men with locali contracture, an implantationmay be underreported very and are difficultmanage. to In this retrospective study, report we on a series of long Vimentin in post LONG TERM ARRAY OF DEVASTATING COMPLICATIONS OF BRACHYTHERAPY OF BRACHYTHERAPY COMPLICATIONS OF DEVASTATING TERM ARRAY LONG S Poster #212 Wiegand²,Wallen²,JaredFisher¹,JohnLucas J. S. DavidHernandez²,Patel², Trushar Raul Ordorica², Philippe E. Spiess³ and Jorge Lockhart² ¹UniversitySouth Florida ²University of College Tampa, Medicine South of FL; Morsani of Fl FL Tampa, Oncology Genitourinary Presented By: and mustbe discussed potential with candidatesminimally for invasive prostate cancer treatmentmodalities. to Due referral pattern and retrospective nature, the overall number of brachytherapy c casesseries emphasizes the importance of prospectively evaluating the long brachytherapy. radiotherapy there was also a significant in cyctoskeletoncofilin regulator the DNA repairand PARP enzyme and actin cytoskeleto therapeutic resistance to in radiotherapy prostate cancer patients. elevated Moreover, PARP Conclusion: controls (p<0.05). potentially reverse th radiotherapy may be of therapeutic value inovercoming RT resistance insubset of prostate cancer patients. 300 Poster #213 THE USE OF SCAFFOLDING TISSUE BIOGRAFTS TO BOLSTER THE VESICOURETHRAL ANASTOMOSIS DURING SALVAGE ROBOTIC PROSTATECTOMY REDUCES LEAK RATES AND CATHETER TIMES Yash Kadakia¹, Jamil Syed², Gabriel Ogaya-Pinies³, Hariharan Ganapathi³, Cathy Jenson³, Janice Doss³, Vladimir Mouraviev³ and Vipul R Patel³ ¹University of Central Florida School of Medicine; ²University of Florida Medical College; ³Global Robotic Institute, Celebration, FL Presented By: Gabriel Ogaya-Pinies, MD Introduction: One of the key contributing factors to the morbidity associated with salvage radical prostatectomy is a significant vesicourethral anastomosis (VUA) disruption. The reason for this leak is often not due to a poorly sutured anastomosis but rather due to postoperative tissue breakdown secondary to poorly vascularized tissue caused by the ablative nature of the primary therapy. We used a tissue biomaterial graft called Matristem from ACell® to provide better integrity and to act as a scaffold for improved healing and prevention of anastomotic disruption. Methods: From March to July in 2015, 8 patients underwent sRARP. The salvage RARP was performed after failure of the primary therapy. Brachytherapy in 3 patients (37.5%), EBRT in 3 patients (37.5%), cryotherapy in 1 patient (12.5%), and high intensity focused ultrasound in 1 patient (12.5%). At the time of the VUA a Matristem graft scaffold was placed. A (2cm x 4cm) sized graft was cut and then sewn into the suture line of the posterior anastomosis. The patients were catheterized for a minimum of 10 days and a cystogram was then performed to assess healing. The primary endpoint measure of vesicourethral anastomosis healing was the absence of anastomotic disruption and significant leak on cystography. Significant anastomotic disruptions are treated with prolonged catheterization and cystograms until resolution. The group that received the Matristem (Group 1) was compared to a control group that was also a salvage group sRALP but who did not have the graft placed (Group 2). A third group was the non-salvage group that was after primary RALP and no graft placed (Group3). Results: The clinically significant anastomotic disruption was observed in one patient (12.5%) with median catheterization time of 11 (10-52) days in the group 1 and in 3 patients (37.5%) in the group 2 with 17 days (9-47), respectively. In Group 3 no leak was registered in all patients (0%). The rate of other perioperative complications according to Clavien definition of ≥ 2 was same in both first two groups – 1 case (12.5%) (p>.3) and no one in third group. In the group 3 no one case of disruption was documented with less catheterization time of median 5 days (5-7) compared to both first groups (p=0.05). Overall sRALP was associated with a higher radiologic leakage rate than RALP. Leakage was seen most frequently after sRALP due to failed primary ERBT. Conclusion: The occurrence of clinically significant anastomotic disruptions after sRALP are significantly reduced by the use of a tissue scaffold incorporated into the VUA. The use of a Matristem graft decreased the rate of disruption enhanced healing and reduced catheter times in patients undergoing sRALP

Poster #214 IDENTIFYING ADDITIONAL LYMPH NODES IN RADICAL PROSTATECTOMY PELVIC LYMPH NODE SPECIMENS Win Shun Lai¹, Jessica Tracht², Jennifer Gordetsky¹,² and Soroush Rais-Bahrami¹,³ ¹Department of Urology, University of Alabama at Birmingham, Birmingham, AL; ²Department of Pathology, University of Alabama at Birmingham, Birmingham, AL; ³Department of Radiology, University of Alabama at Birmingham, Birmingham, AL Presented By: Win Shun V. Lai, MD Introduction: Pelvic lymphadenectomy has prognostic and therapeutic implications in prostate cancer. Pelvic lymphadenectomy specimens are fatty and identification of lymph nodes can be difficult during the grossing process. We investigated the utility of submitting the entire lymph node packet for examination.

302 POSTERS

years and 14.4 he difference in

4: 4: p=0.014). PGY4

. 59.7

303 3, 4: p<0.001 and 1, 2, 3 vs 4: and 1,3, p<0.001 3 2,

n age and PSAn age and 64.9 were vs e grosser,measured as PGY by level, also increases e found total when lymph node packets submitted; were 6.9 (p<0.001). Submitting the lymph entire node packet

. nal lymph nodes being detected specimen. per significant No mph significantlycount was comparing node when lower level upper 8.7 (p=0.0074).Significantly morerequired blocks were using the new

. Entire lymph node packet submissionsignificantly increasesthe total number junior level residents (1, 2 vs 2 (1, residents level junior

. We retrospectively examined 59 radical prostatectomycases node lymph with

29 cases using old grossing methods and 30 cases were identified casesmethods were grossing the using cases old and 30 new using 29

e compared to the others PGY levels(p=0.04). 8.8ng/mL for the old and new methods(p=0.0051 and new the and p=0.13), forPathologic respectively. old 8.8ng/mL

. residents alsofound significantly additional fewer lymph grossing using the nodes new techniqu Methods: dissectionsinstitution our at and 2015.2012 A method new between requiring the total submission of lymphpackets node introduced was We in2014. t assessed lymphidentified, nodes blocks number of submitted, the and proficiency of finding lymph level.nodes on PGY based Results: Conclusion: lymph node grossingmethod. mea The of lymph identified nodes insubmittedpelvic specimens lymphadenectomy during radical prostatectomy. The of experience th T stage, stage, N and grade notwere significantly different the between two groups. Significantlymore lymph nodes wer vs mean 14.1 vs comparingdifference levels allfound notedthe nodes was PGY by lymph in number of of residentsthe processing case (p=0.33). using However, thegrossing new technique,the percent increase ly in residents vs the augmented percentage of yield. node lymph Asmore blocks required are for this new grossingspecimen processing. an increasedthere inmethod, likely will expense be grossing method; mean 13.53 vs resultedmean ina of3 additio 302 Annual Business Meeting Agenda

Saturday, March 19, 2016

I. Report from the President – Jon S. Demos, MD Award Announcements: Health Policy Young Investigator Award Resident Humanitarian Award Distinguished Member Recognition Award

II. Minutes of the 2015 Annual Business Meeting – Glenn M. Preminger, MD

III. Secretary Report – Glenn M. Preminger, MD

IV. Treasurer Report – Scott B. Sellinger, MD

V. Historian Report - Jerry E. Jackson, MD

VI. Committee Reports 1. 2016 Local Arrangements Committee – Melissa R. Kaufman, MD, PhD

2. Committee on Education and Science – S. Duke Herrell III, MD

3. Bylaws Committee: 2016 Bylaws Change - Lee N. Hammontree, MD

4. Finance Committee – Gerard D. Henry, MD

5. Membership Committee – Chad W.M. Ritenour, MD

6. Health Policy Committee – Lorie G. Fleck, MD

VII. Representative to the Board of Directors of the AUA – Thomas F. Stringer, MD

VIII. Future Sites Committee – W. Terry Stallings, MD

IX. Unfinished Business

X. New Business

XI. Honorary Members – Jon S. Demos, MD

XII. Nominating Committee Report and Elections – W. Terry Stallings, MD

XIII. Introduction of Incoming President

XIV. Adjournment

304 MINUTES OF THE 79TH ABM

tive continues

thin the section and Dean G. Assimos, MD MD G. Dean Assimos,

–

Urology Care FoundationUrology Care

ureau has been well received by the received been well by has ureau storian Report to the membership.storian Report the Dr. to

sponsoring a 3

Jack M.Jack MDAmie, Business Meeting

305 –

G. G. MDAssimos, Annual Business MeetingAnnual

Scott B. Sellinger, MD Sellinger, B. Scott s glad to see that there were severalthat thereseepeoples toin were glad Dean

Jerry E.MD Jackson, Jerry

– – -

ed the 2015 SESAUA Annual Business Meeting to order.to Business Meeting Annual 2015 SESAUA ed the nd balance, as of December 31, December totals of $4,757,281. 2014, as nd balance,

Research Scholar 5 residents Increased to funding fromIVUmed the program 3 to SESAUA $67,000 awarded Over residency was programs to covercosts travelparticipateto forAnnual residents the in 2014 Meeting Panamacurrentlymembers enough has wi theper given are one representativebylaws and one alternate representative on the SESAUA Board of Directors. AssociatesWJWeisercontract and renewed. was The section will continue to support 5 IVUmed scholars to support IVUmed 5 continue will The section The fu The The section approved The SESAUA SpeakersB societiesstatecontinue. and will SESAUA investments are now heldVanguardSESAUAat and total investments now are $4,509,901. The SESAUA will sectionThecontinue will the Resident SESAUA at the Bowl movemeeting support residents the who onto National and Residents and ChiefBowl Debate Residents The minutes of the 2014 Annual Business Meeting were BusinessminutesMeeting 2014 of the The Annual

: The Treasurer’s Report was approved as presented. as was approved Report Treasurer’s : The : The Secretary’s ReportSecretary’s was The : as presented. approved

          Minutes 79 of the Treasurer Report Report Treasurer Dr. Jack Amie call Amie Jack Dr. Dr. Amie stated thatmeetingsstated attendedDr. 7 statesociety Amie year he this annual allsuccessful and were provided recent a briefHe meetings. the report on actions:board approved as presented. as approved

Dr. Scott Sellinger provided the following financial highlights: following the provided Sellinger Scott Dr. Jackson provided the listing of member in the Southeastern Section who Jacksonthewho listing in Southeasternmember provided the Section of passed thishave past year: away JacksonDr. Hi Jerry presented the Report from the President President the from Report Secretary Report Secretary to be bright for the Southeasternto theSection. be bright for Action attendance in the morning poster and video sessions. He stated that the statedthatmorningand videoattendance the sessions.the poster in He WomensectionSociety in femalethetoresident going fund to attend of a is Urology Conference. futureeducationalan prospec from The Dr. Assimos stated that it was his last report SESAUA. last Secretary that the Dr.stated as of Assimos his it was thankedsectionHe pasttheforserve the Secretaryto as allowing him for 328 abstracts submittedthree acceptance a 60% years. with There were rate. Assimos Dr. wa Historian Report Report Historian Dr. Dean Assimos presented the minutes BusinessDr. the 2014 Annual Assimos Dean the of presented membershipMeetingthe to for approval. Action: Action Annual 2014 the of Minutes

IV. I. III. V.

II. Unlesscommittee reportswere by otherwisewere vote and all noted, unanimous actions unanimously approved. 304304 Carey Barry, MD, Jordan Baum, MD, Albert Beacham, MD, Joseph Brannen, MD, David Eberle, MD, Christopher Fitzpatrick, MD, Hugh Good, MD, Edward Graves, MD, Steven Hulecki, MD, Luis Isales, MD, William Lucas, MD, Bogdan Marcol, MD, Travis Morgan, MD, Richard Nallinger, MD, Thomas Nesbitt, Jr., MD, Garrell Noah, Jr., MD, Logan Perkins, Jr., MD, W. Glen Wells, MD.

A moment of silence was given to remember those members who have passed.

Action: The Historian Report was approved as presented.

VI. Committee Reports 7. 2015 Local Arrangements Committee – Thomas Shook, MD Dr. Amie presented the local arrangements committee report on behalf of Dr. Shook. He thanked Dr. Shook and his wife for all of their assistance with the planning of the 2015 Annual Meeting.

8. Committee on Education and Science – S. Duke Herrell III, MD Dr. Herrell thanked the Executive Committee again for his appointment as Chair of Committee on Education and Science. Dr. Herrell also recognized the other committee members within the Committee on Education and Science. It was noted that Drs. Charles Pound and Glenn Preminger will be rotating off the committee this year. He stated that we continue to get a large amount of CMEs and will continue to keep that in mind when planning for the 2016 Annual Meeting.

9. Bylaws Committee – Lee N. Hammontree, MD Dr. Hammontree presented the bylaws change to the membership regarding the historian’s term.

Section E. SECRETARY

5. He/she shall cause to be printed supplied at the expense of the Section:

a. The Membership Directory of the Section which shall be updated and mailed at least every two (2) years. shall be made available on the Section’s website.

b. The Program and Abstracts which will be printed and, or provided in electronic format or electronically on the Section’s website, for distributed distribution for the yearly Meeting only.

Section F. TREASURER 3. He/she shall purchase, sell or transfer securities of the Section only upon recommendation of the Committee on Finance or approval of the Executive Committee.

Action: The bylaws change was approved as presented.

4. Finance Committee – Gerard Henry, MD Dr. Henry presented the Finance Committee report to the membership. We have $4.5 million with Vanguard. He stated that our largest expenses are the annual meeting and educational endeavors.

306 MINUTES OF THE 79TH ABM

e tallings tallings Elect Dr.

Dineen Health - Thomas

–

s, MD Dineen Health Policy Policy Dineen Health - ons. g AUA President

nes continue to be a huge benefit continuenes be a huge to

ip Committee report to the Chad W.M. Ritenour, MD MD W.M. Ritenour, Chad

– Executivethefor to privilege Committee J. J. Christian Winter

– 307 W. Terry Stallings, MD Stallings, W. Terry

–

uture Sites Committee reportwas as Sites Committee uture approved

mbined of assets deficit $7,984,000. $147,568,000 a net with of All committee reports were approved as presented. as approved were reports committee All

speakers to related policy health the including Gee Forum. Policy : F The : The report from the representative to the AUA Board of of Board the to AUA representative the from report : The : The Health Policy Council will be consulted during the the during consulted be will Council Policy Health : The : The candidates for SES membership were approved. were membership SES for candidates : The Health Policy Council Council Policy Health committeeSESAUA1.meetingthefor Meeting Approval Annual at a selectionthePolicyth2.like The input Council on Health would of Membership Committee

Representative to the Board of Directors of the AUA AUA the of Directors of Board the to Representative Stringer, MD Stringer, StringerDr. AUA Board Directors report. Thomas The the of presented Southeasternsectionthe hostin of pleasure had presented. Business Unfinished Nothing report. to 6. JacksonDr. Health Jerry presented the Council Policy report of on behalf Winters.Dr. action There four are items: Action William Gee at our meeting this year. The AUA has almost 21,000 members almost 21,000AUA has meetingWilliam this The our year. Gee at inthe in theorganization international with growth members. biggest The SoutheasternThe largestcurrentlythe Section section AUA. is withinthe co AUA has appointmentsJournalNew Smith,AUA include:Joseph the of MD, A. within Urology Editor,EducationVictor Nitti, MD, Inderbir Gill, AUA and Chair, MD, Guideli AUA The Chair. Initiatives Global for international domesticmembers. and Action Dr. Ritenour Membersh presented the members 2,359membership. over with continuesmembershipto Our grow Puerto Rico.from members Panama including and 74 new 33 Action 5.

Nothing report. to New Business Directorswas as presented. approved Sites Future Committee selection process of the speakers for the Gee the for speakers the of process selection sessi focused policy health other and Forum Dr. Terry Stallingsthe thanked FutureSitesserve the Chair. as Stallingsthanked Committee Dr. Dr. also Sellinger AssimosScottDean forselecting and Dr. assistance their the with WeiserWendyteam. S Dr. 2018 Annual and her as Meeting well as statedAnnual year’s that in next Meeting Nashville, Tennessee be held will AnnualAustin,and thebe heldInin Meeting 2017 Texas. 2018 will AnnualSESAUAin Meetingthe Orlando, Florida atbe held will Loews Royal Pacific Resort. Action Action:

VII. IX. X. VIII.

306 XI. Honorary Members – Jack M. Amie, MD Dr. Amie announced names to be approved for Honorary Membership:  J. Leonard Lichtenfeld, MD, MACP  Tom F. Lue, MD  Peter T. Scardino, MD  William Ferniany, PhD  Michael D. Fabrizio, MD  Allen F. Morey, MD  Thomas Crawford, PhD, MBA, FACHE  James M. McKiernan, MD  Douglas A. Husmann, MD  William J. Catalona, MD

Action: The all individuals proposed were approved for Honorary Membership in the Southeastern Section.

XII. Nominating Committee Report and Elections – Randall G. Rowland, MD, PhD Dr. Randall Rowland presented the following slate of nominations for the SESAUA Board of Directors: President Elect - Dean Assimos, MD Secretary - Glenn Preminger, MD Alabama Representative - Peter Kolettis, MD Alabama Representative - Merle Wade, Jr., MD Alabama Alt. Representative - William Terry, Jr., MD Alabama Alt. Representative - Tracey Wilson, MD Florida Representative - Michael Dennis, Jr., MD Florida Representative - Paul Young, MD Florida Alt. Representative - Lawrence Hakim, MD Florida Alt. Representative - Adam Ball, MD Georgia Representative - Kenneth Ogan, MD Georgia Representative - Thomas Shook, MD Georgia Alt. Representative - Joshua Perkel, MD Georgia Alt. Representative - Rabii Madi, MD Kentucky Representative - Katie Ballert, MD Kentucky Alt. Representative - Murali Ankem, MD Louisiana Representative - Benjamin Lee, MD Louisiana Alt. Representative - Jonathan Henderson, MD Mississippi Representative - Chadwick Huckabay, MD Mississippi Alt. Representative - Christopher Bean, MD North Carolina Representative - Gregory Murphy, MD North Carolina Alt. Representative - Brian Cope, MD Panama Representative - Angel Alvarado, MD Panama Alt. Representative- Celeste Alston, MD Puerto Rico Representative- Marcos Perez-Brayfield, MD Puerto Rico Alt. Representative - Eduardo Canto, MD

Dr. Randall Rowland presented the following nominations for SESAUA representative to AUA Committees: AUA Nominating Committee Representative: Charles Pound, MD AUA Nominating Committee Alternate Representative: Raju Thomas, MD AUA Board of Directors Representative: Thomas Stringer, MD AUA Board of Directors Alternate Representative: Raymond Leveillee, MD

Action: The nominations for the SESAUA Board of Directors and the SESAUA representatives to AUA Committees were approved as presented.

308 MINUTES OF THE 79TH ABM - At - Large on Large the -

at - . . Dr. Jon thankedDemos

309

everyone foreveryone the sectionserve opportunity to the as

: Dr. Gregory Murphy was appointed as Member as appointed was Murphy Gregory : Dr. Dr. Raju Thomas called for nominations from the floor for the Member the for floor the from nominations for called Thomas Raju Dr. Large positionLarge Nominating SESAUA on the Murphy Gregory Dr. Committee. was nominated from the floor. Action SESAUA Committee. Nominating SESAUA Respectfully Submitted, Samantha N. Panicol Introduction of Incoming President Incoming of Introduction Amie thankedDr. Jack the Executive Committee for theirguidance congratulatedand Dr. Jack meeting. and a great year wonderful Amie for a Adjournment AmieBusiness AnnualDr. adjourned the Jack 2015 Meeting. President. Dr. Amie introduced Dr. Jon Demos as the incoming SESAUA incomingPresident. the as introduced Jon Amie Dr. Demos Dr. President. sectionthethe to for opportunityDr. great Demos thanked Jon honor and SectionPresidentserve Southeastern the as the of Associate Director Associate

XIII. XIV.

308 Proposed Bylaws Changes

ARTICLE V COMMITTEES

Section B. SPECIAL COMMITTEES

6. HEALTH POLICY COUNCIL

c. The Committee shall consist of one (1) Member from each state in the Section, and Puerto Rico, and Panama plus the Chairperson.

h. There shall be an Alternate for the Chairperson and a second Alternate for the Vice-Chairperson to serve as Alternate Representatives of the Health Policy Council of the AUA appointed by the Executive Committee.

PREAMBLE

Section C. Code of Ethics

Members shall: 1. Conduct professional activities with honesty, integrity, fairness, and good faith . 2. Always treat each other, employees, staff, volunteers and the public with dignity, respect, and courtesy. 3. With enthusiasm act as a goodwill ambassador for the Section.

Article I MEMBERSHIP

Section F. Senior Membership

Active Members are eligible for Senior Membership in the Section if they have been Active Members for 25 20 years in either the Section or the AUA and have reached aged 65, or 20 years of service and are retired, or are permanently disabled.

Article VI MEETINGS

Section A. Annual Meeting

5. Officers shall be installed at the end of the Annual Business Meeting.

310 BYLAWS the the

5. Members Honorary 6. Corresponding Members 7. Members Candidate

311

ction of the American Urological Association, Inc.,

Bylaws EMBERSHIP

ARTICLE elected to Honorary Membership,shall be eligible PREAMBLE

Committee. Applicationmembership forSectionin the

f urology, to promote improved the practice of urology, and to or Members or

ebsite. 2. Seni 3.Associate Members Allied4. Members 1. Active1. Members

forshall officeAllmembersto right the vote. have be entitled or accessto the latest available ofcopy the Articles of Incorporation and Bylaws and the Roster of Membershipavailable on the Section W Each member of the Section must also join the AUA. Each member of the AUA, except corresponding members,must of member also be a the Section. MANDATORY AUA MEMBERSHIP MembershipSectionin the is solely afforded at the discretionthe of Board of Directors and the Section Membership, the with advice of the Membership must be made on forms approved the by Board of Directors and theprovided by Secretary. Mission The Southeastern Se (Section) is professional a organization devoted to the of propagation the highestmedical standards practice of the and to discovery and dissemination of scientific and information. knowledge It is also function of the Sectionto and advocate promote for the practice of urology. CATEGORIES The MembershipSoutheastern theof American the Section of Urological Association, Inc., herein knownafterward as the Section, shallthe categories:consist following of VOTING RIGHTS STATUS AND Only Activemembers, and SeniorActive those and and Senior members are who Objectives The stated objectives of the Section to are perpetuate the finest traditionsencouragescientificmedical the the of arts, to advances in the field o benefit the general welfare. It is Section’s the paramount goal to offer increasing responsibilitiescolleaguesthose vigorous to young exhibiting enthusiasm capability. and

Section C. Section A. Section A.

Section B. Section B.

310

Section D. ELECTION/APPROVAL OF MEMBERSHIP All members shall be elected at the Annual Business Meeting, except for Candidate Members who shall be approved by the Executive Committee periodically throughout the Association year, and Associate and Active Candidates referred by the AUA as otherwise fulfilling Active Membership requirements for those certified within the last 24 months (as per the AUA Bylaws) or Associate candidates moving through the AUA Fast Track Associate Status (as per the AUA Bylaws) who shall be approved by the Executive Committee periodically throughout the Association year.

Section E. ACTIVE MEMBERS Requirements for membership are as follows:

1. Possession of an unlimited license to practice medicine and surgery in the State, Province or Country of the applicant’s practice.

2. Possession of an M.D. or D.O. degree, or United States medical licensure equivalent, and completion of an ACGME accredited urology residency or equivalent by the Royal College of Surgeons (RCS) in Canada or the Quebec Board of Urology or the certifying Board of Urology in the country.

3. Limitation of practice to the specialty of Urology.

4. Certification by the American Board of Urology(ABU), the Royal College of Surgeons(RCS) in Canada or the Quebec Board of Urology or the certifying Board for Urology in the country where practicing within the geographic boundaries of the AUA.

5. Recommendation for membership by two (2) voting members of the AUA, except if certified within the last 24 months (as per item 4 in this section). 6. Letter of recommendation from the Chief of Urology, Medical Director, or Chair of the Credentials Committee at the hospital(s) where the applicant has privileges.

Section F. SENIOR MEMBERS Members are eligible for Senior Membership in the Section if they have been Active Members for 25 years in either the Section or the AUA and have reached the age of 65, or 20 years or service and retired, or are permanently disabled.

Section G. ASSOCIATE MEMBERS Requirements for Associate membership are the same as Active membership, except for Board certification. Associate Members shall pay the annual dues, assessments, and initiation fees as determined by the Board of Directors. They shall not be eligible to vote or hold office, nor has right, title or interest in the real or personal property of the Section.

1. Candidate Members Eligible for Fast Track Associate Status. Associate membership in the Section and the AUA will be offered

312 BYLAWS

and and furnish the

for firstyear. the approved urologyapproved The applicant shall - Reinstatement

memberurologists who - ed by theed by American

Physician Scientists and is not - ndividual ndividual to Associate Member compliance AUA and/or with -

hipis to available non Year Dues.Associate have Members who 313 -

inguished urologists. Candidatesmust be nominated

tomemberspassed have the all qualifying Candidate who examinationAmerican Board Urology. the of of (Part I) policies. Associate Members are practicingare withinthe geographic boundaries of the Section but certified notare of American Board Urology. the by Doctors completeof who Osteopathy AOA recertifiedIf fails Active to Member the become required an by as American certifying other Board Urology (or of AUA Board), the and/or Section transfer will i the memberStatus. decertifiedAmerican becomes Active the If an by certifyingBoardmember of shall board, other Urology or be the automaticallyfor non dropped SectionBylaws, Expulsion pursuant to and residency programs certifi are and OsteopathicSurgery eligibleAssociate are for Board of Member Status. passedcertifyingthe ABU examination (Part II) will be transferred membershipto Active Sectionthein the both and AUA and notified membershipthat active waived are dues Waiver of First of First Waiver orary Members been ActiveSeniororary have shall Members or who

MEMBERS HONORARY Honorary Membersshall be scientists achieved have outstanding who prominencefieldmedicine ina of to related PastPresidents Urology, of the retired Section have from who the active practice Urology, or and/or other dist theby President Active (2) atby two and endorsed leastSenior or majorityMembers.must a by theof be elected They of Board vote Directors and will be presented at the Annual Meeting of election. Hon Section. in the rights previous their retain ALLIED MEMBERS Allied membership is available to Non to is available membership Allied CORRESPONDING MEMBERS Corresponding Membershipis to available urologists practice who thebeyond geographic boundaries ofSection. the 2. usuallyfor availablecertifiedmedical physicians However, boards. by medicine of fields related in persons instances, exceptional in science, do not qualify who for other categories of Section Membership,mayconsideredfor be Allied provided they Membership contributedhave significantly to specialty the of Urology. They shallbe nominated Active two by members Senior or shall who 3.

Section Secretarythe with curriculavitae and other pertinent information. Allied shall thedues, Members pay annual and initiation assessments fees as determined the by Board of Directors. They shall be not eligible office. vote hold to or

Section J. Section I. Section H. 312 be a member of the local or national urological organization in his/her country, and a letter of endorsement of that membership shall be submitted to the Section with the application form. If a national organization does not exist within the applicant’s country, a waiver of this requirement may be considered by the Board of Directors. The applicant’s practice must be limited entirely to the specialty of urology. The applicant must be a graduate of an acceptable medical school who has received a Doctor or Medicine or equivalent degree. The applicant must be in practice for a minimum of two (2) years after completion of residency.

Corresponding Members shall pay the annual dues, assessments and initiation fees as determined by the Board of Directors.

Section K. CANDIDATE MEMBERS Candidate Membership is established to extend Sectional educational and professional advantages to urological residents. The Candidate Member must be practicing and studying within the geographic boundaries of the Section

1. ACGME. Medical Doctors (MD) or Doctors of Osteopathy (DO) enrolled in a urology residency program approved by the Residency Review Committee and ACGME are eligible for Candidate Membership; and after completing training and passing part 1 of the ABU certifying examination are eligible for Associate Member status (Fast Track), Section G.1. Those who successfully pass all parts of the ABU qualifying examination are eligible for Active Member status, Section E.

2. AOA. Doctors of Osteopathy enrolled in an AOA-approved urology residency training program are eligible for candidate member status. DOs completing their training and passing the American Osteopathic Board of Surgery certifying examination are eligible for Associate Member status, Section G.

Section L. PUBLICATION OF NAMES The names of applicants for Active membership which have been approved by the Secretary and Membership Committee shall be available to the membership prior to the Annual Business Meeting.

Section M. TRANSFER OF MEMBERSHIP An Active, Senior, or Associate member in good standing of the AUA and of another Section of the AUA who moves his or her residence or practice into the territory of this Section, and who meets all membership qualifications, is automatically eligible for membership in the Section upon presentation of credentials to the Board of Directors of the Section. These credentials shall include his or her previous Section records and a letter from that Section’s Secretary indicating the applicant’s membership status.

Section N. EXPULSION, DISCIPLINE, RESIGNATION AND REINSTATEMENT All matters of discipline shall be the responsibility of the AUA, in accordance with the Bylaws of the AUA. Members disciplined by the AUA will automatically be disciplined by the Section. Any member

314 BYLAWS

ion ion Elect, -

previously previously

the Board of Directors and the Board Directors the the of and ion of the of Board Directors to ion of

cted in accordance with these Bylaws.cted in these with accordance 315

OFFICERS ARTICLE II ARTICLE appoint Special and Ad Hoc Committees and shall appoint Special and Ad Committees and shall Hoc

te PasttePresident, Secretary, the the Treasurer and paymentfor of or other any dues, reason, may, after - elected. -

The President shallExecutive be the Officer Chief this of Section. He/sheshallserve Chairman as of Executive Committee. He/sheshall preside meetings at all of these bodies and at the Scientific and Business Meetings of the Section. His/her term of officeshall be one (1) year and he may not be re Officersthe of Section shall President, be the the President He/she shall make appointmentstofill vacancies on committees appointed by the Executive Committee. He/shemay call specialmeetings of the Executive Committee Boardand the of Directors. voting election. shall for be necessary the Immedia All Officers shall be elected at Annual the Business Meeting from the slate presented the by Committee on Nominations by or nominationmajoritythefrom votethoseApresent of floor. and the Historian. Officersshallserve without financial remuneration and holdoffice fromconclusion thethe of Meeting Annual at they which are elected until the completion of theirterm office of until or their successors ele are He/sheshall the direct attent violations of the Bylaws and to matters of discipline of members. of discipline of matters to and Bylaws the of violations Vacanciesthat occur in ofany Offices the may be filled a by majorityBoard Directors.the of of vote He/she may make nominations for Honorary Membership. Candidates for office shall be Active Senior or Members in good standingSection, the members of honorary or who Activewere members ingood standing of the Section. In either members standingAUA. must the in of case,they be good

Any member has who resigned or membershipwhose been has deleted for non expelled the by shall AUAautomatically Sect his her or have may be taken actions All terminated. disciplinary membership AUA.theBylaws of the accordanceappealed with to in AUA the PRESIDENT 1. OFFICERS OF THE SECTION OF THE OFFICERS 1. payment of back any dues request owed, reinstatement, subject to the approval ofSectionCommittee the Membership 3. 2. 2. 3. 4. 4. 5. 5.

Section A.

Section B. 314 6. He/She shall appoint an individual urologist and spouse to serve as Chair of the Committee on Arrangements.

7. He/She shall be a member of the Committee on Programs.

Section C. PRESIDENT-ELECT 1. The President-Elect after serving one (1) year in Office shall be elevated to the Office of President automatically and without standing for election.

2. He/she shall perform any duties which are assigned by the President and shall preside in the absence of the President.

3. He/she shall be a Member of the Executive Committee, Committee on Programs and Board of Directors.

Section D. PAST PRESIDENT  The Immediate Past President shall be a Member of the Board of Directors, the Executive Committee, the Committee on Nominations and the Committee on Programs. His/her term of Office shall be one (1) year.

Section E. SECRETARY 1. His/her term of Office shall be three (3) years or until his/her successor assumes Office. He/she may not be elected to more than one (1) term.

2. He/she shall keep precise and complete records of all the business activities and correspondence of the Section.

3. He/she shall oversee the application process and membership records, shall receive and maintain the official Section documents, and shall give formal notice of the Annual Meeting and of special meetings. The Secretary shall preserve the Minutes and records of such meetings.

4. He/she shall notify by letter each newly elected Member of his/her election and send him/her a Certificate of Membership with notification to visit the Section website for a copy of the Section Articles of Incorporation and Bylaws. He/she shall notify Members promptly of any change in their membership classifications.

5. He/she shall cause to be supplied at the expense of the Section:

a. The Membership Directory of the Section shall be made available on the Section’s website.

b. The Program and Abstracts which will be printed, or provided in electronic format or electronically on the Section’s website, for distribution for the yearly Meeting only.

6. He/she shall send official notice of the date, time and place of the Annual Meeting to each Member at his/her last known address at least sixty (60) days before the date of the opening session.

316 BYLAWS the

yment of etary and bers who have have bers who A Membership Membership A

one (21) days one (21) before the date -

rt to the Committee on Nominations, ust be processed Secretary.ust the be by

317

r tor the Annual Meeting all existing and expected

(1) term. selected. Notices of Special Meetings giving the purpose, place, date and shallhour sent be least at twenty His/hertermshallfor Office of three years be (3) until or his/her successor assumes Officemay not be elected and to more than one Executive Committee, Board of Directors and Annual Business Meetingthe of Section. He/she shall the arrange of order businessmeeting for of He/she shall be a member ofExecutive the Committees, Board of Directors,the Committee Programs, on on Bylaws, the Committee the Committee ArrangementsAU on and the Committee. The Secretary shall determine the program, including papers and panels, for the Annual Meeting. He/she shall be Chairmanthe Programs. Committee on of The Treasurer shall be the custodian of the funds the and all property of the Section. The Treasurer shall work thewith Executive Director overseeing all general accounting and financial record keeping functions. He/Sheshall assure prompt pa allSection. authorizedthe of bills He/she shall sell purchase, transfer or securitiestheof Section only upon recommendation Committeethe of on Finance or approval ofExecutive the Committee. shallthecarryof outOffice routine the the under direction duties of Secretary. the The Executive Director shall be the Assistant to the Secr He/sheshall electedletter, notify, officers newly each by or appointed committeemember of his election her or or appointmenttenure that the office. of and of He/she appropriateshall be published cause newsletters to during the Allm newsletters year. been selected representthe to Section AUA Committees, and on memberthe hasmaintained name any not of who Section membership in good standing. He/she shall notify the of AUA names the mem of vacanciesStanding on Special Committees, Committees, and RepresentativesAUA positionsthe to for Executive which Committee determines appointmentstheseBylaws. to according The Secretary shall also repo at least days (30) prior to the Annual Meeting, all existing and expected vacancies forfor nominees positions the and the in AUA Bylaws.Sectionthese accordance in with He/sheshall reportthe to Committee Executive atthirty least (30) days prio

TREASURER 1. 7. 8. 2. 3. 13. 12. 11. 10. 9.

Section F.

316 4. He/she shall, at the expense of the Section, give bond for such sum as may be determined by the Board of Directors, but in no instance less than fifty thousand dollars ($50,000.00).

5. At the discretion of the Executive Committee or the Committee on Finance, he/she shall have an annual compilation made of the finances of the Section by a Certified Public Accountant and shall present a written report at the Annual Meeting of the Section.

6. He/she shall prepare annually a list of Members in arrears and present this list to the Board of Directors.

7. He/she shall be a member of the Board of Directors, the Executive Committee, the Committee on Programs, the Committee on Finance, and the Investment Advisory Committee.

8. The Executive Director shall be the Assistant to the Treasurer and shall carry out the routine duties of the Office under the direction of the Treasurer.

Section G. HISTORIAN 1. This Section shall have a Historian who is elected by membership. He/she shall serve a term of three years, and can be re-elected to serve a second three year term. He/she must be nominated for Office by the Committee on Nominations or from the floor and be elected at the Annual Business Meeting by a majority vote of those present and voting.

2. The Historian is a non-voting member of the Board of Directors and has no functional duties within the Section other than those described below.

3. He/she shall prepare a history of the Section and shall keep records of changes in the Section to its history. He shall present an annual report to the Board of Directors and to the Section at the Annual Business Meeting.

4. He/she shall prepare for publication any historical issues relative to the Section and present them to the Board of Directors.

5. He/she shall be custodian of all records, papers and various paraphernalia which properties are no longer in the custodial care of the Secretary or other Officers of the Section.

6. He/she shall report at the Annual Business Meeting the names of all Members who died in the preceding year.

7. He/she shall be responsible for recording the activities and highlights of each Annual Meeting and shall obtain appropriate documentation of the Meeting.

Section H. EXECUTIVE DIRECTOR

The Executive Director shall be the chief administrative office of the Association, and shall report directly to the Board of Directors, of which he/she shall be an ex officio, non-voting member. The Executive

318 BYLAWS -

of special meetings of special meetings

or shallor be elected for not be limited to those set those be limited set tonot

one (21) days before the date of the

rk of budget the and subjecttheto direction

oard of Directors shallconstitute Directors a quorum. of oard 319

ARTICLE III ARTICLE

red (100) Active or Senior Members or fraction thereof. Active (100) red Members Senior or fraction or thereof.

ate territory or ofSection the in tenwhich more or (10) BOARD OFBOARD DIRECTORS l consist the of Executive Committee,the Chairpersons the of

Boardmeet shallAnnualthe time the annually of the Meeting at of Section. The Board of Directors, herein knownafterward as the Board, shal Standing Committees,the Chairperson of the Health Policy Council,the Section Representative to the Board Directors of of the AUA leastat and Director one (1) Alternate one (1) or from each st Active Senior or Members reside. Statesterritories or inwhich morethan Active (100) one hundred Senior or Section Members resideDirector shall an additionalAlternate have and for each one hund ActiveMembersthemustSection Board be Members the of of theand of AUA. must be sent the by Secretary out to each Board Member and Alternateleast at twenty Special Meetings themay be called of Board the by President or requestby of a majority of Directors. Notice a term of three (3) years and may not succeed themselves. a term of three years (3) and may not succeed themselves. Serving as an Alternate shallnot disqualify a Member from serving as a Director. The Board is responsibleadministrationthe for management and Section. the of Directors and one Alternate for each Direct Meeting. An unfinished term of a Director shall be served by the Alternate.served the by shallAn Director be unfinishedofterm a The mattersThe called votedto upon at be discussed duly and any meetingBoard Directorsshall the of of forth in the notice of such meetings.such forth the of in notice In to order become better acquainted the with activities of the Section, Alternates should Meetingsattend of the Board as non substitutingmembersvoting not when a Director. for A majority of the B the of majority A

1. 1. BOARD OF BOARD DIRECTORS CONSIDERATIONS GENERAL Director need not be a physician nor a member of the Section.member the He/she a nor physicianDirector of be a not need shallthecarry authorityout to have the all programs policies of and Section within the framewo of of elected Board the Directors. and the officers 2. 2. 3. 4. 3. 4. 5.

MEETINGS

Section A.

Section B. 318 Section C. DUTIES 1. Order the disbursement of money.

2. Select the time and place of the Annual Meeting of the Section after considering the recommendation of the Committee to select meeting sites. The Annual Meeting may be omitted by a majority vote of the Board.

3. Receive the annual reports of the Secretary, Treasurer, Historian and the Executive, Standing and Special Committees and take any action on the reports it deems appropriate in accordance with these Bylaws.

4. Elect Honorary members from nominations received from the President. Names of elected members shall be read to the Membership at the Annual Business Meeting.

5. Elect every third year by a majority vote one current Member or past Director, other than an Officer, to serve on the Executive Committee of the Section. If the Director is currently serving as a State Director, that State may elect another Director to complete the unfinished term.

6. Every second year nominate two (2) Section Members interested in research to serve a four (4) year term on the AUA Research Committee. If appointed by the President of the AUA, the Members will serve for two (2) years as Alternate Representatives and two (2) more years as Representatives on the AUA Research Committee.

7. Elect by majority vote qualified Members to fill Unfinished terms in any elected position of the Section.

8. When the Board of Directors deems it appropriate, it may recommend to the Membership the nomination of any Member considered qualified for service as an officer of the AUA. On approval by the Membership, such nomination shall be forwarded to the AUA Nominating Committee by the Section Member of the Nominating Committee of the AUA.

9. Transact any business not specified or prohibited by these Bylaws.

10. It shall employ the Executive Director whose duties, responsibilities and authority shall be as specified in Article II, Section H of these Bylaws. Report all actions to the Membership at the Annual Business Meeting.

Section D. THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS 1. The Executive Committee shall consist of the President, President- Elect, Immediate Past President, Secretary, Treasurer, Chairperson of the Committee on Education and Science, and one (1) Director elected by the Board for a term of three (3) years. The Director may not succeed himself/herself. The President shall be the Chairperson.

2. Duties.

320 BYLAWS

The terms terms The ttee. terms shallterms

as Alternates and Alternatesas and

term entatives and terms shall

l of President.l the serve as Chairperson of theserve Chairperson as of

the number ofthe repres number

321 the number ofrepresentatives number the and epresentative: one (1) Member and one (1) (1) epresentative: and one Member one (1) ARTICLE IV ARTICLE

as Representatives.as

shall be appointed to The Members will serve the serve first will The Members

Committee: one (1) Member and one (1) Alternate to (1) one Member (1) and Committee: one

he best interest of the AUA. best the interest of he term Board.

) terms term(s)) any Alternate.service as counting of not REPRESENTATIVES TO THE AUA THE TO REPRESENTATIVES 2 Toconduct the business of the Section Meetings between of the Board ofotherwiseDirectors except as provided inthese Bylaws. Allaction taken the by Committee shall by be reviewed the Approve Candidate member applications, and Associate and Activemembers candidate the by stipulated as AUA referred in D. Section I, Article Appoint Standing all and Special Committees, the excluding CommitteeArrangementsNominating on and Commi Nominate Section recipients for AUA Awards. Constitute the Committee Programs on is which chaired the by Secretary. Unfinishedterms Representatives of shall AUAto Committees be filled Executive the by Committee. (

Themeet cal Committee shall on

EditorialSection. the Committee of Board of Directors R yearsfor (2) or two Alternate serve to elected Member odd years in shalluntil limitedtoThe Member successors elected. be are his/her two successorsserve for until or elected. are one year his/her the latter of serviceof theshallwith American Bylaws the be in of accordance Association. Urological Research Committee: be in accordance with the Bylaws of American UrologicalBylaws the be in the accordance with Association. be in accordance with the Bylaws of American Urological the Bylawsbe in the accordance with member theone Association. Committee, on more there than is If One Member Nominating Editorial Committee: Committee: Editorial a. b. c. d. e. f. 3.

Representatives to the AUA must be Active Members of the Section and themustRepresentatives Section be Active Members AUA of the to shall expressed policies inthe reflectthethe They Section AUA. of keeping t with In accordance Article with V, Section 1 ofBylaws of the the AUA, the Section will have Representatives as follows: 2. 4. 3. 1. REPRESENTATIONS BYLAWS TO ACCORDING AUA

GENERAL CONSIDERATIONS GENERAL Section B.

Section A. 320

5. Health Policy Council: the number of representatives and terms shall be in accordance with the Bylaws of the American Urological Association. One member will be appointed to Chairperson, another Vice Chairperson, and if more than two members on the Committee, they shall be named members at large.

6. Membership Committee: one (1) Member who is the current Secretary of the Section.

7. Bylaws Committee: the number of representatives and terms shall be in accordance with the Bylaws of the American Urological Association. One member will be appointed to Chairperson, another Vice Chairperson, and if more than two members on the Committee, they shall be named members at large.

8. Audio-Visual Committee: the number of representatives and terms shall be in accordance with the Bylaws of the American Urological Association.

9. Judicial and Ethics Council: the number of representatives and terms shall be in accordance with the Bylaws of the American Urological Association.

Section C. START OF TERM OF SERVICE Representatives of the Section to the AUA shall begin their terms of office immediately following the AUA Meeting of the year in which they are elected or appointed.

Section D. RESPONSIBILITIES TO BOARD OF DIRECTORS These Representatives shall report to the Board of Directors annually.

ARTICLE V

COMMITTEES

Section A. STANDING COMMITTEES 1. Each Standing Committee shall consist of at least six (6) Active Members of the Section. Appointments will be made by the Executive Committee. One of the Committee Members will be named Chairperson and one Vice-Chairperson by the Executive Committee. A Committee Member who is unable to participate actively in the work of the Committee may be replaced by the Executive Committee.

Two (2) Members of each Committee shall be appointed annually for a term of three (3) years and no Member may serve more than two (2) terms on any one Committee. The exception: an individual who rises to the level of Chair of the Committee on Education and Science shall have a three-year term as Chair.

322 BYLAWS

(1)

doing as a a as doing committees - ub-

officio. - wards Programs of the Programswards the of uldbe boldly innovative

in its activities within the Section. the within activities its in

323 pilationfinancesthe of Sectionsubmitted of by ry purposery of the Section. The Committee should

shallcooperate the with Committee on Programs in Its MemberExecutive shall the Chairperson of serve a as soCommittee in Board Directors, the of of and It shall supervise the Postgraduate Education Programs of the Sectioncooperate the and with AUA Committeeon Education Continuing Programs.Member elected the Once of Committee on years. three Chair, shall ofterm be the office the Section and a compilation Treasurer the of ArrangementsSeminar and Committees.certified A audit of the Section’s deemed shall account be requested when appropriate. The Committee shall examine and verify to the Section the annual com ex Theshall Treasurer a Member be It of the for Sessions Scientific the specific making plans Annual Meeting and be responsible the for Visual Education Program, Pyelogram Program and Scientific Exhibits. Itshall administerPrizes A the and Section, be responsiblefor expansionthem of and appoint recipients.Judging select Committees to the ItshallBoard the the of advise overall Directors on fiscal policiesthe of Section and, approval of the with the Board, formulate fiscal rules and regulations. In cooperation professional with investment advisory services the by employed SESAUAshall advise the It shall direct the scientificItshallthe direct and educational activitiesthe of Section, understanding that promotion of these activities is the prima recognize that only its strong, dedicated and enlightened leadership make worthwhile allcan other Section activities and accomplish the stated objective of the Preambleto these Bylaws.this end, Tosho it both inits continuing effort to the upgrade quality of the designs its in and Meeting Annual the of sessions scientific to stimulatethe developmentof strong programs of postgraduate Section. and research within education the

(5) (4) (2) (3) (2) (3) THE COMMITTEE ON FINANCE (1) (4) (1) THEEDUCATION COMMITTEE ON SCIENCE AND

AStanding Committeemay Chairperson appoint s from the general Membership a Standingwith Committee Member as Chairperson. b. EducationScience,Bylaws. Membership, Finance, and (3) (2) and (4) a. The Chairperson Committee of shall Standing each make a formal Boardreportthe of to Directors annually. There shallfour Standing (4) Committees be follows: as

2. 3. 4.

322 Treasurer on the sale, purchase, and/or transfer of the investments of the Section.

(5) It shall recommend the Section’s investment counselor(s) and/or growth managers; monitor the Section’s portfolio at least quarterly for adherence to establish guidelines and performance vs. objectives; and provide formal reports on performance with recommendations for Board of Directors meetings.

c. COMMITTEE ON MEMBERSHIP (1) It shall examine applications for Active Membership and Associate Membership that have not been referred by the AUA as stipulated in Article 1, Section D.

(2) It shall solicit new Members from among the qualified Non- member Urologists residing within the geographical boundaries of the Section.

d. COMMITTEE ON BYLAWS (1) It shall review the Articles of Incorporation and Bylaws annually and make recommendations to the Board of Directors as to any changes that seem desirable.

(2) It shall consider all proposed amendments to the Articles of Incorporation and Bylaws submitted in writing and make recommendations to the Board as to disposition.

(3) It is the responsibility of the Committee to draft proposed changes in the Articles of Incorporation and Bylaws and to furnish them to the Secretary in such a time frame that they may be published and circulated to the Membership at least thirty (30) days in advance of the Annual Meeting.

(4) The Secretary shall be Member ex-officio.

(5) The Chairperson and the Vice-Chairperson shall serve on the AUA Bylaws Committee.

Section B. SPECIAL COMMITTEES 1. COMMITTEE ON PROGRAMS a. The Committee on Programs shall consist of the Members of the Executive Committee; the Secretary shall be the Chairperson.

b. Duties. (1) It shall make long range plans for the content and general format of the Annual Meeting of the Section in close cooperation with the Committee on Education and Science.

(2) It shall arrange the Scientific Program for the Annual Meeting and select from submitted titles of papers those best suited to the contemplated plan of the program.

324 BYLAWS -

d of

rship at its

shall be in accordance shall inaccordance be

Chairperson, shall who be a

three term year (3) service, of as

he American Urological Association. Urological American he bershipshall serve no more than (2) two Elect automatically who shall assume -

325 Large Members are nominated MembersLarge are elected, and or - President officePresident ofthe at end of term. theAny mustnomineethree years (3) of had have satisfactory as experience a Member of the Boar DirectorsGeneral been have or Arrangements term. year Chairperson. forEach year one (1) Historian who has no limitation on termsHistorian service. of no limitation has on who Members and Alternate Members ofBoard the of Directors immediatepredecessors whose are their completing prescribed in Articleprescribedconsultation III, in after the with three is of election Term Societies. State Urological (3) years.

The Chairperson shallto Board report the of Directors at Meeting. Annual the

The At The

Nominees for positions in Section: for positions Nominees (a) with thewith t Bylaws of (b) (c) Nominees for positions in AUA in positions for Nominees (3)

TTEE ON NOMINATIONS (2) Past PresidentselectedExecutive the by Committee. The Chairpersonfivemore thanfor shall years. (5) serve no It shall selectthe sites for future Meetings Annual subject to the approval ofBoard Directors. the of The Committee to Select Meeting Sitesshall consist of the Secretary,the Treasurer and a large Members Active are who Membersthe of Section and AUA. appointed the by Board of Directors to fill a vacancy, for a term theof Section yearsof (2) the during by the two Membership Annual Business Meeting. ThoseCommittee Members elected theby Section Mem The Committee on Nominations shall consist five of (5) mostthreeMembers. the living are These (3) recent Past Presidents inattendance the at Annual meeting at (2) and two consecutivemore (2) terms. two No Members than the of Committee state.shall residein same the Annual Business Meeting a slate of nomineesActive of Membersin Sectiongood standing the AUA. in There and candidateshallforfollows: position (1) one each be as (1) The Chairperson shallthe Past be most President with seniority. The Committee shall presentto Section the Membe

b. a. COMMITTEE TO SELECT MEETING SITES SELECT TO MEETING COMMITTEE COMMI a. b. c.

2. 3.

324

(d) Secretary of the Section. He/she may not be re- elected. Every three (3) years for three (3) year term:

(e) Treasurer of the Section. He/she may not be re- elected. Every Three (3) years for three (3) year term:

(f) No Member of the Nominating Committee shall be eligible for any elective position except that incumbents shall continue for their stated terms of office.

(g) Nominations for all elected positions must be called for from the floor by the President at the Annual Business Meeting before any voting takes place.

4. COMMITTEE ON ARRANGEMENTS a. The Committee on Arrangements shall consist of the Executive Committee and one Active of Senior Member in good standing that shall be appointed by the President to serve for one (1) year as Chair. The next meeting year’s Arrangements Chair shall serve on the Committee ex-officio. When a meeting does not fall within the Section’s boundaries, the Executive committee may elect not to appoint an active or senior member to serve as Chair, and the President shall assume those responsibilities.

b. The Committee on Arrangement shall make all necessary arrangements for the Annual Meeting under the direction of the President. It shall prepare a meeting budget that is financially self-supporting as its objective. The Committee on Arrangements shall keep adequate records of its activities.

c. The Chairperson shall have the power to appoint all local subcommittees and name the Chairperson of each.

d. The Chairperson shall make a final report to the Board of Directors at its next Annual Meeting.

e. With the approval of the President, the Committee shall arrange and supervise the Presidential Dinner to be held during the Annual Meeting. The cost of this dinner shall be borne by the Section. The dinner may be omitted by the majority vote of the Board of Directors.

5. HEALTH POLICY COUNCIL a. The Health Policy Council shall advise the Membership on professional relations, socioeconomic, medical, legal and insurance matters as they relate to the teaching and practice of Urology. They shall also advise on National and Local legislative initiatives effecting urology coding and reimbursement issues, and peer review.

326 BYLAWS

d for the Committee exists

ealth Policy Council shall be

Chairperson to serve as Alternate

utive Committee for three (3) years and

327 MEETINGS eetingSection the shall of such time atand be held ARTICLE VI ARTICLE Chairpersonthe of Health Policymay Council be Chairperson of the Health PolicyCouncil shall be

each membertheeach in form a newsletter of otherwise or mmittee shall consist of one (1) Member from each mmitteefrom Memberone (1) consist each shall of

e three (3) year term.e three year (3) It shall investigate all questions concernwhich principles of medicalthose ethics the and involving rights and standing of Members inrelation to Members other to the public the under directionBoard Directors.the of of The Co The theSection Chairperson.state plus Puerto the Rico in and The State Representative alternate his/her and shall be elected term theserve threeby Societyto a of years. State (3) The Chairperson ofthe H appointed the by Executive Committee for three (3) years and shall serve as one Section Representative to the Health Policy Council AUA. the of ViceThe - appointed the by Exec shallserve as the Section’ssecond Representative the to HealthAUA.the Policy of Council - Vice The advanced to be Chairperson of this Council aftercompletion of th There shallAlternate be an for Chairperson the and a second Alternate for the Vice Representatives of the PolicyHealth Council of the AUA appointedExecutive the by Committee. C COMMITTEES The Annual M place as is designated the of by Board Directors. The Annual Scientific Meeting may majorityomitted by be vote of the Board. These Committees appointed are and the Chairperson named by the President annually to performspecific jobs not lying withinthe ofpurview existing any Committee. They may be reappointed or reconstituted; if however, the nee threebeyond (3) years, it should become a Standing Special or Committee. The Chairperson shall report to the Board of Directors when requested President. the by Official notice the of time and place ofAnnualmust the Meeting be sent to at least ninety (90) days before the meeting.atthe ninety before least days (90)

b. d. c. e. g. f. h.

MEETINGS ANNUAL 1. AD HO 2. 1. 2.

. . Section A Section C 326 3. The order of the program of the scientific portion of the Annual Meeting shall be directed by the Secretary in cooperation with the Committee on Programs, the Committee on Education and Science and the Committee on Arrangements.

4. Papers.

a. Authors who wish to present papers at the Annual Meeting must submit titles and abstracts to the Secretary in accordance with deadlines established by the Committee on Programs.

b. Time allowed for presenting and discussing papers shall be determined by the Committee on Programs.

5. Officers shall be installed at the end of the Annual Business Meeting.

6. Business Meeting.

a. The Annual Business Meeting shall be held during the time of the Annual Meeting.

b. The order of business at the Annual Business Meeting shall be set by the Secretary.

Section B. SPECIAL MEETINGS 1. Special Meetings of the Section for any purpose other than effecting changes in the Bylaws may be called by a two-thirds (2/3) vote of the Board of Directors and shall be held at such time and place as directed by the Board.

2. Notice of a Special Meeting must be sent to the Members at least twenty-one (21) before such a Meeting. The notice must contain a statement of the business to be conducted, and no other business shall be conducted at the Special Meeting.

Section C. QUORUM

The members’ registered and eligible to vote who are present at the Annual Business Meeting and at any Special Meetings shall constitute a quorum for such meetings, and, unless otherwise specifically required by these Bylaws or applicable law, the vote of a majority of such members shall be required to approve any action at such meeting.

ARTICLE VII

DUES AND FEES

Section A. DUES, FEES AND ASSESSMENTS - DETERMINATION The annual dues, the initiation fee and special assessments shall be determined by the Board of Directors on advice of the Committee on Finance. The annual dues are payable in advance. Any Member with a past due account over 120 days shall be dropped from the rolls and

328 BYLAWS

South Carolina,

liamentary Procedure, current edition,

toMembership the thirty leastat days (30)

329 RTICLE IX

ARTICLE X ARTICLE A ARTICLE XI ARTICLE TERRITORY ARTICLE VIII ARTICLE AMENDMENTS RULES OF ORDER RULES

is provided SEAL OF CORPORATION SEAL

third (2/3) vote of the Members present and votinga at - g it or a facsimile otherwise impressed or thereof to used. it a or be g first. first. REPEALING / BYLAWSAMENDING A may QuorumBylaws being present be repealed these amended or a two by his/her name presented to theBoard of Directors for appropriate action. Members requesting transferSenior tomay status delay payment untilBoard request.Directors dues their the of of ruled on has

FISCAL YEAR FISCAL The fiscal of year Sectionshall the date January from first to December thirty- Annual Business Meeting, provided that the proposed revision or amendment prior to the Annual Meeting at which such action is to be taken.such action toprior to Meeting Annual be which is the at The Section shall comprise the states of Alabama, Florida, Georgia, Georgia, Florida, Alabama, ofstates the comprise shall Section The Kentucky, Louisiana, Mississippi, North Carolina, Tennesseeterritories and the Puerto Rico, of Panama U.S. and the they which in initially Section the join who Individuals Islands. Virgin practice, and then at a future date relocate to another Section, may membership. retain Section SturgisPar of Standard Code shall the govern proceedings of Section the unless otherwise provided Bylaws. in these The Corporate seal shall be inscribed thereon the name of the corporation maythe of “Seal”. theseal Said at be altered and the pleasure word majority of the Membershipvoting at an Annual Meeting and may be used causinby

ection B.

Section A.

S 328 Necrology Report

In Loving Memory of:

David B. Baddour, MD Moultrie, GA

Jack N. Dunn, MD Hendersonville, NC

James M. Eaton Jr., MD Newnan, GA

Roy P. Finney, MD Spring Hill, FL

Hector Gutierrez, MD Black Mountain, NC

John M. Harper, MD Pompano Beach, FL

Albert H. Joslin, MD Bowling Green, KY

Dana B. Moody, MD Savannah, GA

Melvin Simmons, MD Sarasota, FL

Thomas A. Stamey, MD Stanford, CA

James H. Sullivan, MD Columbus, GA

W. Jeff Terry Sr., MD Mobile, AL

Jose M. Wasmer, MD Coral Gables, FL

Wade S. Weems, MD Linville, NC

330 REPORTS A

Total

dustry

residents,

6 and reflects6 and an

90, which represents yet to This relationship is vital for the the for vital is This relationship

We our attendees encourage to

ent Bowl and AUA Bowl ent Resident Chief

Please feel free to contact me if you contactPlease tome free feel if you

rograms to covercosts travelto over for rograms

26% 100% 35% 39% The modest surplus is inpart due to the

Early 2016 brought some market declines,

Our investment is portfolio similarto the that of

331 logy (IVU)logy program fundingfor five

For period end December 31, 2015, the portfolio

Our diverse investmentsOur designed well are to handlesuch

$1,137,368 $4,581,611 $1,653,350 $1,790,893 Preliminary Treasurer’s Report Preliminary

The receivable accounts balance is $132,9

2015 Annual a tremendous Savannah Meeting was in success.

Bowl inBowl Savannah, totaling $12,500.

Debate, totaling $8,000. over Continued funding for residents 10 to attend and participate inSES the Resident - Mini Continued support of resident robotic trainingcourse inJanuary 2015. to Up $25,000 pledged annually, 2015. spent in $11,000 with Continued funding for teamat SES AUA Resid $20,000Over intodonations projects humanitarian throughout the world. International Volunteers in Uro SESAUA SESAUA $110,000.income $570,000,a net of exceeded income with totaling $22,500. to $68,000 SESOver awarded residency p meeting.50 residentsto attend annual our We continue to rely heavily on revenues from annual our meeting, In with

6. 4. 5. 7. 2. 1. 3.

e savingse balance account Banktotals Chase with In a total $94. 2015, of $100,000 e SESAUA financial picture remains stable. remains picture SESAUA financial e have any questions any have financials. regarding our Respectfully Submitted, MD Sellinger, B. Scott Treasurer, SESAUA It and privilege honor serve as to is an Treasurer. your Total Th with furtherwith volatility expected. changes. sponsorshiprepresenting close50% to of total our revenue. ongoing success of organization our and annual meeting. interactsupportsponsors. and with our FOR 2015: HIGHLIGHTS be paid industry commitments for the 2016 meeting.be paidindustry 2016 the commitments for SESAUA has one active checking account Chase at general Bank, operating for used and meeting related expenses. As December of 31, 2015, the checking balance is $211,219. The SESAUA fundThe SESAUA 31, December balance, totals of $4,780,58 2015, as operating income of $23,305 for year the 2015. financialmeeting success annual our Savannah, of a slight inoffset the decline by in investment portfolio. singl transferredcash to was checking from investments. SESAUA investmentsVanguard. at held are AUA,managed also Vanguard. by follows: as is composition IncomeFixed Domestic Stocks International Stocks 330 Membership Candidates and Transfers

* Application Not Complete FT AUA Fast Track Application Candidates for Membership

APPLICANTS Active ART, MD Kevin MORALES, MD Walter BACQUE, MD Frank NIEVES, MD Gil Jorge * BONDHUS, MD Marvin O´BRIEN GONZÁLEZ, MD Diahann Krisly * BURGESS, MD Kimberly PINEDA DELGADILLO, MD Albins * CALIFANO, MD John RODRÍGUEZ LAY, MD Ramón CORDOBA, MD Lilia ROGERS, MD William CORR, MD Zachary ROMAN, MD Paola DEL ROSARIO GIBBS, MD Javier ROSS, MD Reynaldo * ELDAIF, MD Bassem SHERMAN, MD Christopher ESPINO ZEPEDA, MD Gustavo * SPEEG, MD Jeremy * GONZALEZ, MD Froylan URENA, MD Ruben GOODWIN, MD Charles VARGAS, MD Adolfo * GRIFFIN, MD Joshua VILUCE, MD Cornelio GUERRERO MONTEZA, MD Don * WATSON, MD Justin HARAWAY, MD Allen ZAKARIA MOHAMED, MBBCh, MSc, PhD Ahmad KIM, MD Jay FT CIMMINO, MD Cara LAINEZ PEREZ, MD Franklin FT HARDIN, MD Brent LE, MD Ngoc-Bich ACTIVE APPLICANTS: 35

Associate * ALEMOZAFFAR, MD Mehrdad PATEL, MD Trushar * ALLAM, DO Christopher POLACKWICH, Jr., MD Alan CADILLO CHAVEZ, MD Ronald RAMPERSAUD, MD Edward CAESAR, MD Scott ROSENBERG, MD Eran CHILDREY, DO, MBS, BS Nefertiti SARKISSIAN, MD Hagop COX, MD Lindsey SELPH, MD John FILSON, MD, MS Christopher * SPANN, MD Alison * FREILICH, MD Drew UDELL, MD Ian GLEASON, MD Joseph FT ALLEN, MD Bryan GROSS, MD Martin FT BRYANT, MD Michael HAMMETT, MD Jessica FT BYRD, MD Joshua * HARTY, MD Niall FT CHESNUT, MD Gregory HENDRIX, MD Lauren FT EBERTOWSKI, II, MD James HERRICK, MD Benjamin FT GAYHEART, MD Dustin HYATT, MD Dustin FT MAZZARELLA, MD Brian * JAYRAM, MD Gautam FT MUTTER, MD Matthew JOHNSON, MD Justin FT POWELL, MD Christopher * MELLIS, MD Adamantios FT RUNNELS, MD Mark MSANGI, MD Gaspar FT SHAPIRO, MD Edan * NICKLES, MD Samuel FT SMITH, MD, FACS Zachary * OWUMI, MD Winifred ASSOCIATE APPLICANTS: 41 TOTAL APPLICANTS: 76

332 REPORTS

TOTAL INTERNAL TRANSFERS: 38 TRANSFERS: INTERNAL TOTAL

TORRES, MD Samuel MD TORRES, Charles MD WILSON, YARBOROUGH, Mark MD TAUB, MD Marc NIEH, Peter MD Elliot MD REISMAN, ROTTENBERG, Howard MD William SAWYER, MD JosephSMITH, Jr., MD SMITH, MD John MOODY, MD BA MS Thomas NADING, Jr., Alexander MD LEVY, MD Orin MD LEVY, ROBER, Paul MD RUBENS, Brandon MD SHANNON, Paul MD WIEGAND, Lucas MD MIYAMOTO, MD Ryan MORRIS, Richard MD

333

ald

26 TRANSFERS: INTERNAL MEMBERSHIP SENIOR O 12 TRANSFERS: INTERNAL MEMBERSHIP ACTIVE TO T

ephen KRAUSE, James MD LEET, Douglas MD GARCIAS, MD V. Alexander V. MD GARCIAS, EVANS, William MD EVANS, FISCHER, Mark MD FOSTER, Jr.,J. MD FRY, MD MatthewFRY, MD BOGACHE, MD, FACS William FACS MD, BOGACHE, CASTLEBERRY, Gordon MD COHEN, Marc MD DONATUCCI, Craig MD BERGNER, MD, FACS, FAAP Don FAAP FACS, MD, BERGNER, BADLANI, Gopal MD DECARO, John MD GUSS, MD St KIM, MD Frank BHALANI, MD Vishal MD BHALANI, MOSES, MD, PhD Kelvin PhD MOSES, MD, Robert MD BADALAMENT,

Membership To Senior

INTERNAL TRANSFERS To Active Membership To Active 332 Report of the SESAUA Representative to the AUA Board of Directors

The current member count of the AUA is 21,252 compared to 20,927 in January of 2015. Active membership remains the primary category at thirty-six percent of total membership, with international membership at nineteen percent and senior membership at sixteen percent. Section membership is 13,930 or sixty-five percent of the total AUA membership. The SESAUA remains the largest section with twenty percent of the total section membership. There are 2,788 total members of the SES with 2,346 voting members.

The AUA’s combined internal financial statements (AUA, Inc., AUAER and UCF) for the period ending 11/30/2015 results in total assets of $189 million, total liabilities of $23.4 million and net assets (equity) of 165.6 million. Seventy-seven percent of the net assets are restricted for use by the board and donors, including research scholar endowments.

The annual meeting provides more operating profit than any other AUA program. However, there has been an eight year trend of decreased revenue with rising related costs resulting in a falling net meeting margin. In response, the AUA BOD approved an increase in registration fees this past year. The Board continues discussions focusing on each element of industry support and strategies to define alternative revenue generating projects and products that fit within the mission of the AUA and provide value to the members. In addition, the Board’s philosophy is to support and invest in member services such as Data, Quality and IT, which offset operating surplus.

I currently serve on the AUA Finance Committee which is assessing AUA’s operating reserve and spending policies in light of two consecutive years of deficit budgeting. Under the direction of AUA treasurer, Steve Schlossberg, the committee continues to address appropriate operating reserve needs, use of dividends and interest to achieve a balanced budget and budget caps on certain major AUA programs.

The AUA full Board and Executive Committee last met in Linthicum, Maryland at AUA Headquarters October 16-18. Multiple AUA reporting agencies participated and following broad discussion, appropriate board actions were initiated.

Following a presentation by Dr. Victor Nitti, Education Chair, the AUA Board approved the purchase and use of the Cleveland Clinic’s Licensed Midlevel Education Program for Clinical Urology as an AUA online educational product, as well as the updated Urologic Robotic Surgery Standard Operating Procedure.

Dr. Aria Olumi, AUA Research Chair, outlined a research strategic plan that increases funds for research through advocacy, promotes investigator funding and support, and disseminates knowledge and scientific exchange through education that was approved by the board.

Dr. Deborah Lightner, Practice Guidelines Chair, presented recommendations to approve the guideline topics of Neurogenic Bladder and recurrent UTI for work to begin in 2016. The Board approved these topics as well as the retirement of the 2008 Deep Vein Thrombosis Best Practice Statement. The Board also approved the AUA Position Statement on HPV Vaccination in Males and Females. AUA census data suggests that ninety-five percent of practicing urologists utilize AUA guidelines for clinical decision making.

The AUA is transitioning the Exam Committee administration to the ABU. The Board is in the midst of discussions centered on Maintenance of Certification requirements, CME requirements, practice logs and practice assessment protocols with the ABU. Discussion includes specific exam modules pertinent and specific to practice. In general, the AUA maintains an educational focus, the ABU remains the certifying entity and there is a unified effort to uncouple MOC from Maintenance of Licensure.

As most of you know, the administration of the Urology Political Action Committee (UROPAC) reverted on January 1st, 2016, to the sole ownership of the AACU. The shared

334 REPORTS

PSTF Reform.PSTF ve. It is apparent which will include include will which ntly metntly and have

rom the to board rom the section and Complex Cases tween three boardstween external and an y complexy and burdensome many over and uding the Urology Healthuding the Policy Urology Forum. ine processes.Finally, the ownership 100% discussingcases. There will be 93 IC/PG 335 e function ourselves and perceive one. as

Muscle Invasive Bladder Cancer. -

Journal of Urology High Impact Articles High Impact Articles Urology of Journal homas F. Stringer, MD, FACS FACS MD, Stringer, F. homas managementmodel the with AUA become had overl years. The joint administration, which was unique to all PACs, elicited inefficiencies that that inefficiencies elicited PACs, to all unique was which administration, joint The years. impacted staff, administration and physicians, including members. board UROPAC The management required UROPAC communication of be administrator.Both organizations felt that couldUROPAC moreoperate efficiently and effectivelysingle the with the as owner/sponsor. AACU Single ownership projected was by both organizations to reduce costs streamland ofto UROPAC felt impart was additional strengthmanagement the Joint to AACU. arrangementsand the persistthe AACU the with affiliation AUA between that agreements address the JAC and themeeting AUA events incl However, the affiliation agreements only are part one of together working for urology. Urology,specialty, asAUA/AACU a thecontinue will strive preserve cohesiveness to to and thatso w sense purpose of and a common The annual meeting added two plenary has new presentation types for this year. They include five panels moderators with presenting and courses and three Guidelinecourses includingStricture Urethral Disease, Surgical ManagementStones and Non of AUA Leadershipand the leadershipof the Society of Urology Cuban rece toagreed provide a licensed educational on 11/5/2016. Cuba program in The Public Policy and Practice Support Division theof AUA supports the 2016 legislative prioritiesPreservation that Screening, US includeAccess 2) PSA of to 1) and EachSection ofcontributesAUA themember one board toAUA. theAlong the with 5 officers, the is board comprisedmembers. of 13 The is AUA developing a job description for Sectionfrom on input Representation current representati each based that there is variability in and responsibilities,reporting interactions and voting status theWinterbetween sectionsmeeting. furtherBoard As the will be discussed which at your representative,my goal is to effectivelycommunicate f from the sectionto the board. Please helpme yourknow to message as your representative.continuouslyI tohonored ammembers serve the the proud of SESAUA as representativeyour AUA BOD. the to Respectively submitted, T 334 Roster of the State Societies and Officers

Please help us keep our information about state urological societies accurate and current. Contact the SESAUA office at (847) 969-0248 if you have information about the following societies:

Alabama Urology Society Information not available at time of printing

Florida Urological Society President: Wade Sexton, MD President-Elect: Rolando Rivera, MD 2016 Meeting: September 1 – 4, Amelia Island, FL

Georgia Urological Association President: Kenneth Ogan, MD President-Elect: Joshua Perkel, MD 2016 Meeting: September 8– 11, Sea Island, GA

Kentucky Urological Association President: David P. Russell, MD

Louisiana Urological Society President: Benjamin Lee, MD 2016 Annual Meeting: April 8 - 10, New Orleans, LA

Mississippi Urologic Society Information not available at time of printing

North Carolina Urological Association President: Cary Robertson, MD President-Elect: Gregory Murphy, MD 2016 Annual Meeting: September 30 - November 1

Puerto Rico Urological Association President: Richard Báez Tellado, MD FACS President-Elect: Ricardo Sánchez Ortíz, MD FACS 2016 Meeting: To Be Announced

South Carolina Urological Association President: Michael S. Hay, MD President-Elect: Sandip Prasad, MD 2016 Meeting: September 23 – 24, Charleston, SC

Tennessee Urological Association President: S. Duke Herrell, MD

336 PREVIOUS OFFICERS AND ANNUAL MEETING SITES

ent Elect Elect Elect Elect Elect Elect Elect Chair Chair ------President President Presid President President President President rary Chair rary Vice Chair Vice Chair y/Treasurer President President President President President President President Tempo

Secretary/Treasurer Secretary/Treasurer Secretar Secretary/Treasurer Secretary/Treasurer Secretary/Treasurer Secretary/Treasurer Secretary/Treasurer Secretary/Treasurer

337

lotte, NC NC lotte, e, AL

Previous Officers and Annual Meeting Sites Annual Officers Previous and

enger, enger, Atlanta,MD; GA Indicates Deceased Member 1932 Birmingham, AL 1933 Richmond, VA Edgar G. Ballenger, MD; Atlanta, GA GAEdgarAtlanta, Ballenger, G. MD; Atlanta,Montague L. GA MD; Boyd, Edgar G. Ballenger, MD; Atlanta, GA GAEdgarAtlanta, Ballenger, G. MD; Earl Floyd, MD; Atlanta, GA GA Atlanta, Earl MD; Floyd, 1934 GAAtlanta, Atlanta,Montague L. GA MD; Boyd, Edgar Ball G. Earl Floyd, MD; Atlanta, GA GA Atlanta, Earl MD; Floyd, H. W.E. Walther,W.E. Orleans, H. LA New MD; Edgar G. Ballenger, MD; Atlanta, GA GAEdgarAtlanta, Ballenger, G. MD; 1935 Nashville, TN Earl Floyd, MD; Atlanta, GA GA Atlanta, Earl MD; Floyd, 1936 Charlotte, NC H. W.E. Walther,W.E. Orleans, H. LA New MD; Hamilton Charlotte, MD; McKay, NC Earl Floyd, MD; Atlanta, GA GA Atlanta, Earl MD; Floyd, 1937 Birmingham, AL George Livermore,TN Memphis, MD; Hamilton Charlotte, MD; McKay, NC Earl Floyd, MD; Atlanta, GA GA Atlanta, Earl MD; Floyd, 1938 Louisville, KY George Livermore,TN Memphis, MD; GA Atlanta, Earl MD; Floyd, Raymond Thompson, Char MD; 1939 Biloxi, MS Earl Floyd, MD; Atlanta, GA GA Atlanta, Earl MD; Floyd, J. Ullman Reaves, MD; Mobile, AL J.AL Mobile,Ullman MD; Reaves, Louis M. Orr, MD; Gainesville, FL FL Gainesville, MD; Orr, M. Louis 1941 Jacksonville, FL JeffersonPennington, Nashville, MD; C. TN FL Gainesville, MD; Orr, M. Louis J. Mobil Ullman MD; Reaves, 1942 Chattanooga, TN JeffersonPennington, Nashville, MD; C. TN FL Gainesville, MD; Orr, M. Louis Harold P. McDonald, Sr., Atlanta,MD; GA                              

        

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      336 1943 New Orleans, LA Louis M. Orr, MD; Gainesville, FL President William E. Coppridge, MD; Durham, NC President-Elect Harold P. McDonald Sr., MD; Atlanta, GA Secretary/Treasurer

1946 Augusta, GA William E. Coppridge, MD; Durham, NC President Hubert K. Turley, Sr., MD; Memphis, TN President-Elect Harold P. McDonald, Sr., MD; Atlanta, GA Secretary/Treasurer

1947 Palm Beach, FL Hubert K. Turley, Sr., MD; Memphis, TN President Robert P. McIver, MD; Jacksonville, FL President-Elect Harold P. McDonald, Sr., MD; Atlanta, GA Secretary/Treasurer

1948 Hollywood Beach, FL Robert P. McIver, MD; Jacksonville, FL President Harold P. McDonald, Sr., MD; Atlanta, GA President-Elect Russell B. Carson, MD; Vero Beach, FL Secretary/Treasurer

1949 Boca Raton, FL Harold P. McDonald, Sr., MD; Atlanta, GA President James J. Ravenel, MD; Charleston, SC President-Elect Russell B. Carson, MD; Vero Beach, FL Secretary/Treasurer

1950 Edgewater Park, MS James J. Ravenel, MD; Charleston, SC President Edgar Burns, MD; New Orleans, LA President-Elect Russell B. Carson, MD; Vero Beach, FL Secretary/Treasurer

1951 Memphis, TN Edgar Burns, MD; New Orleans, LA President Temple Ainsworth, MD; Jackson, MS President-Elect Russell B. Carson, MD; Vero Beach, FL Secretary/Treasurer

1952 Boca Raton, FL Temple Ainsworth, MD; Jackson, MS President W.R. Miner, MD; Covington, KY President-Elect Russell B. Carson, MD; Vero Beach, FL Secretary/Treasurer

1953 Havanna, - Cuba W.R. Miner, MD; Covington, KY President Russell B. Carson, MD; Vero Beach, FL President-Elect Sidney Smith, MD; Raleigh, NC Secretary/Treasurer

1954 Palm Beach, FL Russell B. Carson, MD; Vero Beach, FL President Samuel L. Raines, MD; Memphis, TN President-Elect Sidney Smith, MD; Raleigh; NC Secretary/Treasurer

338 PREVIOUS OFFICERS AND ANNUAL MEETING SITES

r Elect Elect Elect Elect Elect Elect Elect Elect Elect ------t President President President President President President President President President Secretary Secretary Secretary Secretary Secretary Secretary Secretary Secretary Secretary Treasurer Treasurer Treasurer Treasurer Treasurer Treasurer Treasurer Treasurer Treasure President Presiden President President President President President President President

339

rmingham, ALrmingham, , FL Orlando, Orlando, FL - anta, GA

sea

the

- ort Hudson, MD; Birmingham, ALBirmingham, Hudson, MD; ort mes L. Campbell, Jr., MD; Orlando, FL FL Orlando, MD; Jr., Campbell, mes L. 1955 New Orleans, LA Orleans, New 1955 Samuel L. Raines, MD; Memphis, TNSamuel Memphis, MD; Raines, L. 1957 GAAtlanta, Jarratt GA Atlanta, P. Robertson, MD; LawrenceOrangeburg,Sr., P. Thackston, SC MD; Orleans, Robet New MD; F. Sharp, Sr., LA 1958 Hollywood, FL LawrenceOrangeburg,Sr., P. Thackston, SC MD; Frank M. Woods, FrankFL LaBelle, MD; M. Sidney Smith, MD; Raleigh, NC NC Raleigh, MD; Smith, Sidney 1956 Hollywood, FL Jarratt Atl P. Robertson, MD; Sidney Smith, MD; Raleigh, NC NC Raleigh, MD; Smith, Sidney Robet F. Sharp, Sr., MD; New Orleans, Robet New MD; F. Sharp, Sr., LA GA Atlanta, MD; Reiser, Charles Orleans, Robet New MD; F. Sharp, Sr., LA Robet F. Sharp, Sr., MD; New Orleans, Robet New MD; F. Sharp, Sr., LA Charles Reiser, MD; Atlanta, GA Atlanta, MD; Reiser, Charles Ja Woods, Frank FL LaBelle, MD; M. 1959 Louisville, KY Robet F. Sharp, Sr., MD; New Orleans, Robet New MD; F. Sharp, Sr., LA Rudolph Bell, MD; Thomasville, GA GA Thomasville, MD; Bell, Rudolph James L. Campbell,Jr., MD; Hurbert K.TN Turley, Memphis, MD; 1960 Jacksonville, FL Rudolph Bell, MD; Thomasville, GA GA Thomasville, MD; Bell, Rudolph N Lewis Bosworth, Lewis Lexington,N KY MD; 1961 Hollywood James L. Campbell, Jr., MD; Orlando, FL FL Orlando, MD; Jr., Campbell, L. James Hurbert K.TN Turley, Memphis, MD; Alfred D. Mason, Jr., MD; Memphis, TN Jr.,Alfred TN Memphis, MD; Mason, D. N Lewis Bosworth, Lewis Lexington,N KY MD; James L. Campbell, Jr., MD; Orlando, FL FL Orlando, MD; Jr., Campbell, L. James ComfHenry 1962 Belleair, FL Alfred D. Mason, Jr., MD; Memphis, TN Jr.,Alfred TN Memphis, MD; Mason, D. James L. Campbell, Jr., MD; Orlando, FL FL Orlando, MD; Jr., Campbell, L. James Louis Greensboro, Roberts, NC C. MD; 1963 Nassau, Bahamas Henry ComfortHenry Bi Hudson, MD; NC Raleigh, MD; Sr., G. Fox Powell James L. Campbell, Jr., MD; Orlando, FL FL Orlando, MD; Jr., Campbell, L. James Louis C. Roberts, MD; Greensboro, NC Louis Greensboro, Roberts, NC C. MD; DouglasScott, Lexington, KY E. MD;                                  

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        338 1964 Belleair, FL Powell G. Fox, Sr., MD; Raleigh, NC President W. E. Kittredge, MD; New Orleans, LA President-Elect Louis C. Roberts, MD; Greensboro, NC Secretary Douglas E. Scott, MD; Lexington, KY Treasurer

1965 Miami Beach, FL W. E. Kittredge, MD; New Orleans, LA President Douglas E. Scott, MD; Lexington, KY President-Elect David W. Goddard, MD; Daytona Beach, FL Secretary Rafe Banks, Jr., MD; Gainesville, GA Treasurer

1966 Memphis, TN Douglas E. Scott, MD; Lexington, KY President Louis C. Roberts, MD; Greensboro, NC President-Elect David W. Goddard, MD; Daytona Beach, FL Secretary Rafe Banks, Jr., MD; Gainesville, GA Treasurer

1967 Hollywood, FL Louis C. Roberts, MD; Greensboro, NC President Charles Reiser, MD; Atlanta, GA President-Elect David W. Goddard, MD; Daytona Beach, FL Secretary John T. Karaphillis, MD; Belleair, FL Treasurer

1968 Atlanta, GA Charles Reiser, MD; Atlanta, GA President David W. Goddard, MD; Daytona Beach, FL President-Elect R. Prosser Morrow, Jr., MD; New Orleans, LA Secretary John T. Karaphillis, MD; Belleair, FL Treasurer

1969 Hollywood Beach, FL David W. Goddard, MD; Daytona Beach, FL President Henry Comfort Hudson, MD; Birmingham, AL President-Elect R. Prosser Morrow, Jr., MD; New Orleans, LA Secretary Charlton P. Armstrong, II, MD; Greenville, SC Treasurer

1970 TS Hanseatic, Henry Comfort Hudson, MD; Birmingham, AL President Milton M. Coplan, MD; Miami, FL President-Elect R. Prosser Morrow, Jr., MD; New Orleans, LA Secretary Charlton P. Armstrong, II, MD; Greenville, SC Treasurer

1971 Miami Beach, FL Milton M. Coplan, MD; Miami, FL President R. Prosser Morrow, Jr., MD; New Orleans, LA President-Elect Samuel S. Ambrose, MD; Atlanta, GA Secretary George W. Vickery, MD; Gulfport, MS Treasurer

1972 New Orleans, LA R. Prosser Morrow, Jr., MD; New Orleans, LA President Charlton P. Armstrong, II, MD; Greenville, SC President-Elect Samuel S. Ambrose, MD; Atlanta, GA Secretary George W. Vickery, MD; Gulfport, MS Treasurer

340 PREVIOUS OFFICERS AND ANNUAL MEETING SITES

ent Elect Elect Elect Elect Elect Elect Elect Elect Elect ------President President President President President President President Presid President Secretary Secretary Secretary Secretary Secretary Secretary Secretary Secretary Secretary Treasurer Treasurer Treasurer Treasurer Treasurer Treasurer Treasurer Treasurer Treasurer President President President President President President President President President

341

ton, NC

N. Miami, FL Miami, N.

n, MD; The Woodlands, The MD; TX n, Hurbert K.TN Turley, Memphis, MD; Hurbert K.TN Turley, Memphis, MD; GA Atlanta, MD; S. Samuel Ambrose, FL Miami, N. MD; Politano, A. Victor 1974 Marco Island, FL GA Atlanta, MD; S. Samuel Ambrose, 1973 Palm1973 FL Beach, Charlton P. Armstrong, MD William Brannan, MD; The Woodlands, William Brannan, TheTX MD; VictorA. Politano, MD; 1975 GAAtlanta, GA Atlanta, MD; S. Samuel Ambrose, GA Gainesville, Jr., Rafe MD; Banks, William Brannan, MD; The Woodlands, William Brannan, TheTX MD; Victor A. Politano, MD; N. Miami, FL FL Miami, N. MD; Politano, A. Victor 1976 Hollywood, FL KY Versailles, MD; Glenn, F. James Rafe Banks, Jr., MD; Gainesville, GA Gainesville, Jr., Rafe MD; Banks, William Brannan, MD; The Woodlands, William Brannan, TheTX MD; John I. Williams,JohnFort I. FL Lauderdale, MD; James F. Glenn, MD; Versailles, KY KY Versailles, MD; Glenn, F. James 1977 New Orleans, L Orleans, New 1977 Woodlands, William Brannan,The TX MD; Miles W. Thomley, MD; Winter Park, FL FL Park, Winter MD; W. Thomley, Miles Williams,JohnFort I. FL Lauderdale, MD; 1978 Louisville, KY William Branna Victor A. Politano, MD; N. Miami, FL FL Miami, N. MD; Politano, A. Victor Miles W. Thomley, MD; Winter Park, FL FL Park, Winter MD; W. Thomley, Miles Williams,JohnFort I. FL Lauderdale, MD; 1979 Memphis, TN VictorA. Politano, Miami, N. MD; Wilmington,WardJr.,Joseph Hooper, NC MD; Rico Puerto San Juan, 1980 Joseph Ward Hooper, Jr., WilmingMD; Vista, 1981 Lake Buena FL FL Park, Winter MD; W. Thomley, Miles Williams,JohnFort I. FL Lauderdale, MD; Miles W. Thomley, MD; Winter Park, FL FL Park, Winter MD; W. Thomley, Miles Fontaine BruceJr., TN Memphis, MD; Moore, FL Park, Winter MD; W. Thomley, Miles W. LamarWeems, MD; Jackson,MS Fontaine BruceJr., TN Memphis, MD; Moore, W. LamarWeems, MD; Jackson,MS Fontaine BruceJr., TN Memphis, MD; Moore,                                

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              340 1982 New Orleans, LA John I. Williams, MD; Fort Lauderdale, FL President Eugene C. St. Martin, MD; Shreveport, LA President-Elect W. Lamar Weems, MD; Jackson, MS Secretary Edward H. Ray, Jr., MD; Lexington, KY Treasurer

1983 Haines City, FL Eugene C. St. Martin, MD; Shreveport, LA President W. Lamar Weems, MD; Jackson, MS President-Elect William Redd Turner, Jr., MD; Folly Beach, SC Secretary Edward H. Ray, Jr., MD; Lexington, KY Treasurer

1984 Nashville, TN W. Lamar Weems, MD; Jackson, MS President Fontaine Bruce Moore, Jr., MD; Memphis, TN President-Elect William Redd Turner, Jr., MD; Folly Beach, SC Secretary Edward H. Ray, Jr., MD; Lexington, KY Treasurer

1985 Marco Island, FL Fontaine Bruce Moore, Jr., MD; Memphis, TN President Jack Hughes, MD; Durham, NC President-Elect William Redd Turner, Jr., MD; Folly Beach, SC Secretary Robert N. Webster, MD; Tallahassee, FL Treasurer

1986 Dorado Beach, Puerto Rico Jack Hughes, MD; Durham, NC President William Redd Turner, Jr., MD; Folly Beach, SC President-Elect David M. Drylie, MD; Gainesville, FL Secretary Robert N. Webster, MD; Tallahassee, FL Treasurer

1987 New Orleans, LA William Redd Turner, Jr., MD; Folly Beach, SC President Roy Witherington, MD; Sarasota, FL President-Elect David M. Drylie, MD; Gainesville, FL Secretary Robert N. Webster, MD; Tallahassee, FL Treasurer

1988 Boca Raton, FL Roy Witherington, MD; Sarasota, FL President Edward H. Ray, Jr., MD; Lexington, KY President-Elect David M. Drylie, MD; Gainesville, FL Secretary Robert B. Quattlebaum, Jr., MD; Savannah, GA Treasurer

1989 Hilton Head, SC Edward H. Ray, Jr., MD; Lexington, KY President David M. Drylie, MD; Gainesville, FL President-Elect Lloyd H. Harrison, MD; Tobaccoville, NC Secretary Robert B. Quattlebaum, Jr., MD; Savannah, GA Treasurer

1990 Palm Beach, FL David M. Drylie, MD; Gainesville, FL President Robert N. Webster, MD; Tallahassee, FL President-Elect Lloyd H. Harrison, MD; Tobaccoville, NC Secretary Robert B. Quattlebaum, Jr., MD; Savannah, GA Treasurer

342 PREVIOUS OFFICERS AND ANNUAL MEETING SITES

tary etary Elect Elect Elect Elect Elect Elect Elect Elect Elect - - - retary ------ecretary President President President President President President President President President Secretary S Sec Secre Secr Secretary Secretary Secretary Secretary Treasurer Treasurer Treasurer Treasurer Treasurer Treasurer Treasurer Treasurer Treasurer President President President President President President President President President

343

m, NC lem, NC

, NC Salem, NC Sa Sale Salem, NC Salem, NC - - - - -

MD; New Orleans, New MD; LA

1991 GAAtlanta, Robert N. Webster,Robert N. Tallahassee, MD; FL Josiah F. Reed, Jr., MD; Montgomery, AL ALJosiah Montgomery, Jr., Reed, F. MD; Lloyd H. Harrison, MD; Tobaccoville MD; Harrison, H. Lloyd Beach,Myers FL James Fort Jr., Seabury, C. MD; 1992 Charlotte, NC Josiah F. Reed, Jr., MD; Montgomery, AL ALJosiah Montgomery, Jr., Reed, F. MD; Lloyd H. Harrison, MD; Tobaccoville, NC NC Tobaccoville, MD; Harrison, H. Lloyd James C. Seabury, Jr., MD; Fort Myers Beach,Myers FL James Fort Jr., Seabury, C. MD; 1993 Nashville, TN Robert Savannah, GA B.Jr., Quattlebaum, MD; Lloyd H. Harrison, MD; Tobaccoville, NC NC Tobaccoville, MD; Harrison, H. Lloyd WilliamJ. Lexington, MD; McRoberts, KY J. WilliamJ. Lexington, MD; McRoberts, KY Beach,Myers FL James Fort Jr., Seabury, C. MD; 1994 New Orleans, LA Orleans, New 1994 Robert Savannah, GA B.Jr., Quattlebaum, MD; Thomas Lakeland, C. McLaughlin, FL MD; WilliamJ. Lexington, MD; McRoberts, KY Hector Henry, H. II, MD, MPH, MS; Salisbury, NC Vista, 1995 Lake Buena FL Thomas Lakeland, C. McLaughlin, FL MD; WilliamJ. Lexington, MD; McRoberts, KY Hector Henry, H. II, MD, MPH, MS; Salisbury, NC Rico Puerto Croabas, Las 1996 David L. McCullough, MD; WinstonDavidL. McCullough, MD; 1998 Birmingham, AL James C. Seabury, Jr., MD; Fort Myers Beach,Myers FL James Fort Jr., Seabury, C. MD; J. WilliamJ. Lexington, MD; McRoberts, KY David L. McCullough, MD; WinstonDavidL. McCullough, MD; Hector Henry, H. II, MD, MPH, MS; Salisbury, NC 1997 Naples,FL Beach,Myers FL James Fort Jr., Seabury, C. MD; Cecil Morgan, Jr., Birmingham,MD; AL WinstonDavidL. McCullough, MD; LA Orleans, New MD; Earhart, A. Valentine Cecil Morgan, Jr., Birmingham,MD; AL David L. McCullough, MD; WinstonDavidL. McCullough, MD; 1999 Charleston, SC WinstonDavidL. McCullough, MD; KY Lexington, MD; Gee, F. William AntonGA Atlanta,J. Bueschen, MD; Valentine A. Earhart, Anton J. Bueschen, MD; Atlanta, GA AntonGA Atlanta,J. Bueschen, MD; LA Orleans, New MD; Earhart, A. Valentine         

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342 2000 Orlando, FL William F. Gee, MD; Lexington, KY President Hector H. Henry, II, MD, MPH, MS; Salisbury, NC President-Elect Anton J. Bueschen, MD; Atlanta, GA Secretary B. Thomas Brown, MD, MBA; Daytona Beach, FL Treasurer

2001 New Orleans, LA Hector H. Henry, II, MD, MPH, MS; Salisbury, NC President William F. Gee, MD; Lexington, KY Past President Anton J. Bueschen, MD; Atlanta, GA President-Elect Joseph A. Smith, Jr., MD; Nashville, TN Secretary B. Thomas Brown, MD, MBA; Daytona Beach, FL Treasurer

2002 Naples, FL Anton J. Bueschen, MD; Atlanta, GA President Hector H. Henry, II, MD, MPH, MS; Salisbury, NC Past President Valentine A. Earhart, MD; New Orleans, LA President-Elect Joseph A. Smith, Jr., MD; Nashville, TN Secretary B. Thomas Brown, MD, MBA; Daytona Beach, FL Treasurer

2003 Savannah, GA Valentine A. Earhart, MD; New Orleans, LA President Anton J. Bueschen, MD; Atlanta, GA Past President B. Thomas Brown, MD, MBA; Daytona Beach, FL President-Elect Joseph A. Smith, Jr., MD; Nashville, TN Secretary Edward O. Janosko, MD; Wilmington, NC Treasurer

2004 Oranjestad, Aruba B. Thomas Brown, MD, MBA; Daytona Beach, FL President Valentine A. Earhart, MD; New Orleans, LA Past President Joseph A. Smith, Jr., MD; Nashville, TN President-Elect Dennis D. Venable, MD; Shreveport, LA Secretary Edward O. Janosko, MD; Wilmington, NC Treasurer

2005 Charleston, SC Joseph A. Smith, Jr., MD; Nashville, TN President B. Thomas Brown, MD, MBA; Daytona Beach, FL Past President Culley C. Carson, III, MD; Chapel Hill, NC President-Elect Dennis D. Venable, MD; Shreveport, LA Secretary Edward O. Janosko, MD; Wilmington, NC Treasurer

2006 Rio Grande, Puerto Rico Culley C. Carson, III, MD; Chapel Hill, NC President Joseph A. Smith, Jr., MD; Nashville, TN Past President Edward O. Janosko, MD; Wilmington, NC President-Elect Dennis D. Venable, MD; Shreveport, LA Secretary Thomas F. Stringer, MD; Gainesville, FL Treasurer

2007 Lake Buena Vista, FL Edward O. Janosko, MD; Wilmington, NC President Culley C. Carson, III, MD; Chapel Hill, NC Past President Dennis D. Venable, MD; Shreveport, LA President-Elect Raju Thomas, MD, FACS, MHA; New Orleans, LA Secretary Thomas F. Stringer, MD; Gainesville, FL Treasurer

2008 San Diego, CA Dennis D. Venable, MD; Shreveport, LA President Edward O. Janosko, MD; Wilmington, NC Past President

344 PREVIOUS OFFICERS AND ANNUAL MEETING SITES

Elect Elect Elect Elect Elect Elect Elect Elect ------sident President President President President President President President Secretary Secretary Secretary Secretary Secretary Secretary Secretary Secretary Treasurer Treasurer Treasurer Treasurer Treasurer Treasurer Treasurer Treasurer Past PresidentPast Past President Past President Past President Past President Past Pre Past Past President President President President President

President President President President

345

iami, FL iami,

G, Miami, FL G, Miami, G; Miami, FL G; Miami, G; Miami, FL G; Miami, G; M G, City, FL Cooper G; City, FL Cooper ------S; Daphne, AL AL S; Daphne,

, MD,, FRCS

as, MD, FACS, MHA; New Orleans,as, FACS, MD, MHA; New LA . Dineen, MD; Daytona Beach, FL DaytonaFL Dineen, Beach,. MD; MartinK.Daytona Dineen,FL Beach, MD; Raju Thomas, MD, FACS; MHA, New Orleans, LA LA Orleans, New MHA, FACS; MD, Thomas, Raju FL Gainesville, MD; Stringer, F. Thomas 2009 Mobile, AL Martin K. Daytona Dineen,FL Beach, MD; Shreveport,Dennis Venable, D. MD; LA FL Gainesville, MD; Stringer, F. Thomas Raju Thomas, MD, FACS, MHA; New Orleans, LA LA Orleans, New MHA; FACS, MD, Thomas, Raju W. Terry Stallings, AL Daphne, FACS; MD, Thomas F. Stringer, MD; Gainesville, FL FL Gainesville, MD; Stringer, F. Thomas 2010 Miami2010 FL Beach, K Martin LA Orleans, New MHA; FACS, MD, Thomas, Raju RaymondJ. Leveillee, FRCS MD; W. Terry Stallings, AL Daphne, FACS; MD, 2011 New Orleans, LA Orleans, New 2011 Thomas F. Stringer, MD; Gainesville, FL FL Gainesville, MD; Stringer, F. Thomas Raju Thom Raju RandallPhD; Indianapolis, G. MD, IN Rowland, RaymondJ. Leveillee, FRCS MD, W. Terry Stallings, MD, FAC MD, Stallings, W. Terry 2012 Island,Amelia FL RandallPhD; Indianapolis, G. MD, IN Rowland, LA Orleans, New MHA; FACS, MD, Thomas, Raju W. Terry Stallings, AL Daphne, FACS; MD, RaymondJ. Leveillee, MD, FRCS W. Terry Stallings, AL Daphne, FACS; MD, Jon S. Demos, MD; Lexington,S. KYJon MD; Demos, 2013 Williamsburg, VA 2014 Hollywood, FL RandallPhD; Indianapolis, G. MD, IN Rowland, RaymondJ. Leveillee, FRCS MD, Dean G. Assimos, Birmingham,MD; AL Lexington,S. KYJon MD; Demos, RaymondJ. Leveillee; FRCS MD, W. Terry Stallings, AL Daphne, FACS; MD, SimonsIsland,St.Jack Amie, MD; GA M. Dean George Assimos,ALDean Birmingham, MD; Jon S. Demos, MD; Lexington,S. KYJon MD; Demos, 2015 Savannah, GA SimonsIsland,St.Jack Amie, MD; GA M. Raymond J. Leveillee Lexington,S. KYJon MD; Demos, Dean Dean G. Assimos, Birmingham,MD; AL FL Tallahassee, MD; Sellinger, B. Scott

344

Future SESAUA Meetings

81st Annual Meeting of the Southeastern Section of the AUA March 23 – 26, 2017 Hilton Austin Austin, Texas

82nd Annual Meeting of the Southeastern Section of the AUA March 22 – 25, 2018 Loews Royal Pacific Hotel Orlando, Florida

346

NASHVILLE SESAUA 2016

SESAUA Two Woodfield Lake 1100 E. Woodfield Road, Suite 350 Schaumburg, IL 60173-5116 Phone: (847) 969-0248 Fax: (847) 517-7229 Email: [email protected] Website: www.sesaua.org