The annual meeting of the American Urological Association was held virtually this year from Sept. 10 to 13 and attracted participants from around the world, including clinicians, academicians, allied health professionals, and others interested in urology. The conference highlighted recent advances in the prevention, detection, and treatment of urological conditions, with presentations focusing on the advancement of urological patient care.
In one study, Jonathan D. Harper, M.D., of the University of Washington Medicine in Seattle, and colleagues found that patients with kidney stones treated with transcutaneous ultrasound technologies (ultrasonic propulsion and burst wave lithotripsy) pass their kidney stones in an average of four days, with negligible side effects.
The authors recruited participants from the emergency department and clinic who had symptomatic or asymptomatic kidney stones. Patients were treated with ultrasonic propulsion or ultrasonic propulsion plus burst wave lithotripsy to attempt to move the stone ideally into the bladder. Participants were contacted once a week for three weeks to determine whether they had passed their kidney stones, and they had follow-up imaging 90 days postprocedure. The researchers found that 90 percent of participants passed their kidney stones within four days, with minimal side effects and significantly reduced pain.
“It may not be a perfect comparison but the guidelines from the American Urological Association state that 54 percent of stones pass in an average of seven to eight days. Our particular ultrasound approach works by repositioning the stone, breaking up the stone, and potentially stimulating the natural peristalsis of the ureter,” Harper said. “Potentially, in the clinic or in the emergency department, these technologies would provide a nonsurgical option to help stones pass and relieve pain.”
In another study, Evgeniy Kreydin, M.D., from Keck Medicine of the University of Southern California in Los Angeles, and colleagues found that women who report higher amounts of physical activity (whether leisure or work) are less likely to report urinary incontinence of any type.
Using data from the National Health and Nutrition Examination Survey, the authors examined the association between different types of urinary incontinence and the amount of physical activity reported by women. The data were adjusted for factors such as age, body mass index, diabetes, parity, menopause, and smoking. The researchers found that increased physical activity was associated with a lower risk for urinary incontinence.
“This study is another piece of evidence that physical activity and exercise may have a beneficial effect on pelvic floor dysfunction,” Kreydin said. “Just like we encourage patients to lose weight to decrease incontinence, increasing physical activity may be another nonpharmacological means of ameliorating this problem.”
Michael B. Chancellor, M.D., of the Oakland University William Beaumont School of Medicine in Royal Oak, Michigan, and colleagues found that COVID-19 infection may cause COVID-19-associated cystitis, resulting in increased urinary symptoms and biomarkers of inflammation in the urine.
The authors assessed COVID-19-positive patients for new or worsening urological symptoms. Patients’ urine was also analyzed for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and inflammatory cytokines, like the ones that cause a cytokine storm and inflammation in the lungs and other body systems. The researchers found that COVID-19-infected patients reported severe de novo genitourinary symptoms, most notably an increase in urgency, frequency, and nocturia (getting up as many as five times to urinate).
“COVID-19 patients, especially those with COVID-19-associated cystitis, have increased inflammatory cytokines in the urine that may reflect the severity and duration of their disease while they did not have the SARS-CoV-2 virus in their urine,” Chancellor said. “Physicians and health care providers should be aware that COVID-19 may also alter bladder function.”
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