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There were significant benefits in CSS (p<0.001) and OS (p<0.001) favoring sCT. In the second comparison, there were 52 deaths (31 from prostate cancer) for NST vs. 18 deaths (nine from prostate cancer) for sHIFU. There were no significant differences in CSS or OS possibility attributed to reduced sample size and shorter followup of sHIFU cohort.

In select men with recurrent prostate cancer post-radiation, further local treatment may lead to benefits in CSS. These hypothesis-generating findings should ideally be validated in a prospective clinical trial setting.

In select men with recurrent prostate cancer post-radiation, further local treatment may lead to benefits in CSS. These hypothesis-generating findings should ideally be validated in a prospective clinical trial setting.

Testicular cancer is the most commonly diagnosed malignancy in young males. Testicular examination is a non-invasive and inexpensive means of detecting testicular cancer at an early stage. In this project, a set of 3D-printed models was developed to facilitate teaching testicular examination and improving understanding of testicular malignancies among patients and medical learners.

Five scrotum models were designed a control model with healthy testes, and four models containing a healthy testicle and a testicle with an endophytic mass of varying size. The anatomy, texture, and composition of the 3D-printed models were refined using an iterative process between the design team and urologists. The completed models were assessed by six urologists, two urology nurse practitioners, and 32 medical learners. Participants were asked to inspect and palpate each model, and to provide feedback using a five-point Likert scale.

Clinicians reported that the models enabled accurate simulation of a testicular examination involving both healthy and pathological testes (x̅=4.3±1.0). They agreed that the models would be useful teaching tools for both medical learners (x̅=4.8±0.5) and patients (x̅=4.8±0.7). Following an educational session with the models, medical learners reported improvements in confidence and skill in performing a testicular examination.

3D-printed models can effectively simulate palpation of both healthy and pathological testes. The developed models have the potential to be a useful adjunct in teaching testicular examination and in demonstrating abnormal findings that require further investigation.

3D-printed models can effectively simulate palpation of both healthy and pathological testes. The developed models have the potential to be a useful adjunct in teaching testicular examination and in demonstrating abnormal findings that require further investigation.

The purpose of this study was to document the variability of faculty surgeon electrodermal activity (EDA) peaks during laparoscopic donor nephrectomy (LDN) to determine the effect of case difficulty and learner expertise on the stress response.

EDA for a single faculty surgeon was captured over 15 LDN cases using an Empatica E4 wristband. During each case, one of three transplant fellows (novice, intermediate, or expert level LDN expertise) participated. Difficulty was rated preoperatively as "low/moderate/high" by the faculty. EDA peaks were collected and analyzed; the frequency and magnitude of EDA peaks, case difficulty, and fellow expertise were compared using a two-way factorial ANOVA.

The main effects of learner expertise (F[2, 308]=11.27, p<0.001) and difficulty rating (F[2, 414]=15.13, p<0.001) were significant. The interaction between difficulty and expertise on faculty EDA peaks was also significant (F[3, 391]=14.29, p<0.001). The novice fellow resulted in higher faculty EDA levels compared to intermediate and expert fellows on low-difficulty cases, but not moderate- or high-difficulty cases.

This is the first report examining faculty surgeon EDA across cases of varying difficulty and varying learner expertise during a high-stakes operation. EDA levels were inversely proportional to the expertise of the learner and case difficulty, suggestive of a significant impact of learner autonomy on faculty stress response.

This is the first report examining faculty surgeon EDA across cases of varying difficulty and varying learner expertise during a high-stakes operation. EDA levels were inversely proportional to the expertise of the learner and case difficulty, suggestive of a significant impact of learner autonomy on faculty stress response.

Point-of-care ultrasound (POCUS) is an increasingly used bedside tool. ALLN Applications in urology include the assessment of an undifferentiated acute scrotum, renal colic, and the guidance of suprapubic catheter placement. However, the user-dependent nature of this modality necessitates appropriate use and competence. The objective of this study was to develop and evaluate a low-cost, feasible, and guideline-based introductory POCUS program for Canadian urology residents.

Residents from McMaster University's urology program completed a three-hour online course, followed by a three-hour hands-on seminar. Course material was developed by ultrasound educators based on national guidelines. Low-cost testicular phantoms and suprapubic catheter insertion models were constructed. Pre- and post-course surveys focused on participant skill confidence, while multiple-choice questionnaires assessed theoretical knowledge.

Fourteen residents participated in the course. Theoretical knowledge in POCUS improved significantlund educators. Participants significantly improved in theoretical knowledge and skill confidence. Although this study was limited to one residency program, the basis of this course may serve as a foundation for the development of competency-based training for urological POCUS in Canada.

Robotic pediatric urologic surgery has gained widespread adoption over the last decade. This article describes our experience in instituting the first pediatric urologic robotic surgery program in Canada. We evaluated the feasibility and safety of instituting pediatric robot-assisted urologic surgery and report our early outcomes for robot-assisted pyeloplasty (RAP) and ureteric reimplantation (RUR).

We prospectively evaluated all patients undergoing RAP and RUR by a single surgeon from June 2013 to March 2019. Demographic and clinical data were prospectively collected and included sex, age, and preoperative grade of hydronephrosis or reflux. Descriptive statistics were performed, and comparisons were made using Student's t-tests where appropriate. Success was defined as resolution or significant improvement of hydronephrosis following RAP and absence of recurrent urinary tract infection (UTI) and/or persistent vesicoureteric reflux (VUR) following RUR. Complications were described using the Clavien-Dindock of significant complications noted in our study.

Despite limited case volumes, robotic pediatric urologic surgery can be integrated into the Canadian healthcare system with success rates comparable to reported literature. However, compared to open surgery, RAP and especially RUR warrant further study to ensure lack of significant complications noted in our study.

As we progress to an era when patient autonomy and shared decision-making are highly valued, there is a need to also have effective patient-centered communication tools. Radiology reports are designed for clinicians and can be very technical and difficult for patients to understand. It is important for patients to understand their magnetic resonance imaging (MRI) report in order to make an informed treatment decision with their physician. Therefore, we aimed to create a patient-centered prostate MRI report in order to give our patients a better understanding of their clinical condition.

A prototype patient-centered radiology report (PACERR) was created by identifying items to include based on opinions sought from a group of patients undergoing prostate MRI and medical experts. Data was collected in semi-structured interviews using a salient belief question. A prototype PACERR was created in collaboration with human factors engineering and design, medical imaging, biomedical informatics, and cancer patient education groups.

Fifteen patients and eight experts from urology, radiation oncology, radiology, and nursing participated in this study. Patients were particularly interested to have a report with laymen terms, concise language, contextualization of values, definitions of medical terms, and next course of action. Everyone believed the report should include the risk of MRI findings actually being cancer in the subsequent biopsy.

A prostate MRI PACERR has been developed to communicate the most important findings relevant to decision-making in prostate cancer using patient-oriented design principles. The ability of this tool to improve patient knowledge and communication will be explored.

A prostate MRI PACERR has been developed to communicate the most important findings relevant to decision-making in prostate cancer using patient-oriented design principles. The ability of this tool to improve patient knowledge and communication will be explored.

The Wisconsin Stone Quality of Life (WISQOL) questionnaire has been recently developed to objectively assess QOL in patients with nephrolithiasis. However, a French version of the questionnaire was lacking. Therefore, the aim of the present study was to develop and validate the French version of this tool.

The French version of the WISQOL (F-WISQOL) was developed in a multistep process involving primary translation, back-translation, and pilot testing among a group of patients (n=12). Nephrolithiasis patients from two tertiary care institutions were recruited into this study and completed the following questionnaires the medical history form and either the WISQOL or F-WISQOL. Internal consistency was assessed using Cronbach's α, and inter-domain associations were evaluated using Spearman's rank correlation (r). One-way ANOVA was used to compare scores from the two groups (WISQOL and F-WISQOL).

A total of 210 patients were enrolled in this study 68 in the WISQOL group and 148 in the F-WISQOL group. Internal consistency was high for all domains in both groups (F-WISQOL 0.924-0.970; WISQOL 0.888-0.965). No statistically significant difference was found between the two groups' scores. Inter-domain association, measured by Spearman correlation, was moderate to very strong between all the domains in the F-WISQOL. Values ranged from r=0.676-0.915, with acceptable correlation between D1, D2, and D3, but weaker correlation between D4 (vitality) and the three other domains (r=0.676-0.729).

In the present study, the French version of the WISQOL questionnaire was validated at two academic institutions.

In the present study, the French version of the WISQOL questionnaire was validated at two academic institutions.Rationale The impact of coronavirus disease (COVID-19) on patients with interstitial lung disease (ILD) has not been established.Objectives To assess outcomes in patients with ILD hospitalized for COVID-19 versus those without ILD in a contemporaneous age-, sex-, and comorbidity-matched population.Methods An international multicenter audit of patients with a prior diagnosis of ILD admitted to the hospital with COVID-19 between March 1 and May 1, 2020, was undertaken and compared with patients without ILD, obtained from the ISARIC4C (International Severe Acute Respiratory and Emerging Infection Consortium Coronavirus Clinical Characterisation Consortium) cohort, admitted with COVID-19 over the same period. The primary outcome was survival. Secondary analysis distinguished idiopathic pulmonary fibrosis from non-idiopathic pulmonary fibrosis ILD and used lung function to determine the greatest risks of death.Measurements and Main Results Data from 349 patients with ILD across Europe were included, of whom 161 were admitted to the hospital with laboratory or clinical evidence of COVID-19 and eligible for propensity score matching.