Page 5 - CUA 2020_Functional Urology

2020 CUA ABSTRACTS

Unmoderated Poster Session 3: Prostate Cancer, Functional Urology,

Other Urology Topics

UP-3.1 email account, and a computer or a tablet/smart phone. Steps to prepare
Does urethral catheter education improve confidence in community for an e-visit include email invitation, testing connection/device, and instal-
pediatric care providers? A single-institution experience lation of the app. On the day of visit, patients open the invitation email at
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Ming-Hsien Wang , Kathy Luong , Alaina Dozar 1 the scheduled time and click on “join video visit” to meet the urologist. A
1 Urology, Baylor College of Medicine /Texas Children’s Hospital, Woodlands, post-visit survey was completed. Patients underage and those with limited
TX, United States technical skills were assisted by parents, relatives, or primary healthcare
Support: APPs in division of urology. Research support in urology providers. Patients’ demographics, diagnoses, reason for encounter, and
Introduction: Placement of urethral catheters (UC) is a common practice feedback were recorded.
in the management of ill patients. Risk associated with catheters include Results: The study included a total of 156 patients: 108 male and 48
urinary tract infection and trauma resulting in long-term morbidity. The females, aged between seven days and 96 years. Patient encounters
incidence of urethral trauma remains unclear in the pediatric population. included followup to review test results and surgical outcomes (n=107),
As catheter placement technique is a modifiable risk factor for urethral counselling (n=43), and ‘assessments’ (n=6). There were a variety of diagno-
injury, we assessed the knowledge and comfort level of clinical staff who ses. Participants lived near and far, in both rural and urban settings. Patients
work with children via a pre- and post-questionnaire after a continuing rated their experience as: time-saving, convenient, and no traffic jam. In
medical education (CME) supported educational seminar. nine patients, video visit was completed by telephone.
Methods: This prospective pilot study was conducted at a Texas Children’s Conclusions: Home-based video visit is going to grow in urology practices.
community hospital. The Urology Advanced Practice Providers (APPs) Collaborative enrollment of more participants in multiple sites is required
created a CME-approved lecture that was reviewed by fellowship-trained to better understand the benefits and limitations of this technology-driven
urologists. The objectives of the presentation were to: 1) review new devel- “doctor’s house call.”
opments in catheter placement and removal; 2) troubleshoot; 3) recognize
when urology involvement is appropriate; and 4) support a safer environ- UP-3.3
ment. We provided eight-question pre and post-tests, which were distrib- Association between perioperative blood transfusion and survival
uted prior to and immediately following the lecture. Each answer was given in patients undergoing radical cystectomy for bladder cancer
a value of 0 or 1, with 0 indicating an incorrect answer and 1 indicating Nick Dean , Jan K. Rudzinski , Graham Follett , Derrick Tilley , Niels-E. B.
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a correct answer (maximum score 12). Jacobsen , Adrian Fairey 1
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Results: Thirteen of 23 participants completed pre- and post-test question- 1 Urology, University of Alberta, Edmonton, AB, Canada; Cancer Control
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naires. The mean pre-test score was 7 (range 4–10), and the mean post-test Alberta, Alberta Health Services, Calgary, AB, Canada
score was 10.2 (range 8–12). The mean improvement in score was 3.2 Introduction: Perioperative blood transfusion has been associated with
points (range 6–13). The mean improvement in overall confidence after adverse cancer outcomes in colorectal and head and neck cancers. Radical
lecture was 1.3 points (range 0–3), with seven of 13 participants denoting cystectomy for bladder cancer is a high-risk surgical oncology procedure
an improvement in overall comfort. associated with high blood transfusion rates. The objective of the current
Conclusions: This pilot study demonstrates modest improvement in pro- study was to determine the association between receipt of perioperative
vider comfort after CME-supported education on proper UC placement blood transfusion and survival outcomes in patients undergoing radical
techniques. Further studies will be needed to optimize the educational cystectomy for primary bladder cancer at a Canadian center.
approach to decreasing the incidence and morbidity of urethral trauma Methods: The study was a retrospective analysis of prospectively collected
from UC placement. data. Eligible subjects were those with clinical Ta-4N0-3M0 urothelial car-
cinoma of the bladder undergoing curative intent radical cystectomy at the
UP-3.2 University of Alberta between 1994 and 2019. Patients were classified as
Home-based video tele-urology e-visit: “Doctor’s house call” is having received a blood transfusion if they received any blood product
back – a community urology practice experience within 90 days of surgery. The main outcome measures were overall sur-
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O. Emmanuel Abara , Valerie Lamontagne , Ogechi Abara , Nickolas vival (OS) and bladder cancer-specific survival (BCSS). The Kaplan-Meier
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Syvestre 4 method and Cox proportional regression models were used to analyze the
1 Division of Clinical Sciences, Surgery (Urology), Northern Ontario School association between receipt of blood transfusion and survival outcomes.
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of Medicine/RHUPPI, Sudbury/Richmond Hill, ON, Canada; Nursing, Statistical tests were two-sided (p≤0.05).
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North Centennial Manor, Kapuskasing, ON, Canada; Family Medicine/ Results: Between 1994 and 2019, 1094 patient underwent radical cystec-
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Geriatrics, Yuma Regional Medical Center, Yuma, AZ, United States; Family tomy with curative intent; 851 patients (78.3%) were male. Median age
Practice, Sensenbrenner Hospital, Kapuskasing, ON, Canada was 67 years (range 27–89 years). A total of 448 patients (44%) had organ-
Support: Ontario Telemedicine Network (OTN) confined disease (£pT2N0) on final radical cystectomy pathology; 346
Introduction: The uptake of telemedicine in clinical practice is on the rise patients (36%) received a perioperative blood transfusion. After adjustment
among specialties at different paces in Ontario. We studied home-based for case mix, receipt of perioperative blood transfusion was independently
video e-visits in an office urology practice between June 6, 2018 and associated with poorer OS (hazard ratio [HR] 1.26; 95% confidence interval
August 8, 2019. [CI] 1.03–1.54; p=0.024) and BCSS (HR 1.52; 95% CI 1.10–2.11; p=0.012).
Method: Following approval by the Ontario Telemedicine Network (OTN), Conclusions: Perioperative blood transfusion was independently associated
training of the urologist and office staff was completed. Enrolment of patients with poorer survival after radical cystectomy for bladder cancer. Efforts to
was by informed consent. Participants needed to have internet access, an minimize blood loss and restrictive blood product transfusion strategies
seem justified.
S68 CUAJ • June 2020 • Volume 14, Issue 6(Suppl2)
© 2020 Canadian Urological Association