Fardod O'Kelly

The emerging use of Twitter by urological journals.

To assess the emerging use of Twitter by urological journals.

The changing pattern of antimicrobial resistance within 42,033 Escherichia coli isolates from nosocomial, community and urology patient-specific urinary tract infections, Dublin, 1999-2009.

Study Type – Therapy (practice patterns cohort)

Zero Ischemia Laparoscopic Partial Thulium Laser Nephrectomy

BACKGROUND AND PURPOSEnLaser technology presents a promising alternative to achieve tumor excision and renal hemostasis with or without hilar occlusion, yet its use in partial nephrectomy has not been significantly evaluated. We prospectively evaluated the thulium:yttrium-aluminum-garnet laser in laparoscopic partial nephrectomy (LPN) in our institution over a 1-year period.nnnPATIENTS AND METHODSnWe used the thulium laser with a wavelength of 2013 nm in the infrared spectrum. Data were recorded prospectively. Tumor size, preoperative aspects and dimensions used for an anatomical classification (PADUA) score, operative time, warm ischemia time (WIT), and perioperative and postoperative morbidity were recorded. Blood loss, preoperative and postoperative creatinine level, and estimated glomerular filtration rate (eGFR) were also collected.nnnRESULTSnA total of 15 patients underwent consecutive LPN. The mean tumour diameter was 2.85 (1.5-4). The mean PADUA score was 6.8 (6-9). The mean total operative time was 168 minutes (128-306 min). Mean blood loss was 341 mL (0-800 mL). Date of discharge was 3.2 days postoperatively (2-8 days). The renal vessels were not clamped, resulting in a WIT of 0 minutes in all cases. There was no statistical significant increase in serum creatinine level or decrease in eGFR postoperatively. Histologically, the majority of lesions (13/15 patients) were renal-cell carcinoma stage pT1a. In all cases, base margins had negative results for tumor.nnnCONCLUSIONnThe 2013-nm thulium laser system offers excellent hemostasis and precise resection capability of the renal cortex during LPN of small partially exophytic renal tumors. Our series showed excellent perioperative functional and pathologic outcomes, including minimal blood loss, zero ischemia, negative tumor margins, and preservation of renal function.

Rates of self-reported 'burnout' and causative factors amongst urologists in Ireland and the UK: a comparative cross-sectional study.

To determine the incidence of ‘burnout’ among UK and Irish urological consultants and non‐consultant hospital doctors (NCHDs). The second objective was to identify possible causative factors and to investigate the impact of various vocational stressors that urologists face in their day‐to‐day work and to establish whether these correlate with burnout. The third objective was to develop a new questionnaire to complement the Maslach Burnout Inventory (MBI), more specific to urologists as distinct from other surgical/medical specialties, and to use this in addition to the MBI to determine if there is a requirement to develop effective preventative measures for stress in the work place, and develop targeted remedial measures when individuals are affected by burnout.

A comparative bibliometric analysis of the top 150 cited papers in hypospadiology (1945–2013)

INTRODUCTIONnHypospadias, the most common congenital malformation of the penis, is characterized by an abnormal ventral opening of the urethral meatus, abnormal ventral curvature of the penis, and an abnormal distribution of the foreskin around the glans, with a ventrally-deficient hooded foreskin, and has been described in modern peer-reviewed literature since Nobles description in 1853. A dramatic increase in the literature on hypospadiology has focused on two main topics: The aetiology of the condition including molecular mechanisms and environmental influences, as well as surgical techniques to repair the defect, however there have been a number of facets of research stemming from this poorly understood condition in a developing subspecialty (Figure). The majority of these publications focus on the evolution of surgical technique and management. Urethral reconstruction should offer the ability to stand to urinate and combine a satisfactory cosmetic result. The tubularized incised plate repair, popularized by Snodgrass et al., and the Mathieu repair, have been the mainstay for distal hypospadias, however, there have still been a large number of well-described techniques, with no consensus as to the ideal method of repair, some of which is attributed to non-uniform standards of reporting outcomes. There is also no standard objective means to qualitatively assess the importance of each of these contributions.nnnOBJECTIVEnThe objective of this study was to determine the top 150 peer-reviewed articles in the field of hypospadiology by way of citation analysis as a means to determine the importance/relevance of each contribution throughout 8 decades of research.nnnSTUDY DESIGNnA cited reference search was carried out for indexed citations within Web of Science™ Core Collection. The top 150 indexed cited articles containing the topic hypospadias in specific subject categories were compiled using a component of Science Citation Index command. References were then evaluated, and analysed across a number of indices, and over time.nnnRESULTSnThe mean number of citations was 76 for each article. The top 150 articles were published across 21 countries, with the majority originating from the USA. The lead research institution was the University of Texas (Southwestern) Medical Center. In total, the top 3 centers represented 33 publications within the top 150 citations. The most commonly utilized journal was the Journal of Urology. The most cited author was W.T. Snodgrass. 39% papers in the top 150 cited articles were published prior to 1990. Three out of the five papers cited in the 1940s dealt with operative technique to repair hypospadias. The period 2000-2010 in contrast, demonstrated a significant inverse correlation between molecular biology citations, and those for operative techniques, with the incidence of the latter dropping to 6% of all cited papers.nnnDISCUSSIONnThis is the first study of its kind to analyse the most influential articles in hypospadiology, and their characteristics assessed for authorship, content and impact factor. Furthermore it allows data analysis by topic and between time points. This not only de-clutters the wealth of accumulated data on this subject, but also provides an important adjunct to education and training. As with this study, other citation analytical studies in urology found a significant preponderance in cited studies originating from the USA. The prevalence of the US in cited papers doesnt reflect any inherent bias, just a greater number of publications.nnnCONCLUSIONnAlthough there are inherent potential elements of bias in citation analysis, this study demonstrates that citation analysis in a complicated topic can provide a high-throughput, uncomplicated method of quickly deciphering important contributions of authors and institutions to the field of hypospadias research.

Newsworthiness vs scientific impact: are the most highly cited urology papers the most widely disseminated in the media?

To assess whether a correlation exists between newsworthiness (Altmetric score) and scientific impact markers, such as citation analysis, impact factors, and levels of evidence.

Can delayed time to referral to a tertiary level urologist with an abnormal PSA level affect subsequent gleason grade in the opportunistically screened population

There is growing conflict in the literature describing the effect of delayed treatment on outcomes following radical prostatectomy. There is also evidence to suggest progression of low‐risk prostate cancer to develop higher grades and volumes of prostate cancer during active surveillance. It is unknown as to what affect a delay in referral of those men with abnormal screened‐PSA levels have on subsequent Gleason grade.

The effect of social media (#SoMe) on journal impact factor and parental awareness in paediatric urology

BACKGROUNDnSocial media (SoMe) comprises a number of internet-based applications that have the capability to disseminate multimodal media and allow for unprecedented inter-user connectivity. The role of Twitter has been studied in conferences and education; moreover, there is increasing evidence that patients are more likely to use social media for their own health education.nnnOBJECTIVEnThe aim of this study was to assess the impact of social media platforms on the impact factor of both urological and paediatric journals that publish on paediatric urology, and to assess parental awareness of social media in paediatric urology.nnnSTUDY DESIGNnA filtered Journal of Citation Reports (JCR) search was performed for the period 2012-16 for journals that published articles on paediatric urology. Journals were ranked according to impact factor, and each individual journal website was accessed to assess for the presence of social media. Parents in paediatric urology clinics and non-paediatric urology patients also filled out a questionnaire to assess for awareness and attitudes to social media. All statistical analysis was performed using Prism 6 software (Prism 6, GraphPad Software, California, USA).nnnRESULTSnOverall, there were 50 urological journals and 39 paediatric journals with a mean impact factor of 2.303 and 1.766, respectively. There was an overall average increase in impact factor across all urological journals between 2012 and 16. The presence of a Twitter feed was statistically significant for a rise in impact factor over the 4 years (Pxa0=xa00.017). The cohort of parents was statistically more likely to have completed post-secondary education, to have and access to a social media profile, use it for health education, and use it to access journal/physician/hospital social media accounts.nnnDISCUSSIONnThis study examined, for the first time, the role of social media in paediatric urology, and demonstrated that SoMe use is associated with a positive influence in impact factor, but also a parental appetite for it. Limitations included a non-externally validated questionnaire. There may also have been bias in larger journals that generate and maintain social media platforms such as Twitter, which may then in turn have an influence on impact factor.nnnCONCLUSIONSnSocial media use within paediatric urology was associated with a higher impact factor, which remained significant after 4 years of analysis. Parents were more likely to use a wide variety of social media to search for conditions and physicians/healthcare providers; therefore, journals and institutions need to embrace and endorse SoMe as a potential source of important clinical information.

Electroejaculatory stimulation and its implications for male infertility in spinal cord injury: a short history through four decades of sperm retrieval (1975-2010).

p l Few conditions present more of a therapeutic challenge to rehabilitation and successful reproduction than spinal cord injury and dysfunction. In addition to paralysis and loss of pelvic floor function, spinal cord injury often results in anejaculation, defined as the absence of seminal emission in the posterior urethra. In a retrospective review of 560 patients, the most common cause of anejaculation was spinal cord injury, followed by retroperitoneal lymph node dissection, with the 2 accounting for 90% of cases. Many men face changes in sexual activity and the ability to father children naturally because of sacral autonomic disruption, with consequent impotence and anejaculation. Therefore, semen retrieval becomes necessary. We conducted a literature search using the PubMed, MEDLINE, and Cochrane Library databases for studies published from 1930 to 2010 using keywords, such as electroejaculation, spinal cord injury, male infertility, and history. The results were cross-referenced and anonymously repeated to reduce bias. Before ejaculation, the parasympathetic cavernous nerves from the prostatic plexus cause smooth muscle relaxation in the fibrous trabeculae of the coiled helicene arteries and allow blood to fill the corpora cavernosa and corpus spongiosum of the penis. Semen is ejected through the urethra with rhythmic contractions generated by the bulbospongiosus muscle under the control of a spinal nerve reflex (S2-S4) by way of the pudendal nerve. However, with disruption of this neural arc, ejaculation cannot occur. It was recognized at an early stage that the reproductive techniques used for many years in animal husbandry could theoretically be applied to humans. Electroejacu-