Purpose: Although neoadjuvant chemotherapy (NAC) may benefit upper tract urothelial carcinoma (UTUC) treatment, most studies are retrospective and affected by selection bias, as healthier patients are more likely to receive NAC. We therefore aimed to investigate NAC’s impact on cancer specific mortality (CSM) in an other-cause mortality (OCM) matched cohort Methods: The Surveillance, Epidemiology, and End Results database was queried to identify patients with histological diagnosis of UTUC (pT1-4N0-3M0) at radical nephoureterectomy (RNU) between 2007–2021. Patients who underwent systemic therapy before RNU were classified as having received NAC. Cox regression was used to calculate the 5 year-OCM risk, which was used to construct a 1:3 propensity-score matched cohort. Then, in the matched cohort, we performed competing risk regression analysis to investigate the impact of NAC on CSM. Results: We included 4,936 patients, 388 (7.9%) of whom underwent NAC. Median (interquartile range) age at diagnosis was 72 (64–79) years. The 5-year OCM rate was 26.4% versus 37.1% (p=0.004) in patients who received NAC men versus in those who did not receive NAC, but that difference became not statistically significant after matching (p=0.9). The standardized mean difference was 0.0003 for OCM risk, indicating a good match. In the matched cohort, patients in the NAC-group were more likely to be younger (67 vs. 73, p<0.0001), to be diagnosed more recently (2018 vs. 2015, p<0.0001) and to have a pN+UTUC (28.8% vs. 12.3%, p<0.0001), compared to no-NAC group. At MVA analysis, patients who did not undergo NAC had a significantly higher CSM-risk (hazard ratio,1.78; 95% confidence interval, 1.27–2.51; p<0.01), than their counterpart who received NAC. Conclusion Compared to patients who did not receive NAC, those who received NAC seems to have a reduced CSM-risk for UTUC, when matched with their calculated OCM-risk. However, to establish it as the optimal treatment strategy for UTUC, additional prospective randomized studies are needed.

Purpose: The Open Payments Program (OPP), established in 2013 under the Sunshine Act, mandated medical device and pharmaceutical manufacturers to submit records of financial incentives given to physicians for public availability. The study aims to characterize the gap in real general and real research payments between man and woman urologists. Materials and Methods: The study sample included all urologists in the United States who received at least one general or research payment in the OPP database from 2015 to 2021. Recipients were identified using the National Provider Identifier and National Downloadable File datasets. Payments were analyzed by geography, year, payment type, and years since graduation.Multivariable analysis on odds of being in above the median in terms of money received was done with gender as a covariate. This analysis was also completed for all academic urologists. Results: There was a total of 15,980 urologists; 13.6% were woman, and 86.4% were man. Compared to man urologists, woman urologists were less likely to be in the top half of total payments received (odds ratio [OR] 0.62) when adjusted for other variables.When looking at academic urologists, 18.1% were woman and 81.9% were man. However, woman academic urologists were even less likely to be in the top 50% of payments received (OR 0.55). Conclusions This study is the first to characterize the difference in industry payments between man and woman urologists. The results should be utilized to educate physicians and industry, in order to achieve equitable engagement and funding for woman urologists.

Benign prostatic hyperplasia (BPH) is highly prevalent in older men and causes substantial adverse effects on health. The pathogenesis of this disease is not totally clear. Recent reports have suggested a possible relationship between metabolic syndrome (MetS) and BPH. Single components of MetS (obesity, dyslipidemia, hypertension, and insulin resistance) as well as the syndrome itself may predispose patients to a higher risk of BPH and lower urinary tract symptoms (LUTS). This may stem from changes in insulin resistance, increased autonomic activity, impaired nitrergic innervation, increased Rho kinase activity, pro-inflammatory status, and changes in sex hormones that occur in association with MetS. However, the exact underlying mechanisms that regulate the potential relationship between MetS and BPH/LUTS still need to be clarified. Increased physical activity and dietary strategies may help in decreasing the incidence of MetS and its impact on BPH/LUTS. However, differences in the definitions used to address the examined predictors and endpoints preclude the possibility of arriving at definitive conclusions.
Dyslipidemias ; Gonadal Steroid Hormones ; Humans ; Hypertension ; Incidence ; Insulin ; Insulin Resistance ; Lower Urinary Tract Symptoms ; Male ; Motor Activity ; Prostatic Hyperplasia ; rho-Associated Kinases