The Journal of urology Impact Factor & Information

Publisher: American Urological Association, Elsevier

Journal description

The most widely read publication in the field, The Journal of Urology® brings solid coverage of all the clinically relevant information needed to stay at the forefront of this dynamic field. The Journal presents investigative studies on critical areas of research and practice; survey articles providing short condensations of the best and most important urology literature worldwide; and practice-oriented reports on interesting clinical observations.

Current impact factor: 4.47

Impact Factor Rankings

2015 Impact Factor Available summer 2016
2014 Impact Factor 4.471
2013 Impact Factor 3.753
2012 Impact Factor 3.696
2011 Impact Factor 3.746
2010 Impact Factor 3.862
2009 Impact Factor 4.016
2008 Impact Factor 3.952
2007 Impact Factor 4.053
2006 Impact Factor 3.956
2005 Impact Factor 3.592
2004 Impact Factor 3.713
2003 Impact Factor 3.297
2002 Impact Factor 3.03
2001 Impact Factor 3.19
2000 Impact Factor 2.896
1999 Impact Factor 2.486
1998 Impact Factor 2.685
1997 Impact Factor 2.719
1996 Impact Factor 2.668
1995 Impact Factor 2.792
1994 Impact Factor 2.539
1993 Impact Factor 2.231
1992 Impact Factor 1.91

Impact factor over time

Impact factor

Additional details

5-year impact 4.10
Cited half-life 9.60
Immediacy index 1.13
Eigenfactor 0.07
Article influence 1.27
Website Journal of Urology, The website
Other titles Journal of urology (Online), The journal of urology
ISSN 1527-3792
OCLC 42747133
Material type Document, Periodical, Internet resource
Document type Internet Resource, Computer File, Journal / Magazine / Newspaper

Publisher details


  • Pre-print
    • Author can archive a pre-print version
  • Post-print
    • Author can archive a post-print version
  • Conditions
    • Authors pre-print on any website, including arXiv and RePEC
    • Author's post-print on author's personal website immediately
    • Author's post-print on open access repository after an embargo period of between 12 months and 48 months
    • Permitted deposit due to Funding Body, Institutional and Governmental policy or mandate, may be required to comply with embargo periods of 12 months to 48 months
    • Author's post-print may be used to update arXiv and RepEC
    • Publisher's version/PDF cannot be used
    • Must link to publisher version with DOI
    • Author's post-print must be released with a Creative Commons Attribution Non-Commercial No Derivatives License
    • Publisher last reviewed on 03/06/2015
  • Classification
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Publications in this journal

  • The Journal of urology 10/2015; DOI:10.1016/j.juro.2015.07.107
  • The Journal of urology 10/2015; DOI:10.1016/j.juro.2015.07.112
  • The Journal of urology 10/2015; DOI:10.1016/j.juro.2015.07.105
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    ABSTRACT: Purpose: Perirenal fat is associated with poor blood pressure control and chronic kidney disease, but the underlying mechanisms remain elusive. We tested the hypothesis that perirenal fat impairs renal arterial endothelial function in pigs with obesity-metabolic derangements (ObM). Material and methods: Fourteen domestic pigs were studied after 16 weeks of a high-fat/high-fructose diet (ObM) or standard chow (Lean). Renal blood flow (RBF), glomerular filtration rate (GFR), and visceral fat volumes were studied in-vivo with CT. Renal arterial endothelial function was also studied ex-vivo in the organ bath. Results: ObM pigs demonstrated increased body weight, blood pressure, cholesterol, and intra-abdominal fat compared to lean pigs, and perirenal fat volume was significantly larger. RBF and GFR were markedly elevated, while urinary protein level was preserved. Ex-vivo acetylcholine-induced endothelium-dependent vasodilation of renal artery rings was substantially impaired in ObM compared to Lean. Endothelial function was further blunted in both ObM and Lean arterial rings by incubation with perirenal fat harvested from ObM, but not from Lean pigs, and was restored by inhibition of tumor necrosis factor (TNF)-α. ObM perirenal fat also showed increased pro-inflammatory macrophage infiltration and TNF-α expression. Conclusions: ObM perirenal fat directly causes renal artery endothelial dysfunction, partly mediated by TNF-α.
    The Journal of urology 09/2015; DOI:10.1016/j.juro.2015.08.105
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    ABSTRACT: Purpose: Cryoablation and radiofrequency ablation are attractive modalities for small renal masses in patients with substantial comorbidities. However, salvage extirpative therapy for local recurrence following thermal ablation can be challenging due to associated perinephric fibrosis. Methods: Patients with thermal ablation refractory tumors requiring surgical salvage from 1997-2013 were identified and retrospectively reviewed. Results: Twenty-seven patients were managed surgically after failing cryoablation (n=18) or radiofrequency ablation (n=9). Subjective assessment indicated moderate/severe fibrosis in 22 cases (81%). Partial nephrectomy was preferred in all patients but was not possible in 12 primarily due to unfavorable tumor size/location. In the intended partial nephrectomy group (n=15), open surgery was performed in all patients and completed in 14, while one was aborted due to extensive perinephric fibrosis. Radical nephrectomy was planned in 12 patients of whom 8 were managed laparoscopically, with one requiring conversion to open. Median estimated blood loss was 225 ml, 17 patients experienced no complications, and 4 had minor complications. However, 6 patients experienced more significant complications (Clavien III-IVb). Since January 2008, partial nephrectomy was performed more frequently (12/17=71% vs. 2/10=20% for cases prior, p=0.02). Conclusions: Surgical salvage after failed thermal ablation is feasible in most instances, and partial nephrectomy is often possible, but can be challenging due to associated perinephric fibrosis. Difficulty of surgical salvage should be recognized as a potential limitation of the thermal ablation treatment strategy. Prospective studies of TA versus PN should be prioritized to provide higher quality data about the merits and limitations of each approach.
    The Journal of urology 09/2015; DOI:10.1016/j.juro.2015.09.078
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    ABSTRACT: Objective: We evaluated the relative risk of later grade re-classification and outcomes of patients who developed high-volume Gleason 6 prostate cancer (PCa) while on active surveillance (AS). Methods: A prospectively maintained database was used to identify patients on AS between 1998 and 2013. Tumour volume was assessed based on number of positive cores and proportion of core involvement. Chi-square and Fisher's exact test were used for analysis where appropriate. The primary endpoint was development of grade re-classification, defined as grade only and/or grade and volume at the event biopsy. Results: A total of 555 men met study inclusion criteria. Mean follow-up was 46 months. Overall, 70 patients demonstrated an increase in tumour volume at or after their second biopsy (B2). In comparison to those never experiencing volume or grade re-classification, prostate-specific antigen at diagnosis was not significantly different (p=0.95), but median prostate volume was smaller in patients who demonstrated volume re-classification (p <0.001). Incidence of pure volume re-classification was 6.8%, 6.1% and 7.8% at B2, B3, B4 respectively. Men with volume re-classification were more likely to experience later grade re-classification compared to men without, 33.3% vs 9.3%, respectively; P<0.0001). Conclusions: While Gleason 6 PCa has a favourable natural history, it appears that AS patients who experience volume re-classification are at a substantially higher risk of developing grade re-classification. Thus, urologists should pay close attention to tumour core involvement and monitoring should be adjusted accordingly for early volume re-classification in younger men and in good health.
    The Journal of urology 09/2015; DOI:10.1016/j.juro.2015.09.081
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    ABSTRACT: Purpose: Growing evidence suggests that ischemia may contribute to aging-associated bladder dysfunction and lower urinary tract symptoms (LUTS). Our goal was to determine the effects of chronic ischemia on bladder proteomic profiles and characterize downstream signaling pathways. Materials and methods: Bilateral iliac artery atherosclerosis and chronic bladder ischemia were created in male Sprague-Dawley rats. After 8 weeks, cystometrograms were obtained then ischemic and control bladder tissues were processed for label-free quantitative proteomic analysis. Gene Ontology and Ingenuity Pathway Analysis software were used to classify altered proteins in bladder ischemia. Western blot was used to confirm differentially expressed proteins. Tissue structure was examined by transmission electron microscopy. Results: Chronic ischemia resulted in detrusor instability and non-compliance. Proteomic analysis revealed a total of 4277 proteins in the ischemic and 4602 proteins in control bladder tissues. In ischemia, a total of 359 and 66 proteins were differentially expressed with over 2 folds and 5 folds of changes, respectively. In Gene Ontology analysis, differentially expressed proteins were associated with molecular signaling mechanisms underlying proteolysis and degenerative processes. Pathway and network analysis of ischemic tissues suggested that altered proteins are involved in ubiquitination, Nrf2-mediated oxidative stress response, cell death, glucose metabolism, and cytoskeleton remodeling. Western blot verified changes in four representative proteins including Nedd4l, Mpo, Ca3 and Fkbp5. Altered proteomic profile of the bladder was associated with widespread ultrastructural damage. Conclusions: Alterations of bladder proteomic profiles in ischemia may provide new insight into molecular pathways underlying bladder dysfunction and LUTS in pelvic atherosclerosis.
    The Journal of urology 09/2015; DOI:10.1016/j.juro.2015.09.079
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    ABSTRACT: Purpose: To report the diagnostic accuracy of renal mass biopsy (RMB) for a small (≤4 cm) renal mass (SRM) and to identify the predictors of a successful RMB in a contemporary cohort of patients from two large tertiary referral centers. Materials and methods: A total of 442 biopsies of renal tumors ≤4 cm in two tertiary centers between 2008 and 2015 were included. Biopsy outcomes (malignant, benign, or non-diagnostic) and concordance rates between RMB and final surgical pathology were presented. Univariate and multivariate logistic regression analyses were performed to identify factors indicative of a non-diagnostic biopsy. Results: The initial biopsy was diagnostic in 393 cases (88.9%) and non-diagnostic in 49 cases (11.1%). Of the diagnostic biopsies, 76% were renal cell carcinomas (RCCs), and 24% were benign. Histological subtyping and grading in RCC was possible in 90.2% and 31.3% of cases, respectively. A second biopsy was performed in 11 of the 49 non-diagnostic cases, and a diagnosis was possible for 100% (10 RCCs and one oncocytoma). Small tumor size, cystic nature of tumors and a biopsy during the initial years of the study were independent predictors of a non-diagnostic biopsy. Accuracy in identifying malignancies, histotyping, and grading between the RMB and surgical pathology were 97.1%, 95.1%, and 68.8% (2-tier), respectively. Conclusions: An RMB for an SRM can be performed accurately. A non-diagnostic RMB is common in smaller masses, cystic masses and during the initial years of the study. A second biopsy should be considered in non-diagnostic biopsy cases.
    The Journal of urology 09/2015; DOI:10.1016/j.juro.2015.09.073
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    ABSTRACT: Purpose: This study aims to identify important differences in renal function profile (RFP) and potential cutoff values for water and sodium diuresis among participants with nocturnal polyuria (NP) according to different NP definitions. Material & methods: This post hoc analysis is based on a prospective study where participants were asked to complete a bladder diary, to collect urine for a renal function profile (RFP) (8 urine samples every 3 hours over 24h) and to provide a blood sample (osmolality and sodium concentrations). Four definitions of NP are compared with the age dependent NPindex (NPI)>20-33% as reference: NPI>33%, nocturnal urine production (NUP)>90ml/h, NUP>10ml/kg and nocturia index>1,5. Results: A total of 112 participants were included with a mean age of 57 years (SD 16), 41% were female. Significant differences in baseline characteristics and bladder diary parameters were found according to the different definitions. Diuresis rate, free water clearance and sodium clearance have similar courses over 24h for both the subgroup with and without NP based on each definition. The range shows a larger variation for the subgroup with NP compared to the subgroup without NP, especially at night for diuresis rate and FWC. At night, a decrease in FWC is seen for the subgroup with NP based on each definition (p<0.001 to p=0.045), although a significant difference compared to the subgroups without NP is only found with the NUP>90 and NPI>20-33 definitions. For each definition, sodium clearance remains high throughout the night in the subgroup with NP, which differs significantly from the subgroups without NP (p<0.001 to p=0.030). Cut off values for FWC between 12 and 2am based on each definition ranges from -0.65 to -0.85ml/min, for sodium clearance between 3 and 5am values between 0.65 to 0.77ml/min are found, with large differences in sensitivity and specificity according to the chosen definition. Conclusions: There are important differences in age, gender and bladder diary parameters comparing participants with and without NP based on various definitions. Although the course of RFP indicating the underlying pathophysiologic mechanism of NP, does not seem to be influenced by the choice of definition, the sensitivity of cut off values for FWC and sodium clearance differs substantially.However, these results need to be confirmed in a larger homogeneous study sample.
    The Journal of urology 09/2015; DOI:10.1016/j.juro.2015.09.076
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    ABSTRACT: Introduction: Genitourinary (GU) infection after ureteroscopy with laser lithotripsy (URSLL) is a clinically significant event that may lead to expensive and morbid return to the hospital. We sought to evaluate factors associated with post-URSLL infection leading to unplanned hospital return (UR). Methods: We performed a retrospective chart review evaluating all URSLL performed at a single academic institution from April 2011 to August 2014. Data were extracted including patient demographics, comorbidities, surgical encounter characteristics, preoperative urine culture status, antibiotic type/duration, and compliance with AUA Best Practice statement (BPC) for antibiotic prophylaxis. Bivariate and multivariate analyses were performed to determine factors associated with UR. Results: Among 550 patients undergoing URSLL, 45%(248/550) were female with an average age of 56.8(+/-14.8) yrs. A total of 3.4%(19/550) had UR for GU infection, most of these, 78.9%(15/19), requiring inpatient readmission. Overall, BPC was 48.7%(268/550). Infection-related returns were higher in patients undergoing preoperative stenting (84.2%vs.58.6%,p=0.025), with operative time> 120 min (89.5%vs 32.6% p<0.001), and for whom there was BPC (78.9%vs. 47.6%,p = 0.007). These factors remained significant on multivariate analysis (p<0.05). Conclusion: Preoperative stenting and longer operative time were associated with greater likelihood of serious GU infection following URSLL. These patients may warrant additional antibiotic prophylaxis, but further research is needed to more definitively answer this question. Interestingly, AUA BPC was also associated with a higher risk of infection, underscoring the need for locally appropriate prophylaxis strategies, and further study of optimal prophylaxis regimens.
    The Journal of urology 09/2015; DOI:10.1016/j.juro.2015.09.074
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    ABSTRACT: Purpose: We compared culture-independent assessment of microbiota of the lower urinary tract in standard culture negative female UCPPS patients who reported symptom flare to those who did not report a flare. Materials and methods: Initial stream (VB1) and midstream (VB2) urine specimens (n=233 UCPPS patients) were analyzed with Ibis T-5000 Universal Biosensor system technology for comprehensive identification of microorganism species. Differences between flare and non-flare groups for presence or number of different species within a higher level group (richness) were examined by permutational multivariate analysis of variance and logistic regression. Results: Overall, 81 species (35 genera) were detected in VB1 and 73 (33) in VB2. Mean (SD) VB1 and VB2 species count per person was 2.6 (1.5) and 2.4 (1.5) for 86 flare patients and 2.8 (1.3) and 2.5 (1.5) for 127 non-flare patients, respectively. Overall, species composition did not significantly differ between flare and non-flare patients at any level (p=0.14 species, p=0.95, genus in VB1 and VB2, respectively) in multivariate analysis for richness. Univariate analysis, both unadjusted and adjusted, confirmed significantly greater prevalence of fungi (Candida and Saccharomyces) in flare group (15.7%) compared to non-flare group in VB2 (3.9%) (p=0.01). When adjusted for antibiotic use and menstrual phase, women who reported a flare remained more likely to have fungi present in VB2 specimens [OR= 8.3, CI=1.7-39.4)]. Conclusion: Among women with UCPPS the prevalence of fungi (Candida and Saccharomyces sp.) was significantly greater in those who reported a flare compared to those who did not.
    The Journal of urology 09/2015; DOI:10.1016/j.juro.2015.09.075
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    ABSTRACT: Purpose: Although the Clavien-Dindo Classification of Surgical Complications was evaluated using a cohort of adult surgery patients, it is being applied to pediatric populations. We hypothesized that this instrument is not well-suited to children and sought to determine the reliability of the tool in a pediatric urologic population. Materials & methods: We replaced the adult surgical cases in the "Survey to Assess Acceptability and Reproducibility of the Classification" from the original study with pediatric urology cases and mimicked original study methods. The survey was distributed with REDCap electronic data capture tool and Krippendorff's alpha coefficients of reliability (α) were calculated from the responses. Results: There were 51 respondents and 40 complete responses. Krippendorff's alpha coefficient of reliability for the Clavien-Dindo Classification (0.487) did not achieve the minimum level of acceptable agreement (α=0.667) with the pediatric urologic cases, even when the disability suffix (α=0.266) was excluded from the analysis (α=0.632). The accuracy of the grading system with the pediatric urologic surgical cases when excluding the disability suffix (75%, 410/550) was significantly less than the accuracy had been with the original adult cases (90%, 1816/2016; p<0.0001). While 89% (32/36) of respondents thought the system was appropriate for adults, only 49% (17/35) found it appropriate for pediatrics (p<0.001). Conclusions: The Clavien-Dindo Classification of Surgical Complications is not a reliable tool for use in pediatric urology, where its accuracy is significantly decreased from its accuracy with adult surgical cases. Further study is needed to determine if findings are similar across all pediatric surgical groups.
    The Journal of urology 09/2015; DOI:10.1016/j.juro.2015.09.071
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    ABSTRACT: Purpose: The CCP test is a validated molecular assay that assesses prostate cancer-specific disease progression and mortality risk when combined with clinicopathologic parameters. The results from PROCEDE-1000, a large, prospective registry designed to evaluate the impact of the CCP test regarding shared treatment decision making for newly diagnosed prostate cancer patients, are presented here. Materials and methods: Untreated patients with newly diagnosed prostate adenocarcinoma were enrolled and the CCP test was performed on the initial prostate biopsy tissue. A set of four sequential surveys tracked changes relative to initial therapy recommendations (pre-CCP) based on clinopathologic parameters following: physician review of the CCP test result, physician/patient review of the CCP test results, and a minimum of three-months of clinical follow-up (actual treatment). Results: 1206/1596 patients enrolled in this registry were eligible for analysis. There was a significant reduction in the treatment burden recorded at each successive evaluation (P<0.0001), with mean number of treatments per patient decreasing from 1.72 pre-CCP test to 1.16 in actual follow-up. The CCP test caused a change in actual treatment in 47.8% of patients. Of these changes, 72.1% were reductions and 26.9% were increases in treatment. For each clinical risk category, there was a significant change in treatment modality (intervention vs. non-intervention) pre-CCP to post-CCP testing (P=0.0002). Conclusions: The CCP test has a significant impact in assisting physicians and patients reach personalized treatment decisions.
    The Journal of urology 09/2015; DOI:10.1016/j.juro.2015.09.072
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    ABSTRACT: Purpose: Genital infantile hemangiomas (IH) are vascular anomalies often requiring complex management and interdisciplinary care. Propranolol was first used for treatment of IH in 2008 and has since gained acceptance as first line therapy. Materials and methods: We reviewed the presentation, course, management, and outcomes of all cases of genital IH treated with propranolol at a single institution from April 2010 to July 2014. Results: During the study period, 9 patients with genital IH were referred to the Hemangioma Treatment Clinic. Propranolol was initially administered under careful outpatient monitoring at a dose of 1 mg/kg/day in 8 patients. One patient, a 700 gram premature infant, was started on therapy in the inpatient setting at 0.5 mg/kg/day, given her history of prematurity. All patients were successfully escalated to a dose of at least 2 mg/kg/dose for the observation phase after tolerating their starting doses. One patient discontinued propranolol prematurely per parental request due to parental concern over peripheral vasoconstriction. Otherwise, no patient developed significant hypotension, symptomatic bradycardia, hypoglycemia, or other major side effect requiring treatment discontinuation. All patients who continued the treatment protocol had excellent response to therapy. Conclusions: Propranolol therapy for genital IH was successfully initiated and escalated in 9 young children without significant side effects and with marked improvement in genital IH in all patients who continued on treatment. Propranolol is the only FDA-approved therapy for treatment of this vascular anomaly and should be considered first-line therapy for genital IH.
    The Journal of urology 09/2015; DOI:10.1016/j.juro.2015.09.069
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    ABSTRACT: Material and methods: We retrospectively reviewed the records of patients with urolithiasis and , concomitant hypocitraturia and low urine pH as unique abnormalities upon metabolic evaluation treated exclusively with potassium citrate. The cohort was divided into 4 groups based on body mass index (BMI): normal weight, overweight, obese and morbidly obese. Metabolic data was compared between the 4 groups at baseline and subsequent follow up visits up to 2 years. We compared urinary pH and citrate both in absolute values and the relative change in these parameters from baseline. Similarly, we compared the rates of potassium citrate treatment failure. Results: A total of 125 patients with both hypocitraturia and low urine pH were included in this study. Median patient age was 61 years, 80 were males and median BMI was 30.4kg/m(2) . Patients with higher BMI tended to be younger (p=0.010), had lower urinary citrate, but higher sodium, oxalate and uric acid levels whereas urine pH was similar across BMI groups. The pH values and their absolute change from baseline were lower as BMI increased (p≤0.001). Similarly, we noted an association between increasing BMI category and lower urinary citrate levels accompanied by a statistically significant trend indicating lower absolute changes in citrate with increasing BMI (p≤0.001). Potassium citrate dose was increased more frequently among the higher BMI groups. Conclusion: Patients with higher BMI presented lower increase in citrate excretion and urine pH levels after they were started on potassium citrate and they needed more frequently adjustments of their therapy.
    The Journal of urology 09/2015; DOI:10.1016/j.juro.2015.09.070
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    ABSTRACT: Purpose: Oncocytomas are benign tumors often diagnosed incidentally on imaging. Small case series have suggested that the growth kinetics of oncocytomas are similar to those of malignant renal tumors. Biopsy material may be insufficient to exclude a diagnosis of chromophobe renal cell carcinomas (chRCC). We evaluated and compared the growth rates of oncocytomas and chRCCs to improve our understanding of their natural history. Materials and methods: This was a single-center retrospective study of patients diagnosed with lesions suggestive of oncocytomas or chRCCs between 2003 and 2014. The growth rates were estimated using mixed effect linear model. Patient and lesion characteristics were tested using a similar model for association with growth rate. Results: Among the 95 lesions (81 oncocytomas; 14 chRCCs) included in the analysis, 98% were diagnosed on biopsy. The annual growth rate was 0.14cm and 0.38cm for oncocytoma (median follow-up of 34 months) and chRCC (median follow-up of 25 months), respectively (p=0.5). Baseline lesion size was significantly associated with growth (p<0.001). The majority of oncocytomas (74%) and chRCCs (67%) followed up to the 3-year mark had grown. Of these, eight underwent surgery (6 in the chRCC group). The initial diagnosis was confirmed in all of them. Overall, five patients had died, all from non-renal related causes. Conclusion: Although the majority of oncocytic renal neoplasms will grow over time, surveillance appears to remain safe. Patients opting for this strategy should be made aware that a diagnosis of oncocytoma following biopsy is associated with some degree of uncertainty due to the difficulty of differentiating them from other oncocytic renal neoplasms.
    The Journal of urology 09/2015; DOI:10.1016/j.juro.2015.09.067
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    ABSTRACT: Background: Approximately 2-6% of men undergoing vasectomy will ultimately have it reversed. Cost is a major consideration for patients and providers with regards to vasovasostomy. Opportunities for cost savings for vasectomy reversal lie in the reduction of variable costs, namely operative time and materials used. Purpose: This study aims to determine the cost benefits of a modified one-layer vasovasostomy compared to a formal two-layer vasovasostomy. Methods: A retrospective analysis was performed of a single surgeon experience of vasectomy reversals performed from 2010 to 2015. The cohort consisted of men who underwent bilateral vasovasostomy utilizing a formal two-layer or modified one-layer technique. The primary end points of analysis were total operative time; number, cost and type of suture used,and patency/post-surgical semen analysis. Bivariate analysis was performed for these continuous variables utilizing Wilcoxon rank test and chi-square test for categorical variables. Results: Of the 106 men who underwent bilateral vasovasostomy, 81.1% (86/106) had a formal and 18.9% (20/106) had a modified one-layer repair. The modified one-layer closure resulted in significantly shorter operative time, lower microsuture cost, and lower overall operative cost when compared to formal repair (all p < 0.05). There were no statistically significant differences in semen parameters at first post-operative visit between the two techniques. Conclusions: Modified one-layer vasovasostomy resulted in shorter operative times and lower cost when compared to formal repair without compromise of post-procedure patency. In this era of cost containment, the modified repair provides opportunity to perform vasectomy reversal at lower cost to both patients and providers.
    The Journal of urology 09/2015; DOI:10.1016/j.juro.2015.08.102
  • The Journal of urology 09/2015; DOI:10.1016/j.juro.2015.09.033
  • The Journal of urology 09/2015; DOI:10.1016/j.juro.2015.09.060