Benjamin N Breyer

UCSF University of California, San Francisco | UCSF · Department of Urology

Importance Several public recommendations exist regarding the amount of daily water intake, yet the supporting evidence is not clear, and benefits of increasing water consumption are not well-established. Objective To summarize evidence from randomized clinical trials (RCTs) pertaining to the health-related outcomes associated with increased or de...

Objectives To characterise the long‐term success rate of ventral onlay buccal mucosa graft urethroplasty (vBMG) in the management of bulbar urethral stricture disease (USD), assess patient‐reported postoperative satisfaction and decision regret, and delineate clinical factors impacting patient‐reported metrics. Subjects and Methods Patients with p...

Purpose: To compare Fournier gangrene in female and male patients and identify mortality-associated characteristics in both. Materials and methods: We used National Inpatient Sample data (2016-2020) to identify Fournier gangrene cases and extracted demographic, comorbidity, and procedural variables. Multivariable regression models were used to i...

Introduction: We conducted a population-based analysis of Fournier gangrene (FG) to compare risk factors and mortality with those of perineal cellulitis. Methods: We analyzed National Inpatient Sample data (2016-2020) to identify FG and perineal cellulitis cases. Demographic, comorbidity, and procedural data were extracted. Logistic models asses...

Background Consumer product-related genital injuries in females across all age groups are understudied. Existing research focuses primarily on paediatric populations. We aimed to determine characteristics, trends and predictors of hospitalisation. Methods The National Electronic Injury Surveillance System database was queried for female genital in...

Introduction: We sought to determine the utilization of various benign prostatic hyperplasia (BPH) procedures among patients diagnosed with BPH in the US to better understand the dispersion of the various BPH technologies. Methods: The AQUA (AUA Quality) registry was used to identify patients with a diagnosis of BPH from January 2014 to December...

Introduction and objectives: Several factors influence recurrence after urethral stricture repair. The impact of socioeconomic factors on stricture recurrence after urethroplasty is poorly understood. This study aims to assess the impact that social deprivation, an area-level measure of disadvantage, has on urethral stricture recurrence after uret...

Importance Micromobility, the use of small vehicles (primarily scooters and bicycles), has become a standard transportation method in the US. Despite broad adoption of electric micromobility vehicles, there is a paucity of data regarding the injury profiles of these vehicles, particularly in the US. Objective To characterize micromobility injury t...

Purpose: In 2023 the American Urological Association (AUA) requested an Update Literature Review (ULR) to incorporate new evidence generated since the 2019 publication of this Guideline. The resulting 2024 Guideline Amendment addresses updated recommendations to provide guidance for the care of patients with incontinence after prostate treatment (...

Introduction Though urinary incontinence (UI) after prostate treatment often contributes to emotional distress and significantly impacts quality of life, many patients do not discuss this condition with their physicians. We analyzed the patient perspective by examining online support group posts to gain insight into specific challenges associated w...

Introduction: Patient perceptions of physician reimbursement commonly differ from actual reimbursement. This study aims to improve health care cost transparency and trust between patients, physicians, and the health care system by evaluating patient perceptions of Medicare reimbursement for artificial urinary sphincter (AUS) placement. Methods:...

Purpose: Anterior urethral stricture disease (aUSD) is a complex, heterogeneous condition that is idiopathic in origin for most men. This gap in knowledge rarely affects the current management strategy for aUSD, as urethroplasty does not generally consider etiology. However, as we transition towards personalized, minimally invasive treatments for...

Purpose Overactive bladder (OAB) syndrome significantly impairs quality of life, often necessitating pharmacological interventions with associated risks. The fragility of OAB trial outcomes, as measured by the fragility index (FI: smallest number of event changes to reverse statistical significance) and quotient (FQ: FI divided by total sample size...

Background Scant data exists on the impacts of prostate radiation on ejaculatory function. We performed a systematic review and meta-analysis to assess ejaculatory outcomes in men after prostate radiation. Methods We queried PubMed, Embase, and Web of Science to identify 17 articles assessing ejaculatory function post-radiation. The primary outcome...

This cross-sectional study investigates injury trends associated with electric bicycles in the US from 2017 to 2022.

Background This study updates the American Association for Surgery of Trauma (AAST) Organ Injury Scale (OIS) for renal trauma using evidence-based criteria for bleeding control intervention. Methods This was a secondary analysis of a multi-center retrospective study including patients with high grade renal trauma from 7 Level-1 trauma centers from...

BACKGROUND Large language models like GPT-4 have opened new avenues in healthcare and qualitative research. Traditional qualitative methods are time-consuming and require expertise to capture nuance. Although large language models have demonstrated enhanced contextual understanding and inferencing compared to traditional natural language processing...

Prolonged ischemic priapism presents a treatment challenge given the difficulty in achieving detumescence and effects on sexual function. To evaluate current practice patterns, an open, web-based multi-institutional survey querying surgeons’ experience with and perceived efficacy of tunneling maneuvers (corporoglanular tunneling and penoscrotal dec...

Purpose: We evaluate the efficacy and safety profiles of currently available conservative management options for penile and urethral lichen sclerosus. Materials and methods: A systematic review of existing literature on lichen sclerosus was conducted utilizing the PubMed, Embase, and Web of Science databases. References were assessed for relevan...

Objectives To explore the context in which older men navigate treatment for stress urinary incontinence (SUI) following prostate surgery by characterizing lived experience of men with symptomatic SUI. Subjects/Patients and Methods Mixed method study using surveys and semistructured interviews to examine a cohort of men who underwent evaluation for...

Background Pediatric renal trauma is rare and lacks sufficient population-specific data to generate evidence-based management guidelines. A non-operative approach is preferred and has been shown to be safe. However, bleeding risk assessment and management of collecting system injury is not well understood. We introduce the Multi-institutional Pedia...

Purpose To explore the differences of priapism events among a diverse cohort taking erectogenic medicines (i.e., phosphodiesterase type 5 inhibitors [PDE5i] and intracavernousal drugs). Method s We queried the World Health Organization global database of individual case safety reports (VigiBase) for records of the adverse drug reactions (ADR) with...

Background Hemorrhagic cystitis (HC) is an inflammatory disease of the bladder with sustained hematuria for which there is currently no approved drug treatment. We evaluated a liposomal tacrolimus preparation (LP-10) in patients with refractory moderate to severe sterile HC. Methods This phase 2a dose-escalation study assessed the safety and effic...

Objectives: To describe the characteristics, management, and functional outcomes of patients with synchronous urethral stricture disease (SUSD) utilizing a multi-institutional cohort. Methods: Data were collected and assessed from a prospectively maintained, multi-institutional database. Patients who underwent anterior urethroplasty for USD were...

Objective: To contextualize the challenges that persons with congenital genitourinary conditions (CGC) may encounter in adulthood, we examined healthcare access, readiness for self-management, and healthcare utilization of adults with spina bifida (SB). Methods: Through surveys distributed via social media, persons with SB were asked about acces...

Haemorrhagic cystitis (HC) is characterised by persistent haematuria and lower urinary tract symptoms following radiotherapy or chemotherapy. Its pathogenesis is poorly understood but thought to be related to acrolein toxicity following chemotherapy or fibrosis/vascular remodelling after radiotherapy. There is no standard of care for patients with...

Objectives: To systematically compare success, cure and complication rates of urethral sling surgeries in stress urinary incontinence patients with and without a history of pelvic radiotherapy (RT). Materials and methods: We searched PUBMED, EMBASE, and Web of Science to identify relevant articles. The primary outcomes were the success and cure...

Background: To report objective long-term complications and health related quality of life (HRQOL) outcomes after radical prostatectomy (RP) with and without radiation therapy (RT) for prostate cancer (CaP). Methods: We analyzed patients diagnosed with CaP who underwent RP from the UCSF Cancer of the Prostate Strategic Urologic Research Endeavor...

Objective: To clinically validate a previously developed adult acquired buried penis (AABP) classification system that is based on a standardized pre-operative physical exam that subtypes patients by their penile skin/escutcheon complex (P), abdominal pannus (A) and scrotal skin (S). Methods: The Trauma and Urologic Reconstruction Network of Sur...

Purpose To investigate management trends for American Association for the Surgery of Trauma (AAST) grade V renal trauma with focus on non-operative management. Methods We used prospectively collected data as part of the Multi-institutional Genito-Urinary Trauma Study (MiGUTS). We included patients with grade V renal trauma according to the AAST In...

Patient and provider race and gender concordance (patient and physician identify as the same race/ethnicity or gender) may impact patient experience and satisfaction. We sought to examine how patient and physician racial and gender concordance effect patient satisfaction with outpatient clinical encounters. Furthermore, we examined factors that cha...

Background: As perception of penile curvature varies widely, we sought to understand how adults perceive curvature and how these opinions compare with those of patients with curvature, specifically Peyronie's disease (PD). Aim: To investigate the perspectives of curvature correction from adults with and without PD, as well as differences within...

Objective: To study the prevalence and management of shattered kidney and to evaluate if the new description of "loss of identifiable renal anatomy" in the 2018 American Association for the Surgery of Trauma (AAST) organ injury scale (OIS) would improve the ability to predict bleeding control interventions. Methods: We used high-grade renal trau...

Introduction Perception of penile curvature (PC) varies widely, and correction of PC is in the eye of the beholder. Objective We sought to investigate if patients with Peyronie’s Disease (PD) had differing opinions on correction of PC compared to general andrology (AD) patients without PD and general urology (URO) patients. Methods A cross-sectio...

Introduction: Patient satisfaction has been shown to changes based on the distance a patient to see their physician. We sought to examine the effects of telehealth on patient satisfaction. Methods: We examined patient satisfaction survey scores from outpatient clinics at University of California, San Francisco. Patient home and clinic addresses wer...

Background: Male stress urinary incontinence (SUI) is a known complication following surgical intervention on the prostate, particularly following surgery for prostate cancer. Effective surgical treatments for SUI include artificial urinary sphincter (AUS) and male urethral sling. Prior data suggest that men may forego available treatment despite...

Objective: To assess the long-term incidence of treatment-related toxicities and quality of life (QOL) outcomes associated with toxicity after external beam radiotherapy (EBRT) for prostate cancer. Methods: We identified all men who had EBRT between 1994-2017 from CaPSURE, a longitudinal, nationwide prostate cancer registry. CaPSURE was queried...

Objectives: To understand the effect of bicycle saddle shape and size on the pressure transmitted to the perineum, as prolonged perineal pressure and microtrauma amongst avid cyclists may increase the risk for complications following lower genitourinary surgery. Methods: We tested five seats (Bontrager, Waterloo, WI) with varying levels of paddi...

Background: Frailty is common among urology patients in general as well as among men seeking evaluation for stress urinary incontinence (SUI), with 6.1% of men undergoing artificial urinary sphincter placement considered frail. It is unclear if and how patient views on frailty and incontinence severity impact decision-making with regards to SUI tr...

Background We aimed to examine the association between patient age and procedural intervention, especially nephrectomy, in patients with renal trauma in the National Trauma Data Bank (NTDB). Study design We queried the 2013–2020 NTDB for adult renal trauma patients with an American Association for the Surgery of Trauma (AAST) grade. Patients withou...

Objective: To investigate which treatment attributes matter to patients with stress urinary incontinence (SUI), why and how they matter, and the context in which patients consider treatment attributes. Nearly a quarter of older men have decisional regret following SUI treatment. Knowledge of what matters to patients when making SUI treatment decis...

Purpose: To explore the differences among erectile aids (i.e., phosphodiesterase type 5 inhibitors [PDE5i] and intracavernousal drugs) of the relative risk of priapism and identify age groups at risk. Methods: We queried the World Health Organization global database of individual case safety reports (VigiBase) for records of the ADR with sildenafil...

Background: Despite their efficacy and general safety, rare but devastating adverse drug reactions (ADR) have been associated with phosphodiesterase type 5 inhibitors (PDE5is). Objectives: To determine the safety profile of oral PDE5is with a particular focus on priapism and malignant melanoma. Materials and methods: In this case-non-case stud...

Objective: To systematically aggregate and summarize existing data on fistula prevalence among patients with a history of pelvic radiotherapy for prostate cancer. Materials and methods: We queried PubMed, Embase, and Web of Science on October 7, 2020 for peer-reviewed publications pertaining to radiation-induced fistulas in the pelvis. For meta-...

Purpose: To assess the use of conservative management for American Association for the Surgery of Trauma (AAST) grade V renal trauma in the National Trauma Databank (NTDB). Materials and methods: We used data of grade V renal trauma patients in the 2017-2019 NTDB. Conservative management was defined by the absence of surgical or procedural inter...

Purpose Although circumcision is the most commonly performed surgery in males, less is known about the incidence and indications of adult circumcision. In this study, we aim to present the incidence of adult circumcision across the United States. Methods Using IBM MarketScan® Commercial Database from 2015 to 2018, we obtained claims for circumcisi...

Background: Pelvic fracture urethral injury (PFUI) occurs in up to 10% of pelvic fractures. There is mixed evidence supporting early endoscopic urethral realignment (EUR) over suprapubic tube (SPT) placement and delayed urethroplasty. Some studies show decreased urethral obstruction with EUR, while others show few differences. We hypothesized that...

Objectives To determine patient outcomes across a range of pelvic fracture urethral injury (PFUI) severity. PFUI is a devastating consequence of a pelvic fracture. No study has stratified PFUI outcomes based on severity of the urethral distraction injury. Methods Adult male patients with blunt-trauma-related PFUI were followed prospectively for a...

Purpose We aimed to provide a thorough comparative review of the available guidelines on the diagnosis, management, and follow-up for patients with posterior urethral stenosis by the American Urologic Association (2016), Société Internationale d’Urologie (2010), and European Urologic Association (2022). Methods The AUA, SIU, and EAU guidelines wer...