Abstracts from the Abstracts from the Mid-Atlantic Section of the AUA 2021

© The Canadian Journal of Urology TM : International Supplement, October 2021 Display Posters Evaluating Factors Associated with Emergency Department Visits within 30 Days Following Elective Ureteroscopy for Nephrolithiasis J. Kane, J. Pham, E. Eidelman, S. Ramedani, J. Clark, A. Kunselman Penn State College of Medicine, Hershey, PA, USA Introduction and Objective: Ureteroscopy (URS) is a common procedure for definitive treatment of kidney stones; however, there is still variation in preoperative, intraoperative, and postoperative care provided for this procedure. This study evaluated factors associated with unplanned emergency department (ED) visits within 30-days post-ureteroscopy for stones. We attempted to identify dominating factors related to return to the ED and readmission to the hospital following this procedure so that we could potentially institute a plan to decrease unplanned ED visits. Methods: Aretrospective chart reviewwas conducted at an academic tertiary care hospital in rural, central Pennsylvania of patients who had URS for nephrolithiasis from2017-2019. Electronic medical records were accessed, and we collected data on 37 factors which included patient demographics, past medical history, stone characteristics, and surgical features from each chart. Univariate analyses were used to determine predictors of unplanned EDvisits. Results: Of 404 patients who had ureteroscopy, 51 patients (12.6%) made ED visits within 30 days of the procedure; there was no statistical significance between any of the observed factors and return to the ED on univariate analysis. Use of access sheath, although not statistically significant, was protective against return to the ED. The most common reasons for ED visits were flank pain (35%), fever (18%), dislodged or migrated stent (12%), and abdominal pain (6%). Of those who visited the ED, 26 (51%) were ultimately admitted to the hospital for various reasons. Conclusions: No single factor predicted ED visits following URS on univariate analyses. Preoperative patient education about expectations following URS and ensuring adequate pain control may decrease ED visits following URS. Utilization of Ambulatory Surgery Center andAcuteManagement Pathway to Improve Stone Treatment Time A. Wang, J. Cecelic, C. McCammon, J. Malcolm, M. Fabrizio Eastern Virginia Medical School, Virginia Beach, CA, USA Introduction and Objective: Patients with acute renal stone disease often have lengthy wait times from emergency department (ED) to urologist to definitive treatment. Along with this increased wait time comes return ED visits due to pain, which become costly and inconvenient. This prompted our team to create a protocol, called Acute Rapid Stone Treatment Pathway or AiRSTRiP, to be used in conjunction with an ambulatory surgery center (ASC) in effort to use a systematic approach to decrease this wait time and lessen the burden associated with renal stone disease. Methods: We reviewed our database of patients who presented to the EDwith renal colic due to a unilateral stone and subsequently underwent lithotripsy or endoscopic procedures after we gained access to an ASC. Data took place dudring an 8-month period from July 2016 to February 2017 using CPT codes. Halfway through the study, we introduced the AiRSTRiP protocol into our large urology group practice. Pre and post-pathway data were compared using Student t-test to assess AiRSTRiP’s ability to decrease wait time and increase ASC utilization. Results: Out of 2075 procedures performed on 1485 patients, 228 patients qualified for our study, including 149 in our pre-pathway cohort and 79 in our post-pathway cohort. The average stone sizes for each cohort were 7.13 and 7.05 mm, respectively. Utilization of theASC increased significantly from 31.5% to 48% following implementation of the pathway (p = 0.014). Wait times from initial ED visits to office follow-up were notably reduced from 6.5 to 4.3 days (p = 0.0319), while ED to treatment time decreased significantly from 22.5 to 14.2 days (p = 0.0018). Conclusions: We have demonstrated for the first time that implementation of a stone management pathway, in combination with access to an ASC, can significantly reduce wait time for follow-up and definitive treatment for stone disease. Early Return to Continence preservedwith Suprapubic Catheter following Retzius-sparing Prostatectomy C. Delgado 1 , K. Muzzi 1 , S. Engelsgjerd 2 , N. Shaw 2 , K. Kowalczyk 2 1 Georgetown University School of Medicine, Washington, DC, USA; 2 MedStar Georgetown Department of Urology, Washington, DC, USA Introduction and Objective: Retzius-sparing RARP (RS-RARP) provides early and durable postoperative continence without sacrificing oncologic control. While suprapubic tube (SPT) have been used in standard RARP, their use (technically easier with RS-RARP) have not been well studied with RS- RARP. We examined post-operative continence outcomes for SPT compared to urethral catheter (UC) after RS-RARP. Methods: We conducted a retrospective review of all RS-RARP from June 2020 to May 2021 to measure the early continence outcomes. Continence was measured using the Expanded Prostate Cancer Index Clinical Practice (EPIC-CP), which defines continence as the use of 0-1 safety pads. Patients with intraoperative complications and salvage prostatectomy were excluded. Results: Forty-four patients met inclusion criteria. Twenty-two patients with SPT and 22 with UC were included. There was no significant difference between groups for demographic or oncologic outcomes (Table 1). Pre- operative overall EPIC scores were similar (7.2 v 6.9), although patients who went on to have UC had higher baseline EPIC-UI scores (0 ± 0.45 v 1 ± 0.92). Patients in both groups had early return to continence (13 ± 18.0 v 37± 53.5). Conclusions: Patients undergoing RS-RARP have early return to continence which is consistent with prior studies. There was an improvement in early continence in the SPT group compared to UC, driven by continence at time of catheter removal that did not reach significance (Figure 1). Placement of SPT following RS-RARP is safe and effective andmay preserve return of early continence. Further study is warranted. DP-11 DP-12 DP-10 50