Factors Affecting De Novo Urinary Retention after Holmium Laser Enucleation of the Prostate

Objective Patients can experience urinary retention (UR) after Holmium laser enucleation of the prostate (HoLEP) that requires bladder distension during the procedure. The aim of this retrospective study is to identify factors affecting the UR after HoLEP. Materials and Methods 336 patients, which underwent HoLEP for a symptomatic benign prostatic hyperplasia between July 2008 and March 2012, were included in this study. Urethral catheters were routinely removed one or two days after surgery. UR was defined as the need for an indwelling catheter placement following a failure to void after catheter removal. Demographic and clinical parameters were compared between the UR (n = 37) and the non-urinary retention (non-UR; n = 299) groups. Results The mean age of patients was 68.3 (±6.5) years and the mean operative time was 75.3 (±37.4) min. Thirty seven patients (11.0%) experienced a postoperative UR. UR patients voided catheter free an average of 1.9 (±1.7) days after UR. With regard to the causes of UR, 24 (7.1%) and 13 (3.9%) patients experienced a blood clot-related UR and a non-clot related UR respectively. Using multivariate analysis (p<0.05), we found significant differences between the UR and the non-UR groups with regard to a morcellation efficiency (OR 0.701, 95% CI 0.498–0.988) and a bleeding-related complication, such as, a reoperation for bleeding (OR 0.039, 95% CI 0.004–0.383) or a transfusion (OR 0.144, 95% CI 0.027–0.877). Age, history of diabetes, prostate volume, pre-operative post-void residual, bladder contractility index, learning curve, and operative time were not significantly associated with the UR (p>0.05). Conclusions De novo UR after HoLEP was found to be self-limited and it was not related to learning curve, patient age, diabetes, or operative time. Efficient morcellation and careful control of bleeding, which reduces clot formation, decrease the risk of UR after HoLEP.

Characterization of a Novel Mouse Phenotype with Marked Hydrocephalus

In multigenic diseases, disorders where mutations in multiple genes affect the expressivity of the disease, genetic interactions play a major role in prevalence and phenotypic severity. While studying the genetic interactions between Pax3 and EdnrB in the melanocyte lineage, a new phenotype was noted in 80% of Pax3 mutants that we believe to be a novel murine model for hydrocephalus. Hydrocephalus, an accumulation of cerebrospinal fluid in the cranial cavity due to obstruction of flow in and out of the cavity, is one of the most common birth defects surpassing Down syndrome. Characteristic to hydrocephalus is a "domed" head appearance, expansion of the ventricles of the brain, and loss of neurons with hyperproliferation of glial cell types all three of which were seen in the mutant mice. The phenotype also consisted of craniofacial deformities coupled with skeletal defects including, but not limited to kyphosis, lordosis, and an apparent shortening of the some limbs. For the cellular analysis of the hydrocephalus phenotype, brains were removed and stained with two antibodies: Glial Fibrillary Acidic Protein (GFAP) and Neurofilament (NF), which are astrocyte- and neuron- specific respectively. A higher number of cells expressing GF AP and a lower number of cells expressing NF were seen in the mutant brain, when compared to control. For skeletal deformity analysis, affected mice skeletons were stained with Alizarin Red and Alcian Blue showing no apparent difference in ossification. Future genetic analysis of these mutant mice has the potential to identify novel gene modifiers involved in the promotion of this particular phenotype.

Workplace Discrimination Climate and Team Effectiveness: The Mediating Role of Collective Value Congruence, Team Cohesion, and Collective Affective Commitment

This study explored the relationship between workplace discrimination climate on team effectiveness through three serial mediators: collective value congruence, team cohesion, and collective affective commitment. As more individuals of marginalized groups diversify the workforce and as more organizations move toward team-based work (Cannon-Bowers & Bowers, 2010), it is imperative to understand how employees perceive their organization’s discriminatory climate as well as its effect on teams. An archival dataset consisting of 6,824 respondents was used, resulting in 332 work teams with five or more members in each. The data were collected as part of an employee climate survey administered in 2011 throughout the United States’ Department of Defense. The results revealed that the indirect effect through M1 (collective value congruence) and M2 (team cohesion) best accounted for the relationship between workplace discrimination climate (X) and team effectiveness (Y). Meaning, on average, teams that reported a greater climate for workplace discrimination also reported less collective value congruence with their organization (a1 = -1.07, p < .001). With less shared perceptions of value congruence, there is less team cohesion (d21 = .45, p < .001), and with less team cohesion there is less team effectiveness (b2 = .57, p < .001). In addition, because of theoretical overlap, this study makes the case for studying workplace discrimination under the broader construct of workplace aggression within the I/O psychology literature. Exploratory and confirmatory factor analysis found that workplace discrimination based on five types of marginalized groups: race/ethnicity, gender, religion, age, and disability was best explained by a three-factor model, including: career obstruction based on age and disability bias (CO), verbal aggression based on multiple types of bias (VA), and differential treatment based on racial/ethnic bias (DT). There was initial support to claim that workplace discrimination items covary not only based on type, but also based on form (i.e., nonviolent aggressive behaviors). Therefore, the form of workplace discrimination is just as important as the type when studying climate perceptions and team-level effects. Theoretical and organizational implications are also discussed.