Scholars@Duke
Vishnukamal Golla

Vishnukamal Golla

Medical Assistant Professor in the Department of Urology
Urology

Selected Publications

Payment Bundles for Prostatectomy: A New Way to Improve Value for Prostate Cancer Care.

Journal Article Urology · September 2025 American healthcare expenditures exceed $4 trillion annually, with prostate cancer (PCa) accounting for $22 billion. Prostatectomy, a common treatment for PCa, incurs significant cost variability. Value-based care (VBC), emphasizing outcomes and efficiency ... Full text Link to item Cite

Design of Payment and Reimbursement Strategies for Focal Therapy for Acceptance in Value-Based Care Models

Chapter · January 1, 2025 Value-based care payment models provide an opportunity to curb rising healthcare costs. However, there are limited examples of these models in practice for specialty care, even for common and expensive urologic conditions, such as prostate cancer. As the u ... Full text Cite

Long-Term Trends in Decisional Regret Among Men with Localized Prostate Cancer

Journal Article JU Open Plus · April 2024 Purpose:There are several evidence-based treatment options for localized prostate cancer (PCa). Decisional regret (DR), or regret based on the treatment a patient chooses, is poorly under ... Full text Cite

Rural For-Profit Hospitals Are Associated With Higher Commercial Prices for 3 Common Urological Procedures.

Journal Article Urol Pract · November 2023 INTRODUCTION: Rural patients lack access to urological services, and high local prices may dissuade underinsured patients from surgery. We sought to describe commercially insured prices for 3 urological procedures at rural vs metropolitan and for-profit vs ... Full text Link to item Cite

Financial Health of People Living With Dementia and Their Informal Care Partners: Protocol for a Mixed Methods Study.

Journal Article JMIR Res Protoc · July 11, 2023 BACKGROUND: There is a growing body of academic literature focusing on the significant financial burdens placed on people living with cancer, but little evidence exists on the impact of rising costs of care in other vulnerable populations. This financial s ... Full text Link to item Cite

Merit-based Incentive Payment System Quality Reporting in Urology Practices.

Journal Article Urol Pract · May 2023 INTRODUCTION: Most urologists are required to participate in Merit-based Incentive Payment System-an alternative payment model in which physicians must track and report quality measures. However, Merit-based Incentive Payment System measures are urology-sp ... Full text Link to item Cite

Association of Rural Hospital for-Profit Status With Higher Publicly Reported Prices for the Components of Inpatient Hematuria Evaluation Among Commercially Insured Patients.

Journal Article Urol Pract · March 2023 INTRODUCTION: Rural patients have limited access to urological care and are vulnerable to high local prices. Little is known about price variation for urological conditions. We aimed to compare reported commercial prices for the components of inpatient hem ... Full text Link to item Cite

Association Between Cancer Center Accreditation and Compliance With Price Disclosure of Common Oncologic Surgical Procedures.

Journal Article J Natl Compr Canc Netw · November 2022 BACKGROUND: Cancer center accreditation status is predicated on several factors that measure high-value healthcare. However, price transparency, which is critical in healthcare decisions, is not a quality measure included for accreditation. We reported the ... Full text Link to item Cite

Long term cost comparisons of radical cystectomy versus trimodal therapy for muscle-invasive bladder cancer.

Journal Article Urol Oncol · June 2022 BACKGROUND: Earlier studies on the cost of muscle-invasive bladder cancer treatments are limited to short-term costs of care. We determined the 2- and 5-year costs associated with trimodal therapy (TMT) vs. radical cystectomy (RC). METHODS: We performed a ... Full text Link to item Cite

Access to Urological Care for Medicaid-Insured Patients at Urology Practices Acquired by Private Equity Firms.

Journal Article Urology · June 2022 OBJECTIVE: To characterize appointment access for Medicaid-insured patients seeking care at urology practices affiliated with private equity firms in light of the recent national trends in practice consolidation. METHODS: We identified 214 urology offices ... Full text Link to item Cite

The Impact of Health Delivery Integration on Cancer Outcomes.

Journal Article Surg Oncol Clin N Am · January 2022 Although integrated health care has largely been associated with increases in prices and static or decreased quality across many disease states, it has shown some successes in improving cancer care. However, its impact is largely equivocal, making consensu ... Full text Link to item Cite

The role of neoadjuvant chemotherapy, lymph node dissection, and treatment delay in patients with muscle-invasive bladder cancer undergoing partial cystectomy.

Journal Article Urol Oncol · August 2021 OBJECTIVES: To investigate treatment patterns of partial cystectomy (PC), neoadjuvant chemotherapy (NAC), lymph node dissection (LND), and treatment delays, and the associations with overall survival (OS) among patients with muscle-invasive bladder cancer. ... Full text Link to item Cite

Trends in management of ureteral urothelial carcinoma and effects on survival: a hospital-based registry study.

Journal Article Urol Oncol · March 2021 BACKGROUND: High-risk ureteral tumors represent an understudied subset of upper tract urothelial carcinoma, whose surgical management can range from a radical nephroureterectomy (NU) to segmental ureterectomy (SU). OBJECTIVES: To evaluate contemporary tren ... Full text Link to item Cite

Peripherally Acting μ-Opioid Receptor Antagonists in the Management of Postoperative Ileus: a Clinical Review.

Journal Article J Gastrointest Surg · January 2021 Postoperative ileus (POI) and constipation are common secondary effects of opioids and carry significant clinical and economic impacts. μ-Opioid receptors mediate opioid analgesia in the central nervous system (CNS) and gastrointestinal-related effects in ... Full text Link to item Cite

Oncological Monitoring of NonMuscle Invasive Bladder Cancer (NMIBC)

Chapter · January 1, 2021 Bladder cancer is the most common urinary tract malignancy and the fifth leading new cancer diagnosis in the United States. Nonmuscle-invasive bladder cancer (NMIBC) comprises the majority of these cases and is known for its varying oncological outcomes an ... Full text Cite

The Role of Opioids and Their Receptors in Urological Malignancy: A Review.

Journal Article J Urol · December 2020 PURPOSE: We reviewed the literature surrounding the role of opioids and their receptors in urological malignancy. Recent studies have suggested clinically significant effects of agonism or antagonism of opioid receptors on cancer related outcomes and tumor ... Full text Link to item Cite

The association between N-methylnaltrexone, a peripherally acting mu-opioid receptor antagonist, and clinical outcomes in patients undergoing robotic-assisted radical cystectomy.

Journal Article World J Urol · December 2020 PURPOSE: To assess the impact of N-methylnaltrexone, a peripherally acting mu-opioid receptor antagonist, on the post-operative recovery of patients undergoing robotic-assisted radical cystectomy for bladder cancer. METHODS: We retrospectively reviewed pat ... Full text Link to item Cite

Trends in palliative care interventions among patients with advanced bladder, prostate, or kidney cancer: A retrospective cohort study.

Journal Article Urol Oncol · November 2020 BACKGROUND: Palliative care has an established role in improving the quality of life in patients with advanced cancer, but little is known regarding its delivery among patients with urologic malignancies. OBJECTIVE: To determine trends in the utilization o ... Full text Link to item Cite

Predictors of adequate lymph node dissection in patients with non-muscle invasive bladder cancer undergoing radical cystectomy and effect on survival.

Journal Article Urol Oncol · October 2020 INTRODUCTION: Radical cystectomy (RC) is the standard of care for refractory high-risk non-muscle invasive bladder cancer (NMIBC). We aim to identify predictors of adequate lymph node dissection (LND) in a cohort of NMIBC patients undergoing RC, as well as ... Full text Link to item Cite

Analysis of guideline recommended use of renal mass biopsy and association with treatment.

Journal Article Can J Urol · August 2020 INTRODUCTION: Renal mass biopsy (RMB) may not be indicated when the results are unlikely to impact management, such as in young and/or healthy patients and in elderly and/or frail patients. We analyzed the utility of RMB in three patient cohorts stratified ... Link to item Cite

Impact of Diagnosing Urologists and Hospitals on the Use of Radical Cystectomy.

Journal Article Eur Urol Open Sci · July 2020 BACKGROUND: One out of five patients with muscle-invasive bladder cancer undergo radical cystectomy-a guideline-recommended treatment. Previous studies have primarily evaluated patient characteristics associated with the use of radical cystectomy, ignoring ... Full text Link to item Cite

Positive surgical margins at radical prostatectomy in the United States: Institutional variations and predictive factors.

Journal Article Urol Oncol · January 2020 INTRODUCTION: Positive surgical margins (PSMs) are associated with treatment failure after radical prostatectomy (RP) for patients with prostate cancer (CaP). We investigated institutional variations in PSM after RP, as well as clinical and demographic fac ... Full text Link to item Cite

Predicting Short-term Outcomes After Radical Cystectomy Based on Frailty.

Journal Article Urology · November 2019 OBJECTIVE: To evaluate the impact of frailty on adverse perioperative outcomes in patients treated with radical cystectomy for bladder cancer. MATERIAL AND METHODS: We identified 9459 adults (age ≥18) in the Nationwide Readmission Database who underwent ra ... Full text Link to item Cite

Financial Margins for Prostate Cancer Surgery: Quantifying the Impact of Modifiable Cost Inputs in an Episode Based Reimbursement Model.

Conference J Urol · September 2019 PURPOSE: The United States health care system is rapidly moving away from fee for service reimbursement in an effort to improve quality and contain costs. Episode based reimbursement is an increasingly relevant value based payment model of surgical care. W ... Full text Link to item Cite

Cytoreductive nephrectomy in patients with metastatic renal cell carcinoma and venous thrombus-Trends and effect on overall survival.

Journal Article Urol Oncol · September 2019 PURPOSE: Patients with metastatic renal cell carcinoma (mRCC) commonly present with tumor thrombi in the renal vein and inferior vena cava (IVC). The benefit of cytoreductive nephrectomy (CN) in this population is unclear and the effect on overall survival ... Full text Link to item Cite

Absence of Tumor on Repeat Transurethral Resection of Bladder Tumor Does Not Predict Final Pathologic T0 Stage in Bladder Cancer Treated with Radical Cystectomy.

Journal Article Eur Urol Focus · September 2018 BACKGROUND: For patients with bladder cancer (BC) receiving neoadjuvant chemotherapy (NAC), complete pathologic absence of tumor (pT0) at radical cystectomy (RC) is associated with better survival. It is unclear if pT0 status can be attributed to the absen ... Full text Link to item Cite

Laparoscopic and Robotic Techniques for Repair of Female Genitourinary Fistulas

Chapter · January 1, 2018 A genitourinary fistula in women is an abnormal communication that may occur between the ureter, bladder, or urethra and the uterus, cervix, or vagina. Fistulas typically present with continual urinary incontinence of varying degree. While in developing co ... Full text Cite

Testosterone Therapy on Active Surveillance and Following Definitive Treatment for Prostate Cancer.

Journal Article Curr Urol Rep · July 2017 PURPOSE OF REVIEW: Previously considered an absolute contraindication, the use of testosterone therapy in men with prostate cancer has undergone an important paradigm shift. Recent data has changed the way we approach the treatment of testosterone deficien ... Full text Link to item Cite

Sipuleucel-T for metastatic castration-resistant prostate cancer

Journal Article Cochrane Database of Systematic Reviews · June 22, 2016 This is the protocol for a review and there is no abstract. The objectives are as follows: To assess the effects of sipuleucel-T for metastatic castration-resistant prostate cancer. ... Full text Cite

Risk factors for recurrence after surgery in non-metastatic RCC with thrombus: a contemporary multicentre analysis.

Journal Article BJU Int · June 2016 OBJECTIVE: To determine the predictors of post-surgical recurrence for patients with non-metastatic renal cell carcinoma (RCC) and venous thrombus. METHODS: Records from consecutive patients with non-metastatic RCC with tumour thrombus, treated surgically ... Full text Link to item Cite

Sipuleucel-T for metastatic castration-resistant prostate cancer

Journal Article Cochrane Database of Systematic Reviews · January 21, 2016 This is the protocol for a review and there is no abstract. The objectives are as follows: To assess the effects of sipuleucel-T for metastatic castration-resistant prostate cancer. ... Full text Cite

Preoperative predictors of pathological lymph node metastasis in patients with renal cell carcinoma undergoing retroperitoneal lymph node dissection.

Journal Article J Urol · April 2015 PURPOSE: Patients with locally advanced renal cell carcinoma represent a subset that may benefit from retroperitoneal lymph node dissection. We identified preoperative clinical predictors of positive lymph nodes in patients with renal cell carcinoma withou ... Full text Link to item Cite

Primary prevention of bladder cancer: Does the public know the risk factors?

Conference Journal of Clinical Oncology · March 1, 2015 366 Background: Smoking is the single most significant modifiable risk factor for bladder cancer, yet this is not well known outside of the medical community. Previous studies from tertiary referral centers have found that 36-58% ... Full text Cite

Outcomes in patients with p0 versus PCIS on final cystectomy pathology.

Conference Journal of Clinical Oncology · February 1, 2014 312 Background: For patients with superficial bladder cancer, the presence of Carcinoma in situ (CIS) is known to increase the risk of subsequent upper tract recurrence. In this study, we focused on patients with no residual inva ... Full text Cite