Management of urethral strictures: A nationwide survey of urologists in the Kingdom of Saudi Arabia

Context: urethral strictures commonly occur and considered difficult to manage due to high recurrence rate and wide variety of management approach. Aims: This study aims to identify how urologists in Saudi Arabia manage new and recurrent urethral stricture cases and to investigate their opinions regarding urethroplasty. Settings and Design: A cross-sectional study (Online Survey) among urologists. Subjects and Methods: A nationwide survey of urologists registered with the Saudi Commission for Health Specialties was performed through a mailed questionnaire. A total of 603 urologists were selected from all five regions of Saudi Arabia, of whom 216 (35.8%) completed the questionnaire. Statistical Analysis Used: SPSS software version 23 was used for data entry and analysis. Results: Most urologists (40.3%) had treated 1–5 urethral strictures in the past year. The most common procedures used to manage urethral strictures were visual urethrotomy (82.4%), cystoscopy and dilatation (62.2%), and excision and primary anastomosis (20.8%). Minimally invasive procedures were used more frequently than any open urethroplasty techniques. Most urologists (63%) did not perform urethroplasty surgery, and 21.8% were not aware of any adult reconstructive urologists in Saudi Arabia. When used, however, the most commonly performed urethroplasty surgeries were excision and primary anastomosis, dorsal buccal graft augmented urethroplasty, and ventral buccal graft augmented urethroplasty. Conclusions: Minimally invasive methods are easy to perform and have good short-term outcomes. As such, they are more commonly used for the management of urethral strictures. On the other hand, urethroplasty surgeries are challenging procedures that require greater experience and skill

Updates in the pathophysiology of COVID-19 infection in male reproductive and sexual health: a literature review

This extensive comprehensive review explores the impact of the Coronavirus disease 2019 (COVID-19) pandemic on men’s sexual and reproductive health. We conducted a literature review focusing on the possible pathophysiology by which severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) affects men’s sexual and reproductive systems. We reviewed most of the studies that reported the impact of SARS-CoV-2 infection on the Testicular, Epididymal, Prostatic, and Penile tissue. Also, we focused on evaluating the SARS-CoV-2 infection on semen parameters and male reproductive hormones. Finally, we reviewed the COVID-19 vaccine’s effect on male reproductive and sexual health. Findings revealed the adverse consequences of SARS-CoV-2 at cellular and organ levels on the male genital tract. However, the reported data are still controversial. The initial data regarding COVID-19 vaccination was promising promoted safety for men’s reproductive and sexual health. We conclude this paper by offering recommendations to address these adverse consequences and potentially improve sexual and reproductive health among men in the post-COVID-19 pandemic era

SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study

Background: Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods: The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18-49, 50-69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results: NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst case 3066). NNVs for surgical patients remained favourable at a range of SARS-CoV-2 incidence rates in sensitivity analysis modelling. Globally, prioritizing preoperative vaccination of patients needing elective surgery ahead of the general population could prevent an additional 58 687 (best case 115 007, worst case 20 177) COVID-19-related deaths in 1 year. Conclusion: As global roll out of SARS-CoV-2 vaccination proceeds, patients needing elective surgery should be prioritized ahead of the general population