Soc. Int. Urol. J., Volume 2, Issue 6 (November 2021) – 8 articles , Pages 339-381

The lower urinary tract (LUT), in particular the prostate, has been theoretically recognized as a target for SARSCoV-2. Moreover, common pathophysiological mechanisms have been described for BPE/LUTS and COVID-19, including RAS dysregulation, androgen receptors, and MetS-related factors. These factors raise concerns about the possibility of worse urological outcomes due to BPE/LUTS progression in COVID-19 patients. The available results suggest a correlation between SARS-CoV-2 infection, exacerbation or new onset of LUTS, and semen impairment. BPE patients’ care and management have been deeply affected by COVID-19. In the midst of the pandemic, the main urological guidelines suggested postponement of BPH-related deferrable medical examinations and surgery. Telemedicine, therefore, gained attention and interest. Clinical evidence of impaired QoL or complications expedited surgical intervention. An informed consent covering the risk of COVID-19 and a negative molecular PCR within 72 hours of surgery were mandatory. A reduction in procedures under general anaesthesia was recommended. Long waiting lists accrued worldwide during the pandemic, leading to regular review of the BPE waiting lists and patients’ clinical status, encouraging the increase of minimally invasive office-based procedures, even in the post-COVID-19 era, and the improvement of telemedicine. Prospective studies are still needed to assess the course of LUTS/BPE patients after COVID-19. Full article

Objective: To evaluate the impact of the “Movember” awareness campaign (men’s health campaign that takes place every November) on internet search trends for information online about prostate cancer and to compare the results with those for “Pinktober” (the breast cancer awareness campaign that takes place in October) in the Spanish language as an indirect measure of its effectiveness. Methods: Google Trends was used to evaluate the monthly relative search volumes (RSV) of the terms “cáncer de próstata” (prostate cancer), “cáncer de mama” (breast cancer), and “Movember” from January 2009 to December 2019 both in Spain and worldwide (in the Spanish language). Breast cancer was used as a comparator of the campaign impact. Mean increase in RSV on-campaign and off-campaign was calculated and compared using the Mann-Whitney U test and Joinpoint regression analysis to assess loss or gain of interest. Results: The term “cáncer de próstata” showed a statistically significant increase during the campaign months both in Spain (17.4%; P < 0.001) and worldwide (35.4%; P < 0.001). Both “cáncer de próstata” and Movember showed a decreasing trend worldwide and in Spain, while “cáncer de mama” showed an increasing trend. Conclusion: The Movember campaign generates a statistically significant increase in the search trends on “cancer de próstata” (prostate cancer) during the month of November (both in Spain and worldwide); when compared with the breast cancer campaign “Pinktober” these increases are of a lesser magnitude but still significant, suggesting that the campaign is effective beyond the English language, although the interest has been decreasing throughout the years. Full article

Objectives: Whilst ambulatory urodynamics (aUDS) may be used as a second-stage test for patients with refractory lower urinary tract symptoms (LUTS) having non-diagnostic conventional urodynamics (UDS), the evidence for their use is limited. We have assessed the diagnostic utility and consequent symptomatic outcome of aUDS in patients with refractory LUTS. Methods: A retrospective review of a prospectively acquired urodynamics database was made of 84 consecutive patients (23 male) with a median age 50.5 years (range 18 to 79) having aUDS following non-diagnostic or contradictory baseline UDS over a 12-month period. Patient demographics and urodynamic and clinical diagnosis before and after aUDS were recorded. Forty-six patients (55%) had formal urinary symptom assessment recorded before and a minimum of 6 months following aUDS-related change in management. Results: Eighty-two patients (98%) had a urodynamic diagnosis made following aUDS, 57(68%) of whom had detrusor overactivity (DO); the final 2 patients had no abnormalities detected on aUDS. Change in primary UDS diagnosis occurred in 66 patients (79%). Of these 66 patients, 59 (89%) also had their clinical diagnosis changed, and 55 (83%) had their management pathway changed. There was a significant improvement in urinary symptoms 6 months following aUDS. Conclusion: Change in primary diagnosis following aUDS led to a significant change in treatment care pathway and resulted in significant improvement in urinary symptoms. Full article

Objectives: To test the hypothesis that a randomised trial of extended pelvic lymph node dissection (ePLND) can recruit at a rate acceptable for a larger scale trial. To compare the following secondary endpoints between the 2 arms: the rate of protocol violations, the intraoperative and postoperative morbidity of ePLND, and complications, and to evaluate short-term oncological outcomes comparing biochemical recurrence, clinical recurrence, and survival between arms. Patients and Methods: A pilot study will be undertaken at Chris O’Brien Lifehouse and Royal Prince Alfred Hospitals for the NODE trial. Twenty patients will be randomised 1:1 to radical prostatectomy with or without ePLND. Eligible participants will have high-risk prostate cancer and will be scheduled for robotic radical prostatectomy. High-risk disease will be defined as in the 2019 NCCN guidelines (stage ≥ T3a, ISUP Grade Group ≥ 4 or PSA ≥ 20ng/mL). PSMA PET/CT staging not showing any extraprostatic disease will be required. Quality control measures to ensure consistent delivery of high-quality extended lymph node dissections are in place, and surgeons have been selected for their consistent ability to perform such procedures. Results: The trial is currently underway. Conclusion: On current available evidence, it is unclear if ePLND provides additional benefit over radical prostatectomy. Full article