Background Infection is the most feared complication of a penile prosthesis. Diabetes mellitus (DM) is widely known to increase the risk of several infections, but its role in the penile prosthesis is still controversial. This systematic review aims to show the contemporary scenario of penile prosthesis infection and present a meta-analysis about DM contribution to penile prosthesis infection. Methods The review was performed with no language or time limitation, including ten databases. The included articles were about the male population who received a penile prosthesis with no model restriction, with a minimum follow up of 1 year, and outcomes adequately reported. Results The mean infection incidence of penile prosthesis ranged from 0.33 to 11.4%. In early 2000, the general incidence of infection was 3 to 5%, then, the introduction of coated materials decreased it to 0.3 to 2.7%. The meta-analysis showed that diabetes mellitus is related to an increased risk of penile prosthesis infection with an odds ratio of 1.53 (95% CI 1.15–2.04). Conclusions Penile prosthesis infection decreased in the last decades but remains a significant cause of reoperation, and it is related to lower prosthesis survival. Meta-analysis concludes that diabetes mellitus is related to a higher risk of penile prosthesis infection.

Objectives To evaluate the clinical practice of non-muscle invasive bladder cancer (NMIBC) treatment in Brazil in relation to international guidelines: Sociedade Brasileira de Urologia (SBU), European Association of Urology (EAU) and American Urological Association (AUA).Materials and Methods Cross-sectional study using questionnaires about urological practice on treatment of NMIBC during the 32nd Brazilian Congress of Urology. A total of 650 question forms were answered.Results There were 73% of complete answers (total of 476 question forms). In total, 246 urologists (51.68%) lived in the southeast region and 310 (65.13%) treat 1 to 3 cases of NMIBC per month. Low risk cancer: Only 35 urologists (7.5%) apply the single intravesical dose of immediate chemotherapy with Mitomicin C recommended by the above guidelines. Adjuvant therapy with BCG 2 to 4 weeks after TUR is used by 167 participants (35.1%) and 271 urologists (56.9%) use only TUR. High risk tumors: 397 urologists (83.4%) use adjuvant therapy, 375 (78.8%) use BCG 2 to 4 weeks after TUR, of which 306 (64.3%) referred the use for at least one year. Intravesical chemotherapy with Mitomicin C (a controversial recommendation) was used by 22 urologists (4.6%). BCG dose raised a lot of discrepancies. Induction doses of 40, 80 and 120mg were referred by 105 (22%), 193 (40.4%) and 54 (11.3%) respectively. Maintenance doses of 40, 80 and 120mg were referred by 190 (48.7%), 144 (37.0%) and 32 (8.2%) urologists, respectively. Schemes of administration were also varied and the one cited by SWOG protocol was the most used: 142 (29.8%).Conclusion SBU, EAU and AUA guidelines are partially respected by Brazilian urologists, particularly in low risk tumors. In high risk tumors, concordance rates are comparable to international data. Further studies are necessary to fully understand the reasons of such disagreement.

Purpose: To evaluate mini-sling long-term results and correlate them to failure predictors. Many studies show comparable results among different single-incision slings developed as an attempt to reduce complications while keeping good results, but there is a lack of evidence about mini-slings outcomes in the long term. Methods: This prospective, single-center study evaluated 40 patients for long-term outcomes after mini-sling placement. Objective cure was defined as leakage of less than 1 g in 1-hour pad-test and no leakage at Valsalva maneuver. An objective improvement was defined as leakage of a maximum 50% of the preoperative test. Subjective continence was considered as a zero score at International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF). Patients were also evaluated for comorbidities and previous surgeries. Results: The mean age was 56 (±9.3) years, the mean ICIQ-SF score was 16 (±2.98) before surgery and 3.5 (± 5) at last follow-up, showing sustained improvement in the long term, mean 100 (84–109) months follow-up. The objective results show 67.5% of success, 17.5% of improvement, and 15% of failure. Age and parity were not related to outcomes (p = 0.33), but previous surgeries increase failure rate with 5.66 OR (p = 0.04). Success, improvement, and failure rates were 85, 10, and 5% for treatment-naive patients versus 50, 25, and 25% for patients with previous surgeries, respectively. Conclusion: Mini-sling Ophira shows good long-term results with low complications rates in patients without previous anti-incontinence surgery. Randomized trials are necessary to compare mini-slings results to other mid-urethral slings in recurred stress urinary incontinence.

Background: Infection is the most feared complication of penile prosthesis. Diabetes mellitus is a well known to increase risk of several kinds of infection, but its role upon penile prosthesis is not defined. The aim of this systematic review is to show the contemporary scenario of penile prosthesis infection and perform a meta-analysis about diabetes mellitus contribution to penile prosthesis infection. Methods: the review was performed with no language or time limitation, in 10 data bases. There were included articles about male population who received a penile prosthesis with no model restriction, with a minimum follow up of one year and proper outcomes report. Results: The mean incidence of infection after penile prosthesis implant ranged from 0.33 to 11.4%. In early 2000, after several improvements, the general incidence of infection was 3 to 5%. Then, the introduction of coated materials decreased infection to 0.3 to 2.7% . Also, no touch technique and centers of reference with high volume surgeons contributed to reduce infection rates. Meta-analysis showed that diabetes mellitus increases penile prosthesis infection with odds ratio of 1.56 (95% CI: 1.12 - 2.044). Conclusions: Penile prosthesis infection decreased in the last decades, but remains an important cause of reoperation and it is related to lower prosthesis survival. Meta-analysis concludes that diabetes mellitus increases penile prosthesis infection and it should be considered as a risk factor.