The prevalence and estimated incidence of chronic prostatitis/chronic pelvic pain syndrome in urological hospital outpatients in Italy are high. The syndrome is closely related to lifestyle, diet, smoking, gastrointestinal or anorectal disease and impaired sexual function.

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PURPOSE:To evaluate the effect of a1-adrenergic receptor antagonists (a1-ARAs) on pupil diameter and determine whether the diameter predicts intraoperative floppy-iris syndrome (IFIS).

TURP had no negative impact on erectile function in contrast to ejaculatory function. Of the 109 patients with good erectile function in pre-TURP, 5.8% reported a worsening of erectile function after TURP. Among the 136 patients with ED moderate/mild pre-TURP 3.7% reported a worsening in the post-TURP, 16.2% reported an improvement, while 9.5% stopped any sexual activity. In 3.7% of the cases a complete ED was reported after TURP, while a decline of libido and sexual satisfaction was detected in all patients with worsening of sexual function. Retrograde ejaculation was observed in 48% of those sexually active after TURP. Particular attention has to be paid to the psychological aspects, both before surgery and in the postoperative period, which may become an important factor in the decline of sexual activity.

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Objective: To assess the proportion of patients with Peyronie's Disease (PD) and the possible association with its potential risk factors in the general population of the central and western Sicily in our weekly andrological outpatient clinic. Materials and methods: We recruited a sample of 279 consecutive patients consulting our andrological outpatient clinic. Two arms were created: the first one composed by PD patients (men with symptoms suggestive for PD), the second one composed by patients with other andrological diseases (control arm). For each patient we evaluated the age, cigarette smoking, diabetes, blood hypertension and erectile function. In the PD arm we administered validated questionnaires to determine the erectile function status by the International Index of Erectile Function 5 (IIEF-5) and the pain status during erection by the Visual Analogue Scale (VAS). A univariate analysis was conducted using R software. Results: We enrolled 279 consecutive patients. The number of PD patients was 97 (34,7%). The univariate analysis showed a correlation between PD and cigarette smoking (p = 0.0242), blood hypertension (p < 0.001), erectile dysfunction (p < 0.001). No significant association was observed between diabetes and PD (p = 0.358). The median age of PD arm was 60 years and the median age of the control arm was 63,5 years; therefore the median age of PD arm resulted lower than the median age of the control arm (p = 0,031). Conclusions: Peyronie's disease is more common than we might think; furthermore it can be diagnosed among young patients. According to our results, cigarette smoking and blood hypertension may be considered statically significant risk factors for developing PD. On the contrary diabetes seems not to be a risk factor for PD. According to our results PD should be sought also in young patients. Further studies are necessary to confirm that removing the indicated risk factors may reduce the incidence of PD. SummaryNo conflict of interest declared.

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The COVID-19 outbreak, in a few weeks, overloaded Italian hospitals, and the majority of medical procedures were postponed. During the pandemic, with hospital reorganization, clinical and learning activities performed by residents suffered a forced remodulation. The objective of this study is to investigate how urology training in Italy has been affected during the COVID-19 era. In this multi-academic study, we compared residents' training during the highest outbreak level with their previous activity. Overall 387 (67.1%) of the 577 Italian Urology residents participated in a 72-h anonymous online survey with 36 items sent via email. The main outcomes were clinical/surgical activities, social distancing, distance learning, and telemedicine. Clinical and learning activity was significantly reduced for the overall group, and after categorizing residents as those working only in COVID hospitals, both “junior” and “senior” residents, and those working in any of three geographical areas created (Italian regions were clustered in three major zones according to the prevalence of COVID-19). A significant decrease in outpatient activity, invasive diagnostic procedures, and endoscopic and major surgeries was reported. Through multivariate analysis, the specific year of residency has been found to be an independent predictor for all response modification. Being in zone 3 and zone 2 and having “senior” resident status were independent predictors associated with a lower reduction of the clinical and learning activity. Working in a COVID hospital and having “senior” resident status were independent predictors associated with higher reduction of the outpatient activity. Working in zone 3 and having “senior” resident status were independent predictors of lower and higher outpatient surgical activity, respectively. Working in a COVID hospital was an independent predictor associated with robotic surgical activity. The majority of residents reported that distance teaching and multidisciplinary virtual meetings are still not used, and 44.8% reported that their relationships with colleagues decreased. The COVID-19 pandemic presents an unprecedented challenge, including changes in the training and education of urology residents. The COVID era can offer an opportunity to balance and implement innovative solutions that can bridge the educational gap and can be part of future urology training.