Background: The World Health Organization (WHO) declared coronavirus disease-19 (COVID-19) as a pandemic on March 11, 2020. The impact of COVID-19 on urological services in different geographical areas is unknown. Objective: To investigate the global impact of COVID-19 on urological providers and the provision of urological patient care. Design, setting, and participants: A cross-sectional, web-based survey was conducted from March 30, 2020 to April 7, 2020. A 55-item questionnaire was developed to investigate the impact of COVID-19 on various aspects of urological services. Target respondents were practising urologists, urology trainees, and urology nurses/advanced practice providers. Outcome measurements and statistical analysis: The primary outcome was the degree of reduction in urological services, which was further stratified by the geographical location, degree of outbreak, and nature and urgency of urological conditions. The secondary outcome was the duration of delay in urological services. Results and limitations: A total of 1004 participants responded to our survey, and they were mostly based in Asia,

Aims: Ketamine is a general anesthetic. Dissociative effects and low cost led ketamine becoming an illegal recreational drug in young adults. Ketamineinduced uropathy (KIU) is one of the complications observed in abusers. This study aimed to provide a systematic literature review on KIU clinical presentation, pathophysiology, and treatments. Methods: We performed the literature search in PubMed, Web of Science, Scopus, and Embase using the terms ketamine and bladder. English papers on human and animal studies were accepted. Results: A total of 75 papers were selected. Regular ketamine users complain about severe storage symptoms and pelvic pain. Hydronephrosis may develop in long-term abusers and is correlated to the contracted bladder, ureteral stenosis, or vesicoureteral reflux due to ureteral involvement and/or bladder fibrosis. Cystoscopy shows ulcerative cystitis. Ketamine in urine might exert direct toxicity to the urothelium, disrupting its barrier function and enhancing cell apoptosis. The presence of ketamine/ions in the bladder wall result in neurogenic/IgE-mediated inflammation, stimulation of the inducible nitric oxide synthase-cytokines-cyclooxygenase pathway with persistent inflammation and fibrosis. Abstinence is the first therapeutic step. Anti-inflammatory drugs, analgesics and anticholinergics, intravesical instillation of hyaluronic acid, hydrodistension and intravesical injection of botulin toxin-A were helpful in patients with early-stage KIU. In patients with end-stage disease, the control of intractable symptoms and the increase of bladder capacity were the main recommendations to perform augmentation enterocystoplasty.Conclusions: KIU is becoming a worldwide health concern, which should be taken into account in the differential diagnosis of ulcerative cystitis. K E Y W O R D S cystitis, inflammation, ketamine, lower urinary tract symptoms, substance-related disorders, urinary tract 1050 | CASTELLANI ET AL.

Benign prostatic hyperplasia (BPH) is a bothersome condition that has high prevalence in elderly men (Lee, Chan, & Lai, 2017). Majority of practicing urologists treat BPH (Census Results-American Urological Association, n.d.) by medical therapy as well as surgical options (Herr, 2006; Nunes, Antunes, & Constantin, 2017). Removal of obstructive part of the enlarged gland in the transition zone remains the basis of surgical management (Foo, 2017; McNeal, 1988). From the earliest reports of open prostatectomy, the procedure has continued to evolve, with endoscopic procedures currently establishing themselves as a benchmark (Hiraoka & Akimoto, 1989; Mandeville & Mourtzinos, 2016; Millin, 1945). Among them, the status of transurethral resection of prostate (TURP) as gold-standard endoscopic procedure is being continuously challenged with anatomical endoscopic enucleation

Background and Objectives There is an increasing use of social media amongst the urological community. However, it is difficult to identify urological data on various social media platforms in an efficient manner. We proposed a hashtag, #UroSoMe, to be used when posting urology-related content in the social media platforms. The objectives of this article are to describe how #UroSoMe was developed, and to report the data of the first month of #UroSoMe.   Material and Methods The hashtag, #UroSoMe, was introduced to the urological community. The #UroSoMe working group was formed, and the members actively invited and encouraged people to use the hashtag #UroSoMe when posting urology-related contents. After the #UroSoMe (@so_uro) platform on twitter had grown to more than 300 users, the first live event of online case discussion, i.e. #LiveCaseDiscussions, was conducted. A prospective observational study of the hashtag #UroSoMe Twitter activity during the first month of its usage from 14 December 2018 to 13 January 2019 was evaluated. Outcome measures included number of users, number of tweets, user location, top tweeters, top hashtags used and interactions. Analysis was performed using NodeXL (Social Media Research Foundation; California, USA; https://www.smrfoundation.org/nodexl/), Symplur (https:// www.symplur.com) and Twitonomy (https://www.twitonomy.com).   Results The first month of #UroSoMe activity documented 1373 tweets/retweets by 1008 tweeters with 17698 mentions and 1003 replies. The #LiveCaseDiscussions was able to achieve a potential reach of 2,033,352 Twitter users. The top tweets mainly included cases presented by #UroSoMe working group members during #LiveCaseDiscussions. The twitonomy map showed participation from 214 geographical locations. The major groups of participants using the hashtag #UroSoMe were ‘Researcher/Academic’ and ‘Doctor’. The twitter account of #UroSoMe (@so_uro) has now grown to more than 1000 followers.   Conclusions Social media is an excellent platform for interaction amongst the urological community. The results demonstrated that #UroSoMe was able to achieve wide spread engagement from all over the world.

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