Diagnostic and methodological evaluation of studies on the urinary shedding of SARS-CoV-2, compared to stool and serum: A systematic review and meta-analysis.

To assess whether single immediate intravesical chemotherapy (SIIC) adds value to bladder tumour management in combination with novel optical techniques: enhanced transurethral resection of bladder tumour (TURBT). MethodsA systematic search was performed using the PubMed and Web of Science databases in September 2020 according to the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) extension statement for network metaanalyses. Studies that compared recurrence rates among intervention groups (TURBT with photodynamic diagnosis [PDD] AE SIIC, narrow-band imaging [NBI] AE SIIC, or white-light cystoscopy [WLC] + SIIC) and a control group (TURBT with WLC alone) were included. We used the Bayesian approach in the network meta-analysis. ResultsTwenty-two studies (n = 4519) met our eligibility criteria. Out of six different interventions including three different optical techniques, compared to WLC alone, blue-light cystoscopy (BLC) plus SIIC (odds ratio [OR] 0.349, 95% credible interval [CrI] 0.196-0.601) and BLC alone (OR 0.668, 95% CrI 0.459-0.931) were associated with a significantly lower likelihood of 12-month recurrence rate. In the sensitivity analysis, out of eight different interventions compared to WLC alone, PDD by 5-aminolevulinic acid plus SIIC (OR 0.327, 95% CrI 0.159-0.646) and by hexaminolevulinic acid plus SIIC (OR 0.376, 95%

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Ureteral double-J (DJ) stenting is a common urologic procedure in several ureteral surgeries and has been used to manage ureteral obstructions during pregnancy. It may result in early and late complications. We review a rare case of migration of the DJ stent into the cardiovascular system in a pregnant female. We also review the literature. The endoscopic procedure to remove this displacement has been done postnatally with no adverse effects.

Background: Tubularized incised plate (TIP) urethroplasty as the most common hypospadias repair method, aims to achieve normal functioning of the penis along with cosmetic reconstruction. However, there are remaining questions toward anatomical prognostic factors affecting the results of surgery. Lack of age-matched controls or controlling for meatal location, employment of several surgical techniques or multiple surgeons, or age heterogeneity of the study population are the problems affected the results of the current body of literature. Objective: This prospective study aimed to evaluate the preoperative factors to predict future complications associated with hypospadias repair outcomes in males aged between 1-3 years and performed by a single surgeon with employing multivariate analysis. Patients and methods: A prospective cohort of 101 males aging from 1 to 3 years with distal to mid-shaft hypospadias were consecutively selected for TIP repair. The urethral plate dimensions in erect and flaccid states, penile length, glans diameter, and chordee were evaluated individually before reconstruction. After surgery and during follow-up visits, the subsequent transient and persistent complications were recorded. Results: Postoperatively, the acute transient events were observed in 42 cases (41.6%) and the persistent complications in 16 cases (15.8%). The uncomplicated group had a higher percentage of patients with distal meatal location than the complicated group (P=0.01%). Furthermore, fistula formation was notably higher in the group with acute surgical site infection (P<0.001). The analysis also showed the width of the urethral plate to be inversely associated with the development of complications (P=0.03). Conclusion: By performing TIP by a single surgeon on a homogenous study population and eliminating the impact of severe chordee as a potential cofounding variable, this study prospectively found that out of the anatomical specifications, pre- and postoperative factors, the urethral meatus location was the only significant and independent predictor of the development of complications in young children with midshaft to distal hypospadias. Finally based on the inverse association of width with the complications we hypostatized that a combination of urethral width and depth should be considered in the investigation of prognostic factors for hypospadias repair outcomes.

Prostate cancer is a heterogeneous disease that remains dormant for long periods or acts aggressively with poor clinical outcomes. Identifying aggressive prostate tumor behavior using current glandular-focused histopathological criteria is challenging. Recent evidence has implicated the stroma in modulating prostate tumor behavior and in predicting post-surgical outcomes. However, the emergence of stromal signatures has been limited, due in part to the lack of adoption of imaging modalities for stromal-specific profiling. Herein, label-free multiphoton microscopy (MPM), with its ability to image tissue with stromal-specific contrast, is used to identify prostate stromal features associated with aggressive tumor behavior and clinical outcome. MPM was performed on unstained prostatectomy specimens from 59 patients and on biopsy specimens from 17 patients with known post-surgery recurrence status. MPM-identified collagen content, organization, and morphological tumor signatures were extracted for each patient and screened for association with recurrent disease. Compared to tumors from patients whose disease did not recur, tumors from patients with recurrent disease exhibited higher MPM-identified collagen amount and collagen fiber intensity signal and width. Our study shows an association between MPM-identified stromal collagen features of prostate tumors and post-surgical disease recurrence, suggesting their potential for prostate cancer risk assessment.

Objective:Investigating the infectivity of body fluid can be useful for preventative measures in the community and ensuring safety in the operating rooms and on the laboratory practices. Methods:We performed a literature search of clinical trials, cohorts, and case series using PubMed/MEDLINE, Google Scholar, and Cochrane library, and downloadable database of CDC. We excluded case reports and searched all language articles for review and repeated until the final drafting. The search protocol was registered in the PROSPERO database. Results: Thirty studies with urinary sampling for viral shedding were included. A total number of 1,271 patients were enrolled initially, among which 569 patients had undergone urinary testing. Nine studies observed urinary viral shedding in urine from 41 patients. The total incidence of urinary SARS-CoV-2 shedding was 8%, compared to 21.3% and 39.5 % for blood and stool, respectively. The summarized risk ratio (RR) estimates for urine positive rates compared to the pharyngeal rate was 0.08. The pertaining RR urine compared to blood and stool positive rates were 0.20 and 0.33 respectively. Conclusions: Our review concludes that not only the SARS-CoV-2 can be excreted in the urine in eight ?percent of patients but also its incidence may have associations with the severity of the ?systemic disease, ICU admission, and fatality rates. Moreover, the findings in our review ?suggest that a larger population size may reveal more positive urinary cases possibly by ?minimizing biases. However, it is important to notice that it is the naso-pharyngeal specimens, ?stool, and serum that show more possibilities to became positive, respectively.