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    Catheter-associated urinary infections and consequences of using coated versus non-coated urethral catheters-outcomes of a systematic review and meta-analysis of randomized trials
    (MDPI, 2022) Gauhar, Vineet; Castellani, Daniele; Teoh, Jeremy Yuen-Chun; Nedbal, Carlotta; Chiacchio, Giuseppe; Gabrielson, Andrew T.; Heldwein, Flavio Lobo; Wroclawski, Marcelo Langer; de la Rosette, Jean J. M. C. H.; Donalisio da Silva, Rodrigo; Galosi, Andrea Benedetto; Somani, Bhaskar Kumar
    Coated urethral catheters were introduced in clinical practice to reduce the risk of catheter-acquired urinary tract infection (CAUTI). We aimed to systematically review the incidence of CAUTI and adverse effects in randomized clinical trials of patients requiring indwelling bladder catheterization by comparing coated vs. non-coated catheters. This review was performed according to the 2020 PRISMA framework. The incidence of CAUTI and catheter-related adverse events was evaluated using the Cochran-Mantel-Haenszel method with a random-effects model and reported as the risk ratio (RR), 95% CI, and p-values. Significance was set at p < 0.05 and a 95% CI. Twelve studies including 36,783 patients were included for meta-analysis. There was no significant difference in the CAUTI rate between coated and non-coated catheters (RR 0.87 95% CI 0.75-1.00, p = 0.06). Subgroup analysis demonstrated that the risk of CAUTI was significantly lower in the coated group compared with the non-coated group among patients requiring long-term catheterization (>14 days) (RR 0.82 95% CI 0.68-0.99, p = 0.04). There was no difference between the two groups in the incidence of the need for catheter exchange or the incidence of lower urinary tract symptoms after catheter removal. The benefit of coated catheters in reducing CAUTI risk among patients requiring long-term catheterization should be balanced against the increased direct costs to health care systems when compared to non-coated catheters.
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    Complications and outcomes of tubeless versus nephrostomy tube in percutaneous nephrolithotomy: A systematic review and meta-analysis of randomized clinical trials
    (Springer, 2022) Gauhar, Vineet; Traxer, Olivier; Rojo, Esther Garcia; Scarcella, Simone; Pavia, Maria Pia; Chan, Vinson Wai-Shun; Pretore, Eugenio; Wroclawski, Marcelo Langer; Corrales, Mariela; Tiong, Ho Yee; Lim, Ee Jean; Teoh, Jeremy Yuen-Chun; Heng, Chin-Tiong; de la Rosette, Jean J. M. C. H.; Somani, Bhaskar Kuman; Castellani, Daniele
    We aimed to perform a systematic review of randomized trials to summarize the evidence on the safety and stone-free rate after Tubeless percutaneous nephrolithotomy (PCNL) (ureteral stent/catheter, no nephrostomy) compared to Standard PCNL (nephrostomy, with/without ureteral stent/catheter) to evaluate if the tubeless approach is better. The inverse variance of the mean difference with a random effect, 95% Confidence Interval (CI), and p values was used for continuous variables. Categorical variables were assessed using Cochran-Mantel-Haenszel method with the random effect model, and reported as Risk Ratio (RR), 95% CI, and p values. Statistical significance was set at p < 0.05 and a 95% CI. 26 studies were included. Mean operative time was significantly shorter in the Tubeless group (MD-5.18 min, 95% CI - 6.56, - 3.80, p < 0.00001). Mean postoperative length of stay was also significantly shorter in the Tubeless group (MD-1.10 day, 95% CI - 1.48, - 0.71, p < 0.00001). Incidence of blood transfusion, angioembolization for bleeding control, pain score at the first postoperative day, the number of patients requiring postoperative pain medication, fever, urinary infections, sepsis, perirenal fluid collection, pleural breach, hospital readmission, and SFR did not differ between the two groups. Incidence of postoperative urinary fistula was significantly lower in the Tubeless group (RR 0.18, 95% CI 0.07, 0.47, p = 0.0005). This systematic review shows that tubeless PCNL can be safely performed and the standout benefits are shorter operative time and hospital stay, and a lower rate of postoperative urinary fistula.
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    Defining minimal invasive surgical therapy for benign prostatic obstruction surgery: Perspectives from a global knowledge, attitude, and practice survey
    (Elsevier (Singapore) Pte. Ltd., 2024) Cheng, Bryan Kwun-Chung; Yuen, Steffi Kar-Kei; Castellani, Daniele; Wroclawski, Marcelo Langer; Zhao, Hongda; Chiruvella, Mallikarjuna; Chua, Wei -Jin; Tiong, Ho-Yee; Tanıdır, Yılören; de la Rosette, Jean J. M. C. H.; Gauhar, Vineet
    Objective: To scrutinize the definitions of minimal invasive surgical therapy (MIST) and to investigate urologists' knowledge, attitudes, and practices for benign prostatic obstruction surgeries. Methods: A 36 -item survey was developed with a Delphi method. Questions on definitions of MIST and attitudes and practices of benign prostatic obstruction surgeries were included. Urologists were invited globally to complete the online survey. Consensus was achieved when more than or equal to 70% responses were "agree or strongly agree" and less than or equal to 15% responses were "disagree or strongly disagree" (consensus agree), or when more than or equal to 70% responses were "disagree or strongly disagree" and less than or equal to 15% responses were "agree or strongly agree" (consensus disagree). Results: The top three qualities for defining MIST were minimal blood loss (n=466, 80.3%), fast post -operative recovery (n=4 31, 74 .3%), and short hospital stay (n=425, 73.3%). The top three surgeries that were regarded as MIST were Urolift (R) (n=361, 62.2%), Rezum (R) (n=351, 60.5%), and endoscopic enucleation of the prostate (EEP) (n=332, 57.2%). Consensus in the knowledge section was achieved for the superiority of Urolift (R), Rezum (R), and iTIND (R) over transurethral resection of the prostate with regard to blood loss, recovery, day surgery feasibility, and post -operative continence. Consensus in the attitudes section was achieved for the superiority of Urolift (R), Rezum (R), and iTIND (R) over transurethral resection of the prostate with regard to blood loss, recovery, and day surgery feasibility. Consensus on both sections was achieved for EEP as the option with the better symptoms and flow improvement, lower retreatment rate, and better suitable for prostate more than 80 mL. Conclusion: Minimal blood loss, fast post -operative recovery, and short hospital stay were the most important qualities for defining MIST. Urolift (R), Rezum (R), and EEP were regarded as MIST by most urologists.
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    Will "Hybrid" meetings replace face-to-face meetings post COVID-19 era? Perceptions and views from the urological community
    (Elsevier Science Inc, 2021) Hameed, B. M. Zeeshan; Tanıdır, Yılören; Naik, Nithesh; Teoh, Jeremy Yuen-Chun; Shah, Milap; Wroclawski, Marcelo Langer; Castellani, Daniele; İbrahim, Sufyan; da Silva, Rodrigo Donalisio; Rai, Bhavan; de la Rosette, Jean J. M. C. H.; Rajeev, T. P.; Gauhar, Vineet; Somani, Bhaskar
    OBJECTIVE To understand the preference and role of 'hybrid' urological meetings compared to face-to-face and online meetings during and after COVID-19 pandemic. The secondary outcome was finding out the most preferable webinar setting. METHODS An online global survey was done between June 06 and July 05, 2020, using SurveyMonkey. The target participants were urology healthcare providers. The survey was disseminated via mailing lists and the Twitter platform. RESULTS A total of 526 urology providers from 56 countries responded to the survey and it was completed by 73.3%. Participants' overall experience was better in a face-to-face meeting, followed by a hybrid and webinar only meeting. While opportunities for networking was identified as high in face-to-face meeting, online webinars were more cost effective, and learning opportunity and reach of audience was higher for hybrid meetings. For online webinar format, Zoom platform was used by 73% and majority (69%) saw it on their laptop or desktop. The preference was for a 1-hour webinar in the evenings with 3-5 speakers. Urology residents rated face-to-face meetings to have better cost-effectiveness when compared to consultants. Post COVID-19, more than half of all respondents would prefer hybrid meetings compared to the other formats. CONCLUSION While there will be a place for face-to-face meetings, COVID-19 situation has led to a preference towards hybrid meetings which is ideal for a global reach in the future. It is plausible that most urological associations will move towards a hybrid model for their meetings.