Phosphodiesterase type 5 inhibitors as treatment for erectile dysfunction: a webinar-based poll unveiling perceptions of healthcare professionals.

Aim: Erectile dysfunction (ED) is marked by a recurring incapacity to achieve or uphold a satisfactory erection during sexual activities. The study aims to increase awareness about male reproductive health, dispel misconceptions about ED and encourage physician-patient discussions. Materials & methods: A live online poll was conducted during a 3-day webinar titled "Turning the Tide of Men's Health" organized by Viatris™ in collaboration with the Saudi Society of Family and Community Medicine and attended by healthcare professionals (HCPs) from diverse specialties. The attendees voluntarily responded to nine poll questions on adherence to ED medication, use of phosphodiesterase type 5 inhibitors (PDE5is) as cure versus management of ED and patients' challenges. The responses to the poll questions were recorded and assessed to understand the perceptions of HCPs. Results: The poll garnered 10,423 responses from 5831 attendees on the second day of the webinar. The key findings included HCPs' perceptions that PDE5is contribute to ED management not complete cure. The respondents acknowledged that adherence to ED medications might decline on days without planned sexual activity, and long-term adherence on a daily PDE5i is exhibited by a relatively modest percentage of ED patients. The consensus among respondents was that PDE5is do not enhance or generate sexual desire, and the daily schedule of ED treatment may be burdensome for some patients. Conclusion: The findings from this poll offer insights into the perspectives of HCPs regarding the usage of PDE5is to treat ED. Responders of the poll generally agreed that PDE5is can help manage ED without affecting desire, though adherence may be lower on days without planned sexual activity. Furthermore, most respondents acknowledged that adhering to a daily pill regimen posed a greater burden than waiting for the medication to take effect.

Surgicel plug technique versus endoclose technique for port-site closure post minimally invasive (robotic and laparoscopic) surgeries: Retrospective cohort study.

OBJECTIVES: To compares the endoclose technique (ET) techniques and surgicel plug technique (SPT) in terms of port-site related complications. Minimally invasive surgeries (MIS) are widely performed nowadays, nonetheless, port-site closure technique plays a role in the prevention of port-site related complications. METHODS: This retrospective study was carried out at general surgery and urology departments of King Fahad Medical City, Saudi Arabia. Variables that were collected include age, gender, height, weight, body mass index, co-morbidities, type and date of surgery, intraoperative visceral injury or bleeding, technique cost, and port-site post-operative complications (hernia, infection, bleeding, dehiscence, and hypertrophic scarring). Data was collected from electronic medical records. Patients included are whom underwent any minimally invasive procedure from the beginning of 2014 until the end of September 2020. Follow up period was at least for 2 years. RESULTS: We analyzed 397 patients. Surgicel plug technique was more of having hernia (2.3%) than of ET (0%). While ET was more on infection (0.9%) than in SPT, but no significant difference being observed (p=0.064). CONCLUSION: There is no significant difference between the ET and the novel SPT in terms of port-site related complications.

Single-Docking Robotic-Assisted Radical Nephroureterectomy in Morbidly Obese Patient Post-Radical Cystectomy With Ileal Conduit: A Case Report.

Bladder cancer is considered the most prevalent malignancy affecting the urinary tract system. Urothelial carcinoma, also known as transitional cell carcinoma (TCC), can arise from the entire urinary tract, with the bladder considered the primary site of origin and representing 95% of all cases. The management of TCC of the upper urinary tract is mainly by nephroureterectomy (NU). To our knowledge, there are no data regarding single-docking robotic-assisted NU following cystectomy with an ileal conduit. Therefore, in this study, we are reporting a case of single-docking robotic-assisted NU in a patient who previously underwent open cystectomy with an ileal conduit. A case of a 57-year-old female diagnosed with bladder cancer 10 years ago and underwent several transurethral resections of bladder tumor (TURBT) sessions presented for the first time in 2019, complaining of hematuria and dropping in the hemoglobin, which was not improving with multiple TURBT. For that, the patient underwent an open radical cystectomy with an ileal conduit. During the follow-up in 2021, computed tomography (CT) of the pelvis and abdomen with intravenous (IV) contrast showed a 7 mm enhancing lesion in the right proximal ureter, which was suspicious of proximal ureter mass. In 2022, the patient was again seen in the outpatient clinic; a CT of the pelvis and abdomen with IV contrast was done and demonstrated a significant progression of the mass size to 2 x 1.5 cm, with no other intraabdominal or intrathoracic lesions. For that, she underwent a single-docking robotic-assisted NU. To conclude, performing a single-docking robotic-assisted NU in a patient who previously underwent open radical cystectomy with an ileal conduit is challenging due to multiple adhesion and altered anatomy. More studies need to be published regarding the long-term outcomes of such procedures.

Saudi Urological Association consensus guidelines on the use of robotic surgery in urology.

Over the past three decades, minimally invasive robotic technology has evolved substantially in urological practice, replacing many open procedures and becoming part of routine clinical practice. The Health Sector Transformation Program for the Kingdom's Vision 2030 aims to restructure the health sector and optimize its status and prospects as an effective and integrated ecosystem centered on the patient's health. Therefore, this consensus seeks to endorse the clinical practice guidelines for robotic surgery (RS) in the KSA, highlighting its effectiveness, safety, and favorable outcomes compared to open and laparoscopic surgeries in certain procedures when used by trained surgeons in well-structured RS programs.

Patient with duplex ureter injury underwent robot assisted laparoscopic common sheath ureteral reimplantation single docking: Case report.

Ureteral injury is common complication that need comprehensive understanding of ureteral injury management from minimal invasive intervention to ureteral reimplant in both early and late presentation. However, ureteral injury in duplex system rarely reported in literature. Here we are sharing our techniques and challenging in a patient who had a duplex ureteral injury with late presentation underwent robot assisted ureteral reimplantation.