Evaluating the Quality of Overactive Bladder Patient Education Material on YouTube: A Pilot Study Using the Patient Education Materials Assessment Tool.

OBJECTIVES: To assess the characteristics and quality of patient education content for overactive bladder (OAB) on YouTube. METHODS: We searched YouTube on September 10, 2019 and reviewed the top 25 search results for "overactive bladder." For comparison, we reviewed 3 Urology Care Foundation (UCF) OAB education videos on YouTube. Videos were scored using the Agency for Healthcare Research and Quality's Patient Education Materials Assessment Tool (PEMAT) for Audiovisual materials, which is subdivided into understandability and actionability domains, each with a maximum score of 100%. RESULTS: The mean length was 9.5 (0.9-34) minutes and the mean number of views was 151,382 (127-2,032,441). Of the top 25 search results, the mean PEMAT understandability score was 74% ± 16% (range 41%-100%). The mean PEMAT actionability score was 57% ± 39% (range 0%-100%). Seventy-two percent of the reviewed videos featured a physician. In comparison, the 3 UCF videos had an average of 5840 views, 3 minutes length, and PEMAT understandability and actionability scores of 93% and 100%. All UCF OAB videos featured urologists. CONCLUSION: The quality of OAB patient education materials on YouTube varies significantly in understandability and actionability. Although the UCF videos scored much higher on the PEMAT than our reviewed videos, they did not appear within the top 25 search results for OAB. There is great opportunity for the American Urological Association (AUA)/UCF and Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction (SUFU) to increase its outreach to patients on platforms like YouTube.

Men With Severe Oligospermia Appear to Benefit From Varicocele Repair: A Cost-effectiveness Analysis of Assisted Reproductive Technology.

OBJECTIVE: To evaluate the outcomes of men who underwent varicocelectomy for total motile sperm count (TMSC) <2 million and to perform a cost-effectiveness analysis of intrauterine insemination (IUI) and in vitro fertilization with intracyctoplasmic sperm injection after varicocelectomy. METHODS: We prospectively collected data of men with TMSC <2 million who underwent microsurgical subinguinal varicocelectomy. Men with azoospermia were excluded. Serum testosterone, luteinizing hormone, and follicle-stimulating hormone were measured preoperatively. Postoperative semen analysis was collected first at 3 months and then every 3 months thereafter. Cost-effectiveness for assisted reproductive technologies was calculated using reported costs. RESULTS: A total of 17 men underwent varicocele repair for TMSC <2 million. The mean sperm concentration, motility, and TMSC was 1.1 ± 1.4 million/mL, 15.5% ± 12.8%, and 0.44 ± 0.54 million prior to varicocelectomy, respectively. After varicocelectomy, 14 of 17 men had improvements in TMSC. The mean change in sperm concentration, motility, and TMSC was 4.3 ± 4.7 million/mL, 12% ± 17.2%, and 6.0 ± 8.5 million, respectively. The mean postoperative sperm concentration, motility, and TMSC was 5.4 ± 5.4 million/mL, 27.5% ± 25.1%, and 6.5 ± 8.5 million, respectively. A total of 10 of 17 men had TMSC greater than 2 million. Of the 10 men, 1 man achieved spontaneous pregnancy and 7 men underwent a cycle of IUI; 2 of the 7 (28.6%) men achieved successful pregnancy with IUI (cost per pregnancy: $35,924). CONCLUSION: Varicocelectomy increases TMSC in severely oligospermic patients, thus providing previously ineligible couples an opportunity to elect for IUI, a less invasive and less expensive alternative to in vitro fertilization with intracyctoplasmic sperm injection.