Detection of SARS-CoV-2 in semen samples: a scoping review / Detecção de SARS-CoV-2 em amostras de sêmen: revisão de escopo

Background: many doubts about the infection of SARS-CoV-2 were raised, such as sexual transmission, sterility, and changes in fertility procedures; however, information is not clearly stated and organized. Purpose: to review and summarize scientific evidence on detection of SARS-CoV-2 in semen samples of Covid-19 patients. Methods:literature search in PubMed, Web of Science, Scopus, Medline and Embase databases, and followed Scoping Review protocol defined by Joanna Briggs Institute (JBI) after the guiding question "Is it possible to detect SARS-CoV-2 in the semen of adult patients with a confirmed diagnosis of Covid-19?" Results: 287 studies were identified, and, after discerning analysis, 9 studies published in the English language were selected. Three researchers analyzed the studies for SARS-CoV-2 presence in the seminal fluid, patients' severity, days since the onset of disease, diagnosis confirmation, semen collection method, viral analysis method, and sample numbers. Conclusions: it was not possible to find strong evidence to confirm the presence or absence of Covid-19 in the semen of adult patients. New studies on the subject should be better designed, taking into account the possible anatomical and functional conditions and changes of the male reproductive system during and after the infection by SARS-CoV-2 (AU)

Objetivo: Revisar e resumir as evidências científicas em pesquisas realizadas para detectar a presença de SARS-CoV-2 em amostras de sêmen de pacientes com COVID-19. Métodos: A pesquisa de literatura foi conduzida nas bases de dados PubMed, Web of Science, Scopus, Medline e Embase. Seguiu o protocolo de revisão de escopo definido por Joanna Briggs Institute (JBI) e baseou-se na pergunta norteadora "É possível detectar SARS-CoV-2 no sêmen de pacientes adultos com diagnóstico confirmado de Covid-19?". Resultados: 287 estudos foram identificados, 9 estudos publicados em língua inglesa foram selecionados após análise minuciosa. Três pesquisadores analisaram os estudos em busca de presença de SARS-CoV-2 no fluído seminal, gravidade do paciente, dias desde o início da doença, confirmação diagnóstica, método de coleta de sêmen, método de análise viral e número de amostras. Conclusões: Não foi possível identificar fortes evidências para confirmar a presença ou ausência de COVID-19 no sêmen de pacientes adultos. Novos estudos sobre o tema devem ser melhor projetados, levando-se em conta as possíveis condições anatômicas e funcionais e mudanças no sistema reprodutor masculino durante e após a infecção por SARS-CoV-2 (AU)

Detection of SARS-CoV-2 in semen samples: a scoping review / Detecção de SARS-CoV-2 em amostras de sêmen: revisão de escopo

ABSTRAC: :Background: many doubts about the infection of SARS-CoV-2 were raised, such as sexual transmission, sterility, and changes in fertility procedures; however, information is not clearly stated and organized. Purpose: to review and summarize scientific evidence on detection of SARS-CoV-2 in semen samples of Covid-19 patients. Methods:literature search in PubMed, Web of Science, Scopus, Medline and Embase databases, and followed Scoping Review protocol defined by Joanna Briggs Institute (JBI) after the guiding question "Is it possible to detect SARS-CoV-2 in the semen of adult patients with a confirmed diagnosis of Covid-19?" Results: 287 studies were identified, and, after discerning analysis, 9 studies published in the English language were selected. Three researchers analyzed the studies for SARS-CoV-2 presence in the seminal fluid, patients' severity, days since the onset of disease, diagnosis confirmation, semen collection method, viral analysis method, and sample numbers. Conclusions: it was not possible to find strong evidence to confirm the presence or absence of Covid-19 in the semen of adult patients. New studies on the subject should be better designed, taking into account the possible anatomical and functional conditions and changes of the male reproductive system during and after the infection by SARS-CoV-2. (AU)

RESUMO:Objetivo: Revisar e resumir as evidências científicas em pesquisas realizadas para detectar a presença de SARS-CoV-2 em amostras de sêmen de pacientes com COVID-19. Métodos: A pesquisa de literatura foi conduzida nas bases de dados PubMed, Web of Science, Scopus, Medline e Embase. Seguiu o protocolo de revisão de escopo definido por Joanna Briggs Institute (JBI) e baseou-se na pergunta norteadora "É possível detectar SARS-CoV-2 no sêmen de pacientes adultos com diagnóstico confirmado de Covid-19?". Resultados: 287 estudos foram identificados, 9 estudos publicados em língua inglesa foram selecionados após análise minuciosa. Três pesquisadores analisaram os estudos em busca de presença de SARS-CoV-2 no fluído seminal, gravidade do paciente, dias desde o início da doença, confirmação diagnóstica, método de coleta de sêmen, método de análise viral e número de amostras. Conclusões: Não foi possível identificar fortes evidências para confirmar a presença ou ausência de COVID-19 no sêmen de pacientes adultos. Novos estudos sobre o tema devem ser melhor projetados, levando-se em conta as possíveis condições anatômicas e funcionais e mudanças no sistema reprodutor masculino durante e após a infecção por SARS-CoV-2. (AU)

An update on metabolic assessment in patients with urinary lithiasis.

PURPOSE: The objective of this study was to evaluate the prevalence of urinary metabolic abnormalities in patients with urolithiasis and their potential risk factors. METHODS: A total of 905 stone patients were evaluated in a prospective trial from February 2000 to January 2012. Inclusion criteria were as follows: history and/or imaging tests confirming at least 2 separate or concurrent stone episodes; creatinine clearance ≥ 60 mL/min; and negative proteinuria and urine culture. Metabolic study consisted of two 24-h urine collections separated by a period of 3 months for dosing Ca, P, uric acid, Na, K, Mg, oxalate, and citrate. Serum levels of Ca, P, uric acid, Na, K, Cl, Mg, creatinine, and glucose were assessed. Urinary pH and urinary acidification tests were also performed. RESULTS: A total of 735 patients were included, with a mean age of the 40 ± 1.0 year; 96.8 % of patients presented diagnosis of one or more urinary metabolic abnormalities. The most prevalent metabolic abnormalities were hypercalciuria (50.8 %), hypomagnesuria (50.1 %), hypocitraturia (35.4 %), and hyperuricosuria (30.7 %). Body weight was significantly higher in patients with hyperuricosuria (81.20 ± 15.67 kg vs. 70.17 ± 14.13 kg, respectively, p = 0.001). Urinary sodium was significantly higher in patients with hypercalciuria than without (246.97 ± 103.9 mEq/24 h vs. 200.31 ± 91.6 mEq/24 h, p = 0.001) and hyperuricosuria compared to without (283.24 ± 107.95 mEq/24 h vs. 198.57 ± 85.3 mEq/24 h, p = 0.001). CONCLUSION: Urinary metabolic disturbances were diagnosed in 96.8 % of patients in the study. These results warrant metabolic study and follow-up in patients with recurrent lithiasis in order to decrease recurrence rate through specific treatments, modification in alimentary, and behavioral habits.

Influence of clinical therapy and nutritional counseling on the recurrence of urolithiasis.

PURPOSE: To evaluate the influence of combined clinical therapy and nutritional guidance on the recurrence of urolithiasis. METHODS: From our registry of patients with recurrent urolithiasis we selected 57 who had at least 5-years of follow-up. We collected 24h urine samples in order to analyze Ca, Na, uric acid, citrate, oxalate, and Mg concentrations and to assess urine volume. Patients filled out a clinical questionnaire before treatment, and abdominal radiographs and/or ultrasound were performed both before treatment and during the follow-up period. During follow-up, specific and individualized dietary advice was given based on the individual's metabolic disorders. Patients also received specific pharmacological treatment for their metabolic alterations. Outcome measures were metabolites in urine and the urolith recurrence rate. Pre- and post- intervention values were compared using tests as appropriate. RESULTS: Fifty six of the patients were male and the majority of patients were overweight. The mean BMI was 27 kg/m(2). Urinary excretion of calcium, uric acid and sodium decreased significantly over the five year follow-up period. The number of uroliths that formed during the 5-year follow-up also decreased significantly compared to pre-treatment values. CONCLUSION: Individualized dietary advice combined with pharmacological treatment significantly reduces long-term urolithiasis recurrence.

Influence of clinical therapy and nutritional counseling on the recurrence of urolithiasis

PURPOSE: To evaluate the influence of combined clinical therapy and nutritional guidance on the recurrence of urolithiasis. METHODS: From our registry of patients with recurrent urolithiasis we selected 57 who had at least 5-years of follow-up. We collected 24h urine samples in order to analyze Ca, Na, uric acid, citrate, oxalate, and Mg concentrations and to assess urine volume. Patients filled out a clinical questionnaire before treatment, and abdominal radiographs and/or ultrasound were performed both before treatment and during the follow-up period. During follow-up, specific and individualized dietary advice was given based on the individual's metabolic disorders. Patients also received specific pharmacological treatment for their metabolic alterations. Outcome measures were metabolites in urine and the urolith recurrence rate. Pre- and post- intervention values were compared using tests as appropriate. RESULTS: Fifty six of the patients were male and the majority of patients were overweight. The mean BMI was 27 kg/m2. Urinary excretion of calcium, uric acid and sodium decreased significantly over the five year follow-up period. The number of uroliths that formed during the 5-year follow-up also decreased significantly compared to pre-treatment values. CONCLUSION: Individualized dietary advice combined with pharmacological treatment significantly reduces long-term urolithiasis recurrence. .

Renal medullary carcinoma. Case report and review of the literature.

Young patients with sickle cell trait or disease present a higher risk for renal medullary carcinoma, an aggressive renal tumor, with dismal prognosis, with a median survival of 4 months from the time of diagnosis. We report a 26-year-old patient with a 2-month history of bone pain at the right iliac crest, loss of weight, recurrent macroscopic hematuria and abdominal mass. Imaging studies demonstrated a 10-cm mass in the right kidney. Pathological evaluation revealed a medullary carcinoma and the patient died after 4 months, despite adjuvant treatment. Whenever a patient with sickle cell trait or disease presents with hematuria and/or flank pain, the possibility of a renal medullary carcinoma should always be kept in mind, with thorough investigation and expeditious treatment.

Videolaparoscopic orchiectomy and nephrectomy: training model in rats.

OBJECTIVE: Videolaparoscopic surgery conducted on small animals has proved to be of great importance for the improvement of surgical skills. This is a report utilizing an experimental model for laparoscopic orchiectomy and nephrectomy in training courses for urologists. MATERIAL AND METHODS: Of 350 American Wistar rats enrolled, 319 animals underwent laparoscopic orchiectomy and nephrectomy under intraperitoneal general anesthesia. Graspers, dissectors, and a 0-degree telescope were introduced into the peritoneal cavity by two trocars of 5 mm and one of 10 mm, respectively. RESULTS: Of 350 rats enrolled, 15 (4.2%) died due to anesthetic complications and 16 (4.5%) due to cannibalism and stress during transport. A total of 319 rats were operated on, 178 underwent bilateral orchiectomy, two per model (356 operations), and in 141 animals one nephrectomy per model (141 operations) was performed. A total of 497 operations were performed involving 140 urologists. The animals were easy to handle providing adequate practice without the occurrence of any major intraperitoneal lesion and hemorrhage. CONCLUSION: Nephrectomy and orchiectomy are feasible in rats, and this model can be utilized for training videolaparoscopic surgeries.

Intravesical calculus secondary to ethanol gel injection into the prostate.

A 78-year-old man with coagulopathy and lower urinary tract symptoms secondary to benign prostatic hyperplasia underwent transurethral prostate ethanol gel injection. Six months after the injection, the patient presented with irritative symptoms and hematuria. Ultrasonography revealed a 5-cm intravesical calculus. Cystolitholapaxy was unsuccessful, and the patient underwent cystolithotomy with retrieval of a large, soft, round, brownish mass. Histologic examination of the mass demonstrated prostatic hyperplastic glandular stroma with extensive coagulate necrosis and peripheral calcification. To our knowledge, this is the first report of a calculus formed by prostatic tissue slosh after ethanol injection.