Data Availability Statements and Data Sharing in Urology: A False Promise?

BACKGROUND AND OBJECTIVE: It is considered standard for authors of scientific papers to provide access to their raw data. The purpose of this study was to investigate data availability statements (DAS) and the actual availability of data in urology. METHODS: The DAS policies of the top ten urology journals were retrieved. Then 190 selected papers were classified according to their DAS status. Finally, we contacted the corresponding authors of papers that stated that data were available on request to enquire about this possibility. KEY FINDINGS AND LIMITATIONS: All journals either required or highly recommended a DAS. Among the selected articles, 52% (99/190) included a DAS stating data availability, most often on reasonable request to the corresponding author. A formal DAS was lacking in 29.5% (56/190) of the articles, with an additional 18.3% (35/190) citing various reasons for data unavailability. On contact, 23.4% (15/64) of corresponding authors indicated a willingness to share their data. Overall, data were unavailable in 73.7% (140/190) of cases. There was no difference between papers dealing with malignant and benign diseases. CONCLUSIONS AND CLINICAL IMPLICATIONS: There is a gap between the intention to share data and actual practice in major urological journals. As data sharing plays a critical role in safeguarding the reliability of published results and in the potential for reanalysis and merging of datasets, there is a clear need for improvement. Easier access to data repositories and stronger enforcement of existing journal policies are essential. PATIENT SUMMARY: To ensure the reliability of data and allow further analyses, major urology journals require authors to make their data available to other researchers when possible. However, in practice we found that data were only accessible for about a quarter of published scientific papers.

Techniques for Penile Augmentation Surgery: A Systematic Review of Surgical Outcomes, Complications, and Quality of Life.

The increase in practices related to enhancing penile size can be attributed to the belief that an improved genital appearance contributes to a man's virility, coupled with an altered self-perception of his body. It is crucial to tailor interventions to meet the genuine needs of patients by thoroughly assessing their history, psychological state, and potential surgical benefits, all while considering the associated risks of complications. This systematic review aims to summarize the available evidence on outcomes, complications, and quality of life after penile augmentation surgery, examining both minimally invasive and more radical techniques. A search of the PubMed and Scopus databases, focusing on English-language papers published in the last 15 years, was performed in December 2023. Papers discussing surgery in animal models and case reports were excluded from the present study unless further evaluated in a follow-up case series. The primary outcomes were changes in penile dimensions, specifically in terms of length and girth, as well as the incidence of surgical complications and the impact on quality of life. A total of 1670 articles were retrieved from the search and 46 were included for analysis. Procedures for penile length perceived enhancements include lipoplasty, skin reconstruction plasty, V-Y and Z plasty, flap reconstruction, scrotoplasty, ventral phalloplasty, and suspensory ligament release; techniques for increasing corporal penile length include penile disassembly, total phalloplasty, and sliding elongation. Finally, penile girth enhancement may be performed using soft tissue fillers, grafting procedures, biodegradable scaffolds, and Penuma®. In conclusion, while penile augmentation surgeries offer potential solutions for individuals concerned about genital size, the risks and complexities need to be accounted for.

Platelet-rich plasma therapy in erectile dysfunction and Peyronie's disease: a systematic review of the literature.

PURPOSE: Platelet-rich plasma (PRP) as a regenerative therapy has gained interest in the field of andrology for the treatment of erectile dysfunction (ED) and Peyronie's disease (PD). This systematic review aims to critically evaluate the current evidence on the use of PRP for these conditions. METHODS: We performed a systematic literature search according to the PRISMA guidelines using PubMed and Scopus databases in December 2023. Studies were included if they evaluated the effect of PRP therapy for ED or PD in humans. RESULTS: We identified 164 articles, 17 of which were included, consisting of 11 studies on ED, 5 studies on PD, and 1 study on both. We included four randomized controlled trials, 11 prospective cohort studies, and three retrospective cohort studies including a total of 1099 patients. The studies on ED and PD generally showed small to moderate benefits with mild and transient side effects and no major adverse events were reported. General limitations included variations in PRP protocols, small sample sizes, short follow-up periods, and lack of control groups except in the three randomized trials on ED and the one on PD. CONCLUSION: The literature on PRP therapy in andrology is limited and difficult to interpret due to variations in protocols and methodological drawbacks. Further research is necessary to determine the optimal preparation and treatment protocols for PRP therapy and clarify its effectiveness in andrology.

CYP7B1 as a Biomarker for Prostate Cancer Risk and Progression: Metabolic and Oncogenic Signatures (Diagnostic Immunohistochemistry Analysis by Tissue Microarray in Prostate Cancer Patients-Diamond Study).

We aimed to analyze the association between CYP7B1 and prostate cancer, along with its association with proteins involved in cancer and metabolic processes. A retrospective analysis was performed on 390 patients with prostate cancer (PC) or benign prostatic hyperplasia (BPH). We investigated the interactions between CYP7B1 expression and proteins associated with PC and metabolic processes, followed by an analysis of the risk of biochemical recurrence based on CYP7B1 expression. Of the 139 patients with elevated CYP7B1 expression, 92.8% had prostate cancer. Overall, no increased risk of biochemical recurrence was associated with CYP7B1 expression. However, in a non-diabetic subgroup analysis, higher CYP7B1 expression indicated a higher risk of biochemical recurrence, with an HR of 1.78 (CI: 1.0-3.2, p = 0.05). PC is associated with elevated CYP7B1 expression. In a subgroup analysis of non-diabetic patients, elevated CYP7B1 expression was associated with an increased risk of biochemical recurrence, suggesting increased cancer aggressiveness.

Testicular biopsies in men with testicular microlithiasis and additional risk factors for cancer: A case series.

BACKGROUND: Testicular microlithiasis is the presence of small calcifications in the testicular parenchyma. The association between testicular microlithiasis and germ cell neoplasia in situ, a precursor to testicular cancer, is still unclear. OBJECTIVES: To determine the incidence of germ cell neoplasia in situ in men with testicular microlithiasis and evaluate the indication for testicular biopsy according to risk factors in the form of male infertility/reduced semen quality, testicular atrophy, and history of cryptorchidism. MATERIALS AND METHODS: This retrospective case series included all patients diagnosed with testicular microlithiasis who underwent testicular biopsies at three hospitals in Denmark between 2007 and 2021. The medical records of 167 patients were reviewed, and data on patient demographics, testicular microlithiasis characteristics, risk factors, histological findings, and treatments were collected. The main outcome measure was the incidence of germ cell neoplasia in situ in relation to each risk factor. The data were analyzed using descriptive statistics. Logistic regression was used to examine the odds ratio of germ cell neoplasia in situ in patients with testicular microlithiasis and testicular atrophy. RESULTS: Germ cell neoplasia in situ was found in 13 out of 167 patients (7.8% [95% confidence interval: 4.3, 13.2]). Eleven of these had testicular atrophy resulting in a significantly higher incidence in this group than other risk factors (odds ratio 9.36 [95% confidence interval: 2.41, 61.88]; p = 0.004). DISCUSSION: The study comprises the largest cohort to date of men who have undergone testicular biopsies because of testicular microlithiasis and additional risk factors. Limitations include its retrospective design, and relatively low absolute numbers of patients with germ cell neoplasia in situ on biopsies. CONCLUSION: This study found that men with testicular microlithiasis and testicular atrophy are at an increased risk of germ cell neoplasia in situ. Additionally, our results indicate that biopsies should be considered in men with a combination of subfertility and bilateral testicular microlithiasis. Our findings do not support testicular biopsies for men with testicular microlithiasis and other risk factors.

Phosphodiesterase type 5 inhibitors do not prevent curvature progression but shorten pain duration in the active phase of Peyronie's Disease: A retrospective cohort study.

Treatment with Phosphodiesterase Type 5 inhibitors (PDE5is) has shown promise in managing Peyronie's disease (PD) during its active phase. In a retrospective cohort study of 133 PD patients, we compared daily PDE5i treatment (sildenafil 25 mg or tadalafil 5 mg) in Group 1 (n = 101) to no treatment in Group 2 (n = 32). The mean age ± SD was 58.5 ± 10, (range: 29-77) years in Group 1 and 59 ± 13.7 years (range: 23-80) in Group 2 (p = 0.5). Mean symptom onset-to-visit time was 10.6 ± 7.2 months (range: 1-37) in Group 1 and 11 ± 6.3 months (range 3-27) in Group 2 (p = 0.5). Mean penile curvature change was +0.87° (95% CI: -1.8, 3.5) in Group 1 and +5.72° (95% CI: 1.4, 10) in Group 2 (p = 0.07) between first and last observations. Group 1 experienced shorter mean pain duration (9.1 ± 4.7 months, range: 2.5-24) than Group 2 (12.2 ± 6.5 months, range: 5-28) (p = 0.04). When controlling for baseline curvature and symptom onset-to-visit time, there were no differences between groups (-4.7, 95% CI: -10, 0.6) (p = 0.08). In conclusion, continuous PDE5i treatment did not affect PD curvature progression but showed a promising effect on pain.

Quality of information and appropriateness of ChatGPT outputs for urology patients.

BACKGROUND: The proportion of health-related searches on the internet is continuously growing. ChatGPT, a natural language processing (NLP) tool created by OpenAI, has been gaining increasing user attention and can potentially be used as a source for obtaining information related to health concerns. This study aims to analyze the quality and appropriateness of ChatGPT's responses to Urology case studies compared to those of a urologist. METHODS: Data from 100 patient case studies, comprising patient demographics, medical history, and urologic complaints, were sequentially inputted into ChatGPT, one by one. A question was posed to determine the most likely diagnosis, suggested examinations, and treatment options. The responses generated by ChatGPT were then compared to those provided by a board-certified urologist who was blinded to ChatGPT's responses and graded on a 5-point Likert scale based on accuracy, comprehensiveness, and clarity as criterias for appropriateness. The quality of information was graded based on the section 2 of the DISCERN tool and readability assessments were performed using the Flesch Reading Ease (FRE) and Flesch-Kincaid Reading Grade Level (FKGL) formulas. RESULTS: 52% of all responses were deemed appropriate. ChatGPT provided more appropriate responses for non-oncology conditions (58.5%) compared to oncology (52.6%) and emergency urology cases (11.1%) (p = 0.03). The median score of the DISCERN tool was 15 (IQR = 5.3) corresponding to a quality score of poor. The ChatGPT responses demonstrated a college graduate reading level, as indicated by the median FRE score of 18 (IQR = 21) and the median FKGL score of 15.8 (IQR = 3). CONCLUSIONS: ChatGPT serves as an interactive tool for providing medical information online, offering the possibility of enhancing health outcomes and patient satisfaction. Nevertheless, the insufficient appropriateness and poor quality of the responses on Urology cases emphasizes the importance of thorough evaluation and use of NLP-generated outputs when addressing health-related concerns.

The association between Peyronie's disease and depression: a scoping review.

INTRODUCTION: Peyronie's disease (PD) can have an immense psychological impact, with depression being a reported possible, severe consequence. To date, no literature reviews have systematically and critically assessed the relationship between PD and depression. OBJECTIVES: The study sought to identify and critically appraise the current literature on the association between PD and depression. METHODS: Studies had to address men with PD or probable PD and assess depression or depressive symptoms. Quantitative and qualitative, peer-reviewed, primary, empirical studies written in English or Danish were included. According to the guidelines for scoping reviews and the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews) guideline, we performed a systematic review of PubMed, PsycINFO, Embase, CINAHL, the Cochrane Library, and Web of Science. Reference lists of included studies were screened for additional sources. Gray literature was searched for in Google Scholar and Bielefeld Academic Search Engine. Data were charted using a data extraction form, and critical appraisal was performed using the QuADS (quality assessment with diverse studies) tool. RESULTS: Thirteen studies were included. Most studies had a cross-sectional design, and also cohort studies and longitudinal observational studies without a control group were found. Depression was assessed mainly by validated questionnaires or diagnostic codes. Questionnaire studies found a prevalences of moderate to severe depression of 24% to 48%, while studies using diagnostic codes found depression in 4% to 37% of men with PD. The quality of the included studies varied from 38% to 82% of the maximum possible score in the QuADS assessment. CONCLUSION: While most studies describe an association between PD and depression, the evidence is not comprehensive. The current literature is especially at risk of selection bias and the influence of confounding factors, and a direct causality between PD and depression cannot be established. Future research calls for more methodically rigorous studies as well as qualitative studies to understand the relationship.

Quality and benefits of the erectile dysfunction information on websites, social-media, and applications.

Erectile Dysfunction (ED) is defined as the persistent inability to obtain and maintain an erection that enables satisfactory sexual intercourse. ED prevalence vary across age groups, affecting approximately 1-9% of men under 40, 2-9% of those aged 40-59, and increasing to 20-40% for those aged 60-69. However, it remains a frequently untreated or insufficiently treated condition. Especially due to the feeling of discomfort and guilt, patients often avoid consulting their physicians; in this context, digital innovation could potentially play a pivotal role in the diagnosis and management of ED. This narrative review depicts the ongoing status of digital innovations in ED focusing on websites, social media platforms and mobile health applications (MHA). We examined Google, social media platforms (Facebook, Twitter, YouTube, and TikTok), and the recently developed MHA apps on Google Play Store and Apple App Store. Websites provide readily available but sometimes difficult to understand information, while social media is easy to understand and act on. MHA apps are the most complete and trustworthy tool for self-care management. In conclusion, digital innovations are a continuously growing source of information and therapeutic tools.

Erectile Dysfunction Is Associated with Left Ventricular Diastolic Dysfunction: A Systematic Review and Meta-analysis.

CONTEXT: Erectile dysfunction (ED) is associated with an increased risk of cardiovascular morbidity and mortality. OBJECTIVE: To systematically review and analyze the cardiac structure and function in men with ED assessed with echocardiography. EVIDENCE ACQUISITION: We performed a systematic review and meta-analysis according to the guideline of the Preferred Reporting Items for Systematic Reviews and Meta-analyses. We searched PubMed and the Cochrane Library on June 2, 2022, and included studies evaluating cardiac structure and function using echocardiography in men with ED compared with controls without ED. The Newcastle-Ottawa Quality Assessment Scale was used for assessing the quality of studies. We analyzed the mean differences in left ventricular ejection fraction (LVEF), the ratio of early transmitral filling velocity to early diastolic mitral annular velocity (E/e'), ratio of the early to late diastolic transmitral flow velocity (E/A), isovolumic relaxation time (IVRT), and left ventricular mass index (LVMi) in a random-effect model computed using means and standard deviations. The review was preregistered with PROSPERO (CRD42022337183). We received no funding. EVIDENCE SYNTHESIS: We included ten studies with 763 men diagnosed with ED (mean age: 55.6 yr) and 358 control men (mean age: 54.4 yr). E/e' was significantly worse in men with ED than in controls (mean absolute difference = 1.17, 95% confidence interval or CI [0.68, 1.65], p < 0.005). No significant differences were observed in LVEF, E/A, IVRT, or LVMi (-0.06, 95% CI [-1.06, 0.95], p = 0.91; -0.06, 95% CI [-0.24, 0.13], p = 0.55; 11.76, 95% CI [-0.88, 24.39], p = 0.07; and 4.37, 95% CI [-2.91, 11.65], respectively). The studies exhibited heterogeneity regarding study populations, reported echocardiography data, and variations in adjustments for confounding factors. CONCLUSIONS: Left ventricle diastolic dysfunction, as assessed by E/e', was more frequent in men with ED than in matched controls without ED. The results imply that echocardiography may be useful in the cardiovascular evaluation of men with ED to help identify myocardial impairment. PATIENT SUMMARY: This study reviewed for the first time previous research on cardiac structure and function in men with erectile dysfunction (ED), as assessed by echocardiography. We found that men with ED, compared with men without ED, had a higher ratio of early transmitral filling velocity to early diastolic mitral annular velocity , indicating a potentially higher rate of impaired diastolic function-a potential early indicator of heart disease. Identification of early signs of heart problems in men with ED may help initiate necessary lifestyle modifications or preventative therapies before the development of heart disease. However, more research is required to determine the clinical utility of using echocardiography as a risk assessment method.