Prevalence of Urogenital Injury following Road Accident: A Systematic Review.

INTRODUCTION AND HYPOTHESIS: Trauma complications have been one of the most serious public health concerns worldwide. In most reports, urogenital injuries (UGIs) are seen in approximately 10% of adult traumatic patients and less than 3% of children with multiple/severe trauma to the abdomen or pelvis. Traffic accidents are the most common cause of UGIs. The purpose of this study is to systematically determine the prevalence and types of UGIs after car accidents. METHODS: The search strategy was aimed at finding relevant studies in October 2023. No restrictions on language or date were applied. The following criteria were considered eligibility criteria: reporting at least one epidemiological aspect of UGIs in people with road traffic injury (RTI) and a separate epidemiological analysis of RTIs in UGI (we also included those articles that pointed out all RTIs but separately mentioned UGIs). Two experts assessed the reporting quality of articles using standardized critical appraisal instruments from the Joanna Briggs Institute. Statistical analysis for this study was conducted using the CMA statistical software version 3.2.0. RESULTS: A total of 1,466,024 cases following RTIs through 107 studies were included in our review. Of these, 29 studies were related to children (20,036), and the others reported RTIs in adults (1,445,988). The total prevalence was 4.7%, and car accidents were responsible in 36 studies, followed by motorcycle accidents in 25, bicycles in 17 studies, and automobile-pedestrian collisions in 23 related studies. In subgroup analysis based on the damaged organ, the rate of bladder injury was 3.5%. This rate was 5.3% for kidneys. CONCLUSION: This systematic review and meta-analysis found that the prevalence of UGI following RTIs was 4.7%, with car accidents being the most common cause. UGIs were more prevalent in adults than in children, and bladder and kidney injuries were the most commonly reported types. The prevalence of UGI varied by country and study design.

Evaluating the Effectiveness of Intravesical Instillation of BCG by Modified Maintenance Method in Patients With High-Risk Ta and T1 Bladder Cancer: A Randomized Clinical Trial.

Background: It is estimated that 75% of urothelial bladder cancers are non-muscle-invasive cancers (NMIBCs). The development of more effective methods for optimizing the management of this subset of patients is of paramount importance. This study aimed to evaluate the effectiveness and side effects of modified maintenance Bacillus Calmette-Guérin (BCG) therapy in patients with high-risk NMIBC. Methods: A total of 84 patients with NMIBC who met the inclusion criteria were randomly divided into 2 groups of 42 patients after receiving intravesical BCG weekly, 1 month after transurethral resection of the bladder tumor (TURT) for 6 weeks as the induction. In group I, patients continued monthly intravesical instillation of BCG for 6 months as maintenance, whereas group II patients did not. All patients were followed up for recurrence and progression for 2 years. Results: Although the recurrence rate was lower in group I (16.7% vs 31%), there was no significant difference among groups (P = .124). Pathology progression was also lower in group I (7.1% vs 11.9%) with no significant difference among groups (P = .713). Complications were not statistically different among groups (P = .651). A statistically significant difference was not observed between the groups in the acceptance rate of patients (97.6% in group I vs 100% in group II). Conclusions: The recurrence rate and progression rate in NMIBC patients with maintenance-free induction therapy after TURT were almost twice as high as those with 6-month maintenance therapy; however, it was not statistically significant. Modified BCG maintenance protocol made favorable compliance for patients. Trial registration: This study was retrospectively registered at Iranian Registery of Clinical Trials with the code IRCT20220302054165N1.

COVID-19 outbreak and the impact on renal disorders: A rapid review.

In this rapid review, we aimed to evaluate the effect of coronavirus disease 2019 (COVID-19) on renal functions and mortality of patients with kidney diseases. We searched MEDLINE, The Cochrane Library, Scopus, Embase, Web of Science, UpToDate, and TRIP databases using the following keywords: COVID-19, COVID19, 2019-nCoV, 2019-CoV, coronavirus, SARS-nCoV-2, urology, cancer, bladder, prostate, kidney, trauma, stone, neurogenic, and reconstructive. The initial search resulted in 495 records. After the primary screening of titles, abstracts, and full texts and removing duplicates, 10 articles were selected and included in this rapid review. Moreover, we performed meta-analysis of binary data for the outcomes with sufficient data. Owing to a high level of heterogeneity because of different study designs and contexts, we used a random model for the meta-analysis. Only 5 studies were eligible for the meta-analysis. In these studies, comprising 964 COVID-19 positive patients, the cumulative event rate of acute kidney injury (AKI) was 7.1% (95% confidence interval: 1.8%-24.5%, p<0.001, I2=92.4). Based on the qualitative synthesis of the 10 included studies, patients with COVID-19 and kidney diseases had higher risk of in-hospital mortality. If AKI occurs because of the novel coronavirus, the mortality rate will be very high. Therefore, we need further investigations and more studies to recognize the extent and the cause of renal involvement in COVID-19.

Bilateral isolated Epididymal Agenesis in a 32 year old man.

Epididymal agenesis is defined as the absence of the epididymis totally or segmentally, unilateral or bilateral, which is secondary to the Wolffian duct malformation (1). Rete testis, epididymis, vas deferens and seminal vesicle are believed to develop from Wolffian ducts.

Bilateral isolated Epididymal Agenesis in a 32 year old man

Epididymal agenesis is defined as the absence of the epididymis totally or segmentally, unilateral or bilateral, which is secondary to the Wolffian duct malformation (1). Rete testis, epididymis, vas deferens and seminal vesicle are believed to develop from Wolffian ducts.