Influence of social media on urologic knowledge acquisition among young urologists in Saudi Arabia.

Objectives: The present study explores how young urologists in Saudi Arabia are adopting social media as a learning tool and how this new development is shaping as far as learning is concerned. Methods: A 18-item online survey via survemonkey.com was conducted. The survey was distributed through email in Saudi Arabia. The survey targeted young urologists and urology residents. The survey design and distribution was performed according to CHERRIES guidelines. Due to the quantitative nature of study data, SPSS software was used to analyze collected data. Results: A total of 104 young Saudi urologists responded to our survey. Participants were mostly familiar with the use of Twitter (86%), followed closely by YouTube (82%) and then Snapchat and Instagram (73% and 63%, respectively), a large portion (72%) of participants believe that social media has a moderate-to-high influence on their urology knowledge, YouTube was by far the most used source to watch and understand surgical skills, followed by reference books and websites, respectively. Conclusion: Social media has contributed to the spread of medical information among urology community and outside the urology community as well, with easier spread of medical knowledge to all involved by using social media, an extensive impact is achieved to both physicians and patients as well. For future work, this study should be conducted again, to monitor and compare the progression of usage among urologists.

Embolization of an angiomyolipoma in a crossed fused renal ectopia.

Crossed fused ectopic kidney represents a rare congenital malformation, and development of an angiomyolipoma (AML) in a crossed fused ectopia is even rarer. There is no clear association between both entities. However, approximately half of crossed fused renal ectopic patients may develop infections, obstruction and/or nephrolithiasis. Nevertheless, they are very rarely associated with carcinoma. To our knowledge, this is the first case of AML in crossed fused renal ectopia. In this report, we present a patient with a left renal angiomyolipoma in a crossed fused renal ectopia managed by embolization. In addition, a literature review for relevant cases will be provided.

Gubernaculum Sparing Laparoscopic Orchiopexy in Cryptorchidism with Ipsilateral Congenital Absence of the Vas Deferens: Unique Outcome.

Congenital absence of the vas deferens (CAVD) is an uncommon anomaly that occurs in up to 1% of the male population. It can be associated with various other anomalies, including cryptorchidism and renal anomalies, such as renal agenesis. We here present a case of cryptorchidism with ipsilateral congenital absence of the vas deferens and renal agenesis and used the Stephen-Fowler technique for Orchiopexy depending on gubernacular vessels. A 7-month-old boy was referred to our center with left grade 2 hydronephrosis, right renal agenesis, and right impalpable, undescended testis. Examination under anesthesia and laparoscopic exploration with staged Stephen-Fowler orchiopexy were performed. The patient was followed up at 3, 6, and 12 months and had an excellent outcome. Cryptorchidism with congenital ipsilateral absence of the vas deferens and renal agenesis is a rare diagnostic entity. Our case supports the suggested theory that the gubernacular vessels can increase the blood supply to the testis, although further studies are needed to confirm this hypothesis.

Urological knowledge among primary health care physicians in Saudi Arabia.

OBJECTIVES: To evaluate the general knowledge among primary health care (PHC) physicians regarding the management of common urological problems in Saudi Arabia. METHODS: This is an observational prospective study, where a self-administered questionnaire was distributed to practicing PHC physicians in the western region of Saudi Arabia on January 2017. The questionnaire consisted of 21-item questions, inquiring about demographics and general urological knowledge and skills. The management of common urological problems was assessed by case scenarios for specific urological condition, including urethral catheterization, definition and evaluation of hematuria, recognition of age-specific increase in prostatic specific antigen (PSA), and management of lower urinary tract symptoms. Results: A total of 148 questionnaires were distributed, with a response rate of 75.7%, where 112 respondents completed the questionnaires,  including 54.3% residents, 39% general practitioners, and 5.4% specialists. Fifty-seven percent of respondents were males and 68% were Saudi practitioners. A higher number of respondents expressed that they were able to catheterize a male than female patient (56.5% versus 34.3%). Only 6.4% of respondents defined microscopic hematuria accurately. Knowledge about hematuria, serum prostate specific antigen and overactive bladder was low in all groups. Apart from hematuria, seeking urological consultations was less than 35% for all other disease entities. CONCLUSION: Urological knowledge among PHC physicians seems to be insufficient. Significant percentages of the participants were unable to catheterize a female patient, did not know the definition of hematuria; and whether to ask for urological consultations in cases of hematuria, increased PSA, and overactive bladder.

Current status of robot-assisted urologic surgery in Saudi Arabia: Trends and opinions from an Internet-based survey.

OBJECTIVES: The objective of this study is to assess the current status of urologic robot-assisted surgery (RAS) in Saudi Arabia and evaluate perceptions of its importance and utility. METHODS: A 59-item questionnaire was E-mailed to urologists and trainees in Saudi Arabia to assess the demographics and individual and institutional surgical practices of minimally invasive surgery (MIS) with a focus on RAS and urologic subtypes. RESULTS: Ninety-five surveys were completed. Nearly 53%, 46%, and 21% of respondents were formally trained in laparoscopic surgery, MIS, and RAS, respectively. Forty percent had used a robot console during training. Nearly 72% of participants felt that RAS training should be included to accomplish their career goals and stated that it would strengthen the department academically and financially. The absence of a robotic system (45%) and administrative disinterest with lack of support (39%) were the most common deterrents. Robot-assisted radical prostatectomy (RARP), robot-assisted radical cystectomy (RARC), and robot-assisted radical nephrectomy (RARN) were regarded as the gold standard for 34%, 23%, and 17% of respondents, respectively. Respondents would recommend RARP (74%), RARC (50%), and RARN (57%) for themselves or their family. The greatest perceived benefits of RAS were its ease of use and improvement in the patient's quality of life. CONCLUSION: Urologists in Saudi Arabia recognize the superiority of RAS over traditional surgical methods but lack exposure, training, and access to RAS. This survey reveals increasing acceptance of RAS and willingness to incorporate the technology into practice.

The impact of stone composition on renal function.

BACKGROUND: Nephrolithiasis is a common condition that has various classifications according to stone composition. Stone formation can affect renal function; it can be a strong risk factor for chronic kidney disease (CKD). The main objective of this study is to explore the association between creatinine clearance and different stone compositions. METHODS: This is a retrospective cohort study conducted in a tertiary center in Jeddah, Saudi Arabia, between 2005 and 2014. Renal function was assessed by the estimating glomerular filtration rate (eGFR) by the Cockcroft-Gault equation. Stone composition was determined by urinary calculi analysis with infrared spectrometry. RESULTS: Stones of 365 patients, with a mean age of 48.2 ± 13.6 years and a male to female ratio of 3.2:1, were analyzed. Stage 2 CKD has been documented. It involved oxalate, struvite, cystine, and uric acid stones. The worst eGFR was reported for stones containing uric acid. The eGFR was least affected with apatite stones followed by brushite stones. CONCLUSION: Stone disease can affect renal function. Different stone compositions show factor for renal impairment, and this should be considered in patient management. A special precaution should be considered for higher risk groups. Multidisciplinary patient care and immediate referral to a nephrologist are strongly advised.

Bladder leiomyoma in male patient presenting with renal oncocytoma: Are the two conditions related?

A 64-year-old male patient with a large pelvic mass and a right renal mass was referred to our facility. The patient underwent a right radical nephrectomy and pelvic mass excision. A histopathological examination led to a diagnosis of renal oncocytoma and urinary bladder leiomyoma.

Testicular cancer in Down syndrome with spinal cord metastases.

A 22-year-old male patient with Down syndrome was referred to our hospital with a vast left testicular mass. He underwent a left radical inguinal orchiectomy, and a histopathological examination of the mass showed a yolk sac tumor invading the epididymis. The patient was discharged in a satisfactory condition. Sixteen days later, the patient presented again complaining of lower limb weakness. Magnetic resonance imaging of the spine showed metastatic lesions compressing the dorsal spine, and he underwent emergency surgical decompression. The histopathology of the metastatic lesions revealed a yolk sac subtype which was identical to his primary testicular tumor.