Arab Journal of Urology最新文献

{"title":"Arabic translation, cross-cultural adaptation, and psychometric validation of the satisfaction survey for inflatable penile implant: The SSIPI-AR.","authors":"Majd AlKabbani, Nadir Fadol, Fouad Sakr, Khalid AlKubaisi, Kareim Khalafalla, Onder Canguven, Ahmad AlMalki, Ahmad Majzoub","doi":"10.1080/20905998.2026.2648366","DOIUrl":"https://doi.org/10.1080/20905998.2026.2648366","url":null,"abstract":"<p><strong>Objectives: </strong>To culturally adapt and psychometrically validate an Arabic version of the Satisfaction Survey for Inflatable Penile Implant (SSIPI-AR) for assessing patient satisfaction after inflatable penile prosthesis (IPP) implantation among Arabic-speaking men.</p><p><strong>Methods: </strong>We performed a cross-cultural translation and validation study of the 16-item SSIPI using forward translation, synthesis, back-translation, expert committee review, and pilot testing. Adult Arabic-speaking men (≥18 years) who had undergone IPP implantation 6 months to 5 years prior were recruited. Participants completed the SSIPI-AR at baseline and again after 2 weeks. Construct validity was evaluated using exploratory factor analysis (EFA). Reliability was assessed via internal consistency (Cronbach's alpha) and test - retest reliability (intraclass correlation coefficient, ICC). Satisfaction was summarized using total and domain scores.</p><p><strong>Results: </strong>Fifty men were included (mean age 57.5 ± 10.5 years). EFA supported retention of all 16 items with acceptable sampling adequacy (KMO = 0.505) and a significant Bartlett's test (<i>p</i> < 0.001). Four factors explained 81.83% of total variance: Implant Functionality and Usability (6 items), Overall Sexual Confidence and Satisfaction (5 items), Penile Appearance and Regret (3 items), and Concealability and Flaccid Appearance (2 items). Internal consistency was high for the total scale (Cronbach's alpha = 0.897) and subscales (0.816-0.924). Test - retest reliability was excellent (total ICC = 0.985; subscale ICCs 0.958-0.990; all <i>p</i> < 0.001). Mean total satisfaction was 75.31/80 (94.13%), with domain satisfaction ranging from 90.27% (appearance/regret) to 94.45% (sexual confidence/satisfaction).</p><p><strong>Conclusions: </strong>The SSIPI-AR demonstrates strong construct validity, high internal consistency, and excellent test - retest reliability, supporting its use as a brief, culturally appropriate, implant-specific patient-reported outcome measure for quantifying satisfaction after IPP implantation in Arabic-speaking populations.</p>","PeriodicalId":8113,"journal":{"name":"Arab Journal of Urology","volume":"24 4","pages":"296-303"},"PeriodicalIF":2.0,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13637785/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The safety and efficacy of metformin on metabolic syndrome parameters in prostate cancer patients receiving androgen deprivation therapy: A systematic review and meta-analysis.","authors":"Abdullah M Alharran, Munawer A Alsaid, Ali A Hussain, Faisal A Aladwani, Husain Alaradi","doi":"10.1080/20905998.2026.2637371","DOIUrl":"https://doi.org/10.1080/20905998.2026.2637371","url":null,"abstract":"<p><strong>Background: </strong>Prostate cancer patients are more likely to develop metabolic syndrome because androgen deprivation therapy (ADT), a standard treatment for advanced prostate cancer, causes major metabolic syndrome components and associated disorders. Metformin, a low-cost oral antidiabetic with a favorable safety profile, may be useful for preventing metabolic issues associated with ADT. This meta-analysis aims to assess the efficacy and safety of metformin on metabolic syndrome parameters in prostate cancer patients receiving ADT.</p><p><strong>Methods: </strong>In November 2025, we conducted a systematic search of PubMed, Scopus, and the Cochrane Library for randomized and non-randomized controlled trials. Studies were considered eligible if they included adult men (≥18 years) with prostate cancer receiving ADT and assessed metformin versus placebo/standard care on metabolic outcomes. For the meta-analysis, we used R 4.5.0 with R Studio 2024.12.1+563 using a random-effects mode.</p><p><strong>Results: </strong>We included ten trials with a total sample size of 2,642 patients. There were no significant differences in HbA1c (MD = -0.01, 95% CI -0.1; 0.2, P = 0.8), body weight (MD = 0.42, 95% CI -3.31; 4.16, P = 0.8), body mass index (MD = -0.01, 95% CI -0.1; 0.2, P = 0.8), or waist circumference (MD = -1.67, 95% CI -4.6; 1.26, P = 0.26). There was no significant difference in blood pressure, fasting glucose, triglycerides, or HDL cholesterol levels. Metformin was well tolerated but was related with a greater risk of diarrhea (RR = 2.55, 95% CI 1.02; 6.39). The Trial sequential analysis (TSA) stated that the current evidence is insufficient and underpowered.</p><p><strong>Conclusion: </strong>According to our data, metformin did not provide a substantial improvement in metabolic syndrome indices for prostate cancer patients on ADT. Its efficacy as a stand-alone remedy appears to be limited. Future large-scale clinical trials should investigate the role of metformin in combination with structured lifestyle changes.</p>","PeriodicalId":8113,"journal":{"name":"Arab Journal of Urology","volume":"24 4","pages":"356-373"},"PeriodicalIF":2.0,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13637778/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Undiagnosed Undescended Testis in Young Adults in Saudi Arabia: Examination-Based Prevalence, Sociocultural Barriers to Early Care and Public Health Implications.","authors":"Moath K Alfentoukh, Abdullah Ismail Alwehaibi, Ahmed Sulaiman Alwohaibi, Dhafer Abdullah Alshehri, Faisal Fahad Aljuaid, Tariq Abdullah M Aldawqi, Mohammed Ibrahim Aljaber, Hamad Abdulrahman Algaeed, Ahad A Alhabsi, Ahmed Allohidan","doi":"10.1080/20905998.2026.2631902","DOIUrl":"https://doi.org/10.1080/20905998.2026.2631902","url":null,"abstract":"<p><strong>Background: </strong>Undescended testis (UDT) persisting into adulthood increases risks of infertility and testicular cancer. In Saudi Arabia, delayed diagnosis is common and population prevalence of undiagnosed adult UDT is unknown. This study estimated point prevalence of previously unrecognized UDT among healthy young adult males in Riyadh and explored sociocultural barriers to early care.</p><p><strong>Methods: </strong>A cross-sectional, examination-based screening was conducted January - August 2025 at Al Kharj Armed Forces Hospital. Simple random sampling recruited 1349 Saudi males aged 18-28 from university, military and community populations. Trained senior surgeons performed standardized genital examinations; inter-examiner agreement was high (k = 0.91). Structured interviews assessed awareness, stigma, and reasons for non-consultation. Prevalence with 95% Wilson confidence intervals and χ² tests evaluated associations.</p><p><strong>Results: </strong>Mean age was 22.4 ± 2.6 years. Thirty-six participants had previously undiagnosed UDT, yielding a prevalence of 2.67% (95% CI 1.8-3.5%). All cases were unilateral (58.3% right, 41.7% left; <i>p</i> = 0.41). Most UDT were non-palpable (94.4%); associated anomalies were rare (2.8%). Reported reasons for non-consultation included lack of awareness/unnoticed abnormality (66.7%), social stigma (27.8%), and perceived familial normalization (5.6%).</p><p><strong>Conclusions: </strong>The observed high prevalence of undiagnosed UDT in Riyadh young adults exceeds typical adult estimates, indicating missed opportunities for early detection. Low awareness and sociocultural stigma are the main barriers; urgent actions include targeted education, routine genital screening in child and adolescent health encounters, standardized referral pathways, and individualized oncological surveillance or management for newly diagnosed adults.</p>","PeriodicalId":8113,"journal":{"name":"Arab Journal of Urology","volume":"24 4","pages":"349-355"},"PeriodicalIF":2.0,"publicationDate":"2026-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13637788/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hem-o-Lok® clip migration after robotic prostatectomy: PRISMA-guided review with two illustrative cases.","authors":"C P Leiberman, X W J Lee, T Amer, S K Nalagatla","doi":"10.1080/20905998.2026.2623583","DOIUrl":"https://doi.org/10.1080/20905998.2026.2623583","url":null,"abstract":"<p><p>Hem-o-Lok® polymer clips are widely used during robot-assisted radical prostatectomy. Although generally safe, delayed intravesical migration is an under-recognized source of lower urinary tract symptoms, haematuria and bladder stone formation. We report two illustrative cases - one with large bladder calculus formed around an eroded clip and another with spontaneous urethral passage - then synthesize the contemporary literature using a PRISMA-guided search. Across > 100 reported patients, time to presentation ranges from 1 to 252 months. The commonest presentations are LUTS, haematuria and recurrent infection; most cases are diagnosed by cystoscopy (often with confirmatory CT) and managed endoscopically with clip extraction ± laser lithotripsy, with open removal reserved for inaccessible or embedded clips. Proposed mechanisms include clip placement close to the vesicourethral anastomosis, devitalized tissue at the anastomosis, urine leak and radiotherapy-related impaired healing. Preventive strategies center on minimizing clip use near the anastomosis, meticulous retrieval of loose clips, judicious energy use at the apex/bladder neck, and considering alternatives (suture ligation or vessel-sealing devices) where appropriate. Increased awareness can shorten time to diagnosis and reduce morbidity for post-prostatectomy patients presenting with non-specific urinary symptoms years after surgery.</p>","PeriodicalId":8113,"journal":{"name":"Arab Journal of Urology","volume":"24 4","pages":"304-312"},"PeriodicalIF":2.0,"publicationDate":"2026-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13637765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and laboratory predictors of testicular loss in pediatric torsion patients.","authors":"Zlatan Zvizdic, Una Glamoclija, Asmir Jonuzi, Nadja Zvizdic, Semir Vranic","doi":"10.1080/20905998.2026.2625609","DOIUrl":"https://doi.org/10.1080/20905998.2026.2625609","url":null,"abstract":"<p><strong>Objectives: </strong>Pediatric testicular torsion (TT) requires emergency surgical intervention to prevent testicular loss. This study aimed to examine clinical and laboratory parameters that predict intraoperative orchidectomy and testicular atrophy (TA) at one-year follow-up, with a focus on symptom duration and inflammatory biomarkers.</p><p><strong>Materials and methods: </strong>A retrospective cohort study included 90 pediatric patients ( < 18 years) who underwent surgical exploration for TT. Clinical predictors included age, symptom duration, scrotal findings (pain, swelling, redness, high-riding testis), and preoperative preparation time. Laboratory parameters included leukocyte count, platelet count, mean platelet volume (MPV), and C-reactive protein (CRP). Testicular vascularization (normal vs. pathologic) was assessed preoperatively at presentation using color Doppler ultrasound (CDUS). Outcomes were orchiectomy or orchiopexy, and testicular atrophy (≥80% volume loss) at one-year follow-up. Multivariate logistic regression was used to identify independent predictors of testicular loss.</p><p><strong>Results: </strong>Forty patients underwent orchidectomy, and 50 underwent orchidopexy. Among those treated with orchidopexy, TS at one-year follow-up was achieved in 36 patients (72%). Age and type of vascularization were significantly different between patients from the orchidectomy and orchidopexy groups. There was a notably larger number of patients experiencing scrotal redness, swelling, or hardness in the orchidectomy group in comparison to the orchidopexy group. CRP was significantly higher in the orchidectomy group (<i>p</i> = 0.002). Multiple logistic regression indicated considerably increased odds ratios of orchidectomy with symptom duration > 12 hours, younger age, longer preoperative preparation times, and elevated CRP.</p><p><strong>Conclusion: </strong>Delayed presentation ( > 12 hours), younger age, elevated CRP, and longer preoperative preparation time were identified as the strongest predictors of orchidectomy and subsequent testicular atrophy. Symptom duration remained the most critical determinant of failed testicular salvage. These findings highlight the importance of timely recognition and prompt surgical management to optimize outcomes in pediatric testicular torsion.</p>","PeriodicalId":8113,"journal":{"name":"Arab Journal of Urology","volume":"24 4","pages":"342-348"},"PeriodicalIF":2.0,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13637775/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robot assisted radical nephrectomy with inferior vena cava thrombectomy; feasibility and outcome for level 3 thrombus with suprahepatic clamping.","authors":"Kishore Thekke Adiyat, Atanu Kumar Pal, Jeni Mathew, Biju Chandran","doi":"10.1080/20905998.2026.2618296","DOIUrl":"https://doi.org/10.1080/20905998.2026.2618296","url":null,"abstract":"<p><strong>Objective: </strong>To assess the feasibility and safety of robot assisted radical nephrectomy with inferior vena cava thrombectomy (RARN-IVCT) in patients with Level 3 thrombus with suprahepatic clamping.</p><p><strong>Methods: </strong>This is a retrospective analysis of the patients who underwent RARN-IVCT for locally advanced renal cell carcinoma over 6 years. The perioperative, post operative and oncological outcomes were compared between the patients who underwent level 2 vs. level 3 RARN-IVCT.</p><p><strong>Results: </strong>A total of 27 patients who underwent RARN-IVCT during the study period were included in this study. Level I, II, III and IV thrombectomy were performed in two, 14, 10 and one patients, respectively. The mean duration of follow-up was 31.6 ± 20.5 months. The thrombus length, console time, IVC clamp time, total operating time, blood loss and hospital stay were significantly less in the patients with level II IVC thrombus (7.23 ± 2.75 vs. 9.69 ± 2.82 cm, 166.78 ± 90.54 vs. 325.75 ± 105.4 min, 20.84 ± 11.5 vs. 29.6 ± 8.42 min, 337.69 ± 135.1 vs. 529.56 ± 69.45 min, 631.47 ± 321.5 vs. 980.52 ± 453.62 ml, 5.7 ± 2.7 vs. 8.34 ± 3.2 days, level II vs. level III, respectively). The tumour size, the fall of serum creatinine and the complication rates were similar. Only six patients (three patients each in level II and level III) received blood transfusion.</p><p><strong>Conclusion: </strong>RARN-IVCT with supra-hepatic clamping can be used as a safe and feasible approach in carefully selected patients. It can provide good perioperative outcomes without increasing the complications and risking survival.</p>","PeriodicalId":8113,"journal":{"name":"Arab Journal of Urology","volume":"24 4","pages":"334-341"},"PeriodicalIF":2.0,"publicationDate":"2026-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652051/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149164310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low-intensity shockwave therapy in men's health: Insights from a systematic review on erectile dysfunction and CP/CPPS in the Middle East.","authors":"Ahmad Majzoub, Mohamed Arafa, Osama Shaeer, Ahmed Loghmari, Amr Abdelhamed, Mohamed Wael Ragab, Haitham Elbardisi","doi":"10.1080/20905998.2025.2611547","DOIUrl":"https://doi.org/10.1080/20905998.2025.2611547","url":null,"abstract":"<p><p>Low-intensity shockwave therapy (LiSWT) has gained attention as a non-invasive treatment for various men's health conditions, including erectile dysfunction (ED), Peyronie's disease (PD), and chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). However, despite its increasing use, robust evidence supporting its effectiveness remains limited. This systematic review aims to evaluate the efficacy and safety of LiSWT in managing men's health conditions within the Middle East to provide region-tailored clinical recommendations. A systematic search was conducted using PubMed to identify studies that evaluated LiSWT in ED, PD, or CP/CPPS. Studies were included if they employed a prospective design and reported outcomes based on validated questionnaires. The quality of included studies was assessed using the Cochrane Risk of Bias Tool and the Newcastle-Ottawa Scale. Fourteen studies met the inclusion criteria; 7 RCTs, 2 non-randomized comparative studies, and 5 observational studies. Ten studies focused on ED, while 4 evaluated CP/CPPS. No studies on PD were identified. For ED, LiSWT demonstrated significant improvements in IIEF-5 and EHS scores across most studies, with better outcomes observed in younger patients, those with milder ED, and shorter disease duration. However, some studies found no significant differences between LiSWT and PDE-5 inhibitors or sham treatments, with benefits often diminishing over time. For CP/CPPS, LiSWT showed significant reductions in NIH-CPSI and IPSS scores, with improvements sustained up to 12 months. Study quality ranged from moderate to high, though limitations such as high risk of bias in some RCTs and selection bias in observational studies were noted. While LiSWT represents a promising therapeutic option for ED and CP/CPPS, its application should be costumized to meet the specific needs of individual patients. Future research should focus on developing standardized protocols and conducting large-scale randomized controlled trials to establish its long-term efficacy and optimize clinical use in the Middle East.</p>","PeriodicalId":8113,"journal":{"name":"Arab Journal of Urology","volume":"24 4","pages":"277-288"},"PeriodicalIF":2.0,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13637759/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A 6-year retrospective cost-effectiveness analysis of Memokath ureteric stents vs double-J stents - single-centre assessment.","authors":"Mayur Gami, Fawzy Farag, Azad Hawizy","doi":"10.1080/20905998.2025.2605927","DOIUrl":"https://doi.org/10.1080/20905998.2025.2605927","url":null,"abstract":"<p><strong>Introduction: </strong>Double-J (JJ) stents are widely used in obstructive uropathy but are associated with encrustation, infection, migration, and the need for repeated exchanges. Metallic ureteric stents such as the Memokath-051 (MMK), in use since 1996, demonstrate high patency rates and efficacy in both benign and malignant ureteric strictures. While prior studies suggest cost-effectiveness over JJ stents, UK-specific data remain limited. This study evaluates the cost-effectiveness, function, and safety of MMK in chronic obstructive uropathy.</p><p><strong>Materials and methods: </strong>A retrospective cohort study was conducted of adult patients who underwent MMK insertion between March 2016 and August 2022 for malignant or benign ureteric strictures. Patients with pregnancy, acute sepsis, or acute renal failure were excluded. The primary outcome was cost-effectiveness compared with JJ stent exchanges. Secondary outcomes were stent function and safety.</p><p><strong>Results: </strong>Twenty-one patients (10 men, 11 women) were included, with a median age of 69 years (range:46-86). Left ureteric stents accounted for 38%, right ureteric in 52%, and bilaterally in 10%. 81% benign obstruction, with the remaining malignant. Stent lengths ranged from 6-15 cm.After a follow-up of up to 65 months, 52% of patients retained their MMK stent in situ. 20% required removal due to encrustation or haematuria, and 10% experienced spontaneous stent migration. Overall, 70% were successfully managed with MMK. 20% died with the stent in situ (mean duration:15 months). 18% retained stents for >6 months (median: 25 months).Total cost savings were £42,890 compared with repeated JJ stent exchanges, increasing proportionally with stent dwell time. No MMK-related infections or infection-related admissions occurred.</p><p><strong>Conclusion: </strong>Memokath-051 is a safe and cost-effective option for chronic obstructive uropathy, with a clinical success rate of 72% and substantial cost savings, particularly in benign strictures. Patients with malignant obstruction may benefit clinically, though shorter stent duration reduces cost-effectiveness.</p>","PeriodicalId":8113,"journal":{"name":"Arab Journal of Urology","volume":"24 4","pages":"374-380"},"PeriodicalIF":2.0,"publicationDate":"2026-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13637768/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early continence assessment in retzius sparing robot Assisted radical prostatectomy using CMR versius® robotic surgical system.","authors":"Mahmoud Abd El Hakim, Hany El Fayoumy, Farouk El Gamal, Ashraf Abou El Ella, Ahmed S Elsayed, Mostafa Sheba","doi":"10.1080/20905998.2025.2596537","DOIUrl":"https://doi.org/10.1080/20905998.2025.2596537","url":null,"abstract":"<p><strong>Introduction: </strong>Retzius-sparingrobot-assisted radical prostatectomy (RS-RARP) has been shown to significantlyimprove postoperative continence outcomes. Traditionally, this technique isperformed using the Da Vinci® Surgical System. To evaluatealternative robotic systems, we conducted RS-RARP procedures using the Versius® robotic surgical system. This report presents the functional outcomes of ourinitial experience and contributes to the growing body of evidence supportingthe feasibility and efficacy of the Versius® roboticsurgical system in RS-RARP.</p><p><strong>Methods: </strong>This prospective,non-randomized observational study included 50 patients who underwent RS-RARPusing the Versius® robotic surgical system with four bedside units.Surgeries were performed at Cairo University Hospitals (King Fahd Unit) and theRobosurge Center, Cleopatra Hospital Group (CHG) S.A.E. Cairo, Egypt, betweenDecember 2023 and August 2024. The procedure began with a horizontal incisionin the posterior peritoneum. The vasa deferentia were identified and transectedbilaterally. Seminal vesicles were mobilized and dissected after vascularcontrol. Denonvilliers' fascia was incised to develop the posterior planetoward the prostate-urethral junction. Prostatic pedicles were ligated anddivided, followed by lateral dissection to the apex and exposure of the dorsalvein complex. The bladder neck was sharply dissected. Anterior dissection wasperformed while preserving the detrusor and anterior pubovesical complex Urethrovesical anastomosis wascompleted using two 3-0 V-Loc™ sutures.</p><p><strong>Results: </strong>Earlycontinence - defined as use of 0-1 safety pad/day - was achieved in 90% ofpatients, rising to 96% at 6 months. An IIEF-5 score ≥17 was reported in 32% ofpatients at 1, 3, and 6 months postoperatively. The mean operative time was192.9 ± 7.5 minutes, with a mean prostate volume of 51.9 ± 15.9 grams and meanestimated blood loss of 82 mL. The average hospital stay was 2 days, andcatheter removal occurred after a mean of 7 days. Complications occurred in 10%of cases (<i>n</i> = 5), and the positive surgical margin (PSM) rate was 6%.</p><p><strong>Conclusions: </strong>RS-RARP using the Versius® robotic surgical system is feasible and demonstrates favorable early outcomes in terms of continence,potency, and oncological safety. Further studies with larger cohorts andextended follow-up are warranted to validate these findings.</p>","PeriodicalId":8113,"journal":{"name":"Arab Journal of Urology","volume":"24 4","pages":"313-333"},"PeriodicalIF":2.0,"publicationDate":"2025-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13637763/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiological characteristics and temporal trends of male infertility in Egypt (2012-2022): Analysis of 3,037 consecutive cases.","authors":"Ramadan Saleh, Mohamad A Elsuity, Islam R Saleh, Taha Abo-Almagd Abdel-Meguid Hamoda, Pallav Sengupta, Sulagna Dutta, Ralf Henkel","doi":"10.1080/20905998.2025.2590924","DOIUrl":"https://doi.org/10.1080/20905998.2025.2590924","url":null,"abstract":"<p><strong>Background: </strong>Male factors contribute to about half of global infertility cases, yet regional data are limited, particularly in Egypt.</p><p><strong>Objective: </strong>To characterize the sociodemographic, clinical, seminal, and hormonal profiles of infertile Egyptian men and investigate their correlations.</p><p><strong>Methods: </strong>We retrospectively analyzed the medical records of infertile men presented to a single busy andrology/infertility center in Egypt between June 2012 and May 2022. Demographic, clinical, seminal, and hormonal data were reviewed, and trends and correlations were assessed.</p><p><strong>Results: </strong>Of 3,037 men, primary infertility accounted for 76.13%, with a median infertility duration of 4 years. Varicocele was observed in 66.47% of cases, predominantly second-degree. Asthenozoospermia (31.74%), oligoasthenozoospermia (20.78%), and azoospermia (9.12%) were the most frequent semen abnormalities. Median sperm concentration was 24 million/ml, progressive motility 25%, and normal morphology 10%. From 2012 to 2022, median sperm concentration declined from 24 million/ml to 18 million/ml (<i>p</i> = 0.2), progressive motility declined from 25% to 17% (<i>p</i> < 0.001), and normal sperm morphology declined from 10% to 5% (<i>p</i> < 0.001). The COVID-19 pandemic period (2020-2022) exhibited the most prominent reduction in sperm progressive motility (from 21% to 17%; <i>p</i> < 0.001). Smoking negatively correlated with all sperm parameters. Follicle-stimulating hormone and luteinizing hormone levels correlated negatively with semen quality and testicular volume but positively with infertility duration. Neither varicocele grade nor total testosterone levels correlated significantly with sperm parameters.</p><p><strong>Conclusion: </strong>This study identified primary infertility, varicocele diagnosis and asthenozoospermia as predominant findings among infertile Egyptian men. Over a decade, temporal declines in sperm concentration, motility, and morphology were observed, exacerbated by the COVID-19 pandemic. Smoking and elevated gonadotropins negatively influenced semen quality and testicular volume, whereas testosterone levels and varicocele grade showed no significant correlation. These findings highlight the importance of developing integrated, region-specific strategies to address male infertility.</p>","PeriodicalId":8113,"journal":{"name":"Arab Journal of Urology","volume":"24 4","pages":"265-276"},"PeriodicalIF":2.0,"publicationDate":"2025-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13637787/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}