André Van der Merwe

Background: Mpox primarily presents with systemic and cutaneous symptoms. However, it can also lead to urological complications, necessitating specialized attention. The aim of this scoping review is to summarize the current evidence regarding the urological manifestations of Mpox, possible complications, and available treatments. Methods: An electronic systematic search of the current literature was conducted through the Medline and NCBI PubMed and Scopus databases on 18th August 2024. Our study search and inclusion criteria were in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. 9 The search terms and keywords used were: “monkeypox; Mpox” (MeSH Terms), combined with different terms: “urology”, “kidney”, “ureter”, “bladder”, “prostate”, “genitals”, “penis”, “testicles”, “urethra”, in all different possible combinations. Results: A total of 32 articles included in the scoping review. A total of 116 patients were included, all males. The genitals were the most interested organs, associated with urethritis, while bladder and kidneys seemed to be not impacted by the disease. Patients were usually young, with a mean age of 36 years [31.5– 40 years]. The most prevalent risk factor was sexual intercourse in the days/weeks before the appearance of symptoms. All patients had a molecular confirmatory diagnosis by a polymerase chain reaction (PCR) test. Five articles out of 32 (15.6%) reported the need for surgical debridement of penile and genital lesions due to their clinical worsening. However, in most reports, patients experienced spontaneous resolution of the lesions and symptoms. Conclusion: Awareness of Mpox and timely diagnosis are crucial for ensuring appropriate treatment and reducing the need for surgical management and the possible risk of long-term sequelae. Collaboration among dermatologists, infectious disease specialists, and urologists is pivotal to effectively managing Mpox patients.

Introduction: This study aimed to evaluate fresh-frozen cadavers (FFC) as a novel model for percutaneous nephrolithotomy (PCNL) training, focusing on ultrasound-guided supine PCNL. Methods: Sixteen urologists participated in a 2-day course at a tertiary center to assess the utility of an FFC model for ultrasound-guided supine PCNL. After the procedure, the participants completed a 24-question evaluation of the FFC model using a 5-point Likert scale. The questionnaire assessed tissue quality, US imaging, procedural steps, overall experience compared to live patient procedures, and suitability of the model for both basic and advanced supine PCNL training. Results: The tactile sensation, skin stiffness, and distensibility of the calyces resembled real-life scenarios as the cadavers thawed. Similarly, US quality was worse in frozen cadavers and improved after irrigation with the collection system. Valdivia-Galdakao positioning is considered more difficult than in real life, because of rigor mortis. Conclusion: FFC demonstrated robust content validity as a training model for PCNL. The model provides a realistic and effective training experience, offering a promising tool for developing critical surgical skills, while minimizing radiation exposure and procedural risks.

Purpose: Haemorrhagic cystitis may be due to different etiologies with infectious diseases representing an insidious cause to diagnose. The aim of this narrative review is to provide a comprehensive overview of less common but difficult-to-diagnose causes of infectious haemorrhagic cystitis of bacterial, mycobacterial, and parasitic origin, Moreover, we highlight possible diagnostic tools and currently available treatment options in order to give an updated tool for urologists to use in daily practice. Patients and Methods: The search engine PubMed was used to select peer-reviewed articles published from 1/Jan/2010 to 31/Aug/2022. Results: Bacteria, fungal, TB and schistosomiasis are uncommon causes of haemorrhagic cystitis burdened by high morbidity, especially if not promptly diagnosed. Conclusion: Because haemorrhagic cystitis ranges in severity from mild dysuria associated with pelvic discomfort to severe life-threatening haemorrhage, punctual diagnosis, and immediate treatment are essential to avoid further complications.

Background: Stellenbosch University’s (SU) Faculty of Medicine and Health Sciences (FMHS), developed a sexual health course to be integrated throughout the revised medical curriculum.Aim: To use the Sexual Health Education for Professionals Scale (SHEPS) to gather baseline and future follow-up data to inform curriculum development and evaluation.Setting: The first-year medical students (N = 289) of the FMHS SU.Methods: The SHEPS was answered before the start of the sexual health course. The knowledge, communication and attitude sections were answered with a Likert-type scale. Students had to describe their perceived confidence in their knowledge and communication skills to care for patients within specific sexuality-related clinical scenarios. The attitude section measured the students’ level of agreement or disagreement on sexuality-related opinion statements.Results: The response rate was 97%. Most students were female, and 55% of the class were first taught about sexuality in the age group 13–18 years. The students had more confidence in their communication skills than knowledge before any tertiary training. The attitude section revealed a binomial distribution, ranging from acceptance to a more restrictive attitude towards sexual behaviour.Conclusion: It is the first time the SHEPS has been used in a South African context. The results provide novel information about the range of perceived sexual health knowledge, skills and attitudes of first-year medical students before they start tertiary training.Contribution: Findings from this study will guide content development and evaluation of the sexual health course at the institution where the study was conducted, as well as allow for culture sensitive education.

Background: Comorbid depression and anxiety in men with localised prostate cancer (CaP) largely go undiagnosed and untreated and their effects on health-related quality of life (HRQOL) in men with CaP should not be underestimated. We examined the prevalence of depression and anxiety and its association with HRQOL in men about to commence treatment for CaP and the differences between treatment groups, radical prostatectomy (RP) and radiation therapy (RT). Method: One hundred and seven participants from a longitudinal prospective observational study assessing depression, anxiety and HRQOL in men with localised CaP (DAHCaP), were used in this cross-sectional analysis. Data were collected shortly before participants were scheduled to receive their treatment. The Centre for Epidemiologic Studies Depression Scale (CES-D), the State Trait Anxiety Inventory (STAI), the Memorial Anxiety Scale for Prostate Cancer (MAX-PC), the European Organisation for Research and Treatment in Cancer Quality of Life questionnaire (EORTC QLQ-C30) and (EORTC QLQ-PR25) were used in this analysis. Results: Symptoms of depression pre-treatment were noted in 39.3%, state anxiety 28%, trait anxiety 31.4% and prostate cancer anxiety in 12.1% of participants. Statistically significant correlations ( P ≤ .05) with the CES-D and a cluster of symptoms on the EORTC QLQ-C30 domains for Global Health (r _s = −.35), fatigue (r _s = .38), pain (r _s = .32), dyspnoea (r _s = .28), insomnia (r _s = .30) and finance (r _s = .26) and EORTC QLQ-PR25 domains for urinary symptoms (r _s = .43), bowel (r _s = .43) and hormone replacement therapy (HRT) (r _s = .41) were observed. Statistically significant correlations were also noted between the STAI-S and EORTC QLQ-C30 and EORTC QLQ-PR25. No statistically significant difference was noted between treatments. Conclusion: More men were depressed than anxious with significant associations with HRQOL prior to commencement of treatment. CaP treatments should focus not only on the prevailing indisposition but include a psychooncological and HRQOL assessment at pre-treatment in high-risk individuals.

The aim of this review is to analyze and describe the current landscape of bladder cancer diagnostic and surveillance biomarkers. We researched the literature from 2016 to November 2021 to find the most promising new molecules and divided them into seven different subgroups based on their function and location in the cell. Although cystoscopy and cytology are still the gold standard for diagnosis and surveillance when it comes to bladder cancer (BCa), their cost is quite a burden for national health systems worldwide. Currently, the research is focused on finding a biomarker that has high negative predictive value (NPV) and can exclude with a certainty the presence of the tumor, considering missing it could be disastrous for the patient. Every subgroup has its own advantages and disadvantages; for example, protein biomarkers cost less than genomic ones, but on the other hand, they seem to be less precise. We tried to simplify this complicated topic as much as possible in order to make it comprehensible to doctors and urologists that are not as familiar with it, as well as encourage them to actively participate in ongoing research.

Narrative review of 3D imaging for preoperative planning in urology Fabrizio Gallo, Alberto Caviglia, Martina Beverini, André Van der Merwe, Heidi Van Deventer, Maurizio Schenone, Carlo Terrone, Guglielmo Mantica