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Aldo Franco De Rose, Francesca Ambrosini, Luca Genova Gaia, Guglielmo Mantica, Carlo Terrone IRCCS Ospedale Policlinico San Martino, Genova, ItalyCorrespondence: Francesca Ambrosini, Department of Urology - Policlinico San Martino Hospital, University of Genoa, Largo Rosanna Benzi, 10, Genoa, 16132, Italy, Tel +39 3480497079, Email f.ambrosini1@gmail.comPurpose: Literature on priapism as a concomitant manifestation of COVID-19 infection is scarce since less than 10 cases are reported. It is crucial to determine whether priapism in a COVID-19 patient is related to the infection itself or to the ongoing therapy, especially in those critically ill. Our study aims to create an alert for all physicians faced with the management of priapism in SARS-CoV-2 patients. We tried to explore any potential leading factors presenting a case of priapism arising during COVID-19 pneumonia, and we reviewed the current literature available on this topic.Case Presentation: We reported the case of a 62-year-old man with severe COVID-19 pneumonia complicated by acute respiratory distress syndrome who developed ischemic priapism during his stay in intensive unit care. Corporal aspiration was performed with injection of 200 μg of intracavernosal phenylephrine resulting in detumescence. After recovery, the patient reported complete erectile dysfunction.Conclusion: The etiopathogenetic mechanism of priapism remains not completely clear. The most frequently hypothesized cause is the prothrombotic state associated with the infection. Further elements including the drugs administered during the infection may play a crucial role. Further studies are needed to obtain stronger evidence.Keywords: priapism, erectile dysfunction, COVID-19, respiratory distress syndrome

Guglielmo Mantica, Francesca Ambrosini, Stefano Parodi, Stefano Tappero, Carlo Terrone Department of Urology, Policlinico San Martino Hospital, University of Genova, Genova, ItalyCorrespondence: Guglielmo ManticaDepartment of Urology, Policlinico San Martino Hospital, University of Genova, Largo Rosanna Benzi 10, Genova 16132, ItalyTel +39 0105553935Email guglielmo.mantica@gmail.comAbstract: Pyeloplasty is considered the gold standard for the management of ureteropelvic junction obstruction in cases of flank pain, recurrent stone formation or infection, and deteriorating renal function. Over the last two decades, minimally invasive techniques such as robotic (RALP) and laparoscopic pyeloplasty (LP) have become increasingly popular and have been moderately replacing the open approach. This paper aims to provide a comprehensive up-to-date review on safety, efficacy and outcomes regarding robotic repair of UPJO compared to the conventional laparoscopic procedure. RALP represents a viable and innovative alternative to conventional LP with a comparable success and complication rate both in adult and in paediatric fields. The robotic approach seems to add further technical advantages when compared to conventional LP but sustains a higher costs. Currently, the choice to adopt one of the different minimally invasive approaches depends on the surgeon’s preference or experience, and on institutional availability.Keywords: robotic pyeloplasty, laparoscopic pyeloplasty, ureteropelvic junction obstruction, hydronephrosis, pyeloplasty