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Introduction: Despite various studies on the impact of incontinence on patients' lives, the existing literature has not investigated the contribution of nursing care during rehabilitation in terms of quality of life. Fewer data, therefore, exist on the characteristics and perceived impact of the therapeutic relationship as part of the rehabilitation program. Aims: To investigate the characteristics of the nurse–patient therapeutic relationship and its impact throughout the rehabilitation program; to describe the levels of patient burden on everyday activities. Materials and Methods: A monocentric, retrospective, multimethod descriptive study was conducted in the nurse‐led continence clinic of a major teaching hospital in Northern Italy. A phenomenological approach with semistructured interviews was adopted after 6 weeks of rehabilitation, following the method of phenomenological enquiry by Giorgi. The short form 12 questionnaire was administered upon admission of patients to the clinic, after 6 weeks, and during the last consultation to investigate the impact of urinary incontinence (UI) on daily activities and physical and psychological quality of life. Results: Ninety‐one adult patients of both genders presenting for nonneurogenic nonpostpartum UI were consecutively enrolled. Physical scores (PCS‐12) and MCS‐12 scores significantly increased over time. Psychological scores showed great variability upon admission, which was reduced halfway through the rehabilitation program. The thematic analysis highlighted four categories based on data saturation: the impact of UI on daily activities, strategies to face the problem, feelings, and the role of nurses. Conclusions: This mixed‐method investigation suggests the importance of therapeutic nursing relationships, clinical expertise, and rehabilitative skills. Quality of life is arguably related to the positive results of the rehabilitation program but also to the environment, patients perceive in terms of support, honesty, and trust. [ABSTRACT FROM AUTHOR]

We sought to evaluate the effectiveness and acceptability by patients of transcutaneous sacral roots neuromodulation (TSRN) by paravertebral placement of surface electrodes to treat pelvic pain and pelvic muscle stiffness. Pelvic pain is a disabling condition, often related to non‐relaxing pelvic muscles. Causes for the onset are often unclear; noninvasive treatment targeted at maintenance factors can be administered by nurses in some countries. previous studies have investigated the role of invasive stimulation for pelvic pain; TSRN has proved successful in other pelvic disorders. We conducted a pilot study on a sample of consecutive patients of both genders, reporting pelvic pain (chronic or not). Weekly sessions of TSRN with surface electrodes were performed; pain was recorded with the numeric rating scale (NRS) at baseline and after the end of the rehabilitation plan. Therapeutic success was defined as a reduction of 50% in pain scores. Twenty patients were enrolled, most complaining multiple symptoms apart from pain. Seven males had primary prostate pain syndrome, one had history of orthopaedic surgery, and eight had muscle stiffness (Median = 3 out of 4, IQR = [3;3], range [2;4]). Sixteen patients (12 males and 4 females) had chronic pelvic pain. The median NRS values in the sample at baseline was 4[5.5–7.5] with no significant differences between genders (p = 0.144) and decreased significantly (Me = 0.5, IQR[0.0–1.0], p < 0.001) after a median of 20 weekly sessions (range [10–30]). The results indicated clinically relevant benefit for all patients (ω2 = 0.689, 95%IC[0.505–0.793]) Decrease in pelvic muscle stiffness was significant (from Me = 3, IQR [3] to Me = 0, IQR[0–1], p < 0.0001) without differences between the genders (p = 0.711). No significant difference was found in the number of sessions required by males and females to achieve therapeutic success (p = 0.282). TSRN seems a promising treatment for pelvic pain and can be performed in outpatients' clinics with low costs and no invasivity. Further studies on larger, randomized samples are required to confirm these results. [ABSTRACT FROM AUTHOR]

Objective: To describe the trend in surgical volume in urology in Italy during the coronavirus disease 2019 (COVID‐19) outbreak, as a result of the abrupt reorganisation of the Italian national health system to augment care provision to symptomatic patients with COVID‐19. Methods: A total of 33 urological units with physicians affiliated to the AGILE consortium (Italian Group for Advanced Laparo‐Endoscopic Surgery; www.agilegroup.it) were surveyed. Urologists were asked to report the amount of surgical elective procedures week‐by‐week, from the beginning of the emergency to the following month. Results: The 33 hospitals involved in the study account overall for 22 945 beds and are distributed in 13/20 Italian regions. Before the outbreak, the involved urology units performed overall 1213 procedures/week, half of which were oncological. A month later, the number of surgeries had declined by 78%. Lombardy, the first region with positive COVID‐19 cases, experienced a 94% reduction. The decrease in oncological and non‐oncological surgical activity was 35.9% and 89%, respectively. The trend of the decline showed a delay of roughly 2 weeks for the other regions. Conclusion: Italy, a country with a high fatality rate from COVID‐19, experienced a sudden decline in surgical activity. This decline was inversely related to the increase in COVID‐19 care, with potential harm particularly in the oncological field. The Italian experience may be helpful for future surgical pre‐planning in other countries not so drastically affected by the disease to date. [ABSTRACT FROM AUTHOR]

Objective: To discuss the impact of COVID‐19 on global health, particularly on urological practice and to review some of the available recommendations reported in the literature. Material and Methods: In the current narrative review the PubMed database was searched to identify all the related reports discussing the impact of COVID‐19 on the urological field. Results: The COVID‐19 pandemic is the latest and biggest global health threat. Medical and surgical priorities have changed dramatically to cope with the current challenge. These changes include postponements of all elective outpatient visits and surgical procedures to save facilities and resources for urgent cases and patients with COVID‐19 patients. This review discuss some of the related changes in urology. Conclusions: Over the coming weeks, healthcare workers including urologists will be facing increasingly difficult challenges, and consequently, they should adopt triage strategy to avoid wasting of medical resources and they should endorse sufficient protection policies to guard against infection when dealing with COVID‐19 patients. [ABSTRACT FROM AUTHOR]

Objective: The aim of the paper is to provide an overview of intraoperative sampling methods for frozen section (FS) analysis and of surgical techniques for a secondary neurovascular bundle (NVB) resection, as the method of surgical margin (SM) sampling and the management of a positive SM (PSM) at the nerve‐sparing (NS) area are under evaluated issues. FS analysis during radical prostatectomy (RP) can help to tailor the plane of dissection based on cancer extension and thus extend the indications for NS surgery. Evidence Acquisition: We performed a PubMed/Medical Literature Analysis and Retrieval System Online (MEDLINE), Web of Science, Cochrane Library, and Elton B. Stephens Co. (EBSCO)host search to include articles published in the last decade, evaluating FS analysis in the NS area and surgical attempts to convert a PSM to a negative status. Evidence Synthesis: Overall, 19 papers met our inclusion criteria. The ways to collect samples for FS analysis included: systematic (analysing the whole posterolateral aspect of the prostate specimen, i.e., neurovascular structure‐adjacent frozen‐section examination [NeuroSAFE]); magnetic resonance imaging (MRI)‐guided (biopsies from MRI‐suspicious areas, retrieved by the surgeon in a cognitive way); and random biopsies from the soft periprostatic tissues. Techniques to address a PSM in the NS area included: full resection of the spared NVB, from its caudal to cranial aspect, often including the rectolateral part of the Denonvilliers' fascia; partial resection of the NVB, in cases where sampling attempts to localise a PSM; incremental approach, meaning a partial or full resection that extends until no prostate tissue is found in the soft periprostatic environment. Conclusions: There is no homogeneity in prostate sampling for FS analysis, although most recent evidence is moving toward a systematic sampling of the entire NS area. The management of a PSM is variable and can be affected by the sampling strategy (difficult localisation of the persisting tumour at the NVB). The difficult identification of the exact soft tissue location contiguous to a PSM could be considered as the critical point of FS analysis and of spared‐NVB management. [ABSTRACT FROM AUTHOR]

Buschke-Lowenstein tumor (BLT) is a rare giant condyloma acuminatum of the anogenital region, first described by Buschke and Lowenstein as a potential malignant condyloma acuminatum.1 The incidence is estimated to be 0.1% in the general population. The disease affects men more frequently than women (ratio = 2.7:1); the mean age of onset is approximately 45 years.2 BLT usually emerges as a slowly growing cauliflower-like tumor of the anogenital region, which easily infiltrates the adjacent tissues.3 BLT is a sexually transmitted disease; human papillomavirus (HPV) is an important factor in its development. Negative Pressure Therapy (VACUlta, KCl) was then applied as postoperative dressing to keep the matrix in position, without interrupting the silicone sheet (Figure 2C).7 The final histological report confirmed the bioptic diagnosis of BLT, with margins free of disease. [Extracted from the article]

The article looks at the article "Development and internal validation of a side-specific, multiparametric magnetic resonance imaging-based nomogram for the prediction of extracapsular extension of prostate cancer" by A. Martini and others. Topics include use of nomograms to decide whether or not to perform nerve-sparing surgery; concerns related performing multiparametric magnetic resonance imaging either before or after biopsy; and the European Society of Urogenital Radiology guidelines.

Three-dimensional virtual reconstruction with DocDo, a novel interactive tool to score renal mass complexity Three patients had a Clavien II complication (pleural effusion requiring antibiotics); no patient needed blood transfusion. Histopathology revealed a clear-cell carcinoma in six patients, angiomyolipoma in two, oncocytoma in one, and an epithelial neoplasm in the last patient. [Extracted from the article]