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INTRODUCTION AND OBJECTIVE:Guidelines recommend that a history and complete physical exam, including a detailed pelvic exam, be performed for females presenting with recurrent urinary tract infecti...

INTRODUCTION AND OBJECTIVE: The coronavirus disease 2019 (COVID-19) pandemic continues to be a global health crisis despite the recent worldwide vaccine distribution. The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is most commonly believed to cause severe disease manifestations secondary to a cytokine storm. Low testosterone is associated with a proinflammatory environment and it is thought that a eugonadal testosterone level may be protective of increased cytokine activity. Objective: In this study, we explore the association between baseline testosterone level and COVID-19 clinical outcomes. METHODS: Through a retrospective chart review, we identified 188 males from an academic health system in a metropolitan area diagnosed with COVID-19 with measured baseline testosterone levels who were not on testosterone replacement therapy. The 188 males were divided into eugonadal (n=90, >300 ng/dL) and hypogonadal (n=98, ≤300 ng/dL) testosterone groups. Data regarding comorbidities and endpoints such as hospital admission, intensive care unit admission, ventilator utilization, and thromboembolic events were extracted. Chi-square and Fisher's Exact tests examined differences in categorical variables. Logistic regression analysis tested the relationship between testosterone level and endpoints. RESULTS: There were 188 men identified who met our inclusion criteria. There were 90 men in the eugonadal group and 98 men in the hypogonadal group. Median age (IQR) was 55 (43-67) for the eugonadal group and 55 (40-63) for the hypogonadal group, median BMI was 30.6 (27.7-35.4) and 31.3 (26.4-35.6), and median testosterone level was 396 (357-476.3 ng/dL) and 217 (141.3 - 255 ng/dL) for the two groups respectively. Hypogonadism was significantly related to hospital admission (p=0.027). While not statistically significant, there were more ICU admissions (p=0.75), ventilator use (p=0.75), and DVTs seen in the hypogonadal group. On logistic regression analysis, hypogonadism was predictive of hospital admission (p=0.021). CONCLUSIONS: Eugonadal testosterone level may be protective of more severe clinical outcomes in COVID-19. Hypogonadism is associated with increased hospital admission. Further research with a larger sample size needs to be conducted to fully understand the relationship between testosterone and clinical outcomes in COVID-19.

Objective To describe and evaluate a risk-stratified triage pathway for inpatient urology consultations during the SARS-CoV-2 (COVID-19) pandemic. This pathway seeks to outline a urology patient care strategy that reduces the transmission risk to both healthcare providers and patients, reduces the healthcare burden, and maintains appropriate patient care. Materials and Methods Consultations to the urology service during a 3-week period (March 16 to April 2, 2020) were triaged and managed via one of 3 pathways: Standard, Telemedicine, or High-Risk. Standard consults were in-person consults with non COVID-19 patients, High-Risk consults were in-person consults with COVID-19 positive/suspected patients, and Telemedicine consults were telephonic consults for low-acuity urologic issues in either group of patients. Patient demographics, consultation parameters and consultation outcomes were compared to consultations from the month of March 2019. Categorical variables were compared using Chi-square test and continuous variables using Mann-Whitney U test. A P value Results Between March 16 and April 2, 2020, 53 inpatient consultations were performed. By following our triage pathway, a total of 19/53 consultations (35.8%) were performed via Telemedicine with no in-person exposure, 10/53 consultations (18.9%) were High-Risk, in which we strictly controlled the urology team member in-person contact, and the remainder, 24/53 consultations (45.2%), were performed as Standard in-person encounters. COVID-19 associated consultations represented 18/53 (34.0%) of all consultations during this period, and of these, 8/18 (44.4%) were managed successfully via Telemedicine alone. No team member developed COVID-19 infection. Conclusion During the COVID-19 pandemic, most urology consultations can be managed in a patient and physician safety-conscious manner, by implementing a novel triage pathway.

Purpose: Prostate volume is frequently utilized to counsel patients presenting to family medicine physicians with voiding complaints. We evaluated the relation between International Prostate Symptom Score (IPSS) and prostate volume measured by phased-array surface coil magnetic resonance imaging (MRI). Methods: We performed an institutional review board (IRB)–approved retrospective study of all patients who received a prostate MRI between 2015 and 2017. Correlation between the overall IPSS, IPSS components, prostate volume stratified by prostate specific antigen (PSA) (

To explore the potential hurdles surgeons may encounter when preforming surgical correction of penile curvature in patients with Peyronie’s Disease following intralesional collagenase clostridium histolyticum injections. Although limited data exists, retrospective analysis of surgeon experiences in surgical treatment of refractory penile curvature in patients with Peyronie’s disease appears to not result in more post-operative complications and may only slightly increase intra-operative difficulty. As the use of intralesional collagenase clostridium histolyticum continues to increase and patients who demonstrate persistent curvature despite treatment seek further management, the role of investigating the feasibility of surgery demonstrates significant importance. Although limited data exists, it appears that surgery following intralesional collagenase clostridium histolyticum is safe without added post-operative complications. At the present time, however, further data on intra-operative findings and post-operative outcomes remain necessary, and as the use of this intralesional therapy continues to rise, further information should become readily available.