UROFAIR Virtual 2020

© The Canadian Journal of Urology TM : International Supplement, July 2020 C-10148 Chronic Hypertension in Pregnancy and Risk of Hypospadias: Systematic Review and Meta-Analysis Hasan Yahya (1) (1) Faculty Of Medicine University of Brawijaya Introduction and Objectives: Hypospadias is one of the most common birth defects in male infants. Chronic hypertension in pregnancy is a suspected risk factor. We performed a meta-analysis to confirm correlation between chronic hypertension in pregnancy and hypospadias. However there is still debate on the role of hypertension in pregnancy and hypospadia on this congenital malformation. Therefore, we conducted a systematic review and meta-analysis to comprehensively evaluate the relationship between these frequent maternal conditions and hypospadias Methods: Studies are obtained by using MEDLINE and the Cochrane Controlled Trials Register. Keywords were “Hypertension”, “Pregnancy” and “ Hypospadia”. Three studies including 282.670 patients were studied. Review was carried out using the Preferred Reporting Items for Systematic Reviews andMeta-analyses. The datawas evaluated and statistically analyzed by using RevMan version 5.3.0. Results: There is significant difference (P < 0,05) between chronic hypertension in pregnancy and control group among baby with hypospadias (OR 1.56; 95% CI 1.38-1.76; P = 0.00001). Conclusions: Our results indicate that chronic hypertension in pregnancy are positively associatedwith hypospadias. Further studies are needed to confirm the suggestive association, how the mechanisms involved, and to ultimately develop public health strategies geared toward prevention of hypospadias. PrecisionPoint Biopsy and its Feasibility in the Outpatient Setting Under Local Anaesthesia Pravin Viswambaram (1) (1) Fiona Stanley Hospital Introduction and Objectives: Transperineal prostate biopsies have shown to have lower infection rates and are able to target anterior tumours better compared to the TRUS guided prostate biopsies. However, they are usually done under a general anaesthetic (GA). The PrecisionPoint transperineal access system allows the transperineal sampling of the prostate under local anaesthetic (LA). We present our experience in Western Australia. Methods: 93 patients underwent transperineal prostate biopsies using the PrecisionPoint access system at Fiona Stanley Hospital. The initial cases were performed under GAto allow the surgeon to get accustomed to the technique and local anaesthetic protocol. Subsequent cases were done under sedation and then LAalone. Single dose intravenous cephazolin was used as antibiotic prophylaxis. Standard methods were used for analysis. Results: A total of 93 PrecisionPoint transperineal prostate biopsies were done. 41 were done under GA / spinal anaesthetic, 15 under sedation/LA and 37 under LA. All except 4 had pre-biopsy MRI. 34 patients had clinically significant cancer (ISUP2-5) on histopathology while 26 had low grade cancer and 31 had benign biopsies. 2 had neuroendocrine tumour and rectal adenocarcinoma respectively. Of the 67 patients withMRI showing suspicious lesions, 50 had biopsies positive for malignancy. 52 patients had pre-biopsy MRI showing PIRADS 4-5 lesions, of which 25 had clinically significant cancer on biopsy. Out of the 22 patients who had prior negative TRUS biopsies, 10 had cancer detected on PrecisionPoint biopsy. 8 had their low grade cancer upgraded post PrecisionPoint biopsy. Conclusions: PrecisionPoint transperineal prostate biopsy is reliable and feasible under LA. C-10144 Safety and Efficacy of Holmium Enucleation of Prostate (HoLEP) for Octogenarians and Nonagenarians in Singapore Karthik Thandapani (1) (1) Ng Teng Fong General Hospital Introduction and Objectives: As life expectancy in Singapore increases, people in their eighties (octogenarians) and nineties (nonagenarians) are common surgical candidates. LUTS and urinary retention from BPH is prevalent in themand the need for surgical intervention has increased over the years. We evaluate the safety and efficacy of HOLEP in this group of patients. Methods: Between February 2018 andNovember 2019, 76 patients underwent HOLEP by a single surgeon in Ng Teng Fong Hospital, Singapore. We analysed the subgroup of patients between age 80-99 from the prospectively maintained database. Pre-operative and post-operative IPSS, Qmax and PVRU was obtained when possible. Results: 16 patients with a mean age 84.2 years (80-94), underwent HOLEP during the study period. Indications for surgery were chronic urinary retention in 15 patients and LUTS in 1 patient. Pre-operative IDC duration was between 1 month - 6 years. Mean enucleation time was 60.89 minutes (+/- 19.6) Mean histology weight 54.3 g (-/+ 25.2) Mean enucleation efficacy was 0.89 g/min Average length of stay : 5 days Mean IDC time post op: 59.1 +/- 37.3 (hours) 2 patients had prostate cancer on histology ( Gleason 3+3 and Gleason 3+5). 2 patients had a ClavienDindo (CD) grade 2 complication, one requiring blood transfusion, the other needing IV antibiotics for urosepsis post-procedure. 1 patient had a CD Grade 3 complication, needing cystodiathermy under GA for significant hematuria. Average PVRU was 55.9 mls -/+40.3, with no patient needing catheterization during follow-up. Conclusions: HoLEP is a safe and effective treatment for prostatic bladder outlet obstruction in our elderly population. Tobacco Smoking Effects on Male SpermQuality: Systematic Review and Meta Analysis Ryan Ramon (1) (1) Faculty of Medicine, University of Brawijaya Introduction and Objectives: Inadequate sperm quality might be a noteworthy cause of infertility. Toxins from tobacco smoking can potentially affect sperm development and function, with a negative effect on semen parameters. Tobacco smoking is considered to be one of the causes of infertility amongst men. We conducted systematic review and meta-analysis to methodically explore the quality of sperm from tobacco smokers and non tobacco smokers. Methods: Studies were generated from online databases such as Cochrane Controlled trials andMedline. In this study, there were 2287 men consisted of 1051 smokers and 1236 non smokers. Oligozoospermia, asthenozoospermia, and teratozoospermia were appraised as the result. Results: Five studies with 2287 participants were included in the meta- analysis. The endpoints of this analysis revealed that oligozoospermia remarkably higher in smokers (RR: 1.35, 95% CI: 1.10-1.65; P = 0.004) than non-smokers. Asthenozoospermia was significantly higher in smokers (RR: 1.56, 95% CI: 1.09-2.23; P = 0.02) than non-smoker. Teratozoospermia was also significantly higher in smokers (RR: 1.37, 95% CI: 1.12-1.68; P = 0.002) than non-smoker. Conclusions: Regarding to the result fromour analysis comprising 2287 men shows that tobacco smoking is indicated on having influence in lessening the sperm quality (Oligozoospermia, Teratozoospermia, Asthenozoospermia). C-10147 C-10138 16