Among men with lower urinary tract symptoms worse sleep scores were associated with the progression of lower urinary tract symptoms and among asymptomatic men worse sleep scores were suggestively associated with the development of lower urinary tract symptoms. If confirmed, these data suggest that sleep problems may precede such symptoms. Whether treating sleep problems would improve lower urinary tract symptoms requires further testing.

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ConclusionWhile we confirmed that higher BMI was associated with BCR, we found no link between BMI and PSADT at the time of recurrence. Our data suggest obese men do not have more aggressive recurrences. Future studies are needed to test whether obesity predicts response to salvage therapies.

Introduction: We assess issues and challenges in the field of robotic urological surgery during the COVID-19 pandemic, and discuss current and future solutions. Methods:We considered the relevant literature as well as clinical and surgical experience at our institution.Results: A risk-benefit assessment of each patient undergoing robotic urological surgery should be performed during the COVID-19 pandemic, which is based on the urgency of the surgery, and risk of viral diseases and transmission. Preoperative testing and symptom screening are recommended to identify patients with COVID-19. Adequate personal protective equipment for the surgical team is essential to protect patients and health care workers. Although the transmission method has not yet been identified during robotic procedures, efforts should be made to minimize the risk of aerosolization. The anesthesia method should minimize aerosolization of the virus, and negative pressure rooms are strongly preferred for COVID-19 positive patients.Conclusions: Significant challenges have emerged during the COVID-19 pandemic, which also impact the field of robotic urological surgery. Perioperative practices and surgical strategies should be adapted to overcome these challenges with the aim of minimizing risk of transmission while optimizing robotic surgical outcomes. Recommendations will continue to evolve as more data become available.

Background The objective of this study was to describe bladder cancer outcomes as a function of race among patients with high‐risk non–muscle‐invasive bladder cancer (NMIBC) in an equal‐access setting. Methods A total of 412 patients with high‐risk NMIBC who received bacille Calmette‐Guérin (BCG) from January 1, 2010, to December 31, 2015, were assessed. The authors used the Kaplan‐Meier method to estimate event‐free survival and Cox regression to determine the association between race and recurrence, progression, disease‐specific, and overall survival outcomes. Results A total of 372 patients who had complete data were included in the analysis; 48 (13%) and 324 (87%) were Black and White, respectively. There was no difference in age, sex, smoking status, or Charlson Comorbidity Index by race. White patients had a higher socioeconomic status with a greater percentage of patients living above the poverty level in comparison with Black patients (median, 85% vs 77%; P < .001). A total of 360 patients (97%) received adequate induction BCG, and 145 patients (39%) received adequate maintenance BCG therapy. There was no significant difference in rates of adequate induction or maintenance BCG therapy according to race. There was no significant difference in recurrence (hazard ratio [HR], 1.53; 95% confidence interval [CI], 0.64‐3.63), progression (HR, 0.77; 95% CI, 0.33‐1.82), bladder cancer–specific survival (HR, 1.01; 95% CI, 0.30‐3.46), or overall survival (HR, 0.97; 95% CI, 0.56‐1.66) according to Black race versus White race. Conclusions In this small study from an equal‐access setting, there was no difference in the receipt of BCG or any differences in bladder cancer outcomes according to race.