Male stress urinary incontinence (SUI) following prostate treatment is a devastating complaint for many patients. While the artificial urinary sphincter is the gold standard treatment for male SUI, the urethral sling is also popular due to ease of placement, lack of mechanical complexity, and absence of manual dexterity requirement. A literature review was performed of male urethral sling articles spanning the last zz20 years using the PubMed search engine. Clinical practice guidelines were also reviewed for comparison.Four categories of male urethral sling were evaluated: the transobturator AdVance and AdVance XP, the bone-anchored InVance, the quadratic Virtue, and the adjustable sling series. Well selected patients with mild to moderate urinary incontinence and no prior history of radiation experienced the highest success rates at long-term follow up. Patients with post-prostatectomy climacturia also reported improvement in leakage after sling. Concurrent penile prosthesis and sling techniques were reviewed, with favorable short-term outcomes demonstrated. Male urethral sling is a user-friendly surgical procedure with durable long-term outcomes in carefully selected men with mild stress urinary incontinence. Multiple sling types are available with varying degrees of efficacy and complication rates. Longer follow-up and larger cohort sizes are needed for treatment of newer indications such as climacturia as well as techniques involving dual placement of sling and penile prosthesis.

INTRODUCTION AND OBJECTIVE: Multiple studies have found that social media (SoMe) dissemination of published literature may be associated with higher future citation rates, however it is unclear what role influential figures on SoMe play in driving this phenomenon.METHODS: All original articles published in Journal of Urology (JU) and European Urology (EU) in the year 2018 were identified. Reviews, guidelines, and editorials were excluded. For each article, SoMe mentions, followers per tweet, total citations, and article characteristics were extracted through July 2021 via Altmetric. Influential SoMe figures were identified as accounts that tweeted about JU or EU articles with >2000 followers on Twitter with account characteristics collected including total followers, total tweets, engagement statistics, account verification status, and if an official journal account, physician account, or urology specific account.RESULTS: We identified 394 articles with 8,895 total citations which generated 14,119 SoMe posts-13,128 of which were tweets with 33,028,427 combined followers who could have seen these tweets. 478 Twitter SoMe influencers were identified. On panel data regression modeling, tweets about a specific article were positively associated with future citation (estimate: 0.17 e i.e. our model predicts 0.17 future citations per tweet about an article, p<0.001) but total followers per tweet was not associated with future citations (p>0.05). News article and blog posts were also associated with future citations (estimate: 0.35 and 2.7 citations per post, respectively, p<0.001). Overwhelmingly, characteristics of the article such as prospective studies (estimate: 12.9 citations more than cross sectional studies), open access status (estimate: 4.3 citations more if open access), and previously well published authors (estimate: 3.6E-04 future citations per past citationeso 10,000 past citations would predict 3.6 future citations) (p<0.001 for all) were more predictive of future citations than nearly all characteristics of SoMe influencers (Table 1).CONCLUSIONS: While SoMe posts are associated with future citations, there was no correlation between who is posting the tweets and future citations. SoMe posts may celebrate strong published articles but posts by academic SoMe influencers do not appear to drive future citations.

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Purpose:Previous work in urology has shown that men have higher h-indices than women. However, the degree to which h-indices vary by gender within urological subspecialties has not been well defined. Herein, we assess gender differences in h-index among different subspecialties.Materials and Methods:Demographics were recorded for academic urologists using residency program websites as of July 2021. Scopus was queried to identify h-indices. Gender differences in h-index were estimated from a linear mixed-effects regression model with fixed effects for gender, urological subspecialty, MD/PhD status, years since first publication, interactions of subspecialty with years since first publication, and interactions of subspecialty with gender and random effects for AUA section and institution nested within AUA section. The Holm method was used to adjust for multiplicity (7 hypothesis tests).Results:Of 1,694 academic urologists from 137 institutions, 308 were women (18%). Median years since first publication was 20 for men (IQR 13, 29) and 13 for women (IQR 8, 17). Among all academic urologists, the median h-index was 8 points higher for men (15 [IQR 7, 27]) vs women (7 [IQR 5, 12]). There was no significant gender difference in h-index for any of the subspecialties after adjusting for urologist experience and after applying the Holm method for multiplicity correction.Conclusions:We were unable to demonstrate a gender difference in h-index after adjusting for urologist experience for any urological subspecialties. Future study is warranted as women become more senior members of the urological workforce.

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