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Objectives:The objective of this study is to assess the current status of urologic robot-assisted surgery (RAS) in Saudi Arabia and evaluate perceptions of its importance and utility.Methods:A 59-item questionnaire was E-mailed to urologists and trainees in Saudi Arabia to assess the demographics and individual and institutional surgical practices of minimally invasive surgery (MIS) with a focus on RAS and urologic subtypes.Results:Ninety-five surveys were completed. Nearly 53%, 46%, and 21% of respondents were formally trained in laparoscopic surgery, MIS, and RAS, respectively. Forty percent had used a robot console during training. Nearly 72% of participants felt that RAS training should be included to accomplish their career goals and stated that it would strengthen the department academically and financially. The absence of a robotic system (45%) and administrative disinterest with lack of support (39%) were the most common deterrents. Robot-assisted radical prostatectomy (RARP), robot-assisted radical cystectomy (RARC), and robot-assisted radical nephrectomy (RARN) were regarded as the gold standard for 34%, 23%, and 17% of respondents, respectively. Respondents would recommend RARP (74%), RARC (50%), and RARN (57%) for themselves or their family. The greatest perceived benefits of RAS were its ease of use and improvement in the patient's quality of life.Conclusion:Urologists in Saudi Arabia recognize the superiority of RAS over traditional surgical methods but lack exposure, training, and access to RAS. This survey reveals increasing acceptance of RAS and willingness to incorporate the technology into practice.

Objectives: To evaluate the general knowledge among primary health care (PHC) physicians regarding the management of common urological problems in Saudi Arabia. Methods: This is an observational prospective study, where a self-administered questionnaire was distributed to practicing PHC physicians in the western region of Saudi Arabia on January 2017. The questionnaire consisted of 21-item questions, inquiring about demographics and general urological knowledge and skills. The management of common urological problems was assessed by case scenarios for specific urological condition, including urethral catheterization, definition and evaluation of hematuria, recognition of age-specific increase in prostatic specific antigen (PSA), and management of lower urinary tract symptoms. Results: A total of 148 questionnaires were distributed, with a response rate of 75.7%, where 112 respondents completed the questionnaires, including 54.3% residents, 39% general practitioners, and 5.4% specialists. Fifty-seven percent of respondents were males and 68% were Saudi practitioners. A higher number of respondents expressed that they were able to catheterize a male than female patient (56.5% versus 34.3%). Only 6.4% of respondents defined microscopic hematuria accurately. Knowledge about hematuria, serum prostate specific antigen and overactive bladder was low in all groups. Apart from hematuria, seeking urological consultations was less than 35% for all other disease entities. Conclusion: Urological knowledge among PHC physicians seems to be insufficient. Significant percentages of the participants were unable to catheterize a female patient, did not know the definition of hematuria; and whether to ask for urological consultations in cases of hematuria, increased PSA, and overactive bladder.

Background:Nephrolithiasis is a common condition that has various classifications according to stone composition. Stone formation can affect renal function; it can be a strong risk factor for chronic kidney disease (CKD). The main objective of this study is to explore the association between creatinine clearance and different stone compositions.Methods:This is a retrospective cohort study conducted in a tertiary center in Jeddah, Saudi Arabia, between 2005 and 2014. Renal function was assessed by the estimating glomerular filtration rate (eGFR) by the Cockcroft-Gault equation. Stone composition was determined by urinary calculi analysis with infrared spectrometry.Results:Stones of 365 patients, with a mean age of 48.2 ± 13.6 years and a male to female ratio of 3.2:1, were analyzed. Stage 2 CKD has been documented. It involved oxalate, struvite, cystine, and uric acid stones. The worst eGFR was reported for stones containing uric acid. The eGFR was least affected with apatite stones followed by brushite stones.Conclusion:Stone disease can affect renal function. Different stone compositions show factor for renal impairment, and this should be considered in patient management. A special precaution should be considered for higher risk groups. Multidisciplinary patient care and immediate referral to a nephrologist are strongly advised.

A 64-year-old male patient with a large pelvic mass and a right renal mass was referred to our facility. The patient underwent a right radical nephrectomy and pelvic mass excision. A histopathological examination led to a diagnosis of renal oncocytoma and urinary bladder leiomyoma.