Background: Penile fractures are due to a traumatic rupture of the penile tunica albuginea of the corpus cavernosum and may result from numerous etiologies. The purpose of our review is to describe the etiology, management, and outcomes of penile fractures. Methods: A literature review was performed. Results: The diagnosis of penile fractures is usually made clinically but can also be made with the assistance of ultrasound or MRI (magnetic resonance imaging) imaging when unclear. Cystoscopy should be performed when urethral involvement is suspected. Surgical management should be initiated promptly after the diagnosis, and within 24 hours of presentation. Surgical management can include the subcoronal or penoscrotal approach, although the penoscrotal approach is preferred when imaging confirms the location of the injury to be ventral and proximal, due to the reduced morbidity of this technique. Complications following penile fractures include erectile dysfunction, penile curvature, and voiding symptoms, but the incidence of complications is reduced if surgical intervention is performed promptly after fracture presentation. A rare cause of penile fractures is collagenase clostridium histolyticum injection, and these cases should predominantly be managed conservatively. Conclusions: Penile fractures can present in various ways and must be managed surgically and promptly after the diagnosis is made.

Introduction The effect of the SARS-CoV-2 infection and vaccine on male fertility has been a cause of controversy. Studies have found that while active or recovering COVID-19 disease can be associated with decreased sperm counts and quality, the COVID vaccine is not. Despite evidence about the lack of association between the COVID-19 vaccine and male fertility, social media platforms continue to contribute to the spread of misleading information. TikTok is a popular application that has become critical in this regard. Objective To identify the role TikTok contributes to misinformation around the COVID-19 virus, vaccination, and male infertility. Methods 72 videos using the terms #covidvaccine and #malefertility were identified on Tiktok from January 1, 2020 to December 31, 2021. Videos not related to the topic were excluded, leaving 58 videos. Videos were reviewed by five independent researchers. Information collected included video publication date, length, views, likes, comments, presence of US certified medical professional, demographic details of main subject, scientific article cited or displayed, belief held on COVID-19 vaccine, infection and infertility, modified DISCERN score and Patient Materials Assessment Tool (PEMAT). U.S. medical professional certification was determined using certificationmatters.org. The PEMAT score evaluated 17 items regarding understandability and actionability. The modified DISCERN based reliability score ranked quality from 1 = poor, to 5 = excellent. Data was analyzed using SPSS statistics software v24. Results The average video was 51 seconds long, received 34,678 views, 3,301 likes, and 160 comments. The main subject of the videos were predominantly female (53.4%) and white (55.2%). A majority of videos featured a medical professional (67.2%) and were published by medical professionals (63.8%). Up to 46.4% of videos featured a scientific article that was either cited or displayed on the screen. Most videos were of the opinion that the COVID-19 infection causes infertility in men (48.3%) but not the vaccine (37.9%). Only a select few videos believed that the vaccine was responsible for male infertility (6.9%). The most popular video stating the COVID vaccine caused infertility in men had 2,708 views, 336 likes, and 18 comments. The average DISCERN score for the 58 videos was 2.93, PEMAT Understandability score was 76.1%, and PEMAT Actionability score was 25.7%. With the presence of a certified US Medical Professional in the TikTok video, the average DISCERN score (2.00 vs. 3.38, p= .001), PEMAT Understandability Score (67.68 vs. 80.26, p = .015), and PEMAT Actionability Score (13.16 vs. 31.82, p = .024) increased significantly. Videos with medical professionals present had a lower average number of views (31,996 vs. 40179, p = .691), fewer likes (1,902 vs. 6,173, p = .290), and fewer comments (150 vs. 182, p = .737), but none of these differences were statistically significant. Conclusions This study demonstrates that TikTok videos endorsing misinformation are popularly viewed. Among all the misinformation in social media, it is reassuring to see that there are medical professionals interested in promoting medically accurate information. Disclosure No

No abstract

INTRODUCTION AND OBJECTIVE: COVID-19 has caused significant disruption to the management of urological cancer, this study aims to assess 30-day postoperative outcomes for patients undergoing urological cancer surgery during the COVID-19 pandemic.METHODS: COVIDSurg study is the largest international, multicentre study of COVID-19 in surgical patients performed to date. COVIDSurg-Cancer explored the safety of performing elective cancer surgery during the pandemic. All bladder, kidney, UTUC and prostate cancer patients who underwent elective cancer surgery between March 2020 and July 2020 were included. Univariable and multivariable regression was performed to assess association of patient factors with mortality, respiratory complications and operative complications.RESULTS: A total of 1,902 patients from 36 countries were included. 658 (34.6%) patients had bladder cancer, 590 (31.0%) kidney cancer or UTUC, and 654 (34.4%) prostate cancer. These patients underwent elective curative surgery for their cancers (prostatectomies, nephrectomies, cystectomies, nephroureterectomy, TURBTs). 62% of sites were not designated "hot" COVID-19 sites (i.e. did not actively admit patients with COVID-19).A total of 42/1902 (0.2%) patients were diagnosed with COVID-19 during their inpatient stay. 21 (0.1%) mortalities were observed; of those, 8 (38.1%) were diagnosed with COVID-19. Mortalities were found to be more likely in patients with concurrent COVID-19 infection (OR 31.7, 95% CI 12.4-81.42, p<0.001), aged over 80, ASA grade 3þ and ECOG grade 1þ. 40 (0.2%) respiratory complications (acute respiratory distress syndrome or pneumonia) were observed within 30 days of surgery. Respiratory complications were more likely in patients aged with concurrent COVID-19 infection (OR 40.6, p<0.001), over 70, from an area with high community risk or with a revised cardiac risk index of 1þ. There were 84 major complications (Clavien-Dindo score !3). Patients with a concurrent COVID-19 infection (OR 7.45, p<0.001) or aged 80 or above were more likely to experience major complications.CONCLUSIONS: Elective urological cancer surgeries are safe to perform during the COVID-19 pandemic. This study highlights important risk-factors associated with worse outcomes. Our data can inform health services to safely select patients for surgery during the pandemic. Patients with concurrent COVID-19 infection have a higher risk of mortality and respiratory complications and should not undergo surgery if possible.

Purpose To identify demographic trends of foreign object genital injuries presenting to emergency departments from 2011 to 2020. Materials and Methods The National Electronic Injury Surveillance System database reports consumer product-related injuries in United States ED visits. The database was queried to identify 375 cases of genital injuries from 2011 to 2020. Inclusion criteria consisted of cases reporting injuries involving the urethra, penis, or scrotum. Data was reported and analyzed using linear regression. Results Based on 375 cases, an estimated 13,170 (95% confidence interval, 10,817–15,522) patients in the US suffered genital injuries due to foreign bodies between 2011 and 2020. These injuries involved the penis (65.9%), urethra (30.7%) and scrotum (3.5%). Of all patients, 11.8% required hospital admission after treatment of which injuries to the urethra were most common (44.0%). Most of these patients were ages 19 to 64 (66.1%). Consumer products most implicated included rings (50.7%), zippers (17.1%), and pens and pencils (10.3%). Injuries due to zippers and swimming apparel occurred significantly more frequently in patients ages 0–18 (p<0.05). Injuries due to kitchen gadgets occurred significantly more in patients ages ≥65 (p<0.05). Pens, pencils, and massage devices were items that routinely resulted in urethral injuries, often requiring hospitalization. Linear regression showed genital injuries related to foreign objects significantly increased from 2011 to 2020 (p<0.001). Conclusions Due to the nature of injury caused to genitalia by intentional and unintentional exposure to foreign bodies, educating individuals on this topic in sexual education classes is necessary for preventing future injuries.