Laparoscopic donor nephrectomy has become the standard procedure to procure kidney graft. Transplantation using multiple arteries allograft is technically more challenging and still controversial with respect to renal transplantation outcomes. The objective of this study was to examine the transplantation outcome in both donor and recipient outcome of multiple arteries allograft kidney compared with single renal artery kidney. Eligible studies were identified from electronic databases: PubMed, Cochrane CENTRAL, Science Direct, and CINAHL as of October 2016. Relevant parameters explored using Review Manager V5.2 included donor and recipient outcomes. Twenty-four studies were included in this meta-analysis. Compared with SA, MA kidneys were associated with a longer donor operative time. There was no difference between donor length of stay, intraoperative blood loss, hospital stay, first warm ischemic time (WIT-I), and donor surgical complications in donors with multiple arteries compared with single. There was an increased risk of one-year graft loss (OR 1.57, 95% CI 1.09 to 2.26, p = 0.016), recipient vascular complications and recipient ureteral complications in multiple arteries compared with single artery allografts. Kidney transplantation with multiple arteries is relatively as safe as single artery in terms of donor outcomes. However, transplantation with multiple arteries allograft had several potential negative impacts on the recipient outcomes.

Background Varicocele is one of the most common causes of reversible male infertility, and 15% of the varicocele patients with normal semen analysis are diagnosed as infertile. According to the current guidelines, varicocelectomy is indicated based on abnormal sperm parameters and not abnormal DNA fragmentation index (DFI) values. Thus, in this study, we performed a meta-analysis of the effects of varicocelectomy on the DFI and other conventional sperm parameters, and determined whether DFI could be used to indicate varicocelectomy for varicocele patients. Results Through an electronic search of the PubMed, Scopus, EBSCO, and Cochrane databases, we included 7 prospective studies including a total of 289 patients in this meta-analysis. The results showed that varicocelectomy significantly reduced DNA fragmentation (mean difference: − 6.86; 95% confidence interval [CI]: − 10.04, − 3.69; p < 0.00001) and improved sperm concentration (mean difference: 9.59; 95% CI: 7.80, 11.38; p < 0.00001), progressive motility (mean difference: 8.66; 95% CI: 6.96, 10.36; p < 0.00001), and morphology (mean difference: 2.73; 95% CI: 0,65, 4.80; p = 0.01). Conclusion Varicocelectomy reduced DNA fragmentation and improved sperm concentration, progressive motility, and morphology. Additionally, the analysis showed that an abnormal DFI measurement should be considered as an indication for varicocelectomy.

Background: Determining whether members follow guidelines, including guidelines prepared to help direct practice management during the coronavirus disease 2019 (COVID-19) pandemic, is an important goal for medical associations. Objective: To determine whether practice of urologists is in line with guidelines for the management of common urological conditions during the COVID-19 pandemic produced by leading (inter)national urological associations. Design, setting, and participants: Self-selected urologists completed a voluntary survey available online from March 27 to April 11, 2020 and distributed globally by the Société Internationale d'Urologie. Outcome measurements and statistical analysis: Responses to two survey questions on the (1) management of 14 common urological procedures and (2) priority scoring of 10 common urological procedures were evaluated by practice setting and geographical region using chi-square and one-way analysis of variance analyses, respectively. Results and limitations: There were 2494 respondents from 76 countries. Oncological conditions were prioritised over benign conditions, and benign conditions were deferred when feasible and safe. Oncological conditions with the greatest malignant potential were prioritised over less aggressive cancers. Respondents from Europe were least likely to postpone and most likely to prioritise conditions identified by guidelines as being of the highest priority. Respondents' priority scoring of urological procedures closely matched the priorities assigned by guidelines. The main limitation of this study is that respondents were self-selected, and access to the survey was limited by language and technology barriers.