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Meshari A Alzahrani,1 Muhammad Anwar Khan,2,3 Basel O Hakami,4 Abdulaziz Alahmadi,5 Mohammed Alzahrani,6 Faisal Alsaleh,6 Muath Almurayyi,7 Omar Safar,8 Mohammad Shakil Ahmad9 1Department of Urology, College of Medicine, Majmaah University, Al-Majmaah, Saudi Arabia; 2College of Medicine, King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Jeddah, Saudi Arabia; 3King Abdullah International Medical Research Centre (KAIMRC), Jeddah, Saudi Arabia; 4Department of Urologyṣ, King Faisal Medical City for Southern Region (KFMC), Abha, Saudi Arabia; 5College of Medicine, Taibah University, Madinah, Saudi Arabia; 6College of Medicine, King Saud University, Riyadh, Saudi Arabia; 7Urology Department, King Khaled University Medical City, Abha, Saudi Arabia; 8Urology Department, Armed Forces Hospital Southern Region, Khamis Mushayt, Saudi Arabia; 9Department of Family & Community Medicine, College of Medicine, Majmaah University, Al Majmaah, Saudi ArabiaCorrespondence: Meshari A Alzahrani, Department of Urology, College of Medicine, Majmaah University, Al-Majmaah, 11952, Saudi Arabia, Tel +966569990693, Fax +966164042500, Email ma.alzahrani@mu.edu.saBackground: Online medical education is critical for public health literacy and physician efficacy, but it must be trustworthy. Although it has the potential to be a useful resource for medical education, users must be able to identify reliable content.Objective: To assess the scientific quality of Arabic-language video content related to erectile dysfunction that is available on YouTube to learn what information our patients can handle online.Materials and Methods: A comprehensive search of the YouTube database was carried out to identify videos related to erectile dysfunction published in Arabic. The search was conducted using the following keywords: “Erectile dysfunction”, “Sexual dysfunction” and “Impotence”. Without a time, limit, the search was carried out until January 1, 2023. The quality assessment of the videos was done using the Kappa score.Results: The videos in our sample had up to one million views (average 2,627,485.6), and the kappa index was 0.86 (p < 0.001). Of these videos, 16% were considered scientific evidence-based (SEB), and 84% were considered not scientific evidence-based (NSEB) (p < 0.001). The NSEB group addressed details concerning natural remedies, the Psychosocial sphere, and lifestyle, whereas the SEB group tended to be more concerned with physiopathology, etiology, endothelial dysfunction, diagnosis, psychosocial treatment, oral treatment, injections, or prosthesis.Conclusion: On social media, misleading or incorrect information about erectile dysfunction is widely disseminated. This research may support urological and technical oversight and emphasizes guiding patients to the best men’s health options.Keywords: Arabic language, YouTube, erectile dysfunction, videos, internet, social media

Our major aim was to systematically study the effectiveness of phosphodiesterase type 5 inhibitors in treating chronic prostatitis stage III and performed meta-analysis to evaluate the changes occurred in posttreatment scores of National Institutes of Health chronic prostatitis symptom index, international index of erectile function and international prostate symptom score. This meta-analysis was conducted according to the preferred reporting items for systematic reviews and meta-analyses guidelines. Comprehensive research was performed by using online resources like PubMed and the Wiley online library database to gather the relevant literature produced from the y 2010 to 2022. Two authors were assigned to independently collect the relevant information including author name, region of study, study design, treatment, publication year, sample size, voiding parameters, study inclusion and exclusion criteria, urological conditions, drug type, international prostate symptom score, international index of erectile function score, etc. In final screening 17 relevant studies were found. Out of these 17, 5 contained surgical procedure while 4 were narrative analysis. One study was incomplete regarding information. Finally, 7 studies were included for analysis. Total of 584 patients were involved in the selected studies. Three out of seven are from Italy region while two are from Japan and one was from Korea and Egypt respectively. Most of these studies used tadalafil monotherapy while one placebo-controlled trial. A significant difference in pain score, international prostate symptom score domain and National Institutes of Health chronic prostatitis symptom index were observed after consuming 5 mg tadalafil monotherapy. Everyday consumption of oral phosphodiesterase type 5 gave positive outcomes in terms of voiding. A significant difference was observed after using tadalafil monotherapy in the majority of the studies. Hence, tadalafil alone can be used to treat the type III chronic prostatitis. [ABSTRACT FROM AUTHOR]

Background: Erectile dysfunction (ED) and sex hormone profile disturbances are common in ESRD patients., Objective: To assess the effect of kidney transplant (KT) and Hemodialysis/peritoneal dialysis (HD/PD) on the serum sex hormone profile and sexual functions in ESRD patients with ED., Patients and Methods: A single-center, nonconcurrent cohort study included a hundred ESRD patients with ED, on regular HD/PD (group A, n = 50) and after KT (group B, n = 50) at Armed Forces Hospitals Southern Region, KSA., Results: the mean age of patients was 47.3 ± 7.01 and 56.8 ± 9.6 years in groups A and B, respectively. The cohorts were comparable regarding patient demographics, apart from a higher incidence of comorbidities in group B. After KT the mean testosterone level was higher in Group B (13.64 ± 3.21 nmol/L vs 10.26 ± 3.26 nmol/L, p < 0.001). Similarly, LH and prolactin levels were lower in group B than in group A (p < 0.05). As regards sexual function, ED was reported in 92% of patients in group A compared to 42% in group B (p < 0.001). In groups A and B, mild ED was found in 48% and 14% of patients, while moderate ED was found in 16% and 8%, respectively. The mean total IIEF-15 score was 36.42 ± 9.33 and 43.87 ± 9.146 in groups A and B, respectively (p = 0.0001). Sexual desire and orgasm were significantly better in Group B., Conclusions: Our study showed that kidney transplantation could improve erectile function and restore normal sex hormone levels in ESRD male patients with ED, with better outcomes compared to HD/PD.

Objective: To assess the efficacy and safety of Sildenafil citrate in the treatment of ED in (HD) compared to post-RT patients., Patients and Methods: A concurrent cohort prospective study to evaluate the efficacy of Sildenafil in the treatment of ED in 24 HD patients (Group A) and 13 patients with persistent ED one-year post-RT (Group B). The initial dose of Sildenafil was 25 mg, increased to 50 mg if there is an adequate response. An Arabic-translated International Index of Erectile Function (IIEF) questionnaire was completed one week before and after Sildenafil treatment. An IIEF erectile function score of 26 or an improvement of at least 10 points for the total IIEF score was considered a favorable response to Sildenafil., Results: Group A included 22 patients with a mean age of 47.32 ± 7.013 years, whereas Group B included 13 patients with a mean age of 56.87 ± 9.612 years. The overall efficacy rate of Sildenafil was 40.9% and 76.9% in groups A and B, respectively. The post-treatment IIEF5-15 score increased from 11.1 ± 5.99 to 12.5 ± 6.41 (p = .458) and from 11.82 ± 7.534 to 21.91 ± 5.700 (p = .002) in groups A and B, respectively. In both groups, the duration of HD had no impact on ED improvement except in the post-RT non-responder subgroup. Hypertension, gastrointestinal symptoms, and flushing were both groups' most common side effects., Conclusion: RT could enhance the response to sildenafil in treating patients with ED. The outcome is better in younger post-RT patients with moderate and severe erectile dysfunction and shorter dialysis duration., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background: Peyronie's disease (PD) results in curvature, pain, and erectile dysfunction (ED). Penile traction devices (PTDs) are a non-invasive treatment option for PD by applying mechanical forces to elicit biochemical responses that reduce curvature and improve penile function. In the present study, we systematically reviewed and analyzed the literature investigating the use of PTD to treat PD., Methods: We have conducted electronic and manual search strategies within the databases and included articles to find relevant studies. A total of Five studies met all the predefined inclusion criteria and were selected for inclusion in the review. Outcomes assessed are penile length, penile curvature, and erectile function (EF). The study population consisted of patients with PD, the intervention was penile traction therapy (PTT), the comparison was matched placebo or follow-up, and the study design was randomized controlled trials (RCTs) or cohort studies. The Cochrane risk of bias assessed the studies' quality for randomized studies and the Newcastle-Ottawa scale (NOS) for non-randomized observational studies. All statistical analyses were performed using R software. Results were considered statistically significant for P<0.05., Results: Only five studies met inclusion and exclusion criteria and were published between 2014 and 2021. The sample sizes range [51-110], totaling 419, with a mean of 83.8 patients-the follow-up with a mean of 6.75 months. This meta-analysis evaluated the efficacy of PTD on curvature degree, penile length, and EF in patients. There is a significant positive effect on the curvature degree (P=0.0373), while there is no significant effect on penile length and EF (P=0.5315 and 0.1010), respectively. They are Indicating low heterogeneity with an estimated total heterogeneity of 0. Overall, the available evidence does not support the efficacy of the intervention for penile length or EF., Conclusions: The current evidence suggests that PTDs can be a safe and effective treatment option for men with PD to reduce penile curvature. However, further research, including more RCTs with extended follow-up periods, is needed to fully understand their efficacy and determine the ideal timing and patient subtypes that would benefit from PTD., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://tau.amegroups.com/article/view/10.21037/tau-23-310/coif). The authors have no conflicts of interest to declare., (2023 Translational Andrology and Urology. All rights reserved.)

Pulsed radiofrequency, short bursts of radiofrequency energy, has been used by pain practitioners as a non- or minimally neurodestructive technique, an alternative to radiofrequency heat lesions. The clinical advantages and mechanisms of this treatment remain unclear. To review the current clinical implication of the pulsed radiofrequency technique for male patients with chronic scrotal pain. We systematically searched the English literature available at the EMBASE, MEDLINE/PubMed, Google Scholar, and Cochrane Library from inception to 22 November 2022. Only reports on a pulsed radiofrequency application on male patients with chronic scrotal pain were included. The final analysis yielded six reports on the clinical use of pulsed radiofrequency applications in male patients with chronic scrotal pain: six full publications, three case reports, one case series, one prospective uncontrolled pilot study, and one prospective randomized, controlled clinical trial. The accumulation of these data shows that using pulsed radiofrequency generates an increasing interest in pain physicians, radiologists, and urologists for managing chronic scrotal pain. No side effects related to the pulsed radiofrequency technique were reported to date. Further research on the clinical and biological effects is justified. Large sample sizes and randomized clinical trials are warranted.