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ABSTRACT Introduction and objective: Focal cryotherapy emerged as an efficient option to treat favorable and localized prostate cancer (PCa). The purpose of this video is to describe the procedure step by step. Materials and methods: We present the case of a 68 year-old man with localized PCa in the anterior aspect of the prostate. Results: The procedure is performed under general anesthesia, with the patient in lithotomy position. Briefly, the equipment utilized includes the cryotherapy console coupled with an ultrasound system, argon and helium gas bottles, cryoprobes, temperature probes and an urethral warming catheter. The procedure starts with a real-time trans-rectal prostate ultrasound, which is used to outline the prostate, the urethra and the rectal wall. The cryoprobes are pretested and placed in to the prostate through the perineum, following a grid template, along with the temperature sensors under ultrasound guidance. A cystoscopy confirms the right positioning of the needles and the urethral warming catheter is installed. Thereafter, the freeze sequence with argon gas is started, achieving extremely low temperatures (-40°C) to induce tumor cell lysis. Sequentially, the thawing cycle is performed using helium gas. This process is repeated one time. Results among several series showed a biochemical disease-free survival between 71-93% at 9-70 month- follow-up, incontinence rates between 0-3.6% and erectile dysfunction between 0-42% (1–5). Conclusions: Focal cryotherapy is a feasible procedure to treat anterior PCa that may offer minimal morbidity, allowing good cancer control and better functional outcomes when compared to whole-gland treatment.

Over the past three decades, minimally invasive robotic technology has evolved substantially in urological practice, replacing many open procedures and becoming part of routine clinical practice. The Health Sector Transformation Program for the Kingdom's Vision 2030 aims to restructure the health sector and optimize its status and prospects as an effective and integrated ecosystem centered on the patient's health. Therefore, this consensus seeks to endorse the clinical practice guidelines for robotic surgery (RS) in the KSA, highlighting its effectiveness, safety, and favorable outcomes compared to open and laparoscopic surgeries in certain procedures when used by trained surgeons in well-structured RS programs.

The SARS-CoV-2-induced novel coronavirus disease has become a global pandemic. As the latest coronavirus variants are even more infectious and deadly, its treatment is very difficult. Currently used drugs such as remdesivir, saquinavir, and chloroquine have several drawbacks. Recent studies have reported key proteins that could serve as drug targets. Amongst them, the spike (S) glycoprotein is an attractive drug target that plays a prominent role in viral binding and entry. With the aim of targeting and blocking the S protein, we designed a computational study for screening novel antiviral compounds. Molecular docking was used as a screening tool, and Molecular Dynamics (MD) simulations were used to further confirm the stability of ligand-bound complexes. The Asinex antiviral database was screened using a recently resolved S protein (PDB ID: 7C2L). The Schrodinger software suite was used for preparing the protein and ligand structures prior to performing the docking experiment. Based on the docking scores, antiviral compounds were screened and the docked complexes of top-performing hits were tested for complex stability and presence of molecular interactions using MD simulations. Finally, based on the nature of molecular interactions, six prospective hits— LAS 51389346, BDH 33920970, LAS 51389268, LAS 51389282, LAS 51389262, and LAS 51389430—were screened. Among these compounds, LAS 51389268, BDH 33920970, and LAS 51389268 showed consistent and strong binding with S glycoprotein, predicting them as prospective candidates for COVID-19 treatment. In conclusion, this study screened out novel prospective antiviral compounds that can intervene with virion entrance thereby being of potential use to treat COVID-19.

In this work the finite element method was used to analyse the composite patch shape effect of the repair performance. Unlike all the works done conducted so far in this domain, this work proposed here, takes into account the reducing both, the stress intensity factor in repairing crack heads and the maximum shear stresses in the adhesive layer. This is the originality of this work. In function of the surface and the volume of the rectangular patch, three cases were taken into consideration: with conservation of the patches surface and its volume, with a reduction of the patches surface and its volumes, and in the end, with a reduction of the patches surface and conservation of its volume. The obtained results show that in the first case, the patch shape have no effect on the SIF, the sharp edges (obtuse, right and acute) of oblique shapes generate high shear stresses, in the second case, the reduced surfaces lead to significant mass gain with the same SIF values. and to an increase in the maximum shear stresses, in the latter case the patches shapes lead to a reduction of the SIF and the shear stresses.

Introduction The Spies™ system (Karl-Storz®) was introduced into digital ureteroscopy to improve endoscopic vision. To date, there is no data to either indicate which of the Spies modalities is better for improving diagnosis and treatment procedures, nor to compare the modalities in terms of image quality. The aim of this study was to evaluate and compare the image quality of five Spies™ modalities (SM) to the standard white light in an in-vitro model. Materials and Methods Two standardized grids and 3 stones of different composition were recorded in white light and the 5SM (Clara, Chroma, Clara+Chroma), Spectra A and B) using 4 standardized aqueous scenarios. Twelve templates were done in order to simultaneously compare the same objective in the different modalities. Six urologists, five medical students, five urology residents, and five persons not involved with urology evaluated each video on a scale of 1 (very bad) to 5 (very good). Results Comparing white light to SM, subjects scored better the quality of Clara and Clara+Chroma than white light (p=0.0139 and p

ABSTRACT Background Radical prostatectomy (RP) has been used as the main primary treatment for prostate cancer (PCa) for many years with excellent oncologic results. However, approximately 20-40% of those patients has failed to RP and presented biochemical recurrence (BCR). Prostatic specific antigen (PSA) has been the pivotal tool for recurrence diagnosis, but there is no consensus about the best PSA threshold to define BCR until this moment. The natural history of BCR after surgical procedure is highly variable, but it is important to distinguish biochemical and clinical recurrence and to find the correct timing to start multimodal treatment strategy. Also, it is important to understand the role of each clinical and pathological feature of prostate cancer in BCR, progression to metastatic disease and cancer specific mortality (CSM). Review design A simple review was made in Medline for articles written in English language about biochemical recurrence after radical prostatectomy. Objective To provide an updated assessment of BCR definition, its meaning, PCa natural history after BCR and the weight of each clinical/pathological feature and risk group classifications in BCR, metastatic disease and CSM.