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PURPOSE OF REVIEW In the recent two decades, technological breakthrough has tremendously expanded the scope of transurethral prostate surgery. New gadgets and energy devices keep emerging to tackle benign prostatic obstruction, which was dealt with mainly by transurethral resection of prostate in the old days. Although this trend appears fascinating, it also means that urologists need quality training to attain surgical safety in performing these new surgeries. E-learning and simulation training may play an important role in modern urology training. RECENT FINDINGS In this review, we would describe, using up-to-date evidence, the key components of simulation training, the types of simulators currently in use and their respective advantages and limitations. SUMMARY Modern simulation technology enables surgical training in a realistic, reproducible and risk-free environment. Simulation training has been proven to improve both performers' confidence and objective scores in various transurethral prostate surgeries. Its use should therefore be advocated.

Since 1985, ketamine, a frequently used human and veterinary anaesthetic, has been listed as an essential medicine by the World Health Organization. This N-methyl-d-aspartate receptor antagonist has also been used and studied extensively for its role in the treatment of depression. Owing to its potential implications on health when used illicitly, at least 60 countries have already put ketamine under national control. Its illicit use has been reported on a global scale, so are its delirious complications from chronic abuse. The detrimental effects of ketamine abuse encompass different organ systems, where long-lasting complications on the genitourinary, gastrointestinal, hepatobiliary and neuropsychiatric systems stood out. In this relatively new entity of ketamine-associated complications, the importance of proper assessment and building of good rapport is emphasized. Abstinence is the first key for the successful management of its complications. Both medical and surgical management have its role in the multidisciplinary management.

Background Little is known about the key composition of a successful tweet in urology. Objective To investigate for predictors of engagement with urology content on Twitter. Design, setting, and participants This was a cross-sectional study based on 2-wk Twitter data surrounding a major international urology conference. Intervention We examined the engagement for all original tweets containing the hashtags for the European Association of Urology conference (“#EAU19” and/or “#EAU2019”). Outcome measurements and statistical analysis Study outcomes included engagement with tweets, as measured by the number of “likes” and “retweets.” Tweet- and Twitter user–related parameters of each individual tweet were recorded. Multiple linear regression analyses were performed to investigate for predictors of likes and retweets. Results and limitations From March 9 to 22, 2019, there were a total of 37 222 tweets. Among them, 3534 were “original tweets” that had 31 889 likes and 10 031 retweets. On multivariable analysis, the word count, number of mentions, and presence of a photo were predictors of likes and retweets. An increasing number of hashtags were associated with fewer likes. The number of “followings” and “followers” of the contributor, and their time since joining Twitter did not have any associations with the number of likes or retweets. The major limitation of the study is the lack of assessment about the quality of the tweet content. Conclusions Based on the Twitter data from a urology conference, we concluded that the word count, number of mentions, and presence of a photo within the tweet were associated with audience engagement. Patient summary We could engage the audience more successfully by increasing the number of words and mentions, and including a photo within a tweet. The results formulated the basic principles in creating successful tweets for sharing urological knowledge.

Aim To evaluate the progression-free survival (PFS), cancer-specific survival (CSS) and overall survival (OS) of Chinese metastatic prostate cancer patients following primary androgen deprivation therapy (ADT) in relation to prostate-specific antigen (PSA) nadir level. Methods All Chinese prostate cancer patients with bone metastases who were treated with primary ADT from 2000 to 2009 were included. Patients' and disease characteristics were recorded. Patients were categorized into two PSA nadir groups (≤1.0 and >1.0 ng/mL). Associations of PSA nadir with PFS, CSS and OS were analyzed with Kaplan–Meier and Cox regression analyses. The survival outcomes of the two PSA nadir groups were presented. Results Four hundred nineteen patients were included in the study. PSA nadir appeared to be a good predictor for PFS (hazard ratio [HR] 1.86, 95% confidence interval [CI] 1.35–2.56, P 1.0 ng/mL, the median PFS were 15 and 10 months, and the 1-year PFS rates were 64% and 40%, respectively; the median CSS were 42 and 27 months, and the 5-year OS rates were 53% and 28%, respectively; and the median OS were 41 and 24 months, and the 5-year OS rates were 45% and 19%, respectively. Conclusions Higher PSA nadir was associated with shorter PFS, CSS and OS in Chinese metastatic prostate cancer patients following primary ADT. The survival outcomes may serve as references in deciding the best treatment strategy in Chinese prostate cancer patients.