Grand Journal of Urology
E-ISSN : 2757-7163

General Urology
Original Article
Objectives: The aim of this study is to compare two patient groups diagnosed with Fournier's Gangrene (FG) and treated with negative pressure wound therapy (NPWT) and conventional wound dressing (CWD) methods. Materials and Methods: 64 patients with FG, who were followed up and treated at the Urology clinic of University Hospital between January 2011 and July 2020, were included in the study. Patients were divided into two groups: While group 1 received CWD treatment, group 2 received NPWT. Demographic characteristics, etiology, length of stay, number of debridements, additional surgeries, Fournier Gangrene Severity Index (FGSI) scores, analgesic needs, area of necrosis and amount of involvement of the patients were retrospectively analyzed. Results: 37 patients in group 1 and 27 patients in group 2 were included in the study. All patients were male. The mean hospital stay was 17.9 ± 1.8 days in group 1, while it was 12.7 ± 1.1 days in group 2 (p:0.91). The mean debridement numbers in Group 1 and Group 2 were 7.1 ± 0.8 and 3.7 ± 0.3, respectively (p:0.004). The mean number of daily analgesic use in Group 1 and Group 2 was 2.4 ± 0.12 and 1.44 ± 0.08, respectively (p
Grand J Urol 2024;4(1):001-005, DOI: 10.5505/GJU.2024.28290
Objective: To compare traditional and hybrid model of education in urology among 4th-year medical students in terms of training success Materials and Methods: In our urology clinic, the training success scores of seven randomly selected training groups, who were trained with the traditional model between 1998-2018, and the 4th year medical students who were trained with the hybrid model between 2018-2020 and constituted five randomly selected training groups were compared. Of the total 582 medical students, included in the study, 278 (47.8%) were enrolled in the traditional model group, and 304 (52.2%) in the hybrid model group. The training was evaluated with hands-on applications and theoretical and oral exams. Differences between both male and female students and differences that may vary depending on different faculty members teaching the students were evaluated using multivariate logistic regression analysis. Results: The training success rates were significantly higher in the hybrid model group (300/304; 98.7%) than in the traditional model group (261/278; 93.9%) [p:0.002]. Multivariate logistic regression analysis found that factors such as the number of training groups, gender of medical students, and evaluations of different faculty members did not affect the educational success rate. Conclusion: The hybrid model could be accepted as a mobile education model in a sense. The exam results of medical students educated with the hybrid model were better than those receiviing training with the traditional model which can be explained by the increased accessibility of medical students to education in the hybrid model without constraints of time and place. Additionally, it is thought that conducting the oral exam as a "structured oral exam" also contributed to these results.
Grand J Urol 2022;2(1):8-14, DOI: 10.5505/GJU.2022.58067
Objective: Benign prostatic hyperplasia (BPH)-related acute kidney injury (AKI) occurs in male patients as a natural result of aging and androgen exposure. In our study, we investigated the frequency of BPH-related AKI and its relationship with disease severity in patients hospitalized for COVID-19 pneumonia. Materials and Methods: This is a retrospective and observational study on 869 male patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), who were diagnosed with COVID-19 by real-time PCR testing and hospitalized due to COVID-19 pneumonia. None of the patients was admitted to the intensive care unit (ICU). 55 patients out of 869 had BPH. AKI was defined according to Kidney Disease: Improving Global Outcomes (KDIGO) criteria. BPH and non-BPH groups were statistically compared with respect to the existence, frequency, hospitalization duration and in-hospital death. Results: Median age was 70 years for BPH group and BPH patients were significantly older than the non-BPH. Hypertension, coronary artery disease and heart failure were significantly more frequent in the BPH group. On admission, compared with normal serum creatinine, serum urea was significantly higher in the BPH patients. All AKI patients with BPH had three or more comorbidities. During hospitalization, AKI occurred in 7,3% of the BPH patients compared with the non-BPH (0,98%). The incidence of AKI was significantly higher in the patients with BPH (OR:7,94, 95% CI:2,31-27,25). In-hospital death occurred in 16,4% of the patients with BPH. The mortality was significantly lower in non-BPH group (8,6%) compared with the BPH. Our final analysis showed that age, arterial hypertension, prior coronary artery disease and heart failure were independent risk factors for occurred BPH-related AKI. Conclusions: Older male patients with common comorbidities showed a higher risk for mortality from COVID-19 pneumonia. Also, AKI patients with BPH had a poorer prognosis and higher mortality than the non-BPH patients.
Objective: We aimed to investigate the activity of diosmin-hesperidin (DAFLON®) in ischemia-reperfusion injury in the rat kidney. Materials and Methods: Twenty-four Wistar rats were used for the experimental study. Each group comprised of 8 subjects. Sham group (Group 1) was nephrectomized for histopathologic examination and blood samples were obtained for biochemical analysis. Control group (Group 2) was subjected to ischemia for 1 hour and reperfusion for 24 hours, then they were nephrectomized for histopathologic examination and blood samples were taken for biochemical analysis. Treatment group (Group 3) was given 80 mg/kg diosminhesperidin combination (DAFLON®) for 10 days and subjected to ischemia for 1-hour and reperfusion for 24 hours, then they were nephrectomized for histopathologic examination and blood samples were obtained for biochemical analysis. Results: As a result of biochemical analysis and histopathologic examination, more significant results were acquired in regard to other groups. Serum urea values were statistically significant (p
Grand J Urol 2022;2(1):24-25, DOI: 10.5505/GJU.2022.36035
Objective: To evaluate the effect of the pandemic on the publications related to urology. Methods: All publications about urology in the PubMed database between 2016 and 2020 were reviewed. The number and the rate of change in the number of these publications issued between the years 2016- 2019, and in 2020 were recorded. The publications about urology and COVID-19 in the pandemic period were identified, their publication rates among them were examined. Results: There was a reduction of 24.33% in the rates of publications on urology during the pandemic period compared to the time interval between the years 2016, and 2019, but without any statistically significant difference (p=0.122). A statistically significant difference was found only in the number of publications related to urological surgery between 2016- 2019 and 2020 (p=0.045), but without any statistically significant difference in the number of publications on other subdiciplines of urology (p>0.05). The ratio of publications on COVID- 19 and urology to all publications on COVID-19 was 1.33 percent. The ratio of publications on COVID-19 and urology to all publications on urology in 2020 was found to be 1.98 percent. Conclusion: The COVID-19 pandemic did not make a significant difference in the number of publications on urology. Although disasters such as pandemics may not affect the number of publications, they can change the types of publications to which scientists are directed to.
Grand J Urol 2022;2(1):26-32, DOI: 10.5505/GJU.2022.02886
Objective: The Coronavirus Disease-2019 (COVID-19) is particularly more common and deadly among older men who also constitute a significant portion of urology patients. In this study, we aimed to evaluate the change in the diagnostic spectrum in urology outpatient applications after the declaration of pandemic compared to the pre- pandemic period. Materials and Methods: All patients were enrolled between February 12 and May 6, 2020. Demographic, and clinical data of the patients were analyzed pertaining to the period of 4 weeks before, and the first, and second 4 weeks after declaration of the pandemic. Data obtained from the database such as age, gender, diagnoses were anonymized. Recurrent applications with the same diagnosis within ten days after the first presentation were excluded from the analysis. Results: Compared to the pre-pandemic period a significant decrease in the number of patients applied to the urology outpatient clinics after declaration of the pandemic, and in the frequency of diagnoses of prostate diseases, and urine transport, storage and emptying disorders and a significant increase in the frequency of diagnoses of urinary system stone disease, benign or malignant bladder diseases, upper urinary system tumors, and sexual dysfunction were observed after declaration of the pandemic. Conclusion: The risk perception of COVID-19 disease may cause changes in the diagnostic distribution of patients applied to the urology outpatient clinics. During periods of outbreak, the health system must be redesigned by focusing on outpatients.
Grand J Urol 2023;3(2):054-059, DOI: 10.5505/GJU.2023.50470
Objective: This study compared the pre-COVID-19, COVID-19, and post-COVID-19 periods of the patients in terms of urinalysis parameters and assessed the relationships between the changes in these parameters and renal functions. Materials and Methods: Four-hundred-eighty-two moderate and severe COVID-19 patients who had the data of urinalysis performed in the pre-COVID-19 period at most three months before the onset of COVID-19 diagnosis, during COVID-19 disease, and 15 days after they completely recovered from the COVID-19 disease were included in the study. Parameters of bilirubin, erythrocyte, leukocyte, protein, glucose, acidity (pH), and density were analyzed in urine samples, and the results were recorded. Results: CRP, e-GFR, fibrinogen and D-dimer values were found to be significantly different between the three groups (for all parameters p
Grand J Urol 2021;1(2):55-61, DOI: 10.5222/GJU.2021.36855
Objective: Complete urinalysis (CUA) is one of the indispensable screening tests of clinical laboratories. The compatibility of this test with urine culture is of indispensable importance in the diagnosis and treatment of urinary tract infections. We aimed to evaluate the suitability of the leukocyte parameter measured in the microscopic units of the fully automated urine analyzers which replace traditional methods, by grouping them according to the results of chemical analysis. Materials and Methods: Leukocyte counts in the reported CUA results of 4685 outpatients and the results of 113 urine cultures studied on the same day were analyzed. Noncentrifugated urine samples were included in the analysis. Cells were digitally imaged by flow microscopy. Chemical analyzes were performed using dual wavelength reflectance method. Urine samples were evaluated after 24 hours of incubation. Results: High power field (HPF) values were recorded by grouping the leukocyte counts as negative, trace, 1+, 2+ and 3+. The arithmetic means of HPF values of the groups were calculated as 1.2, 2.1, 5.0, 11 and 208 white blood cell (WBCs/HPF). Bacterial growth was detected in 19 of 113 patients and no reproduction was observed in the remaining 94 cases. When results of microscopic examinations and chemical analysis were compared with the culture results, the analytical sensitivity, specificity, positive, and negative predictive values for microscopic urinalysis were 25%, 86%, 61.3%, and 58.3%, respectively. While, the analytical sensitivity, specificity, positive, and negative predictive values for chemical analysis of urine were 25.8%, 87.7%, 69.7%, and 51.4%, respectively. Conclusion: The workload of medical laboratories is increasing, and the use of urine autoanalyzers may be preferred for busy laboratories. In the diagnosis and follow-up of urinary tract infections, complete urinalysis by autoanalysers in which the harmony of their microscopy and chemical units are closely monitored, may reduce the need for unnecessary requests for urine culture, but it cannot replace urine culture.
Grand J Urol 2023;3(3):070-074, DOI: 10.5505/GJU.2023.81300
Objective: As a urological emergency, testicular torsion is one of the causes of acute scrotum in all age groups. This study aimed to evaluate the effectiveness of manual detorsion performed before surgical intervention. Materials and Methods: Retrospective data analysis of the patients with acute scrotum who applied to the emergency department of a 3rd level hospital between the years January 2010 and January 2023 with the complaint acute unbearable pain within the first 12 hours of its onset was performed. Patients were grouped according to whether or not manual detorsion was performed in the emergency department. Successful manual detorsion was defined as postprocedural normal color Doppler ultrasound findings and complete resolution of pain. All patients had undergone surgical exploration. Age, laterality of the torsional testis, manual testicular detorsion attempt (if any), and surgical conditions resulting in testis preservation or orchiectomy were the patient data analyzed. Results: Sixty patients were included in the study. Manual detorsion was performed in 29 (48.3%) patients in the emergency department (Group 1). Scrotal exploration was performed in 31 (51.7%) patients without applying manual detorsion (Group 2). In Group 1, testicular preservation was achieved in 26 (89.7%) patients. In Group 1, in 3 patients (10.3%) testicular necrosis occurred due to failure to achieve adequate blood supply, while orchiectomy was performed in 11 (35.5%) patients in Group 2. Lower rates of orchiectomy were observed in Group 1 compared to Group 2 (p=0.021). We also observed that manual detorsion decreased the rate of orchiectomy (rho- 0.297, p=0.021), and the probability of undergoing orchiectomy increased with increasing age (rho 0.512, p
Grand J Urol 2023;3(3):080-084, DOI: 10.5505/GJU.2023.80774
Objective: This study aims to discuss the techniques for safely, quickly, and successfully removing transurethral (TU) foley catheter balloons in patients who present to the emergency and urology clinics due to the inability to remove the catheter through normal means, and to contribute options and insights to the literature. Materials and Methods: This retrospective study included patients who presented to the emergency department for the inability to remove the TU foley catheter, patients referred to the urology clinic, or patients consulted from other clinics, between January 2017 and September 2022. The treatment methods applied by the urologist in this patient group, hospitalization durations, voiding status, and any developed complications were recorded based on patient files. Results: A total of 22 patients who had a transurethral (TU) catheter inserted for various reasons and were unable to remove it were included in our study. It was found that 7 of the patients had permanent TU catheters due to comorbidities, while the remaining 15 had TU catheters inserted after acute urinary retention. Among them, 2 cases had the catheter removed by cutting the inflation channel, 1 case with the assistance of a guidewire, 2 cases by puncturing the balloon with a needle under transrectal ultrasound guidance, 10 cases by puncturing the catheter balloon with a needle under suprapubic ultrasound guidance, and 7 cases had their catheters removed by laser under anesthesia. Only 1 patient who had the balloon punctured by a needle under transrectal ultrasound guidance developed fever after the procedure and had a total of 5 days of hospitalization, while the others were discharged either immediately after the procedure or 1 day later. Conclusion: Patients with indwelling foley catheters that cannot be removed rarely present to us; however, these patients often come to us in an agitated state after multiple unsuccessful attempts to remove the catheter. Therefore, it is important to know which technique should be applied to this patient group in a faster, appropriate, and reliable manner as soon as possible.
Grand J Urol 2022;2(3):087-092, DOI: 10.5505/GJU.2022.32032
Objective: We aimed to analyze and report the outcomes of patients with retroperitoneal bleeding (RPB) among our COVID-19 inpatients under anticoagulation therapy. Materials and Methods: We retrospectively analyzed 54 patients who were anticoagulated with low- molecular-weight heparin (LMWH) and developed RPB during COVID-19 treatment in the hospital, either in intensive care unit or non-intensive care unit services, between March 2020 and March 2021. The patients' demographic and clinical data were analyzed, and we compared the laboratory results at the time of admission and during episodes of RPB. The patients were divided into conservative and interventional treatment groups. We compared the size of retroperitoneal hematoma, anticoagulant doses, erythrocyte suspension transfusion rates, presence of hyperinflammation syndrome between these groups. Also, treatment modalities and mortality status were shown. The hematoma size and erythrocyte suspension transfusion rates were compared between groups, and their correlation with anticoagulant dose and age were analyzed as well. Results: In the management of RPB that developed, 48 (88.9%) patients were approached conservatively, 4 (7.4%) patients underwent angioembolization, and 2 (3.7%) patients laparotomy. Mortality was observed in 14 (25.9%) patients. Relevant laboratory parameters as lactate dehydrogenase, procalcitonin, interleukin-6 levels and lymphocyte counts were elevated exceedingly, while the hemogram test values were significantly lower during episodes of RPB (p=0.007, p=0.044, p=0.031, p=0.018 and p
Grand J Urol 2021;1(3):89-95, DOI: 10.5222/GJU.2021.14633
Objective: Applications are made to health boards for age assessment, gender determination, employment in some occupational groups and detection of disability. The aim of our study is to determine the defined urological pathologies and their incidence rates in the patients who applied to the health board of our hospital. Materials and Methods: Our study included patients who applied to the urology outpatient clinic of the health board between January 2015 and December 2020 for the purpose of employment in some occupational groups, determination of age, gender, disabilities and obtaining a general health report. Patients were investigated in two different groups, according to their indications for their applications as detection of disabilities and other indications, and the diagnoses were classified under the subheadings of stone diseases, malignancies, neurourology-incontinence, andrology and benign prostatic hyperplasia (BPH). Results: A total of 1453 cases were included in the study. Hundred and fifty-one (10.4%) patients applied for the detection of disability. A total of 206 (17%) patients, including 70 (46.3%) cases in the disability detection group and 136 (10.4%) in the other group had a urological diagnosis. The most common pathology was malignancies with 65 (4.4%) cases, in order of frequency; testicular cancer (n=25: 38.4%), bladder cancer (n=15: 23%), prostate cancer (n=13: 20%), kidney cancer (n=11: 16.9%) and penile cancer (n=1: 1,5%). The second most frequently seen diagnostic group was the stone disease group (n=55: 3.7%), and 17 (30.9%) of them required further investigation after diagnosis. Consequently ESWL (n=6: 10.9%), and surgical intervention (n=4: 7.3%) were planned for the indicated number of patients. Conclusion: Urogenital system malignancies and urinary tract stones have been identified as the most common pathologies in patients who applied to the health board. The fact that some diseases, especially urolithiasis were followed by further examination and treatment, shows the contribution of the health board examinations to the treatment as well as the health status determination feature.
Case Report
Grand J Urol 2023;3(1):035-037, DOI: 10.5505/GJU.2022.88597
Adrenal myelolipoma (AM), with its unique histological appearance, is a rarely encountered benign tumor. It is mostly asymptomatic and is incidentally detected. Rarely, in some large masses, retroperitoneal hemorrhage, which could cause life-threatening shock due to spontaneous rupture of AM may develop. In this case report, we presented a 60-year-old male patient who was admitted with abdominal pain and rapid decline in hemoglobin values. Computed tomography (CT) showed bleeding into the retroperitoneal space secondary to the rupture of myelolipoma measuring 14-cm in diameter in the right adrenal gland. Emergency exploratory laparotomy was performed, and the mass was excised. The possibility of rupture, and bleeding of large adrenal myelolipomas should be taken into consideration and accordingly, follow-up of asymptomatic patients should be done carefully.
Grand J Urol 2021;1(2):71-74, DOI: 10.5222/GJU.2021.25743
Hemorrhagic cystitis (HS) is a frequently seen complication of bone marrow transplantation. This condition occurs depending on the preparatory regimen of bone marrow transplantation. The BK virus (BKV), a human polyomavirus, is a small double helix DNA virüs belonging to the Papovaviridae family. It is commonly found in societies as an occult infection. Whereas, cidofovir (CDV), an acyclic nucleoside phosphonate, is used as a proven antiviral agent against polyomaviruses. In this case report, acute proximal tubular necrosis due to cidofovir used in hemorrhagic cystitis caused by BK virus, and its treatment in a patient diagnosed with T-lymphoblastic lymphoma in remission, and underwent allogeneic stem cell transplantation, was presented.
Concurrence of emphysematous pyelonephritis related to renal tuberculosis and iliopsoas abscess is exceedingly rare, and its coexistence with COVID-19 pneumonia presented as "diabetic ketoacidosis" may have fatal consequences. A 46-year-old diabetic female patient was manifesting signs of septic shock; unconsciousness, febrile episodes, tachycardia and tachypneia when she was first admitted to our emergency department. She had positive real-time PCR test results for COVID-19 four days before her admission with symptoms of abdominal pain, fever, nausea, weakness, chest tightness, and shortness of breath persisting for a week. Blood test results were consistent with diabetic keto acidosis. Computed tomography (CT) showed left-sided emphysematous pyelonephritis and iliopsoas abscess. The patient was managed using percutaneous drainage and empirical antibiotics. Besides, renal tuberculosis was identified in the patient who did not respond to the treatment offered. A poor glycemic control may cause various fatal clinical complications. Concurrence of emphysematous pyelonephritis and iliopsoas abscess may be devastating for the patient that must be promptly managed to avoid any occurrence of septic shock. As the response to the treatment offered was inadequate, the coexistence of other disease states as renal tuberculosis was contemplated.
Grand J Urol 2022;2(3):122-125, DOI: 10.5505/GJU.2022.72692
Zinner syndrome is a rarely seen congenital anomaly characterized with developmental defects of mesonephric (Wolffian) duct including obstruction of the ejaculatory duct, an ipsilateral seminal vesicle cyst, and an ipsilateral renal agenesis. Patients may present with genitourinary system complaints, or they may be completely asymptomatic and detected incidentally. Minimally invasive cyst aspiration and surgical treatment are mainly aimed for symptomatic relief. In this article, a rare case of Zinner Syndrome presenting with signs of urinary retention is presented.
Grand J Urol 2021;1(3):146-149, DOI: 10.5222/GJU.2021.79188
One of the reasons for the high mortality in COVID-19 patients is the increased risk of disseminated intravascular coagulation (DIC) and venous thromboembolism. For this reason, the use of anticoagulant treatments has become widespread. One of the rare complications of anticoagulant therapy is retroperitoneal hemorrhage. These hemorrhagies require immediate intervention. Retroperitoneal hemorrhage should be kept in mind among the many complications that develop in the patient who was followed up during the pandemic period. For this purpose, we present 2 cases who developed spontaneous retroperitoneal bleeding while clinically recovering under COVID-19 treatment.
Clinical Image
Grand J Urol 2023;3(2):068-069, DOI: 10.5505/GJU.2023.54154
Patients with penile lesions often delay seeking medical consultation, leading to advanced presentation of penile malignancies and extensive lesions. The main challenge in diagnosing these lesions is distinguishing between benign and malignant conditions, which cannot be defined on clinical evaluation only. The main concern is diagnosing squamous cell carcinoma and its variants. Benign lesions, such as fibroepithelial polyps, are rare and a diagnosis of exclusion. Fibroepithelial polyps arise from the mesoderm. They can occur anywhere on the skin, more frequently in the groin, axilla, and eyelids. In the urological setting, they are more commonly found in the ureter. There are few reported cases of penile presentation, with the polyps typically appearing on the glans and associated with poor hygiene or urinary catheter use. The possibility of recurrence or malignant transformation has been reported inconsistently in the literature [,]. We present a case with a florid manifestation of fibroepithelial polyps.
Pediatric kidneys are more susceptible to trauma due to poor protective mechanisms due to immature and more pliable thoracic cage, weak abdominal wall musculature and inadequate perirenal fat. Ureteropelvic junction obstruction (UPJO) is one of the most frequently found renal anomaly, and pelvicalyceal (PCS) rupture is a rare presentation whose diagnosis may be delayed due to lack of hematuria and unnoticed trauma. We present a case of child with PCS rupture in solitary functioning right kidney following trivial trauma. A 6 -year- old male child was referred with complaint of abdominal pain with anuria for 2 days after a small fight with a close friend. Physical examination findings were as follows: abdominal distension with fullness in the right renal fossa, stable vitals, and lack of any urine output on catherization, while he had lower hemoglobin (11.6 mg/dl), and higher serum creatinine (1.8 mg/dl) levels. Whole abdominal ultrasound demonstrated grossly hydronephrotic right kidney with large perinephric fluid collection, absence of left kidney, and empty bladder. Contrast Enhanced Computed Tomography (CECT) of the whole abdomen demonstrated right PCS rupture: grossly dilated right PCS with large perinephric fluid collection extending to the pelvis, absence of the left kidney (Figure 1). Right side USG- guided percutaneous nephrostomy (PCN) was performed under general anesthesia and immediately after 500 ml clear urine was drained. While 24 hrurine output reached up to 1000ml, and serum creatinine levels normalized 3 days later. After 6 weeks, repeat CT urography revealed the diagnosis of right UPJO. Then the patient underwent open Anderson- Hynes dismembered pyeloplasty (Figure 2). Figure 1. A-B: Abdominal CECT during initial presentation just after trauma Figure 2. C-D: Follow- up CT urography 6 weeks after trauma E: Intraoperative picture of ureteropelvic junction Most children with grade IV/V renal injury following blunt trauma can be managed nonoperatively []. Kidneys are affected in 8-10% of the cases exposed to blunt abdominal trauma which is seen twice more commonly in children. Trivial trauma leading to PCS rupture is a rare presentation. This is more common in children with hydronephrotic kidney mostly due to UPJO. High level of suspicion is required as occasionally it manifests minimal symptoms so its diagnosis is delayed. Our patient presented as a case of emergency within 2 days after the traumatic incident due to solitary functioning kidney with anuria. DJ stenting and PCN insertion are appropriate options for these patients in emergency situation. Sometimes these patients may present with hemodynamic instability requiring immediate exploration. Judicious and early use of minimally invasive interventions, instead of persisting with nonoperative management improve functional outcomes [].
Letter to the Editor
Grand J Urol 2021;1(1):41-42, DOI: 10.5222/GJU.2021.98608
The new coronaviruses outbreak caused by SARS-CoV-2 (COVID-19) originated from the Chinese region of Wuhan in the last quarter of 2019 affected approximately 75 million people all around the world and caused over 1.6 million deaths []. COVID-19 is a highly contagious viral infection and its main routes for transmission are the person to person contact, touch, and aerosol. While it has detrimental effects on respiratory and cardiovascular systems it also can be found in digestive and urinary systems. The frequently experienced symptoms are fever, dry cough, dyspnea, fatigue, and loss of appetite []. With an ongoing effort, several researchers focused on investigating a drug or vaccine to end the pandemic. Currently, despite there is no drug specifically approved for COVID-19 treatment, there has been more than one vaccine from different nations to prevent the virus spread. Prior to the COVID-19 pandemic, virology research constituted less than 2% of all biomedical research. But this rate has been increased to 10-20% which represents the incredible adaptation potential of the research community. By the way, the COVID-19 pandemic led to a massive influx of publication not only by virologists and infectious health specialists but also by almost all medical disciplines. To facilitate early dissemination of knowledge prior to any peer-review, many articles have been uploaded preprint services []. It is not realistic to assume that a qualified and strict peer-review process could compensate for the high number of submissions. Moreover, someone must be aware that those non-peer-reviewed materials could be picked up by the media and spread to the population. Social distancing and transmission issues have also led to travel and social restrictions that resulted in many trials to be suspended or delaying in patient recruitment []. It is wellknown that generally large-scale randomized trials were not set up in time in the previous pandemic. However, the use of modern information technologies in combination with oldfashioned randomization might lead to the rapid gain of viable results nowadays. Countries might be encouraged to establish clinical-trial networks to activate and arrange large multi-center studies []. COVID-19 pandemic deeply affects not only urological patient care but also urology residency education. Work hours modified and residences redeployed to serve in pandemic services in many countries. This situation came along with the problem of interrupted urologic training and unmet minimal case requirements. Generally, online learning curricula have been well-adopted by urologists. However, recent studies have been shown that such changes caused emotionally and physically stressful situations for trainees []. In conclusion, it is obvious that Coronavirus will continue to be in our daily life for a while. Thus, maintaining research and education is vital in all disciplines of medicine. Contributing to the scientific area with respect to essential requirements and ethics will support the development of all humanity in this crisis. Hereby, We would like to congratulate you on the first issue of your journal planned to be released in such a difficult time and wish you to have significant contributions to the field of urology in a strictly scientific manner. Sincerely yours.