scholarly journals Patients’ values and other decisional factors regarding treatment of hypercalcemia of malignancy: A Systematic Review Protocol

2020 ◽  
Author(s):  
Aya Bassatne ◽  
Maya Rahme ◽  
Thomas Piggott ◽  
Mohammad H Murad ◽  
Layal Hneiny ◽  
...  
Keyword(s):  
Systematic Review ◽  
Observational Studies ◽  
Drug Class ◽  
Treatment Options ◽  
Case Series ◽  
Pharmacological Therapy ◽  
Current Evidence ◽  
Drug Selection ◽  
Hypercalcemia Of Malignancy ◽  
Review Protocol

Abstract Background Hypercalcemia of malignancy is the second most common cause of hypercalcemia and is associated with significant morbidity and mortality. Several treatment options are available including pharmacological therapy with bisphosphonates, denosumab, glucocorticoids, and calcimimetics, as well as conventional therapy with hydration and possibly calcitonin. While guidelines have previously considered treatment effects, no guideline has yet considered a range of contextual factors impacting recommendations for the management. Objective The aim of this study is to summarize the available evidence on important decisional factors for the development of guidelines for the treatment of hypercalcemia of malignancy. These include patient’s values and preferences, cost, acceptability, feasibility, and equity. Methods/Design: This is a systematic review of observational studies, case series, trials, reviews and qualitative studies involving treatment of adult patients with hypercalcemia of malignancy. We developed and executed two independent search strategies using five databases: Pubmed, Medline (OVID), Embase.com, CINAHL (EBSCO) and Cochrane, and reviewed their combined output. Two reviewers screened titles and abstracts and full texts and will implement data abstraction from relevant studies independently and in duplicate. The outcomes of interest are the decisional factors that influence drug selection, with possible subgroup analyses by drug class or etiology of hypercalcemia of malignancy. We will present the data collected in a narrative and thematic approach. Discussion This systematic review will identify important treatment decisional factors, and will assist guidelines panels, physicians and patients to decide on therapeutic options based on the current evidence.

scholarly journals Patients’ values and other decisional factors regarding treatment of hypercalcemia of malignancy: A Systematic Review Protocol

2021 ◽  
Author(s):  
Aya Bassatne ◽  
Maya Rahme ◽  
Thomas Piggott ◽  
Mohammad H Murad ◽  
Layal Hneiny ◽  
...  
Keyword(s):  
Systematic Review ◽  
Observational Studies ◽  
Drug Class ◽  
Treatment Options ◽  
Case Series ◽  
Pharmacological Therapy ◽  
Current Evidence ◽  
Drug Selection ◽  
Hypercalcemia Of Malignancy ◽  
Review Protocol

Abstract Background: Hypercalcemia of malignancy is the second most common cause of hypercalcemia and is associated with significant morbidity and mortality. Several treatment options are available including pharmacological therapy with bisphosphonates, denosumab, glucocorticoids, and calcimimetics, as well as conventional therapy with hydration and possibly calcitonin. While guidelines have previously considered treatment effects, no guideline has yet considered a range of contextual factors impacting recommendations for the management. Objective: The aim of this study is to summarize the available evidence on important decisional factors for the development of guidelines for the treatment of hypercalcemia of malignancy. These include patient’s values and preferences, cost, acceptability, feasibility, and equity. Methods/Design: This is a systematic review of observational studies, case series, trials, reviews and qualitative studies involving treatment of adult patients with hypercalcemia of malignancy. We developed and executed two independent search strategies using five databases: Pubmed, Medline (OVID), Embase.com, CINAHL (EBSCO) and Cochrane, and reviewed their combined output. Two reviewers screened titles and abstracts and full texts and will implement data abstraction from relevant studies independently and in duplicate. The outcomes of interest are the decisional factors that influence drug selection, with possible subgroup analyses by drug class or etiology of hypercalcemia of malignancy. We will present the data collected in a narrative and thematic approach. Discussion: This systematic review will identify important treatment decisional factors, and will assist guidelines panels, physicians and patients to decide on therapeutic options based on the current evidence.

scholarly journals Values and other decisional factors regarding treatment of hypercalcaemia of malignancy: a systematic review protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e051141
Author(s):  
Aya Bassatne ◽  
Maya Rahme ◽  
Thomas Piggott ◽  
M. Hassan Murad ◽  
Layal Hneiny ◽  
...  
Keyword(s):  
Systematic Review ◽  
Observational Studies ◽  
Drug Class ◽  
Treatment Options ◽  
Case Series ◽  
Pharmacological Therapy ◽  
Drug Selection ◽  
Ethical Approval ◽  
Registration Number ◽  
Review Protocol

IntroductionHypercalcaemia of malignancy (HCM) is the second most common cause of hypercalcaemia and is associated with significant morbidity and mortality. Several treatment options are available including pharmacological therapy with bisphosphonates, denosumab, glucocorticoids and calcimimetics, as well as conventional therapy with hydration and possibly calcitonin. While guidelines have previously considered treatment effects, no guideline has yet considered a range of contextual factors impacting recommendations for the management. The aim of this study was to summarise the available evidence on important decisional factors for the development of guidelines for the treatment of HCM. These include patient’s values and preferences, cost, acceptability, feasibility and equity.Methods and analysisThis protocol is registered in PROSPERO (registration number: CRD42021264371). This is a systematic review of observational studies, case series, trials, reviews and qualitative studies involving treatment of adult patients with HCM. We will develop and execute two independent search strategies using five databases: PubMed, Medline (OVID), Embase.com, CINAHL (EBSCO) and Cochrane, and review their combined output. Two reviewers will screen titles and abstracts and full texts and will implement data abstraction from relevant studies independently and in duplicate. The outcomes of interest are the decisional factors that influence drug selection, with possible subgroup summaries by drug class or aetiology of HCM. We will present the data collected in a narrative and thematic approach.Ethics and disseminationEthical approval is not applicable for our study, since we will only collect data from available literature. This systematic review will be submitted to a peer-reviewed journal when completed.

scholarly journals Therapeutic Management of COVID-19 Patients: A systematic review

2020 ◽  
Author(s):  
Mansour Tobaiqy ◽  
Mohammed Qashqary ◽  
Shrooq Al-Dahery ◽  
Alaa Mujallad ◽  
Almonther Abdullah Hershan ◽  
...  
Keyword(s):  
Systematic Review ◽  
Observational Studies ◽  
Treatment Guidelines ◽  
Case Reports ◽  
Case Series ◽  
Systematic Review Protocol ◽  
Search Terms ◽  
Global Pandemic ◽  
Prisma Statement ◽  
Review Protocol

AbstractBackgroundSARS-CoV-2 is the cause of the COVID-19 that has been declared a global pandemic by the WHO in 2020. The COVID-19 treatment guidelines vary in each country, and yet there is no approved therapeutic for COVID-19.Aims of the studythis review aimed to report any evidence of therapeutics used for the management of COVID-19 patients in clinical practice since the emergence of the virus.MethodsA systematic review protocol was developed based on PRISMA Statement. Articles for review were selected from electronic databases (Embase, Medline and Google Scholar). Readily accessible peer-reviewed full articles in English published from December 1 st, 2019 to March 26 th, 2020 were included. The search terms included combinations of: COVID, SARS-COV-2, glucocorticoids, convalescent plasma, antiviral, antibacterial. There were no restrictions on the type of study design eligible for inclusion.ResultsAs of March 26, 2020, of the initial manuscripts identified (n=449) articles. Forty-one studies were included, of which clinical trials (n=3), (case reports n=7), case series (n=10), retrospective (n=11) and prospective (n=10) observational studies. Thirty-six studies were conducted in China (88%).The most common mentioned and reported medicine in this systematic review was corticosteroids (n=25), followed by Lopinavir (n=21) and oseltamivir (n=16).ConclusionsThis is the first systematic review up to date related to the therapeutics used in COVID-19 patients. Only forty-one research articles on COVID-19 and therapeutics were found eligible to be included, most conducted in China, corticosteroid therapy was found to be the most used medicine in these studies.

scholarly journals P.023 Neurostimulation in Drug-Resistant Epilepsy: Systematic Review and Meta-Analysis from the ILAE Evidence-Based Epilepsy Surgery Task Force

2021 ◽  
Vol 48 (s3) ◽  
pp. S26-S26
Author(s):  
L Touma ◽  
B Dansereau ◽  
D Englot ◽  
MR Keezer
Keyword(s):  
Systematic Review ◽  
Observational Studies ◽  
Meta Analysis ◽  
Case Series ◽  
Current Evidence ◽  
Drug Resistant ◽  
Seizure Reduction ◽  
Drug Resistant Epilepsy

Background: Drug-resistant epilepsy (DRE) can affect up to one third of individuals with epilepsy. We conducted a systematic review and meta-analysis of vagus nerve stimulation (VNS), responsive neurostimulation (RNS), and deep brain stimulation (DBS) in patients with DRE to summarize the current evidence on efficacy and tolerability for these neuromodulation modalities. Methods: We searched three online databases with a pre-specified search strategy. We included published randomized controlled trials (RCT) and their open-label extension studies, as well as prospective case series, with samples greater than 20 participants, reporting efficacy and tolerability. Results: We identified 31 studies, six of which are RCTs and 25 prospective observational studies. At long term follow-up, five observational studies for VNS reported a pooled mean decrease in seizure frequency at last follow-up of 35%. In the extension studies for RNS, the median seizure reduction was 53%, 66% and 75.0% at two, five and nine years respectively. For DBS, the median reduction was then 56%, 69% and 75% at two, five and seven years respectively. Conclusions: Neurostimulation modalities are effective for the treatment of DRE, with improving outcomes over time and few major complications. Higher quality long-term data on DBS and RNS suggest larger seizure reduction rates than VNS.

scholarly journals Radiotherapy of oligometastatic prostate cancer: a systematic review

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Paul Rogowski ◽  
Mack Roach ◽  
Nina-Sophie Schmidt-Hegemann ◽  
Christian Trapp ◽  
Rieke von Bestenbostel ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Systematic Review ◽  
Predictive Factors ◽  
Therapeutic Potential ◽  
Case Series ◽  
Current Evidence ◽  
Oligometastatic Disease ◽  
Psma Pet ◽  
Oligometastatic Prostate Cancer ◽  
Prognostic And Predictive Factors

Abstract Background Due to improved imaging sensitivity, the term “oligometastatic” prostate cancer disease is diagnosed more often, leading to an increasing interest in metastasis-directed therapy (MDT). There are two types of radiation based MDT applied when treating oligometastatic disease: (1) stereotactic body radiation therapy (SBRT) generally used for bone metastases; or (2) SBRT for isolated nodal oligometastases combined with prophylactic elective nodal radiotherapy. This review aims to summarize current evidence data, which may shed light on the optimal management of this heterogeneous group of patients. Methods A systematic review of the Medline database through PubMed was performed according to PRISMA guidelines. All relevant studies published up to November 2020 were identified and screened. Fifty-six titles were included. Besides outcome parameters, different prognostic and predictive factors were assessed, including site of metastases, time between primary treatment and MDT, use of systemic therapies, hormone sensitivity, as well as pattern of recurrence. Findings Evidence consists largely of retrospective case series and no consistent precise definition of oligometastasis exists, however, most investigators seem to acknowledge the need to distinguish between patients presenting with what is frequently called “synchronous” versus “metachronous” oligometastatic disease. Available data on radiotherapy as MDT demonstrate high local control rates and a small but relevant proportion of patients without progressive disease after 2 years. This holds true for both hormone sensitive and castration resistant prostate cancer diseases. The use of 68Ga-PSMA PET/CT for staging increased dramatically. Radiation doses and field sizes varied considerably among the studies. The search for relevant prognostic and predictive factors is ongoing. Conclusions To our best knowledge this review on oligometastatic prostate cancer included the largest number of original articles. It demonstrates the therapeutic potential and challenges of MDT for oligometastatic prostate cancer. Prospective studies are under way and will provide further high-level evidence.

A SYSTEMATIC REVIEW OF CLINICAL OUTCOMES IN THE TREATMENT OF TEMPOROMANDIBULAR JOINT DYSFUNCTION USING ULTRASOUND GUIDED ARTHROCENTESIS AND CONVENTIONAL THERAPY

2021 ◽  
pp. 19-22
Author(s):  
Chirag Bhatia ◽  
Hirkani Attarde
Keyword(s):  
Systematic Review ◽  
Temporomandibular Joint ◽  
Operating Time ◽  
Mouth Opening ◽  
Risk Of Bias ◽  
Temporomandibular Joint Disorders ◽  
Current Evidence ◽  
Cochrane Library ◽  
Review Protocol ◽  
Reported Data

Objective: This systematic review aimed to compare outcomes between ultrasound (US)-guided arthrocentesis and conventional arthrocentesis for the management of temporomandibular joint disorders (TMDs). Methods: PubMed, MEDLINE, Cochrane Library, Google Scholar and th EBSCOhost databases were searched up to 30 September 2020 for randomized control trials (RCTs) comparing US-guided and conventional arthrocentesis. The review protocol followed the PRISMA guidelines and was registered in PROSPERO (CRD42020211942). The risk of bias of the studies was independently evaluated using Cochrane Risk of Bias tool. Results: Four RCTs were included. It did not demonstrate any statistically signicant difference in pain or maximal mouth opening (MMO) scores after 1 week and 1 month of follow-up between US-guided and conventional arthrocentesis. Studies also reported data on intra-operative needle relocations and operating time but with conicting results. Conclusion: This study indicates that the use of US during arthrocentesis may not improve postoperative pain and MMO in the short term. Further high-quality adequately powered RCTs are required to strengthen current evidence.

Device and non-device-guided slow breathing to reduce blood pressure in hypertensive patients: a systematic review protocol. (Preprint)

2021 ◽  
Author(s):  
Kamila Shelry Gonçalves ◽  
Ana Carolina Queiroz Godoy Daniel ◽  
José Luiz Tatagiba Lamas ◽  
Henrique Ceretta Oliveira ◽  
Renata Cristina De Campos Pereira Silveira ◽  
...  
Keyword(s):  
Systematic Review ◽  
Blood Pressure ◽  
Current Evidence ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Systematic Review Protocol ◽  
Hypertensive Patients ◽  
Gray Literature ◽  
Review Protocol ◽  
Slow Breathing

UNSTRUCTURED Introduction: Physiotherapy can include both device-guided slow breathing and device-guided slow breathing in the treatment of systemic arterial hypertension. Methods: A systematic search of all published randomized controlled trials on the effects of device-guided and non-device-guided slow breathing on hypertensive patients, without language restriction, will be carried out until January 2020 in nine databases: Pubmed / MEDLINE (Medical Literature Analysis and Retrieval System Online), Latin American and Caribbean Health Sciences Literature (LILACS), EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), Physiotherapy Evidence Database (PEDro), Cumulative Index to Nursing and Allied Health Literature ( CINAHL), Scopus, Web of Science, Livivo, as well as a search of clinical trial records databases, CT.GOV (Clinical trials.Gov), and bases for the Open Grey gray literature, Gray Literature Report, ProQuest Central (Citation, Abstract or Indexing and Dissertations and Theses). In all of these databases, potentially eligible studies including completed and ongoing ECAs were researched. The quality assessment of the included studies will be conducted using the Cochrane Risk of Bias Tool for Randomized Trials. The overall quality of the evidence for each outcome will be assessed using the Grading of Recommendations, Development and Evaluation (GRADE) system. Discussion: This systematic review will provide a summary of the current evidence on the effects of both device-guided slow breathing and device-guided slow breathing on blood pressure levels. This information can contribute to decision making by health professionals related to the use of these interventions in hypertensive patients. Following the guidelines, this systematic review protocol was registered with the Prospective International Register of Systematic Reviews (PROSPERO) number CRD42020147554.

Platelet Concentrate Treatments for Temporomandibular Disorders: A Systematic Review and Meta-analysis

2020 ◽  
pp. 238008442092732
Author(s):  
F.S. Al-Hamed ◽  
A. Hijazi ◽  
Q. Gao ◽  
Z. Badran ◽  
F. Tamimi
Keyword(s):  
Systematic Review ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Mouth Opening ◽  
Case Series ◽  
Platelet Concentrate ◽  
Current Evidence ◽  
Disc Displacement ◽  
Temporomandibular Joint Osteoarthritis ◽  
Vas Scores

Objectives: This systematic review compared platelet concentrates (PCs) versus hyaluronic acid (HA) or saline/Ringer’s solution injections as treatments of temporomandibular osteoarthritis and disc displacement in terms of pain and maximum mouth opening (MMO). Methods: PubMed, Cochrane, and Scopus were searched up to March 6, 2020. Inclusion criteria were randomized clinical trials (RCTs). Exclusion criteria were case series, observational studies, animal studies, and reviews. The Effective Public Health Practice Project (EPHPP) quality assessment tool was used to assess the risk of bias in the included studies. The weighted mean difference was used to compare the results. Results: Nine RCTs were included with a total of 407 patients. The numbers of joints treated were 262, 112, and 112 in the PC, HA, and saline groups, respectively. The quality of studies was rated as strong in 4 studies, moderate in 4 studies, and weak in 1 study. The meta-analysis revealed that PCs decreased pain visual analogue scale (VAS) scores compared to HA by an average of −1.11 (CI, −1.62 to −0.60; P < 0.0001) and −0.57 (CI, −1.55 to 0.41; P = 0.26) at 3 and 12 mo follow-up respectively. Also, the average decrease in pain scores with PC compared to saline was −1.33 (CI, −2.61 to −0.06; P = 0.04), −2.07 (CI, −3.46 to −0.69; P = 0.003), and −2.71 (CI, −4.69 to −0.72; P = 0.008) at 3, 6, and 12 mo, respectively. Regarding MMO measurements, PC was comparable to HA, but it was significantly better than saline after 3 and 6 mo [2.9 mm (CI,1.47 to 4.3; P < 0.0001), and 1.69 mm (CI, 0.13 to 3.25; P = 0.03) respectively]. Conclusion: PC reduces pain VAS scores compared to HA during the first 3 m after treatment, and when compared to saline, it reduces pain and increases MMO for longer durations. However, due to differences between groups regarding PC preparation protocols and study heterogeneity, further standardized RCTs are required. Knowledge Transfer Statement: This study provides researchers and clinicians with quantitative and qualitative analyses of the current evidence regarding the clinical outcomes of platelet concentrate injections in the treatment of temporomandibular joint osteoarthritis and disc displacement in terms of pain control and maximum mouth opening.

scholarly journals Polysulfonate Resins in Hyperkalemia: A Systematic Review

2020 ◽  
Vol 7 ◽  
pp. 205435812096583
Author(s):  
Sheung Wing Sherwin Wong ◽  
Grace Zhang ◽  
Patrick Norman ◽  
Hasitha Welihinda ◽  
Don Thiwanka Wijeratne
Keyword(s):  
Systematic Review ◽  
Serum Potassium ◽  
Observational Studies ◽  
Primary Outcome ◽  
Case Series ◽  
Sodium Polystyrene Sulfonate ◽  
Polystyrene Sulfonate ◽  
High Quality ◽  
High Quality Evidence ◽  
Quality Evidence

Background: Hyperkalemia is a potentially life-threatening electrolyte abnormality defined as a serum potassium above the lab reference range (usually >5.0-5.5 mEq/L). Polystyrene resins, including sodium polystyrene sulfonate (SPS) and calcium polystyrene sulfonate (CPS), have long been used to treat hyperkalemia. Sodium polystyrene sulfonate/calcium polystyrene sulfonate act by exchanging a cation for potassium within the intestinal lumen. While SPS and CPS have been available since the 1960s, there are rising concerns about the validity of the data supporting its use and about serious adverse gastrointestinal effects. Objective: The objective of this systematic review was to quantify the efficacy and safety of polystyrene sulfonate resins (SPS/CPS) in the treatment of adults with hyperkalemia. This review focuses on the randomized control trial (RCT), interventional non-RCT, and observational data available on SPS/CPS use. Design: Systematic review. Setting: Any country of origin. Both inpatient and outpatient settings. Patients: Adults with hyperkalemia treated with polystyrene sulfonate resins. Measurements: The primary outcome was change in serum potassium. The secondary outcomes included adverse effects of SPS/CPS and prevention of recurrent hyperkalemia. Methods: We conducted a systematic review using Cochrane Library, EMBASE (1947-2019), and Medline (1946-2019) databases. Literature reviews, systematic reviews, case studies, case series, and editorial pieces were excluded. Included studies were assessed for risk of bias. Results: Four RCTs, 21 observational studies, and 5 quasi-experimental trials were included. A total of 212 351 patients were included. Two thousand and fifty-eight patients were studied for the primary outcome and 210 293 patients were studied for the secondary outcomes. Study designs were heterogeneous and not amenable to meta-analysis. Most studies included nonhemodialysis outpatients older than 65 years. Of the included studies, 22/25 (88%) demonstrated a reduction of serum potassium >0.5 mEq/L over the study period. The magnitude of reduction in serum potassium of potassium resin compared with placebo or matched controls in the 3 low-risk studies identified was 0.14 to 1.04 mEq/L. However, each study used different dosing regimens. Ten of 22 studies reported the effects of polystyrene resins on serum potassium within 24 hours. A few high-quality observational studies suggest an increased risk of serious adverse gastrointestinal events with a relative risk of 2.10 and a hazard ratio of 1.25 to 1.94; however, the absolute risk remains low. The incidence of adverse gastrointestinal events is 16 to 23 events per 1000 person-years. Limitations: We acknowledge several limitations in this study. Case studies and case series were excluded from the search results. Large case series may have been excluded despite having comparable sample sizes to studies included due to lack of a comparator and calculated estimates. Due to the heterogeneity of the studies, the data were unable to be meta-analyzed and as such the potassium-lowering effect of polystyrene sulfonate resins remains founded on small studies with potential confounders. Conclusions: This systematic review demonstrates a continued lack of high-quality evidence for the use of SPS/CPS in hyperkalemia. Studies investigated highly variable timelines and the most robust evidence for SPS/CPS use is in chronic hyperkalemia. While the absence of high-quality evidence does not exclude the possibility of benefit, prescribers must understand that the use of SPS/CPS in acute hyperkalemia is not supported by high-quality evidence. Trial registration: The protocol for this systematic review was not registered.

scholarly journals Is Non-Chlamydial Non-Gonococcal Urethritis Associated with Significant Clinical Complications in Men? A Systematic Review

2020 ◽  
Vol 14 (1) ◽  
pp. 1-13 ◽  
Author(s):  
Cassandra E.L. Fairhead ◽  
Alexander Hampson ◽  
Louis Dwyer-Hemmings ◽  
Nikhil Vasdev
Keyword(s):  
Systematic Review ◽  
Reactive Arthritis ◽  
Case Reports ◽  
Case Series ◽  
Current Evidence ◽  
Future Research ◽  
Qualitative Synthesis ◽  
Cross Sectional ◽  
Gonococcal Urethritis ◽  
Clinical Complications

Background: It is estimated that between 50 and 89% of non-gonococcal urethritis is not caused by Chlamydia trachomatis. Associations between non-chlamydial non-gonococcal urethritis (NCNGU) with balanoposthitis, epididymo-orchitis and reactive arthritis have been suggested, but evidence to support these often-theoretical relationships is sparse and further investigation is called for. Concerns over increasing antimicrobial resistance has rendered the need for clarity over this question ever more pressing in recent years. A review of the current evidence on the complications of NCNGU in men is therefore urgently warranted. Objective: This systematic review summarizes and evaluates the available evidence that NCNGU, whether symptomatic or asymptomatic, causes the significant complications that are already well-recognized to be associated with non-gonococcal urethritis. These significant complications are epididymo-orchitis, balanoposthitis, and sexually-acquired reactive arthritis (Reiter's syndrome) including arthritis or conjunctivitis. Summary: We conducted a systematic review and qualitative synthesis using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis framework. Five databases (PubMed, EMBASE, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, and British Nursing Index) were searched. We included studies that measured clinical outcome after diagnosis of NCNGU in men. Bias was assessed using variations of the Newcastle-Ottawa scale. Data were extracted and entered into a pre-written data abstraction proforma. Seven peer-review studies were included. This included 2 retrospective cohort studies, 1 case series, 2 case reports and 2 cross-sectional studies. The studies described and analyzed 3 types of complication: balanitis, posthitis and/or meatitis; reactive arthritis and/or conjunctivitis; and epididymitis. All studies reported one or more complications. Key Messages: This review identifies an important avenue for future research: while the available evidence suggests that NCNGU has the potential to cause significant complications in men, with the strongest evidence existing for balanitis, posthitis and/or meatitis, the nature and significance of these relationships is far from clear. The findings of this review suggest that prospective, adequately powered research into whether there is a causal link between NCNGU and significant clinical complications in men would be highly worthwhile. The findings of this review raise important questions about the utility of the term NCNGU in research and clinical practice.

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