Radiation safety knowledge and practices among urologists in Saudi Arabia: A cross-sectional survey analysis Saad Alshahrani, Mahmood Alqunais, Mohammed Alkhaldi, Saad Alqasem, Ali Al-Gonaim, Ashraf El-Metwally Medicine United States, 2025 Fluoroscopy is an essential tool in urological procedures, but it poses significant radiation risks to both patients and healthcare professionals. Urologists require adequate radiation safety knowledge and practices to mitigate these risks. However, studies suggest knowledge gaps and suboptimal implementation of safety measures. This study aimed to assess level of radiation safety knowledge and practices among urologists in Saudi Arabia, and to identify factors associated with better understanding and compliance with safety guidelines, with overall goal of informing strategies to improve radiation safety practices and enhance patient and provider safety. A cross-sectional survey was conducted among urologists in Saudi Arabia during the 36th Saudi Urological Annual Conference in Riyadh (2025). A structured, self-administered questionnaire was used to assess knowledge of radiation physics, awareness of exposure risks, adherence to safety guidelines, use of protective equipment, and participation in training programs. Descriptive statistics and logistic regression analysis were performed to examine associations between demographic and professional factors and radiation safety practices. The study was conducted and reported following the STROBE guidelines for cross-sectional studies. A substantial 47.9% reported no formal radiation safety training, yet 90.4% believed structured training in residency programs is essential. While 78.1% recognized the risks of long-term fluoroscopy exposure, 69.9% did not use dosimeters, and 82.2% relied on automatic settings without dose monitoring. Alarmingly, 41.1% were unfamiliar with adjusting fluoroscopy machine settings. Furthermore, 72.6% lacked formal training on fluoroscopy use, and 46.6% never reviewed safety literature. Despite these shortcomings, 79.5% expressed a strong interest in further education on radiation safety. Non-Saudi urologists showed significantly higher radiation safety knowledge (AOR 5.29, 95% CI 1.34–20.97, P = .02) and practice (OR 4.49, 95% CI 1.50–13.44, P = .007). Fluoroscopy use of > 10 cases/week was also associated with higher knowledge (AOR 5.77, 95% CI 0.49–67.93, P = .06). Significant gaps exist in radiation safety knowledge and practices among urologists in Saudi Arabia. Non-Saudi nationality and higher fluoroscopy use were associated with better knowledge. Formal training programs are urgently needed to improve compliance and mitigate radiation risks.
Perceptions and Practice of Urologists in Saudi Arabia Regarding Sexual Complications Related to LUTS/BPH Management Saad Alshahrani, Abdulrahman Binsaleh, Ahmed Othman Alghamdi, Saad Alqasem, Ali Al-Gonaim, Ashraf El-Metwally Journal of Clinical Medicine, 2025 Objectives: This study aimed to evaluate perceptions and practices of urologists in Saudi Arabia regarding discussions of erectile dysfunction (ED) and ejaculatory dysfunction (EjD) with patients before initiating BPH treatments. Methods: A cross-sectional survey was conducted using a structured questionnaire distributed during the 36th Saudi Urological Annual Conference held in Riyadh in February 2025 among urologists in Saudi Arabia. A binary outcome variable, “frequent and open discussion,” was created based on a scoring system using the median score of these responses. Data analysis included descriptive statistics and univariate (p < 0.25) and multivariate (p < 0.05) logistic regression using SPSS version 27. Results: Discussions about ED risks were most frequent before prescribing 5-alpha reductase inhibitors (5-ARIs) (51.3%) and combined alpha-blockers and 5-ARIs therapy (50.0%), whereas EjD risks were more frequently addressed before alpha-blocker monotherapy (59.2%) and transurethral resection of the prostate (TURP) (56.6%). A substantial proportion of urologists discussed alternative treatments based on sexual dysfunction risks, particularly before TURP (53.9%), alpha-blockers (47.4%), and 5-ARIs (43.4%). Univariate analysis revealed a trend towards more open discussions among non-Saudi urologists (OR 4.58, 95% CI 0.88–23.74, p = 0.06) and a significant association with working in private hospitals (OR 3.68, 95% CI 0.39–35.14, p = 0.03). However, these associations did not hold in multivariate analysis. Conclusions: Urologists in Saudi Arabia demonstrate variability in discussing sexual complications with patients before BPH treatments. Consistent and comprehensive discussions about ED and EjD risks are crucial for informed patient decision-making. Standardized guidelines and educational programs are needed to enhance urologists’ communication skills and ensure consistent patient counseling.
Renal Ultrastructural Alterations Induced by Lead Acetate and Protective Effects of Ginseng Ali Hassan A. Ali, Ali Al-Gonaim, Saad Alqasem, Omar Alanazi International Journal of Biomedicine, 2024 Background: Lead is a hazardous metal that has a variety of physiological, behavioral, and biochemical impacts on people. Lead poisoning is the most common type of heavy metal poisoning. This work was designed to evaluate ginseng's potential cytoprotective effects in a model of lead acetate-induced nephrotoxicity and to explore the specific pathways related to the involvement of oxidative stress, mitochondria, and apoptosis in this process. Methods and Results: For the study, 21 healthy 10-week-old albino rats weighing between 250 g and 310 g were used. The rats were split into three groups, each group consisting of seven rats. Group 1 (control group) included rats that did not receive medicine and were given distilled water orally and regularly. Group 2 included rats given 10mg/kg of lead acetate via gastric gavage once a day for 28 days. Group 3 included rats given, via gastric gavage, 10mg/kg of lead acetate once a day for 28 days and 100mg/kg of ginseng dissolved in 1 ml of distilled water. On the designated day, the animals were anesthetized with ether inhalation, and kidneys were removed through a median abdominal incision. The kidney specimens were cut into serial semi-thin sections and prepared for electron microscopy and transmission electron microscopy. Albino rats exposed to lead acetate experienced changes in the ultrastructure of their renal cortex. Treatment with ginseng dramatically reduced tubular damage, cell apoptosis, and necrotic and degenerative changes. Conclusion: According to our findings, ginseng may shield the kidneys from the harmful effects of lead.
The association of genitourinary cancer among Saudi patients with gastrointestinal stromal tumors and a systematic literature review Raouf Seyam, Kenan Abou Chaer, Ahmed Abouelkhair, Arwa Almouh, Othman Alzahrani, Ahmed Gamal Sayed, Mohammad Alghafees, Razan A. Alhamidi, Ali Al-Gonaim, Turki Al-Hussain, Tarek Mahmoud Amin, Waleed Altaweel Scientific Reports, 2023 The gastrointestinal tract's most commonly occurring primary mesenchymal tumor is the gastrointestinal stromal tumor (GIST). However, few cases worldwide were reported associated with renal cell carcinoma (RCC). Therefore, we aimed to identify the association of genitourinary tumors in patients with GIST in our tertiary care hospital in Saudi Arabia and compare it to the literature. We identified all patients in the pathology department database with the diagnosis of GIST. We excluded duplicate and recurrent cases. We examined patients’ files for the presence of RCC, adrenal tumors, or other genitourinary cancer. A systematic review of the association was conducted. From 2003 to 2020, 170 patients had a histopathologic diagnosis of primary GIST, 100 men and 70 women, median age of 57 (range 9–91) years at the time of diagnosis. The site of primary GIST was gastric 103, small bowel 43, mesenteric 5, omentum/peritoneum 7, abdomen 4, isolated adrenal 1, and other 7. Six patients had associated primary genitourinary cancer. Three patients had RCC (two clear cell RCC and one radiologic diagnosis only), and three had adrenal tumors (one adrenal carcinoma, one an isolated adrenal GIST, and one pheochromocytoma). In addition, two patients had a tumor invading the urinary bladder. Although the cohort included 63 men aged 60 or above (median 71 ± 8.7 years, range 60–94), none demonstrated clinical prostatic carcinoma. Data was compared to 69 systematic review articles. We report the rare association between GIST tumors and primary genitourinary cancer, mainly RCC and adrenal tumors. Also, we identified a secondary invasion of the urinary bladder. Unlike the reported series, none of the older male patients had clinical prostate cancer.
Urolithiasis and water intake in Saudi Arabia, is it a matter of quality or quantity? Ali Al-Gonaim, AbdulrahmanBin Jawhar, HossamS El-Tholoth, Muaiqel Almuaiqel, TarekM AlZahrani, Hamad Al-Akrash, Ahmed AlZahrani Urology Annals, 2022 Introduction: Urolithiasis is a significant problem with an increasing incidence and prevalence worldwide. Multiple factors such as water intake, climate change, dietary habit, and genetic factors can affect stone formation. Our aim is to clarify the relationship between water intake and urolithiasis in Saudi Arabia as a hot climate area. Methods: This cross-sectional internet-based survey was conducted in November 2017. Our study was performed using a standard web-based questionnaire using social media open to all internet users. We excluded the incomplete responses. Analysis of the data was then carried out using Chi-square test and SPSS package version 20. Results: We found a great response to our survey, where 9100 participants responded. Among the participants, 76.6% were females and 23.4% were males. The largest age group was between 18 and 30 years (60.8%). Of the participants, 842 (9.3%) had history of urinary tract stones. About 74.3% of the participants with a history of urinary tract stones were drinking <1 L/day of water in comparison with those who had no history of urinary tract stones who were drinking a minimum of 1.25 L/day in 55.1%. Regarding the type of water intake, there was no significant relationship between the type of water and the incidence of stones formation (P =0.096). The amount of water was significantly correlated with the urolithiasis (P = 0.000). Conclusion: We concluded that the amount of water intake per day significantly correlated with urolithiasis, and according to our study, the minimally accepted intake was ≥1.25 L/day. However, the type of water consumed has no statistically significant impact on stone formation.
Urethral clear cell carcinoma – Case report and review of litrature Ali Al-Gonaim, Omar B. Alfraidi, Tariq Alotaibi, Moayad Saleh alqazlan, Turki Al-Hussain, Sultan S. Alkhateeb Urology Case Reports, 2021 Urethral clear cell carcinoma is very rare disease affecting both sexes, however it is mostly described in female urethra. The origin of this cancer is yet to be discovered. We report a 57 years old lady who presented to our clinic with obstructive lower urinary tract symptoms and found to have a urethral diverticulum containing a soft tissue lesion found to be a clear cell carcinoma after excision. Having high suspicion and early detection of these cases leads to a better outcome.
Scrotal calcinosis effect – Case report and review of literature Ali Al-Gonaim, Hossam S. El-Tholoth, Mohamed AlJafaar, M. Ghanem Sunbuli, Amr Jad Urology Case Reports, 2020 Idiopathic scrotal calcinosis is a benign rare diseases that is characterized by single or multiple scrotal skin calcified nodules without evidence of systemic disease. We report the first case in Saudi Arabia of Idiopathic scrotal calcinosis in a patient whose a 42 years old male, medically and surgically free who presented to our clinic with multiple scrotal nodular lesions in which excision was done and histology showed calcium deposition in basophilic globules which is consistent with Idiopathic scrotal calcinosis. Although pathogenesis and etiology of Idiopathic scrotal calcinosis is controversial, surgical excision is the treatment of choice.
Perceptions and attitudes of primary healthcare providers in Riyadh City, Saudi Arabia, toward the promotion of physical activity Sameer Al-Ghamdi, Mansour Alajmi, Ali Al-Gonaim, Saad Al-Juhayyim, Saad Al-Qasem, Ibrahim Al-Tamimi International Journal of Health Promotion and Education, 2018 Background: Physical inactivity increases the risk of several chronic, non-communicable diseases that ultimately reduces life expectancy. Recently, major lifestyle changes in Saudi Arabia due to economic growth resulted in physical inactivity and low level of physical fitness. Health care professionals can play an important role in developing awareness about physical fitness among people. However, little is known about the impact of current health promotion practices of healthcare providers. This cross-sectional study evaluates primary healthcare providers’ attitudes, knowledge and awareness associated with advising patients about PA during routine consultations. Methods: A quantitative survey on 803 respondents who comprised of general physicians, nurses, nurse assistants, dieticians and health educators in five districts of Riyadh city, Saudi Arabia was conducted using convenience-sampling method. Results: The data showed that most of the primary care staffs are quite enthusiastic in promoting physical activity among the patients and revealed that they routinely discussed and advised about the benefits of physical fitness. However, there are some factors acting as barriers for promoting PA, such as lack of time, lack of educational materials for patients, lack of proper training and protocols, lack of patient cooperation and lack of financial incentive. Conclusion: Proper strategies should be developed to motivate primary healthcare providers, so that they can encourage the general population to be more active physically. Hence, there is an urgent need to integrate PA promotion into practice consultation in Saudi Arabia. In addition, more efforts are required from the policy makers and health professionals to gather sufficient knowledge about current physical activity recommendations.
Ascorbic acid reduces redox potential in human spermatozoa subjected to heat-induced oxidative stress G. Ahmad, A. Agarwal, S. C. Esteves, R. Sharma, M. Almasry, A. Al-Gonaim, G. AlHayaza, N. Singh, L. Al Kattan, W. M. Sannaa, E. Sabanegh Andrologia, 2017 Oxidation–reduction potential (ORP) is a new measure of oxidative stress. It is a balance between the total available oxidants and reductants. This study measures the efficiency of ascorbic acid (AA) against oxidative stress induced by either heat alone or heat and hydrogen peroxide in sperm suspensions using the MiOXSYS System. Two concentrations of ascorbic acid (400 and 600 μmol/L) were tested against heat- and heat plus hydrogen peroxide-induced oxidative stress in sperm suspensions after 2 and 4 hr of incubation. Sperm motility and static oxidation reduction potential (sORP) were measured at 2 and 4 hr of incubation at three different temperatures. A significant decrease in sORP was observed as a function of AA concentration. The 600 μmol/L AA had more pronounced reduction in sORP compared to 400 μmol/L AA (p = .001). Significant decreases in sperm motility ranging from 4.89% to 14.02% were observed both as a function of incubation time and addition of H2O2 (p < .001). Ascorbic acid is efficacious to reduce heat-induced oxidative stress in sperm preparations in vitro. The supplementation of ascorbic acid may be advantageous for semen preparations in IUI, IVF and ICSI.
