A Case of Tadalafil associated Priapism / 대한남성과학회지

We report here on a case of priapism that was associated with the use of tadalafil. A 41 year-old-man visited our urology outpatient department with a relapsed erection he'd experienced for 3 days. He had no contributing factors for the priapism. He had taken tadalafil, which was prescribed at a local medical center 3 days previously. After the development of priapism, he first visited the emergency department of other hospital. Aspiration was done and then the priapism was resolved. Yet the priapism recurred 2 days later, andaspiration and other bedside management failed to resolve it. After his arrival to our department, weimmediately performed a caverno-glandular shunt with 18-gauge needle and we observed bright reddish- color blood. An intracorporal ephedrine injection and saline irrigation were then done. After that, the patient gradually experienced detumescence. The priapism did not recur during the 2 days of the hospitalization period. At the outpatient follow-up of 3 months later, patient almost recovered to his full erectile function and he had normal sexual activity.

Efficacy of Ureteroscopic Removal of Stones with an Ureteral Access Sheath for the Treatment of Ureteral Calculi

PURPOSE: The ureteral access sheath (UAS) was developed to facilitate difficult ureteroscopic procedures. However, some have questioned the safety of the UAS and its likelihood of causing significant ureteral traumas. We evaluated the efficacy and safety of a UAS for managing ureteral calculi. MATERIALS AND METHODS: From July 2005 to June 2008, a total of 122 patients underwent ureteroscopic removal of stones (67 patients with UAS, 55 patients without UAS). Under local, spinal, or general anesthesia, all patients were treated by using a semirigid ureteroscope with or without UAS. The operative results of the patients were assessed with KUB, and excretory urography or ultrasonography were assessed postoperatively after 2 to 4 weeks. We also analyzed the success rates of stone removal and the complication rates for each procedure. RESULTS: Mean stone size and mean operation time were 9.3 mm and 38.8 minutes, respectively, with UAS and 8.9 mm and 40.4 minutes, respectively, without UAS. Overall stone-free rates were 89.6% and 76.4%. Mean hospital stay was 2.0 days and 2.2 days. The time for operation was significantly decreased for upper ureteral stones treated with UAS (p=0.022). The stone-free rates were higher for upper ureteral stones treated with UAS (28/32, 87.5%, p=0.027), especially for stones greater than 10 mm in size (p=0.048). CONCLUSIONS: The use of UAS is effective and safe. The stone-free rates of ureteroscopic removal of stones with UAS were significantly higher than the rates without UAS for large (> or =10 mm) upper ureteral calculi.

Five-Year Outcomes of the IRIS Procedure for the Treatment of Female Stress Urinary Incontinence: Comparison with the TVT Procedure

PURPOSE: We evaluated the long-term efficacy and safety of the innovative replacement of incontinence surgery (IRIS) procedure and compared these with the tension-free vaginal tape (TVT) procedure for the treatment of female stress urinary incontinence. MATERIALS AND METHODS: We included 111 consecutively treated women who underwent IRIS (n=51) or TVT (n=60) between January 2002 and December 2003 and followed them up for at least 5 years postoperatively. We analyzed the 5-year success rate and postoperative complications of the IRIS procedure and compared these with the results of the TVT procedure. RESULTS: The 5-year success rate was 92.2% for the IRIS procedure and 93.3% for the TVT procedure, and the satisfaction rates were 90.2% and 85.0%, respectively. Intraoperative complications for the IRIS group included 4 cases of bladder perforation, and there were 5 cases of bladder perforation in the TVT group. The postoperative complications for the IRIS group included 3 patients with de novo urgency, 2 patients with mesh exposure, and 1 patient with temporary urinary retention. Four patients in the TVT group developed de novo urgency, 2 patients had mesh exposure, and 2 patients showed temporary urinary retention. CONCLUSIONS: Our results suggest that IRIS may be an effective and safe procedure compared with the TVT procedure for more than 5 years.

Congenital Fibroepithelial Polyp of the Penoscrotal Junction / 대한비뇨기과학회지

Fibroepithelial polyps are benign, easily treated, and tumors with a good prognosis in the urinary tract. Congenital fibroepithelial polyps of the external genitalia are rarely reported. We report a case of a congenital fibroepithelial polyp of the penoscrotal junction in an 18-month-old boy. The fibroepithelial polyp was noted at birth with continuous grow. The fibroepithelial polyp was soft, dark-red in color, non-tender, and had a cockscomb shape. We treated the fibroepithelial polyp with simple excision and the histopathologic finding was a fibroepithelial polyp without a malignant component.