Aneurysmal Dilatation of Corpus Cavernosum as an Unusual Complication of Dorsal Penile Neurectomy / 대한남성과학회지

A 43-year-old man presented painless protruding mass on left side of penile shaft only during erection. 1 year ago he had a dorsal penile neurectomy for the treatment of premature ejaculation at local clinic. A protruding cavernousal aneurysm about 2 cm in diameter was developed 6 months after surgery and confirmed on penile duplex ultrasonography after PDE5 inhibitor ingestion with visual sexual stimulation. We have observed the lesion every month and found there was slight enlargement for the last 3 months without any other symptoms. We performed cavernosoplasty under the genereal anesthesia. There was a round cavernosal aneurysm on the left side of penile mid-shaft about 4cm in diameter after artificial erection with intracavernosal saline injection. We prevented cavernosal protrusion by covering the aneurismal surface with bovine pericardium patch (Supple Peri-Guard(R)). There was no side effect for 6 months postoperatively. This is an unusual type of complication of dorsal penile neurectomy.

Clinical Effects of Cycloxygenase-2 Inhibitor on Nocturia

PURPOSE: This study aimed to examine the effects of cyclooxgenase-2 inhibitors on patients with nocturia, whose symptoms persisted after the use of first-line drug therapy, such as alpha blockers and/or anticholinergics. MATERIALS AND METHODS: Thirty-three patients whose symptoms persisted after more than three months of first-line drug therapy were chosen to receive additional COX-2 inhibitors or antidiuretic hormones orally. Seven patients (group 1) were given 80mg of zaltoprofen at night, while 15 (group 2) were given 100mg of nimesulide at night. Desmopressin acetate (0.2mg) was administered at night to 11 patients (group 3) as a control group. Median follow up was 35 days (range, 28~90 days). RESULTS: In 25 patients (75.8%), the severity of nocturia was reduced. The median decline of nocturia in the COX-2 inhibitor groups (groups 1 and 2) was once, and it was statistically significant (p<0.001), while the median decline in each of these groups was twice (p=0.026) and once (p=0.002), respectively. The reduction of nocturia in the control group was once (p=0.011). The differences in reduction between the COX-2 inhibitor group and the control group were not statistically significant (p=0.418). CONCLUSIONS: The effects of the COX-2 inhibitors were not significantly different from those of desmopressin. Combination therapy with COX-2 inhibitors can effectively reduce nocturia in patients with refractory nocturia, following first-line drug therapy.

A Short-Term Analysis of Parameters Affecting the Outcome of Sacral Neuromodulation

PURPOSE: Sacral neuromodulation has become an effective option for controlling intractable symptoms of overactive bladder: urgency and urge incontinence. However, it has its limitations in that an intermittent pulse generator (IPG) is insertable only in patients with symptom improvement of at least 50%. In this study, we aimed to investigate the parameters that predict surgical outcomes. MATERIALS AND METHODS: Data from 31 candidates for sacral neuromodulation were retrospectively analyzed. Twenty patients out of 31 candidates had satisfactory symptom improvement after tinned lead test implantation, which resulted in IPG implantation. Data and neural stimulation parameters were compared and analyzed between successful IPG implants (group 1) and test failures (group 2). RESULTS: The percentage of female patients was higher in the IPG implant group (group 1: 95%, group 2: 64%). There was a significant difference in symptom duration, between the two groups (group 1: 40.5 months, group 2: 91 months). There was a significant difference in the number of episodes of urgency between the two groups (group 1: 6.83/day, group 2: 9.66/day, p=0.012), and severity of urgency showed significant difference between two groups (group 1