Evaluation of the effect of sildenafil and/or doxazosin on Benign prostatic hyperplasia-related lower urinary tract symptoms and erectile dysfunction

To verify the association between lower urinary tract symptoms [LUTS] and erectile dysfunction [ED] and evaluate the influence of sildenafil and doxazosin either as single agents or combined on both symptoms. A prospective randomized study including 150 patients presented with LUTS caused by BPH in association with clinically diagnosed ED, with age equal or more than 45 years from April 2010 to April 20011. They were categorized into three comparative groups each one containing 50 patients. These groups were comparable regarding pretreatment international prostate symptoms score [IPSS] and international index of erectile function [IIEF]. The patients of the first group were given sildenafil 50 mg as monotherapy, those of the second group were given doxazosin 2 mg and those of the third group were given combination of both drugs for 4 months for each group. The main post-treatment parameters for assessment and comparison include assessment of patient's symptoms by repeated IPSS and IIEF, uroflowmetry and assessment of PVR. The statistics was done by use of the chi-square test Pre-treatment parameters were assessed and compared between the three groups. After 4 months of treatment, the comparative parameters were applied to all groups and the differences were measured post-treatment regarding IPSS, erectile function score, uroflowmetry, and post-void residual [PVR] urine. Sildenafil alone caused mild improvement in IPSS, more improvement in IIEF score, and little effect on flow rate and PVR urine. Doxazosin alone caused more improvement in IPSS, flow rate and PVR urine and less improvement in IIEF score. A combination of both sildenafil and doxazosin caused more improvement in all of the comparative parameters than when each drug was given alone. There is a strong relationship between LUTS and ED. Doxazosin or sidenafil as a single drug could be used in treating mild or mild to moderate symptoms but more severe symptoms may usually need a combination of both drugs

Management of symptomatic ureteral calculi during pregnancy: experience of 23 cases

To present our experience in the management of symptomatic ureteral calculi during pregnancy. Twenty-three pregnant women, aged between 19 and 28 years presented to the obstetric and urology departments with renal colic [17 cases, 73.9%] and fever and renal pain [6 cases, 26.1%]; suggesting ureteric stones. The diagnosis was established by ultrasonography [abdominal and transvaginal]. Outpatient follow-up consisted of clinical assessment and abdominal ultrasonography. Follow-up by X-ray of the kidneys, ureter, and bladder [KUB], or intravenous urography [IVU] was done in the postpartum period. Double J [DJ] stent was inserted in six women [26%] with persistent fever followed by extracorporeal shock wave lithotripsy [ESWL] one month post-partum. Ureteroscopic procedure and pneumatic lithotripsy were performed for 17 women [distal ureteric stone in 10, middle ureter in 5, and upper ureteric stone in 2]. Stone-free rate was 100%. No urologic, anesthetic, or obstetric complications were encountered. Ureteroscopy, pneumatic lithotripsy, and DJ insertion could be a definitive and safe option for the treatment of obstructive ureteric stones during pregnancy

Penile fracture: evaluation, therapeutic approches and outcome result. single surgeon experience

The experience of a single surgeon with a series of23 penile fractures, including 21 corrected surgically and 2 managed conservatively, in 3 year period is presented .Standard diagnostic and therapeutic modalities are described. Between December 2004 and October 2007, 23 patients 19 to 58 years old [mean age 38] were evaluated in Assiut university hospital after blunt trauma to the erect penis. The interval from injury to presentation was between 2 and 72 hours. Of these patients, 18 had been injured during sexual intercourse, 3 had been injured during manual detumescence, and 2 due to rolling over in bed. Sonography and MRJ were used for diagnosis in all patients. Surgery in 21, involved a subcoronal incision and degloving in 15 patients and inguinal scrotal incision in 6 patients. 2 patients were treated conservatively after diagnosed by MRJ as deep dorsal vein rupture. Injury involved unilateral and bilateral corporeal rupture in 18 and 3 cases, respectively, and urethral injury in 4. At follow up, all patients [23] reported normal erection and voiding. Mild glanular parathesia on erection and numbness were experienced in 2 patients explored by subcoronal incision and degloving. This study confirmed the overall superiority of immediate surgical repair. MRI is a good and reliable tool for diagnosis of fracture penis and affects the mode of freatment whether conservative or surgical. Scrotal inguinal incision as a method of exploration in fracture penis is effective and reliable as well as subcoronal incision and degloving