ABSTRACT
INTRODUCTION: Erectile dysfunction (ED) is a prevalent condition, especially in aging populations, with significant implications for quality of life. While phosphodiesterase type 5 inhibitors (PDE5Is) are the first-line treatment, a substantial percentage of patients do not respond satisfactorily. This study aimed to identify predictors of PDE5I treatment failure in ED patients. METHODS: Data from January 2016 to January 2022 was reviewed for patients with ED who either failed PDE5I treatment or had a successful outcome. Demographic, medical, and laboratory data were collected and analyzed. Patients with contraindications or who did not complete the treatment were excluded. RESULTS: The treatment failure group comprised 288 patients, while 225 age-matched patients formed the control responder group. There were no significant differences in marriage duration, comorbidities, smoking, or BMI. However, HbA1c levels, free testosterone, and SHBG were significantly different between the two groups. CONCLUSION: This study found that high HbA1c levels, low free testosterone, and high sex hormone-binding globulin (SHBG) were associated with PDE5I treatment failure. Managing high HbA1c levels and addressing hormonal imbalances may enhance PDE5I treatment effectiveness in ED patients. However, further research is needed to explore other factors contributing to treatment outcomes.
ABSTRACT
The bulbar urethra is the most common site of anterior urethral strictures. In this case report, we present a 30-year-old male who was referred to us as a case of mid-bulbar urethral stricture. Urethroplasty was booked and a papillary lesion was found on routine diagnostic cystoscopy. An open biopsy was taken which showed invasive high-grade papillary urothelial carcinoma with squamous differentiation. This case is rare in terms of a young age of incidence, a lack of risk factors, an absence of suspicious symptoms, and a short duration of signs and symptoms. Urologists should consider workup for malignancy even in young patients who present with an idiopathic urethral stricture and a short duration of symptoms.
ABSTRACT
This case report describes a two-step percutaneous nephrolithotomy (PCNL) in a 22-year-old male who had severe kyphoscoliosis and a malrotated kidney. The operation was performed with the patient under general anesthesia and in the left lateral decubitus position. All stones were successfully removed. No complications occurred during surgery, and the patient recovered well. Regardless of the posed challenges for kidney stone treatment in patients with spinal deformities, PCNL is not only a minimally invasive but also a safe and effective treatment option when done under correct positioning. The success rate is high, and the morbidity rate is low. According to the literature, only 125 cases of PCNL implications in kyphoscoliosis patients have been reported in emerging case reports and case series.
