Is bulbospongiosus muscle botox injection safe and effective in treating lifelong premature ejaculation? Randomized controlled study.

PURPOSE: To evaluate the safety and efficacy of botulinum-A toxin injections into the bulbospongiosus muscle for cases of lifelong drug-resistant premature ejaculation (PE). METHODS: Ninety-eight outpatients diagnosed with lifelong PE were randomly assigned to two groups: the botulinum-A toxin group comprising forty-nine patients and the placebo (saline) group also consisting of forty-nine patients. A 100 U botulinum-A toxin was diluted into 10 cc of saline, with 5 cc injected into one side of the muscle (botulinum-A toxin group) guided by ultrasound to distribute across most muscle fibers. The same technique was applied using the same volume of saline injected into the bulbospongiosus muscle. Intravaginal ejaculatory latency time (IELT), scores from the premature ejaculation profile (PEP), Premature Ejaculation Diagnostic Tool (PEDT), International Index of Erectile Function (IIEF), and recording of any complications were obtained. Follow-ups occurred at 1-, 3-, and 6-month post-procedure. RESULTS: Cases receiving injections of botulinum-A toxin into the bulbospongiosus muscle showed notably extended intravaginal ejaculatory latency times compared to their initial performance after treatment. In addition, there were enhancements in PEP scores, and notably, no significant complications were reported. Conversely, the bilateral injection of saline into the bulbospongiosus muscle did not demonstrate any impact on ejaculation latencies. CONCLUSION: Our study demonstrated that the injection of botulinum-A toxin into the bulbospongiosus muscle can serve as a safe and effective option for treating PE. Nonetheless, its clinical application warrants further studies involving larger sample sizes and longer follow-up periods.

Standard versus tubeless mini-percutaneous nephrolithotomy: A randomised controlled trial.

OBJECTIVE: To prospectively compare the outcome of standard mini-percutaneous nephrolithotomy (SmPCNL) versus tubeless mini-percutaneous nephrolithotomy (TmPCNL) as primary treatments of renal stones. PATIENTS AND METHODS: In all, 80 patients with a solitary radio-opaque renal stone and candidates for PCNL were selected. The patients were randomly divided into two groups of 40, one group treated with SmPCNL and the other with TmPCNL. Patients and stone characters, as well as operative and postoperative data of both groups were compared and statistically analysed. RESULTS: There was no significant difference between the two groups for patient demographics and stone characteristics. There was no statistically significant difference between the two groups for the mean operative time, mean postoperative drop in haemoglobin, mean postoperative urine leakage, mean hospital stay, and stone-free rate. The mean (SD) postoperative dose of analgesia was statistically significantly higher in the SmPCNL group compared with the TmPCNL group, at 112.5 (48.03) versus 48.8 (43.5) mg, respectively. CONCLUSION: Both procedures are safe and effective for managing renal stones, without any significant difference between the two procedures; however, the postoperative analgesic requirement is significantly higher in SmPCNL.