Stantoncotton0491

To determine the clinical efficacy of endoscopic transurethral incision (TUI) for boys with refractory daytime incontinence due to a posterior urethral valve with or without nocturnal enuresis.

A total of 20 boys with daytime incontinence were assessed. Twelve boys underwent TUI (TUI+ group) and eight boys continued receiving oral drugs (TUI- group). The primary endpoint was the cure rate associated with TUI or NE in both groups.

Only two boys achieved daytime continence 6 months after TUI, but no boys were cured of nocturnal enuresis 6 months after TUI. The median time to daytime continence was significantly longer in the TUI+ than in the TUI- group (52 vs 27 months, respectively; log rank P = 0.041) and the median time to dry nights was significantly longer in the TUI+ than in the TUI- group (56 vs 36 months, respectively; log rank P = 0.021).

TUI might be not effective in boys with refractory daytime incontinence.

TUI might be not effective in boys with refractory daytime incontinence.

Erectile dysfunction (ED) is a common clinical condition with limited treatment options. The main aim of the present systematic review was to synthesize information on Rho-kinase as a novel therapeutic approach for the treatment of ED.

We performed a systematic literature study in PubMed, Google Scholar and Scopus. Included studies were original articles studied the role of Rho-kinase in the pathogenesis and/or new treatment approach for ED in animal models and clinical studies, published between 2014 and 2019. Data derived from each study were study design used, interventions applied and main treatment outcomes. The quality of the selected articles was assessed by CAMARADES criteria and data were analyzed using descriptive statistics.

A total of 1067 original articles were retrieved in the given period and eighteen papers met our inclusion criteria. Five articles explain the role of Rho-kinase in ED pathogenesis using different models such as cavernous nerve crush injury, heart failure-induced ED, vascical and molecular dysregulation have been improved by inhibition of Rho-kinase.

Targeting Rho-kinase may be a possible target for the treatment of ED secondary to specific causes, and Rho-kinase inhibitors may be a new drug family for the treatment of ED. However, this requires further studies for in-depth understanding.

Targeting Rho-kinase may be a possible target for the treatment of ED secondary to specific causes, and Rho-kinase inhibitors may be a new drug family for the treatment of ED. However, this requires further studies for in-depth understanding.

We wished to present the clinical applications and to evaluate the benefits of the use of a carbon dioxide (CO

) laser versus the conventional procedure for circumcision in adults, in terms of duration of surgery, surgical techniques, complications, pain and cosmetic appearance.

The medical records of 482 patients who had been circumcised were retrospectively evaluated. The patients were divided into two groups 168 patients (Group A) were circumcised with traditional techniques; and 314 patients (Group B) were circumcised using a CO

laser. All the patients were circumcised under local anesthesia. Pain was evaluated using a verbal numerical rating scale for pain assessment. Postoperative wound swelling, bleeding, infection and pain were assessed at 4 hours, 24 hours and 7 days after surgery.

There were no significant differences between the two groups in terms of bleeding and infections. The difference in operating times between the groups was significant (

<0.001). Wound disruptions occurred in one patient in Group A at 3 days and two patients in Group B at 1 week. Pain scores were low and there was less pain in Group B than in Group A during the first 4 hours (1.8 vs 3.7;

<0.002). Compared with the conventional method, the CO

laser technique was associated with much less pain at both 1 day (

<0.002) and 7 days (

<0.001) postoperatively. The cosmetic results were superior in Group B; a linear surgical scar developed in 94.9% of patients in Group B versus 61.3% in Group A (

<0.001).

Our results show that the use of a CO

laser was associated with a shorter operative time, less wound irritation and better cosmetic appearance compared with standard surgical techniques for circumcision.

Our results show that the use of a CO2 laser was associated with a shorter operative time, less wound irritation and better cosmetic appearance compared with standard surgical techniques for circumcision.This study aims to present an alternative technique with the use of a transobturator hybrid sling (autologous fascia lata with a synthetic sling) in two patients with complex urethral diverticulum (CUD), urinary stress incontinence (SUI) and a large incisional infraumbilical hernia. Staged procedures could be performed, but considering the risk of persistence or worsening SUI, and no standard management strategy of SUI associated with CUD; simultaneous treatment was proposed. It is preferable to use autologous materials in such cases. LY2228820 However, the presence of incisional hernia protruded with its content covering the suprapubic area prohibits the retropubic sling technique due to visceral lesion risk. The diverticulum and SUI were repairs in the same surgery using a hybrid transobturator. The technique used for obtaining the fascia lata followed the literature, and a 6 cm segment was acquired. The patients were re-prepared in a lithotomy fashion, and diverticulectomy was performed. The segment of fascia lata was fixed to the mesh and sling was manipulated so that its middle part (fascia) rested directly below the urethra. After 6 months post-operatively, patients referred significant improvement in urinary symptoms. Patients have not had any storage symptoms, International Consultation on Incontinence Questionnaire - Short Form = zero, no SUI, and have not had any mesh-related complications. In conclusion, the present study evaluated a new technique for the treatment of CUD with SUI in a particular clinical scenario. Other studies with extended follow-up periods and larger sample sizes should be performed in this subset of patients.