Background: One of the most prevalent sexual diseases among men is premature ejaculation (PE).Phosphodiesterase type-5 (PDE5) inhibitors used on-demand were successful in treating PE, according to several studies.Aims: To evaluate the safety and the efficacy of tadalafil in treatment of patients with premature ejaculation.Patients and methods: This study was conducted on 30 patients with at least a 3-month history of PE.All patients were submitted to clinical examination with stress on genital examination, laboratory testing for complete blood picture, and hormonal profile.Patients were received on-demand 20 mg tadalafil 2 hours before intercourse.Intravaginal ejaculatory latency time (IELT) was measured in all patients before and after the treatment (at 4, 8, and 12 weeks).Results: The mean age was 33.03 ± 7.5 years, with mean body mass index (BMI) of 28.8 ± 2.9 kg/m².The baseline IELT score was 39.4 ± 10.There was highly statistically significant (p-value < 0.001) increased 4 weeks IELT score (186.6 ± 24.4), 8 weeks IELT score (188.5 ± 21) and 12 weeks IELT score (187.2 ± 20.5) when compared with baseline IELT score (39.4 ± 10).Conclusion: Tadalafil 20 mg on demand is thought to help PE patients with good levels of safety and tolerability.

To compare the efficacy and clinical outcomes of two different stone localization modalities (fluoroscopic or ultrasonic) in SWL treatment of pediatric renal stones. This study was conducted in the period between January 2021 and June 2022 and included 100 children aged 2–16 years who presented with radio-opaque renal pelvic stones < 20 mm. The children were divided in two groups: group I, US-guided (50 patients), and group II, FS-guided SWL (50 patients). SWL was applied under general anesthesia. The follow-up of the patients included a visit every two weeks up to three months. Even though group II's stone-free rate after one month of follow-up was higher than group I's (90

Background: Non-obstructive Azoospermia (NOA) is a common status among infertile men.The objective of the present study is to evaluate the efficacy of I.M administration of human chorionic gonadotropin (HCG) in men with NOA.Patients and methods: This study included a total of 50 with NOA who were administrated I.M injection of HCG 5000 I.U twice weekly for 3 months.The effect of HCG on spermatogenesis was assessed by the presence of motile sperms in the ejaculate in two semen sample.Results: The median of age was 39 (SD 11.37) years with the mean FSH of 28.16 (SD 16.44).Among 50 patients we found that sperms with a variable counts started to appear in semen of 25 patients which is statistically significant (pvalue <0.001).Also, reduction of serum level of FSH was occurred to be 18.65 (SD 13.01) which is highly significant (p-value <0.001).Conclusion: Exogenous administration of HCG can improve spermatogenesis in patients with NOA and decrease level of FSH.

Objective To evaluate efficacy and safety of either or both silodosin and mirabegron as MET for distal ureteric stones ≤ 10 mm. Patients and methods This study enrolled a total of 105 patients, aged between 20 and 56 years, diagnosed by single radiopaque distal ureteral stone measuring ≤ 10 mm. The recruitment period spanned from May 2020 to December 2021. The patients were randomly divided into three groups, with each group consisting of 35 participants. Group A received a once-daily dose of 8 mg of silodosin, group B received a once-daily dose of 50 mg of mirabegron, and group C received a combination of both medications. Treatment was administered to all patients until the stone was expelled or for a maximum duration of four weeks. The stone-free rate was determined by analyzing KUB films with or without ultrasonography. Results The rate of stone expulsion was significantly higher in group C compared to groups A and B (P = 0.04 and P = 0.004, respectively). The mean (standard deviation) time for stone expulsion in groups A, B, and C was 14 ± 2.3 days, 11 ± 3.1 days, and 7 ± 2.2 days, respectively. Group C demonstrated a significantly shorter stone expulsion time compared to groups A and B (P = 0.001 and P = 0.04, respectively). The frequency of renal colic in group C was significantly lower than that in groups A and B, resulting in a reduced requirement for analgesics (P < 0.05). Anejaculation occurred at a significantly higher rate in the silodosin group (73.9%) and combination group (84%) compared to the mirabegron group (P < 0.05). Conclusions The findings of this study suggest that both silodosin and mirabegron are effective treatments for the expulsion of lower ureteric stones. Furthermore, the combination of these medications leads to an increased rate of stone expulsion and a reduced duration of expulsion.

Background: The incidence of urolithiasis in the pediatric population is on the rise.Urolithiasis in the pediatric age group, although occurring less in adults, causes considerable morbidity.The role of ureteroscopy (URS) in the management of calculus anuria could be primary or deferred.The deferred URS after initial ureteral stenting or percutaneous drainage is the standard one.However, the remarkable progress in the manufacturing of ureteroscopes and lithotripters favored the primary URS.Objective: This study aimed to evaluate the results of primary versus deferred URS for management of obstructive calculus anuria (OCA) in children in previous literatures.Methods : We have searched literature in the American National Center for Biotechnology Information (NCBI), PubMed, Google scholar, Egyptian bank of knowledge, and science direct.Conclusion: Primary URS is a definitive stone management technique and an appropriate option that can reduce hospital stay, prevent multiple anesthesia, and alleviate the costs in children with OCA when performed by skilled endourologists.However the deferred URS is a favored procedure for management of calculus anuria in pediatric patients compared to primary URS.

To compare the role of primary and deferred ureteroscopy (URS) in the management of obstructive anuria secondary to ureteric urolithiasis in pediatric patients. This prospective randomized study included 120 children aged ≤ 12 years who presented with obstructive anuria secondary to ureteric urolithiasis between March 2019 and January 2021. The children were subdivided into group A, which included children who had undergone primary URS without pre-stenting, and group B, which included children who had undergone URS after ureteric stenting. All children were clinically compensated and sepsis-free. Patients with underlying urological structural abnormalities were excluded. The operative time, improvement of renal functions, stone-free rate, and complications were compared between the two groups. At the 1-month follow-up, urine analysis; kidney, ureter, and bladder radiography; and ultrasonography were performed. The patient characteristics of both groups did not show any significant difference. Primary URS had failed in ten children (16.6%) in group A. Moreover, failure of stenting was noted in six patients (11%) in group B. The mean operative time for group B was significantly lower than that for group A ( p ≤ 0.001). The stone-free rate was significantly higher in group B ( p ≤ 0.001). The rate of overall complications was higher in group A. Deferred URS is preferable over primary URS in the management of obstructive anuria secondary to ureteric urolithiasis”. In children because of the lower need for ureteric dilatation, higher stone- free rate, shorter procedure time, and lower complication rate.

Background: Men with diabetes mellitus frequently experience erectile dysfunction (ED).Objective: The purpose of this study is to determine whether or not 5 mg of tadalafil daily is effective in treating erectile dysfunction in men who are diabetic.Patients and methods: In this trial, 50 diabetic males with ED were given 5 mg of tadalafil once daily for 12 weeks.Using the International Index of Erectile Function (IIEF) and penis-specific Color Duplex Doppler Ultrasonography, researchers evaluated tadalafil's effects on erection quality and duration.Results: Age of 45 was the median, and the average body mass index was 30.3 kg/m², 54 % of them were smokers.We found statistical significant (p-value < 0.001) increased 12 weeks IIEF score (median = 18.5, IQR = 13 -22) when compared baseline IIEF score (median = 12.4,IQR = 10 -17).Our results showed statistical significant (pvalue < 0.001) increased 12 weeks PSV (median = 36, IQR = 35 -37) when compared with baseline PSV (median = 33, IQR = 30 -35).Using multivariate logistic regression analysis, we demonstrated that smoking, BMI, dyslipidemia and bad glycemic control were predictive factors for ED severity.Conclusion: Taking 5 milligrams of tadalafil once a day may help diabetic men's erectile dysfunction.

Introduction To prospectively compare the perioperative and functional outcomes of laparoscopic (LP) and open pyeloplasty (OP) in three academic institutions. Material and methods Between September 2012 and September 2016, 102 patients with primary uteropelvic junction obstruction (UPJO) underwent pyeloplasty (51 LP and OP for the other 51 patients). Demographic data, perioperative parameters, including operative time, estimated blood loss, complications, length of hospital stay, and functional outcome were compared, and SF-8 Health Survey scoring was recorded for each group. Patients were followed up by ultrasound (US) and /or intravenous urography (IVU) at 3, 6 and 12 months. A MAG-3 renal scan was performed at 3 months postoperatively. Results The mean operative time was significantly shorter in the open group (153.2 42 min vs. 219.8 46 min; P <0.001). Compared to OP, the mean postoperative analgesia (Diclofenac) requirement was significantly less in the LP group (101.1 36 mg vs. 459.1 123 mg; P <0.001). The median hospital stay was significantly shorter for LP (2.7 1.8 days vs. 9.09 7.3 days; P <0.001). The median follow-up period was 19.7 months (12-28 months). The success rate was 96.1% in the OP group and 94.1% in the LP group. Conclusions In spite of being a technically demanding procedure, LP offers faster recovery and higher patient satisfaction. In our hands, OP still has a shorter operative time and relatively lower retreatment rate.

Objective: To compare the outcome of flexible ureteroscopy (F-URS) versus extracorporeal shock wave lithotripsy (ESWL) for the management of renal stone burden less than 2 cm in children. Patients and methods: A randomized comparative study was conducted at our hospital between December 2013 and May 2015. Seventy two children with renal stone burden less than 2 cm were assessed for eligibility. Our primary outcome is to assess the stone free rate after the first session. The secondary goal is to assess the operative outcome and the associated postoperative complications. Results: Finally, 57 children were completed the treatment and follow up; 27 patients in F-URS group and 30 patients in ESWL group. Patient's demographics and stone characteristics were comparable between both groups. F-URS group was associated with significantly longer operative time and hospital stay versus ESWL group. Overall complications occurred in 29.6% and 33.3% in F-URS groups and ESWL group, respectively (p value = 0.1) and most of them were of minor degree. F-URS was associated with significantly higher stone free rate after the first session which reached 81.4% versus 53.3% for ESWL group (p value = 0.00). The overall success was 92.5% and 90% in F-URS and ESWL group, respectively (p value = 0.5). Conclusion: Stone free rate after one session of F-URS is higher than ESWL with comparable rates of complications. F-URS could be offered to children who are less likely to respond completely after ESWL monotherapy. (C) 2018 Pan African Urological Surgeons Association. Production and hosting by Elsevier B.V. This is an open access article under the CC BY-NC-ND license

Introduction and objectives Although extracorporeal shock wave lithotripsy (ESWL) is the first choice for pediatric renal calculi <2 cm, the success rate after the first session is low. This is in contrast to other minimally invasive procedures like percutanous nephrolithotomy (PCNL) and retrograde intrarenal surgery (RIRS), which have higher rates of success. Therefore, the present study sought to identify predictors of success after one session of ESWL. Patients and methods A prospective study including 100 children with renal stone burden <2 cm who underwent ESWL at the present institution. The success rate after the first session was analyzed, and the predictors of success were investigated. The success of ESWL mono-therapy was defined by absence of any residual fragments after 3 months, on non-contrast spiral computerized tomography (NCCT) scan, without need of any additional intervention. Results Between January 2013 and October 2015, 100 children were treated with a Dornier Gemini lithotripter at the present institution. The mean patients age and stone size were 6 years (range: 1.8-14) and 13.1 mm (range: 6e20), respectively. After one session, 47% of patients showed complete clearance 3 months postoperative, those patients versus those who required an additional session or auxiliary procedures were younger in age, with smaller stone size and lower density. On multivariate analysis, only patient age was an independent predictor of success (odds ratio (OR) 0.9; P < 0.001). Conclusion Patient's age was an important predictor for response after ESWL monotherapy: not only did children respond better than adults, but age was also an independent predictor within the pediatric group.

In this article, the response of 12 plain concrete specimens to an impact of hard projectiles was examined in an experimental study. The tests were planned with an aim to observe the influence of using glass fiber reinforced polymer sheets to strengthen plain concrete panels on the performance of concrete under this type of loading. The main findings show that strengthening plain concrete panels with glass fiber reinforced polymer sheets showed satisfactory performance under the impact load; the glass fiber reinforced polymer sheets can be used for strengthening or upgrading concrete structures to improve their resistance against impact. Also, the location of the glass fiber reinforced polymer sheet affects the front and rear face craters.

To evaluate the efficacy of sexual intercourse in expulsion of distal ureteric stones.

Fasciola and Schistosoma spp. are digenetic trematodes that have a major detrimental impact on human health worldwide. It is not unusual to find common molecules among parasites of different species, genera, or phyla. In this study Sodium dodecyl sulphate polyacrylamide gel electrophoresis (SDS-PAGE) was used to identify the common proteins of adult Fasciola and Schistosoma spp. Adult Fasciola spp, were collected from the bile ducts of naturally infected cattle and sheep. Schistosoma mansoni and S. haematobium adults surface antigens were prepared in Theodor Bilharz Research Institute were used. Results showed sharing bands between all worms, which have the same molecular weight of 36 kDa. On the other hand, band with molecular weight 41 kDa was sharing between them except F. hepatica. Bands at 48 and 170 kDa were sharing between all species of Fasciola spp and Schistosoma mansoni.

Objective To evaluate the outcome of primary versus secondary ureteroscopy for pediatric ureteral stones. Patients and methods A retrospective chart review study that included 66 children aged less than 12 years, who were subdivided into two groups: Group A, which included 42 children who had undergone primary ureteroscopy without pre-stenting; and Group B, which included 24 children who had undergone ureteroscopy after ureteric stenting. Kidneys, ureters and bladder radiographs were done on the first postoperative day to assess the degree of stone clearance and stent position. Results Age, gender, stone location and stone size were not significantly different between both groups. In Group A, 31 (73.8%) children required ureteric dilation, 13 (31%) had a tight ureter that failed to respond to dilation, 25 (59.5%) displayed complete stone clearance, and of these, 13 (52%) needed postoperative stenting. One child experienced ureteric injury during stone disintegration and was stented for two weeks. Children in Group B experienced a 95.8% complete stone clearance rate, with no ureteric injury reported; postoperative stenting was performed in three (12.5%) children.. Conclusion Secondary ureteroscopy is preferable over primary ureteroscopy in pediatric populations because of a significantly lower need for ureteric dilation, shorter procedure time and better stone clearance rate..

Objective: Peeping testis is an inconsistently palpable/ seen undescended testis that migrates back and forth at the internal inguinal ring. Both open and laparoscopic orchiopexy are effective forms of management. The present study aimed to evaluate the efficacy and safety of both approaches.Patients and methods: Between September 2007 and January 2012, 46 peeping inguinal testes were randomly treated with either open (25 cases) or laparoscopic (21 cases) orchiopexy procedures. Spermatic vessels were preserved for all cases. Operative details, postoperative morbidity and final testicular site and size were recorded.Results: The median age of the children was 2.5 years (range 0.5-12.0). The follow-up period ranged from 1.0 to 5.5 years. Of these testes, 20 in the open surgery group and 19 in the laparoscopic group maintained correct intrascrotal position (P = 0.428). Re-do orchiopexy was indicated for two cases in the surgical group (P = 0.493). No cases of testicular atrophy or hernia were encountered.Conclusion: Open and laparoscopic orchiopexy procedures for peeping testes are fairly comparable. However, laparoscopy is relatively more effective, as two re-do orchiopexies were required in the open surgical group. (C) 2014 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

Objectives: The aim of our study is to assess the value of deferred endoscopic urethral realignment after traumatic posterior urethral disruption.Patients and methods: Between June 2001 and August 2011, we evaluated 28 patients who presented 3-6 weeks (mean 27 +/- 6 days) after experiencing traumatic posterior urethral disruptions and pelvic fractures; immediate and early realignment were overdue in these cases. Patient variables included mode of presentation, mechanism of trauma, type of pelvic fracture, and Abbreviated Injury Scale (AIS). Under fluoroscopic guidance, a guidewire was passed into the injured urethral segment from the distal to proximal injured ends using a long Chiba needle, and realignment was performed using endoscopic urethrotomy. The follow-up period ranged from 18 to 98 months (mean 43 +/- 22.5 months).Results: After the procedure, 46% of patients were stricture free. After one visual internal urethrotomy (VIU) and two VIU's, 60% and 64% of patients were stricture free. No cases of post-procedural incontinence occurred, and impotence was reported in only 14% of patients. Type of pelvic fracture was the only variable that significantly affected the success rate, where the success rate decreased from 100% in stable pelvic fracture to 25% in bilateral rotationally and vertically unstable pelvic fracture.Conclusion: When early realignment is postponed for any reason, deferred endoscopic realignment is considered an adequate substitute because urethral continuity can be achieved in a group of patients without increase incidence of impotence and incontinence. (C) 2014 Pan African Urological Surgeons' Association. Production and hosting by Elsevier B.V.

Purpose: To present our experience in the management of symptomatic ureteral calculi during pregnancy. Materials andMethods: 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.Results: 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.Conclusions: Ureteroscopy, pneumatic lithotripsy, and DJ insertion could be a definitive and safe option for the treatment of obstructive ureteric stones during pregnancy.

Objectives: We’d like to present our experience in treating long (>5 cm) anterior urethral stricture by penile skin flap as dorsal on-lay in one-stage procedure. Patient and Methods: Between January 1998 and December 2010, 18 patients (aged from 28-65 years) presented with long urethral stricture, 5.6-13.2 cm, (penile in 6, bulbar in 2, and combined in 10 cases), those were repaired utilizing long penile skin flaps placed as dorsal on-lay flap in one-stage (Orandi flap 6 cm in 6 cases, circular flaps 7-10 cm in 8, and spiral flaps 10-15 cm in 4). Uroflowmetry and RUG were done following catheter removal and at 6 and 12 months. Results: The urethral patency was achieved in 77% of patients. The complications were fistula in 1 patient (5.5%), re-stricture occurred in 3 patients (16.6%) that required visual internal urethrotomy (VIU), and 2 patients (11%) showed curvature on erection that did not interfere with sexual intercourse. Diverticulum (penile urethra) was seen in 1 patient (5.5%) containing stones and was excised surgically. There was penile skin loss in 3 patients (16.6%). All patients completed at least one year follow-up period. Conclusion: Free penile skin flaps offer good results (functional and cosmetic) in long anterior urethral stricture. Meticulously fashioned longitudinal, circular or spiral penile skin flaps could bridge urethral defects up to 15 cm long.

Purpose: 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. Material and Methods: 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 IPS Sand IIEF, uroflowmetry and assessment of PVR. The statistics was done by use of the Qui--square test. Results: 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. Conclusions: 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.