No abstract

Urinary schistosomiasis is a preventable disease through nationwide snail control and mass therapy with oral antibilharzial drugs. If not properly treated, long-standing urinary complications may result in serious sequelae that may lead to mortality from renal failure or bladder cancer.

Holmium laser ablation and photoselective vaporization of the prostate are safe and effective in patients with benign prostatic hyperplasia with a small to moderate size prostate. Both procedures are easy to learn but holmium laser ablation of the prostate requires a longer operating time.

The efficacy of sildenafil citrate (Viagra s ), an oral agent for the treatment of erectile dysfunction (ED), has been demonstrated in global studies. This 12-week randomized, double-blind, placebocontrolled, parallel-group, flexible-dose study assessed the efficacy and safety of sildenafil to treat ED in men in Egypt and South Africa. Men with ED of varied etiology were randomized to receive sildenafil 50 mg (n ¼ 128) or placebo (n ¼ 126); doses could be adjusted to 100 or 25 mg. Questions from the International Index of Erectile Function (IIEF) assessing the ability to achieve (Q3) and maintain (Q4) erections demonstrated a significant improvement with sildenafil compared with placebo (Po0.0001). Improved erections were reported by 74% of patients receiving sildenafil and 27% of those receiving placebo (Po0.0001). Headache, dyspepsia, and flushing were the most common adverse events in sildenafil-treated patients. These results are consistent with clinical trials in other countries. We conclude that sildenafil is an efficacious and well-tolerated treatment for men with ED in Egypt and South Africa.

No abstract

The influence of exogeneous infusion of prostaglandins (PGs) of the F2 alpha and E2 series and of indomethacin on micturition cycles was investigated in 30 anaesthetised female dogs. In 30 other animals, urethrovesical disconnection was performed to study the action of PGs and of indomethacin without the muscle continuity factors. In the intact animal model during vesical distension, PGE2 produced a significant urethral pressure drop and a dose-dependent reduction in the threshold micturition volume. PGF2 alpha produced a significant urethral pressure rise. At doses higher than 0.3 micrograms/kg, PGF2 alpha reduced the threshold micturition volume. On the other hand, indomethacin significantly increased the threshold micturition volume and reduced the maximum intravesical pressure. In the disconnected model, PGE2 produced a dose-dependent decrease in the resting urethral pressure and hardly affected the intravesical pressure; PGF2 alpha produced a dose-dependent increase in both urethral and intravesical pressures. Thus it is suggested that endogenous PG release during vesical distension could play a facilitatory role in micturition.

No abstract

The effects of internal stenting of a normal ureter on the upper urinary tract were studied in 34 male rabbits by plain films, intravenous urograms, and 99mTc-DTPA renography at weekly intervals. Moreover, pressure-flow studies of the upper urinary tract were performed, and urine specimens for culture were obtained preoperatively and at the time of sacrifice. Histopathologic examination of the kidney, ureter, and ureterovesical junction was performed after animal sacrifice. Hydroureteronephrosis and stasis with equivocal obstruction were noted after 1 week of stenting. These changes were reversible after stent removal. Prolonged stenting (> 3 weeks) produced moderate to severe hydroureteronephrosis, and renal function was lost in 2 of 18 renal units because of severe hydronephrosis or infection. Ureteral stenting did not produce obstruction at a flow rate as high as 8 ml/minute. Histopathologic examination showed dilation of the pelvicaliceal system and renal tubules, infiltration of the kidney and the ureter with inflammatory cells, mucosal ulceration, and muscular hypertrophy of the ureters. The bladder mucosa showed a severe inflammatory reaction, Brunn nests, and ulceration with occasional metaplasia. Stenting of normal ureters in rabbits produced no harmful effects on the kidney if the stents were removed within 1 week, but prolonged stenting could affect renal and ureteral integrity.