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To evaluate the association between hypertension, male erectile function, Rho-kinase, and cyclic GMP pathways, we monitored neurogenic erectile response in spontaneously hypertensive (SHR) vs normotensive rats. We also evaluated SHR erectile function before and after intracavernosal injection of either the specific Rho-kinase inhibitor Y-27632 or a combination of Y-27632 and the PDE5 inhibitor zaprinast to prevent cGMP degradation. SHR had lower resting baseline corpus cavernosum pressure and a higher threshold for development of tumescence than normotensive rats. In SHR, Y-27632 administration reversed hypertension-related changes in male erectile function; Rho-kinase antagonism and PDE5 inhibition in combination had a synergistic effect in improving the neurogenic erectile response. Our data indicate that hypertension is associated with impairment in the SHR neurogenic erectile response that may involve a derangement in hemodynamic mechanisms in penile erectile tissue. Rho-kinase inhibition alone or combined with PDE5 inhibition may be of value in treating hypertension-related ED.

Laparoscopic and hand-assisted donor nephrectomies have similar outcomes and postoperative pain. Both approaches are well tolerated with minimal complication rates and have similar impact on patients' quality of life.

The findings show a low rate of intraoperative and postoperative complications, most of which were minor complications. There was an increase in operative time and hospital stay in the right-sided group, but no increase in complication rate. There was no significant difference in outcome or complication rate for the overweight patients.

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CoSeal is not as effective as fibrin glue in adhering to the cut renal surface and sealing the collecting system during laparoscopic partial nephrectomy.

Vascular control during laparoscopic donor nephrectomy (LDN) requires expeditious control of the renal artery and vein while preserving maximum graft vascular length. The vascular stapler with three rows of staples on either side of the division has been widely used, but it loses more vascular length than other methods. In the accompanying video, we illustrate vascular control with the different staplers and locking polymer clips. The techniques include two nonabsorbable polymer ligating clips (10-mm Hem-o-Lok; MLX Weck Closure Systems), the Endo-GIA Universal stapler (35-mm length, 2.5-mm staples; Autosuture), and the Endo-TA 30 stapler (30-mm length, 2.5-mm staples; Autosuture). In an in-vitro study, we previously determined that the Endo-TA 30 stapler and the polymer clips resulted in significantly less compromise of the vessel length compared with the other methods of vascular control. LDN has been recently included by the clip manufacturer as a contraindication for the use of the polymer locking clips. The Endo TA stapler can be used when preservation of maximum graft vascular length is important.