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To reduce the learning curves in humans, several training models have been developed for teaching laparoscopic surgery. The aim of various in vitro or in vivo training models is to help surgeons acquire basic laparoscopic skills such as hand-eye coordination, depth perception, and knot-tying, which should always be acquired prior to organ- or procedure-specific skills. Inexpensive video box trainers are best suited for this purpose. However, advanced laparoscopic skills, such as dissection, cutting, coagulation, and stitching, require more sophisticated animal or human cadaver models. The perfect training model should teach the skills required and should be inexpensive, universally available, and anatomically and physiologically identical to an anesthetized patient. In this paper, we review the different animal models for acquiring advanced laparoscopic skills and try to define their advantages and disadvantages.

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The successful introduction of laparoscopic radical prostatectomy at the end of the last millennium represented a quantum leap in the technical development of minimally invasive surgery in urology. Therefore it seemed a logical step that, at the beginning of this millennium, first centers reported their initial experience with laparoscopic radical cystectomy. Based on more than 2000 laparoscopic radical prostatectomies, two centers have performed this procedure in 48 patients including a variety of urinary diversion (i.e. ileal conduit, ileal neobladder, sigmoid neobladder). In this article, all important surgical steps of laparoscopic radical cystectomy are presented, including the description of the most important techniques of urinary diversion. Based on our own experience, the results of 238 cases presented in the current literature are reviewed. The operating time mainly depended on the type and technique of urinary diversion and ranged between 352 and 430 minutes for ileal conduit, and between 478 and 649 minutes for orthotopic neobladder. The complication rate ranged between 16 and 18%, and the reintervention rate was 4-6%. Long-term follow-up is not available, disease-free survival after three years in a limited number of series ranges between 50 and 67%. No port site metastases have been reported so far. Even for the experienced surgeon laparoscopic radical cystectomy with urinary diversion represents a technically challenging procedure. Nevertheless, feasibility and safety have been proved by various authors. However, larger studies with long-term clinical outcome are necessary to determine the final value of the procedure.

A mentored program allows safe introduction of laparoscopic radical prostatectomy into surgical practice. Nevertheless, during the learning curve, longer operating and catheterization times have to be expected.

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urethra of the membranous urethra should be suspended after the anastomosis. Early postoperative continence rate: we retrospectively analyzed the early postoperative urinary continence in 98 patients with LRP. Fifty-six of them underwent modified LRP and 42 with conventional LRP. The results showed that the 1-month urinary continence rate was 57% in the traditional LRP group and 85% in the modified LRP group. Conclusions: The fine anatomy of LRP related structures is the theoretical basis for the improvement of LRP surgery. After conducting the modified LRP surgery based on anatomy, the early urinary continence rate in our center was obviously improved. Abstract: To analyze the experiences of laparoscopic radical cystectomy, modified Wallace ileal conduit retrospectively. To demonstrate the patient positioning, Trocar positioning, operational procedures, key steps and personal experiences of this approach, focusing on the operative techniques and post-operational outcomes of modified Wallace ileal conduit. Cite this abstract as: Yin B. Laparoscopic radical cystectomy, modified Wallace ileal conduit retrospectively. Abstract: Premature ejaculation (PE) occurs when a man ejaculates before he or his partner want climax to happen. For some men, the problem starts with their first sexual experience (primary PE). For others, it happens after a period of normal sexual functioning (secondary PE). In two five nation (Turkey, USA, UK, Netherlands, and Spain) studies of IELT in men from the general population, the median IELT was 5.4 minutes (range, 0.55-44.1minutes) and 6.0 minutes (range, 0.1-52.7 minutes), respectively. In these samples 2.5% of men had an IELT of less than one minute and 6% of less than two minutes PE. Serotonin is the neurotransmitter of greatest interest in the control of ejaculation and has the most robust data in animal and human models. Waldinger et al. hypothesized that lifelong early ejaculation in humans may be explained by a hyposensitivity of the 5-HT2C and/or hypersensitivity of the 5-HT1A receptors. Several forms of pharmacotherapy have been used in the treatment of PE. These include the use of topical local anaesthetics, selective serotonin reuptake inhibitors (SSRI's), tramadol168, phosphodiesterase type 5 inhibitors (PDE5i), and alpha adrenergic blockers170. The use of topical local anaesthetics (LA), such as lidocaine, prilocaine or benzocaine, alone or in association, to diminish the sensitivity of the glans penis is the oldest known pharmacological treatment for PE. The introduction of the selective serotonin reuptake inhibitors, paroxetine, sertraline, fluoxetine, citalopram and the tricyclic antidepressant (TCA) clomipramine has revolutionized the treatment of PE. These drugs block axonal re-uptake of serotonin from the synaptic cleft of central serotonergic