Objectives. To evaluate the safety and efficacy of Tadalafil and Tamsulosin in treating Double J stent related symptoms. Methods. In a prospective study, 161 patients with DJ related symptoms were randomized into 3 groups: Group A patients (54), Group B patients (53), and Group C patients (54). They were given Tadalafil, Tamsulosin, and placebo, respectively, at 1st week till removal of DJ stent at 3rd week. All patients completed Ureteral Stent Symptom Questionnaire (USSQ) at 1st week and at 3rd week. The statistical significant difference among groups was determined by the t-test, Kruskal-Wallis test and multivariate analysis were used to assess association of the variables within the three groups, and the level of significance was set at P < 0.05. Results. Tadalafil and Tamsulosin were comparable in relieving urinary symptoms, general health, and work performance (OR = 0.65, 1.8, and 0.92). But Tadalafil was more effective in relieving body pain, sexual problems, and additional problems than Tamsulosin (OR = 5.95, 19.25, and 2.69) and was statistically significant as P < 0.05. Conclusion. Tadalafil was as effective as Tamsulosin in relieving urinary symptom but more effective in relieving sexual symptoms and body pain.

Prolonged erection and priapism are common complications following intracavernosal injection of vasoactive agents in the management of erectile dysfunction. It is usually treated by intracorporeal drainage and irrigation with sympathomimetic agents. There is no established oral therapy . To study the effect of oral terbutaline on prolonged erection following intracavernosal injection of vasoactive agent, a controlled randomized study was done in 68 patients. Detumescence was achieved in 42 and 15% of the cases with oral terbutaline and placebo, respectively. Results of this study suggest that an initial trial with oral terbutaline for pharmacologically induced prolonged erection may be successful.

IntrOductIOnHypospadias is a congenital anomaly of the urogenital tract which results from an arrest in normal development of urethra, foreskin and ventral aspect of the penis. The phenotype ranges from a mild degree with distal glanular meatus to severe cases with ambiguous genitalia. The incidence is 3.2 per 1000 live male births [1]. The ideal time to correct primary hypospadias is when aged 6-12 months. However, in some developing countries, such as ours, this anomaly may be left untreated until adulthood. A multifactorial aetiology including genetic, endocrine and environmental factors are considered to be involved in the genesis of this anomaly [2]. There is a definite role of paternal abnormalities like scrotal or testicular defect, low sperm motility and abnormal sperm morphology in genesis of hypospadias [3], but the fertility potential of hypospadiac patient has not been clearly defined. The sexual function of patients who have either paediatric or adult hypospadias correction remains one of the enigmatic problems frequently raised by patients. As the child grows into adulthood, sexual function becomes an important issue. There are only few studies in the literature that focus on the sexual function, semen quality and reproductive hormonal profile, the results of these studies are somewhat discordant [4][5][6][7][8]. All these studies were done in group of adult hypospadiac patients who were operated in childhood. To the best of our knowledge, a study assessing the fertility potential in hypospadiac patients, who were operated in adulthood is not available. We hereby attempt to evaluate the fertility potential in hypospadiac patients as compared to age matched healthy controls along with effect of age of surgical correction over fertility potential in hypospadiac patients. MAtErIALS And MEtHOdSThe present study was carried out in the Department of Urology, SMS Medical College Jaipur, Rajasthan, India from September 2013 to December 2015. After ethical clearance from the institutional ethics committee, 86 cases of adult hypospadiac patients with Tanner stage 5 [9] at the time of evaluation were included in this study. Out of 86 patients, 56 were operated during the above study period and rest 30 patients were taken from urology outpatient department clinic, who were operated during childhood and attended the clinic for a variety of reasons, including renal calculus disease, minor degree of lower urinay tract symptoms, symptoms of non-specific flank pain or infertility. All these 30 patients were selected on the basis of discharge card provided by them. Patients with urethral stricture and multiple

Purpose:The aim of the current study was to compare Guy's score and STONE score in predicting the success and complication rate of percutaneous nephrolithotomy (PCNL).Materials and Methods:A total of 445 patients were included in the study between July 2015 and December 2016. The patients were given STONE score and Guy's Stone Score (GSS) grades based on CT scan done preoperatively and intra- and post-operative complications were graded using the modified Clavien grading system. The PCNL were done by a standard technique in prone positions.Results:The success rate in our study was 86.29% and both the GSS and STONE score were significantly associated with a success rate of the procedure. Both the scoring systems correlated with operative time and postoperative hospital stay. Of the total cases, 102 patients (22.92%) experienced complications. A correlation between STONE score stratified into low, moderate, and high nephrolithometry score risk groups (low scores 4–5, moderate scores 6–8, high scores 9–13), and complication was also found (P = 0.04) but not between the GSS and complication rate (P = 0.054).Conclusion:Both GSS and STONE scores are equally effective in predicting success rate of the procedure.

Complete avulsion of the ureter is one of the most serious complications of ureteroscopy. It requires open or laparoscopic intervention for repair. This case report emphasizes its management and presents recommendations for prevention in current urological practice.

Erectile dysfunction (ED) is defined as the persistent inability to attain or maintain an erection sufficient to permit satisfactory sexual activity (Hatzimouratidis et al., 2016). Penile erection is a complex neurovascular phenomenon, and ED may result from various abnormalities arising from vasculogenic, neurogenic, hormonal, anatomical, drug-induced and psychogenic causes (Zhengyan et al., 2014). Endothelial dysfunction (EDys) has been found to be central to atherosclerosis which is one of the most common causes of ED (Gandaglia et al., 2014; Shah et al., 2016). EDys has also been linked to various risk factors like hypertension, diabetes, smoking and other oxidative stressors (Vlachopoulos et al., 2007). Thus, ED has been suggested to be an early marker of cardiovascular disease (CVD) (Shah et al., 2016). Endothelial cells have nitric oxide synthase (eNOS) which is responsible for the formation of nitric oxide (NO) which acts as a relaxing factor and plays a major role in activation and maintenance of the erection process (Aversa et al., 2010). Hyperhomocysteinaemia (HHcy) has a marked inhibitory effect on eNOS and promotes NOS uncoupling (Zhang et al., 2016). Folic acid (FA) has been demonstrated to play an important role in the metabolism of NO by potentially inverting NOS uncoupling (Stoll et al., 2010; Yang et al., 2014). FA supplementation has been found to improve endothelial dysfunction in patients with DM or hypertension (Cui et al., 2017; Hamidi Madani et al., 2013). Compared to the western countries, Asian population differ in genetic makeup, dietary and lifestyle profiles. It has also been found that nutritional deficiencies in FA account for increased

Objectives: The objective of this study is to compare postoperative morbidity of closure versus nonclosure of the lingual mucosa graft (LMG) harvest site in augmentation urethroplasty. Materials and Methods: From January 2015 to November 2016, a total of 42 patients who underwent LMG urethroplasty randomized in 2 groups. In Group 1, donor-harvesting site was left open while in Group 2, donor site was closed. Self-made questionnaires were to assess postoperative pain, difficulty in tongue protrusion, swelling and numbness in graft harvest site, speech impairment, and difficulty in tolerating liquid and regular diet. Results: Mean visual analog scales score was 7.1 in Group 1, and 7.9 in Group 2 on day 0, which was statistically significant. Nearly 90.47% of patients in closure group and 95.23% in nonclosure group were able to swallow liquid diet on day 0 ( P = 0.5604). On day 3, 95.71% of patients in Group 1 and 80% in Group 2 were able to swallow soft diet ( P = 0.1604). Numbness was present in 80.95% Group 1 and 71.42% in Group 2 on day 0, which improved to 28.57% pts in Group 1 and 33.33% in Group 2 on day 3. On day 3, slurring of speech was more frequent in closure group (80%). However, at the end of a week, there was no difference in both groups. Saliva production was significantly increased in Group 1 in the 1 st week. Conclusion: Long-term morbidities of closing or nonclosing the LMG donor site are similar, but in short term, there is less pain, less edema, early recovery of tongue movements in nonclosure groups.

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