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.
Combination therapy with silodosin and solifenacin (group E) was effective for relieving SRS with improved quality of life and less requirement of analgesic than any other groups and should be considered in patients who develop SRS.
Objective:The objective of the study was to compare the outcome of buccal and lingual mucosa graft (LMG) augmentation urethroplasty along with donor sites morbidities in anterior urethra stricture.Subjects and Methods:From September 2010 to January 2014, 125 patients underwent single stage augmentation urethroplasty. They were randomly divided into two groups to receive either buccal mucosa graft (BMG) or LMG. The patients were prospectively followed for complications and outcome.Results:Baseline characteristics such as mean age, etiology, stricture length, and location were comparable in both groups. Overall success rate for Group 1 and Group 2 were 69.2% and 80%, respectively. Mean follow-up periods were 28.2 and 25 months in Group 1 and Group 2, respectively.Conclusions:LMG provides the better outcome with fewer immediate and delayed complications as compared to BMG. The length of stricture and width of graft were main factors affecting the outcome.
Objective: To evaluate the safety and efficacy of silodosin and tadalafil in ease of negotiation of large size ureteroscope (8/9.8 Fr) in the management of ureteral stone. Material and methods:Between June 2015 and May 2016, 86 patients presented with ureteral stone of size 6-15 mm were on consent randomly assigned to 1 of 3 outpatient treatment arms: silodosin (Group A), tadalafil (Group B), and placebo (Group C). After two weeks of therapy 67 patients underwent ureteroscopy, and ureteral orifice configuration, ureteroscopic negotiation, ureteral dilatation, operating time, procedural complication and drug related side effects were noted in each group.Results: Ureteral negotiation was significantly better in Groups A (73.9%) and B (69.6%) as compared to Group C (38.1%) (p<0.01). Statistically significant difference was noted in the requirement for dilatation in Group C (71.4%) as compared to Groups A (26.1%) and B (39.1%) (p<0.01). Ureteral orifice was found to be more dilated in Groups A (69.6%) and B (60.9%) as compared to Group C (28.6%). Mean operating time was statistically lower in Groups A (35.2 min) and B (34.91 min) as compared to Group C (41.14 min) (p<0.01). Conclusion:Both silodosin and tadalafil not only relax ureteral smooth muscle but also help in forward propagation of large size ureteroscope (8/9.8 Fr) without any significant risk of adverse events.Keywords: Silodosin; tadalafil; ureteral stone; ureteroscope; ureteral orifice.Cite this article as: Bhattar R, Jain V, Tomar V, Yadav SS. Safety and efficacy of silodosin and tadalafil in ease of negotiation of large ureteroscope in management of ureteral stone: A prosective randomized trial. Turk J Urol 2017; 43(4): 484-9
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
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