Laparoscopic nephrectomy has become a well established procedure in those urology departments focusing on laparoscopy. The indications and results are reproducible at these centers. However, for patients with severe perinephritis (that is renal tuberculosis, xanthogranulomatous nephritis, posttraumatic atrophy) a higher likelihood of open conversion must be considered.

There is need for prospective, clinical trials to define safe and effective management strategies for patients with low-flow, high-flow or recurrent priapism.

Introduction Peyronie's disease is a sexual medicine condition that may adversely affect male sexual function. Aim To provide expert opinions/recommendations concerning state-of-the-art knowledge for the pathophysiology, diagnosis and treatment of Peyronie's disease. Methods An International Consultation in collaboration with the major urology and sexual medicine associations assembled over 200 multidisciplinary experts from 60 countries into 17 committees. Committee members established specific objectives and scopes for various male and female sexual medicine topics. The recommendations concerning state-of-the-art knowledge in the respective sexual medicine topic represent the opinion of experts from five continents developed in a scientific and debate process. Concerning the Peyronnie's disease committee, there were 10 experts from six countries. Main Outcome Measure Expert opinions/recommendations are based on grading of evidence-based medical literature, extensive internal committee discussion over 2 years, public presentation and deliberation. Results Peyronie's disease is characterized by an inflammatory response beneath the tunica albuginea with fibroblast proliferation forming a thickened fibrous plaque that may cause penile pain, penile curvature and erectile dysfunction. Medical treatments have been described but few prospective controlled trials have revealed significant clinical benefits. Surgical treatments (penile plication, Nesbit excision, plaque incision and grafting and penile prosthesis insertion) should be considered after Peyronie's disease has stabilized. Surgical outcome studies reveal that a stable deformity is best corrected with the least postoperative ED by a Nesbit procedure. Plaque incision and grafting should be reserved for men with good erectile function and marked penile shortening although there is a higher prevalence of postoperative ED. Implantation of a penile prosthesis is an excellent option for men with an accompanying erectile deficit. Conclusions Safe and effective treatments for Peyronie's disease examined by prospective, placebo-controlled, multi-institutional clinical trials are needed.

Introduction Many speculations have been made on the possible existence of a “female prostate gland” and “female ejaculation.” Despite several reports on the subject, controversy still exists around the “female prostate” and whether such a gland might be the source of fluid emitted during orgasm (ejaculation). Aim To investigate the ultrasonographic, biochemical, and endoscopic features in two women who reported actual ejaculations during orgasm. Main Outcome Measures Perineal ultrasound studies, as well as biochemical characteristics of ejaculate and urethroscopy, have been performed in two women. Methods Two premenopausal women—44 and 45 years of age—who actually reported fluid expulsion (ejaculation) during orgasm have been investigated. Ultrasound imaging, biochemical studies of the ejaculated fluid, and endoscopy of the urethra have been used to identify a prostate in the female. Ejaculated fluid parameters have been compared to voided urine samples. Results On high-definition perineal ultrasound images, a structure was identified consistent with the gland tissue surrounding the entire length of the female urethra. On urethroscopy, one midline opening (duct) was seen just inside the external meatus in the six-o’clock position. Biochemically, the fluid emitted during orgasm showed all the parameters found in prostate plasma in contrast to the values measured in voided urine. Conclusions Data of the two women presented further underline the concept of the female prostate both as an organ itself and as the source of female ejaculation.