The effect of puboperiurethral suspension stitch placement on climacturia after robot-assisted laparoscopic radical prostatectomy.

BACKGROUND: Climacturia is defined as urine leakage associated with orgasm and can negatively affect patients' quality of life. The high prevalence of climacturia after radical prostatectomy (RP) has led to continued efforts to reduce climacturia rates. It has been shown that puboperiurethral suspension stitch placement during RP assists in the recovery of urinary continence. AIM: To evaluate the impact of puboperiurethral suspension stitch placement during RP on post-RP climacturia. METHODS: We conducted a retrospective study of patients who underwent nerve-sparing robot-assisted laparoscopic RP (RALP) at our institution between 2016 and 2023. The patients were categorized into 2 groups: Group 1 (n = 32) that underwent nerve-sparing RALP with puboperiurethral suspension stitch placement and Group 2 (n = 62) that underwent nerve-sparing RALP alone. Patients who were not able to achieve penetration at the last follow-up visit were excluded from the study. The clinical history, parameters of prostate cancer, details of medical and surgical treatments, and follow-up data were evaluated. OUTCOMES: Differences in sexual and urinary function, climacturia rates, and complications between nerve-sparing RP with and without puboperiurethral suspension stitch placement. RESULTS: There were no significant differences between the groups in terms of surgical complications. The mean follow-up time was 14.62 ± 3.55 months in Group 1 and 14.43 ± 4.44 months in Group 2 (P = .42). Postoperative erectile functions were similar between the groups. At the last follow-up visit, climacturia was present in 4 patients (12.5%) in Group 1 and 24 patients (38.7%) in Group 2 (P = .016). The long-term stress urinary incontinence rates were similar between the groups. CLINICAL IMPLICATIONS: This study provides comparative results on postoperative climacturia rates between nerve-sparing RALP groups with and without puboperiurethral suspension stitch placement. These results show that puboperiurethral suspension stitch can help to prevent postoperative climacturia after RP. STRENGTH AND LIMITATIONS: This is the first study in the literature that evaluates the effect of puboperiurethral suspension stitch on climacturia. The limitations include the single-center, retrospective design with potential selection bias, possible inaccuracies in the recorded medical data, and challenges in controlling confounding variables. CONCLUSION: Our study demonstrated that puboperiurethral suspension stitch was a feasible option for the prevention of climacturia after RALP without an increased risk of complications.

Quality and Reliability Analysis of Videos About Thulium Laser Enucleation of the Prostate on YouTube.

OBJECTIVE: To assess the reliability and quality analyses of thulium laser enucleation of the prostate (ThuLEP) videos on YouTube, as a source of public information. MATERIALS AND METHODS: In this study, a YouTube search with the keyword "ThuLEP" was performed on November 15, 2022 and 142 videos were listed according to relevance. Video features and source of upload were recorded. The quality of videos was evaluated by using both the Journal of American Medical Association (JAMA) score and the Global Quality Score (GQS); the reliability of videos was evaluated by using 5-point modified DISCERN tool, respectively. The correlation analysis was performed by using Spearman test between video features and these three scores. RESULTS: Seventy-seven videos were analyzed after exclusion and the most common source of upload were urologists (54.5%) and the videos containing only ThuLEP surgery (74%) were the majority of the videos. The median JAMA score, 5-point modified DISCERN score, and GQS were 2, 1, and 1, respectively. There were no statistical differences in these three scores according to the source of the upload. All three scores were analyzed separately by language and no significant statistical difference was found. There was a positive correlation between the video power index and as well as JAMA, GQS, and m.DISCERN scores. CONCLUSION: Despite abundant videos on ThuLEP on YouTube, most of these videos are not targeted to public and information provided may not be as useful for patients. Information presented in these videos may be inaccurate and not reliable.

Long-term results of clam enterocystoplasty in non-neurogenic refractory urge incontinence.

OBJECTIVES: This study aims to assess the efficacy of Clam enterocystoplasty (CECP) surgery for the treatment of non-neurogenic refractory urgency urinary incontinence (UUI). METHODS: We conducted a retrospective evaluation of 17 female patients who underwent CECP for non-neurogenic refractory UUI between May 2010 and November 2022. RESULTS: The median of ICIQ-SF was 19 (15-21) before treatment, which decreased to a median of 0 (0-5) after treatment (p = 0.01). The average preoperative pad use among the participants was 4 (3-6), while it became 0 postoperatively (p < 0.01). The median preoperative cystometric bladder capacity was 251 ml (100-350 ml), increasing to 456 ml (400-650 ml) postoperatively (p < 0.01). According to the Clavien-Dindo classification system, the majority of patients experienced either no complications (66%) or minor complications (CD I/CD II) (33%) within the initial 90 days following surgery. CONCLUSIONS: "Clam" iliocystoplasty emerges as a secure and successful treatment option in the patient group whose symptoms persist after first, second, and third-line treatments with the diagnosis of urge incontinence.

A possible mechanism of erectile dysfunction in coronavirus disease-19: Cavernosal smooth muscle damage: A pilot study / Un posible mecanismo de disfunción eréctil en la enfermedad por coronavirus-19: daño del músculo liso cavernoso: un estudio piloto

Introduction: Studies have reported that coronavirus disease 2019 (COVID-19) may cause erectile dysfunction (ED), however, its role in the pathophysiology of ED has not yet been fully elucidated. We aimed to elucidate COVID-19's effects on cavernosal smooth muscle, which has a pretty important role in erection physiology, by corpus cavernosum electromyography (cc-EMG). Materials and methods: Twenty-nine male patients aged 20–50 years who applied to the urology outpatient clinic due to ED were included in the study. Nine patients that had COVID-19 and were treated as outpatients were classified as group 1, 10 patients who were hospitalized due to COVID-19 were classified as group 2, and 10 patients who did not have COVID-19 were classified as the control group (group 3). Patients underwent diagnostic evaluation including International Index of Erectile Function (IIEF)-5 form, penile color Doppler ultrasonography (CDUS), cc-EMG, and fasting serum levels of reproductive hormones (07–11am). Results: According to penile CDUS and hormonal values results, there was no significant difference between the groups. According to cc-EMG results, amplitudes and relaxation capacities of the cavernosal smooth muscle of patients in group 3 were significantly higher than those in the other groups. Conclusions: COVID-19 can cause ED not only by psychogenic and hormonal factors but also with cavernosal smooth muscle damage. (AU)

Introducción: Los estudios han informado que la COVID-19 puede causar disfunción eréctil, sin embargo, su papel en la fisiopatología de la disfunción eréctil aún no se ha aclarado por completo. Nuestro objetivo era dilucidar los efectos de la COVID-19 en el músculo liso cavernoso, que tiene un papel bastante importante en la fisiología de la erección, mediante electromiografía del cuerpo cavernoso (cc-EMG). Materiales y métodos: Se incluyeron en el estudio 29 pacientes varones de 20 a 50 años de edad que solicitaron la consulta externa de urología debido a disfunción eréctil. Nueve pacientes que tenían COVID-19 y fueron tratados como pacientes ambulatorios se clasificaron como grupo 1, 10 pacientes que fueron hospitalizados debido a COVID-19 se clasificaron como grupo 2 y 10 pacientes que no tenían COVID-19 se clasificaron como grupo control (grupo 3). Los pacientes se sometieron a una evaluación diagnóstica que incluyó el índice internacional de función eréctil (IIEF)-5, ecografía Doppler color del pene (CDUS), cc-EMG y niveles séricos en ayunas de hormonas reproductivas (07-11 am). Resultados: De acuerdo con los resultados de los valores de CDUS y hormonales del pene, no hubo diferencias significativas entre los grupos. De acuerdo con los resultados de cc-EMG, las amplitudes y las capacidades de relajación de las actividades EMG del músculo liso cavernoso de los pacientes del grupo 3 fueron significativamente mayores que las de los otros grupos. Conclusiones: La COVID-19 puede causar disfunción eréctil no solo por factores psicógenos y hormonales, sino también por daño del músculo liso cavernoso. (AU)

A possible mechanism of erectile dysfunction in coronavirus disease-19: Cavernosal smooth muscle damage: A pilot study.

INTRODUCTION: Studies have reported that coronavirus disease 2019 (COVID-19) may cause erectile dysfunction (ED), however, its role in the pathophysiology of ED has not yet been fully elucidated. We aimed to elucidate COVID-19's effects on cavernosal smooth muscle, which has a pretty important role in erection physiology, by corpus cavernosum electromyography (cc-EMG). MATERIALS AND METHODS: Twenty-nine male patients aged 20-50 years who applied to the urology outpatient clinic due to ED were included in the study. Nine patients that had COVID-19 and were treated as outpatients were classified as group 1, 10 patients who were hospitalized due to COVID-19 were classified as group 2, and 10 patients who did not have COVID-19 were classified as the control group (group 3). Patients underwent diagnostic evaluation including International Index of Erectile Function (IIEF)-5 form, penile color Doppler ultrasonography (CDUS), cc-EMG, and fasting serum levels of reproductive hormones (07-11am). RESULTS: According to penile CDUS and hormonal values results, there was no significant difference between the groups. According to cc-EMG results, amplitudes and relaxation capacities of the cavernosal smooth muscle of patients in group 3 were significantly higher than those in the other groups. CONCLUSIONS: COVID-19 can cause ED not only by psychogenic and hormonal factors but also with cavernosal smooth muscle damage. CLINICAL TRIAL REGISTRATION NUMBER: NCT04980508.