Comparison of the efficacy of fluoxetine alone vs. fluoxetine plus local lidocaine ointment in the treatment of premature ejaculation.

OBJECTIVE: The present study compares the efficacy and side effects of fluoxetine alone vs. fluoxetine plus local lidocaine ointment in the treatment of premature ejaculation. METHODS: Forty-three patients suffering from premature ejaculation were studied. The exclusion criteria were erectile dysfunction, loss of libido, alcohol and substance abuse, mental retardation, diabetes mellitus, thyroid disease, hypotension, previous use of these drugs and urogenital infections. The patients' ages ranged from 19 to 48 years (mean age 28 +/- 1.6). They had regular sexual lives. They had normal psychiatric consultation and the Glombock Rast Sexual Satisfactory Test (GRISS) psychiatric test were in accordance with premature ejaculation. RESULTS: The patients were assigned to two groups. Twenty-six patients, aged 21 to 36 years (mean age 27), received only fluoxetine 20 mg/day (1 capsule) for a week which was later increased to 40 mg/day (2 capsules). Seventeen patients, aged 19 to 48 years (mean age 31), were given fluoxetine 20 mg/day plus local application of lidocaine ointment. The patients and partners were re-evaluated 8 weeks after the treatment. The results were classified as unsuccessful, improvement and cure. The chi-square test was used for statistical analysis. In the fluoxetine group, 8 (30.8%) patients cured, 11 (42.2%) showed improvement and there were 7 failures (26.9%). In the combination treatment group, 9 (52.9%) patients cured, improvement was observed in 5 (29.4%) and failure in 3 (17.6%). Side effects in group I were observed in 6 patients (23%) and in 5 (29.4%) in group II. There were no statistical differences between the two groups according to the side effects (p > 0.01). No patients were excluded from the study due to side effects. CONCLUSION: The combination of fluoxetine plus local application of lidocaine ointment was found to be more effective than fluoxetine alone in the treatment of premature ejaculation. However, the results should be confirmed in further studies with a placebo group to rule out the placebo effect.

Comparison of sertraline to fluoxetine with regard to their efficacy and side effects in the treatment of premature ejaculation.

OBJECTIVE: In the present study, two different serotonin re-uptake inhibitors were compared with regard to their efficacy and side effects in the treatment of premature ejaculation. METHODS: Fifty-seven patients with complaint of premature ejaculation were included in the study. Patient ages ranged from 21 to 45 years (mean age 32 +/- 2.6). They had a regular sexual life and were normal after GRISS psychological test and psychiatric evaluation. The patients were randomized into two groups according to the drugs given. Twenty-six patients aged between 21 to 36 years (mean age 27 +/- 1.1) received fluoxetine 20 mg/day for one week and 40 mg/day thereafter (group I). Thirty-one patients aged between 21 to 45 (mean age 34 +/- 1.7) received sertraline 50 mg/day (group II). All the patients and partners were re-evaluated 4 and 8 weeks after the treatment. The results were classified as unsuccessful, improvement and cure. Mann Whitney-U and Pearson chi-square tests were used for statistical analysis. RESULTS: In the fluoxetine group, 8 (30.8%) patients cured, improvement in 11 (42.3%) and failure in 7 (26.9%). In the sertraline group, 12 (38.7%) patients cured, improvement in 10 (32.3%) and failure in 9 (29%). Side effects in group I were nausea in 3, headache in 1 and insomnia in 2 (total 6 patients, 23%). In group II, we observed nausea in 2 and mouth dryness in 6 (total 8 patients, 25.8%). No patients were excluded from the study due to side effects. CONCLUSION: Our results show that different serotonin re-uptake inhibitors have the same efficacy and side effects in the treatment of premature ejaculation.

Transurethral resection of the prostate and laser prostatectomy under local anesthesia.

OBJECTIVE: To perform transurethal resection of the prostate (TURP) and transurethral laser ablation prostatectomy (TULAP) under appropriate local anesthesia. PATIENTS AND METHODS: A total of 54 patients were examined in this study. We carried out TURP in 42 and TULAP in 12 of them under local anesthesia with lignocaine chloride. Patient's discomfort was recorded by means of a four-point descriptive pain scale. RESULTS: We had perfect pain control in the majority of the patients. Patient's acceptance was very high. No patient required conversion to general anesthesia. Complications due to local anesthesia were not observed. CONCLUSION: We believe that ours is a simple, safe and effective procedure.

The outcome of urological findings in operated tethered cord patients.

We studied the urological aspects of the tethered cord syndrome before and after untethering. Presenting urological symptoms include incontinence in 10 (38%), voiding difficulty in 8 (30%), stool soilage in 7 (27%), pollakiuria in 8 (30%) and urgency and symptomatic urinary tract infection in 9 patients (34%). All patients had presacral skin lesion. In all cases cystometric study was done preoperatively and postoperatively. In this study, we noted that the overall clinical symptomatology and urodynamic parameters improved in 67.0% and 49.0%, respectively. Although no patient became normal after surgery, we found better improvement in patients treated promptly by neurosurgical intervention.

Colour penile Doppler ultrasonography with intraurethral prostaglandin-E2: preliminary results.

Intraurethral instillation was used in place of intracavernosal injection of vasoactive agents for the colour Doppler investigation of patients with erectile dysfunction. A total of 19 patients were enrolled in this study. Colour penile Doppler ultrasonography was done with intracavernosal injection of papaverine-HCl 60 mg and intraurethral instillation of prostaglandin-E2 0.5 mg. Arterial diameter, peak systolic velocity and end diastolic velocity were measured before and after papaverine injection and prostaglandin-E2 instillation. Colour penile Doppler parameters increased statistically significantly after papaverine injection and prostaglandin-E2 instillation (p < 0.01). But we did not observe differences between the results after papaverine-HCl and prostaglandin-E2. We believe that prostaglandin-E2 may be used with colour Doppler ultrasonography in the evaluation of patients with erectile dysfunction.

Chlamydial infections and male infertility.

Chlamydial infections may be difficult to diagnose due to the silent symptoms and difficulty in culturing. An infectious process may impair fertility by adversely affecting sperm functions, resulting in testicular damage or causing obstruction of the genital tract. In our study, we tried to find Chlamydial antigen by using EIA (Enzyme Immune Assay) and to compare the Ag(+) and Ag(-) groups according to semen parameters. Except for semen volume, we found significant differences in density, morphology, motility and viability (intervolume p > 0.05, interdensity p < 0.01, intermorphology p < 0.001, intermotility p < 0.001 and interviability p < 0.001).

Urethral sleeve advancement in repairement of distal hypospadias.

Thirtyfive boys with distal hypospadias were operated on using urethral sleeve advancement procedure between 1990 and 1994. Early complications such as hematoma and wound infection, and late complications such as fistula formation and meatal retraction were not seen in the patients except meatal stenosis in first month control in only eight patients. Four of them underwent dilatation and meatotomy was performed in the rest. Both cosmetic and functional results were excellent in the patients in sixth month control.

Phaeochromocytoma in pregnancy: a case report.

A twenty-eight years old patient with phaeochromocytoma in pregnancy is reported. In the second trimester, she was admitted to hospital for complaints of headache, fever, palpitation and weakness. A phaeochromocytoma was diagnosed. Alpha and beta blockers were given to regulate arterial blood pressure until foetal maturity was reached. Delivery was by caesarean section and the operation was continued with a right adrenalectomy. Pathological examination revealed a phaeochromocytoma.

Renocolic fistula secondary to chronic pyelonephritis.

Renocolic fistula is very rare. Only slightly over 100 cases have been reported in the world literature. We present a case of renocolic fistula secondary to chronic pyelonephritis discovered intraoperatively and discuss its diagnosis and management in the light of published data.

Rhabdomyosarcoma of the urinary bladder in an adult.

Primary bladder rhabdomyosarcoma is very rare in adults. We report a 76-year-old man who underwent partial cystectomy with postoperative radiotherapy and had a recurrence 6 months after the operation.

[A case of a schistosomal bladder polyp]. / Bir sistozomal mesane polibi olgusu.

A 67 year old patient who had transürethral resection because of previous diagnosis of bladder tumor and schistosomal polyp was detected on the histopathologic and the microbiologic examinations were presented.