Current Issue : April-June Volume : 2026 Issue Number : 2 Articles : 6 Articles
Background and Objectives: The use of fluoroscopy during retrograde intrarenal surgery (RIRS) results in cumulative ionizing radiation exposure to both the patient and the surgical team. We aimed to evaluate the efficacy and safety of fluoroscopy-free (FF) RIRS performed by experienced surgeons in the management of renal stones <2 cm. Materials and Methods: A total of 255 patients who underwent RIRS for renal stones <2 cm between 2023 and 2025 were retrospectively analyzed. Patients were randomly assigned to the groups. Fluoroscopy was used (FU) during RIRS in 123 patients, whereas fluoroscopy was not used during RIRS in 132 patients. All procedures were performed by a single experienced surgeon. For patients in both groups, the following variables were retrospectively reviewed: demographic characteristics, stone characteristics, localization, and diameter, operative time, fluoroscopy time and dose, postoperative complications, length of hospital stay, and stone-free rates (SFR). Results: The operative time was 34.7 ± 8.7 min in the FF group and 42.0 ± 12.9 min in the FU group, being significantly shorter in the FF group (p < 0.001). No fluoroscopy was used in the FF group, whereas in the FU group the fluoroscopy time and dose were recorded as 7.75 ± 3.6 s and 1.31 ± 0.61 mGy, respectively. There were no significant differences between the groups in terms of length of hospital stay or SFR. No intraoperative complications were observed in either group. Postoperative complications occurred in 29 (21.9%) patients in the FF group and 42 (34.1%) patients in the FU group; the difference between groups was statistically significant (p = 0.030). Conclusions: In appropriately selected patients with renal stones <2 cm, fluoroscopy-free RIRS performed by experienced surgeons can be applied effectively and safely, with shorter operative times and lower complication rates....
Background Erectile dysfunction is a common condition often resistant to single-drug treatments. This study evaluated whether adjunct celecoxib could enhance the effect of tadalafil on erectile function. Methods In this randomized controlled trial, 50 men with moderate-to-severe erectile dysfunction were randomized to tadalafil 5 mg plus celecoxib 200 mg daily (intervention) or tadalafil 5 mg plus placebo (control) for 8 weeks. Erectile function was assessed with the International Index of Erectile Function (IIEF) questionnaire. Results Of 50 randomized, 47 were analyzed (intervention n = 23; control n = 24). Post-treatment total IIEF scores were higher in the intervention group (18.04 ± 5.06) versus control (15.37 ± 3.59; P = 0.042), while the distribution of erectile-dysfunction severity categories did not differ significantly between groups. Conclusions The combination of tadalafil and celecoxib was associated with a statistically significant improvement in IIEF total scores compared with tadalafil alone. However, the distribution of ED-severity categories did not change significantly; the clinical implication of our findings derives from continuous score improvement rather than categorical transition....
Background Implantation of penile prosthesis in cases of fibrotic scarred corporeal tissue is one of the most challenging procedures in prosthetic urology. We present our work with implantation of semirigid penile prostheses in cases of severe scarred corporeal fibrosis using two types of cavernotomes, Uramix cavernotome (Uramix USA) and Shaeer`s coring cavernotome (ShC) either separately or combined. Methods Fourteen cases with severe scarred penile fibrosis underwent semirigid penile prosthesis implantation from September 2021 to May 2023. The institutional ethical committee approved the work that conforms to Helsinki declaration 2013. All participants were fully counseled about their condition and the necessity to redo the implantation with the possibility of postoperative complications together with cancelling the operation in case of dilatation failure. Results In most cases, proximal dilatation was more difficult than distal dilatation. In thirteen patients, penile prosthesis implantation was inserted bilaterally. In one post-priapism patient, dilatation was successful on one side only, and a single rod was implanted. Failure of dilatation of the contralateral side was due to atrophy and thinningout of the corpus cavernosum. Urethral injury, distal perforation or crossing-over was not encountered. Proximal perforation was encountered in three cases, two by Uramix and one by ShC. Corporotomies were then extended, and the rear tip extender was sutured to the tunica albuginea by prolene sutures. In two cases, distal side perforations happened due to misdirection of ShC. In those two cases, penile degloving through the penoscrotal incision was done and the corporeal side perforations were sutured by absorbing sutures under vision. In only four patients, Uramix dilator was used alone to dilate the corpora. In the Uramix group, two patients had girth 12 mm implanted and two had girth 11 mm. In another four patients, the Uramix could not dilate the fibrotic corpora, so ShC was used to excavate the sclerotic cavernosal tissue. Conclusion It is recommended to start first with the Uramix dilators. If corporeal fibrosis is severe, ShC can then be used owing to the higher risk of corporeal perforation that is induced by ShC....
Background Penile fracture is a rare urological emergency involving a traumatic rupture of the tunica albuginea of the corpora cavernosa. This study aims to describe the epidemiological, diagnostic, therapeutic, and prognostic aspects of this condition at a university teaching hospital in Burkina Faso. Patients and methods A descriptive retrospective study was conducted over 3 years (2021–2023) at the Yalgado Ouédraogo University Teaching Hospital (CHU-YO). Data from 19 patients managed for a confirmed penile fracture were collected from clinical files, operative registers, and via telephone interviews. Data were analyzed using Epi Info 7.2.1 and Excel software. Results The mean annual incidence was 6.3 cases. The mean patient age was 34.16 years. The main mechanism was a coital misstep (73.68%). The mean time to consultation was 12.95 h. Diagnosis was purely clinical in all cases. All patients underwent immediate surgical repair. Early postoperative complications (surgical site infection) were rare (10.52%). Long-term, 89.47% of patients had normal erectile function (IIEF-6 score ≥ 26). Conclusion Penile fracture, although rare, is a recognized entity in Burkina Faso. Early surgical treatment, based on reliable clinical diagnosis, offers excellent functional outcomes and a low complication rate, confirming its position as the therapeutic gold standard....
Renal calculi represent a common urological condition, with retrograde intrarenal surgery (RIRS) emerging as the primary treatment modality due to its minimally invasive nature and high efficacy. Elevated intrarenal pressure during RIRS frequently leads to complications such as infection and renal tissue injury, which significantly compromise surgical safety. The suction ureteral access sheath (SUAS), an innovative device, effectively controls intrarenal pressure through active suction, thereby improving surgical visualization and enhancing lithotripsy efficiency. The SUAS has shown to be very useful in clinical practice, and it has become an important tool for making kidney stone surgery safer and more effective. This paper aims to systematically explore the application value of the SUAS to control intrarenal pressure and perform kidney stone surgery, providing theoretical support for clinical practice. The results of related studies have indicated that the SUAS can effectively reduce the peak intrarenal pressure, improve the surgical field, and increase the efficiency of lithotripsy through the mechanism of “perfusion-absorption balance”, thus significantly reducing the postoperative fever, urogenital septicemia, and reoperation rate, especially in complex stones and high-risk groups. In this paper, it can be concluded that the SUAS is a key tool for controlling intrarenal pressure in RIRS, which can significantly improve the safety and effectiveness of surgery and has a broad clinical application prospect....
Background Urolithiasis affects 10–14% of individuals in developed countries, with a rising prevalence of calcium oxalate stones. Citrus juices are rich in citrate—a natural inhibitor of calcium stone formation. This systematic review and meta-analysis assess the impact of citrus juices on urinary parameters related to kidney stone formation. Methods PubMed and Cochrane CENTRAL were systematically searched from inception till October 2024, while following PRISMA guidelines. All clinical trials evaluating the effects of citrus juice consumption on urinary citrate, calcium, oxalate, and pH levels were included in this review. Statistical analyses were performed on Review Manager and effect sizes were pooled as mean differences (MD) with 95% confidence intervals (CI) using a random effects model. Statistical heterogeneity was assessed using I2 statistics and I < 50% was deemed acceptable. The risk of bias was assessed using the Cochrane RoB2 Tool. Results The systematic review included 16 studies (552 patients), with 3 pooled for meta-analysis (240 patients). Citrus juice consumption was associated with trends towards increased urinary citrate levels (MD = 68.82 [-13.93,151.57]; p < 0.10) among patients on juice therapy which gained statistical significance on leave-one-out analysis (MD = 101.11 [55.2,147.02]; P < 0.0001). Changes in urinary calcium, and oxalate levels were non-significant. Urinary pH exhibited no significant changes, although qualitative synthesis suggested potential benefits for kidney stone prevention. Conclusion Citrus juices may enhance urinary citrate levels helping to prevent calcium stone formation. This suggests their role as a safe, natural adjunct to pharmacological treatments. Further trials are warranted to ascertain the benefits of citrus juices in mitigating the risk of kidney stone formation....
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