Objectives: Varicocele is the most common correctable cause of male infertility that always has b... more Objectives: Varicocele is the most common correctable cause of male infertility that always has been a debatable subject as regards how it affects fertility and the best way to treat it. Proper assessment of the disease bilaterality is crucial not to miss one side and not to jeopardize treatment outcome. This study aimed to objectively assess varicocele bilaterality in infertile men aiming to improve treatment outcome in this cohort of patients. Methods: This prospective study was conducted between January 2019 and January 2022 including infertile males with varicoceles. Assessment of missed concomitant contralateral varicocele done pre-operatively by Color Doppler Ultrasound and intraoperatively by intraoperative Doppler device and measurement of maximal vein diameter of contralateral side. Results: A total of 329 cases completed the study. A hundred cases (30.4%) were initially referred as unilateral varicoceles and 229 (69.6%) as bilateral varicoceles. After reassessment of the s...
The Medical Journal of Cairo University, Sep 1, 2018
Background: Tamsulosin is an α-1A-specific blocker which induces selective relaxation of ureteral... more Background: Tamsulosin is an α-1A-specific blocker which induces selective relaxation of ureteral smooth muscle with subsequent inhibition of ureteral spasms and dilatation of the ureteral lumen and facilitates stone expulsion. Aim of the Study: In this prospective randomized study we aimed to assess the efficacy of use of alpha blocker (tamsulosin Hcl 0.4mg) on the outecome of ureteroscopic lithotripsy for distal ureteric stone. Patients and Methods: In a prospective study by a randomized controlled clinical trial, which was performed from September 2016 to March 2017, about 50 patients underwent ureteroscopic lithotripsy with the pneumatic wolf lithotripsy. The patients were randomly divided into 2 groups: The study group including 25 patients, received tamsulosin with our traditional treatment (hydration and analgesic when required), and the control group with 25 patients who received placebo with traditional treatment. Patients prospectively will be evaluated for stone clearing rate by imaging at morning of URSL and at the end of 2 nd week including: (KUB and pelvi abdominal ultrasound)and they will be evaluated for number of colic episodes, analgesic consumption and post-operative complications (haematuria and UTI). Results: The results showed that tamsulosin treatment group had short time of the procedure, easy extraction of the stone fragments, had low expulsion time, low urinary tract symptoms, least analgesic needs and low adverse effects. Conclusions: Administration of α-1A-specific antagon istmade the procedure of short time, easy extraction of the stone fragments reduced analgesic dosage and colic episodes, rate of adverse effects after ureteroscopic lithotripsy of lower ureteral stones and decreased gravel expulsion time after URSL.
The Medical Journal of Cairo University, Jun 1, 2018
Background: Management of urolithiasis varies from simple clinical observation and medical expuls... more Background: Management of urolithiasis varies from simple clinical observation and medical expulsive therapy to the use of refined endourologic techniques to extract the stone. The therapeutic technique currently available comprises ureteroscopy with or without the need for intracorporeal lithotripsy, percutaneous therapy, (PCNL) Extracorporeal Shock Wave Lithotripsy (ESWL), and surgical modalities (4,5). Objective: Urolithiasis (UL) is one of the most common diseases, with worldwide increasing incidence and prevalence. Aim of the Work: Was to report the hazards of Flexible Ureteroscopy (FURS), the re-treatment rate and its complication outcomes for the treatment of renal and ureteral calculi during the learning curve. Patients and Methods: This study was conducted prospectively on forty patients divided into two groups; Group I (ureteric stone group) and Group II (renal stone group)to compare the complications after the introduction of FURS. They underwent FURS and Holmium: YAG laser lithotripsy. The complications were classified using modified stave and the Clavien system (I-IV). Results: The mean patient age in the total procedures was 45.63 ± 10.98 years (range 27.0-62.0 years), and the mean stone size was 1.36±0.37cm (range 0.6-2cm). Group I: Mean stone size 1.36 ±0.37cm, the stone free rate for all cases was 77.3% (100% for stones <1.5cm and 50% for stones ≥ 1.5cm). The overall intra-operative complications rate in all cases was 27.2% (8.3% for stones <1.5 and 50% for stone size ≥ 1.5cm). The overall post-operative complications rate was 27.4% (9% for stones <1.5cm and 60% for stones ≥ 1.5cm. Group II: The mean stone size 1.46 ±0.31, the stone free for all cases was 44.4% (70.0% for stones <1.5cm and 12.5%. for stones ≥ 1.5cm. The overall intra-operative complications rate in all cases was 72.2% (52% for stones <1.5cm and 100% for stones size ≥ 1.5cm. The overall post-operative
Objectives. To determine the differential effects on renal pressures and irrigation flow associat... more Objectives. To determine the differential effects on renal pressures and irrigation flow associated with the application of different ureteral catheters during percutaneous nephrolithotomy. Methods. Using ex vivo fresh cadaveric tissue, we established a percutaneous nephrolithotomy model. After obtaining lower pole percutaneous access, we recorded the pressure and irrigant flow measurements. Measurements were made with an empty ureter, 6F ureteral catheter, occlusion balloon catheter, and ureteral access sheaths (10/12F and 12/14F). Three 1-minute trials for each condition were recorded in each of four kidneys. Results. Ureteral catheterization with both the 10/12F and the 12/14F ureteral access sheaths resulted in significantly decreased intrarenal pressures in the pressure range tested compared with an empty ureter, a ureteral catheter, or an occlusion balloon application. Total irrigant flow for the 12/14F ureteral access sheath was significantly higher than for the empty ureter, ureteral catheter, or occlusion balloon in the entire pressure range evaluated. Conclusions. In this in vitro cadaveric model, application of the ureteral access sheath during percutaneous nephrolithotomy resulted in decreased intrarenal pressures and increased irrigant flow.
To evaluate the impact of a luteinising hormone-releasing hormone (LHRH) agonist, goserelin aceta... more To evaluate the impact of a luteinising hormone-releasing hormone (LHRH) agonist, goserelin acetate (GA), on surgical blood loss during transurethral resection of the prostate (TURP), as well as its histopathological effect on prostatic microvessel density (MVD). Patients and methods: Patients who underwent TURP due to benign prostatic enlargement (60-100 mL) were randomly subdivided into two equal groups according to whether they received preoperative GA administration (3.6 mg; group A) or not (group B). Evaluation parameters were operative time, weight of resected prostatic tissue, perioperative haematocrit (HCT) changes, estimation of intraoperative blood loss, and suburethral and stromal prostatic MVD. Effects of GA on prostate weight and any possible side-effects were also monitored.
Journal of advances in medicine and medical research, Jul 13, 2021
Background: There are some men suffer from infertility, non-obstructive azoospermia is one of the... more Background: There are some men suffer from infertility, non-obstructive azoospermia is one of the causes of infertility, these men need sperm retrieval from testes like microdissection testicular sperm extraction (Micro-TESE). This work aims to assess the different preoperative and intraoperative factors that predict successful sperm retrieval with Microdissection Testicular Sperm Extraction (Micro-TESE) in men with non-obstructive azoospermia. Methods: Our study is a cohort prospective one, conducted on 52 male patients with nonobstructive azoospermia who attended to the outpatient andrology and infertility clinic of Urology Department, Tanta University Hospitals during the period between December2018 to November2019. All patients were subjected to detailed medical history, physical examination, two semen analysis on two different laboratories. Microdissection Testicular Sperm Extraction is performed to all patients after Estimation of serum FSH, LH, testosterone, prolactin, estradiol and scrotal Doppler ultrasonography Results: From 52 patients who have done, Patients were divided in to 2 groups according to the result of Micro-TESE procedure: negative SSR group (28 patients) and positive SSR group (24 patients).In comparison between the two groups according to preoperative factors as age, FSH,
Background and Purpose: The effect of stents on ureteral peristalsis in vivo is not entirely clea... more Background and Purpose: The effect of stents on ureteral peristalsis in vivo is not entirely clear. We sought to develop a minimally invasive method for its study. Materials and Methods: In female domestic pigs, electrical potentials from the ureter were measured by bipolar steel-wire electromyography electrodes delivered laparoscopically. Mechanical movement was measured by giant magneto resistive sensors mounted on custom-made aluminum strips. After baseline values were obtained, the animals were randomized to receive silicone or polyurethane stents, and ureteral peristalsis was measured for 8 hours acutely and for 4 hours 1 week later. Results: Implantation of the devices took an average of 30 minutes. A consistent correlation was found between laparoscopically observed peristaltic waves and the peristalsis detected by the two measuring devices. The devices themselves did not affect peristalsis. Stent insertion increased peristaltic activity initially but later reduced or stopped it. There was no difference in the effects of the two types of stents. Conclusions: The new technique permits close monitoring of ureteral peristalsis in vivo. Smaller stents appear to have less immediate effect than larger ones, but all type of stents tested eventually caused aperistalsis.
Hypothesis / aims of study Painful bladder syndrome/Inerstitial cystitis is a chronic, severely d... more Hypothesis / aims of study Painful bladder syndrome/Inerstitial cystitis is a chronic, severely debilitating disease of the urinary bladder characterized by urinary frequency, urgency, nocturia and pelvic pain in the absence of obvious bladder pathology 1. Painful bladder syndrome/Inerstitial cystitis primarily occurs in middle-aged women, with female to male ratio 9:1 Management of Painful bladder syndrome/Inerstitial cystitis includes diet modification, pelvic floor exercise, oral medications, intravesical therapy and surgical intervention. Neuromodulation is reserved for those cases with persistent unacceptable complains despite oral or intravesical therapy. The Food and Drug Administration (FDA) approved for use of sacral neuromodulation in refractory urge incontinence and chronic non-obstructive retention2. Mac Guire (1983)3 was the first to use percutaneous tibial nerve stimulation for neuromodulation. The mechanism of percutaneous tibial nerve stimulation is thought to be retrograde modification of S3 nerve root function or inhibiting sacral reflexes pathway. The aim of the work is to evaluate the effects of intermittent Percutaneous Tibial Nerve Stimulation (PTNS) in treating refractory cases with Painful bladder syndrome/Inerstitial cystitis (PBS/IC).
Background: Premature ejaculation is a common sexual disorder that significantly impacts the qual... more Background: Premature ejaculation is a common sexual disorder that significantly impacts the quality of life for both men and their partners. Various treatment options have been explored, including behavioral techniques, selective serotonin reuptake inhibitors (SSRIs), and local anesthetics. However, the outcomes of these treatments have been inconsistent for many patients. This study aimed to evaluate the effectiveness and safety of injecting botulinum-A toxin into the bulbospongiosus muscle for treating premature ejaculation (PPE) in Egyptian patients. Materials and methods: Sixty patients with PPE were randomly assigned prospectively to two groups: one receiving botulinum-A toxin injections and the other receiving saline injections as a placebo. The injection was done under US guidance to localize the site of bulbospongiosus muscle. Results: After the follow-up period, 57 patients completed the study. Initially, there were no significant differences between the two groups in term...
Journal of Advances in Medicine and Medical Research
Background: Recent epidemiological and clinical studies confirmed the presence of a strong associ... more Background: Recent epidemiological and clinical studies confirmed the presence of a strong association between substance use disorders and sexual dysfunctions. Studies have demonstrated that prevalence of sexual dysfunctions among addict was about 30 %the most common problem among male substance abuse patients were Erectile Dysfunction (ED) and delayed ejaculation Methods: This cohort comparative study was conducted on of 376 males aged between 18 – 50 years who were substance abusers including tramadol, cannabis and poly substance related and addictive disorders. All participants were subjected to psychiatric interview which was done using SCID-5-CV structured clinical interview for DSM-5 disorders. Psychometric, biochemical, medical and drug history evaluations were also performed. Results: Our results show comparison between four groups (opiates-cannabis-poly substance abuse and control group according to severity of drug abuse, psychiatric evaluation and according to sexual func...
Introduction and hypothesis To report our experience over 12 years in female urethral reconstruct... more Introduction and hypothesis To report our experience over 12 years in female urethral reconstruction with either anterior bladder tube (Tanagho) or labia minora pedicled tube. Patients and methods This retrospective study included 16 patients with posttraumatic urethral loss. The patients were divided into two groups. Group I: included 6 patients managed with combined vaginal and abdominal approach using a proximally based anterior bladder tube (Tanagho) and Group II: included 10 patients underwent repair with labial fat pad flap with concomitant TOT sling. Outcomes included the success or failure of anatomical repair and continence, which was assessed during patient follow up by voiding diary, 24-h pad test and uroflowmetry. Results A total of 15 patients were followed for a mean of 42 months postoperatively, and only one patient was lost to follow up. Total continence was achieved in 10 patients (66.6 %) [4/6 patients (66.6 %) in group I and 6/9 patients (66.6 %) in group II]. Partial continence (i.e., one or two pad per day) was achieved in 2 patients (13.3 %). Failure occurs in 3 cases (20 %) [one case in group I and two cases in group II]. All our patients had a smooth postoperative course. In the labia pedicled tube, meatal stenosis was encountered in one patient and transient postoperative urine retention in 2 patients. Successful anatomical repair was achieved in all our patients. Conclusion Both Bladder tube and labia minora pedicled tube with sling procedure have high success rate with only minor complications and are equally effective in the management of females with total urethral loss. Due to the small number of patients in this study, we still need to extend our study to verify our results.
To evaluate changes in female sexual function after a transobturator vaginal tape (TOT) procedure... more To evaluate changes in female sexual function after a transobturator vaginal tape (TOT) procedure for treating genuine stress urinary incontinence (SUI), and its correlation with patient&amp;amp;amp;amp;#39;s expectation. The study included women treated with a suburethral TOT for genuine SUI, neurologically intact, heterosexual and married, aged &amp;amp;amp;amp;gt;18 years, with no previous history of malignancy, pelvic radiotherapy and no other associated surgical or psychological diseases. Patients were interviewed before surgery and with the aid of a questionnaire including female sexual function, the Beck depression indices and their expectation of sexual function after surgery. Sixty-two premenopausal sexually active women were included (mean age 40.5 years). The cure rate from SUI was 92%, 89%, 87% and 84% at 6, 12, 18 and 24 months, respectively. All patients attended the visit before and the first visit after surgery, while 71%, 42% and 24% were assessed at the 12-, 18 and 24-month visits, respectively. The mean follow-up was 12 months. Fifty-two women resumed their sexual activity early within the 8 weeks after surgery and the frequency of coitus in more than two-thirds of patients was at least once per month. The number of women who expected either looseness or tightness of the vagina was more than that estimated from patient perceptions. There was a difference between the patient&amp;amp;amp;amp;#39;s sensation of vaginal length abnormalities during coitus (two women) and patient expectation (18 women). Although the TOT is effective for treating SUI, counselling the patient and her partner is important in correcting false ideas and expectations about future sexual activity. Indeed, sexual dysfunction is reported after vaginal surgery, with a physiological and psychological background. Further assessment should be used to characterize sexual dysfunction after vaginal surgery for SUI to find new solutions.
Background: Management of urolithiasis varies from simple clinical observation and medical expuls... more Background: Management of urolithiasis varies from simple clinical observation and medical expulsive therapy to the use of refined endourologic techniques to extract the stone. The therapeutic technique currently available comprises ureteroscopy with or without the need for intracorporeal lithotripsy, percutaneous therapy, (PCNL) Extracorporeal Shock Wave Lithotripsy (ESWL), and surgical modalities (4,5). Objective: Urolithiasis (UL) is one of the most common diseases, with worldwide increasing incidence and prevalence. Aim of the Work: Was to report the hazards of Flexible Ureteroscopy (FURS), the re-treatment rate and its complication outcomes for the treatment of renal and ureteral calculi during the learning curve. Patients and Methods: This study was conducted prospectively on forty patients divided into two groups; Group I (ureteric stone group) and Group II (renal stone group)to compare the complications after the introduction of FURS. They underwent FURS and Holmium: YAG laser lithotripsy. The complications were classified using modified stave and the Clavien system (I-IV). Results: The mean patient age in the total procedures was 45.63 ± 10.98 years (range 27.0-62.0 years), and the mean stone size was 1.36±0.37cm (range 0.6-2cm). Group I: Mean stone size 1.36 ±0.37cm, the stone free rate for all cases was 77.3% (100% for stones <1.5cm and 50% for stones ≥ 1.5cm). The overall intra-operative complications rate in all cases was 27.2% (8.3% for stones <1.5 and 50% for stone size ≥ 1.5cm). The overall post-operative complications rate was 27.4% (9% for stones <1.5cm and 60% for stones ≥ 1.5cm. Group II: The mean stone size 1.46 ±0.31, the stone free for all cases was 44.4% (70.0% for stones <1.5cm and 12.5%. for stones ≥ 1.5cm. The overall intra-operative complications rate in all cases was 72.2% (52% for stones <1.5cm and 100% for stones size ≥ 1.5cm. The overall post-operative
Objectives: Varicocele is the most common correctable cause of male infertility that always has b... more Objectives: Varicocele is the most common correctable cause of male infertility that always has been a debatable subject as regards how it affects fertility and the best way to treat it. Proper assessment of the disease bilaterality is crucial not to miss one side and not to jeopardize treatment outcome. This study aimed to objectively assess varicocele bilaterality in infertile men aiming to improve treatment outcome in this cohort of patients. Methods: This prospective study was conducted between January 2019 and January 2022 including infertile males with varicoceles. Assessment of missed concomitant contralateral varicocele done pre-operatively by Color Doppler Ultrasound and intraoperatively by intraoperative Doppler device and measurement of maximal vein diameter of contralateral side. Results: A total of 329 cases completed the study. A hundred cases (30.4%) were initially referred as unilateral varicoceles and 229 (69.6%) as bilateral varicoceles. After reassessment of the s...
The Medical Journal of Cairo University, Sep 1, 2018
Background: Tamsulosin is an α-1A-specific blocker which induces selective relaxation of ureteral... more Background: Tamsulosin is an α-1A-specific blocker which induces selective relaxation of ureteral smooth muscle with subsequent inhibition of ureteral spasms and dilatation of the ureteral lumen and facilitates stone expulsion. Aim of the Study: In this prospective randomized study we aimed to assess the efficacy of use of alpha blocker (tamsulosin Hcl 0.4mg) on the outecome of ureteroscopic lithotripsy for distal ureteric stone. Patients and Methods: In a prospective study by a randomized controlled clinical trial, which was performed from September 2016 to March 2017, about 50 patients underwent ureteroscopic lithotripsy with the pneumatic wolf lithotripsy. The patients were randomly divided into 2 groups: The study group including 25 patients, received tamsulosin with our traditional treatment (hydration and analgesic when required), and the control group with 25 patients who received placebo with traditional treatment. Patients prospectively will be evaluated for stone clearing rate by imaging at morning of URSL and at the end of 2 nd week including: (KUB and pelvi abdominal ultrasound)and they will be evaluated for number of colic episodes, analgesic consumption and post-operative complications (haematuria and UTI). Results: The results showed that tamsulosin treatment group had short time of the procedure, easy extraction of the stone fragments, had low expulsion time, low urinary tract symptoms, least analgesic needs and low adverse effects. Conclusions: Administration of α-1A-specific antagon istmade the procedure of short time, easy extraction of the stone fragments reduced analgesic dosage and colic episodes, rate of adverse effects after ureteroscopic lithotripsy of lower ureteral stones and decreased gravel expulsion time after URSL.
The Medical Journal of Cairo University, Jun 1, 2018
Background: Management of urolithiasis varies from simple clinical observation and medical expuls... more Background: Management of urolithiasis varies from simple clinical observation and medical expulsive therapy to the use of refined endourologic techniques to extract the stone. The therapeutic technique currently available comprises ureteroscopy with or without the need for intracorporeal lithotripsy, percutaneous therapy, (PCNL) Extracorporeal Shock Wave Lithotripsy (ESWL), and surgical modalities (4,5). Objective: Urolithiasis (UL) is one of the most common diseases, with worldwide increasing incidence and prevalence. Aim of the Work: Was to report the hazards of Flexible Ureteroscopy (FURS), the re-treatment rate and its complication outcomes for the treatment of renal and ureteral calculi during the learning curve. Patients and Methods: This study was conducted prospectively on forty patients divided into two groups; Group I (ureteric stone group) and Group II (renal stone group)to compare the complications after the introduction of FURS. They underwent FURS and Holmium: YAG laser lithotripsy. The complications were classified using modified stave and the Clavien system (I-IV). Results: The mean patient age in the total procedures was 45.63 ± 10.98 years (range 27.0-62.0 years), and the mean stone size was 1.36±0.37cm (range 0.6-2cm). Group I: Mean stone size 1.36 ±0.37cm, the stone free rate for all cases was 77.3% (100% for stones <1.5cm and 50% for stones ≥ 1.5cm). The overall intra-operative complications rate in all cases was 27.2% (8.3% for stones <1.5 and 50% for stone size ≥ 1.5cm). The overall post-operative complications rate was 27.4% (9% for stones <1.5cm and 60% for stones ≥ 1.5cm. Group II: The mean stone size 1.46 ±0.31, the stone free for all cases was 44.4% (70.0% for stones <1.5cm and 12.5%. for stones ≥ 1.5cm. The overall intra-operative complications rate in all cases was 72.2% (52% for stones <1.5cm and 100% for stones size ≥ 1.5cm. The overall post-operative
Objectives. To determine the differential effects on renal pressures and irrigation flow associat... more Objectives. To determine the differential effects on renal pressures and irrigation flow associated with the application of different ureteral catheters during percutaneous nephrolithotomy. Methods. Using ex vivo fresh cadaveric tissue, we established a percutaneous nephrolithotomy model. After obtaining lower pole percutaneous access, we recorded the pressure and irrigant flow measurements. Measurements were made with an empty ureter, 6F ureteral catheter, occlusion balloon catheter, and ureteral access sheaths (10/12F and 12/14F). Three 1-minute trials for each condition were recorded in each of four kidneys. Results. Ureteral catheterization with both the 10/12F and the 12/14F ureteral access sheaths resulted in significantly decreased intrarenal pressures in the pressure range tested compared with an empty ureter, a ureteral catheter, or an occlusion balloon application. Total irrigant flow for the 12/14F ureteral access sheath was significantly higher than for the empty ureter, ureteral catheter, or occlusion balloon in the entire pressure range evaluated. Conclusions. In this in vitro cadaveric model, application of the ureteral access sheath during percutaneous nephrolithotomy resulted in decreased intrarenal pressures and increased irrigant flow.
To evaluate the impact of a luteinising hormone-releasing hormone (LHRH) agonist, goserelin aceta... more To evaluate the impact of a luteinising hormone-releasing hormone (LHRH) agonist, goserelin acetate (GA), on surgical blood loss during transurethral resection of the prostate (TURP), as well as its histopathological effect on prostatic microvessel density (MVD). Patients and methods: Patients who underwent TURP due to benign prostatic enlargement (60-100 mL) were randomly subdivided into two equal groups according to whether they received preoperative GA administration (3.6 mg; group A) or not (group B). Evaluation parameters were operative time, weight of resected prostatic tissue, perioperative haematocrit (HCT) changes, estimation of intraoperative blood loss, and suburethral and stromal prostatic MVD. Effects of GA on prostate weight and any possible side-effects were also monitored.
Journal of advances in medicine and medical research, Jul 13, 2021
Background: There are some men suffer from infertility, non-obstructive azoospermia is one of the... more Background: There are some men suffer from infertility, non-obstructive azoospermia is one of the causes of infertility, these men need sperm retrieval from testes like microdissection testicular sperm extraction (Micro-TESE). This work aims to assess the different preoperative and intraoperative factors that predict successful sperm retrieval with Microdissection Testicular Sperm Extraction (Micro-TESE) in men with non-obstructive azoospermia. Methods: Our study is a cohort prospective one, conducted on 52 male patients with nonobstructive azoospermia who attended to the outpatient andrology and infertility clinic of Urology Department, Tanta University Hospitals during the period between December2018 to November2019. All patients were subjected to detailed medical history, physical examination, two semen analysis on two different laboratories. Microdissection Testicular Sperm Extraction is performed to all patients after Estimation of serum FSH, LH, testosterone, prolactin, estradiol and scrotal Doppler ultrasonography Results: From 52 patients who have done, Patients were divided in to 2 groups according to the result of Micro-TESE procedure: negative SSR group (28 patients) and positive SSR group (24 patients).In comparison between the two groups according to preoperative factors as age, FSH,
Background and Purpose: The effect of stents on ureteral peristalsis in vivo is not entirely clea... more Background and Purpose: The effect of stents on ureteral peristalsis in vivo is not entirely clear. We sought to develop a minimally invasive method for its study. Materials and Methods: In female domestic pigs, electrical potentials from the ureter were measured by bipolar steel-wire electromyography electrodes delivered laparoscopically. Mechanical movement was measured by giant magneto resistive sensors mounted on custom-made aluminum strips. After baseline values were obtained, the animals were randomized to receive silicone or polyurethane stents, and ureteral peristalsis was measured for 8 hours acutely and for 4 hours 1 week later. Results: Implantation of the devices took an average of 30 minutes. A consistent correlation was found between laparoscopically observed peristaltic waves and the peristalsis detected by the two measuring devices. The devices themselves did not affect peristalsis. Stent insertion increased peristaltic activity initially but later reduced or stopped it. There was no difference in the effects of the two types of stents. Conclusions: The new technique permits close monitoring of ureteral peristalsis in vivo. Smaller stents appear to have less immediate effect than larger ones, but all type of stents tested eventually caused aperistalsis.
Hypothesis / aims of study Painful bladder syndrome/Inerstitial cystitis is a chronic, severely d... more Hypothesis / aims of study Painful bladder syndrome/Inerstitial cystitis is a chronic, severely debilitating disease of the urinary bladder characterized by urinary frequency, urgency, nocturia and pelvic pain in the absence of obvious bladder pathology 1. Painful bladder syndrome/Inerstitial cystitis primarily occurs in middle-aged women, with female to male ratio 9:1 Management of Painful bladder syndrome/Inerstitial cystitis includes diet modification, pelvic floor exercise, oral medications, intravesical therapy and surgical intervention. Neuromodulation is reserved for those cases with persistent unacceptable complains despite oral or intravesical therapy. The Food and Drug Administration (FDA) approved for use of sacral neuromodulation in refractory urge incontinence and chronic non-obstructive retention2. Mac Guire (1983)3 was the first to use percutaneous tibial nerve stimulation for neuromodulation. The mechanism of percutaneous tibial nerve stimulation is thought to be retrograde modification of S3 nerve root function or inhibiting sacral reflexes pathway. The aim of the work is to evaluate the effects of intermittent Percutaneous Tibial Nerve Stimulation (PTNS) in treating refractory cases with Painful bladder syndrome/Inerstitial cystitis (PBS/IC).
Background: Premature ejaculation is a common sexual disorder that significantly impacts the qual... more Background: Premature ejaculation is a common sexual disorder that significantly impacts the quality of life for both men and their partners. Various treatment options have been explored, including behavioral techniques, selective serotonin reuptake inhibitors (SSRIs), and local anesthetics. However, the outcomes of these treatments have been inconsistent for many patients. This study aimed to evaluate the effectiveness and safety of injecting botulinum-A toxin into the bulbospongiosus muscle for treating premature ejaculation (PPE) in Egyptian patients. Materials and methods: Sixty patients with PPE were randomly assigned prospectively to two groups: one receiving botulinum-A toxin injections and the other receiving saline injections as a placebo. The injection was done under US guidance to localize the site of bulbospongiosus muscle. Results: After the follow-up period, 57 patients completed the study. Initially, there were no significant differences between the two groups in term...
Journal of Advances in Medicine and Medical Research
Background: Recent epidemiological and clinical studies confirmed the presence of a strong associ... more Background: Recent epidemiological and clinical studies confirmed the presence of a strong association between substance use disorders and sexual dysfunctions. Studies have demonstrated that prevalence of sexual dysfunctions among addict was about 30 %the most common problem among male substance abuse patients were Erectile Dysfunction (ED) and delayed ejaculation Methods: This cohort comparative study was conducted on of 376 males aged between 18 – 50 years who were substance abusers including tramadol, cannabis and poly substance related and addictive disorders. All participants were subjected to psychiatric interview which was done using SCID-5-CV structured clinical interview for DSM-5 disorders. Psychometric, biochemical, medical and drug history evaluations were also performed. Results: Our results show comparison between four groups (opiates-cannabis-poly substance abuse and control group according to severity of drug abuse, psychiatric evaluation and according to sexual func...
Introduction and hypothesis To report our experience over 12 years in female urethral reconstruct... more Introduction and hypothesis To report our experience over 12 years in female urethral reconstruction with either anterior bladder tube (Tanagho) or labia minora pedicled tube. Patients and methods This retrospective study included 16 patients with posttraumatic urethral loss. The patients were divided into two groups. Group I: included 6 patients managed with combined vaginal and abdominal approach using a proximally based anterior bladder tube (Tanagho) and Group II: included 10 patients underwent repair with labial fat pad flap with concomitant TOT sling. Outcomes included the success or failure of anatomical repair and continence, which was assessed during patient follow up by voiding diary, 24-h pad test and uroflowmetry. Results A total of 15 patients were followed for a mean of 42 months postoperatively, and only one patient was lost to follow up. Total continence was achieved in 10 patients (66.6 %) [4/6 patients (66.6 %) in group I and 6/9 patients (66.6 %) in group II]. Partial continence (i.e., one or two pad per day) was achieved in 2 patients (13.3 %). Failure occurs in 3 cases (20 %) [one case in group I and two cases in group II]. All our patients had a smooth postoperative course. In the labia pedicled tube, meatal stenosis was encountered in one patient and transient postoperative urine retention in 2 patients. Successful anatomical repair was achieved in all our patients. Conclusion Both Bladder tube and labia minora pedicled tube with sling procedure have high success rate with only minor complications and are equally effective in the management of females with total urethral loss. Due to the small number of patients in this study, we still need to extend our study to verify our results.
To evaluate changes in female sexual function after a transobturator vaginal tape (TOT) procedure... more To evaluate changes in female sexual function after a transobturator vaginal tape (TOT) procedure for treating genuine stress urinary incontinence (SUI), and its correlation with patient&amp;amp;amp;amp;#39;s expectation. The study included women treated with a suburethral TOT for genuine SUI, neurologically intact, heterosexual and married, aged &amp;amp;amp;amp;gt;18 years, with no previous history of malignancy, pelvic radiotherapy and no other associated surgical or psychological diseases. Patients were interviewed before surgery and with the aid of a questionnaire including female sexual function, the Beck depression indices and their expectation of sexual function after surgery. Sixty-two premenopausal sexually active women were included (mean age 40.5 years). The cure rate from SUI was 92%, 89%, 87% and 84% at 6, 12, 18 and 24 months, respectively. All patients attended the visit before and the first visit after surgery, while 71%, 42% and 24% were assessed at the 12-, 18 and 24-month visits, respectively. The mean follow-up was 12 months. Fifty-two women resumed their sexual activity early within the 8 weeks after surgery and the frequency of coitus in more than two-thirds of patients was at least once per month. The number of women who expected either looseness or tightness of the vagina was more than that estimated from patient perceptions. There was a difference between the patient&amp;amp;amp;amp;#39;s sensation of vaginal length abnormalities during coitus (two women) and patient expectation (18 women). Although the TOT is effective for treating SUI, counselling the patient and her partner is important in correcting false ideas and expectations about future sexual activity. Indeed, sexual dysfunction is reported after vaginal surgery, with a physiological and psychological background. Further assessment should be used to characterize sexual dysfunction after vaginal surgery for SUI to find new solutions.
Background: Management of urolithiasis varies from simple clinical observation and medical expuls... more Background: Management of urolithiasis varies from simple clinical observation and medical expulsive therapy to the use of refined endourologic techniques to extract the stone. The therapeutic technique currently available comprises ureteroscopy with or without the need for intracorporeal lithotripsy, percutaneous therapy, (PCNL) Extracorporeal Shock Wave Lithotripsy (ESWL), and surgical modalities (4,5). Objective: Urolithiasis (UL) is one of the most common diseases, with worldwide increasing incidence and prevalence. Aim of the Work: Was to report the hazards of Flexible Ureteroscopy (FURS), the re-treatment rate and its complication outcomes for the treatment of renal and ureteral calculi during the learning curve. Patients and Methods: This study was conducted prospectively on forty patients divided into two groups; Group I (ureteric stone group) and Group II (renal stone group)to compare the complications after the introduction of FURS. They underwent FURS and Holmium: YAG laser lithotripsy. The complications were classified using modified stave and the Clavien system (I-IV). Results: The mean patient age in the total procedures was 45.63 ± 10.98 years (range 27.0-62.0 years), and the mean stone size was 1.36±0.37cm (range 0.6-2cm). Group I: Mean stone size 1.36 ±0.37cm, the stone free rate for all cases was 77.3% (100% for stones <1.5cm and 50% for stones ≥ 1.5cm). The overall intra-operative complications rate in all cases was 27.2% (8.3% for stones <1.5 and 50% for stone size ≥ 1.5cm). The overall post-operative complications rate was 27.4% (9% for stones <1.5cm and 60% for stones ≥ 1.5cm. Group II: The mean stone size 1.46 ±0.31, the stone free for all cases was 44.4% (70.0% for stones <1.5cm and 12.5%. for stones ≥ 1.5cm. The overall intra-operative complications rate in all cases was 72.2% (52% for stones <1.5cm and 100% for stones size ≥ 1.5cm. The overall post-operative
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