A 142-cm knotted electric cable was removed cystoscopically from a 12-year-old girl. Psychiatric evaluation revealed normal childhood curiosity and inquisitiveness and no pathological mental process. Both a urologist and a psychiatrist need to be involved in the management of such patients.

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<b><i>Background:</i></b> Today, medical expulsive therapy (MET) is more effective and commonly used in distal ureteral stones when compared with conservative treatments. Many treatments, namely, alpha-adrenergic blockers and calcium channel blockers, prostaglandin synthesis inhibitors, glyceryl trinitrate, and steroids, have been, therefore, utilized to mitigate such complications and accelerate stone expulsion. Several animal and human studies revealed the presence of β3-receptors in the ureter and bladder, where stimulating these receptors could relax the distal ureteral segment. <b><i>Objectives:</i></b> The aim of the study was to evaluate the efficacy of use of mirabegron as MET for distal ureteral stones (intramural and extramural). <b><i>Methods:</i></b> This is a prospective randomized controlled study including 90 patients who had distal ureteral stones less than 10 mm and were evaluated between January and June 2020. The patients were classified into 3 groups: group (A) 30 patients: mirabegron 50 mg d⁻¹ + diclofenac Na 100 mg tab (to be taken only during colic episodes), group (B) 30 patients: tamsulosin HCL 0.4 mg cap + diclofenac Na 100 mg tab (to be taken only during colic episodes), and group (C) 30 patients: diclofenac Na 100 mg tab only (to be taken only during colic episodes). Age, sex, stone size, laterality, and grade of ureterohydronephrosis were recorded. Patients were observed for 30 days, and ureteroscopy was completed for those with nonexpulsed stones. Follow-up parameters included number of renal colic episodes, duration of medical therapy, stone expulsion time, and stone expulsion rate (SER). <b><i>Results:</i></b> In the group (A), 2 (6.6%) patients were excluded due to nasal congestion, and 1 (3.3%) patient was excluded due to a 20-mm Hg systolic blood pressure increase. Four (13.3%) patients in group (B) were noncompliant on medical treatment. In addition, 2 (6.6%) patients in group (A), 1 (3.3%) patient in group (B), and 5 (16.6%) patients in group (C) who did not attend follow-up examinations were excluded from the study. The SER increased significantly in group (A) and (B) when compared with group (C). The mean time of stone expulsion was about 15, 25, and 12 days for groups A, B, and C, respectively, and there was a significant statistical difference (<i>p</i> value = 0.006) among the 3 groups. The mean number of renal colic episodes of group (A) of patients was 1.8 times, while that of group (B) was 2.6 times and that of group (C) was 2.16 times with no significant statistical difference after comparing the 3 groups (<i>p</i> value = 0.660). <b><i>Conclusions:</i></b> Treatment with mirabegron appears to be a safe and effective medical expulsion therapy for distal ureteric stones and is better than tamsulosin.

INTRODUCTION:Reported complication rates from the Y-V glanuloplasty modification to the Mathieu technique have varied and may be related, at least in part, to inconsistent use of the recommended stent. The purposes of the present investigation were to: (1) describe the intraoperative and postoperative complications associated with the Y-V glanuloplasty modification, and (2) compare results from patients receiving a stent with patients not receiving a stent. METHODS:A total of 56 patients with distal hypospadias were included in this prospective study. Their mean age was 4.5 years (range, 3-8 years). All patients had a Y-V glanuloplasty modified Mathieu technique. They were randomly divided into 2 groups: group 1 (n = 30) had surgery without a urethral stent; group 2 (n = 26) had surgery with insertion of a 10 Fr urethral catheter (Nelaton draining catheter) down to the bladder. The stent was removed 5 days postoperatively. Follow-up evaluation occurred 5-7 days after surgery and then monthly for 12 months and every 3 months for 2 years. Complications were recorded at each visit and compared between groups. RESULTS:A total of 13 patients (43%) in group 1 (without a stent) had complications that included dysuria (n = 10), edema of the glans that resolved after a few days (n = 2), and secondary bleeding due to severe infection and rupture of the flap that required reoperation (n = 1). A total of 7 patients (27%) in group 2 (with a stent) had complications. After removal of the stent, 4 patients had urgency and 3 patients had dysuria that disappeared after few days. None of the patients with a stent had infection or edema of the glans. At the end of the follow-up period, all patients in both groups were in good condition, with the neomeatus located at the tip of the glans.There were no long-term complications. CONCLUSIONS: Y-V glanuloplasty modified Mathieu technique with meticulous subcuticular sutures has a high success rate and is suitable for distal hypospadias. Based on our results and those of previous studies, we do not recommend a catheterless technique. UroToday International Journal ® UI J

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