The CT attenuation value of renal calculi can help to differentiate stones that are likely to fragment easily on ESWL from those that would require a greater number of shock waves for fragmentation or may fail to fragment on ESWL.

These nomograms would help clinicians evaluate flow rates over a wide-range of voided volume as well as age, enabling effective screening of women for voiding dysfunction, and evaluating response to medical or surgical treatment.

PurposeComplications in hypospadias surgery are higher than other reconstructive procedures. The incidence of complications can be reduced if proper preventive measures are taken. The review aims to highlight incidences, causes, and preventive measures of acute complications of hypospadias repair.Materials and MethodsLiterature reports were reviewed in Pubmed by giving the key word acute complications of hypospadias repair, wound infection, wound dehiscence, flap necrosis, edema, penile torsion, urethral fistula, bleeding and hematoma and urethral stents problems. Summaries of all articles were reviewed with full text of relevant article and results were analyzed.ResultsBesides mentioning the complications of hypospadias repair in individual articles on the subject, we did not come across any separate article on this subject in the published English literature. Fistula is the commonest complication followed by edema and penile torsion.ConclusionsMost acute complications can be prevented with adherence to principles of plastic and microsurgery, meticulous preoperative planning, and judicious postoperative care. Deviation from these principles may lead to disaster and even failure of the repair. The aim in hypospadias surgery should be following these principles and bring down the complication rates < 5% in distal hypospadias and < 10% in proximal hypospadias.

Introduction Lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH) and erectile dysfunction are common disorders of advancing age. Aim To evaluate the efficacy and safety of tamsulosin and tadalafil in patients with LUTS due to BPH. Methods In this prospective randomized study, 133 men complaining of LUTS due to BPH were included. Forty-five patients received tamsulosin 0.4 mg/day alone (Group A), 44 patients received tadalafil 10 mg/day (Group B), and combination therapy (tamsulosin and tadalafil both) was instituted in 44 patients (Group C). After a 2-week medication free run-in period, they were evaluated for International Prostatic Symptom Score (IPSS), International Index of Erectile Function score (IIEF5), quality of life (IPSS QoL), maximum urinary flow rate (Qmax), post-void residual urine (PVR) volume, and safety parameters before and at 3 months of treatment. Main Outcome Measures There were primary (IPSS, IPSS QoL index, Qmax, and PVR) and secondary (erectile function [EF] domain scores from IIEF5) efficacy end points. Safety assessment included laboratory tests and patient's reporting of adverse event. Results A significant improvement in IPSS score was observed in all the 3 groups A, B, and C (−50.90%, P &lt; 0.05; −33.50%, P &lt; 0.05; and −53.90%, P &lt; 0.05, respectively). IIEF5 score increased significantly in these three groups (+39.28%, P &lt; 0.05; +45.96%, P &lt; 0.05; and +60.23%, P &lt; 0.05, respectively). A significant increase in Qmax and decrease in PVR were also observed (33.99%, P &lt; 0.05; 29.78%, P &lt; 0.05; and 37.04%, P &lt; 0.05) and (−60.90%, P &lt; 0.05; −49.45%, P &lt; 0.05; and −62.97%, P &lt; 0.05, respectively). The QoL scores improved significantly (−73.35%, P &lt; 0.05; −70.26%, P &lt; 0.05; and −79.65%, P &lt; 0.05, respectively). Side effects were dyspepsia, heartburn, headache, flushing, myalgia, and backache. Adverse effect dropout was 3.7%. No participant experienced any severe or serious adverse events. Conclusions In patients with LUTS due to BPH, tamsulosin and tadalafil alone or in combination cause a significant improvement in patients with LUTS. Their EF also improves with these medications. The improvement is better with combination therapy compared with single agent alone.

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