Nonsomatic factors play a significant role in erectile dysfunction. We assessed the impact on men suffering from male factor infertility by employing the validated Self‐Esteem and Relationship questionnaire (SEAR) and compared the scores with controls. Men with primary infertility were asked to fill SEAR questionnaire. Normal fertile men visiting clinic for unrelated problem or normal male accompanying infertile patients constitute the control group. Transformed score of each domain and total score of SEAR questionnaire and means were compared. Data were analysed by R version 5.2. Univariate and multivariate analyses were done to determine factors predicting self‐esteem and total relationship score. There were 45 men each in the study and control groups. The mean transformed self‐esteem score and total score of infertile men were significantly lower as compared to controls (74.44 versus 95.83) and (73.54 versus 95.86) p‐value of <.0001. Longer duration of infertility, advanced age, diabetes and higher education were factors significantly lowering the scores on univariate analysis, and on multivariate analysis, diabetes was the only significant predictor of total SEAR score in infertile men. Infertility leads to lower self‐esteem, sexual performance and confidence among infertile men as compared to controls. The relationship score worsens with increasing duration of infertility.

Objective: To evaluate the impact of nephrostomy tube type on postoperative pain and blood loss following percutaneous nephrolithotomy (PCNL). Methods: This is a prospective non-randomized study performed at Aga Khan University Hospital from July 2017 to June 2018. In this study we prospectively studied adult patients (16 to 65 years) who underwent unilateral PCNL. Patients who had nephrostomy with balloon (12Fr Foley’s catheter) were compared with patients who had nephrostomy without balloon (12Fr Nelaton™ catheter). STONE Nephrolithometry score was used to assess the stone complexity. Mean pain score at six and 24 hours and mean hemoglobin drop at 24 hours was compared between two groups using independent sample t-test, p-value of <0.05 was considered significant. Results: Over one year, 198 PCNL were performed out of which 119 were included for analysis. Sixty-six had nephrostomy tube with balloon and 53 had nephrostomy tube without balloon. Mean STONE score (9.66±1.4 vs. 9.64±1.24) and operative time (72.84±28.34 vs. 86.05±32.1 minutes) was comparable. Mean postoperative pain score at 6 hours and 24 hours postoperative was significantly lower in balloon group as compared to without balloon group. Mean Hemoglobin drop was similar in both groups (p=0.60). Conclusion: The use of nephrostomy tube with balloon after PCNL as this is associated with less pain and comparable hemoglobin drop as compare to nephrostomy tube without balloon. doi: https://doi.org/10.12669/pjms.36.3.1558 How to cite this:Jamil S, Ather MH. The impact of post PCNL tube type on blood loss and postoperative pain. Pak J Med Sci. 2020;36(3):---------.  doi: https://doi.org/10.12669/pjms.36.3.1558 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Background Intravesical foreign bodies leading to bladder stone and renal insufficiency are rarely reported in literature. Case presentation We report a case of 18-year-old male who presented with renal insufficiency due to bladder outlet obstruction caused by bladder stone formed over electric wire that was self-inserted 1 year ago. We present the symptoms, imaging, diagnosis and treatment of unique complications due to self-insertion of intravesical foreign body. We performed the open vesicolithotomy uneventfully and patient sent for psychiatric evaluation. Our patient’s case was unique for several reasons i.e., inserted foreign body was electric wire, symptoms duration was not very long and it resulted in life threatening complication of renal failure. Conclusion There should be high index of suspicion in young patients with bladder foreign bodies presenting with lower urinary tract symptoms.