PurposeTo stratify complications of percutaneous nephrolithotomy (PCNL) in a single, tertiary hospital by use of the modified Clavien system.Materials and MethodsFrom May 1987 to December 2010, 1,236 cases of PCNL were performed at our institute. Medical records were available for 826 cases of PCNL from 698 patients, from February 1995 to December 2010. Using multiple factors, we retrospectively reviewed and analyzed 698 patients for complication rates classified by the modified Clavien grading system, along with success rates.ResultsIn 698 patients, staghorn stone patients accounted for 33.8% (236 patients). Initial and overall stone-free rates were 69.9% and 88.8%. A total of 297 complications were documented in 282 patients. According to the modified Clavien classification, grade I, II, IIIa, IIIb, IVa, IVb, and V complications were observed in 88 (12.6%), 145 (20.8%), 31 (4.4%), 5 (0.7%), 6 (0.9%), 4 (0.6%), and 3 (0.4%) patients, respectively. Transient peri-nephrostomy catheter urine leakage (15.2%) was the most common complication, followed by transient fever >38° (11%) and transfusion (6.9%). Other individual complications occurred in less than 1.5% of cases. In patients with staghorn stones, grade I, II, IIIb, and IVa complications were significantly more common, and all grade IVb and V complications occurred in patients with staghorn stones.ConclusionsThe modified Clavien classification provides a standardized grading system for complications of PCNL, although consensus on specific complications would prompt better comparison between centers. A shorter operation time is imperative to achieve less bleeding. Previous stone-related fever and staghorn stones are significant contributing factors for developing postoperative fever.

Various postoperative complications have been reported after the use of tension-free vaginal tapes (TVT). The transobturator approach was introduced to minimize the potential complications. The next generation of recently introduced TVT-SECUR is intended to minimize the incidence of complications. Herein we report a case of internal pudendal artery injury sustained during this procedure that was successfully treated by radiological embolization. Angiography with vessel embolization, when available, should be considered when the arterial injury is suspected.

= Abstract =Purpose: The aim of this study was to investigate the effects of new herbal formula (KBMSI-1) on erectile dysfunction in streptozotocin-induced diabetic rat model. Materials and Methods:We used male Sprague-Dawley rats aged 12 weeks and divided into three groups; control (n=8), diabetes (DM) (n=8), DM＋KBMSI-1 200 mg/kg treatment (n=8) groups. The DM groups received a single intraperitoneal injection of streptozotocin (STZ). Distilled water was administered in the control and DM group. To investigate the penile erection, intracavernosal pressure (ICP) and intracavernosal pressure/mean arterial pressure (ICP/MAP) were recorded in all groups. Serial sections of the penis were used to perform Masson's trichrome stain. We analyzed the expression of nNOS and eNOS concentration in the isolated corpus cavernosum by western blotting.Results: Peak ICP/MAP ratio was markedly increased in the treatment group with KBMSI-1 compared with DM group (p＜0.05). Masson's trichrome staining of corpus cavernosum showed increase in smooth muscle volume and the regular arrangement of collagen fibers in KBMSI-1 treatment group compared with DM group. Western blot analysis revealed that the penile expressions of nNOS and eNOS protein were significantly higher in KBMSI-1-treated group than in DM group. Conclusions:This study showed that herbal formulation of KBMSI-1 enhances the penile erection and the level of eNOS and nNOS expression of penile corpus cavernosum in streptozotocin-induced diabetic rat model.

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