Impact of vasectomy on the sexual satisfaction of couples: experience from a specialized clinic.

Introduction: Vasectomy is the simplest, safest, and most effective form of definitive fertility control in men [1]. Vasectomy is used for 10% of contraception worldwide but only for 2% in Germany [2]. The aim of this study was to investigate the impact of vasectomy on the sexual satisfaction of sterilized men and their partners.

Glandular resection and central embedding in hypospadias repair--a novel modification of the Barcat technique.

Purpose: Urethrocutaneous fistula and urethral or meatal stricture, to date, remain the commonest complications of hypospadias repair, with increased tissue tension being a major cause of failure. We developed a novel technique comprising glandular resection and central embedding of the neourethra to specifically address this critical issue. We report the results of the first 112 procedures, of which 7 cases were a secondary hypospadias repair.

[Patients' acceptance of urinary diversion. The pouch of Sisyphus].

It is important that any patient with a urinary diversion can accept the psychological impact alongside the surgical and physical aspects. However, there are currently no validated methods or instruments available to allow direct measurement of this phenomenon in these patients. Health-related quality of life (HRQoL) is often high following different types of urinary diversion-this may suggest a high acceptance level and thus may act as a secondary end point.

Animal models in urinary diversion.

We set out to critically assess the value of animal experimentation in urinary diversion through intestinal segments, as some authors question the effectiveness of animal research, criticising the methodological quality, lack of standardization, inadequate reporting and the few systematic reviews in this field. Based on a comprehensive MEDLINE literature search (MeSH database; search terms: urinary diversion, urinary reservoirs, continent, rat, dog, animal models) we retrieved and evaluated all full-length papers published in English, German, French, and Spanish languages from 1966 to 2011 reporting the use of animal models in the setting of urinary diversion. Studies were stratified according to the addressed research question.

The efferent segment in continent cutaneous urinary diversion: a comprehensive review of the literature.

Objective: To critically assess the biophysical properties and current status of outlet formation in heterotopic intestinal urinary diversion. As despite three decades of clinical experience with continent cutaneous urinary diversion through bowel segments, no consensus has been reached for the optimal efferent segment although its function largely determines patient satisfaction.

Methods: A comprehensive Medline literature search using the Medical Subject Headings database (search terms: continent urinary diversion followed by either efferent segment, nipple, Mitrofanoff, Yang-Monti, Benchekroun, tapered ileum, intussuscepted ileum, Kock pouch, T-valve, or Ghonheim) was conducted to identify all full-length original articles addressing the various principles and techniques of outlet formation as well as their outcomes and complications.

Long-term results of a staged approach: continent urinary diversion in preparation for renal transplantation.

Purpose: We provide the long-term results of renal transplantation into continent urinary intestinal reservoirs as a planned 2-stage procedure.

Materials And Methods: Between November 1990 and January 2009, 18 patients underwent cadaveric or living related renal transplantation into continent urinary reservoirs (continent cutaneous diversion 16, orthotopic substitution 2). All patients were prospectively followed.

Urological complications of laparoscopic inguinal hernia repair: a case series.

Objectives: To illustrate urological complications of laparoscopic inguinal hernia repair and discuss their management.

Patients: Between April 2002 and February 2004, four men (aged 38-63 years) were treated for serious complications 2 days to 11 years after unilateral (1 patient) or bilateral (3 patients) laparoscopic inguinal hernioplasty.

Results: In all cases (extra and intraperitoneal bladder injury, purulent urocystitis due to mesh-erosion of the bladder, secondary retroperitoneal fibrosis) open revision with complete drainage of the urinary tract was chosen as an efficacious therapeutic strategy.

Long-term outcome of patients with high-risk prostate cancer following radical prostatectomy and stage-dependent adjuvant androgen deprivation.

Purpose: To present the long-term outcome of high-risk prostate cancer patients treated by radical retropubic prostatectomy (RRP) and stage-dependent adjuvant androgen deprivation therapy.

Patients And Methods: Between 1989 and 2005, 2,655 patients underwent RRP by 9 surgeons. All cases (n = 372) with high-risk prostate cancer (serum PSA >20 ng/ml, and/or clinical stage T2c or greater, and/or biopsy Gleason score 8 or greater) were identified and analyzed retrospectively.

The worst case: giant exulcerating seminoma.

Ten years after his brother had been treated for seminoma, a 36-year-old male presented with a giant exulcerating mass involving the right testis and both inguinal regions. Subsequent biopsy revealed pure seminoma. Staging computed tomography (CT) showed bulky retroperitoneal and pelvic lymph node metastases.

Nosocomial outbreak of VIM-2 metallo-β-lactamase-producing Pseudomonas aeruginosa associated with retrograde urography.

Pseudomonas aeruginosa is well adapted to the hospital setting and can cause a wide array of nosocomial infections that occasionally culminate in recalcitrant outbreaks. In the present study, we describe the first nosocomial outbreak of infection caused by bla(VIM-2)-positive P. aeruginosa in Germany.

Reactive antibodies against bacillus Calmette-Guerin heat-shock protein-65 potentially predict the outcome of immunotherapy for high-grade transitional cell carcinoma of the bladder.

Background: Intravesical immunotherapy with Mycobacterium bovis (M. bovis) bacillus Calmette-Guerin (BCG) is the current standard of care against superficial, high-grade transitional cell carcinoma (TCC) of the urinary bladder (carcinoma in situ and pathologic T1, grade 3 disease). However, individual patient outcome is barely predictable because of the lack of serum markers.

15 years of continent urinary diversion and enterocystoplasty in children and adolescents: the Würzburg experience.

Objective: To assess the long-term results of continent urinary diversion (CUD) and enterocystoplasty (ECP) in children with irreversible lower urinary tract dysfunction (LUTD).

Patients And Methods: The study included 44 children with irreversible LUTD who had a CUD or ECP between 1992 and 2007. Patients were followed for the functional outcome of surgery with a focus on complications related to the reservoir, bowel, uretero-intestinal anastomosis and upper urinary tract.

Testis-sparing surgery versus radical orchiectomy in patients with Leydig cell tumors.

Objectives: To compare retrospectively the outcome of testis-sparing surgery (TSS) to radical orchiectomy (RO) in patients with Leydig cell tumor (LCT).

Methods: Between 1992 and 2008, 16 patients with LCT of the testis were identified. All but 1 tumor could be detected by ultrasonography.

Metanephric adenoma in a two-year-old child.

Metanephric adenomas in children are very rare. We present the case of a 2-year-old girl with a mass of the left kidney. The lesion was completely removed by nephron-sparing surgery.

[Rational imaging in locally advanced prostate cancer].

Prostate cancer is one of the principal medical problems facing the male population in developed countries with an increasing need for sophisticated imaging techniques and risk-adapted treatment options. This article presents an overview of the current imaging procedures in the diagnosis of locally advanced prostate cancer. Apart from conventional gray-scale transrectal ultrasound (TRUS) as the most frequently used primary imaging modality we describe computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET).

[MRI after renal transplantation with dysfunctional allograft: are there typical diagnoses in the early and late postoperative phases?].

Purpose: The aim of this study was to evaluate the different MRI diagnoses in the early and late post-operative period after renal transplantation with dysfunctional allograft.

Materials And Methods: Due to unknown transplant dysfunction, 49 patients (30-male, 19 female) received a total of 74 MRI studies. According to the date of examination all MRI studies were divided in an early (< or = 60 days, ETP) and a late post-transplant time period (> 60 days, LTP).

[Overview and evolving strategies of ventral hernia repair].

Incisional hernias occur in 5-10% of patients who have undergone laparotomy and are associated with high morbidity and significant socioeconomic costs. Techniques for reinforcing and/or replacing the abdominal wall with alloplastic meshes have reduced the recurrence rate in comparison to suture techniques from about 40% to less than 10%. A number of mesh types and surgical repair procedures are available, namely the onlay, inlay, sublay, underlay, and intraperitoneal onlay mesh (IPOM) techniques.

Solitary schwannoma of the glans penis.

Schwannomas of the penis are extremely rare. A 69-year-old man presented with a circumscribed asymptomatic tumor on the dorsum of the glans penis. Histopathologic examination of the surgical specimen showed a benign schwannoma.

Is there any evidence that one continent diversion is any better than any other or than ileal conduit?

Purpose Of Review: There is an obvious discrepancy between the perceived advantages of the different forms of continent urinary diversion from an expert's point of view and the limited utilization of these techniques outside of academic and tertiary referral centers.

Recent Findings: The vast majority of studies are retrospective with numerous confounding factors and often poorly defined outcomes. The rates of postoperative morbidity and need for reoperation varies widely among studies, even for the same procedure.