Objective:To discuss the effect of simultaneous implantation of artificial cavernous body and urethral sphincter for severe erectile dysfunction and urinary incontinence after traumatic posterior urethral stricture.Methods:A retrospective analysis was performed on 3 patients with traumatic posterior urethral stricture admitted to the Southern Theater General Hospital from January 2021 to December 2022, aged 42, 32, 28 years old, all of whom suffered pelvic fracture and posterior urethral stricture after trauma. Patient 2 were missing left lower limb and patient 3 were missing right lower limb, all of whom had dysuria. Preoperative cystourethrography indicated posterior urethral stricture with a length of 2, 2, 3 cm, respectively. No erectile response and severe erectile dysfunction were reported in penile nocturnal erectile function tests. Posterior urethral stricture was cured by end-to-end anastomosis surgery. After urethral stricture was cured, the nighttime erectile function test indicated severe erectile dysfunction and diagnosed erectile dysfunction and urinary incontinence. After 3 months of continuous administration of sildenafil and/or tadalafil, the erectile dysfunction did not improve, and the score of the international erectile function test was 1, 2, 2 points. Severe erectile dysfunction. The urine could not be controlled, the number of urine pads per day was 6, 6, 8, respectively, and pelvic floor rehabilitation training was adopted for urinary incontinence. 6 months later, urodynamic examination indicated severe stress incontinence, and the urine pad test was 30g, 32g, and 82g per hour. Patients were fully informed of the surgical risks before surgery. Simultaneous implantation of artificial penile cavernous body and artificial urethral sphincter were performed after full preoperative preparation: General anesthesia, supine frog position with transverse incision in upper scrotum, the urethra was separated and the artificial urethral sphincter cuff was easily inserted into the upper scrotum. Then the left and right sides of the penis cavernous sinus were dilated and the length of the cavernous body was measured. Suitable artificial penis cavernous body was implanted, water sacs were placed in the posterior pubic space and the anterior vesical space, and the tubes were connected. The erectile switch was placed under the scrotum, and the incision was closed after repeated testing of urine control and normal erectile function.Results:Three cases were successfully completed. The simultaneous implantation time of artificial cavernous body and artificial urethral sphincter was 270, 260, 240 min, respectively. The catheter was removed 1 week after surgery, and the erection switch was trained 2 weeks after surgery, and full erection was achieved after 1 week. The urine control switch was activated 6 weeks after surgery, and urine control was normal without urine pad. Following up for 12 to 18 months, 2 cases had normal erections and urinary control, 1 case had urethral corrosion 2 months after surgery, the original artificial sphincter was removed completely and a new artificial urethral sphincter was implanted in the same period, the operation was successful, and the follow-up was 1 year, urine control and erectile function returned to normal.Conclusions:For the severe erectile dysfunction and severe urinary incontinence after traumatic posterior urethral stricture, simultaneous implantation of artificial penile cavernous body and artificial urethral sphincter could be alternative choice.

Objective To explore the clinical effect of inlay labial mucosa graft urethroplasty (LMGU) forⅠperiod in the complexity hypospadias.Methods According to the digital table,30 patients with complexity hypospadias were randomly divided into control group and observation group,15 cases in each group.The control group took Ⅰ period operation.The observation group received surgery by stages to complete.Routine urinary diversion during operation was performed after bladder puncture and ostomy,and in the control group,the urethra was placed with self-made 10-14F lateral hole silica gel stent,which was extracted out in the middle of the perineum,left or right.After 12-14d removal postoperative,the urination was observed.The catheter in the observation group was removed after 10 d,the urethroplasty is performed 6 months later.The clinical effects of the two groups were compared.Results In the control group,postoperative urinary fistula in 2 cases(13.3%),urethral orifice in 1 case(6.7%).In the observation group,postoperative urinary fistula in 2 cases(13.3%),6 months postoperatively in patients with urinary fistula to repair fistula was successful,urethral mouth narrow pure line incision.The incidence rate of complication of the control group was 20.0%,which of the observation group was 13.3%,the difference was not significant between the two groups(P>0.05).All cases were followed up for 1 to 2 years,did not occur urinary tract stones,hair growth,oral ulcers,such as the limited mouth complications.The penis was straight,beautiful shape.Conclusion Inlay LMGU Ⅰperiod is suitable for multiple surgery led to the lack of local incidence,urethral plate dysplasia and with severe penis abnormalities such as complexity in patients with hypospadias.The postoperative complications,micturition,penile appearance have no obvious differences compared with the stage,it is worthy of clinical popularization and application.

Objective To summarize experience to prevent the main postoperative complications after hypospadias repairs. Method The clinical data of 189 cases of hypospadias repairs was from May 2005 to August 2010,retrospectively analyzed. Results One hundred and seventy-four cases were surgically cured by single-stage operation. All cases had been followed up for 4-36 (18.5 ± 5.5) months, the cases who had become adults were normal penile development and erectile function. Postoperative complications occurred in 15 cases,9 cases of them were urethral fistulas,6 cases were urethral strictures,all were cured or improved after symptomatic treatments. Conclusions Some methods are necessary to raise single-stage urethroplasty success rate and decrease the incidence of fistulas and strictures, such as preoperative antibiotic prophylaxis,appropriate procedure,intraoperative suprapublic urinary diversion,the good blood supply of the flap, modified enswathement, postoperative manage and nursing.

Objective To summarize the success of congenital penile curvature. Methods 401 cases of con-genital penile curvature,whose average age is 2. 5 years ,ranging from 1 year to 26 years old. Of all cases ,383 patients who have both hypespadias and penile cun, ature, only 18 patients are congenital penile curvatures. 295 paitents are slight curvature,85 patients are moderate curvature and 21 patients are severe curvature. Curvature correction was per-formed on a case-by-case basis by solution fibric trabs of ventrial urethra and surrounding,skin de-gloving, ff necessa-ry,dorsal plication,and confirmed by Gittes test. Results . Curvature correction was possible by mobilization of ure-thra after penile degloviag,only a few need dorsal plieation. Followup for 6 months to 2 years,396 patients are success at once. The others after a second surgery had 100% success. Conclusions Solution fibrie trabs of ventrial urethra and surrounding, skin de-gloving, if necessary,dorsal plication ,is the first choice to repair of the congenital penile cur-vature and have good results.

Objective To improve the success of the urethral stricture repair in males. Methods Chose 101 males of urethral stricture,their median age was 9 years old (range 3 to 57 years old). Of the patients,61 patients had anterior urethral stricture and the posterior urethral stricture occurred in 40 patients. The length of the stricture varied from 0.5 to 2.0 cm. All patients were repaired with the only genital flap suturing the strictural urethra. Results All repairs were completed in 1 stage, follow-up was from 12 to 18 months, excepted for patients with 3 fistula and 3 urethral stricture, 95 patients were voiding a straight stream, the other 6 patients need another surgery. Conclusion It is a good technique to treat urethral stricture with genital flap ff there is short urethral stricture with sufficient genital skin.

Objective To discuss the treatment of urethral stricture after hypospadias reDair.Methods Thirty-seven cases of urethral stricture after hypospadias repair from 1999 to 2006 were ret-rospectively analyzed. Of 37 patients,the stricture was located at the distal end of urethra in 7 cases.There were 3 1 cases with anastomotic stricture.There was 1 case with distal urethral stricture and anastomotic structure.There were 1 3 patients with the simple urethral stricture and the complicated 24 cases.Of 13 simple urethral stricture patients,4 patients were repaired with urethro-meatomy,6 patients with shelf operation and 3 patients with transurethral holmium laser urethrotomy.Eight Pa-tients with complicated urethral fistula,6 patients with urethral diverticula,4 patients with phallo-campsis and 6 patients with many times of postoperative urethral stricture were repaired with shelf op-eration or penis skin flap or septum of scrotum skin flaps urethroplasty. Results The simple stric-tures of 1 2 patients were cured by stage 1 operation,the other one cured after second surgery.Of 8 patients with fistula,7 were cured at stage 1,the other one was cured at the stage 2.Of 6 patients with diverticulum,all were cured at stage 1.Of 4 patients with phallocampsis,3 cases were cured at stage 1,the other one was cured at the stage 2.Of 6 patients with recurrent strictures,all were cured at stage 1.A1l patients were followed up 1 2 to 24 months.The micturition was without difficuItv at stand position. Conclusions Urethral stricture is one of the most common complications after hypos-padias repair.The simple urethral stricture could be repaired with urethro-meatomy or sheIf operation or transurethral holmium laser urethrotomy.The complicated urethral stricture could be reDaired with shelf operation or penis skin flaps or septum of scrotum skin flaps urethroplasty and overjetted with dortos of scrotum flaps.

Objective To investigate the use and effect of dorsal dartos flap wrapping technique in complicated hypospadias fistulas repairs. Methods In the experimental group, the closed fistulas were wrapped with transferred dorsal dartos flap in the 32 cases of complicated hypospadias fistulas from March 2004 to January 2008. In the control group, the routine fistulas repairs were preformed in the 50 cases of complicated hypospadias fistulas from January 1998 to February 2004 . Results All cases had been followed up for 3 - 12 months, there were no fistula in the experimental group. There were 6 fistulas in the control group. There was significant difference between two groups (P<0.05). Conclusions The use of the technique can prevent urethrocutaneous fistulas after complicated hypospadias fistulas repairs, the fistulas rate are reduced for all cases combined. The technique would be the optimal repair for complicated hypospa-dias fistulas.

OBJECTIVETo evaluate the efficacy and safety of intraprostatic injection of Chuanshentong in the treatment of chronic abacterial prostatitis/chronic pelvic pain syndrome(CAP/CPPS).

METHODSRandomized, double blinded, placebo controlled trials were carried out from September 2002 to March 2003. A total of 38 patients with diagnosed CAP/CPPS, 24 experimental and 14 controls, were analyzed. In the trial group, 6 ml of mixed solution of Chuanshentong and lidocaine was transperineally injected into one lobe of the prostate, once a day for 6 days. Likewise, the control group was treated with placebo containing lidocaine. The efficacy was evaluated by the NIH Chronic Prostatitis Symptom Index(CPSI) after a 6-week follow-up. The main semen parameters before and after 3-month treatment were compared.

RESULTSIn the trial group, 13 cases (56.5%) were completely cured, 5 cases(21.7%) showed remarkable effect, and 4 cases (17.4%) were improved. While in the control group, effectiveness was shown in only 2 cases (15.4%), and improvement in 3 cases (23%). CPSI scores decreased significantly after treatment(95% of confidence interval: 17.97-23.08). Chuanshentong solution had no obvious impact on the main semen parameters. No severe adverse effects were observed.

CONCLUSIONTransperineal intraprostatic injection of Chuanshentong is a safe and effective method for the treatment of CAP/CPPS.

Adult ; Chronic Disease ; Double-Blind Method ; Drugs, Chinese Herbal ; adverse effects ; therapeutic use ; Humans ; Injections ; Male ; Middle Aged ; Pelvic Pain ; drug therapy ; Prostatitis ; drug therapy

Objective To study the treatment of middle and lower ureteral stone with polyp by pneumatic lithotripter under ureterscopy. Methods 56 cases of middle and lower ureteral stone with polyp treated from Feb-ruary 2000 to August 2002 were retrospectively analyzed. Results All patients were successfully operated on and no complication occurred. Conclusions Middle and lower ureteral stone with polyp can be treated by pneumatic lithotripter under ureterscopy.

Objective To study the management of Fournier's gangrene.Methods Data of 9 patients were reviewed retrospectively and were discussed according to the treatment,and outcome.U-shaped stents with poly hole and two-end drainage were used in 4 cases in whom the infection was spread along the penis,into the scrotum,up to the abdominal wall and into the perineum.Results We have treated 9 cases in the last 21 years.The patients received surgical treatment including incisions,aggressive debridement,drainage,irrigation,and antibiotic therapy.Left uncovered,the testes were protected in either a thigh or abdominal wall pouch and back in the scrotum resconstructed later with a myocutaneous medial thigh flap.When U-shaped stents was used,redunant debriding was no more necessary.The temperature and hemogram regain quickly,and the average hospitalization days decreased to 14 days.Conclusions Aggressive debridement and broad-spectrum antibiotics remain the hallmarks of treatment.Orchidectomy was erroneously part of the treatment of Fournier's gangrene.The remarkable draining effect of U-shaped stents could promote tissue healing.