Penile fracture is a rare urological emergency that may cause erectile dysfunction (ED). We analyzed the factors affecting erectile function in patients who underwent surgical repair for the management of penile fractures. Eighty-two patients who underwent penile fracture surgery in the Department of Urology, University of Gaziantep (Gaziantep, Türkiye) between January 2012 and January 2023 were evaluated. Age, body mass index, time elapsed from the incident of penile fracture to surgery, size, laterality, level of the defect, causes of fracture, presenting signs and symptoms, and relevant complications were recorded. Erectile function of the patients was evaluated preoperatively and at postoperative 3 rd and 6 th months according to the International Index of Erectile Function-5 (IIEF-5) scoring system. The factors decreasing the erection quality of the patients after surgical repair of penile fractures were investigated using IIEF-5 scoring system. Only age, defect size, and time elapsed from fracture onset to surgery were found to be effective on the occurrence of ED ( P = 0.005, P < 0.001, and P < 0.001, respectively). In the receiver operating characteristic (ROC) analysis, the cut-off values were 12.5 mm for defect size ( P < 0.001), 8.5 h for the time elapsed from fracture onset to surgery ( P = 0.036), and 40.5 years for the age of the patients ( P = 0.005). Delayed surgery, defect size, and advanced age had significant and negative effects on erectile function in cases of penile fracture. Before repair of the defect, patients should be given appropriate counseling about the possibility of ED, and early penile rehabilitation should be initiated.
Humans ; Male ; Erectile Dysfunction/epidemiology* ; Penis/surgery* ; Adult ; Middle Aged ; Risk Factors ; Postoperative Complications/etiology* ; Young Adult ; Rupture/surgery* ; Age Factors ; Aged ; Penile Erection ; Retrospective Studies

PURPOSE: To assess the reliability of percutaneous nephrolithotomy (PNL) in pediatric patients by comparing complications between pediatric patients and adults by use of the modified Clavien grading system. MATERIALS AND METHODS: The data of 74 pediatric (0 to 16 years) and 535 adult (17 years and older) patients who underwent PNL owing to kidney stone disease between January 2005 and December 2011 were analyzed retrospectively. The complications in the pediatric and adult patients were classified in five grades according to the modified Clavien system. RESULTS: The most frequent cause of grade I complications was fever requiring antipyretics, which was seen in 4 pediatric patients (5.4%) and 30 adult patients (5.6%). Grade II complications (blood transfusions, <12 hours urinary leakage) were observed in 11 pediatric patients (14.8%) and 80 adult patients (14.9%). Grade III complications were also seen in 6 pediatric patients (8.1%) (grade IIIb; D-J catheter implantation under general anesthesia) and 78 adult patients (14.5%) (grade IIIa; D-J catheter implantation and angio-embolization under local anesthesia). There was no statistically significant difference between the two groups in terms of grade I, II, or III complications (p>0.05). Colonic injury occured in one patient (1.3%) in the pediatric group (grade IVa). In the adult group, one patient (0.2%) died as the result of myocardial infarction (grade V). CONCLUSIONS: Thanks to technological developments and minimalization of the equipment used, when indicated, pediatric patients can be safely treated with PNL with low complication rates similar to those in adult patients.
Adult ; Antipyretics ; Catheters ; Colon ; Fever ; Humans ; Kidney Calculi ; Myocardial Infarction ; Nephrolithiasis ; Nephrostomy, Percutaneous ; Retrospective Studies

PURPOSE: We aimed to analyze the changes in kidney function during the postoperative early period caused by the application of percutaneous nephrolithotomy (PNL), which is commonly used in kidney stone surgery. MATERIALS AND METHODS: PNL was performed in 80 patients (48 men, 32 women) with kidney stones. The mean age of the patients was 43.71 years (range, 18 to 71 years). Preoperative and postoperative values for stone size, glomerular filtration rate (GFR), serum creatinine, urea, electrolytes (Na, K, Cl), and Hb were compared in 80 patients in whom PNL surgery was performed. The formula of Cockroft-Gault was used to calculate the GFR during the early postoperative period (72 to 96 hours). RESULTS: Statistically significant decreases after PNL were observed in average stone size (preoperative, 627.75+/-375.10 mm2; postoperative, 81.70+/-16.15 mm2), serum urea (preoperative, 38.40+/-17.26 mg/dl; postoperative, 33.28+/-16.98 mg/dl), and creatinine (preoperative, 1.03+/-0.53 mg/dl; postoperative, 0.97+/-0.55 mg/dl) and an increase was observed in GFR (preoperative, 104.30+/-37.30 ml/min; postoperative, 112.38+/-40.1 ml/min). No changes were detected in the serum electrolyte values (Na, K, Cl). Multiple access, operation time, and type of lithotripter did not have any significant effects on the change in the GFR. CONCLUSIONS: In light of our results, PNL for kidney stone operations appears to be a reliable and efficient method that provides recovery of kidney functions in the early post-operative period by increasing the GFR and with high stone-free rates.
Creatinine ; Electrolytes ; Glomerular Filtration Rate ; Humans ; Kidney ; Kidney Calculi ; Light ; Male ; Nephrolithiasis ; Nephrostomy, Percutaneous ; Postoperative Period ; Urea