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A 72 -year- old male patient presented to the clinic complaining of mild dragging scrotal pain and hanging scrotum interfering with his daily activity. Clinical examination revealed grade three left varicocele, enlarged hanging scrotum for more than 15 cm from the scrotal neck. The scrotum was explored and left varicocelectomy was done then scrotoplasty. Fifteen months post-operatively patient has an excellent outcome.

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BACKGROUND: Sexually transmitted diseases (STDs) are one of the most serious diseases in the world. Our aim was to explore the knowledge and attitude about STDs among the youth. PATIENTS AND METHODS: This cross-sectional survey was conducted from August 1 to August 13, 2016. Male and female youth between 18 and 25 years were invited to participate in the survey using social media open to all Internet users consisting of questions and statements about STDs, and then the data were analyzed. RESULTS: We received 5040 responses to the survey; out of these participants 76.6% were females and 23.4% were males with a mean age 21.5 and most of them were single (85.1%). We noticed that most of the respondents selected the Internet (71.7%) as the main source of their knowledge about STDs followed by school, television, and others, respectively. In spite of, 94.08% knew that human immunodeficiency virus/AIDS is an STD, only 43.61% knew that herpes simplex virus is an STD, and only 31.03% knew that Chlamydia is an STD. A high percent (93.1%) agreed that sexual intercourse transmits STDs. Only 59.6% agreed that condom does not provide complete protection from STDs. To our surprise, only 55% considered themselves capable of protecting themselves against STDs. About 95.8% of the participants agreed that STDs should be taught in schools, while 4.2% disagreed. CONCLUSION: We noticed a lack of participant's knowledge regarding the types, mode of transmission, and the ways of protections from STDs and their desire to find out information about STDs. Hence, awareness programs about STDs should be started that aim at encouraging youth to follow our religion and culture.

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AIMS: To assess the effects of different doses and treatment durations of pregabalin and lamotrigine on the urodynamic parameters of an animal model of neurogenic detrusor overactivity (NDO). MATERIALS AND METHODS: Ninety rats were used; six as normal controls and the remaining 84 were divided as follows: Six "paraplegic controls," 6 "paraplegic-vehicle controls," and the remaining 72 divided into two equal groups. Group 1 was divided into six subgroups; pregabalin was given in doses of 10 mg/kg, 20 mg/kg, or 30 mg/kg for 1 or 2 weeks. Group 2 was similarly subdivided; lamotrigine was given in doses of 1.5 mg/kg, 3 mg/kg, or 6 mg/kg for 1 or 2 weeks. RESULTS: All paraplegic controls developed NDO within 3 weeks from spinalization. Their baseline bladder pressure (BBP) 19 ± 4.4 cmH(2) O, detrusor pressure at maximum capacity (DPMaxC) 47.6 ± 4.3 cmH(2) O, bladder capacity (BC) 0.45 ± 0.1 ml, and frequency of detrusor overactivity (FDO) 3.7 ± 0.9/min. Both pregabalin and lamotrigine produced significant improvement. Urodynamic values in those treated with 20 mg pregabalin for 1 or 2 weeks were: BBP 11.7 ± 1.3 and 9 ± 0.2 cmH(2) O, BC 0.6 ± 0.1 and 0.7 ± 0.01 ml, DPMaxC 17.3 ± 4.0 and 23 ± 2.6 cmH(2) O, FDO 2.1 ± 0.2/min and 1.7 ± 0.1/min. Urodynamic values in those treated with 3 mg/kg lamotrigine for 1 or 2 weeks were: BBP 9.7 ± 2.2 and 8.6 ± 1.9 cmH(2) O, DPMaxC 17.2 ± 1.8 and 29 ± 1.2 cmH(2) O, BC 0.7 ± 0.1 and 0.8 ± 0.1 ml, FDO 1.9 ± 0.2/min and 1.9 ± 0.2/min (P < 0.001). CONCLUSIONS: Pregabalin and lamotrigine may represent novel alternative treatments of NDO. Clinical trials remain to be performed.

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INTRODUCTION AND HYPOTHESIS: This literature review, providing reference ranges of normal variability in urodynamic parameters, is the second part of a two-part article. The first part addresses non-invasive urodynamics (UDS), while the second part addresses invasive techniques. METHODS: Data were obtained through MEDLINE from articles published between January 1956 and February 2011, International Continence Society meeting abstracts, and standardization reports. Search terms included cystometry, urethral pressure profilometry, leak point pressure, video UDS, normal volunteer, pressure flow studies, and electromyography. RESULTS: Normal values varied widely in the literature. However, with the help of clinical data, it was possible to define "normality" ranges for most of the different parameters. CONCLUSIONS: Urodynamic evaluation of lower urinary tract (LUT) function is not a physiological test. However, it is still the best available tool for LUT function assessment. Even if normality in UDS can be defined, tests must always be interpreted against patient characteristics, complaints, and symptoms.

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This study aims to provide reference ranges of normal variability in urodynamic parameters through literature review of normal urodynamic values in the literature. Data were obtained through MEDLINE from articles published between January 1956 and February 2011, International Continence Society meeting abstracts and standardization reports. Search terms included urodynamics, bladder diary, uroflowmetry, frequency volume charts, pad tests, normal control, and normal volunteer. Normal values varied widely in the literature. However, with the help of clinical data, it was possible to define "normality" ranges for most of the different parameters. Urodynamic evaluation of lower urinary tract (LUT) function is not a physiological test. However, it is still the best available tool to assess LUT function. Even if normality in urodynamics can be defined, tests must always be interpreted against patient characteristics, complaints, and symptoms.

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Suburethral slings have become the most commonly offered surgical procedure for the correction of stress urinary incontinence in women. Overcorrection of urethral angle or exaggerated applied tension may lead to urethral obstruction, causing complete urinary retention or obstructive voiding symptoms. Acute urinary retention usually indicates immediate surgical intervention. Conversely, obstructive voiding symptoms after a sling procedure require a more thorough evaluation to plan the most appropriate therapy. Different operative procedures ranging from urethrolysis to midline sling incision have been described with high success rates and a small risk of recurrent stress urinary incontinence.

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