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We evaluate quality of life and sexual function before and after transobturator tape procedure (TOT) using the International Consultation on Incontinence Questionnaire (ICIQ -SF) and Female Sexual Function Index (FSFI). Between 2008 and 2013, 92 patients with stress urinary incontinence (SUI) underwent TOT procedure. A total of 81 patients were sexual active and enrolled in the study. All patients completed the Turkish translation ICIQ -SF and FSFI forms before and 1, 3, 6, 12 months after surgery. To evaluate the impact of incontinence and TOT success on sexual function, we compared patients that were dry after surgery and patients still incontinent and/or facing complication. All 81 patients completed the study protocol. The total FSFI score was 21.3 ± 7.9 and statistically significant when compare with preoperative total FSFI score (16.2 ± 7.9). The mean postoperative ICIQ -SF score (2 ± 2.9) was also significantly lower than the mean preoperative ICIQ -SF score (17.3 ± 1.8). Complications were encountered in 13 patients, including vaginal erosion (4 patients), de novo urge incontinence (4 patients), vesico-vaginal fistula (1 case), cysto-rectocele (1 case) and high postoperative residue requiring mesh excision (3 patients). Continent (n = 68) patients had a significantly better postoperative total FSFI and ICIQ -SF score against patients who had urine loss. Our study found a significant improvement of FSFI score and ICIQ -SF score after TOT operation in women with SUI. Additionally, urine loss due to complications was related with worsened FSFI score and ICIQ score compare with healthy patient's scores.

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OBJECTIVES: To examine the relationship between premature ejaculation and plasma melatonin levels, and assess the efficacy of selective serotonin reuptake inhibitors in treating premature ejaculation. METHODS: A total of 60 men with lifelong premature ejaculation and 40 healthy male controls were included in the present study. For each participant, a medical history was obtained, a physical examination was carried out, and intravaginal ejaculation latency time and melatonin levels were measured. Premature ejaculation patients were randomly categorized into three treatment groups: group 1 received fluoxetine (20 mg/day), group 2 received paroxetine (20 mg/day) and group 3 received sertraline (50 mg/day). RESULTS: The mean baseline plasma melatonin levels in men with premature ejaculation were significantly lower than in the healthy controls (5.34 vs 14.84 pg/mL). After 4 weeks of treatment, the mean intravaginal ejaculation latency time scores for all of the premature ejaculation treatment groups showed a significant improvement from the baseline values. The plasma melatonin levels were also significantly increased (P < 0.05) from baseline (5.34 pg/mL) to 9.50 pg/mL, 10.24 pg/mL or 13.30 pg/mL for groups 1, 2 and 3, respectively. CONCLUSIONS: Our findings show that premature ejaculation is associated with decreased plasma melatonin levels. After treatment with selective serotonin reuptake inhibitors, an increased plasma melatonin level can retard ejaculation, presumably by both central and peripheral mechanisms. This is the first study to evaluate the possible role of serotoninergic interactions on the melatoninergic system in premature ejaculation.

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BACKGROUND AND PURPOSE: Ureteroscopic intracorporeal lithotripsy for solitary distal-ureteral stones may be considered a first-line therapy. However, few reports that mention ureteroscopic procedures for multiple ureteral stones were found in the literature. Retrospectively, we reviewed our patients who were treated by ureteroscopy for multiple distal-ureteral stones. PATIENTS AND METHODS: Fifteen patients underwent ureteroscopic pneumatic lithotripsy for unilateral multiple distal-ureteral stones. Ten patients had two stones, four patients had three stones, and another patient had five stones. The average stone number per ureteral unit was 2.44, and the average stone size was 9.7 mm (range 3-23 mm). RESULTS: Eighty percent of the patients (12/15) who had unilateral stones were stone free after the first session of ureteroscopic pneumatic lithotripsy. Two patients underwent a second ureteroscopy procedure for the remaining stone or failure of ureteral access. Overall, 93.3% of the patients (14/15) were stone free. Ureteral perforation as a major complication occurred in one patient (6.6%), who was treated by open surgery. We did not routinely use Double-J ureteral stents after ureteroscopy. Only one patient required stenting because of failure of ureteral access. Steinstrasse was observed in three patients, but it resolved spontaneously in the early postoperative period. CONCLUSION: Ureteroscopic pneumatic lithotripsy has a high success rate with few complications for the treatment of unilateral multiple distal-ureteral stones. Ureteroscopic pneumatic lithotripsy seems very effective for such stones.

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