Pub Date : 2023-01-01DOI: 10.1080/2090598X.2022.2119711
Rickaz Abdul Raheem, Ahsen Razzaq, Victoria Beraud, Richard Menzies-Wilson, Rakan Odeh, Imoh Ibiok, Prashant Mulawkar, Henry Andrews, Iqbal Anjum, Khaled Hosny, Tom Leslie
Introduction: Multi-parametric magnetic resonance imaging (mp-MRI) is currently used to triage patients with suspected prostate cancer, before deciding on prostate biopsies. In our study, we evaluated normal and equivocal pre-biopsy mp-MRIs to see whether it is safe to avoid biopsy with such findings.
Methods: A retrospective study was conducted at a district general hospital in the UK between August 2017 and July 2018. Patients with negative and equivocal prebiopsy mp-MRI with high clinical suspicion of cancer had proceeded to biopsy. MRI reports with prostate imaging reporting and data system (PI-RADS) scores 1, 2, 3 and normal MRI were evaluated against the transrectal ultrasound-guided prostate biopsy (TRUS-PB) outcomes to demonstrate benign pathology, clinically insignificant or clinically significant cancer (csCa). CsCa was defined as Gleason score (GS) ≥3 + 4.
Results: Out of 265 mp-MRIs studied, five (1.9%) were PI-RADS 1, 109 (41.1%) and 84 (31.7%) were PI-RADS 2 and 3 lesions respectively; 67 (25.3%) were reported as normal. Seventy-five (27.3%) patients did not have biopsies following their MRI and 73.3% (51/75) of them had benign feeling prostate. Negative MRIs (PI-RADS 1, 2 and normal MRI) showed 8.8% and PI-RADS 3 lesions demonstrated 11.9% csCa. Negative predictive value for normal MRI was 91.2%. Mean PSA density (PSAD) among the benign, GS 3 + 3 and csCa was 0.14, 0.16 and 0.27 ng/ml/ml respectively and this was statistically significant (p < 0.001). The average percentage of cancer found in GS 3 + 3 and csCa was 3.2% and 20.1%, respectively.
Conclusion: Avoiding TRUS-PB following normal or equivocal mp-MRI should carefully be decided as 18.5% of cancer was demonstrated in this group and 9.8% of those who were diagnosed with cancer were csCa. PSAD and DRE findings provide additional information to help with this decision.
{"title":"Can a prostate biopsy be safely deferred on PI-RADS 1,2 or 3 lesions seen on pre-biopsy mp-MRI?","authors":"Rickaz Abdul Raheem, Ahsen Razzaq, Victoria Beraud, Richard Menzies-Wilson, Rakan Odeh, Imoh Ibiok, Prashant Mulawkar, Henry Andrews, Iqbal Anjum, Khaled Hosny, Tom Leslie","doi":"10.1080/2090598X.2022.2119711","DOIUrl":"https://doi.org/10.1080/2090598X.2022.2119711","url":null,"abstract":"<p><strong>Introduction: </strong>Multi-parametric magnetic resonance imaging (mp-MRI) is currently used to triage patients with suspected prostate cancer, before deciding on prostate biopsies. In our study, we evaluated normal and equivocal pre-biopsy mp-MRIs to see whether it is safe to avoid biopsy with such findings.</p><p><strong>Methods: </strong>A retrospective study was conducted at a district general hospital in the UK between August 2017 and July 2018. Patients with negative and equivocal prebiopsy mp-MRI with high clinical suspicion of cancer had proceeded to biopsy. MRI reports with prostate imaging reporting and data system (PI-RADS) scores 1, 2, 3 and normal MRI were evaluated against the transrectal ultrasound-guided prostate biopsy (TRUS-PB) outcomes to demonstrate benign pathology, clinically insignificant or clinically significant cancer (csCa). CsCa was defined as Gleason score (GS) ≥3 + 4.</p><p><strong>Results: </strong>Out of 265 mp-MRIs studied, five (1.9%) were PI-RADS 1, 109 (41.1%) and 84 (31.7%) were PI-RADS 2 and 3 lesions respectively; 67 (25.3%) were reported as normal. Seventy-five (27.3%) patients did not have biopsies following their MRI and 73.3% (51/75) of them had benign feeling prostate. Negative MRIs (PI-RADS 1, 2 and normal MRI) showed 8.8% and PI-RADS 3 lesions demonstrated 11.9% csCa. Negative predictive value for normal MRI was 91.2%. Mean PSA density (PSAD) among the benign, GS 3 + 3 and csCa was 0.14, 0.16 and 0.27 ng/ml/ml respectively and this was statistically significant (<i>p</i> < 0.001). The average percentage of cancer found in GS 3 + 3 and csCa was 3.2% and 20.1%, respectively.</p><p><strong>Conclusion: </strong>Avoiding TRUS-PB following normal or equivocal mp-MRI should carefully be decided as 18.5% of cancer was demonstrated in this group and 9.8% of those who were diagnosed with cancer were csCa. PSAD and DRE findings provide additional information to help with this decision.</p>","PeriodicalId":8113,"journal":{"name":"Arab Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9930831/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10825693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dear Sir, The evolution of medicine is taken place towards the homogenization of medical terms. The bladder neck contracture (BNC) is a well-known condition to urologists, described as a fibrous narrowing of the bladder neck more or less extended to the prostatic and posterior urethra (Figure 1). It usually occurs as a complication of a surgical or radiotherapeutic approach to the prostate. Albeit its diagnostic and therapeutic aspects have been extensively studied in the literature, its terminology remains a subject of ambiguity, especially in French literature. The French term of « sclérose du col vesical » or « sclérose de la loge prostatique » refers to this entity. In contrast to English literature, which mainly uses the term ‘bladder neck contracture’ or ‘stenosis’ rather than ‘bladder neck sclerosis’, the term ‘sclérose du col vésical’ is the principal terminology used in French literature. In fact, the International Society of Urology (SIU) and the International Consultation on Urological Diseases (ICUD) published, in 2014, recommendations regarding the accuracy of urethral terminology [1]. According to these recommendations, the term ‘bladder neck sclerosis’ should be replaced by ‘bladder neck stenosis’ or ‘stenosis of the vesico-urethral anastomosis’. Despite the effort of learned societies to universally homogenize the medical language, many urologists do not adhere to this terminology and prefer old terms in common practice. This lack of adherence can be seen in both English and French literature. A review of the literature on PubMed, Web of Science, Scopus, and Google Scholar of articles published from 2015 to 2021 using the French terms (sclérose du col), (sclérose de l’anastomose vésico-uréthrale), or (sclérose de la loge prostatique) found 16 articles published in French that continue to use the term ‘sclérose’ to designate the said condition (Table 1), which proves the wide persistent use of this terminology. This letter aims to draw the attention of authors and reviewers to the fact that this terminology is misleading and was previously revisited by learned societies. The term ‘sclerosis’ derives from the Greek word ‘sklēroun’ meaning harden. The French dictionary of ‘Académie de Medecine’ defines ‘sclérose’ as a pathological induration of a tissue affected by fibrosis [2]. The addition of the character of hardness is not constant in all dictionaries. The French dictionary ‘Larousse médical’, for example, considers fibrosis as equivalent to sclerosis [3]. Considering sclerosis as equivalent to fibrosis or just a type of it, Kaynar et al. in 2016, by analyzing the resected specimens of 338 cases of BNC, found varying degrees of inflammation and fibrosis [4]. For all the examined specimens, the term ‘sclerosis’ was not used by the anatomopathologists. Moreover, fibrosis is a physiological healing process constantly found in all previously injured tissues, either by trauma, instrumental maneuvers, infections, or inflammatory proces
{"title":"'Sclérose du col vésical': An obsolete terminology still used by French literature?","authors":"Jihad El Anzaoui, Chatar Achraf, Akajai Ali, Amaziane Ahmed, Lakrabti Naceur, Habyebete Soufiane, Abdelghani Ammani","doi":"10.1080/2090598X.2022.2092994","DOIUrl":"https://doi.org/10.1080/2090598X.2022.2092994","url":null,"abstract":"Dear Sir, The evolution of medicine is taken place towards the homogenization of medical terms. The bladder neck contracture (BNC) is a well-known condition to urologists, described as a fibrous narrowing of the bladder neck more or less extended to the prostatic and posterior urethra (Figure 1). It usually occurs as a complication of a surgical or radiotherapeutic approach to the prostate. Albeit its diagnostic and therapeutic aspects have been extensively studied in the literature, its terminology remains a subject of ambiguity, especially in French literature. The French term of « sclérose du col vesical » or « sclérose de la loge prostatique » refers to this entity. In contrast to English literature, which mainly uses the term ‘bladder neck contracture’ or ‘stenosis’ rather than ‘bladder neck sclerosis’, the term ‘sclérose du col vésical’ is the principal terminology used in French literature. In fact, the International Society of Urology (SIU) and the International Consultation on Urological Diseases (ICUD) published, in 2014, recommendations regarding the accuracy of urethral terminology [1]. According to these recommendations, the term ‘bladder neck sclerosis’ should be replaced by ‘bladder neck stenosis’ or ‘stenosis of the vesico-urethral anastomosis’. Despite the effort of learned societies to universally homogenize the medical language, many urologists do not adhere to this terminology and prefer old terms in common practice. This lack of adherence can be seen in both English and French literature. A review of the literature on PubMed, Web of Science, Scopus, and Google Scholar of articles published from 2015 to 2021 using the French terms (sclérose du col), (sclérose de l’anastomose vésico-uréthrale), or (sclérose de la loge prostatique) found 16 articles published in French that continue to use the term ‘sclérose’ to designate the said condition (Table 1), which proves the wide persistent use of this terminology. This letter aims to draw the attention of authors and reviewers to the fact that this terminology is misleading and was previously revisited by learned societies. The term ‘sclerosis’ derives from the Greek word ‘sklēroun’ meaning harden. The French dictionary of ‘Académie de Medecine’ defines ‘sclérose’ as a pathological induration of a tissue affected by fibrosis [2]. The addition of the character of hardness is not constant in all dictionaries. The French dictionary ‘Larousse médical’, for example, considers fibrosis as equivalent to sclerosis [3]. Considering sclerosis as equivalent to fibrosis or just a type of it, Kaynar et al. in 2016, by analyzing the resected specimens of 338 cases of BNC, found varying degrees of inflammation and fibrosis [4]. For all the examined specimens, the term ‘sclerosis’ was not used by the anatomopathologists. Moreover, fibrosis is a physiological healing process constantly found in all previously injured tissues, either by trauma, instrumental maneuvers, infections, or inflammatory proces","PeriodicalId":8113,"journal":{"name":"Arab Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9930842/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10825696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.1080/2090598X.2022.2138119
Ahmed M Harraz, Adel Nabeeh, Ramy Elbaz, Abdalla Abdelhamid, Mohamed Tharwat, Amr A Elbakry, Ahmed S El-Hefnawy, Ahmed El-Assmy, Ahmed Mosbah, Mohamed H Zahran
Objectives: To identify cystourethrogram (CUG) findings that independently predict the outcome of posterior urethroplasty (PU) following pelvic fracture urethral injury (PFUI).
Methods: Findings of CUG included the location of the proximal end of the bulbar urethra in zones A (superficial) or B (deep) according to its relationship with the pubic arch. Others included the presence of pelvic arch fracture, bladder neck, and posterior urethral appearance. The primary outcome was the need for reintervention either endoscopically or by redo urethroplasty. Independent predictors were modeled using a logistic regression model and a nomogram was constructed and internally validated using 100-bootstrap resampling. Time-to-event analysis was performed to validate the results.
Results: A total of 196 procedures in 158 patients were analyzed. The success rate was 83.7% with 32 (16.3%) procedures requiring direct vision internal urethrotomy, urethroplasty, or both in 13 (6.6%), 12 (6.1%), and 7 (3.6%) patients, respectively. On multivariate analysis, bulbar urethral end located at zone B (odds ratio [OR]: 3.1; 95% confidence interval [CI]: 1.1-8.5; p = 0.02), pubic arch fracture (OR: 3.9; 95%CI: 1.5-9.7; p = 0.003), and previous urethroplasty (OR: 4.2; 95% CI: 1.8-10.1; p = 0.001) were independent predictors. The same predictors were significant in the time-to-event analysis. The nomogram discrimination was 77.3% and 75% in the current data and after validation.
Conclusions: The location of the proximal end of the bulbar urethra and redo urethroplasty could predict the need for reintervention after PU for PFUI. The nomogram could be used preoperatively for patient counseling and procedure planning.
{"title":"Could the bulbar urethral end location on the cystourethrogram predict the outcome after posterior urethroplasty for pelvic fracture urethral injury?","authors":"Ahmed M Harraz, Adel Nabeeh, Ramy Elbaz, Abdalla Abdelhamid, Mohamed Tharwat, Amr A Elbakry, Ahmed S El-Hefnawy, Ahmed El-Assmy, Ahmed Mosbah, Mohamed H Zahran","doi":"10.1080/2090598X.2022.2138119","DOIUrl":"https://doi.org/10.1080/2090598X.2022.2138119","url":null,"abstract":"<p><strong>Objectives: </strong>To identify cystourethrogram (CUG) findings that independently predict the outcome of posterior urethroplasty (PU) following pelvic fracture urethral injury (PFUI).</p><p><strong>Methods: </strong>Findings of CUG included the location of the proximal end of the bulbar urethra in zones A (superficial) or B (deep) according to its relationship with the pubic arch. Others included the presence of pelvic arch fracture, bladder neck, and posterior urethral appearance. The primary outcome was the need for reintervention either endoscopically or by redo urethroplasty. Independent predictors were modeled using a logistic regression model and a nomogram was constructed and internally validated using 100-bootstrap resampling. Time-to-event analysis was performed to validate the results.</p><p><strong>Results: </strong>A total of 196 procedures in 158 patients were analyzed. The success rate was 83.7% with 32 (16.3%) procedures requiring direct vision internal urethrotomy, urethroplasty, or both in 13 (6.6%), 12 (6.1%), and 7 (3.6%) patients, respectively. On multivariate analysis, bulbar urethral end located at zone B (odds ratio [OR]: 3.1; 95% confidence interval [CI]: 1.1-8.5; p = 0.02), pubic arch fracture (OR: 3.9; 95%CI: 1.5-9.7; p = 0.003), and previous urethroplasty (OR: 4.2; 95% CI: 1.8-10.1; p = 0.001) were independent predictors. The same predictors were significant in the time-to-event analysis. The nomogram discrimination was 77.3% and 75% in the current data and after validation.</p><p><strong>Conclusions: </strong>The location of the proximal end of the bulbar urethra and redo urethroplasty could predict the need for reintervention after PU for PFUI. The nomogram could be used preoperatively for patient counseling and procedure planning.</p>","PeriodicalId":8113,"journal":{"name":"Arab Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10208150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10194078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.1080/2090598X.2022.2146859
David A Csuka, John Ha, Andrew S Hanna, Jisoo Kim, William Phan, Ahmed S Ahmed, Gamal M Ghoniem
Objectives: To present a case of foreign body granuloma (FBG) development after injection of calcium hydroxylapatite as a urethral bulking agent and to review all documented cases of this phenomenon in the literature.
Methods: We analyzed a new case of calcium hydroxylapatite-induced FBG. We also conducted a literature review of the PubMed, Embase, CINAHL, and Web of Science databases through March 2022. Reports were included if they contained stress urinary incontinence patients that developed an FBG after calcium hydroxylapatite injection. The cases were reviewed for presenting symptoms, patient demographics, granuloma details, and surgical treatment.
Results: We screened 250 articles and included six articles between 2006 and 2015 in addition to the present case. The median age of the patients was 65.5 years (range 45-93), and all patients were female. The most common presenting symptoms and the proportion of patients affected were difficulty voiding (4/8), recurrent urinary incontinence (3/8), and dyspareunia (2/8). The median time between the first CaHA injection and discovery of the FBG was 5 months (range 1-50). The median longest dimension of the FBGs was 1.85 cm (range 1.0-3.0). The 8 masses observed were evenly distributed throughout the urethra, with 3 in the bladder neck, 2 in the midurethra, and 3 in the distal urethra. Surgical excision was the predominant management choice, with some variation in technique.
Conclusions: Severe, persistent lower urinary tract symptoms after calcium hydroxylapatite injection may indicate an FBG, which has been successfully managed with surgical excision.
目的:报告一例羟基磷灰石钙作为尿道膨胀剂注射后出现的异物肉芽肿(FBG),并回顾文献中所有记录的这种现象的病例。方法:我们分析了一例新的羟基磷灰石钙诱导的FBG。我们还对截至2022年3月的PubMed、Embase、CINAHL和Web of Science数据库进行了文献综述。如果有压力性尿失禁患者在注射羟基磷灰石钙后出现FBG,则纳入报告。我们回顾了这些病例的症状、患者人口统计学、肉芽肿细节和手术治疗。结果:我们筛选了250篇文章,除本病例外,还纳入了2006年至2015年间的6篇文章。患者年龄中位数为65.5岁(45-93岁),均为女性。最常见的症状为排尿困难(4/8)、复发性尿失禁(3/8)和性交困难(2/8)。从第一次注射CaHA到发现FBG的中位时间为5个月(范围1-50)。fbg的中位最长尺寸为1.85 cm(范围1.0-3.0)。观察到的8个肿块均匀分布于尿道各处,其中膀胱颈3个,尿道中2个,尿道远端3个。手术切除是主要的治疗选择,在技术上有一些变化。结论:羟基磷灰石钙注射后严重、持续的下尿路症状可能提示FBG,可通过手术切除成功控制。
{"title":"Foreign body granuloma development after calcium hydroxylapatite injection for stress urinary incontinence: A literature review and case report.","authors":"David A Csuka, John Ha, Andrew S Hanna, Jisoo Kim, William Phan, Ahmed S Ahmed, Gamal M Ghoniem","doi":"10.1080/2090598X.2022.2146859","DOIUrl":"https://doi.org/10.1080/2090598X.2022.2146859","url":null,"abstract":"<p><strong>Objectives: </strong>To present a case of foreign body granuloma (FBG) development after injection of calcium hydroxylapatite as a urethral bulking agent and to review all documented cases of this phenomenon in the literature.</p><p><strong>Methods: </strong>We analyzed a new case of calcium hydroxylapatite-induced FBG. We also conducted a literature review of the PubMed, Embase, CINAHL, and Web of Science databases through March 2022. Reports were included if they contained stress urinary incontinence patients that developed an FBG after calcium hydroxylapatite injection. The cases were reviewed for presenting symptoms, patient demographics, granuloma details, and surgical treatment.</p><p><strong>Results: </strong>We screened 250 articles and included six articles between 2006 and 2015 in addition to the present case. The median age of the patients was 65.5 years (range 45-93), and all patients were female. The most common presenting symptoms and the proportion of patients affected were difficulty voiding (4/8), recurrent urinary incontinence (3/8), and dyspareunia (2/8). The median time between the first CaHA injection and discovery of the FBG was 5 months (range 1-50). The median longest dimension of the FBGs was 1.85 cm (range 1.0-3.0). The 8 masses observed were evenly distributed throughout the urethra, with 3 in the bladder neck, 2 in the midurethra, and 3 in the distal urethra. Surgical excision was the predominant management choice, with some variation in technique.</p><p><strong>Conclusions: </strong>Severe, persistent lower urinary tract symptoms after calcium hydroxylapatite injection may indicate an FBG, which has been successfully managed with surgical excision.</p>","PeriodicalId":8113,"journal":{"name":"Arab Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10208123/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10194080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.1080/2090598X.2022.2135284
Chatar Achraf, Pr Ammani Abdelghani, Pr El Anzaoui Jihad
Objectives: The objective of our study is to discover and evaluate the effects of repeated intralesional injections inside the tunica albuginea of platelet-rich plasma (PRP) in the treatment of Peyronie's disease (PD).
Methods: As part of a prospective study over 12 months from February 2020 until February 2021, on Sixty-five patients with Peyronie's disease, and penile curvature between 25 and 45°. Patients were stratified into two groups, the first with a curvature between 25 and 35° and the second between 35 and 45°. Gathered data included patient-demographics, Injection technique, outcomes: both quantitative (curvature assessments) and qualitative (state of erectile function, pain during intercourse), and complications.
Results:
Patients in both groups received an average of 6.1 injections of PRP during the study period. Angulation was significantly improved in both groups an average final improvement of 16.88° (SD = 3.35) (p < 0.001) in the first group and 17.27° (SD = 4.22) (p < 0.001) in the second group. Pain during sex decreased from 70.7% to 34.25%, and 55.5% of patients had easier sexual intercourse.
Conclusions:
The positive results of our series of treatment for Peyronie's disease by injection of platelet-rich plasma are encouraging both methodologically (simplicity) and clinical (safety and efficacy) as well as patient satisfaction.
{"title":"Platelet-rich plasma in patients affected with Peyronie's disease.","authors":"Chatar Achraf, Pr Ammani Abdelghani, Pr El Anzaoui Jihad","doi":"10.1080/2090598X.2022.2135284","DOIUrl":"https://doi.org/10.1080/2090598X.2022.2135284","url":null,"abstract":"<p><strong>Objectives: </strong>The objective of our study is to discover and evaluate the effects of repeated intralesional injections inside the tunica albuginea of platelet-rich plasma (PRP) in the treatment of Peyronie's disease (PD).</p><p><strong>Methods: </strong>As part of a prospective study over 12 months from February 2020 until February 2021, on Sixty-five patients with Peyronie's disease, and penile curvature between 25 and 45°. Patients were stratified into two groups, the first with a curvature between 25 and 35° and the second between 35 and 45°. Gathered data included patient-demographics, Injection technique, outcomes: both quantitative (curvature assessments) and qualitative (state of erectile function, pain during intercourse), and complications.</p><p><strong>Results: </strong></p><p><p>Patients in both groups received an average of 6.1 injections of PRP during the study period. Angulation was significantly improved in both groups an average final improvement of 16.88° (SD = 3.35) (p < 0.001) in the first group and 17.27° (SD = 4.22) (p < 0.001) in the second group. Pain during sex decreased from 70.7% to 34.25%, and 55.5% of patients had easier sexual intercourse.</p><p><strong>Conclusions: </strong></p><p><p>The positive results of our series of treatment for Peyronie's disease by injection of platelet-rich plasma are encouraging both methodologically (simplicity) and clinical (safety and efficacy) as well as patient satisfaction.</p>","PeriodicalId":8113,"journal":{"name":"Arab Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10208162/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10194082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.1080/2090598X.2022.2141864
Walid El Ansari, Mohamed Arafa, Ahmad Majzoub, Haitham Elbardisi, Ahmed Albakr, Mohammed Mahdi, Kareem El-Ansari, Abdulla Al Ansari, Khalid AlRumaihi
Background: To date, no previous research assessed the bibliometrics of men's sexual and reproductive healthcare (SRHC) across Arab countries. This study appraised the current standing of men's SRHC research in the MENA (Middle East and North Africa) region.
Methods: We performed a bibliometric analysis to assess qualitatively and quantitatively the peer-reviewed articles published from Arab countries from inception to 2022. In addition, we conducted a visualization analysis, and assessed outputs, trends, shortcomings and hotspots over the given time period.
Results: There was a generally low numbers of publications, 98 studies were identified, all with cross-sectional design, and two thirds explored prevention and control of HIV/other STDs. Studies were published in 71 journals, of which the Eastern Mediterranean Health Journal, Journal of Egyptian Public Health Association, AIDS Care and BMC public health were most common. The Journal of Adolescent Health, Fertility Sterility and Journal of Cancer Survivorship were among the highest IF ranking. Publishers were commonly USA or UK-based, median journal IF was 2.09, and five articles were in journals of IF > 4. Saudi Arabia had the highest published output followed by Egypt, Jordan and Lebanon, while 10 Arab countries had no publications on the topic. Corresponding authors expertise fields were most commonly public health, infectious diseases and family medicine). Collaborations in-between MENA countries were notably low.
Conclusions: There is general paucity of published outputs on SRHC. More research across MENA is needed, with more inter-MENA collaborations, and with inclusion of countries that currently have no outputs on SRHC. In order to accomplish such goals, R&D funding and capacity building are required. Research and published outputs should address SRHC burdens.
{"title":"Bibliometric and Visualization Analysis of the Ecology of Men's Sexual and Reproductive Healthcare Research in MENA (1985-2022): Outputs, Trends, Shortcomings and Hotspots.","authors":"Walid El Ansari, Mohamed Arafa, Ahmad Majzoub, Haitham Elbardisi, Ahmed Albakr, Mohammed Mahdi, Kareem El-Ansari, Abdulla Al Ansari, Khalid AlRumaihi","doi":"10.1080/2090598X.2022.2141864","DOIUrl":"https://doi.org/10.1080/2090598X.2022.2141864","url":null,"abstract":"<p><strong>Background: </strong>To date, no previous research assessed the bibliometrics of men's sexual and reproductive healthcare (SRHC) across Arab countries. This study appraised the current standing of men's SRHC research in the MENA (Middle East and North Africa) region.</p><p><strong>Methods: </strong>We performed a bibliometric analysis to assess qualitatively and quantitatively the peer-reviewed articles published from Arab countries from inception to 2022. In addition, we conducted a visualization analysis, and assessed outputs, trends, shortcomings and hotspots over the given time period.</p><p><strong>Results: </strong>There was a generally low numbers of publications, 98 studies were identified, all with cross-sectional design, and two thirds explored prevention and control of HIV/other STDs. Studies were published in 71 journals, of which the Eastern Mediterranean Health Journal, Journal of Egyptian Public Health Association, AIDS Care and BMC public health were most common. The Journal of Adolescent Health, Fertility Sterility and Journal of Cancer Survivorship were among the highest IF ranking. Publishers were commonly USA or UK-based, median journal IF was 2.09, and five articles were in journals of IF > 4. Saudi Arabia had the highest published output followed by Egypt, Jordan and Lebanon, while 10 Arab countries had no publications on the topic. Corresponding authors expertise fields were most commonly public health, infectious diseases and family medicine). Collaborations in-between MENA countries were notably low.</p><p><strong>Conclusions: </strong>There is general paucity of published outputs on SRHC. More research across MENA is needed, with more inter-MENA collaborations, and with inclusion of countries that currently have no outputs on SRHC. In order to accomplish such goals, R&D funding and capacity building are required. Research and published outputs should address SRHC burdens.</p>","PeriodicalId":8113,"journal":{"name":"Arab Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10208131/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10194084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.1080/2090598X.2023.2207415
Kareim Khalafalla, Ahmed Albakr, Walid El Ansari, Ahmad Majzoub, Haitham Elbardisi, Khalid AlRumaihi, Mohamed Arafa
Introduction: Chronic pelvic pain syndrome (CPPS) is a frequent urological diagnosis that affects men's quality of life. Extracorporeal shockwave therapy (ESWT) is a recent treatment option for patients with CPPS. We evaluated ESWT's short and long - term efficacy in managing CPPS.
Methods: This prospective self-controlled study included 75 patients diagnosed with CPPS at our tertiary pelvic pain clinic between January 2017-June 2019. Patients were referred for ESWT and received four sessions one week apart. The National Institute for Health - Chronic Prostatitis Symptom Index (NIH - CPSI) questionnaire was used to assess patients' symptom severity before starting therapy and at 0, 12 and 26 weeks after completing ESWT. Demographics, clinical data and complications were also recorded.
Results: Patients' mean age was 37.9 ± 8.6 years, and mean duration of symptoms was 5 ± 4.5 years. Compared to pre-treatment scores, all patients exhibited improvements across all NIH - CPSI domains directly after completing ESWT (week 0 post-treatment), with a mean difference improvement of 9.26 ± 5.7, 5.2 ± 3.4, 1.19 ± 2.18 and 2.88 ± 2.46 points in the total, pain, urinary symptoms, and quality-of-life scores respectively. At 12 weeks after completing ESWT, 80.9% of patients reported improvements, with mean difference improvement of 8.07 ± 7.56, 4.55 ± 4.6, 0.76 ± 2.48, 2.85 ± 2.78 in the total, pain, urinary symptoms, and quality-of-life scores respectively. Again, none of the patients developed any treatment-related complications. At 26 weeks after completing ESWT, 82.4% of patients reported improvements, with mean difference improvement of 8.29 ± 7.7%, 4.92 ± 4.69, 0.75 ± 2.96, 2.5 ± 3.0 in total, pain, urinary symptoms, and quality-of-life scores respectively. None of the patients developed treatment-related complications.
Conclusions: ESWT is a safe and effective treatment modality for patients with CPPS, with short-term improvement in total, pain, urinary symptom, and quality-of-life scores; and long-term improvement in total, pain, and quality-of-life scores.
{"title":"Short and long-term effectiveness of external shock wave therapy for chronic pelvic pain syndrome in men.","authors":"Kareim Khalafalla, Ahmed Albakr, Walid El Ansari, Ahmad Majzoub, Haitham Elbardisi, Khalid AlRumaihi, Mohamed Arafa","doi":"10.1080/2090598X.2023.2207415","DOIUrl":"https://doi.org/10.1080/2090598X.2023.2207415","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic pelvic pain syndrome (CPPS) is a frequent urological diagnosis that affects men's quality of life. Extracorporeal shockwave therapy (ESWT) is a recent treatment option for patients with CPPS. We evaluated ESWT's short and long - term efficacy in managing CPPS.</p><p><strong>Methods: </strong>This prospective self-controlled study included 75 patients diagnosed with CPPS at our tertiary pelvic pain clinic between January 2017-June 2019. Patients were referred for ESWT and received four sessions one week apart. The National Institute for Health - Chronic Prostatitis Symptom Index (NIH - CPSI) questionnaire was used to assess patients' symptom severity before starting therapy and at 0, 12 and 26 weeks after completing ESWT. Demographics, clinical data and complications were also recorded.</p><p><strong>Results: </strong>Patients' mean age was 37.9 ± 8.6 years, and mean duration of symptoms was 5 ± 4.5 years. Compared to pre-treatment scores, all patients exhibited improvements across all NIH - CPSI domains directly after completing ESWT (week 0 post-treatment), with a mean difference improvement of 9.26 ± 5.7, 5.2 ± 3.4, 1.19 ± 2.18 and 2.88 ± 2.46 points in the total, pain, urinary symptoms, and quality-of-life scores respectively. At 12 weeks after completing ESWT, 80.9% of patients reported improvements, with mean difference improvement of 8.07 ± 7.56, 4.55 ± 4.6, 0.76 ± 2.48, 2.85 ± 2.78 in the total, pain, urinary symptoms, and quality-of-life scores respectively. Again, none of the patients developed any treatment-related complications. At 26 weeks after completing ESWT, 82.4% of patients reported improvements, with mean difference improvement of 8.29 ± 7.7%, 4.92 ± 4.69, 0.75 ± 2.96, 2.5 ± 3.0 in total, pain, urinary symptoms, and quality-of-life scores respectively. None of the patients developed treatment-related complications.</p><p><strong>Conclusions: </strong>ESWT is a safe and effective treatment modality for patients with CPPS, with short-term improvement in total, pain, urinary symptom, and quality-of-life scores; and long-term improvement in total, pain, and quality-of-life scores.</p>","PeriodicalId":8113,"journal":{"name":"Arab Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10373607/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10250116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.1080/2090598X.2022.2097613
Yavuz Güler
Aim: To assess postoperative oral morbidity through meta-analysis of comparative studies for closure or non-closure of the buccal mucosa graft harvest area in patients undergoing urethroplasty.
Methods: A systematic literature review was conducted in January 2022. Randomized controlled studies were assessed according to the Cochrane collaboration guidelines. Postoperative pain, difficult mouth opening, alteration of oral salivation, perioral numbness, and tolerance of solid and liquid intake results were assessed. Standard mean differences and risk ratios with 95% confidence intervals were estimated for relative risk. Assessment was performed with subgroup analyses according to time points.
Results: This meta-analysis included 373 patients in 7 randomized studies. The oral pain overall pooled effect estimates were investigated for the time points of day 0-1, day 3-7 and months 1-6. According to corrected effect estimates after sensitivity analysis, at the day 0-1 time point, the non-closure group was significantly superior compared to the closure group. But there was no difference at the other time points and in total. The overall pooled effect estimates for difficult mouth opening were investigated at 4 time points (day 1, days 5-7, months 1-3 and months 6). After sensitivity analysis, the overall pooled effect estimates at 6 months were significantly superior for the non-closure group. There were no significant differences between the non-closed and closed groups based on the overall pooled-effect estimates for oral numbness, salivary secretion alteration, and tolerance of liquid and solid food variants.
Conclusion: The non-closure group was more advantageous in terms of oral pain in the early postoperative period. There were no differences between the groups in terms of alteration of salivation, oral numbness and toleration of liquid/solid food. Although the non-closed group seems more advantageous in terms of ease in mouth movements, more studies are needed to prove this.
{"title":"Comparison of closure versus non-closure of the intraoral buccal mucosa graft site in urethroplasties. A systematic review and meta-analysis.","authors":"Yavuz Güler","doi":"10.1080/2090598X.2022.2097613","DOIUrl":"https://doi.org/10.1080/2090598X.2022.2097613","url":null,"abstract":"<p><strong>Aim: </strong>To assess postoperative oral morbidity through meta-analysis of comparative studies for closure or non-closure of the buccal mucosa graft harvest area in patients undergoing urethroplasty.</p><p><strong>Methods: </strong>A systematic literature review was conducted in January 2022. Randomized controlled studies were assessed according to the Cochrane collaboration guidelines. Postoperative pain, difficult mouth opening, alteration of oral salivation, perioral numbness, and tolerance of solid and liquid intake results were assessed. Standard mean differences and risk ratios with 95% confidence intervals were estimated for relative risk. Assessment was performed with subgroup analyses according to time points.</p><p><strong>Results: </strong>This meta-analysis included 373 patients in 7 randomized studies. The oral pain overall pooled effect estimates were investigated for the time points of day 0-1, day 3-7 and months 1-6. According to corrected effect estimates after sensitivity analysis, at the day 0-1 time point, the non-closure group was significantly superior compared to the closure group. But there was no difference at the other time points and in total. The overall pooled effect estimates for difficult mouth opening were investigated at 4 time points (day 1, days 5-7, months 1-3 and months 6). After sensitivity analysis, the overall pooled effect estimates at 6 months were significantly superior for the non-closure group. There were no significant differences between the non-closed and closed groups based on the overall pooled-effect estimates for oral numbness, salivary secretion alteration, and tolerance of liquid and solid food variants.</p><p><strong>Conclusion: </strong>The non-closure group was more advantageous in terms of oral pain in the early postoperative period. There were no differences between the groups in terms of alteration of salivation, oral numbness and toleration of liquid/solid food. Although the non-closed group seems more advantageous in terms of ease in mouth movements, more studies are needed to prove this.</p>","PeriodicalId":8113,"journal":{"name":"Arab Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9930765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9315931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.1080/2090598X.2022.2113127
Walid El Ansari, Khalid AlRumaihi, Kareem El-Ansari, Mohamed Arafa, Haitham Elbardisi, Ahmad Majzoub, Ahmad Shamsodini, Abdulla Al Ansari
Objective: We appraised the reporting quality of abstracts of systematic reviews/meta-analyses (SR/MAs) published in one urology journal and explored associations between abstract characteristics and completeness of reporting.
Methods: The Arab Journal of Urology (AJU) was searched for SR/MAs published between January 2011 and 31 May 2022. SR/MAs with structured abstract and quantitative synthesis were eligible. Two reviewers simultaneously together selected the SR/MAs by title, screened the abstracts, and included those based on inclusion/exclusion criteria. Data of a range of characteristics were extracted from each SR/MAs into a spreadsheet. To gauge completeness of reporting, the PRISMA-Abstract checklist (12 items) was used to appraise the extent to which abstracts adhered to the checklist. For each abstract, we computed item, section, and overall adherence. Chi-square and t-tests compared the adherence scores. Univariate and multivariate analyses identified the abstract characteristics associated with overall adherence.
Results: In total, 66 SR/MAs published during the examined period; 62 were included. Partial reporting was not uncommon. In terms of adherence to the 12 PRISMA-A items were: two items exhibited 100% adherence (title, objectives); five items had 80% to <100% adherence (interpretation, included studies, synthesis of results, eligibility criteria, and information sources); two items displayed 40% to <80% adherence (description of the effect, strengths/limitations of evidence); and three items had adherence that fell between 0% and 1.6% (risk of bias, funding/conflict of interest, registration). Multivariable regression revealed two independent predictors of overall adherence: single-country authorship (i.e. no collaboration) was associated with higher overall adherence (P = 0.046); and abstracts from South America were associated with lower overall adherence (P = 0.04).
Conclusion: This study is the first to appraise abstracts of SR/MAs in urology. For high-quality abstracts, improvements are needed in the quality of reporting. Adoption/better adherence to PRISMA-A checklist by editors/authors could improve the reporting quality and completeness of SR/MAs abstracts.
{"title":"Reporting quality of abstracts of systematic reviews/meta-analyses: An appraisal of Arab Journal of Urology across 12 years: the PRISMA-Abstracts checklist.","authors":"Walid El Ansari, Khalid AlRumaihi, Kareem El-Ansari, Mohamed Arafa, Haitham Elbardisi, Ahmad Majzoub, Ahmad Shamsodini, Abdulla Al Ansari","doi":"10.1080/2090598X.2022.2113127","DOIUrl":"https://doi.org/10.1080/2090598X.2022.2113127","url":null,"abstract":"<p><strong>Objective: </strong>We appraised the reporting quality of abstracts of systematic reviews/meta-analyses (SR/MAs) published in one urology journal and explored associations between abstract characteristics and completeness of reporting.</p><p><strong>Methods: </strong>The Arab Journal of Urology (AJU) was searched for SR/MAs published between January 2011 and 31 May 2022. SR/MAs with structured abstract and quantitative synthesis were eligible. Two reviewers simultaneously together selected the SR/MAs by title, screened the abstracts, and included those based on inclusion/exclusion criteria. Data of a range of characteristics were extracted from each SR/MAs into a spreadsheet. To gauge completeness of reporting, the PRISMA-Abstract checklist (12 items) was used to appraise the extent to which abstracts adhered to the checklist. For each abstract, we computed item, section, and overall adherence. Chi-square and t-tests compared the adherence scores. Univariate and multivariate analyses identified the abstract characteristics associated with overall adherence.</p><p><strong>Results: </strong>In total, 66 SR/MAs published during the examined period; 62 were included. Partial reporting was not uncommon. In terms of adherence to the 12 PRISMA-A items were: two items exhibited 100% adherence (title, objectives); five items had 80% to <100% adherence (interpretation, included studies, synthesis of results, eligibility criteria, and information sources); two items displayed 40% to <80% adherence (description of the effect, strengths/limitations of evidence); and three items had adherence that fell between 0% and 1.6% (risk of bias, funding/conflict of interest, registration). Multivariable regression revealed two independent predictors of overall adherence: single-country authorship (i.e. no collaboration) was associated with higher overall adherence (<i>P</i> = 0.046); and abstracts from South America were associated with lower overall adherence (<i>P</i> = 0.04).</p><p><strong>Conclusion: </strong>This study is the first to appraise abstracts of SR/MAs in urology. For high-quality abstracts, improvements are needed in the quality of reporting. Adoption/better adherence to PRISMA-A checklist by editors/authors could improve the reporting quality and completeness of SR/MAs abstracts.</p>","PeriodicalId":8113,"journal":{"name":"Arab Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9930775/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10767427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.1080/2090598X.2022.2100580
Ahmed Sakr, Hazem Elgalaly, Mohamed M Seleem, Mostafa Kamel, Ahmed I El-Sakka, Ibrahim M Ibrahim
Objective: To assess safety and efficacy of hyaluronic acid (HA) gel injection in glans penis for treatment of premature ejaculation (PE) using our new five puncture technique.
Patients and methods: This is a prospective, non-randomized clinical trial on HA gel injection in glans penis for all patients with lifelong PE; all patients were circumcised having heterosexual normal marital life and sexually active. Patients with history of ejaculatory medication use within the previous 3 months, psychiatric disorders, erectile dysfunction, lower urinary tract symptoms (LUTS) due to prostatitis and acquired PE were excluded from the study. A local anesthetic was applied to the skin of glans penis for 30 minutes before the injection of 2 ml HA in glans penis via 30-gauge needle using our new Five-puncture technique. Intra-vaginal ejaculatory latency time (IELT) was measured at 1, 3, 6 and 12 months after injection.
Results: Thirty patients completed our study follow up schedule. Mean age of the patients was 41.72 ± 8.50, while mean age of female partner was 37.23 ± 8.54 years. IELT was highly significantly increased (P-value < 0.001) after HA gel injection from baseline, which was in maximum 37.83 ± 11.01 sec at baseline to 323.03 ± 42.06, 281.07 ± 41.05, 241.03 ± 43.09 and 235.6 ± 41.87 sec after 1, 3, 6 and 12 months, respectively, after injection. Three patients complained from discomfort at the site of injection, two from bullae formation at the site of injection and one from ecchymosis, and all resolved spontaneously after 1 week to 10 days after injection.
Conclusion: HA gel injection in glans penis using our new five-puncture technique is a safe and effective method that ensures a modest long-term significant increase in IELT and improves ejaculatory control.
{"title":"Outcome of hyaluronic acid gel injection in glans penis for treatment of lifelong premature ejaculation: A pilot study.","authors":"Ahmed Sakr, Hazem Elgalaly, Mohamed M Seleem, Mostafa Kamel, Ahmed I El-Sakka, Ibrahim M Ibrahim","doi":"10.1080/2090598X.2022.2100580","DOIUrl":"https://doi.org/10.1080/2090598X.2022.2100580","url":null,"abstract":"<p><strong>Objective: </strong>To assess safety and efficacy of hyaluronic acid (HA) gel injection in glans penis for treatment of premature ejaculation (PE) using our new five puncture technique.</p><p><strong>Patients and methods: </strong>This is a prospective, non-randomized clinical trial on HA gel injection in glans penis for all patients with lifelong PE; all patients were circumcised having heterosexual normal marital life and sexually active. Patients with history of ejaculatory medication use within the previous 3 months, psychiatric disorders, erectile dysfunction, lower urinary tract symptoms (LUTS) due to prostatitis and acquired PE were excluded from the study. A local anesthetic was applied to the skin of glans penis for 30 minutes before the injection of 2 ml HA in glans penis via 30-gauge needle using our new Five-puncture technique. Intra-vaginal ejaculatory latency time (IELT) was measured at 1, 3, 6 and 12 months after injection.</p><p><strong>Results: </strong>Thirty patients completed our study follow up schedule. Mean age of the patients was 41.72 ± 8.50, while mean age of female partner was 37.23 ± 8.54 years. IELT was highly significantly increased (<i>P</i>-value < 0.001) after HA gel injection from baseline, which was in maximum 37.83 ± 11.01 sec at baseline to 323.03 ± 42.06, 281.07 ± 41.05, 241.03 ± 43.09 and 235.6 ± 41.87 sec after 1, 3, 6 and 12 months, respectively, after injection. Three patients complained from discomfort at the site of injection, two from bullae formation at the site of injection and one from ecchymosis, and all resolved spontaneously after 1 week to 10 days after injection.</p><p><strong>Conclusion: </strong>HA gel injection in glans penis using our new five-puncture technique is a safe and effective method that ensures a modest long-term significant increase in IELT and improves ejaculatory control.</p>","PeriodicalId":8113,"journal":{"name":"Arab Journal of Urology","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9930752/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9315934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}