Incidence of Penile Fracture in Iran, a Cross-Sectional Study

Background: Penile fracture is a urological emergency requiring proper diagnosis and treatment. Limited studies conducted in Iran have reported high prevalence of this problem (9.9 per 100,000 male population). In this study, we also examined the causes and symptoms, as well as the type of treatment physicians choose so that in the future, we can use this data to educate physicians and other people in the community about this disease. Methods: First, all urologists across the country were contacted and informed about the project. Then, from February 2017 to February 2018, a pre-prepared questionnaire containing the required information was sent to them and they were asked to complete and send this questionnaire in case of a penile fracture. Then, every two weeks, we reconnected all urologists in different ways (email, phone call, virtual networks, etc.) and collected relevant data. Finally, all data were analyzed using SPSS software, version 19.  Results: The incidence of penile fractures was estimated to be 2.5 per 100,000 men (from 0.38 in the age range of 69-60 years to 3.9 in the age range of 39-30 years). The most common causes of penile fractures were sexual intercourse (64.8%), followed by non-sexual trauma (16.9%) and masturbation (13.3%). Pain, edema and discoloration of the penis were the most common symptoms at the time of admission (83.6%) and most patients (84%) had referred to a physician within the first 24 hours after the accident. 78.9% of urologists believed in emergency surgical treatment, while 20.3% believed in delayed surgical treatment and 0.7% believed in supportive treatment. Conclusion: Because of the cultural diversity of Iran, the rate of penile fracture is very different in different parts of Iran, but its rate is much lower than previous studies

Comparison of Stone Retrieval Basket, Stone Cone and Holmium Laser: Which One Is Better in Retropulsion and Stone-Free Status for Patients with Upper Ureteral Calculi?

Introduction: Transurethral lithotripsy (TUL) is an appropriate treatment for ureteral stones and is usually used for stones in the middle and lower part of the ureter. Different devices such as Holmium laser, stone basket and stone cone exist to prevent any fragments from retropulsion during TUL. The present study aims to compare the advantages and disadvantages of the Holmium laser, stone basket and stone cone. Methods: A retrospective study was conducted from September 2016 to January 2018 comparing various TUL methods in 88 subjects with proximal ureteral calculi. The study participants were devided into four matched groups. The first one included 20 patients undergoing TUL with no device (Group 1), the second group included 22 patients undergoing TUL while using the stone retrieval basket, the third group included 18 patients undergoing TUL while utilizing the stone cone and the fourth group included 28 patients undergoing TUL while using Hol-YAG laser. Results: A residual stone ≥ 3 mm was recorded in 15.9% of the patients. stone free rate were seen in 100%, 90.9, 83.3%and 55% in Holmium laser group, retrieval basket group, stone cone group and no device group respectively(p:0.001). Lowest rate of surgery complications including ureteral perforation, Post-operative fever and mucosal damage between 4 groups (p: 0.003) and highest time of surgery (p: 0.001) belong to laser group. If we want to ignore the laser group, success rate for lithotripsy was better in both groups with stone retrieval device compared to the no device group, but no advantage existed between stone basket and stone cone. Conclusion:We can safely conclude that laser significantly help to prevent stone migration during TUL. If we want to ignore the laser group, success rate for lithotripsy was significantly better in both groups with stone retrieval device compared to the no device group, but no advantage existed between stone basket and stone cone