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Purpose: To compare the efficiency and safety of 3-week and 6-week duration of double-J stent placement in patients who received a kidney transplant. Patients and Methods: Post-transplant recipients were divided into two groups. The duration of double-J stent placement was 6 weeks in group 1 (n = 186) and 3 weeks in group 2 (n = 179). Both groups received similar antibiotics and immunosuppressants. The double-J stents were removed cystoscopically under local anesthesia. The patients were followed up for at least 3 months. Urological complications were recorded, including urinary leakage, obstruction, and urinary tract infections. Results: There were no severe urological complications in both groups. Duration of 3 weeks was as effective as 6 weeks in preventing urological complications such as urinary leak and stenoses. There was no significant difference between the two groups in average duration of macroscopic hematuria, incidents of malposition of double-J stent and calculus formation in or around the stent. Compared with group 1, patients in group 2 had a lower incidence of urinary irritation and fewer urinary tract infection episodes. Conclusions: A shorter duration of double-J stent placement in renal transplantation recipients does not increase urological complications. In addition, it may decrease urinary tract infection and urinary irritation.

Purpose: To introduce and evaluate our open antegrade radical prostatectomy (ARP) technique, a nerve-sparing technique which offers patients better postsurgical urinary continence by our technique of ‘Veil of Aphrodite’. Methods: Ninety consecutive bilateral nerve-sparing ARPs performed using the Veil technique (intrafascial dissection) were compared to control ARP cases using non- or unilateral nerve sparing. Correlation of urinary continence with immunohistochemical (IHC) stains of nerves (S-100) around the prostate capsule was investigated in 20 consecutive patients whose ARPs were performed by a single surgeon. Results: Fifty-one cases (56.7%) had no urinary incontinence and 72 cases (80.0%) had no or only minor urinary leakage (less than 5% in total a day), and these were significantly higher than in the control group (p = 0.000 and 0.003, respectively) without compromising the surgical margins. S-100 IHC stains significantly correlated nerve sparing (bilateral sparing vs. non-sparing, p = 0.0398), urinary continence (no urinary continence vs. more than 5% in total urine volume a day, p = 0.0489), and early removal of catheter (within a week vs. over a week, p = 0.0041). Conclusions: Open nerve-sparing ARP using the Veil technique may offer better urinary continence postoperatively and this may be supported by S-100 IHC results. This method may be adaptable in any surgical institution.

Urinary leakage at the urethrovesical anastomosis is a rare but troublesome complication after radical prostatectomy. Usually, the anastomosis is almost watertight when tested during the operation and small leakages typically seal off in a few days. We describe 3 cases with postoperative urinary leakage where we have utilized a simple procedure of replacing the standard Foley catheter with another catheter with extra side fenestrations close to the anastomosis. Side fenestrations provide efficient drainage at the anastomosis area leading to a rapid resolution of the leakage. The method described represents an effective and low-risk solution to a potentially harmful complication.

Purpose: The two major types of urologic problems after renal transplantation are urinary leakage and obstruction. In this study, we report the urological complications of renal transplantations performed in our hospital during a 22-year period. Patients and Methods: Between 1978 and 2000, 433 consecutive patients underwent renal transplantation. Of those transplants, 50 were cadavers and 383 were living-related donor transplantation. All ureteroneocystostomies were performed with the same technique described by Woodruff. Results: Urological complications developed in 19 (4.23%) recipients. Those complications were urinary leakage in 9 (2%), ureteral obstruction in 9 (2%) and ureteral necrosis in 1 patient (0.23%). All complications occurred during the 6-month postoperative period and after re-operation or conservative management no graft or patient was lost due to urological complications. Conclusion: The quoted overall rate of urological complications varies from 2.9 to 12.5%; our complication rate was 4.23%. This relatively low rate is probably due to the Woodruff ureteroneocystostomy technique.

Introduction: The use of ketamine as a recreational drug is on the increase among young adults attending clubs and parties. Recreational ketamine users have anecdotally reported increased lower urinary tract symptoms while using the substance. Methods: We describe the severe lower urinary tract symptoms experienced in 6 patients with chronic recreational ketamine use. We obtained a detailed history and physical examination along with further investigation to identify a relationship between recreational ketamine use and these symptoms. Results: The urine cultures were sterile in all cases. Intravenous urography was performed in 3 patients and demonstrated bilateral upper ureteric narrow, mild bilateral hydronephrosis and contracted bladder urodynamic studies showed detrusor instability with urinary leakage when the bladder was filled to a capacity of 30– 50 ml. Cystoscopy revealed a small capacity bladder with erythematous lesions throughout the bladder. Bladder biopsies were performed in 3 patients and showed up as chronic cystitis. Ketamine cessation along with intravesical sodium hyaluronate solution appeared to provide some symptomatic relief. Conclusion: Ketamine-associated urinary tract dysfunction appears to be a relatively new clinical phenomenon. The pathological mechanism of ketamine-associated urinary tract dysfunction is unknown and current management strategies are ketamine cessation along with intravesical sodium hyaluronate solution.

Aim: This study was planned to determine the effect of urinary leakage on sexual function during sexual intercourse. Methods: The study group included 32 incontinent women who had urinary leakage during sexual intercourse and the control group consisted of 60 women with no such problem. The Sexual History Form of Schover and Jensen was completed in face-to-face interviews in a private room. Results: When compared with the women without any problem, the women with urinary incontinence were 4.7 times less satisfied with their sexual life and their partners had ejaculation without full erection 3.1 times more. In order to cope with the problem of urinary incontinence during coitus the women themselves adopted several methods. Trying to keep their partners unaware of the problem and deferring the intercourse were among the most frequently adopted methods. 43.7% of the study group indicated that this problem affected their sex life. Conclusions: The results of this study support the view that urinary leakage during coitus affects women’s sex life adversely.