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Objective To assess the perceived importance of male ejaculatory function (EjF) from the perspective of adult men and their sexual partners. Methods In a large survey study, men were asked about the importance of their own EjF. Sexual partners of men were asked about the general importance their partner's EjF, and whether they would support a partner's decision to pursue BPH treatment despite ejaculatory dysfunction. Results One hundred and two men completed the survey section regarding their own EjF, and 100 participants completed the survey section assessing the importance of their male partner's EjF. While 55% of men agreed or strongly agreed that “ejaculation is an important part of an enjoyable sexual experience,” only 30% of partners similarly agreed or strongly agreed (P = .005). A greater percentage of men (12%) agreed or strongly agreed that they “preferred large semen volume” compared to sexual partners of men (3%), however this was not significant. Sixty eight percent of sexual partners would agree or strongly agree to support their male partner's decision to pursue BPH treatment despite potential ejaculatory dysfunction. Conclusion The perceived importance of EjF differs between men and their sexual partners, as men believe ejaculation to be a more important component of an enjoyable sexual experience than their partners.

Background Parastomal and ventral hernias are common complications in patients with continent catheterizable channels or incontinent urinary diversions. Patients with neurogenic bladder are at particularly high risk due to weak abdominal wall musculature, and hernia repair often requires resiting of their stoma. While parastomal hernia repair with urinary stoma resiting has acceptable long-term success rates, it often necessitates a laparotomy which is associated with significant morbidity. Objective To describe a novel approach to combined laparoscopic parastomal hernia repair with resiting of the urinary stoma in patients with neurogenic bladder. The video will outline the surgical steps and pitfalls. Materials and Methods The case begins laparoscopically or robotically with adhesiolysis to dissect out the subfascial portion of the channel and the parastomal hernia. The subfascial portion of the channel is dissected out to the anterior abdominal wall, ensuring to preserve its mesentery. The abdomen is then desufflated and the suprafascial portion of the channel is dissected and the channel dropped into the abdomen. The hernia is then repaired laparoscopically using mesh and the channel is brought out through one of the laparoscopic port sites and matured to the skin. Results In our series of 4 patients, this technique was performed for 2 continent catheterizable channels and 2 incontinent diversions. One patient developed a hernia recurrence 7 months later which was repaired laparoscopically. In another, the stoma was successfully resited but the hernia was unable to be repaired laparoscopically due to dense adhesions. Continent and patency outcomes of the urinary stomas were 100% at a mean follow-up of 2 years. Conclusion Laparoscopic parastomal hernia repair with resiting of the urinary stoma has similar long-term success rates compared to that of an open repair and avoids the morbidity of a laparotomy. This repair can be performed for catheterizable channels or incontinent diversions.

Background Continent cutaneous ileocecocystoplasty (CCIC) involves reconfiguring the ileocecal segment for use as a bladder augment and continent catheterizable channel. CCIC requires release of the hepatic flexure of the colon, which necessitates a longer midline laparotomy than would be required for a standard bladder augmentation. This is associated with high rates of ventral and parastomal hernias. Objectives To describe the technique of hand-assist laparoscopic CCIC and to compare outcomes to open CCIC. Materials and Methods We found pure laparoscopic colon mobilization difficult due to significant colonic distension in patients with neurogenic bladder and bowel. We modified our approach to hand-assisted laparoscopic mobilization for better retraction of the bowel. A 12-mm camera port is placed through the umbilicus, which later serves as the stoma site, and a 5-mm assist port is placed a handbreadth cephalad to the 12-mm port. A Pfannenstiel incision is made for use as the hand port. After colonic mobilization is completed the remainder of the procedure is performed in an open fashion through the Pfannenstiel incision. The primary outcome was 90-day Clavien grade 2 or greater complications. Secondary outcomes included revision rates, wound infection, urinary continence, operative time, and length of stay. Data was analyzed using Mann-Whitney U test and Fisher's exact test. Results Thirty-two laparoscopic and 21 open procedures were reviewed. Those who underwent open procedures were more likely to have undergone prior catheterizable channel or bladder augmentation (7 vs 1, P Conclusion Hand-assist laparoscopic CCIC offers a minimally invasive alternative to open CCIC with fewer short-term complications and comparable long-term outcomes.

Cystic partially differentiated nephroblastoma (CPDN) is a rare multicystic renal tumor along the spectrum of cystic nephroma and cystic Wilms' tumor. There have only been two previously reported cases of bilateral CPDN in the literature. We present here a case of bilateral CPDN vs cystic Wilms' tumor treated with neoadjuvant and adjuvant chemotherapy in addition to a bilateral partial nephrectomy. We also review the relevant literature regarding CPDN in an effort to aid in diagnosis and management of these rare cystic renal tumors.