Adam Hollander

Male orgasmic disorder is common, with few treatment options. Cabergoline is a dopamine agonist that acts centrally to normalize serum prolactin that could improve orgasmic dysfunction. To determine whether cabergoline increases the potential for orgasm in men with orgasmic disorder. A retrospective chart review of men treated in a single andrology clinic for delayed orgasm or anorgasmia in a pilot study using cabergoline 0.5 mg twice weekly was performed. Duration of treatment and response were noted. Medical records were examined for other factors including history of prostatectomy and concomitant androgen supplementation. Subjective improvement in orgasmic function resulting from cabergoline treatment. Of 131 men treated with cabergoline for orgasmic disorder, 87 (66.4%) reported subjective improvement in orgasm and 44 (33.6%) reported no change in orgasm. Duration of therapy (P = .03) and concomitant testosterone therapy (P = .02) were associated with a significant positive resp...

ABSTRACT The overactive bladder (OAB) syndrome is increasingly being recognized as a major contributor to the lower urinary tract symptoms in men previously thought to be only due to bladder outlet obstruction from benign prostatic hyperplasia. Medical and surgical treatments that have historically been used to treat women with OAB are being applied to men with great efficacy and a good safety profile. Additionally, treatments such as the β-3 agonist mirabegron, phosphodiesterase-5 inhibitors, sacral and peripheral neuromodulation, and intravesical botulinum toxin injection are promising emerging therapies for the OAB syndrome. This review discusses the evaluation of the male patient with OAB symptoms such as urgency and urge incontinence, and explores the different therapeutic options available for management of men with OAB.

Urethral diverticulum formation after midurethral sling placement is a very rare complication. Only 3 previous cases have been reported in the English literature. This is the first reported case of urethral diverticulum formation after midurethral sling excision for urethral erosion. A 43-year-old female patient presented with recurrent stress incontinence after midurethral tension-free vaginal tape sling removal for urethral erosion. Retrograde urethrogram demonstrated a urethral diverticulum. Video urodynamics showed a Valsalva leak point pressure of 50 cm H2O at 250 mL. She subsequently underwent urethral diverticulectomy with pubovaginal sling placement. We present the first reported case of urethral diverticulum formation after midurethral sling excision for urethral erosion. Future consideration must be given to full excision of the sling tract during the sling removal operation in cases of urethral erosion to prevent this rare complication.