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Objectives: To assess depression and health-related quality of life (HRQOL) in 89 people with refractory urge incontinence, nonobstructive urinary retention, or urgency frequency enrolled at 13 U.S. study centers. The subjects were part of a large international, multicenter, randomized clinical trial on the safety and efficacy of sacral nerve stimulation for the treatment of refractory voiding dysfunction.Methods: The Beck Depression Index and the Medical Outcomes Study Short-Form 36 were used to assess depression and HRQOL at baseline and at two follow-up visits.Results: Detectable levels of depression and reduced quality of life were noted at baseline. Subjects implanted with the stimulation device reported significant improvements in both HRQOL and depression at 3 months after implant that were maintained for the 6-month study period. Subjects assigned to the delayed implant group showed a slight worsening of HRQOL and depression from baseline to 3 months that continued through the 6-month visit.Conclusions: The results demonstrated the serious impact that unresolved voiding symptoms have on the physical, social, and psychological dimensions of quality of life. Treating refractory voiding dysfunction with sacral nerve stimulation resulted in improvement in both depression and HRQOL. [Copyright &y& Elsevier]

This is a unique case of bilateral metachronous testicular mesothelioma of the tunica vaginalis. Testicular mesothelioma is a rare entity found in patients with or without asbestos occupational exposure. The tumor most commonly presents as a unilateral testicular mass. More rare presentations include bilateral synchronous or metachronous tumors. Treatment is with surgical resection and prognosis is not generally favorable. The benefits of adjuvant therapy with radiation or chemotherapy remain unknown and further studies are needed. [ABSTRACT FROM AUTHOR]

Objective: To assess the patient and perioperative characteristics of urethral diverticulectomy using a large multi-institutional prospectively collected database.Materials and Methods: Female patients were identified using the American College of Surgeons National Surgical Quality Improvement Program participant user files (2007-2012) and current procedural terminology codes for urethral diverticulectomy (53,230). Preoperative variables and 30-day complications were examined.Results: Urethral diverticulectomies were performed on 122 females during the study period. The cohort was relatively healthy; 80% of patients had an American Society of Anesthesiologists score of 1 or 2. The majority of procedures were performed in an outpatient setting (82%). The median procedure length was 77.5 minutes (interquartile range: 50.5-112.5), and the median length of stay was 0 days (interquartile range: 0-1). The overall 30-day complication rate was 3.3% (n = 4): 3 patients developed urinary tract infections (UTIs) and 1 patient developed both a UTI and a superficial wound infection.Conclusion: To our knowledge, our study represents the largest multi-institutional cohort of patients having undergone urethral diverticulectomy. The patients requiring this intervention were relatively healthy, and the procedure itself was short, allowing most patients to be discharged within 24 hours. The 30-day complication rate was very low, with UTI being the most common complication. Thus, patients can continue to be confidently counseled that urethral diverticulectomy is a safe procedure with very few perioperative complications. [ABSTRACT FROM AUTHOR]