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Objective To evaluate the safety and effectiveness of daily 5-mg tadalafil treatment for men who have erectile dysfunction (ED) and premature ejaculation (PE), and to assess the long-term follow-up for ED and PE improvement persistence years after the cessation of medication. Patients and Methods A prospective, single-blind, randomised study included 160 patients with ED and PE. All were evaluated using the International Index of Erectile Function (IIEF-5) questionnaire to evaluate ED and intravaginal ejaculatory latency time (IELT) for PE. Patients were subdivided into two equal groups. Group I (80 patients) treated with daily 5-mg tadalafil for 3 months, and Group II (80 patients) treated with a placebo for the same period. After 3 months of treatment and 2 years later after cessation of tadalafil, all patients were assessed for ED and PE. Results The mean (SD) IELT and IIEF-5 score pre-treatment were 37 (11.24) s and 13.2 (4.2) for Group I, while in Group II they were 35.98 (10.8) s and 13.12 (4.11), respectively. After 3 months of treatment, the mean (SD) IELT in Group I showed a highly significant improvement from 37 (11.24) s to 120.5 (47.37) s (P 0.05]. For the IIEF-5 score, there was a highly significant improvement from baseline to 20.45 (4.5) in Group I (P 0.05]. At 2 years after cessation of tadalafil, there was statistically significant improvement in the IELT and IIEF-5 from baseline to endpoint . Conclusion Oral daily 5-mg tadalafil was effective, tolerable, and safe treatment for patients with ED and PE. Long-term follow-up at 2 years confirmed the persistence of a significant improvement for both ED and PE. Abbreviations: ED: erectile dysfunction; IIEF-5: five-item version of the International Index of Erectile Function questionnaire; IELT: intravaginal ejaculatory latency time; OAD: once-daily; PDE5i: phosphodiesterase-5 inhibitors; PE: premature ejaculation; PRN: pro re nata

Background: Since invention of tubularized incised plate urethroplasty, many modifications have been proposed searching for excellence and perfection. Distal extension of the midline urethral plate incision beyond glanular demarcation as a modification of the standard technique was critically evaluated and compared with the original technique in a prospective study and investigating predictors of success. Methods: In this prospective study, patients with primary distal hypospadias presented for repair between June 2015 and January 2019 were randomized to undergo either extended midline incision of the urethral plate (e-TIP) or standard technique (s-TIP). Cosmetic outcome was evaluated postoperatively using Hypospadias Objective Penile Evaluation (HOPE) score and measuring ventral glans closure length (VGCL) and meatal length (ML). The functional outcome was assessed by uroflowmetry and postvoid residual urine. Qmax and Qave values were plotted against voided volume on a nomogram of age matched children. The impact of preoperative parameters on the outcomes were assessed with linear regression analysis. Results: Out of 110 randomized, 94 cases were available for analysis, 46 in e-TIP group and 48 cases in s-TIP group with comparable preoperative demographics. Postoperatively, higher median (range) of HOPE score in e-TIP was 57(45–60) versus 55(44–60) in s-TIP (p