Nadeem U. Rahman

The effect of neural embryonic stem cell therapy in a rat model of cavernosal nerve injury

To isolate embryonic stem cells that have differentiated along the neuronal cell line, and to assess whether injecting these neural stem cells into the corpus cavernosum influences cavernosal nerve regeneration and functional status.

An animal model to study lower urinary tract symptoms and erectile dysfunction: the hyperlipidaemic rat

To present evidence that rats fed a high‐fat diet could serve as a useful animal model to study both lower urinary tract symptoms (LUTS) and erectile dysfunction (ED), as recent epidemiological studies have shown a strong association between LUTS and ED but the physiological basis behind this relationship is unknown.

The additive erectile recovery effect of brain‐derived neurotrophic factor combined with vascular endothelial growth factor in a rat model of neurogenic impotence

To test the hypothesis that combined intracavernosal injection with vascular endothelial growth factor (VEGF) with adeno‐associated virus‐mediated brain‐derived neurotrophic factor (AAV‐BDNF) synergistically facilitates the neural regeneration and erectile function after cavernosal nerve injury.

Infections and Urinary Stone Disease

The relationship between urinary infections and stone formation has been recognized since antiquity and it has been over a century since bacterial degradation of urea was postulated to cause struvite stones. Specific therapy for urease-producing bacteria, such as urease-inhibitors and antibiotics, has allowed for treatment for this subset of urinary stones. Future directions for research include development of novel urease-inhibitors and chemicals to enhance the protective glycosaminoglycan layer. An improved understanding of the pathogenesis of calcium-based stones has led to the discovery of potential roles for nanobacteria and Oxalobacter formingenes. Methods of altering intestinal regulation of oxalate by reintroduction of lactic acid bacteria may significantly impact the treatment of calcium oxalate stones. The use of catheters, both urethral and ureteral, is common in the urinary tract and is associated with significant morbidity, primarily from associated infections. Catheters to prevent bacterial colonization and formation of biofilms have been created using various coatings, including ciprofloxacin, hydrogel, and silver. Use of these types of catheters may minimize infections and encrustation inherent with their placement in the urinary tract.

Combined external urethral bulking and artificial urinary sphincter for urethral atrophy and stress urinary incontinence

To describe a technique of externally bulking the urethra with a soft‐tissue graft before placing another artificial urinary sphincter (AUS), as when placing another AUS for recurrent male stress urinary incontinence (SUI) other manoeuvres, e.g. placing a tandem cuff or transcorporal cuff, must be used to obtain urinary continence in an atrophic urethra, and each is associated with morbidity.

Mechanism of Continence After Repair of Posterior Urethral Disruption: Evidence of Rhabdosphincter Activity

PURPOSE Controversy exists regarding continence mechanisms in patients who undergo posterior urethral reconstruction after pelvic fracture. Some evidence suggests that continence after posterior urethroplasty is maintained by the bladder neck or proximal urethral mechanism without a functioning distal mechanism. We studied distal urethral sphincter activity in patients who have undergone posterior urethroplasty for pelvic fracture. MATERIALS AND METHODS A total of 12 patients who had undergone surgical repair of urethral disruption involving the prostatomembranous region underwent videourodynamics with urethral pressure profiles at rest, and during stress and hold maneuvers. Bladder pressure and urethral pressure, including proximal and distal urethral sphincter activity and pressure, were assessed in each patient. RESULTS All 12 patients had daytime continence of urine postoperatively with a followup after anastomotic urethroplasty of 12 to 242 months (mean 76). Average maximum urethral pressure was 71 cm H2O. Average maximum urethral closure pressure was 61 cm H2O. The average urethral pressure seen during a brief hold maneuver was 111 cm H2O. Average functional sphincteric length was 2.5 cm. Six of the 12 patients had clear evidence of distal urethral sphincter function, as demonstrated by the profile. CONCLUSIONS Continence after anastomotic urethroplasty for posttraumatic urethral strictures is maintained primarily by the proximal bladder neck. However, there is a significant contribution of the rhabdosphincter in many patients.

Peyronie’s Disease: Surgical Treatment

A detailed medical and psychosexual history of the patient with Peyronie’s disease should include information about the duration and progression of the symptoms, penile rigidity, ability to have sexual intercourse, history of penile trauma or surgery, history of medication, and family history of Peyronie’s disease or Dupuytren’s contracture.