Summary
Several intralesional therapeutic protocols have been proposed for the treatment of Peyronie's disease. Among all, hyaluronic acid (HA) and verapamil have been differently tested. We aimed to ...evaluate the efficacy of intralesional verapamil (ILVI) compared with intralesional HA in patients with early onset of Peyronie's disease (PD). This is a multi‐centre prospective double‐arm, randomized, double‐blinded study comparing ILVI vs. intralesional HA after 12‐weeks. Sexually active men, older than 18 years and affected by the acute phase of PD were eligible for this study. Patients have been double‐blinded randomly divided into two groups (1 : 1 ratio): Group A received intralesional treatment with Verapamil (10 mg in 5 mL of normal saline water) weekly for 12 weeks, while group B received intralesional treatment with HA (0.8% highly purified sodium salt HA 16 mg/2 mL) weekly for 12 weeks. The primary efficacy outcome was the change from the baseline to the endpoint (12 weeks after therapy) for the penile curvature (degree). The secondary outcome was the change in the plaque size and in the International Index of erectile Function (IIEF‐5) score. The difference between post‐ and pre‐treatment plaque size was −1.36 mm (SD ± 1.27) for Group A and −1.80 mm (SD ± 2.47) for Group B (p‐value = NS). IIEF‐5 increased of 1.46 points (SD ± 2.18) in Group A and 1.78 (SD ± 2.48) in Group B (p‐value ± NS). No difference in penile curvature was observed in Group A, while in Group B the penile curvature decreased of 4.60° (SD ± 5.63) from the baseline (p < 0.001) and vs. Group A. According to PGI‐I results, we found significant difference as concerning patient global impression of improvement (PGI‐I) (4.0 vs. 2.0; p < 0.05). This prospective, double‐arm, randomized, double‐blinded study comparing ILVI vs. HA as intralesional therapy showed greater efficacy of HA in terms of penile curvature and PGI‐I.
Summary
Extracorporeal shock wave therapy improves erectile function in patients with Peyronie’s disease. However, erectile dysfunction still persists in many cases. We aimed to investigate the ...effects of extracorporeal shock wave therapy plus tadalafil 5 mg once daily in the management of patients with Peyronie’s disease and erectile dysfunction not previously treated. One hundred patients were enrolled in a prospective, randomized, controlled study. Patients were randomly allocated to receive either extracorporeal shock wave therapy alone for 4 weeks (n = 50) or extracorporeal shock wave therapy plus tadalafil 5 mg once daily for 4 weeks (n = 50). Main outcome measures were: erectile function (evaluated through the shortened version of the International Index of Erectile Function), pain during erection (evaluated through a Visual Analog Scale), plaque size, penile curvature and quality of life (evaluated through an internal questionnaire). Follow‐up evaluations were performed after 12 and 24 weeks. In both groups, at 12 weeks follow‐up, mean Visual Analog Scale score, mean International Index of Erectile Function score and mean quality of life score ameliorated significantly while mean plaque size and mean curvature degree were unchanged. Intergroup analysis revealed a significantly higher mean International Index of Erectile Function score and quality of life score in patients receiving the combination. After 24 weeks, intergroup analysis revealed a significantly higher mean International Index of Erectile Function score and mean quality of life score in patients that received extracorporeal shock wave therapy plus tadalafil. In conclusion extracorporeal shock wave therapy plus tadalafil 5 mg once daily may represent a valid conservative strategy for the management of patients with Peyronie’s disease and erectile dysfunction.
Premature ejaculation (PE) is the most frequent sexual complaint.
To investigate prevalence of PE and its associated conditions.
We analyzed information gathered from men attending a free andrologic ...consultation in 186 Italian medical centers, in the setting of a project focused on andrologic prevention.
Risk factors for PE.
Five hundred sixty‐nine men suffered from lifelong PE; 1,855 had previously normal ejaculation; and 234 had PE not specified. Men with PE were younger than those without, but after adjusting for concomitant erectile dysfunction the risk of PE significantly decreased with aging. Men more educated, or who had experienced a divorce had a slightly increased risk. Also, lifestyle and occupational status affected the risk of PE. Concerning medical history, a decreased risk of PE emerged in men with treated diabetes, and no association was found with hypertension, cardiopathy, hypercholesterolemia, and peripheral or central neuropathy.
The results of the analysis of a large dataset show that subjects with PE who are seeking treatment either have experienced stress‐related problems or have a physical condition predisposing to this dysfunction (genital anomalies, prostate inflammation).
In this study, we aimed to investigate the clearance of type-specific genital human papillomavirus (HPV) infection in heterosexual, non-HPV-vaccinated males whose female partners were positive to HPV ...DNA tests. All consecutive men attending the same sexually transmitted diseases (STD) centre between January 2005 and December 2006 were considered for this study. All subjects (
n
= 1009) underwent a urologic visit and microbiological tests on first void, midstream urine and total ejaculate samples. One hundred and five patients were positive for HPV DNA (10.4 %; mean age: 34.8 ± 5.8 years) and consented to clinical examination and molecular diagnostic assays for HPV detection scheduled every 6 months (median surveillance period of 53.2 months). HPV genotypes were classified as high risk, probable high risk and low risk. HPV-positive samples which did not hybridise with any of the type-specific probes were referred to as positive non-genotypeable. At enrollment, the distribution of HPV genotypes was as follows: high-risk HPV (
n
= 37), probable high-risk HPV (
n
= 6), low-risk HPV (
n
= 23) and non-genotypeable HPV (
n
= 39). A high HPV genotype concordance between stable sexual partners emerged (kappa = 0.92;
p
< 0.001). At the end of the study, 71/105 (67.6 %) subjects were negative for HPV (mean virus clearance time: 24.3 months). With regard to the HPV genotype, virus clearance was observed in 14/37 (37.8 %) high-risk HPV cases, 6/6 (100 %) probable high-risk HPV cases, 20/23 (86.9 %) low-risk HPV cases and 31/39 (79.5 %) non-genotypeable cases. The high-risk HPV genotypes showed the lowest rate and probability of viral clearance (
p
< 0.001). In our series, high-risk HPV infections were more likely to persist over time when compared with other HPV genotypes.
Renal transplantation represents actually the most effective therapy in patients with end-stage renal failure as it is cost effective, allows for a normal life style and reduces the risk of mortality ...from dialysis related complications. Renal transplantation can be classified in deceased- donor or living-donor transplantation, depending on the source of the donor organ. The short-term results of transplants with kidneys from donors over 65 years old are almost similar to those with younger organs, but in these patients it is mandatory to reduce cold ischemia time. In the last years, the demand for kidney transplantation has increased dramatically, which has been associated with an increase in living-donor organ procurement, which presents several advantages. Moreover, new operative techniques have been recently developed in order to improve surgical outcomes and graft survival and to reduce the complications' rate after renal transplantation. The purpose of the present review is to evaluate the published literature regarding the technical aspects and the urological complications associated with renal transplantation.
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