Despite the importance of sexuality for both men and women of all ages, only in the last few years extensive research has been carried out into female sexual problems. It has been discovered that ...sexual problems affect a considerable number of women each year, and this indicates the validity and necessity of further medical studies. We know that female genital sexual response is a combination of vasocongestive and neuromuscular events in the genital tract and pelvic floor which are controlled in part by specific neurotransmitters. Other pelvi-perineal genital structures undergo vasculogenic changes, namely the labia, periurethral glands, urethra and the Halban's fascia but much less attention has been paid to the role of these tissues in sexual response compared to the clitoris and the vagina. The most common etiologies of female sexual dysfunction are vasculogenic, neurogenic, hormonal/endocrine, muscologenic. The increasing various problems of female sexual dysfunction and the interest in the matter and the subsequent research are factors which keep the scientific community involved constantly active.
PurposeTo prospectively evaluate the efficacy and safety of RIRS, SWL and PCNL for lower calyceal stones sized 1–2 cm.Materials and methodsPatients with a single lower calyceal stone with an evidence ...of a CT diameter between 1 and 2 cm were enrolled in this multicenter, randomized, unblinded, clinical trial study. Patients were randomized into three groups: group A: SWL (194 pts); group B: RIRS (207 pts); group C: PCNL (181 pts). Patients were evaluated with KUB radiography (US for uric acid stones) at day 10 and a CT scan after 3 months. The CONSORT 2010 statement was adhered to where possible. The collected data were analyzed.ResultsThe mean stone size was 13.78 mm in group A, 14.82 mm in group B and 15.23 mm in group C (p = 0.34). Group C compared to group B showed longer operative time 72.3 vs. 55.8 min (p = 0.082), fluoroscopic time 175.6 vs. 31.8 min (p = 0.004) and hospital stay 3.7 vs. 1.3 days (p = 0.039). The overall stone-free rate (SFR) was 61.8% for group A, 82.1% for group B and 87.3% for group C. The re-treatment rate was significantly higher in group A compared to the other two groups, 61.3% (p < 0.05). The auxiliary procedure rate was comparable for groups A and B and lower for group C (p < 0.05). The complication rate was 6.7, 14.5 and 19.3% for groups A, B and C, respectively.ConclusionsRIRS and PCNL were more effective than SWL to obtain a better SFR and less auxiliary and re-treatment rate in single lower calyceal stone with a CT diameter between 1 and 2 cm. RIRS compared to PCNL offers the best outcome in terms of procedure length, radiation exposure and hospital stay.ISRCTN 55546280.
Introduction
Metastatic squamous cell carcinoma of the penis is a rare condition in European countries. Neoadjuvant chemotherapy improves local disease control in patients with lymph node metastases ...and/or inoperable disease. Limited data exist on the efficacy and safety of chemotherapy in the adjuvant setting for patients with metastatic disease after previous neoadjuvant chemotherapy and locoregional therapy.
Methods
Twelve patients with metastatic penile carcinoma previously treated with neoadjuvant chemotherapy and locoregional therapy were enrolled into the study. Treatment protocol consisted of paclitaxel 175mg/m
2
at a 3-week interval. Objective response rate according to Response Evaluation Criteria in Solid Tumors, progression-free survival, overall survival and toxicity were evaluated.
Results
A partial objective response, a disease stability, and a disease progression were documented in 3, 3 and 6 patients, respectively. Median progression-free survival and median overall survival were 4 and 6 months, respectively. Treatment was well tolerated; only one case of grade 4 toxicity was reported.
Conclusions
Our initial data suggest that paclitaxel monotherapy is active and well tolerated in patients with metastatic squamous cell penile carcinoma previously treated with neoadjuvant systemic chemotherapy and local therapy. Further studies are therefore needed.
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