Pub Date : 2024-03-18DOI: 10.1590/S1677-5538.IBJU.20244.9902
F. Hadziselimovic
ABSTRACT In 2007 the Nordic group came to the following unanimous conclusions: In general, hormonal treatment is not recommended, considering the poor immediate results and the possible long-term adverse effects on spermatogenesis. Thus, surgery is to be preferred. However, defective mini puberty inducing insufficient gonadotropin secretion is one of the most common causes of nonobstructive azoospermia in men suffering from congenital isolated unilateral or bilateral cryptorchidism. The extent of alteration in the unilateral undescended testis correlate with the contralateral descended testis, indicating that unilateral cryptorchidism is a bilateral disease. Idiopathic central hypogonadism explains the phenomenon of defective mini puberty in otherwise healthy cryptorchid boys. We therefore recommend hormonal treatment for cryptorchid boys with defective mini puberty. Gonadotropin releasing hormone agonist (GnRHa) treatment following surgery to correct cryptorchidism restores mini puberty via endocrinological and transcriptional effects and prevents adult infertility in most cases. Several genes are important for central hypogonadotropic hypogonadism in mammals, including many that are transcribed in both the brain and testis. At the molecular level, there is no convincing evidence that heat shock is responsible for the observed pathological testicular changes. Thus, impaired transformation of gonocytes is not the result of temperature stress but rather a hormonal imbalance. Cryptorchidism should therefore be considered a serious andrological problem that cannot be successfully treated by early orchidopexy alone.
{"title":"Advocating hormonal treatment to prevent adult infertility in patients diagnosed with congenital undescended testes","authors":"F. Hadziselimovic","doi":"10.1590/S1677-5538.IBJU.20244.9902","DOIUrl":"https://doi.org/10.1590/S1677-5538.IBJU.20244.9902","url":null,"abstract":"ABSTRACT In 2007 the Nordic group came to the following unanimous conclusions: In general, hormonal treatment is not recommended, considering the poor immediate results and the possible long-term adverse effects on spermatogenesis. Thus, surgery is to be preferred. However, defective mini puberty inducing insufficient gonadotropin secretion is one of the most common causes of nonobstructive azoospermia in men suffering from congenital isolated unilateral or bilateral cryptorchidism. The extent of alteration in the unilateral undescended testis correlate with the contralateral descended testis, indicating that unilateral cryptorchidism is a bilateral disease. Idiopathic central hypogonadism explains the phenomenon of defective mini puberty in otherwise healthy cryptorchid boys. We therefore recommend hormonal treatment for cryptorchid boys with defective mini puberty. Gonadotropin releasing hormone agonist (GnRHa) treatment following surgery to correct cryptorchidism restores mini puberty via endocrinological and transcriptional effects and prevents adult infertility in most cases. Several genes are important for central hypogonadotropic hypogonadism in mammals, including many that are transcribed in both the brain and testis. At the molecular level, there is no convincing evidence that heat shock is responsible for the observed pathological testicular changes. Thus, impaired transformation of gonocytes is not the result of temperature stress but rather a hormonal imbalance. Cryptorchidism should therefore be considered a serious andrological problem that cannot be successfully treated by early orchidopexy alone.","PeriodicalId":13674,"journal":{"name":"International Brazilian Journal of Urology : official journal of the Brazilian Society of Urology","volume":"353 1","pages":"20 - 27"},"PeriodicalIF":0.0,"publicationDate":"2024-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140232911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-05DOI: 10.1590/S1677-5538.IBJU.2022.0059.1
Hanny Helena Masson Franck, A. C. S. Guedes, Y. F. S. Alvim, Thamires M. S. de Andrade, Liliana Fajardo Oliveira, Lidyanne Ilidia da Silva, A. Figueiredo, José de Bessa Jr., J. M. Netto
1 Departamento de Cirurgia da Faculdade de Medicina – Universidade Federal de Juiz de Fora (UFJF), Juiz de Fora, MG, Brasil; 2 Escola de Enfermagem – Universidade Federal de Juiz de Fora (UFJF), Juiz de Fora, MG, Brasil; 3 Escola de Fisioterapia – Faculdade de Ciências Médicas e da Saúde de Juiz de Fora (HMTJ/SUPREMA), Juiz de Fora, MG, Brasil; 4 Departamento de Cirurgia da Faculdade de Medicina – Universidade Estadual de Feira de Santana (UEFS), Feira de Santana, BA, Brasil
巴西MG州Juiz de Fora联邦大学(UFJF)医学院1外科;2护理学院-瑞士福拉联邦大学(UFJF)，瑞士福拉，MG，巴西;3物理治疗学院- Juiz de Fora医学和健康科学学院(HMTJ/SUPREMA)， Juiz de Fora, MG，巴西;费拉德桑塔纳州立大学(UEFS)医学院外科，费拉德桑塔纳，学士，巴西
{"title":"REPLY TO THE AUTHORS: Re: One-day voiding diary in the evaluation of Lower Urinary Tract Symptoms in children","authors":"Hanny Helena Masson Franck, A. C. S. Guedes, Y. F. S. Alvim, Thamires M. S. de Andrade, Liliana Fajardo Oliveira, Lidyanne Ilidia da Silva, A. Figueiredo, José de Bessa Jr., J. M. Netto","doi":"10.1590/S1677-5538.IBJU.2022.0059.1","DOIUrl":"https://doi.org/10.1590/S1677-5538.IBJU.2022.0059.1","url":null,"abstract":"1 Departamento de Cirurgia da Faculdade de Medicina – Universidade Federal de Juiz de Fora (UFJF), Juiz de Fora, MG, Brasil; 2 Escola de Enfermagem – Universidade Federal de Juiz de Fora (UFJF), Juiz de Fora, MG, Brasil; 3 Escola de Fisioterapia – Faculdade de Ciências Médicas e da Saúde de Juiz de Fora (HMTJ/SUPREMA), Juiz de Fora, MG, Brasil; 4 Departamento de Cirurgia da Faculdade de Medicina – Universidade Estadual de Feira de Santana (UEFS), Feira de Santana, BA, Brasil","PeriodicalId":13674,"journal":{"name":"International Brazilian Journal of Urology : official journal of the Brazilian Society of Urology","volume":"12 1","pages":"397 - 398"},"PeriodicalIF":0.0,"publicationDate":"2023-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74215680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-07-19DOI: 10.1590/S1677-5538.IBJU.2022.0089.1
A. Cavalcanti
In this article, the authors assess the clinical presentation of patients with urethral cuff erosion after the implant of an Artificial Urinary Sphincter (AUS) and also attempt to establish risk factors in this patient population (1). As well pointed out by the authors, this complication has an extreme impact on the treatment of these patients, both in the acute phase, associated with the inflammatory and infectious condition, and late related to the reimplantation of the device. Replantation of AUS after erosion is certainly one of the most challenging conditions in the management of male urinary incontinence. Despite the literature describing statistical data and risk factors for erosion, these hardly describe details about the evolution characteristics of this process. As observed by the authors, most patients present with inflammatory signs in the scrotum, but a significant part of patients (about 1/3) do not present these symptoms, and will exclusively have urinary symptoms (obstruction or incontinence relapse) (2). This is an important finding because even in the absence of inflammatory signs, erosion should be suspected when there are urinary symptoms, whether obstructive or incontinence relapse. In the case of obstructive symptoms, it is important to analyze whether there is a reference to urethral stenosis or urethro-vesical anastomosis in the patient’s clinical history for the differential diagnosis. In the case of incontinence relapse, it is usually more acute when compared to other causes such as urethral atrophy. As well demonstrated in the study, these symptoms can present in combination. In the study, inflammatory symptoms are more associated with obstruction, perhaps due to greater urine leakage, a fact that also justifies lower rates of the combination of incontinence relapse and inflammation. The presence of radiotherapy was more common in patients with erosion when compared to those without erosion, as well as hypertension, coronary heart disease and smoking. The identification of risk factors is essential for patient consent, as well as for technical interventions to be taken to prevent the problem at the time of implantation of the prosthesis. The authors did not demonstrate previous procedures such as urethroplasty as risk factors in this study, but in our opinion, all patients who have an established impact on urethral vascularization a risk factor for cuff erosion. In the specific case of urethroplasty, we should try to preserve the urethra vascularization in all patients who are at risk of developing postoperative incontinence. Early recognition of cuff erosion is critical for an early approach that is likely to be associated with less urethral damage. EDITORIAL COMMENT Vol. 48 (4): 686-687, July August, 2022 doi: 10.1590/S1677-5538.IBJU.2022.0089.1
{"title":"Impact of artificial urinary sphincter erosion in the reimplantation of the device","authors":"A. Cavalcanti","doi":"10.1590/S1677-5538.IBJU.2022.0089.1","DOIUrl":"https://doi.org/10.1590/S1677-5538.IBJU.2022.0089.1","url":null,"abstract":"In this article, the authors assess the clinical presentation of patients with urethral cuff erosion after the implant of an Artificial Urinary Sphincter (AUS) and also attempt to establish risk factors in this patient population (1). As well pointed out by the authors, this complication has an extreme impact on the treatment of these patients, both in the acute phase, associated with the inflammatory and infectious condition, and late related to the reimplantation of the device. Replantation of AUS after erosion is certainly one of the most challenging conditions in the management of male urinary incontinence. Despite the literature describing statistical data and risk factors for erosion, these hardly describe details about the evolution characteristics of this process. As observed by the authors, most patients present with inflammatory signs in the scrotum, but a significant part of patients (about 1/3) do not present these symptoms, and will exclusively have urinary symptoms (obstruction or incontinence relapse) (2). This is an important finding because even in the absence of inflammatory signs, erosion should be suspected when there are urinary symptoms, whether obstructive or incontinence relapse. In the case of obstructive symptoms, it is important to analyze whether there is a reference to urethral stenosis or urethro-vesical anastomosis in the patient’s clinical history for the differential diagnosis. In the case of incontinence relapse, it is usually more acute when compared to other causes such as urethral atrophy. As well demonstrated in the study, these symptoms can present in combination. In the study, inflammatory symptoms are more associated with obstruction, perhaps due to greater urine leakage, a fact that also justifies lower rates of the combination of incontinence relapse and inflammation. The presence of radiotherapy was more common in patients with erosion when compared to those without erosion, as well as hypertension, coronary heart disease and smoking. The identification of risk factors is essential for patient consent, as well as for technical interventions to be taken to prevent the problem at the time of implantation of the prosthesis. The authors did not demonstrate previous procedures such as urethroplasty as risk factors in this study, but in our opinion, all patients who have an established impact on urethral vascularization a risk factor for cuff erosion. In the specific case of urethroplasty, we should try to preserve the urethra vascularization in all patients who are at risk of developing postoperative incontinence. Early recognition of cuff erosion is critical for an early approach that is likely to be associated with less urethral damage. EDITORIAL COMMENT Vol. 48 (4): 686-687, July August, 2022 doi: 10.1590/S1677-5538.IBJU.2022.0089.1","PeriodicalId":13674,"journal":{"name":"International Brazilian Journal of Urology : official journal of the Brazilian Society of Urology","volume":"59 1","pages":"686 - 687"},"PeriodicalIF":0.0,"publicationDate":"2022-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87257035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-07-19DOI: 10.1590/S1677-5538.IBJU.2021.0646.1
C. Riccetto
The authors retrospectively studied a database of 221 patients who underwent correction of stress urinary incontinence (SUI) through the implantation of a SAFYRE VS retropubic sling (96 women) or a homemade polypropylene retropubic sling - HMS (125 patients) between March 2005 and December 2007, comprising a median follow-up of 78.47 (± 38.69) months (1). The evaluation included a telepho-ne call made by a blinded trained researcher for those patients who had completed at least one year of surgery. The HMS was made of a 75g/m 2 , 15mm-wide polypropylene mesh attached with polyglycolic acid sutures at its edges. Both HMS and SAFYRE VS groups presented significant improvements on In-ternational consensus on Incontinence – Urinary Incontinence Short Form questionnaire (ICIQ-UI SF) and there were no differences in satisfaction, subjective cure rates, ICIQ-UI SF, or complications between groups, but a significantly higher frequency of patients of SAFYERE VS group required indwelling urinary catheter over 24
{"title":"The evolution of stress urinary incontinence treatment techniques of the last three decades","authors":"C. Riccetto","doi":"10.1590/S1677-5538.IBJU.2021.0646.1","DOIUrl":"https://doi.org/10.1590/S1677-5538.IBJU.2021.0646.1","url":null,"abstract":"The authors retrospectively studied a database of 221 patients who underwent correction of stress urinary incontinence (SUI) through the implantation of a SAFYRE VS retropubic sling (96 women) or a homemade polypropylene retropubic sling - HMS (125 patients) between March 2005 and December 2007, comprising a median follow-up of 78.47 (± 38.69) months (1). The evaluation included a telepho-ne call made by a blinded trained researcher for those patients who had completed at least one year of surgery. The HMS was made of a 75g/m 2 , 15mm-wide polypropylene mesh attached with polyglycolic acid sutures at its edges. Both HMS and SAFYRE VS groups presented significant improvements on In-ternational consensus on Incontinence – Urinary Incontinence Short Form questionnaire (ICIQ-UI SF) and there were no differences in satisfaction, subjective cure rates, ICIQ-UI SF, or complications between groups, but a significantly higher frequency of patients of SAFYERE VS group required indwelling urinary catheter over 24","PeriodicalId":13674,"journal":{"name":"International Brazilian Journal of Urology : official journal of the Brazilian Society of Urology","volume":"21 1","pages":"660 - 661"},"PeriodicalIF":0.0,"publicationDate":"2022-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84538905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Vesical imaging reporting and data system (VI-RADS) in bladder cancer diagnosis in review in this number of International Brazilian Journal of Urology","authors":"L. Favorito","doi":"10.1590/S1677-5538.IBJU.2022.04.01","DOIUrl":"https://doi.org/10.1590/S1677-5538.IBJU.2022.04.01","url":null,"abstract":"contributions with a of interesting papers in different fields: Robotic Surgery, Prostate Cancer, Overactive Bladder, Bladder Cancer, renal cancer, myelomeningocele, renal stones, congenital adrenal hyperplasia, Testicular torsion, penile cancer, BPH, Urinary incontinence and reconstructive urology.","PeriodicalId":13674,"journal":{"name":"International Brazilian Journal of Urology : official journal of the Brazilian Society of Urology","volume":"21 1","pages":"607 - 608"},"PeriodicalIF":0.0,"publicationDate":"2022-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82466346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-10DOI: 10.1590/S1677-5538.IBJU.2022.0119
Muhammad Achdiar Raizandha, F. Hidayatullah, Y. Kloping, I. Rahman, W. Djatisoesanto, F. Rizaldi
ABSTRACT Purpose: Management of Fournier’s Gangrene (FG) includes broad-spectrum antibiotics with adequate surgical debridement, which should be performed within the first 24 hours of onset. However, this treatment may cause significant loss of tissue and may delay healing with the presence of ischemia. Hyperbaric oxygen therapy (HBOT) has been proposed as adjunctive therapy to assist the healing process. However, its benefit is still debatable. Therefore, this systematic review and meta-analysis aimed to evaluate the effect of HBOT as an adjunct therapy for FG. Materials and Methods: This study complied with the Preferred Reporting Items for Systematic Reviews and Meta-analyses protocol to obtain studies investigating the effect of HBOT on patients with FG. The search is systematically carried out on different databases such as MEDLINE, Embase, and Scopus based on population, intervention, control, and outcomes criteria. A total of 10 articles were retrieved for qualitative and quantitative analysis. Results: There was a significant difference in mortality as patients with FG who received HBOT had a lower number of deaths compared to patients who received conventional therapy (Odds Ratio 0.29; 95% CI 0.12 – 0.69; p = 0.005). However, the mean length of stay with Mean Difference (MD) of -0.18 (95% CI: -7.68 – 7.33; p=0.96) and the number of debridement procedures (MD 1.33; 95% CI: -0.58 – 3.23; p=0.17) were not significantly different. Conclusion: HBOT can be used as an adjunct therapy to prevent an increased risk of mortality in patients with FG.
{"title":"The role of hyperbaric oxygen therapy in Fournier’s Gangrene: A systematic review and meta-analysis of observational studies","authors":"Muhammad Achdiar Raizandha, F. Hidayatullah, Y. Kloping, I. Rahman, W. Djatisoesanto, F. Rizaldi","doi":"10.1590/S1677-5538.IBJU.2022.0119","DOIUrl":"https://doi.org/10.1590/S1677-5538.IBJU.2022.0119","url":null,"abstract":"ABSTRACT Purpose: Management of Fournier’s Gangrene (FG) includes broad-spectrum antibiotics with adequate surgical debridement, which should be performed within the first 24 hours of onset. However, this treatment may cause significant loss of tissue and may delay healing with the presence of ischemia. Hyperbaric oxygen therapy (HBOT) has been proposed as adjunctive therapy to assist the healing process. However, its benefit is still debatable. Therefore, this systematic review and meta-analysis aimed to evaluate the effect of HBOT as an adjunct therapy for FG. Materials and Methods: This study complied with the Preferred Reporting Items for Systematic Reviews and Meta-analyses protocol to obtain studies investigating the effect of HBOT on patients with FG. The search is systematically carried out on different databases such as MEDLINE, Embase, and Scopus based on population, intervention, control, and outcomes criteria. A total of 10 articles were retrieved for qualitative and quantitative analysis. Results: There was a significant difference in mortality as patients with FG who received HBOT had a lower number of deaths compared to patients who received conventional therapy (Odds Ratio 0.29; 95% CI 0.12 – 0.69; p = 0.005). However, the mean length of stay with Mean Difference (MD) of -0.18 (95% CI: -7.68 – 7.33; p=0.96) and the number of debridement procedures (MD 1.33; 95% CI: -0.58 – 3.23; p=0.17) were not significantly different. Conclusion: HBOT can be used as an adjunct therapy to prevent an increased risk of mortality in patients with FG.","PeriodicalId":13674,"journal":{"name":"International Brazilian Journal of Urology : official journal of the Brazilian Society of Urology","volume":"55 1","pages":"771 - 781"},"PeriodicalIF":0.0,"publicationDate":"2022-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80180049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-02DOI: 10.1590/S1677-5538.IBJU.2022.0168
N. Yıldız
I thank the authors of “Percutaneous tibial nerve stimulation versus electrical stimulation with pelvic floor muscle training for overactive bladder syndrome in women: results of a randomized controlled study (1).” I support the importance you attribute to intravaginal electrical stimulation (IVES) and percutaneous tibial nerve stimulation (PTNS) in the management of idiopathic overactive bladder (OAB). The authors stated that PTNS is more effective than IVES in women with idiopathic OAB. Women with antimuscarinic naive OAB were included in this study (1). However, it is known that many patients with idiopathic OAB receive pharmacological treatment before reaching a conservative treatment option such as IVES. As the authors stated, in common practice, antimuscarinic agents are frequently used as an initial treatment although burdened by a low adherence, and these patients need protracted treatment with periodic controls.
{"title":"Re: Percutaneous tibial nerve stimulation versus electrical stimulation with pelvic floor muscle training for overactive bladder syndrome in women: results of a randomized controlled study","authors":"N. Yıldız","doi":"10.1590/S1677-5538.IBJU.2022.0168","DOIUrl":"https://doi.org/10.1590/S1677-5538.IBJU.2022.0168","url":null,"abstract":"I thank the authors of “Percutaneous tibial nerve stimulation versus electrical stimulation with pelvic floor muscle training for overactive bladder syndrome in women: results of a randomized controlled study (1).” I support the importance you attribute to intravaginal electrical stimulation (IVES) and percutaneous tibial nerve stimulation (PTNS) in the management of idiopathic overactive bladder (OAB). The authors stated that PTNS is more effective than IVES in women with idiopathic OAB. Women with antimuscarinic naive OAB were included in this study (1). However, it is known that many patients with idiopathic OAB receive pharmacological treatment before reaching a conservative treatment option such as IVES. As the authors stated, in common practice, antimuscarinic agents are frequently used as an initial treatment although burdened by a low adherence, and these patients need protracted treatment with periodic controls.","PeriodicalId":13674,"journal":{"name":"International Brazilian Journal of Urology : official journal of the Brazilian Society of Urology","volume":"16 1","pages":"732 - 733"},"PeriodicalIF":0.0,"publicationDate":"2022-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79064562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-14DOI: 10.1590/S1677-5538.IBJU.2021.764.1
Valter Javaroni
The global outbreak of coronavirus disease (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) the consequent lockdown had dramatic repercussions at both macrosocial, such as the economy and policy, and microsocial level, such as on the psychological and relational well-being of persons represents an unprecedented challenge for healthcare (1). In June 2020, more than 7.5 million COVID-19 cases have been confirmed worldwide, with more than 420,000 lives lost due to the disease (2), and increased rates of post-traumatic stress disorder (PTSD), depression and anxiety were already expected in the general population, and even more in COVID-19 survivors, following the pandemic (3-6). It has already been shown that sexual dysfunction may be observed in PTSD patients (7), and that emotional numbness can prevent emotional intimacy and connectedness with a partner. So, PTSD symptoms can cause problems in sexual functions, and PTSD can be used as a predictive parameter for sexual dysfunction in these patients (8). The high level of anxiety, anger and irritability observed in PTSD patients not only creates sexual dysfunction independently but also affects sexual dysfunction indirectly due to negative effects on social or romantic relationships and intimacy with the opposite sex (9). It can worse preexisting dysfunctions. Moreover, anger and anxiety might have a bidirectional relationship with erectile function. That is, anger and anxiety can create erectile dysfunction, and sexual dysfunction can induce or increase these symptoms (10). The relationship between erection dysfunction and psychological state has also been examined in large-scale studies. In the National Health and Social Life Survey (NHSLS) study, data show that emotional problems and stress-related problems pose a risk of difficulty being experienced at all stages of sexuality. The researchers concluded that psychological state was an independent factor affecting sexual function (11). In ‘The multinational men’s attitudes to life events and sexuality’ (MALES) study conducted in Europe and North and South America, which included 2,912 men, depression or anxiety was found in 25% of the patients who reported to have ED, while was found in 26% of the patients who reported to have depression or anxiety (12). So, as sexual activity is closely associated with mental and psychological health, it is unsurprising that sexual desire and frequency have declined in both genders during this pandemic (13, 14). An interesting paper from Spain suggested that the social impact of the lockdown is related to gender, age and socioeconomic conditions. Authors found that women and young people had worse mental EDITORIAL COMMENT Vol. 48 (3): 548-552, May June, 2022
{"title":"Editorial Comment: Interaction between the impact of the Coronavirus disease 2019 pandemic and demographic characteristics on sexual/erectile dysfunction in Latin America: crosssectional study","authors":"Valter Javaroni","doi":"10.1590/S1677-5538.IBJU.2021.764.1","DOIUrl":"https://doi.org/10.1590/S1677-5538.IBJU.2021.764.1","url":null,"abstract":"The global outbreak of coronavirus disease (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) the consequent lockdown had dramatic repercussions at both macrosocial, such as the economy and policy, and microsocial level, such as on the psychological and relational well-being of persons represents an unprecedented challenge for healthcare (1). In June 2020, more than 7.5 million COVID-19 cases have been confirmed worldwide, with more than 420,000 lives lost due to the disease (2), and increased rates of post-traumatic stress disorder (PTSD), depression and anxiety were already expected in the general population, and even more in COVID-19 survivors, following the pandemic (3-6). It has already been shown that sexual dysfunction may be observed in PTSD patients (7), and that emotional numbness can prevent emotional intimacy and connectedness with a partner. So, PTSD symptoms can cause problems in sexual functions, and PTSD can be used as a predictive parameter for sexual dysfunction in these patients (8). The high level of anxiety, anger and irritability observed in PTSD patients not only creates sexual dysfunction independently but also affects sexual dysfunction indirectly due to negative effects on social or romantic relationships and intimacy with the opposite sex (9). It can worse preexisting dysfunctions. Moreover, anger and anxiety might have a bidirectional relationship with erectile function. That is, anger and anxiety can create erectile dysfunction, and sexual dysfunction can induce or increase these symptoms (10). The relationship between erection dysfunction and psychological state has also been examined in large-scale studies. In the National Health and Social Life Survey (NHSLS) study, data show that emotional problems and stress-related problems pose a risk of difficulty being experienced at all stages of sexuality. The researchers concluded that psychological state was an independent factor affecting sexual function (11). In ‘The multinational men’s attitudes to life events and sexuality’ (MALES) study conducted in Europe and North and South America, which included 2,912 men, depression or anxiety was found in 25% of the patients who reported to have ED, while was found in 26% of the patients who reported to have depression or anxiety (12). So, as sexual activity is closely associated with mental and psychological health, it is unsurprising that sexual desire and frequency have declined in both genders during this pandemic (13, 14). An interesting paper from Spain suggested that the social impact of the lockdown is related to gender, age and socioeconomic conditions. Authors found that women and young people had worse mental EDITORIAL COMMENT Vol. 48 (3): 548-552, May June, 2022","PeriodicalId":13674,"journal":{"name":"International Brazilian Journal of Urology : official journal of the Brazilian Society of Urology","volume":"4 1","pages":"548 - 552"},"PeriodicalIF":0.0,"publicationDate":"2022-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78307606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-14DOI: 10.1590/S1677-5538.IBJU.2022.03.01
L. Favorito
no definite a higher stone-free a interesting translational study about the lower pole anatomy in anomalous kidneys and concluded that the knowledge of spatial anatomy of lower pole is of utmost importance during endourologic pro-cedures in patients with kidney anomalies. The horseshoe kidneys had more restrictive anatomic factors in lower pole than the complete ureteral duplication.
{"title":"Upper tract urothelial carcinoma and bladder cancer in review in this number of International Brazilian Journal of Urology","authors":"L. Favorito","doi":"10.1590/S1677-5538.IBJU.2022.03.01","DOIUrl":"https://doi.org/10.1590/S1677-5538.IBJU.2022.03.01","url":null,"abstract":"no definite a higher stone-free a interesting translational study about the lower pole anatomy in anomalous kidneys and concluded that the knowledge of spatial anatomy of lower pole is of utmost importance during endourologic pro-cedures in patients with kidney anomalies. The horseshoe kidneys had more restrictive anatomic factors in lower pole than the complete ureteral duplication.","PeriodicalId":13674,"journal":{"name":"International Brazilian Journal of Urology : official journal of the Brazilian Society of Urology","volume":"27 1","pages":"386 - 388"},"PeriodicalIF":0.0,"publicationDate":"2022-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78006145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-10DOI: 10.1590/S1677-5538.IBJU.2022.0147
L. Medina, M. Alsyouf, A. Ghoreifi, A. Sayegh, Kailyn Koh, Wenhao Yu, Sina Sobhani, Antoin Douglawi, H. Djaladat
ABSTRACT Introduction: Upper tract urothelial carcinoma (UTUC) accounts for 5-10% of all urothelial tumors (1). Radical nephroureterectomy (RNU) remains the standard treatment for high, and low-grade UTUC (2). Although the open approach has been considered the gold standard, robotic techniques have shown comparable oncological outcomes with potential advantages in terms of peri-operative morbidity (3). Materials and Methods: We present a novel “Keyhole” technique for management of distal ureter and bladder cuff during robotic RNU. This technique allows the surgeon to directly visualize the ureteric orifices, delineate resection borders, and maintain oncologic principles of en-bloc excision without necessitating secondary cystotomy incision or concomitant endoscopic procedure. Descriptive demographic characteristics, surgical, pathological, and oncological outcomes were analyzed. Complications were reported using the Clavien-Dindo classification system. Results: Between 2015 and 2020, ten patients underwent robotic RNU with bladder cuff excision using the Keyhole technique (single-dock, single-position). Median age was 75 years. Eight patients underwent surgery for right-sided tumors. Median operative time, estimated blood loss, and length of hospital stay were 287 min, 100 mL, and 3 days, respectively. No intraoperative complications occurred, and one grade II complication occurred during the 90-day postoperative period. All patients had high-grade UTUC, being 90% pure urothelial. Bladder recurrences occurred in 30% of patients with an overall median follow-up of 11.2 months. Conclusions: Keyhole technique for the management of distal ureter and bladder cuff during RNU represents a feasible approach with minimal 90-day complications and low bladder recurrence rate at centers of experience.
{"title":"Distal ureter and bladder cuff excision using the “Keyhole Technique” during Robotic Radical Nephroureterectomy","authors":"L. Medina, M. Alsyouf, A. Ghoreifi, A. Sayegh, Kailyn Koh, Wenhao Yu, Sina Sobhani, Antoin Douglawi, H. Djaladat","doi":"10.1590/S1677-5538.IBJU.2022.0147","DOIUrl":"https://doi.org/10.1590/S1677-5538.IBJU.2022.0147","url":null,"abstract":"ABSTRACT Introduction: Upper tract urothelial carcinoma (UTUC) accounts for 5-10% of all urothelial tumors (1). Radical nephroureterectomy (RNU) remains the standard treatment for high, and low-grade UTUC (2). Although the open approach has been considered the gold standard, robotic techniques have shown comparable oncological outcomes with potential advantages in terms of peri-operative morbidity (3). Materials and Methods: We present a novel “Keyhole” technique for management of distal ureter and bladder cuff during robotic RNU. This technique allows the surgeon to directly visualize the ureteric orifices, delineate resection borders, and maintain oncologic principles of en-bloc excision without necessitating secondary cystotomy incision or concomitant endoscopic procedure. Descriptive demographic characteristics, surgical, pathological, and oncological outcomes were analyzed. Complications were reported using the Clavien-Dindo classification system. Results: Between 2015 and 2020, ten patients underwent robotic RNU with bladder cuff excision using the Keyhole technique (single-dock, single-position). Median age was 75 years. Eight patients underwent surgery for right-sided tumors. Median operative time, estimated blood loss, and length of hospital stay were 287 min, 100 mL, and 3 days, respectively. No intraoperative complications occurred, and one grade II complication occurred during the 90-day postoperative period. All patients had high-grade UTUC, being 90% pure urothelial. Bladder recurrences occurred in 30% of patients with an overall median follow-up of 11.2 months. Conclusions: Keyhole technique for the management of distal ureter and bladder cuff during RNU represents a feasible approach with minimal 90-day complications and low bladder recurrence rate at centers of experience.","PeriodicalId":13674,"journal":{"name":"International Brazilian Journal of Urology : official journal of the Brazilian Society of Urology","volume":"84 1","pages":"876 - 877"},"PeriodicalIF":0.0,"publicationDate":"2022-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73920676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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