Pub Date : 2019-01-29DOI: 10.1590/S1677-5538.IBJU.2019.0132
V. Madhusoodanan, P. Patel, T. Lima, Jabez C Gondokusumo, E. Lo, N. Thirumavalavan, L. Lipshultz, R. Ramasamy
ABSTRACT Purpose The 2018 American Urological Association guidelines on the Evaluation and Management of Testosterone Deficiency recommended that 300 ng/dL be used as the threshold for prescribing testosterone replacement therapy (TRT). However, it is not uncommon for men to present with signs and symptoms of testosterone deficiency, despite having testosterone levels greater than 300 ng/dL. There exists scant literature regarding the use of hCG monotherapy for the treatment of hypogonadism in men not interested in fertility. We sought to evaluate serum testosterone response and duration of therapy of hCG monotherapy for men with symptoms of hypogonadism, but total testosterone levels > 300 ng/dL. Materials and Methods We performed a multi-institutional retrospective case series of men receiving hCG monotherapy for symptomatic hypogonadism. We evaluated patient age, treatment indication, hCG dosage, past medical history, physical exam findings and serum testosterone and gonadotropins before and after therapy. Descriptive analysis was performed and Mann Whitney U Test was utilized for statistical analysis. Results Of the 20 men included in the study, treatment indications included low libido (45%), lack of energy (50%), and erectile dysfunction (45%). Mean testosterone improved by 49.9% from a baseline of 362 ng/dL (SD 158) to 519.8 ng/dL (SD 265.6), (p=0.006). Median duration of therapy was 8 months (SD 5 months). Fifty percent of patients reported symptom improvement. Conclusions Treatment of hypogonadal symptoms with hCG for men who have a baseline testosterone level > 300 ng/dL appears to be safe and efficacious with no adverse events.
{"title":"Human Chorionic Gonadotropin monotherapy for the treatment of hypogonadal symptoms in men with total testosterone > 300 ng/dL","authors":"V. Madhusoodanan, P. Patel, T. Lima, Jabez C Gondokusumo, E. Lo, N. Thirumavalavan, L. Lipshultz, R. Ramasamy","doi":"10.1590/S1677-5538.IBJU.2019.0132","DOIUrl":"https://doi.org/10.1590/S1677-5538.IBJU.2019.0132","url":null,"abstract":"ABSTRACT Purpose The 2018 American Urological Association guidelines on the Evaluation and Management of Testosterone Deficiency recommended that 300 ng/dL be used as the threshold for prescribing testosterone replacement therapy (TRT). However, it is not uncommon for men to present with signs and symptoms of testosterone deficiency, despite having testosterone levels greater than 300 ng/dL. There exists scant literature regarding the use of hCG monotherapy for the treatment of hypogonadism in men not interested in fertility. We sought to evaluate serum testosterone response and duration of therapy of hCG monotherapy for men with symptoms of hypogonadism, but total testosterone levels > 300 ng/dL. Materials and Methods We performed a multi-institutional retrospective case series of men receiving hCG monotherapy for symptomatic hypogonadism. We evaluated patient age, treatment indication, hCG dosage, past medical history, physical exam findings and serum testosterone and gonadotropins before and after therapy. Descriptive analysis was performed and Mann Whitney U Test was utilized for statistical analysis. Results Of the 20 men included in the study, treatment indications included low libido (45%), lack of energy (50%), and erectile dysfunction (45%). Mean testosterone improved by 49.9% from a baseline of 362 ng/dL (SD 158) to 519.8 ng/dL (SD 265.6), (p=0.006). Median duration of therapy was 8 months (SD 5 months). Fifty percent of patients reported symptom improvement. Conclusions Treatment of hypogonadal symptoms with hCG for men who have a baseline testosterone level > 300 ng/dL appears to be safe and efficacious with no adverse events.","PeriodicalId":13674,"journal":{"name":"International Brazilian Journal of Urology : official journal of the Brazilian Society of Urology","volume":"56 1","pages":"1008 - 1012"},"PeriodicalIF":0.0,"publicationDate":"2019-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82693246","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 : 2019-01-29DOI: 10.1590/S1677-5538.IBJU.2019.0049
A. Erbin, H. Ozdemir, M. Şahan, M. Savun, A. Çubuk, O. Yazici, M. Akbulut, O. Sarilar
ABSTRACT Purpose We aimed to compare the outcomes of supine and prone miniaturized percutaneous nephrolithotomy (m-PNL) in the treatment of lower pole, middle pole and renal pelvic stones. Materials and Methods 54 patients who performed supine m-PNL between January 2017 and March 2018 and 498 patients who performed prone m-PNL between April 2015 and January 2018 were included in the study. Of the 498 patients, 108 matching 1: 2 in terms of age, gender, body mass index, American Association of Anesthesiology score, stone size, stone localization and hydronephrosis according to the supine m-PNL group were selected as prone m-PNL group. The patients with solitary kidney, upper pole stone, urinary system anomaly or skeletal malformation and pediatric patients (<18 years old) were excluded from the study. The success was defined as ‘complete stone clearance’ and was determined according to the 1st month computed tomography. Results The operation time and fluoroscopy time in supine m-PNL was significantly shorter than prone m-PNL group (58.1±45.9 vs. 80.1±40.0 min and 3.0±1.7 min vs. 4.9±4.5 min, p=0.025 and p=0.01, respectively). When post-operative complications were compared according to the modified Clavien-Dindo classification, overall and subgroup complication rates were comparable between groups. There was no significant difference between the groups in terms of the success rates (supine m-PNL; 72.2%, prone m-PNL; 71.3%, p=0.902). Conclusions Supine m-PNL procedure is more advantageous in terms of operation time and fluoroscopy time in the treatment of lower pole, middle pole and renal pelvic stones.
目的比较仰卧位和俯卧位微型经皮肾镜取石术(m-PNL)治疗盆腔下极、中极和肾盂结石的疗效。材料与方法纳入2017年1月至2018年3月期间进行仰卧位m-PNL的54例患者和2015年4月至2018年1月期间进行俯卧位m-PNL的498例患者。498例患者中，选择年龄、性别、体重指数、美国麻醉协会评分、结石大小、结石定位、肾积水按仰卧位m-PNL组符合1:2的108例患者为俯卧位m-PNL组。排除孤立肾、上极结石、泌尿系统异常或骨骼畸形患者及儿童患者(<18岁)。成功被定义为“完全清除结石”，并根据第一个月的计算机断层扫描来确定。结果仰卧位m-PNL组手术时间和透视时间明显短于俯卧位m-PNL组(58.1±45.9∶80.1±40.0∶3.0±1.7∶4.9±4.5 min, p=0.025和p=0.01)。根据改良的Clavien-Dindo分类比较术后并发症时，两组间总并发症和亚组并发症发生率具有可比性。两组间成功率无显著差异(仰卧位m-PNL;72.2%，倾向于m-PNL;71.3%, p = 0.902)。结论仰卧位m-PNL手术治疗下极、中极及肾盆腔结石在手术时间和透视时间上均有优势。
{"title":"Comparison of supine and prone miniaturized percutaneous nephrolithotomy in the treatment of lower pole, middle pole and renal pelvic stones: A matched pair analysis","authors":"A. Erbin, H. Ozdemir, M. Şahan, M. Savun, A. Çubuk, O. Yazici, M. Akbulut, O. Sarilar","doi":"10.1590/S1677-5538.IBJU.2019.0049","DOIUrl":"https://doi.org/10.1590/S1677-5538.IBJU.2019.0049","url":null,"abstract":"ABSTRACT Purpose We aimed to compare the outcomes of supine and prone miniaturized percutaneous nephrolithotomy (m-PNL) in the treatment of lower pole, middle pole and renal pelvic stones. Materials and Methods 54 patients who performed supine m-PNL between January 2017 and March 2018 and 498 patients who performed prone m-PNL between April 2015 and January 2018 were included in the study. Of the 498 patients, 108 matching 1: 2 in terms of age, gender, body mass index, American Association of Anesthesiology score, stone size, stone localization and hydronephrosis according to the supine m-PNL group were selected as prone m-PNL group. The patients with solitary kidney, upper pole stone, urinary system anomaly or skeletal malformation and pediatric patients (<18 years old) were excluded from the study. The success was defined as ‘complete stone clearance’ and was determined according to the 1st month computed tomography. Results The operation time and fluoroscopy time in supine m-PNL was significantly shorter than prone m-PNL group (58.1±45.9 vs. 80.1±40.0 min and 3.0±1.7 min vs. 4.9±4.5 min, p=0.025 and p=0.01, respectively). When post-operative complications were compared according to the modified Clavien-Dindo classification, overall and subgroup complication rates were comparable between groups. There was no significant difference between the groups in terms of the success rates (supine m-PNL; 72.2%, prone m-PNL; 71.3%, p=0.902). Conclusions Supine m-PNL procedure is more advantageous in terms of operation time and fluoroscopy time in the treatment of lower pole, middle pole and renal pelvic stones.","PeriodicalId":13674,"journal":{"name":"International Brazilian Journal of Urology : official journal of the Brazilian Society of Urology","volume":"202 1","pages":"956 - 964"},"PeriodicalIF":0.0,"publicationDate":"2019-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74886166","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 : 2019-01-29DOI: 10.1590/S1677-5538.IBJU.2018.0781
M. Kadıhasanoğlu, U. Yucetas, E. Karabay, Erkan Sönmezay
ABSTRACT Objective We aimed to evaluate the results of laparoscopic pyeloplasty with concomitant pyelolithotomy and compare results with a cohort of patients undergoing laparoscopic pyeloplasty without pyelolithotomy. Materials and Methods We retrospectively reviewed records of 43 patients undergoing transperitoneal laparoscopic Anderson-Hynes dismembered pyeloplasty between December 2012 and July 2018 at our department. Eighteen patients (42%) underwent laparoscopic pyeloplasty with concomitant pyelolithotomy. The results of patients with renal stones were compared with 25 matched patients undergoing laparoscopic pyeloplasty without concomitant renal stones. Demographic data, operative and stone parameters were compared between the groups. Results The groups were similar regarding to demographic characteristics. All operations were completed laparoscopically with no conversions to open surgery. In 3 cases without renal stones and 15 cases with renal stones, transposition of the ureter due to crossing vessels was performed. The mean stone size was 13±5.24 mm, and the median number of stones was 1 (1-18). The success of laparoscopic pyeloplasty with and without pyelolithotomy was 93.3% and 92.9%, respectively, as confirmed by negative diuretic renogram at postoperative 3rd months. Overall stone-free rate after laparoscopic pyelolithotomy was 93.3%. Mean operative time was 222.6765.71 minutes vs. 219.11±75.63 minutes for the pyeloplasty with concomitant pyelolithotomy vs. pyeloplasty, respectively (p=0.88). Conclusions Laparoscopic pyeloplasty with concomitant pyelolithotomy is a safe and effective intervention with associated good cosmetic results and high stone-free rates without significant increase in operative time or complications.
{"title":"Comparison of the outcomes of laparoscopic pyeloplasty with and without concomitant pyelolithotomy","authors":"M. Kadıhasanoğlu, U. Yucetas, E. Karabay, Erkan Sönmezay","doi":"10.1590/S1677-5538.IBJU.2018.0781","DOIUrl":"https://doi.org/10.1590/S1677-5538.IBJU.2018.0781","url":null,"abstract":"ABSTRACT Objective We aimed to evaluate the results of laparoscopic pyeloplasty with concomitant pyelolithotomy and compare results with a cohort of patients undergoing laparoscopic pyeloplasty without pyelolithotomy. Materials and Methods We retrospectively reviewed records of 43 patients undergoing transperitoneal laparoscopic Anderson-Hynes dismembered pyeloplasty between December 2012 and July 2018 at our department. Eighteen patients (42%) underwent laparoscopic pyeloplasty with concomitant pyelolithotomy. The results of patients with renal stones were compared with 25 matched patients undergoing laparoscopic pyeloplasty without concomitant renal stones. Demographic data, operative and stone parameters were compared between the groups. Results The groups were similar regarding to demographic characteristics. All operations were completed laparoscopically with no conversions to open surgery. In 3 cases without renal stones and 15 cases with renal stones, transposition of the ureter due to crossing vessels was performed. The mean stone size was 13±5.24 mm, and the median number of stones was 1 (1-18). The success of laparoscopic pyeloplasty with and without pyelolithotomy was 93.3% and 92.9%, respectively, as confirmed by negative diuretic renogram at postoperative 3rd months. Overall stone-free rate after laparoscopic pyelolithotomy was 93.3%. Mean operative time was 222.6765.71 minutes vs. 219.11±75.63 minutes for the pyeloplasty with concomitant pyelolithotomy vs. pyeloplasty, respectively (p=0.88). Conclusions Laparoscopic pyeloplasty with concomitant pyelolithotomy is a safe and effective intervention with associated good cosmetic results and high stone-free rates without significant increase in operative time or complications.","PeriodicalId":13674,"journal":{"name":"International Brazilian Journal of Urology : official journal of the Brazilian Society of Urology","volume":"17 1","pages":"965 - 973"},"PeriodicalIF":0.0,"publicationDate":"2019-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72993312","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 : 2019-01-29DOI: 10.1590/S1677-5538.IBJU.2019.0016
Alev Onder, D. Yilmaz-Oral, I. Jerković, A. O. Akdemir, S. Gur
ABSTRACT Cinnamomum cassia (Cinnamon) is a well-known traditional medicine with therapeutic benefits for centuries. We evaluated the effects of cinnamon essential oil (CEO) and its main component cinnamaldehyde (CA) on human corpus cavernosum (HCC) and rat CC. The essential oil of cinnamon was analyzed for the confirmation of the oil profile. HCC specimens from patients undergoing penile prosthesis surgery (age 48-69 years) were utilized for functional studies. In addition, erectile responses in anesthetized control and diabetic rats were evaluated in vivo after intracavernosal injection of CEO and CA, and rat CC strips were placed in organ baths. After precontraction with phenylephrine (10µM), relaxant responses to CEO and CA were investigated. CA (96.9%) was found as the major component. The maximum relaxation responses to CEO and CA were 96.4±3.5% and 96.0±5.0% in HCC and 97.5±5.5% and 96.8±4.8% in rat CC, respectively. There was no difference between control and diabetic rats in relaxation responses to CEO and CA. The relaxant responses obtained with essential oil and CA were not attenuated in the presence of nitric oxide synthase (NOS) inhibitor, and soluble guanylate cyclase inhibitor (sGS) in CC. In vivo, erectile responses in diabetic rats were lower than in control rats, which was restored after intracavernosal injection of CEO and CA. CEO and CA improved erectile function and relaxation of isolated strips of rat CC and HCC by a NO/cGMP-independent mechanism. Further investigations are warranted to fully elucidate the restorative effects of CEO and CA on diabetic erectile dysfunction.
{"title":"Evaluation of relaxant responses properties of cinnamon essential oil and its major component, cinnamaldehyde on human and rat corpus cavernosum","authors":"Alev Onder, D. Yilmaz-Oral, I. Jerković, A. O. Akdemir, S. Gur","doi":"10.1590/S1677-5538.IBJU.2019.0016","DOIUrl":"https://doi.org/10.1590/S1677-5538.IBJU.2019.0016","url":null,"abstract":"ABSTRACT Cinnamomum cassia (Cinnamon) is a well-known traditional medicine with therapeutic benefits for centuries. We evaluated the effects of cinnamon essential oil (CEO) and its main component cinnamaldehyde (CA) on human corpus cavernosum (HCC) and rat CC. The essential oil of cinnamon was analyzed for the confirmation of the oil profile. HCC specimens from patients undergoing penile prosthesis surgery (age 48-69 years) were utilized for functional studies. In addition, erectile responses in anesthetized control and diabetic rats were evaluated in vivo after intracavernosal injection of CEO and CA, and rat CC strips were placed in organ baths. After precontraction with phenylephrine (10µM), relaxant responses to CEO and CA were investigated. CA (96.9%) was found as the major component. The maximum relaxation responses to CEO and CA were 96.4±3.5% and 96.0±5.0% in HCC and 97.5±5.5% and 96.8±4.8% in rat CC, respectively. There was no difference between control and diabetic rats in relaxation responses to CEO and CA. The relaxant responses obtained with essential oil and CA were not attenuated in the presence of nitric oxide synthase (NOS) inhibitor, and soluble guanylate cyclase inhibitor (sGS) in CC. In vivo, erectile responses in diabetic rats were lower than in control rats, which was restored after intracavernosal injection of CEO and CA. CEO and CA improved erectile function and relaxation of isolated strips of rat CC and HCC by a NO/cGMP-independent mechanism. Further investigations are warranted to fully elucidate the restorative effects of CEO and CA on diabetic erectile dysfunction.","PeriodicalId":13674,"journal":{"name":"International Brazilian Journal of Urology : official journal of the Brazilian Society of Urology","volume":"1 1","pages":"1033 - 1042"},"PeriodicalIF":0.0,"publicationDate":"2019-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74268975","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 : 2019-01-29DOI: 10.1590/S1677-5538.IBJU.2019.05.04
R. Silva, J. Leow, Z. Abidin, E. Linden‐Castro, Edgar Ivan Bravo Castro, L. T. Blanco, J. Teoh, P. Contreras, M. Wroclawski
1 Division of Urology, Department of Surgery, University of Colorado School of Medicine, Denver, CO, USA; 2 Department of Surgery, Division of Urology, Denver Health Medical Center, Denver, CO, USA; 3 Department of Urology, Tan Tock Seng Hospital, LKC School of Medicine, Nanyang Technological University, Singapore; 4 Division of Urologic Surgery and Center for Surgery and Public Health, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA; 5 Department of Surgery, Universiti Teknologi MARA, Malaysia; 6 Centro Médico Puerta de Hierro, Zapopan Jalisco, Mexico; 7 Servicio de Urologia, Hospital Central Militar, Mexico; 8 Servicio de Urologia, Hospital Imed Levante, Alicante, Spain; 9 S. H. Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong; 10 Servicio de Urologia del Hospital Alemán. Buenos Aires, Argentina; 11 Hospital Israelita Albert Einstein. São Paulo, SP, Brasil; 12 Hospital Beneficência Brasileira de São Paulo, São Paulo, SP, Brasil ________________________________________________________________________________________
1科罗拉多大学医学院泌尿外科外科，美国科罗拉多州丹佛;2丹佛市卫生医疗中心泌尿外科，美国丹佛市;3新加坡南洋理工大学LKC医学院陈笃生医院泌尿外科;4哈佛医学院布里格姆妇女医院泌尿外科及外科与公共卫生中心，美国马萨诸塞州波士顿;5马来西亚玛拉理工大学外科学系;6墨西哥哈利斯科州萨波潘市耶罗门中心;7墨西哥中央军事医院泌尿科;8西班牙阿利坎特莱万特医院泌尿科;9香港中文大学外科何善衡泌尿外科中心，香港;10医院泌尿科服务Alemán。阿根廷布宜诺斯艾利斯;11以色列医院阿尔伯特·爱因斯坦。巴西圣保罗;12个医院Beneficencia Brasileira de Sao Paulo, SP,巴西圣保罗 ________________________________________________________________________________________
{"title":"Social Media in the Urology Practice | Opinion: NO","authors":"R. Silva, J. Leow, Z. Abidin, E. Linden‐Castro, Edgar Ivan Bravo Castro, L. T. Blanco, J. Teoh, P. Contreras, M. Wroclawski","doi":"10.1590/S1677-5538.IBJU.2019.05.04","DOIUrl":"https://doi.org/10.1590/S1677-5538.IBJU.2019.05.04","url":null,"abstract":"1 Division of Urology, Department of Surgery, University of Colorado School of Medicine, Denver, CO, USA; 2 Department of Surgery, Division of Urology, Denver Health Medical Center, Denver, CO, USA; 3 Department of Urology, Tan Tock Seng Hospital, LKC School of Medicine, Nanyang Technological University, Singapore; 4 Division of Urologic Surgery and Center for Surgery and Public Health, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA; 5 Department of Surgery, Universiti Teknologi MARA, Malaysia; 6 Centro Médico Puerta de Hierro, Zapopan Jalisco, Mexico; 7 Servicio de Urologia, Hospital Central Militar, Mexico; 8 Servicio de Urologia, Hospital Imed Levante, Alicante, Spain; 9 S. H. Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong; 10 Servicio de Urologia del Hospital Alemán. Buenos Aires, Argentina; 11 Hospital Israelita Albert Einstein. São Paulo, SP, Brasil; 12 Hospital Beneficência Brasileira de São Paulo, São Paulo, SP, Brasil ________________________________________________________________________________________","PeriodicalId":13674,"journal":{"name":"International Brazilian Journal of Urology : official journal of the Brazilian Society of Urology","volume":"54 1","pages":"882 - 888"},"PeriodicalIF":0.0,"publicationDate":"2019-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81388424","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 : 2019-01-29DOI: 10.1590/S1677-5538.IBJU.2019.05.01
L. Favorito
The September-October 2019 issue of the International Brazilian Journal of Urology presents original contributions with a lot of interesting papers in different fields: Infertility, Bladder Cancer, Prostate Cancer, Renal Cell Carcinoma, Partial nephrectomy, Kidney stones, Nocturnal Enuresis, Basic Research, Urinary Incontinence, Transplantation, UPJ Obstruction, Pelvic Organ Prolapse, Hypogonadism, Vasectomy, Herbal Medicine in Fertility and Urethral Strictures. The papers come from many different countries such as Italy, Brazil, USA, Turkey, China, France, Iran, Lebanon, Singapore, Colombia, Tunisia, India and Spain, and as usual the editor ́s comment highlights some papers. We decided to comment the paper about a very interesting topic: Penile skin flap for anterior urethral sctricture (1). Doctor Hmida and collegues from the Sahloul Hospital Sousse, Tunisia, performed on page 1057 an interesting study about the Penile skin flap for anterior urethral stricture. They studied 77 patients underwent substitution urethroplasty using dorsal penile skin flap for bulbar urethral strictures. The mean stricture length was 5cm (3-10 cm) and the mean flap length was 6cm. The mean follow-up was 60 months (6-120). The overall success rate was 88%. The authors concluded that urethroplasty using penile skin flap appear to be a safe and efficient technique for the treatment of a long and complex anterior urethral stricture. There are several options for the treatment of anterior urethral stricture (2-4). The patient’s stricture position, length and complexity are important factors to decide the surgical technique (5-7). For long bulbar strictures the buccal mucosa graft (BMG) as gold-standard material due to its histological characteristics and very good long term results (8-12). However, there are multiple situations whereby BMG is inadequate (prior buccal harvest) or inappropriate for utilization (heavy oral radiation). The fascio-cutaneous flaps could be a good option in these situations. The penile skin flap is easy to perform, do not need urethral mobilization and the present paper shows a success rate of 88%, a very significant number. We congratulate the authors for this very important contribution.
{"title":"Bulbar urethral stricture: penile skin flap may be a good option?","authors":"L. Favorito","doi":"10.1590/S1677-5538.IBJU.2019.05.01","DOIUrl":"https://doi.org/10.1590/S1677-5538.IBJU.2019.05.01","url":null,"abstract":"The September-October 2019 issue of the International Brazilian Journal of Urology presents original contributions with a lot of interesting papers in different fields: Infertility, Bladder Cancer, Prostate Cancer, Renal Cell Carcinoma, Partial nephrectomy, Kidney stones, Nocturnal Enuresis, Basic Research, Urinary Incontinence, Transplantation, UPJ Obstruction, Pelvic Organ Prolapse, Hypogonadism, Vasectomy, Herbal Medicine in Fertility and Urethral Strictures. The papers come from many different countries such as Italy, Brazil, USA, Turkey, China, France, Iran, Lebanon, Singapore, Colombia, Tunisia, India and Spain, and as usual the editor ́s comment highlights some papers. We decided to comment the paper about a very interesting topic: Penile skin flap for anterior urethral sctricture (1). Doctor Hmida and collegues from the Sahloul Hospital Sousse, Tunisia, performed on page 1057 an interesting study about the Penile skin flap for anterior urethral stricture. They studied 77 patients underwent substitution urethroplasty using dorsal penile skin flap for bulbar urethral strictures. The mean stricture length was 5cm (3-10 cm) and the mean flap length was 6cm. The mean follow-up was 60 months (6-120). The overall success rate was 88%. The authors concluded that urethroplasty using penile skin flap appear to be a safe and efficient technique for the treatment of a long and complex anterior urethral stricture. There are several options for the treatment of anterior urethral stricture (2-4). The patient’s stricture position, length and complexity are important factors to decide the surgical technique (5-7). For long bulbar strictures the buccal mucosa graft (BMG) as gold-standard material due to its histological characteristics and very good long term results (8-12). However, there are multiple situations whereby BMG is inadequate (prior buccal harvest) or inappropriate for utilization (heavy oral radiation). The fascio-cutaneous flaps could be a good option in these situations. The penile skin flap is easy to perform, do not need urethral mobilization and the present paper shows a success rate of 88%, a very significant number. We congratulate the authors for this very important contribution.","PeriodicalId":13674,"journal":{"name":"International Brazilian Journal of Urology : official journal of the Brazilian Society of Urology","volume":"14 1","pages":"871 - 872"},"PeriodicalIF":0.0,"publicationDate":"2019-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89368325","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 : 2019-01-29DOI: 10.1590/S1677-5538.IBJU.2018.0843
D. Haghmorad, M. Mahmoudi, P. Haghighi, Paria Alidadiani, Ensieh Shahvazian, Parsova Tavasolian, M. Hosseini, M. Mahmoudi
ABSTRACT Objective Anacyclus Pyrethrum (AP) and Tribulus Terrestris (TT) have been reported as male infertility treatment in several studies; however, in Iranian traditional medicine these two plants are prescribed simultaneously. In this study, we aimed to determine the effects of AP and TT extracts both separately and simultaneously on the male Wistar rat fertility parameters. Materials and Methods 32 male Wistar rats were divided into 4 groups: Control, TT, AP, and AT treated groups. Treatment continued for 25 days and rats were weighed daily. Their testes were dissected for histological studies. Sperm analysis including sperm count, viability and motility were performed. Serum was obtained to evaluate testosterone, LH and FSH levels. Histological studies were conducted to study Leydig, and Sertoli cells, spermatogonia and spermatid cell numbers, and to measure seminiferous diameter and epithelium thickness. Results Sperm count increased in all the treatment groups. Sperm viability and motility in AT and AP groups were elevated. TT and AT groups showed significantly increased testosterone level compared to control group (P=004, P=0.000, respectively) and TT, AP and AT treatment groups showed increased LH level (P=0.002, P=0.03 and P=0.000, respectively) compared to control, while only AT group showed increased FSH (p=0.006) compared to control. Histological studies showed significant increase of spermatogonia, Leydig and Sertoli cell numbers and epithelial thickness in AT group compared to other groups. All the treatment groups had higher number of Leydig, spermatogonia and spermatid cells. Conclusion TT and AP improved sexual parameters; however, their simultaneous administration had higher improving effects on studied parameters.
{"title":"Improvement of fertility parameters with Tribulus Terrestris and Anacyclus Pyrethrum treatment in male rats","authors":"D. Haghmorad, M. Mahmoudi, P. Haghighi, Paria Alidadiani, Ensieh Shahvazian, Parsova Tavasolian, M. Hosseini, M. Mahmoudi","doi":"10.1590/S1677-5538.IBJU.2018.0843","DOIUrl":"https://doi.org/10.1590/S1677-5538.IBJU.2018.0843","url":null,"abstract":"ABSTRACT Objective Anacyclus Pyrethrum (AP) and Tribulus Terrestris (TT) have been reported as male infertility treatment in several studies; however, in Iranian traditional medicine these two plants are prescribed simultaneously. In this study, we aimed to determine the effects of AP and TT extracts both separately and simultaneously on the male Wistar rat fertility parameters. Materials and Methods 32 male Wistar rats were divided into 4 groups: Control, TT, AP, and AT treated groups. Treatment continued for 25 days and rats were weighed daily. Their testes were dissected for histological studies. Sperm analysis including sperm count, viability and motility were performed. Serum was obtained to evaluate testosterone, LH and FSH levels. Histological studies were conducted to study Leydig, and Sertoli cells, spermatogonia and spermatid cell numbers, and to measure seminiferous diameter and epithelium thickness. Results Sperm count increased in all the treatment groups. Sperm viability and motility in AT and AP groups were elevated. TT and AT groups showed significantly increased testosterone level compared to control group (P=004, P=0.000, respectively) and TT, AP and AT treatment groups showed increased LH level (P=0.002, P=0.03 and P=0.000, respectively) compared to control, while only AT group showed increased FSH (p=0.006) compared to control. Histological studies showed significant increase of spermatogonia, Leydig and Sertoli cell numbers and epithelial thickness in AT group compared to other groups. All the treatment groups had higher number of Leydig, spermatogonia and spermatid cells. Conclusion TT and AP improved sexual parameters; however, their simultaneous administration had higher improving effects on studied parameters.","PeriodicalId":13674,"journal":{"name":"International Brazilian Journal of Urology : official journal of the Brazilian Society of Urology","volume":"45 1","pages":"1043 - 1054"},"PeriodicalIF":0.0,"publicationDate":"2019-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82568227","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 : 2019-01-29DOI: 10.1590/S1677-5538.IBJU.2019.0061
J. Xing, Jia-xuan Qin, Zonglong Cai, B. Duan, Peide Bai
ABSTRACT Purpose It has been reported that calcitonin receptor (CALCR) gene polymorphisms might be associated with calcium stone urolithiasis. Owing to mixed and inconclusive results, we conducted a meta-analysis to summarize and clarify this association. Materials and Methods A systematic search of studies on the association between CALCR gene polymorphisms and calcium stone urolithiasis susceptibility was conducted in databases. Results Odds ratios and 95% confidence intervals were used to pool the effect size. Five articles were included in our meta-analysis. Conclusions CALCR rs1801197 might be associated with increased risk of calcium stone urolithiasis. There is insufficient data to fully confirm the association between CALCR rs1042138 and calcium stone urolithiasis susceptibility. Well-designed studies with larger sample size and more subgroups are required to validate the risk identified in the current meta-analysis.
{"title":"Association between calcitonin receptor gene polymorphisms and calcium stone urolithiasis: A meta-analysis","authors":"J. Xing, Jia-xuan Qin, Zonglong Cai, B. Duan, Peide Bai","doi":"10.1590/S1677-5538.IBJU.2019.0061","DOIUrl":"https://doi.org/10.1590/S1677-5538.IBJU.2019.0061","url":null,"abstract":"ABSTRACT Purpose It has been reported that calcitonin receptor (CALCR) gene polymorphisms might be associated with calcium stone urolithiasis. Owing to mixed and inconclusive results, we conducted a meta-analysis to summarize and clarify this association. Materials and Methods A systematic search of studies on the association between CALCR gene polymorphisms and calcium stone urolithiasis susceptibility was conducted in databases. Results Odds ratios and 95% confidence intervals were used to pool the effect size. Five articles were included in our meta-analysis. Conclusions CALCR rs1801197 might be associated with increased risk of calcium stone urolithiasis. There is insufficient data to fully confirm the association between CALCR rs1042138 and calcium stone urolithiasis susceptibility. Well-designed studies with larger sample size and more subgroups are required to validate the risk identified in the current meta-analysis.","PeriodicalId":13674,"journal":{"name":"International Brazilian Journal of Urology : official journal of the Brazilian Society of Urology","volume":"68 12","pages":"901 - 909"},"PeriodicalIF":0.0,"publicationDate":"2019-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91419907","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 : 2019-01-29DOI: 10.1590/S1677-5538.IBJU.2019.05.02
A. Stabile, M. Moschini, F. Montorsi, X. Cathelineau, R. Sanchez-Salas
1 Department of Urology and Division of Experimental Oncology, URI, Urological Research Institute, Vita-Salute San Raffaele University, IRCCS San Raffaele Scientific Institute, Milan, Italy; 2 Klinik für Urologie, Luzerner Kantonsspital, Lucerne, Switzerland; 3 Department of Urology, Institut Mutualiste Montsouris and Université Paris Descartes, Paris, France Vol. 45 (5): 873-876, September October, 2019
{"title":"Focal therapy for prostate cancer – index lesion treatment vs. hemiablation. A matter of definition","authors":"A. Stabile, M. Moschini, F. Montorsi, X. Cathelineau, R. Sanchez-Salas","doi":"10.1590/S1677-5538.IBJU.2019.05.02","DOIUrl":"https://doi.org/10.1590/S1677-5538.IBJU.2019.05.02","url":null,"abstract":"1 Department of Urology and Division of Experimental Oncology, URI, Urological Research Institute, Vita-Salute San Raffaele University, IRCCS San Raffaele Scientific Institute, Milan, Italy; 2 Klinik für Urologie, Luzerner Kantonsspital, Lucerne, Switzerland; 3 Department of Urology, Institut Mutualiste Montsouris and Université Paris Descartes, Paris, France Vol. 45 (5): 873-876, September October, 2019","PeriodicalId":13674,"journal":{"name":"International Brazilian Journal of Urology : official journal of the Brazilian Society of Urology","volume":"68 1","pages":"873 - 876"},"PeriodicalIF":0.0,"publicationDate":"2019-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78956346","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 : 2019-01-29DOI: 10.1590/S1677-5538.IBJU.2019.0070
Timothy F. Carroll, A. Christie, M. Foreman, G. Khatri, P. Zimmern
ABSTRACT Objective To evaluate the subjective and objective outcomes of Macroplastique® (MPQ) in women with stress urinary incontinence (SUI) secondary to intrinsic sphincter deficiency (ISD). Materials and Methods Following Institutional Review Board (IRB) approval, charts of non-neurogenic women with SUI secondary to ISD who underwent MPQ injection and had 6 months minimum follow-up were reviewed from a prospectively maintained database. Patients were divided into 3 groups: Naïve (Group I), Prior Anti-Incontinence Surgery (Group II), and combined Prior Bulking Agent and Anti-Incontinence Surgery (Group III). Data collected included SUI self-report, Urogenital Distress Inventory (UDI-6) Question 3, and VAS Quality of Life (QoL) Questionnaire scores at baseline and in follow-up. Three-dimensional ultrasound (3DUS) evaluated volume/configuration of MPQ. Success was defined after the last MPQ injection as a UDI-6 Question 3 score of 0 (dry) or 1, and no reoperation for SUI. Results From 2011-2017, 106 of 142 women met study criteria. At a median follow-up of 20 months (mean=26 months; range: 6-71), success rate was 41% for Group I, 40% for Group II, and 65% for Group III (p = 0.22). QoL scores were significantly improved over baseline in all groups. There was no significant difference in clinical outcome between the asymmetrical and symmetrical group on 3DUS. The completely dry rate was highest in Group III at 29%, compared to 4% for Group I and 15% for Group II (p = 0.05). Conclusion Macroplastique® improved subjective and objective outcome measures for SUI secondary to ISD as both a primary and secondary treatment option in women.
{"title":"Macroplastique for women with stress urinary incontinence secondary to intrinsic sphincter deficiency","authors":"Timothy F. Carroll, A. Christie, M. Foreman, G. Khatri, P. Zimmern","doi":"10.1590/S1677-5538.IBJU.2019.0070","DOIUrl":"https://doi.org/10.1590/S1677-5538.IBJU.2019.0070","url":null,"abstract":"ABSTRACT Objective To evaluate the subjective and objective outcomes of Macroplastique® (MPQ) in women with stress urinary incontinence (SUI) secondary to intrinsic sphincter deficiency (ISD). Materials and Methods Following Institutional Review Board (IRB) approval, charts of non-neurogenic women with SUI secondary to ISD who underwent MPQ injection and had 6 months minimum follow-up were reviewed from a prospectively maintained database. Patients were divided into 3 groups: Naïve (Group I), Prior Anti-Incontinence Surgery (Group II), and combined Prior Bulking Agent and Anti-Incontinence Surgery (Group III). Data collected included SUI self-report, Urogenital Distress Inventory (UDI-6) Question 3, and VAS Quality of Life (QoL) Questionnaire scores at baseline and in follow-up. Three-dimensional ultrasound (3DUS) evaluated volume/configuration of MPQ. Success was defined after the last MPQ injection as a UDI-6 Question 3 score of 0 (dry) or 1, and no reoperation for SUI. Results From 2011-2017, 106 of 142 women met study criteria. At a median follow-up of 20 months (mean=26 months; range: 6-71), success rate was 41% for Group I, 40% for Group II, and 65% for Group III (p = 0.22). QoL scores were significantly improved over baseline in all groups. There was no significant difference in clinical outcome between the asymmetrical and symmetrical group on 3DUS. The completely dry rate was highest in Group III at 29%, compared to 4% for Group I and 15% for Group II (p = 0.05). Conclusion Macroplastique® improved subjective and objective outcome measures for SUI secondary to ISD as both a primary and secondary treatment option in women.","PeriodicalId":13674,"journal":{"name":"International Brazilian Journal of Urology : official journal of the Brazilian Society of Urology","volume":"104 1","pages":"989 - 998"},"PeriodicalIF":0.0,"publicationDate":"2019-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79169357","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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