Revista Internacional De Andrologia最新文献

Introduction

Carpolobia lutea root extract (CLRE) has been reported to enhance penile erection. However, the mechanism involved is poorly understood. We investigated in vitro mechanisms of CLRE action on contractile activity of rabbit corpus cavernosum (CC).

Methods

Corpus cavernosum strips from four healthy male New Zealand rabbits (2.5–3.0 kg) were mounted on an organ chamber and contracted with phenylephrine (PE) (10⁻⁹ to 10⁻⁵ M) and Potassium Chloride (KCl) (10–50 mM) before treatment with various concentrations of CLRE (0.1–1.2 mg/ml). Interactions between CLRE and a Nitric Oxide Synthase (NOS) inhibitor (N-nitro-l-arginine methyl ester – l-NAME 10⁻⁴ M); guanylyl cyclase inhibitors (Oxalodiazolo 4,3-a quinoxalin-1-one – ODQ 10 μM, 20 μM, 30 μM), and (methylene blue 10–30 μM); a cyclooxygenase inhibitor (10⁻⁴ M indomethacin); potassium-channel inhibitors (100 μM tetraethyl ammonium TEA), (100 ηM apamin) and (glibenclamide 10 μM and 20 μM); and a calcium-channel inhibitor (−10⁻⁴ M nifedipine) were investigated.

Results

Maximal contractions of KCl and PE contracted CC strips were significantly reduced in a concentration-dependent manner (40.8 ± 3.6% and 38.6 ± 4.0% from 64.6 ± 2.9% and 98.1 ± 4.2% respectively). Relaxant effect of CLRE was significantly reduced by ODQ (38.6 ± 4.0% to 6.4 ± 1.3% and 38.6 ± 4.0% to 7.2 ± 1.2%), nifedipine (38.6 ± 4.0% to 21.1 ± 2.7%) and glibenclamide (40.8 ± 3.6% to 31.5 ± 3.3%). However l-NAME, indomethacin, methylene blue, TEA and apamin did not inhibit relaxation by CLRE.

Conclusion

Concentration-dependent relaxant effect of CLRE in rabbit CC involves the soluble guanylate cyclase/cyclase Guanosine Monophosphate system, and activation of ATP-dependent K⁺ channels.

Objectives

We aimed to study the risk factors of erectile dysfunction (ED) and different patterns of phosphodiestrase type 5 inhibitors (PDE5is) usage among Egyptian patients.

Patients and methods

One thousand five hundred consecutive Egyptian patients complaining of ED were included in this cross-sectional study from July (2014) to October (2015). Patients were requested to answer the international index of erectile function questionnaire (IIEF-5). Statistical differences between groups were tested using Chi square test and Spearman's rho correlation coefficient for qualitative variables.

Results

Remarkably, significant associations between IIEF scores and aging and diabetes mellitus (DM) and hypertension (HTN) and ischaemic heart disease (IHD) and hyperlipidaemia were shown in the studied patients (p < .0001, p < .0001, p < .0001, p < .0001, p < .0001, respectively). Eventually, our study showed significant correlations between different age groups and morning erection and lower urinary tract symptoms and HTN and IHD and DM where the severity of ED was directly proportional to the absence or decreased strength of morning erection with aging and the increased incidence of LUTS and HTN and IHD and DM with aging (p < .0001; p = .001; p < .0001; p < .0001; p < .0001, respectively).

Conclusion

Our study demonstrated that aging; DM, HTN and hyperlipidaemia are potential major risk factors of ED in Egypt for further validation. In addition, most of the participants used PDE5is without prior medical consultation together with concomitant administration of illicit drugs.

Objective

Spermatogonial stem cells (SSCs) are able to form embryonic stem-like cells (ES-like cells) and embryonic bodies (EBs). Low-intensity ultrasound stimulation (LIUS) has positive effects on the growth and differentiation of the different cells. In this study, we tried to investigate the effects of LIUS on SSC differentiation to ES-like cells.

Materials and methods

SSCs were isolated from neonatal mice and their identification was confirmed by tracking of PLZF, Oct-4, and C-Kit proteins. The SSCs and Sertoli cells were co-cultured in DMEM/F12 supplemented with 15% FBS and LIF. SSCs stimulated by LIUS with 200 mW/CM² intensity. Characterization of obtained ES-like cells was confirmed with Sox2, Oct-4, and SSEA-1 immunofluorescence staining. Also, real-time PCR was performed to analyse the expression of c-Myc and Nanog genes in ES-Like Cells and Stra8, Piwil2 and Plzf genes in SSCs after 21 days of the in vitro culture.

Results

Our results showed c-Kit, PLZF and Oct-4 proteins were expressed positively in SSCs and Sox2, Oct-4, SSEA-1 in the ES-like cells by immunocytochemistry. The results of flow cytometry showed a significant increase in expression of c-Myc and Nanog in ES-like cells compared to SSCs (p < .05), whereas the Stra8, Piwil2, and Plzf became down-regulated during 21 days of culture. ES-like markers cell SSEA-1, Sox2 and Oct-4 were increased in the LIUS group compared to the control group (p < .05).

Conclusion

The results indicated that ES-like cells with pluripotency characteristics were derived from SSCs.

Objective

To assess the status of the sexual education approach with spina bifida (SB) patients.

Materials and methods

An online survey was sent to 223 pediatric urologists from Latin countries, all contacted using email or mobile messaging software. There were 12 questions about participants’ demographic characteristics and SB-specific care topics. Data was collected from January 2019 to January 2020. Checklist for reporting results of internet e-survey (CHERRIES) guidelines were followed to ensure the quality of this study.

Results

We received 101 valid answers from participants practicing in seven different countries. Among these, 98.4% confirmed that sexuality in the SB population is considered relevant, nevertheless it is only evaluated by 62.5%. Transitional urologists discuss sexuality more often than those whose practice consists solely of pediatric patients (70% vs. 50%). Basic surgeon training (urologist vs. pediatric surgeon), age, part or full-time pediatric urology practice and country of participants were of no statistically different influence inrates of approach to sexuality.

Conclusion

Our study demonstrates that pediatric urologists are insufficiently addressing sexuality in SB patients. Those who practise transitional urology show higher rates of approach to sexuality with SB patients, which suggests this is an important model of care.

Introduction

Erectile dysfunction (ED) is the inability to achieve or maintain erection sufficient for satisfactory sexual performance. Although the definition is well known, there are controversial issues about the effects of hormones and inflammation on ED.

Objectives

We aimed to compare the clinical value of the hormonal and inflammation parameters in sexual dysfunction.

Materials and methods

A total of 152 patients diagnosed with erectile dysfunction between September 2018 and March 2019 and 101 healthy males were included in this prospective study as case group and control group, respectively. The 152 patients were divided into three groups based on their total International Index of Erectile Function (IIEF) scores: (I) severe ED, (II) mild-moderate ED and (III) mild ED. All groups were compared in terms of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and total testosterone (TT), estradiol, prolactin, testosterone-to-estradiol ratio and 25 (OH) vitamin D.

Results

Patient and control groups differed significantly in term of NLR, PLR, prolactin and vitamin D (p < 0.001, p = 0.004, p = 0.002, p < 0.001, p < 0.001, respectively). NLR was more significant in determining the severity of ED (p < 0.001). It was observed that libido score (the total score of IIEF items #11 and #12) was negatively associated with prolactin and NLR (p < 0.001, p = 0.023, respectively), was positively associated with vitamin D and TT (p < 0.001, p = 0.02, respectively), and was lower in severe ED patients.

Conclusions

Although more clinical studies are needed, we think that our findings may be useful on these controversial issues of ED.

Objective

To determine the effectiveness and safety in the short, medium, and long term of LISWT in patients with Erectile Dysfunction who do not respond to PDE5 inhibitors.

Methodology

Clinical study, quasi-experimental cohort and systematic review following the guidelines of the Cochrane collaboration and the PRISMA writing guides.

The measurement of the variables was determined as a primary outcome to the evaluation of erectile function, by means of a validated questionnaire. The baseline scale was evaluated, as well as the difference at 1, 3 and 6 months, evidenced by the possibility of maintaining an erection or responding to therapy with PDEi5.

An information search was carried out from its beginning to the current date, in the databases: Medline, Embase, Central, Science Direct and Lilacs.

Results

The studies found used different outcome variables to show efficacy in the follow-up: All the studies used the IIEF-EF as outcome variable in its different variations.

Conclusion

LISWT could be an effective and safe treatment in patients not responding to PDEi5. It is important to point out that the evidence is currently limited, randomized studies with greater methodological rigidity and follow-up longer than 12 months are needed in order to verify the medium and long-term effect of the application of shock waves in this group of patients.

Glandular ischemia is an extremely uncommon dreaded postoperative complication of inflatable penile prosthesis surgery that may lead to penile gangrene and organ loss, whose incidence is difficult to determine. We report the case of a 56-year-old male admitted to our department with complaints of cold and painful glans penis after penile implant one month before. A color Doppler examination revealed the normal intracavernosal arteries with no vascularity in the superficial glans tissues. Due to the mild severity of the ischemia, conservative management was suggested, and consisted of oral pentoxifylline and hyperbaric therapy for 10 days, achieving a significant improvement at 4 months of follow-up.

Introduction

The development of sexual dysfunction (SD) in dialysis patients is multifactorial. We aimed to evaluate whether adequate dialysis had an effect on the development of SD in male and female patients undergoing dialysis due to end stage renal disease. Anxiety, depression, health-related quality of life and the other risk factors related to dialysis were also evaluated in terms of SD.

Methods

Seventy men and 57 women undergoing haemodialysis (HD) or peritoneal dialysis (PD) and 65 healthy male volunteers and 48 healthy female volunteers, age-matched, were included in the study. The International Index of Erectile Function, Female Sexual Function Index, Beck Depression Inventory, Beck Anxiety Inventory and The Short Form-36 Health Survey were applied to all participants. The cut off value of Kt/V was determined as 1.3 for HD and 1.7 for PD to assess dialysis adequacy. Per gender, all the participants were divided into three groups as control, adequate dialysis and non-adequate dialysis.

Results

Dialysis adequacy [OR: 3.225, 95%CI (1.213–8.620), p = .019] was found as a more decisive factor for male SD, while dialysis adequacy [OR: 3.015, 95%CI (.991–7.250), p = .041] and depression [OR: 4.280, 95%CI (1.705–10.747), p = .002] were more significant for female SD. In addition, a strong relationship was found between male SD and physical functioning (r: .524, p = .032), social functioning (r: .565, p = .042), general health (r: .693, p = .037) perception, while female SD was found to be strongly associated with anxiety (r: −.697, p = .002) and depression (r: −.738, p = .001).

Discussion

Dialysis adequacy was found to be the most important factor in reducing SD. Non-adequate dialysis resulted in worse sexual function, higher levels of depression and anxiety. Its negative effect on health-related quality of life was only seen in men.

The prevention of HPV-related diseases is an important healthcare issue due to its increasing incidence. Primary prevention is most important in males as it avoids initial infection and includes the use of condom, circumcision and vaccination. Primary prevention with vaccination is effective in decreasing HPV-related lesions in women up to 45 years old and the existing data for men comes from the experience from vaccinating women. Although it is the only vaccine that prevents cancer, the worldwide rates of vaccination in males is very low due to lack of information related to efficacy and side effects, lack of recommendation from the treating doctor, price and concern about encouragement of sexual promiscuity.

The treatment of condyloma is generally a challenge in clinical practice. Although the spontaneous resolution rate is high, a significant proportion of patients seek treatment, not because of symptomatology, but mainly for aesthetic issues and concerns related to the transmission or worsening of existing lesions. The available treatments should be applied only for clinically evident macroscopic lesions. Ideally, available therapies should have rapid action onset and clearance, resolve symptoms, reduce recurrence rate and viral load, be effective in treating small lesions, and be well tolerated. However, none of the currently available treatments is clearly more effective than the others and there is no ideal treatment for all patients or for all condyloma. Therefore, the therapeutic decision should be based on the clinician's experience, available resources, lesion morphology, size, number and location, primary or recurrent lesions, disease severity, patient preference and expectations, patient's immune competence, convenience, tolerance, cost of treatment and results of previous therapies. The available treatments are divided into three groups: applied by the patient himself (imiquimod 3.75 or 5%, podophyllotoxin .5%, synecatekines 10% or 15%), applied by the health care provider (bi‐ and tricloacetic acids 80%‐90%, intralesional interferon alpha, cryotherapy, surgical removal, electrofulguration, laser ablation) and experimental or alternative therapies (topical cidofovir, intralesional bleomycin, photodynamic therapy). Treatment methodologies can be further divided into their action ‐ ablative or destructive treatment (cryotherapy, electrofulguration, laser ablation, surgical excision), cytotoxic or proapoptotic treatments (podophyllotoxin .5%, 5‐fluoruracil, bleomycin) and immunomodulatory treatments (imiquimod 3.75% or 5%, synecatekines 10% or 15%, intralesional interferon alpha). The overall success rate of the various treatments available ranges from 23% to 94%. Only treatments that include cryotherapy or surgical excision are suitable in condyloma with any anatomical location and that have the highest success rate in monotherapy. Recurrences are common regardless of the treatment received. In contrast, immunomodulatory therapies despite having lower initial clearance rates appear to have higher probabilities of cure in the medium term, with low recurrence rates. Some treatments may be combined with each other and the effectiveness of combined therapies appears to be superior to monotherapy (proactive sequential treatment). The consensuses for the treatment of HPV also consider special situations: immunocompromised patients, meatus and intraurethral lesions and treatment of the partner.