Revista Internacional De Andrologia最新文献

Introduction and objective

Phosphodiesterase-5 inhibitors (PDE-5) are the first-line treatment. ED diagnostic and evaluation methods are clinical: erection self-perception and evaluation questionnaires. It is necessary to identify predictive markers to choose the best drug and the best dose for each individual patient. This study seeks to evaluate the effect of tadalafil 5 mg daily treatment on penile haemodynamics (penis in flaccidity, using doppler ultrasound, without using alprostadil) and to study if these changes are clinically associated.

Material and methods

40 patients who started treatment with tadalafil 5 mg daily were consecutively selected in a prospective study. Each patient underwent a penile doppler ultrasound and completed questionnaires (IIEF-6, EHS, SEP-2, SEP-3) at three different times: before starting the treatment, at 3 months and at 6 months (within the last 30 days without treatment).

Results and conclusions

Tadalafil 5 mg daily treatment for 3 months did not result in significant modifications to VPS and AS. There was clinical improvement according to the questionnaires after three months of treatment, which was not maintained at 6 months. Neither a clinical-radiological correlation nor a haemodynamic value predicting response to treatment could be established.

Objectives

To provide recommendations regarding surgery, follow-up, and management of possible complications related to penile prostheses implantation, during the COVID-19 pandemic.

Material and methods

We designed a critical narrative review of the studies investigating the impact of COVID-19 on urology practice and on penile prosthetic implantology. A comprehensive search in the MEDLINE database was performed. Different combinations of the following keywords were used according to a free-text protocol:: “SARS-CoV-2”, “COVID19“, “COVID Urology”, “COVID19 surgery”, “penile prostheses”. Papers in English and Spanish language, published until September 2020 were included in the review.

Results

Penile prosthesis implantation is an elective surgery which should always be deferred when it cannot be performed in maximum safety conditions. However, it may lead to complications wich must be resolved urgently even within the COVID-19 Era.

Conclusions

Currently, it is mandatory to develop shared strategies to avoid potential COVID-19-related complications for surgical patients. Penile prosthesis implantation should be deferred to avoid unnecessary risks and all preventive measures should be taken to minimize the risks in the event of non-delayable surgery.

Objectives

The aim of the study is to investigate the protective effect of taxifolin (3,5,7,3,4-pentahydroxy flavanone), a strong antioxidant, against testicular I/R injury in rats biochemically and histopathologically.

Materials and methods

50 mg/kg taxifolin was administered to taxifolin + testicular torsion–detorsion (TTTD, n-10) group of Albino Wistar male rats by oral gavage. Distilled water .5 ml as a solvent was administered to testicular torsion–detorsion (TTD, n-10) and Healthy Control (SG, n-10) groups using the same method. An hour after the administration of taxifolin and distilled water, anaesthesia (ketamine 60 mg/kg) was administered to all animal groups. TTD and TTTD group animals were subjected to testicular torsion at 720 degrees for four hours during anaesthesia. At the end of this period, testicular detorsion was applied and perfusion was allowed for four hours. Sham operation was applied to SG group.

Results

Our biochemical experiment results showed that the amount of malondialdehyde (MDA) in testicular tissue of TTD group presented a significant increase compared to SG and TTTD groups whereas total glutathione (tGSH) and superoxide dismutase (SOD) levels decreased. In addition, while TTD group presented severe histopathological damage in germinal epithelium cell and seminiferous tubule, mild damage was observed in TTTD group.

Conclusions

The results of our experiment indicate that taxifolin could be useful in the treatment of testicular I/R damage.

Purpose

Erectile dysfunction (ED) has increased prevalence by age and significantly affects the quality of life of men and their partners. To investigate the relationship between ED and red blood cell distribution width (RDW) values.

Materials and method

Between September 2019 and December 2019, a total of 192 individuals comprising those that were admitted to the urology outpatient clinic with ED complaints and healthy volunteers from among hospital staff were prospectively included in the study. The participants were divided into two groups according to the international erectile function index (IIEF-5) as ED group (n = 148) and control group (n = 44).

Results

There was no statistically significant difference between the two groups in terms of age, smoking status, presence of hypertension, triglyceride, low-density lipoprotein, high-density lipoprotein, total cholesterol, total prostate-specific antigen and haematocrit values. Body mass index, fasting blood sugar, neutrophil–lymphocyte ratio (NLR), and platelet–lymphocyte ratio (PLR) were significantly higher in the ED group (28.5 ± 27.4 kg/m² vs 26.8 ± 26.5 kg/m², p = .021, 109.05 ± 49.7 mg/dl vs 93.39 ± 10.2 mg/dl, p < .001, 2.18 ± 1.3 vs 1.74 ± 0.3, p = .031, and 113.7 ± 47 vs 92.4 ± 24.1, p = .004, respectively). The mean RDW values were 13.7 ± 1.1 in the ED group and 13 ± 0.5 in the control group (p < .001). The multivariate analysis revealed PLR [1.02 OR (1–1.04), p = .007] and RDW [2.75 OR (1.56–4.85), p < .001] as independent predictors for an ED diagnosis.

Conclusion

Based on the strong relationship between RDW and ED, we consider that RDW may be a new indicator in the diagnosis of ED.

Introduction and objectives

Erectile dysfunction (ED) is one of the main threats in diabetic patients. This research aimed to assess the relationship between glycated hemoglobin (HbA1c) level and pharmacopenile duplex ultrasonography (PPDU) indices in diabetic patients with ED.

Materials and methods

A total of 130 males with ED were recruited (100 had diabetes mellitus (DM) and 30 did not as control). The International Index of Erectile Function (IIEF) was used to evaluate patients for ED. Measurement of HbA1c, lipid profile and assessment of erectile function using PPDU were performed. All participants were assessed to take the medical history.

Results

The mean age ± SD was 53.8 ± 8.9 and 53.6 ± 2.8 years for patients and controls, respectively. Patients had variable grades of ED: mild in 20%, mild to moderate in 32.3%, moderate in 35.3%, and severe in 12.3%. A significant association was found between the existence of DM and a deprived response to intracorporeal injection (ICI), rising end-diastolic velocity (EDV), and reducing resistance index (RI) values. Comparing all diabetic groups according to HbA1c with controls, a significant relationship was found in; severity of IIEF-5 score, poor response to ICI, decreased peak systolic velocity (PSV) at 10 min, increased EDV at 10, 20 min and decreased RI at 10, 20 min. A significant relationship was found between smoking, dyslipidaemia, and decreased PSV at 10, 20 min and decreased increment ratio. However, a non-significant relationship was observed between age, type of DM and PPDU parameters.

Conclusion

Poor glycaemic control of DM is associated with an increase in EDV and decrease in RI, and PSV of PPDU.

Introduction

The objective of the study was to explore the effect of the Mindfulness-based program (MBSR) on the sexual health and psychological well-being of professionals and volunteers of Doctors of the World who care for people at risk of social exclusion.

Method

The entire population of a NGO in southern Spain was chosen because it receives a large number of vulnerable people. Quasi-experimental study with pre and post-test measurements. The intervention lasted 8 weeks plus an introductory session, with sessions of 2.5 h. Seven instruments were applied before and after the intervention: (a) Mindfulness Scale (MAAS); (b) Body Connection Scale; (c) Compassion Questionnaire (SCS); (d) Ryff's psychological well-being scale; (e) Hurlbert's Fantastic Sexuality Index; (f) Wilson's Sexual Fantasy Scale, and (g) Hudson's Sexual Satisfaction Index (ISS).

Results

Most of the post-test scores were better compared to the pre-test. On the MAAS scale, the score was higher in the post-test than in the pretest (Wilcoxon = −2668, P<.05) and, in the ISS, the score was also higher in the post-test than in the pre-test (Wilcoxon = −2.201, P<.05). However, in the Bodily Dissociation subscale, the score was lower (Wilcoxon = −2.670, P<.05). All effect sizes were moderate to high.

Conclusions

The application of the MBSR protocol can increase the degree of sexual satisfaction, decrease body dissociation, promote mental health and self-compassion in people who treat vulnerable people, which may have an impact on a higher quality of approach to them.

Background and objective

The objective of the present study is to investigate the contextual characteristics of the onset of gender dysphoria (GD) in trans minors.

Materials and method

All minors who requested consultation in the Gender Identity Treatment Unit from March 2007 to June 2019 participated. Clinical histories were reviewed to obtain the information. Confidentiality was guaranteed.

Results

Sixty-four minors required care, 39.1% were trans women (TW) and 60.9% trans men (TM). The age range was between 6-17 years, with a mean of 14.98. Seventy-five percent of the trans minors located the onset of DG in childhood and 25% in adolescence. Parental reaction was suspicious in 55.6% of cases and surprise in 36.5%; 55.6% presented significant psychological distress before going to the unit.

Family support was present in 57.1%. The role of social networks and the Internet was relevant for 39.7% of the sample. Of the minors, 44.4% had membership or contact with peer groups or LGTBIQ associations. Results were analysed according to sense of gender.

Conclusions

Minors continue to require care in the units, especially TW. Although GD onset in both groups is mainly in childhood, in adolescence it is more frequent in TM. Trans minors are born, develop and build their identity in a specific context, which is in interaction.

Background/objective

Although the increasing prevalence of hypospadias has been reported in many countries, there is a lack of bibliometric studies that make a holistic assessment of the publications about this issue. This study aims to make a holistic evaluation, latest developments, and trend topics about hypospadias publications between 1980 and 2018 through bibliometric analysis.

Methods

All the publications about hypospadias published in the Web of Science index between 1980 and 2018 were downloaded and analyzed using bibliometric methods. The Spearman's correlation coefficient was utilized to analyze the correlations between economic productivity and performance of the countries on hypospadias. Linear regression analysis was performed to estimate the number of publications for the following years.

Results

Bibliometric analyses were performed with 1940 articles. With 527 (27.2%) publications, the USA was the country that made the most contribution to the literature. The top active 3 journals were the Journal of Urology, Journal of Pediatric Urology, and Urology. A high correlation was detected between hypospadias publication productivity and GDP (r = 0.791, p < 0.001). The regression analysis results showed that the expected number of articles to be produced was 95 (75–116) for 2019 and 106 (47–164) for 2024.

Conclusions

This study provides a holistic evaluation of the articles about hypospadias, which is an anomaly that should be repaired and treated with surgery due to its potential problems for the children at kindergarten and school age. Increasing the collaboration between especially developing countries and research in different countries with samples from different communities through multidisciplinary studies are recommended.

Introduction

Hyperprolactinaemia is an unusual cause of erectile dysfunction, yet erectile dysfunction is a common complaint in patients with hyperprolactinaemia. We present a patient with erectile dysfunction without symptoms suggesting hyperprolactinaemia.

Materials and methods

Patient consulted with erectile dysfunction for the past 10 years.

Decreased time and quality of erection with an IIEF score of 14/30.

Lab reports: prolactin 90.2 ng/ml, FSH 1.6 mlU/ml, LH 1.8 UI/L, total testosterone .491 ng/ml. Brain MRI: lateral pituitary micro adenoma, 5 mm in diameter.

Results

Patient in treatment with cabergoline 1 mg per week, after treatment noticed improvement in erectile dysfunction and sexual desire. Actual prolactin 15.4 ng/ml.

Conclusions

Up to 5% of patients with erectile dysfunction are diagnosed with a pituitary adenoma. Erectile dysfunction caused by pituitary neoplasms is a multifactorial disease and elevated prolactin has consequences on testosterone, LH, FSH, and dopamine precursor levels.

Introduction

The association between erectile dysfunction (ED) and cardiovascular disease (CVD) is well known, the latter being an early independent risk factor that can appear up to 5 years before the onset of cardiovascular symptoms. The enzyme endothelial nitric oxide synthase (eNOS) could be implicated in its pathophysiology as an endogenous vasodilator. Our objective was to analyse the influence of variants of the eNOS gene, in the response to treatment of ED, in patients with CVD.

Methodology

Observational, prospective study in patients with ED of the Cardiac Rehabilitation Programme. Demographic variables were collected (International Index of Erectile Function (IIEF), quality of sexual life (mSLQQ), anxiety and depression (HAD), along with cardiovascular risk factors (CVRF). Genetic analysis of polymorphisms T-786C, G894T of the eNOS gene was performed by RT-PCR with TaqMan probe, and the data were analysed using SPSS 25.

Results

Patients (n = 35, 60.8 ± 8.44 years) showed a median CVD (IQR 1-3) with severe ED (IIEF-EF of 9.4 ± 6.73 points) and a low perception of their quality of sexual life (–19.4 ± 8.37 points). At the final visit (n = 15), there were 71% responders to treatment with iPDE5, with a significant improvement in their ED (IIEF = 49.4 ± 17.29, IIEF-FE = 18.5 ± 9.60 scores) and of their quality of sexual life (7 ± 12 scores), with a higher percentage of responders among the native homozygous genotypes -786-TT and 864-TT.

Conclusion

Variants of the NOS3 gene could influence the response to iPDE5. Full analysis of the patient sample will be required to confirm these preliminary results.