A prospective, randomized, single - blind study comparing intraplaque injection of thiocolchicine and verapamil in Peyronie's Disease: a pilot study

ABSTRACT Objectives: To compare the response to tiocolchicine and verapamil injection in the plaque of patients with Peyronie's disease. Materials and Methods: Prospective, single-blind, randomized study, selecting patients who have presented Peyronie's disease for less than 18 months. Thiocolchicine 4mg or verapamil 5mg were given in 7 injections (once a week). Patients who had received any treatment for Peyronie's disease in the past three months were excluded. The parameters used were the International Index of Erectile Function (IIEF-5) score, analysis of the curvature on pharmaco-induced erections and size of the plaque by ultrasonography. Results: Twenty-five patients were randomized, 13 received thiocolchicine and 12 were treated with verapamil. Both groups were statistically similar. The mean curvature was 46.7° and 36.2° before and after thiocolchicine, respectively (p=0.019) and 50.4° and 42.08° before and after verapamil, respectively (p=0.012). The curvature improved in 69% of patients treated with thiocolchicine and in 66% of those who received verapamil. Regarding sexual function, there was an increase in the IIEF-5 from 16.69 to 20.85 (p=0.23) in the thiocolchicine group. In the verapamil group the IIEF-5 score dropped from 17.50 to 16.25 (p=0.58). In the thiocolchicine group, the plaque was reduced in 61% of patients. In the verapamil group, 8% presented decreased plaque size. No adverse event was associated to thiocolchicine. Conclusion: The use of thiocolchicine in Peyronie's disease demonstrated improvement on penile curvature and reduction in plaque size. Thiocolchicine presented similar results to verapamil in curvature assessment. No significant side effects were observed with the use of tiocolchicine.

The use of alpha-1 adrenergic blockers in children with distal ureterolithiasis: a systematic review and meta-analysis

Introduction: Urinary lithiasis is the main urologic cause of emergency treatment in adult patient. In the past years, the incidence in children population has increased. However, literature about the use of alpha-1 adrenergic blockers in pediatric population with distal ureterolithiasis is still scarce. The drug acts by decreasing ureter contractions, especially in the distal portion, facilitating calculus expulsion. Objective: This review has the objective to evaluate the use of alpha-1 adrenergic blockers as medical expulsive treatment in children with distal ureterolithiasis. Evidence Acquisition: An electronic literature search was performed using the MEDLINE, COCHRANE, and LILACS databases. We further searched manually the references of the primary studies. Searches were concluded on October 4th, 2014. Articles were selected, independently and in pairs, by the respective titles and summaries. Any divergence was resolved by consensus. Evidence Synthesis: Alpha-1 adrenergic antagonists increased the probability of calculus expulsion by 27% (NNT=4). Calculi smaller than 5mm, increased by 33% (NNT=3). Larger than 5mm, increased by 34% (NNT=3). Conclusion: Alpha-1 adrenergic blocker use is related with a greater incidence of expulsion of ureteral calculi, smaller or greater than 5mm, and fewer episodes of pain when compared to ibuprofen. However it is necessary larger samples to enhance the power analysis of the expulsion of ureteral calculi larger than 5mm and the episodes of pain. Patient Summary: This review analyzed the outcome of alpha adrenergic antagonist in children with ureteral calculi. We conclude that it is the best medicine for use, since it helps the expulsion of the stone.

Litiase experimental em ratos: papel da hidroclortiazida e de antibioticos na sua prevencao. / Experimental lithiasis in rats: the role of hydrochlorothiazide and antibiotics in its prevention

A etiologia dos calculos associados a presenca de corpo estranho nao e bem conhecida e, no sentido de elucidar melhor esse fenomeno, os autores utilizaram o modelo experimental proposto por Vermeulen.Placas de zinco foram aplicadas na bexiga de 48 ratos Wistar e estes foram divididos em 3 grupos experimentais: grupo A animais controles; grupo B, animais tratados com hidroclortiazida oral; grupo C, animais tratados com tetraciclina oral. Apos 6 semanas, os animais foram sacrificados colhendo-se material da bexiga para estudo bacteriologico e pesando-se os calculos presentes no local. A analise da media dos pesos dos calculos encontrados nestes animais nao demonstrou diferenca estatisticamente significante entre as mesmas, indicando que a formacao de calculos na presenca de corpo estranho nao depende da saturacao local de calcio e nem da existencia de infeccao urinaria

O diagnostico radiologico da impotencia sexual vasculogenica. / Radiologic diagnosis of vasculogenic sexual impotence

O diagnostico e a orientacao terapeutica da impotencia sexual vasculogenica dependem fundamentalmente do exame radiologico.A indicacao deste exame e feita apos exame clinico e intrumental, selecionando-se os casos suspeitos para serem submetidos a angiografia seletiva. E descrita a tecnica do exame radiologico adotada no Hospital da Clinicas de F.M.U.S.P., e discutida a interpretacao dos variados quadros radiologicos que se apresentam e sao ilustrados alguns exemplos das lesoes mais comumente encontradas

Hiperaldosteronismo primario: tratamento cirurgico. / Primary hyperaldosteronism: surgical treatment

Em cinco pacientes que apresentavam hipertensao arterial e hipopotassemia, foram diagnosticados adenomas de supra-renal produtores de aldosterona. A localizacao dos tumores foi feita atraves de exploracao cirurgica, de venografia e de tomografia computadorizada. Apos as adrenelectomias, todos os pacientes ficaram curados de hipertensao arterial e de hipopotassemia

Uretrite gonococica - tratamento com rosoxacin. / Gonococcal urethritis - treatment with rosoxacin

Rosoxacin em dose unica de 300 mg (2 capsulas de 150 mg) por via oral foi usado em 29 pacientes com uretrite aguda gonococica. A Neisseria gonorrhoeae foi a unica bacteria isolada em 22 casos. Nos outros, apareceu associada ao Staphylococcus epidermidis em cinco casos, ao Staphylococcus aureus em um caso e a Klebsiella pneumoniae em um caso. Obteve-se controle clinico e laboratorial em 26 pacientes, dos quais 23 (88,4%) ficaram curados e tres (11,6%) tiveram persistencia da infeccao. As reacoes adversas foram euforia em 4%, excitacao sexual em 4%, sonolencia em 4%, tonturas em 15% e sensacao de embriaguez em 12%. Nao houve alteracoes do hemograma e das provas de funcao hepatica apos o tratamento

Aspectos tecnicos da prostatectomia suprapubica. / Technical aspects of the suprapubic prostatectomy

Os autores discutem os aspectos tecnicos de cirurgia suprapubica da hipertrofia benigna da prostata, salientando as caracteristicas dos acessos transvesical e retropubico

Explosao vesical durante resseccao transuretral de prostata. / Bladder during transurethral resection of prostate

Os autores apresentam um caso de explosao vesical extensa, durante RTU, em paciente com adenoma de prostata.Sugerem como principal fator, para ocorrencia deste tipo de lesao, o acucar de gases na cupula vesical em presenca de faisca eletrica