Minimally Invasive Therapy Using Intralesional OnabotulinumtoxinA in Peyronie's Disease.

PURPOSE: To determine the effectiveness of intralesional administration of onabotulinumtoxinA in patients with Peyronie's disease (PD). MATERIALS AND METHODS: A prospective therapeutic cohort study was undertaken in patients aged ≥ 18 years with stable PD. Intervention included one-time intralesional application of 100 U of onabotulinumtoxinA. We included 22 patients who attended the urology clinic from October 1, 2011 to June 30, 2012. Primary outcome measure was degree of curvature. Secondary outcome measures were thickness of the fibrous plaque, improvement in erectile function and pain. Erectile function was evaluated using the International Index of Erectile Function (IIEF-5) questionnaire. The Visual Analog Scale (VAS) was used to measure pain during an erection. Statistical analyses were performed by Pearson's chi-squared test for categorical variables and student's t-test for quantitative variables. Any P value < .05 was considered statistically significant. RESULTS: The size of the fibrous plaque was reduced from 0.34 ± 0.20 to 0.27 ± 0.13 cm after treatment (P = .014). The curvature initially averaged 32.95 ± 9.21°, and improved to 25 ± 9.38° (P = .025). According to the Kelami classification, the curvature was < 30° in 14 cases (63.6%) and was 30°-60° in eight cases (36.4%). At 16 weeks, the curvature was < 30° in 19 cases (86.4%) and 30°-60° in three cases (13.6%). The IIEF-5 score was 16.18 ± 4.46 before treatment and 18.22 ± 4.55 after treatment (P = .002). Pain was reduced from 3.36 ± 3.48 before treatment to 1.14 ± 1.58 after treatment (P = .001). CONCLUSION: The administration of onabotulinumtoxinA may improve the clinical manifestations of PD resulting from fibrosis, thus improving sexual function in patients.

Freud's Mexican readers.

This essay presents an overview of artists and writers who read Freud's work in Mexico between 1920 and 1968. The focus is on cultural readings of Freud: non-clinical interpretations of psychoanalysis that applied Freud's theory to literary, artistic, philosophical, or religious questions. The essay focuses on Salvador Novo, one of the poets associated with the Contemporáneos group, and his reading of the "Three Essays in the Theory of Sexuality;" Raúl Carrancá y Trujillo, a judge and criminologist who used psychoanalysis in his work, including the trial of Trotky's assassin; Octavio Paz, a poet and intellectual who wrote an essay on Mexican history, "The Labyrinth of Solitude," as a response to "Moses and Monotheism;" and Gregorio Lemercier, a Benedictine monk who placed his monastery in group analysis. These unorthodox readings of Freud opened the door for some of the most daring intellectual experiments in the 20th century.