[Impact of isolation by Sars-CoV-2 on Sexuality. Results of an investigation in Argentina.] / Impacto del aislamiento por Sars CoV-2 en la Sexualidad. Resultados de una investigación en Argentina.

OBJECTIVE: To evaluate the impacton sexuality of the mandatory social isolation linked tothe pandemic by SARS-CoV-2 in an open population ofadults in ArgentinaMATERIAL AND METHOD: An anonymous andvoluntary self-response online questionnaire wasdistributed to an open population of adults who werein mandatory social isolation as consequence of theSARS-CoV-2 Pandemic, between March 31 and June1, 2020. A total of 2214 surveys were collected. At the time the survey was answered, 54.2% had been in isolationfor 6 weeks. RESULTS: We observed that the frequency ofintercourse had an impact in 62.7% of partners livingtogether, increasing by 27.8% and decreasingby 34.9%. Many couples decreased the frequencyof oral sex, anal sex, and mutual and simultaneousmasturbation. On the other hand, hugs, caresses andkisses increased. The presence of children at homeand the longest time in quarantine were closely relatedto the decrease in sexual intercourse frequency.In 50.3% of people who had no cohabitant partner,the frequency of weekly masturbation increased,while 23.7% increased the use of virtual sex. Transgenderpopulation showed that in those with a stablepartner, 68.7% experienced changes in their frequencyof intercourse, similarly to that observed incis population. We also found a higher frequency ofself-stimulation practices in this population. CONCLUSION: In most of the cohabiting couplesof the studied population, the frequency of sexualintercourse and the ways of interaction were affected,without relation to gender identity. An increasein masturbation and virtual sex was observed inpeople who had no cohabitant partner, in addition toa higher frequency of self-stimulation practices intrans individuals. More research and follow-up arerequired to understand the real impact of isolationon sexual health.

OBJETIVO: Evaluar el impacto en lasexualidad del aislamiento social obligatorio vinculadoa la Pandemia por SARS-CoV-2 en una poblaciónabierta de adultos de la Argentina.MATERIAL Y MÉTODO: Se empleo una encuestade auto respuesta, anónima y voluntaria, en unapoblación abierta de adultos que se encontraban enaislamiento social obligatorio como consecuenciade la Pandemia por SARS-CoV-2, durante el periodocomprendido entre el 31 de marzo y el 1 de junio de2020. Recogiendose un total de 2214 encuestas. En elmomento en que respondieron la encuesta el 54,2%llevaba 6 semanas de aislamiento. RESULTADOS: Observamos que en el 62,7% de lasparejas convivientes se modifico la frecuencia de relaciones,aumentando en el 27,8% y disminuyendo enel 34,9%. En general, se vio una disminución del sexooral, anal y de la masturbación mutua y simultánea, ypor otro lado, un aumento de abrazos, besos y caricias.La presencia de hijos en casa y el mayor tiempo decuarentena fueron directamente relacionados con ladisminución de la frecuencia de encuentros sexuales. En el 50,3% de los individuos sin pareja convivienteaumentó la frecuencia de masturbación semanal, y enel 23,7% aumento el uso de sexo virtual. En la poblacióntransgénero se encontró que el 68,7% de los queconvivían con una pareja estable experimentó un impactoen la frecuencia de relaciones sexuales, similara lo encontrado en la población cis. Por otro lado vimosen este subgrupo una mayor práctica de masturbaciónen relación a la población CIS. CONCLUSIÓN: En la mayoría de las parejas convivientesde la población estudiada se vio afectada lafrecuencia de encuentros sexuales y las formas de interacción,sin relación con la identidad de género. Seobservó además un aumento de la masturbación y elsexo virtual en las parejas no convivientes, además demayor frecuencia de prácticas de autoestimulación enlos individuos trans. Se requieren más investigación yseguimiento para comprender el real impacto del asilamientoen la salud sexual.

[Ectopic finding of malleable penile prosthesis extension Tip.] / Hallazgo ectópico de tip de extensión de prótesis peneana maleable.

OBJECTIVE: To report the finding of malleable penile prosthesis extension tips in an ectopic position. METHOD: We retrospectively analyzed two clinical cases of ectopic finding of prosthetic implant extension tips and performed a bibliographic review. RESULTS: In the cases described, conservative behavior was decided given the absence of signs, symptomatology and the efficacy of the normally positioned implant. CONCLUSION: The migration of the penile prosthetic implant is a very uncommon complication, more so the finding of a tip extension in an ectopic position. Reports in the literature on the behavior to follow in this type of complications are absent.

OBJETIVO: Comunicar el hallazgo en posición ectópica de los Tips de extensión de prótesis peneana maleable.MÉTODO: Se analizaron retrospectivamente dos casos clínicos de hallazgo ectópico de tip de extensión de implante protésico y se realizó una revisión bibliográfica. RESULTADOS: En los casos descritos se decidió conducta conservadora dada la ausencia de signos, sintomatología y a la eficacia del implante normoposicionado.CONCLUSIÓN: La migración del implante protésico peneano es una complicación muy infrecuente, más aun el hallazgo en posición ectópica de un tip de extensión. No se reportan informes en la literatura sobre la conducta a seguir ante este tipo de complicaciones.

Twelve-Month Efficacy and Safety of Low-Intensity Shockwave Therapy for Erectile Dysfunction in Patients Who Do Not Respond to Phosphodiesterase Type 5 Inhibitors.

INTRODUCTION: Low-intensity shockwave therapy (LISWT) has recently emerged as a promising method in the treatment of erectile dysfunction (ED). AIM: To assess the long-term results of the effectiveness and safety of LISWT in patients with ED who are non-responders to phosphodiesterase type 5 inhibitor (PDE5i) treatment. METHODS: This open-label, longitudinal, and observational study investigated an uncontrolled population of 50 consecutive patients whose ED was unresponsive to PDE5i treatment. Patients were treated with a four-session LISWT protocol. During active treatment and follow-up, all patients remained on their regular high on-demand or once-daily PDE5i dosing schedules. MAIN OUTCOME MEASURES: Effectiveness was assessed according to the International Index of Erectile Function erectile function domain, questions 2 and 3 of the Sexual Encounter Profile, Erection Hardness Scale, and Global Assessment Question scores at baseline and at 3, 6, 9, and 12 months after treatment. Patients were considered responders whenever they showed improvement in erection parameters in all four assessments and responded positively to the Global Assessment Question. Adverse events were recorded. Statistical variables were applied and findings were considered statistically significant at a P value less than < .05. RESULTS: Eighty percent (mean age = 64.8 years) completed the 12-month follow-up. Positive response rates were 60% of available subjects at the end of the study and 48% of the intent-to-treat population. After the 12-month follow-up, 91.7% of responders maintained their responses. No patient reported treatment-related adverse events. CONCLUSION: LISWT in patients with ED unresponsive to PDE5i treatment was effective and safe in 60% of patients treated. The efficacy response was maintained for 12 months in most patients.

[Effectiveness of low-intensity extracorporeal shock wave therapy on patients with Erectile Dysfunction (ED) who have failed to respond to PDE5i therapy. A pilot study]. / Efectividad de las ondas de choque de Baja intensidad (LISW) en varones con disfunción eréctile (DE) no respondedores a IPDE5. studio piloto.

UNLABELLED: Low-intensity extracorporeal shock wave therapy (LIESWT) of the penis has recently emerged as a promising modality in the treatment of ED. OBJECTIVES: The objective of this paper is to assess the effectiveness and safety of LIESWT on patients with ED who have failed to respond to PDE5i treatment. METHODS: Open label, prospective, longitudinal observational study. The study involved an uncontrolled population of 25 patients. The treatment consisted in applying 20,000 shock waves during a period of four weeks. In each session the patient received 5000 shock waves of 0.09 mJ/mm2: 1800 were applied on the penis (900 on each corpus cavernosum), and 3200 were applied on the perineum (1600 on each crus). During the active treatment and follow-up phases, all patients remained on their regular high on demand or once-a-day dose PDE5i schedules. MAIN OUTCOME MEASURE: Effectiveness was assessed by IIEF-6, SEP2, SEP3 and GAQ. Patients were considered to be responders whenever they improved on all three erection assessment parameters and respond positively to the GAQ at three months post-treatment. Adverse events were recorded. Statistical variables were applied and findings were considered to be statistically significant whenever the P value was<0.05. RESULTS: Eighty percent (median age 63) of the patients (20/25) completed the study. Five patients were lost to follow-up and were excluded from the analysis. Sixty percent (60%) of the patients responded to the treatment, improved the 3 efficacy evaluating parameters and responded positively to the GAQ. The increase in mean IIEF-6 score was of 9 points after the third post-treatment month. There were no patients reporting treatment-related adverse events. CONCLUSIONS: LIESWT for men with ED and that are PDE5i non-responders was safe and effective and restoring PDE5i response in more than 50% of patients.A large-scale multicenter study is required to determine the benefits of this treatment for ED.

Lower urinary tract symptoms and erectile dysfunction from urological consultation in Argentina.

UNLABELLED: Erectile dysfunction (ED) and lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) are often associated, and they both reduce the quality of life of those who suffer from these conditions. OBJECTIVES: Primarily, to determine the relationship of LUTS/BPH as an independent risk factor for suffering ED and, secondarily, the relationship of LUTS/BPH and ED according to the severity of the symptoms. METHODS: A descriptive, analytic, multicentre study was carried out in 580 patients consulting for prostatic control or LUTS. 305 patients, who met the inclusion/exclusion criteria, were included in the analysis. Erectile dysfunction and LUTS were assessed by IIEF5 and IPSS. The presence, predictors and degree of severity of ED were examined according to patients' age and comorbidities. Qualitative and continuous variables were considered for the statistical analysis and simple and multiple regression analyses were applied. A value of p < 0.05 was considered statistically significant. RESULTS: Mean age was 62 years (IQR 56-67) ED prevalence in patients with LUTS/BPH was 83.6%. Patients with ED were older, showed a higher prevalence of hypertension and higher IPSS scores (p < 0.05). Multivariate analysis for ED predictors showed that age, diabetes and IPSS score were significantly associated with ED (p < 0.05). CONCLUSIONS. According to our results, there is a high prevalence of ED in patients with LUTS/BPH, which are also independent risk factors for suffering ED. The presence of ED was more prevalent in moderate LUTS/BPH than in the severe LUTS/BPH. The importance of assessing the sexual health of men consulting for LUTS/BPH is emphasized.

Risk factors of Peyronie's disease. What does our clinical experience show?

INTRODUCTION: Peyronie's disease (PD) is a localized fibrosis that affects the tunica albuginea of the penis. Its origin can be associated with coital penile trauma in men with autoimmune hypersensitivity and a presumed genetic predisposition. AIM: To identify clinical and traumatic risk factors in a patient population with PD, when compared to a control group. METHODS: From November 2007 to March 2010, 317 patients sought medical attention for PD. As control group, 147 consecutive patients, who came for a prostate exam, were studied. Clinical, traumatic, and sexual history of these patients was gathered. Risks factors were considered only if they had been present before the onset of PD symptoms. MAIN OUTCOME MEASURE: The International Index of Erectile Function and the International Prostate Symptoms Score. A univariate logistic regression model (chi-square) (odds ratios [ORs] and 95% confidence intervals [CI]) was used to estimate the association of risk factors with PD; and the Student's t-test was implemented for age. RESULTS: The mean age of patients with PD and control group was 56.7 and 58.8, respectively (P<0.923). The mean evolution time of the disease was 17.7 months (2-48). Erectile dysfunction (ED) and coital trauma constituted the only two independent risk factors for PD compared to the control group (P<0.05 and 0.002, respectively) with an OR of 1.5 (95% CI 1.0-2.3) and 2.69 (95% CI 1.41-5.21), respectively. Patients with ED and diabetes mellitus and with a mild-to-moderate ED also presented a higher predisposition (P=0.008 and 0.00001), with an OR of 3.64 (95% CI 1.33-10.79) and 5.58 (95% CI 3.03-10.42), respectively. CONCLUSION: Erectile dysfunction and coital trauma have proven to be independent risk factors for the development of PD.

Recreational use of phosphodiesterase type 5 inhibitors by healthy young men.

INTRODUCTION: In recent years, PDE5 inhibitors (PDE5i) use has become more popular among men without ED to enhance sexual performance. However, reports in the literature are scarce. AIM: The aim of this study was to evaluate the recreational use of PDE5i in healthy young men. MAIN OUTCOME MEASURES: We evaluated the recreational use of PDE5i among young and healthy men, their main reasons for use, how they were obtained these drugs, and the combination with alcohol or other drugs. METHODS: Descriptive, transversal study consisting in 400 brief surveys with structured multiple choice and open questions. Nonprobability samples (quota samples) included young men between 18 and 30 years of age in a public area (high schools, universities, and gyms) between August and November 2009. Collecting the questionnaires in a sealed box enforced confidentiality. The survey included demographic and sexual health data and PDE5i use characteristics. For statistical analysis we used Fisher's exact and Mann-Whitney tests. RESULTS: A total of 321 questionnaires were appropriate for the purposes of evaluation. Mean age and standard deviation were 25.1±3.3 years old. Regarding PDE5i use, 69 men (21.5%) mentioned trying the pill (being sildenafil the most commonly used one) at least one time in their lives and 37 (53.4%) men combined it with alcohol or drugs. Referred sources of acquisition PDE5i were 75.4% (N=52) from a friend, 17.4% (N=15) from a pharmacy/drugstore without a medical prescription, 4.3% (N=3) prescribed by a physician and 2.9% (N=2) through Internet. There were several reasons for taking PDE5i related to sexual confidence, erection quality, and better sexual performance. CONCLUSION: According to our results, 21.5% of healthy men between 18 and 30 years old used PDE5i as a recreational drug, mostly associated with alcohol or other drugs without medical control. This could have led to misuse and a public health problem. Further studies are needed to evaluate not only PDE5i recreational use prevalence, but also psychosocial determinants, long term safety, misuse, and abuse related to it.

[Percutaneous renal surgery with minimal access: miniperc]. / Cirugía renal percutánea con acceso mínimo: miniperc.

OBJECTIVES: To describe the technique of the minimal access percutaneous nephrolithectomy, miniperc, and to analyze the results obtained with this treatment in adult patients. METHODS: We performed 42 minipercs between august 2002 and December 2003. Mean patient age was 48 years (19-62). The procedure was undertaken using a 14Fr Amplatz sheath. Stone size varied from 1.5-3.5 cm in longest diameter (1.5-7 cm2). Lithofragmentation was performed by pneumatic lithotripsy. RESULTS: Average procedure time was 75.2 min. (range from 60 to 120). All patients were discharged within 24 hours. Only three patients (7.1%) have a hematocrit descent over 2 points. No nephrostomy tube was left for the postoperative time. 95.2% of the patients were stone free 1 month after surgery. CONCLUSIONS: Our results make us consider the minimal access percutaneous nephrolithectomy (Miniperc) a minimal option for the elimination of renal stones, with low morbidity, diminishment of the hospital stays, very low analgesic demand, and no transfusion requirements.