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1.
Artigo em Inglês | MEDLINE | ID: mdl-38651905

RESUMO

INTRODUCTION: We aimed to investigate whether a low intrarenal pressure provided by ureteral access sheath (UAS) use had a positive effect on the prevention of acute kidney injury through the evaluation of the myo-inositol oxygenase (MIOX). MATERIAL AND METHODS: The patients were divided into two groups according to whether a 9.5/11.5-Fr UAS was used during retrograde intrarenal surgery (RIRS): UAS group and non-UAS group. RIRS was performed under gravity irrigation and manual pumping was not used. For the measurement of MIOX, 5 cc blood samples were taken from the patients preoperatively and four hours postoperatively. RESULTS: Operation time and hospital stay were significantly longer in the UAS group. The mean preoperative and postoperative MIOX values were 0.77 ± 0.36 ng/ml and 0.74 ± 0.38 ng/ml, respectively, in the UAS group, and 0.74 ± 0.31 ng/ml and 0.83 ± 0.40 ng/ml, respectively, in the non-UAS group. The mean MIOX change was -0.29 ± 0.36 in the UAS group and 0.08 ± 0.44 in the non-UAS group, indicating no significant difference between the groups. CONCLUSION: Even if UAS is not used, significant acute kidney injury is not observed under gravity irrigation and therefore, if we avoid manual pumping, the intrarenal pressure remains low, thus potentially rendering the use of 9,5/11,5-Fr UAS unnecessary.

2.
Urologia ; 90(2): 335-341, 2023 May.
Artigo em Inglês | MEDLINE | ID: mdl-36062576

RESUMO

OBJECTIVE: Percutaneous nephrolithotomy (PNL) and retrograde intrarenal surgery (RIRS) are common surgical methods in the treatment of kidney stones. Possible effects on kidneys are an important factor in determining the surgical procedure and the surgical method. In our study, kidney injury molecule-1 (KIM-1) and myo-inositol oxygenase (MIOX) were used to compare acute kidney injury in patients that underwent PNL and RIRS. MATERIAL AND METHOD: Eighty patients aged 20-75, who underwent PNL or RIRS in our urology clinic between November 2018 and February 2020 were included in the study. In this prospective study, the demographic characteristics, stone size, operation time, preoperative and postoperative hemoglobin and biochemistry values of the patients were recorded. About 5 cc blood samples taken from the patients before the operation and at the fourth hour after the operation were centrifuged and kept at -80°C, and the KIM-1 and MIOX levels were measured in the biochemistry department. RESULTS: There was no difference between the groups in terms of demographic data; however, the operation time and length of hospital stay were significantly longer in the PNL group. The mean increase in MIOX was 10.583 ± 9.73 and 7.501 ± 16.46 ng/ml in the PNL and RIRS groups, respectively. Although there was a statistically significant increase in both groups, this increase was greater in the PNL group. A significant increase was observed only in the PNL group in the postoperative period (p = 0.003). DISCUSSION AND CONCLUSION: The findings of the study suggest that the PNL procedure causes more damage to the kidneys than RIRS.


Assuntos
Cálculos Renais , Nefrolitotomia Percutânea , Nefrostomia Percutânea , Humanos , Cálculos Renais/cirurgia , Nefrostomia Percutânea/métodos , Estudos Prospectivos , Estudos Retrospectivos , Resultado do Tratamento
3.
Int J Impot Res ; 32(3): 302-307, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-31243353

RESUMO

In patients with coronary artery disease (CAD), fragmented QRS (fQRS) is a practical marker of myocardial ischemia evaluated on electrocardiography (ECG).The current study investigated the connection between FQRS and erectile dysfunction (ED), which is commonly accepted as an early sign and independent predictor of CAD. The study consisted of a 190 ED patients; 47 of them having severe, 44 moderate, 49 mild-to-moderate, and 50 mild ED, and a control group of 51 otherwise healthy adult men. None of the participants had a history of cardiac disease. There was a significant difference among the groups in terms of fQRS; severe, moderate, and mild-to-moderate ED groups had significantly higher rates of fQRS presence on ECG (27.5%, 23.5%, and 22.5%, respectively) in comparison with those of mild ED and the control groups (13.7% and 12.7%, respectively) (p < 0.001). In patients presenting with ED complaints, a fQRS finding on a simple ECG recording may serve as a first sign of the presence of CAD. As far as we know, the present study is the first in the literature assessing the possible relationship between ED and fQRS. On the ECG, the existence of fQRS was considered to be connected with ED; thus, including this basic parameter into the clinical decisions for ED patients may initiate an extensive diagnostic approach for their underlying cardiovascular diseases.


Assuntos
Aterosclerose , Disfunção Erétil , Aterosclerose/complicações , Aterosclerose/diagnóstico , Eletrocardiografia , Disfunção Erétil/diagnóstico , Humanos , Masculino
4.
Rev Int Androl ; 16(3): 87-94, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30300135

RESUMO

BACKGROUND: It has been reported in the literature that proinflammatory interleukin-1 beta (IL-1ß) is increased in cases of testicular ischemia reperfusion (I/R) damage. This information suggests that anakinra, an IL-1ß antagonist, may be effective in testicular I/R damage. OBJECTIVE: In our study, we investigated the effect of anakinra on testicular I/R damage induced in rats with torsion/detorsion. METHODS: The 50mg/kg anakinra+testicular torsion/detorsion (KTD-50) and 100mg/kg anakinra+testicular torsion/detorsion (KTD-100) groups received an intraperitoneal (i.p.) injection of 50mg/kg and 100mg/kg of anakinra, respectively. In turn, the testicular torsion/detorsion (TTD) and sham operation (SOG) groups received a single dose of distilled water as a solvent 1h before ketamine anaesthesia. After the testes of the TTD, KTD-50 and KTD-100 groups were subjected to torsion and detorsion for 4h each, the rats were killed with a high-dose anaesthesia, and their testicles were removed and evaluated through biochemical, gene expression and histopathological examinations. The results were evaluated in comparison with those of the SOG group. RESULTS: The levels of malondialdehyde (MDA), myeloperoxidase (MPO) and IL-1ß showed significant increases in the TTD group, which underwent torsion/detorsion, compared to the KTD-50, KTD-100 and SOG groups. Conversely, the levels of glutathione (tGSH), glutathione peroxidase (GPO) and glutathione s-transferase (GST) were found to be significantly higher in the KTD-50, KTD-100 and SOG groups than in the TTD group. CONCLUSION: Anakinra at a 100mg/kg dose histologically suppressed better oxidative stress and tunica albuginea, germ cell, seminiferous tubule and interstitial damage in the testicular tissue compared to a 50mg/kg dose. Experimental results indicate that anakinra might be beneficial in the attenuation of testicular I/R damage.


Assuntos
Proteína Antagonista do Receptor de Interleucina 1/farmacologia , Estresse Oxidativo/efeitos dos fármacos , Traumatismo por Reperfusão/tratamento farmacológico , Torção do Cordão Espermático/tratamento farmacológico , Animais , Modelos Animais de Doenças , Relação Dose-Resposta a Droga , Glutationa/metabolismo , Glutationa Peroxidase/metabolismo , Proteína Antagonista do Receptor de Interleucina 1/administração & dosagem , Interleucina-1beta/antagonistas & inibidores , Interleucina-1beta/metabolismo , Masculino , Malondialdeído/metabolismo , Peroxidase/metabolismo , Ratos , Ratos Wistar , Túbulos Seminíferos/efeitos dos fármacos , Túbulos Seminíferos/patologia
5.
Int. braz. j. urol ; 44(5): 972-980, Sept.-Oct. 2018. tab, graf
Artigo em Inglês | LILACS | ID: biblio-975624

RESUMO

ABSTRACT Purpose: To evaluate the impact of overactive bladder disorder on patients diagnosed with retrograde ejaculation. Materials and Methods: Retrospective analysis of prospective collected database made. Questionnaires conducted in urology polyclinics in five different centers. Main Outcome Measure(s): International Index of Erectile Function - 5 (IIEF - 5), Overactive Bladder 8 - Question Awareness Tool (OAB - V8), urodynamics, semen analysis. The participants of the study were n = 120 patients. There was retrograde ejaculation (RE) in only n = 47 patients (non / minimal symptomatic patients), n = 73 patients had RE and overactive (OAB) complaints (symptomatic patients) and received anticholinergic treatment (trospium), n = 37 control group patients who only had OAB and received an anticholinergic. Results: While no difference was observed in overactive bladder examination and urodynamic values between the non / minimal symptomatic group and the symptomatic group (p > 0.05), sperm was detected and identified as fructose positive in post - ejaculation urine in the symptomatic group. Thus, it was possible to demonstrate the differences between symptomatic patients and non - symptomatic patients. Consequently, following three - month daily treatment with trospium 30 mg 2 x 1 in the control group and the symptomatic group, it was observed that an evident increase was observed in the sperm count and ejaculate volume in the symptomatic group and that no change was observed in the control group (p < 0.05). Conclusion: This clinical study is the first of its kind in terms of revealing the coexistence of RE with OAB upon performing urodynamics and showing that treatment is possible in selected patients.


Assuntos
Humanos , Masculino , Adulto , Oligospermia/complicações , Antagonistas Colinérgicos/uso terapêutico , Ejaculação/fisiologia , Bexiga Urinária Hiperativa/complicações , Oligospermia/fisiopatologia , Oligospermia/tratamento farmacológico , Contagem de Espermatozoides , Estudos de Casos e Controles , Estudos Retrospectivos , Bexiga Urinária Hiperativa/fisiopatologia , Bexiga Urinária Hiperativa/tratamento farmacológico
6.
Rev. int. androl. (Internet) ; 16(3): 87-94, jul.-sept. 2018. ilus, graf, tab
Artigo em Inglês | IBECS | ID: ibc-178033

RESUMO

It has been reported in the literature that proinflammatory interleukin-1 beta (IL-1β) is increased in cases of testicular ischemia reperfusion (I/R) damage. This information suggests that anakinra, an IL-1β antagonist, may be effective in testicular I/R damage. Objective: In our study, we investigated the effect of anakinra on testicular I/R damage induced in rats with torsion/detorsion. Methods: The 50mg/kg anakinra+testicular torsion/detorsion (KTD-50) and 100mg/kg anakinra+testicular torsion/detorsion (KTD-100) groups received an intraperitoneal (i.p.) injection of 50mg/kg and 100mg/kg of anakinra, respectively. In turn, the testicular torsion/detorsion (TTD) and sham operation (SOG) groups received a single dose of distilled water as a solvent 1h before ketamine anaesthesia. After the testes of the TTD, KTD-50 and KTD-100 groups were subjected to torsion and detorsion for 4h each, the rats were killed with a high-dose anaesthesia, and their testicles were removed and evaluated through biochemical, gene expression and histopathological examinations. The results were evaluated in comparison with those of the SOG group. Results: The levels of malondialdehyde (MDA), myeloperoxidase (MPO) and IL-1β showed significant increases in the TTD group, which underwent torsion/detorsion, compared to the KTD-50, KTD-100 and SOG groups. Conversely, the levels of glutathione (tGSH), glutathione peroxidase (GPO) and glutathione s-transferase (GST) were found to be significantly higher in the KTD-50, KTD-100 and SOG groups than in the TTD group. Conclusion: Anakinra at a 100mg/kg dose histologically suppressed better oxidative stress and tunica albuginea, germ cell, seminiferous tubule and interstitial damage in the testicular tissue compared to a 50mg/kg dose. Experimental results indicate that anakinra might be beneficial in the attenuation of testicular I/R damage


Antecedentes: Se ha reportado en la literatura que citoquinas interleuquina-1 beta (IL-1β) es mayor en el daño de la isquemia reperfusión testicular (I/R). Esta información sugiere que la anakinra, que es un antagonista IL-1β puede ser eficaz en daño testicular I/R. Objetivo: En nuestro estudio se investigó el efecto de este medicamento en daño testicular I/R inducida en ratas con detorsion/torsión. Métodos: KTD-50 grupo recibido intraperitonealmente (i.p.) inyección de 50mg/kg y KTD-100 Grupo 100mg/kg de anakinra, mientras TTD (control) y SOG (sham grupo operación) recibieron una dosis única de agua destilada como solvente, una hora antes de ketamina anestesia. Después de que los testículos de TTD, KTD-50 y KTD-100 grupos fueron sometidas a torsión y detorsion para cuatro por cuatro horas, las ratas fueron asesinados con altas dosis de anestesia, sus testículos fueron extraídos y evaluados a través de la expresión génica, bioquímicas e histopatológicas de exámenes. Los resultados fueron evaluado en comparación con la de SCG grupo. Resultados: Los niveles de MDA, MPO y IL- 1β mostraron incrementos significativos en el grupo TTD/torsión detorsion administrados frente a-50, KTD KTD-100 y SOG grupos. Por el contrario, los niveles de tGSH, GPO y GST resultaron significativamente más altas en KTD-50 KTD-100 y grupos SOG de TTD en grupo. Conclusión: La anakinra en 100mg/kg dosis mejor histológicamente suprime el estrés oxidativo y la túnica albuginea, células germinales, túbulos seminíferos apretadamente enrollados intersticial y daño en el tejido testicular en comparación con la dosis de 50mg/kg. Los resultados experimentales indican que la anakinra puede ser beneficiosa en la atenuación de los daños I/R testicular


Assuntos
Animais , Ratos , Interleucina-1beta/antagonistas & inibidores , Traumatismo por Reperfusão , Estresse Oxidativo , Doenças Testiculares/tratamento farmacológico , Modelos Animais de Doenças , Peroxidase/fisiologia , Glutationa/análise , Glutationa Peroxidase/fisiologia , Expressão Gênica/fisiologia
7.
Int Braz J Urol ; 44(5): 972-980, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30130018

RESUMO

PURPOSE: To evaluate the impact of overactive bladder disorder on patients diagnosed with retrograde ejaculation. MATERIALS AND METHODS: Retrospective analysis of prospective collected database made. Questionnaires conducted in urology polyclinics in five different centers. MAIN OUTCOME MEASURE(S): International Index of Erectile Function - 5 (IIEF - 5), Overactive Bladder 8 - Question Awareness Tool (OAB - V8), urodynamics, semen analysis. The participants of the study were n = 120 patients. There was retrograde ejaculation (RE) in only n = 47 patients (non / minimal symptomatic patients), n = 73 patients had RE and overactive (OAB) complaints (symptomatic patients) and received anticholinergic treatment (trospium), n = 37 control group patients who only had OAB and received an anticholinergic. RESULTS: While no difference was observed in overactive bladder examination and urodynamic values between the non / minimal symptomatic group and the symptomatic group (p > 0.05), sperm was detected and identified as fructose positive in post - ejaculation urine in the symptomatic group. Thus, it was possible to demonstrate the differences between symptomatic patients and non - symptomatic patients. Consequently, following three - month daily treatment with trospium 30 mg 2 x 1 in the control group and the symptomatic group, it was observed that an evident increase was observed in the sperm count and ejaculate volume in the symptomatic group and that no change was observed in the control group (p < 0.05). CONCLUSION: This clinical study is the first of its kind in terms of revealing the coexistence of RE with OAB upon performing urodynamics and showing that treatment is possible in selected patients.


Assuntos
Antagonistas Colinérgicos/uso terapêutico , Ejaculação/fisiologia , Oligospermia/complicações , Bexiga Urinária Hiperativa/complicações , Adulto , Estudos de Casos e Controles , Humanos , Masculino , Oligospermia/tratamento farmacológico , Oligospermia/fisiopatologia , Estudos Retrospectivos , Contagem de Espermatozoides , Bexiga Urinária Hiperativa/tratamento farmacológico , Bexiga Urinária Hiperativa/fisiopatologia
8.
Int. braz. j. urol ; 44(4): 794-799, July-Aug. 2018. tab
Artigo em Inglês | LILACS | ID: biblio-954085

RESUMO

ABSTRACT Objective: Melatonin is a hormone secreted from the pineal gland and has anti-oxidative and anti-inflammatory effects. Oxidative stress is considered as an important factor in the etiology of erectile dysfunction (ED), and in many experimental models, positive results have been obtained with melatonin treatment. This study aimed to measure serum melatonin levels in ED patients and to investigate the possible relationship between ED and melatonin levels. Materials and Methods: Sixty-two patients diagnosed with mild, moderate or severe ED according to the five-item International Erectile Function Index (IIEF-5) and 22 healthy individuals were included in the study. The serum melatonin levels, anthropometric data, and other biochemical and hormonal parameters of all the subjects were recorded. Detailed anamnesis was also obtained in terms of diabetes, hypertension, cardiovascular diseases, smoking status, and alcohol use. Results: The serum melatonin level was found 34.2±13.3 ng/dL in the mild ED group, 33.3±14.7 ng/dL in the moderate ED group, 34.8±17.2 ng/dL in the severe ED group, and 44.6±16.5 ng/dL in the control group. The serum melatonin levels were significantly lower in all ED groups compared to the control group (p=0.019). There was no significant difference in the serum melatonin levels between the three ED groups. Diabetes, hypertension, cardiovascular diseases, smoking and alcohol use were not significantly different between the ED groups (p>0.05). Conclusion: We consider that if our findings are supported by further studies with larger populations, the measurement of the serum melatonin level may have a future role in the diagnosis and treatment of ED.


Assuntos
Humanos , Masculino , Disfunção Erétil/etiologia , Disfunção Erétil/sangue , Melatonina/deficiência , Melatonina/sangue , Triglicerídeos/sangue , Índice de Gravidade de Doença , Ensaio de Imunoadsorção Enzimática , Biomarcadores/sangue , Doenças Cardiovasculares/complicações , Fumar/efeitos adversos , Estudos de Casos e Controles , Colesterol/sangue , Fatores de Risco , Estatísticas não Paramétricas , Estresse Oxidativo , Complicações do Diabetes , Hipertensão/complicações , Pessoa de Meia-Idade
9.
Int Braz J Urol ; 44(4): 794-799, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29757573

RESUMO

OBJECTIVE: Melatonin is a hormone secreted from the pineal gland and has anti-oxidative and anti-inflammatory effects. Oxidative stress is considered as an important factor in the etiology of erectile dysfunction (ED), and in many experimental models, positive results have been obtained with melatonin treatment. This study aimed to measure serum melatonin levels in ED patients and to investigate the possible relationship between ED and melatonin levels. MATERIALS AND METHODS: Sixty-two patients diagnosed with mild, moderate or severe ED according to the five-item International Erectile Function Index (IIEF-5) and 22 healthy individuals were included in the study. The serum melatonin levels, anthropometric data, and other biochemical and hormonal parameters of all the subjects were recorded. Detailed anamnesis was also obtained in terms of diabetes, hypertension, cardiovascular diseases, smoking status, and alcohol use. RESULTS: The serum melatonin level was found 34.2±13.3 ng/dL in the mild ED group, 33.3±14.7 ng/dL in the moderate ED group, 34.8±17.2 ng/dL in the severe ED group, and 44.6±16.5 ng/dL in the control group. The serum melatonin levels were significantly lower in all ED groups compared to the control group (p=0.019). There was no significant difference in the serum melatonin levels between the three ED groups. Diabetes, hypertension, cardiovascular diseases, smoking and alcohol use were not significantly different between the ED groups (p>0.05). CONCLUSION: We consider that if our findings are supported by further studies with larger populations, the measurement of the serum melatonin level may have a future role in the diagnosis and treatment of ED.


Assuntos
Disfunção Erétil/sangue , Disfunção Erétil/etiologia , Melatonina/sangue , Melatonina/deficiência , Adulto , Biomarcadores/sangue , Doenças Cardiovasculares/complicações , Estudos de Casos e Controles , Colesterol/sangue , Complicações do Diabetes , Ensaio de Imunoadsorção Enzimática , Humanos , Hipertensão/complicações , Masculino , Pessoa de Meia-Idade , Estresse Oxidativo , Fatores de Risco , Índice de Gravidade de Doença , Fumar/efeitos adversos , Estatísticas não Paramétricas , Triglicerídeos/sangue
10.
Urologia ; 85(3): 106-110, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29633653

RESUMO

OBJECTIVE: Recent studies have shown that atherosclerosis is associated with erectile dysfunction and the serum bilirubin level. In this study, the serum total bilirubin levels of patients with erectile dysfunction were measured to investigate the relationship between the levels of erectile dysfunction and total bilirubin. METHODS: A total of 94 patients with erectile dysfunction were divided into three groups; severe erectile dysfunction (33 patients), moderate erectile dysfunction (31 patients), and mild erectile dysfunction (30 patients). In addition, a control group was formed with 31 healthy men. The International Index of Erectile Function-5 Questionnaire was used to measure the quality of erection in all the groups. The body mass index was calculated for all the participants. The serum glucose, low-density lipoprotein and high-density lipoprotein, cholesterol, triglyceride, total bilirubin, and total testosterone levels were also determined. RESULTS: No statistically significant difference was observed between the groups in terms of the mean age, hypertension, smoking status, alcohol use, cardiovascular diseases, hepatobiliary disease, diabetes mellitus, and levels of total testosterone, low-density lipoprotein-cholesterol, and triglyceride. However, high-density lipoprotein, body mass index, and total bilirubin were significantly lower compared to the control group (p < 0.001). The serum total bilirubin level was found to be 0.41 ± 0.21 ng/dL in the severe erectile dysfunction, 0.43 ± 0.19 ng/dL in the moderate erectile dysfunction, and 0.48 ± 0.11 ng/dL in the mild erectile dysfunction groups (p < 0.001). CONCLUSION: Considering the significant differences between the erectile dysfunction and control groups in terms of serum total bilirubin levels, a low level of bilirubin may have a role in the etiology of erectile dysfunction.


Assuntos
Bilirrubina/sangue , Disfunção Erétil/sangue , Disfunção Erétil/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Índice de Gravidade de Doença
11.
Korean J Physiol Pharmacol ; 21(5): 457-464, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28883750

RESUMO

Etoricoxib features antioxidant and anti-inflammatory properties concomitantly, suggesting that it may be beneficial in testicular ischemia reperfusion (I/R) damage. Our aim is to investigate the effects of etoricoxib on testicular I/R damage induced with torsion-detorsion (TD). The etoricoxib + torsion-detorsion (ETD) groups of animals were given etoricoxib in 50 and 100 mg/kg of body weight (ETD-50 and ETD-100), while the testes torsion-detorsion (TTD) and sham operation rat group (SOG) animals were given single oral doses of distilled water as a solvent. TTD, ETD-50 and ETD-100 groups were subjected to 720° degrees torsion for four hours, and detorsion for four hours. The SOG group was not subjected to this procedure. Biochemical, gene expression and histopathological analyses were carried out on the testicular tissues. The levels of malondialdehyde (MDA), myeloperoxidase (MPO), interleukin-1 beta (IL-1ß) and tumor necrosis factor alpha (TNF-α) were significantly higher, and the levels of total glutathione (tGSH) and glutathione reductase (GSHRd) were significantly lower in the TTD group, compared to the ETD-50, ETD-100 and SOG groups. Etoricoxib at a dose of 100 mg/kg better prevented I/R damage than the 50 mg/kg dose. Etoricoxib may be useful in clinical practice in the reduction of I/R damage on testes caused by torsion-detorsion.

12.
Kaohsiung J Med Sci ; 33(2): 86-90, 2017 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-28137416

RESUMO

We investigated the effect of spinal anesthesia combined with obturator nerve block (ONB) during the transurethral resection of lateral bladder wall tumors (TUR-BT) on the presence of detrusor muscle tissue in tumor specimens and on tumor recurrence. TUR-BT was performed on 96 patients with a lateral bladder wall tumor under spinal anesthesia in our clinic between January 2011 and December 2015. The patients were divided into two groups: 49 patients only received spinal anesthesia and 47 patients received spinal anesthesia combined with ONB. The groups were retrospectively compared in terms of adductor muscle contraction, bladder perforation, complete tumor resection, presence of muscle tissue in the pathology material, and recurrence rate during follow-up. The obturator reflex was significantly observed in the non-ONB group (p < 0.05). In the ONB group, the percentages of complete resection and detrusor muscle tissue were significantly higher (p = 0.003 and p = 0.001, respectively). The postoperative recurrence rate was found to be significantly higher in the non-ONB group than in the ONB group (p = 0.025). Spinal anesthesia combined with ONB during TUR-BT prevent obturator reflex and facilitate complete resection including detrusor muscle tissue, independent from the size or number of tumors, thus reducing the recurrence of the disease.


Assuntos
Anestésicos Locais , Carcinoma in Situ/cirurgia , Lidocaína , Recidiva Local de Neoplasia/prevenção & controle , Bloqueio Nervoso/métodos , Nervo Obturador , Neoplasias da Bexiga Urinária/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Raquianestesia/métodos , Carcinoma in Situ/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Músculo Liso/cirurgia , Recidiva Local de Neoplasia/patologia , Recidiva Local de Neoplasia/cirurgia , Ureteroscopia/métodos , Bexiga Urinária/inervação , Bexiga Urinária/patologia , Bexiga Urinária/cirurgia , Neoplasias da Bexiga Urinária/patologia
13.
Arch Ital Urol Androl ; 88(1): 4-6, 2016 Mar 31.
Artigo em Inglês | MEDLINE | ID: mdl-27072168

RESUMO

PURPOSE: To evaluate the effect of postoperatively administering a low daily dose of tadalafil on the erectile function of patients who underwent a nerve-sparing radical prostatectomy (NSRP) due to localized prostate cancer (PCa). MATERIALS AND METHODS: Of 138 patients, who underwent NSRP due to PCa between 2012 and 2014, 55 patients who had not had pre-operative erectile dysfunction (ED) were included in the study. The mean age of the patients was 64 (54-72). On the 15th day after surgery, after ultrasound evaluation, all 55 patients started on a daily dose of 5 mg tadalafil that was continued for 2.5 months. The erectile function of patients was evaluated pre-operatively, post-operatively, and at the 3rd and 6th month after surgery using the International Index of Erectile Function (IIEF-5) test. None of the patients was treated with hormonal therapy or radiotherapy before or after surgery. RESULTS: Three patients were excluded from the study due to the adverse effects of tadalafil and two patients elected to discontinue the treatment. Of the remaining 50 patients whose pre-operative erectile function had been found normal, at 3 months after surgery, 36 (72%) had normal erectile function; of the remaining patients in the study six (12%) presented with mild, two (4%) with moderate, and six (12%) with severe ED. Six months after surgery, 35 patients (70%) had normal erectile function while seven (14%) had mild, three (6%) moderate and five (10%) severe ED. There was no statistically significant difference between the results obtained at the 3rd and 6th month follow-up (p > 0.05). Three patients reported adverse effects with tadalafil including flushes in 2 (3.6%) and a headache in 1 (1.8%). CONCLUSIONS: The administration of a 5 mg post-operative dose of tadalafil to patients that had undergone a bilateral NSRP was found to have a positive effect on the recovery and maintenance of erectile function. However, there is still a need to investigate a larger series of cases.


Assuntos
Disfunção Erétil/tratamento farmacológico , Inibidores da Fosfodiesterase 5/uso terapêutico , Prostatectomia/métodos , Tadalafila/uso terapêutico , Idoso , Disfunção Erétil/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Ereção Peniana/efeitos dos fármacos , Inibidores da Fosfodiesterase 5/efeitos adversos , Neoplasias da Próstata/cirurgia , Tadalafila/efeitos adversos , Resultado do Tratamento
14.
Urol Int ; 96(2): 202-6, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26613256

RESUMO

INTRODUCTION: Prostatic urethral lift (PUL) is a minimally invasive procedure for the treatment of lower urinary tract symptoms (LUTSs) secondary to benign prostatic hyperplasia (BPH). The PUL procedure involves the placement of implants that retract the obstructing prostate lobes. This procedure achieves quantifiable improvements in functional outcomes and quality of life (QoL), while preserving erectile and ejaculatory functions. METHODS: Seventeen patients diagnosed with BPH who had undergone the UroLift® procedure between March 2011 and June 2015 were retrospectively evaluated. The parameters evaluated in the pre-operative, intra-operative and 1-year post-operative period were demographic data, and pre-operative, intra-operative and 1-year post-operative results were obtained from the International Prostate Symptom Score (IPSS), Uroflowmetry QoL index, International Index of Erectile Function (IIEF) and Male Sexual Health Questionnaire (MSHQ) for ejaculatory function (MSHQ-EjD). RESULTS: The average improvements from baseline to 12 months after intervention were significant for the total IPSS 9.6. There was a 4.2-point increase in Qmax, a 0.9-point improvement in QoL and a 32% decrease in PVR. No statistically significant difference was found in the IIEF and MSHQ-EjD scores when the pre-operative and post-operative 3rd and 12th month scores were evaluated (p > 0.05). CONCLUSIONS: PUL offers rapid improvement in voiding and storage symptoms, QoL and flow rate that is durable to 12 months after intervention. PUL is a minimally invasive procedure that has the moderate effect in treating troublesome LUTS secondary to benign prostatic obstruction and preserving total sexual function.


Assuntos
Sintomas do Trato Urinário Inferior/cirurgia , Hiperplasia Prostática/complicações , Uretra/cirurgia , Procedimentos Cirúrgicos Urológicos Masculinos/instrumentação , Ejaculação , Humanos , Sintomas do Trato Urinário Inferior/diagnóstico , Sintomas do Trato Urinário Inferior/etiologia , Sintomas do Trato Urinário Inferior/fisiopatologia , Masculino , Ereção Peniana , Hiperplasia Prostática/diagnóstico , Desenho de Prótese , Qualidade de Vida , Recuperação de Função Fisiológica , Estudos Retrospectivos , Inquéritos e Questionários , Fatores de Tempo , Resultado do Tratamento , Uretra/fisiopatologia , Urodinâmica , Procedimentos Cirúrgicos Urológicos Masculinos/efeitos adversos
15.
Urol J ; 12(6): 2452-6, 2015 Dec 23.
Artigo em Inglês | MEDLINE | ID: mdl-26706745

RESUMO

PURPOSE: Transurethral resection of the prostate (TURP) is considered gold standard for surgical treatment of benign prostatic hyperplasia (BPH). In this study, we aimed to compare post-operative clinical outcomes and adverse effects between monopolar and bipolar TURPs. MATERIALS AND METHODS: The study included 590 patients who underwent TURP by a single urologist (E.H.) between June 2006 and June 2014 with a diagnosis of BPH. Patients were divided into two groups as monopolar TURP (group 1, n = 300) and bipolar TURP (group 2, n = 290). Patients receiving oral anticoagulants or aspirin and those with prostate cancer diagnosis were not included in the study. Data regarding pre-operative age, International Prostate Symptom Score (IPSS), maximum urinary flow rate (Qmax), post voiding residual urine volume (PVR), serum prostate specific antigen (PSA) levels and prostate volume (Vp) of the patients were gathered from medical records. Groups were compared in terms of catheterization, operation time, hemoglobin (Hb) decrease, and IPSS, Qmax, and PVR values at post-operative 12th month follow-up visit. RESULTS: From pre-operative to post-operative period, IPSS, Qmax and PVR showed significant improvements within both groups (P < .001). When groups were compared with each other, bipolar TURP group had significantly lesser catheterization time and hemoglobin decrease than monopolar TURP group, while no significant differences were detected regarding all other variables. CONCLUSION: Bipolar and monopolar TURPs are both effective and safe treatment modality for BPH. Bipolar TURP is superior to conventional monopolar TURP in terms of catheterization time and Hb decrease.


Assuntos
Hiperplasia Prostática/cirurgia , Prostatismo/cirurgia , Ressecção Transuretral da Próstata/métodos , Idoso , Hemoglobinas/metabolismo , Humanos , Masculino , Pessoa de Meia-Idade , Duração da Cirurgia , Hiperplasia Prostática/complicações , Hiperplasia Prostática/fisiopatologia , Prostatismo/etiologia , Prostatismo/fisiopatologia , Índice de Gravidade de Doença , Fatores de Tempo , Ressecção Transuretral da Próstata/efeitos adversos , Resultado do Tratamento , Cateterismo Urinário , Urodinâmica
16.
Case Rep Urol ; 2014: 218037, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25349769

RESUMO

Clean intermittent self-catheterization is the standard method for bladder evacuation in these patients today. The patient was diagnosed with urethrogluteal fistula and gluteal-perineal abscess by radiological evaluation. Gluteal drainage decreased after cystostomy. In our paper, a case of urethrogluteal fistula and pelvic urinoma that developed as a result of the use of clean intermittent self-catheterization (CISC), which is rarely found in the literature, is presented.

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