Treatment of erectile dysfunction by intracavernosal administration of mesenchymal stem cells in patients with diabetes mellitus.

Erectile dysfunction is observed in about 50% of men. It has been found that diabetes mellitus increases its prevalence to 19-86.3%, necessitating attention to a therapeutic strategy. Among the available treatment methods, intracavernosal injections of mesenchymal stem cells have proven to be particularly effective. OBJECTIVE: The purpose of study is to assess and analyse the effectiveness of their use in the treatment of erectile dysfunction in patients with diabetes mellitus. MATERIALS AND METHODS: The literature search was conducted using systematic methods and analysis in databases such as Web of Science, Scopus, PubMed, Elsevier, and Springer, with 41 sources included for further review. RESULTS: The study highlights microangiopathic and neuropathic links as key factors in erectile dysfunction development in diabetic patients, stemming from endothelial dysfunction and conductivity disturbances. Mesenchymal stem cell therapy from bone marrow, adipose tissue, and umbilical cord mitigates pathogenic impact through regenerative and anti-apoptotic effects. Due to this, most studies indicate high efficacy of the treatment and rapid therapeutic action through intracavernosal administration. Some studies suggest an increase in the body's receptor sensitivity to other drugs, such as sildenafil. CONCLUSION: From the perspective of further research on this issue, standardising the preparation of stem cells and the treatment method using a large sample size is essential to introduce such a method as an extremely promising therapy for this delicate issue in men into practical medicine. The practical value of the study lies in the systematisation of information on different sources of mesenchymal stem cells for treating erectile dysfunction.

Evaluation of the effect of Bernoulli maneuver on operative time during mini-percutaneous nephrolithotomy: A prospective randomized study.

PURPOSE: To evaluate the effect of 'Bernoulli maneuver' (bringing the access sheath to horizontal plane) on operative time and stone free rates in patients undergoing mini-percutaneous nephrolithotomy (PCNL). MATERIALS AND METHODS: All consecutive patients with a solitary kidney stone undergoing a mini-PCNL between 2015 and 2016 were included into this study. Patients were randomized either to standard prone or control (C) group patients or to tilted prone with 'Bernoulli maneuver' group (B) patients. Pre-, intra-, and postoperative characteristics of these 2 groups were recorded and analyzed. RESULTS: A total of 67 patients were included in the study. Of these, 40 patients were randomized to group C and 27 to group B. The mean (95% confidence limits) stone size (mm) in group C and B was 14 (13, 15) and 13 (11, 14), respectively (p=0.26). Nephroscopy time was shorter in Bernoulli group (35 minutes vs. 23 minutes, p=1.5·10-5, and Bayes factor BF10=2,340, and Cohen standardized effect size dst=1.2). The difference made it up 12 minutes (with 95% confidence interval from 8 to 18 minutes). There were no statistically significant differences between groups regarding white blood cell, creatinine level and stone-free status defined by computed tomography on the first postoperative day. CONCLUSIONS: In our study the 'Bernoulli maneuver' led to a shorter nephroscopy time in mini-PCNL. This maneuver can significantly reduce nephroscopy time and save significant amount of operative time, especially in tertiary referral centers with high-volume mini-PCNL procedures.