The role of diallyl thiosulfinate associated with nuciferine and diosgenin in the treatment of premature ejaculation: A pilot study.

OBJECTIVE: To assess the efficacy and safety of an association of diallyl thiosulfinate with nuciferine and diosgenin in the treatment of a group of patients suffering from premature ejaculation (PE), primary or secondary to erectile dysfunction (ED). MATERIALS AND METHODS: From July 2015 to October 2016, 143 patients (mean age 25.3; range 18-39) affected by PE completed the study and were finally analyzed in this phase I study. All patients, after clinical assessment and laboratory evaluation were asked to take an association of diallyl thiosulfinate with nuciferine and diosgenin as oral tablet, once a day, on alternate days, for three months. At the baseline and after three months of treatment, each patient was asked to complete the following questionnaires: International Index of Erectile Function (IIEF-5), Premature Ejaculation Diagnostic Tool (PEDT), Male Sexual Health Questionnaire (MSHQ). RESULTS: A statistical significant improvement in terms of erectile function, comparing the IIEF-5 value at baseline and follow- up visit was found (respectively IIEF-5: 8.7 vs 14.01; p < 0.001). Moreover, at follow-up visit, 97/143 men (67.8%) referred a subjective improvement of the erection quality and a better control of the ejaculation (PROs). The IELT improved too between the baseline evaluation and the follow-up visit (p < 0.001). CONCLUSION: In conclusion, our study, even if supported by preliminary results, showed how Diallyl Thiosulfinate, Nuciferine and Diosgenin is able to improve the control of ejaculation in patients suffering from PE, primary or secondary to ED without any significant adverse effects.

[Prevention of venous thromboembolism in urologic neoplasms]. / Profilassi del tromboembolismo venoso in urologia oncologica.

PURPOSE: We report our past experience on a sample of patients who underwent pelvic surgery to treat infiltrating bladder tumours. RESULTS: We observed the highest incidence of TVP (33.3%, 3 out of 9) in those patients with higher risk due to anaesthesia and type of surgery. One of our patients died of pulmonary embolism. DISCUSSION: Abdominal pelvic surgery in tumour-bearing patients can be risky due to high incidence of distal and proximal venous thrombosis often resulting in fatal pulmonary embolism (EP). The general risk factors should be evaluated. The diagnosis of venous thrombosis can be difficult to achieve only by clinical examination. Heparin administration as well as surgical techniques and physiotherapy are used as prophylactic measures to reduce the risk of venous thrombosis and to speed up recovery. Nowadays, there is an increasing risk of running into legal problems if appropriate measures to minimise the thromboembolism are not taken.

[Obstructive uropathy secondary to recurrent pelvic endometriosis: description of a clinical case]. / Uropatia ostruttiva secondaria ad endometriosi pelvica recidivante: descrizione di un caso clinico.

The typical presentation of endometriosis is pelvic pain. Patients with with endometriosis often have associated fertility disorders even if their relationship with the symptoms and signs of endometriosis is not evident. The first line of treatment for endometriosis must be surgery. In case of infertility the preferred approach is laparoscopic, maybe in association with medical treatment and possibly followed up by a second-look. In cases with relevant pelvic pain and involvement of other organs, laparotomy is necessary, particularly when a deep endometriosis is infiltrating the uterosacral ligaments, the rectovaginal septum and the bladder. Medical treatment of endometriosis is based upon the hormone-dependency of the endometriotic lesions inducing a resting status. Adhesions, endometriomas or fibrous sequelae do not respond to medical treatment. We describe a case of recurrent endometriosis treated with radical surgery for relevant lesions and fibrous adhesions of ureters with consequent bilateral hydronephrosis.

Trombosis venosa profunda en pacientes con cistectomía radical de salvación / Deep venous thrombosis in patients undergoing salvage radical cystectomy

OBJETIVOS: La presentación de trombosis venosa profunda en pacientes tumorales, ya fue observada por Trousseau, el siglo pasado. Las alteraciones de la coagulación que ocurren en pacientes tumorales pueden causar trombosis venosa profunda (TVP), especialmente en pacientes con metástasis. La quimioterapia antitumoral, puede incluso incrementar el riesgo de trombosis. En este trabajo presentamos nuestra experiencia. MÉTODO: Hemos analizado las historias clínicas de pacientes sometidos a cistectomía radical de salvación. RESULTADOS: Hemos encontrado la incidencia muy alta de TVP (33,3 por ciento; 3 de 9), en pacientes con riesgo anestésico alto y necesidad de cirugía urgente. Uno de nuestros pacientes falleció de trombosis pulmonar. CONCLUSIONES: El diagnóstico de TVP y trombosis pulmonar, no siempre es fácil y es necesario hacer todas las pruebas para llegar al diagnóstico (examen clínico, test analíticos, etc...) (AU)