The value of audiovisual sexual stimulation with virtual reality in diagnosing erectile dysfunction.

Background: The traditional audiovisual sexual stimulation (AVSS) test may experience limitations including low erectile response rate and lack of unified diagnostic criteria. Aim: We aimed to explore the clinical value of AVSS with virtual reality (VR-AVSS) test in assessing erectile function and diagnosing erectile dysfunction (ED). Methods: Participants 18 to 60 years of age were screened for analysis in 3 clinical centers from June 2020 to March 2022. Demographic data, 5-item International Index of Erectile Function (IIEF-5), erectile hardness score (EHS), and self-reported symptom questions were collected. The ED patients and control patients were confirmed according to the IIEF-5 and EHS. All subjects watched a 60-minute erotic video by VR device during RigiScan recording. The parameters including tip average rigidity, tip effective erectile duration (duration of rigidity ≥60%, tip effective erectile duration), base average rigidity, and base effective erectile duration were evaluated. Outcomes: The main outcome of interest was the application of VR immersion technology to improve the traditional AVSS test. Results: A total of 301 ED cases and 100 eligible control patients were included for final analysis. Compared with control patients, ED cases had significantly lower IIEF-5 scores, EHS, positive response rate, and erectile rigidity and duration. The positive response rate of ED and control patients were 75.5% and 90.9%, respectively. The cutoff points of tip average rigidity, tip effective erectile duration, base average rigidity, and base effective erectile duration were 40.5% (sensitivity: 77.6%, specificity: 70.2%; P < .001), 4.75 minutes (sensitivity: 75.9%, specificity: 75.4%; P < .001), 48.5% (sensitivity: 77.6%, specificity: 75.1%; P < .001), and 7.75 minutes (sensitivity: 79.3%, specificity: 75.7%; P < .001). Clinical Implications: The technological superiority of VR will enable the VR-AVSS immersion test to be a more accurate detection than traditional AVSS modes. Strengths and Limitations: Our study applied VR immersion technology to establish the standard operation procedure for the AVSS test, which could effectively reduce the interference of adverse factors and minimize the detecting errors. However, the test data only included positive response subjects, so the true erectile status of men with a negative response to the AVSS test cannot be obtained. Conclusions: The VR-AVSS test can effectively improve the diagnostic accuracy of ED. The average rigidity and effective erectile duration were the optimal diagnostic parameters for excluding ED.

Overexpression of spindle and kinetochore-associated protein 1 contributes to the progression of prostate cancer.

Spindle and kinetochore-associated protein 1 is a microtubule-binding subcomplex of the outer kinetochore that is essential for proper chromosome segregation. Recently, spindle and kinetochore-associated protein 1 has been highlighted as a biomarker in various cancers; however, the precise role of spindle and kinetochore-associated protein 1 in prostate cancer remains unknown. This study aims to evaluate whether spindle and kinetochore-associated protein 1 affects the biological behaviors of prostate cancer. We investigated the expression of spindle and kinetochore-associated protein 1 in a series of prostate cancer tissues as well as in a panel of prostate cancer cell lines. Cell proliferation, migration, and invasion were evaluated in spindle and kinetochore-associated protein 1 knockdown prostate cancer cell lines by MTT and Transwell assays. Our results showed that the expression of spindle and kinetochore-associated protein 1 was remarkably upregulated in prostate cancer at both messenger RNA and protein levels compared with non-cancerous tissue. Knockdown of spindle and kinetochore-associated protein 1 repressed the ability of cell proliferation, migration, and invasion of prostate cancer cells. Moreover, inhibition of spindle and kinetochore-associated protein 1 could inhibit the activity of AKT and ERK pathway. In conclusion, our findings suggest that spindle and kinetochore-associated protein 1 could serve as a potential therapeutic target in prostate cancer patients.

Numb had anti-tumor effects in prostatic cancer.

AIM: The aim of this study was to explain the Numb anti-cancer effects in the prostatic cancer. METHODS: Collecting the 20 prostatic cancer patients and analyzing the correlation between Numb and Glease score. Transfection Numb into DU-145 and PC-3 cells, measuring the proliferation rate of difference groups by MTT assay, evaluating the cell apoptosis and cell cycle of difference group by Flow cytometry; measuring the invasion and migration abilities by transwell and wound healing assays. In the nude mice experiment, establish prostatic cancer nude mouse subcutaneous planting tumor model by DU-145 cells, Injection the Numb from tail vein. Evaluating the tumor volume and weight. RESULTS: The Numb protein expression was decreased with Glease score increasing. The proliferation rate of Numb groups were significantly decreased compared with NC groups (P<0.05, respectively). The apoptosis and G1 phase rates of Numb groups were significantly enhanced compared with NC groups (P<0.05, respectively). The invasion and migration abilities of Numb group cells were significantly weaken compared with NC groups (P<0.05, respectively). In the WB assay, The relative proteins (Numb, P53, Cyclin D1, Rac1, MMP-2 and MMP-9) expression were significantly differences between NC and Numb groups (P<0.05, respectively). In the vivo experiment, the tumor volume and weight of Numb group was significantly lighter than NC group (P<0.05, respectively). CONCLUSION: Overexpression Numb had anti-cancer effects to prostatic cancer in vitro and vivo experiments, the mechanism might be P53/Cyclin D1 and Rac1/MMP-2/-9 signaling pathway.

Port-site metastasis as a primary complication following retroperitoneal laparoscopic radical resection of renal pelvis carcinoma or nephron-sparing surgery: A report of three cases and review of the literature.

The present study reports the clinical data of two patients with renal pelvis carcinoma and one patient with renal carcinoma who developed port-site metastasis following retroperitoneal laparoscopic surgery. The current study aimed to identify the cause and prognosis of the occurrence of port-site metastasis subsequent to laparoscopic radical resection of renal pelvis carcinoma and nephron-sparing surgery. Post-operative pathology confirmed the presence of high-grade urothelial cell carcinoma in two patients and Fuhrman grade 3 renal clear cell carcinoma in one patient. Port-site metastasis was initially detected 1-7 months post-surgery. The two patients with renal pelvis carcinoma succumbed to the disease 2 and 4 months following the identification of the port-site metastasis, respectively, whereas the patient with renal carcinoma survived with no disease progression during the targeted therapy period. The occurrence of port-site metastasis may be attributed to systemic and local factors. Measures to reduce the development of this complication include strict compliance with the operating guidelines for tumor surgery, avoidance of air leakage at the port-site, complete removal of the specimen with an impermeable bag, irrigation of the laparoscopic instruments and incisional wound with povidone-iodine when necessary, and enhancement of the body's immunity. Close post-operative follow-up observation for signs of recurrence or metastasis is essential, and systemic chemotherapy may be required in patients with high-grade renal pelvis carcinoma and renal carcinoma in order to prolong life expectancy.

Renal cell carcinoma with metachronous metastasis to the contralateral adrenal gland and urinary bladder: A case report.

The adrenal gland and urinary bladder are rare localizations of metastases of renal cell carcinoma (RCC). In the present study, a case of metastasis to the contralateral adrenal gland and urinary bladder of clear cell-type RCC (ccRCC) in the left kidney is reported in a male who had undergone left radical nephrectomy at 55 years of age. Computed tomography (CT) revealed a mass in the right adrenal gland 5 years following surgery, and type-B ultrasound demonstrated a 1.0-cm solid space-occupying lesion in the right wall of the bladder. Consequently, laparoscopic right adrenalectomy and transurethral resection of the bladder tumor were performed. Furthermore, based on histopathological examination and immunohistochemical staining, the patient was pathologically diagnosed with contralateral adrenal gland and urinary bladder metastasis of ccRCC. CT performed at the 1-year follow-up detected multiple solid space-occupying lesions in the right kidney. Therefore, the patient was treated with sunitinib targeted therapy. To date, the patient is generally in good condition, without evident drug side effects or complaints of discomfort.

[Efficacy and safety of vardenafil in the treatment of erectile dysfunction: a report of 700 cases].

OBJECTIVE: To evaluate the efficacy and safety of long-term on-demand use of vardenafil in the treatment of erectile dysfunction (ED). METHODS: We conducted a questionnaire investigation among 891 ED patients treated by on-demand use of oral vardenafil at 20 mg every 3 days from March 2007 to January 2010, covering the general information of the patients, their need for and attitudes towards the treatment, clinical efficacy and adverse events of the drug, and satisfaction of the patients and their partners after 12 weeks of treatment. RESULTS: Treatment and follow-up were completed in 700 patients, of whom 504 (72%) achieved sufficient hardness and duration of penile erection and overall sexual satisfaction, 84 (12%) admitted to improvement of erectile hardness and duration but not adequate satisfaction, and the other 112 (16%) experienced no significant changes. Significant differences were found in IIEF-5 scores, Rigiscan test results and partners TSS scores before and after the treatment (P < 0.05). Most frequent adverse events included flushing (15%), dizziness and headache (10%), dyspepsia (3%), and nasal congestion (1%). CONCLUSION: Long-term on-demand use of oral vardenafil, in addition to its safety and good tolerance, can effectively improve the erectile function of ED patients, their success rate of sexual intercourse, and overall quality of sexual life.

[Replacement of plaque by buccal mucosa in the treatment of Peyronies disease: a report of 27 cases].

OBJECTIVE: To evaluate the clinical results of the replacement of plaque by buccal mucosa in the treatment of Peyronie's disease. METHODS: We performed surgical replacement of the plaque by free autograft of buccal mucosa on 27 patients with Peyronie's disease, ranging in age from 24 to 72 years (mean 53), varying in disease course between 1 and 13 years, with a penile curvature angle of 30 degrees - 80 degrees in erection. Of the total number, 15 patients had the plaque located in the dorsal root, 6 in the dorsal shaft, 3 in the subcoronal shaft and 3 in the ventral shaft of the penis; 24 had 1 plaque, 2 had 2 and 1 had 3, ranging in size from 0.7 cm x 0.7 cm to 1.6 cm x 1.0 cm. RESULTS: Satisfactory results were achieved in all the cases, with no such complications as hematoma, infection, oral numbness, and tightness of the mouth. Of the 24 cases that were followed up for 0.5 to 7 years, complete straightening of the penis was achieved in 21, slight residual curvature (< 15 degrees) was noted in 3, a little shortening of the penis (< 1 cm) in 2, and erectile pain in 3. CONCLUSION: Buccal mucosa, with a stable elasticity and no shrinkage, can be recommended for wide use in the surgical treatment of Peyronie's disease.

[Type V phosphodiesterase inhibitor erection-provoking test with audio-visual sexual stimulation for the diagnosis of erectile dysfunction].

OBJECTIVE: To evaluate the type V phosphodiesterase (PDE-5) inhibitor erection-provoking test with audio-visual sexual stimulation in the diagnosis of erectile dysfunction. METHODS: A total of 853 out-patients diagnosed with erectile dysfunction were divided into an injury and a non-injury group. After scored on IIEF-5 questionnaires, all the patients received oral administration of PDE-5 inhibitors and, 30 minutes later, audio-visual sexual stimulation. The data on penile erection were recorded with Rigiscan Plus. RESULTS: The patients with mild, moderate and severe ED accounted for 18.8, 31.9 and 49.3% in the injury group, and 50.6, 39.8 and 9.6% in the non-injury group, with statistic differences between the two groups in the mild and severe parts (P < 0.05). The rates of conspicuous effectiveness, effectiveness, ineffectiveness and total effectiveness of the combined method were 13.0, 14.5, 72.5 and 27.5% in the injury group, but 55.7, 20.7, 23.6 and 76.4% in the non-injury group, with significant differences (P < 0.05). CONCLUSION: The PDE-5 inhibitor erection-provoking test with audio-visual sexual stimulation is a simple, practical, safe and effective method for the differentiation of organic from psychological erectile dysfunction.

[Deep sarcoma of the penis: a report of 2 cases and review of the literature].

OBJECTIVE: To investigate the clinical characteristics, diagnosis, treatment and prognosis of deep sarcoma of the penis. METHODS: The pathological and clinical data of 2 cases of deep sarcoma of the penis were analyzed retrospectively and the literature reviewed. RESULTS: Both of the cases were treated by total penectomy. Epithelioid angiosarcoma of the penis was confirmed by postoperative pathology in one patient, who died of pulmonary metastasis in the eighth month after the operation; and epithelioid sarcoma of the penis was confirmed in the other, who died of brain metastasis in the second month after the operation. CONCLUSION: Deep sarcoma of the penis is rare but can be diagnosed pathologically. Total penectomy is the main option for its treatment. Node dissection, with poor prognosis, is not recommended unless adenopathy is palpable.