Adjustable Continence Therapy for the treatment of male stress urinary incontinence: a single-centre study.

Objective: To evaluate the Adjustable Continence Therapy (ProACT) device, a new device for the treatment of male stress urinary incontinence resulting from compromised sphincteric function.

Material And Methods: A total of 64 males with post-prostatectomy incontinence underwent ProACT implantation. Efficacy was assessed by means of a daily pad count, a direct visual stress test, administration of the Incontinence Quality of Life (IQOL) and patient global impression (PGI) questionnaires and use of a visual analogue scale (VAS) to assess improvement in incontinence.

Finasteride 5 mg and sexual side effects: how many of these are related to a nocebo phenomenon?

Introduction: Sexual adverse experiences such as erectile dysfunction (ED), loss of libido, and ejaculation disorders have been consistent side effects of finasteride in a maximum percentage of 15% after 1 year of therapy. Such data could be seen as far from reality, if compared to a higher percentage that may be found in any common clinical practice.

Aim: This study aims to explain the dichotomy between literature's data and clinical practice data.

Male and female sexual dysfunction (SD) after radical pelvic urological surgery.

Major pelvic urological surgery comprises radical prostatectomy and radical cystectomy in the male patient and radical cystectomy in the female. Postsurgical sexual dysfunction (SD) has been reported with a high prevalence in both sexes and is becoming increasingly important in the patient's view as a result of improved cancer prognosis, refinements in surgical technique, and increased awareness of quality of life aspects that involve sexual satisfaction. The pathophysiology of the problem is essentially related to the disruption of the nerves during the procedure, although a vascular impairment may also be implicated.

New insights into the pathogenesis of penile shortening after radical prostatectomy and the role of postoperative sexual function.

Purpose: We assessed penile changes after radical prostatectomy by performing serial penile measurements. The potential effect of nerve sparing surgery and the recovery of erectile function on the degree of penile shortening were also evaluated.

Materials And Methods: A total of 126 consecutive patients were enrolled.

An unusual presentation of ureteric colic.

A patient presented with acute pain in the right iliac fossa and was found to have a small stone in the lower ureter of a crossed ectopic right kidney. This unique presentation highlights the potential pitfalls that may occur when assessing an acute pain in the right iliac fossa and reminds the invaluable role of IVP.

Is radical prostatectomy feasible in all cases of locally advanced non-bone metastatic prostate cancer? Results of a single-institution study.

Objectives: Previous prospective studies of the surgical treatment of locally advanced prostate cancer have enrolled patients selected on the basis of a limited T3 disease extension. The aim of the present study was to assess the feasibility and the oncologic outcome of radical prostatectomy administered to a consecutive unselected series of advanced, non-bone metastatic prostate cancers.

Methods: Between March 1998 and February 2003 radical prostatectomy was offered at our institution to any patient diagnosed with prostate cancer with no sign of extranodal metastatic disease.

Alfuzosin (10 mg) does not affect blood pressure in young healthy men.

Objectives: Alfuzosin 10mg is a uroselective alpha(1)-adrenoceptor antagonist used to treat lower urinary tract symptoms suggestive of benign prostatic hyperplasia. Recent studies have suggested the potential efficacy of alfuzosin in the treatment of distal ureteral stones and prostatitis syndrome, two conditions frequently encountered in young patients. The objective of this study was to evaluate the effect of 10mg alfuzosin on blood pressure (BP) and heart rate (HR) in young healthy volunteers.

Inguinal versus subinguinal varicocele vein ligation using magnifying loupe under local anesthesia: which technique is preferable in clinical practice?

Objectives: To compare the intraoperative results of inguinal versus subinguinal varicocelectomy using magnifying loupe, in terms of vein ligation and arterial preservation, recurrence rate, and patient tolerability.

Methods: Ninety-nine patients were randomized to undergo a varicocele repair with an inguinal or a subinguinal approach under local anesthesia. Data concerning the number of veins ligated and arterial preservation were recorded during each procedure.

Sacral neuromodulation for urinary retention in a kidney-transplant patient.

Bladder outlet obstruction can negatively affect renal function in the kidney transplant population. Functional obstruction represents a clinical challenge as conventional treatments are either ineffective or not recommended. Sacral neuromodulation was successfully used in functional voiding dysfunction in a kidney transplant patient.

Upper urinary tract complications in pregnant women with an ileal conduit. Lessons learned from two cases.

We describe the occurrence of severe upper urinary tract complications during pregnancy in two women with an ileal conduit. The first patient developed several episodes of left pyelonephritis throughout the duration of her pregnancy but never received proper antibiotic prophylaxis. Intravenous urography performed after delivery documented bilateral staghorn kidney stones and a non-functioning left kidney.

A prospective evaluation of efficacy and compliance with a multistep treatment approach for erectile dysfunction in patients after non-nerve sparing radical prostatectomy.

Objective: To assess the response rate to different erectile aids in a consecutive series of patients treated with non-nerve sparing radical prostatectomy (NNSRP).

Patients And Methods: Ninety-four potent men were counselled about the different treatment options to restore an assisted erection before they had NNSRP. They were invited to participate in a multiphase protocol involving the sequential use of different erectile aids which aimed at restoring erectile function after surgery.

Phase II study to investigate the ablative efficacy of intravesical administration of gemcitabine in intermediate-risk superficial bladder cancer (SBC).

Objective: Phase I studies have so far demonstrated that intravesical Gemcitabine up to a 40 mg/ml concentration is well tolerated and has a substantial ablative activity on high-risk BCG refractory SBC. New treatment options are needed for intermediate-risk SBC recurring after conventional intravesical treatments. The purpose of the present study was to investigate the ablative efficacy of intravesical Gemcitabine on intermediate-risk SBC.

Metastasis markers in bladder cancer: a review of the literature and clinical considerations.

Cancer invasion and metastasis develop through a sequence of processes involving loss of cell-cell and cell-matrix adhesions, proteolysis and induction of angiogenesis. We reviewed the current literature on the molecules that have been shown to play a significant role in these three steps of metastatisation in bladder cancer (BC) cells and their host microenvironment. Particular emphasis was given to markers that are assessable through immunohistochemistry and for which an additional prognostic value over the TNM variables has been recognized, in order to identify a subset of tumour markers readily available for application in daily clinical practice.

Pathological findings of penile fractures and their surgical management.

Objective: In the present review we discuss the clinical presentation and the surgical approach, together with the intraoperative findings and postoperative complications which occurred in 7 patients presented for our observation with a penile injury and submitted to immediate surgical exploration.

Materials And Methods: Our series, despite the relatively small number of cases, provide a complete pattern of the different intraoperative findings that may be encountered when approaching a penile trauma. This includes extremely rare cases like a completely transected urethra, a fracture at the base of the penis and a rupture of the deep dorsal vein.

Is there an optimal time for intracavernous prostaglandin E1 rehabilitation following nonnerve sparing radical prostatectomy? Results from a hemodynamic prospective study.

Purpose: Previous studies have shown that early intracavernous prostaglandin E1 injection may reduce significantly the incidence of veno-occlusive dysfunction before spontaneous erections recover after nerve sparing radical prostatectomy. We identify the more convenient postoperative timing for successful intracavernous injection rehabilitation in a series of patients who underwent nonnerve sparing radical prostatectomy.

Materials And Methods: A total of 73 patients with a normal preoperative International Index of Erectile Function score were randomly allocated to undergo dynamic color Doppler ultrasound study 20 mg.

Ex vivo chemosensitivity to mitomycin C in bladder cancer and its relationship with P-glycoprotein and apoptotic factors.

Background: Intravesical treatment with mitomycin C (MMC) leads to a complete response rate of around 40% in superficial bladder cancer (TCC). In order to determine in advance which patients will fail to respond, we describe a study assessing the feasibility of applying the ATP assay to test the chemosensitivity of samples from patients with this disease.

Materials And Methods: TURBT or biopsy samples were received from 27 patients, 23 of which were suitable for the ATP assay (16 primary tumours and 7 recurrences).