Efficacy of spermatic vein ligation in patients affected by high grade left varicocele.

Purpose: To study the effect of high grade varicocele treatment in infertile patients.

Materials And Methods: Seventy-five patients were selected by the following criteria: infertility persisting for more than 1 year; abnormal semen parameters; no other infertility-related disease; no obvious causes of infertility in the subject's partner; basal eco-color Doppler ultrasound demonstrating continuous reflux in the spermatic vein. All patients considered for the study had at least a six months period from the diagnosis to the surgery due to waiting list, choice of the patient or time needed to complete diagnostic evaluation of the couple.

The role of bladder neck preservation during radical prostatectomy: clinical and urodynamic study.

Aims: Bladder neck preservation has caused an increase in urinary continence following radical prostatectomy, and has given rise to much controversy. We have reviewed our clinical and urodynamic experience collected since 1995 in patients subjected to radical prostatectomy with bladder neck preservation.

Materials And Methods: 180 patients were followed postoperatively using a pad test, an incontinence questionnaire and PSA dosage.

Preservation of cavernosal erectile function after soft penile prosthesis implant in Peyronie's disease: long-term followup.

The aim of this retrospective study is to evaluate the long-term followup of soft penile SSDA prosthesis, without plaque surgery in the treatment of Peyronie's disease. This study included 12 men with Peyronie's disease who underwent placement of a penile prosthesis. All patients were followed for at least 6 years.

Leydig cell tumour of the testis: presentation, therapy, long-term follow-up and the role of organ-sparing surgery in a single-institution experience.

Objective: To report our single-centre experience of patients with Leydig cell tumour (LCT) of the testis, which represents the most frequent interstitial neoplasm of the testis, and for which the natural history and therapy are debated.

Patients And Methods: Between 1990 and 2006, 37 patients were treated for LCT of the testis. All patients had testicular markers assessed and 21 (57%) had their hormonal profile assessed (total testosterone, follicle-stimulating hormone, luteinizing hormone and oestradiol).

The natural history of Peyronie's disease.

Objective: Many physical or medical therapeutic approaches, systemic or local, have been suggested for treatment of Peyronie's disease. These approaches claim a discrete percentage of success in terms of clinical stabilization or improvement. The aim of our work was to evaluate the "natural history" of this disease.

Evaluation of post-operative residual function of corpora cavernosa after soft penile prosthesis implant for Peyronie's disease.

Objective: The aim of this study is to evaluate the results of surgical implant with a new soft penile prosthesis, called SSDA, without plaque surgery in the treatment of impotence associated with Peyronie's disease.

Materials And Methods: This study included 64 men with Peyronie's disease who underwent placement of a penile prosthesis. All the patients were followed for at least one year.

"Ejaculatory disorders and alpha1-adrenoceptor antagonists therapy: clinical and experimental researches".

Background: It is well known that the use of the alpha-adrenergic receptor antagonists in the BPH therapy may induce ejaculatory disorder. A review of clinical literature shows a greater incidence of ejaculatory disorder during the use of tamsulosin compared with alfuzosin. Anejaculation has been until now referred to retrograde ejaculation due to relaxation of prostatic and bladder neck smooth muscle tone.

Reduction in PSA messenger-RNA expression and clinical recurrence in patients with prostatic cancer undergoing neoadjuvant therapy before radical prostatectomy.

BACKGROUND: We assessed the incidence of micro-metastases at surgical margins (SM) and pelvic lymph nodes (LN) in patients submitted to radical retropubic prostatectomy (RP) after neoadjuvant therapy (NT) or to RP alone. We compared traditional staging to molecular detection of PSA using Taqman-based quantitative real-time PCR (qrt-PCR) never used before for this purpose. METHODS: 29 patients were assigned to NT plus RP (arm A) or RP alone (arm B).

[Evaluation of FSH and Leydig cells function in patients with varicocele].

The endocrine alterations in patients affected with varicocele are heterogenous in relation to some clinical aspects: orchidometry, bilateral lesion, decreased spermatozoa count and disease history. The decreased function of Leydig cells in patients affected with varicocele is related to alterations of the serotonin metabolism and to the impairment of testosterone biosynthesis. An exaggerated increase of FSH and LH after GnRH stimulation can be observed.

Neoadiuvant Treatment With Intravesical Interleukin-2 for Recurrent Superficial Transitional Bladder Carcinoma Ta-T1/G1-2.

SUMMARY: The aim of this study was to evaluate the direct action of IL-2 on recurrent superficial transitional bladder carcinoma and the effect on recurrence rate. 27 patients were submitted to neoadjuvant treatment by intra-vesical instillation of recombinant IL-2 and to transurethral resection. We did not observe any effect on neoplasms but the recurrence rate was less than the expected one.

Neoadiuvant treatment with intravesical interleukin-2 for recurrent superficial transitional bladder carcinoma Ta-T1/G1-2.

The aim of this study was to evaluate the direct action of IL-2 on recurrent superficial transitional bladder carcinoma and the effect on recurrence rate. 27 patients were submitted to neoadjuvant treatment by intra-vesical instillation of recombinant IL-2 and to transurethral resection. We did not observe any effect on neoplasms but the recurrence rate was less than the expected one.

Conservative surgery in small renal tumors: our experience.

Objective: We evaluated the effectiveness and safety of the nephron-sparing surgery in the treatment of low stage, easily accessible renal cell carcinoma versus radical nephrectomy, the "gold standard" therapy according to data in the literature.

Methods: From 1988 to 1996, 36 patients (11 women and 25 men; mean age 59.6 years) with a small (< or = 5 cm) solitary renal cell carcinoma and a normal contralateral kidney were submitted to tumor enucleation through a transperitoneal approach.

Low-grade left varicocele in patients over 30 years old:the effect of spermatic vein ligation on fertility.

Objectives: To evaluate the effect of spermatic vein ligation in patients over 30 years old and with low-grade left varicocele, and thus help to establish whether such patients might benefit from surgery.

Patients And Methods: A randomized study was conducted on 68 infertile patients (30-38 years old) with evidence of sperm abnormalities and who had low-grade varicocele (grade I according to Hirsch), comparing left spermatic vein ligation with no treatment. The outcome was assessed by standard sperm analysis and eventual paternity.

Bilateral varicocele: impact of right spermatic vein ligation on fertility.

The most frequent cause of male infertility is left varicocele. The surgical or laparoscopic approach for spermatic vein ligation is considered the best method of treatment. The approach to a clinically significant left varicocele associated with a right varicocele (frequently of a smaller size) is not univocal.

Comparative effects of alfuzosin versus Serenoa repens in the treatment of symptomatic benign prostatic hyperplasia.

Objectives: Sixty-three patients suffering from benign prostatic hyperplasia (BPH) entered a double-blind, comparative, parallel-groups study lasting 3 weeks, carried out to compare the efficacy and safety of alfuzosin 2.5 mg tid (n = 32) vs serenoa repens 160 mg bid (n = 31) in BPH.

Methods: Efficacy was assessed both on clinical symptoms (Boyarsky's scale, visual analogue scale, clinical global impression), urinary flow rates (uroflowmetry) and residual urinary volume (transabdominal ultrasound).

[Reevaluation of impotence following TURP].

Impotence following transurethral prostatectomy is one of the main complications that still has a controversial origin. Many authors, reporting their experience, have demonstrated that this complication is due both to psychological problems and to organic causes. We review retrospectively 68 patients submitted to TURP.

[Experience with the determination of LDH-X in seminal plasma as diagnostic and prognostic factor in varicocele].

We studied the biochemical and functional properties of semen to evidence markers of diseases concerning fertility. We examined LDH especially isoenzyme LDHx in semen of patients with varicocele, diagnosed by clinical evaluation and doppler velocimetry. The existence of this enzyme is closely associated with active spermatogenesis.

Deep dorsal vein arterialization in vasculogenic impotence: our experience.

We describe our experience of surgical therapy for vasculogenic impotence, using a technique of arterialization of the deep dorsal vein. This technique was chosen because vascular anastomosis can easily be performed, and because of the possibility of inducing haemodynamic mechanisms which favour the maintenance of rigidity, using venous arterialization. The operation was performed on 22 selected subjects with positive results.

Postpubertal cryptorchidism: review and evaluation of the fertility.

We assessed the fertility of 91 patients affected by unilateral cryptorchidism who were subjected to postpubertal orchidopexy in the last 15 years. All cases were clinically examined, evaluated by semen analysis and Doppler ultrasound of the spermatic artery. Twenty-two patients underwent testicular biopsy.

[Evaluation of the activity of the bladder detrusor muscle and analysis of bladder function in subjects with diabetes mellitus under insulin treatment].

The present report concerns investigations of detrusor muscle adrenergic innervations in patients affected by bladder neuropathy secondary to diabetes without obstructive disturbances. Detrusor contractile activity evoked by NE is markedly reduced which can probably be attributed to receptor deficit. Urodynamic evaluation demonstrated a prevalence of sensory peripheral neuropathy than a motor conduction abnormality.

Plasma sex hormone binding globulin in patients with prostatic carcinoma.

The concentrations of sex hormone binding globulin (SHBG) were measured in the plasma of 56 men, who were 47 to 85 years of age, by time-resolved immunofluorometric assay with a monoclonal antibody. Twenty-five of the men had untreated carcinoma of the prostate and 17 had untreated prostatic hyperplasia. There were 14 healthy control subjects.

[Arterialization of the deep dorsal vein in selected cases of vasculogenic impotence].

We report our study of surgical treatment of vasculogenic impotence using the technique of arterialization of the deep dorsal vein. The results of the operation performed in 13 selected cases are good although the follow-up is still short. The reasons why we consider this technique preferable to the others available for penile revascularization are discussed.