Premature ejaculation: Pharmacotherapy vs group psychotherapy alone or in combination

Objectives: Premature Ejaculation (PE), the commonest sexual dysfunction in males, is generally treated with local anesthetic and SSRI (Dapoxetine). The aim of our study was investigate Group Psychotherapy as an alternative treatment for PE and compare the efficacy of pharmacological treatment and psychotherapy, either alone or in combination, in terms of response and improved Quality of Life (QoL). From a male outpatient population screened for PE, those who received a diagnosis of PE were proposed for the study, enrolled and divided into 3 groups (A, B and C). Each group was treated with Dapoxetine, Group Psychotherapy alone and Dapoxetine and Group Psychotherapy, respectively. Materials …

Compliance to therapy with Dapoxetine in comparison to a conventional selective serotonin reuptake inhibitor (Citalopram) in 118 patients with premature ejaculation.

Premature Ejaculation (PE) is a sexual dysfunction that concern 20-30% of the male population. Dapoxetine is a new serotonine re-uptake inhibitor (SSRI)specific for PE treatment.Aim of the study is to assess compliance and effectiveness of the treatment with dapoxetine compared to the treatment with citalopram (a classic SSRI used to treat PE).

Dall'erba spaccapietre alla medicina ayurvedica. Attualità sulle cosiddette medicine non convenzionali in urologia.

Analisi preliminare dei fattori demografici ed eziopatogenetici in pazienti affetti da carcinoma vescicale a medio rischio di recidiva

Le disfunzioni sessuali maschili I

La cistectomia seminal-sparing nelle patologie non neoplastiche.

PURPOSE. Seminal-sparing cystectomy is reported in literature only with reference to oncological conditions. However, it can be applied also in non-neoplastic conditions in young patients with good renal function. In the present report we will describe our experience in this field, with special reference to erectile function, urinary continence, fertility and feasibility. MATERIALS AND METHODS. Between 2000 and 2009 we have treated five patients with seminalsparing cystectomy for benign conditions, namely sclerosing cystitis, tuberculosis and a benign paraganglioma. All patients underwent a complete diagnostic evaluation including CT of upper abdomen and pelvis, and bone scintigraphy. Digit…

uso degli alfa-bloccanti nell'ipertrofia prostatica benigna: il problema della "floppy iris syndrome". Risultati di uno studio caso-controllo per la valutazione del rischio pre-operatorio con la misura del diametro pupillare.

-

Compliance to therapy with Dapoxetine in patients affected by Premature Ejaculation

Introduction Premature ejaculation (PE) is a sexual dysfunction with high prevalence. According to some reports, it is present in about 20-30% of the male population. Since 2009 PE has been treated with a novel inhibitor of serotonin re-uptake, Dapoxetine, which has been reported to be specifically active for PE. Materials and Methods 59 patients have been selected among the patients affected by PE observed at the outpatient department of Urology and Andrology of the “Paolo Giaccone” University Policlinic Hospital of Palermo. Diagnosis was confirmed unequivocally in all patients, who were suitable for drug treatment and accepted to participate in the study. They were divided in 2 groups: on…

Circumcision in Nesbit Corporoplasty: A Mandatory Time? Our Experience on 158 Patients

Introduction The Nesbit procedure is the most common surgical technique to correct congenital or acquired penile curvature. It is a common opinion that this surgical procedure has to be completed with a circumcision to prevent foreskin necrosis or phimosis. According to our experience we believe that some procedural “tricks” could strongly reduce that mechanical and ischemic trauma on the foreskin responsible for these complications. Materials and Methods From 1988 to 2010 we selected 158 patients treated with Nesbit's corporoplasty. The procedure was recommended to patients who presented a penile curvature wider than 30° and reporting however some difficulty or pain at coitus, or to patien…

Le prostatiti.

Environmental Risk Factors in Superficial Bladder Cancer

As a preliminary approach to define the object of larger case-control studies, the distribution of potential risk factors coming from environmental pollution among patients affected by superficial bladder cancer (TCCB) has been analyzed. Material e Methods. The analysis included only patients affected by medium risk superficial TCCB. Forty Italian urological centres joined the study. Detailed information about age, sex, residency, employment, active and passive cigarette smoking, water resource, hair-dye use were centralized. All patients underwent TUR and early intravesical chemotherapy. The distribution of the above mentioned environmental factors was related to tumor characteristics suc…

Eiaculazione precoce: Trattamenti a confronto. Terapia medica vs terapia medica in associazione con Psicoterapia di gruppo vs Psicoterapia di Gruppo - Poster P45

Scopo del lavoro Scopo dello studio è valutare in pz affetti da Eiaculazione Precoce (EP) il trattamento associato Farmaco+Psicoterapia di gruppo, vs Farmaco, vs Psicoterapia di gruppo in termini di aumento del Tempo di latenza eiaculatoria intravaginale (IELT) e migliore Qualità di vita (QoL). Materiali e metodi Tra gennaio e dicembre 2012 sono stati osservati tra la popolazione maschile afferita all’U.O.C. di Urologia del Policlinico P. Giaccone di Palermo 540 pz affetti da EP. Da questa popolazione selezionata è stato arruolato un campione di 270 pz secondo i criteri di inclusione: IELT ≤ a 2 minuti, Premature Ejaculation Diagnostic Tool (PEDT) ≥9, età 18-70 anni. Criteri di esclusione: …

Cytokines gene expression in the tunica albuginea in patients with Peyronie’s disease. Pilot study with a control group

INTRODUCTION: We decided to conduct a study to investigate the presence of cytokines in the albuginea of subjects with Peyronie's disease (PD). Cytokines, as responsible for intercellular communication, maybe involved in the pathogenesis of the disease. The identification of one or more involved cytokines may, in fact, be useful in the pharmacological treatment with biologic drugs that are able to interfere with specific cytokines. MATERIALS AND METHODS: Between January 2009 and Decembre 2010 at the Clinic of Urological outpatients clinic of the Policlinico of Palermo were recruited 20 subjects with PD, mean age 62.3 years (range 51-70) and 8 subjects with congenital recurvatum penis (mean …

Sindromi prostatitiche croniche (SPC), Chronic Pelvic Pain Syndrome e cistite interstiziale. Semplice analogia o unità patogenetica? Risultati di uno studio pilota sul trattamento delle SPC con associazione di un anti-istaminico ed un eparinoide.

SAFETY AND TOLERABILITY OF LOCAL TREATMENT WITH ILOPROST, A PROSTACYCLIN ANALOGUE, IN PATIENTS WITH PEYRONIE'S DISEASE. A PHASE I STUDY

Objective. To assess the possibility of intralesional therapy for the treatment of Peyronie's disease, we have verified the safety and tolerability of intralesional injections of Iloprost ( an I 2 Prostacyclin analogue) for its property to suppress the production of CTFG in fibroblasts. CTFG is a connective tissue growth factor that acts in concert with TGF-β to stimulate the fibrotic process. Materials and methods. 38 patients with Peyronie’s disease were preliminarily evaluated by considering the symptoms, the degree of penile curvature, and the size of the plaque. Each patient received weekly intralesional injections of 200 ng of Iloprost in 1 ml normal saline for 5 weeks. If tolerated, …

"LUTS E DE NELLA PRATICA CLINICA ANDROLOGICA IN SICILIA: ANALISI EPIDEMIOLOGICA SU CONDIZIONI DI FAMILIARITA' (PATOLOGIE URO-GENITALI), COMORBIDITA', ALTERAZIONI" (C33) ALL'ESAME OBIETTIVO.

APPROCCIO FARMACOLOGICO NEL PAZIENTE CON MALATTIA NON SUSCETTIBILE DI TERAPE LOCO-REGIONALI AD INTENTO CURATIVO.

La circoncisione nella corporoplastica secondo Nesbit: tempo obbligatorio? Esperienza su 158 pazienti (Circumcision in Nesbit corporoplasty: a mandatory time? Our experience on 158 patients)

INTRODUCTION: The Nesbit procedure is the most common surgical technique to correct congenital or acquired penile curvature. It is a common opinion that this surgical procedure has to be completed with a circumcision to prevent foreskin necrosis or phimosis. According to our experience we believe that some procedural "tricks" could strongly reduce that mechanical and ischemic trauma on the foreskin responsible for these complications. MATERIALS AND METHODS: From 1988 to 2010 we selected 158 patients treated with Nesbit's corporoplasty. The procedure was recommended to patients who presented a penile curvature wider than 30° and reporting however some difficulty or pain at coitus, or to pati…

246 Premature ejaculation: Comparison of treatment. Pharmacotherapy vs pharmacotherapy in association with group psychotherapy vs group psychotherapy

PROSTATA (PROSTATITI, IPERTROFIA PROSTATICA, CANCRO DELLA PROSTATA)

Cytokines gene expression in the tunica albuginea of patients with Peyronie’s disease. Pilot study with a control group

INTRODUCTION & OBJECTIVES: Cytokines may be involved in the pathogenesis of the Peyronie's disease (PD). Cytokines levels in tunica albuginea (TA) specimens were measured by Real Time PCR in PD patients and in control group. MATERIAL & METHODS: Between January 2009 and December 2010 20 PD patients affected by PD and 8 patients affected by congenital recurvatum penis (control group) undergoing surgery were entered in the study. Routine histological examination and measurement by Real Time PCR of the expression of the encoding genes for IL-2, IL-4, IL-6, IL-10, IL-13, TGF-β1, TNF-α, IFN-γ and Metalloproteinase (MMP-2) were performed. For the normalization of data, GAPDH (glucerldehyde-3 fosfa…

Cytokine gene expression in the tunica albuginea of patients with Peyronie's disease. Pilot study with a control group.

Introduction and objective Cytokines may be involved in the pathogenesis of Peyronie's disease (PD). In this case, biological drugs, acting on specific cytokines, could be adopted in the pharmacological treatment of the disease. Materials and Methods Twenty PD patients and 8 patients affected by congenital recurvatum penis (control group) who underwent corporoplasty were enrolled in the study Histological examination and measurement by Real Time PCR of the expression of the encoding genes for IL-2, IL-4, IL-6, IL-10, IL-13, TGF-β, TNF-α and IFN-γ were performed on the removed tunica albuginea (TA). For the normalization of data GAPDH (glucerldehyde-3fosfatehydrogenase) and GUSB (β-glucuroni…

Premature Ejaculation: Comparison of treatment. Pharmacotherapy vs Pharmacotherapy in association with group psychotherapy vs group psychotherapy

Introduction & Objectives: The aim of our study was to compare and analyse the effectiveness of pharmacological treatment and the psychotherapy alone or in association in terms of increase of Quality of Life (QoL) measured through Premature Ejaculation Diagnostic Tool (PEDT) and increase of intravaginal eiaculation latency time (IELT) in patients affected by primitive premature ejaculation(PE). Material & Methods: Between January and December 2012, in our department underwent to medical examination 540 patients complaining PE. Criteria for enrollment were primitive PE with IELT ≤ 2 minutes, PEDT > 9 and absence of psychiatric disease, severe chronic disease, drugs and alcool abuse. Out of 5…

Safety and tolerability of local treatment with iloprost, a prostacyclin analogue, in patients with Peyronie's disease: a phase I study

[Penile Flexiflate® Surgitek prosthesis explant and simultaneous three-component hydraulic Titan® Alpha 1 prosthesis implantation, with double incision technique in a patient with kidney and pancreas transplant].

Introduction and Objectives We treated a 45 years old patient, suffering from diabetes mellitus since childhood, with retinal, neurovascular and kidney complications. In 1988, for erectile dysfunction (ED) resistant to medical injective treatment, the patient underwent ligation of the dorsal vein of the penis without any result. In 1989 a Flexiflate® hydraulic prosthesis was implanted with resolution of ED. In 2005 the patient underwent simultaneous kidney and pancreas transplant with a trans-laparotomic approach for end stage renal disease and diabetes mellitus. In 2009, because of the Flexiflate® Surgitek malfunction, the patient underwent explantation of the Flexiflate® prosthesis and si…

ASSOCIAZIONE DI SERENOA REPENS, URTICA DIOICA E PINUS PINASTER. SICUREZZA ED EFFICACIA NEL TRATTAMENTO DEI SINTOMI DEL BASSO TRATTO URINARIO. STUDIO PROSPETTICO SU 320 PAZIENTI

INTRODUCTION. Serenoa repens (saw palmetto) has been employed for the treatment of lower urinary tract symptoms (LUTS) for several years. Its mechanism of action is believed to be due to antiandrogenic, antiproliferative and antinflammatory properties. An association of Serenoa with the nettle “Utica dioica” showing antiproliferative activity and the pine “Pinus pinaster” derivative, showing antinflammatory action, has been proposed in recent years. Such an action is hoped to act not only by reducing LUTS but also by preventing the development of prostate cancer. MATHERIAL AND METHODS. During the years 2007 and 2008, 320 patients suffering from LUTS were treated with an association of Seren…

SICUREZZA E TOLLERABILITA' DEL TRATTAMENTO LOCALE CON ILOPROST IN PAZIENTI AFFETTI DA MALATTIA DI LA PEYRONIE. STUDIO PILOTA DI FASE 1 E PROPOSTA DI NUOVO QUESTIONARIO PER LA VALUTAZIONE SINTOMATOLOGICA

Purpose. Intralesional therapy is a less invasive method for the treatment of Peyronie's disease. The objective of this study was to evaluate safety and tolerability of intralesional injections of Iloprost (I2 Prostacyclin analogue) for its property to suppress in fibroblasts CTFG (Connective tissue growth factor) production, which acts in concert with TGF-ß to stimulate the fibrotic process.?Methods. Nineteen patients with Peyronie's disease were preliminarily evaluated by considering the degree of penile curvature, plaque size and local and systemic symptoms. Each patient then received weekly intralesional injections of 200ng of Iloprost in 1 ml of normal saline for 4-5 weeks. If tolerate…

Sexual dysfunctions after transurethral resection of the prostate (TURP): evidence from a retrospective study on 264 patients

Objectives: Benign prostatic hyperplasia (BPH) and sexual dysfunctions are diseases with a high prevalence in aged men. Several studies have found a link between BPH and LUTS resulting from deterioration in sexual function in men aged 50 years and older for whom TURP is considered the gold standard. The impact of TURP on sexual functions still remain uncertain, nor is it clear what pathophysiological mechanism underlying the emergence of new episodes of Erectile Dysfunction (ED) following TURP in patients with normal sexual function before surgery, while retrograde ejaculation and ejaculate volume reduction represent a clear side effect; derived from BPH treatment. The aim of this study was…

Cytokine gene expression in the tunica albuginea in patients with Peyronie's disease. Pilot study with a control group

INTRODUZIONE: Abbiamo pensato di effettuare uno studio che indagasse circa la presenza delle citochine nell’albuginea di soggetti affetti da malattia di La Peyronie. Le citochine, in quanto responsabili della comunicazione intercellulare, potrebbero essere coinvolte nella patogenesi della malattia. L’individuazione di una o più citochine responsabili potrebbe, infatti, risultare utile nel trattamento farmacologico grazie ai c.d. farmaci biologici, in grado di interferire con le citochine. MATERIALI E METODI: Per lo studio sono stati reclutati tra gennaio 2009 e dicembre 2010 presso l’Ambulatorio di Chirurgia Andrologica del Policlinico di Palermo 20 soggetti affetti da malattia di La Peyron…

Risultati di uno studio piolota di fase I-II con gemcitabina endovescicale nel tumore vescicale superficiale (Ta-T1).

Le disfunzioni sessuali maschili II

Valore clinico della riduzione del PSA in soggetti candidati all’agobiopsia prostatica

Espianto di protesi peniena Flexiflater® AMS e contemporaneo impianto di protesi tricomponente idraulica Titan ® Alpha 1, con tecnica a doppia incisione in paziente con trapianto di rene e pancreas

Introduction and Objectives. We treated a 45 years old patient, suffering from diabetes mellitus since childhood, with retinal, neurovascular and kidney complications. In 1988, for erectile dysfunction (ED) resistant to medical injective treatment, the patient underwent ligation of the dorsal vein of the penis without any result. In 1989 a Flexiflate® hydraulic prosthesis was implanted with resolution of ED. In 2005 the patient underwent simultaneous kidney and pancreas transplant with a trans-laparotomic approach for end stage renal disease and diabetes mellitus. In 2009, because of the Flexiflate® Surgitek malfunction, the patient underwent explantation of the Flexiflate® prosthesis and s…