Advances in Urology最新文献

{"title":"Analysis of Learning Curve in Robot-Assisted Radical Prostatectomy Performed by a Surgeon.","authors":"Roman I Slusarenco,&nbsp;Konstantin V Mikheev,&nbsp;Artem O Prostomolotov,&nbsp;Roman B Sukhanov,&nbsp;Evgeny A Bezrukov","doi":"10.1155/2020/9191830","DOIUrl":"https://doi.org/10.1155/2020/9191830","url":null,"abstract":"<p><p>This study aimed to report the learning curve in robot-assisted radical prostatectomy (RARP) performed by one surgeon who is experienced in laparoscopic prostatectomies. The records of 145 RARP cases performed between 2015 and 2017 were evaluated retrospectively. Patients were divided into three groups: group 1 comprised the first 49 cases, group 2 comprised 50-88 cases, and the rest of the cases were assigned to group 3. Continence was defined as the necessity to use at least one pad during a day. Additionally, erectile function recovery was defined as having erection sufficient for sexual intercourse regardless of using a phosphodiesterase type 5 inhibitor. Continence and erectile function recovery were assessed during interviews at 3, 6, and 12 months after surgery. First, all procedures were successfully performed without conversions or blood transfusions. The median follow-up period was 22 months. Moreover, the median skin-to-skin operative time (OT) was 220 minutes. The median blood loss was 150 ml, and the mean hospital stay was 8.9 ± 3.87 days. The median prostate volume was 36 cm³. The overall positive surgical margin rate was 13.1%. Overall, 38 (26.2%) postoperative complications were observed, and 17.9% of them were graded as minor. Anastomotic leakage decreased significantly from group 1 to group 3 (26.5% and 7%, respectively). The continence recovery (0-1 pad) rates were 60.6%, 75.7%, and 84.9% at 3, 6, and 12 months after surgery, respectively. Subsequently, the erectile function recovery rates were 50.9% and 65.4% at 6 and 12 months after surgery, respectively. In conclusion, there are several types of learning curves for RARP. First, the shallowest learning curve was observed for the OT. Regarding the analysis of \"advanced learning curve,\" demonstrating the improvement of OT and blood loss is considered insufficient. Therefore, additional oncological and functional results that require a longer period of investigation are required.</p>","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2020-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/9191830","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38056903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Critical Assessment of Single-Use Ureteroscopes in an <i>In Vivo</i> Porcine Model.","authors":"Brian Ceballos,&nbsp;Charles U Nottingham,&nbsp;Seth K Bechis,&nbsp;Roger L Sur,&nbsp;Brian R Matlaga,&nbsp;Amy E Krambeck","doi":"10.1155/2020/3842680","DOIUrl":"https://doi.org/10.1155/2020/3842680","url":null,"abstract":"<p><strong>Methods: </strong>A female pig was placed under general anesthesia and positioned supine, and retrograde access to the renal collecting system was obtained. The LithoVue (Boston Scientific) and Uscope (Pusen Medical) were evaluated by three experienced surgeons, and each surgeon started with a new scope. The following parameters were compared between each ureteroscope: time for navigation to upper and lower pole calyces with and without implements (1.9 F basket, 200 <i>μ</i>m laser fiber, and 365 <i>μ</i>m laser fiber for upper only) in the working channel and subjective evaluations of maneuverability, irrigant flow through the scope, lever force, ergonomics, and scope optics.</p><p><strong>Results: </strong>Navigation to the lower pole calyx was significantly faster with LithoVue compared to Uscope when the working channel was empty (24.3 vs. 49.4 seconds, <i>p</i> < 0.01) and with a 200 <i>μ</i>m fiber (63.6 vs. 94.4 seconds, <i>p</i>=0.04), but not with the 1.9 F basket. Navigation to the upper pole calyx was similar for all categories except faster with LithoVue containing the 365 <i>μ</i>m fiber (67.1 vs. 99.7 seconds, <i>p</i>=0.02). Subjective assessments of scope maneuverability to upper and lower pole calyces when the scope was empty and with implements favored LithoVue in all categories, as did assessments of irrigant flow, illumination, image quality, and field of view. Both scopes had similar scores of lever force and ergonomics.</p><p><strong>Conclusions: </strong>In an <i>in vivo</i> porcine model, the type of single-use ureteroscope employed affected the navigation times and subjective assessments of maneuverability and visualization. In all cases, LithoVue provided either equivalent or superior metrics than Uscope. Further clinical studies are necessary to determine the implications of these findings.</p>","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2020-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/3842680","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37923570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Microbiome within Primary Tumor Tissue from Renal Cell Carcinoma May Be Associated with PD-L1 Expression of the Venous Tumor Thrombus.","authors":"Michael A Liss,&nbsp;Yidong Chen,&nbsp;Ronald Rodriguez,&nbsp;Deepak Pruthi,&nbsp;Teresa Johnson-Pais,&nbsp;Hanzhang Wang,&nbsp;Ahmed Mansour,&nbsp;James R White,&nbsp;Dharam Kaushik","doi":"10.1155/2020/9068068","DOIUrl":"https://doi.org/10.1155/2020/9068068","url":null,"abstract":"<p><strong>Objective: </strong>To perform a proof of concept microbiome evaluation and PD-L1 expression profiling in clear-cell renal cell carcinoma (cc-RCC) with associated tumor thrombus (TT).</p><p><strong>Methods: </strong>After IRB approval, six patients underwent radical nephrectomy (RN) with venous tumor thrombectomy (VTT). We collected fresh tissue specimens from normal adjacent, tumor, and thrombus tissues. We utilized RNA sequencing to obtain PD-L1 expression profiles and perform microbiome analysis. Statistical assessment was performed using Student's <i>t</i>-test, chi-square, and spearman rank correlations using SPSS v25.</p><p><strong>Results: </strong>We noted the tumor thrombus to be mostly devoid of diverse microbiota. A large proportion of <i>Staphylococcus epidermidus</i> was detected and unknown if this is a surgical or postsurgical contaminant; however, it was noted more in the thrombus than other tissues. Microbiome diversity profiles were most abundant in the primary tumor compared to the thrombus or normal adjacent tissue. Differential expression of PD-L1 was examined in the tumor thrombus to the normal background tissue and noted three of the six subjects had a threshold above 2-fold. These three similar subjects had foreign microbiota that are typical residents of the oral microbiome.</p><p><strong>Conclusion: </strong>Renal tumors have more diverse microbiomes than normal adjacent tissue. Identification of resident oral microbiome profiles in clear-cell renal cancer with tumor thrombus provides a potential biomarker for thrombus response to PD-L1 inhibition.</p>","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2020-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/9068068","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37717870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Tamsulosin plus Tadalafil versus Tamsulosin as Medical Expulsive Therapy for Lower Ureteric Stones: A Randomized Controlled Trial.","authors":"Diwas Gnyawali,&nbsp;Manish Man Pradhan,&nbsp;Prem Raj Sigdel,&nbsp;Purushottam Parajuli,&nbsp;Sampanna Chudal,&nbsp;Sujeet Poudyal,&nbsp;Suman Chapagain,&nbsp;Bhoj Raj Luitel,&nbsp;Pawan Raj Chalise,&nbsp;Uttam Sharma,&nbsp;Prem Raj Gyawali","doi":"10.1155/2020/4347598","DOIUrl":"https://doi.org/10.1155/2020/4347598","url":null,"abstract":"<p><strong>Introduction: </strong>Urolithiasis is one of the common disorder with which about 1/5^th is found in the ureter, of which 2/3^rd is seen in the lower ureter. Medical expulsive therapy is one of the routine modalities of treatment which uses various drugs acting on the ureter smooth muscle by different mechanism. We aim to compare the efficacy of combination vs. single drug.</p><p><strong>Methods: </strong>This randomized controlled trial was done in 176 consecutive patients over a period of six months (March 2019 to August 2019) in Department of Urology and Kidney Transplant Surgery, Tribhuvan University Teaching. Participants were divided into two groups (Group A, tamsulosin plus tadalafil, and Group B, tamsulosin) from computer-generated random numbers. Therapy was continued for a maximum of 3 weeks. Stone expulsion rate, time to stone expulsion, analgesic use, number of colic and emergency room visits for pain, early intervention, and adverse effects of drugs were recorded.</p><p><strong>Results: </strong>Among 176 patients who were enrolled in study, 7 were lost to follow-up, and 5 people required immediate intervention. There was a significant higher stone passage rate in group A than group B (64 vs. 50; <i>P</i>=0.025) and shorter expulsion time (1.66 vs. 2.32 weeks <i>P</i>=0.001) and less number of emergency room visits and colic episodes. No significant side effects were noted during study.</p><p><strong>Conclusion: </strong>Tamsulosin plus Tadalafil is more effective than tamsulosin with early passage of stone and decreased number of colic episodes and emergency visits without significant side effects for lower ureteric calculi of 5 mm to 10 mm.</p>","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2020-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/4347598","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37937284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prospective Multicenter Open-Label One-Arm Trial Investigating a Pumpkin Seed, Isoflavonoids, and Cranberry Mix in Lower Urinary Tract Symptoms/Benign Prostatic Hyperplasia: A Pilot Study.","authors":"Elie Nemr,&nbsp;Elie El Helou,&nbsp;Georges Mjaess,&nbsp;Albert Semaan,&nbsp;Josselin Abi Chebel","doi":"10.1155/2020/6325490","DOIUrl":"https://doi.org/10.1155/2020/6325490","url":null,"abstract":"<p><p>Phytotherapy for lower urinary tract symptoms (LUTSs) due to benign prostate hyperplasia (BPH) is progressively demanded by patients and trusted by physicians. The aim was to assess the efficacy of a mix of pumpkin seed extract, soy germ isoflavonoids, and cranberry (Novex®) in the management of mild to moderate LUTS in BPH patients. Male patients aged ≥40 years, who had had mild to moderate LUTS for >6 months at screening, with no previous therapy or who are still symptomatic despite current use of alpha-blockers, were recruited. Exclusion criteria were an IPSS >19 and an age >80 years. The mixed compound was administered orally, daily, for 3 months. Patients were evaluated by means of IPSS, urological quality of life (uQoL) index, and International Index of Erectile Function (IIEF-5) at 3 visits: baseline (visit 1), 30 days (visit 2), and 90 days after treatment (visit 3). Among 163 screened patients, 128 patients (61.8 ± 9.9 years) were recruited. IPSS improved from 15 (Q1 : 12-Q3 : 17) in visit 1, to 11 (Q1 : 8-Q3 : 14) in visit 2, and to 9 (Q1 : 6-Q3 : 12) in visit 3 (<i>p</i> < 0.001). uQoL improved from 4 (3-4) in visit 1, to 3 (2-3) in visit 2, and to 2 (1-2) in visit 3 (<i>p</i> < 0.001). The patients had an IIEF-5 score of 15 (12-18.7) in visit 1, 15 (12-18) in visit 2, and 17 (13-19) in visit 3 (<i>p</i>=0.99 visits 1 vs. 2, <i>p</i>=0.004 visits 2 vs. 3, and <i>p</i>=0.001 visits 1 vs. 3). Treating mild to moderate LUTS/BPH patients with Novex® might therefore relieve symptoms, improve the quality of life, and have a mild beneficial effect on erectile function.</p>","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2020-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/6325490","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37773190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Traumatic Bladder Ruptures: A Ten-Year Review at a Level 1 Trauma Center.","authors":"John Barnard, Tyler Overholt, Ali Hajiran, Chad Crigger, Morris Jessop, Jennifer Knight, Chad Morley","doi":"10.1155/2019/2614586","DOIUrl":"10.1155/2019/2614586","url":null,"abstract":"<p><p>Bladder rupture occurs in only 1.6% of blunt abdominopelvic trauma cases. Although rare, bladder rupture can result in significant morbidity if undiagnosed or inappropriately managed. AUA Urotrauma Guidelines suggest that urethral catheter drainage is a standard of care for both extraperitoneal and intraperitoneal bladder rupture regardless of the need for surgical repair. However, no specific guidance is given regarding the length of catheterization. The present study seeks to summarize contemporary management of bladder trauma at our tertiary care center, assess the impact of length of catheterization on bladder injuries and complications, and develop a protocol for management of bladder injuries from time of injury to catheter removal. A retrospective review was performed on 34,413 blunt trauma cases to identify traumatic bladder ruptures over the past 10 years (January 2008-January 2018) at our tertiary care facility. Patient data were collected including age, gender, BMI, mechanism of injury, and type of injury. The primary treatment modality (surgical repair vs. catheter drainage only), length of catheterization, and post-injury complications were also assessed. Review of our institutional trauma database identified 44 patients with bladder trauma. Mean age was 41 years, mean BMI was 24.8 kg/m², 95% were Caucasian, and 55% were female. Motor vehicle collision (MVC) was the most common mechanism, representing 45% of total injuries. Other mechanisms included falls (20%) and all-terrain vehicle (ATV) accidents (13.6%). 31 patients had extraperitoneal injury, and 13 were intraperitoneal. Pelvic fractures were present in 93%, and 39% had additional solid organ injuries. Formal cystogram was performed in 59% on presentation, and mean time to cystogram was 4 hours. Gross hematuria was noted in 95% of cases. Operative management was performed for all intraperitoneal injuries and 35.5% of extraperitoneal cases. Bladder closure in operative cases was typically performed in 2 layers with absorbable suture in a running fashion. The intraperitoneal and extraperitoneal injuries managed operatively were compared, and length of catheterization (28 d vs. 22 d, <i>p</i>=0.46), time from injury to normal fluorocystogram (19.8 d vs. 20.7 d, <i>p</i>=0.80), and time from injury to repair (4.3 vs. 60.5 h, <i>p</i>=0.23) were not statistically different between cohorts. Patients whose catheter remained in place for greater than 14 days had prolonged time to initial cystogram (26.6 d vs. 11.5 d) compared with those whose foley catheter was removed within 14 days. The complication rate was 21% for catheters left more than 14 days while patients whose catheter remained less than 14 days experienced no complications. The present study provides a 10-year retrospective review characterizing the presentation, management, and follow-up of bladder trauma patients at our level 1 trauma center. Based on our findings, we have developed an institutional proto","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2019-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6930775/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37523580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nephrolithiasis and Polycystic Ovary Syndrome: A Case-Control Study Evaluating Testosterone and Urinary Stone Metabolic Panels","authors":"Donald Fedrigon, Kareem Alazem, S. Sivalingam, M. Monga, Juan Calle","doi":"10.1155/2019/3679493","DOIUrl":"https://doi.org/10.1155/2019/3679493","url":null,"abstract":"Introduction Both elevated testosterone and polycystic ovary syndrome (PCOS) have been speculated as possible risk factors for kidney stone formation; however, the details of this potential relationship with regards to 24-hour urine metabolic panels and stone composition have not previously been characterized. Methods A total of 74 PCOS patients were retrospectively identified and matched with a cohort of female stone formers at a 3 : 1 ratio (by age and BMI). All patients had 24-hour urinary metabolic panels and stone compositions. These groups were compared using Pearson chi-square and Student t-tests. Additionally, the PCOS group was differentiated based on free testosterone using multivariate analysis. Results The case-control cohort showed that PCOS patients had significantly lower sodium excretion (p=0.015) and hypernatriuria rates (28.9% vs 50.9%, p=0.009). The PCOS-testosterone cohort demonstrated that high testosterone patients had significantly higher citrate values (p=0.041) and significantly lower odds of hypocitraturia (36.7% vs 54.2%, OR = 0.2, p=0.042). The high testosterone group also had higher sodium excretion (p=0.058) with significantly higher odds of having hypernatriuria (40.0% vs 13.6%, OR = 13.3, p=0.021). No significant patterns were revealed based on stone composition analysis. Conclusions Compared to healthy stone formers, PCOS patients did not demonstrate significant differences in 24-hour urine and stone composition values. Elevated free testosterone in PCOS patients has a significant association with higher urinary citrate and sodium values: findings that in and of themselves do not confirm the hypothesized increased risk of stone formation. This patient cohort may provide deeper insight into the interplay between androgens and stone formation; however, further study is needed to fully characterize the possible relationship between PCOS and stone formation.","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2019-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/3679493","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42381711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Insights into the Regulatory Roles of E3 Ubiquitin Ligases Associated with VHL-HIF Axis in Clear Cell Renal Cell Carcinoma","authors":"Wuping Yang, Zhi Li, B. Hong, Y. Gong, K. Gong","doi":"10.1155/2019/2967183","DOIUrl":"https://doi.org/10.1155/2019/2967183","url":null,"abstract":"Renal cell carcinoma (RCC) accounts for up to 85% to 90% of all kidney cancers. Clear cell RCC (ccRCC), the major subtype of RCC, is mainly characterized by the inactivation of the tumor suppressor gene VHL. pVHL as an E3 ubiquitin ligase targets the hydroxylated form of HIF-α for proteasomal degradation. The loss of VHL function leads to HIF-α aggregation as the main mechanism of ccRCC. Recently, the regulations of ccRCC through other E3 ubiquitin ligases are emerging. Moreover, most of them are associated with the VHL-HIF axis. In this review, we mainly focus on seven E3 ubiquitin ligases JADE1, SIAH1, CHIP, FBXW7, MDM2, SPOP, and HAF. Based on reported researches of these ligases on ccRCC, they are divided into two groups: JADE1, SIAH1, CHIP, and FBXW7 that negatively regulate the growth of ccRCC; MDM2, SPOP, and HAF that promote ccRCC progression. In addition, we further verify these possible links between these E3 ligases and VHL-HIF axis in ccRCC based on The Cancer Genome Atlas RNA-seq and Clinical data. Understanding the mechanisms by which these ligases regulate ccRCC, especially the interplay between these ligases and VHL-HIF axis may enable the development of novel therapeutic approaches for ccRCC. Overall, the present review reveals the potential mechanism by which seven ligases (JADE1, SIAH1, CHIP, FBXW7, MDM2, SPOP, and HAF) regulate ccRCC progression in detail, especially their relationship to VHL-HIF axis.","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2019-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48978826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Histoprotective Effect of Essential Oil from <i>Citrus aurantifolia</i> in Testosterone-Induced Benign Prostatic Hyperplasia Rat.","authors":"Desmond O Acheampong, Isaac K Barffour, Alex Boye, Ernest A Asiamah, Francis A Armah, Christian K Adokoh, Joy F Oluyemi, Benjamin Adrah, Richard Opoku, Emmanuel Adakudugu","doi":"10.1155/2019/3031609","DOIUrl":"10.1155/2019/3031609","url":null,"abstract":"<p><strong>Background: </strong>Benign prostatic hyperplasia (BPH) is a common urological disorder reported among ageing men.</p><p><strong>Objective: </strong>The study assessed histoprotective effect of lime essential oil (LEO) in a rat model of testosterone-induced benign prostatic hyperplasia (BPH) and evaluated its ability to reverse testosterone-mediated changes in the testis, kidney, and liver.</p><p><strong>Materials and methods: </strong>Adult Sprague Dawley (aged 12 weeks, 240-390 g) male rats were intramuscularly injected with testosterone enanthate (TE) (10 mg/kg) reconstituted in olive oil for ten days to establish benign prostatic hyperplasia (serum PSA level ≥ 1.24 ng/ml) in. After confirmation of BPH (sustained serum PSA level ≥ 1.24 ng/ml), rats in all groups (LEO: 30, 100, and 300 mg/kg, <i>po</i>, <i>n</i> = 6; finasteride: 15 mg/kg, <i>po</i>, <i>n</i> = 6) except model (BPH without treatment) and sham (no BPH and no treatment) groups were treated for 21 days. At the end of treatment, rats were anesthetised and blood was collected via cardiac puncture to determine serum PSA and total antioxidant capacity (TAC) levels. The prostate gland, testis, kidney, and liver were harvested, weighed, histologically processed and stained with H&E.</p><p><strong>Results: </strong>LEO- and finasteride-treated groups recorded lesser mean prostatic weights relative to their model group. Baseline mean serum PSA level of LEO- and finasteride-treated groups reduced significantly (<i>p</i> < 0.05) relative to model group. Serum TAC levels were also higher in LEO- and finasteride-treated groups relative to model group. LEO-treated groups had less thickened glandular epithelium, smaller acini, fewer prostatic secretions and more fibromuscular stroma relative to model group. LEO and finasteride treatment produced improved histomorphological characteristics of testis, kidney, and liver compared to model group.</p><p><strong>Conclusion: </strong>By the current results, <i>Citrus aurantifolia</i> LEO may possess active agents that can be explored for translational medicine against BPH.</p>","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2019-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6778952/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43550651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of Priapism Secondary to Drugs for Erectile Dysfunction","authors":"José Pablo Saffon Cuartas, C. Sandoval-Salinas, Juan M. Martínez, H. Corredor","doi":"10.1155/2019/6214921","DOIUrl":"https://doi.org/10.1155/2019/6214921","url":null,"abstract":"Priapism may present as a side effect in patients treated with medications for erectile dysfunction, in which it should be controlled in a timely manner to avoid complications. There is little information regarding the use of local measures for the treatment of this condition. This study was done with the objective to describe the management of priapism secondary to erectile dysfunction drugs in a cohort of men. Records of emergencies and adverse events were reviewed by two researchers to identify patients diagnosed with erectile dysfunction who received oral or intracavernosal drugs for their illness and presented priapism. Sociodemographic data, clinical background, and information on the duration, management, and evolution of the priapism were extracted. Priapism incidence, percentage of improvement by type of treatment subgroups, and frequency of complications were estimated. 698 patients were treated with PDE-5 inhibitors and 2,135 with intracavernosal drugs. Thirty-one patients (1.4%) reported at least one priapism event during treatment, all with intracavernosal drugs. Treatment with local measures was effective for 10 (32.2%) patients, 1 (3.2%) required terbutaline, 19 (61.2%) used intracavernosal etilefrine, and 1 (3.2%) required drainage and flushing of cavernous bodies. After the priapism episode, 3 (9.6%) patients required an increased dose of the drug in order to achieve satisfactory erection. The results suggest that in men treated for priapism secondary to the use of sexual impotence drugs, initial treatment with local measures and etilefrine can achieve detumescence, decreasing the need for invasive procedures or surgery as a first-line therapy alternative. It is necessary to carry out research studies to confirm this hypothesis.","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2019-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/6214921","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49078194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}