Bruno Nascimento

Ranolazine Exerts Potent Effects on Atrial Electrical Properties and Abbreviates Atrial Fibrillation Duration in the Intact Porcine Heart

Introduction: In vitro studies and ambulatory ECG recordings from the MERLIN TIMI‐36 clinical trial suggest that the novel antianginal agent ranolazine may have the potential to suppress atrial arrhythmias. However, there are no reports of effects of ranolazine on atrial electrophysiologic properties in large intact animals.

Recurrent Penile Fracture—Case Report and Alternative Surgical Approach

Introduction Penile refracture is an exceedingly rare event, with very few published studies. To the best of our knowledge, this is the first documented case in the literature of penile fracture with 3 same-site recurrences. Aims To describe the case of a 25-year-old Caucasian man with recurrent penile fracture ultimately treated with resuture and patch reinforcement. Methods Patient history (clinical and surgical) and literature review. Results After the 3rd same-site recurrence, patch reinforcement over the sutured area was performed. The patient had an uneventful recovery and no recurrences to date. Conclusion There is no evidence indicating the superiority of non-absorbable sutures. Bovine pericardium reinforcement over the sutured area was used to minimize the chance of another recurrence. More studies are necessary to investigate its safety and efficacy in this scenario. Nascimento B, Guglielmetti GB, Miranda EP, et al. Recurrent Penile Fracture—Case Report and Alternative Surgical Approach. Sex Med 2018;6:263–266.

PD45-07 CRITICAL ANALYSIS OF PENILE DUPLEX DOPPLER ULTRASOUND (PDDU) IN ERECTILE DYSFUNCTION (ED): TECHNICAL AND INTERPRETATION DEFICIENCIES

There were no statistically significant differences in I-PSS or NIH-CPSI scores between the two groups. High intensity cyclists had a significantly higher mean SHIM score compared to lower intensity cyclists (20.6 vs 19.5) p<0.01, but no significant differences were found in I-PSS and NIH-CPSI scores. After adjusting for age, cyclists had significantly higher odds of perineal numbness compared to non-cyclists, odds ratio1⁄410.6 (95% confidence interval 8.3-13.7). Bike seat type had no significant effect in any of the above mentioned results. CONCLUSIONS: Contrary to prior studies suggesting that cycling may cause ED, our study shows that cyclists have no worse erectile function than non-cyclists. We also showed that cycling does not affect LUTS. Further research is warranted to gain insight into these results, but this study suggests that cardiovascular benefits of exercise may outweigh any theoretical deterrent of cycling.

MP84-02 UTILITY OF 2D PHOTOGRAPHY IN THE ASSESSMENT OF PENILE CURVATURE IN MEN WITH PEYRONIE's DISEASE (PD): THE GOSOFT STUDY

INTRODUCTION AND OBJECTIVES: Penile duplex Doppler ultrasound (PDDU) with intracavernosal injection (ICI) with erectogenic agents is commonly used to evaluate vascular parameters in men with erectile dysfunction (ED). Recent studies have suggested significant variability in outcomes based on ICI dosing protocols, suggesting a need for standardization of injection protocols. Given a lack of literature on this topic, we sought to identify predictors for increased need of ICI dosing to achieve adequate rigidity at the time of PDDU. METHODS: A retrospective chart review was performed of all patients undergoing PDDU for evaluation of ED from January 2014 to November 2015. At the time of PDDU, men received a combination of papaverine(30 mg/mL), phentolamine(1 mg/mL), and alprostadil(10 mcg/mL) in 0.1 mL increments until an erection sufficient for penetration was achieved or 1.0 cc was administered. Clinicopathologic and demographic variables were reviewed, and univariate and multivariate analyses were used to identify characteristics associated with increased erectogenic requirements. RESULTS: A total of 262 men (mean age 53;) underwent PDDU during the study period. Mean IIEF-6 score was 12.4 (SD 10.2), and a mean 2.1 injections (SD 1.1) with 0.34 cc (SD 0.34) were administered. On multivariate analysis, lower IIEF-ED domain score (p<0.01), coronary disease (p1⁄40.03), and diabetes (p1⁄40.01) were associated with increased requirement for erectogenic medications. CONCLUSIONS: Patients with lower IIEF scores, coronary disease, and diabetes mellitus may require higher volumes of erectogenic medications at the time of PDDU. This information may help to create standardized and efficient protocols for repeated dosing regimen.

PD40-05 EVALUATION OF LAPAROSCOPIC PYELOPLASTY AS AN ALTERNATIVE TO NEPHRECTOMY IN ADULTS WITH POORLY FUNCTIONING KIDNEYS DUE TO URETEROPELVIC OBSTRUCTION

INTRODUCTION AND OBJECTIVES: Laparoscopic pyeloplasty has been considered the gold-standard treatment for adults with ureteropelvic junction obstruction (UPJO). Likewise, it is well established in adults that a symptomatic non-functioning renal unit should be removed. This study aimed to evaluate safety, kidney function recovery and symptoms improvement after laparoscopic pyeloplasty in adults with poorly functioning kidneys due to UPJO. METHODS: Retrospective data analysis from August 2008 to November 2015, from a prospectively maintained database, was performed. Patients with poorly functioning kidney who underwent Anderson-Hynes dismembered laparoscopic pyeloplasty were included. In one patient, the retroperitoneal approach was preferred due to multiple previous abdominal surgeries. Poor function was defined as a split renal function of 15% in renal scintigraphy with Tc-99m DMSA. Pre and postoperative data were compared regarding differential renal function (DRF) and symptoms. Success was defined as split renal function stabilization (absolute variation of less than 5% in renal scintigraphy) and symptoms improvement. Outcome (renal function stabilization, intra and pos-op complications and symptoms) was further compared to a similar group of patients who underwent Anderson-Hynes dismembered laparoscopic pyeloplasty in normal functioning renal units. RESULTS: We identified 167 patients who underwent laparoscopic pyeloplasty in our service. From those, 14 patients had poor renal function, with a mean age of 37 years (23 60 years). No major intra or post-operative complications were seen. At a mean follow up of 21.2 months (4-53 m) all patients reported symptoms improvement, no cases of recurrent pyelonephritis or stone formation was seen. Until this date, no patient needed further surgical treatment as re-pyeloplasty, endoscopic treatment or nephrectomy. Complete symptom resolution was seen in 10 patients (71%). One patient, despite showing complete symptom resolution, had decreased postoperative DRF in renal scintigraphy. Overall success rate was 92.8% (13/14). Split renal function remained stable in 11 patients (78,6%), considerably decreased in 1 (7.1%) and considerably increased in 2 (14.3%) patients. Renal function stabilization, intra and post-operative complications were statically similar (p>0.05) when compared to patients with normal functioning renal units who underwent the same procedure. No patient with normal functions renal units showed improvement in DRF measured with Tc99m DMSA. CONCLUSIONS: Laparoscopic pyeloplasty is an alternative to nephrectomy in adults with poorly functioning kidneys due to UPJO, enabling good symptom control with possible considerable improvement in renal function. In this study, laparoscopic pyeloplasty in this of patients showed similar outcomes and success rates to those presented by patients with normal functioning renal units.