F. Del Giudice

Minimally invasive infrapubic inflatable penile prosthesis implant for erectile dysfunction: evaluation of efficacy, satisfaction profile and complications

Erectile dysfunction (ED), the second most common male sexual disorder, has an important impact on man sexuality and quality of life affecting also female partner’s sexual life. ED is usually related to cardiovascular disease or is an iatrogenic cause of pelvic surgery. Many non-surgical treatments have been developed with results that are controversial, while surgical treatment has reached high levels of satisfaction. The aim is to evaluate outcomes and complications related to prosthesis implant in patients suffering from ED not responding to conventional medical therapy or reporting side effects with such a therapy. One hundred eighty Caucasian male suffering from ED were selected. The patient population were divided into two groups: 84 patients with diabetes and metabolic syndrome (group A) and 96 patients with dysfunction following laparoscopic radical prostatectomy for prostate cancer (group B). All subjects underwent primary inflatable penile prosthesis implant with an infrapubic minimally invasive approach. During 12 months of follow-up, we reported 3 (1.67%) explants for infection, 1 (0.56%) urethral erosion, 1 (0.56%) prosthesis extrusion while no intraoperative complications were reported. Mean International Index of Erectile Function-5 (IIEF-5) was 8.2±4.0 and after the surgery (12 months later) was 20.6±2.7. The improvement after the implant is significant in both groups without a statistically significant difference between the two groups (P-value 0.65). Mean Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) score 1 year after the implant is 72.2±20.7, and there was no statistically significant difference between groups A and B (P-value 0.55). Implantation of an inflatable prosthesis, for treatment of ED, is a safe and efficacious approach; and the patient and partner satisfaction is very high. Surgical technique should be minimally invasive and latest technology equipment should be implanted in order to decrease after surgery common complications (infection and mechanical failure).

Effect of metabolic and antioxidant supplementation on sperm parameters in oligo-astheno-teratozoospermia, with and without varicocele: A double-blind placebo-controlled study

Since sperm require high energy levels to perform their specialised function, it is vital that essential nutrients are available for spermatozoa when they develop, capacitate and acquire motility. However, they are vulnerable to a lack of energy and excess amounts of reactive oxygen species, which can impair sperm function, lead to immotility, acrosomal reaction impairment, DNA fragmentation and cell death. This monocentric, randomised, double‐blind, placebo‐controlled trial investigated the effect of 6 months of supplementation with l‐carnitine, acetyl‐l‐carnitine and other micronutrients on sperm quality in 104 subjects with oligo‐ and/or astheno‐ and/or teratozoospermia with or without varicocele. In 94 patients who completed the study, sperm concentration was significantly increased in supplemented patients compared to the placebo (p = .0186). Total sperm count also increased significantly (p = .0117) in the supplemented group as compared to the placebo group. Both, progressive and total motility were higher in supplemented patients (p = .0088 and p = .0120, respectively). Although pregnancy rate was not an endpoint of the study, of the 12 pregnancies that occurred during the follow‐up, 10 were reported in the supplementation group. In general, all these changes were more evident in varicocele patients. In conclusion, supplementation with metabolic and antioxidant compounds could be efficacious when included in strategies to improve fertility.

The long-term prognostic value of survivin expressing circulating tumor cells in patients with high-risk non-muscle invasive bladder cancer (NMIBC)

Materials & Methods The study was conducted using tumor tissue and blood samples from 54 patients with a primary diagnosis of T1G3 NMIBC. Survivin was evaluated by reverse transcription-polymerase chain reaction in tumor tissues. CTCs were isolated from blood by CELLectionTM Dynabeads (Invitrogen, Carlsbad, CA, USA). Cells were lysed and cDNA was synthesized and analysed for the expression of CD45, CK8 and survivin. The endpoints of this longtermanalysis were disease-free survival, DFS and cancer specific survival, CSS. .

Effect of antioxidant supplementation on sperm parameters in oligo-astheno-teratozoospermia, with and without varicocele: A double blind place controlled (DBPC) study

Sperm has high energy requirement for maturation, capacitation and motility. Many factors affecting sperm quality act through decreasing energy and increasing reactive oxygen species (ROS) by causing mitochondrial dysfunction. To determine the effect of an antioxidant supplementation on sperm quality in subjects with oligoor astheno-teratozoospermia, with and without varicocele and history of difficulty conceiving. This was a monocentric, randomized, DBPC with a total of 104 patients (52 supplementation and 52 placebo) with varicocele and without. The study evaluated the efficacy of 6 months of supplementation versus placebo. Spermogram evaluation was done at the beginning of treatment (V1) and at the end of the treatment (V2). Sperm count in patients with varicocele was 39.3 +/SD 16.8 in placebo group and 49.4 +/18.9 in supplementation group; in patients without varicocele 47.5 +/7.9 in placebo group and 52.3 +/9.1 in supplementation group. Total sperm motility in patients with varicocele was 33.9+/6.9 in placebo group and 38.3+/8.0 in supplementation group; in patients without varicocele was 35.0 +/7.5 in placebo group and 39.9 +/8.0 in supplementation group. Progressive sperm motility in patients with varicocele was 23.1 +/SD 6.7 in placebo group and 27.4 +/7.9 in supplementation group; in patients without varicocele was 25.1 +/7.0 in placebo group and 29.7 +/9.1 in supplementation group. In our study, at the end of the treatment we observed a marked increase in quality parameters of sperm such as count and in total and progressive motility especially in varicocele patients. The supplementation was safe and no adverse events were observed.