Furio Pirozzi Farina

Combination of intralesional verapamil and oral antioxidants for Peyronie's disease: a prospective, randomised controlled study.

The aim of this study was to evaluate the efficacy of the association of intralesional verapamil (ILV) injection with oral antioxidants compared with ILV monotherapy in patients with early onset of Peyronies disease (PD) at 12‐week follow‐up. Group A (n = 52) received ILV 10 mg weekly for 12 weeks, while group B (n = 53) received ILV 10 mg weekly for 12 weeks + antioxidants orally one tablet once a day for 3 months. The main efficacy outcomes were the change in plaque size (PS), penile curvature (PC), visual analogue score (VAS), IIEF‐15 and IIEF‐15 subdomains. Both groups showed significant improvement from baseline to week 12 relative to PS and PC, while group B also in IIEF‐15 score (mean difference: 5.51, P < 0.01) and VAS (mean difference: −2.71, P < 0.01). No significant differences were observed between both groups in PS and PC. Finally, both groups showed significant increase in orgasmic function (IIEF‐OF) and overall satisfaction (IIEF‐OS), while group B showed significant improvement also in intercourse satisfaction (IIEF‐IS). Significant differences were found relative to IIEF‐OF, IIEF‐IS, IIEF‐OS and VAS scores in the group B compared with group A. Patients affected by PD may benefit from combination treatment with ILV and oral antioxidants thanks to the improvement in IIEF‐OF, IIEF‐IS and IIEF‐OS at 12 weeks.

Comments concerning the real risk of sexual adverse events secondary to the use of 5-ARIs

Treatment-induced sexual dysfunctions (SD) are a recurrent and controversial topic in recent literature on the adverse events related to the use of 5-alpha-reductase inhibitors (5ARIs) (1, 2). In order to deal adequately with the various aspects of this topic, it is necessary to first cover some of the steps that allow a better definition and understanding of the subject.

[Painful ejaculation: a review].

Pain at ejaculation/orgasm perceived in perineum, urethra and/or urethral meatus, has a profound impact on the quality of life of the affected man. Although underestimated, this condition is reported to have a 1-9.7% prevalence over the general population. METHODS. Structured review of the relevant available literature. RESULTS. Among the main causes of pain experienced at ejaculation/orgasm are: prostatevesicular causes (LUTS/BPH, prostatitis, ejaculatory duct obstruction, vesicular stone), postsurgical causes (radical prostatectomy, inguinal hernioplasty), pharmacologic causes (antidepressants), psychogenic causes (psychosexual conflicts, sexual abuse), rare causes. For these pathologies, diagnostic and therapeutic strategies have been proposed. CONCLUSIONS. Ejaculatory pain is associated with a high level of personal distress, and represents a possible request for help within the andrologic/urologic area. Each field specialist should be competent in correctly interpreting every single case, in order to manage it appropriately.