G. Daricello

PSA reduction (after antibiotics) permits to avoid or postpone prostate biopsy in selected patients.

Microscopic foci of prostatitis may induce prostate-specific antigen (PSA) increase. PSA reduction after antibiotics might identify those patients in whom biopsy can be avoided. Ninety-nine patients received ciprofloxacin for 3 weeks, of whom 59 showed PSA reduction. Histology detected small foci of prostatitis in 65% of cases. Carcinoma was found in 40 and 20.3% of patients with unchanged or decreased PSA, respectively (P=0.03). No cancer was detected if PSA decreased below 4 ng/ml or more than 70%. Biopsy can be postponed, with a low risk of missing a cancer, if PSA decreases more than 70% or below 4 ng/ml.

Long‐term outcome of antiandrogen monotherapy in advanced prostate carcinoma: 12‐year results of a phase II study

To present the long‐term outcome of patients with locally advanced or metastatic prostate carcinoma treated by first‐line antiandrogen monotherapy.

Results of a Phase I-II Pilot Study with Intravescical Gemcitabine in Superficial Bladder Cancer (Ta-T1)

To study the ablative activity of intravescical gemcitabine against superficial transitional cell carcinoma of the bladder at different doses and concentrations. Methods Twenty-seven patients were treated with intravescical gemcitabine after transurethral resection, during which one to three papillary marker lesions were left unresected. Starting 14 days after transurethral resection, six gemcitabine instillations were given at weekly intervals. Gemcitabine, diluted in 50 mL of saline solution and maintained for 2 hr, was given at a dose of 500, 1000 and 2000 mg in groups of nine patients each. A complete response (CR) was defined as negative cutologycystoscopy and biopsy findings. Results Of the 27 patients, one was lost to follow-up, and of the remaining 26 patients, six (23%) achieved a CR. A CR was achieved in one patient (12.5%), in two patients (22.2%) and in three patients (33.3%) at dose of 500, 1000 and 2000 mg, respectively. A partial response was obtained in two additional patients (22%) at a dose of 500 and 1000 mg. Bladder Tis was diagnosed in two patients with a CR at 8 and 3 months, respectively. Systemic and local tolerability was excellent, and the interruption of treatment was not required. Conclusions Our experience has shown the good tolerability and the potential efficacy of intravescical gemcitabine against recurrent transitional cell carcinoma of the bladder. Gemcitabine could be proposed, if our results are confirmed by larger studies, as a second-line therapy in patients who cannot tolerate more aggressive intravescical therapy.

[Results of a single blind study placebo vs Diallil-Tiosulphinate, Nucipherine and Diosgenin in patients reponders to Tadalafil 5 mg].

The aim of the study is to evaluate the efficacy of Diallil-Tiosulphinate, Nuciepherine and Diosgenin in the treatment of erectile dysfunction. In our study were selected 120 men affected by erectile dysfunction. They were filled in a self-administered questionnaire International Index of Sexual Medicine. 74 of them reported a moderate erectile dysfunction and 46 reported a severe ED. All patients were treated with Tadalafil 5 mg once a day for 90 days. They were re-evaluated with the same questionnaire after three months of therapy. In 75% of the patients there was an improvement of IIEF-5 score. Only the 90 patients responders to Tadalafil once a day were randomized and divided into two groups, each formed by 45 subjects. The group A was treated with the association of Diallil-Tiosulfinate, Nucipherine and Diosgenin on alternate days. The patients of group B were treated with placebo. After three months, there was a new evaluation with IIEF-5 score. In group A we reported a maintenance of improvement post-Tadalafil in 36 patients;in group B, only 18 patients have maintained the previous improvement, according to IIEF-5 score. The χ2 test is 13,38, with a p-value of about 0,00013. The maintenances odds ratio, confronting the two groups, is 6 with a confidences interval of 95%. The study shows that the utilization of the association therapy in patients with erectile dysfunction responders to Tadalafil once a day is able to duplicate the odds of maintenances improvement compared to placebo.