Ricardo Reges

Long-term administration of BAY 41-2272 prevents bladder dysfunction in nitric oxide-deficient rats†‡

Chronic blockade of nitric oxide (NO) synthesis leads to detrusor smooth muscle overactivity. This study aimed to evaluate the protective effects of BAY 41‐2272, a soluble guanlylate cyclase activator, on changes in cystometric parameters in NO‐deficient rats.

Primary leiomyosarcoma of the inferior vena cava: How should it be treated and the vein anatomy re-established?

Abstract:  Retroperitoneal sarcomas are responsible for 10–15% of all sarcomas in soft tissue. Leiomyosarcoma of the inferior vena cava has a slow growth rate, and the initial symptoms are related to the affected segment of the vein. A 56‐year‐old woman with leiomyosarcoma of the middle segment of the inferior vena cava underwent en‐block resection of the affected segment of the vena cava and the right kidney. The inferior segment of the vena cava was tied, and the superior segment was anastomosed to the left renal vein using a polyester prosthesis. The patient was followed for 14 months and did not present any postoperative intercurrence. In conclusion, the leiomyosarcoma is a rare tumor that should be surgically treated with wide margin resections in order to prevent relapses.

Effect of acute administration of sildenafil to rats with detrusor overactivity induced by chronic deficiency of nitric oxide

PURPOSE Recently, the effect of phosphodiesterase inhibitors (PDE5i) in the lower urinary tract symptoms (LUTS) associated to benign prostatic hyperplasia have been studied thoroughly. However, it remains unclear how the PDE5i improve LUTS. Therefore, the aim of the present study was to evaluate the potential of acute administration of the PDE5i sildenafil to improve detrusor overactivity (DO) induced by Nω-nitro-L-arginine methyl ester hydrochloride (L-NAME), an nitric oxide sinthase (NOS) inhibitor, in rats. MATERIALS AND METHODS Twenty-seven MALE adult Wistar Rats were divided into the following groups: (1) control, (2) L-NAME, (3) sildenafil alone, and (4) L-NAME + sildenafil. The NOS blocker L-NAME (20 mg/rat/day) was given in the drinking water. Sildenafil (100 µg/kg) was administrated intravenously (i.v.) acutely, diluted in cremophor, propylene glycol and water. All animals underwent to anesthetized cystometograms. RESULTS The chronic and systemic administration of L-NAME markedly increased the number of non voiding contractions (2.62 (± 0.89)), and frequency of micturition (1.97 (± 0.78)), as well increased volume threshold (2.83 mL (± 1.64)) compared with control group, the number of non voiding contractions (1.17 (± 0.75)), frequency of micturition (1.08 (± 0.65)) and volume threshold (1.16 mL (± 0.38)), p < 0.001, p = 0.01, and p = 0.04, respectively. Sildenafil infusion decreased the number of micturition cycles significantly from the baseline to end point (-0.93 (± 0.34)) in nitric oxide (NO) deficient animals compared with sildenafil infusion alone (control) in animals with normal NO level (0.13 (± 0.25)), p = 0.03. CONCLUSION Systemic reduction of nitric oxide causes detrusor overactivity and acute infusion of sildenafil reduces the number of micturition cycles in chronic NO-deficient rats.

Seguimiento a largo plazo del soporte uretral tendinoso: un enfoque anatómico para incontinencia urinaria de esfuerzo

Los procedimientos tipo sling han sido utilizados por decadas para el manejo de la incontinencia urinaria de esfuerzo (IUE) femenina, pero solo en la decada pasada han llegado a ser la tecnica de eleccion. Los procedimientos minimamente invasivos son el procedimiento de eleccion en algunos centros por su eficacia y baja morbilidad. El soporte uretral tendinoso (TUS) representa un enfoque anatomico que consiste en colocar una cincha de baja tension a nivel de la uretra media, anclada al arco tendineo de manera bilateral. De febrero 1999 a octubre 2000, 25 pacientes femeninas con IUE y con una edad media de 53 anos fueron intervenidas mediante TUS. De ellas, 23 pudieron evaluarse a largo plazo con un seguimiento un maximo 72 meses. Despues de 6 meses, 20 pacientes (87%) se encontraban secas, 2 (8,7%) mejoraron y 1 (4,3%) era incontinente. Sin embargo, al final del seguimiento, 15 pacientes estaban continentes (65,2%), 3 (13%) mejoraron y 5 (21%) seguian incontinentes. Por lo que, el TUS es un concepto que merece investigaciones adicionales.

Administration of BAY 41-2272 prevents bladder dysfunction in nitric-oxide deficient rats

OBJECTIVE to evaluate the protective effects of BAY 41-2272, a soluble guanylate cyclase activator, on changes in cystometric parameters in rats deficient in nitric oxide (NO). METHODS Rats were divided into the following groups: (a) control; (b) DMSO; (c) L-NAME; (d) BAY 41-2272 alone; (e) L-NAME + BAY 41-2272. The NO synthase blocker L-NAME (20 mg/rat/day) was given in drinking water concomitantly or not with BAY 41-2272 (10 mg/kg/day, given by gavage). RESULTS Chronic L-NAME treatment markedly increased the mean arterial blood pressure, and co-treatment with BAY 41-2272 nearly reversed L-NAME-induced rise on mean arterial blood pressure. Non-void contractions were significantly increased in L-NAME group (0.90 ± 0.1 number/minute) compared with either DMSO or control group (0.49 ± 0.1 number/minute), which were prevented by co-treatment with BAY 41-2272 (0.56 ± 025 number/minute; p < 0.05). The threshold and peak pressure increased by 70 and 44%, respectively, after chronic L-NAME treatment, while co-treatment with BAY 41-2272 largely attenuated both effects (27 and 22% increase, respectively). The frequency of micturition cycles decreased by about of 50% in L-NAME-treated rats compared with control animals, and co-treatment with BAY 41-2272 normalized this parameter. CONCLUSIONS Our data show that long-term oral administration of BAY 41-2272 counteracts the bladder dysfunction seen in NO-deficient rats, indicating that restoration of the NO-cGMP pathway by this compound may be of beneficial value to treat bladder symptoms.

MP26-05 RELAXING EFFECT OF PHOSPHODIESTERASE INHIBITORS AND β3-ADRENOCEPTOR AGONIST IN AN EXPERIMENTAL MODEL OF DETRUSOR OVERACTIVITY

nanoparticles. Based on characterization of the ECA matrix by biomimetic analyses, this novel collagen-based biotextile may serve as a promising pelvic fascial substitute material for slings and reconstructive surgery. These findings support further experimentation of adding other nano-particles and cross-linking manufacturing steps to further enhance the balance between additional biomechanical and biocompatibility features.

Split Technique in Horseshoe Kidney Transplantation

Background/Aims: Nowadays, owing to a greater number of patients waiting for a kidney donation and to a shortage of organs donated, more suitable organ acceptance criteria have been formulated. Horseshoe kidney transplantations have become feasible giving good allograft outcomes. The aim of this paper is to illustrate the split technique in horseshoe kidney transplantation and to report long-term results. Methods: During the period from February 2004 to February 2005, two horseshoe kidneys were harvested from multiple organ retrieval. The surgical features and outcomes of these 2 cases are described separately. Mean follow-up time was 12.3 months. Conclusions: Organs that were previously said to be marginal are being used more regularly and the more suitable selection does not exclude elderly donors with or without underlying diseases. Horseshoe kidney transplantation requires greater skills and experience of the surgeons compared to conventional kidney transplantation. This kind of renal abnormality has to be considered a feasible option for transplantation. Good long-term results are reported.