RESUMEN
PURPOSE: This study aimed to examine current global practices in regenerative therapy (RT) for erectile dysfunction (ED) and to establish expert recommendations for its use, addressing the current lack of solid evidence and standardized guidelines. MATERIALS AND METHODS: A 39-question survey was developed by senior Global Andrology Forum (GAF) experts to comprehensively cover clinical aspects of RT. This was distributed globally via a secure online Google Form to ED specialists through the GAF website, international professional societies, and social media, the responses were analyzed and presented for frequencies as percentages. Consensus on expert recommendations for RT use was achieved using the Delphi method. RESULTS: Out of 479 respondents from 62 countries, a third reported using RT for ED. The most popular treatment was low-intensity shock wave therapy (54.6%), followed by platelet-rich plasma (24.5%) and their combination (14.7%), with stem cell therapy being the least used (3.7%). The primary indication for RT was the refractory or adverse effects of PDE5 inhibitors, with the best effectiveness reported in middle-aged and mild-to-moderate ED patients. Respondents were confident about its overall safety, with a significant number expressing interest in RT's future use, despite pending guidelines support. CONCLUSIONS: This inaugural global survey reveals a growing use of RT in ED treatment, showcasing its diverse clinical applications and potential for future widespread adoption. However, the lack of comprehensive evidence and clear guidelines requires further research to standardize RT practices in ED treatment.
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6-Cyanodopamine is a novel catecholamine released from rabbit isolated heart. However, it is not known whether this catecholamine presents any biological activity. Here, it was evaluated whether 6-cyanodopamine (6-CYD) is released from rat vas deferens and its effect on this tissue contractility. Basal release of 6-CYD, 6-nitrodopamine (6-ND), 6-bromodopamine, 6-nitrodopa, and 6-nitroadrenaline from vas deferens were quantified by LC-MS/MS. Electric-field stimulation (EFS) and concentration-response curves to noradrenaline, adrenaline, and dopamine of the rat isolated epididymal vas deferens (RIEVD) were performed in the absence and presence of 6-CYD and /or 6-ND. Expression of tyrosine hydroxylase was assessed by immunohistochemistry. The rat isolated vas deferens released significant amounts of both 6-CYD and 6-ND. The voltage-gated sodium channel blocker tetrodotoxin had no effect on the release of 6-CYD, but it virtually abolished 6-ND release. 6-CYD alone exhibited a negligible RIEVD contractile activity; however, at 10 nM, 6-CYD significantly potentiated the noradrenaline- and EFS-induced RIEVD contractions, whereas at 10 and 100 nM, it also significantly potentiated the adrenaline- and dopamine-induced contractions. The potentiation of noradrenaline- and adrenaline-induced contractions by 6-CYD was unaffected by tetrodotoxin. Co-incubation of 6-CYD (100 pM) with 6-ND (10 pM) caused a significant leftward shift and increased the maximal contractile responses to noradrenaline, even in the presence of tetrodotoxin. Immunohistochemistry revealed the presence of tyrosine hydroxylase in both epithelial cell cytoplasm of the mucosae and nerve fibers of RIEVD. The identification of epithelium-derived 6-CYD and its remarkable synergism with catecholamines indicate that epithelial cells may regulate vas deferens smooth muscle contractility.
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Dopamina , Contracción Muscular , Conducto Deferente , Masculino , Animales , Conducto Deferente/efectos de los fármacos , Conducto Deferente/metabolismo , Conducto Deferente/fisiología , Contracción Muscular/efectos de los fármacos , Ratas , Dopamina/metabolismo , Dopamina/farmacología , Ratas Wistar , Norepinefrina/farmacología , Norepinefrina/metabolismo , Músculo Liso/efectos de los fármacos , Músculo Liso/metabolismo , Músculo Liso/fisiología , Estimulación Eléctrica , Epinefrina/farmacología , Tirosina 3-Monooxigenasa/metabolismoRESUMEN
OBJECTIVE: To explore factors influencing microdissection testicular sperm extraction (micro-TESE) success in hypogonadal men with nonobstructive azoospermia (NOA). DESIGN: A cohort study. SETTING: University-affiliated male reproductive health center. PATIENT(S): A total of 616 consecutive patients with NOA and hypogonadism (total testosterone [T] levels <350 ng/dL) underwent micro-TESE between 2014 and 2021. All patients had no prior sperm retrieval (SR) history. INTERVENTION(S): Patients aged 23-55 years underwent comprehensive clinical, laboratory, and histopathological diagnostic evaluation for NOA and were further categorized into two cohorts on the basis of pre-SR hormonal stimulation. MAIN OUTCOME MEASURE(S): A multivariable logistic regression analysis explored the associations between patient variables and micro-TESE success, defined as the presence of viable spermatozoa in extracted specimens. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were computed to assess the relationship between SR success and relevant predictors. Sperm retrieval rates were compared between patients receiving or not hormonal stimulation, and logistic regression analysis evaluated the effect of baseline follicle-stimulating hormone levels (i.e., normogonadotropic vs. hypergonadotropic classes) on SR success. RESULT(S): The overall micro-TESE success rate was 56.6%. Baseline follicle-stimulating hormone levels (aOR, 0.97; 95% CI, 0.94-0.99), pre-SR hormonal stimulation (aOR, 2.54; 95% CI, 1.64-3.93), presence of clinical varicocele (aOR, 0.05; 95% CI, 0.01-0.51), history of previous varicocelectomy (aOR, 2.55; 95% CI, 1.26-5.16), and testicular histopathology were independent predictors of SR success. Among hormone-pretreated patients, pre-micro-TESE T levels and delta T (an absolute increase in T levels from baseline) were associated with SR success. A pre-micro-TESE T level of 418.5 ng/dL (area under the curve value: 0.78) and a delta T of 258 ng/dL (area under the value: 0.76) distinguished patients with positive and negative SR outcomes. Subgroup analysis showed that pre-SR hormonal stimulation yielded a greater benefit for normogonadotropic patients than for those who were hypergonadotropic. CONCLUSION(S): This study underscores the association between clinical factors and micro-TESE success in hypogonadal men with NOA. Although causality is not established, our findings suggest that these patients may benefit from pre-SR interventions, particularly hormonal stimulation and varicocele repair. CLINICAL TRIAL REGISTRATION NUMBER: NCT05110391.
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AIMS: To evaluate the basal release of 6-nitrodopamine (6-ND) from human isolated seminal vesicles (HISV) and to characterize its action and origin. MAIN METHODS: Left HISV obtained from patients undergoing prostatectomy surgery was suspended in a 3-mL organ bath containing warmed (37 °C) and gassed (95%O2:5%CO2) Krebs-Henseleit's solution (KHS) with ascorbic acid. An aliquot of 2 mL of the supernatant was used to quantify catecholamines by LC-MS/MS. For functional studies, concentration-responses curves to catecholamines were obtained, and pEC50 and Emax values were calculated. Detection of tyrosine hydroxylase and S100 protein were also carried out by both immunohistochemistry and fluorescence in-situ hybridization assays (FISH). KEY FINDINGS: Basal release of 6-ND was higher than the other catecholamines (14.76 ± 14.54, 4.99 ± 6.92, 3.72 ± 4.35 and 5.13 ± 5.76 nM for 6-ND, noradrenaline, adrenaline, and dopamine, respectively). In contrast to the other catecholamines, the basal release of 6-ND was not affected by the sodium current (Nav) channel inhibitor tetrodotoxin (1 µM; 10.4 ± 8.9 and 10.4 ± 7.9 nM, before and after tetrodotoxin, respectively). All the catecholamines produced concentration-dependent HISV contractions (pEC50 4.1 ± 0.2, 4.9 ± 0.3, 5.0 ± 0.3, and 3.9 ± 0.8 for 6-ND, noradrenaline, adrenaline, and dopamine, respectively), but 6-ND was 10-times less potent than noradrenaline and adrenaline. However, preincubation with very low concentration of 6-ND (10-8 M, 30 min) produced significant leftward shifts of the concentration-response curves to noradrenaline. Immunohistochemical and FISH assays identified tyrosine hydroxylase in tissue epithelium of HISV strips. SIGNIFICANCE: Epithelium-derived 6-ND is the major catecholamine released from human isolated seminal vesicles and that modulates smooth muscle contractility by potentiating noradrenaline-induced contractions.
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Dopamina , Norepinefrina , Vesículas Seminales , Humanos , Masculino , Norepinefrina/farmacología , Norepinefrina/metabolismo , Vesículas Seminales/efectos de los fármacos , Vesículas Seminales/metabolismo , Dopamina/metabolismo , Dopamina/farmacología , Persona de Mediana Edad , Epitelio/metabolismo , Epitelio/efectos de los fármacos , Contracción Muscular/efectos de los fármacos , Anciano , Catecolaminas/metabolismoRESUMEN
BACKGROUND: 6-Nitrodopamine (6-ND) is a novel endogenous catecholamine that has a potent relaxant action on vascular smooth muscle in vitro. OBJECTIVES: To evaluate the basal release of 6-ND and noradrenaline from rabbit-isolated corpus cavernosum (RbCC) and its relaxing action on this tissue. METHODS: Rabbit corpus cavernosa were dissected and suspended in a 5-mL organ bath containing oxygenated Krebs-Henseleit's solution. 6-ND and noradrenaline release was quantified by liquid chromatography coupled to tandem mass spectrometry. The relaxant activity of 6-ND was assessed in RbCC strips pre-contracted with endothelin-1 (10 nM). RESULTS: Rabbit corpus cavernosum presented basal release of both 6-ND (2.9 ± 0.8 ng/mL, n = 12) and noradrenaline (1.7 ± 1.3 ng/mL, n = 12). The 6-ND release was reduced by pre-treatment with Nω-nitro-l-arginine methyl ester (l-NAME) (100 µM), whereas that of noradrenaline was unaffected. Tetrodotoxin (TTX, 1 µM) abolished the noradrenaline release but had no effect on 6-ND release, indicating a non-neurogenic origin for 6-ND. 6-ND and the selective dopamine D2-agonist L-741,626 caused concentration-dependent RbCC relaxations (pEC50 of 11 ± 0.15 and 11.15 ± 0.28, respectively). Pre-treatment with either l-NAME or the soluble guanylate cyclase inhibitor 1H-[1,2,4] oxadiazolo[4,3-a]quinoxalin-1-on (ODQ) (100 µM) caused a rightward shift of the concentration-response curve to 6-ND, without affecting the L-741,626 responses. In TTX (100 nM)-pre-treated preparations, neither l-NAME nor ODQ shifted the 6-ND concentration-response curve. Dopamine, noradrenaline, and adrenaline caused concentration-dependent RbCC contractions. Pre-incubation with 6-ND concentration-dependently inhibited the dopamine-induced contractions, without affecting those induced by either noradrenaline or adrenaline. DISCUSSION AND CONCLUSION: 6-Nitrodopamine is the most potent endogenous relaxant agent in RbCC ever described and represents a novel mechanism by which NO causes corpus cavernosum smooth muscle relaxation. The finding that 6-ND acts as a truly selective dopamine D2-receptor antagonist indicates that the balance of dopamine and 6-ND release/synthesis may be the main mechanism that modulates corpus cavernosum smooth muscle tonus in vivo.
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Relajación Muscular , Norepinefrina , Pene , Animales , Conejos , Pene/efectos de los fármacos , Masculino , Norepinefrina/farmacología , Relajación Muscular/efectos de los fármacos , Dopamina/metabolismo , Dopamina/farmacologíaRESUMEN
ABSTRACT CONTEXT: Lymphedema consists of extracellular fluid retention caused by lymphatic obstruction. In chronic forms, fat and fibrous tissue accumulation is observed. Genital lymphedema is a rare condition in developed countries and may have primary or acquired etiology. It generally leads to urinary, sexual and social impairment. Clinical treatment usually has low effectiveness, and surgical resection is frequently indicated. CASE REPORT: We report a case of a male-to-female transgender patient who was referred for treatment of chronic genital lymphedema. She had a history of pelvic radiotherapy to treat anal cancer and of liquid silicone injections to the buttock and thigh regions for esthetic purposes. Radiological examinations showed signs both of tissue infiltration by liquid silicone and of granulomas, lymphadenopathy and lymphedema. Surgical treatment was performed on the area affected, in which lymphedematous tissue was excised from the scrotum while preserving the penis and testicles, with satisfactory results. Histopathological examination showed alterations compatible with tissue infiltration by exogenous material, along with chronic lymphedema. CONCLUSION: Genital lymphedema may be caused by an association of lesions due to liquid silicone injections and radiotherapy in the pelvic region. Cancer treatment decisions for patients who previously underwent liquid silicone injection should take this information into account, since it may represent a risk factor for radiotherapy complications.
RESUMO CONTEXTO: O linfedema consiste de retenção de fluido extracelular causada por obstrução linfática. Nas formas crônicas, observa-se acúmulo de tecido adiposo e fibrose. O linfedema genital é uma doença rara em países desenvolvidos e pode ter etiologia primária ou adquirida, em geral cursando com disfunções urinária e sexual, bem como com prejuízo do convívio social. O tratamento clínico é, em geral, pouco efetivo, indicando-se com frequência a abordagem cirúrgica, com excisão da área afetada. RELATO DE CASO: Relata-se o caso de paciente feminina transgênero, encaminhada para tratamento de linfedema genital crônico. Havia antecedente pessoal de tratamento de câncer de canal anal com radioterapia pélvica e de injeções de silicone líquido em glúteos e coxas com finalidade estética. Exames radiológicos mostraram tanto sinais de infiltração tecidual por silicone líquido como granulomas e linfadenopatia como de linfedema. Foi realizado o tratamento cirúrgico da área afetada, com excisão do tecido linfadenomatoso do escroto, preservando o pênis e testículos, com resultado satisfatório. A análise histopatológica mostrou achados compatíveis com infiltração tecidual por material exógeno, bem como com linfedema crônico. CONCLUSÃO: O linfedema genital pode ser causado pela associação de lesão por injeção de silicone líquido e radioterapia na região pélvica. As decisões no tratamento de neoplasias em pacientes previamente submetidos a injeção de silicone líquido devem levar em conta esse fato, já que pode representar fator de risco para complicações de tratamento radioterápico.
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Humanos , Masculino , Femenino , Enfermedades del Pene/etiología , Siliconas/efectos adversos , Personas Transgénero , Linfedema/etiología , Enfermedades del Pene/cirugía , Enfermedades del Pene/diagnóstico por imagen , Colgajos Quirúrgicos , Espectroscopía de Resonancia Magnética , Linfedema/cirugía , Linfedema/diagnóstico por imagenRESUMEN
Purpose To validate the Quality of Erection Questionnaire (QEQ) considering Brazilian social-cultural aspects. Materials and Methods To determine equivalence between the Portuguese and the English QEQ versions, the Portuguese version was back-translated by two professors who are native English speakers. After language equivalence had been determined, urologists considered the QEQ Portuguese version suitable. Men with self-reported erectile dysfunction (ED) and infertile men who had a stable sexual relationship for at least 6 months were invited to answer the QEQ, the International Index of Erectile Function (IIEF) and the RAND 36-Item Health Survey (RAND-36). The questionnaires were presented together and answered without help in a private room. Internal consistency (Cronbach’s α), test-retest reliability (Spearman), convergent validity (Spearman correlation) coefficients and known-groups validity (the ability of the QEQ Portuguese version to differentiate erectile dysfunction severity groups) were assessed. Results We recruited 197 men (167 ED patients and 30 non-ED patients), mean age of 53.3 and median of 55.5 years (23-82 years). The Portuguese version of the QEQ had high internal consistency (Cronbach α=0.93), high stability between test and retest (ICC 0.83, with IC 95%: 0.76-0.88, p<0.001) and Spearman correlation coefficient r=0.82 (p<0.001), which demonstrated the high correlation between the QEQ and IIEF results. The correlations between the QEQ and RAND-36 were significantly low in ED (r=0.20, p=0.01) and non-ED patients (r=0.37, p=0.04). Conclusion The QEQ Portuguese version presented good psychometric properties and high convergent validity in relation to IIEF. The low correlations between the QEQ and the RAND-36, as well as between the IIEF and the RAND-36 indicated IIEF and QEQ specificity, which may have resulted from the patients’ psychological adaptations that minimized the impact of ED on ...
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Adulto , Anciano , Anciano de 80 o más Años , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven , Disfunción Eréctil/diagnóstico , Erección Peniana , Calidad de Vida , Encuestas y Cuestionarios/normas , Brasil , Comparación Transcultural , Lenguaje , Satisfacción Personal , Psicometría/métodos , Reproducibilidad de los Resultados , Índice de Severidad de la Enfermedad , Estadísticas no Paramétricas , TraduccionesRESUMEN
Pacientes diabéticos, candidatos a transplante renal, necessitam de cuidados odontológicos, curativos e preventivos, para erradicação de focos infecciosos e manutenção da saúde bucal, sendo um fator de êxito do transplante renal. Com o objetivo de avaliar as condições de saúde bucal de diabéticos candidatos a transplante renal, foram estudados dez doentes, sendo quatro mulheres e seis homens, com idade entre 23 e 59 anos, destacando-se a prevenção e o tratamento, mediante Protocolo do Serviço de Odontologia do HC da Unicamp, avaliando-se as doenças odontológicas prevalentes (doença periodontal, cárie e problema endodôntico e a necessidade de extração dentária). Todos os doentes examinados apresentavam doença periodontal, sendo que, em oito deles, diagnosticou-se cárie e, em cinco, houve necessidade de extração dentária. A pesquisa revelou doença periodontal com índice de Diagnóstico e Resposta Periodontal (PSR). Variando de 1 a 4, sendo Código 1 em um paciente (10%), Código 2 em quatro (40,0%), Código 3 em dois (20%) e Código 4 nos outros três (30,0%). O índice de Sangramento Gengival variou de 20 a 100%, com maioria, entre 21 e 40% (30% dos pacientes). O índice de Placa Bacteriana variou de 64 a 100%, sendo 100% em 90% dos pacientes. O CPO-D variou de 11 a 32, sendo a maioria de 26 a 32 (50% dos pacientes). O tratamento consistiu na remoção dos focos infecciosos. Assim, o diagnóstico e indicação do tratamento dessas doenças, concorrem para a diminuição do risco e aumento do sucesso do transplante, evidenciando a obrigatoriedade do tratamento odontológico em todos os pacientes, por apresentarem alta incidência de focos de infecção bucal.
The aim of this study was to evaluate the oral health in ten diabetic renal transplant candidates, four women and six men, between 23 and 59 years old. A pre-transplantation dental guideline was established to prepare the patient to the surgery decreasing the risk of infection. All the patients who underwent the dental treatment had periodontal disease; eight of them whit caries diagnosis; five needed extraction. All the patients were treated by removing the focus of infection so the diagnosis and indications of treatment of these diseases leads to increase the risk and raise success of the transplantation. In summary, all diabetic renal transplant candidates need to perform a pre-operative dental care, treat all active dental disease and essentially reinforce oral hygiene and home care instructions to improve survival rates of transplantation. Appropriate follow-up and oral health care must be arranged by a specialist.
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Humanos , Masculino , Femenino , Adulto , Insuficiencia Renal/complicaciones , Salud Bucal , Trasplante de Riñón , Trasplante de Riñón/efectos adversosRESUMEN
A disfunção erétil ou "incapacidade de obter e manter ereção peniana" é condição antiga na história da humanidade. No entanto, ainda é uma entidade muito frequente nos consultórios médicos que merece atenção, abordagem e tratamento específico.Apesar do grande avanço da medicina, a história clínica e exame físico são partes fundamentais no diagnóstico e conduta desses pacientes. Durante anamnese detalhada, as causas etiológicas podem ser facilmente identificadas e direcionar a forma de tratamento mais adequada.Nos últimos anos vários novos métodos terapêuticos foram desenvolvidos e outros, utilizados no passado, foram aperfeiçoados. Dentre esses, os principais são: os inibidores da 5-fosfodiesterase (5FDE), avaliação psicológica, injeções intracavernosas e próteses penianas.Com certeza, a medicação via oral utilizada sob demanda mudou a história da disfunção erétil e se tornou o tratamento mais utilizado e efetivo para esse grupo de pacientes. Por esse motivo, especialistas no assunto se referem à história da disfunção erétil como "era pré e pós-inibidores da 5FDE".
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Humanos , Masculino , Disfunción Eréctil/diagnóstico , Disfunción Eréctil/etiología , Disfunción Eréctil/fisiopatología , Disfunción Eréctil/psicología , Disfunción Eréctil/terapia , Salud del HombreAsunto(s)
Anciano , Conducta Sexual , Disfunción Eréctil , Salud del Anciano , Sexualidad , Disfunción Eréctil/terapiaRESUMEN
Apresentamos a organizaçäo básica, funcionamento e resultados obtidos pelo trabalho desenvolvido na Central de Captaçäo de Orgäos da Unicampi. Sobre os resultados, discutimos a respeito da recusa familiar e o número de doadores por milhäo de habitantes, mostrando que os índices de recusa familiar estäo dentro das melhores taxas mundiais e que o número de doadores por milhäo de habitantes está muito abaixo do esperado se comparado com os melhores centros. Concluímos que deve haver mais empenho dos profissionais de saúde na detecçäo, notificaçäo e preservaçäo dos potenciais doadores, melhorando, assim, o índice de doadores por milhäo de habitantes
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Humanos , Recién Nacido , Lactante , Preescolar , Niño , Adolescente , Adulto , Persona de Mediana Edad , Actitud del Personal de Salud , Obtención de Tejidos y Órganos/estadística & datos numéricos , Trasplante de Órganos , Donantes de Tejidos/provisión & distribución , Brasil , Obtención de Tejidos y Órganos/historia , Obtención de Tejidos y Órganos/métodos , Donantes de TejidosRESUMEN
Cinco pacientes submetidos a transplante renal evoluíram com linfoceles sintomáticas, quatro com hidronefrose e reduçäo da funçäo renal e um com dor e compressäo inguinal-escrotal. Foram tratados pela técnica de marsupializaçäo intraperitoneal videolaparoscópica. O tempo médio de cirurgia foi de 96 minutos (variou de45 a 210 min.) e o sangramento foi desprezível. Ocorreu em um paciente a secçäo acidental do ureter do rim transplantado, que foi tratada por cirurgia aberta, com bom resultado. Houve recidiva da linfocele em outro paciente, que foi drenada externamente com sucesso. Os pacientes receberam alta em média depois de 2,7 dias e foram acompanhados por um tempo médio de 11,4 meses, ficando todos curados
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Humanos , Masculino , Adolescente , Adulto , Persona de Mediana Edad , Trasplante de Riñón/efectos adversos , Laparoscopía , Linfocele/cirugía , Hidronefrosis/etiología , Linfocele/etiologíaRESUMEN
Paciente com epispádia incontinente, 19 anos, submetida a enterocistoplastia e correçao uretral, que engravidou. Durante a gestaçao, apresentou várias infecçoes urinárias, sem comprometimento da bolsa ileal, da funçao renal ou do feto. Foi submetida a cesariana eletiva, a termo, sem intercorrências tanto para o feto quanto para a mae. As dificuldades no manuseio destas pacientes pelo obstetra sao discutidas.
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Humanos , Femenino , Embarazo , Adulto , Antibacterianos/uso terapéutico , Epispadias/cirugía , Íleon/cirugía , Infecciones Urinarias/tratamiento farmacológico , Complicaciones del Embarazo , Uretra/cirugía , Incontinencia Urinaria/cirugía , CesáreaRESUMEN
Com o objetivo de verificar a eficácia e a tolerabilidade da fosfomicina trometamol versus sulfametoxazol-trimetoprima na profilaxia de infecçåo urinária em uretrocistoscopia, foi realizado estudo prospectivo e randomizado em 90 pacientes. Foram distribuídos ao acaso em três grupos de 30 pacientes, que receberam, duas horas antes do procedimento: 3.000 mg de fosfomicina trometamol em dose única (Grupo I); 800 mg de sulfametoxazol e 160 mg de trimetoprima a cada 12 horas continuando por mais três dias (Grupo II); um comprimido de placebo (Grupo III). Todos os pacientes apresentavam urocultura prévia negativa. Realizou-se uroculturas de controle oito e 30 dias após o procedimento. Os resultados obtidos mostraram prevençåo da infecçåo urinária em 93,3 por cento no Grupo I, 90 por cento no Grupo II e 73,3 por cento no Grupo III. A bactéria mais frequentemente encontrada foi a Escherichia coli. Nenhum dos pacientes investigados apresentou efeitos colaterais significativos. Conclui-se que os dois medicamentos em estudo såo eficazes na profilaxia da infecçåo urinária. A posologia em dose única da fosfomicina trometamol representa vantagem pois permite maior adesåo ao tratamento
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Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Endoscopía/efectos adversos , Infecciones Urinarias/prevención & control , Premedicación , Urología , Antiinfecciosos Urinarios , Fosfomicina/uso terapéutico , Infecciones Urinarias/microbiología , Trometamina/uso terapéuticoRESUMEN
Apesar do grande avanço no estudo da impotência sexual, o implante de prótese peniana ainda é a cirurgia com mais alto índice de sucesso nesse tratamento. Setenta e cinco pacientes com disfunçao erétil de várias etiologias foram submetidos a implantes de prótese peniana sob anestesia local, com dilataçao cuidadosa dos corpos cavernosos, visando a manutençao da vascularizaçao intracavernosa e a obtençao de ereçao residual durante a relaçao sexual. A idade dos pacientes variou de 36 a 63 anos (mediana de 56 anos) e a prótese utilizada foi do tipo Jonas, semi-rígida. Nenhum paciente reclamou de dor durante a cirurgia, apesar de nao-utilizaçao de sedaçao. O tempo médio de hospitalizaçao foi de seis horas. Todos os pacientes referiam aumento de calibre peniano durante a relaçao sexual. A anestesia local provou ser eficiente, confortável e segura para o paciente. A dilataçao cuidadosa dos corpos cavernosos possibilitou ereçao residual durante a relaçao sexual.
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Humanos , Masculino , Adulto , Persona de Mediana Edad , Disfunción Eréctil/cirugía , Prótesis de Pene , Anestesia Local , Dilatación/métodosRESUMEN
Com o intuito de melhorar o acervo e cadastramento de pacientes portadores de disfunçäo sexual e infertilidade masculina, bem como facilitar o acesso às informaçöes provenientes dos atos cirúrgicos dos pacientes submetidos a transplante renal, foram criados três bancos de dados em linguagem dBASE III para microcomputadores do PC ("personal computer") com 512 Kbytes de memória RAM. A sistematizaçäo dos dados permite acesso rápido e seguro às informaçöes, seja na clínica diária, ou seja para levantamentos estatísticos e pesquisa médica, através da recuperaçäo dos dados. A recuperaçäo pode ser realizada segundo várias combinaçöes definidas a partir de critérios espcificados pelo usuário. A sistematizaçäo dos dados, por sua rapidez e eficiência, reduz a força e tempo de trabalho, e traz vantagens financeiras inquestionáveis, justificando assim o emprego da informatizaçäo no gerenciamento de dados