[Sildenafil assumption and acute effects on the uroflowmetric parameters]. / Assunzione di sildenafil e repida variazione dei parametri uroflussometrici.

AIM: In the recent literature, great attention has been given to the evaluation of the real effectiveness of the phosphodiesterase type 5 inhibitors (PDE-5i), usually prescribed for the erectile dysfunction (ED), in the treatment of the lower urinary tracts symptoms (LUTS). The aim of this study was the evaluation of the acute effects of sildenafil on the uroflowmetric parameters. METHODS: Within September 2011 and February 2012, twenty-seven patients, affected by ED with a IIEF-5 score ≤21 and a contextual IPSS within 8 e 19, have been selected and enrolled in this study. Two uroflowmetric measurements with suprapubic ultrasound valuation of the post voiding residual (PVR) were performed on each patient, 2 hours before and after the administration of sildenafil (50 mg). RESULTS: The average age of the patients came out within di 47.3±9.4 years. On the baseline, the average of the Qmax registered has been 15.6±3.3 mL/s, the average Qave has been 8.2±3.2 mL/s and the average resulted 32.5±11.4 mL. After the mono-administration of sildenafil 50 mg, the average Qmax value, the Qave one and the RPM one turned out into 17.7±5.1 mL/s, 10.1±3.5 mL/s and 22.6±9.6 mL. The differences within the standard values, were considered statistically relevant (P<0.05). CONCLUSIONS: Actually, the study shows that, in the acute phase, the administration of sildenafil 50 mg leads to effects on the uroflowmetric standards on men affected by LUTS and DE.

[New prospective therapy for benign prostatic hyperplasia with finasteride]. / Nuove prospettive terapeutiche nella iperplasia prostatica benigna con la Finasteride.

A randomized, double blind, placebo-controlled study (placebo and Finasteride 1 or 5 mg/die) was carried out in 34 patients with benign prostatic hyperplasia (BPH). After 12 months of treatment all patients received Finasteride 5 mg/die. Follow-up ranges from 18 to 36 months. One year after treatment, patients receiving Finasteride 1 or 5 mg/die, showed significant decrease (one-way ANOVA) of serum dihydrotestosterone (-70.1% and -69.6%, respectively), serum prostate specific antigen (-50% and -50.8%, respectively) and prostate volume (-36.3% and -31.8%, respectively). Comparable modifications of such parameters were observed in the placebo group only during the second year of the study when they were shifted to Finasteride treatment (5 mg/die). No increase of serum testosterone was observed in any group. Maximum urinary flow rate increased on the average, after one year, by 2.6 and 3.6 ml/s in patients receiving Finasteride 1 and 5 mg/die, respectively; a 1.3 ml/s increase occurred in the placebo group. The total urinary symptom score (Boyarsky) decreased in all three patient groups. Results of this study show that a few months are necessary to exert a significant therapeutic effect. The drug is well tolerated and does not decrease the patient's sexual activity. Finasteride certainly opens new perspectives in the treatment of BPH.

[Transurethral thermotherapy by microwaves in patients with benign obstructive prostatic hypertrophy]. / La thermothérapie transurétrale par micro-ondes chez les patients ayant une hypertrophie prostatique bénigne obstructive.

The effect of transurethral microwave thermotherapy (TUMT) with Prostatron in patients with benign prostatic hypertrophy was investigated. Two hundred and one patients were treated between January 1991 and June 1992 after informed consent was signed. The following examinations were carried out at screening: interview (including symptoms score evaluation), physical examination (including digital rectal examination), haematology and blood chemistry (including prostate specific antigen), ECG, chest Xray, kidney, bladder and prostate (transrectal) ultrasound sonography (USS) and uroflowmetry; pressure-flow study was performed in a selected group of patients. All enrolled patients had Madsen symptom score > or = 8; peak flow rate < or = 15 ml/s and post void residual urine < or = 200 ml. Patients with obstructive middle lobe of the prostate, any BPH complication or any suspicion of prostatic carcinoma were excluded from the study. Microwave thermotherapy with Prostatron was carried out according to software generation 2.0 (Prostasoft 2.0), the c10 (black) catheter was used in all patients. Follow-up visits were scheduled at 1 week, 1, 3, 6, 12, 18 months after microwave thermotherapy. Overall short- and long-term morbidity rates were 6.09 and 2.73 per cent, respectively. At 12 months, Madsen score was found to be reduced from 11.7 +/- 4.78 to 4.43 +/- 3.30; maximum flow rate (Qmax) was increased from 8.91 +/- 4.20 to 13.20 +/- 4.86; post void residual urine (PVRU) was reduced from 131 +/- 17.6 to 67.40 +/- 34.50.(ABSTRACT TRUNCATED AT 250 WORDS)

Transurethral microwave thermotherapy in the treatment of symptomatic benign prostatic hyperplasia.

One hundred and forty-four patients with symptomatic benign prostatic hyperplasia were treated by transurethral microwave thermotherapy between January and December 1991. Before entering the study, all patients had a Boyarsky symptom score > or = 8, peak flow rate < or = 15 ml/s and postvoiding residual urine < or = 200 ml. Transurethral thermotherapy with the Prostatron (Technomed) was carried out as a single session (60 min) without any analgesia or sedation. Acute urinary retention occurred in 19.4% of the patients after treatment requiring catheterization for 2-3 weeks; morbidity rate was 5.5%. Six months after treatment, Boyarsky symptom score decreased from 11.73 +/- 4.97 to 4.40 +/- 3.21 (mean values +/- SD); peak flow rate increased on average from 8.97 +/- 4.18 to 13.07 +/- 4.87 ml/s and postvoiding residual urine decreased from 135 +/- 17.9 to 63 +/- 34.7 ml. Slight further improvement was shown, in a few patients, at the 1-year follow-up visit.

Review of norfloxacin in lower urinary tract infections.

A review of worldwide clinical trials with norfloxacin in the treatment of uncomplicated urinary tract infections (UTIs), as well as our personal experience with 215 assessable patients, is presented. Almost all patients received 400 mg b.i.d. for 3-15 days. Bacteriological eradication (10(4) CFU/ml of urine or less) was achieved in more than 90% of patients. Short-term therapy (3 days) with norfloxacin proved to be as effective and tolerable as a 10- to 14-day conventional therapeutic schedule in the treatment of lower uncomplicated UTIs. Overall incidence of drug-related adverse experiences was 2.3%.

Testicular changes after treatment with a GnRH analog (buserelin) in association with cyproterone acetate in men with prostatic cancer.

Twelve patients (age range: 53-78 years) with prostatic cancer were treated with Buserelin (1.2 mg/day) and cyproterone acetate (150 mg/day). Testicular biopsies performed after 13-96 weeks of treatment were compared to those obtained from 6 untreated men of similar age. Deranged spermatogenesis was observed in all but 1 treated patient. The appearance of immature Sertoli cells and atrophic Leydig cells suggests a condition of pharmacologic 'hypophysectomy'. The variable damage to the seminiferous epithelium and findings of an incomplete involution of Leydig cells suggested a decreased but still present testicular steroidogenesis.