RESUMO
Background: Varicocele still today represents a common cause of infertility in young men. The treatment strategy remains a surgical approach such as scleroembolization; however, the complete restoration of spermatic parameters afterward requires an average of six or more months to fully regain optimal seminal parameters. Recently, many studies have demonstrated the beneficial effects of Resveratrol in male fertility, given its potential anti-inflammatory, antiapoptotic, and mitochondrial effects. Therefore, Resveratrol-based nutraceuticals could be promising as an adjuvant to mitigate subfertility in patients with varicocele. Methods: In the present study, we retrospectively analyzed the effects of the administration of a Resveratrol-based nutraceutical after the scleroembolization procedure. The improvement of sperm quality in terms of number, motility, and morphology were considered to be the study's main endpoints. A spreadsheet program was used for data analysis, and a p-value of <0.05 was considered significant. Results: We found a statistically significant improvement in the spermatic parameters (sperm count and total motility) and an increase in normal sperm after only 4 months of treatment. The supplementation with a Resveratrol-based nutraceutical associated with the surgical procedure showed encouraging results if compared to data from a control group and the results reported in the literature linked to scleroembolization practice alone. In fact, there was a clear improvement in the seminal parameters at 4 months. Conclusions: This suggests the positive impact of the Resveratrol-based nutraceutical in synergizing with scleroembolization in reducing the time needed to fully recover sperm function.
RESUMO
INTRODUCTION AND OBJECTIVE: The urinary incontinence after radical prostatectomy is secondary to neuropathy with various degrees from neurapraxia to neurotmesis. We propose to apply therapeutic and rehabilitative models appropriate to the diagnosis and to evaluate the results. MATERIALS AND METHODS: We examined 79 homogeneous patients with urinary incontinence after radical prostatectomy. After having defined the diagnosis by a urodynamic examination, the study of pudendal nerve somatosensory-evoked potentials (SEPs) and perineal electromyography (EMG), patients were divided into four groups (A; B; C; D) and submitted to different clinical drug protocols and rehabilitation. After 3 months, patients were reevaluated. RESULTS: Twenty-eight patients with idiopathic overactive bladder (Group A) have been treated with anticholinergics: two unchanged (7%); 14 improved (50%); and 12 recovered (43%). Sixteen patients with overactive bladder and sphincter incompetence (Group B) have practiced physiokinesis therapy (FKT) of pelvic floor and anticholinergic therapy: one unchanged (6%); eight improved (50%); and seven recovered (44%). Fourteen patients with perineal incompetence to continence (Group C) have been treated with FES, FKT of pelvic floor, and Biofeedback: three patients were unchanged (21%); five improved (36%); and six recovered (43%). Twenty-one patients with sphincter denervation (Group D) performed FES, FKT of pelvic floor, and Biofeedback: 16 unchanged (76%); five improved (24%); and zero recovered (0%). Of these 16 patients, six non-responders have placed a transobturator tape (TOT) sling and four an artificial sphincter. CONCLUSIONS: A therapy adherent to the diagnosis increases success rate.