Can Dopamine Depletion at DAT Scan in a Non Parkinson Patient be the Cause a Refractory Overactive Bladder?

We report here the first case of treatment of idiopathic refractory overactive bladder with dopamine. A female patient consulted for urge incontinence. Management included all recommended treatments without success. DAT scan was finally performed showing clear reduction in dopamine secretion without diagnosis of any neurological condition. Patient started dopamine treatment. At 1 month, patient described persistence of mild urgency and frequency but complete resolution of urge incontinence. At 3 months patient was completely dry with only persistence of mild frequency. Functional imaging and central nervous system target might represent new ways of managing idiopathic overactive bladder.

[New methods for the evaluation of cervico-prostatic obstruction]. / Nuovi metodi di valutazione dell'ostruzione cervico-prostatica.

To study outflow obstructions Schafer (1989) has recently proposed a simplified method based on a graph derived from over 1000 pre and post-op. P/F studies. 42 patients with BPH were evaluated according to this method. 11 patients had no outlet obstruction (26%). Surprisingly, only 15 had a normal detrusor, while 27 had a weak detrusor. The second part of the study concerns 24 patients with post-prostatectomy frequency-dysuria syndrome. Only 21% of these patients showed an outlet obstruction; while 58% showed a weak detrusor as responsible for their symptoms.

[Anamnestic criteria for sexual evaluation in the andrological field]. / Criteri anamnestici di valutazione sessuologica in campo andrologico.

What is the cause for impotence? In the recent years psychological studies have accredited some insights and modern neurological and vascular technologies have identified some previously idiopathic or misdiagnosed causes. The postulated ratio of psychogenic to organic dysfunction varies from 20:1 to 1:7 and this ratio may vary form one cultural area to the next. The authors underline that the main characteristic of the groups of males complaining of erectile dysfunction is heterogeneity and that the diagnostic procedure for finding the correct etiology may be rather cumbersome. Of primary importance is the patient's history to obtain a precise description of the dysfunction. Graber has suggested a more systematic approach to create a scientific nosology in the area of erectile failure. The phenomenon of morning erections must be inquired as well as the evaluation of the genital reflexes. A series of new diagnostic procedures has been developed but the Authors underline that it is preferable to use noninvasive techniques.

[Prosthetic implants for penile induration]. / Impianti protesici nell'induratio penis plastica.

From 1982 to 1988 we have evaluated 283 patients affected by Peyronie's disease. 81 of these complained erectile disfunction. Semirigid penile prosthesis were inserted in 38 patients with severe induratio penis plastica. Following surgery the patients were given a sexual questionnaire in order to determine whether they had realised their expectations as well as partner acceptance. Our results appear to be favourable and prosthesis insertion in selected patients with Peronie's disease seems to be the safest, most economical and best accepted choice.