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1.
J Sex Med ; 12(7): 1646-53, 2015 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-26193766

RESUMEN

INTRODUCTION: Among the many treatments for erectile dysfunction, implantation of a penile prosthesis has been associated with high patient satisfaction rates. Prosthesis replacement has become an accepted procedure in the event of device malfunction or complications, but to our knowledge, there are no data regarding the impact of implant replacement on patients and partner satisfaction. AIM: The aim of our study was to assess and to compare the level of satisfaction, with a first or second penile prosthesis implantation (PPI), in men with refractory erectile dysfunction and their partners. METHODS: A survey study based on a five-item questionnaire was carried out at our center between January 1999 and January 2012. MAIN OUTCOME MEASURES: The main outcome measure used was the level of patient and partner satisfaction with sexual intercourse after PPI. RESULTS: Of the 190 eligible patients, 149 (78%) completed the survey (110 underwent a first implant and 39 a reimplant). Seventy-nine percent of first-time implanted patients and 80% of the reimplanted patients (P > 0.05; not significant [ns]) reported satisfactory sexual intercourse (very or moderately satisfied), while 74% and 80% of their partners reported satisfactory intercourses, respectively (P > 0.05; ns). Overall, 73.7% of first implants and 70% of second implants reported that they would undergo the procedure again if the PPI failed (P > 0.05; ns). With regards to cosmetic aspects, 13% of the first implants' and 15% of second implants' partners reported either penile shortness or soft glans as the main causes of their dissatisfaction. Only 2.4% of first implants and 1% of reimplanted patients expressed difficulty in manipulating the device. CONCLUSIONS: PPI is successful in returning the ability for satisfactory sexual intercourse to both first implant and reimplanted patients and their respective partners.


Asunto(s)
Coito/psicología , Disfunción Eréctil/cirugía , Implantación de Pene/métodos , Prótesis de Pene/estadística & datos numéricos , Satisfacción Personal , Parejas Sexuales/psicología , Adulto , Disfunción Eréctil/psicología , Humanos , Masculino , Persona de Mediana Edad , Satisfacción del Paciente , Implantación de Pene/psicología , Reimplantación , Autoinforme
2.
Arch Esp Urol ; 67(10): 839-47, 2014 Dec.
Artículo en Inglés, Español | MEDLINE | ID: mdl-25582903

RESUMEN

OBJECTIVES: Avanafil is a highly selective phosfosdiesterase 5 inhibitor (PDE5 inhibitor), with rapid onset of action, approved by the Food and Drug Administration (FDA) and the European Medicines Agency for the treatment of erectile dysfunction (ED). It had been recently commercialized in Spain. This article presents a detailed review of the available literature, where the safety, tolerability and efficacy of avanafil were evaluated. METHODS: A systematic literature search using the Medline database was performed. The search included the terms Avanafil and erectile dysfunction. The pivotal studies of clinical development of the drug, and also those randomized, double-blind, placebo-controlled, well-designed studies were analyzed. We included those studies published in English up to January 2014. Likewise, studies of the pharmacokinetics and pharmacodynamics of the drug were also included. RESULTS: The avanafil pivotal studies, conducted in general population of patients with ED, patients with Diabetes mellitus type I and II and patients with ED secondary to nerve sparing radical prostatectomy were analyzed. In all these studies, avanafil demonstrated a statistically significant improvement in erectile function (IIEF), and all the coprimary outcomes (SEP2 and SEP3) compared to placebo. Also, a good tolerance profile and few side effects compared to placebo were evident. CONCLUSIONS: Avanafil is a selective PDE5 inhibitors, that is rapidly absorbed and that has a short time to peak response. It found to be effective in randomized, double-blind, placebo-controlled trials conducted in men with erectile dysfunction, including in patients with diabetes mellitus and after radical prostatectomy. It was generally well tolerated across trials, with very few patients withdrawing because of adverse effects. Similarly, avanafil had a significantly lower rate of hemodynamic side effects compared with sildenafil.


Asunto(s)
Disfunción Eréctil/tratamiento farmacológico , Inhibidores de Fosfodiesterasa 5/uso terapéutico , Pirimidinas/uso terapéutico , Adulto , Humanos , Masculino , Resultado del Tratamiento
3.
Minerva Urol Nephrol ; 75(4): 521-528, 2023 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-37199530

RESUMEN

BACKGROUND: Several factors impact the preservation of renal function after partial nephrectomy. Warm ischemia time is the main modifiable surgical factor. Renorrhaphy represents the key of hemostasia, but it is associated with increase of warm ischemia time and complications. The aim of this study was to describe our initial surgical experience with a new surgical technique for sutureless partial nephrectomy, based on the application of our own developed renal-sutureless-device-RSD. METHODS: Between 2020-2021, 10 patients diagnosed with renal cell carcinoma stage cT1a-b cN0M0 with an exophytic component were operated using renal-sutureless-device-RSD. Surgical technique of sutureless partial nephrectomy with renal-sutureless-device-RSD is described in a step-by-step fashion. Clinical data was collected in a dedicated database. Presurgical, intraoperative, postoperative variables, pathology and functional results were evaluated. Medians and ranges of values for selected variables were reported as descriptive statistics. RESULTS: Partial nephrectomy was carried out with the use of renal-sutureless-device-RSD without renorrhaphy in all cases (70%cT1a-30%cT1b). Median tumor size was 3.15 cm (IQR: 2.5-4.5). R.E.N.A.L Score had a range between 4a-10. Median surgical time was 97.5 minutes (IQR 75-105). Renal artery clamping was only required in 4 cases, with a median warm ischemia time of 12.5 minutes (IQR 10-15). No blood transfusion, intraoperative and postoperative complications were noted. Free-of-disease margin rate achieved was 90%. Median length of stay was 2 days (IQR 2-2). Laboratory data on hemoglobin and hematocrit levels, as well as renal function tests, remained stable after partial nephrectomy. CONCLUSIONS: Our initial experience suggests that a sutureless PN using the RSD device is feasible and safe. Further investigation is needed to determine the clinical benefit of this technique.


Asunto(s)
Neoplasias Renales , Laparoscopía , Humanos , Neoplasias Renales/cirugía , Neoplasias Renales/patología , Estudios Retrospectivos , Laparoscopía/métodos , Riñón/diagnóstico por imagen , Riñón/cirugía , Riñón/fisiología , Nefrectomía/métodos
4.
Int J Impot Res ; 34(4): 327-331, 2022 May.
Artículo en Inglés | MEDLINE | ID: mdl-35538312

RESUMEN

Since ancient times, men have tried to change the size and shape of their genitals. Bites from insects or poisonous snakes and weights were among the first methods used for this purpose. In the first half of the 1900s, the scientific push regarding male genital aesthetic surgery began. Scrotoplasty, penile suspensory ligament release, injection of hyaluronic acid as filler, use of several types of grafts, lipofilling, and liposuction are techniques currently used. The Penuma® implant has recently been described with promising results. We are living in the era of tailored surgery and regenerative medicine. Shortly the surgeons will have to know several surgical techniques and adapt them to the patient. New fillers with ideal characteristics, innovative prosthetic devices, and stem cells will probably be the protagonists of future aesthetic surgery. The main effort of the scientific community should be directed towards the design of new randomized controlled trials to increase the evidence on the efficacy and safety of the topic, with the ultimate aim of allowing clear recommendations from scientific societies.


Asunto(s)
Procedimientos de Cirugía Plástica , Cirugía Plástica , Estética , Humanos , Ácido Hialurónico , Masculino , Pene/cirugía , Procedimientos de Cirugía Plástica/métodos , Cirugía Plástica/métodos , Procedimientos Quirúrgicos Urogenitales
5.
Rev Int Androl ; 19(1): 69-72, 2021.
Artículo en Español | MEDLINE | ID: mdl-31899188

RESUMEN

Penile cancer is a neoplasm that predominantly affects males in the sixth decade of life, with an incidence of .3-1 per 100,000. Traditionally, the treatment of the primary lesion has consisted of total or partial amputation of the penis. However, the psychological and functional impact has influenced the development of preservation techniques We present 2males with lesions on the glans diagnosed by biopsy of squamous cell carcinoma. The patients underwent glandectomy and reconstruction with free thigh skin graft. The pathological anatomy was superficial squamous cell carcinoma. 6 months later the patients are free of disease and satisfied with the result of the intervention In our opinion, this technique enables an adequate cosmetic and functional result without affecting oncological control and without increasing morbidity or operative time.


Asunto(s)
Carcinoma de Células Escamosas , Neoplasias del Pene , Carcinoma de Células Escamosas/cirugía , Humanos , Masculino , Neoplasias del Pene/cirugía , Trasplante de Piel , Muslo/cirugía , Procedimientos Quirúrgicos Urológicos Masculinos
6.
Arch Esp Urol ; 73(5): 395-404, 2020 Jun.
Artículo en Español | MEDLINE | ID: mdl-32538811

RESUMEN

PURPOSE: The COVID-19 pandemic which has affected Spain since the beginning of 2020 compels us to determine recomendations for the practice of Andrology in present times. MATERIALS AND METHODS: A web search is carried out in English and Spanish and a joint proposal is defined by experts in Andrology from different regions of Spain. RESULTS: Most diagnostic and therapeutic procedures in Andrology can be safey postponed during the COVID-19 pandemic. Online consultations and outpatient surgeries must be encouraged. Andrologic emergencies and penile cancer management should be considered high priority, and should be diagnosed and treated promptly even in the most severe phases of the pandemic.


INTRODUCCIÓN: La pandemia COVID-19 que ha afectado a España desde comienzos de 2020 obliga a definir unas recomendaciones para la práctica de la Andrología en la actualidad.MATERIAL Y MÉTODOS: Se realiza una búsqueda web en inglés y español y se define una propuesta conjunta por parte de expertos en Andrología de distintas regiones de España.RESULTADOS: La mayor parte de los procedimientos diagnósticos y terapéuticos en Andrología pueden ser demorados con seguridad durante la pandemia COVID-19. Se debe fomentar la consulta telemática y la cirugía ambulatoria. Las urgencias andrológicas y el manejo del cáncer de pene deben considerarse una prioridad alta, diagnosticándose y tratándose con brevedadi ncluso en las fases más severas de la pandemia.


Asunto(s)
Infecciones por Coronavirus , Pandemias , Neoplasias del Pene , Neumonía Viral , Andrología , Betacoronavirus , COVID-19 , Infecciones por Coronavirus/epidemiología , Humanos , Masculino , Neoplasias del Pene/diagnóstico , Neoplasias del Pene/terapia , Neumonía Viral/epidemiología , SARS-CoV-2 , España
8.
Ther Adv Urol ; 6(5): 192-7, 2014 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-25276229

RESUMEN

INTRODUCTION: Peyronie's disease (PD) is a chronic wound-healing disorder characterized by formation of fibrous inelastic scarring of the tunica albuginea resulting in a variety of penile deformities. In most cases, PD is accompanied by a physical and psychological impact. Xiaflex® is an injectable collagenase clostridium histolyticum (CCh) preparation consisting of a predetermined mixture of two distinct collagenases. Recently the US Food and Drug Administration (FDA) approved Xiaflex® for the nonsurgical treatment of men with PD with curvature of 30° or more and tangible scar tissue plaque in their penis. METHOD: This article presents a comprehensive review of the updated information on the use of Xiaflex® for the nonsurgical treatment of PD. RESULTS: Mean improvements in penile curvature ranging from 29% to 34% and in bother domain scores have been reported. The majority of the reported adverse effects are mild or moderate and 79% resolve without intervention. CONCLUSION: The combined results of these trials have led to the FDA approval of CCh for the treatment of PD. However, the long-term effects and results need further investigation, with large follow-up series. Considering these results, future perspectives will probably result in the use of a combined or sequential therapy including CCh.

9.
Med Clin (Barc) ; 139(13): 582-7, 2012 Dec 01.
Artículo en Español | MEDLINE | ID: mdl-22982131

RESUMEN

OBJECTIVE: To review the role of α-blockers in various urological conditions such as benign prostatic hyperplasia, overactive bladder, chronic prostatitis, and erectile dysfunction and as expulsive treatment of distal ureteral stones. MATERIAL AND METHODS: We reviewed the latest scientific evidence in all the fields mentioned above, performing a critical analysis. CONCLUSION: α-blockers are now considered first-line treatment in lower urinary tract symptoms secondary to benign prostatic hyperplasia, but the indications go beyond, and are able to improve, alone or in combination with other drugs, the previously mentioned pathologies. The uroselective properties of some α-blockers make them a highly safe medication.


Asunto(s)
Antagonistas Adrenérgicos alfa/uso terapéutico , Trastornos Urinarios/tratamiento farmacológico , Anciano , Enfermedad Crónica , Ensayos Clínicos como Asunto , Comorbilidad , Disfunción Eréctil/tratamiento farmacológico , Disfunción Eréctil/epidemiología , Disfunción Eréctil/fisiopatología , Humanos , Masculino , Persona de Mediana Edad , Estudios Multicéntricos como Asunto , Músculo Liso/efectos de los fármacos , Hiperplasia Prostática/complicaciones , Prostatitis/tratamiento farmacológico , Cálculos Ureterales/tratamiento farmacológico , Vejiga Urinaria/efectos de los fármacos , Vejiga Urinaria Hiperactiva/tratamiento farmacológico , Trastornos Urinarios/epidemiología , Trastornos Urinarios/etiología , Trastornos Urinarios/fisiopatología
10.
Rev. int. androl. (Internet) ; 19(1): 69-72, ene.-mar. 2021. tab, ilus
Artículo en Español | IBECS (España) | ID: ibc-201673

RESUMEN

El cáncer de pene es una neoplasia que afecta predominantemente a varones en la sexta década de la vida, con una incidencia de 0,3-1 por 100.000 habitantes. Tradicionalmente, el tratamiento de la lesión primaria ha consistido en la amputación total o parcial del pene. Sin embargo, el impacto psicológico y funcional ha influido en el desarrollo de técnicas de preservación. Presentamos a 2 pacientes con lesiones localizadas en el glande, diagnosticados mediante biopsia de carcinoma epidermoide. Ambos pacientes fueron tratados mediante glandectomía y reconstrucción con injerto libre de piel de muslo. La anatomía patológica fue de carcinoma epidermoide superficial. Seis meses después los pacientes se encuentran libres de enfermedad y satisfechos con el resultado de la intervención. En nuestra opinión, esta técnica permite obtener un adecuado resultado cosmético y funcional, sin perjuicio del control oncológico, y sin incrementar la morbilidad ni el tiempo operatorio


Penile cancer is a neoplasm that predominantly affects males in the sixth decade of life, with an incidence of .3-1 per 100,000. Traditionally, the treatment of the primary lesion has consisted of total or partial amputation of the penis. However, the psychological and functional impact has influenced the development of preservation techniques. We present 2 males with lesions on the glans diagnosed by biopsy of squamous cell carcinoma. The patients underwent glandectomy and reconstruction with free thigh skin graft. The pathological anatomy was superficial squamous cell carcinoma. 6 months later the patients are free of disease and satisfied with the result of the intervention. In our opinion, this technique enables an adequate cosmetic and functional result without affecting oncological control and without increasing morbidity or operative time


Asunto(s)
Humanos , Masculino , Persona de Mediana Edad , Anciano , Neoplasias del Pene/cirugía , Neoplasias del Pene/diagnóstico , Procedimientos Quirúrgicos Urológicos Masculinos/métodos , Pene/patología , Pene/cirugía , Carcinoma de Células Escamosas/cirugía
11.
Rev. int. androl. (Internet) ; 18(3): 117-123, jul.-sept. 2020.
Artículo en Español | IBECS (España) | ID: ibc-192625

RESUMEN

OBJETIVO: El objetivo de esta revisión es resumir la evidencia disponible sobre los posibles efectos adversos del SARS-CoV-2 en el sistema reproductor masculino y proporcionar una declaración de posición oficial de la Asociación Española de Andrología, Medicina Sexual y Reproductiva (ASESA). MÉTODOS: Se realizó una búsqueda exhaustiva en las bibliotecas Pubmed, Web of Science, Embase, Medline, Cochrane y MedRxiv. RESULTADOS: No se ha confirmado la orquitis como una posible complicación de la infección por SARS-CoV-2. Un estudio informó que el 19% de los hombres con COVID-19 presentaban molestias escrotales sugestivas de orquitis viral, que no se pudo confirmar. Es posible que el virus no infecte los testículos directamente, si no que desencadene una respuesta autoinmune secundaria y que cause una orquitis autoinmune. COVID-19 se ha asociado con anormalidades en la coagulación por lo que la orquitis podría ser el resultado de una vasculitis segmentaria. Los datos disponibles sobre la presencia del virus en semen son contradictorios. Sólo un estudio informó de la presencia de ARN en el 15,8% de enfermos de COVID-19. La presencia de ácido nucleico o antígeno en el semen no implica la existencia de virus con capacidad de replicación o infección. En hombres con COVID-19 se ha observado un incremento significativo de LH en suero y una drástica disminución de la ratio T/LH y FSH/LH, congruente con un hipogonadismo subclínico. CONCLUSIONES: Los datos disponibles y los hallazgos de los estudios recientes se basan en tamaños de muestra pequeños y proporcionan informaciones contradictorias. Existe la posibilidad teórica de que pueda producirse daño testicular y posterior infertilidad después de la infección por COVID-19, por lo que especialmente para aquellos hombres en edad reproductiva, se debe sugerir consulta y evaluación de la función gonadal y análisis de semen. En cuanto a la posibilidad de transmisión sexual, no hay evidencia suficiente para respaldar la necesidad de que las parejas asintomáticas eviten las relaciones sexuales para protegerse contra la transmisión del virus. Se necesita más investigación para comprender los impactos a largo plazo del SARS-CoV-2 en la función reproductiva masculina, incluidos sus posibles efectos sobre la fertilidad y la función endocrina testicular


OBJECTIVE: The main objective of this revision is to summarize the current existing evidence of the potential adverse effects of SARS-CoV-2 on the male reproductive system and provide the recommendations of the Asociación Española de Andrología, Medicina Sexual y Reproductiva (ASESA) concerning the implications of COVID-19 infection in the management of male infertilty patients and testicular endocrine dysfunction. METHODS: A comprehensive systematic literature search of the databases of PubMed, Web of Science, Embase, Medline, Cochrane and MedRxiv, was carried out. RESULTS: The presence of orchitis as a potential complication of the infection by SARS-CoV-2 has not yet been confirmed. One study reported that 19% of males with COVID-19 infection had scrotal symptoms suggestive of viral orchitis which could not be confirmed. It is possible that the virus, rather than infecting the testes directly, may induce a secondary autoimmune response leading to autoimmune orchitis. COVID-19 has been associated with coagulation disorders and thus the orchitis could be the result of segmental vasculitis. Existing data concerning the presence of the virus in semen are contradictory. Only one study reported the presence of RNA in 15.8% of patients with COVID-19. However, the presence of nucleic acid or antigen in semen is not synonyms of viral replication capacity and infectivity. It has been reported an increase in serum levels of LH in males with COVID-19 and a significant reduction in the T/LH and FSH/LH ratios, consistent with subclinical hypogonadism. CONCLUSIONS: The findings of recent reports related to the potential effects of COVID-19 infection on the male reproductive system are based on poorly designed, small sample size studies that provide inconclusive, contradictory results. Since there still exists a theoretical possibility of testicular damage and male infertilty as a result of the infection by COVID-19, males of reproductive age should be evaluated for gonadal function and semen analysis. With regard to the sexual transmission of the virus, there is not sufficient evidence to recommend asymptomatic couples to abstein from having sex in order to protect themselves from being infected by the virus. Additional studies are needed to understand the long-term effects of SARS-CoV-2 on male reproductive function, including male fertility potential and endocrine testicular function


Asunto(s)
Humanos , Infecciones por Coronavirus/epidemiología , Síndrome Respiratorio Agudo Grave/epidemiología , Orquitis/epidemiología , Infertilidad Masculina/epidemiología , Infecciones por Coronavirus/complicaciones , Síndrome Respiratorio Agudo Grave/complicaciones , Coronavirus Relacionado al Síndrome Respiratorio Agudo Severo/patogenicidad , 50242 , Semen/virología
12.
Arch. esp. urol. (Ed. impr.) ; 73(5): 395-404, jun. 2020. tab
Artículo en Español | IBECS (España) | ID: ibc-189697

RESUMEN

INTRODUCCIÓN: La pandemia COVID-19 que ha afectado a España desde comienzos de 2020 obliga a definir unas recomendaciones para la práctica de la Andrología en la actualidad. MATERIAL Y MÉTODOS: Se realiza una búsqueda web en inglés y español y se define una propuesta conjunta por parte de expertos en Andrología de distintas regiones de España. RESULTADOS: La mayor parte de los procedimientos diagnósticos y terapéuticos en Andrología pueden ser demorados con seguridad durante la pandemia COVID-19. Se debe fomentar la consulta telemática y la cirugía ambulatoria. Las urgencias andrológicas y el manejo del cáncer de pene deben considerarse una prioridad alta, diagnosticándose y tratándose con brevedadi ncluso en las fases más severas de la pandemia


PURPOSE: The COVID-19 pandemic which has affected Spain since the beginning of 2020 compels us to determine recomendations for the practice of Andrology in present times. MATERIALS AND METHODS: A web search is carried out in English and Spanish and a joint proposal is defined by experts in Andrology from different regions of Spain. RESULTS: Most diagnostic and therapeutic procedures in Andrology can be safey postponed during the COVID-19 pandemic. Online consultations and outpatient surgeries must be encouraged. Andrologic emergencies and penile cancer management should be considered high priority, and should be diagnosed and treated promptly even in the most severe phases of the pandemic


Asunto(s)
Humanos , Masculino , Infecciones por Coronavirus/prevención & control , Neumonía Viral/prevención & control , Pandemias , Andrología/normas , Neoplasias del Pene/diagnóstico , Neoplasias del Pene/terapia , Telemedicina , Guías de Práctica Clínica como Asunto , Medicina Basada en la Evidencia
13.
Arch. esp. urol. (Ed. impr.) ; 67(10): 839-847, dic. 2014. tab
Artículo en Español | IBECS (España) | ID: ibc-131712

RESUMEN

OBJETIVO: Avanafilo es un inhibidor de la fosfodiesterasa 5 (IPDE5) altamente selectivo, aprobado por la Food and Drug Administration (FDA) y por la Agencia Europea del medicamento, para el tratamiento de la disfunción eréctil (DE), comercializado recientemente en España. Este artículo presenta una revisión de la literatura, donde se evalúa la seguridad, tolerabilidad y eficacia de avanafilo. MÉTODOS: Se realizó una búsqueda sistemática de la literatura utilizando la base de datos Medline, que incluyó los términos Avanafilo y disfunción eréctil. Se analizaron los estudios pivotales del desarrollo clínico del fármaco, así como aquellos ensayos clínicos aleatorizados, doble ciego y controlados con placebo, bien diseñados, publicados en inglés hasta Enero de 2014. Igualmente, se incluyeron estudios acerca de la farmacocinética y farmacodinámica del fármaco. RESULTADOS: Se analizaron los estudios pivotales de Avanafilo, llevados a cabo en la población general de pacientes con DE, en pacientes con DE y diabetes mellitus tipo I y II y en pacientes con DE secundaria a prostatectomía radical, demostrando una mejoría estadísticamente significativa de la función eréctil (IIEF) y del resto de los objetivos primarios (SEP2 y SEP3), respecto a placebo. De igual manera, avanafilo presentó un buen perfil de tolerancia y escasos efectos adversos. CONCLUSIONES: Avanafilo es un IPDE5 de vida media corta e inicio rápido de acción. Su eficacia clínica con respecto a placebo ha sido demostrada en ensayos clínicos aleatorizados, doble ciego, controlados con placebo, en pacientes con DE. Adicionalmente, su eficacia ha sido demostrada en pacientes diabéticos y pacientes sometidos a prostatectomía radical. Avanafilo, ha demostrado ser un fármaco seguro y bien tolerado. Los efectos adversos registrados fueron de carácter leve o moderado, con una baja tasa de abandono del fármaco debido a éstos. Adicionalmente cuenta con menores tasas de efectos hemodinámicos respecto a sildenafilo


OBJETIVES: Avanafil is a highly selective phosfosdiesterase 5 inhibitor (PDE5 inhibitor), with rapid onset of action, approved by the Food and Drug Administration (FDA) and the European Medicines Agency for the treatment of erectile dysfunction (ED). It had been recently commercialized in Spain. This article presents a detailed review of the available literature, where the safety, tolerability and efficacy of avanafil were evaluated. METHODS: A systematic literature search using the Medline database was performed. The search included the terms Avanafil and erectile dysfunction. The pivotal studies of clinical development of the drug, and also those randomized, double-blind, placebo-controlled, well-designed studies were analyzed. We included those studies published in English up to January 2014. Likewise, studies of the pharmacokinetics and pharmacodynamics of the drug were also included. RESULTS: The avanafil pivotal studies, conducted in general population of patients with ED, patients with Diabetes mellitus type I and II and patients with ED secondary to nerve sparing radical prostatectomy were analyzed. In all these studies, avanafil demonstrated a statistically significant improvement in erectile function /(IIEF), and all the coprimary outcomes (SEP2 and SEP3) compared to placebo. Also, a good tolerance profile and few side effects compared to placebo were evident. CONCLUSIONS: Avanafil is a selective PDE5 inhibitors, that is rapidly absorbed and that has a short time to peak response. It found to be effective in randomized, double-blind, placebo-controlled trials conducted in men with erectile dysfunction, including in patients with diabetes mellitus and after radical prostatectomy. It was generally well tolerated across trials, with very few patients withdrawing because of adverse effects. Similarly, avanafil had a significantly lower rate of hemodynamic side effects compared with sildenafil


Asunto(s)
Humanos , Masculino , Adulto , Disfunción Eréctil/complicaciones , Disfunción Eréctil/diagnóstico , Disfunción Eréctil/metabolismo , Preparaciones Farmacéuticas/administración & dosificación , Preparaciones Farmacéuticas/análisis , Prostatectomía , Prostatectomía/instrumentación , Disfunción Eréctil/prevención & control , Disfunción Eréctil/psicología , Preparaciones Farmacéuticas/síntesis química , Preparaciones Farmacéuticas , Prostatectomía/métodos , Prostatectomía
14.
Arch Esp Urol ; 57(6): 619-24, 2004.
Artículo en Español | MEDLINE | ID: mdl-15382437

RESUMEN

OBJECTIVES: To evaluate the functional results and incidence of complications in a series of pediatric renal transplants using grafts from pediatric donors under 3 years of age. METHODS: We review a serious of 19 renal transplants consecutively performed in pediatric receptors with donors under the age of 3 years. We analyze immediate function, medical and surgical complications, and long and mid-term graft and patient survivals. RESULTS: We observed initial graft dysfunction in 9 patients (47.4%). Six patients had vascular complications (31.5%). More vascular complications appeared in kidneys preserved with EC solution (35.3%) in comparison with UW solution (23.5%) (p < 0.05). 1, 5, 10, and 12 year actuarial graft survivals were 57.8%, 41.4%, 35.5% and 35.5%, respectively. Based on preservation solution, 1, 5, and 10 year actuarial graft survivals for EC were 44%, 33% and 16%, respectively; results improved with UW solution up to 60%, 50%, and 50% respectively (p < 0.001). CONCLUSIONS: Kidneys from donors under the age of the 3 years in pediatric receptors suffer a high incidence of vascular complications offering a low graft survival on the long-term, being these facts more evident when simpler preservation solutions are employed.


Asunto(s)
Trasplante de Riñón/métodos , Riñón , Donantes de Tejidos , Adolescente , Factores de Edad , Niño , Preescolar , Femenino , Estudios de Seguimiento , Supervivencia de Injerto , Humanos , Trasplante de Riñón/efectos adversos , Masculino , Complicaciones Posoperatorias
16.
Med. clín (Ed. impr.) ; 139(13): 582-587, dic. 2012.
Artículo en Español | IBECS (España) | ID: ibc-109610

RESUMEN

Objetivo. Revisar el papel de los alfa-bloqueantes en distintos trastornos urológicos como son la hipertrofia benigna de próstata, la vejiga hiperactiva, la prostatitis crónica, la disfución eréctil y el tratamiento expulsivo de la litiasis ureteral distal. Material y método. Se revisa la evidencia científica más actual en todos los campos anteriormente citados, haciéndose un análisis crítico de los mismos. Conclusiones. Los alfa-bloqueantes se consideran en la actualidad el tratamiento de primera elección en los síntomas del tracto urinario inferior secundarios al crecimiento prostático benigno, pero sus indicaciones van más allá, pudiendo mejorar solos o en adyuvancia con otros fármacos los procesos patológicos anteriormente citados. La uroselectividad de alguno de ellos les hace que tengan una seguridad muy alta en su utilización(AU)


Objective. To review the role of alpha-blockers in various urological conditions such as benign prostatic hyperplasia, overactive bladder, chronic prostatitis, and erectile dysfunction and as expulsive treatment of distal ureteral stones. Material and methods. We reviewed the latest scientific evidence in all the fields mentioned above, performing a critical analysis. Conclusion. alpha-blockers are now considered first-line treatment in lower urinary tract symptoms secondary to benign prostatic hyperplasia, but the indications go beyond, and are able to improve, alone or in combination with other drugs, the previously mentioned pathologies. The uroselective properties of some alpha-blockers make them a highly safe medication(AU)


Asunto(s)
Humanos , Antagonistas Adrenérgicos alfa/uso terapéutico , Enfermedades Urológicas/tratamiento farmacológico , Hiperplasia Prostática/tratamiento farmacológico , Prostatitis/tratamiento farmacológico , Disfunción Eréctil/tratamiento farmacológico , Vejiga Urinaria Hiperactiva/tratamiento farmacológico , Quimioterapia Adyuvante
17.
Arch. esp. urol. (Ed. impr.) ; 64(7): 636-639, sept. 2011. ilus
Artículo en Español | IBECS (España) | ID: ibc-94337

RESUMEN

OBJETIVO: Presentación de dos nuevos casos de sarcoma de Ewing / tumor neuroectodérmico primitivo renal primario, uno de ellos con trombo en cava.MÉTODO: Caracterización de los dos casos clínicos y revisión bibliográfica mediante búsqueda en pubmed.RESULTADO: Presentamos los casos de dos varones diagnosticados de sarcoma de Ewing renal primario, que han sido tratados con nefrectomía y quimioterapia adyuvante; encontrándose en remisión completa hasta la fecha.CONCLUSIÓN: El sarcoma de Ewing / tumor neuroectodérmico primitivo renal primario es una entidad rara que afecta mayoritariamente a adultos jóvenes. La historia natural de estos tumores es la evolución hacia una enfermedad metastásica y la muerte. El tratamiento es multimodal, y combina cirugía y quimioterapia. El papel de la radioterapia no está bien establecido(AU)


OBJECTIVE: To report two new cases of Ewing`s sarcoma/ primitive neuroectodermal tumor of the kidney, one of them with tumor thrombus in cava.METHOD: Characterization of two new cases and literature review by PubMed search.RESULTS: We report the cases of two men diagnosed with primary renal Ewing`s sarcoma, who have been treated with nephrectomy and adjuvant chemotherapy, being in complete remission to date.CONCLUSION: Ewing`s sarcoma / primitive neuroectodermal tumor of the kidney is a rare condition that mainly affects young adults. The natural history of these tumors is the evolution towards metastatic disease and death. Treatment is multimodal, combining surgery and chemotherapy. The role of radiotherapy is not well established


Asunto(s)
Humanos , Masculino , Adulto , Sarcoma de Ewing/complicaciones , Sarcoma de Ewing/diagnóstico , Tumores Neuroectodérmicos Periféricos Primitivos/complicaciones , Tumores Neuroectodérmicos Periféricos Primitivos/diagnóstico , Tumores Neuroectodérmicos Periféricos Primitivos/cirugía , Nefrectomía/métodos , Quimioterapia Adyuvante , Radioterapia Adyuvante , Terapia Combinada/métodos , Sarcoma de Ewing/fisiopatología , Nefrectomía/tendencias , Quimioterapia Adyuvante/métodos , Sarcoma de Ewing/cirugía , Sarcoma de Ewing , Tumores Neuroectodérmicos Periféricos Primitivos/fisiopatología , Tumores Neuroectodérmicos Periféricos Primitivos , Quimioterapia Adyuvante/tendencias , Radioterapia Adyuvante/tendencias
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