Spironolactone Induces Vasodilation by Endothelium-Dependent Mechanisms Involving NO and by Endothelium-Independent Mechanisms Blocking Ca2+ Channels.

BACKGROUND: Spironolactone (SPI) is a diuretic widely used to treat cardiovascular diseases (CVD) and is non-specific for mineralocorticoid receptors (MR) and with an affinity for progesterone (PR) and androgen (AR) receptors. Since 2009, it has been suggested that pharmaceuticals are emerging contaminants (called EDC), and recently, it was reported that most EDC are AR and MR antagonists and estrogen receptors (ER) agonists. Concerning SPI, endocrine-disrupting effects were observed in female western mosquitofish, but there are still no data regarding the SPI effects as a possible human EDC. METHODS: In this work, aortic rings were used to analyze the contractility effects of SPI and the mode of action concerning the involvement of Ca2+ channels and endothelial pathways. Moreover, cytotoxic effects were analyzed by MTT assays. RESULTS: SPI induces vasodilation in the rat aorta by endothelium-dependent mechanisms involving NO and by endothelium-independent mechanisms blocking Ca2+ channels. Moreover, a non-monotonic effect characteristic of EDC was observed for SPI-induced decrease in cell viability. CONCLUSIONS: Our findings suggest that SPI may act as an EDC at a human level. However, ex vivo studies with human arteries should be carried out to better understand this drug's implications for human health and future generations.

Recognition of COVID-19 with occupational origin: a comparison between European countries.

OBJECTIVES: This study aims to present an overview of the formal recognition of COVID-19 as occupational disease (OD) or injury (OI) across Europe. METHODS: A COVID-19 questionnaire was designed by a task group within COST-funded OMEGA-NET and sent to occupational health experts of 37 countries in WHO European region, with a last update in April 2022. RESULTS: The questionnaire was filled out by experts from 35 countries. There are large differences between national systems regarding the recognition of OD and OI: 40% of countries have a list system, 57% a mixed system and one country an open system. In most countries, COVID-19 can be recognised as an OD (57%). In four countries, COVID-19 can be recognised as OI (11%) and in seven countries as either OD or OI (20%). In two countries, there is no recognition possible to date. Thirty-two countries (91%) recognise COVID-19 as OD/OI among healthcare workers. Working in certain jobs is considered proof of occupational exposure in 25 countries, contact with a colleague with confirmed infection in 19 countries, and contact with clients with confirmed infection in 21 countries. In most countries (57%), a positive PCR test is considered proof of disease. The three most common compensation benefits for COVID-19 as OI/OD are disability pension, treatment and rehabilitation. Long COVID is included in 26 countries. CONCLUSIONS: COVID-19 can be recognised as OD or OI in 94% of the European countries completing this survey, across different social security and embedded occupational health systems.

Acute graft thrombosis in patients who underwent renal transplant and received anticoagulant or antiplatelet agents. A systematic review and meta-analysis.

OBJECTIVES: Thrombosis is a major cause of early allograft loss in renal transplantation. Herein, we assessed the frequency of acute graft thrombosis in patients who underwent renal transplant and received anticoagulant or antiplatelet agents. METHODS: We performed a systematic review of all available case series studies of anticoagulant and/or antiplatelet prophylaxis of thrombosis in renal transplantation. The data were pooled in a proportional meta-analysis. RESULTS: Twenty-one case series were identified from 7,160 retrieved titles. A total of 3,246 patients were analyzed (1,718 treated with antiplatelet and/or anticoagulant agents and 1,528 non-treated control subjects). Allograft thrombosis occurred in 7.24% (95% CI 3.45 to 12.27%) of the patients receiving no intervention compared with 3.38% (95% CI 1.45 to 6.1%), 1.2% (95% CI 0.6 to 2.1%) and 0.47% (95% CI 0.001 to 1.79%) of the patients in the anticoagulant, aspirin, and aspirin + anticoagulant groups, respectively. The bleeding complication rate for anticoagulants was significantly higher than in the other groups. CONCLUSIONS: Our data suggests that anticoagulants, and aspirin, either alone or in association with an anticoagulant, seem to have a low frequency of acute allograft thrombosis after kidney transplantation. Higher hemorrhagic complication rates might occur when anticoagulants are used.

Fasting and 24-h urine pH in patients with urolithiasis using potassium citrate.

PURPOSE: To evaluate the correlation between the pH readings in 24-h urine and the random fasting specimen in patients with urolithiasis using 2 methods. METHODS: A total of 114 patients with urinary lithiasis using potassium citrate were prospectively analyzed. All patients collected 24-h urine and an additional sample, after nocturnal fasting, collected on the day they brought the 24-h sample at the lab. Two different methods (test strip and digital meter) were used to determine pH values. RESULTS: The pH analysis using strips in the 24-h urine presented a mean value similar to the one obtained in the fasting sample (6.07 ± 0.74 vs. 6.02 ± 0.82, respectively; P > 0.05). The same behavior was seen considering the readings with a digital pH meter (5.8 ± 0.78 vs. 5.75 ± 0.83; P > 0.05). However, readings conducted in the same specimen with pH meter and test strip were dissonant (P < 0.05), suggesting that the colorimetric method is not reliable in the assessment of urinary pH in this population. CONCLUSION: pH assessment in a random urinary specimen proved as efficient as the 24-h urine standard method to monitor patients with kidney stones in the use of potassium citrate. Classical test strip analysis is not sensitive enough to evaluate the urine pH in this population and digital pH meter reading is preferred.

Clinical and Functional Results of Reverse Total Shoulder Arthroplasty and Postoperative Rehabilitation Protocol.

Purpose This retrospective study aims to analyze the clinical and functional results obtained over a seven-year period of performing reverse total shoulder arthroplasty (RTSA) and the subsequent postoperative rehabilitation protocol. Methods We analyzed data from 80 patients who were evaluated at a preoperative, as well as monthly postoperative outpatient consultation, until the discharge from the rehabilitation program, using Constant Score (CS). Results A comparison of preoperative and postoperative (after rehabilitation protocol) results revealed an improved functional score of absolute CS (20.8 increase), normal relative CS (29.1 increase), and individual relative CS (31.7 increase) with statistical significance (p<0.05). From the analysis of CS subscores, there was a positive evolution of the pain subscore, as well as flexion, abduction, and external rotation combined with abduction range of motion (ROM). Contrarily, there was a negative evolution of the combined internal rotation, extension, and adduction ROM, as well as deltoid muscle strength. No statistically significant correlations were found between age and postoperative CS, as well as between the time interval from surgery to the beginning of outpatient rehabilitation and CS evolution. Conclusion Our study demonstrates that RTSA is an effective therapeutic option that, if combined with a well-structured rehabilitation program, can improve pain, mobility, and upper limb functionality.

Multiple analyses suggests texture features can indicate the presence of tumor in the prostate tissue.

Several studies have demonstrated statistical and texture analysis abilities to differentiate cancerous from healthy tissue in magnetic resonance imaging. This study developed a method based on texture analysis and machine learning to differentiate prostate findings. Forty-eight male patients with PI-RADS classification and subsequent radical prostatectomy histopathological analysis were used as gold standard. Experienced radiologists delimited the regions of interest in magnetic resonance images. Six different groups of images were used to perform multiple analyses (seven analyses variations). Those analyses were outlined by specialists in urology as those of most significant importance for the classification. Forty texture features were extracted from each image and processed with Random Forest, Support Vector Machine, K-Nearest Neighbors, and Naive Bayes. Those seven analyses variation results were described in terms of area under the ROC curve (AUC), accuracy, F-score, precision and sensitivity. The highest AUC (93.7%) and accuracy (88.8%) were obtained when differentiating the group with both MRI and histopathology positive findings against the group with both negative MRI and histopathology. When differentiating the group with both MRI and histopathology positive findings versus the peripheral image zone group the AUC value was 86.6%. When differentiating the group with negative MRI/positive histopathology versus the group with both negative MRI and histopathology the AUC value was 80.7%. The evaluation of statistical and texture analysis promoted very suggestive indications for future work in prostate cancer suspicious regions. The method is fast for both region of interest selection and classification with machine learning and the result brings original contributions in the classification of different groups of patients. This tool is low-cost, and can be used to assist diagnostic decisions.

Work-life prevalence of self-reported occupational injuries in mothers of a birth cohort.

Purpose. This study investigated self-reported occupational injuries among mothers in a large birth cohort study and the relation of their characteristics to different injury outcomes: occurrence, severity, temporal proximity and recurrence. Methods. We asked 4338 women whether they had been in 'an accident at work, even if it did not require medical treatment', and the number of accidents throughout their working life, type of injury and whether it occurred within the last 12 months. Results. Over one-fifth (21.8%) of working-age mothers reported having at least one occupational injury throughout their working life. Wounds and superficial injuries were the most frequently reported types of occupational injuries (11.0%), followed by dislocated bones and joints, sprains and strains (10.7%). Women who reported a history of occupational injuries also had a higher likelihood of reporting a work-related health problem (adjusted odds ratio [OR] = 2.64; 95% confidence interval [CI] [2.27, 3.07]) and of having a partner who also reported an occupational injury throughout their working life (adjusted OR = 1.86; 95% CI [1.33, 2.62]). Associations remained fairly stable across all outcomes. Conclusions. Our findings point towards a broadened understanding of occupational injury consequences and research focusing on family-level factors that account for the embeddedness of workers in households.

Impact of Time-Zero Biopsy on the Outcome of Transplanted Kidneys.

BACKGROUND: A low supply of donated organs led to the expansion of criteria for kidney transplantation (KT), and the impact on late glomerular function rates (eGFR) is still uncertain. This study aimed to correlate the histologic findings at time-zero biopsy (TzB) with the final eGFR, to identify criteria that could help achieve a more thorough preimplantation evaluation of the organ. METHODS: Records from 395 adult deceased KTs were reviewed. TzBs were analyzed considering histologic criteria by compartment (vascular, interstitial, tubular, and inflammatory) and correlated with the eGFR after 1 year. RESULTS: Among donors, 56.9% were men (mean age 39 years), with the main causes of death being brain trauma (44.2%) and stroke (46.0%). Histologic analysis of TzB revealed 6.0% of glomerulosclerosis; 18.8% presenting vascular alterations; interstitial fibrosis in 54.6%; tubular changes in 76.9%, and nonspecific inflammatory infiltrate in 2.3%. Linear regression analysis showed that the main histologic findings that had impact in the eGFR were interstitial fibrosis (P = .000), followed by tubular alterations (P = .036) and glomerulosclerosis (P = .008). CONCLUSIONS: Histologic variables like interstitial fibrosis and tubular alterations show the most significant negative correlation with final eGFR. The effect of glomerulosclerosis may not be as important as formerly suggested in the literature.

Musculoskeletal Disorders' Classification Proposal for Application in Occupational Medicine.

Occupational-specific classifications of musculoskeletal disorders (MSD) are scarce and do not answer specific clinical questions. Thus, a specific classification was developed and proposed, covering criteria applicable to daily clinical activity. It was considered that the disorder development process is the same across all work-related MSDs (WRMSDs). Concepts of clinical pathology were applied to the characteristics of WRMSDs pathophysiology, cellular and tissue alterations. Then, the correlation of the inflammatory mechanisms with the injury onset mode was graded into four levels (MSDs 0-3). Criteria of legal, occupational and internal medicine, semiology, physiology and orthopaedics, image medicine and diagnostics were applied. Next, the classification was analysed by experts, two occupational physicians, two physiatrists and occupational physicians and one orthopaedist. This approach will allow WRMSD prevention and improve therapeutic management, preventing injuries from becoming chronic and facilitating communication between occupational health physicians and the other specialities. The four levels tool relate aetiopathogenic, clinical, occupational and radiological concepts into a single classification. This allows for improving the ability to determine a WRMSD and understanding what preventive and therapeutic measures should be taken, avoiding chronicity. The developed tool is straightforward, easy to understand and suitable for WRMSDs, facilitating communication between occupational physicians and physicians from other specialities.

Effects of Obesity and Diabetes on Sperm Cell Proteomics in Rats.

Infertility caused by male factors is potentially associated with metabolic disorders such as obesity and/or diabetes. This experimental study was conducted in a male rodent model to assess the effects of different diseases on semen quality and sperm proteomics. Ten Wistar rats were used for each treatment. Rats were fed commercial food provided controllably to the control group and the diabetic group, and a hypercaloric diet supplemented with 5% sucrose in water was provided ad libitum to the obese group for 38 weeks. Diabetes was induced with 35 mg/kg streptozotocin. After euthanasia, testicles, spermatozoa, fat, and blood (serum) samples were collected. Spermatozoa were evaluated for quality and subjected to proteomics analyses. Histology and cytology of the testis, and serum leptin, adiponectin, interleukin 8 (IL-8), blood glucose, and testosterone levels, were also assessed. Body weight, retroperitoneal and testicular fat, and the Lee index were also measured. Obesity and diabetes were induced. The diabetic group showed noticeable changes in spermatogenesis and sperm quality. The mass spectrometry proteomics data have been deposited in Mendeley Data (doi: 10.17632/rfp7kfjcsd.5). Fifteen proteins varied in abundance between groups, especially proteins related to energy production and structural function of the spermatozoa, suggesting disturbances in energy production with a subsequent alteration in sperm motility in both groups, but with a compensatory response in the obese group.

Development and Validation of an Age-Appropriate Website for Children Requiring Clean Intermittent Catheterization.

PURPOSE: This study describes the development and validation of an age-appropriate website for preschool children who require clean intermittent catheterization (CIC). METHODS: An age-appropriate website was developed at an academic medical center in Brazil and included child-friendly characters, details of the urinary system anatomy and physiology, hand-washing, and the CIC procedure. Content was validated by physicians, nurses, and health informatics professionals. Face validity was assessed by parents. FINDINGS: Content and face validity indices were 0.94 and 0.92, respectively. CONCLUSIONS: The free website (www.doutorbexiga.com.br) was successfully validated and considered suitable and user-friendly for the health education of children requiring CIC. CLINICAL RELEVANCE: Physicians and nurses can use the website as a model for developing similar materials. The website can be a resource for health professionals and parents of children with spinal cord injury or other neurological disorders to encourage children to learn about CIC through animated educational materials.

Pelvic floor muscle strength is correlated with sexual function.

PURPOSE: Sexual performance is related to proprioception and pelvic floor muscle strength (PFMS). The aim of this study was to correlate sexual activity and orgasm with PFMS. MATERIALS AND METHODS: A total of 140 healthy continent female were prospectively distributed into 4 groups according to age: Group 1 (G1), 30-40; Group 2 (G2), 41-50; Group 3 (G3), 51-60; Group 4 (G4), over 60 years old. Evaluated parameters were: frequency of sexual activity and orgasm achievement; body mass index (BMI) and objective evaluation of PFMS using perineometer and surface electromyography. RESULTS: BMI was higher in G4 compared to G1 (p=0.042). Women who reported sexual activity was significantly higher in G1 compared to G3 and G4 (94.1% vs. 66.7% and 37.5%, respectively; p=0.001). Orgasm was more frequently in G1 compared to G3 and G4 (91.2% vs. 63.9% and 28.1%, respectively; p=0.001), demonstrating that sexual activity and orgasm decrease after age 51. The duration of PFM contraction was significantly higher in women who had sexual intercourse (p=0.033) and orgasm (p=0.018). CONCLUSIONS: Although the frequency of sexual intercourse and orgasm may decrease with aging, a relationship between sexual activity and PFMS remains apparent, once both sexually active women and those who have orgasms showed better PFM endurance than non-sexually active ones.

Effects of tadalafil to prevent injury on corpus cavernosum after vascular or nervous peri-prostatic bundle injury. Experimental model in rats.

PURPOSE: To evaluate the effects of tadalafil (TD) in preventing histological alterations of the corpus cavernosum caused by isolated lesions of cavernous nerve (ILCN) and artery (ILCA) in rats. METHODS: Fifty male Wistar rats were randomly assigned in five groups: G1: control; G2: bilateral ILCN; G3: bilateral ILCA; G4: ILCN+TD; G5: ILCA+TD. The cavernous bodies were submitted to histomorphometry, immunohistochemistry and biochemical analysis. RESULTS: Nerve density was significantly higher in G2 and G4 compared to control (22.62±2.84 and 19.53±3.47 vs. 15.72±1.82; respectively, p<0.05). Smooth muscle density was significantly lower in G2 and G3 in comparison to G1 (12.87±1.90 and 18.93±1.51 vs. 21.78±1.81, respectively; p<0.05). A significant decrease in the sinusoidal lumen area was observed in G2 compared to controls (5.01±1.62 vs. 9.88±3.66, respectively; p<0.05) and the blood vessel density was increased in G2 and G3 (29.32±4.13 e 20.80±2.47 vs. 10.13±2.71, p<0.05). Collagen density was higher in G3 compared to G1 (93.76±15.81 vs. 64.59±19.25; p<0.05). CONCLUSIONS: Histomorphometric alterations caused by ILCN were more intense than those produced by vascular injury, but the collagen analyses showed more fibrosis in animals with ILCA. TD was effective in preventing the majority of the alterations induced by the periprostatic bundle injury.

Impact of adjusted kidney volume measured in the bench surgery on one-year renal function in kidney transplantation.

BACKGROUND: Kidney transplantation is the treatment of choice in patient with end stage chronic kidney disease, offering the best long term survival and greater Quality of Life in this group of patients. Graft volume was correlated with improved renal function in living donor transplantations. The primary aim of this study was to correlate renal volume adjusted to body surface area with renal function one year (estimated glomerular filtration rate; eGFR) after kidney transplantation. METHODS: This single-center, prospective cohort study included 256 patients who underwent kidney transplantation from January 2011 through December 2015 at Hospital das Clínicas de Botucatu-UNESP. We evaluated three kidney measurements during the bench surgery; the final graft volume was calculated using the ellipsoid formula and adjusted to body surface area. RESULTS: In the living donors there was positive correlation between adjusted graft volume and eGFR (r = 0.311, p = 0.008). Multivariate analysis revealed that low rejection rate and increased adjusted graft volume were independent factors correlated with eGFR. In deceased donors, there was no correlation between adjusted kidney volume and eGFR (r = 0.08, p = 0.279) in univariate analysis, but a multivariate analysis indicated that lower kidney donor profile index (KDPI), absence of rejection and high adjusted kidney volume were independent factors for better eGFR. CONCLUSION: Adjusted kidney volume was positively correlated with a satisfactory eGFR at one year after living donor and deceased donor transplantations.

Impact of vulvovaginal atrophy on pelvic floor muscle strength in healthy continent women.

OBJECTIVES: To assess the correlation between hormonal status and pelvic floor muscle strength. METHODS: A total of 140 continent women were prospectively evaluated, and divided into four groups according to age: group 1 (n = 34) aged 30-40 years; group 2 (n = 38) aged 41-50 years; group 3 (n = 35) aged 51-60; and group 4 (n = 33) aged >60 years. The following parameters were evaluated: demographic data using clinical questionnaire; hypermobility of the bladder neck using swab test; vaginal trophism by gynecological examination; hormonal status of the vagina by cytology; and pelvic floor muscle strength using a perineometer and electromyography. RESULTS: There were no statistical differences between pelvic floor muscle strength, demographic characteristics, vaginal trophism and hypermobility of the bladder neck between groups (P > 0.05). There was a larger number of women with vaginal atrophy among those aged >60 years. Vaginal trophism assessed by pelvic examination was highly consistent with the findings of colpocytology (kappa test = 0.888). Electromyography showed that women with hypermobility had lower muscle resistance (endurance) when compared with those without hypermobility. CONCLUSIONS: Although vaginal atrophy is more intense in women aged >60 years, no difference can be found in the pelvic floor muscle strength during the physiological aging process in continent women. As a consequence, trophism is not the only factor related to pelvic floor muscle strength, and it should not preclude the selection of patients who are referred to prophylaxis.

Effects of tadalafil to prevent injury on corpus cavernosum after vascular or nervous peri-prostatic bundle injury. Experimental model in rats

Abstract Purpose: To evaluate the effects of tadalafil (TD) in preventing histological alterations of the corpus cavernosum caused by isolated lesions of cavernous nerve (ILCN) and artery (ILCA) in rats. Methods: Fifty male Wistar rats were randomly assigned in five groups: G1: control; G2: bilateral ILCN; G3: bilateral ILCA; G4: ILCN+TD; G5: ILCA+TD. The cavernous bodies were submitted to histomorphometry, immunohistochemistry and biochemical analysis. Results: Nerve density was significantly higher in G2 and G4 compared to control (22.62±2.84 and 19.53±3.47 vs. 15.72±1.82; respectively, p<0.05). Smooth muscle density was significantly lower in G2 and G3 in comparison to G1 (12.87±1.90 and 18.93±1.51 vs. 21.78±1.81, respectively; p<0.05). A significant decrease in the sinusoidal lumen area was observed in G2 compared to controls (5.01±1.62 vs. 9.88±3.66, respectively; p<0.05) and the blood vessel density was increased in G2 and G3 (29.32±4.13 e 20.80±2.47 vs. 10.13±2.71, p<0.05). Collagen density was higher in G3 compared to G1 (93.76±15.81 vs. 64.59±19.25; p<0.05). Conclusions: Histomorphometric alterations caused by ILCN were more intense than those produced by vascular injury, but the collagen analyses showed more fibrosis in animals with ILCA. TD was effective in preventing the majority of the alterations induced by the periprostatic bundle injury.

Musculoskeletal injuries and absenteeism among healthcare professionals-ICD-10 characterization.

INTRODUCTION: Healthcare workers account for 10% of the EU's total workforce, with a significant proportion of those employed in hospitals. Musculoskeletal injuries are the predominant group of injuries in healthcare professionals due to the physical demands of their work, such as the mobilization and positioning of the dependent patients. The management of this type of problem should take into account direct and indirect costs, such as periods of incapacity for work due to illness, hiring and training of new employees during periods of absence, reduced levels of productivity and the effects on production and quality of work. OBJECTIVES: 1-Characterization of injuries resulting from occupational accidents in hospital workers according to the International Classification of Diseases ICD-10; 2-Identification of the predictive factors of absenteeism duration due to temporary work incapacity in workplace accidents. METHODS: A retrospective observational study was conducted based on the analysis of 1621 cases of work-related accidents of employees of Centro Hospitalar São João from January 2011 to December 2014. An ICD-10 classification code was associated with each of the accident cases, based on pre-established criteria for classification of the specific diagnoses of musculoskeletal injuries. The duration of temporary work incapacity was compared between the categories of sociodemographic variables, among six categories of ICD-10 primary diagnosis (reclassification), and between the two major chapters of ICD-10 classification-chapter XIX (direct trauma) and chapter XIII (indirect trauma-strain injuries). The sociodemographic predictors of the occurrence of strain injuries were determined by logistic regression. A multinomial logistic regression analysis was conducted with selection of duration of work incapacity as the dependent variable. RESULTS: A total of 824 cases of musculoskeletal injuries occurred on hospital premises during the study period, which corresponded to a total of 22159 lost workdays in the context of temporary work incapacity due to work injury. According to the ICD-10 reclassification, the three most frequent diagnostic groups were direct lower limb trauma (n = 230, 27.9%), spinal strain injuries (n = 194, 23.5%) and direct upper limb trauma (n = 174, 21.1%). Significant differences were observed in temporary work incapacity duration among the ICD-10 diagnostic categories: spinal strain injuries were the diagnostic group associated with longer duration of temporary work incapacity, with a median = 14.0 (25-75th percentile: 6.0-35.0). The only variable that demonstrated to be significantly predictive of temporary work incapacity less than or greater than 20 days was the ICD-10 diagnostic group. The regression results revealed a 5-fold increase in risk in the case of spinal strain injuries for temporary work incapacity durations of less than or greater than 20 days (OR = 5.58 and OR = 5.89 respectively). CONCLUSIONS: The study findings support the benefits of the characterization of workplace injuries by medical diagnostic groups, namely in the interpretation of the sequelae of the accidents and the medical contextualization of the accidents. Association of ICD-10characterization can improve the analysis of workplace accidents at an institutional level, and promote the implementation of preventive measures and control of absenteeism.

Artificial sphincter "BR - SL - AS 904" in the treatment of urinary incontinence after radical prostatectomy: efficacy, practicality and safety in a prospective and multicenter study

ABSTRACT Purpose: The objective of the present study is to test the efficiency and practicality of a new artificial sphincter "BR - SL - AS - 904" in the control of urinary incontinence in post - PR patients and to evaluate their complications. Patients and Methods: Fifteen patients with incontinence after one year of radical prostatectomy were included prospectively. All patients underwent artificial urethral sphincter (AUS) implant "BR - SL - AS - 904" according to established technique. Independent variables such as free urinary flow, PAD weight test, ICIQ - SF score and urinary symptoms through the IPSS score were compared in different follow-up moments. Results: Patients submitted to AUS implantation did not present trans - operative or post - operative complications related to the surgical act such as: infection, hematoma, erosion or urinary retention. Device was inert to the body during the follow-up, showing an excellent adaptation of the patients, besides the easy handling. The mean age was 68.20 years 40% of the patients had systemic arterial hypertension, 6.7% diabetes mellitus, 6.7% were hypertensive and diabetic, 13.4% were hypertensive, had diabetes and hypercholesterolemia and 26.7% patients had no comorbidities. It was evidenced that the urinary flow peak during the follow-up remained stable. Decreased averages and median PAD weight test were 135.19 to 75.72 and 106.00 to 23.50, respectively. The IPSS score decreased and the quality of life increased (12.33 to 3.40 and 2.50 to 3.20 respectively). The ICQF - SF questionnaire score also showed a decrease, ranging from 16, 71 to 7.33. Conclusion: The artificial sphincter implant "BR - SL - AS 904" was reproducible, safe and effective in the control of urinary incontinence in post - PR patients.

Artificial sphincter "BR - SL - AS 904" in the treatment of urinary incontinence after radical prostatectomy: efficacy, practicality and safety in a prospective and multicenter study.

PURPOSE: The objective of the present study is to test the efficiency and practicality of a new artificial sphincter "BR - SL - AS - 904" in the control of urinary incontinence in post - PR patients and to evaluate their complications. PATIENTS AND METHODS: Fifteen patients with incontinence after one year of radical prostatectomy were included prospectively. All patients underwent artificial urethral sphincter (AUS) implant "BR - SL - AS - 904" according to established technique. Independent variables such as free urinary flow, PAD weight test, ICIQ - SF score and urinary symptoms through the IPSS score were compared in different follow-up moments. RESULTS: Patients submitted to AUS implantation did not present trans - operative or post - operative complications related to the surgical act such as: infection, hematoma, erosion or urinary retention. Device was inert to the body during the follow-up, showing an excellent adaptation of the patients, besides the easy handling. The mean age was 68.20 years 40% of the patients had systemic arterial hypertension, 6.7% diabetes mellitus, 6.7% were hypertensive and diabetic, 13.4% were hypertensive, had diabetes and hypercholesterolemia and 26.7% patients had no comorbidities. It was evidenced that the urinary flow peak during the follow-up remained stable. Decreased averages and median PAD weight test were 135.19 to 75.72 and 106.00 to 23.50, respectively. The IPSS score decreased and the quality of life increased (12.33 to 3.40 and 2.50 to 3.20 respectively). The ICQF - SF questionnaire score also showed a decrease, ranging from 16, 71 to 7.33. CONCLUSION: The artificial sphincter implant "BR - SL - AS 904" was reproducible, safe and effective in the control of urinary incontinence in post - PR patients.