Treatment with sildenafil citrate in renal transplant patients with erectile dysfunction.

OBJECTIVE: To assess the safety and efficacy of sildenafil citrate in renal transplant patients with erectile dysfunction, as up to half of men with renal failure may be affected and only 60-75% recover potency after transplantation. PATIENTS AND METHODS: Fifty patients with erectile dysfunction and a functioning renal transplant were treated using sildenafil (mean age 54 years, mean time on dialysis 35 months, mean time from transplantation 20 months). The hypogastric artery was not used during transplantation in any patient. Sildenafil citrate was prescribed at doses of 25 or 50 mg depending on baseline creatinine values and on the response, and plasma levels of cyclosporin/FK506 were monitored. RESULTS: Thirty patients (60%) had a satisfactory response, with a mean time on dialysis of 23 months. Six patients (12%) did not take the sildenafil and in 14 (28%) the drug was ineffective. The mean time on dialysis in this group was 43 months. Six patients (12%) had side-effects that in no case led to withdrawal of treatment. Plasma levels of cyclosporin/FK506 remained within the safety and efficacy limits in all patients. CONCLUSIONS: Treatment with sildenafil citrate in renal transplant patients with erectile dysfunction is an effective and safe option, with few side-effects. Plasma levels of immunosuppressants are unchanged. The response was more effective in patients with a shorter time on dialysis, as penile vascular disease is less advanced.

[Retrovesical hydatic cyst]. / Quiste hidatídico retrovesical.

The hydatid disease is a common condition in endemic countries, generally involving the liver or the lungs. Genitourinary tract involvement is quite uncommon, and the organ most usually affected is the kidney. A retrovesical location is even more rare. The present paper contributes one case with no evidence of hydatidosis in any other abdominal organ and describes the diagnostic and therapeutic protocol followed.

[Response of superficial bladder carcinoma to prophylacit treatment with mitomycin-C versus interferon. Preliminary study]. / Respuesta en el carcinoma superficial de vejiga al tratamiento profiláctico con Mitomycin-C versus interferon. Estudio preliminar.

The efficacy of two protocols for the prevention of relapse using Mitomycin-C and alpha-Interferon in 56 patients with surface bladder carcinoma (stages Ta-T1) treated with TUR was compared in a prospective study. Relapse percentages and rates, related to the tumours' presentation characteristics (single, multiple, primary, recurrent), as well as their systemic and local toxicity, were evaluated. The study of statistical significance is made using the squared-chi test, and it is completed with a Fisher's test for groups containing few elements for accuracy. The results show no statistical differences (log rank p = 0.313) between the two groups of endovesical therapy, both confirming to be effective as adjuvant therapy to TUR in surface bladder tumours.

[Vulvar metastasis in renal adenocarcinoma]. / Metástasis vulvar en el adenocarcinoma renal.

We report an additional case of vulvar metastasis as the presenting symptom of renal adenocarcinoma. The hypothesis that have been put forward relative to the route of spread of this type of metastasis are discussed and the literature reviewed.

[Complete androgenic blockade: myth or reality. Study and follow-up of 35 patients with advanced carcinoma of the prostate]. / Bloqueo androgénico completo: mito o realidad. Estudio y seguimiento de 35 pacientes con carcinoma de próstata avanzado.

Retrospective evaluation of the efficacy of complete androgenic blockade started by Labrie et al. using therapy with leuprolide acetate in monthly dosage of 7.5 mg i.m. associated to flutamide at the usual dosage in 35 patients with prostate adenocarcinoma in C-D1-D2 stages, who had not been given prior anti-neoplastic therapy. Clinical and analytical control studies were carried out during therapy follow-up for a maximum time of 36 months. The objective response of adverse events that can be superimposed to previous studies carried out with analogs on daily administration was assessed. Castration levels achieved were maintained for the length of the study below 50 ng/dl. Correlation between tissue type, rated according to the Mostofi classification, evolution or degree of response obtained and preserved increase of tumour markers (PSA, PAP, LDH, Prolactin) was evaluated; the evolution observed in patients who maintained high values of markers was worse with the referred treatment.