Satisfacción y adherencia al tratamiento en disfunción eréctil a medio y largo plazo / Satisfaction and treatment adherence in erectile dysfunction in the medium and long term

Introducción: El objetivo ha sido mostrar la satisfacción y adherencia al tratamiento en disfunción eréctil (DE) a medio y largo plazo. Material y métodos: Estudio descriptivo y comparativo llevado a cabo en 2 centros mediante entrevistas telefónicas a pacientes que realizaron una primera visita entre 2012 y 2014 por DE. Se realizó una anamnesis completa sobre el uso y abandono del tratamiento. En caso de uso actual se cumplimentaron los cuestionarios EDITS y GAQ, y en caso de uso pasado solo el GAQ. Para el análisis estadístico se utilizaron el test exacto de Fisher para las comparaciones de porcentajes y el test de Kruskal-Wallis para comparar medias. Resultados: Doscientos cincuenta pacientes incluidos, habiendo recetado a un 20,8% alprostadilo intrauretral (AL-IU), a un 17,2% alprostadilo intracavenoso (AL-IC), a un 92,8% un primer IPD5, y a un 24,8% al menos un segundo IPD5. El abandono del tratamiento fue del 62,07% en el primer IPD5 utilizado, del 41,94% en el último IPD5 probado, del 69,23% en el AL-IU y del 65,11% en el AL-IC (p = 0,007). La principal razón de abandono en los IPD5 fue la falta de respuesta (32,76% de individuos que los toman). En el caso del AL-IU y AL-IC, además de esta destacan las reacciones adversas (28,85% y 11,63% respectivamente). La media de utilización hasta el abandono fue de 4,3 meses en IPD5, 2,2 meses en AL-IU y 5,5 meses en AL-IC (p = 0,064). Las puntaciones del GAQ y EDITS más favorables se observaron en los IPD5 (EDITS de 74). Sildenafilo y tadalafilo tienen los tiempos más largos de uso (media mayor de 5 meses). Conclusiones: El porcentaje de abandono en el tratamiento de la DE es alto, con tiempos cortos de uso de pocos meses, siendo las principales causas de abandono la falta de respuesta y las reacciones adversas. Los fármacos que aportan mayor satisfacción son los IPD5, sin existir diferencias significativas en el tiempo medio de uso entre los diferentes tipos y en aspectos como la media de uso hasta el abandono o los porcentajes de abandono

Introduction: The aim of this study was to show the satisfaction and treatment adherence in erectile dysfunction (ED) in the medium and long term.Material and methods: A descriptive, comparative study was conducted in 2 centres through telephone interviews with patients who came for an initial visit between 2012 and 2014 for ED. A complete case history review was conducted on the use of and withdrawal from treatment. For current use, the Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) and the Global Assessment Questionnaire (GAQ) were filled out; for past use, only the GAQ was filled out. For the statistical analysis, we employed Fisher's exact test for comparisons of percentages and the Kruskal-Wallis test to compare means. Results: The study included 250 patients; 20.8% were prescribed intraurethral alprostadil (ALP-IU), 17.2% were prescribed intracavernous alprostadil (ALP-IC), 92.8% were prescribed a first IPD5, and 24.8% were prescribed at least a second IPD5. The treatment withdrawal rate was 62.07% for the first IPD5, 41.94% for the last IPD5, 69.23% for the ALP-IU and 65.11% for the ALP-IC (P = .007). The main reason for withdrawal for the IPD5 was a lack of response (32.76% of those who took IPD5). In addition to withdrawal, there were adverse reactions for ALP-IU and ALP-IC (28.85% and 11.63%, respectively). The mean duration of use until withdrawal was 4.3 months for IPD5, 2.2 months for ALP-IU and 5.5 months for ALP-IC (P = .064). The most favourable GAQ and EDITS scores were observed for IPD5 (EDITS score of 74). Sildenafil and tadalafil had the longest usage times (mean >5 months). Conclusions: The withdrawal rate for treating ED is high, with short usage times of a few months. A lack of response and adverse reactions were the main causes for withdrawal. The drugs that provide greater satisfaction are the IPD5, although there are no significant differences in the mean usage time between the different types and in aspects such as the mean usage time to withdrawal or the withdrawal rates

Satisfaction and treatment adherence in erectile dysfunction in the medium and long term. / Satisfacción y adherencia al tratamiento en disfunción eréctil a medio y largo plazo.

INTRODUCTION: The aim of this study was to show the satisfaction and treatment adherence in erectile dysfunction (ED) in the medium and long term. MATERIAL AND METHODS: A descriptive, comparative study was conducted in 2 centres through telephone interviews with patients who came for an initial visit between 2012 and 2014 for ED. A complete case history review was conducted on the use of and withdrawal from treatment. For current use, the Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) and the Global Assessment Questionnaire (GAQ) were filled out; for past use, only the GAQ was filled out. For the statistical analysis, we employed Fisher's exact test for comparisons of percentages and the Kruskal-Wallis test to compare means. RESULTS: The study included 250 patients; 20.8% were prescribed intraurethral alprostadil (ALP-IU), 17.2% were prescribed intracavernous alprostadil (ALP-IC), 92.8% were prescribed a first IPD5, and 24.8% were prescribed at least a second IPD5. The treatment withdrawal rate was 62.07% for the first IPD5, 41.94% for the last IPD5, 69.23% for the ALP-IU and 65.11% for the ALP-IC (P=.007). The main reason for withdrawal for the IPD5 was a lack of response (32.76% of those who took IPD5). In addition to withdrawal, there were adverse reactions for ALP-IU and ALP-IC (28.85% and 11.63%, respectively). The mean duration of use until withdrawal was 4.3 months for IPD5, 2.2 months for ALP-IU and 5.5 months for ALP-IC (P=.064). The most favourable GAQ and EDITS scores were observed for IPD5 (EDITS score of 74). Sildenafil and tadalafil had the longest usage times (mean >5 months). CONCLUSIONS: The withdrawal rate for treating ED is high, with short usage times of a few months. A lack of response and adverse reactions were the main causes for withdrawal. The drugs that provide greater satisfaction are the IPD5, although there are no significant differences in the mean usage time between the different types and in aspects such as the mean usage time to withdrawal or the withdrawal rates.

Un tumor genitourinario infrecuente: sarcomas paratesticulares / Paratesticular sarcoma: An infrequent genitourinary tumor

OBJETIVO: Exponer los aspectos relacionados con el diagnóstico, terapéutica y seguimiento de los sarcomas paratesticulares, a partir de la presentación de tres casos con diferente histología. MÉTODO: Descripción de los casos clínicos, el manejo quirúrgico, y los resultados anatomopatológicos de las piezas quirúrgicas. RESULTADOS: Presentamos tres casos de pacientes con sarcomas paratesticulares, un caso de rabdomiosarcoma y dos de liposarcoma. Dos pacientes tuvieron una primera y única cirugía exitosa, mientras que el tercero precisó de reintervención tras recidiva. Actualmente los tres se encuentran libre de enfermedad. CONCLUSIONES: Los sarcomas paratesticulares son neoplasias infrecuentes en urología. Es esencial que el urólogo sospeche esta posibilidad ante un tumor paratesticular, pues la radicalidad en la cirugía será el factor más determinante en el éxito del tratamiento. Las terapias adyuvantes deben individualizarse en cada caso, y el seguimiento tras la cirugía conviene que sea estrecho, dada la mala evolución de estos tumores en muchos casos

OBJECTIVE: To expose the features related to the diagnosis, therapy and follow-up of paratesticular sarcomas, through the presentation of three cases with different histologies. METHODS: Description of the clinical cases, surgical management, and pathological results of the surgical specimens. RESULTS: We present three cases of paratesticular sarcomas, one case being a rhabdomyosarcoma and two liposarcomas. Two patients underwent a single successful surgery, while the third one required a second intervention after recurrence. Today all three patients are free of disease. CONCLUSIONS: Malignant paratesticular sarcomas are infrequent neoplasias in urology. It is essential that the urologist is aware of this possibility when faced with a paratesticular tumor, since radicalness of surgery will be the most decisive factor in the success of the treatment. Adjuvant therapies must be individualized in each case, and the follow-up after surgery should be close, given the poor evolution of these tumors in many cases