Efficacy of pentoxifylline in Peyronie's disease: Clinical case of a young man.

Peyronie's disease (PD) is a localized connective tissue disorder of the tunica albuginea of the penis and its surrounding tissue which results in a painful erection, penile curvature and erectile dysfunction. The great number and variety of purposed treatments for PD is in proportion to the difficulty of its management.In fact no medical treatment is currently available to cure patients with PD. Pentoxifylline (PTX) is a non specific phosphodiesterase inhibitor with anti-inflammatory properties that has been used to treat claudication. PTX has also been used to decrease inflammation and fibrosis in kidney transplants, open heart surgery, dermatological conditions and after radiation injury. With respect to penile diseases, clinical studies have suggested that PTX decreases calcification in new-onset PD. These traits make PTX an interesting potential option for PD therapy.

Genital diseases awareness in young male students: Is information necessary to protect them?

INTRODUCTION: Few studies on the prevalence of male sexual diseases are currently available due to difficult application of observational studies or andrological disease prevention campaigns on large series of apparently healthy subjects. The medical check-up linked to compulsory military service represented in Italy a valid tool for epidemiological and observational study for 18 year old boys from 1861 to 2004. The stopping of compulsory military service and its related medical check-up could have determined an important social impact in terms of a lower level of attention and care on male genital/sexual diseases. The aim of the present observational study was to check the prevalence of genital/sexual diseases among young male high-school students and promote an alternative campaign of information among young students. METHODS: A prospective observational analytical study on young male students was conducted by 6 urological centres. Genital and sexually transmitted diseases were presented with slides to students in a general assembly. Some students were then counselled and filled out a short questionnaire on their lifestyle. RESULTS: 12,535 students (10,432 males-83.6%) followed the presentation. and 4,897 males (46.7%) decided to be checked-up by the urologist and out of them 1554 (31.7%) presented relevant andrological diseases. Five-hundred students completed the questionnaire concerning their lifestyle. Many of them had not yet experienced condom use during sexual intercourse (27.8%). Drug abuse was reported by 39.6% of subjects and alcohol consumption in 80.8% of them. CONCLUSIONS: These data suggest the need for a national information campaign on male sexual disorders to promote sexual health.

(Micro)surgical and percutaneous procedures in the management of varicocele: 25 years of experience.

BACKGROUND: The effectiveness of different procedures for varicocele varies in terms of recurrence, sperm-count improvement, pregnancies and deliveries. OBJECTIVES: To determine if microsurgical varicocelectomy plus antegrade sclerotherapy under local anaesthesia is the first choice surgical modality to treat this disease. METHODS: Since 1983 out of more than 1000 patients treated for primitive varicocele, we considered 800 patients with a follow-up of two years. Out of them 195 underwent a "standard" surgical procedure, 280 received a percutaneous sclerotherapy and 325 were managed microsurgically. Out of the last group, the first 90 cases were operated by microsurgical technique alone, while the remaining were offered microsurgery plus antegrade sclerotherapy. RESULTS: Traditional surgery had the higher incidence of relapse whereas percutaneous sclerotherapy needed use of Gianturco's coil to minimize relapses. Microsurgical technique plus antegrade sclerotherapy had the lower incidence of failures. CONCLUSIONS: An extensive experience through the years led us to consider microsurgery plus sclerotherapy as the first choice treatment for varicocele.

Clinical use of ultrasonography associated with color Doppler in the diagnosis and follow-up of acute pyelonephritis.

OBJECTIVES: The purpose of this study is to evaluate the current role of the Ultrasound associated with the color-Doppler in the diagnosis of acute pyelonephritis (APN) and to compare ultrasound images with CT images in order to reduce the amount radiation absorbe without significant loss of diagnostic efficacy, since this disease in most cases affects young adults. MATERIAL AND METHODS: We studied 38 patients (aged 17-65 years) who presented from September 2007 to March 2010 to the emergency department with suspected diagnosis of APN. All patients underwent first to an ultrasound study, then to abdominal CT. Renal, perirenal and extrarenal tomographic findings usually associated with acute pyelonephritis were analyzed, in an attempt to identify what are the differences with respect to the images obtained with an ultrasound study. All patients then performed ultrasonography and/or abdominal CT evaluation one month later, 25 patients repeated both examinations, while the other 13 repeated only ultrasound. RESULTS: In 38 subjects with suspected APN, CT assessed the presence in 79% and in 21% the absence of the disease. Ultrasonography in 68% of cases diagnosed APN, by an increase in kidney size related to the presence of hypoechoic areas associated to edema, blurred margins and reduction of the color-Doppler vascularity. Ultrasound associated with the use of color-Doppler revealed a sensibility of 76% and specificity of 75%. Color and power-Doppler have better diagnostic accuracy than basic gray scale ultrasound, in the diagnosis of focal pyelonephritis. CONCLUSIONS: Therefore the combined use of ultrasound and color-Doppler can obtain useful information about the diagnosis and follow-up of the disease, with an improvement in terms of cost, without significantly altering the diagnostic efficacy and reducing the amount of radiation absorbed.