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García-Gómez B, Martínez-Salamanca JI, Sarquella-Geli J, Justo-Quintas J, García-Rojo E, Fernández-Pascual E, Ruíz-Castañé E, Romero-Otero J. Correction: Peyronie's Disease Questionnaire (PDQ): Spanish translation and validation. Int J Impot Res 2024; 36:102. [PMID: 37464022 DOI: 10.1038/s41443-023-00734-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Affiliation(s)
- Borja García-Gómez
- Urology Department, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain
| | | | | | | | - Esther García-Rojo
- Urology Department, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain
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Alonso-Isa M, García-Gómez B, González-Ginel I, García-Rayo-Encina C, Del Prado Caro-González M, Medina-Polo J, García-Rojo E, Romero-Otero J. Conservative Non-surgical Options for Erectile Dysfunction. Curr Urol Rep 2023; 24:75-104. [PMID: 36445614 DOI: 10.1007/s11934-022-01137-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE OF REVIEW This study aimed to review recent evidence on conservative non-surgical options for erectile dysfunction (ED) in men. A narrative review of the literature was performed. A comprehensive search in the MEDLINE, Embase, and Cochrane databases was done. Papers in English language, published from May 2017 until May 2022, were included. Papers reporting basic research or animal research were excluded, as long as reviews or meta-analyses. Congress reports, clinical cases, or clinical trials protocols with no results were also excluded. RECENT FINDINGS We found a multitude of different treatment modalities for ED. We must take into account the type of patient, their comorbidities, the origin of their ED, and its severity in order to reproduce effective results using these therapies. Some of the treatments show good results with a good level of evidence (new IPDE5 formulations, intracavernous injections, shock wave therapy, hormonal theraphy, psycho-sexual theraphy). However, others (some new molecules, stem cell theraphy, platelet-rich plasma injections, oxygenation-based therapy, nutraceuticals), although some of them present promising results, require randomized studies with a larger number of patients and a longer follow-up time to be able to establish firm recommendations. Regarding the conservative treatment of erectile dysfunction, in recent years, some therapies have been consolidated as effective and safe for certain types of patients. On the other hand, other treatment modalities, although promising, still lack the evidence and the necessary follow-up to be recommended in daily practice.
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Affiliation(s)
- Manuel Alonso-Isa
- Department of Urology, Hospital Universitario 12 Octubre, Instituto de Investigación Sanitaria Hospital, 12 de Octubre (imas12), Madrid, Spain
- Department of Urology, HM Hospitales (Montepríncipe, Puerta del Sur, Sanchinarro), Madrid, Spain
- ROC Clinic, Madrid, Spain
| | - Borja García-Gómez
- Department of Urology, Hospital Universitario 12 Octubre, Instituto de Investigación Sanitaria Hospital, 12 de Octubre (imas12), Madrid, Spain
- Department of Urology, HM Hospitales (Montepríncipe, Puerta del Sur, Sanchinarro), Madrid, Spain
- ROC Clinic, Madrid, Spain
| | - Ignacio González-Ginel
- Department of Urology, Hospital Universitario 12 Octubre, Instituto de Investigación Sanitaria Hospital, 12 de Octubre (imas12), Madrid, Spain
| | - Clara García-Rayo-Encina
- Department of Urology, Hospital Universitario 12 Octubre, Instituto de Investigación Sanitaria Hospital, 12 de Octubre (imas12), Madrid, Spain
| | - María Del Prado Caro-González
- Department of Urology, Hospital Universitario 12 Octubre, Instituto de Investigación Sanitaria Hospital, 12 de Octubre (imas12), Madrid, Spain
| | - José Medina-Polo
- Department of Urology, Hospital Universitario 12 Octubre, Instituto de Investigación Sanitaria Hospital, 12 de Octubre (imas12), Madrid, Spain
- Department of Urology, HM Hospitales (Montepríncipe, Puerta del Sur, Sanchinarro), Madrid, Spain
- ROC Clinic, Madrid, Spain
| | - Esther García-Rojo
- Department of Urology, HM Hospitales (Montepríncipe, Puerta del Sur, Sanchinarro), Madrid, Spain
- ROC Clinic, Madrid, Spain
| | - Javier Romero-Otero
- Department of Urology, HM Hospitales (Montepríncipe, Puerta del Sur, Sanchinarro), Madrid, Spain.
- ROC Clinic, Madrid, Spain.
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Alonso Isa M, García-Gómez B, Celada-Luis G, García-Rojo E, Fiorillo A, Medina-Polo J, Tueti-Silva D, García-Cruz E, Romero-Otero J. A morphometric analysis of the penis before and after prostaglandin injection: Is shower and grower even a thing? Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00619-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Sevilleja-Ortiz A, El Assar M, García-Gómez B, La Fuente JM, Alonso-Isa M, Romero-Otero J, Martínez-Salamanca JI, Fernández A, Rodríguez-Mañas L, Angulo J. STIM/Orai Inhibition as a Strategy for Alleviating Diabetic Erectile Dysfunction Through Modulation of Rat and Human Penile Tissue Contractility and in vivo Potentiation of Erectile Responses. J Sex Med 2022; 19:1733-1749. [PMID: 36195535 DOI: 10.1016/j.jsxm.2022.08.200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 07/12/2022] [Accepted: 08/23/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND Stromal interaction molecule (STIM)/Orai calcium entry system appears to have a role in erectile dysfunction (ED) pathophysiology but its specific contribution to diabetic ED was not elucidated. AIM To evaluate STIM/Orai inhibition on functional alterations associated with diabetic ED in rat and human penile tissues and on in vivo erectile responses in diabetic rats. METHODS Rat corpus cavernosum (RCC) strips from nondiabetic (No DM) and streptozotocin-induced diabetic (DM) rats and human penile resistance arteries (HPRA) and corpus cavernosum (HCC) from ED patients undergoing penile prosthesis insertion were functionally evaluated in organ chambers and wire myographs. Erectile function in vivo in rats was assessed by intracavernosal pressure (ICP) responses to cavernous nerve electrical stimulation (CNES). Expression of STIM/Orai elements in HCC was determined by immunofluorescence and immunoblot. MAIN OUTCOME MEASURES Functional responses in RCC, HCC and HPRA and STIM/Orai protein expression in HCC. In vivo erectile responses to CNES. RESULTS Inhibition of Orai channels with YM-58483 (20 µM) significantly reduced adrenergic contractions in RCC but more effectively in DM. Thromboxane-induced and neurogenic contractions were reduced by STIM/Orai inhibition while defective endothelial, neurogenic and PDE5 inhibitor-induced relaxations were enhanced by YM-58483 (10 µM) in RCC from DM rats. In vivo, YM-58483 caused erections and attenuated diabetes-related impairment of erectile responses. YM-58483 potentiated the effects of PDE5 inhibition. In human tissues, STIM/Orai inhibition depressed adrenergic and thromboxane-induced contractions in ED patients more effectively in those with type 2 diabetes. Diabetes was associated with increased expression of Orai1 and Orai3 in ED patients. CLINICAL TRANSLATION Targeting STIM/Orai to alleviate diabetes-related functional alterations of penile vascular tissue could improve erectile function and potentiate therapeutic effects of PDE5 inhibitors in diabetic ED. STRENGTHS AND LIMITATIONS Improving effects of STIM/Orai inhibition on diabetes-related functional impairment was evidenced in vitro and in vivo in an animal model and validated in human tissues from ED patients. Functional findings were complemented with expression results. Main limitation was low numbers of human experiments due to limited human tissue availability. CONCLUSIONS STIM/Orai inhibition alleviated alterations of functional responses in vitro and improved erectile responses in vivo in diabetic rats, potentiating the effects of PDE5 inhibition. STIM/Orai inhibition was validated as a target to modulate functional alterations of human penile vascular tissue in diabetic ED where Orai1 and Orai3 channels were upregulated. STIM/Orai inhibition could be a potential therapeutic strategy to overcome poor response to conventional ED therapy in diabetic patients. Sevilleja-Ortiz A, El Assar M, García-Gómez B, et al. STIM/Orai Inhibition as a Strategy for Alleviating Diabetic Erectile Dysfunction Through Modulation of Rat and Human Penile Tissue Contractility and in vivo Potentiation of Erectile Responses. J Sex Med 2022;19:1733-1749.
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Affiliation(s)
- Alejandro Sevilleja-Ortiz
- Fundación para la Investigación Biomédica del Hospital Universitario Ramón y Cajal, Madrid, Spain; Servicio de Histología-Investigación, Unidad de Investigación Traslacional en Cardiología (IRYCIS-UFV), Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Mariam El Assar
- Fundación para la Investigación Biomédica del Hospital Universitario de Getafe, Getafe, Spain; Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
| | - Borja García-Gómez
- Servicio de Urología, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain
| | - José M La Fuente
- Serviço de Urologia, Hospital Geral de Santo Antonio, Porto, Portugal
| | - Manuel Alonso-Isa
- Servicio de Urología, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain
| | | | | | - Argentina Fernández
- Servicio de Histología-Investigación, Unidad de Investigación Traslacional en Cardiología (IRYCIS-UFV), Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Leocadio Rodríguez-Mañas
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain; Servicio de Geriatría, Hospital Universitario de Getafe, Getafe, Spain
| | - Javier Angulo
- Servicio de Histología-Investigación, Unidad de Investigación Traslacional en Cardiología (IRYCIS-UFV), Hospital Universitario Ramón y Cajal, Madrid, Spain; Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain.
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El Assar M, García-Rojo E, Sevilleja-Ortiz A, Sánchez-Ferrer A, Fernández A, García-Gómez B, Romero-Otero J, Rodríguez-Mañas L, Angulo J. Functional Role of STIM-1 and Orai1 in Human Microvascular Aging. Cells 2022; 11:cells11223675. [PMID: 36429103 PMCID: PMC9688234 DOI: 10.3390/cells11223675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 11/14/2022] [Accepted: 11/16/2022] [Indexed: 11/22/2022] Open
Abstract
The impact of aging on vascular function is heterogeneous depending on the vascular territories. Calcium regulation plays a key role in vascular function and has been implicated in aging-related hypercontractility of corpus cavernosum. We aimed to evaluate stromal interaction molecule (STIM)/Orai system involvement in aging-related vascular alterations in the human macro and microvasculature. Aortae specimens and mesenteric arteries (MA), obtained from 45 organ donors, were functionally evaluated in organ chambers and wire myographs. Subjects were divided into groups either younger or older than 65-years old. The expressions of STIM-1, Orai1, and Orai3 were determined by immunofluorescence in the aorta and MA, and by Western blot in the aorta homogenates. The inhibition of STIM/Orai with YM-58483 (20 μM) reversed adrenergic hypercontractility in MA from older subjects but did not modify aging-related hypercontractility in the aortic strips. Aging was related to an increased expression of Orai1 in human aorta, while Orai1 and STIM-1 were upregulated in MA. STIM-1 and Orai1 protein expressions were inversely correlated to endothelial function in MA. Circulating levels of Orai1 were correlated with the inflammatory factor TNF-α and with the endothelial dysfunction marker asymmetric dimethylarginine. Aging is associated with an increased expression of the STIM/Orai system in human vessels with functional relevance only in the microvascular territory, suggesting its role in aging-related microvascular dysfunction.
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Affiliation(s)
- Mariam El Assar
- Fundación para la Investigación Biomédica, Hospital Universitario de Getafe, 28905 Getafe, Spain
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Esther García-Rojo
- Servicio de Urología, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), 28041 Madrid, Spain
| | - Alejandro Sevilleja-Ortiz
- Fundación para la Investigación Biomédica, Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain
| | - Alberto Sánchez-Ferrer
- Fundación para la Investigación Biomédica, Hospital Universitario de Getafe, 28905 Getafe, Spain
| | - Argentina Fernández
- Servicio de Histología-Investigación, Unidad de Investigación Traslacional en Cardiología (IRYCIS-UFV), Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain
| | - Borja García-Gómez
- Servicio de Urología, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), 28041 Madrid, Spain
| | - Javier Romero-Otero
- Servicio de Urología, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), 28041 Madrid, Spain
| | - Leocadio Rodríguez-Mañas
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Servicio de Geriatría, Hospital Universitario de Getafe, 28905 Getafe, Spain
| | - Javier Angulo
- Servicio de Histología-Investigación, Unidad de Investigación Traslacional en Cardiología (IRYCIS-UFV), Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain
- Correspondence:
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La Fuente PJM, Fernández A, García-Rojo E, García-Gómez B, Fernández-Pascual E, Curvo R, Romero-Otero J, Martínez-Salamanca JI, Angulo J. Transient receptor potential channel 5 (trpc5) inhibitor, ac1903, produces relaxation and improves endothelial function in human and rat penile vascular tissues. J Sex Med 2022. [DOI: 10.1016/j.jsxm.2022.08.083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Manfredi C, García-Gómez B, Arcaniolo D, García-Rojo E, Crocerossa F, Autorino R, Gratzke C, De Sio M, Romero-Otero J. Impact of Surgery for Benign Prostatic Hyperplasia on Sexual Function: A Systematic Review and Meta-analysis of Erectile Function and Ejaculatory Function. Eur Urol Focus 2022; 8:1711-1732. [PMID: 35803852 DOI: 10.1016/j.euf.2022.06.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 06/17/2022] [Indexed: 01/25/2023]
Abstract
CONTEXT Several sexual side effects, including erectile, ejaculatory, and orgasmic dysfunction, were reported with the majority of surgical procedures for benign prostatic obstruction (BPO). OBJECTIVE To systematically review current evidence regarding the impact of benign prostatic hyperplasia (BPH) surgery on sexual function. EVIDENCE ACQUISITION A comprehensive bibliographic search on the MEDLINE, Cochrane Library, Embase, Web of Science, and Google Scholar databases was conducted in July 2021. The population, intervention, comparator, and outcome (PICO) model was used to define study eligibility. Studies were Included if they assessed patients with BPO and related lower urinary tract symptoms (P) undergoing BPH surgery (I) with or without a comparison between surgical treatments (C) evaluating the impact on sexual function (O). Retrospective and prospective primary studies were included. A pooled analysis was conducted on studies including the postoperative assessment of International Index of Erectile Function (IIEF)-5, Male Sexual Health Questionnaire-Ejaculatory Dysfunction (MSHQ-EjD; Function and/or Bother), or retrograde ejaculation (RE) rate (PROSPERO database ID: CRD42020177907). EVIDENCE SYNTHESIS A total of 151 studies investigating 20 531 patients were included. Forty-eight randomized controlled trials evaluating 5045 individuals were eligible for the meta-analysis. In most studies (122, 80.8%), only erectile and/or ejaculatory function was evaluated. A substantial number of articles (67, 44.4%) also used nonvalidated tools to evaluate erectile and/or ejaculatory function. The pooled analysis showed no statistically significant changes in IIEF-5 score compared with baseline for the transurethral resection of the prostate (TURP; weighted mean difference [WMD] 0.76 pts; 95% confidence interval [CI] -0.1, 1.62; p = 0.08), laser procedure (WMD 0.33 pts; 95% CI -0.1, 0.77; p = 0.13), and minimally invasive treatment (WMD -1.37 pts; 95% CI -3.19, 0.44; p = 0.14) groups. A statistically significantly higher rate of RE was found after TURP (risk ratio [RR] 13.31; 95% CI 8.37, 21.17; p < 0.00001), other electrosurgical procedures (RR 34.77; 95% CI 10.58, 127.82; p < 0.00001), and the entire laser group (RR 17.37; 95% CI 5.93, 50.81; p < 0.00001). No statistically significant increase in RE rate was described after most of the minimally invasive procedures (p > 0.05). The pooled analysis of MSHQ-EjD scores was possible only for prostatic urethral lift, showing no statistically significant difference between baseline and post-treatment MSHQ-EjD Function scores (WMD -0.80 pts; 95% CI -2.41, 0.81; p = 0.33), but postoperative MSHQ-EjD Bother scores were significantly higher (WMD 0.76 pts; 95% CI 0.22, 1.30; p = 0.006). CONCLUSIONS Erectile function appears to be unaffected by most surgical procedures for BPO. RE is a very common adverse event of BPH surgery, although emerging minimally invasive surgical procedures could be associated with a lower risk. PATIENT SUMMARY Benign prostatic hyperplasia surgery can have an impact on sexual function, mainly involving ejaculatory function.
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Affiliation(s)
- Celeste Manfredi
- Urology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Borja García-Gómez
- Department of Urology, Hospital Universitario 12 Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain; Department of Urology, HM Hospitales (Montepríncipe, Puerta del Sur, Sanchinarro), Madrid, Spain; ROC Clinic, Madrid, Spain
| | - Davide Arcaniolo
- Urology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Esther García-Rojo
- Department of Urology, HM Hospitales (Montepríncipe, Puerta del Sur, Sanchinarro), Madrid, Spain; ROC Clinic, Madrid, Spain
| | - Fabio Crocerossa
- Department of Urology, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Riccardo Autorino
- Division of Urology, Virginia Commonwealth University, Richmond, VA, USA
| | - Christian Gratzke
- Department of Urology, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Marco De Sio
- Urology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Javier Romero-Otero
- Department of Urology, HM Hospitales (Montepríncipe, Puerta del Sur, Sanchinarro), Madrid, Spain; ROC Clinic, Madrid, Spain.
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Assar ME, Angulo J, García-Rojo E, Sevilleja-Ortiz A, García-Gómez B, Fernández A, Sánchez-Ferrer A, La Fuente JM, Romero-Otero J, Rodríguez-Mañas L. Early manifestation of aging-related vascular dysfunction in human penile vasculature-A potential explanation for the role of erectile dysfunction as a harbinger of systemic vascular disease. GeroScience 2022; 44:485-501. [PMID: 34962617 PMCID: PMC8811115 DOI: 10.1007/s11357-021-00507-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 12/22/2021] [Indexed: 01/05/2023] Open
Abstract
Advanced age is related to functional alterations of human vasculature, but erectile dysfunction precedes systemic manifestations of vascular disease. The current study aimed to simultaneously evaluate the influence of aging on vascular function (relaxation and contraction responses) in systemic human vascular territories: aorta (HA) and resistance mesenteric arteries (HMA) and human corpus cavernosum (HCC) and penile resistance arteries (HPRA). Associations of oxidative stress and inflammation circulating biomarkers with age and functional responses were also determined. Vascular specimens were obtained from 76 organ donors (age range 18-87). Four age-groups were established: < 40, 40-55, 56-65 and > 65 years old. Increasing age was associated with a decline in endothelium-dependent relaxation induced by BK in HMA (r = -0.597, p = 0.0001), or by ACh in HCC (r = -0.505, p = 0.0022), and HPRA (r = -0.601, p = 0.0012). Significant impairment was detected at > 65 years old in HMA but earlier in penile vasculature (> 55 years old). Age-related reduction to H2O2-vasodilatory response started before in HCC (56-65 years old) than in HA (> 65 years old). In contrast to relaxation responses, aging-related hypercontractility to adrenergic stimulation was homogeneous: contractions significantly increased in subjects > 55 years old in all tested vessels. Although not significantly age related, circulating levels of ADMA (r = -0.681, p = 0.0052) and TNF-α (r = -0.537, p = 0.0385) were negatively correlated with endothelial vasodilation in HMA but not in HCC or HPRA. Penile vasculature exhibits an early impairment of endothelium-dependent and H2O2-induced vasodilations when compared to mesenteric microcirculation and aorta. Therefore, functional susceptibility of penile vasculature to the aging process may account for anticipation of erectile dysfunction to systemic manifestations of vascular disease.
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Affiliation(s)
- Mariam El Assar
- Fundación de Investigación Biomédica, del Hospital Universitario de Getafe, Getafe, Spain
- Centro de Investigación Biomédica en Red de Fragilidad Y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
| | - Javier Angulo
- Centro de Investigación Biomédica en Red de Fragilidad Y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
- Servicio de Histología-Investigación, Unidad de Investigación Traslacional en Cardiología (IRYCIS-UFV), Hospital Universitario Ramón Y Cajal, Madrid, Spain
| | - Esther García-Rojo
- Department of Urology, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital, 12 de Octubre (imas12), Madrid, Spain
| | - Alejandro Sevilleja-Ortiz
- Servicio de Histología-Investigación, Unidad de Investigación Traslacional en Cardiología (IRYCIS-UFV), Hospital Universitario Ramón Y Cajal, Madrid, Spain
| | - Borja García-Gómez
- Department of Urology, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital, 12 de Octubre (imas12), Madrid, Spain
| | - Argentina Fernández
- Servicio de Histología-Investigación, Unidad de Investigación Traslacional en Cardiología (IRYCIS-UFV), Hospital Universitario Ramón Y Cajal, Madrid, Spain
| | - Alberto Sánchez-Ferrer
- Fundación de Investigación Biomédica, del Hospital Universitario de Getafe, Getafe, Spain
| | - José M La Fuente
- Serviço de Urologia, Hospital Geral Santo Antonio, Porto, Portugal
| | - Javier Romero-Otero
- Department of Urology, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital, 12 de Octubre (imas12), Madrid, Spain
| | - Leocadio Rodríguez-Mañas
- Fundación de Investigación Biomédica, del Hospital Universitario de Getafe, Getafe, Spain.
- Centro de Investigación Biomédica en Red de Fragilidad Y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain.
- Division of Geriatric Medicine, Servicio de Geriatría, Hospital Universitario de Getafe, Ctra de Toledo km 12, 500, 8905, Getafe, Spain.
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García-Gómez B, Alonso-Isa M, Celada-Luis G, Jauregibeitia-Ansotegi I, García-Rojo E, Santos-Pérez de la Blanca R, Romero-Otero J. Analysis of the relationship between sexual satisfaction, erectile dysfunction, and penile vascular parameters in a cohort of patients. Transl Androl Urol 2022; 10:4313-4319. [PMID: 35070813 PMCID: PMC8749074 DOI: 10.21037/tau-21-792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 12/06/2021] [Indexed: 11/06/2022] Open
Abstract
Background Erectile dysfunction (ED) is the second sexual dysfunction affecting men. Penile duplex ultrasound (PDU) with intracavernous injection of a vasoactive agent as alprostadil or papaverine, may play an important role in differentiating psychogenic from vasculogenic ED (arterial or venooclusive) and may also have an important role in the secondary prevention of cardiovascular events. The aim of this study is to investigate the relationship between the vascular parameters and sexual satisfaction as established by a questionnaire. Methods Prospective, multicenter analysis of all patients who underwent a PDU between September 2018 and April 2021 in four centers, including patients who were >18 years old and underwent a PDU for ED, Peyronie's disease (PD) or other reasons, signed informed consent and completed an adapted version of the Brief Sexual Symptom Checklist (BSSC). All the patients underwent a standard technique, and from a total of 325 patients, 16 were excluded because of low testosterone levels, and 15 due to missing data. Results A total of 294 patients were included for the analysis. Significant differences were found between patients with and without ED defined by their score in the Sexual Health Inventory for Men (SHIM) questionnaire in the PSV at 10', adjusted for age (38.07 vs. 44.95 cm/s; P=0.016), and in the PSV and the EHS at 10' for sexually satisfied and non-satisfied patients, and a significant correlation with those parameters and the probability of being sexually satisfied (r=0.147, P=0.011; r=0.132, P=0.023; respectively). Conclusions In our clinical practice we used the cut-off of >35 cm/s, that seems to be quite low looking at our results. The 10' measurement may be more sensitive in order to establish a diagnosis. BSSC questionnaire is a simple, easy-to perform tool to screen those patients at risk of developing sexual dysfunctions.
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Affiliation(s)
- Borja García-Gómez
- Urology Department, Hospital Universitario HM Montepríncipe, Boadilla del Monte, Spain.,ROC Clinic, Madrid, Spain
| | - Manuel Alonso-Isa
- ROC Clinic, Madrid, Spain.,Urology Department, Hospital Universitario HM Puerta del Sur, Móstoles, Spain
| | | | | | - Esther García-Rojo
- Urology Department, Hospital Universitario HM Montepríncipe, Boadilla del Monte, Spain
| | | | - Javier Romero-Otero
- Urology Department, Hospital Universitario HM Montepríncipe, Boadilla del Monte, Spain.,ROC Clinic, Madrid, Spain.,Urology Department, Hospital Universitario HM Puerta del Sur, Móstoles, Spain.,Urology Department, Hospital Universitario HM Sanchinarro, Madrid, Spain
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10
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Sevilleja-Ortiz A, El Assar M, García-Rojo E, García-Gómez B, Fernández A, Sánchez-Ferrer A, La Fuente JM, Romero-Otero J, Rodríguez-Mañas L, Angulo J. Ageing-induced hypercontractility is related to functional enhancement of STIM/Orai and upregulation of Orai 3 in rat and human penile tissue. Mech Ageing Dev 2021; 200:111590. [PMID: 34699858 DOI: 10.1016/j.mad.2021.111590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 10/19/2021] [Accepted: 10/21/2021] [Indexed: 10/20/2022]
Abstract
The role of STIM/Orai calcium entry system on vascular ageing has not been elucidated. We aimed to evaluate the influence of ageing on STIM/Orai signalling and its role on ageing-induced alterations of contractile function in rat corpus cavernosum (RCC) and human penile resistance arteries (HPRA) and corpus cavernosum (HCC). RCC was obtained from 3 months-old and 20 months-old animals. HPRA and HCC were obtained from organ donors of varied ages without history of erectile dysfunction. Aging was associated with enhanced norepinephrine (NE)- and thromboxane analogue (U46619)-induced contractions in RCC which were significantly inhibited by the STIM/Orai inhibitor, YM-58483 (20 μM). Other STIM/Orai inhibitor, 2-aminoethyldiphenylborate also reduced NE-induced contractions in RCC from aged rats. YM-58483 significantly reduced neurogenic contractions and potentiated neurogenic relaxations in RCC from aged rats. In HCC and HPRA, NE-induced contractions were significantly enhanced in older subjects (>65 years-old) but YM-58483 completely reversed ageing-related hypercontractility. Ageing did not modify STIM-1 and Orai1 protein expressions but Orai3 was significantly overexpressed in cavernosal tissue from old rats and older subjects. Contribution of STIM/Orai to cavernosal contraction increases with ageing together with increased expression of Orai3. Orai inhibition could be a potential therapeutic strategy to reduce ageing-related impact on vascular/erectile function.
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Affiliation(s)
- Alejandro Sevilleja-Ortiz
- Department of Histology-Research, Unidad de Investigación Traslacional en Cardiología (UFV-IRYCIS), Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Mariam El Assar
- Fundación para la Investigación Biomédica, Hospital Universitario de Getafe, Getafe, Spain
| | - Esther García-Rojo
- Department of Urology, Hospital Universitario HM Sanchinarro, HM Hospitales, Madrid, Spain
| | - Borja García-Gómez
- Department of Urology, Hospital Universitario HM Sanchinarro, HM Hospitales, Madrid, Spain; Department of Urology, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain
| | - Argentina Fernández
- Department of Histology-Research, Unidad de Investigación Traslacional en Cardiología (UFV-IRYCIS), Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Alberto Sánchez-Ferrer
- Fundación para la Investigación Biomédica, Hospital Universitario de Getafe, Getafe, Spain
| | - José M La Fuente
- Department of Urology, Hospital Geral Santo Antonio, Porto, Portugal
| | - Javier Romero-Otero
- Department of Urology, Hospital Universitario HM Sanchinarro, HM Hospitales, Madrid, Spain; Department of Urology, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain
| | | | - Javier Angulo
- Department of Histology-Research, Unidad de Investigación Traslacional en Cardiología (UFV-IRYCIS), Hospital Universitario Ramón y Cajal, Madrid, Spain.
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11
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Alonso-Isa M, García-Gómez B, García-Rojo E, Medina-Polo J, Manfredi C, Rodríguez-Antolín A, Romero-Otero J. [Penile prosthesis implantation in the covid era. post-surgery follow up and management of complications]. Rev Int Androl 2021; 20:62-67. [PMID: 34303628 PMCID: PMC8295190 DOI: 10.1016/j.androl.2020.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 10/07/2020] [Accepted: 10/18/2020] [Indexed: 11/01/2022]
Abstract
OBJECTIVES To provide recommendations regarding surgery, follow-up, and management of possible complications related to penile prostheses implantation, during the COVID-19 pandemic. MATERIAL AND METHODS We designed a critical narrative review of the studies investigating the impact of COVID-19 on urology practice and on penile prosthetic implantology. A comprehensive search in the MEDLINE database was performed. Different combinations of the following keywords were used according to a free-text protocol:: "SARS-CoV-2", "COVID19", "COVID Urology", "COVID19 surgery", "penile prostheses". Papers in English and Spanish language, published until September 2020 were included in the review. RESULTS Penile prosthesis implantation is an elective surgery which should always be deferred when it cannot be performed in maximum safety conditions. However, it may lead to complications wich must be resolved urgently even within the COVID-19 Era. CONCLUSIONS Currently, it is mandatory to develop shared strategies to avoid potential COVID-19-related complications for surgical patients. Penile prosthesis implantation should be deferred to avoid unnecessary risks and all preventive measures should be taken to minimize the risks in the event of non-delayable surgery.
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Affiliation(s)
- Manuel Alonso-Isa
- Departmento de Urología, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, España; Hospital Universitario HM Puerta del Sur, Móstoles, Madrid, España.
| | - Borja García-Gómez
- Departmento de Urología, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, España; Hospital Universitario HM Montepríncipe, Boadilla del Monte, Madrid, España
| | - Esther García-Rojo
- Departmento de Urología, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, España
| | - José Medina-Polo
- Departmento de Urología, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, España; Hospital Universitario HM Montepríncipe, Boadilla del Monte, Madrid, España
| | - Celeste Manfredi
- Hospital Universitario HM Puerta del Sur, Móstoles, Madrid, España; Hospital Universitario HM Montepríncipe, Boadilla del Monte, Madrid, España; Unidas of Urología, Universidad de Campania Luigi Vanvitelli, Nápoles, Italia
| | - Alfredo Rodríguez-Antolín
- Departmento de Urología, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, España
| | - Javier Romero-Otero
- Departmento de Urología, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, España; Hospital Universitario HM Puerta del Sur, Móstoles, Madrid, España; Hospital Universitario HM Montepríncipe, Boadilla del Monte, Madrid, España
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12
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García-Gómez B, Martínez-Salamanca JI, Sarquella-Geli J, Justo-Quintas J, García-Rojo E, Fernández-Pascual E, Ruíz-Castañé E, Romero-Otero J. Peyronie's Disease Questionnaire (PDQ): Spanish translation and validation. Int J Impot Res 2021; 34:501-504. [PMID: 34282285 DOI: 10.1038/s41443-021-00460-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 06/25/2021] [Accepted: 07/06/2021] [Indexed: 11/09/2022]
Abstract
The Peyronie's Disease Questionnaire (PDQ) is a 15-question self-reported questionnaire that evaluates the severity and physical and psychosexual issues of Peyronie's disease (PD) symptoms in three scales: "psychological and physical symptoms," "penile pain," and "symptom bother." Previous studies validated the PDQ US version and confirmed its test-retest reliability and responsiveness. The aim is to translate and validate the Spanish version of the PDQ to be used in the clinical practice and in PD research studies in Spain. A non-interventional, observational study with 160 PD patients was conducted. Patients included from four healthcare centers in Spain and completed the PDQ in two study visits separated for a period of 4-7 days from March 2018 to June 2019. Patients received no type of treatment or intervention. Different statistical tests were applied to the data in order to validate the structural and construct of the PDQ, as well as its internal reliability, temporal stability reliability, reliability between observers, and test-retest reliability. Cronbach's alpha over 0.9 showed good internal consistency. We found an ICC agreement of 0.82 (test-retest) for the three scales of the Spanish version of the PDQ, which demonstrates good reliability. When comparing Visit 1 and Visit 2 questionnaires mean scores, the PDQ showed non-significant differences, as expected because no intervention or treatment was administered to the patients between visits. Translation and validation of the PDQ for the Spanish population makes available a valid, useful, and reliable tool to properly evaluate quality of life of men suffering PD.
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Affiliation(s)
- Borja García-Gómez
- Urology Department, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain
| | | | | | | | - Esther García-Rojo
- Urology Department, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain
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13
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García-Gómez B, Aversa A, Alonso-Isa M, Parnham A, Serefoglu EC, Corona G, Bettocchi C, Reisman Y, Romero-Otero J. The Use of Penile Traction Devices for Peyronie's Disease: Position Statements from the European Society for Sexual Medicine. Sex Med 2021; 9:100387. [PMID: 34273788 PMCID: PMC8360933 DOI: 10.1016/j.esxm.2021.100387] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 04/10/2021] [Accepted: 05/03/2021] [Indexed: 10/29/2022] Open
Abstract
INTRODUCTION Penile traction therapy (PTT) aims to non-surgically reduce curvature, enhance girth, and recover lost length. Available clinical practice guidelines however lack clear recommendations regarding their use. AIM To present a comprehensive review and recommendation regarding the available evidence to the use of PTT in Peyronie's disease (PD). METHODS A systematic literature search was performed on Pubmed and Medline for relevant studies from all times until 2019. Studies of PTT (monotherapy and in combination) in patients with PD with any documented degree of curvature and in either the acute or chronic phase of the disease were included. Full texts not published in English language were excluded. MAIN OUTCOMES MEASURES Several scenarios, including preclinical data have been investigated. For each topic covered evidence was analyzed and expert opinion was stated. RESULTS The paucity of high-level studies precluded any strong recommendations, however, specific statements on this topic, summarizing the ESSM position, were provided. The available data about the use of PTT in PD are still poor, and the impact of this therapy for the treatment of PD has not been clearly stablished. Available data in the clinical setting are still poor, and the impact of these devices on PD evolution has not been clearly established. CONCLUSION PTT seems to be a valid treatment option for PD, although there is not enough evidence to give any definitive recommendation in any clinical scenario. García-Gómez B, Aversa A, Alonso-Isa M et al. The Use of Penile Traction Devices for Peyronie's Disease: Position Statements from the European Society for Sexual Medicine. Sex Med 2021;9:100387.
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Affiliation(s)
- Borja García-Gómez
- Departamento de Urología, Hospital Universitario HM Montepríncipe, HM Hospitales. Universidad San Pablo-CEU, Madrid, Spain; Departamento de Urología, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain
| | - Antonio Aversa
- Department of Experimental and Clinical Medicine; University of Catanzaro Magna Graecia, Catanzaro, Italy
| | - Manuel Alonso-Isa
- Departamento de Urología, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain
| | - Arie Parnham
- The Christie NHS Foundation Trust, the University of Manchester, Manchester
| | | | - Giovanni Corona
- Endocrinology Unit, Medical Department, Azienda Usl, Maggiore-Bellaria Hospital, Bologna, Italy
| | - Carlo Bettocchi
- Department of Urology, University of Bari, Bari, Apulia, Italy
| | - Yacov Reisman
- Department of Urology, Amstelland Hospital, Amstelveen, The Netherlands
| | - Javier Romero-Otero
- Departamento de Urología, Hospital Universitario HM Montepríncipe, HM Hospitales. Universidad San Pablo-CEU, Madrid, Spain; Departamento de Urología, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain.
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14
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García-Rojo E, Manfredi C, Santos-Pérez-de-la-Blanca R, Tejido-Sánchez Á, García-Gómez B, Aliaga-Benítez M, Romero-Otero J, Rodriguez-Antolín A. [Impact of COVID-19 outbreak on urology surgical waiting lists and waiting lists prioritization strategies in the Post-COVID-19 era]. Actas Urol Esp 2021; 45:207-214. [PMID: 34017152 PMCID: PMC7648495 DOI: 10.1016/j.acuro.2020.11.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 10/28/2020] [Accepted: 11/03/2020] [Indexed: 12/11/2022]
Abstract
Introduction The suspension of most elective surgeries during COVID-19 pandemic caused the lengthening of urology surgical waiting lists. The objective of this study is to evaluate the impact of COVID-19 pandemic on urology surgical waiting list in a high-volume hospital. Methods An observational descriptive study was designed. All patients included in the urology surgical waiting list of our high-volume center on May 1st 2020 (46 days after the suspension of elective surgery) were analyzed. Baseline variables, priority on the waiting list, main urological disease, type of scheduled surgery, and waiting time were recorded. Other variables recorded were the presence of a urinary catheter, number of accesses to the emergency department, evidence of COVID-19 infection, number of deaths and their cause. The waiting time for each disease was compared with the time to surgery in 2019. Results A total of 350 patients were included. The mean (SD) time on the waiting list was 97.33 (55.47) days. Priority 1 patients, who normally should undergo surgery within 30 days, were on the waiting list for a mean (SD) time of 60.51 (20.14) days. They were mainly patients with ureteral lithiasis (25.6%), high-risk or muscle-invasive bladder cancer (20.9%) and high-risk prostate cancer (13.9%). The mean waiting time had already significantly exceeded the mean time to surgery in 2019 for radical cystectomy (p = 0.04) and URS (p = 0.003). Conclusions The suspension of most elective surgeries due to COVID-19 had a significant impact on urology surgical waiting list of our high-volume center, especially in priority 1 group.
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Affiliation(s)
- E García-Rojo
- Servicio de Urología, Instituto de Investigación Sanitaria (imas12), Hospital 12 de Octubre, Madrid, España
| | - C Manfredi
- Servicio de Urología, Instituto de Investigación Sanitaria (imas12), Hospital 12 de Octubre, Madrid, España
- Departamento de Cirugía de la Mujer, el Niño y Cirugía General y Especializada, Universidad de Campania «Luigi Vanvitelli», Nápoles, Italia
| | | | - Á Tejido-Sánchez
- Servicio de Urología, Instituto de Investigación Sanitaria (imas12), Hospital 12 de Octubre, Madrid, España
| | - B García-Gómez
- Servicio de Urología, Instituto de Investigación Sanitaria (imas12), Hospital 12 de Octubre, Madrid, España
| | - M Aliaga-Benítez
- Servicio de Admisión y Documentación Clínica, Hospital 12 de Octubre, Madrid, España
| | - J Romero-Otero
- Servicio de Urología, Instituto de Investigación Sanitaria (imas12), Hospital 12 de Octubre, Madrid, España
| | - A Rodriguez-Antolín
- Servicio de Urología, Instituto de Investigación Sanitaria (imas12), Hospital 12 de Octubre, Madrid, España
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15
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Romero-Otero J, Manfredi C, Ralph D, Osmonov D, Verze P, Castiglione F, Serefoglu EC, Bozzini G, García-Gómez B. Non-invasive and surgical penile enhancement interventions for aesthetic or therapeutic purposes: a systematic review. BJU Int 2020; 127:269-291. [PMID: 32575166 DOI: 10.1111/bju.15145] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To systematically review the literature in order to investigate the efficacy and safety of surgical and non-invasive penile enhancement procedures for aesthetic and therapeutic purposes. METHODS A systematic search for papers investigating penile enhancement procedures was performed using the MEDLINE database. Articles published from January 2010 to December 2019, written in English, including >10 cases, and reporting objective length and/or girth outcomes, were included. Studies without primary data and conference abstracts were excluded. The main outcome measure was objective length and/or girth improvement. The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. RESULTS Out of 220 unique records, a total of 57 were reviewed. Eighteen studies assessed interventions for penile enhancement in 1764 healthy men complaining of small penis. Thirty-nine studies investigated 2587 men with concomitant pathologies consisting mostly of Peyronie's disease and erectile dysfunction. Twenty-five studies evaluated non-invasive interventions and 32 studies assessed surgical interventions, for a total of 2192 and 2159 men, respectively. Non-invasive interventions, including traction therapies and injection of fillers, were safe and mostly efficacious, whereas surgical interventions were associated with minor complications and mostly increased penile dimensions and/or corrected penile curvature. Overall, the quality of studies was low, and standardized criteria to evaluate and report efficacy and safety of procedures, as well as patient satisfaction, were missing. CONCLUSION The quality of the studies on penile enhancement procedures published in the last decade is still low. This prevents us from establishing recommendations based on scientific evidence regarding the efficacy and safety of interventions that are performed to increase the penis size for aesthetic or therapeutic indications.
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Affiliation(s)
- Javier Romero-Otero
- Urology Department, Hospital Universitario 12 Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain.,Urology Department, Hospital Universitario HM Montepríncipe, Madrid, Spain
| | - Celeste Manfredi
- Urology Unit, Department of Neurosciences, Reproductive Sciences, and Odontostomatology, University of Naples 'Federico II', Naples, Italy
| | - David Ralph
- Institute of Urology, University College London Hospitals, London, UK
| | - Daniar Osmonov
- Department of Urology, University Hospital Schleswig Holstein, Campus Kiel, Kiel, Germany
| | - Paolo Verze
- Department of Medicine, Surgery and Dentistry 'Scuola Medica Salernitana', University of Salerno, Salerno, Italy
| | - Fabio Castiglione
- Department of Urology, University College London Hospitals NHS Trust, London, UK
| | - Ege Can Serefoglu
- Department of Urology, Biruni University School of Medicine, Istanbul, Turkey
| | - Giorgio Bozzini
- Department of Urology, ASST Valle Olona, Busto A. Lombardia, Italy
| | - Borja García-Gómez
- Urology Department, Hospital Universitario 12 Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain.,Urology Department, Hospital Universitario HM Montepríncipe, Madrid, Spain
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16
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Medina-Polo J, García-Gómez B, Alonso-Isa M, Romero-Otero J. Clinical guidelines on erectile dysfunction surgery: EAU-AUA perspectives. Actas Urol Esp 2020; 44:289-293. [PMID: 32172988 DOI: 10.1016/j.acuro.2019.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Accepted: 10/28/2019] [Indexed: 10/24/2022]
Abstract
INTRODUCTION The implantation of a penile prosthesis is considered a third-line treatment and is indicated in patients who do not respond adequately to pharmacotherapy or require definitive treatment. Currently, the most used devices are 3-component penile prostheses, which presently account for more than 90% of the implants used. MATERIAL AND METHODS We reviewed the evidence and the recommendations of the clinical practice guidelines regarding surgery in patients with erectile dysfunction. RESULTS The recommendations of the clinical practice guidelines on surgery in patients with erectile dysfunction are summarized as follows: men with erectile dysfunction should be informed about the option of penile prosthesis implant treatment, commenting on the benefits, risks and consequences; men with erectile dysfunction who have agreed to receive penile prosthesis should be advised on post-surgical expectations; penile prosthesis implants should not be performed in patients with systemic, cutaneous or urinary tract infection; in young men with erectile dysfunction and focal penile or pelvic arterial obstruction who do not have generalized vascular disease or veno-occlusive dysfunction, penile arterial reconstruction can be considered; in men with erectile dysfunction, penile venous surgery is not recommended. CONCLUSIONS The use of penile prostheses offers high satisfaction rates to both the patient and his partner. However, it is crucial to adequately inform and warn patients about possible complications and consequences.
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17
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Angulo J, Sevilleja-Ortiz A, García-Rojo E, Fernández A, García-Gómez B, Medina-Polo J, Alonso-Isa M, El Assar M, Rodríguez-Mañas L, Romero-Otero J. PS-3-6 Orai Channel Inhibition Modulates Hypercontractility in Corpus Cavernosum From Diabetic Rats and Diabetic ED Patients where Orai Expression Is Upregulated. J Sex Med 2020. [DOI: 10.1016/j.jsxm.2020.04.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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18
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Sevilleja-Ortiz A, El Assar M, García-Rojo E, Romero-Otero J, García-Gómez B, Fernández A, Medina-Polo J, La Fuente JM, Rodríguez-Mañas L, Angulo J. Enhanced Contribution of Orai Channels to Contractility of Human Penile Smooth Muscle in Erectile Dysfunction. J Sex Med 2020; 17:881-891. [DOI: 10.1016/j.jsxm.2020.02.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 02/14/2020] [Accepted: 02/19/2020] [Indexed: 12/11/2022]
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19
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Romero-Otero J, Lauterbach R, Aversa A, Serefoglu EC, García-Gómez B, Parnham A, Skrodzka M, Krychman M, Reisman Y, Corona G, Lowenstein L. Laser-Based Devices for Female Genitourinary Indications: Position Statements From the European Society for Sexual Medicine (ESSM). J Sex Med 2020; 17:841-848. [PMID: 32201147 DOI: 10.1016/j.jsxm.2020.02.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 02/09/2020] [Accepted: 02/12/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Laser-based technologies have been commercially marketed as "wonder treatments" without a sufficient and adequate body of evidence. In addition, on July 30, 2018, the U.S. Food and Drug Administration issued a warning regarding the safety of the use of laser-based devices for the following indications: vaginal "rejuvenation" or cosmetic vaginal procedures, vaginal conditions and symptoms related to menopause, urinary incontinence, and sexual function. AIM To perform a thorough review of the available literature regarding laser-based vaginal devices for the treatment of female genitourinary indications and summarize the results in several short statements according to the level of evidence. METHODS A comprehensive review of the literature regarding laser treatments for gynecological indications was performed based on several databases. Eligible were studies that included at least 15 patients. OUTCOMES Several aspects, including preclinical data, have been investigated. For each topic covered, data on laser-based devices were analyzed. RESULTS Despite the high heterogeneity of studies and its limitations, the committee released several statements regarding the use of laser-based devices for genitourinary indications. CLINICAL IMPLICATIONS Available data in the clinical setting are still poor, and the impact of these technologies on vaginal symptoms and signs has not been clearly established. STRENGTHS & LIMITATIONS All studies have been evaluated by a panel of experts providing recommendations for clinical practice. CONCLUSION It is too early in the evolution and research of laser-based devices to make decisive recommendations regarding vaginal treatments. There is grave need to carry out randomized controlled trials with proper design for safety reasons, possible harm, and short-/long-term benefits for the different indications studied.
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Affiliation(s)
- Javier Romero-Otero
- Urology Department, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria, Madrid, Spain.
| | - Roy Lauterbach
- Department of Obstetrics and Gynecology, Rambam Health Care Campus, Haifa, Israel
| | - Antonio Aversa
- Department of Experimental and Clinical Medicine, University of Catanzaro Magna Graecia, Catanzaro, Italy
| | - Ege Can Serefoglu
- Department of Urology, Biruni University School of Medicine, Istambul, Turkey
| | | | - Arie Parnham
- Andrology Department, University College, London, UK
| | - Marta Skrodzka
- Southern California Center for Sexual Health and Survivorship Medicine, Newport Beach, CA, USA
| | | | - Yacov Reisman
- Endocrinology Unit, Medical Department, Azienda USL, Maggiore-Bellaria Hospital, Bologna, Italy
| | - Giovanni Corona
- Urology Department, Hospital Universitario HM Montepríncipe, Madrid, Spain
| | - Lior Lowenstein
- Department of Obstetrics and Gynecology, Rambam Health Care Campus, Haifa, Israel
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20
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Romero-Otero J, Lauterbach R, Aversa A, Serefoglu EC, García-Gómez B, Parnhan A, Skrodzka M, Krychman M, Reisman Y, Corona G, Lowenstein L. Radiofrequency-Based Devices for Female Genito-Urinary Indications: Position Statements From the European Society of Sexual Medicine. J Sex Med 2020; 17:393-399. [PMID: 32129169 DOI: 10.1016/j.jsxm.2019.12.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 12/07/2019] [Accepted: 12/11/2019] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Radiofrequency (RF)-based treatment has been introduced as an esthetic alternative treatment for various medical indications without the scientific backup of a satisfactory body of evidence. Furthermore, the United States Food and Drug Administration issued a warning regarding the safety of energy-based technologies for indications such as vaginal "rejuvenation," cosmetic vaginal treatment, vaginal conditions related to menopause, and symptoms of urinary incontinence and sexual function on July 30, 2018. AIM To perform a thorough review of the existing literature regarding RF-based vaginal devices for the treatment of female genitourinary indications and summarize the evidence available in a few short statements. METHODS A thorough review of the literature regarding RF treatments for gynecological indications was performed based on several databases. Studies that included at least 15 patients were eligible for analysis. MAIN OUTCOME MEASURE Efficacy of RF devices for different genitourinary indications. RESULTS Although a high level of heterogeneity of studies poses a serious challenge, the committee reached a decision on several statements related to the use of RF-based devices for genitourinary indications. CLINICAL IMPLICATIONS RF-based vaginal treatments have not been studied thoroughly enough in order to establish decisive recommendations regarding their safety and efficacy. STRENGTH & LIMITATIONS These position statements have been established by a group of experts. The lack of strong evidence makes it difficult to give decisive recommendations. CONCLUSIONS Further randomized controlled trials with proper methodology and design are required to establish both benefits and possible harm these treatments may have in both short and long term for all the different indications studied. Otero JR, Lauterbach R, Aversa A, et al. Radiofrequency-Based Devices for Female Genito-Urinary Indications: Position Statements From the European Society of Sexual Medicine. J Sex Med 2020;17:393-399.
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Affiliation(s)
- Javier Romero-Otero
- Urology Department, Hospital Universitario 12 de Octubre, Madrid, Spain; Hospital Universitario HM Montepríncipe, Boadilla del Monte, Madrid, Spain.
| | - Roy Lauterbach
- Department of Obstetrics and Gynecology, Rambam Health Care Campus, Haifa, Israel
| | - Antonio Aversa
- Department of Experimental and Clinical Medicine, Magna Graecia University of Catanzaro Magna Graecia, Catanzaro, Italy
| | | | | | - Arie Parnhan
- The Christie NHS Foundation Trust, Manchester, UK
| | | | - Michael Krychman
- Southern California Center for Sexual Health and Survivorship Medicine, CA, USA
| | | | - Giovanni Corona
- Endocrinology Unit, Medical Department, Azienda USL, Maggiore-Bellaria Hospital, Bologna, Italy
| | - Lior Lowenstein
- Department of Obstetrics and Gynecology, Rambam Health Care Campus, Haifa, Israel
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García-Gómez B, González-Padilla DA, Alonso-Isa M, Medina-Polo J, Romero-Otero J. Plication techniques in Peyronie's disease: new developments. Int J Impot Res 2019; 32:30-36. [PMID: 31582822 DOI: 10.1038/s41443-019-0204-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 06/30/2019] [Accepted: 08/13/2019] [Indexed: 01/08/2023]
Abstract
To date, surgical correction remains the gold standard for patients with stable Peyronie's disease (PD) due to its high efficacy and low morbidity. Among the surgical procedures, penile plication (PP) can be offered to men who have adequate erectile function and penile length (>13 cm), with a curvature <60° and a predicted shortening of maximum 20% of the penis. The aim of this paper is to review the new developments that have emerged in the last years about the use of PP in patients with PD. A nonsystematic review of the literature was carried out searching in the PubMed and EMBASE databases from January 01, 2009 to April 01, 2019 including the words 'Peyronie', 'penile curvature', 'penile induration', 'plication', and 'plicature'. New developments in PP in the last 10 years include avoiding degloving by using a penoscrotal incision, a new mathematical model to predict loss of length after PP, a wider range of indications including patients with severe (≥60°) or complex curvatures, burying knots to avoid later discomfort, and thinning or incising the plaque to prevent excessive shortening. PP is a well-founded procedure with great results in appropriately selected patients. Given the lack of any prospective randomized trial, no clear recommendation can be made of one technique over another.
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Affiliation(s)
- Borja García-Gómez
- Hospital Universitario 12 Octubre. Grupo de Investigación Salud Integral del Varón i+D+I, Madrid, Spain.,Hospital Universitario HM Montepríncipe, Madrid, Spain
| | | | - Manuel Alonso-Isa
- Hospital Universitario 12 Octubre. Grupo de Investigación Salud Integral del Varón i+D+I, Madrid, Spain
| | - Jose Medina-Polo
- Hospital Universitario 12 Octubre. Grupo de Investigación Salud Integral del Varón i+D+I, Madrid, Spain.,Hospital Universitario HM Montepríncipe, Madrid, Spain
| | - Javier Romero-Otero
- Hospital Universitario 12 Octubre. Grupo de Investigación Salud Integral del Varón i+D+I, Madrid, Spain. .,Hospital Universitario HM Montepríncipe, Madrid, Spain.
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22
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Romero-Otero J, García González L, García-Gómez B, Alonso-Isa M, García-Rojo E, Gil-Moradillo J, Duarte-Ojeda JM, Rodríguez-Antolín A. Analysis of Holmium Laser Enucleation of the Prostate in a High-Volume Center: The Impact of Concomitant Holmium Laser Cystolitholapaxy. J Endourol 2019; 33:564-569. [DOI: 10.1089/end.2019.0019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Javier Romero-Otero
- Hospital Universitario 12 de Octubre, Grupo de Investigación Salud Integral del Varón i+D+I, Madrid, Spain
- Hospital Universitario HM Montepríncipe, Boadilla del Monte, Madrid, Spain
- Hospital Universitario La Luz, Madrid, Spain
| | - Lucía García González
- Hospital Universitario 12 de Octubre, Grupo de Investigación Salud Integral del Varón i+D+I, Madrid, Spain
- Hospital Universitario La Luz, Madrid, Spain
| | - Borja García-Gómez
- Hospital Universitario 12 de Octubre, Grupo de Investigación Salud Integral del Varón i+D+I, Madrid, Spain
- Hospital Universitario HM Montepríncipe, Boadilla del Monte, Madrid, Spain
| | - Manuel Alonso-Isa
- Hospital Universitario 12 de Octubre, Grupo de Investigación Salud Integral del Varón i+D+I, Madrid, Spain
| | - Esther García-Rojo
- Hospital Universitario 12 de Octubre, Grupo de Investigación Salud Integral del Varón i+D+I, Madrid, Spain
| | - Javier Gil-Moradillo
- Hospital Universitario 12 de Octubre, Grupo de Investigación Salud Integral del Varón i+D+I, Madrid, Spain
| | - José Manuel Duarte-Ojeda
- Hospital Universitario 12 de Octubre, Grupo de Investigación Salud Integral del Varón i+D+I, Madrid, Spain
- Hospital Universitario La Luz, Madrid, Spain
| | - Alfredo Rodríguez-Antolín
- Hospital Universitario 12 de Octubre, Grupo de Investigación Salud Integral del Varón i+D+I, Madrid, Spain
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23
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Romero-Otero J, García-González L, García-Gómez B, Justo-Quintas J, García-Rojo E, González-Padilla DA, Sopeña-Sutil R, Duarte-Ojeda JM, Rodríguez-Antolín A. Factors Influencing Intraoperative Blood Loss in Patients Undergoing Holmium Laser Enucleation of the Prostate (HoLEP) for Benign Prostatic Hyperplasia: A Large Multicenter Analysis. Urology 2019; 132:177-182. [PMID: 31252004 DOI: 10.1016/j.urology.2019.06.024] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Revised: 06/02/2019] [Accepted: 06/17/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To assess blood loss during holmium laser enucleation of the prostate (HoLEP) and investigate the factors influencing it. PATIENTS AND METHODS Analysis of patients with benign prostatic hyperplasia (BPH) treated with HoLEP at 3 centers. Hemoglobin and hematocrit were measured before surgery and hospital discharge. All blood transfusions performed during and after HoLEP were recorded. Blood loss outcomes were analyzed regarding antithrombotic (antiplatelet/anticoagulant) therapies and drug treatments for BPH and other conditions. RESULTS The analysis included 963 patients with a mean age of 72 years. Mean (range) prostate size was 102 (40-316) g; 28% of patients were receiving antiplatelets and 11% anticoagulants. Mean (range) prostate-specific antigen was 6.0 (0.3-43.5) ng/dL. Mean (range) operation time was 77 (28-178) minutes. Bladder calculi were found in 54 (5.6%) patients; all of them were successfully treated with cystolitholapaxy. Forty-eight (5%) patients required blood transfusion during or immediately after the HoLEP procedure. Overall, mean (SD) hemoglobin decreased from 14.6 (1.5) g/dL to 12.3 (2.1) g/dL (P <.001), and mean (SD) hematocrit decreased from 44.3% (4.7) to 37.7% (6.5) (P <.001). Neither hemoglobin nor hematocrit decreases were significantly different between patients receiving and not receiving antithrombotic therapy or BPH therapy. CONCLUSION HoLEP is safe and has no remarkable impact on blood loss. Patients at high risk, such as those receiving antithrombotic therapy, had the same outcome than the rest regarding blood loss, although showed a higher transfusion rate. Operating time may influence hemoglobin decrease; therefore, it should be considered in patients with higher risk of bleeding.
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Affiliation(s)
- Javier Romero-Otero
- Hospital Universitario 12 Octubre. Grupo de Investigación Salud Integral del Varón i+D+I, Madrid, Spain; Hospital Universitario Montepríncipe, Madrid, Spain; Hospital Universitario La Luz, Madrid, Spain.
| | - Lucía García-González
- Hospital Universitario 12 Octubre. Grupo de Investigación Salud Integral del Varón i+D+I, Madrid, Spain; Hospital Universitario La Luz, Madrid, Spain
| | - Borja García-Gómez
- Hospital Universitario 12 Octubre. Grupo de Investigación Salud Integral del Varón i+D+I, Madrid, Spain; Hospital Universitario Montepríncipe, Madrid, Spain
| | - Juan Justo-Quintas
- Hospital Universitario 12 Octubre. Grupo de Investigación Salud Integral del Varón i+D+I, Madrid, Spain
| | - Esther García-Rojo
- Hospital Universitario 12 Octubre. Grupo de Investigación Salud Integral del Varón i+D+I, Madrid, Spain
| | | | - Raquel Sopeña-Sutil
- Hospital Universitario 12 Octubre. Grupo de Investigación Salud Integral del Varón i+D+I, Madrid, Spain; Hospital Universitario Montepríncipe, Madrid, Spain
| | - Jose Manuel Duarte-Ojeda
- Hospital Universitario 12 Octubre. Grupo de Investigación Salud Integral del Varón i+D+I, Madrid, Spain; Hospital Universitario La Luz, Madrid, Spain
| | - Alfredo Rodríguez-Antolín
- Hospital Universitario 12 Octubre. Grupo de Investigación Salud Integral del Varón i+D+I, Madrid, Spain; Hospital Universitario Montepríncipe, Madrid, Spain
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24
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García-Rojo E, Medina-Polo J, Sopeña-Sutil R, Guerrero-Ramos F, García-Gómez B, Aguilar-Gisbert L, García-Álvarez G, Azcutia-Gómez MR, Gómez-Martín F, Molero-García JM, Pereda-Arregui E, Vargas-Machuca Cabañero MC, Villacampa-Aubá F, Tejido Sánchez Á. Analysis of referrals after a synergic work between Primary Care and Urology. Impact of joint protocol implementation and a continuing education program in our healthcare area. Actas Urol Esp 2019; 43:176-181. [PMID: 30824338 DOI: 10.1016/j.acuro.2018.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 10/07/2018] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To analyse the evolution and adequacy of referrals from Primary Care to Urology, after the implementation of referral protocols on the most frequent urological diseases and the establishment of a continuing education program. MATERIAL AND METHODS A Primary Care-Urology work group was created in 2011. Initially, performance and clinical practice protocols in prostatic pathology (BPH and PSA) were established. These were supported by training sessions for primary care physicians. After analysing the effect of the mentioned joint work, 3more (scrotal pathology, urinary tract infections and urinary incontinence) were included. We analysed and compared the referrals and their adequacy before and after the establishment of the protocols. RESULTS The most common referral causes were symptoms of the lower urinary tract due to BPH, which initially represented 22.8% of the total, and decreased to 16.9%. After the introduction of the new algorithms, we observed a decrease in referrals for scrotal pathology (13-14% to 7.8%), an increase in urinary incontinence referrals (3% al 10.3%) and those related to urinary tract infections remained stable. The adequacy to the protocols improved progressively: LUTS from 46% to 65.3%; PSA from 55% to 84.4% and urinary incontinence from 66.2% to 73.1%. Adequacy in scrotal pathology decreased (de 67.1% a 63.3%), while in UTI it stayed much the same (around 76%). CONCLUSIONS The joint work between Urology and Primary Care achieves an improvement in referrals adequacy regarding the most frequent urological pathologies.
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Affiliation(s)
- E García-Rojo
- Servicio de Urología, Hospital Universitario 12 de Octubre, Madrid, España.
| | - J Medina-Polo
- Servicio de Urología, Hospital Universitario 12 de Octubre, Madrid, España
| | - R Sopeña-Sutil
- Servicio de Urología, Hospital Universitario 12 de Octubre, Madrid, España
| | - F Guerrero-Ramos
- Servicio de Urología, Hospital Universitario 12 de Octubre, Madrid, España
| | - B García-Gómez
- Servicio de Urología, Hospital Universitario 12 de Octubre, Madrid, España
| | - L Aguilar-Gisbert
- Servicio de Urología, Hospital Universitario 12 de Octubre, Madrid, España
| | - G García-Álvarez
- Dirección Continuidad Asistencial Centro, Hospital Universitario 12 de Octubre, Madrid, España
| | - M R Azcutia-Gómez
- Dirección Continuidad Asistencial Centro, Hospital Universitario 12 de Octubre, Madrid, España
| | - F Gómez-Martín
- Centro de Salud Joaquín Rodrigo, Dirección Asistencial Centro, Madrid, España
| | - J M Molero-García
- Centro de Salud San Andrés, Dirección Asistencial Centro, Madrid, España
| | - E Pereda-Arregui
- Centro de Salud Almendrales, Dirección Asistencial Centro, Madrid, España
| | | | - F Villacampa-Aubá
- Servicio de Urología, Hospital Universitario 12 de Octubre, Madrid, España
| | - Á Tejido Sánchez
- Servicio de Urología, Hospital Universitario 12 de Octubre, Madrid, España
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González-Padilla DA, González-Díaz A, García-Gómez B, Villacampa-Aubá F, Miranda-Utrera N, Rodríguez-Antolín A, Guerrero-Ramos F. Cystoscopy Real-Time Self-Visualization and Its Impact in Patient's Pain Perception. J Endourol 2019; 33:309-313. [PMID: 30793929 DOI: 10.1089/end.2018.0768] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES To determine if self-visualization of ambulatory cystoscopy provides a decrease in pain perception in male and female patients. METHODS A quasi-randomized controlled trial involving patients scheduled for ambulatory cystoscopy from August to November 2017. The indications were: hematuria, bladder cancer surveillance, lower urinary tract symptoms, and incontinence. The patients were quasi-randomized into two groups by scheduled date. Both groups received the same explanation before and during cystoscopy. The variables analyzed were gender, age, Visual Analog Scale (VAS) score, number of previous cystoscopies, and indication and positivity of the test for bladder neoplasia. All patients were analyzed by group and gender separately. The statistical tests used were: Wilcoxon rank-sum, Kruskal-Wallis, Mann-Whitney U test, Pearson correlation, and linear regression. RESULTS Four hundred four patients were included (318 males and 86 females) and divided into two groups, group A (no self-visualization, n = 239) and group B (self-visualization, n = 165). In males, mean VAS score was 2.6 for group A and 2.5 for group B (p = 0.276); in females, VAS score was 2.78 for group A and 1.64 for group B (p = 0.008). Regarding the remaining variables analyzed, neither positivity of the test for neoplasia (p = 0.14) nor cystoscopy indication (p = 0.597) had any influence. In patients with two or more previous cystoscopies, a reduction in mean VAS score was seen in both genders. In males having their first cystoscopy the mean VAS score was 3.1 and decreased to 2.1 for the third or more (p = 0.001); in females the mean VAS score was 2.89 for the first and 1.56 for the third or more (p = 0.02), although this benefit tended to disappear when the number of previous cystoscopies was taken into account. CONCLUSION In male patients, self-visualization of cystoscopy did not impact pain perception, while in female patients, it seemed to provide a benefit. The number of previous cystoscopies had an influence, diminishing the perception of pain, regardless of whether the patient visualized the procedure or not.
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Affiliation(s)
| | | | - Borja García-Gómez
- 1 Department of Urology, University Hospital 12 de Octubre, Madrid, Spain
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26
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Angulo J, El Assar M, Romero-Otero J, La Fuente J, Fernández A, Sánchez-Ferrer A, Sevilleja-Ortiz A, García-Gómez B, Medina-Polo J, Rodríguez-Mañas L. 018 Antagonizing penile smooth muscle contraction by inhibition of orai calcium channels. A potential therapeutic target in erectile dysfunction. J Sex Med 2018. [DOI: 10.1016/j.jsxm.2018.04.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Medina-Polo J, Arrébola-Pajares A, de la Rosa-Kehrmann S, Romero-Otero J, García-Gómez B, Alonso-Isa M, Lara-Isla A, Duarte-Ojeda JM, Rodríguez-Antolín A, Passas-Martínez JB. [Correlation between symptoms and urodynamic results in patients with urinary incontinence after radical prostatectomy.]. ARCH ESP UROL 2018; 71:523-530. [PMID: 29991660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
OBJECTIVES Urinary incontinence (UI) is a significant complication after radical prostatectomy (RP). Although sphincter incompetence is considered the main cause; bladder dysfunction can contribute substantially. Our objective was to evaluate the results of the urodynamic study (UDS) in men with UI after radical prostatectomy and analyze the correlation between symptoms and urodynamic parameters. METHODS We carried out a retrospective study reviewing the symptoms and urodynamics in patients with urinary incontinence after RP. We describe the symptoms, urodynamic findings and we analyze the correlation between both. RESULTS Our study included 74 patients. The median number of pads used per day was 3. 61% reported urgency, 63% stress urinary incontinence, 11% urgency urinary incontinence and 26% mixed urinary incontinence. The UDS showed stress urinary incontinence in 53% of patients, detrusor overactivity in 53% and, reduced bladder compliance in 43%. Urgency urinary incontinence was reported in 56% of patients with reduced bladder compliance. Urodynamics showed no incontinence in 16% of patients, of whom 80% showed urgency urinary incontinence. Urodynamics data showing obstruction of the urinary tract was reported in 17% and detrusor hypo or acontractility in 36%. Among patients with obstruction, 46% showed incontinence due to detrusor overactivity. The correlation of symptoms and urodynamics showed that only 31% of patients with stress urinary incontinence had incontinence due to detrusor overactivity in urodynamics. Among those with mixed urinary incontinence, urodynamic stress urinary incontinence only was found in 42% and 33% incontinence due to detrusor overactivity only. Finally, among those with symptoms of urgency urinary incontinence, the urodynamics showed detrusor overactivity in 27%. CONCLUSIONS In patients with urinary incontinence after radical prostatectomy, there is a high percentage of patients with urinary tract obstruction, detrusor overactivity and decreased compliance. Moreover, the correlation between symptoms and urodynamics is low.
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Affiliation(s)
- José Medina-Polo
- Servicio de Urología. Hospital Universitario 12 de Octubre. Madrid. España
| | | | | | | | - Borja García-Gómez
- Servicio de Urología. Hospital Universitario 12 de Octubre. Madrid. España
| | - Manuel Alonso-Isa
- Servicio de Urología. Hospital Universitario 12 de Octubre. Madrid. España
| | - Alba Lara-Isla
- Servicio de Urología. Hospital Universitario 12 de Octubre. Madrid. España
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Romero-Otero J, Angulo J, Medina-Polo J, García-Gómez B, El Assar M, La Fuente JM, Fernández A, Sánchez-Ferrer A, Sevilleja-Ortiz A, Rodríguez-Mañas L. MP43-08 INHIBITION OF PENILE SMOOTH MUSCLE CONTRACTION BY BLOCKADE OF STIM/ORAI CALCIUM ENTRY SYSTEM AS A POTENTIAL STRATEGY FOR ERECTILE DYSFUNCTION. J Urol 2018. [DOI: 10.1016/j.juro.2018.02.1407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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García-Gómez B, García-Cruz E, Bozzini G, Justo-Quintas J, García-Rojo E, Alonso-Isa M, Romero-Otero J. Sexual Satisfaction: An Opportunity to Explore Overall Health in Men. Urology 2017; 107:149-154. [DOI: 10.1016/j.urology.2017.06.031] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Revised: 06/17/2017] [Accepted: 06/20/2017] [Indexed: 01/21/2023]
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Romero-Otero J, García-Gómez B, Duarte-Ojeda JM, Rodríguez-Antolín A, Vilaseca A, Carlsson SV, Touijer KA. Active surveillance for prostate cancer. Int J Urol 2015; 23:211-8. [PMID: 26621054 DOI: 10.1111/iju.13016] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Accepted: 10/20/2015] [Indexed: 12/20/2022]
Abstract
It is worth distinguishing between the two strategies of expectant management for prostate cancer. Watchful waiting entails administering non-curative androgen deprivation therapy to patients on development of symptomatic progression, whereas active surveillance entails delivering curative treatment on signs of disease progression. The objectives of the two management strategies and the patients enrolled in either are different: (i) to review the role of active surveillance as a management strategy for patients with low-risk prostate cancer; and (ii) review the benefits and pitfalls of active surveillance. We carried out a systematic review of active surveillance for prostate cancer in the literature using the National Center for Biotechnology Information's electronic database, PubMed. We carried out a search in English using the terms: active surveillance, prostate cancer, watchful waiting and conservative management. Selected studies were required to have a comprehensive description of the demographic and disease characteristics of the patients at the time of diagnosis, inclusion criteria for surveillance, and a protocol for the patients' follow up. Review articles were included, but not multiple papers from the same datasets. Active surveillance appears to reduce overtreatment in patients with low-risk prostate cancer without compromising cancer-specific survival at 10 years. Therefore, active surveillance is an option for select patients who want to avoid the side-effects inherent to the different types of immediate treatment. However, inclusion criteria for active surveillance and the most appropriate method of monitoring patients on active surveillance have not yet been standardized.
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Affiliation(s)
| | | | | | | | - Antoni Vilaseca
- Urology Department, Memorial Sloan Kettering Cancer Center, New York City, New York, USA
| | - Sigrid V Carlsson
- Urology Department, Memorial Sloan Kettering Cancer Center, New York City, New York, USA.,Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Karim A Touijer
- Urology Department, Memorial Sloan Kettering Cancer Center, New York City, New York, USA
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