Search

Objectives: To assess YouTube™ videos’ quality on prostate checks, especially on the digital rectal exam (DRE), and to investigate if they can inform patients correctly and eradicate their beliefs and myths.Methods: A search using as keywords “digital rectal exam for prostate cancer” was performed on the YouTubeTM platform. We selected the first 100 videos. To assess video quality content, Patient Education Materials Assessment Tool for audio-visual content (PEMAT A/V) and Misinformation tool were used.Results: Seventy-three videos were suitable for the analyses. The median PEMAT A/V Understandability score and PEMAT A/V Actionability score were 46.2% (interquartile range [IQR]: 30.8-76.9) and 50.0% (IQR: 25.0-75.0), respectively. The medi-an PEMAT A/V Understandability and Actionability scores were 69.2% (IQR: 46.2-88.5) vs 46.2% (IQR: 30.8-61.5) (p = 0.01) and 100.0% (IQR: 87.5-100.0) vs 25.0% (IQR: 25.0-68.8)(p < 0.001), for healthcare workers vs patients, respectively. According to the Misinformation tool, the median misinforma-tion score of the overall videos was 2.2 (IQR:1.7-2.8). According to the target audience, the misinformation score was 2.8 (IQR: 2.4-3.5) vs 2.0 (IQR: 1.5-2.8) (p = 0.02), for healthcare workers vs patients, respectively. Conclusions: Currently, based on our analyses, YouTubeTM videos’ quality on DRE resulted unsatisfactory according to the PEMAT A/V score and the Misinformation tool. Videos targeted to healthcare workers got higher quality scores if compared to videos targeted to patients. Therefore, YouTubeTM videos’ may not be considered a reliable source of information on DRE for patients.

To the Editor, Erectile dysfunction (ED) is defined as the persistent inability to achieve or maintain penile erection sufficient for satisfactory sexual performance. ED represents one of the most important male sexual dysfunctions with a prevalence of 52% and affecting more than 150 million men worldwide (estimated to be 322 million worldwide for 2025) [...]

Introduction: Nowadays numerous mobile health applications (MHA) have been developed to assist and simplify the life of patients affected by erectile dysfunction (ED), however the scientific quality and the adherence to guidelines are not yet addressed and solved. Materials and methods: On 17 January 2022, we conducted a search in the Apple App Store and Google Play Store.We reviewed all mobile apps from iTunes App Store and Google Play Store for ED and evaluated different aspects as well as their usage in screening, prevention, management, and their adherence to EAU guidelines. Results: A total of 18 apps were reviewed. All apps are geared towards the patient and provide information about diagnoses and treatment of ED. Conclusions: MHA represent an integral part of patients’ lives, and apps providing services for male sexual dysfunction are constantly increasing. Despite this the overall quality is still low. Although many of these devices are useful in ED, the problems of scientific validation, content, and quality are not yet solved. Further work is needed to improve the quality of apps and developing new accessible, user designed, and high-quality apps.

Objective: The risk factors for benign prostatic enlargement (BPE) are not well understood and particularly few data are available from Italian population. Materials and methods: This was an observational cross sectional study aimed to examine the association between several risk factors and BPE. During the “#Controllati2017” initiative, men aged 18 years or more were invited to attend participating urologic centers for a free of charge visit for counseling about urologic or andrologic conditions. Each participating man underwent a physical examination including digital rectal examination (DRE). Further he was asked about his medical history, urologic symptoms, sexual activity and related problems. Diagnosis of BPE was made by the urologist after DRE. Results: Out of the 1902 [mean age 54 years (SD 12, range 18-92)] considered men, a total of 603 subjects (31.7%) had diagnosis of BPE. The diagnosis of BPE increased from 9.3% in men aged < = 50 years, to 34.1% in those aged 51-60 years and to 58.7% among men aged > 60 years. A history of hypertension, diabetes, heart diseases, hypercholesterolemia and hypertriglyceridemia were all significantly associated with an increased risk of BPE in the total series and, although not always in a statistically significant way, in strata of age. Physical activity (PA) was significantly associated with a decreased risk of BPE. We have further analyzed the risk of BPE in men with one or more of the identified risk factors (i.e. hypertension, diabetes, heart disease, hypercholesterolemia, hypertriglyceridemia and low PA): the risk of BPE increased with number of risk factors reported by the subjects. The estimated risk were higher among younger men. Conclusion: In our study a history of hypertension, diabetes, heart disease, hypercholesterolemia and hypertriglyceridemia increased the risk and physical activity lowered the risk of BPE. This risk profile was observed also in men aged < 50 years.

Lipomas are benign mesenchymal tumours that are rarely seen in the scrotum. Few cases of primary scrotal lipomas originating from the scrotal wall have been reported in the literature. We describe the case of a giant primary intrascrotal lipoma presenting as scrotal swelling and discomfort. Findings from scrotal magnetic resonance imaging were highly suspicious for lipoma. The mass was completely excised and histological examination confirmed the diagnosis of lipoma.

FederAnziani Senior Italia and SIU – Italian Society of Urology – have decided to work together to draft a document focussing on Benign Prostatic Hyperplasia (BPH), and to stress the importance of adherence with pharmacological treatment in this setting, from both a scientific and a patient standpoint. Starting from a literature search, the two associations analysed to what extent an increase in treatment adherence amongst these patients influences hospital savings and to what extent therapy persistence levels are affected by monotherapy rather than free drug combinations. These estimates were performed only on patients taking medicinal products belonging to the 5 α-reductase inhibitors (5ARI) class that, although not indispensable, are the compounds that bring the greatest benefits, especially in the elderly and for which we know that every additional 30 days of therapy reduced the likelihood of acute urinary retention (AUR) and surgery by 14% and 11% respectively *. The results show that the use of fixed combination therapy would involve an increase in persistence due to the lower rate of patients abandoning treatment over time. Each 30 day-increment of 5ARI therapy, i.e. for an expenditure of 10.6 million euros extra per year for 5ARI medication, savings of approximately 24.3 million euros in hospital costs could be achieved.

Introduction: Although the pathophysiology of the testicular damage associated with varicocele remains unclear, sperm DNA damage has been identified as a potential explanation for this cause of male infertility. The current study was designed to determine the extent of sperm nuclear DNA damage in patients with varicocele, and to examine its relationship with parameters of seminal motility. Materials and method: Semen samples from 60 patients with clinical varicocele and 90 infertile men without varicocele were examined. Varicocele sperm samples were classified as normal or pathological according to the 1999 World Health Organizzation guidelines. Sperm DNA damage was evalutated using the Halosperm kit, an improved Sperm Chromatin Dispersion (SCD) test. Results: The DNA fragmentation index (DFI: percentage of sperm with denatured nuclei) values was significantly higher in patients with varicocele, either with normal or abnormal (DFI 25.8 ± 3.2 vs 17.4 ± 2.8 - P < 0,01) semen profiles. In addition, an inverse correlation was found between spermatic motility and the degree of spermatic DNA fragmentation in patients with clinical varicocele. Conclusions: Varicocele is associated with high levels of DNA-damage in spermatozoa. In addition, in subjects with varicocele, abnormal spermatozoa motility is associated with higher levels of sperm DNA fragmentation. DNA fragmentation may therefore be an essential additional diagnostic test that should be recommended for patients with clinical varicocele.

Objectives: Erectile Dysfunction Observational Study (EDOS) is a 6 months observational, prospective, multicentre trial, which enrolled more than 8,000 patients referring to physicians to seek treatment for ED or to modify their current therapy; it was conducted in 9 European countries. Objective of this trial was to outline general characteristics of these populations and related treatment patterns, to assess their efficacy, motivation for treatment extension or discontinuation and patients' overall satisfaction in clinical practice. Baseline characteristics of Italian enrolled population provide the Italian patient profile seeking ED treatment. Materials and Methods: The Italian centres involved in this study enrolled, from April 2003 to April 2004, 1,419 men, aged over 18. All of them had already requested to their general practitioner or specialist to start a treatment for ED or to modify a previously initiated therapy. Baseline assessment together with all demographic data, included collecting information about: education, socioeconomic position, clinical history, co-morbidities, ED current therapies, concomitant pharmacological therapies (antidepressants, antihypertensive and other cardiovascular drugs, hypolipidemic drugs, antipsychotics, and anti-cancer agents). All patients filled in IIEF-EF e SF-PAIRS questionnaires, and responded to single item question 1 (SIQ1: During last 6 months, did not your erection last long enough for you to start and have a successful sexual intercourse?). Results: Of the 1,419 men enrolled, 1,357 were eligible for the study. Mean age was 55 years and BMI=26.8 kg/m 2. 83% of patients' education was above primary school; 52% had a full time job, while 37% was retired. 88.5% reported a steady relationship, and 71.5% reported that this relationship had been longer than 10 years. 70.4% of patients were smokers or ex-smokers, while potus history was infrequent. ED was mild or moderate in 61.6% cases and had a psychogenic, organic or mixed origin respectively in 24%, 33% and 43%; 59% of patients had a story of ED more than one year. 43% was assuming other drugs for concurrent diseases, mainly antihypertensive drugs (71%). Conclusions: Italian outcomes from EDOS study allow us to outline the "average patient" profile, who in Italian clinical practice seeks treatment for ED.