Search

Introduction: Infection Human Papillomavirus (HPV) is the cause of several disease in men and in women: genital warts, penile and cervical intraepithelial neoplasia, invasive penile carcinoma and cervical cancer. However, less is known about HPV infection and prevalence of HPV types in men. Materials and Methods: 820 genital samples of men (age 19-77; mean age: 36.7 ys) who had come to the Virology laboratory of the Department of Sciences for Health Promotion and Mother and Child Care (Policlinico, University of Palermo, Italy) were examined for HPV infection. The study included men with genital warts, men with atypical genital lesion, partners of HPV-positive women and asymptomatic men for Sexually Transmitted Diseases (STD) diagnostic evaluation. HPV-DNA genotyping was performed by the INNOLiPA HPV Genotyping Extra II Test (Fujirebio) and nested PCR/sequencing method. Results: 461/820 (56.2%) genital samples were HPV positive. The highest HPV detection rate was found in the 25-34 year age group (41.4%), followed by the 35-44 group (31.7%). Oncogenic types were found in 360 (78.1%) samples, alone 228 (63.3%) or with non-oncogenic types 132 (36.7%). Multiple HPV type infections were shown in 225 (48.8%) samples of whom 109 (23.6%) had two genotypes, 58 (12.6%) three genotypes, 38 (8.2%) four genotypes, 15 (3.2%) five genotypes, 3 (0.6%) six genotypes and then only 2 (0.4%) eight genotypes. Thirty-eight different HPV types were identified: the mostly frequent were HPV-16 (19.9% of HPV positive patients), -51 and -6 (18.2%), -31 (13.9%), -66 (13.7%), -53 (11%), -18 (7.6%), -44 (7.1%), -56 (7%), -11 (5.8%), -39 and –52 (5.6%), -54 (5.2%), -58 (5%), -62 (4.5%); other viral types occurred at a frequency of less than 4.0%. Men who have made the HPV test: 138 (16.8%) were diagnosed with genital warts, 3 (0.4%) carcinomas, 413 (50.3%) were HPV-positive women partners, 30 (3.6%) presence of an atypical genital lesion, 236 (28.7%) men who wanted a full assessment of sexual transmitted diseases. HPV infection was evident in 100% men with carcinomas, in 103 (74.6%) men with genital warts, in 254 men (61.5%) partners of HPV-positive women, in 11 (36.6%) men with presence of an atypical genital lesion and in 90 (38.1%) in asymptomatic men. HPV-16 was prevalent in 2 (66.7%) men with carcinoma, in 55 (21.6%) men HPV-positive women partners and in 3 (27.3) men with atypical genital lesion; HPV-6 in 36 (35%) men with genital warts and in 19 (21.1%) asymptomatic men. Discussion and conclusions: this study showed a high prevalence of genital HPV infection in Sicilian men. This information will contribute to elucidating the epidemiology of HPV infection in man, and it will also be helpful in the implementation of future prevention strategies.

The aim of the study is to evaluate the efficacy of Diallil-Tiosulphinate, Nuciepherine and Diosgenin in the treatment of erectile dysfunction. In our study were selected 120 men affected by erectile dysfunction. They were filled in a self-administered questionnaire International Index of Sexual Medicine. 74 of them reported a moderate erectile dysfunction and 46 reported a severe ED. All patients were treated with Tadalafil 5 mg once a day for 90 days. They were re-evaluated with the same questionnaire after three months of therapy. In 75% of the patients there was an improvement of IIEF-5 score. Only the 90 patients responders to Tadalafil once a day were randomized and divided into two groups, each formed by 45 subjects. The group A was treated with the association of Diallil-Tiosulfinate, Nucipherine and Diosgenin on alternate days. The patients of group B were treated with placebo. After three months, there was a new evaluation with IIEF-5 score. In group A we reported a maintenance of improvement post-Tadalafil in 36 patients;in group B, only 18 patients have maintained the previous improvement, according to IIEF-5 score. The χ2 test is 13,38, with a p-value of about 0,00013.The maintenance’s odds ratio, confronting the two groups, is 6 with a confidence’s interval of 95%. The study shows that the utilization of the association therapy in patients with erectile dysfunction responders to Tadalafil once a day is able to duplicate the odds of maintenance’s improvement compared to placebo.

OBJECTIVE: To present the long-term outcome of patients with locally advanced or metastatic prostate carcinoma treated by first-line antiandrogen monotherapy. PATIENTS AND METHODS: From 1983 to 1990, 41 patients with advanced prostate carcinoma were treated with flutamide monotherapy until progression or the appearance of toxicity. Twenty-five patients (61%) had T3-T4N0M0 and 16 (39%) T2-4N0-3M1 prostate carcinoma. Consensus criteria were adopted to evaluate the response. Plasma testosterone and sexual function were recorded for the first 3 years. RESULTS: Flutamide was administered for up to 147 months; seven patients (17%) interrupted the treatment because of toxicity. There was an objective response in 17 (41%) patients; 20 (49%) had stable disease while four (10%) progressed. There were objective responses, lasting up to 150 months, in 82% of those with M0 and in 18% with M1 disease (P = 0.05). The median time to progression in patients with an objective response and stable disease was 45 and 16 months, respectively (P < 0.001). Thirty-one patients (76%) died from prostate cancer and 10 (24%) from unrelated diseases. The median survival was 67 and 36 months in patients with an objective response and stable disease, respectively (P < 0.001). There was an improvement in performance status in 85% and reduction in bone pain in 83% of the patients; sexual activity was maintained in 63%. CONCLUSION: Monotherapy with flutamide is well tolerated. Objective responses are more frequent in patients with locally advanced disease. Patients with an objective response within 6 months have a prolonged progression-free and overall survival.

OBJECTIVES: To evaluate a highly selected population of patients affected by T1G3 bladder transitional cell carcinoma (TCCB) treated by transurethral resection (TUR) and adjuvant intravesical chemotherapy. MATERIALS AND METHODS: Between January 1976 and April 1999, 137 patients with T1G3 TCCB were treated by TUR plus intravesical chemotherapy. Particularly, a sequential combination of mitomycin C (MMC) and epirubicin (EPI) was adopted in 91 patients (66.4%). The main exclusion criteria were concomitant or previous Tis, previous T1G3 TCCB, tumor size greater than 3 centimeters and number of tumors more than 3. TUR was repeated if a superficial tumor recurred. Patients went off study if Tis, recurrent T1G3 or invasive tumor were detected during treatment or thereafter. Adjuvant therapy, recurrence and progression were considered in multivariate analysis regarding recurrence, progression and survival respectively. RESULTS: Observation period was up to 240 months with a minimum of 2 years in 112 patients (82%). Seventy patients (51%) recurred. The recurring tumor was again a T1G3 in 22 (16%) patients. Thirteen patients (9.5%) progressed. The 5-year progression-free survival rate was 90%. Median progression-free survival was 149 months. Twenty-two patients (16%) died, 9 (6.6%) of whom due to bladder cancer. Median overall survival was 155 months. The 3- and 5-year disease-free overall survival rates were 89% and 80% respectively. Ten cystectomies (7.3%) were performed. In conclusion, 123 patients (90%) maintained their intact bladder with a mean disease-free overall survival of 104 months. The sequential combination of MMC and EPI adjuvant therapy resulted more effective to be than single drug chemotherapy on recurrence rate (p=0.0021) but had no impact upon progression (p=0.127) and specific survival (p=0.163). Progression (p

Microscopic foci of prostatitis may induce prostate-specific antigen (PSA) increase. PSA reduction after antibiotics might identify those patients in whom biopsy can be avoided. Ninety-nine patients received ciprofloxacin for 3 weeks, of whom 59 showed PSA reduction. Histology detected small foci of prostatitis in 65% of cases. Carcinoma was found in 40 and 20.3% of patients with unchanged or decreased PSA, respectively (P=0.03). No cancer was detected if PSA decreased below 4 ng/ml or more than 70%. Biopsy can be postponed, with a low risk of missing a cancer, if PSA decreases more than 70% or below 4 ng/ml.