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Athanasios Zachariou,1,2 Dimitrios Zachariou,1,2 Aris Kaltsas,1 Ioannis Giannakis,1 Fotios Dimitriadis,3 Erriketi Douvli,1 Ioannis Champilomatis,1 Chrysanthi Kounavou,1 Athanasios Papatsoris,4 Panagiota Tsounapi,5 Charalampos Mamoulakis,6 Atsushi Takenaka,5 Nikolaos Sofikitis1 1Department of Urology, University of Ioannina, Ioannina, Greece; 2Physical Medicine and Rehabilitation Centre EU PRATTEIN, Volos, Greece; 3Department of Urology, Aristotle University of Thessaloniki, Thessaloniki, Greece; 4 2nd Department of Urology, Sismanogleion General Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece; 5Department of Urology, Faculty of Medicine, Tottori University, Yonago, Japan; 6Department of Urology, Medical School, University of Crete, Heraklion, GreeceCorrespondence: Athanasios Zachariou, Urology Department, Ioannina University, Volos, 38221, Greece, Tel +302421026937, Email zahariou@otenet.grPurpose: Clean intermittent self-catheterization (CISC) is a safe and effective alternative to managing incomplete bladder emptying in patients afflicted with neurogenic bladder conditions. The Intermittent Catheterisation Difficulty Questionnaire (ICDQ) is a validated questionnaire concerning the assessment of catheter use and patient difficulties during CISC. The present study aimed to translate and validate the ICDQ into the Greek language. A subsequent outcome was to substantiate the requirement of both urologist consultation with patients undergoing CISC and the detailed evaluation of various therapeutic options with the consultation of other specialist physicians.Material and Methods: The study was undertaken between March 2022 and July 2022 and involved patients in an outpatient department of a Rehabilitation Centre. Sixty-two neurologic patients suffering from spinal cord injury (SCI), multiple sclerosis (MS), cauda equina (CE), and myelitis represented a convenience sample. To calculate test-retest reliability, patients filled out two consecutive questionnaires; an initial one and a second after one week. The socio and demographic circumstances of all participants were evaluated.Results: The mean ICDQ total score at the test and retest was 5.96± 1.28 (mean total score ± standard deviation) and 5.91± 1.29, respectively. Evaluation of the data concerning alterations between men and women did not reveal statistically significant differences. Cronbach’s alpha coefficient was 0.94, which proves the inter-correlation between the different topics. An ICC of 0.97 indicated very high intra-rater reliability.Conclusion: ICDQ, a valid and reliable self-administered screening tool for CISC difficulties faced by patients using this procedure regularly, was successfully translated and validated into Greek. A more detailed evaluation and understanding of these difficulties would enhance the quality of CISC and allow for more suitable treatment and the selection of catheter types used. These improved treatment strategies are possible as repeated use and constant comparison of ICDQ scores determine treatment impact, facilitating treatment regimen modification, should it be required.Keywords: ICDQ, clean intermittent self-catheterisation, urinary tract infection, urethral stricture, translation, validation, Greek

The therapeutic range of cyclic nucleotide phosphodiesterase 5 inhibitors (PDE5) inhibitors is getting wider in the last years. This review study focuses on the potential employment of PDE5 inhibitors as an adjunct tool for the therapeutic management of male infertility. The literature tends to suggest a beneficial effect of PDE5 inhibitors on Leydig and Sertoli cells secretory function. It also appears that PDE5 inhibitors play a role in the regulation of the contractility of the testicular tunica albuginea and the epididymis. Moreover, scientific data suggest that PDE5 inhibitors enhance the prostatic secretory function leading to an improvement in sperm motility. Other studies additionally demonstrate the role of PDE5 inhibitors in the regulation of the sperm capacitation process. Placebo-controlled, randomized, blind studies are necessary to unambiguously incorporate PDE5 inhibitors as an adjunct tool for the pharmaceutical treatment of semen disorders and male infertility.

Glucose-6 phosphate dehydrogenase (G6PD) deficiency has an estimated prevalence of 5 -7.5% of the global population. Administration of some drugs in G6PD deficient patients may result in clinical conditions of varying severity, including potentially fatal sequels. For these reasons, in case of G6PD deficiency, the use of high dose toxic chemotherapy regimens in potentially curable malignancies with associated risk of tumor lysis syndrome, such as in advanced germ cell tumors, raises both physicians' preoccupations and issues for safeguard patients' health. Nonetheless no systematic information is actually available for safety in premedication to be administered, chemotherapy regimens adopted, and supportive care drugs needed to be provided in some particular situations.We present a case of a patient with metastatic testicular cancer and known g6pd deficiency, admitted in our department. We also performed a literature review in tree medical libraries searching for articles addressing the overmentioned security issues.Available literature is particularly scant. nonetheless, there is no evidence contradicting the administration of cytotoxic chemotherapy to G6PD deficient individuals. Our patient was able to complete the preplaned chemotherapy cycles, without any complications.Given the absence of data supporting the limitation of chemotherapy to G6PD deficient patients, the latter should not be deprived of the indicated antineoplastic treatment. However, certain premedication agents must be avoided. Continuous patient monitoring during treatment may alleviate physicians' and patients' anxiety and preoccupations.

Athanasios Zachariou,1,2 Maria Filiponi,2 Aris Kaltsas,1,2 Fotios Dimitriadis,3 Ioannis Champilomatis,1 Athanasios Paliouras,1 Panagiota Tsounapi,4 Charalampos Mamoulakis,5 Atsushi Takenaka,4 Nikolaos Sofikitis1 1Urology Department, School of Medicine, Ioannina University, Ioannina, Greece; 2Incontinence Unit, Physical Medicine and Rehabilitation Centre EU PRATTEIN, Volos, Greece; 3 1st Urology Department, School of Medicine, Aristotle University, Thessaloniki, Greece; 4Urology Department, School of Medicine, Tottori University, Yonago, Japan; 5Urology Department, Medical School, University of Crete, Heraklion, GreeceCorrespondence: Athanasios ZachariouUrology Department, Ioannina University, 3 Spyridi Street, Volos, 38221, GreeceTel +306937227778Fax +302421026932Email zahariou@otenet.grPurpose: Older people, especially women, have the highest known prevalence of urinary incontinence (UI) of any other age-group. Continual care provision for elderly incontinent females is an incredibly arduous process, yet only very few studies have investigated the issue. Aim of the study was to evaluate the impact of mirabegron’s treatment on the degree of burden experienced by caregivers of elderly female patients with UI.Patients and Methods: A hundred and eighty-six caregivers of older females with mixed or urgency UI besides various conditions (strokes, post-operative recovery after major surgery, etc.) were included in the study. Group A comprised 91 patients that did not want to receive any treatment for UI. Group B consisted of 95 elderly females treated for UI with mirabegron 50 mg/daily for three months. All caregivers completed the Zarit Burden Scale (ZBS) questionnaire at the outset and after the three months. All patients completed a bladder diary at the beginning and at the end of the observation/medication period.Results: Patients receiving mirabegron presented a statistically significant improvement in UI parameters. Their caregivers showed a statistically significant decrease in the ZBS total score as well as separate domains.Conclusion: This pilot study confirms that mirabegron administration can improve the quality of life of older females suffering from UI while substantially relieving caregiver burden. Recognizing the physical and emotional reactions of caregivers may help health providers deliver better support and resources to meet the needs of caregivers and patients alike.Keywords: mirabegron, caregiver, Zarit Burden Scale, aging, incontinence