Search

Epidemiologic data indicate that female sexual dysfunctions concern from 20 to 60 % of the population [1–9].

Aims: In this prospective controlled randomized trial we assessed the effects of early, intensive, prolonged pelvic floor exercises (PFE) on urinary incontinence following bladder neck (BN) sparing RRP. Methods: A sample of 152 patients with localized prostate cancer underwent RRP with BN preservation. Out of this group we randomized 107 incontinent patients into 2 groups. We considered incontinent patients with 24 hr Pad test >2 g. The T group received instructions regarding an intensive program of PFE, from 7 days after catheter removal for as long as any degree of incontinence persisted, within a period of 1 year. The control (C) group did not receive instructions. The outcome was assessed using the 24 hr Pad test, a visual analogue scale (VAS) and a single question of QoL. Results at baseline and at 1, 3, 6, and 12 months were available for 54 and 40 patients, respectively. Results: The overall spontaneous continence rate after catheter removal was 23.6%. The proportion of men still incontinent was significantly higher in the C group than treatment (T) group at 1 (97.5% vs. 83.3%; P ¼ 0.04), 3 (77.5% vs. 53.7%; P ¼ 0.03), 6 (60% vs. 33.3%; P ¼ 0.01), and 12 months (52.5% vs. 16.6%; P < 0.01). Similarly, the VAS and the response to the QoL question at 12 months significantly differed between the two groups (P ¼ 0.01 and 0.03, respectively). Conclusions: Our study suggests that early intensive prolonged PFE can further increase the number of continent patients and this improvement persists in the first 12 months. The second 6 months following surgery are still useful to recovery. Neurourol. Urodynam. 26:985–989, 2007. 2007 Wiley-Liss, Inc.

Prostatic inflammation is widespread in the male population. Two groups of 50 patients each with symptoms of prostatic inflammation and ecocolorDoppler indicative of prostatitis were identified. Both groups were further subdivided into two subgroups (respectively A1, A2, B1, and B2). Group A1 underwent therapy with oral levofloxacin 500 mg daily for 10 days plus co-treatment with oral Serenoa repens (320 mg) plus Bromeline plus Nettle (Prostamev Plus®) daily for two months; Group A2 with oral levofloxacin 500 mg daily for 10 days plus oral Serenoa repens extract 320 mg/day for two months; Group B1 specific antibiotic treatment for 10 days (included levofloxacin if sensitive) plus co-treatment with oral Serenoa repens (320 mg) plus Bromeline plus Nettle (Prostamev Plus®) daily for two months; Group B2 with specific antibiotic treatment for 10 days plus Serenoa repens 320 mg/day for two months. The groups treated with Prostamev Plus® in comparison to the groups treated with Serenoa repens extract (saw palmetto) achieved better improvements of both IPSS score, urinary flow and sexual life.

To assess the precision of five different calculation methods in real-time bladder volume measurement.Bladders from 10 medical staff volunteers were examined. Two examinations of each subject were performed by one examiner using the same ultrasound scannet Five different calculation algorithms were used on the frozen ultrasound pictures: the prolate ellipsoid method based on the formula: volume = length x width x heigth x 0.52 on two dimensions; the double area method based on the formula: volume = ex [C1 + C2 x ln(A1) + C3 x ln(A2)] on two dimensions; The double ellipsoid method on two dimensions; the method of one dimension of the shape of the bladder outlined manually with the maximal longitudinal diameter; the method of one dimension of the shape of the bladder outlined by smooth ellipsoid with the maximal longitudinal diameter After registration of the voided volume the subjects were scanned again in order to assure complete emptying.Voided volumes ranged from 120 ml to 465 ml. The precision of each method was equal. Errors were not more than 25% of the voided volume. No significant improvement in accuracy for any of the methods was found.Ultrasound bladder volume calculation is an easy method for estimation of bladder volume. Errors can be reasonably accepted. Large variation, irrespective of methods, from the true bladder volume, indicates that the clinical evaluation of ultrasound bladder measurement must be interpreted with great care in some patients.

To detect obstruction in patients with LUTS suggestive of BPH comparing the prostatic intravesical protrusion detected by abdominal ultrasounds with uroflowmetry testing results with urodynamic study to make evidence of obstruction.A series of 25 patients (mean age 67.9 years) at the first visit for BPH problems, underwent to routine examination including: abdominal ultrasound examination, TRUS, uroflowmetry IPSS and QoL questionnaires and urodynamic evaluation. We evaluated the degree in mm of prostatic intravesical protrusion by ultrasounds with a bladder volume between 150-220 cc. The degree of protrusion was classified as mild (5 mm), moderate (5-10 mm) and severe (10 mm), Qmax was divided in obstructed (10 ml/s), equivocal (10-15 ml/s) and unobstructed (15 ml/s). Confirmation or not of obstruction was validated by urodynamic study.mean prostate volume was 41.4cc; IPSS 22.4; Quality of Life 4.0; post voided residual urine 97.8 cc; DAMPF 62.6; Schäfer 3.4; Qmax 9.9 ml/s. Almost all the patients with severe protrusion had obstructed flow confirmed by P/F study. Patients with severe protrusion and unobstructedflow have obstruction compensated by high pressure voiding.These results, despite of the numbers of patients, suggest that the degree of prostatic protrusion measured by abdominal ultrasounds is a data that, if correlated to obstructed Qmax, can be used in the evaluation of BPH patients and their grade of obstruction.

Mondor reported the first superficial venous thrombosis on the chest wall in 1939. This condition is usually a benign and self-limited process, requiring only symptomatic treatment. Mondor's disease of the penis is an uncommon condition, which usually involves the superficial dorsal veins, it was first described by Braun-Falco in 1955. Isolated superficial dorsal vein-thrombosis was reported in 1958 by Helm et al. Since then around fifty cases have been reported. Patients experience a cord or string-like induration along the penile superficial dorsal vein, which is often painful and accompanied by localized inflammatory changes. This condition is benign and self-limited in most patients with complete resolution after 6 to 8 weeks of conservative management although sometimes surgery is indicated when it is associated with chronic or severe local pain.We report on a 23-year sold man with Mondor's disease of the penis following a normal sexual intercourse, who recently underwent microsurgical left varicocelectomy.Treatment consisted in NSAID Aulin (100 mg orally twice a day for 3 weeks) Ciproxin (500 mg orally twice a day for 10 days), Reparil 1 x 3 orally for 25 days and Lansox 30 mg orally 1 per day for 21 days. The patient was advised to abstain from sexual intercourse or masturbation until the thrombosis had completely resolved. In the follow-up visit there was the complete resolution of the disease with no evidence of superficial dorsal vein thrombosis or palpable penile plaque 30 days later. The patient was also able to have sexual intercourse without problems.Although penile Mondors' disease is rare, proper clinical diagnosis and consequent reassurance can help the patient to dissipate the anxiety and the following erectile dysfunction. Ultrasound and Doppler Ultrasonography examination was not useful for diagnosis but helped the clinician to show the patient that the disease is a benign condition.