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Erectile dysfunction (ED) affects more than 30 million men; endothelial dysfunction plays a significant role in EDs pathogenesis. The aim of this study was to administer mesenchymal stem cells (MSC) derived from adipose tissue and platelet lysate (PL) into patients with erectile dysfunction. This pilot study enrolled eight patients with diagnosed ED. Patients enrolled were suffering from organic ED due to diabetes melitus, hypertension, hypercholesterolaemia, and Peyronie disease. The patients were distributed in 2 groups. Patients in group A received adipose derived mesenchymal stem cells (ADMSC) resuspended in PL while patients in group B received only PL. ADMSCs were isolated from patients’ adipose tissue and expanded. In addition, blood sampling was obtained from the patients in order to isolate platelet lysate. After the application of the above treatments, patients were evaluated with an International Index of Erectile Function (IIEF-5) questionnaire, penile triplex, and reported morning erections. After MSCs and PL administration, patients presented improved erectile function after 1 and 3 months of follow-up. A statistically significant difference was observed in the IIEF-5 score before and after administration of both treatments after the first month (p < 0.05) and the third month (p < 0.05). No statistically significant difference was observed in the IIEF-5 score between group A and B patients. All patients were characterized by improved penile triplex and increased morning erections. No severe adverse reactions were observed in any patient except a minor pain at the site of injection, which was in the limits of tolerability. The results of this study indicated the satisfactory use of MSCs and PL in ED. MSCs in combination with PL or PL alone seems to be very promising, especially without having the negative effects of the current therapeutic treatment.

The purpose of this study was to investigate the effects of radical prostatectomy (RP) for prostate cancer, transurethral resection of the prostate (TURP) for benign prostate hyperplasia (BPH), and the alterations induced by ageing on quality of life, urinary and sexual function, and bother. We evaluated 283 patients who filled in and returned the questionnaire used. A total of 105 were treated with RP and were selected prostate cancer patients with localised disease without recurrences. An additional 98 underwent TURP for BPH and a third group consisted of 80 apparently healthy men. The general quality of life was estimated by the Rand 36-Item Health Survey 1.0. Urinary function was estimated by the AUA Symptom Index and the UCLA Prostate Cancer Index (urinary function and bother scale). Sexual function and bother, were explored using the Brief Male Sexual Function Inventory for Urology. Patient outcome 2 years post treatment was compared to the pre-treatment status and to that of the matched control population. General quality of life was not affected by RP or TURP, with the exception of an increase in the emotional/well being domain in RP patients to control group levels. After RP there was more bother reported for the urinary function than urinary malfunction itself, while TURP, as expected, restored urinary function and bother to normal population norms. Elderly males had urinary function and bother similar to the operated patients. Estimating sexual function on RP patients, erectile dysfunction (ED) predominates, leading to decreased sexual life. TURP marginally affects sexual life, mainly due to the loss of ejaculation, while in men from the control group, sexual function, although affected, was still present.

Intracorporeal treatment of urolithiasis is characterized by continuous technological evolution. In this review we present updated data upon the use of ureteroscopy for the management of urolithiasis. Novel digital flexible ureteroscopes are used in clinical practice. Ureteroscopic working tools are revolutionized resulting in safer and more efficient procedures. Special categories of stone patients such as pregnant women, children and patients on anticoagulation medication can now undergo uneventful ureteroscopy. Routine insertion of stents and access sheaths as well as bilateral ureteroscopy is still a controversial issue. Future perspectives include smaller and better instruments to visualize and treat a stone, while robotic ureteroscopy is becoming a fascinating reality.Key words: evolution, indications, technique, ureteroscopy. IntroductionSince its first description over 20 years ago, ureteroscopic surgery (URS) has progressed from an awkward diagnostic procedure with limited visualization to a precise, complex surgical intervention allowing access to the entire collecting system. 1 Current practice patterns in the management of upper urinary tract stones reveal that fellowshiptrained endourologists, academic urologists, and urologists in practice for less than 5 years are more likely to utilize URS and/or percutaneous nephrolithotomy (PCNL) and less likely to utilize extracorporeal shock wave lithotripsy (SWL).2 Herein, we review the relevant literature, published in Medline-indexed journals since 2008, upon the ureteroscopic treatment of urolithiasis (Table 1). Stone location Renal stonesFlexible URS is indicated in treating renal stones less than 15 mm that do not respond to SWL and is an attractive option for treating renal and ureteral stones in the same patient in a single session.3 Stone size larger than 15 mm is associated with single-session treatment failure for stone-free status. 4 In the vast majority, cases of flexible URS for unilateral renal stones can be performed as outpatient procedures. In a study of 51 patients with 161 renal stones (mean stone size of 6.6 mm), the overall stone-free rate after one and two procedures was 64.7% and 92.2%, respectively.5 In 97.6% of the cases the operation was performed on an outpatient basis.Perlmutter et al. studied whether stone location affects the stone-free rates of flexible URS. 6 A total of 86 renal stones were treated and the stone-free rates were 100% for upper pole stones, 95.8% for middle pole and 90.9% for lower pole stones (P = 0.338). Lower pole stones may not be easily accessed and fragmented because of acute infundibular angles and reduced deflection of ureteroscopes. This can be overcome by relocating lower pole stones into a more favorable location before fragmentation. A prospective randomized trial comparing SWL (32 patients) and URS (35 patients) for lower pole caliceal stones of 1 cm or less, demonstrated a statistically significant difference in stonefree rates in favor of URS.7 However, SWL was associated with greater pa...