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Introduction In recent years, recreational use of phosphodiesterase type 5 (PDE5) inhibitors has become popular as a sexual enhancement aid among some men without erectile dysfunction (ED) and even among women. Aim The aim of the present study, therefore, was to investigate the recreational use of PDE5 among young and healthy men. Main Outcome Measures We evaluated the use of PDE5 inhibitors among young and healthy men, their main reasons for using these drugs, and their expectations regarding its effects. Methods A survey was carried out among 167 male medical students (21.2 ± 2.3 years, range 17–31). The surveys were divided into domains, assessing epidemiological data, use of PDE5 inhibitor, and the simplified International Index of Erectile Function (IIEF-5). Results All men considered themselves with perfect erectile function. However, 9% reported previous use of PDE5 inhibitors. Of these, 46.7% had used PDE5 inhibitors more than three times, and 71.4% had mixed them with alcohol. Among this group of men, 13.3% had ED according to the IIEF-5. ED occurring with condom use, however, was twice more common, and 71.4% of the men who had taken PDE5 inhibitors thought that the drug had potential to facilitate condom use. Conclusion In conclusion, the use of PDE5 inhibitors by young men is more frequent than previously reported. Condom-related ED seems to be an underestimated problem, frequently solved with PDE5 inhibitors. However, potential deleterious effects might exist. Because PDE5 inhibitors are being used as non-prescribed drugs by as much as 9% of young men, further studies must evaluate the effects of these drugs in young and healthy men.

Proximal ureteral stone treatment requires multiple procedures until complete stone-free status is achieved. Laparoscopic ureterolithotomy is associated with higher success rates and fewer surgical procedures, but with more postoperative pain, longer procedures and a longer hospital stay. Although it is associated with the highest success rates for large proximal ureteral calculi, laparoscopic ureterolithotomy remains a salvage, second line procedure, and it seems more advantageous than open ureterolithotomy. At less well equipped centers, where semirigid ureterolithotripsy or extracorporeal shock wave lithotripsy is not available, it remains a good treatment option.

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Helminth infection is not as prevalent as previously reported in urban slums in São Paulo, neither as clinical disease nor in soil samples. Protozoa intestinal infection, however, is still frequent in some marginalized populations in São Paulo. Improvement in living standards, mostly sanitation might decrease the prevalence of these diseases.

Objectives• To evaluate hyaluronan-mediated motility receptor (RHAMM) expression in normal, hyperplasic and neoplastic prostate tissue after various types and durations of androgen-deprivation therapy (ADT). Clinical and oncological data from men with localised prostate adenocarcinoma were also assessed and compared with RHAMM expression data. Patients and Methods• Data from 367 men who underwent histological evaluation of the prostate were retrospectively evaluated under six conditions: (i) benign prostatic hyperplasia (BPH), (ii) BPH treated with finasteride, (iii) prostate cancer without ADT, (iv) prostate cancer treated with neoadjuvant ADT before prostatectomy (cyproterone 200 mg/day), (v) castration-resistant prostate cancer (CRPC), and (vi) normal peritumoral prostate tissue.• Tissue microarrays were constructed and 1354 cores were evaluated for immunohistochemical RHAMM expression. Results• There was no RHAMM expression in any tissue from normal patients or those with BPH or prostate cancer without ADT.• There was RHAMM expression in 39.4% of prostate cancer tissues treated with ADT and in 46.2% of CRPC samples (P = 0.001).• There was a significant increase in RHAMM expression with increased ADT duration in group 4, with a marked increase in RHAMM expression after 6-12 months of ADT (P = 0.04).• No prognostic or clinical factors related to prostate cancer were associated with RHAMM expression. Conclusions• RHAMM expression in prostate cancer is directly associated with ADT. Significant RHAMM expression occurs as early as after 1 month of ADT and progressively increases with ADT duration.• When prostate cancer becomes CRPC, RHAMM expression is higher. RHAMM expression was not associated with prostate cancer prognostic factors.• RHAMM overexpression may contribute to the development of hormonal resistance in prostate cancer.

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