Background: The purpose of this study was to determine the effectiveness of an adjustable sling compared with an artificial urinary sphincter (AUS) in patients with severe urinary incontinence (SUI) postprostatectomy (PP). Methods: This review was carried out following the Cochrane Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) declaration. We searched Medline, Embase, LILACS, and CENTRAL databases. Studies with patients older than 18 years of age with SUI PP who underwent sling or AUS intervention and had been monitored for longer than 12 months were included. Results: Seven studies were included, yielding a sample size of 420. Pads were reportedly dry or improved in 70% of the sling group compared with 74% in the AUS group. The Incontinence Impact Questionnaire, Short Form (IIQ-7) was the most frequently used scale and showed improvement, with a score of 82.8% in the AUS group compared with 86.1% in the sling group. When comparing interventions with nonintervention, relative risks (RRs) of 35.37 (95% confidence interval [CI]: 7.17–174.35) and 45.14 (95% CI: 11.09–183.70) were found for the adjustable sling and AUS, respectively, which were statistically significant. No significant differences were found when AUS versus adjustable sling were compared, with an RR of 0.78 (95% CI: 0.09–6.56). We found a low risk of bias in most studies. Conclusions: Both interventions can reduce incontinence and improve the quality of life of patients with SUI PP. The published literature is substantially limited as no randomized clinical trials are available, no consensus has been reached regarding the definition of severity of incontinence, and considerable heterogeneity exists across the outcome variables measured.
Aim:To describe the association between partial thrombosis of the corpus cavernosum, partial priapism, and hard flaccid syndrome.Methods: A scoping review was performed according to the recommendations of the Joanna Briggs Institute. Moreover, we performed a search strategy using the MED-LINE, EMBASE, and CENTRAL databases. We included the available information, evaluating the conditions of partial thrombosis of the corpus cavernosum, partial priapism, and hard flaccid syndrome, and their molecular and physiological mechanisms and clinical presentation. Results:We identified 207 articles and chose eight studies published between 2001 and 2021. The total number of patients was 34, and their mean age was 28.2 years.Moreover, in 84% of the studies, the pathophysiology of the events was related to microtrauma or prolonged perineal compression. Additionally, 94.2% of the patients had some degree of erectile dysfunction. In addition, out of all patients, 94% underwent magnetic resonance imaging (MRI). However, patients with hard flaccid syndrome did not show relevant findings in these studies. Conversely, MRI showed asymmetry in the proximal corpora cavernosa, thrombosed corpus cavernosum segments, and mainly cavernous fibrous septum in patients with partial cavernous thrombosis and partial priapism. Conclusion:Partial thrombosis of the corpus cavernosum, partial priapism, and hard flaccid syndrome occurred more frequently in young patients, possibly related to microtraumas that generate cavernous fibrosis and trigger alterations in the erection of the distal portion of the penis. Additionally, they cause proximal hardening of the pelvis, perineal pain, painful ejaculations, and cavernous asymmetry. Moreover, the imaging characteristics are similar in patients with partial priapism and partial cavernous thrombosis.
Introducción: La presencia de bacterias en semen (bacteriospermia) es una condición patológica asociada con infertilidad y con prevalencia de hasta el 35%. Objetivo: Reportar el caso de un paciente con oligoastenozoospermia manejado en la consulta de infertilidad. Caso:Paciente masculino de 33 años de edad con historia de dificultad para la concepción, antecedente de orquiectomía por torsión testicular a los 16 años, infección por Chlamydia trachomatis a los 20 años. Examen físico normal, ecografía doppler testicular con varicocele izquierdo leve. Espermograma con oligoastenozoospermia y espermocultivo en agar sangre positivo para Streptococcus spp y agar chocolate para Streptococcus spp. Se inició manejo con ampicilina Sulbactam durante 14 días y control a los 3 meses con nuevo espermograma con mejoría marcada de la concentración y la movilidad progresiva espermática. Resultado: La pareja logro un embarazo exitoso con bebe vivo en casa. Conclusión: La colonización bacteriana del semen contribuye a alteraciones de la calidad seminal, por lo tanto, determinar la presencia de bacterias en las parejas infértiles podría ser de utilidad para el mejoramiento de los parámetros seminales y lograr un embarazo exitoso.
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