Introduction
Cavernous nerve injury (CNI) in rats and radical prostatectomy (RP) in men result in loss of nitrergic function and increased adrenergic-neurogenic contractions of cavernosal tissue.
Aim
To evaluate the modulation of the α-adrenergic system as a strategy to relieve erectile dysfunction (ED) and functional cavernosal alterations induced by CNI.
Methods
A non-selective α-blocker (phentolamine 1 mg/kg daily), a selective α1A-blocker (silodosin [SILOD] 0.1 mg/kg daily), or vehicle was orally administered for 4 weeks after bilateral crush CNI (BCNI). Erectile and neurogenic responses of the corpus cavernosum (CC) were evaluated. The acute effects of SILOD also were evaluated in vivo (0.03 mg/kg intravenously) and ex vivo (10 nmol/L). The effects of SILOD and tadalafil (TAD) on nitrergic relaxations were determined in human CC from patients with ED with a vascular etiology or ED secondary to RP.
Main Outcome Measures
Erectile responses in vivo in rats and neurogenic contractions and relaxations of rat and human CC.
Results
Long-term treatment with SILOD significantly improved erectile responses and allowed for the potentiation of erectile responses by acute treatment with TAD (0.3 mg/kg intravenously) in rats with BCNI. SILOD partly recovered nitrergic relaxations and normalized neurogenic contractions in CC from rats with BCNI. Long-term treatment with SILOD partly prevented BCNI-induced decreases in neuronal nitric oxide synthase expression. Acute administration of SILOD (0.03 mg/kg intravenously) improved erectile responses in vivo and potentiated nitrergic relaxation and decreased neurogenic contractions ex vivo in CC from rats with BCNI. In human CC from patients with ED with a vascular etiology, TAD (30 nmol/L), SILOD (10 nmol/L), or their combination increased nitrergic relaxations. Potentiation by TAD was lost in human CC from patients with ED after RP but was recovered after co-treatment with SILOD.
Conclusion
α-Adrenergic modulation, especially selective α1A-blockade, improves erectile and cavernosal functions after BCNI. Modulation of the adrenergic system, mainly in combination strategies, could have a role in the management of ED after RP.
Testicular cancer (TC) is among the most common malignancies in the young male. Awareness plays an important role, because delay in diagnosis affects outcome. Testicular self-examination (TSE) is controversial, but recent evidence shows some cost benefits in performing this exam versus a late-stage diagnosis. The aims of this study are to determine and compare awareness for TC and TSE in males and females with the actual knowledge to this disease in an academic population. An exploratory study using an online questionnaire about TC and TSE was performed in a public university. Answers were collected and submitted to statistical analysis. A total of 815 participants-507 males (62.2 %) and 308 females (37.7 %)-answered the survey. The participants that responded that they were aware of TC were 399/507 (78.7 %) males and 275/308 (89.3 %) females. About half (48.9 %) of male and 42.2 % of female respondents did not answered correctly to most common symptom, and only 15 % of males and 25 % of females answered to the question on age at diagnosis. Both gender subjects rated TSE as very important, and the majority of females were motivated to advise male partners or friends to perform TSE. This study reported a good awareness on TC and TSE, but comparing to the correct knowledge about this disease, results are disappointing. The actual knowledge about TC is low and comparable in men and women. Women revealed a better understanding of this disease and importance of TSE, suggesting that they can assume an important role in promoting health behaviors in men.
Purpose. Bladder cancer is a frequent cause of haematuria in elderly patients, and bladder ultrasound (US) is a valuable tool in diagnosing these malignancies. We examined the accuracy of 3D bladder US in diagnosing bladder tumors in patients with haematuria. Patients and Methods. Twenty-one patients observed in the emergency department for haematuria underwent a kidney and bladder US. Patients with normal or uncertain bladder US findings underwent a 3D US and a cystoscopy. Results. In 5 (23.8%) patients, the 3D US detected bladder tumours not seen in 2D US. All these patients were found to have bladder tumours on cystoscopy. Another 5 (23.8%) patients with uncertain findings on 2D US had normal 3D US and cystoscopy. 3D US showed a sensitivity of 83.3% and a specificity of 100% with a positive predicted value and negative predictive values of 100% and 93.8%, respectively. Conclusion. 3D US was more sensitive than 2D US in diagnosing bladder tumours in patients with haematuria.
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