RESUMO
OBJECTIVE: To evaluate the efficacy of continuous intravesical irrigation with saline plus amikacin as adjuvant therapy and to evaluate the computed tomography (CT) scan in supine and prone positions (CystoCT scan) as an alternative diagnostic and evaluation method of intramural gas in emphysematous cystitis (EC) before and after treatment. METHODS: Consecutive patients with a diagnosis of EC who were hospitalized between March 2006 and January 2011 were investigated. The diagnosis was made by CystoCT scan. Treatment consisted of intravenous antibiotics, control of concomitant diseases, and placement of a 3-way urinary catheter for continuous irrigation of 500 mg of amikacin diluted in 1 l of saline given on days 0, 3, and 7. Treatment was considered successful when there was an absence of gas in the bladder wall, the urine culture was negative, there was clinical improvement, and there was an absence of toxicity. RESULTS: Eleven patients were hospitalized with a diagnosis of EC during the study period. Four were excluded from the study, 2 due to the lack of confirmation of the diagnosis with the CystoCT scan. Treatment was successful in all patients; for 6 (86%) this was achieved in 3 days and for 1 (14%) in 7 days. No toxicity was reported. CONCLUSIONS: Continuous intravesical irrigation with saline plus amikacin as adjuvant treatment of EC is an inexpensive, effective, and safe tool that might help conventional treatment and provide a rapid recovery. The CystoCT scan is an alternative method to diagnose and evaluate intramural gas in EC patients. These findings should be challenged in a randomized, multi-centre, placebo-controlled clinical trial.
Assuntos
Cistite/diagnóstico por imagem , Cistite/terapia , Enfisema/diagnóstico por imagem , Enfisema/terapia , Irrigação Terapêutica/métodos , Administração Intravesical , Humanos , Decúbito Ventral , Estatísticas não Paramétricas , Decúbito Dorsal , Tomografia Computadorizada por Raios X/métodos , Resultado do TratamentoRESUMO
UNLABELLED: SUMMAR OBJECTIVES: To find the detection rate of prostate cancer (PCa) in our population with PSA values between 2.6 and 4 ng/ml. METHODS: We included 33 consecutive patients with a median age of 66 years, that had a Transrectal Ultrasound (TRUS) guided biopsy with PSA between 2.6-4 ng/ml. Patients were divided into 2 groups. Group 1: patients with normal Digital Rectal Examination (DRE) and Group 2: Patients with DRE with asymmetry not definitive of PCa. EXCLUSION CRITERIA: known history of PCa, intraepithelial neoplasia or Positive DRE. Statistical analysis/ Chi square, t-student and Fischer exact test. RESULTS: Twenty eight percent of the patients had positive biopsy for PCa. Fifty six percent were Gleason 6 and 44% Gleason 7. Group 1 had 59%(20) and Group 2 41% (13) in. In Group 1 16% had positive biopsy for PCa vs 46% in group 2 (p 0.04) RR 3.07. CONCLUSIONS: There are traces that the detection rate in our population could be lower in comparison with what has been reported in the literature. DRE is crucial in the initial evaluation; asymmetry could increase 3 fold the risk of having PCa.
Assuntos
Antígeno Prostático Específico/sangue , Neoplasias da Próstata/sangue , Neoplasias da Próstata/diagnóstico , Idoso , Hospitais , Humanos , Masculino , México , Pessoa de Meia-Idade , Estudos ProspectivosRESUMO
OBJECTIVE To evaluate the indications for penile prosthesis implantation in the treatment of erectile dysfunction (ED) before and after the introduction of sildenafil. PATIENTS AND METHODS Penile prosthesis implantation was indicated in 144 men with ED at our institution between 1992 and 2007; 83 (55.6%) accepted the procedure, 55 (38.2%) refused it and six (4.2%) accepted but eventually had no surgery. Sixty-seven patients were operated primarily, and the remainder were referred cases with complications after or dissatisfaction with primary operations done elsewhere. Thirty-two were operated before the introduction of sildenafil (BS) and 35 after (AS). RESULTS In the BS group the most frequent aetiology was vascular disease, with 11(34%) vs two (6%) in the AS group. The most frequent aetiology in the AS group was previous radical pelvic surgery (radical prostatectomy, sigmoidectomy, etc.) with 17 (49%) vs none in the BS group. There were no significant differences in complication rates in both groups. Satisfaction rates in patients with malleable and inflatable devices were 36 (86%) and 17 (85%), respectively. CONCLUSIONS After the introduction of oral therapy for ED there were some changes in the aetiology of refractory ED; ED after radical prostatectomy is gaining acceptance as the main reason for a penile implant.
Assuntos
Disfunção Erétil/terapia , Implante Peniano/métodos , Prótese de Pênis , Inibidores de Fosfodiesterase/uso terapêutico , Piperazinas/uso terapêutico , Sulfonas/uso terapêutico , Humanos , Masculino , Satisfação do Paciente , Implante Peniano/efeitos adversos , Implante Peniano/tendências , Prótese de Pênis/efeitos adversos , Prótese de Pênis/tendências , Complicações Pós-Operatórias/etiologia , Prostatectomia , Purinas/uso terapêutico , Citrato de Sildenafila , Resultado do TratamentoRESUMO
OBJECTIVE: To evaluate sexual satisfaction on women who have experienced sexual intercourse with the same partner on non-circumcised and circumcised states. MATERIAL AND METHODS: A total of 19 women between 19 and 53 y/o, median age 30, in which their sexual partner was programmed for circumcision were included in this study. The survey was a validated version on the Changes on Sexual Functioning Questionnaire (CSFQ). General sexual satisfaction, pain during vaginal penetration, desire, vaginal orgasm, vaginal lubrication, sexual frequency changes in oral and/or anal sexual activities and esthetical perception on circumcised penis were surveyed before the procedure and 2 months after. RESULTS: Changes on Vaginal lubrication during intercourse were significant (p = 0.004), it diminished from 78% to 63%. There were no statistically significant differences on general sexual satisfaction, pain during vaginal penetration, desire, vaginal orgasm. CONCLUSIONS: Circumcision has either negative or positive effect on female's partner perception of sexual satisfaction.