Navegando por Palavras-chave "penis"
Agora exibindo 1 - 7 de 7
Resultados por página
Opções de Ordenação
- ItemAcesso aberto (Open Access)An alternative non-invasive treatment for Peyronie's disease(Sociedade Brasileira de Urologia, 2004-06-01) Claro, Joaquim A. [UNIFESP]; Passerotti, Carlo Camargo [UNIFESP]; Figueiredo Neto, Antonio C. [UNIFESP]; Nardozza Júnior, Archimedes [UNIFESP]; Ortiz, Valdemar [UNIFESP]; Srougi, Miguel [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)OBJECTIVE: Surgical correction of the deformity and plaque caused by Peyronie's disease has some important disadvantages and extracorporeal shockwave therapy (ESWT) emerged as a new promising therapy. We evaluated prospectively the efficacy and safety of the association of high dose vitamin E and ESWT as a non-invasive treatment for the disease. MATERIALS AND METHODS: Twenty-five patients 42 to 68 years old (mean = 54) presenting penile deviation and sexual distress caused by Peyronie's disease were treated in a non-invasive manner. The time of penile deviation ranged from 16 to 52 months (mean = 30). All patients had previous unsuccessful treatment for Peyronie's disease. The angulation's deformity of the penis was assessed by photography at home. The patients received vitamin E (l.200 mg daily) during 3 months and underwent 3 to 6 sessions (mean = 3) of ESWT (3,000 to 4,000 shockwaves) at a power level of l to 2 at 1-week intervals. RESULTS: From 25 patients treated, 16 (64%) reported an improvement in penile angulation, with a mean reduction of 21 degrees (10 to 40). Eight patients reported improvement in their spontaneous erections. Overall, the patients presented only minimal bruising at the site of treatment and skin hematoma. Four patients presented urethral bleeding. The mean angulation after treatment in the control group was 48.67 degrees (30 - 70) and in the study group was 24.42 degrees (0 - 70), statistically significant. CONCLUSION: Considering the common complications and the unsatisfactory outcome of the surgical correction for Peyronie's disease, the association of high dose vitamin E and ESWT represents a good option for a non-invasive, effective and safe treatment of the penile deformity.
- ItemSomente MetadadadosCongenital Megaprepuce: A New Alternative Technique for Surgical Correction(Brazilian Soc Urol, 2008-05-01) Leao, Jovelino Q.; Freitas Filho, Luiz G. [UNIFESP]; Gomes, Adriano L.; Heinsich, Antonio C.; Carnevale, Jose; Darcy Vargas Childrens Hosp; Universidade Federal de São Paulo (UNIFESP)Objective: To present a new alternative technique for surgical treatment of congenital megaprepuce.Materials and Methods: From April 2004 to April 2006, five patients aged 2 to 5 years were treated using the new technique. The technique is described and illustrated. It differs from other techniques in that it takes into consideration the constant ballooning of the foreskin, which gives to the external genitalia the aspect of a penoscrotal transposition. Cosmetic and functional success were also assessed by a case review.Results: After a follow-up of 1 to 3 years, all patients have normal voiding and a satisfactory cosmetic aspect.Conclusion: This new technique could be a useful alternative in treatment of the congenital megaprepuce.
- ItemAcesso aberto (Open Access)Effect of sildenafil in cavernous arteries of patients with erectile dysfunction(Sociedade Brasileira de Urologia, 2003-08-01) Claro, Joaquim A [UNIFESP]; Ximenes, Sergio Felix [UNIFESP]; Nardozza Júnior, Archimedes [UNIFESP]; Andrade, Enrico [UNIFESP]; Messina, Leonardo [UNIFESP]; Srougi, Miguel [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)INTRODUCTION: Sildenafil citrate is a type 5 phosphodiesterase inhibitor, which has demonstrated excellent results in the treatment of erectile dysfunction. The effect of sildenafil citrate in the cavernous arteries of patients with erectile dysfunction has not been established yet. The objective of this study was to assess the effect of sildenafil citrate in the cavernous arteries of patients with erectile dysfunction, following an intracavernous injection of alprostadil. MATERIALS AND METHODS: 29 male patients, with mean age of 53.8 years (32 to 75 years), were prospectively evaluated. The mean time with complaint of erectile dysfunction was 50.5 months (6 to 168 months). Each patient was his own control. Patients underwent a measurement of peak systolic velocity before and after use of sildenafil citrate associated with 5 micrograms of alprostadil, through ultrasonic velocitometry Knoll/MIDUS® system. In the interval between measurements, approximately 15 days, patients used 3 tablets of sildenafil at home with their partners. RESULTS: Using only 5 mcg of alprostadil, average peak systolic velocity was 23.9 cm/s, and when associated to 50 mg of sildenafil it was 24.8 cm/s. Despite the increase in the flow rate caused by sildenafil, the difference was not statistically significant, Zcalculated = - 0.695 NS (Wilcoxon test). Twenty one of the 29 patients (72.4%) showed global improvement in sexual performance with the use of sildenafil citrate at home. There was not a statistically significant correlation between the global response to sildenafil citrate and the increase in the peak systolic velocity. CONCLUSION: We concluded that, even though the use of 50 mg of sildenafil citrate associated with 5 mcg of alprostadil provides an increase in the peak systolic velocity of the cavernous arteries, there was no statistic difference in relation to alprostadil alone. There was no correlation between the global response to sildenafil and the increase in the peak systolic velocity
- ItemSomente MetadadadosExpressão de fatores indutores de fibrose no tecido cavernoso de pacientes com disfunção erétil pós prostatectomia radical(Universidade Federal de São Paulo (UNIFESP), 2015-12-15) Cabrini, Marcelo Rodrigues [UNIFESP]; Ribeiro, Cassio Andreoni Ribeiro [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Objectives: To characterize transforming growth factor beta 1 (TGF?1) and related signaling pathway proteins in a large cohort of human penile tissue (HPT) samples from men with post-radical prostatectomy (RP) erectile dysfunction (ED). Method: HPT was collected from patients undergoing penile prosthesis implantation for postradical prostatectomy erectile dysfunction (RP-ED; n = 57). Two groups of tissue were used for comparison: organic ED (O-ED; n = 30), also collected during penile prosthesis implantation, and control (CON; n = 6), collected from patients undergoing partial penectomy, without ED. Western blot analysis was performed to investigate the protein expressions of TGF?1, thrombospondin 1 (TSP1; an activator of TGF?1), a family of transcriptional factors activated by TGF?1 (Smad2, phospho-Smad2- serine-465/467 [pSmad2], Smad3, phospho-Smad3-serine-423/425 [pSmad3]), and fibronectin (FN; an extracellular matrix glycoprotein induced by TGF?1). Results: Expressions of TGF?1 and TSP1 were significantly higher in RP-ED (p <0.05) and OED (p <0.05) groups compared with that of the CON group and were not different between either ED groups. Expressions of Smad2, pSmad2, Smad3, pSmad3, and FN were similar among all groups. Within the RP-ED group, a subgroup analysis showed that body mass index (BMI)>25Kg/m2 was related to increased expression of TGF?1 and TSP1, previous history of intracavernosal injection was related to increased expression of TGF?1 (p<0.05), and time from RP to penile prosthesis implantation (moment of tissue collection) was related to increased expression of pSmad2 (p<0.05). Conclusions: Our results demonstrate that TSP1- and TGF?1- dependent fibrotic changes occur in penile tissue in patients with ED regardless of etiology. The unchanged expression of the Smad transcriptional factors may be reconciled by a Smad-independent downstream signaling pathway transmitting TGF?1 signals. Among RP-ED men, BMI, previous use of intracavernosal injection and time sice RP affect fibrotic protein expression.
- ItemSomente MetadadadosPhalloplasty and urethroplasty in children with penile agenesis: Preliminary report(Elsevier B.V., 2007-03-01) De Castro, Roberto; Merlini, Emilio; Rigamonti, Waifro; Macedo, Antonio; Osped Maggiore Bologna; Univ Padua; Universidade Federal de São Paulo (UNIFESP)Purpose: Female gender has been assigned to 46,XY newborns affected by aphallia, possibly resulting in subsequent gender dysphoria. Prenatal and postnatal effects of the androgens on the brain and sexual orientation cannot be modified later. Therefore, patients affected by aphallia should be raised as males. Because definitive forearm flap phalloplasty is generally not recommended before puberty, we performed a preliminary penile reconstruction during childhood in 4 patients.Materials and Methods: Four patients with aphallia who had no sex reassignment at birth were treated at age 9, 17 and 36 months, and 12 years in a single operation. the urethral channel was dissected through an anterior-sagittal-transanorectal approach, and then phalloplasty and urethroplasty were carried out using an abdominal skin flap and a bladder/buccal mucosa free graft.Results: Immediate postoperative outcome was excellent in all the patients. One patient had excellent functional and cosmetic results at 5 years, while 2 had a partial dorsal urethral dehiscence resulting in an epispadiac urethra at 2 years, and 1 had necrosis of the distal urethra and was voiding through a scrotal urethrostomy at 9 months postoperatively. Phalloplasty survived and provided an adequate male appearance in all patients.Conclusions: Opposite gender should not be assigned in patients affected by penile agenesis, who are better raised according to their karyotype and hormonal production. Definitive phalloplasty in adults may achieve good results. Nevertheless, this procedure is generally performed in postpubertal boys and it is not easily available everywhere. Therefore, we believe that social and psychological concerns justified this type of phalloplasty as a palliative preliminary procedure in 3 of our patients. in those countries where definitive forearm phalloplasty is not available our method may also be justified in older children (as in 1 of our patients) as an attempt at a definitive procedure.
- ItemSomente MetadadadosPriapism is Associated with Sleep Hypoxemia in Sickle Cell Disease(Elsevier B.V., 2012-10-01) Roizenblatt, Marina [UNIFESP]; Figueiredo, Maria Stella [UNIFESP]; Cancado, Rodolfo Delfini; Pollack-Filho, Frederico [UNIFESP]; Almeida Santos Arruda, Martha Mariana de [UNIFESP]; Vicari, Perla [UNIFESP]; Sato, Joao Ricardo; Tufik, Sergio [UNIFESP]; Roizenblatt, Suely [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade Federal do ABC (UFABC)Purpose: We assessed penile rigidity during sleep and the relationship of sleep abnormalities with priapism in adults with sickle cell disease.Materials and Methods: This was a case-control study of 18 patients with sickle cell disease and a history of priapism during the previous year, and 16 controls with sickle cell disease. Participants underwent overnight polysomnography and RigiScan (R) Plus recording to detect penile rigidity oscillations.Results: the priapism group (cases) showed a higher apnea-hypopnea index and oxyhemoglobin desaturation parameters than controls. A lower positive correlation between the apnea-hypopnea index and oxyhemoglobin desaturation time was observed in cases than in controls (Spearman coefficient rho = 0.49, p = 0.05 vs rho = 0.76, p < 0.01), suggesting that desaturation events occurred independently of apnea. Two controls and 14 cases had a total sleep time that was greater than 10% with oxyhemoglobin saturation less than 90% but without CO2 retention. Penile rigidity events were observed during rapid eye movement sleep and during stage 2 of nonrapid eye movement sleep, particularly in cases. the duration of penile rigidity events concomitant to respiratory events was higher in cases than in controls. Regression analysis revealed that the periodic limb movement and desaturation indexes were associated with priapism after adjusting for rapid eye movement sleep and lung involvement. Finally, oxyhemoglobin saturation less than 90% was associated with priapism after adjusting for lung involvement, hyperhemolysis and the apnea-hypopnea index.Conclusions: Oxyhemoglobin desaturation during sleep was associated with priapism history. It may underlie the distribution pattern of penile rigidity events during sleep in these patients.
- ItemAcesso aberto (Open Access)Study of the efficacy of Korean Red Ginseng in the treatment of erectile dysfunction(Blackwell Publishing, 2007-03-01) Andrade, Enrico de; Mesquita, Alexandre A. de; Claro, Joaquim de Almeida [UNIFESP]; Andrade, Priscila M. de; Ortiz, Valdemar [UNIFESP]; Paranhos, Mario; Srougi, Miguel; Universidade de São Paulo (USP); Universidade Federal de São Paulo (UNIFESP)Aim: To examine the treatment efficacy of Korean Red Ginseng (KRG) in impotent men with erectile dysfunction (ED). Methods: A total of 60 patients presenting mild or mild to moderate ED were enrolled in a double-blind, placebo-controlled study in which the efficacies of KRG and a placebo were compared. the patients received either 1 000 mg (3 times daily) of KRG or a placebo. Results: the five-item version of the International Index of Erectile Function (IIEF-5) score after the treatment was significantly higher in the KRG group compared with that before the treatment (from 16.4 +/- 2.9 to 21.0 +/- 6.3, P < 0.0001). in contrast, there was no difference before and after the treatment in the placebo group (from 17.0 +/- 3.1 to 17.7 +/- 5.6, P > 0.05). in the KRG group, 20 patients (66.6%), reported improved erection, significant in the global efficacy question (P < 0.01); in the placebo group there was no significance. Scores on questions 2 (rigidity), 3 (penetration), 4 and 5 (maintenance), were significantly higher for KRG than those for the placebo when those questions were answered after 12 weeks of each treatment (P < 0.01). When the score in the KRG group was compared to the placebo group after the treatment, there was a significant improvement in total score (IIEF-5 score) in questions 3 and 5 for the KRG-treated group (P < 0.001 and P < 0.0001, respectively). the levels of serum testosterone, prolactine and cholesterol after the treatment were not statistically significant different between the KRG and the placebo group (P > 0.05). Conclusion: Our data show that KRG can be an effective alternative to the invasive approaches for treating male ED.