Effect of sildenafil on platelet function and platelet cGMP of patients with erectile dysfunction

To investigate the effect of sildenafil on platelet function and cyclic guanosine monophosphate (cGMP) levels in patients with erectile dysfunction, we evaluated the association between erectile function and platelet responses after administration of 100 mg sildenafil. Erectile responses were monitored after 8 daily doses of the drug. Adenosine diphosphate (ADP) and collagen-induced platelet aggregation and simultaneous adenosine triphosphate (ATP) release and cGMP levels were determined before and after sildenafil therapy. Basal levels for platelet aggregation, ATP release and cGMP were compared with age-matched controls. There was no difference among basal levels of platelet responses between patients and controls, except for ADP-induced platelet aggregation (P = 0.04). It was significantly higher in the patient group. Analysis of the responses to sildenafil revealed that for the patients who showed a positive erectile response, there was a significant increase in platelet cGMP (P = 0.028) and a decrease in ADP-induced platelet aggregation (P = 0.04). However, for those who showed a negative or poor erectile response, there was no change in platelet cGMP levels and platelet functions. Sildenafil did not affect collagen-induced platelet responses although cGMP levels of the responders increased. It is concluded that sildenafil increases platelet cGMP in the patients with positive erectile response. Therefore, it has been speculated that platelet cGMP may be used as an index for erectile response. © 2015 Blackwell Verlag GmbH

Clinical results of transurethral electrovaporization resection of prostate (TUVRP) with two different electrodes versus TURP: A randomized prospective clinical study [Prostatin Iki Farkli Elektrotla Yapilan Transüretral Elektrovaporizasyon Rezeksiyonu (TUVRP) ile TURP Kli?ik Sonuçlarinin Karşilaştirilmasi: Randomize Prospektif Kl·inik Bir Çalişma]

Introduction: The aim of our study was to compare the results of conventional transurethral electroresection of the prostate (TURP) and transurethral vaporization and resection of the prostate (TUVRP) operations in patients with symptomatic bladder outlet obstruction due to prostatic enlargement. Materials and Methods: 59 consecutive patients with symptomatic bladder outlet obstruction due to prostatic enlargement and prostate size between 20-60 g were prospectively randomized to two treatment groups; one group underwent standard TURP and the other TUVRP. Eligibility criteria included IPSS result 8 or grater, Qmax <15 ml/sec and prostate volume of 20 to 60 gm on transrectal ultrasonography. Patients less than 50 years old and those with a known neurogenic bladder, cancer of the prostate or bladder, history of prostate surgery or currently taking medications known to affect voiding function (alfa blockers) were excluded from this study. Patients were followed-up at 1, 3 and 12 months after treatment. International Prostate Symptom Score (IPSS), maximum flow rate (Qmax), post-voiding residual urine volume (PVR) and transrectal ultrasound results were recorded during the follow-up period. Kruskal-Wallis variance analysis, Wilcoxon test and Bonferroni corrected Wilcoxon test was used for statistical analysis to compare the preoperative and postoperative data. Results: With respect to efficacy parameters (IPSS, Qmax, PVR and prostate volume) we did not observe statistically significant difference among those groups (TURP and TUVRP). Also the complications were similar on both groups. Conclusions: TUVRP seems to be a safe and efficacious modification of TURP (with) and the main advantage of this technique is to produce a more accurate TURP operation with less hemorrhage by improving surgeon's comfort during the resection