The efficacy of an association of palmitoylethanolamide and alpha-lipoic acid in patients with chronic prostatitis/chronic pelvic pain syndrome: A randomized clinical trial

Background: Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a complex condition, characterized by uncertain etiology and by limited response to therapy. The definition of CP/CPPS includes genitourinary pain with or without voiding symptoms in the absence of uropathogenic bacteria, as detected by standard microbiological methods, or another identifiable cause such as malignancy. The efficacy of various medical therapies, has been evaluated in clinical studies, but evidence is lacking or conflicting. We compared Serenoa Repens in monotherapy versus Palmitoylethanolamide (PEA) in combination with Alpha-lipoic acid (ALA) and evaluated the efficacy of these treatments in patients with CP/CPPS. Methods: We conducted a randomized, single-blind trial. 44 patients diagnosed with CP/CPPS (mean age 41.32 ± 1.686 years) were randomly assigned to treatment with Palmitoylethanolamide 300 mg plus Alpha-lipoic acid 300 mg (Peanase®), or Serenoa Repens at 320 mg. Three questionnaires (NIH-CPSI, IPSS and IIEF5) were administered at baseline and after 12 weeks of treatment in each group. Results: 12 week treatment with Peanase significantly improved the IPSS score compared to the same period of treatment with Serenoa Repens, and significantly reduced NIH-CPSI score. Similar results were observed in the different NIH-CPSI subscores break down. However, the same treatment did not result in significant improvement of the IIEF5 score. Both treatments did not produce undesired effects. Conclusions: The present results document the efficacy of an association of Palmitoylethanolamide (PEA) and Alpha-lipoic acid (ALA) administered for 12 weeks for treating patients with CP/CPPS, compared with Serenoa Repens monotherapy

The role of diallyl thiosulfinate associated with nuciferine and diosgenin in the treatment of premature ejaculation: a pilot study

Objective: To assess the efficacy and safety of an association of diallyl thiosulfinate with nuciferine and diosgenin in the treatment of a group of patients suffering from premature ejaculation (PE), primary or secondary to erectile dysfunction (ED). Materials and methods: From July 2015 to October 2016, 143 patients (mean age 25.3; range 18-39) affected by PE completed the study and were finally analyzed in this phase I study. All patients, after clinical assessment and laboratory evaluation were asked to take an association of diallyl thiosulfinate with nuciferine and diosgenin as oral tablet, once a day, on alternate days, for three months. At the baseline and after three months of treatment, each patient was asked to complete the following questionnaires: International Index of Erectile Function (IIEF-5), Premature Ejaculation Diagnostic Tool (PEDT), Male Sexual Health Questionnaire (MSHQ). Results: A statistical significant improvement in terms of erectile function, comparing the IIEF-5 value at baseline and follow-up visit was found (respectively IIEF-5: 8.7 vs 14.01; p < 0.001). Moreover, at follow-up visit, 97/143 men (67.8%) referred a subjective improvement of the erection quality and a better control of the ejaculation (PROs). The IELT improved too between the baseline evaluation and the follow-up visit (p < 0.001). Conclusion: In conclusion, our study, even if supported by preliminary results, showed how Diallyl Thiosulfinate, Nuciferine and Diosgenin is able to improve the control of ejaculation in patients suffering from PE, primary or secondary to ED without any significant adverse effects

Urologists' knowledge base and practice patterns in Peyronie's disease. A national survey of members of the italian andrology society.

Peyronie's disease is a chronic inflammatory disease involving the formation of plaque in the tunica albuginea of the corpora cavernosa, resulting in penis deformity. It is often associated with penile pain, especially in younger patients, but it is not rare for pain to be absent; the disease is also associated with erectile dysfunction and a depressive state in a large percentage of cases. Objective: Aim of our study was to explore the basic knowledge base and diagnostic and therapeutic practice patterns in Peyronie's disease (PD) of a large number of physicians belonging to the Italian Andrology Society (SIA). Methods: Our survey is based on two questionnaires which were e-mailed to the members of the SIA. The first questionnaire explored diagnostic and therapeutic practice patterns of SIA physicians, while the second questionnaire focused on their knowledge of the disease, as well as their training and level of experience in the specific field. We then planned to compare our outcomes with similar PD surveys from other countries. Results: The first questionnaire was answered by 142 SIA physicians. The second questionnaire was answered by 83 SIA physicians. Most respondents (74.6%) chose penile ultrasonography as first-line diagnostic approach and 47.1% prefer to perform a color Doppler ultrasound after pharmaco-induced erection. Concerning the therapeutic practice patterns in active stage of the disease, most respondents (99.29%) prefer conservative medical therapy. Additionally, most respondents (64.78%), when failure of conservative treatment had been established, considered surgical treatment necessary, specifically corporoplasty, which may be associated with other techniques. Conclusions: The results of our survey show that, in comparison to their foreign counterparts, Italian SIA uro-andrologists have a more proactive diagnostic approach right from when patients first present. When PD is still in its active stage, SIA uro-andrologists mostly opt for medical therapy. In advanced disease or if conservative treatment fails, our survey indicates a greater preference for surgical treatment. Answers to the theoretical knowledge questions showed that SIA physicians have a good understanding of the disease's etiology, epidemiology, and clinical picture, and of the appropriate indications for treatment

A "real life" investigation on the prescriptive habits among Italian andrologists: The "CONSER" survey from Italian Society of Andrology (SIA) on Sildenafil oral film

Even if oral type 5 phosphodiesterase inhibitors (PDE5i) seem an effective treatment for erectile dysfunction (ED), the drop-out is high among patients. For this reason, pharmaceutical companies are encouraged to develop new administration routes, such as the orally disintegrating film. The aim of this study was to analyse the prescription habit of Italian andrologists affiliated to Italian Society of Andrology (SIA) in the era of new oro-dispersible formulation of sildenafil. A 12-items dedicated questionnaire has been distributed to 77 urologists andrologists. As a result of the questionnaire, sildenafil is still the preferred drug of Italian andrologists as it is considered the safest and the most effective. It combines the speed of action and the discretion of the intake that are very important issues for the adherence to the treatment according to the Italian sample. Physicians have also reported the positive feedback of the patients taking sildenafil film as they consider the oro-dispersible formulation either comparable or superior to the old tablet. In conclusion this new formulation has given a new life to an old molecule like sildenafil, and Italian andrologists considered this new pharmaceutical formulation as a good tool to improve the patient's adherence to the treatment and quality of life

Analysis of environmental benefits resulting from use of hydrogen technology in handling operations at airports

Airports and nearby areas are currently facing an increasing pollution due to the growth of air transport traffic. Airport air pollution is produced not only by aircraft during landing and take-off cycles but also by the ground support equipment (GSE) during the airport handling activities. This paper investigates the potential of hydrogen as an alternative fuel for GSE vehicles to mitigate the airport air pollution. For this purpose, a methodology is developed to assess the environmental benefits attainable with the introduction of hydrogen technology for GSE vehicles powered by proton exchange membrane (PEM) fuel cells. This methodology compares, for a given scenario, the direct emissions produced by fuel combustion and the indirect emissions related to fuel production for both diesel and hydrogen technologies. Steam methane reforming and electrolysis technologies are investigated for the production of gaseous hydrogen at the airport. The pollutants investigated comprise carbon monoxide, total hydrocarbons, nitrogen oxides, sulphur oxides, particulate matter and volatile organic compounds. The main inputs for the methodology are the number of air transport movements, the aircraft fleet mix, the turnaround times for handling operations, the type of GSEs used, and the ratio of GSE vehicles converted to hydrogen (type, power installed, etc.). A preliminary cost analysis of a ground power unit powered by PEM fuel cells is also presented. The airport planners and policy makers can use this study to define a feasible environmental policy based on the use of new technologies such as hydrogen

Analysis of environmental benefits resulting from use of hydrogen technology in handling operations at airports

Airports and nearby areas are currently facing an increasing pollution due to the growth of air transport traffic. Airport air pollution is produced not only by aircraft during landing and take-off cycles but also by the ground support equipment (GSE) during the airport handling activities. This paper investigates the potential of hydrogen as an alternative fuel for GSE vehicles to mitigate the airport air pollution. For this purpose, a methodology is developed to assess the environmental benefits attainable with the introduction of hydrogen technology for GSE vehicles powered by proton exchange membrane (PEM) fuel cells. This methodology compares, for a given scenario, the direct emissions produced by fuel combustion and the indirect emissions related to fuel production for both diesel and hydrogen technologies. Steam methane reforming and electrolysis technologies are investigated for the production of gaseous hydrogen at the airport. The pollutants investigated comprise carbon monoxide, total hydrocarbons, nitrogen oxides, sulphur oxides, particulate matter and volatile organic compounds. The main inputs for the methodology are the number of air transport movements, the aircraft fleet mix, the turnaround times for handling operations, the type of GSEs used, and the ratio of GSE vehicles converted to hydrogen (type, power installed, etc.). A preliminary cost analysis of a ground power unit powered by PEM fuel cells is also presented. The airport planners and policy makers can use this study to define a feasible environmental policy based on the use of new technologies such as hydrogen

Male sexual distress: from definition to clinical approach

Objectives. The Italian Society of Andrology recently described Male Sexual Distress (MSD) as a new condition. A self-administered ad-hoc questionnaire, the Sexual Distress Evaluation Questionnaire for Men (SDEQ-M), has been subsequently validated. Our present aim is to perform a Study on Prevalence, Risk Factors and Quality of Life in male people affected by Sexual Distress attending Andrology Clinics across Italy. Materials and Methods. Type of study: naturalistic, cross-sectional, multicentric. Enrollment: sequential, at Andrology Specialist Clinics. Expected number of centers involved: 50, throughout Italy. Inclusion Criteria: age >18, subjects affected with ED or MSD, informed consent signature. Used scales: SDEQ-M; International Index of Erectile Function (IIEF); Quality of erections (Erection Hardness Score, Quality of Erection Questionnaire); Quality of life (EQ-5D Questionnaire); Life Satisfaction Scale. Results. Total expected number of enrolled subjects: 1000 men. An interim report of the study will be presented at the Congress. Discussion. Sexual Distress sufferers have impairment of their sexual health, with possible significant impact on their emotional, mental and social well-being. The Italian Society of Andrology feels that it is the duty of the Sexual Medicine specialist to acknowledge the requests for help presented also by these sufferers. This study is instrumental in further elucidating the implications of Sexual Distress, through: investigation of its prevalence, identification of possible risk factors, measurement of the quality of life of men affected by Sexual Distress

Journey into the realm of requests for help presented to sexual medicine specialists: Introducing male sexual distress

Introduction: The recent availability of noninvasive pharmacological remedies for male sexual function triggered an exponential increase in the number of men requesting help in the sexuality area. Aim: The Italian Society of Andrology explored requests for help, not included in formerly established clinical categories of sexual medicine. Methods: A central board of 67 andrologists identified new areas of requests for help, instrumental for a web-based questionnaire, forwarded to 912 members of the Italian Society of Andrology. Results were submitted to an independent consensus development panel. Main Outcome Measures: A questionnaire response rate of 30.8% was considered acceptable according to standard response rates of medical specialist samples. Results: The Central Board interaction identified two new domains of requests for help: sexual distress and unconventional requests for pro-erectile medications. Web-based questionnaire results suggested that such domains account for 29% and 9% respectively of all requests for help already presented by male patients at sexual medicine clinics. The Independent Consensus Development Panel issued a final consensus document; herewith, the statement defining male sexual distress: A non-transitory condition and/or feeling of inadequacy such as to impair "sexual health" (WHO working definition). Inadequacy can originate both from physiological modifications of male sexual functions, and from diseases, dysfunctions, dysfunctional symptoms and dysmorphisms, both of andrological and non-andrological origin, which do not relate to "erectile dysfunction" (NIH Consensus Development Panel definition), but that might also induce erectile dysfunction. Sexual Distress can lead to a request for help which needs to be acknowledged. Conclusion: The Italian Society of Andrology identified two new areas of requests for help concerning male sexual issues: sexual distress and unconventional requests for pro-erectile medications. These domains, which do not represent new diseases, nonetheless induce the sufferers to seek help and, accordingly, need to be acknowledged. © 2007 International Society for Sexual Medicine

Giammusso corporoplasty for the treatment of isolated congenital ventral penile curvature: Results and long-term follow-up

: The aim was to retrospectively evaluate our experience in a large series of patients affected by isolated congenital ventral penile curvature, surgically treated using a previously described modified incisional corporoplasty. Two hundred and six patients with isolated congenital ventral penile curvature underwent a modified incisional corporoplasty. Mean age at surgery was 20.7 ± 5.5 years, and degree of ventral curvature was 60 ± 23°. After the point of maximum convexity identification, Buck's fascia was vertically opened along the deep dorsal vein, which was partially ligated, resected and removed. Tunica albuginea was then longitudinally incised and transversally closed. Post-operative follow-up examination was performed at 2 weeks, 6, 12 and 24 months and then annually. Surgical time was 79 ± 12 min. At follow-up, 189 out of 198 patients (95%) were completely satisfied, four patients (2%) complained a recurrence of penile curvature, and 6 (3%) complained about shortening of the penis. None of the patients had any interference with sexual activity. One patient (0.5%) showed erectile dysfunction 5 years after surgery, but there was no organic dysfunction during examination. The proposed technique allows correction of ventral congenital penile curvature without dorsal neurovascular bundle manipulation, resulting in minimum trauma of the erectile tissue, without injury to nerve fibres