Catheters and Infections

Catheters are used for effective drainage of the bladder, either temporally or permanently, in the presence of physiological and anatomical defects or obstruction of the lower urinary tract. Catheters are used for a variety of reasons, as follows, to maintain bladder drainage during and following surgery or epidurals anesthesia for minimizing and prevention of the risk of distension injuries; investigations, for accurate urine output measurement, and measurement of post-micturition residuals; treatments, to relieve urinary retention or for chemotherapy instillation; intractable incontinence, as the final option for containment

Clinical analysis in young patient with persistent sexual dysfunctions after finasteride assumption to prevent male pattern hair loss.

7Clinical analysis in young patient with persistent sexual dysfunctions after finasteride assumption to prevent male pattern hair lossnonenoneTrombetta C.; Mazzon G.; Liguori; G.; Ollandini; G.; Cauci; S.; Toffoli; G.; Erika; E.Trombetta, Carlo; Mazzon, G.; Liguori, Giovanni; Ollandini, G.; Cauci, S.; Toffoli, G.; Erika, E

Should older patients be offered varicocoele correction to improve their fertility?

We reviewed a large number of patients from 2000 to 2010 that underwent varicocoele correction using the retrograde sclerotization approach. Three hundred and seventy-six of them were included in the study, as they met the inclusion criteria. Mean age at the time of surgery was 32 years (SD: 6.5); 32% of them were 35 years and older. Patients were classified according to the clinical classification (GC) and Sarteschi's Doppler ultrasound classification (GS). The patients showed up at the clinic after an average time of 30 months of referred infertility related (SD: 28.54). Patients underwent pre-operative assessment with physical examination, sperm analysis and Doppler ultrasound, and again the same assessment at least 3 months after surgery. We evaluated the following parameters: sperm concentration (millions/mL, CONC), percentage motility (a+b, MOT) and the percentage of morphologically typical spermatozoa (MOR). Univariate and Multivariate analysis were performed. The research of Pearson's coefficients was performed to test the correlation between sperm parameters and age, SG, CG. Semen specimens were evaluated according to WHO 1999 criteria. Mean CONC varied from 34.5 to 47.0 millions/mL (+12.5; p < 0.001); MOT from 27.2 to 34.5% (+7.3%; p < 0.001); and MOR from 44.0 to 47.6% (+3.6%; p = 0.001). Univariable and multivariable analysis of variance related to age showed no significant difference of parameters improvement. Pearson's correlation coefficient for pre-operative and post-operative sperm MOT related to patients' age was respectively -0.11 (p < 0.001) and -0.18 (p = 0.04). No other significance was found. Usefulness of treating infertile patients affected by varicocoele is confirmed: varicocoele correction leads to significant sperm parameters improvement. There is no evidence of different improvement related to patients' age. The decline in sperm motility related to age of the patients seems to be only age-dependent: the usefulness of treating patients affected by varicocoele is not influenced by their age: treatment should also be offered to older patients

Predictive factors of better improvement in semen quality after sclerotization of varicocele: preliminary report

Introduction. Controversial data on effectiveness of varicocele correction are available, and still clear predictive factors of better semen quality improvement are lacking. To determine whether age of patients, clinical classification and colorDoppler classification are related to a different semen quality improvement after sclerotization of varicocele. Material and methods. 113 patients with left unilateral varicocele were selected between 2002 and 2007, as they met the criteria of low sperm density, no endocrinological failures and no recidivation of varicocele after correction. All patients underwent retrograde percutaneous sclerotization of varicocele or, if not possible, anterograde sclerotization. All patients underwent physical examination, FSH measurement, seminal analysis (sperm density, motility and percent of regular-morphology sperms), scrotal ultrasonography and colorDoppler scrotal evaluation. At least 3 months postoperative, they were assessed with the same protocol. Results. Mean age was 32,2 yr. We found improvement in seminal param- eters among the whole population (sperm density: +92,4% percent of mobile cells: +42,2%, percent of normal cells: +21,7%; p < 0,001). We found no significance in differences among semen quality improvement of patients of different ages (sperm density variation among patients 18-29 yrs: 14,7; 30- 39: 10,2; > 39: 20,3; p > 0,2). We found no significance in differences among semen quality improvement of patients with subclinical vs. clinical varicocele. Significant evidence of higher improvement in semen quality parameters have been found among patients with basal renal reflow at preoperative evaluation vs. patients without basal renal reflow (sperm density: +139% vs. +53%, p = 0,006). Conclusions. Treatment of varicocele results in improvement of seminal quality among all patients. Age is not related to a different outcome. The presence of a basal renal preoperative reflow is associated with higher improvement in semen quality parameters after sclerotizatio

Reconstructive penile surgery: A review

A variety of surgical procedures have been described to treat various penile diseases. Nowadays the purpose of all surgical techniques in penile surgery is not only the correct treatment of the primary condition, but also to preserve sexual function and to maintain cosmesis of the penis. Appropriate treatment options should be individualized according to the patients' expectations and erectile capacity. The present paper reviews recent advances in the field of penile reconstructive surgery using knowledge obtained from the contemporary literature