Efeito da Circuncisão na Sexualidade Masculina

Introduction: The effect of circumcision on male sexual function is controversial and may have positive or negative effects on various domains of sexuality (erectile function, ejaculation, orgasm, desire). We aimed to assess the sexual function before circumcision and after circumcision. Methods: The sample was composed for all patients circumcised by the same surgeon (principal investigator) in the last 26 months, under the age of 60 and with recent sexual activity. For evaluation of sexual function before and after circumcision we used the International Index of Erectile Function-5 (IIEF-5) questionnaire (Portuguese validated version) and Brief Male Sexual Function Inventory (BMSFI), (the pre-circumcision data was obtained retrospectively). It was also questioned the reason for circumcision, the intravaginal ejaculatory latency time (IELT) and the degree of satisfaction with the procedure. The interviews were in person or by telephone. Results: The sample was composed for 25 patients with a mean age of 36.3 ± 10.3 years (lim: 22-55). The evaluation was performed on a mean time of 11.4 ± 5.4 months after the surgery (lim: 5-26). Of all patients, 52.0% reported an improved sex life, 44.0% did not note any difference and 4.0% reported worse sex life. A total of 92.0% of the patients would repeat the surgery. There were no statistical significant differences between pre-circumcision and post-circumcision results concerning IELT (p=0.608), sexual satisfaction (p=0.130), BMFSI total score (p=0.054) and IIEF-5 score (p=0.351). There was a correlation between BMFSI score (before and after circumcision) and IIEF-5 score (before and after circumcision), respectively (p<0.001). Conclusion: Circumcision does not seem to influence the sexual function of patients. Most patients would repeat the procedure and report improvements in their sex life after surgery.Introdução: O efeito da circuncisão sobre a função sexual masculina é controverso, podendo ter efeitos positivos ou negativos em vários domínios da sexualidade (função erétil, ejaculação, orgasmo, desejo). O objetivo foi avaliar o efeito da circuncisão na função sexual. Métodos: Amostra composta por todos os doentes circuncisados pelo mesmo cirurgião (investigador principal) nos últimos 26 meses, com idade inferior a 60 anos e com atividade sexual nos 30 dias prévios às entrevistas. Para avaliação da função sexual pré e pós-circuncisão foram usados os questionários International Index of Erectile Function-5 (IIEF-5) e o Brief Male Sexual Function Inventory (BMSFI), sendo que os dados pré-circuncisão foram obtidos de forma retrospetiva. Foram ainda questionados o motivo da circuncisão, o tempo de latência intravaginal e o grau de satisfação dos doentes com o procedimento. Resultados: Amostra composta por 25 doentes, idade média de 36,3±10,3 anos (lim: 22-55), sendo a avaliação realizada em média 11,4±5,4 meses após a cirurgia (lim: 5-26). Dos indivíduos avaliados, 52.0% referiram melhoria da vida sexual, 44,0% não notaram diferença e 4,0% referiram agravamento. Repetiriam a cirurgia 92,0% dos indivíduos.Não existiram diferenças estatisticamente significativas entre os resultados pré-circuncisão e pós-circuncisão em relação ao IELT (p=0,608), satisfação sexual “subjetiva” (p=0,130), score total do BMFSI (p=0.054) e score do IIEF-5 (p=0,351).Há uma correlação entre os scores BMFSI pré-circuncisão e pós-circuncisão e os scores IIEF-5 pré e pós-circuncisão, respetivamente (p<0,001). Discussão e Conclusão: A circuncisão não parece influenciar negativamente a função sexual. A maioria dos doentes repetiria o procedimento e refere melhorias na sua vida sexual após a cirurgia

Inhibition of bladder tumor growth by chitooligosaccharides in an experimental carcinogenesis model

Urinary bladder cancer is one of the most common cancers worldwide, with the highest incidence in industrialized countries. Patients with cancer commonly use unconventional and complementary therapy including nutraceuticals. In this study we evaluated the efficacy of chitooligosaccharides (in orange juice) in rat bladder cancer chemoprevention and as therapeutic agent, on a rat model of urinary bladder carcinogenesis induced with N-butyl-N-(4-hydroxybutyl) nitrosamine. Results indicate that chitooligosaccharides may have a preventive effect on bladder cancer development and a curative effect upon established bladder tumors, dependent on the concentration ingested 500 mg/kg b.w., every three days, showed capacity to inhibit and prevent the proliferation of bladder cancer; however, this was associated with secondary effects such as hypercholesterolemia and hypertriglyceridemia. The use of lower doses (50 and 250 mg/kg b.w.) showed only therapeutic effects. It is further suggested that this antitumor effect might be due to its expected anti-inflammatory action, as well as by mechanisms not directly dependent of COX-2 inhibition, such as cellular proliferation control and improvement in antioxidant profile.info:eu-repo/semantics/publishedVersio

A potential signature for muscle-invasive tumors

Funding: This work was supported by the Astellas European Foundation Uro-Oncology Grant 2014; JABA RECORDATI Urology 2011 - Portuguese Society of Urology; Portuguese Foundation for Science and Technology (Strategic Project: PEst-C/SAU/UI3282/2013 and UID/NEU/04539/2013); GAI/FMUC and Santander Totta (Ref. FreitasGomes04.01.13) and Center of Investigation in Environment, Genetics and Oncobiology (CIMAGO), Portugal (Ref. 14/12). Margarida FerreiraTeixeira benefits from a PhD scholarship from the Portuguese Foundation for Science and Technology (Reference SFRH/BD/77314/2011).Striking evidence associates cancer stem cells (CSCs) to the high recurrence rates and poor survival of patients with muscle-invasive bladder cancer (BC). However, the prognostic implication of those cells in risk stratification is not firmly established, mainly due to the functional and phenotypic heterogeneity of CSCs populations, as well as, to the conflicting data regarding their identification based on a single specific marker. This emphasizes the need to exploit putative CSC-related molecular markers with potential prognostic significance in BC patients. This study aimed to isolate and characterize bladder CSCs making use of different functional and molecular approaches. The data obtained provide strong evidence that muscle-invasive BC is enriched with a heterogeneous stem-like population characterized by enhanced chemoresistance and tumor initiating properties, able to recapitulate the heterogeneity of the original tumor. Additionally, a logistic regression analysis identified a 2-gene stem-like signature (SOX2 and ALDH2) that allows a 93% accurate discrimination between non-muscle-invasive and invasive tumors. Our findings suggest that a stemness-related gene signature, combined with a cluster of markers to more narrowly refine the CSC phenotype, could better identify BC patients that would benefit from a more aggressive therapeutic intervention targeting CSCs population.publishersversionpublishe

Supportive Care Network: Evaluation of Its Impact on the Performance of a Urology Department

Introduction: Hospitals are dealing with patients who may have clinical discharge but cannot return to their home due to non-medical issues. Material and Methods: Cross-sectional analysis of all the cases referred to the Integrated Care Network during the year 2016. Evaluation of waiting times, typology, reason for referral and clinical parameters. IBM SPSS 24.0 software was used for all statistical analyses. Results: In the evaluated period, 2294 patients were discharged from our department. Of these, 55 were referred to Integrated Care Network. The mean length of hospitalization of the patients referred to the network was 20.6 ± 11.4 days, and the mean overall length of hospital stay in the period analyzed was 4.8 ± 0.9 days. The mean time between hospitalization and referral for continuing care was 10.7 ± 7.2 days. The time between referral and discharge of the hospital was 10.0 ± 8.7 days. Thirty-nine (70.9%) patients were hospitalized for oncological diseases. The most common referral was to Palliative Care units (n = 16; 29.1%). Patients referred to Palliative Care units showed the largest waiting times between the referral for the network and the hospital discharge, 12.2 ± 10.51 days. We observed 289 hospitalization days with patients who had no need of specialized urological care. Discussion: In order to reduce time between referral to the network and hospital discharge, there is a need for enhanced cooperation and coordination among doctors, nurses and social workers. Conclusion: Early identification by physicians and nurses of patients who will require care after discharge will provide a better response from social workers and increased hospital performance

Predictive factors for successful testicular biopsy

Introduction: Infertility, the inability to conceive, constitutes a major problem in modern societies. It affects 10 to 15 percent of couples in the United States. Evaluation of infertile men is usually complex and often demands a testicular biopsy. Materials and methods: We reviewed all azoospermic men submitted to testicular biopsy, in our center, during infertility investigation between January 2015 and December 2021. Results: A total of 117 patients with a mean age of 36.5 was considered. Biopsy was positive, as defined by the presence of viable spermatozoids by microscopy, in 48.7% of patients (n = 57). Patients were divided in two separate groups based on positive (PB) or negative biopsy (NB) and compared. PB-group had normal serum total testosterone levels and higher than NB-group (3.7 ng/mL vs. 2.85 ng/mL, p = 0.021), and normal serum FSH levels and lower than NB-group (6.0 mIU/mL vs. 16.0 mIU/mL, p < 0.001). The groups were similar concerning serum LH levels (3.9 mIU/mL vs. 6.3 mIU/mL, p = 0.343. Conclusions: Predicting outcomes of testicular biopsy is a difficult task. Our study found that men with normal testicular volume, normal levels of testosterone and FSH and those with type 1 diabetes mellitus had a higher probability of positive testicular biopsy

Inhibition of bladder tumour growth by sirolimus in an experimental carcinogenesis model

To investigate the anticarcinogenic effects of sirolimus 2 mg/kg/day on a rat model of urinary bladder carcinogenesis induced with N-butyl-N(4-hydroxybutyl)nitrosamine (BBN)

Surveillance as a safe and effective option for treatment of stage I seminoma

Introduction: Stage I seminoma has a very good prognosis, yet approximately 15% have subclinical metastatic disease and will relapse after orchidectomy alone. Several management approaches have been investigated. We aimed to evaluate the clinical outcomes of real-world patients with stage I seminoma, analysing prognostic factors influencing treatment choice and oncological outcomes. Methods: Retrospective, single institution study, with 55 patients diagnosed with clinical stage I seminoma between 2007 and 2020. Selected patients were analysed regarding three management approaches - surveillance, adjuvant radiotherapy and adjuvant carboplatin AUC7. Overall survival and progression-free survival outcomes were analysed. Predictors of treatment choice were determined, and predictors of recurrence were analysed in patients on active surveillance. Results: The median follow-up time was 91 months (13-165). Overall survival at 10 years was 98.2%. Stage I seminoma patients had a 1-, 3- and 10-year progression free survival of 98%, 94% and 89%, respectively. Three-year progression free survival was 92.0% for those on active surveillance (IC95%, 91.5-92.5%), 95.2% for carboplatin (IC95%, 94.8-95.6%) and 100% for those on adjuvant radiotherapy (p > 0.05). All relapses on active surveillance protocols occurred during the first 24 months. Overall, 43% of patients who underwent adjuvant treatment reported adverse effects of therapy, with higher incidence on radiotherapy group (63%). Conclusions: Stage I seminoma have excellent prognosis, high cure rates, and low treatment-associated morbidity. Active surveillance is a safe modality when applied to selected patients. Adjuvant radiotherapy and adjuvant chemotherapy with carboplatin show similar results, with fewer adverse effects on chemotherapy arm

Prognostic value of subclassification (pT2 stage) of pathologically organ-confined prostate cancer: Confirmation of the changes introduced in the 8th edition of the American Joint Committee on Cancer (AJCC) staging system

Objective: The last edition of the AJCC staging system eliminated the pT2 subclassification of prostate cancer (PCa). Our objective was to evaluate the association of pT2 subclassification with the oncological results of patients with PCa who underwent radical prostatectomy (RP). Material and methods: We evaluated 367 patients who underwent RP between 2009 and 2016, with pT2 disease in the final pathological evaluation. We assessed differences in rates of biochemical recurrence (BCR), metastasis and mortality between T2 substages (pT2a/b vs pT2c). Results: Fifty-three (14.4%) patients presented pT2a/b disease and 314 (85.6%) pT2c disease. The mean follow-up time was 4.9 ± 2.6 years. Grade group scores (p = 0.1) and prostate specific antigen (PSA) (p = 0.2) did not differed between pT2 substages. The rate of BCR in pT2a/b and pT2c patients was 11.3% and 18.2%, respectively (p = 0.2). Five (9.4%) patients with pT2a/b and 45 (14.3%) with pT2c substage underwent salvage radiotherapy (p = 0.3). The rate of positive surgical margins did not differ between groups (p = 0.2). Seven (2.2%) patients with pT2c had lymph nodes or distant metastases. The overall survival was 92.5% and 93.6% in pT2a/b and pT2c, respectively (p = 0.2). Conclusion: Our results are in accordance with the changes introduced in the 8th edition of the AJCC staging system in which the pT2 subclassification was eliminated

Effects of Sitagliptin Treatment on Dysmetabolism, Inflammation, and Oxidative Stress in an Animal Model of Type 2 Diabetes (ZDF Rat)

The purpose of this paper is to evaluate the chronic effect of sitagliptin on metabolic profile, inflammation, and redox status in the Zucker Diabetic Fatty (ZDF) rat, an animal model of obese type 2 diabetes. Diabetic and obese ZDF (fa/fa) rats and their controls (ZDF +/+) were treated during 6 weeks with vehicle (control) and sitagliptin (10mg/kg/bw). Glucose, HbA1c, insulin, Total-c, TGs, IL-1β, TNF-α, CRPhs, and adiponectin were assessed in serum and MDA and TAS in serum, pancreas, and heart. Pancreatic histology was also evaluated. Sitagliptin in diabetic rats promoted a decrease in glucose, HbA1c, Total-c, and TGs accompanied by a partial prevention of insulinopenia, together, with a decrease in CRPhs and IL-1β. Sitagliptin also showed a positive impact on lipid peroxidation and hypertension prevention. In conclusion, chronic sitagliptin treatment corrected the glycaemic dysmetabolism, hypertriglyceridaemia, inflammation, and hypertension, reduced the severity of the histopathological lesions of pancreatic endocrine and exocrine tissues, together with a favourable redox status, which might be a further advantage in the management of diabetes and its proatherogenic comorbidities