Early penile-only metastasis of urothelial bladder carcinoma

Penile metastasis rarely occurs as a unique and early distant recurrence of urothelial bladder carcinoma. A 77-year-old male underwent a radical cystoprostatecomy for a pT3a urothelial bladder cancer. Preoperative imaging workup concluded to a disease confined to the bladder. The patient consulted 5 months later for a penile induration. Computed tomography imaging revealed a suspicious penile nodule with no other nodal or visceral lesion. Total penectomy after a confirmatory biopsy confirmed the infiltration of the corpora cavernosa, the corpus spongiosum and the urethra by a urothelial metastasis of bladder cancer. Distant recurrences after radical surgery for locally advanced bladder cancer may occur as a unique early metastasis located to the penis.

EXPERIENCE OF PREMATURE EJACULATION CORRECTION BY COMBINED THERAPY OF PLATELET-RICH PLASMA AND LOW-INTENSITY SHOCK-WAVE THERAPY

Relevance. The spectrum of combined mechanisms of action of PRP-therapy, LISWT and LNP therapy suggests the clinical eff ect for patients with fi broplastic penile induration, which currently does not have conservative therapies that have suffi cient effi cacy.The aim of the study was to determine the effi cacy of combined PRP-therapy with intracavernous activation of growth factors by LISWT method + LNP and ICA pharmacotherapy in treatment of fi broplastic penile induction.Design. The study group comprised 23 patients of the Men’s Health Clinic in Kyiv, suff ering from fi broplastic penile inducing (Peyronie’s disease, ICD-10: N48.6) with erectile dysfunction.Results of the study. A 6-month follow-up observation showed a reduction of pain during erection, a signifi cant improvement in erectile function, a total regression of the areas less than 25 mm2 and a signifi cant decrease in the density and area of the induration areas that over 25 mm2.Conclusions. It has been established that the therapeutic model of the combined use of PRP-therapy with intracavernous activation of growth factors by LISWT method + LOD + ICA in the treatment of fi broplastic penile induration, shows a pronounced clinical eff ect, which makes this therapeutic model a promising option for conservative correction of pain and erectile dysfunction in fi broplastic penile induration.

EXPERIENCE OF COMBINING PLATELET-RICH AUTOPLASM THERAPY AND LOW-INTENSITY SHOCK-WAVE THERAPY IN TREATMENT OF PEYRONIE’S DISEASE

Relevance. The spectrum of combined mechanisms of action of PRP-therapy, LISWT and LNP therapy suggests the clinical eff ect for patients with fi broplastic penile induration, which currently does not have conservative therapies that have suffi cient effi cacy.The aim of the study was to determine the effi cacy of combined PRP-therapy with intracavernous activation of growth factors by LISWT method + LNP and ICA pharmacotherapy in treatment of fi broplastic penile induction.Design. The study group comprised 23 patients of the Men’s Health Clinic in Kyiv, suff ering from fi broplastic penile inducing (Peyronie’s disease, ICD-10: N48.6) with erectile dysfunction.Results of the study. A 6-month follow-up observation showed a reduction of pain during erection, a signifi cant improvement in erectile function, a total regression of the areas less than 25 mm2 and a signifi cant decrease in the density and area of the induration areas that over 25 mm2. Conclusions. It has been established that the therapeutic model of the combined use of PRP-therapy with intracavernous activation of growth factors by LISWT method + LOD + ICA in the treatment of fi broplastic penile induration, shows a pronounced clinical eff ect, which makes this therapeutic model a promising option for conservative correction of pain and erectile dysfunction in fi broplastic penile induration.

Peyronie’s disease: A “triple oxygenant therapy”

Objectives: To evaluate the effects of upregulators of nitric oxide in one patient with Peyronie’s disease, after non significant improvement following intracavernosal verapamil. Methods: A 20-years-old Caucasian male presented with penile induration in flaccid state, persistent during erection and associated with mild pain at third middle of penis. After treatment with intracavernosal verapamil for 4 months with relief of penile discomfort, followed by counseling on the use of penile extender for at least 6 hours per day, he was prescribed pentoxifylline associated with tadalafil plus levo-arginine, propionil-carnitine and Vitamin B3. Results: After almost 2 years, the septal thickness was reduced at ultrasound evaluation after this “triple oxygenant therapy”. Conclusion: NO-iNOS biology in Peyronie patients is the very protagonist in modulating penile fibrosis through up-regulation of NO-cGMP pathway that influences penile health by preventing and reversing fibrosis in the tunical albuginea.