Efficacy of pentoxifylline in Peyronie’s disease: Clinical case of a young man

Peyronie’s disease (PD) is a localized connective tissue disorder of the tunica albuginea of the penis and its surrounding tissue which results in a painful erection, penile curvature and erectile dysfunction. The great number and variety of purposed treatments for PD is in proportion to the difficulty of its management.In fact no medical treatment is currently available to cure patients with PD. Pentoxifylline (PTX) is a non specific phosphodiesterase inhibitor with anti-inflammatory properties that has been used to treat claudication. PTX has also been used to decrease inflammation and fibrosis in kidney transplants, open heart surgery, dermatological conditions and after radiation injury. With respect to penile diseases, clinical studies have suggested that PTX decreases calcification in new-onset PD. These traits make PTX an interesting potential option for PD therapy.

Practical recommendations for performing ultrasound scanning in the urological and andrological fields

Aim: US scanning has been defined as the urologist’s stethoscope. These recommendations have been drawn up with the aim of ensuring minimum standards of excellence for ultrasound imaging in urological and andrological practice. A series of essential recommendations are made, to be followed during ultrasound investigations in kidney, prostate, bladder, scrotal and penile diseases. Methods: Members of the Imaging Working Group of the Italian Society of Urology (SIU) in collaboration with the Italian Society of Ultrasound in Urology, Andrology and Nephrology (SIEUN) identified expert Urologists, Andrologists, Nephrologists and Radiologists. The recommendations are based on review of the literature, previously published recommendations, books and the opinions of the experts. The final document was reviewed by national experts, including members of the Italian Society of Radiology. Results: Recommendations are listed in 5 chapters, focused on: kidney, bladder, prostate and seminal vesicles, scrotum and testis, penis, including penile echo-doppler. In each chapter clear definitions are made of: indications, technological standards of the devices, the method of performance of the investigation. The findings to be reported are described and discussed, and examples of final reports for each organ are included. In the tables, the ultrasound features of the principal male uro-genital diseases are summarized. Diagnostic accuracy and second level investigations are considered. Conclusions: Ultrasound is an integral part of the diagnosis and follow-up of diseases of the urinary system and male genitals in patients of all ages, in both the hospital and outpatient setting. These recommendations are dedicated to enhancing communication and evidence-based medicine in an inter- and multi-disciplinary approach. The ability to perform and interpret ultrasound imaging correctly has become an integral part of clinical practice in uro-andrology, but intra and inter-observer variability is a well known limitation. These recommendations will help to improve reliability and reproducibility in uro-andrological ultrasound scanning.

Nd:YAG laser in penile diseases. Indications and limits

— Penile cancer is an uncommon malignancy in the western world (1–2% of all malignancies in males). Traditionally it is treated by penis amputation. Today with laser therapy a new opportunity is offered. 16 patients referred to our Dept. for early stage penile cancer. 2 TIS, 7 T1, 1 T2 penile cancer and 6 with Erythroplasia of Queyrat. Before treatment the patients underwent cold biopsy in order to establish the tumour grading and staging of malignancy. A laser irradiation was performed under local anaesthesia using 25–35 Watt/3 sec in the penile cancer and 15–20 Watt/2 sec in the Erytroplasia of Queyrat. There were no complications after treatment. All patients were observed during follow-up every month after the irradiation until the sixth month and then every 3 months. No-one developed local recurrence or metastatic disease: Nd:YAG laser seems to offer a safe, easy treatment compared to traditional surgery. It can be performed under local, anaesthesia without bleeding, permits good local tumour control, a good cosmetic aspect and, finally full functionality of the penis.