To assess QoL of patients submitted to penile prosthesis implantation (PPI), using the validated questionnaire Quality of Life and Sexuality with Penile Prosthesis (QoLSPP). Data from a national multi-institutional database of PPI including patients treated from 2014 to 2017 in Italy (INSIST-ED) were analysed. All data have been prospectively recorded by 45 surgeons on a dedicated website (www.registro.andrologiaitaliana.it) and revised by a single datamanager. Etiology of erectile dysfunction (ED) and type of implanted prosthesis were analysed. Surgeons were categorized as high-, mid- or low-experienced implanters according to the No. of procedures performed within the investigated time period (low: <20; mid: 20-50; high: ≥50). In order to simultaneously evaluate perceived penile prosthesis function and QoL, all patients were re-assessed at 1-yr follow-up with the QoLSPP questionnaire. Linear regression analyses assessed the correlation between clinical variables, functional outcomes and QoL. Overall, 643 patients were included in the database. Complete follow-up data were available for 110 (17.1%) patients [median age 60 years (IQR: 56 – 67)]. Of them, 95 (86.3%) patients received a hydraulic penile prosthesis and 15 (13.6%) a non-hydraulic model, respectively. Overall, 40.3% (44) of patients were submitted to PPI for post-pelvic surgery ED, while 40.3% (44) and 17.4% (19) had Peyronie’s disease and vasculogenic ED, respectively. A total of 37%(41) of PPI were conducted by high-experienced surgeons. At 1-yr follow-up, high median scores were reported for the QoLSPP functional (F:23/25), Personal (P:13/15), Relational (R:17/20) and Social (S:13/15) domains. At both univariate and multivariate linear regression analyses, surgeon experience was the only factor significantly associated with higher scores of each QoLSPP domain, after accounting for age, ED etiology, prosthesis type and surgical approach (penoscrotal vs. others). Patients operated by high-experienced surgeons reported a 10.2 (95%CI:6.1-14.2, p<0.001) points higher QoLSPP total score at follow-up.

We compared baseline characteristics data of patients submitted to penile prosthesis implantation (PPI), from two prospective multicenter population-based registries on penile prostheses surgery. Data were collected from the Italian multi-institutional, monitored and internal review board (IRB) approved registry on PPI (INSIST-ED) including data from 33 institutions. Similarly, data from the IRB-approved Prospective Registry of Outcomes with Penile Prosthesis for Erectile Restoration (PROPPER), a large prospective dataset including data from 13 North American sites, were also collected. Both registries include data on patient’s baseline characteristics, ED etiology, surgical and peri-operative management strategies. As a primary outcome of this study, a pooled data analysis was conducted to assess differences in patient’s baseline characteristics between the two registries; continuous and categorical variables were analyzed with the Wilcoxon Rank Sum test and the Pearson’s Chi square test, accordingly. Data from 405(23.2%) patients from the INSIST-ED registry and 1340(76.8%) from the PROPPER study were analyzed. Patients in the PROPPER study were older compared to those included in the Italian registry [median (IQR): 65 (58- 70)vrs 62 (56-67); p<0.001]. Overall, radical prostatectomy (RP) was the most common ED etiology, reported in 486(27.9%) cases; however, the distribution of ED etiologies was significantly different between the two registries: cardiovascular disease [251(18.7%)] and diabetes [282 (21%)] were more frequently reported as a main cause of ED in the PROPPER study compared to the INSIST-ED [31(7.7%) and 43(10.6%), respectively; p<0.001]. Conversely, more patients were submitted to PPI for ED secondary to Peyronie’s disease [68(16.8%) vs 123(9.2%); p<0.001] and pelvic surgery other than RP [40(9.9%) vs 21 (1.6%); p<0.001] in the INSIST-ED registry compared to the PROPPER. Moreover, although being infrequent in both studies, more patients were submitted to PPI after radiation therapy in the PROPPER study compared to the INSIST-ED [36 (2.7%) vs 1(0.2%);p=0.003].

European Journal of PainVolume 13, Issue S1 p. S52c-S53 151 ALTERED EXPRESSION OF ATF-3 IN PRIMARY AFFERENT NEURONS DURING INFLAMMATORY PAIN D. Nascimento, D. Nascimento Instituto de Histologia e Embriologia, Faculdade de Medicina do Porto, Portugal, Oporto, PortugalSearch for more papers by this authorD. Pozza, D. Pozza Instituto de Histologia e Embriologia, Faculdade de Medicina do Porto, Portugal, Oporto, PortugalSearch for more papers by this authorJ.M. Castro-Lopes, J.M. Castro-Lopes Instituto de Histologia e Embriologia, Faculdade de Medicina do Porto, Portugal, Oporto, Portugal Instituto de Biologia Molecular e Celular (IBMC), Universidade do Porto, Oporto, PortugalSearch for more papers by this authorF.L. Neto, F.L. Neto Instituto de Histologia e Embriologia, Faculdade de Medicina do Porto, Portugal, Oporto, PortugalSearch for more papers by this author D. Nascimento, D. Nascimento Instituto de Histologia e Embriologia, Faculdade de Medicina do Porto, Portugal, Oporto, PortugalSearch for more papers by this authorD. Pozza, D. Pozza Instituto de Histologia e Embriologia, Faculdade de Medicina do Porto, Portugal, Oporto, PortugalSearch for more papers by this authorJ.M. Castro-Lopes, J.M. Castro-Lopes Instituto de Histologia e Embriologia, Faculdade de Medicina do Porto, Portugal, Oporto, Portugal Instituto de Biologia Molecular e Celular (IBMC), Universidade do Porto, Oporto, PortugalSearch for more papers by this authorF.L. Neto, F.L. Neto Instituto de Histologia e Embriologia, Faculdade de Medicina do Porto, Portugal, Oporto, PortugalSearch for more papers by this author First published: 12 January 2012 https://doi.org/10.1016/S1090-3801(09)60154-3Citations: 1Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article.Citing Literature Volume13, IssueS1September 2009Pages S52c-S53 RelatedInformation

European Journal of PainVolume 13, Issue S1 p. S118b-S118 394 A SPARED NERVE INJURY MODEL OF TRIGEMINAL PAIN: SNI-FACE D. Pozza, D. Pozza Instituto de Histologia e Embriologia, Faculdade de Medicina, Universidade do Porto, Portugal IBMC — Instituto de Biologia Molecular e Celular, Universidade do Porto, Porto, PortugalSearch for more papers by this authorA. Avelino, A. Avelino Instituto de Histologia e Embriologia, Faculdade de Medicina, Universidade do Porto, Portugal IBMC — Instituto de Biologia Molecular e Celular, Universidade do Porto, Porto, PortugalSearch for more papers by this authorF. Neto, F. Neto Instituto de Histologia e Embriologia, Faculdade de Medicina, Universidade do Porto, Portugal IBMC — Instituto de Biologia Molecular e Celular, Universidade do Porto, Porto, PortugalSearch for more papers by this authorJ. Castro-Lopes, J. Castro-Lopes Instituto de Histologia e Embriologia, Faculdade de Medicina, Universidade do Porto, Portugal IBMC — Instituto de Biologia Molecular e Celular, Universidade do Porto, Porto, PortugalSearch for more papers by this author D. Pozza, D. Pozza Instituto de Histologia e Embriologia, Faculdade de Medicina, Universidade do Porto, Portugal IBMC — Instituto de Biologia Molecular e Celular, Universidade do Porto, Porto, PortugalSearch for more papers by this authorA. Avelino, A. Avelino Instituto de Histologia e Embriologia, Faculdade de Medicina, Universidade do Porto, Portugal IBMC — Instituto de Biologia Molecular e Celular, Universidade do Porto, Porto, PortugalSearch for more papers by this authorF. Neto, F. Neto Instituto de Histologia e Embriologia, Faculdade de Medicina, Universidade do Porto, Portugal IBMC — Instituto de Biologia Molecular e Celular, Universidade do Porto, Porto, PortugalSearch for more papers by this authorJ. Castro-Lopes, J. Castro-Lopes Instituto de Histologia e Embriologia, Faculdade de Medicina, Universidade do Porto, Portugal IBMC — Instituto de Biologia Molecular e Celular, Universidade do Porto, Porto, PortugalSearch for more papers by this author First published: 12 January 2012 https://doi.org/10.1016/S1090-3801(09)60397-9Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume13, IssueS1September 2009Pages S118b-S118 RelatedInformation

Patients over 65 years of age would like to continue in enjoying sexual activity but sometimes they suffer some metabolic or vascular pathology interfering with correct erection. 868 patients, between 65 and 80 years of age, visited our centre from 1986 to 2006, complaining ED and searching a medical treatment or solution. We considered 15 patients (68-80 yrs) submitted to penile implants. All pts were married; 3 of them reported not to have sexual activity with their wives. All pts refused ICIs, Sildenafil or Vacuum Devices. Penile prostheses were proposed as the only option to restore their penetrative function and 15 pts accepted. AMS600 (5 pts), Mentor Acu Form (3 pts), AMS Hydroflex (1 pt), AMS Dynaflex (2 pts), Mentor Alpha I (2 pts), AMS 700 (2 pts) prostheses. Spinal (13 pts) and local anaesthesia (2 pts) were utilized. All patient were checked 12 months after surgery. After one year we recorded 4 deaths, not linked to prostheses or sexual intercourses. 3 pts had prostatic surgery 2-3 years after prosthetic implant. Only 2 patients reported general unsatisfaction probably due to a scarce acceptance or refusal by their wives. 13 patients reported complete satisfaction to the annual control and follow-up. Data of our experience show that the prosthetic solution can represent a valid option for patient over 65 who desire to maintain their sexual function and who do not respond or can not currently use other available pharmacological solutions.

Between July 1995 and May 1996, 36 patients with non-obstructive azoospermia of secretory origin underwent intracytoplasmic injection of spermatids. A previous histological biopsy was performed on all patients: 15 had spermatogenic arrest, a further 13 had Sertoli cell-only syndrome, and the remaining eight had post-cryptorchidism tubal atrophy. The ejaculate was duly examined and a complete absence of spermatozoa and spermatids was confirmed, with only bacteria and debris being found. Testicular sperm extraction (TESE) was then performed. In 19 out of 36 cases round spermatids only were found, while elongated spermatids were found in the remaining 17. Both round and elongated spermatids were isolated and used for injection. A total of 135 oocytes at metaphase II were recovered from 19 partners and injected with round spermatids, while 123 mature oocytes from 17 partners were injected with elongated spermatids. The number of oocytes fertilized, as judged by the presence of two pronuclei, was 75 (55.5%) and 71 (57.7%) respectively. By 34 h after injection, the number of embryos which had cleaved to the 2-cell stage was 56 (74.6%) with round spermatids and 55 (77.4%) with elongated spermatids. All cleaved embryos were transferred into the uterus of the partners. Clinical pregnancies were established in two cases of round spermatid cycles (10.5%) (both are still ongoing), and three cases of elongated spermatid cycles (17.6%) (two are still ongoing; one was lost after 8 weeks of gestation). Chromosomal analysis showed that all fetuses had a normal karyotype (three male and one female) with no chromosomal abnormalities.

OBJECTIVES:In cases of failure of the vascular occlusive system, testing with both nocturnal and real-time monitoring will offer the possibility of making an accurate diagnosis of venous occlusive dysfunction.METHODS/RESULTS:The study was conducted in 124 cases suspected as having venous occlusive dysfunction (VOD). All patients were submitted to cavernometry, which confirmed VOD in 41 cases; however, the existence of a venous disorder could not be established in 83 cases. Nocturnal monitoring with the Rigiscan System was performed in 68 cases; no organic disorder was found in 6 cases.CONCLUSIONS:Although the results of nocturnal monitoring with the Rigiscan is not always consistent, in our experience it has been useful in both nocturnal and real-time monitoring of the erectile responses during many diagnostic tests such as VSS or intracavernosal injection of vasoactive agents.

The clinical experience of an andrological center in the use of the intra cavernous injections of vaso-active drugs is revisited. Clinical data concerning 1513 ICIs performed, in the last ten years, in 1038 patients have been considered. Various vasoactive drugs have been utilized. Mainly papaverine and prostaglandin E1 are usually employed. The experience and the establishment of the modalities of use both as diagnostic tool and as therapeutic procedure of this particular type of stimulation of the intracavernous vascular system has greatly reduced the possibility of complications and collateral side effects.

For a long period of time, azoospermia has been considered a condition with poor therapeutical possibilities. Even in successful cases the number of pregnancies has been very low. With the new techniques in artificial insemination and fertilization there is new interest in treating azoospermic patients. A complete diagnostic procedure should be performed. The use of bilateral scrotal exploration and testicular biopsy allow better chances of diagnosis and treatment. More than 25% of azoospermic patients observed in an Andrological Centre could be surgically treated. Positive results were obtained in 80% of cases submitted to surgery.

Coenzyme Q10 (CoQ10) levels were assayed in total seminal fluid or both in seminal fluid and seminal plasma in 77 subjects with normal or pathological findings at standard semen analysis. CoQ10 levels showed a significant correlation with sperm count and with sperm motility. An interesting exception was constituted by patients with varicocele, in whom the correlation with sperm concentration was preserved, whereas the correlation with sperm motility was lacking. Moreover, they showed an increased ratio of plasma CoQ to total seminal CoQ10 in comparison with the other subjects. These data suggest a pathophysiological meaning of CoQ10 in human seminal fluid and a possible molecular defect in varicocele patients. CoQ10 measurement could represent an important examination in infertile patients; moreover, from these results a rationale might arise for a possible treatment with exogenous CoQ10 in dyspermic patients.

ABSTRACT: The Audio Visual Sexual Stimulation (AVSS) test represents a simple method to investigate impotence (Condra et al, 1991). It represents the most physiological and less invasive test that is able to induce an erectile response in the laboratory (Wagner et al, 1981). It does not require complicated tools and gives us much information concerning the nature of erectile disorders and also a first insight on the etiological causes (Virag, 1987). The patient is placed in a diagnostic room that should be sufficiently comfortable and watches an “erotic” videotape. The patient also uses earphones to stimulate the hearing and to be isolated from the ambient. A Rigiscan Is applied to obtain a real‐time recording of the erectile response elicited by the AVSS (Pozza et al, 1990). The same procedure is utilized performing the AVSS after intracavemous Injection (ICI) test if the induced erection is not completely rigid. We can have four different responses to AVSS: (1) completely negative or absent response with a fiat tracing on Rigiscan, (2) feeble erectile activity when the Rigiscan shows erectile activity with rigidity of less than 50%, (3) moderate or fair activity if the erection is between 50 and 70% in rigidity, (4) good response when the patient gets an erection with rigidity above 70%. We can also obtain an erectile response characterized by moderate to good but of very brief duration. That means that there is a loss of rigidity during the blank periods of the AVSS. A group of 250 patients complaining of erectile disorders was investigated. The relationships with intracavernous injection of vasoactive drugs and conclusive diagnosis were evaluated. Good responses exclude the presence of relevant organic disease. Negative responses to the AVSS test could be due to relevant organic disease but also to cultural, social, and angiogenic factors. Feeble or moderate responses are considered to be related to organic factors and require other investigations. The presence of alternating erections is independent from the degree of penile rigidity. This pattern is very frequent in patients affected by venogenic impotence. Only 10 psychogenic patients (14.2%) showed feeble response compared to 42 arteriogenic (46.1%) and 19 venogenic ones (40.4%). A good response was observed in 13 venogenic patients (27.6%) even if with alternating erections. It was also observed in seven arteriogenic (7.7%), whereas it was present in 22 psychogenic patients (31.4%). Actually, we found that a feeble erection was associated with organicity in 84.8% of cases (73 out of 86), and a good one was associated with psychogenic causes in 37.5% (15 out of 40). A particular group of patients is that affected by corporal venoocclusive dysfunction (CVOD). Many of these patients show a peculiar erectile response characterized by good, complete erections during the AVSS with sudden decrease of rigidity during the blank periods of the video. Many patients (41 out of 54 cases: 75.9%) with such erectile response showed CVOD, which was confirmed by dynamic cavernometry. The AVSS represents the ideal test in the diagnostic approach to erectile disorders also because it is simple, cheap, and not invasive. The test could represent an acceptable diagnostic tool for those patients who refuse the ICI test or who have diseases that make the ICI dangerous (coagulation problems, hemodialysis, etc.).

The problem of the surgical treatment of varicocele at adolescence is discussed. We tried to establish a good method for surgical operation capable eliminating the renal-spermatic reflux, the stasis of blood into the pampiniformis plexus with the increase of temperature and the altered metabolic exchanges with the spermatogenetic tissue. The technique of high ligation and division of the spermatic veins with Bilateral Scrotal Exploration (BSE), spermatic venography, microsurgical excision of dilated veins of the plexus and eversion of vaginalis membrane in order to avoid the frequent appearance of postoperative hydrocele is presented in a group of 150 adolescent patients.