Sexual dysfunction is a potential side effect of BPH (benign prostatic hyperplasia) and LUTS (lower urinary tract symptoms) drugs: this article is a critical review of the current literature. Many studies have been published on this topic. Methodological flaws limit the conclusions of these studies, mainly because of the lack of diagnostic criteria for ejaculatory and sexual desire dysfunction. Few of these studies are RCTs. The ?-blocker (also called ?1-adrenergic antagonist, alpha-adrenoceptor antagonist, alpha-blocker or AB) and 5-ARI (also called 5?-reductase inhibitor or testosterone-5-alpha reductase inhibitor) drugs can in particular cause erectile dysfunction, ejaculatory disorders and reduction of sexual desire. The sexual side effect profile of these drugs is different. Among the ?-blockers, silodosin appears have the highest incidence of ejaculatory disorders. Persistent sexual side effects after discontinuation of finasteride has recently been reported, however further studies are needed to clarify the true incidence and the significance of this finding. It is desirable that future studies include validated tools to assess and diagnose sexual dysfunction induced by these medications, especially for ejaculation and sexual desire disorders. Only a small amount of research has intentionally set out to investigate sexual dysfunction caused by ?-blocker and 5-ARI drugs: studies to specifically assess sexual dysfunction induced by these drugs are needed. Further studies are also needed to assess in the long term the role of combined therapy of phosphodiesterase type 5 inhibitors and ?-blockers or 5-ARIs in treating LUTS/BPH. Methods: This study was conducted in 2014 using the paper and electronic resources of the library of the ?Azienda Provinciale per i Servizi Sanitari (APSS)? in Trento, Italy (http://atoz.ebsco.com/Titles/2793). The library has access to a wide range of databases including DYNAMED, MEDLINE Full Text, CINAHL Plus Full Text, The Cochrane Library, Micromedex healthcare series, BMJ Clinical Evidence. The full list of available journals can be viewed at http://atoz.ebsco.com/Titles/2793, or at the APSS web site (http://www.apss.tn.it). In completing this review, a literature search was conducted using the key words ?benign prostatic hyperplasia drugs?, ?lower urinary tract symptoms drugs?, ??-blockers?, ?5-ARIs?, ?sexual dysfunction?, ?sexual side effects?, ?treatment-emergent sexual dysfunction?, ?phosphodiesterase type 5 (PDE5) inhibitors?. All resulting listed articles were reviewed. Studies published between 2002 and December 2014 were included in the review. We included all studies that explicitly reported data on sexual dysfunction during treatment with ?-blockers and 5-ARIs. We also reviewed studies that have evaluated the use of phosphodiesterase type 5 (PDE5) inhibitors in combination with these drugs. The purpose was to identify possible intervention strategies for sexual dysfunction related to these drugs.

This is a critical review of the current literature data about sexual dysfunction as a potential side effect related to drugs commonly used for the treatment of Benign Prostatic Hyperplasia and Lower Urinary Tract Symptoms. In this narrative review, we analyzed data from the literature related to the development of sexual dysfunctions during the treatment of BPH or LUTS. Both α-blockers and 5-alpha reductase inhibitors (5-ARIs) can induce erectile dysfunction, ejaculatory disorders and a reduction in sexual desire. The sexual side effect profile of these drugs is different. Among the α-blockers, silodosin appears to have the highest incidence of ejaculatory disorders. Persistent sexual side effects after the discontinuation of finasteride have been recently reported; however, further studies are needed to clarify the true incidence and the significance of this finding. However, most of the published studies are affected by a weak methodology and other important limitations, with only a few RCTs available. Therefore, it is desirable that future studies will include validated tools to assess and diagnose the sexual dysfunction induced by these medications, especially for ejaculation and sexual desire disorders.

Quantitative analysis of biopsy specimens of the testis represents the most direct indicator of spermatogenic function, whereas conventional microscopical procedures are open to subjective interpretation. In this study, the quantification of germ cell lines by means of flow cytometry was investigated and the results compared to histological findings. We studied 23 infertile men with azoospermia or oligospermia. The percentage of haploid-A, diploid –-D, tetraploid-T compartments was determined for each patient. Spermatogenesis was considered normal, decreased or in complete maturation arrest when histograms showed A>D>T, D>A>T or D>T>A patterns respectively. Comparing histograms and histological findings, excellent correlation was found in cases displaying absence of aploid cells, while 3 out 7 histograms showing hypospermatogenesis corresponded to normal spermatogenesis on biopsy specimens. Additionally, one case with complete maturation arrest histogram showed hypospermatogenesis on histologic sample. DNA flow cytometry provides a rapid and objective assessment of spermatogenesis in the investigation of male infertility. Importantly, this procedure might also be performed on aspiration biopsy, avoiding the costs and complications of surgery.

Il mancato rispetto di alcune semplici regole di buon uso possono provocare gravi e a volte irreversibili danni a chi sia portatore di un dispositivo protesico penieno. In questa presentazione di un caso ne avremo un esempio eclatante.

Nelle lesioni traumatiche renali, la metodica angiografica, oltre ad essere di valido ausilio nella diagnosi di sede dell'eventuale emorragia associata, permette una terapia immediata di queste lesioni, evitando così manovre chirurgiche ben più invasive e rischiose.