Objectives HA is a natural component of the human body. It fulfills several biological functions including immune-modulation and anti-inflammatory effects. HA is considered to treat several andrological issues such as premature ejaculation, penile enlargement and recently Peyronie disease. The aim of this study is to evaluate the safety and the efficacy of a new protocol based on intraplaque injection of cross-linked hyaluronic acid plus modeling and stretching, in men with the chronic phase of Peyronie's Disease. Methods At baseline all the patients were evaluated via intra-cavernous injection of a vasoactive agents and performed also the PD Questionnaire (PDQ) and the International Index of Erectile Function (IIEF) questionnaires. The protocol consisted in an intraplaque injection of HA (under block of 15 mL plain mepivacain 1%) every other week for a total of three injections in six weeks, plus penile modeling after each injection. Each patient also performed a daily use of vacuum erection device and (self) modeling and stretching in the days following the injections. Results 23 patients were recruited in the study. Two patients were excluded because they did not correctly performe home protocol. Median curvature at baseline was 55° (IQR= 45 - 65). Nineteen out of 21 patients (90%) showed a reduction in the degree of curvature by a mean of 11.9 ± 7.3°. A statistically significant improvement in IIEF - Intercourse satisfaction domain (from baseline: 6.41 ± 3.8 to 8 week: 8.76 ± 2.8; p<0.001) and PDQ- Symptoms Bother domain (from baseline: 8.75 ± 4.1 to 8 week: 7.4 ± 3.3; p<0.001) was also detected. Conclusions The findings of the study show that this new protocol based is able to significantly reduce penile curvature in patients suffering from a chronic phase of PD. Our intent is to continue the study further to better understand the impact that IIHA therapy on the management of PD in terms of patient satisfaction and reduction in the need for surgery. Conflicts of Interest The authors involved in this study certify that they have NO affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

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Urothelial bladder cancer (UBC) is an exceptionally rare condition in adolescents between 15 and 19 years of age. Typically, adolescents and pediatric patients with UBC are more likely to have a favorable histological report. The aim of the paper is to report our experience in the management of a 16-year-old patient with UBC with no risk factors that came to the office because of a history of painless gross hematuria.