Introduction In recent years, PDE5 inhibitors (PDE5i) use has become more popular among men without ED to enhance sexual performance. However, reports in the literature are scarce. Aim The aim of this study was to evaluate the recreational use of PDE5i in healthy young men. Main Outcome Measures We evaluated the recreational use of PDE5i among young and healthy men, their main reasons for use, how they were obtained these drugs, and the combination with alcohol or other drugs. Methods Descriptive, transversal study consisting in 400 brief surveys with structured multiple choice and open questions. Nonprobability samples (quota samples) included young men between 18 and 30 years of age in a public area (high schools, universities, and gyms) between August and November 2009. Collecting the questionnaires in a sealed box enforced confidentiality. The survey included demographic and sexual health data and PDE5i use characteristics. For statistical analysis we used Fisher’s exact and Mann–Whitney tests. Results A total of 321 questionnaires were appropriate for the purposes of evaluation. Mean age and standard deviation were 25.1 ± 3,3 years old. Regarding PDE5i use, 69 men (21.5%) mentioned trying the pill (being sildenafil the most commonly used one) at least one time in their lives and 37 (53.4%) men combined it with alcohol or drugs. Referred sources of acquisition PDE5i were 75.4% (N = 52) from a friend, 17.4% (N = 15) from a pharmacy/drugstore without a medical prescription, 4.3% (N = 3) prescribed by a physician and 2.9% (N = 2) through Internet. There were several reasons for taking PDE5i related to sexual confidence, erection quality, and better sexual performance. Conclusion According to our results, 21.5% of healthy men between 18 and 30 years old used PDE5i as a recreational drug, mostly associated with alcohol or other drugs without medical control. This could have led to misuse and a public health problem. Further studies are needed to evaluate not only PDE5i recreational use prevalence, but also psychosocial determinants, long term safety, misuse, and abuse related to it.

IntroductionLow-intensity shockwave therapy (LISWT) has recently emerged as a promising method in the treatment of erectile dysfunction (ED).AimTo assess the long-term results of the effectiveness and safety of LISWT in patients with ED who are non-responders to phosphodiesterase type 5 inhibitor (PDE5i) treatment.MethodsThis open-label, longitudinal, and observational study investigated an uncontrolled population of 50 consecutive patients whose ED was unresponsive to PDE5i treatment. Patients were treated with a four-session LISWT protocol. During active treatment and follow-up, all patients remained on their regular high on-demand or once-daily PDE5i dosing schedules.Main Outcome MeasuresEffectiveness was assessed according to the International Index of Erectile Function erectile function domain, questions 2 and 3 of the Sexual Encounter Profile, Erection Hardness Scale, and Global Assessment Question scores at baseline and at 3, 6, 9, and 12 months after treatment. Patients were considered responders whenever they showed improvement in erection parameters in all four assessments and responded positively to the Global Assessment Question. Adverse events were recorded. Statistical variables were applied and findings were considered statistically significant at a P value less than < .05.ResultsEighty percent (mean age = 64.8 years) completed the 12-month follow-up. Positive response rates were 60% of available subjects at the end of the study and 48% of the intent-to-treat population. After the 12-month follow-up, 91.7% of responders maintained their responses. No patient reported treatment-related adverse events.ConclusionLISWT in patients with ED unresponsive to PDE5i treatment was effective and safe in 60% of patients treated. The efficacy response was maintained for 12 months in most patients.

Introduction Peyronie’s disease (PD) is a localized fibrosis that affects the tunica albuginea of the penis. Its origin can be associated with coital penile trauma in men with autoimmune hypersensitivity and a presumed genetic predisposition. Aim To identify clinical and traumatic risk factors in a patient population with PD, when compared to a control group. Methods From November 2007 to March 2010, 317 patients sought medical attention for PD. As control group, 147 consecutive patients, who came for a prostate exam, were studied. Clinical, traumatic, and sexual history of these patients was gathered. Risks factors were considered only if they had been present before the onset of PD symptoms. Main Outcome Measure The International Index of Erectile Function and the International Prostate Symptoms Score. A univariate logistic regression model (chi-square) (odds ratios [ORs] and 95% confidence intervals [CI] ) was used to estimate the association of risk factors with PD; and the Student’s t-test was implemented for age. Results The mean age of patients with PD and control group was 56.7 and 58.8, respectively (P &lt; 0.923). The mean evolution time of the disease was 17.7 months (2–48). Erectile dysfunction (ED) and coital trauma constituted the only two independent risk factors for PD compared to the control group (P &lt; 0.05 and 0.002, respectively) with an OR of 1.5 (95% CI 1.0–2.3) and 2.69 (95% CI 1.41–5.21), respectively. Patients with ED and diabetes mellitus and with a mild-to-moderate ED also presented a higher predisposition (P = 0.008 and 0.00001), with an OR of 3.64 (95% CI 1.33–10.79) and 5.58 (95% CI 3.03–10.42), respectively. Conclusion Erectile dysfunction and coital trauma have proven to be independent risk factors for the development of PD.

Our results make us consider the minimal access percutaneous nephrolithectomy (Miniperc) a minimal option for the elimination of renal stones, with low morbidity, diminishment of the hospital stays, very low analgesic demand, and no transfusion requirements.