ABSTRACT Objectives: To compare the response to tiocolchicine and verapamil injection in the plaque of patients with Peyronie's disease. Materials and Methods: Prospective, single-blind, randomized study, selecting patients who have presented Peyronie's disease for less than 18 months. Thiocolchicine 4mg or verapamil 5mg were given in 7 injections (once a week). Patients who had received any treatment for Peyronie's disease in the past three months were excluded. The parameters used were the International Index of Erectile Function (IIEF-5) score, analysis of the curvature on pharmaco-induced erections and size of the plaque by ultrasonography. Results: Twenty-five patients were randomized, 13 received thiocolchicine and 12 were treated with verapamil. Both groups were statistically similar. The mean curvature was 46.7° and 36.2° before and after thiocolchicine, respectively (p=0.019) and 50.4° and 42.08° before and after verapamil, respectively (p=0.012). The curvature improved in 69% of patients treated with thiocolchicine and in 66% of those who received verapamil. Regarding sexual function, there was an increase in the IIEF-5 from 16.69 to 20.85 (p=0.23) in the thiocolchicine group. In the verapamil group the IIEF-5 score dropped from 17.50 to 16.25 (p=0.58). In the thiocolchicine group, the plaque was reduced in 61% of patients. In the verapamil group, 8% presented decreased plaque size. No adverse event was associated to thiocolchicine. Conclusion: The use of thiocolchicine in Peyronie's disease demonstrated improvement on penile curvature and reduction in plaque size. Thiocolchicine presented similar results to verapamil in curvature assessment. No significant side effects were observed with the use of tiocolchicine.

Introduction: Urinary lithiasis is the main urologic cause of emergency treatment in adult patient. In the past years, the incidence in children population has increased. However, literature about the use of alpha-1 adrenergic blockers in pediatric population with distal ureterolithiasis is still scarce. The drug acts by decreasing ureter contractions, especially in the distal portion, facilitating calculus expulsion. Objective: This review has the objective to evaluate the use of alpha-1 adrenergic blockers as medical expulsive treatment in children with distal ureterolithiasis. Evidence Acquisition: An electronic literature search was performed using the MEDLINE, COCHRANE, and LILACS databases. We further searched manually the references of the primary studies. Searches were concluded on October 4th, 2014. Articles were selected, independently and in pairs, by the respective titles and summaries. Any divergence was resolved by consensus. Evidence Synthesis: Alpha-1 adrenergic antagonists increased the probability of calculus expulsion by 27% (NNT=4). Calculi smaller than 5mm, increased by 33% (NNT=3). Larger than 5mm, increased by 34% (NNT=3). Conclusion: Alpha-1 adrenergic blocker use is related with a greater incidence of expulsion of ureteral calculi, smaller or greater than 5mm, and fewer episodes of pain when compared to ibuprofen. However it is necessary larger samples to enhance the power analysis of the expulsion of ureteral calculi larger than 5mm and the episodes of pain. Patient Summary: This review analyzed the outcome of alpha adrenergic antagonist in children with ureteral calculi. We conclude that it is the best medicine for use, since it helps the expulsion of the stone.

Objective: To retrospectively review the response of patients with Peyronie’s disease (PD) treated with colchicine as monotherapy and colchicine plus Vitamin E. Material and methods: We evaluated 100 men with PD. A dose of 1.5mg/day oral Colchicine as monotherapy (CCM) was given to 59 patients and 1.5/800mg/day oral Colchicine/Vitamin E (CCVE) to 41. Response was categorized as follows: Good response, when at least 2 of the following conditions were achieved: Decrease/stabilization of curvature and/or plaque and/or pain relief. Partial response if one of the former conditions were observed. No response and worsening. No statistical differences between groups were found. Results: Good response was observed in 39% vs 41% in the CCM and CCVE groups respectively. When looking at each variable, we observed improvement on the plaque’s size in 36 vs 29%, pain relief in 46 vs 57% and curvature 32 vs 33% in the CCM and CCVE respectively. None of these differences were statistically significant. Conclusion: Oral conservative treatment with CCVE failed to show statistically significant differences in efficacy in pain relief, penile curvature or plaque size against CCM in this study. However, there is slight evidence of a positive prognostic effect on the conservative treatment when history of previous unsuccessful PD treatment was recorded, this was statistically significant in the CCVE group, supporting the theory of a combined treatment. A randomized double blind placebo controlled study with a sample size calculation should be performed to confirm our results.

Objetivo: Revisar de manera retrospectiva la respuesta de pacientes con enfermedad de Peyronie (EP) tratados con colchicina como monoterapia (CM) o combinada con vitamina E (CVE). Material y métodos: Evaluamos 100 pacientes con EP. La CM por vía oral en dosis de 1,5mg/día fue recibida por 59 pacientes, y la CVE en dosis de 1,5/800mg/día fue recibida por 41 pacientes. La respuesta fue definida de la siguiente manera: respuesta buena, cuando al menos 2 de las siguientes condiciones fueron alcanzadas: disminución/estabilización de la curvatura y/o tamaño de la placa y/o alivio del dolor; respuesta parcial, cuando se alcanzó al menos una de las condiciones anteriores. Así como ausencia de respuesta o empeoramiento. No hubo diferencias significativas en los grupos. Resultados: Hubo buena respuesta en el 39 y el 41% de los pacientes del grupo CM y CVE, respectivamente. Mejora por variable: tamaño de la placa en el 36 vs. el 29%, alivio del dolor en el 45 vs. el 57%, curvatura en el 32 vs. el 33% en los grupos CM y CVE, respectivamente. Ninguna de estas diferencias fue estadísticamente significativa. Conclusiones: La CVE no demostró diferencias estadísticamente significativas en la eficacia del alivio del dolor, curvatura y tamaño/consistencia de la placa vs. el grupo control. Sin embargo, existe ligera evidencia de un efecto pronóstico positivo en el tratamiento conservador de la EP si hay antecedente de tratamiento previo fallido, que fue estadísticamente significativo en el grupo CVE, fomentando la teoría del tratamiento combinado. Un estudio aleatorizado, doble ciego controlado con placebo debe realizarse para confirmar estos resultados.

Objectives: Cis-platinum based chemotherapy agents are widely used in treatment of testicular cancer and its deleterious effects on spermatogenesis are well known. Therefore an extensive survey was undertaken to evaluate the effects of antioxidants in combination with Cis-platinum in an attempt to minimize its effects upon spermatogenic function of adult rats. Methods: A short-term prospective study (thirteen days) including twenty-four adult male Wistar rats was performed. Animals were assigned into one of three groups (eight per group): GI-control, GII-Cis-platinum treated and GIII-Cis-platinum plus superoxide dismutase and catalase. Histological analyses included germ cell counts, germ to Sertoli cell ratios and estimation of volume density components as well as the determination of the sperm reserves. Data was examined through one-way analysis of variance at 5% level of significance. Results: Germ cell numbers, germ cell to Sertoli cell ratios, organ weights (except body weight) and sperm reserves presented no differences among groups. However, the volumetric proportion of some components (tubular epithelium, tunica propria, Leydig cell nuclei and stroma) were affected (p<0.05) by treatment. The most prominent testicular component, the seminiferous epithelium was reduced (p<0.05) in Cis-platinum treated animals (GII). Conclusion: The use of antioxidant in association with Cis-platinum did not affect sperm production (germ cell numbers, germ to Sertoli cell ratios and sperm reserves) of adult rats. However, the deleterious effect of Cis-platinum on the seminiferous tubule epithelium was minimized by antioxidants.

Objetivos: Los agentes quimioterapéuticos basados en el cisplatino se utilizan ampliamente en el tratamiento del cáncer testicular, y sus efectos perjudiciales sobre la espermatogénesis se conocen bien. En consecuencia, se emprendió un amplio estudio para evaluar los efectos de los antioxidantes en combinación con el cisplatino en un intento de reducir sus efectos sobre la función espermática de ratas adultas. Métodos: Se realizó un estudio prospectivo a corto placo (13 días) sobre 24 ratas Wistar macho adultas. Se asignó a los animales a uno de 3 grupos (8 por grupo): GI-control, GII-tratado con cisplatino y GIII-cisplatino más superóxido dismutasa y catalasa. Los análisis histológicos incluyeron recuentos de células germinales, relaciones entre células germinales y de Sertoli y estimación de la densidad de volumen de los componentes, así como determinación de las reservas de espermatozoides. Los datos se examinaron mediante análisis de la varianza de una vía al nivel de significación del 5%. Resultados: No se hallaron diferencias entre los grupos en el número de células germinales, las relaciones entre células germinales y de Sertoli, el peso de los órganos (excepto el peso corporal) y las reservas de espermatozoides. Sin embargo, el tratamiento afectó (p<0,05) a la proporción volumétrica de algunos componentes (epitelio tubular, túnica propia, núcleos y estroma de células de Leydig). El componente testicular más prominente, el epitelio seminífero, se redujo (p<0,05) en los animales tratados con cisplatino (GII). Conclusión: El uso de antioxidante en asociación con cisplatino no afectó a la producción de espermatozoides (número de células germinales, relaciones entre células germinales y de Sertoli y reservas de espermatozoides) de ratas adultas. Sin embargo, los antioxidantes limitaron el efecto perjudicial del cisplatino sobre el epitelio de los túbulos seminíferos.