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Pelvic muscle floor rehabilitation as a therapeutic option in lifelong premature ejaculation： long-term outcomes

Asian Journal of Andrology 2018年第6期20卷 572-575页

作者： Antonio Luigi Pastore Giovanni Palleschi Andrea Fuschi Yazan AI Salhi Alessandro Zucchi Giorgio Bozzini Ester IUiano elisabetta costantini Antonio Carbone Uroiogy Unit Department of Medico-Surgical Sciences and Biotechnologies ICOT Faculty of Pharmacy and Medicine 'Sapienza' University of Rome Latina (LT) 04100 Italy Uroresearch Nonprofit Association for Research in Urology Latina 04100 Italy Department of Urology and Andrology University of Perugia Perugia 05156 Italy Department of Urology MATER DOMINI Humanitas Castellanza (VA) 21053 Italy

The aim of the study was to evaluate the long-term outcomes of pelvic floor muscle （PFM） rehabilitation in males with lifelong premature ejaculation （PE）, using intravaginal ejaculatory latency time （IELT） and the self-report Premature Ejaculation Diagnostic Tool （PEDT） as primary outcomes. A total of 154 participants were retrospectively reviewed in this study, with 122 completing the training protocol. At baseline, all participants had an IELT 〈60 s and PEDT score 〉11. Participants completed a 12-week program of PFM rehabilitation, including physio-kinesiotherapy treatment, electrostimulation, and biofeedback, with three sessions per week, with 20 min for each component completed at each session. The effectiveness of intervention was evaluated by comparing the change in the geometric mean of IELT and PEDT values, from baseline, at 3, 6, and 12 months during the intervention, and at 24 and 36 months postintervention, using a paired sample 2-tailed t-test, including the associated 95% confidence intervals. Of the 122 participants who completed PFM rehabilitation, 111 gained control of their ejaculation reflex, with a mean IELT of 161.6 s and PEDT score of 2.3 at the 12-week endpoint of the intervention, representing an increase from baseline of 40.4 s and 17.0 scores, respectively, for IELT and PEDT （P 〈 0.0001）. Of the 95 participants who completed the 36-month follow-up, 64% and 56% maintained satisfactory eiaculation control at 24 and 36 months oostintervention, respectively.

关键词： biofeedback electrostimulation intravaginal ejaculatory latency time pelvic floor rehabilitation premature ejaculation premature ejaculation diagnostic tool

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Reconstructive surgery in Peyronie's disease: What's new?

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World Journal of Clinical Urology 2015年第1期4卷 1-4页

作者： elisabetta costantini Alessandro Zucchi Urology and Andrology Department University of Perugia

Surgical treatment of Peyronie's disease(PD) is still a challenge and a gold standard approach does not exist; however the main goal is to straight penile shaft, and to restore penetrative and coital capacity. The less invasive approach aims to correct curvature without intervening directly on the fibrous plaque while the more complex "corporoplasty" applies specific geometric criteria and uses different autologous and heterologous grafts. Each approach has its pros and cons and decisionmaking should be tailored to the individual patient's expectations. Other surgical options include different use of patches to cover the tunica albuginea defect, with the choice depending on the surgeon's personal experience. Despite the wide range of autologous(buccal mucosa, vein, dermis, etc.) and heterologous grafts(bovine pericardium, swine intestinal submucosa, porcine dermis, etc.) none currently represents the real "gold standard" because the data are extremely variable and frequently not representative. Several factors seem to favor buccal mucosa grafts over inert biocompatible materials: as vital tissue, buccal mucosa tends to heal rapidly, immediately integrating with the surrounding albuginea tissue. This translates into a more rapid resumption of spontaneous erections(after 3/4 d) and sexual activity and into a reduced risk of curvature relapse and erectile dysfunction after surgery. Another advantage of the buccal mucosa graft is its low cost. In conclusion, despite the recent development of some exciting new surgical techniques we are still unable to deliver a definitive take-home message about reconstructive surgery in PD because the majority of the studies reported insufficient data. However, since it is clear that major outcomes, besides the cosmetic result, are the patient's and partner's satisfaction and the economic impact of each technique, we recommend they be included among the outcome assessment parameters in further

关键词： Reconstructive urology Peyronie’s disease Corporoplasty

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Urodynamic test and female urinary stress incontinence:An open debate

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World Journal of Clinical Urology 2015年第2期4卷 75-77页

作者： Enrico Finazzi Agrò Valerio Iacovelli elisabetta costantini Department of Experimental Medicine and Surgery University of Rome Tor Vergata and UOSD of Functional Urology Tor Vergata University Hospital School of Specialization in Urology University of Rome Tor Vergata Department of Surgical and Biomedical Science Urology and Andrology Clinic Urogynaecological Section University of Perugia

In this editorial we discussed the pros and cons of urodynamics in the assessment of female stress urinary incontinence.

关键词： Urodynamic Female urinary incontinence Stress urinary incontinence

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