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Comparison of the Melatonin Receptor Agonist Ramelteon and the Non-Benzodiazepine Hypnotic Zolpidem for Nocturia

Open Journal of urology 2013年第8期3卷 293-298页

作者： Hideki Mukouyama Kimio Sugaya Saori Nishijima Hidekatsu Naka Misao sakumoto Tomohiro Onaga Katsumi Kadekawa Katsuhiro Ashitomi Department of urology Nanbu Tokushukai Hospital Okinawa Japan Department of urology Okinawa Kyodo Hospital Okinawa Japan Nishizaki Hospital Okinawa Japan sakumoto urology and dermatology clinic Okinawa Japan Southern Knights’ Laboratory LLP Okinawa Japan

To examine the efficacy of the melatonin receptor agonist ramelteon for nocturia, it was compared with zolpidem, a conventional non-benzodiazepine hypnotic. A total of 50 patients with nocturia (32 urinations/night) were enrolled. Subjects assigned odd numbers or even numbers were respectively prescribed 8 mg of ramelteon (n = 27;mean age: 75 years) or 5 mg of zolpidem (n = 23;mean age: 73 years) once a day before sleeping for 4 weeks. The daytime and nighttime frequencies of urination, as well as the results of global self-assessment by the patients, were compared between the two groups before and after 4 weeks of treatment. Both ramelteon and zolpidem caused a significant decrease of nocturia to about once per night after 4 weeks. The global self-assessment rating at 4 weeks was “good” or “fair” for more patients in the zolpidem group than in the ramelteon group, while the rating was “excellent” or “no change” for more patients in the ramelteon group. There were no serious adverse events in either group. Ramelteon was safe and effective for nocturia, achieving similar results to zolpidem. However, responders and non-responders to ramelteon were more clearly distinguished. Ramelteon might be effective for patients with sleep disturbance and nocturia because of low melatonin levels. Therefore, as diagnostic therapy for identification of nocturia caused by sleep disturbance and melatonin deficiency, ramelteon should be administered to patients who do not respond to alpha-1 antagonists and/or anticholinergic agents.

关键词： Ramelteon Nocturia Melatonin Zolpidem

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The impact of autophagy in spermiogenesis

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Asian Journal of Andrology 2017年第6期19卷 617-618页

作者： Nihan Ozturk Klaus Steger Undraga Schagdarsurengin clinic of urology Pediatric Urology and AndrologySection Molecular Andrology Justus-Liebig-UniversityGiessen Schubertstrasse 81 35392 GiessenGermany.

Autophagy is an evolutionarily .conserved self-digestion process whichis essential to keep basal homeostasis in a cell. During this process, degradation and recycling of many cytoplasmic components including the long-lived, unnecessary or aggregated proteins and damaged organelles is achieved through lysosomal machinery. Autophagy has a critical role for lower eukaryotic organisms such as yeast to survive and adapt to nutrient starvation conditions. In addition to this primary function, autophagy appears as a crucial mechanism for cell differentiation and development enabling the cells to modify their content and morphology in response to environmental and hormonal cues. A recent study by Shang et all shed more light on the molecular mechanisms of how autophagy regulates spermiogenesis.

关键词： impact autophagy spermiogenesis

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Boswellia resin extract and propolis derived polyphenols in patients with type III chronic prostatitis/chronic pelvic pain syndrome:An Italian prospective multicenter study

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Asian Journal of urology 2022年第2期9卷 139-145页

作者： Fabrizio Presicce Francesco Barrese Andrea Cantiani Alessio Filianoti Domenico Tuzzolo Paolo Di Palma Stefano Lauretti Stefano Brunori Marco Martini San Filippo Neri Hospital Department of UrologyRomeItaly Sant’Eugenio Hospital Department of UrologyRomeItaly Casa del Sole clinic Department of UrologyFormiaItaly Fabrizio Spaziani Hospital Department of UrologyFrosinoneItaly Santa Caterina della Rosa clinic Department of UrologyRomeItaly Villa Stuart clinic Department of UrologyRomeItaly

Objective:To assess the efficacy and safety of a treatment regimen based on rectal administration of Boswellia resin extract and propolis derived polyphenols in patients with type IIIa and type IIIb chronic prostatitis and chronic pelvic pain syndrome(CP/CPPS).Methods:Patients with type IIIa and type IIIb CP/CPPS received one rectal suppository a day for 15 days per month for 3 consecutive *** were evaluated with National Institutes of Health-Chronic Prostatitis Symptom Index(NIH-CPSI),the International Prostate Symptom Scores(IPSS),International Index of Erectile Function(IIEF),four-glass test,uroflowmetry,and prostate-specific antigen assessments at baseline and at Week 4,and Week *** endpoints were improvement in pain domain of NIH-CPSI and improvement of NIH-CPSI total *** outcomes included improvement of micturition and quality of life(QoL)domains of NIH-CPSI ***:A total of 61 males were *** adverse events were *** improvements from baseline to Day 30 were reported for NIH-CPSI total score(mean difference:-9.2;p<0.01),NIH-CPSI pain domain(mean difference:-5.5;p<0.01),NIH-CPSI micturition domain,NIH-CPSI QoL domain,and IPSS total score(mean difference:-5.6;p<0.01).No significant changes from baseline in terms of IIEF score or maximum flow rate were *** final follow-up(Day 90),further significant improvements in terms of NIH-CPSI total score(mean difference:-12.2;p<0.01),NIH-CPSI pain domain(mean difference:-6.6;p<0.01),NIH-CPSI micturition domain,NIH-CPSI QoL domain,and IPSS total score were ***:Rectal administration of Boswellia resin extract and propolis derived polyphenols is well tolerated and delivers a significant symptomatic improvement in most patients with type IIIa and type IIIb CP/CPPS.

关键词： Boswellia serrata Chronic prostatitis Chronic pelvic pain syndrome Propolis Treatment

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Use of a lyophilized bovine pericardium graft to repair tunical defect in patients with Peyronie＇s disease： experience in a clinical setting

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Asian Journal of Andrology 2017年第3期19卷 316-320页

作者： Javier Romero Otero Borja Garcia Gomez Jose Medina Polo Carlos Pascual Mateoe Silvia Garcia Barreras Eduard Garcia Cruz Javier de la Riva de la Vifia Alfredo Rodriguez Antolin 12 de Octubre University Hospital Department of Urology Madrid Spain Monteprincipe University Hospital Department of Urology Madrid Spain clinic Hospital Department of Urology Barcelona Spain

Many different materials are available for grafting during surgery for Peyronie＇s disease （PD）. To study the outcomes associated with the use of a lyophilized bovine pericardium graft （Peri-Guard） to repair tunical defects in patients with PD, descriptive study of 43 patients with disabling penile curvature was performed. Curvature was measured before and after the intervention using a standardized procedure. Surgical technique was plaque excision and grafting of the tunical defect carried out by a single surgeon. A lyophilized bovine pericardium patch was used for grafting. We measured the change in penile curvature and length, the ability to perform successful sexual intercourse without further pharmacological or surgical treatment, and the satisfaction with treatment. Follow-up data were available for a total of 41 patients. Median age was 50 years （IQR 48-52）; mean follow-up time was 14 ± 6 months. Complete penile straightening was achieved in 33 patients （80.5%） and five patients （12.2%） had curvature under 20. Three months after surgery and stretching therapy, mean （s.d.） flaccid penile length increased from 11.2 ± 2.8 cm to 12.1 ± 2.9 cm （P = 0.062）. Seventy-five percentage of patients reported being able to achieve successful intercourse without further treatment. Eighty-five percentage of patients reported to be satisfied with the treatment. There was no evidence of tissue rejection or infection, and only four patients suffered an adverse event. Plaque excision and grafting of the tunical defect with lyophilized bovine pericardium seems to be a safe and effective treatment for patients with PD.

关键词： penile curvature pericardium patch Peyronie's disease surgical treatment

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Future considerations in prosthetic urology

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Asian Journal of Andrology 2020年第1期22卷 70-75页

作者： Landon Trost Mayo clinic Department of Urology200 First St SW RochesterMN 55905USA

Since their popularization,genitourinary prosthetics have remained a gold-standard therapy for the treatment of erectile dysfunction and stress urinary incontinence and in cases of testicular loss or *** have also represented an area of significant innovation,which has contributed to excellent long-term *** this history,the objective of the current review was to provide a 5-10-year outlook on anticipated trends and developments in the field of genitourinary *** accomplish this objective,a PubMed and patent search was performed of topics relating to penile and testicular prostheses and urinary *** regard to penile prostheses,findings demonstrated several new concepts including temperature-sensitive alloys,automated pumps,devices designed specifically for neophalluses,and improved malleable *** artificial urinary sphincters,new concepts include the ability to add or remove fluid from an existing system,two-piece systems,and new mechanisms to occlude the *** testicular prosthetics,future implementations may not only better replicate the feel of a biological testicle but also add endocrinological *** device innovation,the future of prosthetics is also one of expanding geographic boundaries,which necessitates variable cost modeling and regulatory *** trends are also changing,with a greater emphasis on nonnarcotic,postoperative pain control,outpatient surgeries,and adjunctive techniques to lengthen the penis and address concomitant stress incontinence,among *** with device and surgical changes,future considerations also include a greater need for education and training,particularly given the rapid expansion of sexual medicine into developing nations.

关键词： erectile dysfunction penile induration penile prosthesis prostheses and implants stress urinary incontinence

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Simultaneous vs staged treatment of urolithiasis in patients undergoing radical prostatectomy

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World Journal of clinical Cases 2014年第11期2卷 698-704页

作者： Boyd R Viers Matthew K Tollefson David E Patterson Matthew T Gettman Amy E Krambeck Mayo clinic Department of urology Rochester MN 55902 United States

AIM: To assess the outcomes of men treated for urolithiasis at the time of radical ***: From 1991 to 2010, 22 patients were retrospectively identified who were treated simultaneously(n = 10) at radical prostatectomy, or(n = 12) within 120 d prior to prostatectomy, for urolithiasis. clinical characteristics were reviewed including: type of prostatectomy and stone surgery, location and amount of stone burden, perioperative change in hemoglobin and creatinine, stent frequency, total hospital d, stone-free rates, additional stone procedures and complications. Long-term functional outcomes including stress urinary incontinence and bladder neck contracture were reported. Differences between cohorts(simultaneous vs staged treatment) were assessed. RESULTS: Among men undergoing radical prostatectomy, primary stone procedures included 12 ureteroscopy, 6 shock wave lithotripsy, 2 open nephrolithotomyand 2 percutaneous nephrolithotomy. In staged shock wave lithotripsy there were 4 complications and 3 additional procedures vs 1(P = 0.5) and 0(P = 0.2) in the simultaneous cohort. Meanwhile in staged ureteroscopy there were 5 complications and 1 additional procedure vs 1(P = 0.2) and 1(P = 0.9) in the simultaneous cohort. Additional procedures for residual stones was greater among patients with asymptomatic upper tract calculi 3(60%) relative to patients with symptomatic stones 2(13%; P = 0.02). Likewise, patients with proximal or multiple calculi had a greater total hospital days 5.5 vs 4.1(P = 0.04), additional procedures 6 vs 0(P = 0.04) and lower stone-free rates 39% vs 89%(P = 0.02) relative to men with distal stones. Finally, there was no difference in the incidence of bladder neck contracture(P = 0.4) or stress urinary incontinence(P = 0.7) between ***: Ureteroscopic treatment of symptomatic distal urolithiasis at radical prostatectomy appears to be safe and efficacious with a low rate of adverse postoperative outcomes.

关键词： Urolithiasis Kidney stone Prostate cancer Radical prostatectomy

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46 XX karyotype during male fertility evaluation; case series and literature review

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Asian Journal of Andrology 2017年第2期19卷 168-172页

作者： Ahmad Majzoub Mohamed Arafa Christopher Starks Haitham Elbardisi Sami A1 Said Edmund Sabanegh Jr Cleveland clinic Foundation Department of Urology Cleveland Ohio USA Hamad Medical Corporation Department of Urology Qatar Cairo University Department of Andrology Giza Egypt Reston Hospital Department of Urology Virginia USA

Forty-six XX disorder of sex development is an uncommon medical condition observed at times during the evaluation of a man＇s fertility. The following is a case series and literature review of phenotypically normal men diagnosed with this karyotype. Our goal is to comprehend the patients＇ clinical presentation as well as their laboratory results aiming to explore options available for their management. A formal literature review through PubMed and MEDLINE databases was performed using ＂46 XX man＂ as a word search. A total of 55 patients, including those conveyed in this article were diagnosed with a 46 XX karyotype during their fertility evaluation. The patients＇ mean age _＋ s.d. was 34 ＋ 10 years and their mean height ＋ s.d. was 166 ＋ 6.5 cm. Overall, they presented with hypergonadotropic hypogonadism. Sexual dysfunction, reduced hair distribution, and gynecomastia were reported in 20% （4120）, 25.8% （8/31）, and 42% （13131） of the patients, respectively. The SRYgene was detected in 36 （83.7%） and was absent in the remaining seven （16.3%） patients. We found that a multidisciplinary approach to management is preferred in 46 XX patients. Screening for remnants of the mullerian ducts and for malignant transformation in dysgenetic gonads is imperative. Hypogonadism should be addressed, while fertility options are in vitro fertilization with donor sperm or adoption.

关键词： hypogonadism infertility male sex-determining region XX disorders of sex development

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Low hypoxia inducible factor-1α(HIF-1α)expression in testicular germ cell tumors--a major reason for enhanced chemosensitivity?

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Chinese Journal of Cancer Research 2017年第4期29卷 374-378页

作者： niraj shenoy roxana dronca fernando quevedo stephen a boorjian john cheville brian costello manish kohli thomas witzig lance pagliaro division of oncology mayo clinicRochesterMN 55905usa department of urology mayo clinicRochesterMN 55905usa division of clinical pathology mayo clinicRochesterMN 55905usa

The molecular basis for enhanced chemosensitivity of testicular germ cell tumors （GCT） has been an area of great interest, as it could potentially give us therapeutic leads in other resistant malignancies. Thus far, however, the increased sensitivity of C＆T has been variously attributed to multiple factors -- an inability to detoxify cisplatin, a lack of export pumps, an inability to repair the DNA damage, an intact apoptotic cascade and lack of p53 mutation; but a unifying underlying etiology leading to the aforementioned processes and having a translational implication has so far been elusive. Herein, we offer evidence to support a potential significant role for the previously demonstrated low hypoxia inducible factor-la （HIF-la） expression in mediating the general exquisite chemosensitivity of testicular GCT, through the aforementioned processes. This molecular mechanism based hypothesis could have a significant translational implication in platinum refractory GCT as well as other platinum resistant malignancies.

关键词： Hypoxia inducible factor-la (HIF-la) testicular germ cell tumor chemosensitivity

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Erectile function and late-onset hypogonadism symptoms related to lower urinary tract symptom severity in elderly men

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Asian Journal of Andrology 2013年第6期15卷 785-789,I0008页

作者： Ozan Bozkurt Deniz Bolat Omer Demir Oktay Ucer Ali Sahin Burak Ozcift Abdulkadir Pekta Tahir Turan Bilal H Gümü Ertan Cans Ahmet Bolukbasi Haluk Erol Adil Esenx Department of urology Dokuz Eylul University Faculty of Medicine Izmir 35340 Turkey Division of urology Doc. Dr. Yasar Eryilmaz Dogubayazit State Hospital Agri 04900 Turkey Department of urology Celal Bayar University Manisa 45040 Turkey Department of urology Sifa University Izmir 35230 Turkey clinic of urology Ataturk Training and Research Hospital Izmir 35965 Turkey Division of urology Adiyaman 82. Yll State Hospital Adiyaman 02040 Turkey Department of urology Pamukkale University Faculty of Medicine Denizli 20020 Turkey clinic of urology Tepecik Training and Research Hospital Izmir 35120 Turkey Department of urology Adnan Menderes University Faculty of Medicine Aydin 09100 Turkey

The aim of this study was to evaluate the relationship between lower urinary tract symptoms （LUTSs）, erectile dysfunction （ED） and symptomatic late-onset hypogonadism （SLOH） in ageing men in the Aegean region of Turkey. Five hundred consecutive patients 〉40 years old who had been in a steady sexual relationship for the past 6 months and were admitted to one of six urology clinics were included in the study. Serum prostate-specific antigen and testosterone levels and urinary flow rates were measured. All patients filled out the International Prostate Symptom Score and Quality of Life （IPSS-QoL）, International Index of Erectile Function （IIEF） and Aging Males＇ Symptoms （AMS） scale forms. Of the patients, 23.9% had mild LUTSs, 53.3% had moderate LUTSs and 22.8% had severe LUTSs. The total testosterone level did not differ between groups. Additionally, 69.6% had ED. The presence of impotence increased with increasing LUTS severity. Symptomatic late-onset hypogonadism （AMS 〉27） was observed in 71.2% of the patients. The prevalence of severe hypogonadism symptoms increased with the IPSS scores. A correlation analysis revealed that all three questionnaire scores were significantly correlated. In conclusion, LUTS severity is an age-independent risk factor for ED and SLOH. LUTS severity and SLOH symptoms appear to have a strong link that requires etiological and biological clarification in future studies.

关键词： ageing male erectile dysfunction lower urinary tract symptoms symptomatic late-onset hypogonadism symptom scores testosterone

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A comparison of artificial urinary sphincter outcomes after primary implantation and first revision surgery

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Asian Journal of urology 2021年第3期8卷 298-302页

作者： Kevin J.Hebert Brian J.Linder Griffin T.Morrisson Laureano Rangel Latuche Daniel S.Elliott Department of urology Mayo ClinicRochesterMNUSA Department of Health Sciences Research Mayo ClinicRochesterMNUSA

Objective:The artificial urinary sphincter(AUS)is the gold standard for severe male stress urinary incontinence,though evaluations of specific predictors for device outcomes are *** sought to compare outcomes between primary and revision AUS surgery for non-infectious ***:We identified 2045 consecutive AUS surgeries at Mayo clinic(Rochester,MN,USA)from 1983 to *** these,1079 were primary AUS implantations and 281 were initial revision surgeries,which comprised our study *** survival rates,including overall and specific rates for device infection/erosion,urethral atrophy and mechanical failure,were compared between primary AUS placements versus revision *** follow-up was obtained through office examination,written correspondence,or telephone ***:During the study period,1079(79.3%)patients had a primary AUS placement and 281(20.7%)patients underwent a first revision surgery for mechanical failure or urethral *** undergoing revision surgery were found to have adverse 1-and 5-year AUS device survival on Kaplan-Meier analysis,90%vs.85% and 74%vs.61%,respectively(p<0.001).Specifically,revision surgery was associated with a significantly increased cumulative incidence of explantation for device infection/urethral erosion(4.2%vs.7.5%at 1 year;p=0.02),with similar rates of repeat surgery for mechanical failure(p=0.43)and urethral atrophy(p=0.77).Conclusions:Our findings suggest a significantly higher rate of overall device failure following revision AUS surgery,which is likely secondary to an increased rate of infection/urethral erosion events.

关键词： Artificial urinary sphincter Outcomes Revision Urinary incontinence Urethra Post prostatectomy incontinence

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