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Zucchi A.,University of Perugia | Cai T.,Santa Chiara Regional Hospital | Cavallini G.,Medicitalia Andrological Section | D'Achille G.,Urology Unit San Giacomo Hospital | And 4 more authors.
Urologia Internationalis | Year: 2016

Lichen sclerosus (LS) is an inflammatory and chronic disease that causes itching, pain, dysuria, urinary retention, dyspareunia and sexual dysfunction, in both men and women. The first line pharmacological treatment is based on the use of topical steroids, which have proved their efficacy in 60-70% of cases but with a high rate of relapses in time (50-80% of the patients of both sexes). The purpose of our non-randomised prospective pilot study was to evaluate the efficacy and tolerability of a new loco regional therapy with polydeoxyribonucleotides (PDRN) in the treatment of male genital LS. PDRN is an healing and anti-dystrophic drug with anti-inflammatory effects, through the reduction of cytokine. Twenty one male patients suffering from genital LS were recruited. All the patients were submitted to treatment using loco-regional intradermal injections with PDRN. Dermatology Life Quality Index (DLQI), International Index of Erectile Function (IIEF-5) and PGI-I questionnaires were administered at baseline and at the end of treatment in order to evaluate the results of this treatment. The statistical evaluation of the data obtained with the DLQI questionnaire showed a marked improvement of the overall conditions in terms of quality of life, with an average change of scores from 15 to 4 (p < 0.0001). PGI-I questionnaire showed that 80% of the patients treated considered their post-treatment conditions as 'improved'. There was no significant change in terms of sexual function according to the IIEF questionnaire (p = 0.189). The results obtained show the excellent tolerability and the therapeutic efficacy of PDRN, with clear improvement of the local symptoms and of the quality of life. © 2016 S. Karger AG, Basel. Copyright: All rights reserved.


Cavallini G.,Medicitalia andrological Section | Cristina Magli M.,Laboratory of Assisted Reproduction | Crippa A.,Laboratory of Assisted Reproduction | Pia Ferraretti A.,Operative Unit of Assisted Reproduction | Gianaroli L.,Operative Unit of Assisted Reproduction
Asian Journal of Andrology | Year: 2012

The objective of this study was to investigate whether medical therapy can reduce sperm aneuploidy levels and improve the results of intracytoplasmic sperm injection (ICSI) in patients with severe idiopathic oligoasthenoteratospermia (OAT). Thirty-three infertile couples requiring ICSI because of severe idiopathic OAT after at least one unsuccessful ICSI cycle were considered. Semen parameters (concentration, motility and morphology), the percentage of aneuploid sperm and the results of ICSI (the number of oocytes fertilized, embryos transferred, biochemical pregnancies, clinical pregnancies and live births) were compared before and after a 3-month course of treatment with L-carnitine 1 g given twice per dayacetyl-L-carnitine 500mg given twice per day+one 30-mg cinnoxicam tablet every 4 days. Aneuploidy was assessed using fluorescent in situ hybridisation (FISH) performed on chromosomes X, Y, 13, 15, 16, 17, 18, 21 and 22. The results showed that 22 of the 33 patients had a reduced frequency of aneuploid sperm and improved sperm morphology after treatment (group 1), and 11 showed no change (group 2). The numbers of biochemical pregnancies, clinical pregnancies and live births were significantly higher in group 1 than in group 2. No significant difference was found between the groups regarding the numbers of oocytes fertilized and embryos transferred. The side effects were negligible. The numbers of ICSI pregnancies and live births in severe idiopathic OAT patients improved with a course of L-carnitine, acetyl-L-carnitine and cinnoxicam. © 2012 AJA, SIMM & SJTU. All rights reserved.


Cavallini G.,Medicitalia Andrological Section | Paulis G.,Regina Apostolorum Hospital
Urology | Year: 2013

Objective: To look for a link between compensation of diabetes in patients with uncompensated/undiagnosed diabetes with chronic Peyronie's disease (PD) and improvement of their PD symptoms. Methods: Thirty-six nonsmoking patients with uncompensated diabetes and PD were studied. The plaque area and pain (ie, PD symptoms) were compared before and after a strict control of hemoglobin A1c and of glycemia at a timeframe of 37 ± 13 weeks. Thirty-two nonsmoking nondiabetic patients with PD who had their PD symptoms assessed twice with a mean time lag of 39 ± 11 weeks were used as controls. The differences in PD symptoms between the 2 assessments were evaluated using the Wilcoxon test. A Spearman rank correlation test was used to identify any correlation between glycemia before diabetic compensation and the percentage of decrease in the size of plaque of patients with diabetes. Results: Plaque area and pain diminished in patients with diabetes, coincidentally with diabetes compensation and antidiabetic therapy administration. On the other hand, the controls had their plaque area significantly increased while their pain was not modified. The Spearman tests found a significant correlation between glycemia before diabetic compensation and the percentage of decrease in the size of plaque of patients with diabetes. Conclusion: Diabetes compensation and/or antidiabetic therapy improved PD symptoms. © 2013 Elsevier Inc.


Paulis G.,Regina Apostolorum Hospital | Cavallini G.,Medicitalia Andrological Section | Brancato T.,Regina Apostolorum Hospital | Alvaro R.,University of Rome Tor Vergata
Inflammation and Allergy - Drug Targets | Year: 2013

Peyronie's Disease (PD) is a connective tissue disorder involving the growth of fibrous plaques in penile corpora cavernosa (tunica albuginea). The conservative treatment is indicated in the development stage of PD for at least one year after diagnosis and in case of penile pain. This study was conducted to demonstrate the possible effectiveness of the new substances of Peironimev-plus®. Sixty four patients (age: 29-65 years, mean: 52.57 ± 9.06) diagnosed with PD were enrolled in a medical treatment. All patients underwent the following diagnostic tests: penile ultrasound, photographic documentation of penile curvature, IIEF questionnaire (erectile function score), pain evaluation with Visual Analogue pain Scale (VAS). The patients were divided into two treatment groups with different combinations of drugs: A = Peironimev-plus/oral/one tablet-daily + Verapamil injection (peri-lesional) 10 mg/every two weeks + Verapamil iontophoresis/5 mg/three times a week - for 6 months; B = Verapamil injection (peri-lesional) 10 mg/every two weeks + Verapamil iontophoresis/5 mg/three times a week - for 6 months. Intergroup analysis revealed statistically significant differences: in group A the effective plaque size reduction was -30.8% while in the group B the reduction was -18.0% (p=0.000). In group A the improvement of curvature occurred in 85.1% of the cases while in group B this occurred only in 53.5% (p=0.024), moreover the mean curvature decrease was respectively - 8.7° and - 4.6° (p=0.002). IIEF score was significantly improved in group A patients with erectile dysfunction (p=0.02). Our results suggest that Peironimev-plus is an effective drug in treating PD and it may help to prevent the progression of PD. © 2013 Bentham Science Publishers.


Cavallini G.,Medicitalia Andrological Section | Biagiotti G.,Medicitalia Andrological Section
Asian Pacific Journal of Reproduction | Year: 2012

Objective: It was the aim of this research to assess whether Tadalafil 5 mg once daily can improves the sperm count of unexplained infertile males with erectile deficiency induced by the emotional stress of attempting to father children. Methods: Two groups, each made up of 30 unexplained infertile males with psychogenic erectile deficiency related to attempts to father children received Tadalafil 5 mg once daily (Group 1) or a placebo (Group 2) for one month. Unexplained infertile men are intended as normospermic men who could not father children over a one year period and whose female partner is free of factors causing infertility. The endpoints were: differences between the groups in restoring erectile response, modifying sperm count, side effects and modifications of sperm analyses with respect to resolution or not of the erectile deficiency irrespective of the substance (Tadalafil or placebo) used. The means were compared using analysis of variance and the percentages using the chi square test. Results: The patients who received Tadalafil had their sperm volume, concentration and motility increased, but not the percentage of typical forms. Patients who received a placebo had no significant improvement. Additional analyses indicated that sperm volume, concentration and motility (but not morphology) significantly increased only in the patients who restored erectile response to sexual stimulation, independently of Tadalafil or placebo administration. No significant side effects were present. Conclusions: It is thought that therapies aimed at removing emotional stress linked to the performance anxiety of fathering children might improve sperm count in unexplained infertile couples. © 2012 Hainan Medical College.


PubMed | Medicitalia Andrological Section
Type: Journal Article | Journal: Urology | Year: 2013

To look for a link between compensation of diabetes in patients with uncompensated/undiagnosed diabetes with chronic Peyronies disease (PD) and improvement of their PD symptoms.Thirty-six nonsmoking patients with uncompensated diabetes and PD were studied. The plaque area and pain (ie, PD symptoms) were compared before and after a strict control of hemoglobin A1c and of glycemia at a timeframe of 37 13 weeks. Thirty-two nonsmoking nondiabetic patients with PD who had their PD symptoms assessed twice with a mean time lag of 39 11 weeks were used as controls. The differences in PD symptoms between the 2 assessments were evaluated using the Wilcoxon test. A Spearman rank correlation test was used to identify any correlation between glycemia before diabetic compensation and the percentage of decrease in the size of plaque of patients with diabetes.Plaque area and pain diminished in patients with diabetes, coincidentally with diabetes compensation and antidiabetic therapy administration. On the other hand, the controls had their plaque area significantly increased while their pain was not modified. The Spearman tests found a significant correlation between glycemia before diabetic compensation and the percentage of decrease in the size of plaque of patients with diabetes.Diabetes compensation and/or antidiabetic therapy improved PD symptoms.

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