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Biomedical subjects

L Cormio

Publications and source records attributed to L Cormio.

At least 19 recordsLinked to original sources
PubMed2004

The effects of androgen depletion on human erectile function: a prospective study in male-to-female transsexuals.

The objective of the study was to determine the effects of androgen depletion on erectile function in a population of male-to-female transsexuals. The erectile function of 25 consecutive male-to-female transsexuals on androgen depletion treatment and scheduled for surgical gender reassignment was prospectively evaluated using medical and sexual history, physical examination, total serum testosterone, International Index of Erectile Function (IIEF-15) questionnaire, penile colour-coded Doppler ultrasonography (CDU) after pharmacological stimulation and nocturnal penile tumescence (NPT) test. All but one had undetectable or low testosterone. Subjective erectile function, according to IIEF-15 scores, and penile CDU findings did not correlate with testosterone levels, whereas NPT test findings correlated well with testosterone levels. These findings would suggest that nocturnal erections are androgen-dependent whereas sexually induced erections are androgen-independent. It can also be assumed that testosterone is important but not essential for male erectile function and that other androgen-independent pathways can be responsible for sexually induced erections.

5-alpha Reductase Inhibitors↗
PubMed2002

Antimicrobial prophylaxis for transrectal prostatic biopsy: a prospective study of ciprofloxacin vs piperacillin/tazobactam.

OBJECTIVE: To compare the efficacy of short-term parenteral prophylaxis with piperacillin/tazobactam (P/T) with long-term oral prophylaxis with ciprofloxacin in preventing infective complications after transrectal prostatic biopsy (TPB). PATIENTS AND METHODS: Patients scheduled for TPB were randomized to receive P/T (2250 mg intramuscular) twice daily for 2 days (Group 1), or ciprofloxacin (500 mg orally) twice daily for 7 days (Group 2), beginning on the evening before the procedure in both groups. All patients received a 100-mL phosphate enema 3 h before TPB. Evaluation included self-recording of body temperature in the 3 days after TPB, and culture of mid-stream urine (MSU) samples taken before and 3 and 15 days after TPB. Patients with indwelling urethral catheters or taking antibiotics or immunosuppressive drugs were excluded, as were patients with positive MSU cultures before TPB. RESULTS: Of the 138 evaluable patients, 72 received parenteral P/T and 66 oral ciprofloxacin. Bacteriuria (> 105 c.f.u./mL) after TPB occurred in two of 72 (2.8%) patients in Group 1 and in three of 66 (4.5%) patients in Group 2; this difference was not statistically significant (P > 0.1). However, of the five patients with bacteriuria, two were symptomatic and both were in Group 2. Pyrexia occurred in only one patient in Group 2 with symptomatic urinary tract infection, and required hospitalization. No other patient reported a body temperature openface> 37.5 degrees C or drug-related side-effects. CONCLUSIONS: This prospective study showed that short-term prophylaxis with P/T was associated with a low rate of asymptomatic bacteriuria, requiring no further treatment, whereas although the rate was similar on long-term prophylaxis with ciprofloxacin patients required further treatment, with one needing hospitalization. We recommend short-term prophylaxis with P/T despite its disadvantages of cost and parenteral administration.

Anti-Infective Agents↗
PubMed2002

Tunica albuginea plication for the correction of penile curvature.

OBJECTIVE: To evaluate the efficacy of tunica albuginea plication (TAP) in the correction of congenital and acquired penile curvatures and determine key points for a successful outcome of this procedure. MATERIALS AND METHODS: From December 1995 to January 2001, 40 patients with penile curvature (10 congenital and 30 secondary to Peyronie's disease) underwent surgical correction by TAP. Indications were difficult or impossible penetration, normal erectile function, stable disease. For TAP we used non-absorbable inverted stitches tied with the assistant pushing down the tunica albuginea with a mosquito clamp to create an adequate groove for the knot. The results were evaluated subjectively and objectively. RESULTS: At mean follow-up of 30 months, full subjective and objective success (straight penis, mild shortening, normal erection, penetration and sensation) was achieved in 37 (92.5%) patients. Objective but not subjective success was achieved in 2 patients (5%), 1 complaining of psychogenic erectile dysfunction and the other of excessive penile shortening. There was only one failure, namely persistent glans numbness due to damage of the non-mobilized neurovascular bundle. CONCLUSIONS: TAP is a simple and effective method for the correction of congenital and acquired penile curvatures. Key points for successful outcome are adequate preoperative evaluation and counselling, careful preparation of tunica albuginea, mobilization of urethra or neurovascular bundle when needed, use of inverted stitches carefully buried, objective postoperative evaluation with a pharmacological erection test.

Adult↗
PubMed2001

Calyceal rupture and perirenal urinoma as a presenting sign of recurrent ovarian cancer.

BACKGROUND: Rupture of the urinary collecting system with peripelvic extravasation of urine is an uncommon pathologic condition usually associated with ureteral obstruction from calculi. CASE: We report a patient with calyceal rupture and peripelvic extravasation of urine secondary to distal ureteral obstruction by recurrent ovarian carcinoma. Diagnosis was established with computed tomography and renal scans. Placement of an indwelling ureteral stent via a nephrostomy resolved the urinoma. CONCLUSION: Gynecologic oncologists should be aware that calyceal rupture is a potential complication of gynecologic malignancy. Causes of perirenal urinary extravasation and approaches to diagnosis and management are reviewed.

Aged↗
PubMed2001

Bacterial adhesion to urethral catheters: role of coating materials and immersion in antibiotic solution.

OBJECTIVE: To determine whether new coating materials (silver and hydrogel) or immersion in antibiotic solution may reduce or prevent bacterial adhesion to urethral catheters. METHODS: Precut segment of Teflon-, silver- and hydrogel-coated urethral catheters were incubated with two uropathogenic bacterial strains with and without previous immersion in antibiotic solution. Tobramycin, ceftriaxone and ciprofloxacin solutions were used as these antibiotics are commonly administered for the prophylaxis and treatment of urinary tract infection (UTI), especially in hospitals. RESULTS: Microbiological analysis showed that the new coating materials (silver and hydrogel) did not reduce bacterial adhesion to urethral catheters, whereas immersion in antibiotic solution yielded a statistically significant (p<0.05) reduction in bacterial adhesion to the test items. Among the antibiotic solutions tested, ciprofloxacin performed significantly better (p<0.005) than ceftriaxone and tobramycin. CONCLUSIONS: Immersion in a suitable antibiotic solution may significantly reduce bacterial adhesion to urethral catheters and consequently reduce the risk of UTI in connection with these devices. Although experimental, these findings may be of clinical relevance and provide grounds for further studies in vivo.

Anti-Bacterial Agents↗
PubMed1999

Nocturnal enuresis can be caused by absorptive hypercalciuria.

OBJECTIVE: The aim of this study was to determine whether nocturnal enuresis (NE) can be caused by absorptive hypercalciuria. MATERIALS AND METHODS: From 1981 to 1995, 406 patients with primary monosymptomatic nocturnal enuresis were studied. Up to 1989 (Group 1), urinary electrolytes and urinary creatinine were not evaluated, but since 1990 (Group 2) these tests have been performed routinely. In doing so, we noticed that in 8 patients in Group 2 and in 13 patients in Group 1 with persistent NE the urinary calcium and the urinary calcium/creatinine ratios were significantly high (p < 0.001). These patients were submitted to Pak's test and parathyroid hormone (PTH) and antidiuretic hormone (ADH) measurements. RESULTS: In all 21 patients, PTH and ADH levels were normal, while the Pak's test showed absorptive hypercalciuria. They were given an appropriate diet. After 3 months, NE had ceased completely in 4 patients (19%); bedwetting episodes diminished and calciuria levels were found to be borderline in the remaining 17. A new urodynamic evaluation showed normal patterns in 12 and detrusor instability (DI) in 5. Patients with DI received oxybutinine: enuresis disappeared in all. The remaining 12 children with persistent NE and normal urodynamic findings and the child with DI and persistent NE empirically received DDAVP; enuresis ceased in all of them within 1 month and calciuria stabilized at normal levels. CONCLUSIONS: This study revealed that absorptive hypercalciuria can be responsible for NE and can be treated with the combination of diet and DDAVP.

Calcium↗
PubMed1998

Resistance index as a prognostic factor for prolonged erection after penile dynamic colour Doppler ultrasonography.

OBJECTIVE: To identify an objective and reliable prognostic factor for prolonged erection after penile dynamic colour Doppler ultrasonography (CDU). METHODS: From June 1995 to July 1996, 156 patients suffering from erectile dysfunction were submitted to penile dynamic CDU at our institution. From June to December 1995 (Group 1), patients with rigid erection at the end of the test were invited to wait 90 min for a review. If detumescence had not occurred at the first review, they were invited to wait another 60 min for a second review. If detumescence had not occurred at this stage, they were given an intracavernous injection (ICI) of etilefrin to induce detumescence. To test the validity of the findings obtained in Group 1, from January to July 1996 (Group 2) patients with rigid erection and resistance index (RI) < or = 1.00 at the end of penile dynamic CDU were sent home and invited to return to the hospital if erection lasted more than 2 h, while those with rigid erection and RI > 1.00 were immediately given an ICI of etilefrin to induce detumescence. RESULTS: Of the 62 patients in Group 1, 31 yielded a rigid erection. Seven refused to wait for a review. They were given an ICI of etilefrin and excluded from the study. Of the 24 evaluable patients, 10 presented spontaneous detumescence at the first review. RI was < or = 1.00 in 7, and > 1.00 in the other 3. None of the remaining 14 patients presented spontaneous detumescence at the second review. RI was > 1.00 in all of them. They were successfully managed with an ICI of etilefrin. Of the 94 patients in Group 2, 43 yielded a rigid erection. Twenty had a RI < or = 1.00 and therefore were sent home. None of them returned to the hospital. Contacted by phone, they all said that spontaneous detumescence had occurred within a couple of hours. Of the 23 patients with RI > 1.00, 22 were immediately given an ICI of etilefrin. One who refused returned to the hospital 4 h later with a prolonged erection which was successfully managed with an ICI of etilefrin. CONCLUSIONS: This study showed that RI is a reliable prognostic factor for prolonged erection. In patients with RI > 1.00 at the end of penile dynamic CDU, immediate prevention of prolonged erection is recommendable to avoid unpleasant sequelae.

Adult↗
PubMed1997

Is it possible to prevent bacterial adhesion onto ureteric stents?

The aim of this study was to determine whether the use of bactericidal coatings or immersion in antibiotic solution reduces or prevents bacterial adhesion onto ureteric stents. Precut segments of full silicone, silver-coated and hydrogel-coated ureteric stents were incubated with two uropathogenic bacterial strains with and without previous immersion in antibiotic solution. Tobramycin, ceftriaxone and ciprofloxacin solutions were used, as these antibiotics are commonly administered for the prophylaxis and treatment of urinary tract infection (UTI). Microbiological analysis showed that immersion of ureteric stents in ceftriaxone and ciprofloxacin yielded a significant reduction of bacterial adhesion, whereas immersion in tobramycin did not. The surface material of the stents had no direct influence on bacterial adhesion. In this experimental study, neither the silver nor the hydrogel coat reduced bacterial adhesion onto ureteric stents whereas immersion in a suitable antibiotic solution significantly reduced and even prevented this phenomenon, probably due to the adhesion of the antibiotic onto the stent surface. Prevention of bacterial adhesion onto ureteric stents is essential to reduce the risk of UTI in connection with these devices.

Anti-Bacterial Agents↗
PubMed1997

Immersion in antibiotic solution prevents bacterial adhesion onto biodegradable prostatic stents.

OBJECTIVE: To determine whether immersion in antibiotic solution reduces or prevents bacterial adhesion onto biodegradable prostatic stents. MATERIALS AND METHODS: Pre-cut segments of polyglycolic acid (PGA) and polylactic acid (PLA) prostatic stents were incubated with two common uropathogenic bacterial strains (Enterococcus faecalis and Escherichia coli) with and without previous immersion in antibiotic solution. Tobramycin, ceftriaxone and ciprofloxacin solutions were used, as these antibiotics are commonly administered for the prophylaxis and treatment of urinary tract infection (UTI). RESULTS: Immersion in ciprofloxacin solution prevented the adherence of both bacterial strains. Immersion in ceftriaxone solution prevented only the adherence of the E. coli strain. Immersion in tobramycin solution had no effect on either of the strains. The stent materials per se did not influence bacterial adhesion. After immersion in ciprofloxacin, the stent segments retained significant antibacterial activity even after one day's incubation in saline. CONCLUSION: Immersion in a suitable antibiotic solution may significantly reduce and even prevent bacterial adhesion onto biodegradable prostatic stents. Preventing bacterial adhesion may reduce the risk of UTI during the use of these devices.

Anti-Bacterial Agents↗
PubMed1997

Fibromatosis of the female pelvis.

BACKGROUND AND AIMS: Desmoid tumour is a rare entity characterized by benign proliferation of fibroblasts. Although non malignant, this tumour can be life-threatening due to its invasive property and high recurrence rate. MATERIAL AND METHODS: We report a case of pelvic fibromatosis whereby the tumour was completely resected without sacrificing organs or major vessels. RESULTS: Thirty months after surgery the patient is asymptomatic, without any sign of recurrent disease. CONCLUSIONS: Radical surgery represents the main primary treatment for pelvic fibromatosis. The other available therapeutic options are discussed.

Adult↗
PubMed1996

Biocompatibility of latex and silicone T tubes in the porcine common bile duct: an experimental study.

Toxicity of materials used in indwelling drains or catheters has the potential to damage surrounding tissues. The biocompatibility of biliary T-tubes was investigated using in groups of piglets (total 30 animals). In group 1 (n=16) a choledochotomy was performed with insertion of a latex T-tube (n=6) or a silicone T-tube (n=8), or without a T-tube (n=2). In group 2 (n=14) the common bile duct (CBD) was 3/4-transected, and the lesion was sutured over a latex T-tube (n=4) or a silicone T-tube (n=5), or without a T-tube (n=5). The groups were reoperated upon after 2 and 6 weeks respectively, and the CBD was harvested for scanning electron microscopy and light microscopy. The T-tubes were examined for cell culture toxicity with a DNA synthesis inhibition test. According to the cell culture tests, latex T-tubes were toxic and silicone T-tubes nontoxic. T-tubes induced moderate to pronounced fibrosis and epithelial damage in the CBD wall, but did not induce excessive fibrosis or scarring at the site of CBD suture. In the 6-week study period, however, the grade of tissue reactions in the CBD did not correlate with the toxicity of the T-tube materials, but rather reflected a foreign body reaction and mechanical pressure. Although gross anatomical changes did not occur, neither material seemed to be completely harmless for porcine CBD wall.

Animals↗
PubMed1996

Aortofemoral surgery and sexual function.

OBJECTIVES: To determine the incidence and pathophysiology of erectile dysfunction (ED) in patients with aortoiliac occlusive disease (AIOD) and the effects of aortofemoral surgery, including endarterectomy (E) and reconstruction (R), on erectile function (EF). DESIGN: Evaluation of EF before and 3 months after surgery. METHODS: 31 out of 40 male patients scheduled for aortofemoral surgery were given multiple choice questionnaires and penile dynamic Colour Doppler Ultrasonography. RESULTS: Of the 31 who agreed to enter the study five (16%) were found to be potent and 26 (84%) to suffer from ED. This was purely arteriogenic in 8% of the cases, purely venogenic in 23%, combined arteriogenic and venogenic in 53%, and neurogenic in 16%. Twenty patients returned for postoperative evaluation of EF, nine who had undergone E and 11 who had undergone R. Improvement of EF, in terms of increased penile arterial inflow, occurred in seven patients, six who had undergone E and one who had undergone R. EF remained unchanged in nine patients, three who had undergone E and six who had undergone R. Deterioration of EF occurred in four patients, all who had undergone R, and was attributable to decreased arterial inflow in two cases and to neurogenic surgical injury in the other two. CONCLUSIONS: The majority of patients with AIOD suffers from ED. Reduced penile arterial inflow and cavernovenous leakage are equally important in the pathophysiology of ED in patients with AIOD, suggesting that atherosclerosis may also compromise the penile veno-occlusive mechanism. Endarterectomy seems more likely than reconstruction to improve or maintain EF.

Aorta, Abdominal↗
PubMed1996

Bacterial adhesion and biofilm formation on various double-J stents in vivo and in vitro.

The aim of this study was to determine whether bacterial adhesion and biofilm formation occur on various ureteric stent materials in vivo and in vitro and whether there is any correlation between biofilm formation and urinary tract infection. Using an open surgical procedure, 23 double-J stents of 8 different types were inserted in the ureters of 13 piglets. After 6 weeks intubation, 2 (9%) of the 23 stented renal units yielded positive urine culture. Scanning Electron Microscopy (SEM) showed sporadic bacteria on 7 (30%) of the 23 indwelling ureteric stents and bacterial biofilms on only 2 (9%), those indwelling the renal units which yielded positive urine cultures. Precut segments of the 8 double-J stent brands were incubated with 5 different bacterial strains. Microbiological and SEM analysis of the stents revealed that only 0.1-0.01% of the bacterial inoculum adhered to the stents. There was no statistically significant difference in bacterial adherence to the various stent materials. Interestingly, the two Escherichia coli strains with P-fimbriae adhered significantly more than the two without P-fimbriae. Sporadic bacterial adhesion to ureteric stents seemed to have little clinical significance whereas biofilm formation seemed to result in urinary tract infection. None of the tested stents proved to be superior to the others in this respect, and adhesion appeared to depend on the virulence of the bacteria rather than the properties of the biomaterials.

Animals↗
PubMed1996

A positive pharmacological erection test does not rule out arteriogenic erectile dysfunction.

PURPOSE: We tested the assumption that a positive pharmacological erection test implies normal penile vascular status. MATERIALS AND METHODS: From March 1991 to February 1995, 372 patients with erectile dysfunction were referred to our institutions. Penile hemodynamics were studied in 205 patients with color coded Doppler ultrasonography after intracavernous injection of 40 micrograms. prostaglandin E1. RESULTS: Of the 205 patients undergoing color coded Doppler utrasonography 92 had a rigid erection, that is a positive pharmacological erection test. Doppler wave analysis showed that 76 of the 92 patients (82%) had normal and 7 (8%) had borderline arterial function (peak systolic velocity greater than 35 and 25 to 35 cm. per second, respectively), while 9 (10%) had arterial insufficiency (peak systolic velocity less than 25 cm. per second). All 92 patients had a normal veno-occlusive mechanism (resistance index greater than 0.90). Of the 9 patients with pure arteriogenic erectile dysfunction 8 had risk factors for arterial insufficiency, such as aortoiliac occlusive disease (5), diabetes mellitus (3), longer than 20-year smoking history (8) and hypertension (7). CONCLUSIONS: Our study shows hemodynamically that a positive pharmacological erection test does not rule out arteriogenic erectile dysfunction.

Adult↗
PubMed1996

Etilefrine in the prevention of prolonged erection after diagnostic pharmacological stimulation.

The aim of this study was to verify the efficacy and safety of intracavernous injection of etilefrine hydrochloride in the prevention of pharmacologically induced prolonged erection. Two hundred rigid erections due to diagnostic pharmacological stimulation were treated with immediate intracavernous injection of 5 to 10 mg etilefrine hydrochloride. Penile response and general side effects after the injection were recorded. Patients were interviewed after 1-2 weeks about possible side effects. Detumescence occurred within 10 minutes in 194 (97%) cases. In the remaining six (3%), detumescence occurred after cavernous aspiration and additional injection of 5 mg etilefrine. Thirteen patients (6.5%) had transitory palpitations. None of the patients had hypertensive crisis, cardiac arrythmia or ischaemic events. Intracavernous injection of etilefrine is effective and safe in preventing prolonged erection after diagnostic pharmacological stimulation.

Adult↗
PubMed1996

[Role of dynamic penile color Doppler echography in the evaluation of the patient with La Peyronie's disease].

From March 1995 to February 1996, sixteen consecutive patients with Peyronie's Disease (PD) were routinely submitted to penile dynamic colour-coded doppler ultrasonography (CCDU). The test yielded normal results in 6 patients who had no erectile problems and in other 4 patients who conversely complained of reduced erectile function. In the other 6 patients who complained of reduced erectile function, the test pointed out pure arteriogenic failure in 1 case, pure venogenic failure in 4, and mixed arteriogenic and venogenic failure in 1. CCDU enables a precise assessment of erectile function as well of the site, kind and entity of the penile curvature to be corrected. These data are very useful when planning the surgical approach for each patient.

Alprostadil↗
PubMed1996

[Penile dynamic color Doppler echography in the diagnosis of erection disorders].

Penile dynamic colour-coded doppler ultrasonography (CCDU) provides reliable information on both hemodynamic factors, arterial inflow and veno-occlusive mechanism, involved in erectile function. However false negative results may occur due to sympathetic discharge and consequent incomplete smooth muscle relaxation. From March 1994 to February 1996, 150 patients suffering from ED were submitted to penile dynamic CCDU after high-dose (40 micrograms) pharmacostimulation and manual genital stimulation. False negative results occurred only in 3 (2%) patients. This experience suggests that high-dose pharmacostimulation and manual genital stimulation may reduce the occurrence of false negative results, further increasing the diagnostic value of CCDU.

Adult↗