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Biomedical subjects

Shane Russell

Publications and source records attributed to Shane Russell.

4 recordsLinked to original sources

Systematic evidence-based analysis of plaque injection therapy for Peyronie's disease.

OBJECTIVE: We evaluated the peer-reviewed urology literature for intraplaque injection of medication for Peyronie's disease and assessed the quality of studies via rigorous evidence-based medicine criteria. METHODS: We performed a search of peer-reviewed literature looking at all agents used to treat Peyronie's disease by intraplaque injections. These were then evaluated using the Oxford Centre for Evidence-Based Medicine criteria, which ranks studies from strongest (level 1) to weakest (level 5) strength of evidence. RESULTS: Of the 19 studies found involving injection therapy for Peyronie's disease, 17 showed positive results. Six studies using injectable corticosteroids were identified and though all showed positive results, they were of level 4 quality. Two collagenase injection studies (one level 4 and one level 2 study) were identified, both of which showed positive results. All four verapamil injection studies found (three level 4 and one level 2 study) showed positive results. Seven papers involving interferon alpha2-beta injections were evaluated (six level 4 and one level 1 study), five of which showed positive outcomes and two of which showed no significant benefit. CONCLUSIONS: Ninety percent of the studies regarding Peyronie's disease showed positive outcomes. Unfortunately, most of these have not offered convincing evidence-based data, with only one positive study meeting level 1 Oxford criteria for clinical efficacy. Standardised outcome measures were not used, making comparisons difficult. These results reveal the need for the development of validated outcome measures and well-designed controlled trials to determine optimal therapeutic intervention for this disorder.

Adrenal Cortex Hormones↗

Metabolic syndrome and lower urinary tract symptoms secondary to benign prostatic hyperplasia.

Increasing evidence recently has pointed toward a relationship between lower urinary tract symptoms (LUTS) and the presence of metabolic syndrome. This relationship has been supported by recent epidemiologic findings. Possible pathophysiologic links also have been proposed to explain the relationship between these two syndromes. The increasing prevalence of obesity in the United States makes this an increasingly relevant problem. Animal studies support a link between autonomic nervous system (ANS) overactivity and the development of urinary symptoms, low bladder compliance, compensatory prostatic hyperplasia, and blockage of the same using alpha-blockade. There appears to be a significant link between ANS overactivity as part of the metabolic syndrome and LUTS secondary to benign prostatic hyperplasia (BPH). However, it is unlikely that ANS overactivity could be responsible for the development of LUTS. Rather, ANS overactivity plays a key role in increasing the severity of LUTS above an intrinsic basal intensity that is determined by the genitourinary anatomic/pathophysiologic characteristics of each BPH patient. This paper defines metabolic syndrome as a collection of abnormalities, including being overweight (visceral abdominal fat distribution), dyslipidemia, hypertension, impaired glucose metabolism, elevated C-reactive protein (chronic inflammation), and autonomic-sympathetic overactivity, with insulin resistance as the hypothesized underlying pathogenic mechanisms.

Animals↗

Lower urinary tract symptoms and erectile dysfunction: epidemiology and treatment in the aging man.

Lower urinary tract symptoms (LUTS) and erectile dysfunction (ED) are common urologic problems that are seen in the aging male population. Until recently, aging itself was considered the common link between ED and LUTS. However, recent studies have shown that the links between these two disease processes are much more complex and are possibly inter-related with a common mechanism. This newly recognized independent relationship between ED and LUTS has the potential to have a profound impact on the way we diagnose and treat these common urologic disorders.

Age Factors↗

The physiology of erectile dysfunction.

Male erectile dysfunction is a common urologic disorder which can have a profound detrimental impact on a patient's quality of life. Normal erectile function represents a complex physiologic process requiring integrated synchronized function of vascular, neurologic, and musculoskeletal body systems, with significant psychologic factors playing a role as well. A breakdown in any one of these body systems can contribute to the development of erectile dysfunction. As men age, many of the same risk factors for the development of cardiovascular disease also can have a detrimental effect on the organ systems needed for good erectile function. A solid grasp of the anatomy and physiology involved in normal erectile function is important in understanding the interactions between cardiovascular disease and erectile dysfunction, and in developing new ways to effectively treat and prevent both disease processes in the future.

Cardiovascular Diseases↗