Navegando por Palavras-chave "Radical prostatectomy"
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- ItemAcesso aberto (Open Access)Avaliação do efeito da eletroestimulação funcional como reabilitação peniana na função erétil de pacientes submetidos à prostatectomia radical(Universidade Federal de São Paulo (UNIFESP), 2018-09-24) Bispo, Ana Paula dos Santos [UNIFESP]; Mesquita, Roberto Andre Soler [UNIFESP]; http://lattes.cnpq.br/9038872306641159; http://lattes.cnpq.br/2262290125054480; Universidade Federal de São Paulo (UNIFESP)Introduction: Erectile dysfunction (ED) after radical prostatectomy is a peculiar form of ED, which preserved with the direct causal event. Objective: To evaluate the effect of functional electrostimulation as a penile rehabilitation procedure on the erectile function of postprostatectomy patients. Methods: This was a prospective, blind, randomized, shamcontrolled trial with 49 patients at the Division of Urology of UNIFESPEPM, through 2014 to 2017. The study included patients undergoing radical prostatectomy with bilateral preservation of the neurovascular bundle, with previous unassisted normal erectile function (International Index of Erectile Function – Erectile Function domain [IIEFEF] score ≥ 26). Patients were undergo functional electrostimulation (FES) or sham procedure. Penile rehabilitation was performed for 6 months, with frequency: 50 Hz; pulse width: 250 microseconds; contraction: 6 seconds; rest: 12 seconds. Patients were evaluated at 1, 3, 6, 9 and 12 months after the start of the procedures. The primary endpoint was proportion of patients with IIEFEF score ≥ 22 after 12 months of the start of treatment. Secondary endpoints included rate of positive responses to Sexual Encounter Profile (SEP) questions 2 and 3 and to Global Assessment Question (GAQ) questions 1 and 2. Results: After 12 months of the start of the study procedures 52.2% and 19.2% of patients reached IIEFEF score ≥ 22 in FES and sham groups, respectively (p = 0,016). A significantly higher proportion of patients in FES group compared to sham group had positive responses to SEP2 and GAQ1 from the 6th month to the end of the study. There was numerical, but no statistical, difference in the rate of SEP3 and GAQ2 positive responses between the groups. Conclusion: Functional electrostimulation was efficacious and safe as a penile rehabilitation procedure in improving recovery of erectile function in patients undergoing radical prostatectomy.
- ItemAcesso aberto (Open Access)Intracavernous injection in the treatment of erectile dysfunction after radical prostatectomy: an observational study(Associação Paulista de Medicina - APM, 2001-07-01) Claro, Joaquim de Almeida [UNIFESP]; Aboim, José Elêrton de [UNIFESP]; Maríngolo, Marcelo [UNIFESP]; Andrade, Enrico [UNIFESP]; Aguiar, Wilson [UNIFESP]; Nogueira, Marcos [UNIFESP]; Nardozza Júnior, Archimedes [UNIFESP]; Srougi, Miguel [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)CONTEXT: Despite the recent improvements in performing radical retropubic prostatectomy that have led to a considerable decrease in the complication rate, erectile dysfunction still represents a major problem. Moreover, less invasive treatment options that are emerging for erectile dysfunction have not shown satisfactory results in managing these patients. OBJECTIVE: To study the efficacy and side effects of self-injection therapy in the treatment of men who had become impotent after undergoing radical prostatectomy due to prostate cancer, over a study period of 96 months. DESIGN: Observational study. SETTING: University Referral Center. PARTICIPANTS: 168 patients with erectile dysfunction, aged 43 to 78 years old, who underwent radical retropubic prostatectomy due to localized prostate cancer. PROCEDURES: The patients were treated with self-injection therapy using papaverine, phentolamine and prostaglandin E1, at home. RESULTS: This study showed an acceptable 94.6% success rate, with no life-threatening complications. In addition to this, our series presented a 13.1% cure rate with this therapy. CONCLUSION: Self-injection therapy with papaverine, phentolamine and prostaglandin E1 is effective and safe in the treatment of erectile dysfunction after radical prostatectomy.
- ItemSomente MetadadadosIs There Any Change in Pelvic Floor Electromyography During the First 6 Months After Radical Retropubic Prostatectomy?(Springer, 2015-03-01) Hacad, Claudia R. [UNIFESP]; Glazer, Howard I.; Zambon, Joao Paulo C. [UNIFESP]; Burti, Juliana S. [UNIFESP]; Almeida, Fernando G. [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Cornell UnivThe aim of this study is to determine electromyographic pelvic floor muscles activity during the first 6 months post RRP and its relationship to urinary continence. Thirty-eight men (mean age of 63.1 +/- A 5.7 year) with prostate cancer scheduled for open radical retropubic prostatectomy were evaluated. Exclusion criteria: pelvic radiotherapy, systemic or neurologic diseases, pre-operative International Prostate Symptoms Score (IPSS) > 7 and OABq a parts per thousand yen8. Surface electromyography (sEMG) evaluation, IPSS, Urinary Distress Inventory, Incontinence Impact Questionnaire, and Overactive Bladder Questionnaire-short form were applied before and at 1, 3, and 6 months after RRP. Six months after surgery, 18 men (47.4 %) presented urinary leakage. the sEMG evaluations within the first 6 months presented changes in fast contraction amplitude (p = 0.006), rest amplitude after fast contraction (p = 0.04), 10 s sustained contraction mean amplitude (p = 0.024) and final rest amplitude (p = 0.011). We observed that continent and incontinent patients as a group presented electromyographic changes during the first 6 months after radical prostatectomy that could be justified by the denervation/reinnervation of the external urethral sphincter. This finding is consistent with the adaptation of the pelvic floor musculature to the new urethral sphincter condition following surgery.