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Objectives: HA is a natural component of the human body. It fulfills several biological functions including immune-modulation and anti-inflammatory effects. HA is considered to treat several andrological issues such as premature ejaculation, penile enlargement and recently Peyronie disease. The aim of this study is to evaluate the safety and the efficacy of a new protocol based on intraplaque injection of cross-linked hyaluronic acid plus modeling and stretching, in men with the chronic phase of Peyronie's Disease. Methods: At baseline all the patients were evaluated via intra-cavernous injection of a vasoactive agents and performed also the PD Questionnaire (PDQ) and the International Index of Erectile Function (IIEF) questionnaires. The protocol consisted in an intraplaque injection of HA (under block of 15 mL plain mepivacain 1%) every other week for a total of three injections in six weeks, plus penile modeling after each injection. Each patient also performed a daily use of vacuum erection device and (self) modeling and stretching in the days following the injections. Results: 23 patients were recruited in the study. Two patients were excluded because they did not correctly performe home protocol. Median curvature at baseline was 55° (IQR= 45 - 65). Nineteen out of 21 patients (90%) showed a reduction in the degree of curvature by a mean of 11.9 ± 7.3°. A statistically significant improvement in IIEF - Intercourse satisfaction domain (from baseline: 6.41 ± 3.8 to 8 week: 8.76 ± 2.8; p<0.001) and PDQ- Symptoms Bother domain (from baseline: 8.75 ± 4.1 to 8 week: 7.4 ± 3.3; p<0.001) was also detected. Conclusions: The findings of the study show that this new protocol based is able to significantly reduce penile curvature in patients suffering from a chronic phase of PD. Our intent is to continue the study further to better understand the impact that IIHA therapy on the management of PD in terms of patient satisfaction and reduction in the need for surgery. Conflicts of Interest: The authors involved in this study certify that they have NO affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers' bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript. [ABSTRACT FROM AUTHOR]

Objectives: Testicular cancer (TC) accounts for 1% of all tumors and 6-24% of these patients are azoospermic at diagnosis. Moreover in most of these patients, adjuvant chemotherapy results in a decreased spermatogenesis function. The aim of the present study is to report the outcomes of onco-microTESE in our center case series. Methods: From January 2019 to September 2022 we enrolled eleven patients aged from twenty-four to thirty-nine affected by testicular cancer and azoospermia. The diagnosis of TC was made by physical examination, scrotal ultrasound and tumor markers (αFP, βHCG, LDH). Two semen analysis and evaluation of testosterone, FSH, LH, estradiol, prolactin were performed before treatment. After surgery, tumor volume (TuV) and testicular volume (TeV) were measured and the ratio between them was evaluated (TuV/TeV). All patients underwent onco-microTESE with the help of an operator microscope and with the aid of a biologist in the surgery room. Statistical analyses were performed to correlate FSH, TuV and TeV. Results: Six out of eleven patients had high FSH level while the LH was normal in all patients. In five out of eleven patients testicular volume was <12ml. Spermatozoa were successfully retrieved and frozen from 4/11 testes (36.36%). In all these cases TuV/TeV were <0,1 and in three out of four patients FSH was normal Conclusions: In conclusion onco-microTESE should be considered the gold standard for patients with concomitant azoospermia and TC. Despite the low number of patients enrolled due to the rarity of such a condition, we observed a positive correlation between normal FSH and TuV/TeV<0,1 with surgical sperm retrieval (SSR). Further studies are required to evaluate the effective use of these parameters in preoperative evaluation of azoospermic patients with testicular tumors. Conflicts of Interest: The Authors declair no conflict of interest. [ABSTRACT FROM AUTHOR]

Objectives: Our aim is to compare two different surgical techniques for the treatment of penile paraffinoma in order to identify the most suitable technique for the characteristics of each patient. Methods: We described two different surgical techniques for the correction of penile paraffinoma performed in our Urological Unit. In this video we report two cases. The first patient was a 23 years-old Bulgarian male admitted to our hospital in 2020 with penile swelling and sexual discomfort due to paraffin injected 1 year before to increase penile girth. The patient underwent a 2-stages surgical technique: during the first stage the paraffinoma was excised. The penis was buried into the scrotum. Three months later a scrotoplasty was performed. The second patient a 40 years-old Serbian men presented to our hospital in 2019 with a severe penile deformity due to multiple paraffine self-injection resulting in pain and sexual discomfort. The patient underwent a paraffinoma excision and split-thickness skin graft in one stage. Two different questionnaires, the international index of erectile function (IIEF-5) and a 6-items questionnaire on the satisfaction of genital aesthetics, were delivered to the paients by email at 3, 6 and 12 months. Results: Erectile dysfunction was not reported and the scores of the IIEF-5 were comparable during the follow up. Both patients were satisfied with the aesthetic of their genitalia, however the first patient scored better in the 6-items questionnaire. No intra/post-operative complications were observed in both techniques. Conclusions: In our experience patients with no scrotal involvement and suitable scrotal size benefit a dual stage technique with scrotoplasty in terms of better aesthetic outcome rather than a split-thickness skin graft. Otherwise patients with small scrotum size or scrotal involvement might undergo split thickness skin graft which provides good aesthetic outcome and a comparable sexual function. From our experice the surgeon should be skilled in both technique and a careful evaluation of patient's charactheristics should suggest wich technique fits the patient. Conflicts of Interest: The Authors declair no conflict of interest. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the differences in terms of aesthetic and functional outcomes of two different surgical techniques in the treatment of penile paraffinoma. Methods: From September 2018 to July 2022 we selected 9 patients with penile paraffinoma. Patients were then subdivided into 2 groups. In group 1 (G1), four patients underwent a paraffinoma excision and split thickness skin graft reconstruction in one stage. Inclusion criteria for G1: patients suffering penile paraffinoma with small scrotum size or scrotal involvement. In group 2 (G2), five patients underwent 2-stages surgical technique: on the first stage we performed excision of paraffinoma and penile scrotalization. three-six month later during the second stage, a scrotoplasty was performed. All participants were invited to complete two different questionnaires, the international index of erectile function (IIEF-5) and a 6-items questionnaire on the satisfaction of genital aesthetics. The questionnaires were delivered by email. Datas were collected up to one year after surgery and a statistical analysis using SPSS V 26.0 3.4. Results: No statistical significant differences in terms of IIEF-5 were observed between G1 (20,5 IQR 19-21,25) and G2 (20 IQR 19-22) (p-value 0,49). Otherwise, a statistically significant difference (p-value <0,05) was recorded between G1-G2 in the 6-items questionnaires regarding the satisfaction of genital aesthetics (9,00 IQR 6,75-10,5 vs 13 IQR 4-11 respectively). Conclusions: In our experience, in patients suffering from penile paraffinoma with no scrotal involvement, a dual stage technique with scrotoplasty is resulting in better aesthetic outcomes rather than a split thickness skin graft. However, a single stage technique, using a split thickness skin graft, also provides good clinical outcome, including acceptable cosmetic results, patient satisfaction, and sexual function. Therefore, in our opinion, both techniques should be considered to enable surgeons to choose from among them based on the patient's preoperative characteristics. Conflicts of Interest: The Authors declair no conflict of interest. [ABSTRACT FROM AUTHOR]