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For long time the role of phytotherapy and diet has been known to be useful in managing and rological pathologies. Nowadays, phytotherapy knowledge among urologists is quite restricted; though, they are gaining more and more practice in relation to many different urological diseases, even though the mechanism of action and pharmacokinetics characteristics remain unknown.The mechanism of action is often represented by vasodilatation of genital area and stimulation of lumbar plexus. Many reports suggest that diet can reduce the incidence of prostate pathologies and improve sexual and reproductive activity. In this article the most common phytotherapy agents are presented, together with their mechanism of action, side-effects and toxicity characteristics.

Objective:In order to investigate the possible association between mast cells (MCs) and the fibrous plaque of La Peyronie’s disease, the number of MCs in normal penile tissue and in the fibrous plaque was determined.Methods:The control group consisted of 5 total and 3 partial penectomies with no fibrotic lesions, while the study group consisted of 23 excisional biopsies from cases of La Peyronie’s disease dating back to at least 2 years earlier and with no signs of activity. The biopsies included tissues from the tunica albuginea (TA), the areolar tissue (Br) between the tunica and the erectile tissue (CC) and from the latter. The number of MCs was counted with the aid of an image analysis program following staining the antibody antitryptase.Results:In the cases of La Peyronie’s disease the number of MCs/mm2 was significantly higher in the TA and Br but lower in the CC. The MCs were related to fibroblasts and vasculonervous channels in the TA, and were concentrated around the fibrous plaques and granulation tissue between the TA and BR and between the latter and the CC.Conclusion:Our data indicate that MCs have a role in the genesis of the fibrous plaque in the TA and in the persistent inflammation in the Br. Medical treatment aimed at repressing MC activation and proliferation locally might be useful in La Peyronie’s disease.

Subrini's new prosthetic devices are two soft silicone cylinders, with good patient tolerance over time, that are easily insertable surgically and that make full use of the patient's remaining erectile ability (complementary erection). They have a dual function: reducing cavernosal volume and providing prosthetic support. Patients who retain even minimal erectile function make eligible candidates for this type of implant. Between 1991-1994 we performed surgery to insert such devices in 224 pts. aged 28 to 73 years. A sub-coronal access for exposure was used in ali cases. Operating time was 30 minutes and hospital stay 3 days on average. 33 patients had Peyronie's disease, 36 required only locai anaesthesia. 162 patients could be followed long-term (129 with uncomplicated erectile deficit; 33 with I.P.P.). Aesthetic and functional results were generally satisfactory, as ali patients were able to resumé full sexual activity. Post-implant glans displacement and its asymmetrical insertion over the cavernosal apices (ptosis - glandular asymmetry) were corrected by glandulopexy (partial glans mobilization on the corpora cavernosa and its symmetrical repositioning).

— The Authors show the sequential events of the metastasization process based on the most recent theories. They especially underline the importance of angiogenesis and organotropism of the neoplastic cells in “metastatic fall”. The deeper knowledge of all the biological and genetic mechanisms means new diagnostic and therapeutical approaches can be applied.

Impairment of male sexual function is often associated with reduction in libido and can also occur at a relatively young age (30–50 years). In these cases pharmacological treatment may be clinically important. The effectiveness of the association L-arginine, fluid ginseng-guaranà and dried royal jelly was assessed. The choice of active ingredients was mainly based on their complete lack of side effects. A comparative double blind experimental model of research was used, patients being randomised into two groups. L-arginine HCL 2 g x 3 daily, dried royal jelly 200 mg, fluid ginseng 200 mg and guaranà 40 mg were given to 50 patients for two months. The other patients received a placebo. Clinical examination was repeated at monthly intervals. Treatment resulted in a significant improvement of the “libido intensity” symptom at the second and third control. An improvement in erectile maintenance was also noted at the third visit and, to a lesser extent, in all the other symptoms, whereas the placebo group showed non appreciable improvement. Results of this clinical study confirm the effectiveness of pharmacological therapy with arginine and natural supplies in young patients with impaired sexual function. There is also the interesting possibility of cyclic repetition of the treatment throughout the year in order to reinforce results and prevent a relapse.