Search

Purpose: The aim of this work was to analyze and contrast the effectiveness and safety of intralesional HA in the acute stage of PD with that of verapamil injection. Methods: In this prospective, randomized clinical trial, 42 PD-affected, sexually active men between the ages of >18 and 70 participated. Two groups of patients were recruited; group A obtained weekly intralesional treatment with HA for 12 weeks, whereas group B obtained weekly intralesional therapy with verapamil for 12 weeks. Physical examinations and Duplex Doppler ultrasound were performed on all patients. Results: The penile curvature was significantly decreased at 12 weeks after therapy in contrast to baseline in group A (34.1 ± 6.77° vs. 24.7 ± 9.72°, p = 0.005), and was significantly decreased at 12 weeks after therapy compared to baseline in group B (36.2 ± 7.43° vs. 30.8 ± 8.63 °, p = 0.047). The decrease in penile curvature at 12 weeks after therapy was noticeably better in group A in contrast to group B (24.7 ± 9.72° vs. 30.8 ± 8.63°, p = 0.038). Conclusion: HA is emerging as a valid choice for the treatment of PD in terms of resolution of the acute phase of the disease, and it is plausible to posit that the use of HA may contribute to the stabilization of the disease and decrease the need for the subsequent choice of a possible surgical strategy, with the ability to reduce penile pain and have a stronger impact on penile curvature and patient satisfaction. [ABSTRACT FROM AUTHOR]

Objectives: To compare the efficacy and safety of shockwave lithotripsy (SWL) using a narrow focus or wide focus for renal stones. Patients and Methods: A double‐blind randomised trial included adult patients with a solitary radio‐opaque renal pelvic stone of 1–2 cm. Patients were randomised into two groups: narrow‐focus (2 mm) SWL and wide‐focus (8 mm) SWL. The stone‐free rate (SFR) and presence of complications such as haematuria, fever, pain, and peri‐renal haematoma were evaluated. Pre‐ and postoperative urinary markers (neutrophil gelatinase‐associated lipocalin [NGAL] and kidney injury molecule 1 [KIM‐1]) concentrations were compared to assess renal injury. Results: A total of 135 patients were recruited for this study. The SFR after the first SWL session was 79.2% and 69.1% in narrow‐ and wide‐focus groups, respectively. There was a comparable rise in the median 2‐h NGAL concentration in both groups (P = 0.62). However, the rise in the median (interquartile range [IQR]) 2‐h KIM‐1 concentration was significantly higher in the narrow‐focus group at 4.9 (4.6, 5.8) ng/mL compared with the wide‐focus group at 4.4 (3.2, 5.7) ng/mL (P = 0.02). Nevertheless, the 3‐day NGAL and KIM‐1 urinary marker concentrations were significantly improved (P = 0.263 and P = 0.963, respectively). The overall SFR after three sessions was 86.6% and 86.8% in the narrow‐ and wide‐focus groups, respectively (P = 0.77). Both groups were comparable for complications, apart from the median pain score and the percentage of high‐grade haematuria, which were significantly higher in the narrow‐focus group (P < 0.001 and P = 0.03, respectively). Conclusion: Narrow‐ and wide‐focus SWL were associated with comparable outcomes and re‐treatment rates. However, narrow‐focus SWL was associated with significantly higher morbidity in terms of pain and haematuria. [ABSTRACT FROM AUTHOR]