Papers by Javier Romero-Otero
Current Urology Reports, Nov 29, 2022
The Journal of Sexual Medicine
The Journal of Sexual Medicine
International Journal of Impotence Research
Insights Into Incontinence and the Pelvic Floor
GeroScience, 2021
Advanced age is related to functional alterations of human vasculature, but erectile dysfunction ... more Advanced age is related to functional alterations of human vasculature, but erectile dysfunction precedes systemic manifestations of vascular disease. The current study aimed to simultaneously evaluate the influence of aging on vascular function (relaxation and contraction responses) in systemic human vascular territories: aorta (HA) and resistance mesenteric arteries (HMA) and human corpus cavernosum (HCC) and penile resistance arteries (HPRA). Associations of oxidative stress and inflammation circulating biomarkers with age and functional responses were also determined. Vascular specimens were obtained from 76 organ donors (age range 18–87). Four age-groups were established: < 40, 40–55, 56–65 and > 65 years old. Increasing age was associated with a decline in endothelium-dependent relaxation induced by BK in HMA (r = -0.597, p = 0.0001), or by ACh in HCC (r = -0.505, p = 0.0022), and HPRA (r = -0.601, p = 0.0012). Significant impairment was detected at > 65 years old in HMA but earlier in penile vasculature (> 55 years old). Age-related reduction to H 2 O 2 -vasodilatory response started before in HCC (56–65 years old) than in HA (> 65 years old). In contrast to relaxation responses, aging-related hypercontractility to adrenergic stimulation was homogeneous: contractions significantly increased in subjects > 55 years old in all tested vessels. Although not significantly age related, circulating levels of ADMA (r = -0.681, p = 0.0052) and TNF-α (r = -0.537, p = 0.0385) were negatively correlated with endothelial vasodilation in HMA but not in HCC or HPRA. Penile vasculature exhibits an early impairment of endothelium-dependent and H 2 O 2 -induced vasodilations when compared to mesenteric microcirculation and aorta. Therefore, functional susceptibility of penile vasculature to the aging process may account for anticipation of erectile dysfunction to systemic manifestations of vascular disease.
Mechanisms of Ageing and Development, 2021
The role of STIM/Orai calcium entry system on vascular ageing has not been elucidated. We aimed t... more The role of STIM/Orai calcium entry system on vascular ageing has not been elucidated. We aimed to evaluate the influence of ageing on STIM/Orai signalling and its role on ageing-induced alterations of contractile function in rat corpus cavernosum (RCC) and human penile resistance arteries (HPRA) and corpus cavernosum (HCC). RCC was obtained from 3 months-old and 20 months-old animals. HPRA and HCC were obtained from organ donors of varied ages without history of erectile dysfunction. Aging was associated with enhanced norepinephrine (NE)- and thromboxane analogue (U46619)-induced contractions in RCC which were significantly inhibited by the STIM/Orai inhibitor, YM-58483 (20 µM). Other STIM/Orai inhibitor, 2-aminoethyldiphenylborate also reduced NE-induced contractions in RCC from aged rats. YM-58483 significantly reduced neurogenic contractions and potentiated neurogenic relaxations in RCC from aged rats. In HCC and HPRA, NE-induced contractions were significantly enhanced in older subjects (>65 years-old) but YM-58483 completely reversed ageing-related hypercontractility. Ageing did not modify STIM-1 and Orai1 protein expressions but Orai3 was significantly overexpressed in cavernosal tissue from old rats and older subjects. Contribution of STIM/Orai to cavernosal contraction increases with ageing together with increased expression of Orai3. Orai inhibition could be a potential therapeutic strategy to reduce ageing-related impact on vascular/erectile function.
The Journal of Sexual Medicine, 2020
Introduction Radiofrequency (RF)-based treatment has been introduced as an esthetic alternative t... more Introduction Radiofrequency (RF)-based treatment has been introduced as an esthetic alternative treatment for various medical indications without the scientific backup of a satisfactory body of evidence. Furthermore, the United States Food and Drug Administration issued a warning regarding the safety of energy-based technologies for indications such as vaginal “rejuvenation," cosmetic vaginal treatment, vaginal conditions related to menopause, and symptoms of urinary incontinence and sexual function on July 30, 2018. Aim To perform a thorough review of the existing literature regarding RF-based vaginal devices for the treatment of female genitourinary indications and summarize the evidence available in a few short statements. Methods A thorough review of the literature regarding RF treatments for gynecological indications was performed based on several databases. Studies that included at least 15 patients were eligible for analysis. Main Outcome Measure Efficacy of RF devices f...
Archivos Espanoles De Urologia, 2013
International Journal of Impotence Research, 2021
The aim of this review is to describe reported techniques and to provide available scientific dat... more The aim of this review is to describe reported techniques and to provide available scientific data on the success of penis length procedures for cosmetic purposes. Penis lengthening methods remain a controversial issue. Penis size is a matter of great interest among men who are affected by ‘small penis anxiety’’ or just believe themselves to have a small penis, even though the dimensions of the organ fall within the normal range. We performed a narrative review of the literature based on a comprehensive search in the MEDLINE database for original articles published until March 2021, referring to lengthening approaches exclusively for aesthetical reasons. Abstracts, opinion papers and case series ≤10 patients were not considered. We included the results of 14 papers in the review that gathered the experience obtained in a total of 1661 patients. Four of the studies referred to non-surgical procedures for penile length augmentation (PLA) and the remaining 10 analyzed the results of invasive (surgical) procedures. Both invasive and non-invasive techniques achieve similar improvements in penis length. These procedures vary in complexity and require specialized training and experience. However, the low scientific quality of the analyzed papers makes it difficult to establish recommendations to choose one technique over any other. However, it seems reasonable that, if possible, non-invasive techniques should be proposed as a first-line treatment. Before deciding the procedure, we must carry out a correct psychological evaluation of our patients, discuss with them the technique of choice, and adjust their expectations.
International Journal of Impotence Research, 2021
Andrologia, 2020
Peyronie's disease (PD) is an acquired pathology characterized by the formation of fibrous plaque... more Peyronie's disease (PD) is an acquired pathology characterized by the formation of fibrous plaques in the context of the tunica albuginea of the penis, with consequent development of penile deformities (Al-Thakafi & Al-Hathal, 2016). Although the epidemiological data are limited and inconsistent, different studies described an incidence of up to 5% in the general male population (La Pera et al., 2001; Lindsay et al., 1991), with peaks of up to 20.3% in selected subgroups (Arafa, Eid, El-Badry, Ezz-Eldine, & Shamloul, 2007). It affects males of all ages, being more prevalent in middle-advanced age (Schwarzer et al., 2001), but presenting a more aggressive course in younger patients (Taylor & Levine, 2007). It was related to multiple risk factors, being repeated micro-trauma during sexual intercourse the most accredited etiopathogenic theory (Bjekic, Vlajinac, Sipetic, & Marinkovic, 2006; Kadioglu et al., 2002). The natural history of PD is generally subdivided into two successive stages: one acute or inflammatory, with variable duration, followed by another chronic or stable. The acute phase is characterized by pain with erections and the presence of an inflammatory plaque that causes the associated malformations (curvature, shortening or narrowing). In the chronic stage, the inflammation decreases, pain
The Journal of Urology, 2007
The Journal of Urology, 2007
THE JOURNAL OF UROLOGy® giving a cumulative 5-yr BCR-free rate of 75% (n=1001). The mean follow-u... more THE JOURNAL OF UROLOGy® giving a cumulative 5-yr BCR-free rate of 75% (n=1001). The mean follow-up was 22.3 mo (95%CI, 20,24.6). In multivariable Cox regression analysis, higher serum PSA (p < 0.001). palpable nodule (p = 0.009), presence of extracapsular extension (ECE; p = 0.038), seminal vesicle invasion (SVI; p < 0.001), pathologic Gleason 4 + 3 (p < 0.001), and pathologic Gleason 8-10 (p < 0.001) when compared to pathologic Gleason < 6 were significantly associated with shorter time to BCR. The concordance index for the model was 0.86. The overall PSM rate was 13%; 9% for capsule-confined disease (pT2) and 24% for extracapsular extension (pT3). CONCLUSIONS: LRP seems to offer comparable oncologic outcomes to open surgery; however, more extended follow-up of patients is needed to better assess the oncologic safety of the LRP.
The Journal of Urology, 2007
The Journal of Urology, 2007
Following the anastomosis and the final catheter placement, the prosthesis is completely deflated... more Following the anastomosis and the final catheter placement, the prosthesis is completely deflated, inflating the reservoir. RESULTS: This technique for managing the reservoir of an IPP results in preservation of the prosthesis. CONCLUSIONS: RALRP is a feasible option for patients with an IPP and clinically localized prostate cancer.
Archivos espanoles de urologia, 2018
Urology is defined as the medical-surgical specialty that includes the study, diagnosis and treat... more Urology is defined as the medical-surgical specialty that includes the study, diagnosis and treatment of medical conditions of the urinary system. It is well specified by the National Commission of Specialties that we must know the medical pathology that concerns us. However, on occasions, resident training focuses on the surgical field and oncological pathology, which, although one of the main pillars of the specialty, is usually to the detriment of training in medical and functional pathology. We conducted a survey of residents in the fourth year of Urology in Spain, where we asked about the quality of training in Andrology and Functional Urology. The average rotation time is 3.5 months in each unit. Only 20% consider that their training is satisfactory and sufficient in Andrology. Seventy-five percent of residents surveyed believe that their training in Functional Urology is acceptable or sufficient, both medical and surgical. There are numerous fields of action to improve the tr...
European Urology Supplements, 2007
Introduction & Objectives: Radical prostatectomy is considered the treatment of choice for tumors... more Introduction & Objectives: Radical prostatectomy is considered the treatment of choice for tumors localized within the prostate gland. This surgical procedure is usually performed using the retrograde technique as described by Walsh and co-workers. In recent years, the antegrade approach, originally described by Campbell was newly discovered due to the advent of laparoscopic radical prostatectomy. The aim of this study is to present the functional results of antegrade open radical prostatectomy, specifically reporting on the incidence of recovery of continence and potency. Material & Methods: We reviewed the clinical and pathological data of 488 patients who had antegrade radical retropubic prostatectomy for clinically localized prostate cancer between 2000 and 2005. The entire prostate was examined, all specimens were staged according to the 1997 American Joint Committee on Cancer (AJCC) staging system. Patients were interviewed during an office visit, and we considered as "continent" patients who did not require pads or other kind of protection, and "potent" patients that were able to have satisfactory sexual intercourse, with or without the use of phosphodiesterase type 5 (PDE 5) inhibitors. Results: After a minimum follow up of 12 months, 94.1% (459/488) of patients were completely continent, and of those 43.4% (199/459) reported complete continence at one month outpatient visit. Referring to recovery of potency, it was evaluated in 302 patients (61.8%) who had nerve sparing radical prostatectomy and did not receive adjuvant therapy; of these, 227 (75.2%) had a bilateral nerve sparing procedure and 75 (24.8%) had the sparing procedure performed only on one side. After a minimum follow up of 12 months 69.6% of patients who had bilateral nerve sparing procedure and 38.6% of those who had monolateral nerve sparing prostatectomy were potent with or without the use of PDE 5 inhibitors. Conclusions: Antegrade radical prostatectomy can provide optimal functional results in term of recovery of continence probably due to a complete definition of the anatomical boundaries of the apex. Moreover, it can provide a safe nerve sparing procedure with similar results to those reported by the retrograde approach.
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Papers by Javier Romero-Otero