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Carlos Da Ros

Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Urology, Faculty Member

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Carlos Teodósio Da Ros received his MD in 1988 at the Santa Maria Federal University (UFSM), Brazil. He did a residency program in General Surgery and Urology (1989-1992) at Santa Casa de Misericórdia Hospital, in Porto Alegre. He received his Master Degree in Pharmacoloby in1996 at Health Sciences Federal University at Porto Alegre and his PhD in Surgical Clinic in 1999 at the same University. He did a Fellowship in Andrology at the Urology Department of the Tulane University, New Orleans, USA, in 1996. He is a Board Certified Urologist by the Brazilian Society of Urology. He has published over 100 scientific papers and review articles in peer reviewed scientific journals, authored over 20 book chapters, presented over 300 papers in meetings and over 350 lectures at both national and international scientific meetings. He is a member of several medical societies (American Urological Association, International Society of Sexual Medicine, Brazilian Society of Urology, Brazilian Association of the Study of Sexual Medicine, European Association of Urology and Latin American Society of Sexual Medicine).
Personal CV: http://lattes.cnpq.br/7839778030294104 or http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4700855U8

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Papers by Carlos Da Ros

Prosthetic Penile Infection: “Rescue Procedure” with Rifamycin

The Journal of Urology, Dec 1, 1992

Low Serum Testosterone Levels Are Associated with Positive Surgical Margins in Radical Retropubic Prostatectomy: Hypogonadism Represents Bad Prognosis in Prostate Cancer

The Journal of Urology, Dec 1, 2005

It has been reported that more aggressive prostate cancer (PC) can be associated with low serum t... more It has been reported that more aggressive prostate cancer (PC) can be associated with low serum testosterone levels. The relationship between serum androgens and PC is still not completely understood. In this study we examined the association of prognostic factors in men who underwent radical retropubic (RRP) prostatectomy with low or normal total testosterone. We retrospectively evaluated 64 consecutive patients with localized PC treated with RRP between July 2002 and November 2003. PC was diagnosed by transrectal ultrasonography guided biopsy performed for either a suspicious digital rectal examination or serum prostate specific antigen greater than 4.0 ng/ml. Gleason score was determined in prostatic biopsies. Pathological TNM staging (1997), capsular perforation, seminal vesicle involvement and surgical margin status were determined in all surgical specimens. The threshold for serum total testosterone was 270 ng/dl. In all analyses p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.05 was considered statistically significant. There were no statistically significant differences among prostate specific antigen, Gleason score (biopsy or specimen), pathological stage, capsular perforation and seminal vesicle involvement. However, patients with low total testosterone had increased positive surgical margins (p = 0.026). Patients with low total testosterone more frequently present with positive surgical margins in RRP specimens. The true association between low testosterone and poor clinical outcome in the long term needs validation in large prospective studies.

Global epidemiology of sexually transmitted diseases

Asian Journal of Andrology, 2008

Sexually transmitted diseases (STDs) are among the first ten causes of unpleasant diseases in you... more Sexually transmitted diseases (STDs) are among the first ten causes of unpleasant diseases in young adult males in developing countries and the second major cause of unpleasant diseases in young adult women. Adolescents and young adults (15-24 years old) make up only 25% of the sexually active population, but represent almost 50% of all new acquired STDs. In general, STDs are epidemics and present an enormous health and economic consequences. An adequate screening for STDs should be done on a routine basis in every part of the world. Many STDs are asymptomatic and therefore can difficult to control. The purpose of reporting of STDs is to ensure that persons who are infected will be quickly diagnosed and appropriately treated to control the spread of infection and also so that partners are notified, tested and appropriately treated. It is estimated that reported cases of STDs represent only 50%-80% of reportable STD infections in the United States, reflecting limited screening and low disease reporting. High-risk sexual behavior is a highly contributive factor of this process as it often leads to teenage pregnancies and HIV/AIDS. One possible explanation for this behavior is that people do not have enough information about the transmission of STDs or ignore the precautions required for safe sex. Approximately 60% of new HIV infections worldwide occur in young people. The frequency of high-risk behaviors among youths may also be influenced by opportunity to engage in them, particularly the amount of time that they are unsupervised by adults. However, in diagnosing and treating these patients, we can effectively prevent the spread of HIV/AIDS. Individuals infected with STDs are 5-10 times more likely than uninfected individuals to acquire or transmit HIV through sexual contact. The breaking of the genital tract lining or skin creates a portal of entry for HIV and, hence, HIV-infected individuals with other STDs are more likely to shed HIV in their genital secretions. To date, the condom is the most effective method available for males for protection against STDs. It is important to control STDs, and prevention can be the key of this process. Prevention can be achieved through education of the population, identification of symptomatic and asymptomatic people, and effective diagnosis and treatment of these patients and their partners.

Carcinoma de úraco

Revista Brasileira de Cancerologia, Jul 26, 2023

1249: Expression of Matrixmetalloproteinase Inhibitors: a New Paradigm in Peyronie's Disease

The Journal of Urology, Apr 1, 2004

Does Intratesticular Testosterone Administration Modify the Evolution of Transitory Testicular Ischemia in Prepubertal Rats?

The Journal of Urology, May 1, 1998

Purpose: Testicular torsion followed by ischemia results in variable degrees of infertility and u... more Purpose: Testicular torsion followed by ischemia results in variable degrees of infertility and until now there appears to be no effective way to recover it. Testosterone participation in the maintenance of male sexual organs and spermatogenesis led us to hypothesize that intratesticular administration could recover ischemic injury. Materials and Methods: We divided 40 Wistar rats in 2 groups, of 20 each. One group was control and the other underwent a 120-minute testicular ischemia by means of a vascular clamp on the left spermatic cord. Each group was further subdivided in 2 subgroups. The first one was observed and the second received intratesticular testosterone 25 mg. starting on the third day after injury and during the next 7 consecutive days. Half the animals were sacrificed 30 days after injury and the remaining ones after 60 days. Weight, volume, number of seminiferous tubules, histology and spermatogenesis of the same side and contralateral testes were examined. For statistical analysis ANOVA and Fisher's tests were applied. Results: It was found that testosterone was capable of acting upon volume and weight of the left testis (p = 0.0001). The animals receiving intratesticular testosterone showed lower testicular weight and volume after 30 and 60 days, respectively. This subgroup also showed a higher number of seminiferous tubules, modified histology and absent spermatogenesis suggesting testicular atrophy. Conclusions: We concluded that intratesticular injection of testosterone 25 mg. once a day during 7 consecutive days after transitory testicular ischemia causes ipsilateral testis atrophy. The animals in control group showed testicular histological recovery 60 days after injury. There were no significant histological differences in the contralateral testes.

Can we recommend varicocele surgery for men with hypogonadism?

PubMed, Jul 28, 2023

Varicocele is a frequent finding, identified in 15% of the male general population and, among tho... more Varicocele is a frequent finding, identified in 15% of the male general population and, among those with infertility, the prevalence is around 35% for primary infertility and 80% for secondary infertility (1, 2). This pathology can be defined as an abnormal tortuous dilation of internal spermatic veins and pampiniform plexus in spermatic cord. Some risk factors such as age, height, lifestyle habits are associated with the presence of varicocele, however it seems that an increase of body mass index decreased risk of varicocele (3). The early diagnosis and treatment aim to avoid the possible progressive duration-dependent reduction in testicular function, demonstrated as impaired semen parameters, low testosterone (TT) levels and increased sperm DNA fragmentation levels, particularly stress-induced sperm DNA damage (1, 4, 5). Many hypotheses have been proposed to explain the consequences of varicocele in testicular function, such as testicular hyperthermia, hypoxia, hormonal dysfunction, decreased blood flow, backflow of metabolites from the adrenal gland, impairment of Leydig cells (6-8). Furthermore, Weiss et al. reported a reduced testosterone synthesis in individuals with varicocele (9). Another study suggests that Leydig cell hyperplasia, commonly seen in patients with varicocele, is a compensatory reaction to Leydig cell dysfunction and impaired testosterone synthesis (10). In men presenting with both hypogonadism and varicocele, the stimulation of hypothalamic-pituitary-gonadal axis with gonadotropins or clomiphene citrate is feasible. If combined with varicocelectomy, the serum levels of TT can be further improved. However, the real benefit of this treatment remains unclear (11, 12). The treatment of the varicocele will at least stop possible further varicocele-induced testicular damage and, in a majority of men, lead to improved semen parameters (13), enhanced Leydig cell function in association with increased TT levels and as a consequence, improved quality of the semen due to the reduction in DNA damage (10, 14). The present review compiles the effects of varicocelectomy in men with hypogonadism on TT serum levels. MATERIALS AND METHODS We selected articles published from 1975 to 2022. Studies were obtained using PubMed. The search terms "varicocele", "hypogonadism" and "testosterone level" were used as filters. The

Long-term follow-up of penile curvature correction utilizing autologous albugineal crural graft

International Braz J Urol, Apr 1, 2012

Suprarenal Aorta Reconstruction Using a Saphenous Spiral Graft

Journal of Trauma-injury Infection and Critical Care, Jul 1, 1994

Twenty-five milligrams of clomiphene citrate presents positive effect on treatment of male testosterone deficiency - a prospective study

International Braz J Urol, Aug 1, 2012

Male testosterone deficiency is associated with bad sexual function and quality of life (QoL). Th... more Male testosterone deficiency is associated with bad sexual function and quality of life (QoL). The aim of this study was to determine whether a daily dose of 25 mg clomiphene citrate (CC) is effective in stimulating the endogenous testosterone production pathway and to address the applicability of this medication as a therapeutic option for symptomatic hypogonadism. Materials and Methods: This was a prospective study. Men with low sexual desire and testosterone levels (T) below 400 ng/dL were selected to receive CC. Blood samples were obtained to determine baseline measurements of serum T, estradiol, LH, lipid profile and fasting plasma glucose. Each patient was treated with a daily dose of 25 mg CC for at least 3 months. Patients were asked if they experienced any side effects related to the use of CC and if they experienced any improvement in their sexual profile. Paired samples T-test was utilized to analyze responses to therapy. Results: Our cohort consisted of 125 men with hypogonadism and low libido. Mean age was 62 years (± 11.1 years). Serum T levels ranged from 309 ng/dL (baseline, mean value) to 642 ng/dL (3 months after CC initiation, mean value) (p < 0.001). Serum cholesterol levels ranged from 197 to 186 mg/dL (p = 0.003). There were no statistically significant differences when comparing pre and post-treatment HDL-Cholesterol, triglycerides, fasting plasma glucose and prolactin. All men reported improvements in the post-treatment QoL scores. No serious adverse events were recorded. Conclusions: The CC was effective in stimulating the endogenous production of testosterone. A lower level of total cholesterol was verified after three months of treatment. This medication should be considered as a therapeutic option for some patients with symptomatic male testosterone deficiency.

O-22 Testosterone Replacement Therapy, 1% Gel vs Depot Injection: A Multicentric Clinocal Experience with 305 Patients

The Journal of Sexual Medicine, 2020

Eficácia do citrato de sildenafila em pacientes com disfunção erétil submetidos à prostatectomia radical

Revista Brasileira de …

Efficacy of sildenafil in patients with erectile dysfunction and previous radical prostatectomy. ... more

2015 Journal of Urology Consultants

The Journal of Urology, 2016

A randomised, double-blind study comparing the efficacy and tolerability of controlled-release doxazosin and tamsulosin in the treatment of benign prostatic hyperplasia in Brazil

by Walter Koff, Antonio Carlos Lima Pompeo, Carlos Cairoli, and Carlos Da Ros

International Journal of Clinical Practice, 2006

Brazilian patients with benign prostatic hyperplasia were randomised in a 12-week, double-blind, ... more Brazilian patients with benign prostatic hyperplasia were randomised in a 12-week, double-blind, double-dummy study to receive doxazosin gastrointestinal therapeutic system (GITS) 4 mg q.i.d. (n ¼ 82) or tamsulosin 0.4 q.i.d. (n ¼ 83). Primary endpoints were the absolute and percentage change from baseline in symptoms measured by International Prostate Symptom Score (IPSS). Secondary endpoints included IPSS, quality-of-life (QOL) question from the IPSS, and questions 6 and 7 of the Sexual Function Abbreviated Questionnaire (SFAQ) at weeks 4 and 12. Doxazosin GITS and tamsulosin improved IPSS with no significant differences between groups at week 12. During weeks 4-8, tamsulosin-treated patients demonstrated a slower improvement (p 0 0.001) in IPSS than doxazosin GITS-treated patients. The proportion of satisfied patients was observed earlier with doxazosin GITS (p ¼ 0.006) vs. tamsulosin. At week 12, the proportion of patients with little or no difficulty at ejaculation (Q6 of SFAQ) was higher in the doxazosin GITS group (p ¼ 0.019). Both treatments were well tolerated.

Environmental Issues Resulting in Hypogonadism in Brazilian Men

Bioenvironmental Issues Affecting Men's Reproductive and Sexual Health, 2018

Abstract A significant increase in the incidence of endocrine abnormalities has been described in... more Abstract A significant increase in the incidence of endocrine abnormalities has been described in the literature, raising questions about their causes. Part of this effect may result from synthetic toxic substances or persistent organic pollutants (POPs) acting on the endocrine system (endocrine disrupters—EDs), many of which are routinely used in work and agricultural processes. These pollutants are fabricated bioaccumulative compounds with long half-lives, and the effect of these substances can be temporary or permanent. In terms of health, interference at the endocrine system by any type of substance can cause concern. There is evidence that these EDs have hormonal activity in vitro, and there is considerable observational evidence of sexuality-modifying effects. It is very important to know how any kind of manufactured product could interfere with environment and people. In Brazil, we have the National Health Surveillance Agency (ANVISA) that addresses these questions (Brazilian health surveillance and the approach to the specific cases of ED). An extensive number of epidemiological studies have addressed the possible effects of exposure to POPs on male reproductive health, but the results are conflicting. Despite the known environmental and human health impact caused by water contamination by EDs and other POPs, few studies have been conducted in Brazil for the diagnosis of these compounds in the environment.

The role of clomiphene citrate in late onset male hypogonadism

International braz j urol

DOES INTRATESTICULAR TESTOSTERONE ADMINISTRATION MODIFY THE EVOLUTION OF TRANSITORY TESTICULAR ISCHEMIA IN PREPUBERTAL RATS?

by Claudio Teloken and Carlos Da Ros

Journal of Urology, 1998

PurposeTesticular torsion followed by ischemia results in variable degrees of infertility and unt... more PurposeTesticular torsion followed by ischemia results in variable degrees of infertility and until now there appears to be no effective way to recover it. Testosterone participation in the maintenance of male sexual organs and spermatogenesis led us to hypothesize that intratesticular administration could recover ischemic injury.

Chapter 29 – Role of Risk Factors Such as Smoking, Alcohol, and Substance Abuse on Sexual Health of Brazilian Men

The association between alcohol and tobacco is well described in the literature. Recent studies s... more The association between alcohol and tobacco is well described in the literature. Recent studies suggest that alcohol and nicotine have interactive pharmacological effects that motivate their combined use, in addition to maintenance, and dependency on both substances [1,2]. Nearly one in five individuals with nicotine dependence also meets criteria for alcohol dependence, and conversely, half of individuals with alcohol dependence are dependent on nicotine [2,3]. Erectile dysfunction, defined as the inability to attain and maintain penile erection, is a common medical disorder, which decreases the quality of life of the couples and is related with hypertension, metabolic syndrome, diabetes mellitus, dyslipidemia, sedentary lifestyle, obesity, and alcoholism [4].

Disfunção Erétil

A disfunção erétil (DE) é uma condição médica muito prevalente onde mais da metade dos homens adu... more A disfunção erétil (DE) é uma condição médica muito prevalente onde mais da metade dos homens adultos apresentam alguma queixa relacionada a suas ereções. A DE é mais comumente encontrada nos homens com vários componentes da síndrome metabólica, que reúne fatores de risco para diabetes e doença cardiovascular. A disfunção endotelial é um fator etiológico unificador para muitos dos aspectos da síndrome metabólica, especialmente para o diabetes e a doença cardiovascular. A etiologia multifatorial da DE, especialmente em pacientes com síndrome metabólica, aumenta a complexidade no manejo deste problema. Deve-se estar ciente dos fatores fisiopatológicos relacionados à DE para buscar as melhores alternativas e resultados no tratamento destes pacientes. Quaisquer fatores de risco (tabagismo, diabetes, sedentarismo, obesidade, hipertensão e dislipidemia) para doença cardiovascular devem ser modificados ou tratados.

Prevalence of Peyronie's disease in men over 50-y-old from Southern Brazil

International Journal of Impotence Research, 2001

Prosthetic Penile Infection: “Rescue Procedure” with Rifamycin

The Journal of Urology, Dec 1, 1992

Low Serum Testosterone Levels Are Associated with Positive Surgical Margins in Radical Retropubic Prostatectomy: Hypogonadism Represents Bad Prognosis in Prostate Cancer

The Journal of Urology, Dec 1, 2005

It has been reported that more aggressive prostate cancer (PC) can be associated with low serum t... more It has been reported that more aggressive prostate cancer (PC) can be associated with low serum testosterone levels. The relationship between serum androgens and PC is still not completely understood. In this study we examined the association of prognostic factors in men who underwent radical retropubic (RRP) prostatectomy with low or normal total testosterone. We retrospectively evaluated 64 consecutive patients with localized PC treated with RRP between July 2002 and November 2003. PC was diagnosed by transrectal ultrasonography guided biopsy performed for either a suspicious digital rectal examination or serum prostate specific antigen greater than 4.0 ng/ml. Gleason score was determined in prostatic biopsies. Pathological TNM staging (1997), capsular perforation, seminal vesicle involvement and surgical margin status were determined in all surgical specimens. The threshold for serum total testosterone was 270 ng/dl. In all analyses p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.05 was considered statistically significant. There were no statistically significant differences among prostate specific antigen, Gleason score (biopsy or specimen), pathological stage, capsular perforation and seminal vesicle involvement. However, patients with low total testosterone had increased positive surgical margins (p = 0.026). Patients with low total testosterone more frequently present with positive surgical margins in RRP specimens. The true association between low testosterone and poor clinical outcome in the long term needs validation in large prospective studies.

Global epidemiology of sexually transmitted diseases

Asian Journal of Andrology, 2008

Sexually transmitted diseases (STDs) are among the first ten causes of unpleasant diseases in you... more Sexually transmitted diseases (STDs) are among the first ten causes of unpleasant diseases in young adult males in developing countries and the second major cause of unpleasant diseases in young adult women. Adolescents and young adults (15-24 years old) make up only 25% of the sexually active population, but represent almost 50% of all new acquired STDs. In general, STDs are epidemics and present an enormous health and economic consequences. An adequate screening for STDs should be done on a routine basis in every part of the world. Many STDs are asymptomatic and therefore can difficult to control. The purpose of reporting of STDs is to ensure that persons who are infected will be quickly diagnosed and appropriately treated to control the spread of infection and also so that partners are notified, tested and appropriately treated. It is estimated that reported cases of STDs represent only 50%-80% of reportable STD infections in the United States, reflecting limited screening and low disease reporting. High-risk sexual behavior is a highly contributive factor of this process as it often leads to teenage pregnancies and HIV/AIDS. One possible explanation for this behavior is that people do not have enough information about the transmission of STDs or ignore the precautions required for safe sex. Approximately 60% of new HIV infections worldwide occur in young people. The frequency of high-risk behaviors among youths may also be influenced by opportunity to engage in them, particularly the amount of time that they are unsupervised by adults. However, in diagnosing and treating these patients, we can effectively prevent the spread of HIV/AIDS. Individuals infected with STDs are 5-10 times more likely than uninfected individuals to acquire or transmit HIV through sexual contact. The breaking of the genital tract lining or skin creates a portal of entry for HIV and, hence, HIV-infected individuals with other STDs are more likely to shed HIV in their genital secretions. To date, the condom is the most effective method available for males for protection against STDs. It is important to control STDs, and prevention can be the key of this process. Prevention can be achieved through education of the population, identification of symptomatic and asymptomatic people, and effective diagnosis and treatment of these patients and their partners.

Carcinoma de úraco

Revista Brasileira de Cancerologia, Jul 26, 2023

1249: Expression of Matrixmetalloproteinase Inhibitors: a New Paradigm in Peyronie's Disease

The Journal of Urology, Apr 1, 2004

Does Intratesticular Testosterone Administration Modify the Evolution of Transitory Testicular Ischemia in Prepubertal Rats?

The Journal of Urology, May 1, 1998

Purpose: Testicular torsion followed by ischemia results in variable degrees of infertility and u... more Purpose: Testicular torsion followed by ischemia results in variable degrees of infertility and until now there appears to be no effective way to recover it. Testosterone participation in the maintenance of male sexual organs and spermatogenesis led us to hypothesize that intratesticular administration could recover ischemic injury. Materials and Methods: We divided 40 Wistar rats in 2 groups, of 20 each. One group was control and the other underwent a 120-minute testicular ischemia by means of a vascular clamp on the left spermatic cord. Each group was further subdivided in 2 subgroups. The first one was observed and the second received intratesticular testosterone 25 mg. starting on the third day after injury and during the next 7 consecutive days. Half the animals were sacrificed 30 days after injury and the remaining ones after 60 days. Weight, volume, number of seminiferous tubules, histology and spermatogenesis of the same side and contralateral testes were examined. For statistical analysis ANOVA and Fisher's tests were applied. Results: It was found that testosterone was capable of acting upon volume and weight of the left testis (p = 0.0001). The animals receiving intratesticular testosterone showed lower testicular weight and volume after 30 and 60 days, respectively. This subgroup also showed a higher number of seminiferous tubules, modified histology and absent spermatogenesis suggesting testicular atrophy. Conclusions: We concluded that intratesticular injection of testosterone 25 mg. once a day during 7 consecutive days after transitory testicular ischemia causes ipsilateral testis atrophy. The animals in control group showed testicular histological recovery 60 days after injury. There were no significant histological differences in the contralateral testes.

Can we recommend varicocele surgery for men with hypogonadism?

PubMed, Jul 28, 2023

Varicocele is a frequent finding, identified in 15% of the male general population and, among tho... more Varicocele is a frequent finding, identified in 15% of the male general population and, among those with infertility, the prevalence is around 35% for primary infertility and 80% for secondary infertility (1, 2). This pathology can be defined as an abnormal tortuous dilation of internal spermatic veins and pampiniform plexus in spermatic cord. Some risk factors such as age, height, lifestyle habits are associated with the presence of varicocele, however it seems that an increase of body mass index decreased risk of varicocele (3). The early diagnosis and treatment aim to avoid the possible progressive duration-dependent reduction in testicular function, demonstrated as impaired semen parameters, low testosterone (TT) levels and increased sperm DNA fragmentation levels, particularly stress-induced sperm DNA damage (1, 4, 5). Many hypotheses have been proposed to explain the consequences of varicocele in testicular function, such as testicular hyperthermia, hypoxia, hormonal dysfunction, decreased blood flow, backflow of metabolites from the adrenal gland, impairment of Leydig cells (6-8). Furthermore, Weiss et al. reported a reduced testosterone synthesis in individuals with varicocele (9). Another study suggests that Leydig cell hyperplasia, commonly seen in patients with varicocele, is a compensatory reaction to Leydig cell dysfunction and impaired testosterone synthesis (10). In men presenting with both hypogonadism and varicocele, the stimulation of hypothalamic-pituitary-gonadal axis with gonadotropins or clomiphene citrate is feasible. If combined with varicocelectomy, the serum levels of TT can be further improved. However, the real benefit of this treatment remains unclear (11, 12). The treatment of the varicocele will at least stop possible further varicocele-induced testicular damage and, in a majority of men, lead to improved semen parameters (13), enhanced Leydig cell function in association with increased TT levels and as a consequence, improved quality of the semen due to the reduction in DNA damage (10, 14). The present review compiles the effects of varicocelectomy in men with hypogonadism on TT serum levels. MATERIALS AND METHODS We selected articles published from 1975 to 2022. Studies were obtained using PubMed. The search terms "varicocele", "hypogonadism" and "testosterone level" were used as filters. The

Long-term follow-up of penile curvature correction utilizing autologous albugineal crural graft

International Braz J Urol, Apr 1, 2012

Suprarenal Aorta Reconstruction Using a Saphenous Spiral Graft

Journal of Trauma-injury Infection and Critical Care, Jul 1, 1994

Twenty-five milligrams of clomiphene citrate presents positive effect on treatment of male testosterone deficiency - a prospective study

International Braz J Urol, Aug 1, 2012

Male testosterone deficiency is associated with bad sexual function and quality of life (QoL). Th... more Male testosterone deficiency is associated with bad sexual function and quality of life (QoL). The aim of this study was to determine whether a daily dose of 25 mg clomiphene citrate (CC) is effective in stimulating the endogenous testosterone production pathway and to address the applicability of this medication as a therapeutic option for symptomatic hypogonadism. Materials and Methods: This was a prospective study. Men with low sexual desire and testosterone levels (T) below 400 ng/dL were selected to receive CC. Blood samples were obtained to determine baseline measurements of serum T, estradiol, LH, lipid profile and fasting plasma glucose. Each patient was treated with a daily dose of 25 mg CC for at least 3 months. Patients were asked if they experienced any side effects related to the use of CC and if they experienced any improvement in their sexual profile. Paired samples T-test was utilized to analyze responses to therapy. Results: Our cohort consisted of 125 men with hypogonadism and low libido. Mean age was 62 years (± 11.1 years). Serum T levels ranged from 309 ng/dL (baseline, mean value) to 642 ng/dL (3 months after CC initiation, mean value) (p < 0.001). Serum cholesterol levels ranged from 197 to 186 mg/dL (p = 0.003). There were no statistically significant differences when comparing pre and post-treatment HDL-Cholesterol, triglycerides, fasting plasma glucose and prolactin. All men reported improvements in the post-treatment QoL scores. No serious adverse events were recorded. Conclusions: The CC was effective in stimulating the endogenous production of testosterone. A lower level of total cholesterol was verified after three months of treatment. This medication should be considered as a therapeutic option for some patients with symptomatic male testosterone deficiency.

O-22 Testosterone Replacement Therapy, 1% Gel vs Depot Injection: A Multicentric Clinocal Experience with 305 Patients

The Journal of Sexual Medicine, 2020

Eficácia do citrato de sildenafila em pacientes com disfunção erétil submetidos à prostatectomia radical

Revista Brasileira de …

Efficacy of sildenafil in patients with erectile dysfunction and previous radical prostatectomy. ... more

2015 Journal of Urology Consultants

The Journal of Urology, 2016

A randomised, double-blind study comparing the efficacy and tolerability of controlled-release doxazosin and tamsulosin in the treatment of benign prostatic hyperplasia in Brazil

by Walter Koff, Antonio Carlos Lima Pompeo, Carlos Cairoli, and Carlos Da Ros

International Journal of Clinical Practice, 2006

Brazilian patients with benign prostatic hyperplasia were randomised in a 12-week, double-blind, ... more Brazilian patients with benign prostatic hyperplasia were randomised in a 12-week, double-blind, double-dummy study to receive doxazosin gastrointestinal therapeutic system (GITS) 4 mg q.i.d. (n ¼ 82) or tamsulosin 0.4 q.i.d. (n ¼ 83). Primary endpoints were the absolute and percentage change from baseline in symptoms measured by International Prostate Symptom Score (IPSS). Secondary endpoints included IPSS, quality-of-life (QOL) question from the IPSS, and questions 6 and 7 of the Sexual Function Abbreviated Questionnaire (SFAQ) at weeks 4 and 12. Doxazosin GITS and tamsulosin improved IPSS with no significant differences between groups at week 12. During weeks 4-8, tamsulosin-treated patients demonstrated a slower improvement (p 0 0.001) in IPSS than doxazosin GITS-treated patients. The proportion of satisfied patients was observed earlier with doxazosin GITS (p ¼ 0.006) vs. tamsulosin. At week 12, the proportion of patients with little or no difficulty at ejaculation (Q6 of SFAQ) was higher in the doxazosin GITS group (p ¼ 0.019). Both treatments were well tolerated.

Environmental Issues Resulting in Hypogonadism in Brazilian Men

Bioenvironmental Issues Affecting Men's Reproductive and Sexual Health, 2018

Abstract A significant increase in the incidence of endocrine abnormalities has been described in... more Abstract A significant increase in the incidence of endocrine abnormalities has been described in the literature, raising questions about their causes. Part of this effect may result from synthetic toxic substances or persistent organic pollutants (POPs) acting on the endocrine system (endocrine disrupters—EDs), many of which are routinely used in work and agricultural processes. These pollutants are fabricated bioaccumulative compounds with long half-lives, and the effect of these substances can be temporary or permanent. In terms of health, interference at the endocrine system by any type of substance can cause concern. There is evidence that these EDs have hormonal activity in vitro, and there is considerable observational evidence of sexuality-modifying effects. It is very important to know how any kind of manufactured product could interfere with environment and people. In Brazil, we have the National Health Surveillance Agency (ANVISA) that addresses these questions (Brazilian health surveillance and the approach to the specific cases of ED). An extensive number of epidemiological studies have addressed the possible effects of exposure to POPs on male reproductive health, but the results are conflicting. Despite the known environmental and human health impact caused by water contamination by EDs and other POPs, few studies have been conducted in Brazil for the diagnosis of these compounds in the environment.

The role of clomiphene citrate in late onset male hypogonadism

International braz j urol

DOES INTRATESTICULAR TESTOSTERONE ADMINISTRATION MODIFY THE EVOLUTION OF TRANSITORY TESTICULAR ISCHEMIA IN PREPUBERTAL RATS?

by Claudio Teloken and Carlos Da Ros

Journal of Urology, 1998

PurposeTesticular torsion followed by ischemia results in variable degrees of infertility and unt... more PurposeTesticular torsion followed by ischemia results in variable degrees of infertility and until now there appears to be no effective way to recover it. Testosterone participation in the maintenance of male sexual organs and spermatogenesis led us to hypothesize that intratesticular administration could recover ischemic injury.

Chapter 29 – Role of Risk Factors Such as Smoking, Alcohol, and Substance Abuse on Sexual Health of Brazilian Men

The association between alcohol and tobacco is well described in the literature. Recent studies s... more The association between alcohol and tobacco is well described in the literature. Recent studies suggest that alcohol and nicotine have interactive pharmacological effects that motivate their combined use, in addition to maintenance, and dependency on both substances [1,2]. Nearly one in five individuals with nicotine dependence also meets criteria for alcohol dependence, and conversely, half of individuals with alcohol dependence are dependent on nicotine [2,3]. Erectile dysfunction, defined as the inability to attain and maintain penile erection, is a common medical disorder, which decreases the quality of life of the couples and is related with hypertension, metabolic syndrome, diabetes mellitus, dyslipidemia, sedentary lifestyle, obesity, and alcoholism [4].

Disfunção Erétil

A disfunção erétil (DE) é uma condição médica muito prevalente onde mais da metade dos homens adu... more A disfunção erétil (DE) é uma condição médica muito prevalente onde mais da metade dos homens adultos apresentam alguma queixa relacionada a suas ereções. A DE é mais comumente encontrada nos homens com vários componentes da síndrome metabólica, que reúne fatores de risco para diabetes e doença cardiovascular. A disfunção endotelial é um fator etiológico unificador para muitos dos aspectos da síndrome metabólica, especialmente para o diabetes e a doença cardiovascular. A etiologia multifatorial da DE, especialmente em pacientes com síndrome metabólica, aumenta a complexidade no manejo deste problema. Deve-se estar ciente dos fatores fisiopatológicos relacionados à DE para buscar as melhores alternativas e resultados no tratamento destes pacientes. Quaisquer fatores de risco (tabagismo, diabetes, sedentarismo, obesidade, hipertensão e dislipidemia) para doença cardiovascular devem ser modificados ou tratados.

Prevalence of Peyronie's disease in men over 50-y-old from Southern Brazil

International Journal of Impotence Research, 2001