- Email: [email protected]
WS027 Oral drugs for erectile dysfunction
S84
Workshops
-Assessment
and Management
Bee and Wasp Allergy WS023 Bee and wasp allergy - Clinical picture and diagnosis B. Przybilla. Denatologische Universitiit,
Munich,
Klinik
und Poliklinik
der
Germany
Bee or wasp (BW) stings can induce different types of reaction among which IgE-mediated systemic anaphylactic reactions (SAR) are the most important. Severity of SAR should be graded, there may occur only skin symptoms (flushing, generalised urticaria, pruritus), minor respiratory, cardiovascular and/or gastro-intestinal symptoms, full shock (frequently with loss of consciousness), or cardiac and respiratory arrest. Adequate immediate treatment is necessary and may prevent fatal outcome. Patients at risk should always carry with them an emergency kit. Diagnosis of BW allergy is based on history, skin tests with venoms and determination of venom-specific serum IgE-antibodies. Diagnostics aim to classify the type of reaction and to identify the culprit insect. As about 25% of the population exhibit indications of BW sensitisation at testing, and otherwise even patients with severe SAR exhibit only low (or even no) test reactivity, careful interpretation of the individual results is needed. Various parameters determine the test results, e.g. reactivity decreases depending on the time interval to the precedent sting reaction and is increased in patients with sensitisation to aero-allergens. All patients diagnosed to have experienced SAR due to IgE-mediated BW allergy should be treated with immunotherapy.
WS024 Principles of immunotherapy Bruce Mitchell. Ireland Abstract not available.
Assessmentand Management of Erectile Dysfunction WSO25 lntracavernosal u El
injection of prostaglandin
F. Menchini-Fabris, P. Rossi, S. Simi, I. Fiorini. Post-graduate School of Endocrinology and Metabolic Diseases, Andrology University
of Pisa,
Italy
Intracavemosal injection of PGEl succeds in promoting a sustained penile erection in 70% of men. Porst reported a recovery of spontaeous erection after 3 months of PGEI in 30% of men. Sahenz de Tejada hypotizes the recovery to be due to an improved NO production. Nitric Oxide is released by endothelium lining in response to various chemical (e.g. Achetilcoline) or physical (e.g. shear stress) stimuli. Penile erection is promoted by CAMP and cGMP pathways leading to phosphorilation of proteinkinase A and G respectively and relaxation of smooth muscle cells.
of Erectile
Dysfunction
Nitric oxide is involved in cGMP pathway, NO synthase strictly depends upon blood oxigen levels and according to literature PG E 1 intracavemosal injection may enhance penile oxigen pressure improving NO synthase activity and NO cavemosal levels. In the present study NO cavemosal levels were assessed before and after intracavemosal Pg E 1 injection in 30 men divided into three group according to penile color doppler flowmetry. The assessment employs nitrate redutase enzyme converting nitrates into nitrites and Griess reactive shifting into a red nitro compound read by spectrophotometer (wave-lenght 540 p).
WS026 lntraurethral therapy for erectile dysfunction Philip Kell. Whittington
Hospital,
London,
UK
Intracavemosal prostaglandin is a widely recognised treatment modality in the management of erectile dysfunction (ED). Injection therapy however does have its disadvantages not the least being patients’ reluctance to administer this therapy leading to a significant percentage stopping therapy within 1 year. This paper discusses a novel method of delivering this drug for use in ED.
WS027 Oral drugs for erectile dysfunction Francesco Montorsi. Divisione Raffaele,
Milan,
di Urologia,
Istituto
San
Italy
The importance of oral drugs is related to the increasing patients’ demand for therapeutic regimens which result as effective and easier to use than intracavemous injections. The two most widely used oral drugs for erectile dysfunction are yohimbine and trazodone. The former has shown to produce positive results in psychogenic and mildly organic impotent patients. The latter has shown to improve nocturnal erections and it has been associated with the occurrence of priapism. The combination of the two drugs seems to produce synergistic therapeutic effects without a significant increase of adverse effects. Apomorphine is another interesting drug which unfortunately has been associated with significant gastrointestinal adverse effects; a new delivery format is currently under investigation. Phentolamine is widely used in multi drug regimens for injection therapy and it is currently tested for oral use with preliminary satisfactory results. Arginine is a precursor of nitric oxide and it has been suggested as a potentially useful drug when given at large doses. Naltrexone is an anti-opioid agent which has shown some effects in selected patient populations. Other drugs have been proposed but insufficient scientific data have been produced.
WS028 Sildenafil - Recent developments W.W. Dinsmore. Northern
Ireland
It is now recogniseed that Nitric oxide (cGMP) cascades mediates erections. Sildenafil is a selected inhibitor of PDE.5 the predominant isoenzyme causing breakdown of cGMP in the human corpus cavemosa. In a recent study of 35 1 male patients
Workshops
-Assessment
and Management
Bee and Wasp Allergy WS023 Bee and wasp allergy - Clinical picture and diagnosis B. Przybilla. Denatologische Universitiit,
Munich,
Klinik
und Poliklinik
der
Germany
Bee or wasp (BW) stings can induce different types of reaction among which IgE-mediated systemic anaphylactic reactions (SAR) are the most important. Severity of SAR should be graded, there may occur only skin symptoms (flushing, generalised urticaria, pruritus), minor respiratory, cardiovascular and/or gastro-intestinal symptoms, full shock (frequently with loss of consciousness), or cardiac and respiratory arrest. Adequate immediate treatment is necessary and may prevent fatal outcome. Patients at risk should always carry with them an emergency kit. Diagnosis of BW allergy is based on history, skin tests with venoms and determination of venom-specific serum IgE-antibodies. Diagnostics aim to classify the type of reaction and to identify the culprit insect. As about 25% of the population exhibit indications of BW sensitisation at testing, and otherwise even patients with severe SAR exhibit only low (or even no) test reactivity, careful interpretation of the individual results is needed. Various parameters determine the test results, e.g. reactivity decreases depending on the time interval to the precedent sting reaction and is increased in patients with sensitisation to aero-allergens. All patients diagnosed to have experienced SAR due to IgE-mediated BW allergy should be treated with immunotherapy.
WS024 Principles of immunotherapy Bruce Mitchell. Ireland Abstract not available.
Assessmentand Management of Erectile Dysfunction WSO25 lntracavernosal u El
injection of prostaglandin
F. Menchini-Fabris, P. Rossi, S. Simi, I. Fiorini. Post-graduate School of Endocrinology and Metabolic Diseases, Andrology University
of Pisa,
Italy
Intracavemosal injection of PGEl succeds in promoting a sustained penile erection in 70% of men. Porst reported a recovery of spontaeous erection after 3 months of PGEI in 30% of men. Sahenz de Tejada hypotizes the recovery to be due to an improved NO production. Nitric Oxide is released by endothelium lining in response to various chemical (e.g. Achetilcoline) or physical (e.g. shear stress) stimuli. Penile erection is promoted by CAMP and cGMP pathways leading to phosphorilation of proteinkinase A and G respectively and relaxation of smooth muscle cells.
of Erectile
Dysfunction
Nitric oxide is involved in cGMP pathway, NO synthase strictly depends upon blood oxigen levels and according to literature PG E 1 intracavemosal injection may enhance penile oxigen pressure improving NO synthase activity and NO cavemosal levels. In the present study NO cavemosal levels were assessed before and after intracavemosal Pg E 1 injection in 30 men divided into three group according to penile color doppler flowmetry. The assessment employs nitrate redutase enzyme converting nitrates into nitrites and Griess reactive shifting into a red nitro compound read by spectrophotometer (wave-lenght 540 p).
WS026 lntraurethral therapy for erectile dysfunction Philip Kell. Whittington
Hospital,
London,
UK
Intracavemosal prostaglandin is a widely recognised treatment modality in the management of erectile dysfunction (ED). Injection therapy however does have its disadvantages not the least being patients’ reluctance to administer this therapy leading to a significant percentage stopping therapy within 1 year. This paper discusses a novel method of delivering this drug for use in ED.
WS027 Oral drugs for erectile dysfunction Francesco Montorsi. Divisione Raffaele,
Milan,
di Urologia,
Istituto
San
Italy
The importance of oral drugs is related to the increasing patients’ demand for therapeutic regimens which result as effective and easier to use than intracavemous injections. The two most widely used oral drugs for erectile dysfunction are yohimbine and trazodone. The former has shown to produce positive results in psychogenic and mildly organic impotent patients. The latter has shown to improve nocturnal erections and it has been associated with the occurrence of priapism. The combination of the two drugs seems to produce synergistic therapeutic effects without a significant increase of adverse effects. Apomorphine is another interesting drug which unfortunately has been associated with significant gastrointestinal adverse effects; a new delivery format is currently under investigation. Phentolamine is widely used in multi drug regimens for injection therapy and it is currently tested for oral use with preliminary satisfactory results. Arginine is a precursor of nitric oxide and it has been suggested as a potentially useful drug when given at large doses. Naltrexone is an anti-opioid agent which has shown some effects in selected patient populations. Other drugs have been proposed but insufficient scientific data have been produced.
WS028 Sildenafil - Recent developments W.W. Dinsmore. Northern
Ireland
It is now recogniseed that Nitric oxide (cGMP) cascades mediates erections. Sildenafil is a selected inhibitor of PDE.5 the predominant isoenzyme causing breakdown of cGMP in the human corpus cavemosa. In a recent study of 35 1 male patients