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  • article 6 Citação(ões) na Scopus
    Periurethral muscle-derived mononuclear cell injection improves urethral sphincter restoration in rats
    (2017) TURCO, Marcelo Pitelli; SOUZA, Alex Balduino de; SOUSA, Isida de Campos; FRATINI, Paula; VERAS, Mariana Matera; RODRIGUES, Marcio Nogueira; BESSA JR., Jose de; BROLIO, Marina Pandolphi; LEITE, Katia Ramos Moreira; BRUSCHINI, Homero; SROUGI, Miguel; MIGLINO, Maria Angelica; GOMES, Cristiano Mendes
    AimsInvestigate the effect of a novel cell-based therapy with skeletal muscle-derived mononuclear cells (SMDMCs) in a rat model of stress urinary incontinence. MethodsMale Wistar-Kyoto rats' hind limb muscles were enzymatically dissociated, and SMDMCs were isolated without needing expansion. The cell population was characterized. Twenty female rats underwent urethrolysis. One week later, 10 rats received periurethral injection of 10(6) cells (SMDMC group), and 10 rats received saline injections (Saline group). Ten rats underwent sham surgery (Sham group). Four weeks after injection, animals were euthanized and the urethra was removed. The incorporation of SMDMCs in the female urethra was evaluated with fluorescence in situ hybridization for the detection of Y-chromosomes. Hematoxylin and eosin, Masson's trichrome staining, and immunohistochemistry for actin and myosin were performed. The muscle/connective tissue, actin and myosin ratios were calculated. Morphological evaluation of the urethral diameters and fractional areas of the lumen, mucosa, and muscular layer was performed. ResultsSMDMCs population was consistent with the presence of muscle cells, muscle satellite cells, perivascular cells, muscle progenitor cells, and endothelial cells. SMDMCs were incorporated into the urethra. A significant decrease in the muscle/connective tissue ratio was observed in the Saline group compared with the SMDMC and Sham groups. The proportions of actin and myosin were significantly decreased in the Saline group. No differences were observed in the morphometric parameters. ConclusionsSDMSC were incorporated into the rat urethra and promoted histological recovery of the damaged urethral sphincter, resulting in decreased connective tissue deposition and increased muscle content.
  • article 8 Citação(ões) na Scopus
    Lower urinary tract symptoms in children and adolescents with Williams-Beuren syndrome
    (2017) SAMMOUR, Z. M.; BESSA JR., J. de; HISANO, M.; BRUSCHINI, H.; KIM, C. A.; SROUGI, M.; GOMES, C. M.
    Introduction Williams-Beuren syndrome (WBS) is a genetic condition caused by a microscopic deletion in the chromosome band 7q11.23. Individuals with WBS may present with congenital cardiovascular defects, neurodevelopmental disturbances and structural abnormalities of the urinary tract. Lower urinary tract symptoms (LUTS) seem to be frequent in this population, but studies on this topic are scarce and based on small case series. Objective To systematically evaluate the prevalence of lower urinary tract symptoms (LUTS) and the acquisition of bladder control in a large population with WBS. Study design A cross-sectional study evaluating 87 consecutive patients with WBS; there were 41 girls and 46 boys. Genetic studies confirmed WBS in all patients. Subjects were clinically evaluated with: a history of LUTS obtained from the parents and child, a structured questionnaire of LUTS, a 3-day urinary frequency-volume chart, a quality of life question regarding LUTS, and physical examination. A history regarding the acquisition of bladder control was directly evaluated from the parents. Results Mean age of patients was 9.0 +/- 4.2 years, ranging from 3 to 19 years. Based on the symptoms questionnaire and the frequency-volume chart, 70 patients (80.5%) were symptomatic. The most common symptom was urgency, affecting 61 (70.1%) patients, followed by increased urinary frequency in 60 (68.9%) patients, and urge-incontinence in 53 (60.9%), as shown in Summary Fig. More than half of the children reported nocturnal enuresis, including 61% of the girls and 52% of the boys. Twenty-three patients (25.6%) had a history of urinary tract infections. The mean age for acquisition of dryness during the day was 4.4 +/- 1.9 years. Parents of 61 patients (70.1%) acknowledged that LUTS had a significant impact on the quality of life of their children. Discussion A high prevalence of LUTS was confirmed with a significant negative impact on quality of life in a large population of children and adolescents with WBS. It was shown for the first time that the achievement of daytime bladder control is delayed in children with WBS. Although LUTS are not recognized as one of the leading features of the syndrome, it is believed that it should be considered as a significant characteristic of the clinical diagnosis of WBS. Conclusions LUTS are highly prevalent in children and adolescents with WBS and have a significant negative impact on patient's quality of life.
  • article 38 Citação(ões) na Scopus
    Early postoperative pelvic-floor biofeedback improves erectile function in men undergoing radical prostatectomy: a prospective, randomized, controlled trial
    (2012) PROTA, C.; GOMES, C. M.; RIBEIRO, L. H. S.; BESSA JR., J. de; NAKANO, E.; DALL'OGLIO, M.; BRUSCHINI, H.; SROUGI, M.
    Erectile dysfunction (ED) and urinary incontinence are common complications following radical prostatectomy (RP). Although pelvic-floor biofeedback training (PFBT) may improve urinary continence following RP, its effects on the recovery of potency are unknown. Fifty-two patients selected for RP were prospectively randomized for a treatment group (n=26) receiving PFBT once a week for 3 months and home exercises or a control group (n=26), in which patients received verbal instructions to contract the pelvic floor. Erectile function (EF) was evaluated with the International Index of Erectile Function-5 (IIEF-5) before surgery and 1, 3, 6 and 12 months postoperatively. Patients were considered potent when they had a total IIEF-5 score >20. Continence status was assessed and defined as the use of no pads. Groups were comparable in terms of age, body mass index, diabetes, pathological tumor stage and neurovascular bundle preservation. A significant reduction in IIEF-5 scores was observed after surgery in both groups. In the treatment group, 8 (47.1%) patients recovered potency 12 months postoperatively, as opposed to 2 (12.5%) in the control group (P=0.032). The absolute risk reduction was 34.6% (95% confidence interval (CI): 3.8-64%) and the number needed to treat was 3 (95% CI: 1.5-17.2). A strong association between recovery of potency and urinary continence was observed, with continent patients having a 5.4 higher chance of being potent (P=0.04). Early PFBT appears to have a significant impact on the recovery of EF after RP. Urinary continence status was a good indicator of EF recovery, with continent patients having a higher chance of being potent.
  • conferenceObject
    IMPACT OF DETRUSOR SPHINCTER DYSSYNERGIA ON CLINICAL AND URODYNAMIC PARAMETERS OF PATIENTS WITH NEUROMYELITIS OPTICA
    (2012) CARVALHO, Fabricio; GOMES, Cristiano; PEREIRA, Samira; BESSA JR., Jose; CALLEGARO, Dagoberto; MARCHIORI, Paulo; BRUSCHINI, Homero; SROUGI, Miguel
  • article 21 Citação(ões) na Scopus
    Congenital genitourinary abnormalities in children with Williams-Beuren syndrome
    (2014) SAMMOUR, Zein M.; GOMES, Cristiano M.; BESSA JR., Jose de; PINHEIRO, Marcello S.; KIM, Chong A. E.; HISANO, Marcelo; BRUSCHINI, Homero; SROUGI, Miguel
    Objective: Williams-Beuren syndrome (WBS) is an autosomal dominant disorder caused by a gene deletion on chromosome 7q11.23. Patients with WBS usually show a group of features such as developmental delay, cardiovascular anomalies, mental retardation, and characteristic facial appearance. Abdominal wall defects, external genitalia anomalies, and structural abnormalities of the urinary tract have been scarcely evaluated and were the focus of our study. Materials and methods: We prospectively evaluated 41 boys and 38 girls with WBS, with a mean age of 8.8 +/- 4.1 (range 3-19 years). All patients were examined for the evaluation of inguinal and umbilical hernias and genital anomalies. All patients were offered a radiological evaluation, including urinary tract ultrasound, voiding cystourethrogram, and dimercaptosuccinic acid renal scintigraphy (DMSA scan). Results: Of the 41 boys, 30 (73.1%) had abnormalities on physical examination, including bilateral undescended testis in 13 (31.7%), retractile testis in four (9.7%), hypospadias in four (9.7%), and unilateral cryptorchidism in three (7.3%) patients. Of the 38 female subjects, 17 (44.7%) had at least one abnormality, including umbilical hernia in 11 (28.9%), unilateral inguinal hernia in four (10.5%), and bilateral inguinal hernia in three (7.8%) patients. Uroradiological abnormalities were found in 41 patients (51.9%). On sonography, six (7.6%) patients had unilateral hydronephrosis, three (3.8%) had a duplicated collecting system, and two (2.5%) had kidney stones. On DMSA, performed in 36 patients, four (11.1%) had unilateral renal scarring and two (5.5%) had bilateral renal scarring. Cystourethrography was obtained from 56 patients, of whom 27 (48.2%) had bladder diverticulum, 18 (32.1%) had bladder wall trabeculation, and three (5.3%) had vesicoureteral reflux. We found no association of urological abnormalities with cardiovascular defects. Conclusions: Patients with WBS have a high prevalence of abdominal wall, external genitalia, and urological abnormalities, emphasizing the importance of proper physical examination and radiological investigation in this population.
  • conferenceObject
    ASSESSMENT OF THE MALE SEXUAL QUOTIENT SCALE RELIABILITY TO EVALUATE SEXUAL FUNCTION OF MEN WITH SPINAL CORD INJURY
    (2015) MIRANDA, Eduardo; GOMES, Cristiano; BESSA JUNIOR, Jose de; CASTRO FILHO, Jose de; BELLUCCI, Carlos; BATTISTELLA, Linamara; BARROS FILHO, Tarcisio; CARVALHO, Fabricio; ABDO, Carmita; BRUSCHINI, Homero; NAHAS, William; SROUGI, Miguel
  • article 5 Citação(ões) na Scopus
    The role of urinary KIM-1, NGAL, CA19-9 and beta 2-microglobulin in the assessment of ureteropelvic junction obstruction in adults
    (2017) MIRANDA, Eduardo P.; DUARTE, Ricardo J.; BESSA JR., Jose de; LOPES, Roberto I.; SROUGI, Victor; ANDRADE, Hiury S.; BANDEIRA, Rodolfo A. S. T.; ARAP, Marco A.; MITRE, Anuar I.; VIANA, Nayara I.; REIS, Sabrina T.; LEITE, Katia R. M.; SROUGI, Miguel
    Purpose: The objective of this study is to evaluate the diagnostic properties of urinary biomarkers in adults with ureteropelvic junction obstruction: KIM-1, NGAL, CA19-9, and beta 2-microglobulin. We also assessed urinary biomarker concentrations following pyeloplasty. Material and methods: We prospectively studied adults from December 2013 to February 2015. We included 47 patients with a mean age of 38.6 +/- 12.7 years. Each patient provided four samples of voided urine for biomarker measurement, one at pre-operative consultation and the others at 1, 3, and 6 months of post-operative follow-up. The control group consisted of 40 healthy individuals with no hydronephrosis on ultrasound evaluation. Results: KIM-1 had an area under the curve of 0.79 (95% CI 0.70-0.89), NGAL 0.71 (95% CI 0.61-0.83), CA19-9 0.70 (95% CI 0.60-0.81), and beta 2-microgloblin 0.61 (95% CI 0.50-0.73). KIM-1 was the most sensitive marker with a cut-off of 170.4 pg/mg creatinine (sensitivity 91.4%, specificity 59.1%), whereas CA19-9 was the most specific with a cut-off of 51.3 U/mg creatinine (sensitivity 48.9%, specificity 88.0%). Urinary concentrations of biomarkers decreased after pyeloplasty. Conclusions: The evaluation of urinary biomarkers is useful in adults undergoing pyeloplasty. KIM-1, NGAL, and CA19-9 were elevated and significantly decreased after surgery.
  • article 1 Citação(ões) na Scopus
    Longitudinal Improvement of Lower Urinary Tract Symptoms in Williams-Beuren Syndrome
    (2021) SAMMOUR, Zein M.; HISANO, Marcelo; JR, Jose de Bessa; BRUSCHINI, Homero; NAHAS, William C.; SROUGI, Miguel; GOMES, Cristiano M.
    Purpose: Williams-Beuren syndrome is a chromosomal disorder caused by a deletion at region 7q11.23. Lower urinary tract symptoms are highly prevalent and significantly affect quality of life. We assessed the long-term out-comes of lower urinary tract symptoms in children with Williams-Beuren syndrome. Materials and Methods: From February 2001 to July 2016, 90 patients with Williams-Beuren syndrome were evaluated in our hospital, of whom 31 (20 boys) had at least 5 years of followup. Baseline evaluation included a history of lower urinary tract symptoms, frequency-volume chart and the impact on quality of life measured on a scale of 0 (delighted) to 6 (terrible). Pharmacological therapy with oxybutynin or doxazosin was offered to symptomatic patients. We present the outcome of lower urinary tract symptoms after 5 and 10 years of followup. Results: At baseline 27 (87.1%) patients were symptomatic. Median duration of followup was 10 (range 6-13) years. Pharmacological therapy was started for 25 (92.6%) symptomatic patients at baseline, including oxybutynin for 19 (76.0%), doxazosin for 1 (4.0%) and a combination of the 2 agents for 5 (20.0%). Medical therapy was still in use by 61.2% after 5 years and 52.9% after 10 years (p=0.043). Median duration of pharmacological treatment was 7 (range 6-11) years. A significant improvement of lower urinary tract symptoms was observed over time, with 35.5% and 29.5% patients considered symptomatic after 5 years and 10 years, respectively (p < 0.001). Quality of life was also markedly improved over time (p < 0.001). Conclusions: This long-term study showed significant improvement of lower urinary tract symptoms in children and adolescents with Williams-Beuren syndrome over time. Long-term pharmacological treatment was needed in most patients.
  • bookPart
    Exame das vias urinárias e sistema reprodutor masculino
    (2021) HENRIQUES, João Victor Teixeira; MOROMIZATO, Juliana Kanate Mazzoni; JúNIOR, José de Bessa; GOMES, Cristiana Mendes
  • conferenceObject
    CORRELATION BETWEEN LIBIDO AND TESTOSTERONE: ESTRADIOL RATIO IN MEN WITH SEXUAL DYSFUNCTION
    (2023) NETO, R. Pedrenho; NASCIMENTO, B. Chiesa Gouveia; NUNES, R. Dos Santos Sobreira; GISMONDI, J. Pedro; BESSA JR., J. De; NAHAS, W. Carlos; HALLAK, J.