FLAVIO EDUARDO TRIGO ROCHA
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
5 resultados
Resultados de Busca
Agora exibindo 1 - 5 de 5
- Profile of sexuality and symptoms of lower urinary tract in non-institutionalized elderly(2020) TAHA, Khaled Ahmed; ROCHA, Flavio Trigo; CASTILHO, LisiasIntroduction: Urinary or sexual dysfunction in the elderly are underreported. However, they are highly prevalent. This study aims to identify the prevalence of these conditions. Objective: The aim is to carry out an investigation in non-institutionalized individuals over 60 years of age, to obtain data on its sexual and urinary health in Sao Paulo, Campinas, Santo Andre and Londrina. Results: 6.000 questionnaires were distributed, and 3425 were included in the study, for the analysis of the questionnaires separately. In relation to ADAM, 92% of the 1385 evaluated were suspicious of androgen deficiency (ADAM). As for the male sexual function, it was observed 37% of premature ejaculation. As for the female sexual function, 1300 (74%) did not practice sexual intercourse and the main reasons were: lack of partner and lack of sexual desire. In addition, 988 (78%) of women who had no sexual intercourse responded that they didn't want sex and, more importantly, about 22% of them would like to have sexual intercourse. International prostate symptom score (IPSS) showed gradual worsening of urinary symptoms with increasing age, being the most prevalent: nocturia and urinary urgency. As for the female IPSS, we noted that even after 80 years, the majority have mild symptoms related to voiding dysfunction; with increasing age there is a gradual increase in the result of the IPSS. Conclusion: Due to the large number of sexual and urinary disorders found, we recommend the improvement in health conditions, promoting a better quality of life in the elderly.
- Factors affecting urinary continence and sexual potency recovery after robotic-assisted radical prostatectomy(2019) NEUMAIER, Mark Fernando; SEGALL JUNIOR, Carlos Henrique; HISANO, Marcelo; ROCHA, Flavio Eduardo Trigo; ARAP, Sami; ARAP, Marco A.Introduction: Robot-assisted radical prostatectomy (RARP) is the most recent surgical technique for localized prostate cancer. The Da Vinci (Intuitive Surgical, Sunnyvale, CA) system was first introduced in Brazil in 2008, with a fast growing number of surgeries performed each year. Objective: Our primary endpoint is to analyze possible predictors of functional outcomes, related to patient and tumor features. As secondary endpoint, describe functional outcomes (urinary continence and sexual potency) from RARP performed in the Sirio-Liban8 Hospital (SLH), a private institution, in Sao Paulo, from April 2008 to December 2015. Materials and Method: Data from 104 consecutive patients operated by two surgeons from the SLH (MA and SA) between 2008 and 2015, with a minimum 12 months follow-up, were collected. Patient features (age, body mass index - BMI, PSA, date of surgery and sexual function), tumor features (tumor stage, Gleason and surgical margins) and followup data (time to reach urinary continence and sexual potency) were the variables collected at 1, 3, 6 and 12 month and every 6 months thereafter. Continence was defined as the use of no pad on medical interview and sexual potency defined as the capability for vaginal penetration with or without fosphodiesterase type 5 inhibitors. Results: Mean age was 60 years old and mean BMI was 28.45 kg/m2. BMI >30kg/m2 (p<0.001) and age (p=0.011) were significant predictors for worse sexual potency after surgery. After 1, 3, 6 and 12 months, 20.7%, 45.7%, 60.9% and 71.8% from patients were potent, respectively. The urinary continence was reached in 36.5%, 80.3%, 88.6% and 92.8% after 1, 3, 6 and 12 months, respectively. Until the end of the study, only one patient was incontinent and 20.7% were impotent. Conclusion: Age was a predictor of urinary and erectile function recovery in 12 months. BMI was significant factor for potency recovery. We obtained in a private hospital good functional results after 12 months of follow-up.
- Neurogenic bladder - concepts and treatment recommendations(2022) TRUZZI, Jose Carlos; ALMEIDA, Fernando Goncalves de; SACOMANI, Carlos Alberto; REIS, Joceara; ROCHA, Flavio Eduardo TrigoIntroduction: Bladder and urinary sphincter malfunctioning that results from some change in the central and/or peripheral nervous system is defined as neurogenic bladder. The urinary tract symptoms that can be related to its filling, emptying, or both have a significant impact on the quality of life of individuals. The present review was based on the document prepared for the public health system in Brazil as a treatment guidelines proposal. Material and Methods: Survey questions were structured as per PICO (Population, Intervention, Control, and Outcome). Search strategies were defined and performed in the MEDLINE/Pubmed, Embase, Epistemonikos and Google Scholar databases. The selection of articles followed the evidence hierarchy concept; evidence body was identified, and the quantitative study data were extracted. The quality of evidence and grade of recommendation were qualitatively assessed according to GRADE (Grading of Recommendations, Assessment, Development and Evaluations). Results: A total of 2.707 articles were identified, with 49 of them being selected to compose the basis for this review. Neurogenic bladder treatments were classified according to their focus on filling or emptying symptoms and sub- classified in pharmacological and surgical treatments. Conclusion: Treatment guidelines are important tools for the public health system to promote the best practice when treating neurogenic bladder patients.
- Overactive bladder-18 years - Part II(2016) TRUZZI, Jose Carlos; GOMES, Cristiano Mendes; BEZERRA, Carlos A.; PLATA, Ivan Mauricio; CAMPOS, Jose; GARRIDO, Gustavo Luis; ALMEIDA, Fernando G.; AVERBECK, Marcio Augusto; FORNARI, Alexandre; SALAZAR, Anibal; DELL'ORO, Arturo; CINTRA, Caio; SACOMANI, Carlos Alberto Ricetto; TAPIA, Juan Pablo; BRAMBILA, Eduardo; LONGO, Emilio Miguel; ROCHA, Flavio Trigo; COUTINHO, Francisco; FAVRE, Gabriel; GARCIA, Jose Antonio; CASTANO, Juan; REYES, Miguel; LEYTON, Rodrigo Eugenio; FERREIRA, Ruiter Silva; DURAN, Sergio; LOPEZ, Vanda; REGES, RicardoTraditionally, the treatment of overactive bladder syndrome has been based on the use of oral medications with the purpose of reestablishing the detrusor stability. The recent better understanding of the urothelial physiology fostered conceptual changes, and the oral anticholinergics - pillars of the overactive bladder pharmacotherapy - started to be not only recognized for their properties of inhibiting the detrusor contractile activity, but also their action on the bladder afference, and therefore, on the reduction of the symptoms that constitute the syndrome. Beta-adrenergic agonists, which were recently added to the list of drugs for the treatment of overactive bladder, still wait for a definitive positioning - as either a second-line therapy or an adjuvant to oral anticholinergics. Conservative treatment failure, whether due to unsatisfactory results or the presence of adverse side effects, define it as refractory overactive bladder. In this context, the intravesical injection of botulinum toxin type A emerged as an effective option for the existing gap between the primary measures and more complex procedures such as bladder augmentation. Sacral neuromodulation, described three decades ago, had its indication reinforced in this overactive bladder era. Likewise, the electric stimulation of the tibial nerve is now a minimally invasive alternative to treat those with refractory overactive bladder. The results of the systematic literature review on the oral pharmacological treatment and the treatment of refractory overactive bladder gave rise to this second part of the review article Overactive Bladder - 18 years, prepared during the 1st Latin-American Consultation on Overactive Bladder.
- Overactive bladder-18 years - Part I(2016) TRUZZI, Jose Carlos; GOMES, Cristiano Mendes; BEZERRA, Carlos A.; PLATA, Ivan Mauricio; CAMPOS, Jose; GARRIDO, Gustavo Luis; ALMEIDA, Fernando G.; AVERBECK, Marcio Augusto; FORNARI, Alexandre; SALAZAR, Anibal; DELL'ORO, Arturo; CINTRA, Caio; SACOMANI, Carlos Alberto Ricetto; TAPIA, Juan Pablo; BRAMBILA, Eduardo; LONGO, Emilio Miguel; ROCHA, Flavio Trigo; COUTINHO, Francisco; FAVRE, Gabriel; GARCIA, Jose Antonio; CASTANO, Juan; REYES, Miguel; LEYTON, Rodrigo Eugenio; FERREIRA, Ruiter Silva; DURAN, Sergio; LOPEZ, Vanda; REGES, RicardoOveractive bladder syndrome is one of the lower urinary tract dysfunctions with the highest number of scientific publications over the past two decades. This shows the growing interest in better understanding this syndrome, which gathers symptoms of urinary urgency and increased daytime and nighttime voiding frequency, with or without urinary incontinence and results in a negative impact on the quality of life of approximately one out of six individuals - including both genders and almost all age groups. The possibility of establishing the diagnosis just from clinical data made patients' access to specialized care easier. Physiotherapy resources have been incorporated into the urological daily practice. A number of more selective antimuscarinic drugs with consequent lower adverse event rates were released. Recently, a new class of oral drugs, beta-adrenergic agonists has become part of the armamentarium for Overactive Bladder. Botulinum toxin injections in the bladder and sacral neuromodulation are routine modalities of treatment for refractory cases. During the 1st Latin-American Consultation on Overactive Bladder, a comprehensive review of the literature related to the evolution of the concept, epidemiology, diagnosis, and management was conducted. This text corresponds to the first part of the review Overactive Bladder 18-years.