OBJECTIVE: Percutaneous aspiration sclerotherapy is indicated for treatment of symptomatic renalcysts. The efficacy and safety of the different sclerosing agents have been sources of debate anddisagreement. The purpose of this study was to assess the efficacy and safety of using tetracyclineaspiration sclerotherapy in a systematic review of the literature. MATERIALS AND METHODS: A systematic search was conducted on the following electronic databases:Cochrane Central Register of Controlled Trials, EMBASE, PubMed and HERDIN (until November2017). Studies of cyst volume reduction after tetracycline aspiration sclerotherapy were included forfull text evaluation. The quality of the studies and the risk of bias were assessed independently by theauthors, based on the Cochrane Handbook for Systematic Reviews of Interventions. RESULTS: Three studies were included for full-text assessment. They included 87 patients. Overall, riskof bias was high. Complete renal cyst disappearance ranged between 29%-100% after a follow-upperiod of 3-36 months. Partial success/>50% renal cyst reduction ranged between 85.7%-100%.Complications were minor and self-limited, postoperative procedural pain occurred most frequently. CONCLUSION The authors found good results with respect to efficacy and safety after tetracyclineaspiration sclerotherapy of renal cysts. However, due to high risk of bias in the included studies,definite conclusions regarding efficacy could not be drawn.

OBJECTIVE: To identify and assess the available literature in evaluating the efficacy and safety of ketoconazole in preventing postoperative erection among patients who underwent penile or urethral reconstructive surgery.
METHODS: From the period of 1990 to September 2016, the investigators assessed Cochrane Central Register of Controlled Trials, EMBASE, HERDIN, and PubMed for studies evaluating the efficacy and safety of ketoconazole in preventing post operative erection among patients who underwent penile or urethral reconstructive surgery. Review authors selected articles for inclusion, extracted date and and assessed trial quality.
RESULTS: One randomized controlled study and 2 retrospective studies were included in the review. Three studies for a total of 83 patients ages 17-32 comprised the evidence for this review. All trials investigated the efficacy and safety of ketoconazole in the prevention of post operative erection. In both retrospective studies, ketoconazole had significant prevention of erection in however both of these studies were non-RCTs. In the randomized control study by DeCastro et.al.,ketoconazole had no significant difference in the prevention of post operative erection against placebo. Sixteen out of 19 patients (84%) taking ketoconazole had episodes of erection and 15 out of 18 patients in the placebo group (83%) had episodes of erection. Common side effects include nausea (9-21%) and elevated liver enzymes (0-5.3%). Other reported adverse events include feet swelling,pruritus,frequent urination and headache. Present in only 1 out of the 31 patients (3.2%) in the study of DeCastro. All these adverse events were not statistically significant.
CONCLUSION: This review demonstrated that the use of Ketoconazole in the prevention of postoperative erection remains inconclusive. Further prospective randomized controlled trials with testosterone assay will help determine the appropriate dose and its efficacy in the prevention of postoperative erections. Ketoconazole is relatively safe if target testosterone levels are achieved using the 400mg/tab TID dosing.

Human ; Male ; Female ; Aged ; Middle Aged ; Adult ; Adolescent ; Headache ; Ketoconazole ; Liver ; Nausea ; Penile Erection ; Penis ; Pruritus ; Reconstructive Surgical Procedures ; Testosterone ; Urethra ; Urination