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Screening for Prostate Cancer: US Preventive Services Task Force Recommendation Statement.

IMPORTANCE: In the United States, the lifetime risk of being diagnosed with prostate cancer is approximately 13%, and the lifetime risk of d … frequent false-positive results and psychological harms. Harms of prostate cancer treatment include erectile dysfunction, urinary incontinence, and bowel symptoms. About 1 in 5 men who undergo radical prostatectomy develop long-term urinary incontinence, and 2 in 3 men will experience long-term erectile dysfunction. Adequate evidence shows that the harms of screening …

Primary neurolymphomatosis presenting as paraparesis and diplopia in a young man.

A man in his mid-20s presented with a 5-month history of bilateral lower limb weakness and wasting along with bladder symptoms and erectile dysfunction. Additionally, he had binocular diplopia and progressive drooping of both eyelids. His clinical presentation was suggestive of bilateral third cranial nerve involvement with lumbosacral polyradiculopathy. Initial treatment with steroids for suspected idiopathic lumbosacral polyradiculopathy syndrome proved ineffective, as his symptoms progressively worsened without other systemic manifestations. We diagnosed a rare and treatable neurological co…

Unraveling Bacillus Calmette-Guérin (BCG) Therapy Side Effects in Bladder Cancer: A Tale of Triumph Over Treatment Challenges.

This case report presents a 66-year-old male with a complex medical history, including testicular cancer, chronic obstructive pulmonary disease, obstructive sleep apnea, tobacco use disorder, erectile dysfunction, and obesity. The patient exhibited recurrent gross hematuria, leading to a comprehensive workup. Cystoscopy revealed a bladder tumor, prompting transurethral resection and mitomycin C instillation. Subsequent intravesical Bacillus Calmette-Guérin (BCG) therapy was initiated but resulted in severe sepsis during maintenance. Despite initial suspicion of BCG-induced sepsis, further eval…

Bilateral neurosensory retinal detachment secondary to tadalafil treatment.

A 53-year-old male with no systemic disorders, other than controlled arterial hypertension, presented with asymptomatic, bilateral neurosensory retinal detachment (NRD) detected during a routine revision. The patient reported the use of tadalafil (a phosphodiesterase-5 inhibitor [PDE5I]) for erectile dysfunction. Following suspension of the drug, subretinal fluid reabsorption was confirmed, with the persistence of chronic alterations in the optical coherence tomography (OCT) and the visual field. PDE5Is have ocular side effects, including exudative retinal detachment. Although no direct causal…

Patient Centered Medical Home: What May Be on the Horizon for Urologists.

INTRODUCTION: Medicine has used acronyms for hundreds of years to describe clinical conditions. METHODS: In urology the acronyms BPH (benign prostatic hyperplasia), ED (erectile dysfunction), IC (interstitial cystitis) and AUR (acute urinary retention) are examples with which we are all familiar. Today we use acronyms to describe the organizational and structural aspects of medicine. RESULTS: The 2 most recent medical acronyms are PPACA (Patient Protection and Affordable Care Act) and ACO (accountable care organization). Now a new acronym, PCMH (patient centered medical home), is looming on …

Pharmacotherapy for biochemical recurrences after therapy for localised prostate cancer.

Prostate-specific antigen (PSA) has revolutionised screening for and monitoring of prostate cancer (CaP). Currently, most men failing potentially curative CaP therapies develop biochemical evidence of recurrent disease (defined by detectable PSA levels) long before the onset of clinical symptoms. Androgen deprivation therapy (ADT) remains the gold standard for the treatment of metastatic CaP. Conventional ADT is orchiectomy or luteinising hormone-releasing hormone agonists. ADT is most commonly associated with side effects such as erectile dysfunction, decreased libido, gynecomastia and osteop…

Prevalence of Sexual Dysfunction among Infertile Women Attending Gynaecology Outpatient Clinic in a Tertiary Hospital in Northwest Nigeria.

BACKGROUND: Infertility adversely affects sexual well-being, but the prevalence and correlates of female sexual dysfunction (FSD) among infe … sexual abuse (aOR = 5.77, p = 0.036), male-factor infertility (aOR = 4.94, p = 0.006), and spousal erectile dysfunction (aOR = 9.05, p = <0.001). CONCLUSION: Over half of infertile women at ABUTH reported sexual dysfunction, mainly low desire. These findings emphasize the importance of integrating routine psychosexual screening and counseling into infertility care t …

British Society for Sexual Medicine (BSSM) Position Statement on Premature Ejaculation.

To provide an evidence based consensus on the diagnosis and management of premature ejaculation (PE). The British Society for Sexual Medicine (BSSM) takes issue with the advice to use off label treatments, such as daily selective serotonin reuptake inhibitors treatment, favoring on-demand dapoxetine. There is increasing evidence for the use of PDE5 inhibitors which are superior to a placebo for the treatment of PE. A recent meta-analysis of international PE guidelines supports the need for research to investigate the association of PE with erectile dysfunction (ED), prostatitis and thyroid dis…

Aspects of nitric oxide in health and disease: a focus on hypertension and cardiovascular disease.

Nitric oxide (nitrogen monoxide) (NO) plays an important role in a wide range of physiologic processes. A major mediator of endothelial func … plicated in a broad range of other disorders, including pulmonary hypertension, insulin resistance, erectile dysfunction, and preeclampsia. Numerous therapies designed to target NO are being investigated and developed, including NO donors and stimulants. The recent African-American Heart Failure Trial (A-HeFT) showed that the NO donor isosorbide dinitrate, combined wi …

Skin-Related Sexual Life Questionnaire (SRSLQ): Creation and Validation of the Questionnaire.

Background and Objectives: The assessment of sexual dysfunction among psoriatic patients still remains a great diagnostic difficulty due to … LQI). In addition, all men were asked to fulfil the five-item version of the International Index of Erectile Dysfunction (IIEF-5) at the time of examination and 7 days after enrollment. The disease severity was assessed via the PASI scale. Results: The statistical analysis of internal consistency of SRSLQ showed very good integrity, with a Cronbach α coefficient of 0. …

Assessment of sexual function before medically assisted procreation: A mixed-methods study among a sample of infertile women and men cared for in a fertility center.

A mixed-methods study was conducted to investigate sexual function among infertile patients undergoing medically assisted procreation for the first time. The study employed an interview and content analysis approach, involving 45 infertile patients prior to their medically assisted procreation procedures. The findings revealed that infertile patients are a group at risk for sexual distress. Furthermore, patients with sexual dysfunctions exhibited lower levels of sexual activity, potentially diminishing their chances of achieving pregnancy. Participants faced challenges in openly discussing the

Autonomic Dysfunction in α-Synucleinopathies.

The α-synucleinopathies are a group of neurodegenerative diseases characterized by abnormal accumulation of insoluble α-synuclein in neurons … ts with PAF often present with orthostatic hypotension, reduced heart rate variability, anhydrosis, erectile dysfunction, and constipation, without motor or cognitive impairment. These patients also have an increased risk of developing an α-synucleinopathy with central involvement, such as PD, DLB, or MSA in later life, possibly indicating a pathophysiological disease …

Discussing sexual function in the cardiology practice.

BACKGROUND: In patients with cardiovascular disease, sexual dysfunction is frequently encountered. Erectile dysfunction shares the same modifiable risk factors as coronary artery disease and the fear of triggering cardiovascular events can create stress and anxiety impacting the sexual lives of patients and their partners. To optimise healthcare, knowledge of cardiologists' attitude and practice patterns regarding the discussion about sexual function is essential. METHODS: A 31-itemed anonymous questionnaire was mailed to 980 members of the Netherlands Society of Cardiology (cardiologists and…

Change in sexual dysfunction with aripiprazole: a switching or add-on study.

Sexual dysfunction and raised prolactin are common adverse effects of many anti-psychotics. Aripiprazole is an atypical anti-psychotic associated with a reduction in prolactin level in anti-psychotic-induced hyperprolactinemia. Our hypothesis was that switching from another anti-psychotic to aripiprazole would be associated with a reduction in sexual dysfunction. An open label switch to aripiprazole was offered to 27 subjects with inadequate therapeutic response or intolerance to another anti-psychotic, who were followed up for 26 weeks. Serial clinical ratings included the Anti-psychotic Non-

[Psychosocial aspects of patients with sexual dysfunction].

UNLABELLED: Sexual dysfunctions are common among the general population. An essential part of the assignments to specialized sexual medicine … sexual desire (51.2%), followed by nonorganic vaginism (20.9%) and orgasm disorders (11.6%), in men erectile dysfunction (50.0%), followed by premature ejaculation (26.1%) and lack or loss of sexual desire (15.2%). The studied subjects showed distinctively lower values in their sense of coherence than men and women in the general population. The patients were much mor …

Irisin Improves High-Fat Diet-Induced Sexual Dysfunction in Obese Male Rats.

INTRODUCTION: Obesity is known to cause sexual dysfunction including erectile dysfunction and poor semen quality. Lifestyle modifications such as exercise have increasingly been more recognized to lower the likelihood of having sexual dysfunction or infertility in obese men. In this context, as an exercise-mimetic hormone, irisin has a potential to improve obesity-related reproductive dysfunctions. We aimed to elucidate possible effects of irisin on high-fat diet (HFD)-induced reproductive dysfunction in obese male rats. METHODS: Rats were divided into four groups: vehicle, irisin, obese, and…

Targeting Side Effects Associated with Androgen Deprivation Therapy Using Melatonin: A Randomized Trial on Hot Flashes and Sexual Health in Prostate Cancer Patients.

OBJECTIVE: The aim of this study was to examine melatonin as a potential adjunct therapy for managing treatment-related symptoms in prostate cancer patients, particularly those undergoing androgen deprivation therapy (ADT). METHODS: In light of the increasing incidence of prostate cancer among younger males, this randomized, double-blind, placebo-controlled clinical trial was conducted at the Hematology-Oncology Center of Omid Hospital in Isfahan, Iran, between October 2019 and October 2020. Forty-one prostate cancer patients experiencing hot flashes or sexual dysfunction due to ADT were rand

Penile strangulation by metallic key holder in an adolescent: a case report and literature review.

INTRODUCTION AND IMPORTANCE: Penile strangulation is an uncommon urological emergency in which an external constricting object initially imp … aintains urinary and sexual function, whereas delayed intervention increases the risk of stricture, erectile dysfunction, and gangrene. Coordinated surgical management and psychiatric follow-up are essential to optimize outcomes and reduce recurrence. CONCLUSION: Penile strangulation demands urgent, device-specific intervention guided by assessment of constriction du …

Сексуальное здоровье после неврологических расстройств: всеобъемлющий обзор данных о лечении.

Предыстория/задачи: Сексуальная дисфункция (СД) и более широкие проблемы сексуального здоровья являются распространенными после неврологических расстройств, однако улики вмешательства разрознены по различным условиям и результатам. В ходе этого зонтичного обзора были собраны и оценены на систематической основе данные о мерах, направленных на УР и сексуальное здоровье неврологических групп населения, а также квалифицированные выводы с использованием достоверной информации. Методы: с момента создания были проведены обыски PubMed, Web of Science, Cochrane Bibrary, Embase, PsycINFO, EBCOCOhost и S

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… PDE5 inhibitors again appear beneficial for men with erectile dysfunction, although trials are few and follow-up is short [ 51 , 53 , 57 , 79 ]. … Pharmacological trials for erectile dysfunction or premature ejaculation after stroke are rare, underpowered, and not pooled, limiting inferences [ 48 , 50 ]. …

Quality-of-life outcomes following Aquablation in men with poor initial quality of life: pooled analysis of five international studies.

INTRODUCTION: This study aims to evaluate the relationship between specific baseline clinical factors and quality of life (QoL) outcomes at three months in men presenting with poor initial QoL. METHODS: This multinational study was conducted a retrospective analysis of international data from men with poor baseline QoL scores (4, 5, or 6) who underwent Aquablation for benign prostatic hyperplasia (BPH). The study involved 310 men with QoL ≤2 and 104 men with QoL >2 at 3 months post-treatment. Baseline clinical characteristics were collected, including the International Prostate Symptom Score