Sustainable long-term results on postoperative sexual activity after radical prostatectomy when a clinical sexologist is included in the sexual rehabilitation process. A retrospective study on 7 years postoperative outcome.

Introduction: The aim of this study was to perform a retrospective evaluation of long-term sustainability of a postoperative combined penile and sexual rehabilitation program involving a clinical sexologist (CS) for preoperative fully potent men undergoing daVinci robotic radical prostatectomy (dVRP) regardless of whether preservation of the neurovascular bundles was performed or not.

Material And Methods: The study included 79 preoperatively potent and sexually active patients (aged 45-74 years, mean 61) that had undergone a dVRP due to localized prostate cancer and during the 1 postoperative year participated in a combined penile and sexual rehabilitation program involving a CS. The subjects were followed up with the same interview and questionnaires at approximately 1, 3 and 7 years postoperatively.

Are TRUS-guided prostate biopsies in clinical practice robust enough to make a correct assessment of the surgical strategy in prostatectomies? Poor correlation between preoperative prostate biopsies and postoperative specimens.

TRUS-guided prostatic biopsies are the mainstay procedure to diagnose prostatic cancer. The aim was to investigate how accurate and reliable these biopsies are by comparing them with the final pathology results after prostatectomy. One hundred consecutive patients diagnosed with localized prostatic cancer using this technique and who subsequently underwent a radical prostatectomy in Västerbotten County were included in this study.

Improvement in sexual function after robot-assisted radical prostatectomy: A rehabilitation program with involvement of a clinical sexologist.

Introduction: To prospectively evaluate if the inclusion of a clinical sexologist in a penile and sexual rehabilitation program improves sexual function one year after prostate cancer surgery.

Material And Methods: Twelve months after da Vinci Radical Prostatectomy (dVRP) for prostate cancer, 28 fully potent (IIEF-5 >21) and sexually active men (ages 47-69 years, mean 61) who, in 2008, were enrolled in a prospectively monitored penile rehabilitation program (reference group) were compared with 79 fully potent (IIEF-5 >21) and sexually active men (ages 45-74 years, mean 61) enrolled in 2009 (study group); whose program differed by the inclusion of evaluation and treatment by a clinical sexologist.

Results: Twelve months after dVRP, seventeen patients in the reference group (61%) were sexually active with regular penetrating sexual activity compared to sixty-six (84%) in the study group (p = 0.

Sildenafil citrate 100 mg starting dose in men with erectile dysfunction in an international, double-blind, placebo-controlled study: effect on the sexual experience and reducing feelings of anxiety about the next intercourse attempt.

Introduction: Sildenafil citrate 50 mg is the recommended starting dose for men with erectile dysfunction (ED); however, most men are later titrated to sildenafil 100 mg for improved efficacy.

Aim: Assess the tolerability and efficacy of sildenafil initiated at the 100-mg dose in men with ED.

Methods: Men with ED (score < or =25 on the Erectile Function domain of the International Index of Erectile Function) who had received < or =6 total doses of a phosphodiesterase type 5 inhibitor and none within 4 weeks were randomized to 8 weeks of double-blind, placebo-controlled (DBPC), fixed-dose treatment (50 or 100 mg sildenafil or placebo) followed by 4 weeks of open-label flexible-dose sildenafil (50 or 100 mg).

In men with erectile dysfunction, satisfaction with quality of erections correlates with erection hardness, treatment satisfaction, and emotional well-being.

Introduction: The validated Quality of Erection Questionnaire (QEQ) evaluates satisfaction with erection quality.

Aim: To collate QEQ data, including correlations between QEQ outcomes and outcomes assessing emotional well-being, treatment satisfaction, and erection hardness after sildenafil citrate treatment.

Methods: In four trials, men older than 18 years and with erectile dysfunction, a stable sexual partner, and no recent phosphodiesterase type 5 inhibitor use were randomized to double-blind flexible-dose sildenafil or placebo (1:1 ratio) for 6 or 10 weeks (two trials), fixed-dose 50 mg, 100 mg, and placebo (1:1:1 ratio) for 8 weeks (one trial), and 50 mg and 100 mg (1:1 ratio) for 4 weeks after 4 weeks of single-blind sildenafil 50 mg.

Giving patients with erectile dysfunction the opportunity to try all three available phosphodiesterase type 5 inhibitors contributes to better long-term treatment compliance.

Introduction: There are three phosphodiesterase type 5 (PDE5) inhibitors marketed, sildenafil, Vardenafil, and tadalafil for oral treatment of erectile dysfunction (ED). Although the treatment is simple and mostly effective, around 50% has ceased to use the medication within 2 years. One recently described way to improve the compliance is to let the patient try all the three PDE5 inhibitors and to prescribe the drug(s) he and his partner desires.

Is sex only for the healthy and wealthy?

Objective: To study reasons for Sildenafil (a phosphodiesterase type 5 inhibitor) treatment abortion in erectile dysfunction (ED), with special regard to the relation between cost and use.

Methods: Men (N = 132) with ED, where treatment with Sildenafil was instituted between 1998 and 2000, were mailed a questionnaire in February 2003, regarding their current ED treatment, including frequency of use, reasons for change or discontinuation, effect on partner relations, and total income of the household.

Results: The response rate was 69%.

Relationships between lower urinary tract symptoms, the bother they induce and erectile dysfunction.

Objective: To study the relationships between lower urinary tract symptoms (LUTS), LUTS-induced bother, age and erectile dysfunction.

Material And Methods: A survey consisting of two questionnaires, the International Prostate Symptom Score (IPSS) (reflecting LUTS) and the International Index of Erectile Function (IIEF)-5 (reflecting erectile function), together with instructions on how to perform timed micturition, was sent to 2000 randomly selected men (age range 60-70 years) living in the five counties surrounding our hospital. The IPSS questionnaire included a question concerning the degree of bother induced by LUTS.

Prescribing all phosphodiesterase 5 inhibitors to a patient with erectile dysfunction--a realistic and feasible option in everyday clinical practice--outcomes of a simple treatment regime.

Objective: In clinical practice, to apply and evaluate outcomes of a treatment regime, in which the patient had the opportunity to try all the available phosphodiesterase 5 (PDE5) inhibitors.

Methods: Patients eligible for treatment with PDE5 inhibitors were prescribed 8 tablets with a shorter-acting substance (four tablets sildenafil 100mg and four tablets vardenafil 20mg) and eight tablets with a long-acting substance (tadalafil 20mg). Outcomes of the regime were recorded.

Treatment for erectile dysfunction based on patient-reported outcomes: to every man the PDE5 inhibitor that he finds superior.

Erectile dysfunction (ED) is a common medical condition linked both to aging and to many medical conditions such as diabetes mellitus and cardiovascular disease. Although a common condition, treatment for ED has in the past been conducted by a few specialists, mostly urologists and sex therapists. The revolutionary introduction of oral therapy, and the massive amount of research into sexual dysfunction that followed, has led to paradigm shift in the treatment of ED.

Relationship between benign prostatic hyperplasia and lower urinary tract symptoms and correlation between prostate volume and serum prostate-specific antigen in clinical routine.

Objectives: To evaluate how often benign prostatic hyperplasia (BPH) was diagnosed in men referred as a result of lower urinary tract symptoms (LUTS) and to investigate the correlation between prostate volume and serum prostate-specific antigen (s-PSA).

Material And Methods: The study subjects comprised men (n = 119; mean age 68 years) consecutively referred to a urological clinic as a result of LUTS for whom the information in the referral forms gave no indications of malignant disease or infection. The patients were evaluated according to regional guidelines.

Is erectile dysfunction really a clinically useful predictor of cardiovascular disease?

Objective: To evaluate the possible connection between erectile dysfunction (ED) and cardiovascular disease (CVD) in one of its more severe forms, namely myocardial infarction (MI).

Material And Methods: The incidence of ED in men hospitalized due to MI (n=100) was compared with that reported in a questionnaire sent to an age-matched control population (n=129).

Results: The incidence of ED before MI (34%) was similar to that in the control population (30%).

Switching patients with erectile dysfunction from sildenafil citrate to tadalafil: results of a European multicenter, open-label study of patient preference.

Background: Three inhibitors of phosphodiesterase 5 (PDE5) are now available for the treatment of erectile dysfunction (ED): sildenafil citrate, vardenafil, and tadalafil. Pharmacologic differences between these compounds may result in patient preferences for one over another and may influence treatment decisions made by the physician and patient. Therefore, clinical research is needed to investigate whether individual properties of the PDE5 inhibitors play a role in shaping patient preference.

[Uneven quality of referrals for lower urinary tract symptoms in men].

Referrals (N = 126) for LUTS (lower urinary tract symptoms) in men over 40 years of age were scrutinized. Descriptions regarding symptom duration, type and intensity were unsatisfactory in 25% of the forms. Not a single work-up prior to referral was completed in accordance with the established protocol.