65 research outputs found
Re: Indwelling Ureteral Stents and Sexual Health: A Prospective, Multivariate Analysis. M. C. Sighinolfi, S. Micali, S. De Stefani, A. Mofferdin, M. Grande, M. Giacometti, N. Ferrari, M. Rivalta and G. Bianchi J Urol 2007; 178: 229-231
No full textReply by Authors
During the last few decades progress in endourology has led to a widespread application of such techniques, and procedures such as ureteral stenting and nephrostomic drainage have become routinely adopted. As a result, the number of patients dealing with these devices has rapidly increased, thus focusing attention on the related quality of life.
Consistent with this statement, Joshi et al developed the Ureteral Stent Symptom Questionnaire in 2003,1 which represents a validated instrument to assess stent related bother, concerns and impact on global quality of life. [5] and [7] The USSQ actually addresses in a proper and detailed approach the whole of urinary symptoms, as well as the consequent bother that so frequently affects these patients. Domains regarding pain and stent related therapies (antibiotics, painkillers) are accurately designed. Furthermore, work, occupation, social activities and relationships are considered with regard to ureteral stent permanence. Sexuality is assessed in the questionnaire by 4 questions, investigating the presence vs absence of sexual activity, and then dealing with pain and sexual satisfaction. As a result, all crucial points of stent related sexuality are analyzed according to the questionnaire.
However, the aim of our study was to perform a detailed analysis of all the domains connected to sexuality in both genders with particular attention to erectile function, which has been so widely addressed in the last decade.8 Moreover, since female sexuality represents a complexity of events, we attempted to investigate all steps of the process to emphasize the critical points. In this setting the use of the International Index of Erectile Function-5 and the Female Sexual Function Index seems to be an adequate choice, matching our aims more properly. Furthermore, an additional end point of the study was to investigate thoroughly the sequential changes that occur in sexual health before and after stent insertion, and this goal can be achieved only with specific questionnaires administered to the patient before the procedure.
Since the recent literature focuses on the relationship between erectile dysfunction and lower urinary tract symptoms,9 we analyzed the correlation between urinary complaints and sexual dysfunction. Although this outcome can be assessed even with the USSQ, the use of specific questionnaires considering different sorts of symptoms is highly recommended to perform a critical and statistical analysis. Behind this consideration, our outcomes are consistent with those previously reported in other studies.
Ureteral stenting is a simple and safe procedure for the urologist but has significant consequences on the routine life of the patient in all of its main areas. The USSQ is a consistent and reliable instrument to analyze those concerns, and physicians have to consider this tool in urological practice.
References
1H.B. Joshi, N. Newns, A. Stainthorpe, R.P. MacDonagh, F.X. Keeley Jr, A.G. Timoney
Ureteral Stent Symptom Questionnaire: development and validation of a multidimensional quality of life measur
Renal staghorn calculosis: Endourological treatment.
No full textRenal staghorn calculosis: Endourological treatment
A knotted multi-length ureteral stent: a rare complication
No full textUreteral catheters represent essential devices in the management of upper urinary tract obstruction; complications are unusual. Knotting of the stent at its proximal coiled end is a very rare but potentially dangerous event that should be promptly recognized
Intracavernous prostaglandin E1 infusion in diabetes with associated ischemic necrosis of the gland penis
No full textPenile necrosis is a rare event. It has been described as acomplication of diabetes or in systemic vasculitis.1 Ischemicdamages may also arise following genital reconstructive surgery.Necrosis of the glans is generally the first evidence of abroader lesion that may involve the urethra and perineum inso-called Fournier’s necrotizing fasciitis.2 A solitary lesion of theglans without shaft involvement has been described rarely. Ahyperbaric camera represents one of the best therapeutic solutionsin these patients, although intracavernous infusion ofprostaglandin has been shown to be particularly effective
Percutaneous alcoholization of simple renal cysts: long term results.
No full textThe authors report their experience with 92 patients treated by percutaneous alcoholization of simple renal cysts between July 1987 and December 1995. 49 patients were male, 43 female; the average age was 60 years (range 25-80). The treatment was performed because of symptoms and/or complications in 70 cases. The remaining 22 patients were asymptomatic, but their cysts showed a fast increase in size at repeated ultrasonographies. The average size of the cysts was 9.8 cm (range 4-17cm). They were located at the upper pole of the kidney in 24% of cases at the median third in 26%. and at the lower pole in 50%. All patients were treated in the prone position. The technique was different from the original Bean's procedure because the drainage of the cyst cavity was left in place until the epithelial cells of the cyst wall completely ceased their secretory activity. The pig-tail was removed on average 3-4 days after treatment. The average followup was 63 months (range 12-113). Symptoms completely disappeared in all cases. Recurrences with a volume larger than 30% compared to the initial one were observed in only 8 patients (8.7% of cases). Complications, such as fever and transient urinary leakage, seldom occurred. The authors conclude that percutaneous alcoholization today represents the first choice option for most renal cysts
How effective is extracorporeal shock wave lithotripsy with modern lithotripter devices? A prospective and preliminary assessment.
No full textHow effective is extracorporeal shock wave lithotripsy with modern lithotripter devices? A prospective and preliminary assessment
Comparison of the quality of life of patients treated by surgery or radiotherapy in epidermoid cancer of the penis
No full textOBJECTIVE: The purpose of our work is to examine how partially or totally radical
surgery and radiotherapy can weigh on quality of life in patients with squamous
carcinoma of the penis, considering whether quality of life can be a good
criterion in treatment options.
MATERIAL AND METHODS: We have interviewed 17 patients alive and disease-free
(average follow-up 69.43 months) after surgical treatment or radiotherapy for
cancer of the penis (emasculation, 2; total amputation of the penis, 2; partial
penectomy, 11; radiotherapy, 2). Tests used: General Health Questionnaire
(G.H.Q.-12 by D. Goldberg); Hospital Anxiety and Depression Scale (H.A.D.S.);
Social Problem Questionnaire (S.P.Q.); Overall Sexual Functioning Questionnaire
(O.S.F.Q); Family APGAR Questionnaire (F.A.Q.); Performance Status ECOG.
RESULTS: Thirty-five per cent of the patients presented limitations in their
state of health and social problems. Anxiety was evident in 29.5% of the patients
and depression in 6%. The global sexual function was compromised in 76.5%.
CONCLUSION: The profile of quality of life resulted compromised in the patients
who had undergone radical surgical treatment. The sexual function was the most
altered component. The impact of the pathology and its treatment on the other
domains of quality of life proved less significant
Percutaneous, laparoscopic, and surgical treatment of idiopathic varicocele: analysis of costs
No full textNitinol guidewires semplified ureterorenoscopy?
No full textNitinol guidewires semplified ureterorenoscopy
Bacille Calmette-Guérin intravesical instillation and erectile function: is there a concern?
No full textThe aim of our study was to evaluate the effect of bacille Calmette-Guerin (BCG) therapy on erectile function in a cohort of male patients affected by non-muscle invasive bladder cancer. Thirty male patients undergoing BCG treatment for non-muscle invasive bladder cancer were enrolled in the study. Their mean age was 60.4 years. None of the patients had risk factors for erectile dysfunction (ED). All subjects underwent a BCG standard schedule therapy (once weekly instillation for 6 weeks). International Index of Erectile Function (IIEF-5) and International Prostate Symptom score (I-PSS) were addressed to the patients during the treatment schedule (at fourth or fifth instillation) and 1 month after the last instillation. The mean IIEF-5 score was 17.6 +/- 6.7 during therapy and 21.7 +/- 2.92 a month after the last instillation (P = 0.008). Baseline ED and the association with lower urinary tract symptoms are variables significantly connected with post-treatment results (P = 0.016 and 0.00 respectively) whereas the age seems not to be related to ED (P = 0.256). No major side effects were recorded. It is concluded that BCG treatment is effective for prophylaxis of non-muscle invasive bladder cancer; however, it may induce a high incidence of ED. Although this effect is transient and reversible, erectile failure is another source of psychological distress that adversely affects the quality of life of men undergoing BCG treatment
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