sodium-ethylxanthate and Erectile-Dysfunction

Sexual function is an important component of cardiac patients' quality of life and subjective well being. Patients, however, are often uninformed regarding the question of resuming sexual activity after a cardiac event. Recent epidemiologic data reveal that sexual problems are widespread and adversely affect mood, well-being, and interpersonal functioning Erectile dysfunction (ED) is the most commonly recognized and treated sexual dysfunction. It affects > 30% of men 40 to 70 years of age and its prevalence in patients with cardiovascular disease is higher than in the general population. International Guidelines has faced the problem of resuming sexual activity after a cardiac event and of the eventual suitability to the use of sildenafil or other selective inhibitor of cGMP-specific phosphodiesterase type 5 (5-PDE) for the therapy of ED in these patients. The clinical judgment should be based on the integration of clinical and instrumental data, on the evaluation of the compatibility with the foreseen energetic cost of the effort connected to sexual activity and, in case of prescription of 5-PDE inhibitors, on the eventual incompatibility with the therapy undertaken (in particular with nitrates). In the review the main reference points of literature are supplied in order to have the chance of giving motivated technical advice. Finally it is extremely important to face the problem of resuming sexual activity systematically within the cardiac rehabilitation program, with educational sessions, individual or couple conversations, and with the aid of information pamphlets.

Topics: Erectile Dysfunction; Female; Heart Diseases; Humans; Male; Piperazines; Purines; Sex; Sildenafil Citrate; Sulfones

Topics: Aged; Aging; Erectile Dysfunction; Female; Humans; Male; Sex; Urology

Prosthetic surgery for impotence has been transformed by the development of inflatable prostheses in the place of older semirigid models. Despite the popularity of this new technique, it raises certain questions concerning the functional results and complications of this surgery, which have only occasionally been studied concomitantly in the literature. The sexuality of patients has generally been evaluated on the basis of answers to a questionnaire sent to the patients. This study reports our experience, compared to the data in the literature, based on 58 insertions of inflatable prosthesis between October 1987 and October 1991. After rigorous patient selection and a mean follow-up of 30 months, the surgeon evaluated the objective results (mechanical functioning of the prosthesis, complications) and subjective results (sexuality) in 51 patients. 69.4% of patients presented an anomaly of prosthesis function, 10.3% developed an infection of the prosthesis, 34.5% required removal of the prosthesis, 59% declared that they were satisfied sexually and sexual activity was restored in 55%. This study therefore appears to contradict the optimistic data reported in the literature.

Topics: Adult; Aged; Erectile Dysfunction; Follow-Up Studies; Humans; Male; Middle Aged; Patient Satisfaction; Penile Prosthesis; Prosthesis Design; Prosthesis Failure; Sex; Skin Ulcer; Surgical Wound Infection

Impotence occurs commonly with advancing age. Approximately one half of impotent males over 50 years of age have a vascular cause for their impotence. Vascular impotence is often the harbinger of vascular disease in other organs of the body. Hypogonadism occurs in up to one fourth of older men. The relationship of hypogonadism to impotence is uncertain. Medications and neurologic diseases (both central and peripheral) are other major causes of impotence. The treatment of impotence has been revolutionized with the widespread availability of vacuum tumescent devices. The alterations in female sexuality with advancing age have been less well studied. Hysterectomies and bilateral oophorectomies are most probably done more often than necessary in the United States and may alter sexuality. There is some evidence supporting a role for estrogens and testosterone in the regulation of female libido. Physicians need to be more aware of the rapid changes in our understanding of human sexuality and aging.

Topics: Aged; Aged, 80 and over; Aging; Erectile Dysfunction; Female; Humans; Male; Menopause; Penile Erection; Sex; Testosterone

Topics: Blood Pressure; Cardiovascular Agents; Electrocardiography; Erectile Dysfunction; Female; Heart Diseases; Heart Rate; Humans; Male; Sex

Topics: Adolescent; Adult; Aged; Aging; Coitus; Diagnosis, Differential; Erectile Dysfunction; Female; Humans; Male; Middle Aged; Orgasm; Sex

Topics: Adolescent; Adult; Arthritis, Rheumatoid; Asthma; Cardiovascular Diseases; Coitus; Counseling; Diabetes Complications; Disabled Persons; Erectile Dysfunction; Female; Humans; Kidney Diseases; Lung Diseases, Obstructive; Male; Pregnancy; Sex; Sexual Dysfunction, Physiological; Spinal Cord Injuries

A person's sexual readjustment following a physical disability has traditionally been ignored by health care professionals. Since the occupational therapist often facilitates a person's resumption of activities of daily living, the therapist is in a special position to provide counseling. Understanding, support, and correct information are needed most. As derived from a search of the literature, sexual functioning is discussed in relation to the following disabilities: stroke, heart disease, diabetes mellitus, muscular dystrophy, multiple sclerosis, renal disease, spinal cord injury, pulmonary disease, arthritis, and alcoholism.

Topics: Adult; Alcoholism; Asthma; Cerebrovascular Disorders; Coitus; Diabetes Mellitus; Disabled Persons; Ejaculation; Erectile Dysfunction; Female; Heart Diseases; Humans; Libido; Male; Multiple Sclerosis; Orgasm; Sex; Sexual Behavior; Spinal Cord Injuries; Testis; Vagina

Topics: Age Factors; Anxiety; Culture; Disease; Drive; Drug-Related Side Effects and Adverse Reactions; Erectile Dysfunction; Fear; Genetics, Behavioral; Hostility; Humans; Male; Mythology; Personality; Psychophysiologic Disorders; Psychotic Disorders; Research; Sex; Sex Education; Statistics as Topic; Superstitions

In contrast to the impressive advances made in somatic research on erectile dysfunction, psychogenic erectile dysfunction is usually treated as a monolithic block. In this study, we evaluated the erectogenic power of creative-dynamic image synthesis in men with psychogenic erectile dysfunction. Sixty-nine men with a mean age of 46 y, suffering from erectile dysfunction of no known organic cause, were entered in a placebo-controlled study in which the erectogenic power of imagination, yohimbine and a placebo were compared. There was a significant difference between the subjective results of creative-dynamic image synthesis (75% increase of potency) and those achieved through treatment with the drug yohimbine (55% increase in potency) and with a placebo (30% increase in potency). Creative-dynamic image synthesis is a potent initiator of erections in men with psychogenic erectile dysfunction, has no known side effects and is very cost-effective.

Topics: Adrenergic alpha-Antagonists; Adult; Erectile Dysfunction; Humans; Imagination; Male; Middle Aged; Psychophysiologic Disorders; Psychotherapy; Sex; Yohimbine

Audiovisual sexual stimulation (AVSS) is frequently employed to promote cavernosal smooth muscle relaxation (SMR) in hemodynamic diagnostic settings for erectile dysfunction. Our aim has been to adapt conventional AVSS to the particular test conditions of pharmacocavernosometry and pharmacocavernosography (DICC), by the use of virtual glasses. Thirty-seven consecutive patients undergoing DICC were randomized in two groups: no-AVSS and AVSS through commercially available virtual glasses (VG-AVSS) with tri-dimensional capabilities and stereophonic headphones. Such device partially excludes the patient from the surrounding environment. In both groups a standard dose of vasoactive agents was intracavernosally administered, and possibly repeated (re-dosing), until complete SMR was obtained (3 doses/patient maximum). Psychometric tests (State Trait Anxiety Inventory and ad hoc visual analogue scales for embarrassment, stress and pain) were administered before and after DICC. The no-AVSS group consisted of 18 patients, the AVSS group of 19. Number of needed vasoactive agent doses: in the no-AVSS group 6 patients needed 1 dose, 3 patients 2, 9 patients 3 (mean dose number: 2.17); in the AVSS group 15 patients needed 1 dose, 1 patient 2, 3 patients 3 (mean dose number: 1.37). The difference in the number of doses used in the two groups was statistically significant (Student's t-test P = 0.007). Complete SMR, regardless of the number of used doses: in the no-AVSS group 9 patients (50%) achieved complete SMR, in the AVSS group 16 patients (84.2%). The difference in the two groups was statistically significant (chi-square P = 0.026). From evaluated psychometric measures no statistically significant difference between the two groups was detected. VG-AVSS significantly promotes complete SMR without increasing test related stress or anxiety. Its induced arousal suggests the possibility of performing dynamic evaluations of the erectile function with the oral agent sildenafil in place of intracavernosally administered vasoactive agents. VG-AVSS furthermore constitutes a promising tool for the investigation of normal physiology and pathophysiology of female sexual function.

Topics: Adult; Aged; Audiovisual Aids; Erectile Dysfunction; Eyeglasses; Humans; Male; Middle Aged; Muscle Relaxation; Muscle, Smooth; Papaverine; Penis; Phentolamine; Phosphodiesterase Inhibitors; Piperazines; Pressure; Prospective Studies; Psychometrics; Purines; Sex; Sildenafil Citrate; Sulfones; User-Computer Interface; Vasodilator Agents

Topics: Adult; Aged; Beauty; Botulinum Toxins, Type A; Erectile Dysfunction; Female; Germany; Humans; Male; Middle Aged; Sex; Skin Aging; Social Marketing

Topics: Angiotensin Receptor Antagonists; Angiotensins; Antihypertensive Agents; Clinical Trials as Topic; Erectile Dysfunction; Humans; Hypertension; Male; Orgasm; Penile Erection; Sex; Tetrazoles; Time Factors; Valine; Valsartan

The objective of vascular surgery for erectile dysfunction is to provide long-term improvement of erectile function. We evaluated that claim after deep dorsal vein arterialization by a cross-sectional study of multifaceted male sexual function with the validated International Index of Erectile Function (IIEF).. We performed a mail survey of male sexual function after deep dorsal vein arterialization in 68 consecutive literate men who underwent surgery between 1984 and 1998 for severe erectile dysfunction. The IIEF questionnaire and a questionnaire on patient characteristics were answered in a self-administered and nominative manner. Scores of the responders pertaining to the 5 domains of male sexuality were compared with those of the control groups used for the psychometric validation of the IIEF.. Of the patients 38 (55.9%) with a mean age plus or minus standard deviation of 46.5 +/- 11.9 years responded. Mean followup was 61.2 +/- 34.7 months. Compared to controls with erectile dysfunction controls men who underwent deep dorsal vein penile arterialization had significantly higher scores for erectile function, sexual desire, orgasmic function, intercourse satisfaction and overall satisfaction. Conversely compared with normal controls these patients reported significantly lower erectile function, orgasmic function, intercourse satisfaction and overall satisfaction scores, whereas sexual desire scores were similar in the 2 groups. No correlations were noted of the 5 IIEF domains with the duration of followup after arterialization. When erectile function scores were graded, 25.0% and 28.1% of patients reported no and or mild dysfunction, respectively, while 15.6% still complained of severe erectile dysfunction.. Long-term improvement in the various aspects of male sexual function was observed after deep dorsal vein penile arterialization in a significant proportion of patients.

Topics: Coitus; Cross-Sectional Studies; Erectile Dysfunction; Humans; Libido; Male; Middle Aged; Orgasm; Penis; Sex; Surveys and Questionnaires

This study investigates the influence of erectile dysfunction (ED) on daily life and the attitude of citizens toward ED treatments.. A mail survey targeting married males and females, aged 30-79, was conducted throughout the nation. The effective responses were 2,034 males and 1,820 females.. The ED prevalence rate of male respondents was 29.9% and that of females (indicating the recognition of husband's ED) was 30.1%. For both males and females, the frequency of sexual intercourse and satisfaction about their sexual lives were significantly lower in respondents with ED. 23.6% of males with ED and 16.0% of females whose husbands have ED experienced a negative influence of their married lives. Among male ED sufferers, however, only 4.8% of them had consulted a physician. The reasons cited most often for not consulting a physician were: "no influence on daily life", "not annoyed by ED", and "no interest in sex", Moreover, the barriers to visiting physicians were frequently cited, such as "shyness", "don't know which hospital to go to", and "expensive". With regard to insurance coverage of ED treatment, 80% or more of both men and women say that "it should be reimbursed for all ED patients" or "it should be conditionally reimbursed".. It becomes clear that ED is found at considerable frequency. However, only 4.8% of ED patients had received appropriate treatment at medical facilities. With regard to insurance coverage for ED treatment, it turned out that 80% or more of both men and women supported reimbursement for ED treatment.

Topics: Activities of Daily Living; Adult; Aged; Attitude to Health; Erectile Dysfunction; Female; Humans; Male; Middle Aged; Sex

Long-term efficacy and safety of sildenafil was assessed in 1008 patients with erectile dysfunction (ED) enrolled in four flexible-dose (25 - 100 mg), open-label, 36- or 52-week extension studies. After 36 and 52 weeks, 92% and 89% of patients felt that treatment with sildenafil had improved their erections. Responses to a Sexual Function Questionnaire indicated that 52 weeks of sildenafil treatment resulted in clinically significant improvements in the duration and firmness of erections, overall satisfaction with sex life, and the frequency of stimulated erections. Commonly reported adverse events (AEs) were headache, flushing, dyspepsia, and rhinitis, which were generally mild to moderate. Reports of abnormal vision were consistent with previous clinical trials. The occurrence of treatment-related cardiovascular AEs, such as hypertension, tachycardia, and palpitation, was <1%. Discontinuations due to treatment-related AEs were low (2%). Long-term therapy does not diminish the efficacy of sildenafil in patients with ED and remains well tolerated.

Topics: Administration, Oral; Adult; Aged; Aged, 80 and over; Erectile Dysfunction; Humans; Male; Middle Aged; Penile Erection; Piperazines; Purines; Safety; Sex; Sildenafil Citrate; Sulfones; Surveys and Questionnaires

Patients with prostate cancer and their physicians need knowledge of treatment options and their potential complications, but limited data on complications are available in unselected population-based cohorts of patients.. To measure changes in urinary and sexual function in men who have undergone radical prostatectomy for clinically localized prostate cancer.. The Prostate Cancer Outcomes Study, a population-based longitudinal cohort study with up to 24 months of follow-up.. Population-based cancer registries in 6 geographic regions of the United States.. A total of 1291 black, white, and Hispanic men aged 39 to 79 years who were diagnosed as having primary prostate cancer between October 1, 1994, and October 31, 1995, and who underwent radical prostatectomy within 6 months of diagnosis for clinically localized disease.. Distribution of and change in urinary and sexual function measures reported by patients at baseline and 6, 12, and 24 months after diagnosis.. At 18 or more months following radical prostatectomy, 8.4% of men were incontinent and 59.9% were impotent. Among men who were potent before surgery, the proportion of men reporting impotence at 18 or more months after surgery varied according to whether the procedure was nerve sparing (65.6% of non-nerve-sparing, 58.6% of unilateral, and 56.0% of bilateral nerve-sparing). At 18 or more months after surgery, 41.9% reported that their sexual performance was a moderate-to-large problem. Both sexual and urinary function varied by age (39.0% of men aged <60 years vs 15.3 %-21.7% of older men were potent at > or =18 months [P<.001]; 13.8% of men aged 75-79 years vs 0.7%-3.6% of younger men experienced the highest level of incontinence at > or =18 months [P = .03]), and sexual function also varied by race (38.4% of black men reported firm erections at > or =18 months vs 25.9% of Hispanic and 21.3% of white men; P = .001).. Our study suggests that radical prostatectomy is associated with significant erectile dysfunction and some decline in urinary function. These results may be particularly helpful to community-based physicians and their patients with prostate cancer who face difficult treatment decisions.

Topics: Adult; Aged; Data Collection; Erectile Dysfunction; Follow-Up Studies; Humans; Longitudinal Studies; Male; Middle Aged; Outcome Assessment, Health Care; Prostatectomy; Prostatic Neoplasms; Regression Analysis; Sex; Urinary Incontinence; Urinary Tract

The last few decades have seen a marked increase in mean life expectancy in Central Europe. This has made elderly people and their quality of life a matter of ever-increasing medical concern. Available data from the United States and Scandinavia relating to erectile dysfunction (ED) do not enable us to draw valid conclusions about the current situation in Germany. The aim of the present study was to evaluate the epidemiology of male sexuality in Germany, and the proportion of men who need medical treatment because of increased suffering from this.A newly developed and validated questionnaire on male erectile dysfunction was mailed to a representative population sample of 8000 men, 30-80 y of age in the Cologne urban district. The response included 4489 evaluable replies (56.1%). The response rates in different age groups ranged from 49.2% to 68.4%. Regular sexual activity was reported by 96.0% (youngest age group) to 71.3% (oldest group). There were 31.5%-44% of responders who were dissatisfied with their current sex life. The prevalence of ED was 19.2%, with a steep age-related increase (2.3-53.4%) and a high co-morbidity of ED with hypertension, diabetes, pelvic surgery and 'lower urinary tract symptoms'. When treatment need was defined by co-occurrence of ED and dissatisfaction with sex life, 6.9% men required treatment for ED. Oral treatment of ED was preferred by 73.8% of respondents. There were 46.2% respondents who were willing to contribute more than DM 50 (25 Euro) per month for ED treatment. We conclude that regular sexual activity is a normal finding in advanced age. ED is a frequent disorder, contributing to dissatisfaction with sex life in a considerable proportion of men. The high burden of ED is reflected in willingness to pay for treatment. ED is frequently associated with chronic diseases. Therefore adequate diagnostic workup is essential, to offer patients individually adapted treatment. General non-reimbursability of treatment for ED appears to be unacceptable.

Topics: Adult; Age Distribution; Aged; Aged, 80 and over; Attitude to Health; Erectile Dysfunction; Germany; Health Surveys; Humans; Male; Middle Aged; Prevalence; Sex; Surveys and Questionnaires

Topics: Adult; Erectile Dysfunction; Health Status; Humans; Male; Sex

Late-life sexuality is an important quality-of-life issue that has been minimally explored. This survey seeks to extend our knowledge of the relationship of sexual attitudes and preferences to sexual functioning of a large group of older, community-dwelling men.. Older men aged 58-94 (N = 1,202) were surveyed with an anonymous self-administered questionnaire including 63 items regarding present and past, actual and desired sexual practices and attitudes.. Although age correlated consistently with increased erectile dysfunction and decreased sexual activity, a substantial number of older men continued active sexual behaviors supported by positive attitudes toward sexual function. It was found that both health status and perceived partner's responsiveness are prominent moderators of the age effect.. In the absence of social isolation and health issues, many older men show persistently active sexual lifestyles as evidenced in their interest and participation in sexual activities. These findings negate a portion of the starkly negative imagery of sexual expression in aging males.

Topics: Aged; Aged, 80 and over; Aging; Attitude to Health; Erectile Dysfunction; Health Status; Humans; Life Style; Male; Middle Aged; Penile Erection; Personal Satisfaction; Quality of Life; Sex; Sexual Behavior; Sexual Partners; Sexuality; Surveys and Questionnaires

The importance of a medical sexological diagnosis, carried on with methodological and clinical rigour by specialists competent in the andrological as well as in the sexological field and the need of a close collaboration with the uro-andrologist is analyzed. From the diagnostic point of view, the priority role of the medical sexologist in the diagnosis of andrological problems with a functional etiology, in the evaluation of negative NPT, VSS and pharmaco-injection tests, secondary advantages of the symptom and of the partner's role in the genesis and in the maintenance of the problem is finally discussed.

Topics: Diagnosis, Differential; Ejaculation; Erectile Dysfunction; Humans; Male; Sex; Sexual Dysfunctions, Psychological; Urology

Three crises facing sexology are described: what is happening with sexuality in the culture, what is happening with sexuality in academia, and what is happening with sexuality in medicine. In each case, the response of sexology has been benign neglect, disinterest, and a failure to understand the profound implications of these challenges for a field that considers itself the premiere source of accurate facts and comprehensive theories about sexuality. As a consequence we are losing control of our subject matter, and we are losing our professional legitimacy. A wake-up call is offered for sexologists to become more knowledgeable, for our paradigms and organizations to become more inclusive, and for our research methods to become more sophisticated.

Topics: Culture; Erectile Dysfunction; Female; Gender Identity; Humans; Male; Mass Media; Prejudice; Public Relations; Sex; Sexual Behavior; Specialization; United States

Topics: Erectile Dysfunction; Female; Humans; Male; Neoplasms; Penis; Sex; Wounds, Nonpenetrating

After having emphasized the importance of interdisciplinary diagnostic approach to the sexual impotence as a symptom and having made some comments about the erection's physiology, the Authors, according to their experience, take drugs into consideration for elective treatment of sexual intercourse.

Topics: Erectile Dysfunction; Humans; Male; Sex

Topics: Aged; Clinical Nursing Research; Erectile Dysfunction; Humans; Male; Orgasm; Prostatectomy; Self Concept; Sex

Twenty-seven patients with adenocarcinoma of the prostate, and available partners, were interviewed to qualitatively and quantitatively assess their level of sexual function prior to and 12 months after radiotherapy. Assessments were made using the Derogatis Interview for Sexual Functioning (DISF). Five domains of sexual functioning are measured: sexual fantasy, arousal, experience, orgasm, and drive. Prior to therapy 17 of 27 patients (62.9%) were considered impotent. There were eight patients with a DISF score of less than 20 who were impotent. Six patients had a DISF score of greater than 47 and were considered potent. Of the patients with DISF scores between 20-47 four were potent, and nine were impotent. Post radiation therapy three of the patients considered potent (with a score greater than 47) maintained their potent status. Four patients considered impotent prior to therapy became potent after therapy. All patients with a score less than 20 prior to radiation therapy remained impotent after therapy. Results indicate that an objective evaluation of sexual function pre treatment is necessary to determine the effect of radiotherapy. Our method of qualitative assessment of sexual function was easy to implement, was reproducible and could be used to evaluate long-term effects of radiotherapy on sexual function. Of the patients presenting for radiotherapy, 62.9% were impotent. Twelve months after radiation therapy 19 of 27 (70.3%) were impotent.

Topics: Adenocarcinoma; Adult; Aged; Aged, 80 and over; Erectile Dysfunction; Humans; Male; Middle Aged; Prostatic Neoplasms; Radiotherapy; Sex

Men over 50 may experience a decline in sexual, physical and intellectual potency. In many respects this is analogous to the menopause, hence the term male menopause. Although this term suggests profound hormonal changes and loss of reproductive capacity these do not occur in men. The hormonal changes are subtle and loss of fertility is relative. Other changes, part of normal ageing, include degeneration of neural tissue, arterial occlusion and loss of tissue turgor.

Topics: Aging; Erectile Dysfunction; Humans; Male; Middle Aged; Sex; Sex Characteristics; Testosterone

Normal aging plus certain prevalent diseases are believed to render many elderly men impotent. Recent studies have suggested that educated middle-class and upper-class elderly men continue sexual activity, despite erectile dysfunction, by employing alternative practices such as mutual masturbation and oral sex. Few elderly men of lower socioeconomic background have been included in these studies, however. Using physician-administered interviews, 87 men attending an urban Veterans Administration geriatric clinic were studied to determine (1) the prevalence of erectile dysfunction, and (2) the sexual practices and attitudes of this group. Of the 87 men, 28% reported complete loss of erectile function, while 31% had frequent difficulties achieving vaginal intromission. Unlike economically advantaged groups, only 29% used mutual masturbation and 16% used oral sex. Attitudes toward these practices were negative. With one exception, men unable to perform coitus ceased all heterosexual activities.

Topics: Aged; Aged, 80 and over; Attitude to Health; Erectile Dysfunction; Humans; Male; Masturbation; Middle Aged; Sex; Sexual Behavior; Socioeconomic Factors

Dhat syndrome is a culture-bound sex neurosis of the Indian subcontinent. Fifty-two patients with a presenting complaint of passage of 'Dhat' in urine were studied. Diagnosis of neurotic depression, anxiety neurosis, hypochondriacal neurosis, and psychogenic impotence were made in 21, 19, 3, and 1 cases respectively. Seven patients received the diagnosis of pure Dhat syndrome, and one of gonorrhoea.

Topics: Adolescent; Adult; Anxiety Disorders; Culture; Depressive Disorder; Ejaculation; Erectile Dysfunction; Humans; Hypochondriasis; India; Male; Semen; Sex; Syndrome; Urine

Topics: Acquired Immunodeficiency Syndrome; Erectile Dysfunction; Humans; Male; Sex; Sexual Behavior; United States

Topics: Erectile Dysfunction; Humans; Male; Psychotherapy; Sex; Urology

Topics: Colostomy; Erectile Dysfunction; Humans; Ileostomy; Male; Sex; Urinary Diversion

To confirm the usefulness of our new erectile function test, Psychogenic Erection Monitoring using Sexual Stimulation Score, we monitored results in 150 patients with suspected impotence. As compared with conventional methods, this new test reduced the number of false negative and positive recordings and proved a useful method for diagnosis of impotence.

Topics: Adult; Erectile Dysfunction; Humans; Male; Middle Aged; Monitoring, Physiologic; Penile Erection; Penis; Photic Stimulation; Predictive Value of Tests; Sex

Topics: Aged; Attitude of Health Personnel; Communication; Erectile Dysfunction; Female; Humans; Interpersonal Relations; Male; Nurse-Patient Relations; Sex

Topics: Adult; Diabetes Mellitus; Diabetes Mellitus, Type 1; Erectile Dysfunction; Female; Humans; Male; Orgasm; Sex

Physicians and patients frequently misunderstand the sexual changes that are normal in elderly men. These include increased time and stimulation to attain an erection, decreased ejaculatory volume, rapid detumescence after intercourse and a prolonged refractory period before further erection is possible. Coupled with medical or psychologic illnesses, these changes may precipitate impotence. Surgical, pharmacologic and psychologic modes of therapy may be effective in treating impotence in elderly men.

Topics: Aged; Aging; Erectile Dysfunction; Humans; Libido; Male; Medical History Taking; Physical Examination; Sex

Topics: Adult; Erectile Dysfunction; Humans; Male; Penile Erection; Sex

Topics: Adult; Aged; Aging; Alcoholism; Arthritis; Attitude; Erectile Dysfunction; Ethics, Medical; Female; Humans; Male; Middle Aged; Posture; Prostatectomy; Sex

Male hyperprolactinemia (HPRL) is known to induce different types of sexual dysfunctions. In order to determine the incidence of HPRL among patients referred for sexual dysfunction, serum prolactin (PRL) was assayed in 1053 clinically idiopathic cases. Among 850 cases complaining of erectile impotence, 10 with marked HPRL (1.1%, PRL above 35 ng/ml) were found, of whom 6 cases were associated with a pituitary adenoma. 17 mild HPRL (2%, PRL 20-35 ng/ml) were also found. Among 124 cases with premature ejaculation, 13 (10%) mild HPRL were found. Serum PRL was normal in 51 cases complaining of an ejaculation without orgasm, and 27 patients exclusively complaining of reduced sexual desire. Our results lay stress on the fact that serum PRL must be assayed in every case of clinically idiopathic erectile impotence. Indeed, 5 of the 10 marked HPRL patients would have been misdiagnosed if we had only assayed this hormone when plasma testosterone was below the normal range. Moreover, in order to shed some light on the mechanisms by which HPRL disturbs male sexual function, the sexual behaviour of 17 markedly HPRL males was compared to their serum levels of PRL and testosterone, first before treatment, then at regular intervals during treatment. Our main conclusion is that impotence cannot be totally explained by a decrease in plasma testosterone, because this steroid hormone was within the normal range 7 of the 16 impotent patients. Moreover, when serum PRL was lowered by bromocriptine, 6 patients recovered their potency before plasma testosterone clearly increased, and in 3 of those patients before it reached the normal range.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adenoma; Adult; Bromocriptine; Erectile Dysfunction; Follow-Up Studies; Humans; Hyperprolactinemia; Male; Middle Aged; Penile Erection; Pituitary Neoplasms; Prolactin; Psychotherapy; Sex

The technique for radical retropubic prostatectomy has been modified to avoid injury to the branches of the pelvic plexus that innervate the corpora cavernosa. The surgical procedure is based on an understanding of the anatomical relationships between the branches of the pelvic plexus that innervate the corpora cavernosa, the capsular branches of the prostatic vessels that provide the scaffolding for these nerves, and the lateral pelvic fascia. The modifications involve two steps in the procedure: 1) the incision in the lateral pelvic fascia is placed anterior to the neurovascular bundle, which is located dorsolateral to the prostate along the pelvic sidewall; 2) the lateral pedicle is divided close to the prostate to avoid injury to the branches of the pelvic plexus that accompany the capsular vessels of the prostate. Pathologic evaluation of 16 prostatic specimens removed by this modified procedure demonstrated no compromise in the adequacy of the surgical margins. Postoperative sexual function was evaluated in 12 men who underwent the procedure 2-10 months previously. All have experienced erections and six have achieved successful vaginal penetration and orgasm. Of the six patients with sexual partners who have been followed 6 months or longer, five (83%) are fully potent. These data indicate that it is possible to cure localized prostatic cancer with surgery and maintain postoperative sexual function.

Topics: Adenocarcinoma; Erectile Dysfunction; Humans; Male; Penis; Prostatectomy; Prostatic Neoplasms; Sex

Topics: Counseling; Erectile Dysfunction; Gender Identity; Humans; Male; Neoplasms; Sex

Topics: Erectile Dysfunction; Follow-Up Studies; Humans; Male; Penis; Prostheses and Implants; Sex; Spinal Cord Injuries; Urinary Bladder, Neurogenic; Urinary Catheterization

Topics: Alcoholism; Breast Neoplasms; Erectile Dysfunction; Female; Humans; Male; Penile Neoplasms; Sex; Sex Education

Although sexual dysfunction in the male diabetic has been recognized for many years, only recently has systematic investigation been undertaken to understand the problems involved. The marked increase of impotence in diabetes has been shown to be, to a significant extent, a result of diabetic autonomic pelvic neuropathy. However, awareness of other causes of impotence is essential for proper diagnosis and appropriate therapy. Strikingly, the marked impact of diabetes on male sexual function is not shared by the female diabetic patient, whose sex interest and orgasmic reaction are essentially unimpaired when compared with those of the nondiabetic female.

Topics: Autonomic Nervous System; Diabetic Neuropathies; Erectile Dysfunction; Female; Humans; Libido; Male; Orgasm; Penis; Sex

Topics: Erectile Dysfunction; Famous Persons; Female; History of Medicine; Humans; Literature, Modern; Male; Sex; United States

Topics: Adult; Erectile Dysfunction; Female; Humans; Male; Marital Therapy; Myocardial Infarction; Sex; Sexual Behavior; Sexual Dysfunction, Physiological

20 patients with well functioning kidneys were investigated psychiatrically and had to judge on their libido and potency prior to the onset of their illness under chronic hemodialysis and after transplantation. The psychometric instrument used was the FPI (Freiburger Persönlichkeits-Inventar). The sexual activity was found to be either significantly reduced or absent in 80% during hemodialysis. Following transplantation more than 50% sexually fully recovered. In patients with persistent sexual dysfunction in the post-transplant period depressive symptoms were found four times as much as in those with a complete recovery. Psychometrically the latter characterized themselves as more active, optimistic but even as less self-critical. Therapeutic aspects are being discussed.

Topics: Depression; Erectile Dysfunction; Humans; Kidney Transplantation; Libido; Long-Term Care; Male; Postoperative Complications; Renal Dialysis; Sex; Time Factors; Transplantation, Homologous

Topics: Age Factors; Aged; Aging; Androgens; Attitude; Coitus; Erectile Dysfunction; Estradiol Congeners; Estrogens; Female; Gonadotropins, Pituitary; Humans; Hypothalamus; Libido; Male; Menopause; Middle Aged; Ovary; Pituitary Gland; Progesterone; Psychophysiologic Disorders; Sex; Sex Factors; Testis; Testosterone

Topics: Adult; Catholicism; Emigration and Immigration; Erectile Dysfunction; Ethnicity; Female; Homosexuality; Humans; Judaism; Male; Marriage; Maryland; Neurotic Disorders; Personality Disorders; Psychoanalytic Therapy; Religion; Religion and Psychology; Sex; Sex Factors; Sexual Dysfunctions, Psychological; Surveys and Questionnaires

Topics: Adult; Delayed-Action Preparations; Dose-Response Relationship, Drug; Erectile Dysfunction; Humans; Libido; Male; Sex; Spermatogenesis; Testosterone

Topics: Erectile Dysfunction; Group Processes; Humans; Male; Psychosexual Development; Sex; Sexual Behavior; Social Conformity

Topics: Adolescent; Adult; Body Image; Child; Ejaculation; Erectile Dysfunction; Female; Homosexuality; Humans; Interpersonal Relations; Male; Mother-Child Relations; Orgasm; Parent-Child Relations; Psychosexual Development; Reproduction; Self Concept; Sex; Sex Education; Sexual Behavior; Sexual Dysfunction, Physiological; Sibling Relations; Vaginal Diseases

Topics: Alcoholism; Anxiety; Attitude; Depression; Erectile Dysfunction; Humans; Male; Paraphilic Disorders; Phobic Disorders; Psychosexual Development; Sex

Topics: Erectile Dysfunction; Female; Humans; Male; Sex; Sexual Dysfunctions, Psychological

Topics: Erectile Dysfunction; Female; Humans; Male; Sex; Sexual Dysfunctions, Psychological