In this study we determine the sexual problems and the prevalence of erectile dysfunction (ED) in male hemodialysis patients by means of the International Index of Erectile Function (IIEF). A total of 187 male patients were included in the study. All of the patients who underwent hemodialysis were asked to complete the IIEF questionnaire. The IIEF domain scores were calculated and erectile dysfunction grading was determined on erectile function domain. Patients were also asked to report whether they had disclosed their sexual problems to physicians or not.The mean age was 49.3 AE 13.2 y and the duration of hemodialysis was 38.1 AE 8.4 months. By means of the IIEF, the prevalence of erectile dysfunction of any degree was 80.7%. The prevalence of any ED for the patients < 50 y and ! 50 y was 74.5% and 86.6%, respectively. The prevalence and the severity of ED was significantly higher in patients ! 50 y. The frequency of intercourse attempts during the last four weeks was 1 -2 in 130 (69.5%) of patients. Only 1% of patients disclosed their erectile problems and sought medical assistance prior to our study.Erectile dysfunction is highly prevalent in hemodialysis patients. The prevalence and the severity of ED increased with age. Evaluations for ED should be included in routine assessment of hemodialysis patients.
Objective To assess the efficacy of sildenafil for erectile dysfunction (ED) in patients on haemodialysis (HD) or peritoneal dialysis (PD), as men with end-stage renal disease (ESRD) often have sexual dysfunction (up to 82% among those on chronic dialysis). Patients and methods Forty-one patients with ED and in ESRD participated in an open-label prospective study. Thirty patients on HD and 11 on PD were asked to complete the International Index of Erectile Function (IIEF) and Fugl-Meyer life-satisfaction scale before and after sildenafil treatment. A total score in the erectile function domain of ≤ 25 was accepted as indicating ED. All patients were started on a 25-mg dose, which was increased to 50 mg if there was no response after two trials. In addition, the overall efficacy question was used to evaluate satisfaction, and patients reported any side-effects during treatment. Results The erectile function and intercourse satisfaction domains improved significantly in both groups ( P < 0.01). After sildenafil treatment, two-thirds of those on HD (20/30) and nine of the 11 on PD recovered their erectile function. The pretreatment scores on the IIEF and four domains (except sexual desire) of those responding were significantly higher than in those not responding ( P < 0.05). The satisfaction rate on the overall efficacy question was 80% and 82% for the HD and PD groups, respectively. At least one sideeffect was seen in 17 patients (43%); one had severe hypotension in the PD group. Overall, mild headache (seven patients, 18%) and flushing (12, 30%) were reported most often. Conclusions Sildenafil is a safe and satisfactory drug for improving erectile function in patients with ESRD.Patients were satisfied whether treated by HD or PD. Pretreatment scores on the IIEF may be useful for predicting the success of treatment.
We suggest that HUmax, HUmin and HUave values are significant predictors of SWL success for both kidney and ureteral stones. They might be used in daily clinical practice for patient counselling.
We present a case of a bladder stone that had formed around the intravesical portion of tension-free vaginal tape (TVT) material following unnoticed bladder perforation during the procedure. Endoscopic lithotripsy of the bladder calculi was performed and the TVT sling material was removed by an endoscopic approach. High clinical suspicion of bladder complications is necessary when evaluating patients presenting with urinary symptoms after a TVT procedure.
Objective: Our aim was to determine the safety and feasibility of catheter removal on the first morning after transurethral prostatectomy. Methods: Fifty-four patients who underwent transurethral prostatectomy were included in a prospective study. The decision to remove the catheters on the first morning after surgery was based on the color of the catheter effluent, absence of clots, normal vital signs and adequate urine output. Patients who voided successfully were discharged on the same day as catheter removal. Results: Catheters were removed in 43 (79.6%) patients on postoperative day 1. Of these patients 40 (93%) voided successfully, however 3 of them required recatheterization due to bleeding or urinary retention. The criteria for catheter removal were not met in 11 patients and their catheters were removed on postoperative day 2 in 2 and on postoperative day 3 in 9. The mean length of hospital stay after surgery was 1.74 days for the entire group and 1.41 days for those in whom the catheter was removed on postoperative day 1. Conclusion: Overnight catheterization after transurethral prostatectomy seems to be a feasible approach without leading to significant morbidity in selected patients.
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