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Immediate treatment with 150 mg. bicalutamide daily, either alone or as adjuvant to treatment of curative intent, significantly reduces the risk of disease progression in patients with localized or locally advanced prostate cancer. This benefit must be balanced with the morbidity associated with long-term hormonal therapy. Followup is ongoing to determine potential survival benefits of this treatment approach.

Introduction The transobturator suburethral tape (TOT) and tension-free vaginal tape obturator (TVT-O) procedures are relatively new incontinence treatment procedures. Studies on the influence on sexual function as a result of these procedures are limited. Aim The influence of TOT or TVT-O for the surgical treatment of stress urinary incontinence (SUI) on female sexual function. Methods We evaluated 77 sexually active patients after TVT-O (N=34, mean age 53.2 years) and TOT (OB-TAPE, Porges) (N=44, mean age 52.0 years) placement for SUI based on the responses to a mailed questionnaire 3 months after the operation. Main Outcome Measure Difference in postoperative sexual complaints related to the TVT-O (inside-out) and TOT (outside-in) procedure. Results Postoperative TOT and TVT-O: There was almost no difference in frequency of sexual intercourse and an improvement of the continence during intercourse; continence was reported in 33 patients (42.3%) before and 67 patients (78.4%) after operation. The appreciation of sexual intercourse was improved in 15 patients (19.2%) and worsened in eight patients (10.3%). Postoperative TVT-O vs. TOT: No difference was seen in lost of lubrication, clitoral tumescence reduction, and clitoral sensibility reduction between both procedures. Pain because of vaginal narrowing was seen significantly more in the TOT procedure group. Conclusion Overall, in this study, the technique of TOT gave rise to more sexual dysfunction than TVT-O. However, because of the successful outcome on incontinence, both procedures had, overall, a positive effect on sexual function. The cause of significant more pain during intercourse as a result of vaginal narrowing in the TOT procedure requires further investigation. Like other studies, this study demonstrated that incontinence surgery can have a positive and negative outcome on sexual function. It is important to put this issue in the informed consent.

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OBJECTIVETo review previous reports of carcinoid (an endocrine tumour mostly of the gastrointestinal tract) tumours of the testis.METHODSCarcinoid tumours of the testis are rare and can be divided into primary carcinoid (group 1), testicular metastasis from another location (group 2) and carcinoid within a testicular teratoma (group 3). A case of testicular carcinoid within our clinic prompted us to review previous reports; all the cases found were assessed for patient and tumour characteristics, diagnostic tools used, treatment and prognosis.RESULTSIn all, 62 cases were assessed and divided into groups 1 (44 patients), 2 (six) and 3 (12), respectively. Seven patients in group 1 developed metastases. A wide variety of diagnostic tools was used to search for other tumour sites. All patients were treated with orchidectomy. Three patients with a primary carcinoid were treated with adjuvant chemotherapy (two) or radiotherapy (one), with unknown results. All but one of the nine patients who died were known to have metastasis, either from a primary testicular carcinoid or testicular metastases from an intestinal carcinoid.CONCLUSIONWhen a testicular carcinoid tumour is discovered, other tumour sites should be excluded. The most useful diagnostic tools for this purpose seem to be urinary 5‐hydroxyindoleacetic acid measurement, somatostatin receptor scintigraphy, computed tomography and video‐capsule endoscopy. Localized testicular carcinoid tumours have an excellent prognosis after orchidectomy.

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