The MALES study confirms the high prevalence rates of ED and its association with co-morbid medical conditions, such as diabetes and depression, reported in other large-scale, epidemiological studies. Despite the advent of oral phosphodiesterase inhibitors, only 58% of ED sufferers consult a physician about their problem, and only 16% of men with self-reported ED maintain their use of oral therapy.

Introduction Much research has explored the experience of erectile dysfunction (ED) among men with ED, but far less attention has been paid to the perceptions and sexual experiences of the female partners of men with ED. Aim The objective of this study was to characterize the attitudes, beliefs, and sexual experience of female partners of men with erectile difficulties. Methods Female partners of men with ED who had participated in the Men’s Attitudes to Life Events and Sexuality (MALES) study were recruited for this research via mail or Internet, after their male partners consented to this contact. Female partners of men with ED (N=293) responded to questionnaire measures assessing their frequency of sexual activity and the nature of their sexual experience, both before and after the development of their partner’s ED, and in relation to their partner’s use of phosphodiesterase type 5 (PDE5) inhibitors. Results Women reported engaging in sexual activity significantly less frequently after their partner developed ED in comparison with before (P<0.001). Moreover, significantly fewer women experienced sexual desire, arousal, or orgasm “almost always” or “most times,” and significantly fewer women reported satisfaction with their sexual relationship after their partner developed ED, compared with before (P<0.001). Decreases in female sexual satisfaction and frequency of orgasm were significantly related to the male partner’s self–reported severity of ED (P<0.01). The proportion of women who experienced sexual desire, arousal, and orgasm “almost always” or “most times” was significantly higher in the group whose partners were currently using a PDE5 inhibitor (P<0.05). Conclusion Erectile dysfunction has significant adverse effects on the female partner’s sexual experience. Women with partners who were currently using PDE5 inhibitors had a more satisfying sexual experience than those whose partners did not use a PDE5 inhibitor.

BackgroundEpiploic appendagitis (EA) is a rare cause of focal abdominal pain in otherwise healthy patients with mild or absent secondary signs of abdominal pathology. It can mimick diverticulitis or appendicitis on clinical exam. The diagnosis of EA is very infrequent, due in part to low or absent awareness among general surgeons. The objective of this work was to review the authors' experience and describe the clinical presentation of EA.MethodsAll patients diagnosed with EA between January 2004 and December 2006 at an urban surgical emergency room were retrospectively reviewed by two authors in order to share the authors' experience with this rare diagnosis. The operations were performed by two surgeons. Pathological examinations of specimens were performed by a single pathologist. A review of clinical presentation is additionally undertaken.ResultsTen patients (3 females and 7 males, average age: 44.6 years, range: 27–76 years) were diagnosed with symptomatic EA. Abdominal pain was the leading symptom, the pain being localized in the left (8 patients, 80 %) and right (2 patients, 20%) lower quadrant. All patients were afebrile, and with the exception of one patient, nausea, vomiting, and diarrhea were not present. CRP was slightly increased (mean: 1.2 mg/DL) in three patients (33%). Computed tomography findings specific for EA were present in five patients. Treatment was laparoscopic excision (n = 8), excision via conventional laparotomy (n = 1) and conservative therapy (n = 1).ConclusionIn patients with localized, sharp, acute abdominal pain not associated with other symptoms such as nausea, vomiting, fever or atypical laboratory values, the diagnosis of EA should be considered. Although infrequent up to date, with the increase of primary abdominal CT scans and ultrasound EA may well be diagnosed more frequently in the future.

Sexuality research focuses almost exclusively on individuals rather than couples, though ongoing relationships are very important for most people and cultures. The present study was the first to examine sexual and relationship parameters of middle-aged and older couples in committed relationships of 1-51 years duration. Survey research was conducted in Brazil, Germany, Japan, Spain, and the U.S. targeting 200 men aged 40-70 and their female partners in each country, with 1,009 couples in the final sample. Key demographic, health, physical intimacy, sexual behavior, sexual function, and sexual history variables were used to model relationship happiness and sexual satisfaction. The median ages were 55 for men and 52 for women; median relationship duration was 25 years. Relationship satisfaction in men depended on health, physical intimacy, and sexual functioning, while in women only sexual functioning predicted relationship satisfaction. Models predicting sexual satisfaction included significant physical intimacy and sexual functioning for both genders and, for men, more frequent recent sexual activity and fewer lifetime partners. Longer relationship duration predicted greater relationship happiness and sexual satisfaction for men. However, women in relationships of 20 to 40 years were significantly less likely than men to report relationship happiness. Compared to men, women showed lower sexual satisfaction early in the relationship and greater sexual satisfaction later. Within the long-term committed relationship context, there were significant gender differences in correlates of sexual and relationship satisfaction, with sexual functioning a common predictor of both types of satisfaction and physical intimacy a more consistent and salient predictor for men.