Both laparoscopic and Lichtenstein hernioplasties have a low risk for hernia recurrence if proper mesh size is used. The patients who undergo hernioplasty with open mesh hernioplasty seem to experience chronic symptoms and pain more often than those managed with the laparoscopic procedure.

The objective of the study was to investigate the effects of dihydrotestosterone (DHT) gel on general well-being, sexual function, and the prostate in aging men. A total of 120 men participated in this randomized, placebo-controlled study (60 DHT and 60 placebo). All subjects had nocturnal penile tumescence once per week or less, andropause symptoms, and a serum T level of 15 nmol/liter or less and/or a serum SHBG level greater than 30 nmol/liter. The mean age was 58 yr (range, 50-70 yr). Of these subjects, 114 men completed the study. DHT was administered transdermally for 6 months, and the dose varied from 125-250 mg/d. General well-being symptoms and sexual function were evaluated using a questionnaire, and prostate symptoms were evaluated using the International Prostate Symptoms Score, transrectal ultrasonography, and assay of serum prostate-specific antigen. Early morning erections improved transiently in the DHT group at 3 months of treatment (P< 0.003), and the ability to maintain erection improved in the DHT group compared with the placebo group (P < 0.04). No significant changes were observed in general well-being between the placebo and the DHT group. Serum concentrations of LH, FSH, E2, T, and SHBG decreased significantly during DHT treatment. Treatment with DHT did not affect liver function or the lipid profile. Hemoglobin concentrations increased from 146.0 +/- 8.2 to 154.8 +/- 11.4 g/liter, and hematocrit from 43.5 +/- 2.5% to 45.8 +/- 3.4% (P < 0.001). Prostate weight and prostate-specific antigen levels did not change during the treatment. No major adverse events were observed. Transdermal administration of DHT improves sexual function and may be a useful alternative for androgen replacement. As estrogens are thought to play a role in the pathogenesis of prostate hyperplasia, DHT may be beneficial, compared with aromatizing androgens, in the treatment of aging men.

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The purpose of this prospective study was to evaluate the sexual function of patients with benign prostatic hyperplasia (BPH) before and after transurethral resection of the prostate (TURP). The sexual functions of 155 patients with BPH were evaluated before TURP and 6 and 12 months afterwards. The mean age of the patients was 69 years (range 49-86 years). The only significant change in sexual function after TURP was improvement in early morning erections (P < 0.01). Sixty-eight per cent of the patients were satisfied with their sex life before TURP, 69% after 6 months and 67% after 12 months. The corresponding percentages of patients satisfied with their libido were 60%, 59% and 54%. Only 26% of the patients had completely satisfactory erections before TURP, while 22% had them 6 months later and 24% 12 months later. The proportion of fully impotent patients was 11% before the procedure, 13% after 6 months and 16% after 12 months. In 84% of the patients ejaculation was retrograde 6 months and 12 months after TURP. We conclude that TURP does not affect the sexual function of patients with BPH, with the exception of retrograde ejaculation.