Profil épidémiologique des urgences péniennes au CHU de Libreville / Epidemiological profile of penile emergencies at the University Hospital of Libreville

Introduction : Les urgences péniennes sont multiples et variées. Elles peuvent mettre en jeu le pronostic fonctionnel sexuel du patient. L'objectif de notre étude était de rapporter les aspects cliniques et thérapeutiques des urgences péniennes au CHU de Libreville. Matériel et Méthodes : Nous avons réalisé une étude rétrospective de janvier 2016 à décembre 2020 au service d'urologie du CHU de Libreville. Les variables comprenaient les données sociodémographiques, cliniques et thérapeutiques des patients pris en charge pour une urgence pénienne. Résultats : Durant cette période, 63 patients ont été pris en charge pour urgences péniennes. L'âge moyen était de 27±17,3 ans avec des extrêmes de 1 et 90 ans. Les urgences péniennes les plus fréquentes étaient le priapisme (55,5%) et la fracture de verge (15,9%). Le délai moyen de consultation en urologie était de 121 343,3 heures pour une médiane de 10 heures tandis que celui de prise en charge était de 34,3±74,6 pour une médiane de 2 heures. Les principaux gestes effectués étaient la ponction des corps caverneux (n=29, 46%) suivie de l'albuginorraphie (n=9, 14,3%) et du shunt caverno spongieux (n=9, 14,3%). Conclusion : Les urgences péniennes sont relativement fréquentes. Elles sont dominées par le priapisme et la fracture de verge dans notre contexte. Le pronostic fonctionnel sexuel est bon mais le délai de prise en charge demeure encore long.

Introduction: Penile emergencies are multiple and varied. They can jeopardize the patient's functional sexual prognosis. The objective of our study was to report the clinical and therapeutic aspects of penile emergencies at the University Hospital of Libreville. Material and Methods: We conducted a retrospective study from January 2016 to December 2020 at the Urology Department of the CHU of Libreville. Variables included sociodemographic, clinical and therapeutic data of patients managed for a penile emergency. Results: During this period, 63 patients were managed for penile emergencies. The mean age was 27±17.3 years with extremes of 1 and 90 years. The most frequent penile emergencies were priapism (55.5%) and penile fracture (15.9%). The mean time to consultation in urology was 121,343.3 hours with a median of 10 hours, while the mean time to management was 34.3±74.6 with a median of 2 hours. The main procedures performed were corpora cavernosa puncture (n=29, 46%) followed by albuginorraphy (n=9, 14.3%) and cavernospongiosus shunt (n=9, 14.3%). Conclusion: Penile emergencies are relatively frequent. They are dominated by priapism and penile fracture in our context. The sexual functional prognosis is good but the delay of management remains long.

Prevalence and correlates of erectile dysfunction among long-distance commercial vehicle drivers and commercial motorcycle riders in Ibadan Nigeria: a comparative cross-sectional study

Background: Erectile dysfunction (ED) is a global public health problem that affects the quality of life, interpersonal, occupational, and social functioning of sufferers. Despite being high-risk groups, there is a paucity of data on erectile dysfunction among commercial vehicle drivers and motorcycle riders. Objectives: We aimed to determine and compare the prevalence and factors associated with ED among long-distance commercial vehicle drivers (CVDs) and commercial motorcycle riders (CMRs) in Ibadan, Nigeria. Methods: We used a comparative cross-sectional study design to enroll eligible male respondents in selected motor/motorcycle parks within Ibadan metropolis. Interviewer administered questionnaires were used to elicit sociodemographic/health-related characteristics, and ED status among participants. Data was analyzed using STATA version 12. Chi-square and Binary logistic regression were conducted to explore the association between ED and other covariates. Analyses were performed at 5% significance level. Results: The prevalence of ED was significantly higher among motorcycle riders than vehicle drivers (71.4% vs 47.4%, p = 0.001). Predictors of ED among CMRs were monogamous marriage type and history of perineal injury; while among CVRs were aged above 40-years, history of perineal injury, and current use of alcohol. Conclusion: There is a need for public education and awareness programmes on ED to reduce the burden and improve well-being in these populations

Profil pharmaco-doppler pénien des patients coronariens souffrant de dysfonction érectile à l'Institut de Cardiologie d'Abidjan une série de 30 cas / Penile pharmaco doppler profile of coronary patients with erectile dysfunction at the Abidjan Cardiology Institute: a series of 30 cases

Contexte et objectif. La maladie athéromateuse dont la coronaropathie étant une pathologie diffuse peut être prévenue par le contrôle des facteurs de risqué cardiovasculaire. Le but de cette étude était de décrire les caractéristiques pharmaco doppler pénien des patients coronariens souffrant de dysfonction érectile. Méthodes. Il s'agissait d'une série analytique des cas suivie entre juin 2020 et février 2021. Elle concernait des patients ayant des lésions athéromateuses significatives à la coronographie et souffrant de dysfonction érectile. Nous avons évalué les caractéristiques pharmaco doppler pénien. La qualité d'érection était appréciée par le score de rigidité Erectile Hardness Score (EHS). Résultats. Trente-six patients étaient inclus. L'âge moyen était de 56 ± 8,4 ans. le pic de Vitesse systolique au repos (PSVr) moyen des patients était de 13,7 cm/s ± 5,9. Le pic de vitesse systolique post injection (PSV pi) moyen des patients était de 23,9 cm/s ± 5,4. Les causes étaient principalement artérielles de 75%. La qualité d'érection était appréciée selon le score EHS : E1 (83%), E2 (22%), E3 (5%) et E4 (3%). Conclusion. La dysfunction érectile est associée aux facteurs de risque cardiovasculaire selon plusieurs études. L'echodoppler pénien avait occupé une place importante dans le diagnostic étiologique. Les causes retrouvées étaient principalement artérielles avec une baisse de PSVpi<25 cm/s.

Cavernosal artery peak systolic velocity among normal adults in Abuja, Nigeria: A Baseline parameter for sonographic diagnosis of vasculogenic erectile dysfunction

Background: Erectile dysfunction is consistent inability to achieve and maintain erection of sufficient rigidity for satisfactory sexual performance. It is well known that the hemodynamic function of the penis correlates well with the peak systolic velocity (PSV) of the cavernosal artery (CA) which is the most reliable, sensitive, and objective parameter used in evaluating the state of the erectile tissues of the penis. This study was aimed at establishing the normal CA PSV in this environment, as it may differ from the values among Americans, Caucasians, and Asians. Materials and Methods: The study was conducted between July 2015 and January 2017, at the Department of Radiology, Federal Medical Centre, Abuja. Twenty-nine consecutive patients referred by the urologist to the radiology department of the aforementioned institution for penile ultrasound were evaluated using triplex Doppler sonography with high-frequency linear array transducer. The penile scan was done before and after intracavernosal injection of 10­20 µg prostaglandin E1. The waveforms of CAs were obtained alternately using the angle of inclination ≤60°, and the PSV of the CA was documented at 5-min interval, from 5 to 40 min. Results: PSV of CA varied between 26 and 104.4 cm/s (mean: 46.72 ± 16.21) among the entire research participants. No significant discrepancy was noted between PSV of the right and left cavernosal arteries. The PSV had a strong positive relationship with age (P = 0.002), with the highest values found among those ≤30 years. Conclusion: The mean PSV of cavernosal arteries established in this study is not significantly different from the values obtained among Americans, Caucasians, and Asians, indicating that racial difference has no effect on this important sonographic variable

Erectile Dysfunction in a Sub-Saharan African population: Profile and Correlates in a Tertiary Care Hospital

Background: Erectile dysfunction (ED) is a common complaint in general medical practice. This study describes the clinicodemographic features of ED. Materials and Methods: Two hundred and twelve subjects in the outpatient clinic of a tertiary care hospital were interviewed for demographic data; tobacco smoking; alcohol consumption; history of medications; previous abdominal surgery; history of diabetes mellitus; hypertension and ED; duration of ED if present; self-assessment of the level of sexual satisfaction; partner's assessment of the level of sexual satisfaction; type of remedies sought and used for ED in the past; whether or not subject has discussed the problem and patients' perception of the cause of the ED; all were interviewed with the international index of erectile function questionnaire for ED. Data was analyzed as appropriate. Results: Forty-two (19.8) had ED and ED score was associated with age (P = 0.013); educational level (P 0.001); monthly income (P 0.001); alcohol consumption (P

The Prevalence of Erectile Dysfunction at a Primary Healthcare Clinic in Durban; KwaZulu-Natal

Objectives: The objectives of this study were to determine the prevalence of erectile dysfunction (ED) in men attending a primary healthcare (PHC) clinic in Durban; KwaZulu-Natal; and to document any relationship between ED and age; smoking; economic status and co-morbid conditions. Design: An observational; descriptive; cross-sectional study. Setting and subjects: More than 50 of men aged 40-70 years experience some degree of erectile dysfunction. However; no data is available on the prevalence of ED in a primary healthcare (PHC) setting in KwaZulu-Natal. Between February and March 2008; 1 300 questionnaires were distributed to men aged 18 years and older with no exclusion criteria; attending a general PHC clinic. Outcome measures: Responses were captured using a validated structured questionnaire (International Index of Erectile Function-15). Results: Eight hundred and three questionnaires were eligible for analysis. The overall prevalence rate of ED was 64.9 (621); of whom 14.6 (117) had mild ED; 19.9 (160) moderate ED; and 30.4 (244) severe ED. Erectile dysfunction increased with age; and there was a strong association between ED and economic status and co-morbid conditions. Conclusion: The prevalence of ED at this urban PHC clinic was high. Increased awareness by doctors working in the clinic may result in improved assessment and appropriate treatment that will enhance patients' quality of life

Hypertension and Sexual Dysfunction

Hypertension is a major independent cardiovascular risk factor; and also a marker of survival risk. Quality of life during the treatment of hypertension is an important health issue; as one in every five treated patients with hypertension will discontinue their therapy due to sideeffects.1 Discontinuation of therapy; and poor compliance with therapy; will eventually lead to a poorer outcome. The appearance of treatment-related side- effects may actually make patients feel worse than they did prior to treatment; when most hypertensive patients are asymptomatic. Sexual dysfunction is a potential side-effect of therapy; and may lead to poor therapy compliance

Non-Motor Symptoms of Parkinson's Disease: Diagnosis and Management

Bacground: Non-motor symptoms (NMS) of Parkinson's disease (PD) are a key determinant of health; quality of life (QoL) and societal cost of PD. They are often less appreciated than motor symptoms but are important sources of disability for manyPDpatients. Methods:Literature search was performed using the reference databases Medline; Science Citation Index and EMBASE. The keywords used were 'non-motor symptoms'; Parkinson's disease; olfaction and constipation. Papers discovered by this search were reviewed; as were references cited therein. Results: Contrary to common perception; many NMS of PD occur early in PD and some may even predate thediagnosis of PD that is based on motor signs. These include olfactory deficit; sleep problems such as rapid eye movement behaviour disorder; constipation and the more recently described male erectile dysfunctionThere is compelling evidence that nonmotor symptoms of PD play a dominant role in the QoL and disability of PD patients and the QoLof their 'informal' carers. Effective clinical management of PD therefore demands that these symptoms be identified and to the extent possible treated

Non-Motor Symptoms of Parkinson's Disease: Diagnosis and Management

Non-motor symptoms (NMS) of Parkinson's disease (PD) are a key determinant of health; quality of life (QoL) and societal cost of PD. They are often less appreciated than motor symptoms but are important sources of disability for manyPDpatients. Literature search was performed using the reference databases Medline; Science Citation Index and EMBASE. The keywords used were 'non-motor symptoms'; Parkinson's disease; olfaction and constipation. Papers discovered by this search were reviewed; as were references cited therein. Contrary to common perception; many NMS of PD occur early in PD and some may even predate the diagnosis of PD that is based on motor signs. These include olfactory deficit; sleep problems such as rapid eye movement behaviour disorder; constipation and the more recently described male erectile dysfunction.There is compelling evidence that nonmotor symptoms of PD play a dominant role in the QoL and disability of PD patients and the QoLof their 'informal' carers. Effective clinical management of PD therefore demands that these symptoms be identified and to the extent possible treated

Erectile dysfunction in older male stroke patients: correlation between side of hemiplegia and erectile function

This study was conducted to determine the effects of hemiplegia on erectile function in stroke patients. One hundred and five stroke patients grouped into left (61.78±7.79 years) and 55 right hemiplegic (62.11 ± 9.32 years) and 40 age-matched controls (64.00± 8.53 years).The International Index of Erectile Function questionnaire was used for data collection. One way analysis of variance and Spearman correlation tests were used in data analysis. Erectile function was significantly decreased in the both right (IIEF-5, 7.55 ± 4.07) and left hemiplegic groups (IIEF-5, 10.40 ± 5. 70) compared with the control group (IIEF-5, 20.50 ±4.2 7) p<0.05. Side of hemiplegia significantly correlated with erectile dysfunction at p<0.01. Conclusively, stroke mostly affects erectile function of right hemiplegia (Afr J Reprod Health 2009; 13[2]:49-54)

The Substitution of Phentolamine with an Equal amount of Chlorpromazine as an Alpha-Blocker in Vasoactive Cocktails used for Intracavernous Injection Therapy for the Treatment of Erectile Dysfunction

Introduction: This brief report describes the replacement of phentolamine mesylate with an equal amount of chlorpromazine HCl in vasoactive drug mixtures used as intracavernous (IC) injection therapy for treating erectile dysfunction (ED). Phentolamine; amongst other drugs; had been used in drug injection therapy for the treatment of ED; but was replaced as single drug therapy by more effective drugs; such as alprostadil (prostaglandin E1). It has; however; still widely been used as alpha-blocking agent in vasoactive drug cocktails. Phentolamine has a synergistic effect with alprostadil; papaverine and atropine in drug combination cocktails. These injection mixtures are very effective for treating ED and are commonly known as bimixtures; trimixtures and quadmixtures. The vasoactive drug; phentolamine; was withdrawn from the market in South Africa. Chlorpromazine (a phenothiazine) was suggested as an alternative alpha-blocking agent to be used in drug cocktails for the IC treatment of ED.Methods: Three hundred and sixty-four (364) patients were questioned and evaluated during follow-up visits to an ED clinic after phentolamine mesylate was replaced with an equal amount of chlorpromazine HCL in their regular IC injection preparations. The collected data is based on results from self-administration at home.Results: No significantly unusual adverse effects or altered efficacy of the new preparations were reported. The patients noted a change in the colour of the drug mixtures that contain chlorpromazine and papaverine. Despite this slight change in colour; the effectiveness of the mixtures remained the same if a use-before date of three months was adhered to.Conclusion: The results indicate that phentolamine mesylate can effectively be replaced with an equal amount of chlorpromazine HCL in IC drug cocktails for the treatment of ED

Etude de l'insuffisance érectile dans une population d'hommes jeunes et sexuellement actifs au Burkina Faso

Objectif: Notre tude avait pour objectif de dterminer la prvalence de l'insuffisance rectile (IE) dans notre environnement et d'valuer les connaissances et les attitudes des sujets qui en souffrent. Mthodologie: Il s'agissait d'une enqute transversale sur six mois concernant des sujets gs de 18 ans et plus du monde de travail, ralise au cours d'une visite annuelle des travailleurs des entreprises de la place et de quelques fonctionnaires. Les sujets ayant accept de participer l'enqute (855 hommes), avaient remplir deux questionnaires: la version 5 items de l'International Iindex of Erectile Function (IIEF5), qui value la fonction rectile et, un questionnaire labor par nous mme, dans le but d'valuer les connaissances et les attitudes des enquts, vis vis de l'IE. Les questionnaires ont ensuite t dpouills et analyss sur micro ordinateur l'aide du logiciel Epi info. Rsultats: Les 855 sujets qui ont particip l'enqute reprsentaient 80% de tous ceux qui ont t sollicits. L'ge moyen des enquts tait de 37,4 ± 9,1; plus des 2/3 (78%) taient maris et monogames dans 69%. La prvalence globale note tait de 47% et on a remarqu que celle-ci augmentait avec l'ge. Trois facteurs de risque ont t mis en exergue: l'ge, l'hypertension artrielle (HTA) et la maladie hmorrodaire. Si l'ge et l'HTA sont des facteurs de risque classiques, la maladie hmorrodaire l'est moins; par contre il a t beaucoup invoqu par de nombreux enquts. 93,2% des sujets interrogs seraient prts consulter pour IE, alors que seulement 3,8% l'avaient effectivement dj fait. Conclusion: L'insuffisance rectile s'est rvl comme un problme rel vcu dans notre environnement. Cependant nos rsultats ne peuvent pas tre gnraliss et nous envisageons d'autres tudes, en population gnrale, qui nous permettraient de tirer des enseignements et de mieux organiser la prise en charge de ces patients

Nouvelle approche du traitement de l'impuissance sexuelle masculine: medecines naturelles et phytotherapie

La certitude est le dernier ne des produits utilises pour traiter toutes les formes d'impuissance. Ce nouveau produit miracle resulte de l'association synergique de principes actifs comprenant: papaverine; alpha-bloquants et diverses substances qui agissent sur la neuro-transmission