Erectile dysfunction in patients with chronic renal failure

OBJECTIVE: Determine the prevalence of erectile dysfunction in patients undergoing hemodialysis MATERIALS AND METHODS: This cross-sectional study was carried out to determine the prevalence of erectile dysfunction in a population of 58 patients in hemodialysis program. Erectile dysfunction was assessed by using the International Index of Erectile Function (IIEF). Information on demographic data, renal failure, comorbidities, laboratory tests and search for medical treatment for erectile dysfunction by means of interviews and researches in medical charts was obtained. Student t test was utilized to compare the laboratory results between group of patients with and without erectile dysfunction. The chi-square test was utilized to compare the comorbidities and the characteristics of the population studied between the groups of patients with and without erectile dysfunction. The significance level considered was 5 percent RESULTS: Mean patient age was 50.2 ± 14.6 years and the time of hemodialysis was 30.4 ± 28.4 months. The prevalence of erectile dysfunction was 60.3 percent. A progressive increase respecting the age was reported. In patients younger than 50 years, this prevalence reached 31.4 percent and in patients older than 50 years, this prevalence reached 68.6 percent. With respect to the comorbidities, hypertensive patients prevailed with 94.8 percent of the total, whilst diabetic patients represented 24.9 percent. However only the association between diabetes and erectile dysfunction was significant. Patients with erectile dysfunction presented significantly lower values for serum creatinine and Kt/V. There was no variation between the groups with reference to calcium, potassium, phosphorus, hematocrit, hemoglobin, pre- and post-dialysis urea values. There was no correlation between erectile dysfunction and time of dialysis. Amongst patients with erectile dysfunction, 8.6 percent sought medical care CONCLUSIONS: The...

Effect of sildenafil in cavernous arteries of patients with erectile dysfunction

INTRODUCTION: Sildenafil citrate is a type 5 phosphodiesterase inhibitor, which has demonstrated excellent results in the treatment of erectile dysfunction. The effect of sildenafil citrate in the cavernous arteries of patients with erectile dysfunction has not been established yet. The objective of this study was to assess the effect of sildenafil citrate in the cavernous arteries of patients with erectile dysfunction, following an intracavernous injection of alprostadil. MATERIALS AND METHODS: 29 male patients, with mean age of 53.8 years (32 to 75 years), were prospectively evaluated. The mean time with complaint of erectile dysfunction was 50.5 months (6 to 168 months). Each patient was his own control. Patients underwent a measurement of peak systolic velocity before and after use of sildenafil citrate associated with 5 micrograms of alprostadil, through ultrasonic velocitometry Knoll/MIDUS® system. In the interval between measurements, approximately 15 days, patients used 3 tablets of sildenafil at home with their partners. RESULTS: Using only 5 mcg of alprostadil, average peak systolic velocity was 23.9 cm/s, and when associated to 50 mg of sildenafil it was 24.8 cm/s. Despite the increase in the flow rate caused by sildenafil, the difference was not statistically significant, Zcalculated = - 0.695 NS (Wilcoxon test). Twenty one of the 29 patients (72.4 percent) showed global improvement in sexual performance with the use of sildenafil citrate at home. There was not a statistically significant correlation between the global response to sildenafil citrate and the increase in the peak systolic velocity. CONCLUSION: We concluded that, even though the use of 50 mg of sildenafil citrate associated with 5 mcg of alprostadil provides an increase in the peak systolic velocity of the cavernous arteries, there was no statistic difference in relation to alprostadil alone. There was no correlation between the global response to sildenafil and the increase in the peak systolic velocity.

Disfunçäo erétil / Erectile dysfunction

Na introduçäo, os autores apresentam dados epidemiológicos da disfunçäo erétil (DE) e, em seguida, o diagnóstico clínico da DE de origem orgânica e psicogênica, bem como o diagnóstico laboratorial. O tratamento é subdividido em informaçöes gerais, medicamentos por via oral (sildenafil e análogos, ioimbina e fentolamina, apomorfina, trazodone e L-arginina), medicamentos por via uretral (alprostadil), farmacoterapia intracavernosa, bombas de vácuo e próteses penianas. Os autores concluem que existiu uma grande evoluçäo da fisiopatologia e do tratamento da DE e que esta doença é bastante comum, existindo soluçöes para restabelecer o bem-estar do paciente.(au)

Infecçöes do trato urinário nos homens / Men's urinary tract infections

A ITU é um dos problemas mais freqüêntes na prática médica, sendo responsável por morbidez e custos consideráveis. A maioria das ITU em homens é considerada complicada, visto que grande parte delas ocorre nos recém-natos, lactentes ou idosos, e estäo associadas a anormalidades urológicas. Em homens idosos as infecçöes säo mais freqüêntes devido ao aumento do volume prostático, que leve a uma obstruçäo infravesical.(au)