ABSTRACT
ABSTRACT Purpose To determine whether there is a difference in sexual function after modified and classical TOT procedures. Materials and Methods Of the 80 sexually active women with SUI, 36 underwent an original outside-in TOT as described by Delorme, and 44 underwent modified TOT procedure, between 2011 and 2015. The severity of incontinence and sexual function were evaluated using International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) and Female Sexual Function Index (FSFI) questionnaires preoperatively and 3 months after surgery. Results The postoperative ICIQ-SF score was significantly lower than the preoperative ICIQ-SF score in both groups (p=0.004 for modified TOT and p=0.002 for classical TOT). There was no significant difference in the ICIQ-SF score reduction between the two groups (14.1±2.1 vs. 14.4±1.9; p=0.892). Complication rates according to the Clavien-Dindo classification were also similar in both groups. In both groups, difference between preoperative and postoperative FSFI scores revealed a statistically significant improvement in all domains. Comparison of postoperative 3-month FSFI scores of modified and classical TOT groups showed statistically significant differences in arousal, lubrication and orgasm domains. Desire, satisfaction, pain and total FSFI scores did not differ significantly between two groups. Conclusion The modified TOT technique is a simple, reliable and minimal invasive procedure. The cure rate of incontinence and complication rates are the same as those of the classical TOT technique. However, due to the positive effects of minimal tissue damage on sexual arousal and orgasmic function, modified TOT has an advantage over the classical TOT.
Subject(s)
Humans , Female , Adult , Aged , Sexual Dysfunction, Physiological/physiopathology , Urinary Incontinence, Stress/surgery , Urinary Incontinence, Stress/physiopathology , Sexuality/physiology , Suburethral Slings , Postoperative Period , Quality of Life , Sexual Dysfunction, Physiological/psychology , Severity of Illness Index , Prospective Studies , Surveys and Questionnaires , Treatment Outcome , Patient Satisfaction , Statistics, Nonparametric , Sexuality/psychology , Cystoscopy/methods , Educational Status , Equipment Design , Preoperative Period , Middle Aged , NeedlesABSTRACT
Objective: To analyze potential factors affecting the outcomes of docetaxel and prednisone (DP) combination therapy in patients with castration resistant prostate cancer (CRPC). Methods: A total of 272 patients were treated with DP chemotherapy for CRPC between April 2006 and January 2014. Patients received docetaxel (75 mg/m2) administered as ≥1-h intravenous infusion on day 1, every 3 weeks plus oral prednisone 5 mg twice daily starting on day 1 and continuing throughout the treatment. Patients were evaluated for prostate specific antigen (PSA) response, toxicity and factors affecting the treatment outcomes. Results: 132 (48.6%) patients achieved a PSA response (47 complete and 85 partial response). There were no differences between PSA responders and PSA non-responders in terms of age, gleason score, initial PSA value and Eastern Cooperative Oncology Group (ECOG) performance status. Alkaline phosphatase (ALP) level of non-responders was significantly higher compared to PSA responders (p= 0.042), total serum protein levels (p=0.035) and albumin (p=0.012) were significantly lower in non-responder group. Median survival rate of PSA responders was significantly higher compared to PSA non-responders (19 months vs 14 months, p= 0.000). The most common grade 3-4 toxicity of chemotherapy was neutropenia which was observed in 95 (34.7%) patients. Conclusions: Serum ALP, total protein and albumin levels can be used to predict treatment outcomes following docetaxel and prednisone combination therapy in patients with CRPC.
ABSTRACT
Penile prostheses are subject to a continuous development and have gained better mechanical reliability and safety during the last decades. In this study, we aimed to investigate the outcomes and satisfaction rates of inflatable penile prosthesis (IPP) and semirigid penile prosthesis (SPP) implantation.
From August 2001 to June 2012, 257 men with erectile dysfunction (ED) underwent penile prosthesis implantation (PPI) at our institution. Of the 257 patients, 118 underwent implantation of IPP and 139 underwent SPP implantation. The pre-operative and post-operative erectile status of the patients were assessed by international index of erectile function (IIEF) questionnaire. The satisfaction of patients and partners were evaluated by a telephone interview using the erectile dysfunction inventory of treatment satisfaction (EDITS) questionnaire and EDITS partner survey.
The overall major complication rate was higher in IPP group. PPI led to a significant improvement in IIEF scores in both groups. For IPP and SPP groups the average EDITS scores were 78±11and 57±8, respectively, and that for the partners were 72±10 and 49±7, respectively (p<0.05).
Although the IPP implantation have better satisfaction rates, the SPP implantation is still a viable treatment option in the surgical treatment of ED because of low cost and high durability with acceptable satisfaction rates.