Quality of life after radical cystectomy for bladder cancer in men with an ileal conduit or continent urinary diversion: a comparative study

To investigate quality of life [QoL] domains with three forms of urinary diversions, including ileal conduit, MAINZ pouch, and orthotopic ileal neobladder after radical cystectomy in men with muscle-invasive bladder cancer. In a prospective study, 149 men underwent radical cystectomy and urinary diversion [70 ileal conduit, 16 MAINZ pouch, and 63 orthotopic ileal neobladder]. Different domains of QoL, including general and physical conditions, psychological status, social status, sexual life, diversion-related symptoms, and satisfaction with the treatment were assessed using an author constructed questionnaire. Assessment was performed at three months postoperatively. In questions addressing psychological status, social status, and sexual life, patients with continent diversion had a more favorable outcome [P = 0.002, P = 0.01, and P = 0.002, respectively]. The rate of erectile dysfunction did not differ significantly between the three groups [P = 0.21]. The rate and global satisfaction was higher with the MAINZ pouch [68.7%] and ileal neobladder [76.2%] as compared with the ileal conduit group [52.8%] [P = 0.002]. Continent urinary diversion after radical cystectomy provides better results in terms of QoL as compared with ileal conduit diversion.

Erectile dysfunction: clinical guidelines [1]

According to a survey, the Massachusetts Male Aging Study, 52% of men beyond 40 years of age may have some degrees of erectile failure, and it is projected to affect 322 million men worldwide by 2025. We present a framework for the evaluation, treatment, and follow-up of the male patient who presents with erectile dysfunction. A comprehensive review of the literature was conducted using the MEDLINE database for all articles from 1975 through 2004 on male sexual dysfunction and the most pertinent articles are discussed. Remarkable progress has been made in the treatment of erectile dysfunction [ED]. Erectile dysfunction is a common condition associated with aging, chronic illnesses and various modifiable risk factors. Erectile dysfunction can be due to vasculogenic, neurogenic, hormonal, and/or psychogenic factors as well as alterations in the nitric oxide/cyclic guanosine monophosphate pathway or other regulatory mechanisms. The number of consultations from new patients presenting with erectile dysfunction and resulting costs for health care systems are increasing. Urologist should be the evaluating physician who supervises the surgical, medical, and hormonal treatment and who refers the patient, as necessary, to other members of the multidisciplinary team. Erectile dysfunction has a significant negative impact on quality of life. Male sexual dysfunction, especially erectile dysfunction, necessitates a comprehensive medical and psychologic evaluation involving both partners. All possible risk factors should be outlined and corrected, when feasible

Erectile dysfunction: clinical guidelines [2]

According to a survey, the Massachusetts Male Aging Study, 52% of men beyond 40 years of age may have some degrees of erectile failure, and it is projected to affect 322 million men worldwide by 2025. We present a framework for the evaluation, treatment, and follow-up of the male patient who presents with erectile dysfunction. A comprehensive review of the literature was conducted using the MEDLINE database for all articles from 1975 through 2004 on male sexual dysfunction and the most pertinent articles are discussed. Remarkable progress has been made in the treatment of erectile dysfunction [ED]. Erectile dysfunction is a common condition associated with aging, chronic illnesses and various modifiable risk factors. Erectile dysfunction can be due to vasculogenic, neurogenic, hormonal, and/or psychogenic factors as well as alterations in the nitric oxide/cyclic guanosine monophosphate pathway or other regulatory mechanisms. The number of consultations from new patients presenting with erectile dysfunction and resulting costs for health care systems are increasing. Urologist should be the evaluating physician who supervises the surgical, medical, and hormonal treatment and who refers the patient, as necessary, to other members of the multidisciplinary team. Erectile dysfunction has a significant negative impact on quality of life. Male sexual dysfunction, especially erectile dysfunction, necessitates a comprehensive medical and psychologic evaluation involving both partners. All possible risk factors should be outlined and corrected, when feasible