Preliminary development of a questionnaire assessing the impact of psoriasis and psoriatic arthritis on patient's perception of sexuality.

Psoriasis and psoriatic arthritis impact sexuality and intimate relationships in both men and women, and can be associated with sexual dysfunctions.The aim of this study was to develop and validate a specific questionnaire assessing the impact of psoriasis and psoriatic arthritis on patients' sexuality. Two focus groups of patients, concerned by sexuality, were conducted in February 2015. Based on the verbatim transcripts, a content analysis was performed by a psychologist trained in qualitative procedures.After analysis of the verbatim reports by the research group, a preliminary questionnaire comprising 22 questions was drawn up. The areas covered by the questions concerned: the quality of daily life, tolerance of the cutaneous state by the patient, tiredness, mobility and flexibility of the joints, outside activities involving movement of all or part of the body. In the following step the questions were then submitted to a panel of experts for selection using a Delphi method. The experts were questioned about item relevance and content. After expert consensus had been reached, the instructions to participants completing the questionnaire, the wording of items, and the possible answers were finalized.The final questionnaire (comprising 14 questions) is entitled "Questionnaire of sexual quality of life perceived by patients with cutaneous and/or articular psoriasis" (short denomination: Qualipsosex). The quantitative step has not yet been conducted. This step will aim to evaluate the metrologic qualities (reliability, validity, and responsiveness) of the questionnaire and will need to be validated according to the consensus-based standards for the selection of health measurement instrument checklist.

Adrenal rest tissue in gonads of patients with classical congenital adrenal hyperplasia: multicenter study of 45 French male patients.

OBJECTIVES: Several cases of testicular adrenal rest tumours have been reported in men with congenital adrenal hyperplasia (CAH) due to the classical form of 21-hydroxylase deficiency but the prevalence has not been established. The aims of this report were to evaluate the frequency of testicular adrenal rest tissue in this population in a retrospective multicentre study involving eight endocrinology centres, and to determine whether treatment or genetic background had an impact on the occurrence of adrenal rest tissue. MATERIAL AND METHODS: Testicular adrenal rest tissue (TART) was sought clinically and with ultrasound examination in forty-five males with CAH due to the classical form of 21-hydroxylase deficiency. When the diagnosis of testicular adrenal rest tumours was sought, good observance of treatment was judged on biological concentrations of 17-hydroxyprogesterone (17OHP), delta4-androstenedione, active renin and testosterone. The results of affected and non-affected subjects were compared. RESULTS: TART was detected in none of the 18 subjects aged 1 to 15years but was detected in 14 of the 27 subjects aged more than 15years. Five patients with an abnormal echography result had no clinical signs. Therapeutic control evaluated at diagnosis of TART seemed less effective when diagnosis was made in patients with adrenal rest tissue compared to TART-free subjects. Various genotypes were observed in patients with or without TART. CONCLUSION: Due to the high prevalence of TART in classical CAH and the delayed clinical diagnosis, testicular ultrasonography must be performed before puberty and thereafter regularly during adulthood even if the clinical examination is normal.

[Diagnosis of male anorgasmia]. / Diagnostic d'une anorgasmie masculine.

Anorgasmia (anejaculation without orgasm) is defined as persistent or frequent absence of orgasm after a normal phase of sexual arousal. Delayed ejaculation is a minor form of anorgasmia. The prevalence of male anorgasmia was estimated in the ACSF (France 1993) and NHSLS (USA 1999) surveys to be 14 and 8%, respectively. The aetiological diagnosis of anorgasmia is essentially based on clinical interview. The risk factors for anorgasmia are usually psychological but can also be neurological and drug-related in some cases. In particular, alpha-blockers, often used in urology, and serotonin and/or noradrenaline reuptake inhibitor antidepressants fairly frequently induce delayed orgasm or anorgasmia. A psychological assessment should be proposed for patients with anorgasmia with no organic risk factor.

[Chronic prostatitis and chronic pelvic pain syndrome: a survey of French urologists]. / Prostatite chronique et syndrome douloureux pelvien chronique de l'homme. Enquête auprès des urologues français.

UNLABELLED: OBJECTIVE OF THE SURVEY: To determine the usual practice of French urologists in relation to the diagnostic and therapeutic management of chronic prostatitis. MATERIAL AND METHODS: A questionnaire on the diagnostic and therapeutic management of chronic prostatitis was sent by mail in June 2003 to 810 urologists, members of the Association Française d'Urologie and working in France. RESULTS: 124 (15%) urologists returned the questionnaire. 61% of these urologists diagnosed less than 11 new cases of chronic prostatitis per year and 65% were not familiar with the new classification proposed in 1995 in the USA by the NIH (National Institutes of Heath) designed to remove this disease from the strict context of the prostate, placing greater emphasis on the concept of pain and introducing the concept of male chronic pelvic pain syndrome. 83% of urologists performed microbiological investigations often or always, but only 10% often or always performed a Meares and Stamey test comprising analysis of prostatic secretions after massage and 68% never performed this test. On the other hand, 76% of urologists ordered a first-stream urine culture, 61% ordered a second-stream urine culture and 76% ordered semen culture. 73% often or always prescribed antibiotics (82% used fluoroquinolones and 43% used the trimethoprim-sulfmethoxazole combination). Even in the absence of microbiological proof of infection, 41% of urologists often or always prescribed antibiotics, 89% sometimes or often prescribed an alpha-blocking agent, 89% sometimes, often or always prescribed a non-steroidal anti-inflammatory drug, 81% sometimes, often or always prescribed analgesics, 52% sometimes or often prescribed anxiolytics, and 66% sometimes or often referred the patient to another specialist. CONCLUSION: This survey shows that chronic prostatitis, now generally referred to as "chronic pelvic pain syndrome", continues to raise diagnostic and therapeutic problems for French urologists.