Subjective effects of Lepidium meyenii (Maca) extract on well-being and sexual performances in patients with mild erectile dysfunction: a randomised, double-blind clinical trial.

Lepidium meyenii (Maca) is a cultivated root belonging to the brassica family used in the Andean region for its supposed aphrodisiac properties. We carried out a double-blind clinical trial on 50 Caucasian men affected by mild erectile dysfunction (ED), randomised to treatment with Maca dry extract, 2400 mg, or placebo. The treatment effect on ED and subjective well-being was tested administrating before and after 12 weeks the International Index of Erectile Function (IIEF-5) and the Satisfaction Profile (SAT-P). After 12 weeks of treatment, both Maca- and placebo-treated patients experienced a significant increase in IIEF-5 score (P < 0.05 for both). However, patients taking Maca experienced a more significant increase than those taking placebo (1.6 +/- 1.1 versus 0.5 +/- 0.6, P < 0.001). Both Maca- and placebo-treated subjects experienced a significant improvement in psychological performance-related SAT-P score, but the Maca group higher than that of placebo group (+9 +/- 6 versus +6 +/- 5, P < 0.05). However, only Maca-treated patients experienced a significant improvement in physical and social performance-related SAT-P score compared with the baseline (+7 +/- 6 and +7 +/- 6, both P < 0.05). In conclusion, our data support a small but significant effect of Maca supplementation on subjective perception of general and sexual well-being in adult patients with mild ED.

[Radical prostatectomy: which quality of life?]. / Prostatectomia radicale retropubica: quale qualità di vita?

The aim of the present study was to evaluate quality of life in patients submitted to radical prostatectomy, by correlating the results of the postoperative condition with follow- up data at 6 and 12 months. MATERIALS AND METHODS. Between october 2004 and december 2005, 68 patients - mean age 68 (range 49-76) - treated with radical retro-pubic prostatectomy for localized prostate cancer (T2a, T2b, No, Mo) were consecutively enrolled onto the study. All patients underwent sexual as well as urinary incontinence rehabilitation, showing good compliance. We evaluated quality of life before prostatectomy (T0), 6 (T1) and 12 (T2) months after surgery through the Short Form 36 questionnaire, for which an analysis of variance for repeated measures was carried out. Patients were interviewed by our department psychologist regarding urinary incontinence and erectile dysfunction. All patients were disease-free at the time of evaluation. RESULTS. No significant differences were observed between physical and mental health indices. Conversely, a significant improvement (p<0.001) was seen in all SF-36-questionnaire 8 scales, comparing preoperative T0 values with T1 and T2 values. Of the 68 patients, 53 (78%) no longer needed pads at the T2 follow-up, while 15 (22%) reported using 3-4 pads/day. A significant worsening of the sexual function (maintenance of erection) was observed in 51 (75%) patients, who had reported having normal sexual activity preoperatively (T0). On the other hand, 17 (25%) patients reported having an adequate erection to engage in sexual intercourse. CONCLUSIONS. Despite the differences observed in physical and mental health scores during the three periods evaluated (T0, T1 and T2), overall quality of life does not appear to have been greatly compromised by surgery. At T2 follow-up, in fact, all 68 patients reported to be satisfied with having undergone radical prostatectomy because of its benefits in terms of survival and its limited effects on their quality of life.

Cystadenoma of the seminal vesicle: US and CT findings.

Ultrasonographic (US) and computed tomographic (CT) features of a cystadenoma of the seminal vesicle are presented.

Beta-human chorionic gonadotropin and alpha-fetoprotein in central and peripheral venous blood of patients with testicular tumors.

From January 1989 to June 1991, 18 patients ranging in age from 19 to 41 (mean 34) years with testicular tumor were examined. 14 patients had seminoma (11 typical and 3 spermatocytic) and 4 patients had a mixed form (2 seminoma + embryonal tumor and 2 seminoma + teratocarcinoma). Serum levels of beta-human chorionic gonadotropin and alpha-fetoprotein from peripheral venous blood and from spermatic venous vessel were evaluated in every patient. All patients with seminoma and in a patient with mixed tumor (seminoma + embryonal tumor) the markers were regular. The increase of the markers was found in the peripheral and in spermatic blood of 3 patients (2 seminoma + embryonal carcinoma and 1 seminoma + teratocarcinoma). For these reasons the values of spermatic vessels are an important confirmation of the level of peripheral markers.

Sexual dysfunction after excision of the rectum.

From January 1986 up January 1988 a series of 18 patients--age average 49--were studied. All of them had undergone the amputation of the rectum for carcinoma with the Miles resection technique (15 p.), or for ulcerous rectumcolitis (3 p.). Six months after operation the patients were given a questionnaire in order to obtain information about their sexual activity. Exams on the liverkidney functioning, the hormone dosage (FSH, LH, prolactin, testosterone), penile Doppler flowmetry, and the sacral latency test were performed. The patients were also given a Jonas erectiometer to be used at home. The procedures followed have shown in most patients normal hormonal, vascular, and neurologic parameters, thus confirming the absence of relevant erectile deficits. Only one patient no longer had erections after the surgical intervention. It was reported a decrease and some sort of difficulty in the sexual intercourse owing to the presence of colostomy conditioning the physical and psychological relations with the partner. Spermatic fluid results altered after operation: absent in 8 cases, backwards in 3, diminished in 6, and normal in 4.

Chemical prosthesis.

The approach to patients suffering from erectile failure includes medical and sexual anamnesis, Doppler ultrasound, Jonas erectiometer and Sacral Latency Test. At present, the use of papaverine directly in corpora cavernosa seems indicated in performance anxiety dysfunctions used together with psycotherapy and in slight arterial deficiencies, diabetes, after destructive pelvic surgery and in neurological lesions. From January 1986 we have performed 150 I.C. injections of papaverine. Experience in 60 patients is described. Seven patients are now self-injecting.