Erectile Dysfunction in Men with and without Lower Urinary Tract Symptoms in Nigeria.

PURPOSE: Much attention has been focused in recent decades on the effects of erectile dysfunction (ED) secondary to lower urinary tract symptoms (LUTS), potentially underestimating its effects in men without LUTS. This study aimed to compare the prevalence and predictors of ED in men with and without LUTS. MATERIALS AND METHODS: The International Index of Erectile Function questionnaire was administered to 303 patients between January 2014 and June 2016. Within this sample, 147 patients with LUTS (cases) were compared to 156 men without LUTS who were matched for age, level of education, and occupation (controls). RESULTS: The mean age was 66.03±9.64 years and 65.78±8.61 years for the cases and controls, respectively. The prevalence of ED was 64.6% and 73.7% (odds ratio [OR], 1.54; 95% confidence interval [CI], 0.94~2.51) in the case cohort and controls, respectively (p=0.086). There was no difference in the prevalence of impaired erectile function (p=0.067), impaired orgasmic function (p=0.108), impaired sexual desire (p=0.291), impaired intercourse satisfaction (p=0.869), or impaired overall satisfaction (p=0.191). Multivariate logistic regression analysis showed that being currently employed was a significant predictor of ED both in men with LUTS (OR, 8.08; 95% CI, 1.51~9.27; p=0.004) and in men without LUTS (OR, 7.00; 95% CI, 1.49~14.51; p=0.008). Being married only predicted for impaired EF in men without LUTS (OR, 6.34; 95% CI, 1.40~15.20; p<0.05). CONCLUSIONS: ED was not found to be more prevalent in men with LUTS. Being employed was a predictor of ED in both groups of men, while being married was also a predictor of ED in men without LUTS.

Comparison of ease of induction of spinal anaesthesia in sitting with legs parallel on the table versus traditional sitting position.

INTRODUCTION: It is sometimes difficult for some patients to optimally flex their hips and knees making traditional position for induction of spinal anaesthesia difficult to achieve. The ease of induction of spinal anaesthesia was compared with patients in sitting position with legs remaining on the table (new sitting method) versus legs placed on the side stool (traditional sitting method). METHODS: One hundred eligible elderly patients, aged between 65 and 80 years, scheduled for open prostactectomy, were prospectively randomized to 2 groups, LS and LT. Patients in (LS group) had their spinal anaesthesia induced in sitting position with their legs placed on the stool while patients in (LT group) had their spinal anaesthesia induced in sitting position with their legs remaning on the operating table. The primary endpoint was correct needle placement. Numbers of attempts, needle redirections and patients' comfort were determined to compare outcome in the two groups. RESULTS: More patients in LS group (78%) than those in the LT group (64%) had successful placement of spinal needle at first attempt (P = 0.12, RR = 1.6, 95% CI = 0.863-3.102). Needle redirections were similar at first attempt (52% versus 40%; P = 0.22). The groups were equivalent with respect to 100% overall success rate (P = 1.000). It took longer time to induce spinal anaesthesia in patients in LS group (240 vs 125s, p < 0.001). Patients in LT were more comfotable. CONCLUSION: The 100% overall success rate was comparable. However, patients were generally more comfortable with their legs placed on the table.

Severity of Lower Urinary Tract Symptoms among Middle Aged and Elderly Nigerian Men: Impact on Quality of Life.

Objectives. To compare the severity of LUTS among middle aged and elderly Nigerian men and determine the influence of LUTS severity on QoL. Methods. This cross-sectional study was conducted among new patients presenting with LUTS attending Urology clinic between 2011 and 2015. Assessment of symptoms was based on IPSS and bother score completed by the eligible subjects on the same day of their clinic visits. Results. Four hundred patients were studied comprising 229 middle aged and 171 elderly men. Interquartile range (IQR) of IPSS scores for men <65 years and those ≥65 years was 14.0 (16.0) and 19 (15.0), respectively (p < 0.001). Mild LUTS was significantly associated with best, good, and poor quality of life while moderate LUTS was associated with poor QoL. Severe LUTS was significantly associated with all the categories of QoL (Best-Worst). Among the cohort of subjects with poor QoL, elderly patients had a significantly higher median IPSS score (p < 0.05). Conclusions. There is no level of severity of LUTS in which patients' QoL is not impaired although mild symptomatology may be associated with better QoL and severe symptomatology with poor QoL. Careful attention to QoL may help identify patients who require early and prompt treatment irrespective of the IPSS.