Prevalence of metabolic syndrome and its association with erectile dysfunction among urologic patients: metabolic backgrounds of erectile dysfunction.

OBJECTIVES: To identify the prevalence of metabolic syndrome (MS) and its association with erectile dysfunction (ED) among urologic patients. METHODS: The study population consisted of 393 male patients aged 40 to 70 years, who were admitted to the urology clinics of four different institutions from February to March 2005. The waist circumference (WC) and triglyceride (TG) and high-density lipoprotein (HDL) cholesterol levels were measured. Patients were divided into two groups: group 1 consisted of patients with a WC greater than 102 cm, and group 2 consisted of patients with a WC of less than 102 cm. The erectile status of the two groups was compared. RESULTS: Of the 393 patients, 157 (39.9%) had MS. Of the 393 patients, 124 with MS (79%) and 146 without MS (61.9%) had ED. The presence of MS was significantly associated with ED (P <0.001). In the presence of an increased WC with normal serum HDL and TG levels, the relative risk of ED was 1.94. If the patient with an increased WC had a pathologic level of HDL or TG, the relative risk of ED increased up to 2.97-fold. The relative risk of ED in the presence of an increased WC, together with pathologic levels of HDL and TG, was 3.38. CONCLUSIONS: In our study, MS was strongly associated with ED. Fasting blood glucose levels, hypertension, and WC are the most significant risk factors predicting the risk of ED. A more pronounced increase in ED risk in the presence of abdominal obesity, together with altered TG and HDL cholesterol levels, may indicate a special metabolic background of ED regarding lipid metabolism.

Analysis of premature ejaculation in hemodialysis patients using the International Index of Erectile Function.

OBJECTIVE: We have conducted the following study to determine the prevalence of premature ejaculation in male hemodialysis patients and its impact on sexual quality of life. METHODS: This study was performed in hemodialysis facilities. Patients were asked to complete the International Index of Erectile Function (IIEF) questionnaire and also to report their ejaculation status. 98 male hemodialysis patients with normal potency were included in the study. The IIEF domain scores were determined, and the overall and relationship satisfaction rates were calculated for the patients with and without premature ejaculation separately. RESULTS: The mean age was 45.9 (range 30-69) years and the duration of hemodialysis was 37.8 (range 7-84) months. Premature ejaculation was determined in 31 (31.6%) patients. Patients with premature ejaculation experienced significantly lower overall satisfaction scores. Items of satisfaction with overall sexual life and sexual relationship with partner were responded to with a score of 'moderately satisfied' or 'very satisfied' in 47 and 53% of patients with premature ejaculation and 84 and 86% of patients without premature ejaculation, respectively. CONCLUSIONS: Premature ejaculation is a prevalent disorder in hemodialysis patients and seems to affect the satisfaction rate and sexual quality of life of these patients.

Early catheter removal following transurethral prostatectomy: overnight catheterization.

OBJECTIVE: Our aim was to determine the safety and feasibility of catheter removal on the first morning after transurethral prostatectomy. METHODS: Fifty-four patients who underwent transurethral prostatectomy were included in a prospective study. The decision to remove the catheters on the first morning after surgery was based on the color of the catheter effluent, absence of clots, normal vital signs and adequate urine output. Patients who voided successfully were discharged on the same day as catheter removal. RESULTS: Catheters were removed in 43 (79.6%) patients on postoperative day 1. Of these patients 40 (93%) voided successfully, however 3 of them required recatheterization due to bleeding or urinary retention. The criteria for catheter removal were not met in 11 patients and their catheters were removed on postoperative day 2 in 2 and on postoperative day 3 in 9. The mean length of hospital stay after surgery was 1.74 days for the entire group and 1.41 days for those in whom the catheter was removed on postoperative day 1. CONCLUSION: Overnight catheterization after transurethral prostatectomy seems to be a feasible approach without leading to significant morbidity in selected patients.