Evaluating dose regimens of apomorphine, an open-label study.

The aim of the study was to investigate the safety and efficacy of apomorphine SL (apo SL) 2 and 3 mg, using a dose-optimisation regime in 110 Asian men with erectile dysfunction (ED) during a 10-week open-label study. Based on daily diaries kept by each patient, 63% showed an improvement in their sexual life. Patient responses to the International Index for Erection Function 15 questionnaires showed that there was an improvement in erectile function from baseline score after treatment with apo SL (from 15.9 to 20.4), and intercourse satisfaction (from 7.7 to 9.9), as well as slight improvements in orgasmic function (from 6.8 to 7.5) and total satisfaction (from 41.9 to 50.8). There was no marked improvement seen in sexual desire. In conclusion, apo SL is safe and efficacious in the treatment of ED in this patient population, irrespective of underlying diseases and concomitant medications.

Prevalence of erectile dysfunction in Thailand. Thai Erectile Dysfunction Epidemiological Study Group.

A study of the prevalence rate of erectile dysfunction (ED) in the Thai population has never been done previously, except for a small study in the hospital. The project was carried out across the whole country, including in the north, south, eastern and central plains, and there were representatives from one small and one large province and the Bangkok metropolitan area. There were 250 males in each area, giving as total of 1250 males. The interviews were carried out in urban areas, so that the questions and answers could produce good data. The interviewer was trained by one of our EDACTT members, before going to the interview locations, and the supervisor were also onsite to clarify any the questions that might occur. The questions and pretest were carried out stringently, to help in term of statistics. All the health questions were asked taking care to accommodate the interviewee's feelings, so as not to cause embarrassment. The interviews were held individually and strictly privately, so that the interviewees could speak freely The interviewees were between 40 and 70-years old, to match with MMAS. The rate of ED in this age group is increasing gradually, and the relationship between ED and hypertension, diabetics or heart disease, and lifestyle factors, including smoking habits, alcohol consumption, caffeine and risk factors is of interest.

Ten years' experience with enterocystoplasty.

Eighteen augmentation cystoplasties and 18 substitution cystoplasties were performed during the last 10 yrs. The indications for augmentation cystoplasty were tuberculous cystitis, interstitial cystitis, detrusor hyperreflexia, and a poor compliant neuropathic bladder. The indications for substitution cystoplasty were a neuropathic bladder and carcinoma of the bladder. Voiding was satisfactory in 11 cases of the augmentation cystoplasty group and in 14 cases of the substitution cystoplasty group. The remaining patients required clean intermittent self catheterization. Revision of the bladder neck was necessary after augmentation cystoplasty in 2 cases. Incontinence of urine occurred in 1 case of each group, both being neuropathic bladder cases with poor sphincter function. Incontinence from detrusor hyperreflexia present before the operation was improved after "clam" enterocystoplasty in all of the 3 cases. Enuresis occurred in 11 cases of the substitution cystoplasty group. Early complications included troublesome mucus plugs, perforation of the neobladder, a persistent suprapubic fistula and one perioperative death. A total of 23 patients were available for follow-up for an average of 17 months (range 6 months to 8 yrs). Thirteen were alive and well, 5 were alive with poor health. Late complications included uretero-vesical junction obstruction, vesico-ureteric reflux, vesical stones, recurrent urinary tract infection, entero-vesical junction narrowing, renal deterioration, gut obstruction, death from chronic renal failure, and death from progression of carcinoma of the bladder. The reoperation rate for complications was 7/23 or 30.43 per cent. The entero-cystoplasty is an operation not to be taken lightly because of the complications and reoperation rate.