RESUMO
Penile fracture is a well-recognized, relatively uncommon medical condition and its etiology differs according to geographic area. In this review article, we evaluated literature reported in the past decade, aiming to verify whether there has been any change in the etiology of this condition. A literature review was done for studies published in the past 10 years and focusing on the etiology of penile fracture. Inclusion criteria comprised articles in English language, of sample size more than 10 patients and originating from the Middle East and Central Asia. Data relating to the studied population, etiology of penile fracture, clinical presentation, investigations, management, and outcome was analyzed. One thousand six hundred and twenty-nine patients from 21 original articles were included in the study. The mean age ± standard deviation of the patients was 33.3 ± 3.23 years. Etiologies of penile fracture were vigorous sexual intercourse, manual bending of erect penis, vigorous masturbation, rolling over in bed and blunt trauma in 41%, 29%, 10%, 14% and 6% patients, respectively. Treatment choices were surgery and conservative, in 1580 (95%), 83 (5%) patients, respectively. A higher incidence of complications was found in conservatively treated patients. As a conclusion, in the last 10 years, vigorous sexual intercourse was the commonest etiology of penile fracture in the Middle East and Central Asia regions. Surgery remains the preferred treatment option for patients diagnosed with penile fracture.
RESUMO
AIM: The aim of this study is to investigate the prevalence of erectile dysfunction (ED) in Qatar and to determine the risk factors associated with it. MATERIALS AND METHODS: This is a cross-sectional survey study of men attending the outpatient department at Hamad Medical Corporation in Qatar between February 2012 and February 2013. The International Index of Erectile Function (IIEF)-5 questionnaire was used for data collection. In addition to the IIEF-5 score, each participant's medical history was taken, with special emphasis on risk factors for ED, including diabetes mellitus (DM), hypertension (HTN), dyslipidemia, coronary artery disease (CAD), and smoking habits, and on their body mass index. RESULTS: One thousand fifty-two participants were randomly selected to fill out the IIEF-5 questionnaire. The participants' mean age (±SD) was 41.87 ± 13.24 years. Analysis of replies to the IIEF-5 showed that ED was present in 573 out of 1,052 participants (54.5%). Fifty-six (5%) participants had severe ED, 61 (6%) had moderate ED, 173 (16%) had mild to moderate ED, and 283 (27%) had mild ED. Risk factors for ED that held statistical significance were age (odds ratio [OR] = 2.9, 95% confidence interval [CI] 2.1-4.1, P < 0.001), DM (OR = 2.6, 95% CI 1.7-3.9, P < 0.001), HTN (OR = 1.6, 95% CI 1.1-2.5, P = 0.012), dyslipidemia (OR = 1.5, 95% CI 1.1-2.4, P = 0.024), and CAD (OR = 3.2, 95% CI 1.3-7.5, P = 0.009). CONCLUSION: We found that the prevalence rate of ED in Qatar is quite similar to the regional reported rates. Overall, we demonstrated that nearly more than half of our participants suffered from ED. Besides age, DM, HTN, CAD, and dyslipidemia were found to be the most important risk factors for ED. Al Naimi A, Majzoub AA, Talib RA, Canguven O, and Al Ansari A. Erectile dysfunction in Qatar: Prevalence and risk factors in 1,052 participants-A pilot study. Sex Med 2014;2:91-95.
RESUMO
OBJECTIVE: To investigate the role of an abnormal prostate-specific antigen (PSA) level and abnormal findings on a digital rectal examination (DRE) in the detection of prostate cancer in men in Qatar. PATIENTS AND METHODS: Between June 2008 and September 2012, 651 patients had a transrectal ultrasonography-guided biopsy of the prostate (TRUSBP) at our centre. The indications for a biopsy were a high PSA level (>4 ng/mL), or an abnormal DRE result. Patients were assessed by a thorough history, clinical examination and routine laboratory investigations. Data, including age, DRE findings, TRUS findings, total PSA level, prostate volume and the pathology results, were evaluated. RESULTS: The mean (SD) age of the 651 patients was 64.1 (7.4) years. Prostate cancer was detected in 181 men (27.8%), benign prostatic hyperplasia in 275 (42.2%) and prostatitis in 236 (36.4%). The sensitivity and specificity for detecting prostate cancer were 93.9% and 8.5% for an abnormal PSA level (>4 ng/mL), 46.1% and 84.7% for abnormal DRE findings, and 95% and 30.2% for the two combined. Using a receiver operating characteristics curve, a PSA threshold of 7.9 ng/mL had a sensitivity of 56.6% and specificity of 52.8%. When a PSA threshold of 7.9 ng/mL was used in combination with abnormal DRE findings, the overall accuracy was 76.9%. CONCLUSION: The PSA threshold level of 7.9 ng/mL, determined by this analysis, has a higher likelihood of detecting prostate cancer in men in Qatar. However, it failed to detect cancer in substantially many men with statistically significant disease.
RESUMO
OBJECTIVES: To compare the frequency of infection after transrectal ultrasonography (TRUS)-guided biopsy of the prostate (TRUSBP) using prophylactic ciprofloxacin with or without adding cefuroxime. PATIENTS AND METHODS: Between June 2008 and October 2009, 205 consecutive patients had TRUSBP with the use of oral 500 mg ciprofloxacin twice per day, 2 days before and 3 days after the biopsy (defined as group A). Starting from November 2009 and onwards, 250 consecutive patients had TRUSBP using the same previous protocol of antibiotic prophylaxis but with the addition of intravenous 1.5 g cefuroxime given 30 min before the procedure (defined as group B). The incidence of sepsis after TRUSBP, together with the results of urine and blood cultures and antibiotic sensitivity, were compared between the groups. RESULTS: Fever after TRUSBP was recorded in 18 of 205 patients in group A (8.8%) and in nine of 250 in group B (3.6%); the difference was significant (P = 0.018). Urine culture was positive in 14 and five of patients in groups A and B, respectively, with extended-spectrum ß-lactamase-producing (ESBL) Escherichia coli as the most common organism. The blood culture was positive in seven and three patients in groups A and B, respectively, with ESBL E. coli as the most common organism. All patients who had sepsis after TRUSBP sepsis were treated successfully. CONCLUSION: Adding a single intravenous injection with 1.5 g of cefuroxime to oral ciprofloxacin significantly reduced the frequency of infectious complications after TRUSBP.
