Does laparoscopic colorectal resection for diverticular disease impair male urinary and sexual function?

BACKGROUND: Laparoscopic colorectal resection may induce bladder and sexual dysfunction secondary to injury to the autonomic nervous system. The aim of this study was to evaluate urinary and sexual function in male patients after laparoscopic colorectal resection for diverticular disease. METHODS: From January 1997 to March 2002, we performed a retrospective analysis of urinary and sexual function in 56 consecutive male patients who had undergone laparoscopic colorectal resection for diverticular disease. Preoperative and 6-month postoperative assessment was carried out using data collected via standardized postal questionnaires. RESULTS: Three patients were excluded (one had a prior prostatectomy, one had Peyronie's disease, and one was treated with neuroleptics). Fifty-three patients with a mean age of 54 A+/- 2 years were included in the study. There were no conversions. The morbidity rate was 9.4%. Mean follow-up was 27 A+/- 2 months. There was no significant difference in preoperative and postoperative urinary function. Fifty-one patients (96%) were sexually active preoperatively and were still sexually active postoperatively. Compared with the preoperative period, postoperative impairment of libido, erection, ejaculation, and orgasm were not significant. Every patient was able to achieve ejaculation after the intervention, and no retrograde ejaculations were reported. One patient was unable to have an erection after the intervention. CONCLUSION: Laparoscopic colorectal resection for diverticular disease does not significantly impair urinary and sexual function.

[Reflex sympathetic dystrophy involving the ankle in pregnancy: characteristics and therapeutic management]. / Algoneurodystrophie de la cheville au cours d'une grossesse: particularités et prise en charge thérapeutique.

We report the case of a multigravida presenting in the first trimester of pregnancy with reflex sympathetic dystrophy involving both ankles. Preferential location of reflex sympathetic dystrophy in pregnancy is classically the hip (9 times out of 10). Symptoms develop mostly with primipara in the third trimester of pregnancy or in post-partum. Fracture is the major risk of reflex sympathetic dystrophy. Peculiarities of reflex sympathetic dystrophy's treatment in the course of pregnancy are evoked. The end of the pregnancy can be shortened with the aim of stabilizing disease even to activate its healing. Pathophysiologic mechanisms of reflex sympathetic dystrophy in pregnancy seem multiple and complex. Our observation, by its atypical characteristics, recalls it.

[How to prescribing Viagra in practice...]. / Comment prescrire le VIAGRA en pratique.

Diabetes can induce sexual disorders by different mechanisms. These troubles are more frequent in diabetics subjects. Thus, management of sexual impotence is an important aspect of diabetes care. However, most diabetologists are not trained to treat sexual disorders. The recent availability of oral drugs, i. e. Sildenafil (Viagra), has partly simplified the treatment of sexual impotence, particularly in diabetic patients. However, Viagra is efficient in only 60% cases in diabetic subjects. In the remaining cases, intracavernosal injections or vacuum can be used. Since Viagra has been available, more diabetic patients complained with sexual disorders, and ask for treatment of impotence. Cardio-vascular diseases must retain more attention in diabetic patients who are exposed to silencious myocardial ischemia. In such subjects, Viagra is not contra-indicated, but must be used after myocardial explorations, especially if the patients have cardio-vascular risk factors. However, patients and their doctors have been threatened by death cases reported with Viagra in United States. The lack of detailed informations has restrained Viagra's prescription. The following explains how to manage sexual disorders as part of diabetes care, and suggests rules for Viagra's prescription in diabetic patients.

[Keratoscopy in cataract surgery]. / La kératoscopie dans la chirurgie de la cataracte.

The peroperative keratoscopy is a subjective method with approximates results (error of 30% on medium power of astigmatisme postoperative). Its advantages with regard to peroperative keratometry are its simplicity, quickness, non-expansivity and efficiency.

[New sub-retinal vessels after chorio-retinal wound caused by intra-ocular foreign body (1 case)]. / Néo-vaisseaux sous-rétiniens après plaie chorio-rétinienne par corps étranger intra-oculaire (1 cas).

We report one case of subretinal neovascularization developed on a chorioretinal scar after metallic intraocular foreign-body trauma. New vessels, occurred three years after the injury at the initial impact site, reached first the foveola and could not be treated by laser photocoagulation.

[Reticular macular dystrophy and Steinert disease]. / Dystrophie réticulée de la macula et maladie de Steinert.

We studied the macular lesions of 14 patients with myotonic dystrophy. 4 of them presented signs of reticula dystrophy of the macular pigmentary epithelium. We searched the association with other ocular modifications.

[Malignant transformation of a nevus of ota]. / Transformation maligne d'un naevus de Ota.

The association of naevus of Ota and choroidal melanoma is reported in a 83 years-old monophtalm caucasian man. Because of no tumoral spreading in this monophtalm patient, the tumor is treated by physical technique with iridium disc. In the next months, complications of this physical treatment appeared. The authors remind the clinical aspect of the disease and the different associations, also that the frequency of coming of the main complication of the affection: the choroidal melanoma.

[Per-coelioscopic salpingectomy in extra-uterine pregnancy. A series of 25 cases]. / Salpingectomie per-coelioscopique pour grossesse extra-utérine. Série de 25 cas.

25 cases of extra uterine pregnancy treated by salpingectomy via laparoscopy, representing 33 p. cent of all ectopic pregnancies reported between September 1985 and 1986. The authors describe the techniques, its advantages and its drawbacks. This technique represents an interesting alternative to classical laparotomy in the treatment of extra uterine pregnancy since it allows: a reduced surgical time and shortened hospital stay, a lesser risk of adhesions, an uneventful postoperative course, a good esthetic result.

[Post-traumatic feto-maternal hemorrhage. Apropos of a case]. / Hémorragie foeto-maternelle post-traumatique. A propos d'un cas.

When a sinusoidal fetal heart rate pattern suggestive of severe anaemia is found one always has to think of feto-maternal haemorrhage. The diagnosis is made using the Kleihauer test. The quantity of fetal blood loss as estimated by this test must be suspect from this case history and from the figures that are quoted in the literature. It will probably be advisable to compare the Kleihauer test and electrophoresis of the haemoglobin in trying to estimate the quantity of blood that has passed from the fetus to the mother. In any case of trauma it is important to look for evidence of feto-maternal haemorrhage.

[Priapism after cavernography. Report of an original case]. / Priapisme après cavernographie. Rapport d'un cas original.

The authors report a case of priapism following cavernography with secondary fibrosis of the corpora cavernosa demonstrated histologically. They stress the importance of a rigorous cavernography technique which must take account of the respective tissue toxicity of the various contrast media used.

[Treatment of curvatures of the penis. New therapeutic approach. Apropos of 46 cases]. / Traitement des incurvations de verge. Nouvelle approache thérapeutique. A propos de quarante-six cas.

The authors describe their technique for correction of curvatures of the phallus, regardless of its aetiology, applied to 46 cases (36 cases of Peyronie's disease and 10 cases of congenital curvature without hypospadias). The proposed technique was inspired by the technique described by Nesbit.