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1.
Tech Coloproctol ; 27(2): 125-133, 2023 02.
Artículo en Inglés | MEDLINE | ID: mdl-36520243

RESUMEN

BACKGROUND: Chronic anal fissure is one of the most common anorectal diseases and is associated with reduced quality of life. The aim of this study was to investigate the effects of pelvic floor physical therapy on quality of life in patients with chronic anal fissure using the Short-Form 36 Health Survey (RAND-36). METHODS: Adult patients, with chronic anal fissure and concomitant pelvic floor dysfunction, such as dyssynergia and increased pelvic floor muscle tone, were recruited at the Proctos Clinic in the Netherlands, between December 2018 and July 2021 and randomly assigned to an intervention group, receiving 8 weeks of pelvic floor physical therapy or assigned to a control group receiving postponed pelvic floor physical therapy (PAF trial). Quality of life and pain ratings were outcomes of the study and were measured at 8- and 20-week follow-up. RESULTS: One hundred patients (50 women and 50 men, median age 44.6 years [range 19-68 years]), completed the RAND-36 questionnaire and visual analog (VAS) pain scale score at admission. A significant improvement was found at 20-week follow-up in all domains of the RAND-36; physical functioning, pain, health change (p < 0.001); physical role, vitality, general health, social functioning, emotional role, mental health (p < 0.05). VAS pain was significantly reduced at 8 weeks (mean estimated difference 1.98; 95% CI 1.55-2.42, p < 0.001) and remained significant at 20-week follow-up (p < 0.001). The difference between the groups as regards change in the mean pain intensity scores at 8 weeks was 2.48 (95% CI - 3.20 to - 1.75; p < 0.001). Compared to the reference values of the general Dutch population, the patients in our study with a chronic anal fissure and pelvic floor dysfunction reported an impaired quality of life in 8 of 9 domains of the RAND-36. After treatment, significant lower scores were found in 2 out of 9 domains. CONCLUSIONS: The results of this study provide evidence that treatment by pelvic floor physical therapy improves quality of life and reduces pain, making it an important tool in management of chronic anal fissure and concomitant pelvic floor dysfunction.


Asunto(s)
Fisura Anal , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven , Fisura Anal/terapia , Dolor , Diafragma Pélvico , Modalidades de Fisioterapia , Calidad de Vida , Resultado del Tratamiento
2.
J Cancer Educ ; 38(1): 106-114, 2023 02.
Artículo en Inglés | MEDLINE | ID: mdl-34623602

RESUMEN

Cancer diagnosis and treatment may influence reproductive planning and impact fertility in patients of reproductive age. Although guidelines have been established in the past decade, education, practice, and attitudes of medical oncologists regarding fertility preservation remain undecided. A nationwide survey was performed among members of the Dutch Society for Medical Oncology. Demographics, practice, knowledge, and barriers were measured regarding information provision of fertility preservation towards cancer patients of childbearing age. From 392 members, 120 oncologists completed the questionnaire (30.6%). Majority of oncologists was convinced it is their responsibility to discuss impact of cancer treatment to fertility (93.2%), yet 68.3% discussed the subject often or always (n = 82). Oncologists employed in district general hospitals were less likely to discuss fertility (p = 0.033). On average, 44.6% of reproductive men and 28.9% of reproductive women is referred to fertility specialists. Half of the respondents declared to possess sufficient knowledge regarding fertility preservation (n = 57, 47.5%). Poor prognosis (53%), unlikely survival (43.1%), and high chances on fertility recovery (28.7%) were identified as barriers to discussing fertility preservation. Among oncologists, impact of cancer treatment on fertility is a well-accepted responsibility to counsel. Despite, self-reported knowledge regarding fertility preservation is strongly varying. In practice, fertility is discussed to some extent, influenced by several barriers and depending on prognosis and type of hospital. Patients benefit from knowledge improvement among oncology care providers concerning fertility effects of cancer treatment. Education during medical school, residency, and among practicing oncologists may raise awareness, together with enhancement of referral possibilities.


Asunto(s)
Preservación de la Fertilidad , Infertilidad , Neoplasias , Oncólogos , Masculino , Humanos , Femenino , Pautas de la Práctica en Medicina , Infertilidad/prevención & control , Neoplasias/complicaciones , Neoplasias/terapia , Encuestas y Cuestionarios
3.
Support Care Cancer ; 30(5): 4035-4047, 2022 May.
Artículo en Inglés | MEDLINE | ID: mdl-35064326

RESUMEN

BACKGROUND: Anti-cancer drugs commonly adversely affect fertility and sexual function. Despite this, patients report a lack of counselling of these potential adverse effects. The aim was to determine Dutch oncologists' knowledge about the adverse effects of various cancer drugs on fertility and sexual function. METHODS: A cross-sectional survey was sent to members of the Dutch Society for Medical Oncology (n = 433). The survey questions included various cancer drugs' adverse effects on fertility, ovulation, spermatogenesis, and sexual function. RESULTS: One hundred and five of 392 oncologists responded (26.8%). Oncologists were more aware of the adverse effects on fertility compared to sexual function. Drugs that were mostly believed to negatively affect fertility were cisplatin (n = 81, 80.2%), epirubicin (n = 78, 78.0%) and cyclophosphamide (n = 80, 77.7%). Regarding sexual function, most mentioned drugs were tamoxifen (n = 67, 65.7%), GnRH-agonists (n = 64, 63.4%) and cisplatin (n = 58, 57.4%). Oncologists with expertise in urology possessed more awareness regarding sexuality-related adverse effects (cisplatin p = 0.038, etoposide p = 0.025, ifosfamide p = 0.06, vinblastine p = 0.000). CONCLUSION: Results revealed that oncologists have different beliefs about possible sexual and fertility-related adverse effects concerning medication resources and literature. Based on our results, oncologists do not possess sufficient knowledge to inform patients about sexual and fertility-related adverse effects.


Asunto(s)
Neoplasias , Oncólogos , Actitud del Personal de Salud , Estudios Transversales , Femenino , Fertilidad , Humanos , Masculino , Neoplasias/tratamiento farmacológico , Pautas de la Práctica en Medicina
4.
J Sex Marital Ther ; 46(3): 205-226, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31762399

RESUMEN

It is well known that breast cancer treatment can affect sexuality. This survey evaluated the needs of breast cancer patients and partners regarding sexual care. The majority of patients (80.4%) and partners (73.7%) did not receive any information regarding sexuality. Although only a quarter of all respondents reported a direct need for information regarding sexuality, most valued an opportunity to discuss sexuality. The nurse practitioner was the most preferable care provider to provide information about sexuality, supported by a brochure or website. Patients considered during treatment as most suitable timing of discussing sexuality, and partners before the start of treatment.


Asunto(s)
Neoplasias de la Mama/psicología , Conducta en la Búsqueda de Información , Salud Sexual , Parejas Sexuales/psicología , Sexualidad , Adulto , Anciano , Anciano de 80 o más Años , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Países Bajos/epidemiología , Encuestas y Cuestionarios
5.
J Cancer Educ ; 35(6): 1072-1088, 2020 12.
Artículo en Inglés | MEDLINE | ID: mdl-31209770

RESUMEN

Sexuality is a significant quality-of-life concern for many cancer patients. Patients may be disadvantaged if they are not informed and not offered sexual health care. We sought to reveal oncologists' current practice and opinions concerning sexual counselling. The aim of this study was to explore the knowledge, attitude and practice patterns of Dutch medical oncologists regarding treatment-related sexual dysfunction. Questionnaires were sent to 433 members of the Dutch Society of Medical Oncology. The majority (81.5%) of the 120 responding medical oncologists (response rate 30.6%) stated they discussed sexual function with fewer than half of their patients. At the same time, 75.8% of the participating oncologists agreed that addressing sexual function is their responsibility. Sexual function was discussed more often with younger patients and patients with a curative treatment intent. Barriers for avoiding discussing sexual function were lack of time (56.1%), training (49.5%) and advanced age of the patient (50.4%). More than half (64.6%) stated they had little knowledge about the subject and the majority (72.9%) wanted to acquire additional training in sexual function counselling. Medical oncologists accept that sexual function counselling falls within their profession, yet they admit to not counselling patients routinely concerning sexual function. Only in a minority of cases do medical oncologists inform their patients about sexual side effects of treatment. Whether they counsel patients is related to how they view patient's prognosis, patient's age, and self-reported knowledge. Findings indicate there is a role for developing education and practical training.


Asunto(s)
Consejo/métodos , Neoplasias/psicología , Oncólogos/psicología , Pautas de la Práctica en Medicina/estadística & datos numéricos , Calidad de Vida , Disfunciones Sexuales Fisiológicas/terapia , Adulto , Actitud del Personal de Salud , Femenino , Humanos , Masculino , Persona de Mediana Edad , Salud Sexual , Encuestas y Cuestionarios
6.
J Neural Transm (Vienna) ; 126(10): 1273-1280, 2019 10.
Artículo en Inglés | MEDLINE | ID: mdl-31396705

RESUMEN

Sexual dysfunction is a major non-motor feature of Parkinson's disease (PD) that may affect the quality of life of many patients. In a Dutch survey, we demonstrated that neurologists often fail to discuss sexuality with their patients. Our objective was to determine to which extent neurologists in Spain and Germany address sexuality with their patients and whether cross-cultural differences exist. A 30-item questionnaire was sent out to 1650 German and 460 Spanish neurologists. The questionnaire addressed attitudes, knowledge, barriers, and feelings of responsibility regarding sexuality in PD. 160 German and 32 Spanish respondents completed and returned the questionnaire. The majority of German and Spanish participants discuss sexual dysfunction 'regularly' with male patients (61.7% and 78.9%, respectively), but 'seldom' with female patients (68.8% and 78.1%, respectively). Important barriers for German and Spanish respondents to discuss sexual dysfunction were patients not expressing sexual complaints spontaneously (52.9% and 75.0%, respectively) and insufficient consultation time (32.2% and 71.9%, respectively). Sexual dysfunction in PD was considered important by 68.3% of German and 96.9% of Spanish participants. German and Spanish neurologists do not routinely discuss sexual dysfunction with their patients, although many of them consider it important to address this topic. It is unclear why this lack of discussing sexual dysfunction is especially found for female patients and whether cultural aspects are involved. We recommend a self-assessment tool for patients to track their symptoms prior to consultation visits and advocate local guidelines that formulate who is responsible for discussing sexual dysfunction.


Asunto(s)
Actitud del Personal de Salud , Neurólogos/psicología , Enfermedad de Parkinson/psicología , Relaciones Médico-Paciente , Sexualidad/psicología , Encuestas y Cuestionarios , Adulto , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Internacionalidad , Masculino , Persona de Mediana Edad , Enfermedad de Parkinson/terapia , Sexualidad/fisiología
7.
Neurourol Urodyn ; 38(8): 2368-2373, 2019 11.
Artículo en Inglés | MEDLINE | ID: mdl-31486148

RESUMEN

AIMS: During filling cystometry, urethral pressure variations (UPV) can be observed. The clinical relevance and a clear definition of this phenomenon are still a matter of debate. For further research and definition of UPV, it is important to determine how this condition can best be demonstrated. The purpose of this study is to compare continuous urethral pressure measurements with a single urethral-sensor catheter and a triple urethral-sensor catheter in demonstrating UPV. METHODS: Seventy-five adult female patients requiring urodynamic investigation enrolled in this prospective study. All patients underwent two series of filling and voiding cystometry. One series was performed with a dual-air balloon sensor urodynamic catheter, the other series with a triple urethral-sensor catheter. UPV were defined as urethral pressure drop exceeding 30 cmH2O. RESULTS: The prevalence of UPV was 37.3% (28 out of 75 patients), more common than detrusor overactivity. The triple urethral-sensor catheter was more sensitive than the single urethral-sensor catheter: In eight patients UPV were demonstrated with both catheters and in 18 patients only in the measurement with the triple urethral-sensor catheter. This difference in detection was significant (P < .001). CONCLUSION: There is an additional value in measurement with the triple urethral-sensor catheter for demonstration of UPV during filling cystometry. Currently, continuous measurement of urethral pressure during filling cystometry and UPV is not defined within International Continence Society terminology. The single urethral-sensor catheter is useful for a start, however, it demonstrates less than half of all UPV.


Asunto(s)
Uretra/fisiología , Catéteres Urinarios , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Presión , Estudios Prospectivos , Uretra/fisiopatología , Vejiga Urinaria Hiperactiva/fisiopatología , Urodinámica , Adulto Joven
8.
Artículo en Inglés | MEDLINE | ID: mdl-28026055

RESUMEN

Cancer and its treatments may result in impaired fertility, which could cause long-term distress to cancer survivors. For eligible patients, fertility preservation (FP) is available to secure future reproductive potential. Many physicians, however, feel inhibited about discussing FP. Oncology nurses may serve as an initiator for discussing the subject and provide additional support. Our aim was to investigate their knowledge about FP, the way they apply this, and possible barriers to discussing FP with patients of reproductive age. A questionnaire was administered via mail, Internet and the Dutch Oncology Nursing Congress. Four hundred and twenty-one oncology nurses participated, a third of whom (31.1%) had "sufficient" knowledge of FP. Twenty-eight per cent of participants reported that they "never/hardly ever" discussed FP; 32.2% "almost always/always." FP discussions were more frequently performed by graduate nurses, academic nurses, experienced nurses and nurses with sufficient knowledge. Reasons for not discussing FP were a "lack of knowledge" (25.2%), "poor prognosis" (16.4%) and "lack of time" (10.5%). In conclusion, several obstacles may result in FP not being routinely discussed, specifically a lack of knowledge. Yet nurses feel responsible for addressing the issue, indicating that assistance with FP discussions should be encouraged. Educational training about FP is recommended.


Asunto(s)
Actitud del Personal de Salud , Preservación de la Fertilidad , Conocimientos, Actitudes y Práctica en Salud , Neoplasias/complicaciones , Enfermeras y Enfermeros/psicología , Enfermería Oncológica , Adulto , Consejo , Estudios Transversales , Femenino , Preservación de la Fertilidad/enfermería , Humanos , Masculino , Persona de Mediana Edad , Neoplasias/enfermería , Países Bajos , Encuestas y Cuestionarios , Adulto Joven
9.
Artículo en Inglés | MEDLINE | ID: mdl-28026069

RESUMEN

Objective was to investigate content of written information material and availability of sexual health care for men experiencing sexual dysfunction (SD) after prostate cancer treatment. A cross-sectional survey was conducted among Dutch urology and radiotherapy departments to evaluate information materials and availability of sexual health care. Out of 71 eligible departments, 34 urology and 15 radiotherapy departments participated in the survey (response rate 69.0%). Fifty-nine brochures corresponding to 31 urology and 11 radiotherapy departments were analysed. In 88.1% of collected information material, sexual health was mentioned. Regarding extensiveness, 20.4% of the brochures contained extensive information, 50.8% moderate amount of information and 28.8% contained little or no information. Urology departments provided pre-treatment nurse consultations more often than radiotherapy departments. Sexual counselling was more frequently provided by urology departments. Urology departments were more aware of adequate referral possibilities. Information material provided by Dutch urology and radiotherapy departments does not address treatment-related SD routinely. Sexual health care is not available everywhere for men experiencing SD. Applying a standard regarding content of sexual health in information material is recommended as well as improved awareness of referral possibilities and enhanced provision of pre-treatment nurse consultations for men experiencing SD after prostate cancer treatment.


Asunto(s)
Accesibilidad a los Servicios de Salud , Difusión de la Información , Folletos , Neoplasias de la Próstata/terapia , Salud Reproductiva , Disfunciones Sexuales Fisiológicas , Urología , Braquiterapia , Estudios Transversales , Departamentos de Hospitales , Humanos , Masculino , Países Bajos , Prostatectomía , Oncología por Radiación , Radioterapia , Encuestas y Cuestionarios
10.
Eur Spine J ; 26(3): 894-904, 2017 03.
Artículo en Inglés | MEDLINE | ID: mdl-28102451

RESUMEN

BACKGROUND: Even though micturition, defecation, and sexual function are substantially affected in cauda equina syndrome (CES), data on outcome are scarce. METHODS: Medical files of patients operated on lumbar herniated disc were screened for CES and retrospectively analyzed for baseline characteristics, outcome of micturition, defecation, and sexual function and possible predictors. RESULTS: Seventy-five CES patients (52% men) were included with a mean age of 44 years. L5-S1 was the most common affected level. Duration of CES complaints at presentation was, on average, 84 h (median 48 h). Prevalence of symptoms at presentation: sciatica (97%), altered sensation of the saddle area (93%), micturition dysfunction (92%), and defecation dysfunction (74%). Only 26 patients were asked about sexual dysfunction of whom 25 patients experienced dysfunction. Female gender was associated with more defecation dysfunction at presentation than male gender (OR 4.11; p = 0.039). All patients underwent decompressive surgery. Two post-operative follow-up (FU) moments took place after a mean of 75 h and 63 days. Outcomes at second FU moment: micturition dysfunction 48%, defecation dysfunction 42%, sexual dysfunction 53%, sciatica 48%, and altered sensation of the saddle area 57%. A shorter time to decompression was associated with more sciatica at FU 1 (p = 0.042) which effect had disappeared at FU 2. CONCLUSION: This study is unique in (1) displaying the presenting features in a large cohort of CES patients, (2) demonstrating that recovery after decompression is slow and far from complete in the majority of patients with regard to micturition, defecation, and sexual function and (3) evaluating predictors for outcome.


Asunto(s)
Descompresión Quirúrgica/métodos , Desplazamiento del Disco Intervertebral/cirugía , Polirradiculopatía/cirugía , Adulto , Anciano , Estudios de Cohortes , Defecación , Femenino , Humanos , Desplazamiento del Disco Intervertebral/complicaciones , Desplazamiento del Disco Intervertebral/fisiopatología , Masculino , Persona de Mediana Edad , Polirradiculopatía/complicaciones , Polirradiculopatía/fisiopatología , Estudios Retrospectivos , Ciática/etiología , Disfunciones Sexuales Fisiológicas/etiología , Disfunciones Sexuales Fisiológicas/fisiopatología , Factores de Tiempo , Resultado del Tratamiento , Micción , Trastornos Urinarios/etiología , Trastornos Urinarios/fisiopatología
12.
Eur Spine J ; 25(3): 766-73, 2016 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-25962812

RESUMEN

BACKGROUND: The possible detrimental effects of spinal disease on sexual health are widely recognized; however, it is not known to what extent neurosurgeons discuss this topic with their patients. The aim of this study is to identify knowledge, attitude and practice patterns of neurosurgeons counseling their patients about sexual health. METHODS: All members of the Dutch Association of Neurosurgery (neurosurgeons and residents) were sent a questionnaire addressing their attitudes, knowledge and practice patterns regarding discussing sexual health. RESULTS: Response rate was 62% with 89 questionnaires suitable for analysis. The majority of participants (83%) were male; mean age, 42.4 years. The mean experience in neurosurgical practice was 9 years. Respondents assumed that in 34% of their patients, sexual health was affected due to spinal disease. The majority of respondents (64%) stated that responsibility for discussing sexual health lies (partly) with the neurosurgeon; however, 73% indicated to (almost) never do this. The main reasons for not discussing sexual health were patients' old age (42%), lack of knowledge (38%) and lack of patients' initiative to bring up the subject (36%). Twenty-six percent indicated lack of time as a reason. There was no evidence for gender or doctor's age discordance as important barriers. Fifty percent of participants wished to gain more knowledge on discussing sexual health with patients. CONCLUSION: This study shows that despite high prevalence of sexual dysfunction (SD) in spinal patients, counseling about sexual health is not often done in neurosurgical care. More training on sexual health counseling early in the residency program seems critical. By initiating the discussion, clinicians who deal with spinal patients have the potential to detect sexual dysfunction (SD) and to refer adequately when necessary, thereby improving overall quality of life of their patients.


Asunto(s)
Educación del Paciente como Asunto/normas , Disfunciones Sexuales Fisiológicas/etiología , Disfunciones Sexuales Psicológicas/etiología , Traumatismos de la Médula Espinal/complicaciones , Adulto , Anciano , Actitud del Personal de Salud , Competencia Clínica , Consejo , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Países Bajos , Educación del Paciente como Asunto/métodos , Relaciones Médico-Paciente , Pautas de la Práctica en Medicina/estadística & datos numéricos , Calidad de Vida/psicología , Derivación y Consulta/estadística & datos numéricos , Salud Reproductiva , Disfunciones Sexuales Fisiológicas/rehabilitación , Disfunciones Sexuales Psicológicas/rehabilitación , Traumatismos de la Médula Espinal/rehabilitación , Adulto Joven
13.
Eur Spine J ; 25(9): 2945-51, 2016 09.
Artículo en Inglés | MEDLINE | ID: mdl-27037919

RESUMEN

PURPOSE: Due to advancing insights, discussing fertility in spinal care is an emerging topic. Studies among neurosurgeons to evaluate clinical practice about discussing fertility are non-existent. The aim of this study is to review knowledge, attitude and practice patterns regarding discussing fertility in spinal care. METHODS: Dutch neurosurgeons and residents were sent a mail-based questionnaire addressing attitude, knowledge and practice patterns regarding discussing fertility. RESULTS: Response rate was 62 % (compared to mean of 28 % in similar surveys) with 89 questionnaires suitable for analysis. Mean age was 42 years with 83 % of respondents being male. A quarter of respondents stated neurosurgeons are responsible to discuss fertility, with 12 % indicating to actually do this. Fertility is discussed more often with patients with cauda equina syndrome (70 %) and with men (p = 0.006). Merely 8 % of respondents stated to have adequate knowledge on fertility preservation (FP); this percentage was higher for doctors with spinal surgery as specialty (p = 0.015). In case of cauda equina syndrome, doctors with more knowledge discussed fertility more often (p = 0.002). Fifty-three percent of neurosurgeons wished to enhance their knowledge, in order to feel more comfortable to discuss fertility with their patients. Five percent indicated to have ever referred a patient to a fertility specialist. CONCLUSION: With the exception of cauda equina syndrome, fertility is not routinely discussed in spinal care. Fertility is discussed more often with men. Recent guidelines state that discussing fertility is an essential part of good practice in spinal care. Education on fertility and FP needs to be integrated in the neurosurgical training program to create more awareness, and to enable clinicians to provide adequate information and care to the patient.


Asunto(s)
Conocimientos, Actitudes y Práctica en Salud , Pautas de la Práctica en Medicina , Derivación y Consulta/normas , Disfunciones Sexuales Fisiológicas , Disfunciones Sexuales Psicológicas , Enfermedades de la Columna Vertebral , Adulto , Competencia Clínica , Femenino , Preservación de la Fertilidad , Humanos , Internado y Residencia , Masculino , Persona de Mediana Edad , Países Bajos , Neurocirujanos/psicología , Disfunciones Sexuales Fisiológicas/etiología , Disfunciones Sexuales Fisiológicas/prevención & control , Disfunciones Sexuales Psicológicas/etiología , Disfunciones Sexuales Psicológicas/prevención & control , Traumatismos de la Médula Espinal/complicaciones , Enfermedades de la Columna Vertebral/complicaciones , Enfermedades de la Columna Vertebral/cirugía
15.
J Surg Oncol ; 110(7): 845-50, 2014 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-25111761

RESUMEN

BACKGROUND AND OBJECTIVES: Unlike other cancers, the Sentinel Lymph Node (SLN) procedure in bladder cancer requires special attention to the injection technique. The aim of this study was to assess feasibility and to optimize tracer injection technique for SLN mapping in bladder cancer patients using NIR fluorescence imaging. METHODS: Twenty patients with invasive bladder cancer scheduled for radical cystectomy were prospectively enrolled. Indocyanine green (ICG) bound to human serum albumin (complex ICG:HSA; 500 µM) was injected peritumourally to permit SLN mapping. ICG:HSA was first administrated serosally (n = 5), and subsequently mucosally by cystoscopic injection (n = 15). In the last cohort of 12 patients treated with cystoscopic injection, the bladder was kept filled with saline for at least 15 min. RESULTS: Fluorescent lymph nodes were observed only in the patient group with cystoscopic injection of ICG:HSA. Filling of the bladder post-injection was of added value to promote drainage of ICG:HSA to the lymph nodes, and in 11 of these 12 patients (92%) one or more NIR fluorescent lymph nodes were identified. CONCLUSIONS: The current study demonstrates proof-of-principle of using NIR fluorescence imaging for SLN identification in bladder cancer. Cystoscopic injection with distension of the bladder appears optimal for SLN mapping.


Asunto(s)
Colorantes Fluorescentes , Ganglios Linfáticos/patología , Neoplasias/tratamiento farmacológico , Biopsia del Ganglio Linfático Centinela , Espectroscopía Infrarroja Corta/métodos , Neoplasias de la Vejiga Urinaria/patología , Anciano , Colorantes , Estudios de Factibilidad , Femenino , Estudios de Seguimiento , Humanos , Verde de Indocianina , Ganglios Linfáticos/cirugía , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Neoplasias/patología , Pronóstico , Estudios Prospectivos , Neoplasias de la Vejiga Urinaria/cirugía
16.
Neth Heart J ; 22(1): 11-9, 2014 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-24155101

RESUMEN

Several antihypertensive drugs, such as diuretics and ß-blockers, can negatively affect sexual function, leading to diminished quality of life and often to noncompliance with the therapy. Other drug classes, however, such as angiotensin II receptor blockers (ARBs) are able to improve patients' sexual function. Sufficient knowledge about the effects of these widely used antihypertensive drugs will make it possible for cardiologists and general practitioners to spare and even improve patients' sexual health by switching to different classes of cardiac medication. Nevertheless, previous data (part I) indicate that most cardiologists lack knowledge about the effects cardiovascular agents can have on sexual function and will thus not be able to provide the necessary holistic patient care with regard to prescribing these drugs. To be able to improve healthcare on this point, we aimed to provide a practical overview, for use by cardiologists as well as other healthcare professionals, dealing with sexual dysfunction in their clinical practices. Therefore, a systematic review of the literature was performed. The eight most widely used classes of antihypertensive drugs have been categorised in a clear table, marking whether they have a positive, negative or no effect on sexual function.

17.
ESMO Open ; 9(2): 102231, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38244349

RESUMEN

BACKGROUND: Testicular cancer incidence among adolescents and young adults (AYAs, aged 18-39 years at diagnosis) is increasing worldwide and most patients will survive the initial disease. Still, detailed epidemiological information about testicular cancer among AYAs is scarce. This study aimed to provide a detailed overview of testicular cancer trends in incidence, treatment, long-term relative survival and mortality by histological subtype among AYAs diagnosed in the Netherlands between 1989 and 2019. MATERIALS AND METHODS: Data of all malignant testicular cancers (ICD-code C62) were extracted from the Netherlands Cancer Registry. Mortality data were retrieved from Statistics Netherlands. European age-standardized incidence and mortality rates with average annual percentage change statistics and relative survival estimates up to 20 years of follow-up were calculated. RESULTS: A total of 12 528 testicular cancers were diagnosed between 1989 and 2019. Comparing 1989-1999 to 2010-2019, the incidence increased from 4.4 to 11.4 for seminomas and from 5.7 to 11.1 per 100 000 person-years for non-seminomas. Rising trends were most prominent for localized disease. Radiotherapy use in localized testicular seminomas declined from 78% in 1989-1993 to 5% in 2015-2019. Meanwhile, there was a slight increase in chemotherapy use. Most AYAs with localized seminomas and non-seminomas received active surveillance only (>80%). Overall, relative survival estimates remained well above 90% even at 20 years of follow-up for both seminomas and non-seminomas. Mortality rates declined from 0.5 to 0.4 per 100 000 person-years between 1989-1999 and 2010-2019. CONCLUSIONS: The incidence of seminoma and non-seminoma testicular cancers significantly increased in AYAs in the Netherlands between 1989 and 2019. There was a shift towards less-aggressive treatment regimens without negative survival effects. Relative survival estimates remained well above 90% at 20 years of follow-up in most cases. Testicular cancer mortality was already low, but has improved further over time, which makes survivorship care an important issue for these young adults.


Asunto(s)
Neoplasias de Células Germinales y Embrionarias , Seminoma , Neoplasias Testiculares , Masculino , Humanos , Adolescente , Adulto Joven , Seminoma/epidemiología , Seminoma/terapia , Incidencia , Neoplasias Testiculares/epidemiología , Neoplasias Testiculares/terapia , Neoplasias Testiculares/patología , Países Bajos/epidemiología
18.
Eur Spine J ; 22(5): 1019-29, 2013 May.
Artículo en Inglés | MEDLINE | ID: mdl-23238848

RESUMEN

PURPOSE: Cauda equina syndrome (CES) is a rare complication of lumbar disk herniation. Although micturition, defecation and/or sexual function are by definition affected, little seems to be known about long-term outcome. Aim of this study is to review current literature on outcome of micturition, defecation and sexual function in CES due to lumbar disk herniation. METHODS: A literature search was done in Pubmed, Embase and Web of Science using a sensitive search string combination. Studies were selected by predefined selection criteria and risk of bias was assessed using a Cochrane checklist adjusted for this purpose. RESULTS: Fifteen studies were included. Risk of bias varied with six studies showing low risk. Mean minimal follow-up time was 17.0 months (range 3-24 months). All studies evaluated micturition and reported dysfunction at follow-up in 42.5% (range 13.3-90.0%). Defecation and sexual function were evaluated in eight and nine studies, respectively, and reported to be 49.6 (range 10.5-90.0%) and 44.3% (range 10.0-76.6%), respectively. Only two studies assessed sexual function in all patients at follow-up. CONCLUSION: This review offers an insight into the extent of micturition dysfunction, defecation dysfunction and sexual dysfunction (SD) in CES after decompression. Our findings show that dysfunction is extremely common, even at long-term follow-up. A condition as invalidating as CES requires proper patient information and the outcomes presented here may help in providing those data. Bias in included studies, lack of universal definitions and incomplete follow-up results qualify these data as the best we momentarily have, but still subject to improvement. Since SD seems to be severely underreported, we recommend further research to explore the extent of this problem, as well as the use of questionnaires in future clinical (prospective) studies to accomplish a more patient-based approach.


Asunto(s)
Desplazamiento del Disco Intervertebral/fisiopatología , Vértebras Lumbares/fisiopatología , Polirradiculopatía/fisiopatología , Enfermedades del Recto/fisiopatología , Disfunciones Sexuales Fisiológicas/fisiopatología , Trastornos Urinarios/fisiopatología , Defecación/fisiología , Humanos , Desplazamiento del Disco Intervertebral/complicaciones , Desplazamiento del Disco Intervertebral/cirugía , Vértebras Lumbares/cirugía , Polirradiculopatía/etiología , Polirradiculopatía/cirugía , Enfermedades del Recto/etiología , Enfermedades del Recto/cirugía , Disfunciones Sexuales Fisiológicas/etiología , Micción/fisiología , Trastornos Urinarios/etiología , Trastornos Urinarios/cirugía
19.
Neth Heart J ; 21(12): 540-4, 2013 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-24072687

RESUMEN

INTRODUCTION: Several cardiovascular agents, such as diuretics and ß-blockers, can negatively affect sexual function, leading to noncompliance with therapy. Others such as angiotensin II receptor blockers (ARBs) can improve patients' sexual function. AIMS: We aimed to gain insight into cardiologists' knowledge about the effects of cardiovascular drugs on sexual function and whether they take this knowledge into account when prescribing drugs. METHODS: An anonymous questionnaire was mailed to 980 members of the Netherlands Society of Cardiologists (cardiologists and residents in training). RESULTS: Almost 54 % of Dutch cardiologists responded; 414 questionnaires were analysed. Forty-five percent of cardiologists were aware that diuretics can negatively affect sexual function, 93.1 % knew about the negative effects ß-blockers can have, but only 9.2 % were aware that ARBs can have positive effects on sexual health. Almost half of respondents (48.2 %) stated they change medication regularly in an attempt to improve sexual function. Experienced cardiologists said they do this significantly more often than less experienced ones. CONCLUSIONS: Cardiologists' knowledge about the effects of cardiovascular drugs on sexual health appears to be insufficient. Sexual dysfunction is not routinely taken into account when cardiologists prescribe drugs.

20.
Int Urogynecol J ; 23(5): 589-95, 2012 May.
Artículo en Inglés | MEDLINE | ID: mdl-22109702

RESUMEN

INTRODUCTION AND HYPOTHESIS: The objective of this study was the assessment of the efficiency of the MiniArc for curing stress urinary incontinence. METHODS: Seventy-seven patients, operated on from March 2008 to November 2009, were evaluated in this study. One-year post-operative data are presented. All patients suffered from predominant stress urinary incontinence. After 1 year, response was 74%. Evaluation was performed using a questionnaire consisting of the EuroQol-5 Dimensions, the Patient Global Impression of Improvement, the Incontinence Impact Questionnaire, the Urinary Distress Inventory, the Prolapse/Urinary Incontinence Sexual Questionnaire, short form, and the Defecation Distress Inventory. RESULTS: One year after surgery, 68% of the patients stated an improvement in their incontinence status, while only 44% stated to be completely dry. CONCLUSION: The 1-year follow-up suggests that the MiniArc is less effective in the treatment of stress urinary incontinence than the TVT.


Asunto(s)
Procedimientos Quirúrgicos Ginecológicos/métodos , Cabestrillo Suburetral , Incontinencia Urinaria de Esfuerzo/cirugía , Adulto , Anciano , Anciano de 80 o más Años , Índice de Masa Corporal , Femenino , Estudios de Seguimiento , Humanos , Persona de Mediana Edad , Periodo Posoperatorio , Estudios Prospectivos , Encuestas y Cuestionarios , Resultado del Tratamiento
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