Sexual dysfunction in Epileptic men

The aim of this study was to evaluate the frequency of sexual dysfunction among epileptic patients. Eighty married men between 22 and 50 years with a confirmed diagnosis of epilepsy were enrolled in this study. Patients with other neurological diseases, hypertension, cardiovascular diseases, diabetes mellitus, underlying urogenital diseases, and impaired general health status were excluded. Furthermore, those with mental health problems were identified by the standardized General Health Questionnaire-28 and were excluded. Demographic and clinical characteristics of the disease were evaluated, and sexual function was assessed by the self-administered questionnaire of the International Index of Erectile Function-15 [IIEF-15]. Of 80 patients, 34 [42.5%] had erectile dysfunction. There were no differences between the patients in the 3 age groups [>30 years, 30 to 40 years, and > 40 years] in the IIEF scores. Type of seizure had a significant correlation with erectile function score [P=.008]. None of the IIEF domains scores were different between the patients with controlled epilepsy and those with uncontrolled epilepsy during the previous 6 months. However, frequency of epileptic seizures [before treatment] correlated with the scores for erectile function [r=0.31; P=.005], orgasmic function [r=0.23; P=.04], and sexual desire [r=0.24'P=.03]. It seems that the main aspects of sexual activity such as erectile function, orgasmic function, and sexual desire are frequently impaired in epileptic patients. Our findings were also indicative of a higher risk of sexual dysfunction in patients with partial seizures

Improvement of erectile dysfunction after kidney transplantation the role of the associated factors

The aim of this study was to evaluate erectile dysfunction [ED] in hemodialysis patients and the factors influencing ED after a successful kidney transplantation. A total of 64 patients on hemodialysis were evaluated before and 6 months after the kidney transplantation. They were all recipients of their first kidney allografts from living unrelated donors and had a functional kidney allograft during the follow-up. The 5-item version of the International Index of Erectile Function [IIEF-5] was used to assess their erectile function. A group of age-matched controls were compared with them before transplantation. The effects of pretransplant IIEF-5 score, age at transplantation, the artery used for anastomosis, and duration of the dialysis prior to transplantation on ED were also studied. Fifty-six of the patients [87.5%] and 23 of the controls [35.9%] had ED [P < .001]. The prevalence of ED was 87.5% in the hemodialysis patients. There was no relationship between the duration of dialysis and the severity of ED. Successful transplantation improved IIEF-5 score significantly [13.6 +/- 5.2 before and 19.2 +/- 5.0 after transplantation; P < .001]. Based on the IIEF-5 scores, the severity of ED increased in 6 [9.4%] patients; 8 [12.5%] experienced no change in their erectile function; and 50 [78.1%] reported an improved erectile function. Preoperative IIEF-5 score and age at transplantation had statistically significant associations with ED improvement [P < .001; P = .02]. Erectile dysfunction is highly prevalent in hemodialysis patients and significantly improves after successful kidney transplantation. Younger patients with a less severe ED have the most improvement after transplantation

Posttransplant infectious complications: a prospective study on 142 kidney allograft recipients

We evaluated the posttransplant complications resulting from infections and their association with graft function, immunosuppressive drugs, and mortality. A total of 142 kidney allograft recipients were followed for 1 year after transplantation. The patients' status was assessed during regular visits, and data including clinical characteristics, infections, serum creatinine level, acute rejection episodes, immunosuppressive regimen, graft function, and mortality were recorded and analyzed. Infections occurred in 77 patients [54%]. The lower urinary [42%] and respiratory [6.3%] tracts were the most common sites of infection. The most frequent causative organisms were Klebsiella in 34 [24%] and cytomegalovirus in 25 patients [18%]. Wound infection occurred in 7 patients [5%]. The mortality rate was 7.7% and infection-related death was seen in 5 patients [3.5%] who developed sepsis. Graft loss was seen in 16 patients [11%], of whom 2 developed cytomegalovirus infection, 2 experienced urinary tract infection, and 5 developed sepsis and died. Mycobacterial and hepatitis C infections were noticeably rare [0.7% and 2.8%, respectively]. This study showed that infections are important causes of morbidity and mortality during the posttransplant period. We recommend that serologic tests be performed before and after transplantation to recognize and meticulously follow those who are at risk. In our study, high-risk patients were those with elevated serum creatinine levels who received high doses of immunosuppressive drugs. As the urinary tract is the most common site of infection, early removal of urethral catheter is recommended to reduce the risk of infection

relationship between lipid profile and erectile dysfunction

To evaluate the relationship between serum lipids including cholesterol, low-density lipoprotein [LDL], high-density lipoprotein [HDL], and triglyceride and erectile dysfunction [ED]. From January 2000 to June 2003, 100 patients with organic ED, who were referred to our center, were selected and their lipid profile [Cholesterol, Triglyceride, HDL, LDL] were assessed. The results were compared with those in 100 healthy individuals. Mean age of men in the study and control groups were 43.72 +/- 9.76 and 43.59 +/- 10.51 years, respectively. Mean plasma cholesterol and LDL levels in individuals suffering from erectile dysfunction were significantly higher than controls [P = 0.04 and P = 0.02, respectively]. However, no difference in the mean plasma triglyceride and HDL levels was seen. Odds Ratios for high plasma cholesterol level [>240 mg/dl] and high plasma LDL level [>160 mg/dl] were 1.74 and 1.97, respectively [r2 = 0.04 and r2 = 0.04]. Using linear regression analysis, the regression coefficient for cholesterol and LDL versus the International Index of Erectile Dysfunction Questionnaire [IIEF] score were -0.036 and -0.035, respectively [95% confidence interval: 0.98 - 2.5 for cholesterol and 1.13 - 2.81 for LDL]. The impact of total cholesterol and particularly LDL on men's erectile function underlines the role of hyperlipidemia treatment in prevention of ED and emerges a holistic management in ED patients

Seminal plasma magnesium and premature ejaculation: a case-control study

Our aim was to determine the relationship between genuine premature ejaculation and serum and seminal plasma magnesium. In a case-control study carried out between January 2002 and December 2003, 19 patients with premature ejaculation were evaluated and compared with 19 patients without premature ejaculation. Patients with organic and psychogenic causes were excluded. Seminal plasma and serum magnesium levels were measured using atomic absorption spectrophotometery. Seminal plasma magnesium levels in study patients [94.73 +/- 10.87 mg/L] were significantly lower than they were in controls [116.68 +/- 11.63 mg/L, P<0.001], but there were no such differences regarding serum magnesium levels [study patients, 20.26 +/- 2.66 mg/L; controls, 20.73 +/- 2.80 mg/L]. Semen-to-serum-magnesium ratio was significantly lower in patients with premature ejaculation [P<0.001]. Also, a reverse relationship between body mass index and genuine premature ejaculation was found [P=0.027]. Genuine premature ejaculation has a significant relationship with decreased levels of seminal plasma magnesium. Further studies are needed to clarify the actual role of magnesium in the physiology of the male reproductive tract, especially its association with premature ejaculation

Preoperative corporal biopsy as a predictor of postoperative results in venoocclusive erectile dysfunction

Our aim was to investigate the association of corporeal cavernosal pathology with venoocclusive erectile dysfunction [ED] and whether preoperative corporeal biopsy can help predict postoperative results. Thirty-six patients with venoocclusive ED underwent corporeal cavernosal biopsy and venous ligation. Preoperative assessment included complete physical examination, international index of erectile dysfunction [IIEF] scoring, nocturnal penile tumescence, penile Doppler ultrasonography, cavernosography, and, if needed, cavernosometry. Three months postoperatively, all patient parameters were reevaluated and compared with the preoperative results. Biopsy results of 43 patients with penile fracture were used for controls. The mean age of the patients with ED was 32.1 +/- 8.6 years. The IIEF score and peak systolic velocity of the cavernosal artery in the patients did not differ postoperatively. The mean end diastolic velocity, however, decreased from 11.0 cm/s to 5.1 cm/s [P=.023]. Only 2 patients had satisfactory penile rigidity after venous ligation. Pathologically, 23 patients had a slight decrease of cavernosal smooth muscle cells, while in 9 patients, the cavernosal smooth muscles were markedly decreased and replaced by collagen fibers. Four patients had normal histologies, and all responded either partially or completely to surgical therapy. In the control group, 41 of 43 patients had normal histologies, and 2 had a slight decrease of smooth muscle cell mass. Decreased cavernosal smooth muscle mass may impair erectile function. Its association with venoocclusive ED may be a poor prognostic factor of the outcome of surgical therapy. For the preoperative evaluation of patients, we propose cavernosal biopsy