Male circumcision does not result in inferior perceived male sexual function - a systematic review.

INTRODUCTION: The debate on non-medical male circumcision has gaining momentum during the past few years. The objective of this systematic review was to determine if circumcision, medical indication or age at circumcision had an impact on perceived sexual function in males. METHODS: Systematic searches were performed in MEDLINE and Embase. The included studies compared long-term sexual function in circumcised and non-circumcised males, before and after circumcision, or compared different ages at circumcision. The quality of the studies was assessed according to the level of evidence (Grade A-D). RESULTS: Database and hand searches yielded 3,677 records. Inclusion criteria were fulfilled in 38 studies including two randomised trials. Overall, the only identified differences in sexual function in circumcised males were decreased premature ejaculation and increased penile sensitivity (Grade A-B). Following non-medical circumcision, no inferior sexual function was reported (A-B). Following medical circumcision, most outcomes were comparable (B); however, problems in obtaining an orgasm were increased (C) and erectile dysfunction was reported with inconsistency (D). A younger age at circumcision seemed to cause less sexual dysfunction than circumcision later in life. CONCLUSIONS: The hypothesis of inferior male sexual function following circumcision could not be supported by the findings of this systematic review. However, further studies on medical circumcision and age at circumcision are required.

[Surgical treatment of benign prostatic hypertrophy]. / Kirurgisk behandling af forstørret prostata.

Transurethral resection of the prostate (TURP) has become the "gold standard" although there is risk of postoperative bleeding and TUR syndrome. The main advantage of photoselective vaporisation of the prostate (PVP) is minimal bleeding; however, long-term results of PVP are pending. Transvesical prostatectomy is limited today to large prostates because of the high perioperative morbidity. Transurethral microwave therapy (TUMT) has lost some of its popularity because of post treatment catherization for several weeks and reduced long-term results compared with TURP.

[Prostatitis--pelvic pain syndrome]. / Prostatitis--pelvic pain syndrome.

Prostatitis is classified according to the National Institute of Health Prostatitis Classification. The term Chronic Pelvic Pain Syndrome (CPPS) covers the symptomathology and clinical findings. The main symptoms are pain and voiding disorders. Acute bacterial prostatitis is only seen in 5% of cases. The vast majority of symptoms are found in CPPS, and urodynamic investigation is crucial in order to identify bladder neck dysfunction which occurs in a considerable number of patients.

[Distribution of colonic surgery among surgeons in the city of Copenhagen]. / Fordeling af colonkirurgi på operatører i hovedstadsområdet.

INTRODUCTION: The outcome of some surgical procedures is related to the surgeon's experience. We examined how much experience surgeons in 12 hospitals in the region of Copenhagen gained in colon surgery in 1999. MATERIAL AND METHODS: The Ministry of Health identified the number of colon patients operated on in the region of Copenhagen in 1999. The departments were asked to validate the lists of patients and to fill in a questionnaire describing the surgeon's experience in that year. RESULTS: Eleven of 12 departments answered the questionnaire (92%). One hundred and two senior surgeons operated on 674 patients. Forty of the surgeons operated on one to four patients in 1999, and only five performed 15 or more operations. More than 50% of the surgical procedures were carried out by surgeons who performed fewer than 10 colon operations in 1999. Most of the low-volume surgeons' operations were performed during calls. DISCUSSION: Colon surgery in the region of Copenhagen was performed by a large number of surgeons in many hospitals in 1999. Hospital volume was not associated with surgeon volume.