Opinions, Attitudes, and Perceptions in Relation to Erectile Dysfunction and Premature Ejaculation in the Undiagnosed Spanish Male Population. Results of the PANDORA Project.

BACKGROUND: Approximately 43% of Spanish men report experiencing premature ejaculation (PE) at some point in their lives and 12.1% suffer from erectile dysfunction (ED), of whom only 16.5% have seen a doctor. Despite this, ED and PE remain undiagnosed among a supposedly healthy segment of the population. AIM: To assess the general knowledge of a representative population of healthy Spanish males of the symptoms, treatment, and expectations related to ED and PE. METHODS: This was a descriptive study based on an online questionnaire in which 2,515 males aged 25-75 years with no history of ED and/or PE presented their perception of aspects related to symptoms, diagnosis, treatment, and expectations in ED and PE. MAIN OUTCOME MEASURES: The study provided an evaluation of the knowledge, attitude, and underdiagnosis of ED and/or PE in healthy males and the approach taken by urology specialists and other disciplines. RESULTS: The survey was completed by 2,515 healthy males, including over 80% of those who had completed secondary or higher education. 60% of the sample had never seen a urologist and 59% and 62% of the participating men responded correctly to the statements about PE and ED, respectively. Their lack of knowledge of the therapeutic alternatives was clear (74% and 76% of the panel were unaware of the existence of effective treatments for ED and PE, respectively). Despite the initiative shown by some participants in seeking information about each condition (10.3% for ED; 16.7% for PE), only 4.7% of them had been questioned about ED by a medical practitioner (1.9% for PE). The underdiagnosis rate stood at 3.5% for ED (5.6% participants >65 years) and at about 10% for PE. CLINICAL IMPLICATIONS: These results will represent a point of departure for establishing some recommendations to improve the detection and treatment of these disorders. STRENGTHS & LIMITATIONS: This is the first study of its kind in Spain to analyze the underdiagnosis of ED and/or PE inferred from data reported by a population of healthy males. Screening for ED was performed with a validated questionnaire. However, the rest of the research was conducted using adaptations of validated questionnaires or a self-designed questionnaire based on and in consultation with a group of experienced andrologists. CONCLUSION: People need to have greater knowledge of both the conditions and the related false myths to make sure that they are familiar with the existence of drug treatments and socio-sanitary interventions. Primary care physicians and urologists should also be more proactive in routine visits in order to achieve better management of ED and PE. Prieto-Castro R, Puigvert-Martínez AM, Artigas-Feliu R, et al. Opinions, Attitudes, and Perceptions in Relation to Erectile Dysfunction and Premature Ejaculation in the Undiagnosed Spanish Male Population. Results of the PANDORA Project. J Sex Med 2020;17:1495-1508.

Priapismo / Priapism

El priapismo ha sido definido por la AFUD como “la condición patológica caracterizada por una erección peneana que persiste más allá o no está relacionada con la estimulación sexual”. La fisiopatología del priapismo ha sido una gran desconocida hasta que se comienzan a hacer estudios clínicos en pacientes en su mayoría afectos de disfunción eréctil, en cuyo diagnóstico o tratamiento se veían involucrados los medicamentos vasoactivos por vía intracavernosa. El priapismo se clasifica en isquémico (veno-oclusivo) que es la forma más frecuente y Priapismo Arterial (no-isquémico) que es la presentación menos frecuente, causada por la entrada de flujo sanguíneo cavernoso no controlado. El propósito de esta revisión es documentar la fisiopatología de los tipos de priapismo y tratar de esquematizarla conducta diagnóstica y terapéutica ante ellos (AU)

Priapism has been defined by AFUD as a pathological condition which consists in a penile erection that persists moreover or is not related to sexual stimulation. Priapism pathophysiology has remained unknown until differents groups of clinical investigators began to research about this entity in patients complaining of erectile dysfunction, who where receiving treatment with intracavernosal vasoactive molecules. Priapism can be clasified into ischaemic (venocclusive): the most prevalent type, or Arterial (non-ischaemic). The purpose of this revision is to update the pathophysiology of the two types of priapism and to create an algorithm of therapeutical and diagnostic approach (AU)

[Priapism]. / Priapismo.

Priapism has been defined by AFUD as a pathological condition which consists in a penile erection that persists moreover or is not related to sexual stimulation. Priapism pathophysiology has remained unknown until differents groups of clinical investigators began to research about this entity in patients complaining of erectile dysfunction, who where receiving treatment with intracavernosal vasoactive molecules. Priapism can be clasified into ischaemic (venocclusive): the most prevalent type, or Arterial (non-ischaemic). The purpose of this revision is to update the pathophysiology of the two types of priapism and to create an algorithm of therapeutical and diagnostic approach.

[TESE-ICSI in the treatment of male infertility secondary to tuberculosis. Report of a case]. / TESE-ICSI como tratamiento de la infertilidad masculina secundaria a TBC. A propósito de un caso.

OBJECTIVE: To report a case of infertility treated by TESE-ICSI in a patient with tuberculosis of the seminal duct. METHODS: A 32-year-old patient consulted for primary infertility with a history of 7 years. The fertility studies demonstrated azoospermia, hypospermia and genitourinary tuberculosis involving the entire seminal duct. RESULTS: After the tuberculosis had been treated satisfactorily, TESE, IVF and ICSI were performed with success. CONCLUSIONS: Tuberculosis of the seminal duct can cause primary obstructive infertility. TRA is an alternative when spermatogenesis is preserved. In this patient TESE-ICSI was performed with success.

[Our clinical experience with the use of ++sildenafil citrate to treat erectile dysfunction]. / Nuestra experiencia clínica con el uso del citrato de sildenafilo para tratar la disfunción erectil.

OBJECTIVE: To evaluate the response and adverse effects to treatment with Sildenefil in those patients with an erectile dysfunction who, according to our protocol, were considered as candidates for this therapeutic option. MATERIALS AND METHODS: We reviewed the clinical histories of 180 patients seen in our service from november 1988 to February 1999 as a result of an erectile dysfunction. Those patients in whom the use of Sildenefil was not contraindicated were prescribed this product at does of 50 mg. The response to treatment was subjectively evaluated based on the option of the patient when comparing his quality of life before and after treatment. RESULTS: Out of 180 patients, 144 started treatment as indicated. Of these, 67% expressed a positive response, while 33% did not respond to treatment. Adverse effects were notice by 26% of patients, but in 97% of them they were not severe enough to withdraw the medication. CONCLUSIONS: Two-thirds of 144 patients with erectile dysfunctions of heterogeneous origin responded positively to treatment with Sildenefil. One fourth of them reported some ort of adverse effect, but almost none of them stopped the medication for this reason.

[Morphologic changes in the penis. Impotence coeundi without erectile dysfunction]. / Alteraciones morfológicas del pene. Impotencia coeundi sin disfunción eréctil.

Erectile dysfunction is not the only cause of impotence in the male; impotencia coeundi may result from various disorders, although cavernosal erectile function is normal. The present study reviews the congenital and acquired penile disorders, as well as the cutaneous disorders that may cause penile morphological changes.