[Male sexuality after external continent urinary diversion type Mitrofanoff]. / Étude de la sexualité masculine après dérivation urinaire externe continente de type Mitrofanoff.

OBJECTIVE: To evaluate the influence of continent external urinary diversion type Mitrofanoff on male sexuality. MATERIAL AND METHODS: Between 1992 and 2011, 140 patients underwent continent urinary diversion type Mitrofanoff at an academic hospital. Among 76 men, 46 were interviewed about their sexuality after this operation. This study was performed using a set of validated questionnaires (IIEF, DAN PSS and Urolife), grouped by the model of the CTMH. Patients were divided according to their marital status: group 1: patients married before surgery (15 cases), group 2: patients married after surgery (7 cases) and group 3: singles (24 cases). RESULTS: In the first group, the functional dimension of sexuality was positive with an overall score of 81%, the sexual discomfort score was assessed at 26 % and the sexual satisfaction score was 77%. In the second group, sexual function was considered conserved in all cases with a satisfaction score estimated at 98%. These patients reported a feeling of well-being following the disappearance of urinary incontinence with integrity of their body images. In contrast, in the last group, relatively impaired sexual function was noted (65%) with a satisfaction score estimated at 59%. These disorders were multifactorial, mainly related to neurological causal pathology. CONCLUSION: To our knowledge, this is the first study about male sexuality in patients with a continent urinary diversion type Mitrofanoff. Marital status has a major role in the sexuality of these patients. A prospective study with pre- and postoperative evaluation will better clarify the factors affecting sexuality in these patients.

O deslumbramento como dois paradigmas distintos do impossível: um estudo da desigualdade entre os sexos / Le ravissement qui représente deux paradigmes distincts de l'impossible: une étude de l'inégalité entre les sexes / The amazement as a representation of two different paradigms of the impossible: a study of inequality between sexes

Buscando investigar as consequências psíquicas da diferença anatômica entre os sexos, podemos admitir a existência de traços dessas consequências na obra O deslumbramento, de Marguerite Duras, especialmente no que diz respeito aos dois personagens principais, Hold, do lado do masculino, e Lol, do feminino. Tomaremos, como gozo fálico, aquilo que Hold tem a dizer sobre Lol e seu impulso constante por dizê-la", causando o que denominaremos deslumbramento, o qual constitui o sintoma masculino. Pois, para não ter de lidar com sua própria falta, o homem se ocupa da falta na mulher, de lhe oferecer semblantes. Se deslumbra por essa falta fálica e causa deslumbramento à mulher com os semblantes que oferece. A parceria sintomática entre um homem e uma mulher pela via do deslumbramento, ou, ainda, pela lógica fálica, entrega, portanto, ao portador do falo a responsabilidade de oferecer semblantes, ditos e discursos à sua parceira faltosa na partilha sexual. O termo "devastação" estaria presente para além da lógica fálica, quando o deslumbramento fracassa e evidencia os danos da permanência da mulher em uma posição de objeto sustentada por tais semblantes e ditos

Quand nous chechons a comprendre les conséquences psychiques de la différence anatomique entre les sexes, on peut percevoir l'existence de traces de ces conséquences dans l'oeuvre Le Ravissement de Lol V. Stein,de Marguerite Duras, spécialement en ce qui concerne les deux personnages principaux, Hold, du côté masculin, et Lol, du féminin. Nous considérerons comme jouissance phallique ce que Hold a à dire sur Lol et son impulsion constante de "la dire", provoquant ce que nous appellerons ravissement, ce qui constitue le symptôme masculin. Alors, pour ne pas être confronté à son propre manque, l'homme s'occupe du manque chez la femme, lui offrant des semblants. Il est ravi par ce manque phallique et lui cause un ravissement par les semblants qu'il lui offre. Le partenariat symptomatique entre un homme et une femme par la voie du ravissement, ou encore par la logique phallique, fournit donc au porteur du phallus la responsabilité d'offrir des semblants, des dits et des discours à sa partenaire incomplète dans l' échange sexuel. Le terme «ravage¼ sera utilisé pour expliquer ce qui est au-delà de la logique phallique, lorsque le ravissement échoue et montre les dommages de la permanence de la femme en position d'objet soutenue par ces dits et semblants

While investigating the psychic consequences of the anatomical difference between sexes, we can perceive existing traces of these consequences in the work The Ravishing of Lol Stein,by Marguerite Duras. This happens especially as it refers to the two main characters, Hold, on the male side, and Lol, on the female side. We will consider as phallic enjoyment what Hold has to say about Lol and his constant impulse "to speak her," causing what we will call amazement which constitutes the male symptom. Thus, in order notto have to deal with his own lack, the man deals with the lack in the woman, offering her semblances. He is amazed by her phallic absence and causes the woman to be ravished by the semblances he offers her. The symptomatic partnership between a man and a woman by the means of ravishing, in phallic logic, gives the phallus bearer the responsibility to offer semblance, sayings, and speeches to his lacking partner in the sexual exchange. The word --ravage--will be used to explain what is beyond the phallic logic, when the amazement fails and shows the damages caused to the woman's permanence in a position of objectification, supported by such semblances and sayings