INTRODUCTION: The objective of this study was to investigate the effect and feasibility of linear low-intensity extracorporeal shockwave therapy (LI-LiESWT) as a penile rehabilitation method for erectile dysfunction (ED) after bilateral nerve-sparing (NS) radical prostatectomy (RP). METHODS: Patients who had undergone bilateral NS RP (either radical retropubic prostatectomy or robot-assisted laparoscopic RP), 3 or more months prior to the study, and who had no ED preoperatively and were suffering from mild to severe postoperative ED were included in the study. Four treatments were given over a 4-week period, using the PiezoWave2 device with a linear shockwave applicator and the linear shockwave tissue coverage (LSTC-ED®) technique. If the improvement in erectile function was still considered insufficient (less than an IIEF-5 score of 22-25) at 2 months after the start of LI-LiESWT, penile rehabilitation was supplemented by pharmacological penile rehabilitation. The final effect of treatment was evaluated after 12 months. The main outcome measure was changes in the five-item International Index of Erectile Function (IIEF-5) score. RESULTS: Between September 2019 and September 2020, a total of 40 patients were included in the study and randomly divided into 2 groups: treatment group and sham group. Eight patients were excluded from the study and were not evaluated due to other conditions which required additional treatment (COVID-19 disease, postoperative incontinence, urethral stricture, and ischemic stroke). Thirty-two patients were included in the final analysis: 16 in the control group and 16 in the intervention group. At 6 months from the end of treatment, patients in both the treatment and the sham group achieved physiological IIEF-5 values, and the beneficial effect persisted for 12 months after the end of treatment. CONCLUSIONS: LI-LiESWT using the LSTC-ED® technique is a suitable and safe method for penile rehabilitation in patients with ED after bilateral NS RP, not only because of the vasculogenic effect of LI-LiESWT but also because of its neuroprotective and/or regenerative effects.
- MeSH
- COVID-19 * MeSH
- erekce penisu MeSH
- erektilní dysfunkce * etiologie terapie MeSH
- léčba mimotělní rázovou vlnou * škodlivé účinky MeSH
- lidé MeSH
- prostatektomie škodlivé účinky metody MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- randomizované kontrolované studie MeSH
Erektilní dysfunkce a předčasná ejakulace patří k nejčastějším sexuálním poruchám u mužů. Ovlivňují fyzické i psychosociální zdraví mužů a mají významný vliv na kvalitu života nemocných i jejich partnerů. Incidence erektilní dysfunkce stále narůstá. Léčba erektilní dysfunkce zahrnuje perorální přípravky, léčbu rázovou vlnou, podtlakové přístroje, intrakavernózní injekce a penilní protézy. Nejběžněji jsou k léčbě erektilní dysfunkce využívány inhibitory PDE5. Zatímco léčba erektilní dysfunkce je orientovaná na muže, léčba předčasné ejakulace je orientovaná na uspokojení ženy. Používáme sexoterapeutické metody a farmakoterapii. Distribuce dapoxetinu v České republice skončila.
Erectile dysfunction and premature ejaculation belong to the most common sexual disorders in men. They affect the physical and psychosocial health of men and have a significant impact on the quality of life of patients and their partners. The incidence of erectile dysfunction continues to increase. Treatment of erectile dysfunction includes oral preparations, shock wave treatment, vacuum devices, intracavernous injections and penile prostheses. Most commonly used to treat erectile dysfunction are PDE5 inhibitors. While the treatment of erectile dysfunction is maleoriented, the treatment of premature ejaculation is oriented towards satisfying the woman. We use sexotherapy methods and drug therapy. The distribution of dapoxetine in the Czech Republic has ended.
- MeSH
- alprostadil farmakologie terapeutické užití MeSH
- erektilní dysfunkce * diagnóza etiologie terapie MeSH
- inhibitory fosfodiesterasy 5 farmakologie škodlivé účinky terapeutické užití MeSH
- lidé MeSH
- penilní protézy MeSH
- předčasná ejakulace diagnóza terapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
INTRODUCTION: Low-intensity extracorporeal shock wave therapy (Li-ESWT) is a new treatment modality for erectile dysfunction (ED). Our aim was to evaluate the treatment outcome of Li-ESWT for ED in single-blind, placebo controlled, randomized clinical trial. METHODS: Sixty patients were randomized into 2 age-matched groups: Group A - treatment and Group B - placebo. Treatment consisted of 4 sessions on the PiezoWave2 unit (R. Wolf and ELvation Medical). Effectiveness was assessed according to the International Index of Erectile Function 5 (IIEF-5), Erectile Hardness Score (EHS), questions 2 and 3 of the Sexual Encounter Profile (SEP 2, SEP 3), and Global Assessment Question (GAQ) scores at baseline and 4 and 12 weeks after treatment. We evaluated patient's and partner's subjective satisfaction. RESULTS: A statistically significant difference between the groups was found at 4 and 12 weeks after treatment with regard to the quality of erection as measured by the IIEF-5 (p = 0.049 and p < 0.001, respectively), the EHS after week 12 (p < 0.001), an increase in the EHS after 4 and 12 weeks (p = 0.030 and p < 0.001, respectively), after 12 weeks in GAQ (p < 0.001), SEP 2 (p = 0.05), SEP 3 (p < 0.001), and patient's satisfaction (p < 0.001) and partner's satisfaction (p < 0.001). CONCLUSIONS: The randomized single-blind study confirms that Li-ESWT significantly improves erectile function.
- MeSH
- dospělí MeSH
- erektilní dysfunkce terapie MeSH
- jednoduchá slepá metoda MeSH
- léčba mimotělní rázovou vlnou * MeSH
- lidé středního věku MeSH
- lidé MeSH
- senioři MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- Publikační typ
- časopisecké články MeSH
- randomizované kontrolované studie MeSH
- Publikační typ
- abstrakt z konference MeSH
INTRODUCTION: After spinal cord injury (SCI), individuals are typically considered by the general public to be asexual. Handicapped women have more problems with socio-sexual adaptation, stemming from low self-confidence, low self-esteem, and the absence of spontaneity. AIMS: To determine changes in the sexual lives of women after SCI. METHODS: A self-constructed questionnaire was used to map sexual function after SCI. We retrospectively compared sexual function in 30 women with SCI with that in 30 without SCI who led an active sexual life. Descriptive and inductive statistics were applied using the Student paired and non-paired t-tests and the Levene test. MAIN OUTCOME MEASURES: The main variables were presence vs absence of sexual dysfunction in a group of women after SCI and a comparison of the incidence of sexual dysfunctions in women after SCI with that of a control group. RESULTS: A significant difference was ascertained in women with SCI in sexual desire (P < .001), lubrication (P < .001), and reaching orgasm before and after injury (P = .030). A comparison of the two groups showed a significant difference in the realization of coital sexual activity (P < .001), erotogenous zones of the mouth (P = .016), nipples (P = .022), and genitals (P < .001), and in the ability to reach orgasm (P = .033). The negative impact of incontinence on the sexual life of women with SCI proved significant (P < .001). Negative factors for sexual activity in women with SCI were lower sensitivity in 16 (53%), spasms and mobility problems in 12 (40%), lower desire in 11 (36%), pain in 4 (13%), and a less accommodating partner in 3 (10%). CONCLUSION: Intercourse was the preferred sexual activity in women with SCI. Compared with the period before injury, there was significant lowering of sexual desire, impaired lubrication, and orgasmic ability after SCI. A comparison of the two groups showed a difference in erotogenous zones and in reaching orgasm. Sramkova T, Skrivanova K, Dolan I, et al. Women's Sex Life After Spinal Cord Injury. Sex Med 2017;5:e255-e259.
- Publikační typ
- časopisecké články MeSH
Erektilní dysfunkce a předčasná ejakulace jsou onemocnění, která ovlivňují fyzické a psychosociální zdraví a mají významný vliv na kvalitu života nemocných i jejich partnerů. Tři linie léčby erektilní dysfunkce zahrnují perorální léčbu, podtlakové přístroje, intrakavernózní léčbu, penilní protézy a novou léčbu rázovou vlnou. Současná léčba erektilní dysfunkce spočívá v podávání PDE5 inhibitorů, je bezpečná a dobře tolerovaná. Moderní léčba předčasné ejakulace je perorální léčba dapoxetinem. Dapoxetin signifikantně prodlužuje intravaginální ejakulační latenční čas ve srovnání s placebem, zvyšuje kontrolu ejakulace, redukuje stres i interpersonální těžkosti a zvyšuje satisfakci.
Erectile dysfunction and premature ejaculation are disorders, they affect physical and psychosocial health and have a significant impact on the QOL of sufferers and their partners. Three lines erectile dysfunction therapy include oral therapy, vacuum constriction device, intracavernous therapy, penile prosthesis and novel shock wave therapy. Current oral form of erectile dysfunction therapy by PDE5 inhibitors is safe and effective and is well tolerated. The modern premature ejaculation therapy is an oral treatment with dapoxetine. Dapoxetine significantly prolonged intravaginal ejaculatory latency time compared with placebo, increases the control of ejaculation, reduces stress and interpersonal difficulties, increases satisfaction.
- Klíčová slova
- dapoxetin,
- MeSH
- benzylaminy kontraindikace terapeutické užití MeSH
- erektilní dysfunkce * diagnóza etiologie terapie MeSH
- inhibitory fosfodiesterasy 5 terapeutické užití MeSH
- lidé MeSH
- naftaleny kontraindikace terapeutické užití MeSH
- předčasná ejakulace * diagnóza etiologie farmakoterapie MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- přehledy MeSH
- Publikační typ
- abstrakt z konference MeSH
- Publikační typ
- abstrakt z konference MeSH
- Publikační typ
- abstrakt z konference MeSH
