Q95466714
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Incidence karcinomu prostaty se zvyšuje celosvětově a onemocnění je stále častěji diagnostikováno i u relativně mladých mužů. Radikální prostatektomie je nejčastější standardní kurativní léčebnou modalitou lokalizovaného karcinomu prostaty. Jednou z častých komplikací radikální prostatektomie je porucha sexuálních funkcí, mezi které patří i erektilní dysfunkce. Nyní máme k dispozici řadu studií, ve kterých byly zkoumány různé modality penilní rehabilitace: aplikace PDE-5 inhibitorů, vakuová zařízení, intrakavernózní či transuretrální aplikace vazodilatačních látek. Existují též četné studie poskytující informaci o výhodách aktivního přístupu k této problematice. Univerzální strategie rehabilitace erektilní funkce zatím není nalezena, avšak zahrnuje Časné a pravidelné použití prostředků k dosažení erekce. Je důležité výše uvedenou informaci probrat s pacientem ještě před operací a po operaci by si pacient měl vybrat pro sebe vhodnou léčebnou strategii.
- MeSH
- aplikace lokální MeSH
- inhibitory fosfodiesteras terapeutické užití MeSH
- nádory prostaty chirurgie komplikace MeSH
- prostaglandiny E aplikace a dávkování terapeutické užití MeSH
- prostatektomie metody škodlivé účinky MeSH
- sexuální dysfunkce fyziologická etiologie patofyziologie terapie MeSH
- vakuum MeSH
- Check Tag
- mužské pohlaví MeSH
Varicocelectomy is the most common procedure for male infertility. The introduction of microsurgical techniques has revolutionized the treatment of male infertility. Material and methods: Over a 4-year period, 217 patients underwent microsurgical varicocelectomy at our center. Pre-operative semen values were compared with the post-operative values. Results: Significant improvement of spermiogram occurs in 70.35%. Pregnancy rate 41%. Conclusions: Microsurgical varicocelectomy is a safe and effective option for the management of varicocele-induced male infertility. It leads to improvement in all semen parameters and increases the possibility of spontaneous pregnancies.
- MeSH
- erektilní dysfunkce rehabilitace MeSH
- lidé MeSH
- medicína založená na důkazech trendy MeSH
- nádory prostaty chirurgie rehabilitace terapie MeSH
- prognóza MeSH
- prostaglandiny E aplikace a dávkování terapeutické užití MeSH
- prostatektomie metody rehabilitace využití MeSH
- rizikové faktory MeSH
- způsoby aplikace léků MeSH
- Check Tag
- lidé MeSH
Penile implantation is the most invasive but still the most effective choice of erectile dysfunction treatment. Its role is very often not mentioned to patients suffering by erectile dysfunction who failed less invasive methods of treatment, because physicians do not have enough experience with that therapy. Material and methods: Authors represent own series of 65 patients operated on in the period 1992–2002 and followed up 5–15 years (mean 10.6 years). Patients have been questioned by specific questionnaire created by authors. Results: 97% of patients answered that prosthesis fulfilled their expectations, ability of sexual intercourse has been in 100% better, frequency of intercourse increased in 80% of patients, self-esteem improved (in sexual activities in 100% in social activities in 81% in professional activities in 74%), relationship with partner improved in 93% of patients, sexual activities evaluated by partner are better in 90%. 97% of patients would recommend that procedure to the other patient and 97% would undergo surgery again in the case of repeated decision making. Conclusions: Penile prosthesis implantation is invasive but very effective treatment alternative and brings high satisfaction to properly selected patients and their partners. Specialists should keep it in mind and recommend as option to patients in whom less invasive treatment fails.
There is recently obvious increasing number of prostate cancer confined to prostate gland in men of relatively young age. Unfortunately, the consequent definitive treatment could negatively affect patient's quality of life. In spite of improved radical prostatectomy techniques, pretty common complication today, besides quite rare urinary incontinence, is erectile dysfunction. Erection is according to different authors normalized in 16%–85% of patients after 6–24 months. Rehabilitation of erectile function is dependent on surgical technique, advancement of tumor, status of erectile function prior surgery and age of patient. According to the literature, active attitude to that problem enabled to higher percentage of patients faster rehabilitation of erectile function after radical prostatectomy. Authors try to bring overview of current possibilities of erectile function rehabilitation.
