There is a close relationship between sexual activity and meals or alcohol consumption. It is of great clinical significance for clinicians to understand the effects of food and alcohol on the pharmacokinetics of phosphodiesterase-5 inhibitor vardenafil so as to give correct instructions to patients. Although a high-fat ( > 55% fat calories) meal modestly reduces C(max) by 18% and prolongs t(max) of vardenafil by approximately 1 hour, no significant effects of a typical moderate-fat meal (30% fat calories) on vardenafil pharmacokinetics were observed in a study carried out in 25 healthy adult males. So the adjustment of vardenafil dosage is not warranted based on a wide therapeutic index and the efficacy observed with vardenafil in Phase III studies, which need not be restricted with respect to food. In another study, the pharmacokinetics and safety profile of vardenafil were not affected if it was taken together with 0.5 g/kg ethanol. The above characteristics of vardenafil make the administration more convenient for patients.
Adult ; Alcohol Drinking ; Erectile Dysfunction ; drug therapy ; Food-Drug Interactions ; Humans ; Imidazoles ; adverse effects ; pharmacokinetics ; Male ; Phosphodiesterase Inhibitors ; adverse effects ; pharmacokinetics ; Piperazines ; adverse effects ; pharmacokinetics ; Sulfones ; adverse effects ; pharmacokinetics ; Triazines ; adverse effects ; pharmacokinetics ; Vardenafil Dihydrochloride

Objective To explore the monitoring methods for pancreatic graft function after upper abdominal cluster transplantation.Methods Analysis of the clinical data of 5 cases of successful upper abdominal(cluster) transplantation in our center.Results The patients recovered well after the operation.Endocrine and exocrine functions of all the pancreas graft returned to normal without any rejection.Conclusions Dynamic monitoring of blood glucose,C-peptide,blood insulin,blood amylase,urine amylase,amylase in abdominal drainage and duodenal tube decompression drainage,in addition to Doppler color ultrasound examination,can effectively detect the endocrine and exocrine function of the pancreas graft.

OBJECTIVETo evaluate the efficacy and safety of sildenafil on erectile dysfunction in the aged men with diabetes.

METHODSOne hundred and ten patients aged 55 years old above with type I or II diabetes and a minimum 3-month history of ED were studied. Patients were instructed to take one dose of their treatment orally at any time before anticipated sexual activity. Changes from baseline in mean scores on the erectile function domain of the International index of Erectile Function and changes from baseline in the proportion of "yes" responses to question 2, and 3, of the Sexual Encounter Profile were coprimary outcome measures.

RESULTSTreatment with sildenafil significantly improved all primary efficacy variables.

CONCLUSIONSildenafil therapy significantly enhanced erectile function and was well tolerated by men with diabetes and ED.

Aged ; Diabetes Complications ; drug therapy ; Erectile Dysfunction ; drug therapy ; Humans ; Male ; Middle Aged ; Phosphodiesterase Inhibitors ; therapeutic use ; Piperazines ; therapeutic use ; Purines ; therapeutic use ; Sildenafil Citrate ; Sulfones ; therapeutic use ; Surveys and Questionnaires

OBJECTIVETo evaluate deep penile arterial flow after an intracavernosal injection with prostaglandin E1 in patients with erectile dysfunction (ED).

METHODS527 patients with ED were evaluated using Color Doppler Ultrasonography. Diagnostic tests were undertaken after an intracavernosal injection with 20 microg prostaglandin El. The peak systolic velocity (PSV), end diastolic velocity (EDV) and resistive index (RI) were analysed.

RESULTSThere were 112 patients (26.99%) with nonvasculogenic ED, 207 patients (49.88%) with arteriogenic ED, 144 patients (34.70%)with venogenic ED, 64 patients (15.42%)with mixed ED.

CONCLUSIONThe Color Doppler Ultrasonography technique allows accurate location and evaluation of deep penile arteries. Vascular pathology may be differentiated after an intracavernosal injection with a vasomotor agent. Recognising the pathological pattern assists in choosing the best method of treatment.

Adult ; Blood Flow Velocity ; Humans ; Impotence, Vasculogenic ; diagnostic imaging ; physiopathology ; Male ; Middle Aged ; Penis ; blood supply ; diagnostic imaging ; Regional Blood Flow ; Ultrasonography, Doppler, Color

OBJECTIVETo evaluate the sex therapy for erectile dysfunction (ED).

METHODSWe recommended the sex therapy to ED patients and their partners (11 couples in all) in the outpatient department. Of the total number of volunteers, 2 males were accompanied by ejaculation disorder, another 2 with hyposexuality, and 1 female had vaginismus. The effect of the therapy was assessed and the problems with it analyzed by interviews with the subjects and the results of International Index of Erectile Function (IIEF) before and after the treatment.

RESULTSOf the 11 pairs of volunteers, 5 quitted halfway and 1 discontinued at the therapists' decision. The 5 couples who accomplished the whole therapy felt more satisfied with their sexual life and general relationship, with improved scores on all the items of IIEF, particularly on erectile function (EF), with the only exception of sexual desire (SD).

CONCLUSIONThe sex therapy is effective not only for ED but also for other accompanying sexual dysfunctions, the sexual dysfunctions of the patients' partners and the improvement of the general relationship of the couples.

Adult ; Aged ; Behavior Therapy ; methods ; Erectile Dysfunction ; therapy ; Female ; Humans ; Male ; Middle Aged ; Sexual Behavior ; Sexual Partners ; Treatment Outcome

OBJECTIVESTo study the etiology of persistent hematospermia and to evaluate the efficacy of transrectal ultrasonography (TRUS)-guided transperineal needle aspiration and irrigation for diagnosis and treatment of persistent hematospermia.

METHODSTwelve patients were included in the study, with a mean age of (36.4 +/- 10.8) years old, and a mean duration of the disease of (13.9 +/- 6.4) months. After the expressed prostatic secretion (EPS) by prostatic massage was cultured, patients with recurrent hematospermia received TRUS-guided transperineal needle aspiration for seminal vesicle fluid (SVF), which was sent for bacteriological and cytological examination. If the EPS culture were positive, certain antibiotics according to the drug sensitivity assay were injected into the abnormal seminal vesicle(s) via TRUS-guided transperineal needle puncture. The treatment would be repeated one month later if the patients still had hematospermia. The patients were followed up every three months.

RESULTSAbnormal images were found in left seminal vesicle (SV) in 4 cases, right in 3 cases, bilateral in 2 cases, and no abnormal findings in 3 cases. The abnormal findings included: 7 cases of SV and/or ejaculatory duct dilation, 3 cases of thickening SV wall, 3 cases of calcification or calculi of SV, and 1 case of Müllerian duct cyst. SVF cultures were positive in 7 cases: methicillin-resistant Staphylococcus aureus (MRSA) 4 cases, methicillin-resistant coagulase-negative Staphylococcus (MRCNS), E. Coli, Proteus mirabilis 1 case, respectively. In five of these 7 cases, bacteriological cultures of SVF and EPS showed the same results. All patients were treated by TRUS-guided transperineal injection of certain antibiotics into SV. Seven cases were injected once, 5 cases twice. The mean follow-up period of 10 patients was (16.7 +/- 5.9) months. Hematospermia disappeared in 6 cases.

CONCLUSIONSSV infection of bacteria, especially infection of the drug resistant strains was one of the main causes of persistent hematospermia. The difficulties in treatment of persistent hematospermia were due to infection of drug resistant bacteria, calcification or calculi of SV, obstruction of ejaculatory duct. TRUS-guided transperineal aspiration of SVF was helpful to the etiologic diagnosis of persistent hematospermia.

Adult ; Drug Resistance, Bacterial ; Genital Diseases, Male ; etiology ; microbiology ; Humans ; Male ; Middle Aged ; Pilot Projects ; Seminal Vesicles ; microbiology ; Ultrasound, High-Intensity Focused, Transrectal

OBJECTIVESThe physicians knowledge and attitude to erectile dysfunction (ED) is very important to the diagnosis and management of this disease. We investigated the physicians and practitioners knowledge of ED, attitude to ED, and if they actively find the underlying ED patients.

METHODSThree hundreds and one physicians and practitioners in Beijing completed a questionnaire. The subjects included urologists, cardiologists, endocrinologists, surgeons, orthopaedicians and community practitioners.

RESULTSThe definition of ED was well known by most subjects (83.4%). Many agreed that ED was a common condition in the aging men (85.0%), and it was an important health problem (78.7%) and it was the local signs of certain systemic diseases (89.7%). The most common risk factors of ED enumerated by the physicians were diabetes (45.5%), hypertension (12.6%) and coronary artery diseases (12.0%). 45.5% physicians met the patients who initiated questions about ED. 32.6% physicians would discuss ED with the patients if the patients initiate questions about ED. 95.0% non-urological physicians would refer the ED patients to urologists or andrologists. 43.5% of all the physicians never asked their patients about erectile function, this proportions in the subgroups of urologists, non-urological physicians and community practitioners were 7.2%, 55.3% and 60.5% respectively (P < 0.01). The most common reasons for the physicians not to initiate the inquiries about ED was "the patients would not have ED if they didnt complain about it" (42.2%), "there was no ED patients in my specialty" (20.9%), "diagnosis and treatment of ED was not my business" (17.3%), "have no time" (15.6%), "feel embarrassed" (13.6%).

CONCLUSIONSMost physicians regarded ED as an important health problem and a common condition in aging men, but they didnt take an active attitude to ED in their clinical practice.

Aging ; Attitude of Health Personnel ; China ; epidemiology ; Education, Medical ; Erectile Dysfunction ; epidemiology ; etiology ; Female ; Humans ; Knowledge ; Male ; Physicians ; psychology ; Risk Factors

OBJECTIVETo discuss the factors that affect the clinical application of sex therapy for erectile dysfunction (ED).

METHODSUrological researchers recommended free sex therapy to ED patients and their partners in the outpatient department and studied the factors affecting the patients of Medicaid their partnersology, acceptance of sex therapy by interview and observation.

RESULTSMany patients refused sex therapy. Only 11 pairs of volunteers underwent it, of whom 5 pairs gave up halfway, 1 pair were stopped by the therapist due to the breakup of their marriage, and merely 5 pairs accomplished the whole course. Among the 5 pairs of quitters, 2 pairs thought of their problem as organic and turned to drug therapy, 1 pair withdrew because the patient's girlfriend broke up with him, 1 pair gave up because they lived in another city too far away from the clinic, and the other pair discontinued because they could not spare the time from their work.

CONCLUSIONSMany factors affect the clinical application of sex therapy for ED in China. Apart from the shortage of qualified professional sex therapists, some factors from the patients and their partners are at work, such as stress of work, lack of time, home location, education background, relationship between the patient and his partner, attitude to sex therapy, and so on.

Adolescent ; Adult ; Erectile Dysfunction ; therapy ; Female ; Humans ; Male ; Marital Therapy ; methods ; Sex Counseling ; methods ; Sexual Partners

OBJECTIVETo evaluate the long-term efficacy of transrectal ultrasonography (TRUS)-guided transperineal needle aspiration and irrigation for persistent hematospermia.

METHODSIncluded in the study were 12 patients with persistent hematospermia, aged (36.4 +/- 10.8) years, and with a course of the disease of (13.9 +/- 6.4) months. After the expressed prostatic secretion (EPS) by prostatic massage cultured, the patients received TRUS-guided transperineal needle aspiration for seminal vesicle fluid (SVF) for bacteriological examination. For the EPS positive patients, antibiotics were selected according to the drug sensitivity assay and injected into the abnormal seminal vesicle (SV) via TRUS-guided transperineal needle puncture. The treatment was repeated one month later for those still with hematospermia. The patients were followed up every three months.

RESULTSAbnormal images were found in the SV and/or ejaculatory duct in 9 cases, including SV and/or ejaculatory duct dilation, SV wall thickening, calcification or calculi of SV, and müllerian duct cyst. SVF cultures were positive in 7 cases, including 4 cases of methicillin-resistant Staphylococcus aurous (MRSA), 1 case of methicillin-resistant coagulase-negative staphylococcus (MRCNS), 1 case of E. Coli, and 1 case of Proteus mirabili. All the patients were treated by TRUS-guided transperineal injection of certain antibiotics into SV. Ten of them were followed up for (31.4 +/- 5.7) months. Hematospermia disappeared in 3 cases and relapsed at least once in the other 7. The last follow-up showed hematospermia recurrence in 2 cases.

CONCLUSIONTRUS-guided transperineal irrigation of antibiotics into SV is effective to a certain extent for persistent hematospermia.

Adult ; Anti-Bacterial Agents ; administration & dosage ; Follow-Up Studies ; Hemospermia ; diagnostic imaging ; therapy ; Humans ; Male ; Middle Aged ; Rectum ; diagnostic imaging ; Seminal Vesicles ; Suction ; Therapeutic Irrigation ; Treatment Outcome ; Ultrasonography

OBJECTIVETo elevate the diagnosis and differential diagnosis levels of epididymal mass by sonography.

METHODSThis was a retrospective study of 179 cases of epididymal mass treated by surgery in our hospital between 1990 and 2005. The analysis was focused on pathological and sonographic features.

RESULTS179 patients with mean age of 51.4 +/- 14.7 were enrolled. The epididymal mass was classified into four groups: epididymal cyst (n = 98), nonspecific epididymitis (n = 27), tuberculous epididymitis (n = 33) , and epididymal tumor (n = 21). Epididymal cyst could be easily diagnosed by ultrasound, the diagnostic rate was 93.8%, but nonspecific epididymitis and tuberculous epididymitis were hard to differentiate, complicating with multiple organs lesions may distinguish tuberculous from nonspecific epididymitis. Tuberculous epididymitis could be easily diagnosed when cold abscess, calcification and sinus tract emerged. The majority epididymal tumors were benign, and malignant cases were rarely seen. Patient's history, physical examination and sonographic features were all essential to make a right diagnosis.

CONCLUSIONUltrasound features may be helpful to the differential diagnosis of epididymal mass and ultrasound should be the first choice of image detection in epididymal lesions.

Adolescent ; Adult ; Aged ; Diagnosis, Differential ; Epididymis ; Epididymitis ; diagnostic imaging ; Genital Neoplasms, Male ; diagnostic imaging ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Tuberculosis, Male Genital ; diagnostic imaging ; Ultrasonography