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Effectiveness and Prognosis: Drainage Skin-Bridge Sparing Surgery Combined with Fistulotomy versus Fistulotomy Only in the Treatment of Anal Fistula. JOURNAL OF HEALTHCARE ENGINEERING 2021; 2021:6940072. [PMID: 34876965 PMCID: PMC8645410 DOI: 10.1155/2021/6940072] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 08/28/2021] [Accepted: 09/04/2021] [Indexed: 02/07/2023]
Abstract
Objective This study intends to analyze the difference in the efficacy of drainage skin-bridge sparing surgery combined fistulotomy (DSCF) and fistulotomy alone. Methods 125 patients with anal fistula were enrolled as study subjects and randomly divided into control group (CG) and observation group (OG) by double-blind lottery. The CG received drainage skin-bridge sparing surgery with fistulotomy and the OG received fistulotomy only. Results The VAS scores of the trauma in the OG were lower than those in the CG on 1st day of surgery and 7 days after surgery (P < 0.05). The length of hospital stay and time to wound healing were shorter in the OG than in the CG (P < 0.05). The incidence of postoperative bleeding in the OG was 9.52%, which was lower than 22.58% in the CG (P < 0.05). The rectal examination scores were lower in the OG than in the CG at 3 and 5 days postoperatively (P < 0.05). The Wexner scores of solid incontinence (0 to 4), liquid incontinence (0 to 4), gas incontinence (0 to 4), pad wearing (0 to 4), and lifestyle alteration (0 to 4) in the OG were lower than those of the CG at 5 days postoperatively (P < 0.05). Voiding function scores were lower in the OG than in the CG at 2 and 3 days postoperatively (P < 0.05). Conclusions The efficacy of drainage skin-bridge sparing surgery combined fistulotomy is better than that of fistulotomy alone, which can accelerate postoperative healing, enhance urinary function, reduce postoperative bleeding, and improve anal function.
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Yang L, Lee JA, Heer E, Pernar C, Colditz GA, Pakpahan R, Imm KR, Kim EH, Grubb RL, Wolin KY, Kibel AS, Sutcliffe S. One-year urinary and sexual outcome trajectories among prostate cancer patients treated by radical prostatectomy: a prospective study. BMC Urol 2021; 21:81. [PMID: 34001094 PMCID: PMC8130427 DOI: 10.1186/s12894-021-00845-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 04/28/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND To examine one-year trajectories of urinary and sexual outcomes, and correlates of these trajectories, among prostate cancer patients treated by radical prostatectomy (RP). METHODS Study participants were recruited from 2011 to 2014 at two US institutions. Self-reported urinary and sexual outcomes were measured at baseline before surgery, and 5 weeks, 6 months and 12 months after surgery, using the modified Expanded Prostate Cancer Index Composite-50 (EPIC-50). Changes in EPIC-50 scores from baseline were categorized as improved (beyond baseline), maintained, or impaired (below baseline), using previously-reported minimum clinically important differences. RESULTS Of the 426 eligible participants who completed the baseline survey, 395 provided data on at least one EPIC-50 sub-scale at 5 weeks and 12 months, and were analyzed. Although all mean EPIC-50 scores declined markedly 5 weeks after surgery and then recovered to near (incontinence-related outcomes) or below (sexual outcomes) baseline levels by 12 months post-surgery, some men experienced improvement beyond their baseline levels on each sub-scale (3.3-51% depending on the sub-scale). Having benign prostatic hyperplasia (BPH) at baseline (prostate size ≥ 40 g; an International Prostate Symptom Index Score ≥ 8; or using BPH medications) was associated with post-surgical improvements in voiding dysfunction-related bother at 5 weeks (OR = 3.9, 95% CI: 2.1-7.2) and 12 months (OR = 3.3, 95% CI: 2.0-5.7); and in sexual bother at 5 weeks (OR = 5.7, 95% CI:1.7-19.3) and 12 months (OR = 3.0, 95% CI: 1.2-7.1). CONCLUSIONS Our findings provide additional support for considering baseline BPH symptoms when selecting the best therapy for early-stage prostate cancer.
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Affiliation(s)
- Lin Yang
- Department of Cancer Epidemiology and Prevention Research, Cancer Research and Analytics, Cancer Care Alberta, Alberta Health Services, 5th Floor, Holy Cross Centre, Box ACB, 2210 - 2 St. SW, Calgary, AB T2S 3C3 Canada
- Departments of Oncology and Community Health Sciences, University of Calgary, Calgary, Canada
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, 600 S. Taylor Ave., 2nd floor, Rm. 208S, Campus Box 8100, St. Louis, MO 63110 USA
| | - Jung Ae Lee
- Agricultural Statistics Laboratory, University of Arkansas, Fayetteville, USA
| | - Emily Heer
- Department of Cancer Epidemiology and Prevention Research, Cancer Research and Analytics, Cancer Care Alberta, Alberta Health Services, 5th Floor, Holy Cross Centre, Box ACB, 2210 - 2 St. SW, Calgary, AB T2S 3C3 Canada
| | - Claire Pernar
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA USA
| | - Graham A. Colditz
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, 600 S. Taylor Ave., 2nd floor, Rm. 208S, Campus Box 8100, St. Louis, MO 63110 USA
| | - Ratna Pakpahan
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, 600 S. Taylor Ave., 2nd floor, Rm. 208S, Campus Box 8100, St. Louis, MO 63110 USA
| | - Kellie R. Imm
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, 600 S. Taylor Ave., 2nd floor, Rm. 208S, Campus Box 8100, St. Louis, MO 63110 USA
- Division of Health Behavior Research, Department of Preventive Medicine, Keck School of Medicine of the
University of Southern California, 2001 N Soto St., Los Angeles, CA 90032 USA
| | - Eric H. Kim
- Department of Cancer Epidemiology and Prevention Research, Cancer Research and Analytics, Cancer Care Alberta, Alberta Health Services, 5th Floor, Holy Cross Centre, Box ACB, 2210 - 2 St. SW, Calgary, AB T2S 3C3 Canada
- Departments of Oncology and Community Health Sciences, University of Calgary, Calgary, Canada
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, 600 S. Taylor Ave., 2nd floor, Rm. 208S, Campus Box 8100, St. Louis, MO 63110 USA
- Agricultural Statistics Laboratory, University of Arkansas, Fayetteville, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA USA
- Division of Urological Surgery, Department of Surgery, Washington University School of Medicine, St Louis, USA
- Department of Urology, Medical University of South Carolina, Charleston, USA
- Coeus Health, Chicago, IL USA
- Division of Urology, Department of Surgery, Brigham and Women’s Hospital, Boston, USA
- Division of Health Behavior Research, Department of Preventive Medicine, Keck School of Medicine of the
University of Southern California, 2001 N Soto St., Los Angeles, CA 90032 USA
| | - Robert L. Grubb
- Division of Urological Surgery, Department of Surgery, Washington University School of Medicine, St Louis, USA
- Department of Urology, Medical University of South Carolina, Charleston, USA
| | | | - Adam S. Kibel
- Division of Urology, Department of Surgery, Brigham and Women’s Hospital, Boston, USA
| | - Siobhan Sutcliffe
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, 600 S. Taylor Ave., 2nd floor, Rm. 208S, Campus Box 8100, St. Louis, MO 63110 USA
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Walker LM, Santos-Iglesias P. On the Relationship Between Erectile Function and Sexual Distress in Men with Prostate Cancer. ARCHIVES OF SEXUAL BEHAVIOR 2020; 49:1575-1588. [PMID: 32072396 DOI: 10.1007/s10508-019-01603-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 11/26/2019] [Accepted: 11/28/2019] [Indexed: 06/10/2023]
Abstract
Erectile difficulties are common after prostate cancer (PCa) treatment and are associated with sexual distress. However, the relationship between erectile function and sexual distress has yet to be carefully examined. This study had three goals: (1) examine the relationship between erectile function and sexual distress; (2) determine groups of men based on erectile function and sexual distress; and (3) examine the psychosexual characteristics of these groups. A cross section of 233 sexually active men after PCa treatment (age M = 64.90 years, SD = 7.50) completed an online survey containing demographic, health, and sexuality and relationship questionnaires. The relationship between erectile function and sexual distress was curvilinear. Four groups of men were found: good erectile function and low sexual distress, poor erectile function and high sexual distress, but also good erectile function yet high sexual distress, and poor erectile function and low sexual distress. Regardless of erectile function, men with greater sexual distress were more depressed, reported additional sexual concerns, placed less value on sex, were less sexually satisfied, and used protective buffering communication more frequently. They were also less likely to be satisfied with their adaptation to sexual changes and less likely to have found a solution to those changes. The relationship between erectile function and sexual distress is complex, characterized by a wide array of responses to erectile function (high and low distress) and multiple correlates of sexual distress. These results broaden the concept of sexual recovery after PCa treatment, which may assist clinicians and researchers to better address sexual problems after PCa treatment.
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Affiliation(s)
- Lauren M Walker
- Tom Baker Cancer Centre-Holy Cross Site, Division of Psychosocial Oncology, Department of Oncology, University of Calgary, 2202 2nd Street SW, Calgary, AB, T2S 3C1, Canada.
- Arnie Charbonneau Cancer Institute, University of Calgary, Calgary, AB, Canada.
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