1
|
Asanad K, Horns JJ, Driggs N, Samplaski MK, Hotaling JM. Untreated hypogonadism and testosterone replacement therapy in hypogonadal men are associated with a decreased risk of subsequent prostate cancer: a population-based study. Int J Impot Res 2024:10.1038/s41443-023-00820-3. [PMID: 38177194 DOI: 10.1038/s41443-023-00820-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 12/08/2023] [Accepted: 12/20/2023] [Indexed: 01/06/2024]
Abstract
We sought to understand the relationship between hypogonadism and testosterone replacement therapy (TRT) in hypogonadal men on the risk of developing localized and metastatic prostate cancer. We used the Merative MarketScan database of commercial claims encounters to identify men diagnosed with hypogonadism. These men were matched to eugonadal men who served as controls. Multivariate negative binomial regression analysis of prostate cancer diagnoses, hypogonadism, and TRT in hypogonadal men adjusting for various known confounding factors was used to understand the impact of hypogonadism and TRT on prostate cancer risk. We identified 3,222,904 men who met inclusion criteria, of which 50% were diagnosed with hypogonadism (1,611,452) and each were matched to a control (1,611,452). The incidence of prostate cancer was 2.16%, 1.55%, and 1.99% in eugonadal controls, hypogonadal men on TRT, and hypogonadal men without TRT, respectively (p < 0.001). Untreated hypogonadism was independently associated with a decreased risk of localized prostate cancer (IRR 0.46, 95% CI 0.43-0.50, p < 0.001) compared to eugonadal controls. Hypogonadal men on TRT also had a significantly decreased risk of localized prostate cancer (IRR 0.49, 95% CI 0.45-0.53, p < 0.001). Furthermore, hypogonadal men on TRT (IRR 0.21, 95% CI 0.19-0.24, p < 0.001) or without TRT (IRR 0.20, 95% CI 0.18-0.22, p < 0.001) both had significantly decreased risk of metastatic prostate cancer, respectively. Our population-based analysis suggests that untreated hypogonadism in men is associated with a 50% decreased incidence of localized prostate cancer and an 80% decreased incidence of metastatic prostate cancer. TRT in hypogonadal men was also associated with a decreased risk of subsequent prostate cancer. Further research is needed to better understand the relationship between hypogonadism and TRT in hypogonadal men on the risk of subsequent prostate cancer.
Collapse
Affiliation(s)
- Kian Asanad
- Institute of Urology, University of Southern California, Los Angeles, CA, USA
| | - Joshua J Horns
- Surgical Population Analysis Research Core, University of Utah, Salt Lake City, UT, USA
| | - Nathan Driggs
- Surgical Population Analysis Research Core, University of Utah, Salt Lake City, UT, USA
| | - Mary K Samplaski
- Institute of Urology, University of Southern California, Los Angeles, CA, USA
| | - James M Hotaling
- Division of Urology, Department of Surgery, University of Utah, Salt Lake City, UT, USA.
| |
Collapse
|
2
|
Testosterone therapy in prostate cancer: is it still a controversy? Curr Opin Urol 2022; 32:598-606. [PMID: 36081393 DOI: 10.1097/mou.0000000000001039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW The benefits of testosterone therapy (TTh) in the hypogonadal male can be dramatic. Historically, TTh has been contraindicated in prostate cancer (PCa). Current evidence has redefined our understanding of the influence serum testosterone has on prostatic androgen activity. Increasing numbers of hypogonadal men with coexisting PCa emphasizes the importance of describing those who may safely receive TTh. This review aims to present literature that evaluates the efficacy and safety of TTh in men with coexisting PCa. RECENT FINDINGS Our study, a comprehensive review of published literature regarding TTh in men with a history of PCa, consisted of studies conducted from the 1940s to 2022. Our review discusses evidence in accordance with previous studies that TTh has a role in patients with localized PCa as it has not been reported to increase rates of recurrence or progression of PCa. SUMMARY The use of TTh in hypongonadal men with a localized PCa has been shown to have positive clinical outcomes without increasing the rate of disease progression or recurrence. Further research, in a randomized controlled setting, is warranted.
Collapse
|
3
|
Mohamad Anuar MF, Solihin Rezali M, Mohamed Daud MA, Ismail SB. A community-based study on lower urinary tract symptoms in Malaysian males aged 40 years and above. Sci Rep 2022; 12:2345. [PMID: 35149733 PMCID: PMC8837662 DOI: 10.1038/s41598-022-05890-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Accepted: 01/12/2022] [Indexed: 11/17/2022] Open
Abstract
Lower urinary tract symptoms (LUTS) commonly affecting ageing men and is thought to be linked with other comorbidities and unhealthy lifestyles. This study was performed to report the prevalence of LUTS and its association with quality of life (QOL) in urination and other related factors. The study was part of the National Health and Morbidity Survey (NHMS) 2019, a cross-sectional community-based survey in Malaysia. Validated self-administered bilingual International Prostate Symptom Score (IPSS) was used to assess the LUTS. Other comorbidities and unhealthy lifestyles were recorded using face-to-face interview and in-situ measurements such as anthropometry assessment and blood measurement. There were a total of 2251 respondents. 16.3% of the respondents had clinically significant LUTS (IPSS ≥ 8). LUTS was found to be significantly associated with QOL, age and inactive physical activities. Nocturia was the most prevalent and bothersome symptom. LUTS is a common condition and adversely affect QOL. Ageing and physically inactive males are associated with the development of LUTS. It is recommended to increase public awareness of the condition and availability of treatment options for LUTS. Any upcoming survey should have a more in-depth investigation such as clinical profiling of subjects.
Collapse
Affiliation(s)
- Mohamad Fuad Mohamad Anuar
- Sector for Biostatistic and Repository Data, Office of NIH Manager, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Selangor, Malaysia.
| | - Muhammad Solihin Rezali
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Selangor, Malaysia
| | - Mohamed Ashraf Mohamed Daud
- Urology Unit, Department of Surgery, Hospital Universiti Sains Malaysia, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Shaiful Bahari Ismail
- Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| |
Collapse
|
4
|
Irfan M, Hussain NHN, Noor NM, Mohamed M, Sidi H, Ismail SB. Epidemiology of Male Sexual Dysfunction in Asian and European Regions: A Systematic Review. Am J Mens Health 2021; 14:1557988320937200. [PMID: 32623948 PMCID: PMC7338652 DOI: 10.1177/1557988320937200] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Male sexual dysfunctions (MSDs) often remain undiagnosed and untreated in Asia
compared to Europe due to conservative cultural and religious beliefs,
socioeconomic conditions, and lack of awareness. There is a tendency for the use
of traditional medicines and noncompliance with and reduced access to modern
healthcare. The present systematic review compared the incidence and factors of
MSD in European and Asian populations. English language
population/community-based original articles on MSDs published in MEDLINE from
2008 to 2018 were retrieved. A total of 5392 studies were retrieved, of which 50
(25 Asian and 25 European) were finally included in this review. The prevalence
of erectile dysfunction (ED) (0%–95.0% vs. 0.9%–88.8%), low satisfaction
(3.2%–37.6% vs. 4.1%–28.3%), and hypoactive sexual desire disorder (HSDD)
(0.7%–81.4 vs. 0%–65.5%) was higher in Asian than in European men, whereas the
prevalence of anorgasmia (0.4% vs. 3%–65%) was lower in Asian than in European
men. Age was an independent positive factor of MSD. In European men over 60
years old, the prevalence of premature ejaculation (PE) decreased. The
prevalence of MSD was higher in questionnaires than in interviews. The
significant factors were age, single status, low socioeconomic status, poor
general health, less physical activity, cardiovascular diseases, diabetes,
obesity, lower urinary tract symptoms, prostatitis, anxiety, depression and
alcohol, tobacco, and drug use. The prevalence of MSD differed slightly in Asian
and European men. There is a need to conduct large studies on the various Asian
populations for the effective management of MSD.
Collapse
Affiliation(s)
- Muhammad Irfan
- Women's Health Development Unit, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.,Department of Zoology, Pir Mehr Ali Shah Arid Agriculture University, Rawalpindi, Pakistan
| | - Nik Hazlina Nik Hussain
- Women's Health Development Unit, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Norhayati Mohd Noor
- Department of Family Medicine, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Mahaneem Mohamed
- Department of Physiology, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Hatta Sidi
- Department of Psychiatry, Faculty of Medicine, The National University of Malaysia, Kuala Lumpur, Malaysia
| | - Shaiful Bahari Ismail
- Department of Family Medicine, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| |
Collapse
|
5
|
Grech LB, Allan M, de Courten B. Sexual dysfunction in men with multiple sclerosis. Syst Rev 2021; 10:86. [PMID: 33773599 PMCID: PMC8005241 DOI: 10.1186/s13643-021-01643-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 03/19/2021] [Indexed: 11/29/2022] Open
Affiliation(s)
- Lisa B Grech
- Department of Medicine, School of Clinical Sciences, Monash University, Clayton, 3168, Victoria, Australia. .,Melbourne School of Psychological Sciences, University of Melbourne, Parkville, Victoria, 3010, Australia.
| | - Michelle Allan
- Department of Neurology, Monash Medical Centre, Monash Health, Clayton, Victoria, 3168, Australia
| | - Barbora de Courten
- Department of Medicine, School of Clinical Sciences, Monash University, Clayton, 3168, Victoria, Australia
| |
Collapse
|
6
|
Vinnik T, Kreinin A, Abildinova G, Batpenova G, Kirby M, Pinhasov A. Biological Sex and IgE Sensitization Influence Severity of Depression and Cortisol Levels in Atopic Dermatitis. Dermatology 2020; 236:336-344. [PMID: 31914445 DOI: 10.1159/000504388] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Accepted: 10/25/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Depression is a common comorbid condition with atopic dermatitis (AD), particularly during the active disease cycle. Controversial results regarding the contribution of biological sex, immunoglobulin E (IgE) sensitization, and cortisol on AD severity and comorbid depression justify further investigation. OBJECTIVE AND METHODS To explore the influence of sex and IgE sensitization on biochemical and psychological parameters, and severity of AD, a case-control study of 105 volunteers (56 AD, 49 healthy controls (HC); 50 males, 55 females) was conducted over 10 weeks, starting at dermatological symptom onset. Disease severity, serum IgE, cortisol and testosterone levels, and depression scores were assessed at study baseline and after 10 weeks of conventional treatment. RESULTS Dermatological severity differed among AD males by IgE sensitization and was elevated in males with extrinsic atopic dermatitis (EAD). Hamilton Depression Rating Scale (HAMD) scores were elevated in all patients at study baseline and improved with symptom reduction to HC levels, except female EAD. Severity of depression and dermatitis were correlated in EAD males at baseline and at week 10. Serum cortisol was elevated in male EAD at baseline, in contrast to males with intrinsic atopic dermatitis (IAD) at week 10. In addition, cortisol levels were found negatively correlated with SCORAD and HAMD scores in EAD males at week 10. CONCLUSION Pathophysiological features of AD and depression are likely related to different inflammation-based effects and appear to be biological sex-dependent. Cortisol levels depend on biological sex and IgE sensitization in AD and increase in males with EAD at exacerbation and IAD males at resolution. Biological sex-related disease triggers, IgE sensitization, and cortisol levels are important for the understanding of the mechanisms underlying AD and comorbid depression.
Collapse
Affiliation(s)
- Tatyana Vinnik
- Department of Molecular Biology, Ariel University, Ariel, Israel, .,Department of Dermatovenereology, Astana Medical University, Nur-Sultan, Kazakhstan,
| | | | - Gulshara Abildinova
- Medical Centre Hospital of the President's Affairs Administration of the Republic of Kazakhstan, Nur-Sultan, Kazakhstan
| | - Gulnar Batpenova
- Department of Dermatovenereology, Astana Medical University, Nur-Sultan, Kazakhstan
| | - Michael Kirby
- Department of Molecular Biology, Ariel University, Ariel, Israel
| | - Albert Pinhasov
- Department of Molecular Biology, Ariel University, Ariel, Israel
| |
Collapse
|
7
|
Ng YL, Teoh SH, Mohd Radzniwan AR, Syahnaz MH. Prevalence and associated factors of undiagnosed glycaemic disorders in men with erectile dysfunction attending a primary care clinic. J Taibah Univ Med Sci 2019; 14:88-94. [PMID: 31435395 PMCID: PMC6695078 DOI: 10.1016/j.jtumed.2018.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 12/07/2018] [Accepted: 12/10/2018] [Indexed: 11/23/2022] Open
Abstract
Objectives Undiagnosed glycaemic disorders remain a major health concern as in such cases the opportunity for early interventions that can potentially prevent complications is missed. Erectile dysfunction (ED) has been suggested as a predictor for glycaemic disorders in men. However, data on men with ED having undiagnosed glycaemic disorders is limited, especially in the Malaysian context. This study aimed to identify prevalence and associated factors of undiagnosed glycaemic disorders in men with ED. Methods We applied a cross-sectional purposive sampling technique on a group of 114 men with ED without underlying glycaemic disorders. They underwent a 2-h oral glucose tolerance test and the cases were then classified into two groups: normal and undiagnosed glycaemic disorders groups. The glycaemic disorders group consisted of patients with diabetes mellitus (DM), impaired glucose tolerance (IGT), and impaired fasting glucose (IFG). The patients were interviewed, and their medical records were reviewed for their sociodemographic and clinical profiles. Results Prevalence of undiagnosed glycaemic disorders in men with ED was 41.2%. Higher age (adjusted OR = 1.10, 95% CI: 1.03, 1.17, p = 0.002) and BMI (adjusted OR = 1.16, 95% CI: 1.05, 1.29, p = 0.003) were found to be significantly associated with undiagnosed glycaemic disorders. Conclusion This study found that men with ED had a high prevalence of undiagnosed glycaemic disorders. ED was associated with advancing age and higher BMI. Further research to validate the findings of this study is needed to increase the prevalence of DM screening among men with ED.
Collapse
Affiliation(s)
- Yoke Lan Ng
- Klinik Kesihatan Inanam, Ministry of Health Malaysia, Kota Kinabalu, Sabah, Malaysia
| | - Soo Huat Teoh
- Lifestyle Science Cluster, Advanced Medical and Dental Institute, Universiti Sains Malaysia, Penang, Malaysia
| | - A Rashid Mohd Radzniwan
- Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia, Kuala Lumpur, Malaysia
| | - Mohd Hashim Syahnaz
- Department of Family Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| |
Collapse
|
8
|
Muhamad S, Sengupta P, Ramli R, Nasir A. Sociodemographic factors associated with semen quality among Malaysian men attending fertility clinic. Andrologia 2019; 51:e13383. [DOI: 10.1111/and.13383] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 06/21/2019] [Accepted: 07/10/2019] [Indexed: 01/25/2023] Open
Affiliation(s)
- Suriyani Muhamad
- School of Social and Economic Development Universiti Malaysia Terengganu Kuala Nerus Malaysia
| | - Pallav Sengupta
- Faculty of Medicine and Biomedical Sciences MAHSA University Jenjarom Malaysia
| | - Roszaman Ramli
- Kulliyyah of Medicine International Islamic University Malaysia Kuantan Malaysia
| | - Aslina Nasir
- School of Informatics and Applied Mathematics Universiti Malaysia Terengganu Kuala Nerus Malaysia
| |
Collapse
|
9
|
Mark R, Huri HZ, Razack AHA. Demographic, clinical and lifestyle predictors for severity of erectile dysfunction and biomarkers level in Malaysian patients. BRAZ J PHARM SCI 2018. [DOI: 10.1590/s2175-97902018000317552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
| | - Hasniza Zaman Huri
- University of Malaya, Malaysia; University Malaya Medical Centre, Malaysia
| | | |
Collapse
|
10
|
Nordin RB, Soni T, Kaur A, Loh KP, Miranda S. Prevalence and predictors of erectile dysfunction in adult male outpatient clinic attendees in Johor, Malaysia. Singapore Med J 2018; 60:40-47. [PMID: 29774359 DOI: 10.11622/smedj.2018049] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Erectile dysfunction (ED) is a serious global burden that affects men as well as their partners. This study aimed to determine the prevalence and predictors of ED among male outpatient clinic attendees in Johor, Malaysia. METHODS We conducted a cross-sectional study of Malaysian men aged ≥ 18 years attending two major outpatient clinics in Johor Bahru and Segamat in Johor, Malaysia, between 1 January 2016 and 31 March 2016. Subjects were chosen via simple random sampling and 400 patients were recruited. The study instrument was a survey form that consisted of three sections: sociodemographic and comorbid profile, validated English and Malay versions of the 15-item International Index of Erectile Function, and the 21-item Depression Anxiety Stress Scale. RESULTS The overall prevalence of self-reported ED was 81.5%. The prevalence of ED according to severity was as follows: mild (17.0%), mild to moderate (23.8%), moderate (11.3%) and severe (29.5%). Multivariate analysis showed that ED was associated with increasing age (odds ratio [OR] 4.023, 95% confidence interval [CI] 1.633-9.913), Indian as compared to Malay ethnicity (OR 3.252, 95% CI 1.280-8.262), secondary as compared to tertiary education (OR 2.171, 95% CI 1.203-3.919), single as compared to married status (OR 6.119, 95% CI 2.542-14.734) and stress (OR 4.259, 95% CI 1.793-10.114). CONCLUSION ED has significant prevalence and severity among adult male outpatient clinic attendees in Johor. Increasing age, Indian ethnicity, lower educational level, singlehood and stress were significant predictors of ED.
Collapse
Affiliation(s)
- Rusli Bin Nordin
- Clinical School Johor Bahru, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Johor Bahru, Johor, Malaysia
| | - Trived Soni
- Clinical School Johor Bahru, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Johor Bahru, Johor, Malaysia
| | - Amrina Kaur
- Clinical School Johor Bahru, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Johor Bahru, Johor, Malaysia
| | - Kean Por Loh
- Clinical School Johor Bahru, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Johor Bahru, Johor, Malaysia
| | - Shashi Miranda
- Clinical School Johor Bahru, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Johor Bahru, Johor, Malaysia
| |
Collapse
|
11
|
De Nunzio C, Roehrborn CG, Andersson KE, McVary KT. Erectile Dysfunction and Lower Urinary Tract Symptoms. Eur Urol Focus 2017; 3:352-363. [PMID: 29191671 DOI: 10.1016/j.euf.2017.11.004] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 10/12/2017] [Accepted: 11/13/2017] [Indexed: 01/10/2023]
Abstract
CONTEXT Lower urinary tract symptoms (LUTSs) and erectile dysfunction (ED) are substantial health concerns with a significant impact on the overall male quality of life. OBJECTIVE To evaluate the available evidence of the association between LUTSs and ED in patients with benign prostatic hyperplasia (BPH), and discuss possible clinical implications for the management of LUTS/BPH. EVIDENCE ACQUISITION A systematic review of the existing literature published between 1997 and June 2017 and available in the Medline, Scopus, and Web of Science databases was conducted using both the Medical Subject Heading (MeSH) and free-text protocols. The MeSH search was conducted by combining the following terms: "lower urinary tract symptoms," "LUTS," "benign prostatic hyperplasia," "BPH," "erectile dysfunction," "sexual dysfunction," "BPE," and "benign prostatic enlargement." The Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines were followed. EVIDENCE SYNTHESIS Several community-based studies in different geographical areas have provided strong evidence of an age-independent association between LUTSs and ED. Several biological mechanisms have been proposed to explain this association, but further research is required to better understand the molecular pathways involved. It is necessary to evaluate the possible impact of the metabolic syndrome treatment on LUTS/ED management. Considering the possible relationship between LUTSs and ED, their impact on the quality of life, and the possible adverse effects associated with LUTS medical treatment, clinicians should always evaluate ED in patients with LUTSs and take the opportunity to evaluate patients reporting ED for LUTSs. CONCLUSIONS Data from the peer-reviewed literature suggest the existence of an association between LUTS/BPH and ED, although their casual relationship has not been established yet. Emerging data also suggest that pathophysiological mechanisms involved in the metabolic syndrome are key factors in both disorders. Considering the association, it is also recommended that men presenting with LUTSs or ED should be evaluated for both disorders. A better understanding of the molecular pathways behind this association may also help identify new possible targets and develop novel therapeutic approaches to manage LUTSs and ED. PATIENT SUMMARY In this manuscript, we report on all the available evidence linking erectile dysfunction and lower urinary tract symptoms. Our findings suggest the existence of a strong relationship between these two conditions. On the basis of these findings, we recommend that clinicians always explore both conditions in male patients presenting with either of symptoms.
Collapse
Affiliation(s)
- Cosimo De Nunzio
- Department of Urology, Sant'Andrea Hospital, "La Sapienza" University, Roma, Italy.
| | - Claus G Roehrborn
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | | | - Kevin T McVary
- Southern Illinois University School of Medicine, Springfield, IL, USA
| |
Collapse
|
12
|
Anaissie J, DeLay KJ, Wang W, Hatzichristodoulou G, Hellstrom WJ. Testosterone deficiency in adults and corresponding treatment patterns across the globe. Transl Androl Urol 2017; 6:183-191. [PMID: 28540225 PMCID: PMC5422691 DOI: 10.21037/tau.2016.11.16] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
The global prevalence of testosterone deficiency (TD) ranges from 10–40%. The actual diagnosis of TD is controversial, as a wide range of total testosterone (TT) thresholds are used for diagnosis (200–400 ng/dL), and physicians differ in their emphasis placed on clinical symptoms. There are also significant global differences in the prescription patterns of testosterone replacement therapy (TRT). In the United States, prescription of TRT is significantly higher than the rest of the world, increasing 3-fold over the last 10 years and more so in eugonadal men. The majority of treating physicians emphasizes clinical symptomology of TD over laboratory values, and up to one-fourth of their patients do not even have serum testosterone levels. There are significant inter-physician differences in willingness to prescribe TRT in the setting of prostate cancer. Data is scarce on testosterone prescribing patterns in Africa, Asia, and the Middle East. More literature is needed to better characterize how physicians from different regions diagnose TD.
Collapse
Affiliation(s)
- James Anaissie
- Department of Urology, Tulane University School of Medicine, New Orleans, LA, USA
| | - Kent J DeLay
- Department of Urology, Tulane University School of Medicine, New Orleans, LA, USA
| | - William Wang
- Department of Urology, Tulane University School of Medicine, New Orleans, LA, USA
| | | | - Wayne J Hellstrom
- Department of Urology, Tulane University School of Medicine, New Orleans, LA, USA
| |
Collapse
|
13
|
Huri HZ, Mat Sanusi ND, Razack AHA, Mark R. Association of psychological factors, patients' knowledge, and management among patients with erectile dysfunction. Patient Prefer Adherence 2016; 10:807-23. [PMID: 27257374 PMCID: PMC4874731 DOI: 10.2147/ppa.s99544] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Erectile dysfunction (ED) is one of the most common health problems in men. ED can significantly affect a man's psychological well-being and overall health. PURPOSE To investigate the association of psychological factors, patients' knowledge, and management among ED patients. PATIENTS AND METHODS A total of 93 patients with an age range from 31 to 81 years who have undergone treatment for ED were included in this study. RESULTS It was found that the feeling of blame (P=0.001), guilt (P=0.001), anger or bitterness (P=0.001), depression (P=0.001), feeling like a failure (P=0.001), and the feeling of letting down a partner during intercourse (P=0.001) were significantly associated with ED. Age was also found to be significantly associated with patients' psychological scale (P=0.004). In addition, the majority of patients in this study practice the right method of administration of ED therapy. However, no significant correlation was found between patients' knowledge of ED therapy and demographic characteristics. CONCLUSION This study concluded that ED does affect psychological well-being of people. In addition, patient's knowledge about ED and its management is also crucial in ensuring that the patient achieves optimal therapeutic outcomes from ED therapy.
Collapse
Affiliation(s)
- Hasniza Zaman Huri
- Department of Pharmacy, University of Malaya Medical Centre, Kuala Lumpur, Malaysia
- Clinical Investigation Center, University of Malaya Medical Centre, Kuala Lumpur, Malaysia
| | | | | | - Raymond Mark
- Department of Pharmacy, University of Malaya Medical Centre, Kuala Lumpur, Malaysia
| |
Collapse
|
14
|
Chung CM, Lu MZH, Wong CYT, Goh SGK, Azhar MIM, Lim YM, Rusli BN, Khalid BAK. The SAD-MEN questionnaire: a new and reliable questionnaire for assessing sexual dysfunction in Asians with diabetes. Diabet Med 2016; 33. [PMID: 26202696 PMCID: PMC5057321 DOI: 10.1111/dme.12864] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
AIM The aim of this study is to construct a new tool for the assessment of sexual dysfunction among men with diabetes that is valid and reliable across different ethnicities, languages and socio-economic backgrounds in South East Asia. METHODS Focus group interviews were conducted to determine the construct of the questionnaire. Content and face validity were assessed by a panel of experts. A pilot study was conducted to validate the Sexual Dysfunction in Asian Men with Diabetes (SAD-MEN) questionnaire in English and Malay. The International Index of Erectile Function-5 (IIEF-5) was used for comparison. Construct validity was assessed using exploratory factor analysis, reliability was determined using Cronbach's α (> 0.700), and test-retest reliability using Spearman's rank correlation coefficient. RESULTS The SAD-MEN questionnaire yielded moderate face and content validity, with high reliability as shown by Cronbach's α values of 0.949 for sexual performance and 0.775 for sexual desire for the English version. The Malay language questionnaire had a Cronbach's α value of 0.945 for sexual performance and 0.750 for sexual desire. Test-retest reliability using Spearman's test gave correlation coefficients of r = 0.853, P = 0.000 for the English language questionnaire and r = 0.908, P = 0.000 for the Malay language questionnaire. CONCLUSION The SAD-MEN questionnaire is a valid and reliable tool by which to assess sexual dysfunction in English- and Malay-speaking Malaysian and South East Asian men with diabetes.
Collapse
MESH Headings
- Adult
- Aged
- China/ethnology
- Cohort Studies
- Culturally Competent Care
- Diabetes Mellitus, Type 2/complications
- Diabetes Mellitus, Type 2/psychology
- Focus Groups
- Humans
- India/ethnology
- Malaysia
- Male
- Middle Aged
- Pilot Projects
- Psychiatric Status Rating Scales
- Reproducibility of Results
- Self Report
- Severity of Illness Index
- Sexual Dysfunction, Physiological/complications
- Sexual Dysfunction, Physiological/diagnosis
- Sexual Dysfunction, Physiological/ethnology
- Sexual Dysfunction, Physiological/physiopathology
- Sexual Dysfunctions, Psychological/complications
- Sexual Dysfunctions, Psychological/diagnosis
- Sexual Dysfunctions, Psychological/ethnology
- Sexual Dysfunctions, Psychological/physiopathology
- Socioeconomic Factors
Collapse
Affiliation(s)
- C. M. Chung
- Clinical School Johor BahruJeffrey Cheah School of Medicine and Health SciencesMonash UniversityJohorMalaysia
| | - M. Z. H. Lu
- Clinical School Johor BahruJeffrey Cheah School of Medicine and Health SciencesMonash UniversityJohorMalaysia
| | - C. Y. T. Wong
- Clinical School Johor BahruJeffrey Cheah School of Medicine and Health SciencesMonash UniversityJohorMalaysia
| | - S. G. K. Goh
- Jeffrey Cheah School of Medicine and Health SciencesMonash UniversityBandar SunwayMalaysia
| | - M. I. M. Azhar
- Clinical School Johor BahruJeffrey Cheah School of Medicine and Health SciencesMonash UniversityJohorMalaysia
| | - Y. M. Lim
- Clinical School Johor BahruJeffrey Cheah School of Medicine and Health SciencesMonash UniversityJohorMalaysia
| | - B. N. Rusli
- Clinical School Johor BahruJeffrey Cheah School of Medicine and Health SciencesMonash UniversityJohorMalaysia
| | - B. A. K. Khalid
- Jeffrey Cheah School of Medicine and Health SciencesMonash UniversityBandar SunwayMalaysia
| |
Collapse
|
15
|
Tong SF, Low WY, Ismail SB, Trevena L, Wilcock S. Determinants of doctors' decisions to inquire about sexual dysfunction in Malaysian primary care settings. Transl Androl Urol 2016; 2:281-90. [PMID: 26816741 PMCID: PMC4708114 DOI: 10.3978/j.issn.2223-4683.2013.09.14] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background Perceptions of how receptive men are to sexual health inquiry may affect Malaysian primary care doctors’ decisions to initiate such a discussion with their male patients. This paper quantifies the impact of doctors’ perceptions of men’s receptivity on male sexual health inquiry. Sexual health inquiry is one of the five areas in a study on determinants of offering preventive health checks to Malaysian men. Methods This was a cross sectional survey among primary care doctors in Malaysia. The questionnaire was based on an empirical model defining the determinants of primary care doctors’ intention to offer health checks. The questionnaire measured: (I) perceived receptivity of male patients to sexual health inquiry; (II) doctors’ attitudes towards the importance of sexual health inquiries; (III) perceived competence and, (IV) perceived external barriers. The outcome variable was doctors’ intention in asking about sexual dysfunction in three different contexts (minor complaints visits, follow-up visits and health checks visits). All items were measured on the Likert scale of 1 to 5 (strongly disagree/unlikely to strongly agree/likely) and internally validated. Results 198 doctors participated (response rate 70.4%). Female primary care doctors constituted 54.5%. 78% of respondents were unlikely to ask about sexual dysfunction in visits for minor complaints to their male patients, 43.6% in follow up visits and 28.2% in health checks visits. In ordinal regression analysis, positive perception of men’s receptivity to sexual health inquiry significantly predicted the doctors’ intention in asking sexual dysfunction in all three contexts; i.e., minor complaints visits (P=0.013), follow-up visits (P<0.0001) and health checks visits (P=0.002). Perceived competence in sexual health inquiry predicted their intention in the follow-up visits (P=0.006) and health checks visits (P<0.001). Lower cost to health checks only predicted their intention in the follow-up visits (P=0.010). Conclusions Whilst sexual health inquiry should be initiated in an appropriate context, ‘perceived receptivity’ to sexual health inquiry significantly affected doctors’ intention in initiating sexual health inquiry to their male patients. Malaysian men’s health may be substantially improved by strategies that assist doctors to identify patient ‘receptivity’.
Collapse
Affiliation(s)
- Seng Fah Tong
- 1 Department of Family Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia ; 2 Central clinical school, University of Sydney, Sydney, Australia ; 3 Dean's office, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia ; 4 Department of Family Medicine, Universiti Sains Malaysia, Kubang Krian, Malaysia ; 5 School of Public Health, University of Sydney, Sydney, Australia
| | - Wah Yun Low
- 1 Department of Family Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia ; 2 Central clinical school, University of Sydney, Sydney, Australia ; 3 Dean's office, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia ; 4 Department of Family Medicine, Universiti Sains Malaysia, Kubang Krian, Malaysia ; 5 School of Public Health, University of Sydney, Sydney, Australia
| | - Shaiful Bahari Ismail
- 1 Department of Family Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia ; 2 Central clinical school, University of Sydney, Sydney, Australia ; 3 Dean's office, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia ; 4 Department of Family Medicine, Universiti Sains Malaysia, Kubang Krian, Malaysia ; 5 School of Public Health, University of Sydney, Sydney, Australia
| | - Lyndal Trevena
- 1 Department of Family Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia ; 2 Central clinical school, University of Sydney, Sydney, Australia ; 3 Dean's office, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia ; 4 Department of Family Medicine, Universiti Sains Malaysia, Kubang Krian, Malaysia ; 5 School of Public Health, University of Sydney, Sydney, Australia
| | - Simon Wilcock
- 1 Department of Family Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia ; 2 Central clinical school, University of Sydney, Sydney, Australia ; 3 Dean's office, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia ; 4 Department of Family Medicine, Universiti Sains Malaysia, Kubang Krian, Malaysia ; 5 School of Public Health, University of Sydney, Sydney, Australia
| |
Collapse
|
16
|
Lim J, Bhoo-Pathy N, Sothilingam S, Malek R, Sundram M, Tan GH, Bahadzor B, Ong TA, Ng KL, Abdul Razack AH. Cardiovascular Risk Factors and Ethnicity Are Independent Factors Associated with Lower Urinary Tract Symptoms. PLoS One 2015; 10:e0130820. [PMID: 26098884 PMCID: PMC4476577 DOI: 10.1371/journal.pone.0130820] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2015] [Accepted: 05/26/2015] [Indexed: 11/22/2022] Open
Abstract
Objectives To determine the lower urinary tract symptoms (LUTS) profile and factors affecting its degree of severity including cardiovascular risk profile, age, ethnicity, education level and prostate volume in a multiethnic Asian setting. Materials and Methods We conducted a cross-sectional study of 1021 men aged 40–79 years with no clinical evidence of prostate cancer, prostate surgery or 5α-reductase inhibitor treatment of known prostate conditions. The severity of LUTS was assessed using the International Prostate Symptom Score (IPSS). Potential factors associated with LUTS including age, ethnicity, education, history of hypertension, diabetes and hypercholesterolemia, height, weight, and prostate volume were evaluated using univariable and multivariable analyses. Results There were 506 (50%) men found to have moderate-to-severe LUTS attaining an IPSS above 7. Overall, nocturia (45.5%) was the most frequently reported symptom. Multivariable analysis showed that age, ethnicity, prostate volume and history of hypertension and hypercholesterolemia were independent factors associated with severity of LUTS (p < 0.05). Considering individual lower urinary tract symptoms, we found a strong association of storage symptom with history of hypertension and hypercholesterolemia. Malay men were significantly bothered by post micturition symptom compared to their Chinese and Indian counterparts. Stratified analyses of LUTS demonstrated a mutually exclusive cardiovascular risk factors profile defined by ethnicity. Conclusion Severity of LUTS varies between different ethnicities across all age groups. In addition to age and prostate volume, ethnicity and cardiovascular risk factors including hypertension and hypercholesterolemia may also need to be taken into account in managing men with LUTS.
Collapse
Affiliation(s)
- Jasmine Lim
- Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Nirmala Bhoo-Pathy
- Julius Center University of Malaya, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Primary Care, University Medical Center Utrecht, 3508GA, Utrecht, Netherlands
| | | | - Rohan Malek
- Department of Urology, Selayang Hospital, Selangor, Malaysia
| | - Murali Sundram
- Department of Urology, Kuala Lumpur Hospital, Kuala Lumpur, Malaysia
| | - Guan Hee Tan
- Department of Surgery, University Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia
| | - Badrulhisham Bahadzor
- Department of Surgery, University Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia
| | - Teng Aik Ong
- Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Keng Lim Ng
- Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Centre for Kidney Disease Research, School of Medicine, University of Queensland, Translational Research Institute, Brisbane, Australia
| | - Azad Hassan Abdul Razack
- Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- * E-mail:
| |
Collapse
|
17
|
Elhanbly SM, Elkholy AAM, Alghobary M, Abou Al-Ghar M. Clinical predictive factors of sildenafil response: a penile hemodynamic study. Andrology 2015; 3:241-6. [PMID: 25644869 DOI: 10.1111/andr.271] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2013] [Revised: 07/09/2014] [Accepted: 08/05/2014] [Indexed: 11/29/2022]
Affiliation(s)
- S. M. Elhanbly
- Andrology Unit; Mansoura University Hospital; Mansoura Faculty of Medicine; Mansoura Egypt
| | - A. A.-M. Elkholy
- Andrology Unit; Mansoura University Hospital; Mansoura Faculty of Medicine; Mansoura Egypt
| | - M. Alghobary
- Andrology Unit; Mansoura University Hospital; Mansoura Faculty of Medicine; Mansoura Egypt
| | - M. Abou Al-Ghar
- Radiology Department; Urology Center; Mansoura Faculty of Medicine; Mansoura Egypt
| |
Collapse
|
18
|
Foster SA, Shortridge EF, DiBonaventura M, Viktrup L. Predictors of self-reported benign prostatic hyperplasia in European men: analysis of the European National Health and Wellness Survey. World J Urol 2014; 33:639-47. [PMID: 25100623 DOI: 10.1007/s00345-014-1366-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2013] [Accepted: 07/13/2014] [Indexed: 11/25/2022] Open
Abstract
PURPOSE This study aimed to identify predictors of European men who self-reported being diagnosed with benign prostatic hyperplasia (DxBPH) compared to men with moderate-to-severe lower urinary tract symptoms [American Urological Association Symptom Index (AUA-SI) score ≥8] who did not self-report a BPH diagnosis (non-DxBPH). METHODS Data were taken from the 2010 European National Health and Wellness Survey; a cross-sectional, self-administered, Internet-based questionnaire. This analysis included males ≥40 years with DxBPH or without DxBPH, but with AUA-SI ≥8. Chi-square tests were used for categorical variables and independent samples t tests were used for continuous variables. Logistic regressions were conducted among all men ≥40 years to predict being DxBPH. RESULTS About 1,638 DxBPH and 3,676 non-DxBPH men were included. The estimated prevalence of DxBPH and non-DxBPH was 8.53 and 19.13 %. Men with DxBPH were older than non-DxBPH males (mean age 66.1 and 58.3, P < 0.001). The mean AUA-SI score was 11.3 for DxBPH and 13.2 for non-DxBPH. Being older (OR = 1.077), having a university education (OR = 1.252), having private health insurance (OR = 1.186), and specific health behaviors/attitudes [regular exercise (OR = 1.191), visiting a doctor within the previous 6 months (OR = 2.398), consulting with a medical professional when not feeling well (OR = 1.097), reporting having an attentive doctor (OR = 1.112)], and higher voiding symptoms (OR = 1.032) were significant predictors of DxBPH. CONCLUSIONS Older men with higher education and access to care and more engagement in their healthcare were more likely to self-report being diagnosed.
Collapse
Affiliation(s)
- Shonda A Foster
- Lilly Corporate Center, Eli Lilly and Company, Indianapolis, IN, 46285, USA,
| | | | | | | |
Collapse
|
19
|
Systematic Literature Review of the Epidemiology of Nongenetic Forms of Hypogonadism in Adult Males. ACTA ACUST UNITED AC 2014. [DOI: 10.1155/2014/190347] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
This study summarizes the literature on the prevalence, incidence, and proportion of patients receiving treatment for male hypogonadism and a systematic literature search was performed for articles published in the last 20 years. Of the 97 studies identified, 96 examined the prevalence, 2 examined the incidence, and 4 examined the proportion of males with hypogonadism patients receiving treatment. Based on studies conducted in Europe and USA, the prevalence of hypogonadism in the general population ranged from 2.1% to 12.8% of middle-aged to older men, with an estimated incidence of 12 new cases per 1,000 person-years. Prevalence was higher among patients with comorbid conditions, such as type 2 diabetes mellitus and obesity. Approximately 10–12% of men with hypogonadism were receiving testosterone treatment. This literature review suggests that there is potentially a significant burden of hypogonadism in the general population. Burden seems to increase with age and in the presence of certain disease conditions. Data suggests that many hypogonadal men who may benefit from testosterone replacement are not receiving treatment. This may be the result of underdiagnosis of the disease, lack of awareness by patients or physicians, irregularities surrounding the diagnostic criteria, and deficiency of long-term safety studies.
Collapse
|
20
|
Cho SY, Son H, Kim SW, Paick JS. Should men with mild erectile dysfunction be closely evaluated for cardiovascular diseases in the Korean population? Aging Male 2014; 17:81-6. [PMID: 24397687 DOI: 10.3109/13685538.2013.873782] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
This study compared demographic characteristics and prevalence of cardiovascular comorbidities between men with mild erectile dysfunction (ED) and men with more severe ED. Men with 6-month history of ED and in monogamous heterosexual relationships were included. Non-responders to type 5 phosphodiesterase inhibitors or patients receiving regular treatment with nitrate, anticoagulants, androgens, and anti-androgens were excluded. ED was defined according to the International Index of Erectile Function questionnaire score: no ED (≥26), mild ED (22-25), and others (<22). The review identified 70 patients with mild ED (6.0%, group A) and 1098 patients with more severe ED (94.0%, group B) were included. Of the patients in group B, 365 had mild-to-moderate ED (30.5%), 505 had moderate ED (43.2%), and 233 had severe ED (20.0%). Mean ages and body mass indices showed no differences between groups A and B. Group A had shorter mean duration of ED (p = 0.025). Although patients in group A had milder ED with shorter duration than group B patients, cardiovascular risk factors such as diabetes, hypertension and lipid disorder were still common for group A. The most common comorbidity was diabetes, which was twice as likely for patients in group B. Except for diabetes the prevalence of all diseases was comparable between the two groups. In conclusion, patients with mild ED should be closely evaluated for cardiovascular comorbidities.
Collapse
Affiliation(s)
- Sung Yong Cho
- Department of Urology, Seoul National University Boramae Medical Center , Seoul , Republic of Korea and
| | | | | | | |
Collapse
|
21
|
Tong SF, Khoo EM, Low WY, Ng CJ, Wong CH, Yusoff HM, Abu Bakar AI, Tan HM, Jiwa M. Health Innovation Project: A Concept Paper on a Virtual Health Promotion Program for Men. JOURNAL OF MEN'S HEALTH 2014. [DOI: 10.1089/jomh.2013.0020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
22
|
Fadzil MA, Sidi H, Ismail Z, Hassan MRC, Thuzar K, Midin M, Nik Jaafar NR, Das S. Socio-demographic and psychosocial correlates of erectile dysfunction among hypertensive patients. Compr Psychiatry 2014; 55 Suppl 1:S23-8. [PMID: 23453753 DOI: 10.1016/j.comppsych.2012.12.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2012] [Revised: 12/31/2012] [Accepted: 12/31/2012] [Indexed: 01/23/2023] Open
Abstract
OBJECTIVE The main aim of the study was to estimate the prevalence of ED and the associated socio-demographic and psychological correlates among hypertensive patients from a rural multiethnic community in Malaysia. METHODS A cross-sectional study was conducted among hypertensive patients attending rural primary care clinics. The socio-demographic, health characteristics, erectile function and levels of depression, anxiety and stress were recorded and analysed. The International Index of ErectileFunction-5 (IIEF-5) questionnaire and the Depression, Anxiety and Stress Scale (DASS-21) were used to assess erectile function and the levels of depression, anxiety and stress, respectively. RESULTS A total of 253 hypertensive patients comprising 178 (70.4%) Malays, 56 (22.1%) Chinese and 18 (7.5%) Indians participated. The mean age of participants was 59.8 ± 10.62 years. Overall, the prevalence rate of ED was 62%: 90 (35%) with moderate and 69 (27%) with severe ED. The prevalence rate of ED among those aged 65 years or older (83.1%) was significantly higher than those less than 65 years (51.8%), (p<0.001). Higher prevalence rates were also noted among the Chinese (78.6%) compared to Malays (59.6%) and Indians (50%) (p=0.021); lower education level (69.1%) (p=0.026), among hypertensive patients with concomitant diabetes mellitus (70.6%) (p=0.026) and WHR ≥ 0.9 (31.3%) (p=0.021). However, no significant association was found between depression, anxiety and stress scores with IIEF-5 score. CONCLUSION The prevalence rate of ED among Malaysian hypertensive patients is high. The rate increases significantly with age, Chinese ethnicity, concomitant diabetes mellitus, lower education level, WHR and the number of pack years of smoking. ED should be properly recognized and managed in hypertensive patients.
Collapse
|
23
|
Foster SA, Annunziata K, Shortridge EF, Freedman D, Viktrup L. Erectile dysfunction with or without coexisting benign prostatic hyperplasia in the general US population: analysis of US National Health and Wellness Survey. Curr Med Res Opin 2013; 29:1709-17. [PMID: 23971532 DOI: 10.1185/03007995.2013.837385] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Erectile dysfunction (ED) and benign prostatic hyperplasia (BPH) commonly affect older men. There is limited epidemiology information on coexisting ED and BPH. This study assessed self-reported prevalence of ED with or without a diagnosis of BPH (ED/DxBPH versus ED only) in US men. METHODS Men ≥40 years old, who reported experiencing ED in the past 6 months with or without a diagnosis of BPH, were identified from the nationally representative 2011 US National Health and Wellness Survey (NHWS) - a cross-sectional, self-administered online survey. Unpaired t-tests were used to compare characteristics between ED-only and ED/DxBPH populations. RESULTS The prevalence of ED only and ED/DxBPH was 24.6% and 4.9% (mean ages of 60 and 68 years, respectively). About two-thirds of those with ED only and ED/DxBPH reported speaking to their physician about ED. About 23% of either group reported currently using ED medication and 11.7% of men with ED only were prescribed ED medication by a urologist, compared to 31.1% with ED/DxBPH. Approximately 51.7% of men with ED/DxBPH were taking BPH medication. Overall, 37.3% of men with ED only and 74.6% with ED/DxBPH reported moderate-to-severe urinary symptoms on the American Urological Association-Symptom Index (AUA-SI ≥8). CONCLUSION While self-reported ED is common, few men with ED in the US population report being diagnosed with BPH. The majority of ED only and ED/DxBPH men reported speaking to a physician about ED; however, few reported currently taking ED medication. A majority of men with ED/DxBPH reported an AUA-SI score ≥8, but only half reported taking BPH medications. Thus, although men are experiencing erectile or urinary symptoms, many remain untreated. A limitation of this study is that symptoms and diagnosis were self-reported and may not reflect how these conditions are diagnosed in a healthcare setting; however, patient self-report provides a unique perspective on the burden associated with these conditions.
Collapse
|
24
|
Hwang HJ, Kim YS, Sunwoo S, Yu BY, Bae WK, Park JS, Park YJ, Park YK, Yang YJ, Kim CM, Hong JH. Prevalence and Correlates of Late-Onset Hypogonadism Among Korean Men Aged 40 Years or Older in Primary Care. JOURNAL OF MENS HEALTH 2013. [DOI: 10.1089/jomh.2013.1505] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
|
25
|
Komiya A, Kino M, Kato T, Suzuki H, Ichikawa T, Fuse H. Correlations Among Urinary, Sexual, and Testicular Functions and Health-Related Quality of Life. JOURNAL OF MEN'S HEALTH 2013. [DOI: 10.1089/jomh.2012.00040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
26
|
Seftel AD, de la Rosette J, Birt J, Porter V, Zarotsky V, Viktrup L. Coexisting lower urinary tract symptoms and erectile dysfunction: a systematic review of epidemiological data. Int J Clin Pract 2013; 67:32-45. [PMID: 23082930 DOI: 10.1111/ijcp.12044] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE Assess and categorise the available prevalence data on coexistent LUTS and ED in the general population and among individuals consulting a healthcare provider for any reason or when seeking treatment for LUTS and/or ED. METHODS Literature search of English-language articles published during the last 15 years. RESULTS Of 23 relevant studies identified, 12 used both the International Prostate Symptom Score (IPSS) and International Index of Erectile Function (IIEF) as assessment tools and 11 used alternative approaches. In studies using both IPSS and IIEF, overall prevalence of coexistent LUTS/ED of any severity was not assessable for men in the general population, but rates ranged from 14-37% based on alternative assessments. In the general male population, 13-29% had moderate to severe LUTS and 8-35% had moderate to severe ED. In studies using both IPSS and IIEF, overall prevalence of coexistent LUTS and ED of any severity was 71-80% among men seeking treatment for LUTS, and 74% based on alternative assessments. Among men who sought treatment for either condition, 67-100% had moderate to severe LUTS and 43-59% had moderate to severe ED. Coexistence of LUTS and ED increased with age, ranging from 59-86% among men aged 40s to 60s in primary care to 79-100% in treatment-seeking men with LUTS aged 50s to 70s. Impact on QoL varied, but health-related QoL was generally worse in treatment-seeking men compared with men in the general population. CONCLUSIONS Although less than one-third of middle-aged and older men in the general population have coexisting LUTS and ED, most men seeking treatment for either LUTS or ED have both conditions. Symptom severity and impact on QoL in each condition increase when LUTS and ED coexist.
Collapse
Affiliation(s)
- A D Seftel
- Department of Urology, Cooper University Hospitals, Camden, NJ 081003, USA.
| | | | | | | | | | | |
Collapse
|
27
|
Randomized Clinical Trial on the Use of PHYSTA Freeze-Dried Water Extract of Eurycoma longifolia for the Improvement of Quality of Life and Sexual Well-Being in Men. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2012; 2012:429268. [PMID: 23243445 PMCID: PMC3518798 DOI: 10.1155/2012/429268] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/15/2012] [Accepted: 09/26/2012] [Indexed: 11/22/2022]
Abstract
Eurycoma longifolia is reputed as an aphrodisiac and remedy for decreased male libido. A randomized, double-blind, placebo controlled, parallel group study was carried out to investigate the clinical evidence of E. longifolia in men. The 12-week study in 109 men between 30 and 55 years of age consisted of either treatment of 300 mg of water extract of E. longifolia (Physta) or placebo. Primary endpoints were the Quality of Life investigated by SF-36 questionnaire and Sexual Well-Being investigated by International Index of Erectile Function (IIEF) and Sexual Health Questionnaires (SHQ); Seminal Fluid Analysis (SFA), fat mass and safety profiles. Repeated measures ANOVA analysis was used to compare changes in the endpoints. The E. longifolia (EL) group significantly improved in the domain Physical Functioning of SF-36, from baseline to week 12 compared to placebo (P = 0.006) and in between group at week 12 (P = 0.028). The EL group showed higher scores in the overall Erectile Function domain in IIEF (P < 0.001), sexual libido (14% by week 12), SFA- with sperm motility at 44.4%, and semen volume at 18.2% at the end of treatment. Subjects with BMI ≥ 25 kg/m2 significantly improved in fat mass lost (P = 0.008). All safety parameters were comparable to placebo.
Collapse
|
28
|
Shaeer O, Shaeer K. The Global Online Sexuality Survey (GOSS): the United States of America in 2011. Chapter I: erectile dysfunction among English-speakers. J Sex Med 2012; 9:3018-27. [PMID: 23088651 DOI: 10.1111/j.1743-6109.2012.02976.x] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
INTRODUCTION The Global Online Sexuality Survey (GOSS) is a worldwide epidemiologic study of sexuality and sexual disorders, based on validated questionnaires and applying age adjustment to the World Standard Population (WSP) by the World Health Organization. In 2010, the first report of GOSS came from the Middle East, describing an erectile dysfunction (ED) prevalence rate of 47%. AIM This report studies the prevalence rate of ED in the United States as of 2011-2012 and evaluates risk factors for ED. MAIN OUTCOME MEASURES Prevalence of ED. METHODS GOSS was randomly deployed to English-speaking male web surfers in the United States via paid advertising on Facebook, comprising 146 questions including the abbreviated 5-item International Index of Erectile Function. RESULTS Two thousand twenty-two males participated; with a mean age was 52.38 years ± 14.5. Prevalence of ED was 37.7%, adjusted to 33.7% according to WSP, comparable across ethnic groups. The following risk factors were associated with higher risk for ED: diabetes mellitus, hypertension with and without antihypertensive treatment, coronary heart disease, obesity (defined by body mass index), difficult micturition, subjectively reported depression, interpersonal distress, subjectively reported impotence, in addition to novel factors such as subjectively reported premature ejaculation (PE) and concerns over genital size (not a smaller penis per se), low libido, and irregular coitus. Frequency of smoking and alcohol were not associated with higher prevalence of ED, although duration of smoking was. CONCLUSION Adjusted to WSP, prevalence rate of ED in the United States of America is 33.7% in the year 2011, in contrast to the adjusted prevalence in the Middle East (47%). Most of the classical risk factors for ED play the same role in the United States and the World, including diabetes, hypertension, and aging. Concerns over genital size and PE are emerging risk factors for ED.
Collapse
Affiliation(s)
- Osama Shaeer
- Kasr El Aini Faculty of Medicine, Department of Andrology, Cairo University, Cairo, Egypt.
| | | |
Collapse
|
29
|
Yokoyama O, Yoshida M, Kim SC, Wang CJ, Imaoka T, Morisaki Y, Viktrup L. Tadalafil once daily for lower urinary tract symptoms suggestive of benign prostatic hyperplasia: a randomized placebo- and tamsulosin-controlled 12-week study in Asian men. Int J Urol 2012; 20:193-201. [PMID: 22958078 DOI: 10.1111/j.1442-2042.2012.03130.x] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2012] [Accepted: 07/26/2012] [Indexed: 12/18/2022]
Abstract
OBJECTIVES To examine the efficacy and safety of tadalafil in Asian men with lower urinary tract symptoms suggestive of benign prostatic hyperplasia. METHODS Asian men with lower urinary tract symptoms suggestive of benign prostatic hyperplasia were randomized to once-daily placebo (n=154), tadalafil 2.5 mg (n=151), tadalafil 5.0 mg (n=155) or tamsulosin 0.2 mg (active control, n=152) for 12 weeks. RESULTS Total International Prostate Symptom Score least-squares mean changes from baseline to end-point significantly improved with tadalafil 2.5 mg (-4.8, P=0.003) and 5 mg (-4.7, P=0.004) versus placebo (-3.0). Significant improvement in the International Prostate Symptom Score versus placebo was observed earlier (week 2) for tadalafil 5.0 mg than for tadalafil 2.5 mg (week 8). Significant improvements (P<0.05) in both tadalafil groups versus placebo were observed for the International Prostate Symptom Score voiding subscore, International Prostate Symptom Score Quality of Life, and for Patient and Clinician Global Impressions of Improvement. Significant improvements versus placebo were observed in the International Prostate Symptom Score storage subscore for tadalafil 5.0 mg (-1.7, P=0.021), but not tadalafil 2.5 mg (-1.5, P=0.072). No significant improvements in benign prostatic hyperplasia Impact Index or improvements in peak urinary flow rates were observed with tadalafil 2.5 mg or 5.0 mg versus placebo. Tamsulosin treatment resulted in significant improvements versus placebo across all efficacy parameters, except for peak urinary flow rates. Safety results were consistent with the known tadalafil and tamsulosin safety profiles. CONCLUSIONS Tadalafil once daily represents an effective and well tolerated medical treatment for Asian men presenting with lower urinary tract symptoms suggestive of benign prostatic hyperplasia.
Collapse
Affiliation(s)
- Osamu Yokoyama
- Department of Urology, Faculty of Medical Science, University of Fukui, Fukui, Japan
| | | | | | | | | | | | | |
Collapse
|
30
|
Tong SF, Low WY. Public health strategies to address Asian men's health needs. Asia Pac J Public Health 2012; 24:543-55. [PMID: 22815311 DOI: 10.1177/1010539512452756] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Men's health discourse has been around for more than 2 decades. The higher mortality rates and the shorter life expectancy in Asian men compared with their women counterparts show the disadvantaged status of men's health. Thus, discussions on men's health should address their health needs and not be confined to sex-specific male urology and reproductive health. In Asia, assessing men's health needs is challenging because of the vast differences in the socioeconomic status and the diverse culture among its member countries. Although, the epidemiology of men's health provides the focus for what to address in improving men's health, having an optimal strategy requires the understanding of men's health-seeking behaviors and the social determinants surrounding them. Thus, public health approaches addressing health behaviors and health promotion in the society should be one of the keys in improving men's health status. Locally relevant information is needed to inform effective public health approaches.
Collapse
Affiliation(s)
- Seng Fah Tong
- Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
| | | |
Collapse
|
31
|
Tong SF, Ng CJ, Lee BC, Lee VKM, Khoo EM, Lee EG, Tan HM. Effect of long-acting testosterone undecanoate treatment on quality of life in men with testosterone deficiency syndrome: a double blind randomized controlled trial. Asian J Androl 2012; 14:604-11. [PMID: 22635164 PMCID: PMC3720089 DOI: 10.1038/aja.2011.178] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2011] [Revised: 09/11/2011] [Accepted: 11/27/2011] [Indexed: 11/08/2022] Open
Abstract
This study aimed to investigate the effect of intramuscular injection of testosterone undecanoate on overall quality of life (QoL) in men with testosterone deficiency syndrome (TDS). A randomized controlled trial over a 12-month period was carried out in 2009. One hundred and twenty men aged 40 years and above with a diagnosis of TDS (serum total testosterone <12 nmol l(-1) and total Aging Male Symptom (AMS) scores ≥27) were invited to participate. Interventions comprised intramuscular injection of either placebo or 1000 mg testosterone undecanoate, given at weeks 0, 6, 18, 30 and 42. This paper presents the secondary analysis of QoL changes measured in the scores of Short-Form-12 (SF-12) scale at baseline, weeks 30 and 48 after the first injection. A total of 56/60 and 58/60 men from the active treatment and placebo group, respectively, completed the study. At week 48, before adjusting for baseline differences, the QoL of men in the treatment group improved significantly in five out of the eight domains on SF-12. The physical health composite scores improved 4.0 points from a baseline of 41.9±7.0 in the treatment group compared to 0.8 point from a baseline of 43.7±7.1 in the placebo group (F=3.652, P=0.027). The mental health composite scores improved 4.4 points from a baseline of 37.1±9.0 in the treatment group compared to 1.0 points from a baseline of 37.6±7.9 in the placebo group (F=4.514, P=0.018). After adjusting for baseline differences, significant improvement was observed in mental health composite scores, but not in physical health composite scores. Long-acting testosterone undecanoate significantly improved the mental health component of QoL in men with TDS.
Collapse
Affiliation(s)
- Seng-Fah Tong
- Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia.
| | | | | | | | | | | | | |
Collapse
|
32
|
Tan HM, Tong SF, Ho CCK. Men's health: sexual dysfunction, physical, and psychological health--is there a link? J Sex Med 2011; 9:663-71. [PMID: 22188573 DOI: 10.1111/j.1743-6109.2011.02582.x] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
INTRODUCTION Sexual dysfunction in men, such as erectile dysfunction, hypogonadism, and premature ejaculation, generates considerable attention. Its association with physical and psychological health is an issue which should be addressed seriously. AIM A review of the literature pertaining to the correlation between sexual dysfunction and physical and psychological health. METHODS PubMed search for relevant publications on the association between sexual dysfunction in men and physical and psychological health. MAIN OUTCOME MEASURE Clinical and epidemiological evidence that demonstrates the association between sexual dysfunction in men and physical and psychological health. RESULTS Sexual dysfunction, i.e., erectile dysfunction, hypogonadism, and premature ejaculation, has been shown to be associated with physical and psychological health. There is a strong correlation between sexual dysfunction and cardiovascular disease, metabolic syndrome, quality of life, and depression. CONCLUSION The association between men's sexual dysfunction and physical and psychological health is real and proven. Therefore, it should not be taken lightly but instead treated as a life-threatening medical problem.
Collapse
|
33
|
Gacci M, Eardley I, Giuliano F, Hatzichristou D, Kaplan SA, Maggi M, McVary KT, Mirone V, Porst H, Roehrborn CG. Critical Analysis of the Relationship Between Sexual Dysfunctions and Lower Urinary Tract Symptoms Due to Benign Prostatic Hyperplasia. Eur Urol 2011; 60:809-25. [DOI: 10.1016/j.eururo.2011.06.037] [Citation(s) in RCA: 186] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2011] [Accepted: 06/20/2011] [Indexed: 12/24/2022]
|
34
|
Sharifuddin N, Abdul AAF, Hamzah MS, Abdul RR, Zainuddin Z, Puteh SEW, Abdul HMZ, Aziz NA. A cross-sectional study of hypertensive outpatients to determine the necessity of asking about erectile dysfunction symptoms. S Afr Fam Pract (2004) 2011. [DOI: 10.1080/20786204.2011.10874119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Affiliation(s)
| | - Aziz AF Abdul
- Department of Family Medicine, University Kebangsaan, Malaysia Medical Centre
| | - MS Hamzah
- Department of Family Medicine, University Kebangsaan, Malaysia Medical Centre
| | - Rashid R Abdul
- Department of Family Medicine, University Kebangsaan, Malaysia Medical Centre
| | - Z Zainuddin
- Urology Unit, University Kebangsaan, Malaysia Medical Centre
| | - SEW Puteh
- department of Community Health, University Kebangsaan, Malaysia Medical Centre
| | - Hamid MZ Abdul
- Faculty of Medicine and Health Sciences, Universiti Putra Malaysia
| | - NA Aziz
- Department of Family Medicine, University Kebangsaan, Malaysia Medical Centre
| |
Collapse
|
35
|
Abstract
Sex has always been a taboo subject in Asian society. However, over the past few years, awareness in the field of men's sexual health has improved, and interest in sexual health research has recently increased. The epidemiology and prevalence of erectile dysfunction, hypogonadism and premature ejaculation in Asia are similar in the West. However, several issues are specific to Asian males, including culture and beliefs, awareness, compliance and the availability of traditional/complementary medicine. In Asia, sexual medicine is still in its infancy, and a concerted effort from the government, relevant societies, physicians and the media is required to propel sexual medicine to the forefront of health care.
Collapse
|
36
|
Shaeer O, Shaeer K. The Global Online Sexuality Survey (GOSS): erectile dysfunction among Arabic-speaking internet users in the Middle East. J Sex Med 2011; 8:2152-60; quiz 2160-3. [PMID: 21569214 DOI: 10.1111/j.1743-6109.2011.02297.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
INTRODUCTION Epidemiologic studies exploring sexuality across different cultures and geographic regions are scanty, particularly from the Middle East. The Global Online Sexuality Survey (GOSS) is an Internet-based survey investigating male and female sexual function. GOSS-Arabic-Males is the Arabic version targeting males in the Middle East, exploring prevalence rate of and factors affecting erectile dysfunction and its therapeutic trends, as well as premature ejaculation, attitudes toward genital size, and contraception. AIM To explore epidemiologic aspects of male sexuality through an online survey. MAIN OUTCOME MEASURES Prevalence rate of erectile dysfunction, its relationship to risk factors, and therapeutic trends. METHODS The online survey was randomly offered to Web surfers in the Middle East. RESULTS Eight hundred four subjects completed the survey. The overall prevalence of ED was 45.1%, strongly correlating with various risk factors studied, including age, diabetes, hypertension under treatment, depression, concerns over genital size, interpersonal distress, premature ejaculation, low libido, and subjective reports of penile deviation. Adjusted to the World Standard Population, the prevalence rate for ED was 47%. Phosphodiesterase (PDE) inhibitors gave a poor response among those with low libido and interpersonal distress, emphasizing the need for proper diagnosis and psychological counseling parallel to medical treatment. Furthermore, PDE inhibitors were stigmatized with unrealistic concerns that decreased their utility to a great extent. CONCLUSION In the study population of Arab-speaking Internet users, prevalence of erectile dysfunction and effect of risk factors have proven similar to reports from different parts of the world, though not unanimously. Premature ejaculation, low desire, concerns over penile size, and penile curvature are factors to be considered in the evaluation of ED patients. PDE inhibitors are stigmatized with false beliefs that should be addressed through mass media and counseling if this population is to take full benefit from this therapeutic option.
Collapse
Affiliation(s)
- Osama Shaeer
- Kasr El Aini Faculty of Medicine, Department of Andrology, Cairo University, Cairo, Egypt.
| | | |
Collapse
|
37
|
Prevalence and medical management of erectile dysfunction in Asia. Asian J Androl 2011; 13:543-9. [PMID: 21460862 DOI: 10.1038/aja.2010.131] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Erectile dysfunction (ED) is an important worldwide health issue that has a significant negative impact on the quality of life and life satisfaction of both the affected individual and his partner. Here we review the prevalence of ED in Asia, associated factors that may influence sexual attitudes and sexual behaviours, and randomized clinical trials (RCTs) of phosphodiesterase-5 (PDE-5) inhibitors to evaluate the clinical efficacy and safety of PDE-5 inhibitors in Asian men. We searched for English-language articles in MEDLINE and PubMed from January 2000 to September 2010. Our results showed that the overall reported prevalence rate of ED in Asia ranged widely, from 2% to 88%. This finding indicates that ED is a common and major health problem in this region. However, sociocultural and economic factors in Asia prevent people from seeking and obtaining appropriate medical care. We found reports on five kinds of PDE-5 inhibitors for the management of ED: sildenafil, vardenafil, tadalafil, udenafil and mirodenafil. The results of RCTs showed that these five PDE-5 inhibitors are more effective than placebo in improving erectile function in Asian men with ED and that these drugs have similar efficacy and safety profiles.
Collapse
|
38
|
Abstract
Men's health concerns have evolved from the traditional andrology and male sexual health to a more holistic approach that encompasses male psychological, social and physical health. The poor state of health in men compared to their female counterparts is well documented. A review of the epidemiological data from Malaysia noted a similar trend in which men die at higher rates in under 1 and above 15 years old groups and most disease categories compared to women. In Malaysia, the main causes of death in men are non-communicable diseases and injuries. Risk factors, such as risk-taking behaviour, smoking and hypertension, are prevalent and amenable to early interventions. Erectile dysfunction, premature ejaculation and prostate disorders are also prevalent. However, many of these morbidities go unreported and are not diagnosed early; therefore, opportunities for early intervention are missed. This reflects poor health knowledge and inadequate health-care utilisation among Malaysian men. Their health-seeking behaviour has been shown to be strongly influenced by family members and friends. However, more research is needed to identify men's unmet health-care needs and to develop optimal strategies for addressing them. Because the Malaysian population is aging and there is an increase in sedentary lifestyles, optimizing men's health will remain a challenge unless effective measures are implemented. The existing male-unfriendly health-care system and the negative influence of masculinity on men's health behaviour must be addressed. A national men's health policy based on a male-friendly approach to health-care delivery is urgently needed to provide a framework for addressing these challenges.
Collapse
|
39
|
Abstract
The aging man is becoming a major burden to Asian countries because of the current poor health status of Asian men and the aging Asian population. Life expectancy at birth for men is shorter than women by an average of 4 years in Asian countries and major causes of death are cardiovascular disease, cancers, injuries and infections. However, there are considerable variations between Asian countries because of great disparity in socioeconomic status. Male-specific disorders, such as male sexual health and urological conditions, are other major health burdens because they have a great impact on men's quality of life. More importantly, many risk factors to the causes of mortality and morbidities, such as high-risk behavior and smoking, can be improved with health promotion and early intervention. The current evidence suggests that the poor health status of men is the result of their poor health care utilization, negative health-seeking behavior, the adverse social environment for men and gender-insensitive health care delivery. However, much evidence is still needed as Asian countries have great diversity in culture, societal values and men's needs. Asian time-tested wisdom on a balanced healthy lifestyle to longevity should be explored as potential men's health promotional programs. Taking into account Asian men's health-care needs, a gender-streamlined approach and man-friendly health care delivery should be on the national agenda in managing the aging man.
Collapse
Affiliation(s)
- Seng Fah Tong
- Department of Family Medicine, National University of Malaysia, Kuala Lumpur, Malaysia.
| | | | | |
Collapse
|
40
|
Lee JC, Bénard F, Carrier S, Talwar V, Defoy I. Do men with mild erectile dysfunction have the same risk factors as the general erectile dysfunction clinical trial population? BJU Int 2010; 107:956-60. [PMID: 20950304 DOI: 10.1111/j.1464-410x.2010.09691.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE • To compare the underlying risk for diseases associated with erectile dysfunction (ED; i.e. cardiovascular disease and diabetes) in a population of men with mild ED relative to a general ED clinical trial population. PATIENTS AND METHODS • Men enrolled in a randomized, double-blind placebo-controlled (DBPC) trial of sildenafil for the treatment of mild ED were compared with a database of men enrolled in 67 of the manufacturer's other DBPC sildenafil trials. • The main outcome measures were baseline demographics, comorbidities and concomitant medications. RESULTS • In both populations, most men were white, approximately one quarter were smokers, and most had an organic component to their ED etiology. • In the mild ED population (N = 176) versus the database population (N = 14,537), mean ± sd (range) age was 50 ± 12 (19-84) versus 55 ± 11 (18-89) years, body mass index was 29 ± 5 (20-48) versus 28 ± 5 (11-64) kg/m² and ED duration was 3.5 ± 3.2 (< 1-18) versus 4.6 ± 4.7 (< 1-45) years. • The prevalence of comorbidities associated with ED was similar (hypertension 26.1% (n = 46) vs 32.8%; diabetes mellitus 13.6% (n = 24) vs 22.1%; dyslipidemias 12.5% (n = 22) vs 11.7%; hypercholesterolemia 12.5% (n = 22) vs 9.5%; gastro-esophageal reflux disease 10.8% (n = 19) vs 6.0%; benign prostatic hyperplasia 9.7% (n = 17) vs 9.9%; depression 6.3% (n = 11) vs 5.6%; and anxiety 4.0% (n = 7) vs 1.6%), as was the rate of use of medications for those comorbidities. CONCLUSIONS • Men with mild ED have similar risk factors to a general ED clinical trial population. Thus, mild ED is an important indicator of risk for underlying disease associated with ED. • Inquiry into ED should be part of routine clinical evaluation to facilitate rapid identification and early intervention. • Men complaining of mild ED should be evaluated adequately for underlying cardiovascular risk.
Collapse
Affiliation(s)
- Jay C Lee
- Rockyview Hospital, Calgary, QC, Canada.
| | | | | | | | | |
Collapse
|
41
|
Van Ahlen H, Zumbé J, Stauch K, Hanisch JU. The Real-Life Safety and Efficacy of Vardenafil (REALISE) Study: Results in Men from Europe and Overseas with Erectile Dysfunction and Cardiovascular or Metabolic Conditions. J Sex Med 2010; 7:3161-9. [DOI: 10.1111/j.1743-6109.2010.01921.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
42
|
Abstract
Like other nations experiencing rapid industrialization, urbanization and a nutrition transition, there is concern in Malaysia of a possible escalation in the prevalence of overweight and obesity. In 1996, the National Health and Morbidity Survey reported a 16.6% and 4.4% prevalence of overweight and obesity, respectively. In the following decade, there have been several national and community surveys on overweight and obesity in Malaysia. The objective of this systematic review is to describe the trend from 1996 to 2009 in the prevalence of overweight and obesity in adults in Malaysia nationally and by gender, age and race. Results indicate that there has been a small rise in overweight adults in the years 1996, 2003 and 2006 (20.7%, 26.7% and 29.1%) and a much more dramatic increase in obesity in 1996, 2003, 2004 and 2006 (5.5%, 12.2%, 12.3% and 14.0%). Evidence showed a greater risk for overweight and obesity among women compared with men. Based on the highest-quality studies, overweight and obesity levels were highest among adults 40-59 years old. Overweight levels were highest among Indians, followed by Malays, Chinese and Aboriginals, with less consistency across studies on the order of risk or obesity by ethnicity.
Collapse
Affiliation(s)
- A Z Khambalia
- Julius Center, AsiaLink, Department of Social and Preventive Medicine, University of Malaya, Kuala Lumpur, Malaysia.
| | | |
Collapse
|
43
|
Holden CA, McLachlan RI, Pitts M, Cumming R, Wittert G, Ehsani JP, de Kretser DM, Handelsman DJ. Determinants of male reproductive health disorders: the Men in Australia Telephone Survey (MATeS). BMC Public Health 2010; 10:96. [PMID: 20181284 PMCID: PMC2839972 DOI: 10.1186/1471-2458-10-96] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2009] [Accepted: 02/24/2010] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The relationship between reproductive health disorders and lifestyle factors in middle-aged and older men is not clear. The aim of this study is to describe lifestyle and biomedical associations as possible causes of erectile dysfunction (ED), prostate disease (PD), lower urinary tract symptoms (LUTS) and perceived symptoms of androgen deficiency (pAD) in a representative population of middle-aged and older men, using the Men in Australia Telephone Survey (MATeS). METHODS A representative sample (n = 5990) of men aged 40+ years, stratified by age and State, was contacted by random selection of households, with an individual response rate of 78%. All men participated in a 20-minute computer-assisted telephone interview exploring general and reproductive health. Associations between male reproductive health disorders and lifestyle and biomedical factors were analysed using multivariate logistic regression (odds ratio [95% confidence interval]). Variables studied included age, body mass index, waist circumference, smoking, alcohol consumption, physical activity, co-morbid disease and medication use for hypertension, high cholesterol and symptoms of depression. RESULTS Controlling for age and a range of lifestyle and co-morbid exposures, sedentary lifestyle and being underweight was associated with an increased likelihood of ED (1.4 [1.1-1.8]; 2.9 [1.5-5.8], respectively) and pAD (1.3 [1.1-1.7]; 2.7 [1.4-5.0], respectively. Diabetes and cardiovascular disease were both associated with ED, with hypertension strongly associated with LUTS and pAD. Current smoking (inverse association) and depressive symptomatology were the only variables independently associated with PD. All reproductive disorders showed consistent associations with depression (measured either by depressive symptomatology or medication use) in both age-adjusted and multivariate analyses. CONCLUSION A range of lifestyle factors, more often associated with chronic disease, were significantly associated with male reproductive health disorders. Education strategies directed to improving general health may also confer benefits to male reproductive health.
Collapse
Affiliation(s)
- Carol A Holden
- Andrology Australia, Monash Institute of Medical Research, Monash University, Melbourne, Victoria, Australia.
| | | | | | | | | | | | | | | |
Collapse
|
44
|
Corona G, Lee DM, Forti G, O'Connor DB, Maggi M, O'Neill TW, Pendleton N, Bartfai G, Boonen S, Casanueva FF, Finn JD, Giwercman A, Han TS, Huhtaniemi IT, Kula K, Lean MEJ, Punab M, Silman AJ, Vanderschueren D, Wu FCW. Age-related changes in general and sexual health in middle-aged and older men: results from the European Male Ageing Study (EMAS). J Sex Med 2009; 7:1362-80. [PMID: 19929914 DOI: 10.1111/j.1743-6109.2009.01601.x] [Citation(s) in RCA: 312] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Limited information is available concerning the general and sexual health status of European men. AIM To investigate the age-related changes in general and sexual health in middle-aged and older men from different countries of the European Union. METHODS This is a cross-sectional multicenter survey performed on a sample of 3,369 community-dwelling men aged 40-79 years old (mean 60 + or - 11 years). Subjects were randomly selected from eight European centers including centers from nontransitional (Florence [Italy], Leuven [Belgium], Malmö[Sweden], Manchester [United Kingdom], Santiago de Compostela [Spain]) and transitional countries (Lodz [Poland], Szeged [Hungary], Tartu [Estonia]). MAIN OUTCOME MEASURES Different parameters were evaluated including the Beck's Depression Inventory for the quantification of depressive symptoms, the Short Form-36 Health Survey for the assessment of the quality of life (QoL), the International Prostate Symptom Score for the evaluation of lower urinary tract symptoms, and the European Male Ageing Study sexual function questionnaire for the study of sexual function. RESULTS More than 50% of subjects reported the presence of one or more common morbidities. Overall, hypertension (29%), obesity (24%), and heart diseases (16%) were the most prevalent conditions. Around 30% of men reported erectile dysfunction (ED) and 6% reported severe orgasmic impairment, both of which were closely associated with age and concomitant morbidities. Only 38% of men reporting ED were concerned about it. Furthermore, concern about ED increased with age, peaking in the 50-59 years age band, but decreased thereafter. Men in transitional countries reported a higher prevalence of morbidities and impairment of sexual function as well as a lower QoL. CONCLUSION Sexual health declined while concomitant morbidities increased in European men as a function of age. The burden of general and sexual health is higher in transitional countries, emphasizing the need to develop more effective strategies to promote healthy aging for men in these countries.
Collapse
Affiliation(s)
- Giovanni Corona
- Andrology Unit, Department of Clinical Physiopathology, University of Florence, Florence, Italy
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
45
|
Dell'Osso L, Carmassi C, Carlini M, Rucci P, Torri P, Cesari D, Landi P, Ciapparelli A, Maggi M. Sexual dysfunctions and suicidality in patients with bipolar disorder and unipolar depression. J Sex Med 2009; 6:3063-70. [PMID: 19732307 DOI: 10.1111/j.1743-6109.2009.01455.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
INTRODUCTION Impairment in sexual function is frequent and underestimated in patients with mental disorders, particularly in those with mood disorders. Few studies have examined the relationship between sexual dysfunctions and the clinical characteristics of mood disorders. AIM The aim of the present study was to explore the frequency of sexual dysfunctions in patients with bipolar I disorder (BD) and unipolar depression (UD) with respect to control subjects, as well as their relationship with suicidality. MAIN OUTCOME MEASURES Assessments included: the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (SCID-I/P), the 24-item Brief Psychiatric Rating Scale and the Mood Spectrum Self-Report, a questionnaire exploring lifetime mood spectrum symptomatology including symptoms of sexual functioning and suicidality. METHODS A consecutive sample of 142 patients (60 BD and 82 UD) and a comparison group of 101 control subjects were recruited in a multicenter study involving 11 academic departments of psychiatry. RESULTS Lifetime impairment in the sexual response cycle, including desire, excitement, and ability to achieve orgasm, was significantly more common in patients with mood disorders compared with control subjects. Increase in sexual activity and promiscuity were significantly more common in patients with BD vs. the other two groups. Lifetime dysfunctions in all three phases of the sexual response cycle explored were significantly associated with lifetime suicide attempts in patients with BD and with thoughts of death in patients with UD. In BD patients, the lifetime presence of periods with frequent changes of sexual partners was significantly associated with thoughts of death. CONCLUSIONS Our findings suggest the importance of assessing sexual dysfunctions in patients with either BD or UD, as they may be clinically helpful in identifying phenotypes of mood disorders characterized by high suicidality.
Collapse
Affiliation(s)
- Liliana Dell'Osso
- Psychiatry Unit, Department of Psychiatry, Neurobiology, Pharmacology and Biotechnology, University of Pisa, Pisa 56100, Italy
| | | | | | | | | | | | | | | | | |
Collapse
|
46
|
Jung JH, Jae SU, Kam SC, Hyun JS. Correlation between Lower Urinary Tract Symptoms (LUTS) and Sexual Function in Benign Prostatic Hyperplasia: Impact of Treatment of LUTS on Sexual Function. J Sex Med 2009; 6:2299-304. [DOI: 10.1111/j.1743-6109.2009.01324.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
47
|
Lee YC, Wu WJ, Liu CC, Wang CJ, Li WM, Huang CH, Yeh HC, Ke HL, Huang SP. The associations among eNOS G894T gene polymorphism, erectile dysfunction, and benign prostate hyperplasia-related lower urinary tract symptoms. J Sex Med 2009; 6:3158-65. [PMID: 19515207 DOI: 10.1111/j.1743-6109.2009.01353.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
INTRODUCTION A number of literature has now identified the role of impaired nitric oxide synthase/nitric oxide pathway in the endothelium as the central to the development of erectile dysfunction (ED) and benign prostate hyperplasia-related lower urinary tract symptoms (BPH/LUTS). Recently a few studies have reported the associations between endothelial nitric oxide synthase (eNOS) G894T gene polymorphisms and ED. However, there has been no report investigating the eNOS G894T genetic susceptibility factor for both ED and BPH/LUTS. AIM To investigate the possible associations among eNOS G894T polymorphism, ED, and BPH/LUTS in a Taiwanese population. MAIN OUTCOME MEASURES Patients with ED were defined as those having a 5-item International Index of Erectile Function-5 <21. METHODS In all, 372 Taiwanese men underwent a free health screening were enrolled. All the men had complete clinical data and questionnaires taken. The eNOS G894T polymorphisms were determined using the polymerase chain reaction-restriction fragment length polymorphism method. RESULTS Three hundred seventy-two men had a mean (standard deviation) age of 60.2 (8.8) years. With multivariate analysis, our data identified that aging, diabetes mellitus (DM), and eNOS G894T gene polymorphism were three independent common risk factors for both ED and BPH/LUTS (P < 0.001, P = 0.036, and P = 0.039 for ED; P = 0.034, P = 0.004, and P = 0.016 for BPH/LUTS, respectively). The eNOS 894T allele carriers had significantly higher prevalence of ED (77.9% vs. 60.4%, P = 0.012) and higher International Prostate Symptom score (IPSS) (13.3 +/- 10.7 vs. 9.3 +/- 7.8, P = 0.001) than G allele carriers. CONCLUSIONS Our results showed that aging, DM, and eNOS 894T allele carrier gene polymorphism were the three independently common risk factors for both ED and BPH/LUTS in the Taiwanese population. The eNOS 894T allele carriers had significantly higher frequencies of ED and higher IPSS, suggesting that eNOS G894T gene polymorphisms may play an implication as a genetic susceptibility factor for both ED and BPH/LUTS.
Collapse
Affiliation(s)
- Yung-Chin Lee
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | | | | | | | | | | | | | | | | |
Collapse
|
48
|
Lee SH, Kim JC, Lee JY, Kim JH, Oh CY, Lee SW, Yoo SJ, Chung BH. Effects of components of metabolic syndrome on sexual function in Korean BPH/LUTS patients. J Sex Med 2009; 6:2292-8. [PMID: 19493291 DOI: 10.1111/j.1743-6109.2009.01325.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
INTRODUCTION There are limited data concerning the association between components of metabolic syndrome and sexual function in men aged 40 years and older in Korean benign prostatic hyperplasia (BPH) patients. AIM To examine the effects of metabolic markers on sexual function in Korean BPH patients and to evaluate obesity as a causal factor for the development of BPH and sexual dysfunction in a large population of Korean men. METHODS This is a multicenter, cross-sectional, prospective study conducted at four centers in Korea. A total 602 men with LUTS secondary to BPH were included. BPH/LUTS cases were men with international prostate symptom scores (IPSS) >or=8 points and prostate volume >or=20 cc by transrectal ultrasound of the prostate. Height, weight, and waist circumference were measured. Trained interviewers using the structured Male Sexual Health Questionnaire (MSHQ) and International Index of Erectile Function (IIEF-15) collected information on sexual function. MAIN OUTCOME MEASURES Sexual function using IIEF-15 and MSHQ was assessed according to presence of diabetes mellitus (DM) or hypertension, waist circumference and BMI. RESULTS BPH patients with DM or hypertension had significantly lower sexual function, and satisfaction scores on the MSHQ were significantly lower in BPH patients with hypertension. In the central obesity group, prostate volume was significantly greater compared to the normal waist group (P = 0.01). Moreover, in Korean BPH/LUTS patients, central obesity was significantly related to sexual function. BPH/LUTS represented by IPSS was significantly correlated with prostate volume and MSHQ and IIEF-15 scores. In addition, severe LUTS was significantly related to all domains of the MSHQ. CONCLUSIONS This study provides evidence that in the Korean population, sexual function is more closely associated to central obesity than general obesity. The relationship of comorbidities such as diabetes, hypertension, and sexual dysfunction determined by the MSHQ correlated with that determined by the IIEF-15.
Collapse
Affiliation(s)
- Seung Hwan Lee
- Department of Urology, Yonsei University Health System, Seoul, Korea
| | | | | | | | | | | | | | | |
Collapse
|
49
|
|