Effects of heart rate reduction with ivabradine on the international ındex of erectile function (IIEF-5) in patients with heart failure

Introduction: The presence of concomitant erectile dysfunction (ED) with heart failure (HF) is not surprising, because endothelial dysfunction is pathophysiologic signature of both ED and HF. ED significantly and adversely affects quality of life in patients with HF. It was demonstrated that ivabradine treatment can improve endothelial function and ED in experimental models. In this study, we aimed to determine the effect of ivabradine treatment on ED in patients with HF via International Index of Erectile Function (IIEF-5) questionaire.

Material and methods: Consequently, 29 patients, between 18 and 70?years of age, male with chronic HF known for at least 1?year, New York Heart Association functional class I–II, left ventricule ejection fraction less than 40%, in sinus rhythm with a resting HR of at least 70 beats per minute (b.p.m.), who were intended to be treated with ivabradine according to the decision of their physicians were evaluated to determine ED. We used the Turkish version of the IIEF-5 questionnaire to evaluate ED on the last 6-month period. Twenty-four of 29 patients who scored ≤21 were considered to have ED and included to the study. IIEF-5 scores for each question and domains were calculated for all responders at baseline and at 6-month follow-up visit in order to determine any effect of ivabradine treatment on ED in patients with HF.

Results: According to the data of survey, Cronbach's alpha coeffient for all of the patients who were included into the study were 0.84 and detected highly reliable. IEFF-5 questionnaire scores increased significantly (p?=?.003) after the ivabradine treatment, on the contrary, significant decrease in HR was revealed as expected. HR is decreased steadily after ivabradine treatment and mean decrease in HR was 11.5?±?9.4 in this study population. Likewise, negative correlation was demonstrated between decrease in HR (p?p?=?.003).

Conclusion: Although lack of patients with HF have been evaluated in this study population, initial results seem promising that ivabradine has favorable effects on ED. These findings were postulated to be dependent exclusively on HR reduction. As a sequel, cardiologist should avoid neglecting ED to improve medical compliance as well as quality of life in patients with heart failure. This pilot study provide some data for further randomized controlled studies.     

Sildenafil versus continuous positive airway pressure for erectile dysfunction in men with obstructive sleep apnea: a meta-analysis

Objective.?To evaluate the effectiveness of sildenafil versus continuous positive airway pressure (CPAP) for patients with erectile dysfunction (ED) and obstructive sleep apnea (OSA).

Methods.?This is a meta-analysis of a randomized controlled trial. The main outcome measures for effectiveness were the percentage of successful intercourse attempts, International Index of Erectile Function (IIEF) domain scores (erectile function, EF) and the satisfaction levels of the patients and their partners with the treatment for ED.

Results.?Two randomized controlled trials totaling 70 patients were included. Meta-analysis results are as follows: after 12 weeks of treatment, patients under sildenafil demonstrated a significant advantage over under CPAP in terms of the percentage of successful intercourse attempts [OR?=?3.24, 95% CI (2.37–4.43)], EF scores [WMD?=?3.57, 95%CI (1.68–5.45)], and the satisfaction levels of the patients and their partners with the treatment for ED [OR?=?3.56, 95% CI (1.27–9.98)].

Conclusion.?Current clinical studies might confirm that both therapeutic methods were safe and effective, but sildenafil was superior to CPAP in the treatment of ED in men with OSA. We conclude that new therapeutic agents or a combination of the two methods should be studied further.     

Erectile dysfunction is a marker for obstructive sleep apnea

Purpose: To investigate the prevalence of erectile dysfunction (ED) in patients with obstructive sleep apnea (OSA) with and without any other comorbidities.

Methods: The patient group was newly diagnosed as having OSA (apnea–hypopnea index [AHI]?>?5/h) using a polysomnographic examination. A group of subjects with simple snoring were included into the control group. Clinically relevant comorbidities were systematically assessed in face-to-face interviews. All patients were asked to complete the 15-item International Index of Erectile Function (IIEF-15) questionnaire for the evaluation of ED. The patients with OSA and ED were evaluated according to these comorbidities.

Results: Of the 94 patients, 39 patients were excluded because of severe diseases. OSA was observed in 38 (69.1%) of the 55 patients. ED was seen in 24 (63.2%) patients with OSA, and in 8 (47.1%) patients without OSA (p?>?0.05). There were no statistical differences between the groups’ ages, IIEF scores, and body mass index (BMI) scores. There were statistically significant differences between the groups’ AHI scores (p?p?Conclusion: The rate of ED was higher in patients with OSA who had no other comorbidities. Therefore, ED can be a sensitive marker of OSA.     

The real-life perception of efficacy,attitude, satisfaction and safety of vardenafil therapy (REPEAT): a prospective,non-interventional,observational study

Abstract

This study assessed the improvement in relationship quality, effectiveness and safety associated with vardenafil for the treatment of erectile dysfunction (ED). The study was conducted in 1433 centres across 21 countries and comprised a baseline patient visit and up to four follow-up visits during an observational period of 1 year. Relationship quality, happiness, satisfaction with vardenafil treatment, and safety and tolerability were assessed by physician interviews and patient and partner questionnaires. Overall, 7496 patients were enrolled in the study, of which 7430 were included in the safety analyses and 6470 in the effectiveness analyses. Relationship quality, assessed by a relationship questionnaire (partnerschaftsfragebogen [PFB]), was improved at last observation carried forward, compared with baseline, in both patients and partners and satisfaction with the effectiveness of vardenafil treatment was high. Vardenafil was well tolerated and adverse events were consistent with the known safety profile of phosphodiesterase type 5 inhibitors. These results confirm the well-established effectiveness and safety profiles of vardenafil. This study is the first to demonstrate improvements in relationship quality following vardenafil therapy, in both patients and partners, using the PFB questionnaire.     

Androgen deficiency in the adult male

Introduction. The purpose of this study was to investigate the association between severity of lower urinary tract symptoms (LUTS), erectile dysfunction (ED) and metabolic syndrome.

Methods. Our study population included a consecutive series of 190 patients with LUTS (International Prostate Symptom Score-IPSS >7) with or without manifestations of the metabolic syndrome. The diagnoses of diabetes mellitus and hypertension were obtained from the patient's medical history. Data on blood pressure, waist measure, body height and weight were collected and body mass index were calculated. Patients were assessed based on the International Index of Erectile Function (IIEF) for ED and IPSS and IPSS-Quality of Life for LUTS. Blood samples were drawn from fasting patients to determine, fasting blood glucose (FBG), triglycerides, HDL-cholesterol and serum total testosterone levels.

Results. In severe LUTS patient group, IIEF erectile function domain scores were significantly lower than moderate LUTS patient group (p < 0.05). Multiple logistic regression analysis confirmed that presence of ED was the most predictor of severe LUTS. The prevalence of metabolic syndrome was higher in patients with severe LUTS (26%vs. 46%, p = 0.009). The severe form of the LUTS was significantly correlated with waist circumference >102 cm (p < 0.05), blood pressure ≥130/85 mmHg (p < 0.05) and FBG >110 mg/dl (p < 0.01).

Conclusion. Obesity, high plasma level of FBG and hypertension constitute risk factors for the development of severe LUTS. Metabolic syndrome may play a key role in the pathogenesis in both ED and LUTS. Presence of ED is the most predictor of severe LUTS.     

Treatment of lower urinary tract symptoms/benign prostatic hyperplasia and erectile dysfunction

Abstract

This article summarizes years of challenging research on erectile dysfunction (ED), a condition that has an important social and cultural relevance. Preclinical and clinical research progress has led to new therapeutic approaches to ED in patients with different comorbidities and particularly in those with low urinary tract symptoms (LUTS)/benign prostatic hyperplasia (BPH). These goals were possible only by combined work of specialists and researchers of different and intertwined medical disciplines. Currently, tadalafil (5?mg/d) is the best choice; other phosphodiesterase-5 inhibitors (PDE5i) are not included among options, despite the growing evidence of therapeutic effects. Different regimens of tadalafil may be prescribed based on patient needs, severity of LUTS/BPH – ED profile, and clinical experience. An integrated approach is necessary to choose for a combined therapy with PDE5i and α-blockers following urological and cardiac counseling in terms of outcomes and adverse effects.     

The effect of lifestyle modification and glycemic control on the efficiency of sildenafil citrate in patients with erectile dysfunction due to type-2 diabetes mellitus

Abstract

Objectives: We evaluated the effect of lifestyle modifications and glycemic control on the efficiency of sildenafil citrate in patients with type-2 diabetes (T2DM) and erectile dysfunction (ED).

Methods: Eighty-three men with ED due to T2DM were included in the study. The Group 1 (n?=?41) patients received lifestyle modifications (diet and exercise), and medical treatment for intensive glycemic control. In Group 2 (n?=?42), in addition to the intensive glycemic control, the patients were given sildenafil citrate® 100?mg for 2–3 per weeks. The changes in ED were compared between the two groups after three months of treatment.

Results: The mean age was 54.9?±?9.1 (26–75) years. An increase in the IIEF-5 scores was observed in 23 of 41 patients in Group 1 (44.2%) and 29 of 42 in Group 2 (55.8%). When the changes of the IIEF-5 scores were evaluated, the mean increase was 2.5 in Group 1, and 5.0 in Group 2 (p?=?0.012). The mean IIEF changes according to the duration of diabetes were 4.8 in <5 years, 3.6 in 5–10 years and 1.6 in >10 years (p?=?0.021).

Conclusions: Glycemic control and lifestyle changes are not solely adequate for a better sexual function in ED due to diabetes, and sildenafil citrate should be used additionally.     

Circadian rhythm of hot flashes and activity levels among prostate cancer patients on androgen deprivation therapy

Abstract

Background: Modifiable risk factors contribute to the pathogenesis of cardiovascular disease (CVD) and erectile dysfunction (ED). We aimed to compare the knowledge about the contribution of modifiable risk factors to the pathogenesis of CVD and ED. The impact of patients’ having modifiable risk factors on the awareness of their negative influence on the development of CVD and ED was examined.

Methods: To this multicenter cohort study, we included 417 patients with CHD who had been hospitalized in the cardiology or cardiac surgery department during the previous six weeks and underwent cardiac rehabilitation in one of the five centers. Knowledge about modifiable risk factors was collected. ED was assessed by an abridged IIEF-5 questionnaire. Comparisons between groups were conducted using the Student’s t-test, Mann–Whitney U test, and Kruskal–Wallis test. Relationships were analyzed with Spearman's rank correlation coefficient.

Results: The mean number of correctly identified risk factors for CVD was significantly higher than those for ED (3.71?±?1.87 vs. 2.00?±?1.94; p?<?.0001). Smoking was the most recognized risk factor both for CVD and ED. Dyslipidemia was least frequently identified as a risk factor for CVD. Sedentary lifestyle was the only risk factor whose incidence did not affect the level of patient knowledge.

Conclusions: Cardiac patients with ED know more about risk factors for CVD than ED. It is necessary to include information about the negative impact of modifiable risk factors on sexual health into education programs promoting healthy lifestyles in men with cardiovascular diseases.     

Financing Rural New England University Health Services: A Pilot Study

Abstract

Patient satisfaction in university health settings has received little research attention, and it is unclear whether the issue is being addressed in college health clinics. Because providers may make their own evaluations of patient satisfaction in the absence of other information, the authors conducted a study to determine whether healthcare providers at a university health clinic could accurately assess patient satisfaction. Ten providers completed a 10-item questionnaire immediately following the medical encounter to rate their perceptions of selected patients' levels of satisfaction. After seeing a healthcare provider, 201 patients completed a comparable questionnaire indicating how satisfied they were with the experience. Responses of providers and patients were compared, using a paired-sample t test. The results showed that providers' ratings were significantly lower than patients' ratings, indicating that providers were unable to judge patient satisfaction accurately. The results suggest that formal evaluations of patient satisfaction should be included in college health services.     

The impact of metabolic syndrome on serum total testosterone level in patients with erectile dysfunction

Abstract

Objectives: To determine the association between metabolic syndrome (MetS) and serum testosterone levels (TT) in patients with erectile dysfunction (ED).

Methods: This study included 280 ED patients above 40-years-of-age. Participants were divided into two groups according to 2005 criteria of International Diabetes Federation. The severity of ED was determined according to the International Index of Erectile Function-EF (IIEF-EF score; 0–10 severe ED, 11–25 mild to moderate ED). The severity of ED, serum TT levels and other MetS components were compared between the groups.

Results: The mean age of the patients was 55.7?±?8.2 years. One hundred eighteen patients (%42.1) had MetS. Sixty-eight patients with MetS (57.6%) and 71 patients without MetS (43.8%) had severe ED (p?=?0.031). A total of 46 (16.4%) patients had hypogonadism. Hypogonadism was seen more prevalent in patients with MetS (22.9% vs. 11.7%, p?=?0.013). Logistic regression analyses for ED risk factors demonstrated that abnormal FBG increased the relative risk of severe ED up to 10.7-fold (p?<?0.001) but not presence of hypogonadism (p?=?0.706).

Conclusion: Metabolic syndrome was seen in almost half of the patients with ED. ED was more severe among MetS patients. Hypogonadism alone is a not risk factor for severe ED.     

Administration of daily 5 mg tadalafil improves endothelial function in patients with benign prostatic hyperplasia

Introduction: Tadalafil is a promising phosphodiesterase (PDE) 5 inhibitor prescribed for erectile dysfunction (ED). Daily low dose (5?mg) of tadalafil has also been used for the treatment of male lower urinary tract symptoms (LUTS) associated with benign prostate hyperplasia (BPH). PDE5 inhibitors induce relaxation of smooth muscle cells in the urethra, prostate, bladder neck, and blood vessels. The aim of this study was to investigate the efficacy of tadalafil on vessels endothelial function, in patients with male LUTS symptoms associated with BPH.

Methods: The Institutional Review Board (IRB) approved this clinical study and informed consents had been obtained from 81 BPH patients.

The following male LUTS parameters: international prostate symptom score (IPSS), overactive bladder symptom score (OABSS), voiding volume, max and mean voiding flow on voiding flowmetry examination and post-voiding residual urine (RU) were compared at 0, 1, 3, 6, and 12 months after a daily dose of 5?mg tadalafil.

In addition, erectile function was evaluated by the sexual health inventory for men (SHIM) score and vessels endothelial function and peripheral neuropathy were assessed by the brachial-ankle pulse wave velocity (baPWV), ankle brachial index (ABI), and vibration perception threshold (VPT) at 0, 3, 6, and 12 months after treatment.

Results: The mean age of 81 patients was 66.4?±?11.4 years old. Their prostate size was 30.2?±?22.1?ml.

Male LUTS parameters including IPSS, OABSS, and RU showed significant improvement from 1 to 12 months after tadalafil administration. Max and mean voiding flow was significantly increased at 6 months after tadalafil treatment.

The SHIM score showed significant improvement after 3 months. Whilst, the results of baPWV also showed significant improvement from 3 to 12 months. ABI was also significantly improved at 6 months. However, there was no change in the VPT at any time point.

Conclusions: Tadalafil is effective for both male LUTS and ED. It is also shown that tadalafil improves baPWV, which we can conclude that higher vessels elasticity has been obtained. This major finding of this study shows that tadalafil has the potency to improve vessels endothelial dysfunction in patients with BPH.     

The relationship of salivary testosterone and male sexual dysfunction in opioid-associated androgen deficiency (OPIAD)

Background: Opioids are an effective treatment for chronic non-malignant pain (CNP). Long-term use risks and side effects such as opioid-induced androgen deficiency (OPIAD) exist. This could be measured by saliva testosterone (Sal-T).

Objectives: To evaluate OPIAD in long-term opioid use in CNP patients.

Methods: A cross-sectional study included CNP male outpatients under opioid treatment. Total-Testosterone (Total-T), Free-Testosterone (Free-T), Bio-Testosterone (Bio-T) and Sal-T were measured. Correlations were calculated by Spearman’s rho (SPSS 20).

Results: From 2012 to 2014, 134 from 249 (54%) consecutive male outpatients reported erectile dysfunction (ED), 37% of them related to opioids and 19% evidenced OPIAD. A total of 120 subjects (94 cases and 26 matched-controls) were included. A significantly lower luteinizing hormone, Total-T and Free-T were found, as well as, a significant correlation between Sal-T and Total-T (r?=?0.234, p?=?0.039), Bio-T (r?=?0.241, p?=?0.039), IIEF (r?=?0.363, p?=?0.003) and HAD-anxiety (r =??0.414, p?=?0.012) in OPIAD patients. Sal-T levels were significantly lower in patients with severe–moderate ED versus mild ED (p?=?0.045) and in patients with severe ED versus moderate–mild ED (p?=?0.036).

Conclusions: These data demonstrate the high prevalence of ED in long-term use of opioids, part of this is associated to OPIAD, which can be tested by Sal-T as a non-invasive approach.     

Are urge incontinence and aging risk factors of erectile dysfunction in patients with male lower urinary tract symptoms?

Introduction: Several studies have indicated that erectile dysfunction (ED) patients also suffer from lower urinary tract symptoms (LUTS). We investigated a group of men with LUTS and assessed their sexual function with the aim of being able to predict ED risk factors and introduce ED treatments earlier for this patient group.

Methods: International Prostate Symptom Score (IPSS), Overactive Bladder Symptoms Score (OABSS) and Sexual Health Inventory for Men (SHIM) score were obtained from 236 men with LUTS at their first out-patients visit. Clinical parameters such as body mass index, prostate volume, residual urine volume and prostate specific antigen were also evaluated. The relationship between the SHIM score and other clinical data was analyzed.

Results: According to the SHIM score, ED in men with LUTS was severe 15%, moderate 19%, moderate to mild 28%, mild 17%, normal 7% and data was incomplete in 14%. Based on the results of a multivariate analysis, aging (p?p?=?0.024) were significantly correlated to severe and moderate ED. Furthermore, among OAB symptoms score items, urge urinary incontinence was a risk factor for severe and moderate ED (p?=?0.005).

Conclusion: Aging and OAB (notably urinary urge incontinence) are risk factors for severe and moderate ED in men with LUTS.     

Sex life after 65: How does erectile dysfunction affect ageing and elderly men?

Introduction. We report the findings pertinent to the ageing and elderly participants of a population-based study of erectile dysfunction (ED).

Method. We examined the sociodemographic characteristics, self-reported morbidities and responses to the 5-item International Index of Erectile Function (IIEF-5) of participants aged ≥65 years and ≥80 years.

Results. Most (73%) participants were married or had partners. Among the participants aged ≥65 years, the prevalence of ED (IIEF-5 scores <22) was 67% and of severe ED (IIEF-5 scores <8) 48%. About 32% were sexually active, and 11% had regular sexual intercourse. Cardiovascular disease (CVD) was reported in 37% and diabetes mellitus (DM) in 13%, with odds of ED at 3.91 and 4.68, respectively. Among those aged ≥80 years, the prevalence of ED was 68% and of severe ED 57%. About 12% were sexually active, and 3% had regular sexual intercourse. CVD was reported in 44% and DM in 11%, with corresponding odds of ED at 2.55 and 2.90.

Conclusions. Most ageing and elderly men are in a relationship and many are sexually active. ED is prevalent and severe. Morbidities are common and significantly associated with ED, impairing the sex lives of affected men.     

Evaluation of the relationship between compliance with the follow-up and treatment protocol and health literacy in bladder tumor patients

Abstract

Objective: To investigate the relationship between the compliance of bladder cancer patients with cystoscopic follow-up and the treatment protocol, and their health literacy.

Methods: Patients who underwent transurethral resection surgery for bladder tumor were found to have non-muscular invasive bladder carcinoma on pathology examination and then underwent cystoscopic follow-up for 1?year or more were included in the study. Cystoscopic follow-up was recommended to the low- and high-risk groups in terms of progression and recurrence. The patients were evaluated with the Health Literacy Survey-European Union scale.

Results: The mean age of the patients was 67.13?±?10.77 years. The treatment continuity rate was 80.50% (n?=?33) in the adequate health literacy group (n?=?41) and significantly higher than the 56.50% (n?=?48) rate in the inadequate health literacy group (n?=?85) (p?=?.008). The health literacy results revealed that the health promotion and general index score was higher in the group of patients under the age of 65.

Conclusions: Adequate health literacy in bladder cancer patients is associated with better compliance with the treatment protocol. Young patients show better compliance with the follow-up protocol recommended by the physician. Increasing the follow-up protocol compliance of elderly patients with inadequate health literacy is necessary.     

Association between sarcopenia and erectile dysfunction in males with type II diabetes mellitus

Background: The prevalence rates for both sarcopenia and erectile dysfunction (ED) gradually increase in middle-aged and elderly diabetic male population and they impair physical functioning, sexual functioning, and quality of life. The aim of the present study was to evaluate the sarcopenia in patients with diabetic ED.

Methods: The study included 98 male patients with type II diabetes mellitus (DM) aged 18–80?years. Blood chemistry and hormone levels were obtained. The International Index of Erectile Function (IIEF-5) questionnaire was administered to the patients. The patients were divided into three groups according to the IIEF-5 score; a score of 5–10 points indicated severe ED, a score of 11–20 indicated moderate ED, and a score of 21–25 points indicated no ED. The muscle mass, handgrip strength, timed up and go test, upper mid-arm circumference, calf circumference, and body mass index were obtained. The statistical analysis was performed using MedCalc Statistical Software version 12.7.7. All parameters were compared between the three groups.

Results: Of 98 patients included in the study, 84 patients had severe sarcopenia, 13 had moderate sarcopenia, while only one patient had normal muscle mass. The mean age was 56.59?±?11.46?years. When patients were divided into three groups according to IIEF-5 score, 38 had severe ED, 39 had moderate ED, and 21 had no ED. There was a significant difference between the three groups in terms of handgrip strength, timed up and go test scores, upper mid-arm circumference, and calf circumference (p?Conclusions: Although muscle mass remains unchanged, muscle strength and physical performance decrease in diabetic ED patients. Diabetic patients with severe and moderate ED have lower muscle strength and physical performance.     

Increased prevalence of erectile dysfunction (ED): Results of the second epidemiological study on sexual activity and prevalence of ED in Thai males

Objective.?The aim of this study is to investigate changes in sexual activity and the prevalence of erectile dysfunction (ED) in Thai males. In addition, the treatment-seeking behaviour of Thai patients suffering from ED is also investigated.

Materials and methods.?In a cross sectional study using a standardized questionnaire with a multi-stage stratified random sampling, 2,269 men aged 40–70 were interviewed. The questionnaire was designed to investigate the effects of socioeconomic factors, medical conditions and unhealthy lifestyles on the development of ED. Furthermore, the questionnaire was designed to characterize the treatment-seeking behaviour of Thai patients suffering from ED.

Results.?Compared to the first report dated the year 2000, the prevalence of ED has increased from 37.5% to 42.18%. In terms of socioeconomic factors, the highest prevalence of ED was observed among unemployed men (78.51%). Prostatism and/or prostatitis (Odd ratios (OR) = 2.02) and long histories of smoking (more than 30 years, OR = 2.36) were identified as statistically significant risk factors for ED, with p-values of <0.001. It is important to notice that 38.78% of the ED patients wanted to discuss their problem with spouses or partners. Three quarters of the ED patients (74.54%) preferred oral medication as therapy.

Conclusions.?The epidemiology of ED in Thailand is changing. An increased prevalence of ED does require further epidemiological studies on a regular basis in order to better understand the etiology of ED and look for measures (such as education) to counter the disease.     

The promised planet: alliances and struggles of the gerontocracy in American television science fiction of the 1960s

Introduction.?Erectile dysfunction (ED) is a common medical disorder affecting the aging male. A man's perception of a disease affects his health seeking behaviour. This study aimed to explore perceptions of ED among men with ED and how these perceptions came about.

Methods.?This qualitative study utilized in-depth interviews involving 17 urban men aged between 40 and 75 years old.

Results.?Misconceptions existed regarding the definitions of ED. Most men perceived impotence to be more serious than ED. Although most were aware of the medical causes of ED, ‘overuse of penis’ and black magic were mentioned as culturally-related causes. ED was perceived as a serious problem associated with loss of manhood and it had a significant impact on relationships with their partners. However, some adopted an ‘accepting’ view and attributed it to aging and fate. Most men were only familiar with PDE-5 inhibitors and traditional therapies. PDE-5 inhibitors were perceived to be effective but they were concerned about side effects and costs.

Conclusions.?Identifying men's perceptions of ED and its treatment would help doctors in their consultation, and inform health policy makers in planning appropriate public education and services.     

Very Brief Interventions in College Mental Health

Abstract

Although short encounters account for one-half of college mental health practice, they're often viewed as an unavoidable evil rather than a desired outcome. In order to evaluate client satisfaction with very brief interventions the authors mailed questionaires to 215 clients who had mental health encounters lasting no more than three sessions. Seventy-two percent of respondents were satisfied with their treatment. Thirty-six percent reported that they terminated because they felt they satisfied the conditions of the consultation, as opposed to 16% who left dissatisfied and 29% who left because they were referred elsewhere. A chart review revealed that in 45% of cases the decision to terminate was made unilaterally by the client. These findings suggest that very brief interventions are more often associated with rapid goal achievement than with client dissatisfaction.     

Impact of metabolic syndrome on erectile dysfunction and lower urinary tract symptoms in benign prostatic hyperplasia patients

Introduction.?The aim of this study was to investigate the relationship among metabolic syndrome (MetS), erectile dysfunction (ED) and lower urinary tract symptoms (LUTS) in patients with benign prostatic hyperplasia (BPH).

Methods.?Our study included 106 patients with BPH, 33 (31.1%) of whom had MetS. Blood pressures, waist circumferences, serum levels of fasting blood glucose, high density lipoprotein and triglyceride of patients were recorded. Erectile functions of the patients were evaluated by International Index of Erectile Function (IIEF). Patients were divided into two groups according to IIEF scores, namely ‘mild/no ED’ and ‘moderate/severe ED’. IIEF scores of ED groups were between 17 and 30 and 6–16 in turn. LUTS severities were assessed by International Prostate Symptom Score (IPSS) and classified as mild (IPSS 0–7), moderate (IPSS 8–19) and severe (IPSS 20–35).

Results.?There was a significant difference between ED groups concerning MetS presence (p?=?0.032). MetS presence was not found to be associated with the severity of LUTS (p?=?0.144). There was no correlation between ED groups regarding LUTS severity (p?=?0.303).

Conclusion.?Results of the present study showed a correlation between MetS presence and ED. In the light of our results, MetS seems to play an important role in the etiopathogenesis of ED in patients with BPH.