The journal of sexual medicine
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Long-acting subcutaneous testosterone pellets provide sustained and steady testosterone levels for 3 to 6 months. Testopel subcutaneous crystalline testosterone pellets are U.S.-approved for the treatment of men with testosterone deficiency syndrome. Published experience with testosterone pellets manufactured by Organon has noted relatively high rates of pellet extrusion and infection. ⋯ Testosterone replacement with long-acting Testopel pellets had a lower rate of infection (0.3%, 1/292 procedures) as compared with historical data from the Organon testosterone pellet (1.4-6.8%). Additionally, the rate of pellet extrusion was substantially lower (0.3%, 1/292 procedures) as compared with historical data (8.5-12%). None of the patients who complied with post-implant procedure instructions experienced infection or pellet extrusion. Patient satisfaction was high and serum hormone values were improved. The low infection and extrusion rates observed may have been the result of the manufacturing process, which results in small, smooth-surfaced pellets; the absence of foreign material within the pellet packaging; and/or differences in the surgical implantation technique used. Though Testopel pellets have been used in the United States for several decades, more research is needed to document their safety and efficacy.
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Clinical Trial
Sexual function improvement following surgery for stress incontinence: the relevance of coital incontinence.
Little is known about the impact of surgery for stress urinary incontinence (SUI) on female sexual function, and results are conflicting. ⋯ Women with coital incontinence show a significant higher improvement in sexual function after surgery for SUI compared to women without coital incontinence. Our results suggest that improvement in coital incontinence results in improvement of sexual function. Therefore, coital incontinence is a prognostic factor for improvement of sexual function following incontinence surgery.
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Obstructive sleep apnea (OSA) has been linked with erectile dysfunction (ED), but it is unknown whether this association is maintained in the presence of other risk factors for ED. ⋯ ED and overall sexual dysfunction were highly prevalent in patients with suspected OSA. Irrespective of known risk factors, mean nocturnal SaO(2) was an additional, independent correlate of these dysfunctions, suggesting that OSA-related intermittent nocturnal hypoxemia specifically contributes to their development.
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Female sexual dysfunction (FSD) is a highly prevalent and often underestimated problem. There is a strong association between urological complaints and FSD. ⋯ Overall, many urologists do not consistently ask each female patient for sexual function and underestimate the prevalence of FSD. For the majority of the members of the Dutch Urological Association, FSD is not part of routine urological practice. There is, therefore, a need for better implementation of education and training at both undergraduate and postgraduate levels.