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Re: A Critical Evaluation of Salivary Testosterone as a Method for the Assessment of Serum Testosterone
MALE AND FEMALE SEXUAL FUNCTION AND DYSFUNCTION; ANDROLOGY
1773
Re: Preoperative Erectile Function is the Only Predictor of the Use of a High Number of Phosphodiesterase Type-5 Inhibitors after Bilateral Nerve-Sparing Radical Prostatectomy G. Gandaglia, A. Gallina, N. Suardi, F. Abdollah, N. Passoni, M. Bianchi, E. Zaffuto, A. Nini, D. Vizziello, A. Salonia, F. Montorsi and A. Briganti Department of Urology, Urological Research Institute, University Vita-Salute San Raffaele and San Raffaele Scientific Institute, San Raffaele Hospital, Milan, Italy Int J Impot Res 2014; Epub ahead of print.
Abstract available at http://jurology.com/ Editorial Comment: The aim of this study was to identify predictors of increased (at least once weekly) use of phosphodiesterase type 5 inhibitors (PDE5-Is) postoperatively among 184 patients taking proerectile medications on demand. At a mean followup of 22.7 months 116 patients (63%) recovered erectile function (EF). Overall EF recovery rates at 1 and 2-year followup were 47.3% and 65.4%, respectively. A total of 43 patients (23.4%) used PDE5-Is at least once weekly. Preoperative EF was the only predictor of increased use of PDE5-Is after bilateral nerve sparing radical prostatectomy. This is another in a series of studies demonstrating that patients who undergo bilateral nerve sparing prostatectomy seem to be able to recover erectile function following surgery. Other patients had modest responses to PDE5-I use. Allen D. Seftel, MD
Suggested Reading Harris CR, Punnen S and Carroll PR: Men with low preoperative sexual function may benefit from nerve sparing radical prostatectomy. J Urol 2013; 190: 981. Pastuszak AW, Pearlman AM, Lai WS et al: Testosterone replacement therapy in patients with prostate cancer after radical prostatectomy. J Urol 2013; 190: 639.
Re: Predictors of Sexual Dysfunction Incidence and Remission in Men S. A. Martin, E. Atlantis, K. Lange, A. W. Taylor, P. O’Loughlin and G. A. Wittert; Florey Adelaide Male Ageing Study Freemasons Foundation Centre for Men’s Health and Discipline of Medicine, University of Adelaide, Adelaide, South Australia, Australia J Sex Med 2014; 11: 1136e1147.
Abstract available at http://jurology.com/ Editorial Comment: The authors provide fascinating data. Erectile dysfunction and low sexual desire are reviewed. The data support previously held notions of the causation of erectile dysfunction and low desire, and to some degree reaffirm the historical etiologies. These data open the door for many interesting questions and further study. Allen D. Seftel, MD
Re: A Critical Evaluation of Salivary Testosterone as a Method for the Assessment of Serum Testosterone T. Fiers, J. Delanghe, G. T’Sjoen, E. Van Caenegem, K. Wierckx and J. M. Kaufman Clinical Chemistry and Endocrinology, Ghent University Hospital, Ghent, Belgium Steroids 2014; 86: 5e9.
1774
MALE AND FEMALE SEXUAL FUNCTION AND DYSFUNCTION; ANDROLOGY
Abstract available at http://jurology.com/ Editorial Comment: These data support the method of collection of salivary secretions for testosterone analysis. However, the data do not seem to support the use of salivary testosterone as a diagnostic tool. Allen D. Seftel, MD
Re: Alcohol and Male Reproductive Health: A Cross-Sectional Study of 8344 Healthy Men from Europe and the USA T. K. Jensen, S. Swan, N. Jørgensen, J. Toppari, B. Redmon, M. Punab, E. Z. Drobnis, T. B. Haugen, B. Zilaitiene, A. E. Sparks, D. S. Irvine, C. Wang, P. Jouannet, C. Brazil, U. Paasch, A. Salzbrunn, N. E. Skakkebæk and A. M. Andersson University of Southern Denmark, Odense, and Rigshospitalet and Copenhagen University Hospital, Copenhagen, Denmark, University of Turku, Turku, Finland, Tartu University Clinicum, Tartu, Estonia, Faculty of Health Sciences and Akershus University College of Applied Sciences, Oslo, Norway, Lithuanian University of Health Sciences, Kaunas, Lithuania, NHS Education for Scotland and Royal Infirmary of Edinburgh, Edinburgh, United Kingdom, Hopital Cochin, Universite Paris V, Paris, France, University of Leipzig, Leipzig and Universitatsklinikum Hamburg-Eppendorf, Hamburg, Germany, Icahn School of Medicine at Mount Sinai, New York, New York, University of Minnesota, Minneapolis, Minnesota, School of Medicine, University of Missouri, Columbia, Missouri, University of Iowa, Iowa City, Iowa, and Harbor-UCLA Medical Center, Torrance and University of California, Davis, Sacramento, California Hum Reprod 2014; 29: 1801e1809.
Abstract available at http://jurology.com/ Editorial Comment: These are interesting data. The authors noted a linear association between alcohol intake and free testosterone levels in a population of 8,344 healthy men. The finding of increased serum testosterone with increased alcohol intake was consistent across populations and countries. The mechanism is postulated to be a change in metabolism of steroids in the liver. Because few men in this study population drank more than moderately and information on alcohol intake was only obtained for the week before the visit, this study cannot address the effect of high alcohol consumption of longer duration or binge drinking on male reproductive hormones. Nonetheless, these are provocative data. Allen D. Seftel, MD
Re: A Population-Based Analysis of Contemporary Rates of Reoperation for Penile Prosthesis Procedures S. Grewal, J. Vetter, S. B. Brandes and S. A. Strope Division of Urology, Department of Surgery, Washington University in St. Louis, St. Louis, Missouri Urology 2014; 84: 112e116.
Abstract available at http://jurology.com/ Editorial Comment: The authors performed a population based comparison of inflatable and semirigid penile prostheses to determine contemporary rates of reoperation and to identify factors impacting the type of prosthetic implanted. They examined patient level discharge data and files from the Agency for Healthcare Research and Quality for semirigid and inflatable prosthesis procedures performed for erectile dysfunction from 2006 to 2009 in the state of California. A total of 2,263 cases (inflatable in 1,824 and semirigid in 439) were included. Overall reoperation rate was 7.42%. There was no difference in the overall revision rate between the 2 groups (7.52% for semirigid and 7.40% for inflatable prosthesis). The reoperation rate secondary to infectious complications was 3.6% (4.5% for semirigid and 3.23% for inflatable prosthesis). The revision rate secondary to noninfectious failure
1773
Re: Preoperative Erectile Function is the Only Predictor of the Use of a High Number of Phosphodiesterase Type-5 Inhibitors after Bilateral Nerve-Sparing Radical Prostatectomy G. Gandaglia, A. Gallina, N. Suardi, F. Abdollah, N. Passoni, M. Bianchi, E. Zaffuto, A. Nini, D. Vizziello, A. Salonia, F. Montorsi and A. Briganti Department of Urology, Urological Research Institute, University Vita-Salute San Raffaele and San Raffaele Scientific Institute, San Raffaele Hospital, Milan, Italy Int J Impot Res 2014; Epub ahead of print.
Abstract available at http://jurology.com/ Editorial Comment: The aim of this study was to identify predictors of increased (at least once weekly) use of phosphodiesterase type 5 inhibitors (PDE5-Is) postoperatively among 184 patients taking proerectile medications on demand. At a mean followup of 22.7 months 116 patients (63%) recovered erectile function (EF). Overall EF recovery rates at 1 and 2-year followup were 47.3% and 65.4%, respectively. A total of 43 patients (23.4%) used PDE5-Is at least once weekly. Preoperative EF was the only predictor of increased use of PDE5-Is after bilateral nerve sparing radical prostatectomy. This is another in a series of studies demonstrating that patients who undergo bilateral nerve sparing prostatectomy seem to be able to recover erectile function following surgery. Other patients had modest responses to PDE5-I use. Allen D. Seftel, MD
Suggested Reading Harris CR, Punnen S and Carroll PR: Men with low preoperative sexual function may benefit from nerve sparing radical prostatectomy. J Urol 2013; 190: 981. Pastuszak AW, Pearlman AM, Lai WS et al: Testosterone replacement therapy in patients with prostate cancer after radical prostatectomy. J Urol 2013; 190: 639.
Re: Predictors of Sexual Dysfunction Incidence and Remission in Men S. A. Martin, E. Atlantis, K. Lange, A. W. Taylor, P. O’Loughlin and G. A. Wittert; Florey Adelaide Male Ageing Study Freemasons Foundation Centre for Men’s Health and Discipline of Medicine, University of Adelaide, Adelaide, South Australia, Australia J Sex Med 2014; 11: 1136e1147.
Abstract available at http://jurology.com/ Editorial Comment: The authors provide fascinating data. Erectile dysfunction and low sexual desire are reviewed. The data support previously held notions of the causation of erectile dysfunction and low desire, and to some degree reaffirm the historical etiologies. These data open the door for many interesting questions and further study. Allen D. Seftel, MD
Re: A Critical Evaluation of Salivary Testosterone as a Method for the Assessment of Serum Testosterone T. Fiers, J. Delanghe, G. T’Sjoen, E. Van Caenegem, K. Wierckx and J. M. Kaufman Clinical Chemistry and Endocrinology, Ghent University Hospital, Ghent, Belgium Steroids 2014; 86: 5e9.
1774
MALE AND FEMALE SEXUAL FUNCTION AND DYSFUNCTION; ANDROLOGY
Abstract available at http://jurology.com/ Editorial Comment: These data support the method of collection of salivary secretions for testosterone analysis. However, the data do not seem to support the use of salivary testosterone as a diagnostic tool. Allen D. Seftel, MD
Re: Alcohol and Male Reproductive Health: A Cross-Sectional Study of 8344 Healthy Men from Europe and the USA T. K. Jensen, S. Swan, N. Jørgensen, J. Toppari, B. Redmon, M. Punab, E. Z. Drobnis, T. B. Haugen, B. Zilaitiene, A. E. Sparks, D. S. Irvine, C. Wang, P. Jouannet, C. Brazil, U. Paasch, A. Salzbrunn, N. E. Skakkebæk and A. M. Andersson University of Southern Denmark, Odense, and Rigshospitalet and Copenhagen University Hospital, Copenhagen, Denmark, University of Turku, Turku, Finland, Tartu University Clinicum, Tartu, Estonia, Faculty of Health Sciences and Akershus University College of Applied Sciences, Oslo, Norway, Lithuanian University of Health Sciences, Kaunas, Lithuania, NHS Education for Scotland and Royal Infirmary of Edinburgh, Edinburgh, United Kingdom, Hopital Cochin, Universite Paris V, Paris, France, University of Leipzig, Leipzig and Universitatsklinikum Hamburg-Eppendorf, Hamburg, Germany, Icahn School of Medicine at Mount Sinai, New York, New York, University of Minnesota, Minneapolis, Minnesota, School of Medicine, University of Missouri, Columbia, Missouri, University of Iowa, Iowa City, Iowa, and Harbor-UCLA Medical Center, Torrance and University of California, Davis, Sacramento, California Hum Reprod 2014; 29: 1801e1809.
Abstract available at http://jurology.com/ Editorial Comment: These are interesting data. The authors noted a linear association between alcohol intake and free testosterone levels in a population of 8,344 healthy men. The finding of increased serum testosterone with increased alcohol intake was consistent across populations and countries. The mechanism is postulated to be a change in metabolism of steroids in the liver. Because few men in this study population drank more than moderately and information on alcohol intake was only obtained for the week before the visit, this study cannot address the effect of high alcohol consumption of longer duration or binge drinking on male reproductive hormones. Nonetheless, these are provocative data. Allen D. Seftel, MD
Re: A Population-Based Analysis of Contemporary Rates of Reoperation for Penile Prosthesis Procedures S. Grewal, J. Vetter, S. B. Brandes and S. A. Strope Division of Urology, Department of Surgery, Washington University in St. Louis, St. Louis, Missouri Urology 2014; 84: 112e116.
Abstract available at http://jurology.com/ Editorial Comment: The authors performed a population based comparison of inflatable and semirigid penile prostheses to determine contemporary rates of reoperation and to identify factors impacting the type of prosthetic implanted. They examined patient level discharge data and files from the Agency for Healthcare Research and Quality for semirigid and inflatable prosthesis procedures performed for erectile dysfunction from 2006 to 2009 in the state of California. A total of 2,263 cases (inflatable in 1,824 and semirigid in 439) were included. Overall reoperation rate was 7.42%. There was no difference in the overall revision rate between the 2 groups (7.52% for semirigid and 7.40% for inflatable prosthesis). The reoperation rate secondary to infectious complications was 3.6% (4.5% for semirigid and 3.23% for inflatable prosthesis). The revision rate secondary to noninfectious failure