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Anton Ponholzer

Publications and source records attributed to Anton Ponholzer.

At least 19 recordsLinked to original sources

Is the metabolic syndrome an independent risk factor for erectile dysfunction?

PURPOSE: We determined the role of the metabolic syndrome as an independent risk factor for erectile dysfunction. MATERIALS AND METHODS: Men participating in a health screening project completed the International Index of Erectile Function-5. The metabolic syndrome was defined according to the 2005 International Diabetes Federation consensus definition. Multiple linear regression, ANOVA and chi-square tests were used to investigate the impact of the metabolic syndrome on erectile dysfunction. RESULTS: A total of 2,371 men with a mean age of 46.1 years (SD 9.9, range 30 to 69) were analyzed. Of the men 33.4% (652) had no erectile dysfunction (International Index of Erectile Function-5 score 22 to 25), 59.7% (1,166) had mild erectile dysfunction (International Index of Erectile Function-5 score 17 to 21) and 6.9% (134) had moderate to severe erectile dysfunction (International Index of Erectile Function-5 score 5 to 16). The metabolic syndrome was present in 33.8% (794). In a multiple linear regression analysis an increased waist-to-hip ratio (p = 0.01) and metabolic syndrome (p = 0.01) turned out to be independently associated with a decreased International Index of Erectile Function-5 score. When stratified according to age, the metabolic syndrome was correlated to erectile dysfunction only in men 50 years old or older with an increase of severe erectile dysfunction by 48% (p = 0.01). CONCLUSIONS: The metabolic syndrome and an increased waist-to-hip ratio are independently associated with a decreased International Index of Erectile Function-5 score. The metabolic syndrome in men older than 50 years is significantly associated with a higher proportion of moderate to severe erectile dysfunction.

Adult↗

Palliative transurethral resection of the prostate: functional outcome and impact on survival.

OBJECTIVE: To assess the long-term functional and oncological outcome in a consecutive series of patients undergoing palliative transurethral resection of the prostate (pTURP). PATIENTS AND METHODS: We retrospectively assessed all patients who had a pTURP between 1992 and 2004 at our institution. Patients with incidental prostate cancer (pT1a/pT1b) were excluded. In all, 89 patients (mean age 75.9 years, sd 0.9, at diagnosis) entered the study. RESULTS: The median (range) prostate-specific antigen level at diagnosis was 25.7 (0.7-5000) ng/mL and the mean Gleason score was 7. The mean (sd, range) interval between the diagnosis of prostate cancer and pTURP was 1.5 (0.3, 0.5-10.9) years. The indications for pTURP were refractory urinary retention in 30%, severe bladder outlet obstruction with a postvoid residual urine volume of > 100 mL in 43%, and bladder stones, haematuria and hydronephrosis in 9% each. The mean (sd, range) follow-up after pTURP was 2.6 (0.2, 0.1-7.3) years. The peri-operative mortality (<30 days) was 2%, and 22 patients (25%) died during the follow-up. As estimated by Kaplan-Meier analysis, the 1-, 2- and 5-year survival rates were 83%, 70% and 61%, respectively. Patients with prostate cancer in the pTURP specimen had a shorter 3-year survival (52%) than those with a negative histology (89%, P = 0.03). At the last follow-up, 79% of men voided spontaneously and were continent. A repeat pTURP was necessary in 25% of patients, 11% required permanent catheterization and 10% were incontinent. CONCLUSION: Despite greater peri-operative mortality and morbidity than conventional TURP, pTURP is a fairly safe and effective procedure. Although a potential negative impact of pTURP on survival cannot be excluded, the estimated 5-year survival of 61% in this series seems to justify this intervention.

Aged↗

Prevalence and correlates for interstitial cystitis symptoms in women participating in a health screening project.

OBJECTIVES: To determine the prevalence of interstitial cystitis (IC) symptoms in an urban female population, to study their impact on quality of life and sexual function, and to identify correlates for IC symptoms. METHODS: Women attending a voluntary health survey project in Vienna underwent a detailed health investigation and completed a questionnaire containing the O'Leary-Sant IC questionnaire. Women with high (> or =12) symptom and problem scores including nocturia (>2) and pain were considered most likely to have IC. RESULTS: A total of 981 women, aged 19 to 89 yr (mean, 49.1+/-14.7 yr), participated in the study. Of these, 57.9% had a low IC symptom score (score 0-3), 25.9% mild IC symptoms (score 4-6), 13.9% moderate symptoms (score 7-11), and 2.3% a high symptom score (score 12-20). The IC problem score revealed a similar pattern. The overall prevalence of IC was 306/100,000 women with the highest value (464/100,000) in middle-aged women (40-59 yr). About two thirds of the women with moderate to high risk for IC reported an impairment of quality of life; 35% reported an effect on their sexual life. In a multivariate analysis, bowel disorders (p=0.016) and psychological stress (p=0.029) were correlated to the probability of IC. CONCLUSION: The prevalence of IC symptoms is higher than previously estimated and substantially affects quality of life and sexuality.

Adult↗

Radical prostatectomy in Austria: a nationwide analysis of 16,524 cases.

OBJECTIVES: To analyse demographics and outcome of radical prostatectomy (RPE) in Austria in a nationwide series. METHODS: All patients (n=16,524) who underwent RPE in public hospitals (covering 95% of all surgical procedures) in Austria between 1992 and 2003 were analysed. Patient demographics, interventions for anastomotic strictures/urinary incontinence/inguinal hernias, perioperative mortality, and overall survival (OS) were determined. Data were provided by the Austrian Health Institute (OBIG). For decades Austria has had a public and equal access health system with compulsory insurance coverage. RESULTS: The annual number of RPEs increased from 396 in 1992 to 2640 (+666%) in 2003; the mean age at surgery declined from 64+/-6.3 yr (1992) to 62.0+/-6.7 yr (2003). An endourologic intervention for anastomotic strictures was performed in 8.5% (45-49 yr: 5.8%; 70-74 yr: 10.8%). An artificial urinary sphincter was implanted in 1.6% with a 5-fold increase from the youngest (0.5%; 45-49 yr) to 2.5% in those aged 70-74 yr. Overall, 6.4% of men underwent an inguinal herniotomy after RPE. The 30-d mortality rate was 0.12%. The 5-yr OS declined from 95% in those aged 50-59 yr to 89.8% in those aged 60-69 yr to 82% in the oldest age group (70-79 yr). CONCLUSIONS: This nationwide analysis describes the current standard of RPE in Austria. The perioperative mortality was low, the risk of total incontinence acceptable, and the OS indistinguishable to the life expectancy of the age-matched male population in Austria.

Aged↗

Lower urinary tract symptoms, urinary incontinence, sexual function and quality of life after radical prostatectomy and external beam radiation therapy: real life experience in Austria.

The objective of this study was to assess lower urinary tract symptoms (LUTS), urinary incontinence (UI), erectile dysfunction (ED) and quality of life after radical prostatectomy (RPE) and external beam radiation therapy (EBRT) in a "real-life" setting. A consecutive series of patients undergoing routine follow-up after RPE and EBRT at 28 Austrian institutions were analyzed. Men who received adjuvant therapy were excluded. All patients completed a questionnaire on (a) LUTS and UI, (b) sexual function and (c) quality of life. A total of 364 patients following RPE and 82 after EBRT entered this study and were compared in a matched pair analysis (1:1) based on age, PSA at diagnosis and follow-up (RPE: n=82; EBRT: n=82). Mean time-interval between treatment and current investigation was 4.6 years for RPE and 4.4 years for EBRT (n.s.). UI was reported by 41.3% after RPE and 18.8% after EBRT (P=0.001). Urgency was more frequent after EBRT, this difference, however, did not reach statistical significance. Moderate to severe ED (IIEF-5, <17) was present in 80.0% after RPE and in 80.8% after EBRT (n.s.). On a ten-point scale, RPE-patients rated their quality of life higher (7.3) than after EBRT (6.7) (P=0.01). In this "real-life" setting, RPE and EBRT had significant, yet divergent effects on LUTS, UI and sexual function. The respective numbers were substantially higher than those usually reported by physician-directed studies and centers of excellence.

Austria↗

Incidence and remission of female urinary incontinence over 6.5 years: analysis of a health screening project.

OBJECTIVES: To analyse the incidence and remission of female urinary incontinence (UI) over 6.5 years and to identify risk factors for the development of UI. METHODS: Women who underwent a health investigation in 1998 or 1999 in the area of Vienna completed the Bristol Female Lower Urinary Tract Symptoms questionnaire. In 2005, all women (n=925) aged >/=20 yr in 1999 who were still living in the area of Vienna were invited to recomplete the questionnaire. RESULTS: The response rate was 47.7% (n=441; age range, 20-84 yr), and the mean follow-up was 6.5 yr. The overall prevalence of UI was 32% at baseline and increased to 43% in 6.5 years. The mean annual cumulative incidence of UI was 3.9%, with the lowest rate (2.3%) in the youngest age group (20-39 yr) and the highest (7.3%) in those aged 70 yr or older. The mean annual full remission rate was 2.9%, with no clear age dependency. More than half (55.6%) of the women with a full remission had only a mild form of UI at baseline. In a multivariate analysis, urgency (p=0.008) and age (p=0.024) were correlated to the risk of de novo UI. CONCLUSIONS: This longitudinal study demonstrates that UI is not necessarily a progressive process but rather is a dynamic one.

Adult↗

The association between vascular risk factors and lower urinary tract symptoms in both sexes.

OBJECTIVES: To test the potential role of atherosclerosis in the development of lower urinary tract symptoms (LUTS), we investigated the association between vascular risk factors and LUTS in both sexes. METHODS: Men and women participating in a health screening project completed the International Prostate Symptom Score (IPSS). In parallel all individuals underwent a detailed health investigation with assessment of diabetes mellitus, hypertension, hyperlipidemia, and nicotine use. RESULTS: A total of 1724 men (52.3+/-9.1yr, mean+/-standard deviation; IPSS: 6.3+/-4.3) and 812 women (56.0+/-9.9 yr; IPSS: 5.2+/-4.9) entered the study. A total of 62.5% (n=1077) of men had no vascular risk factor, 32.1% (n=554) one, and 5.4% (n=93) two or more; the corresponding figures for women were 64.7% (n=525), 30.7% (n=249), and 4.7% (n=38). In men, the IPSS was identical in those with no (6.2+/-4.1) and one (6.2+/-4.4) vascular risk factor yet increased to 7.7+/-5.5 (+24.2%) in those with two or more risk factors (p=0.01). In women, the IPSS increased from 4.8+/-4.6 in those with no vascular risk factor to 5.7+/-5.3 (+18.7%) with one and 7.0+/-5.7 (+45.8%) with two or more factors (p=0.05). CONCLUSIONS: Our data suggest that vascular risk factors play a role in the development of LUTS in both sexes. This observation opens new aspects in our understanding of the pathogenesis of LUTS and warrants future studies.

Adult↗

The association between lower urinary tract symptoms and renal function in men: a cross-sectional and 5-year longitudinal analysis.

PURPOSE: We assessed the association between LUTS and renal function in men in a cross-sectional and a longitudinal study. MATERIALS AND METHODS: Men participating in health investigation in Vienna entered this study. In the cross-sectional analysis a consecutive series of men were studied and in the longitudinal analysis men were reevaluated after 5 years. LUTS were assessed by I-PSS and renal function was evaluated by GFR, as calculated by the Cockcroft-Gault equation. RESULTS: A total of 2.469 men with a mean age of 47.1 years (range 30 to 80) entered the cross-sectional study and 439 with a mean age of 51.7 years (range 45 to 79) could be assessed in longitudinal analysis. In the cross-sectional study there was no association between the degree of LUTS and GFR during 5 life decades (p = 0.55). An identical pattern was observed for irritative and obstructive scores. In the longitudinal cohort mean GFR +/- SD decreased from 84.3 +/- 20.2 ml per minute at baseline to 79.2 +/- 18.7 ml per minute after 5 years (-6.0%, p <0.0001). The mean decrease in GFR after 5 years was 4.5 ml per minute (-5.4%) in men without/mild LUTS (I-PSS 7 or less at ages 55.4 +/- 11.0 years), 3.9 ml per minute (-4.9%) in those with moderate LUTS (I-PSS 8 to 20 at ages 61.3 +/- 11.6 years) and 4.2 ml per minute (-5.2%) in those with severe LUTS (I-PSS greater than 20 at ages 64.3 +/- 7.4 years). On linear regression analysis in the 2 study cohorts neither I-PSS, nor obstructive or irritative score affected GFR (p >0.05). The only determinants for GFR less than 90 ml per minute were age (p <0.0001) and hypertension (p <0.0001). CONCLUSIONS: LUTS do not represent an independent risk factor for impaired renal function in men.

Adult↗

Prostatic phyto-oestrogen tissue levels in different Austrian regions.

INTRODUCTION: A number of studies suggest that the low incidence of prostate cancer as well as benign prostatic enlargement in Asia depends on the extended consumption of phyto-oestrogens in these parts of the world. In most Asian men, phyto-oestrogen levels are multiple higher compared to Austrian (European) men. The aim of our study was to evaluate, according to the East-West decline, whether there were significant differences within the Austrian population. We compared prostate phyto-oestrogen tissue levels of men living in three different geographical regions of Austria. We further compared men living in rural and urban environments. MATERIAL AND METHODS: Prostatic tissue samples of 103 men undergoing surgery for benign prostatic hyperplasia or prostate cancer were collected and frozen at -40 degrees C. In tissue samples, enterolactone (representative for lignans) and genistein levels (representative for isoflavones) were determined in duplicate by monoclonal antibody-based immunoassays. We subsequently compared tissue levels of men living in rural and urban environments and different geographical regions of Austria. RESULTS: Prostatic enterolactone tissue levels were similar in men living in an urban (median 19.1 ng/g dry weight, range 1.5-76.4) or rural environment (median 15.7 range 0.6-140.6) p = 0.99. The respective values for genistein were 20.5 ng/g dry weight (range 4.6-47.4) and 9.3 (range 0.1-156.7) p = 0.77. Furthermore, enterolactone (p = 0.1) and genistein (p = 0.65) levels were similar in three different geographic regions in Austria. CONCLUSION: No significant differences regarding genistein and enterolactone were found between our study populations. However, we found a wide variation between individual patients.

Austria↗

Follow-up of men obtaining a six-core versus a ten-core benign prostate biopsy 7 years previously.

The aim of this study is to evaluate the proportion of repeat biopsies after 7 years in men with an initial benign six- or ten-core biopsy as well as the incidence of prostate cancer (PC) in the repeat biopsies. In this retrospective longitudinal study, 116 men with an elevated prostate-specific antigen (PSA) and/or a suspicious digital rectal examination (DRE) who have had a benign prostate biopsy between January 1997 and September 1997 were included. Fifty-eight men had an initial benign six-core biopsy (median PSA 7.5 ng/ml, range 0.3-67) (group A), and 58 men had an initial benign ten-core biopsy (median PSA 7.5 ng/ml, range 0.8-91.4) (group B). We analysed men with a pathological PSA velocity, a persistently elevated PSA, an abnormal DRE, a high-grade prostatic intraepithelial neoplasia or atypical adenomatous hyperplasia, or atypical small acinar proliferation as indication for rebiopsy. Furthermore, we analysed a subgroup with exclusively an increased PSA velocity (>0.75 ng/ml per year) as indication for rebiopsy. In group A, 14 men had a follow-up biopsy. In this group, follow-up biopsies yielded PC in eight men (13.8%), six (10.3%) had a negative follow-up biopsy. In contrast, in group B only four men (3.4%) had a follow-up biopsy (P=0.005). Two of them (3.4%) had PC (P=0.02), two cases (3.4%) showed a benign histology (P=0.06). The use of an extended biopsy protocol at the initial evaluation reduces the number of repeat biopsies required and decreases the number of PC detection in the follow-up biopsy cohort.

Adult↗

Insulin-like growth factor 1, chromogranin A and prostate specific antigen serum levels in prostate cancer patients and controls.

OBJECTIVE: Insulin-like growth factor 1 (IGF-1) and chromogranin A (CGA) are currently discussed as supplemental serum markers for prostate cancer (PC) diagnosis. To address this issue we determined serum levels of IGF-1, CGA and PSA in men with newly diagnosed PC and controls. METHODS: A consecutive series of 156 men (median age: 67 yrs) with newly diagnosed, untreated PC and 271 controls (69 yrs) were recruited. The diagnosis of PC was made by transrectal ultrasound guided biopsies only. In controls, the presence of PC was excluded by digito-rectal examination, serum prostate specific antigen (PSA) levels by using age-specific reference values and-if indicated-by transrectal ultrasound guided 12-core biopsies. Serum levels of IGF-1, CGA and PSA were compared between cases and controls and correlated to histopathological findings and age. RESULTS: Serum PSA-levels were significantly higher in men with PC (49.6+/-13.9 ng/ml, mean+/-standard error of the mean; median: 7.0 ng/ml) than in controls (2.6+/-0.2 ng/ml; median: 1.3 ng/ml) (p<0.001). In contrast, serum levels of IGF-1 (PC: 166+/-6.1 ng/ml, median: 155 ng/ml; controls: 159+/-4.5 ng/ml, 153 ng/ml) and CGA (PC: 92+/-7.4 U/l, median: 67 U/l; controls: 117+/-12.0 U/l; median: 74 U/l) were identical in both groups (p>0.05). Serum levels of IGF-1 and CGA revealed no correlation to serum PSA, Gleason score and number of positive biopsy cores. In the PC-cohort all three serum markers did not correlate with age. In controls, PSA (p=0.018) and CGA (p<0.001) correlated positively and IGF-1 (p<0.001) negatively with age. CONCLUSION: Our data suggest that quantification of IGF-1 and CGA-serum levels provides no useful information in the diagnosis of PC.

Adult↗

Prevalence and risk factors for erectile dysfunction in 2869 men using a validated questionnaire.

PURPOSE: To assess prevalence and risk factors for erectile dysfunction (ED) by using the International Index of Erectile Function- 5 (IIEF-5) in men undergoing a health investigation. METHODS: Men aged 20-80 years participating in a health-screening project in the area of Vienna completed the IIEF-5 for evaluation of ED. In parallel, all men underwent a detailed health examination including physical assessment, evaluation of various life-style factors, medical history and a blood analysis. RESULTS: A total of 2869 men were analysed. According to the IIEF-5 score, 32.2% reported on any degree of ED (IIEF-5 score <22), 23.7% had mild ED (IIEF-5 score 17-21), 5.0% mild to moderate ED (IIEF-5 score 12-16), 2.2% moderate ED (IIEF-5 score 8-11) and 1.3% severe ED (IIEF-5 score 5-7). The proportion of men with ED remained stable from 20 to 50 years (26-29%) and increased thereafter to 37.5% (51-60 years) and to 71.2% in those 71-80 years of age. Severe ED (IIEF-5 score 5-7) increased from 0.4% (20-30 years) to 0.5% (41-50 years), 1.3% (51-60 years) and to 9.6% in those aged 71-80 years. Risk factors for ED were age, diabetes (OR: 3.0; 95%CI: 1.53-5.87), hyperlipidemia (OR: 2.29; 95%CI: 1.42-3.7), lower urinary tract symptoms (OR: 2.2; 95%CI: 1.76-2.76), hypertension (OR: 2.05; 95%CI: 1.61-2.6), psychological stress (OR: 1.68; 95%CI: 1.43-1.98) and low physical activity (OR: 1.35; 95%CI: 1.15-1.6) (all, p < 0.05). CONCLUSION: Overall, 32.2% of men in our study had ED according to the IIEF-5. Apart from age, most important risk factors for ED were diabetes, hyperlipidemia, lower urinary tract symptoms, hypertension and psychological stress.

Adult↗

Prevalence of the overactive bladder syndrome by applying the International Continence Society definition.

PURPOSE: To determine the prevalence of the overactive bladder (OAB) syndrome in an urban population by using the International Continence Society (ICS) definition and to determine its impact on quality of life and sexual function. METHODS: Women and men participating in a health screening project in the area of Vienna completed the Bristol Lower Urinary Tract Symptoms (LUTS) questionnaire. To assess the prevalence of OAB the 2002 ICS definition was applied. In addition, all participants underwent a detailed health examination, including physical assessment, evaluation of life style factors, laboratory study and urinalysis. RESULTS: A total of 1199 men and 1219 women aged 20-91 years were analysed. The prevalence of OAB in men (48.5+/-13.1 years) was 10.2% (OABdry: 8.4%; OABwet: 1.8%) and 16.8% in women (49.5+/-13.5 years; OABdry:10.3%; OABwet: 6.5%). In women, the prevalence of OABdry remained fairly stable over 6 life decades, while OABwet increased substantially after the age of 40 years. In men OABwet and OABdry increased after the third life decade. In men with OAB, 48% did not report a negative impact on quality of life, 36% had minimal, 9.8% moderate and 2.5% severe impairment; the respective percentages for women were 53%, 33%, 7.3% and 6.3%. OABwet had a more profound impact on quality of life. A negative impact of OAB on sexuality was reported by 24% of men and 31% of women. CONCLUSION: The high prevalence of OAB in this population, its negative impact of quality of life and sexuality underline the importance of this syndrome.

Adult↗

Is erectile dysfunction an indicator for increased risk of coronary heart disease and stroke?

BACKGROUND: Considered to be a manifestation of a generalized vascular disease, erectile dysfunction (ED) could serve as an indicator for future cardiovascular events. Aim of this study was therefore to evaluate the role of ED as a predictor for coronary heart disease (CHD) and stroke. METHODS: Men participating in a health-screening project in the area of Vienna completed the International Index of Erectile Function-5 questionnaire (IIEF5) to assess prevalence and severity of ED. Additionally, all men underwent a detailed health examination. The risk for CHD or stroke within 10 years depending on the severity of ED was estimated according to Framingham risk profile algorithms. RESULTS: In the CHD risk cohort (n = 2.495; 46.2 +/- 9.9 yrs) men with moderate/severe ED (IIEF5 5-16; n = 163) had a 65% increased relative risk for developing CHD within 10 yrs compared to those without ED (IIEF5 22-25; n = 1.784) (absolute risk: 8.0% for no ED to 13.2% for moderate/severe ED; p < 0.001). Relative risk increase ranged from 13.9% for those aged 30-39 yrs (p = 0.121), to 42.2% for 40-49 yrs (p = 0.012), 27.7% for 50-59 yrs (p = 0.048) and 27.1% for 60-69 yrs (p = 0.021). In the stroke risk population (n = 644; 61.3 +/- 5.1 yrs) men with moderate/severe ED (n = 99) were at a 43% relative risk increase for a stroke within 10 years (absolute risk: 9.3% for no ED to 13.3% for moderate/severe ED; p = 0.041). Increased risk varied between 38.6% for men aged 55-59 yrs (p = 0.013), 24.7% for 60-64 yrs (p = 0.072), 35.9% for 65-69 yrs (p = 0.046) and 43.6% for 70-74 yrs (p = 0.049). CONCLUSIONS: Moderate to severe ED, but not mild ED is associated with a considerably increased risk for CHD or stroke within 10 years. A thorough medical surveillance seems therefore advisable for men with ED including cardiological evaluation, treatment of risk factors and lifestyle modifications.

Adult↗

The effect on erectile function of 103palladium implantation for localized prostate cancer.

OBJECTIVE: To determine in a prospective study the effect on erectile function of (103)Pd brachytherapy for localized prostate cancer, using a validated questionnaire. PATIENTS AND METHODS: Between July 1999 and April 2003, 113 men with localized prostate cancer were treated by permanent implantation of (103)Pd seeds, of whom 78 with a follow-up of 30 months were included in this study. No patient received supplemental external beam radiation therapy. At baseline and 3-month intervals, erectile function (EF) was assessed by the EF domain score of the International Index of Erectile Function-15 (IIEF-15); 77% received (neo)adjuvant antiandrogen therapy for up to 3 months. RESULTS: At baseline, 27 (35%) patients had no erectile dysfunction (ED; EF domain score 26-30), 24 (31%) had mild/moderate ED (score 11-25) and 27 (35%) severe ED (score 6-10). The mean EF domain score decreased from 17 to 12 (P < 0.001) after 30 months. Overall, 52 men (67%, including those with severe ED at baseline) remained in the same ED category at 30 months after therapy as before, 12 (15%) deteriorated by one category, 14 (18%) by two or more, and no patient improved. Of the 27 patients fully potent (score 26-30) at baseline, 37% remained so after 30 months, 19% developed mild and the remaining 44% moderate/severe ED. In a multivariate analysis, neither age nor preoperative prostate-specific antigen level, prostate volume, D90, hormonal treatment, diabetes, smoking or hypertension were predictive of preserving potency (P > 0.05). CONCLUSIONS: There was a high prevalence of pre-existing ED in these men; 57% of men fully potent or with mild ED at baseline remained so 30 months after brachytherapy.

Aged↗

Female sexual dysfunction in a healthy Austrian cohort: prevalence and risk factors.

PURPOSE: Data on prevalence and risk factors for female sexual dysfunction (FSD) are rare, particularly from Europe. Aim of our study was therefore to investigate this issue in a cohort of women undergoing a health investigation. PATIENTS AND METHODS: A consecutive series of women aged 20-80 years participating in a health-screening project in Vienna underwent a detailed health investigation and completed a 23-item questionnaire on several aspects of FSD including desire, arousal, pain and orgasmic disorders. Prevalence of FSD in different age groups and risk factors for FSD were calculated. RESULTS: A total of 703 women aged 43+/-15 years entered this study. Within the total study population, 22% reported on desire disorders, 35% on arousal disorders, and 39% on orgasmic problems, all of which increased significantly with age. Pain disorders were reported by 12.8% being most frequently in the women aged 20-39 years. In women aged 60-69 years, still 50% reported having at least "occasionally" sexual desire and 30% had more than two sexual intercourses per month. In this age group, 50% stated that a healthy sexual life is at least moderately important to them. Apart from age few risk factors for FSD were identified. Sportive activity was the only correlate to desire- and arousal disorders, psychological stress for orgasmic disorders. CONCLUSIONS: This study provides insights into age-specific changes of FSD in apparently healthy women. The importance of this subject is underlined by the high prevalence of FSD particularly in the elderly paralleled by a persisting interest in sexual activity.

Adult↗

Elective open nephron-sparing surgery for renal masses: single-center experience with 129 consecutive patients.

OBJECTIVES: To present our experience with elective, open, nephron-sparing surgery for renal masses in a contemporary, consecutive series. METHODS: In this retrospective study, the files of all patients who underwent elective nephron-sparing surgery between January 1996 and December 2002 at our institution were reviewed. The preoperative workup included renal ultrasonography and abdominal computed tomography. The histologic findings, complications, and oncologic outcome were studied. The surgical technique (ischemia and regional hypothermia) was identical in all patients. RESULTS: A total of 129 patients (mean age 61 years) were analyzed. The mean +/- standard deviation tumor size on preoperative computed tomography was 4.0 +/- 2.4 cm. Renal cell carcinoma was present in 86 patients (66.7%), a benign cyst in 18 (13.9%), oncocytoma in 10 (7.8%), angiomyolipoma in 7 (5.5%), adenoma in 4 (3.1%), xanthogranulomatous pyelonephritis in 3 (2.3%), and metastasis of a malignant melanoma in 1 patient. Two patients (1.6%) required secondary nephrectomy because of postoperative bleeding. After a median follow-up of 34 months (range 2 to 91), no patient had developed local recurrence, one (0.8%) had developed lymph node metastasis, and two (1.6%) had developed distant metastases. The creatinine clearance decreased from 77 +/- 27 mL/min before surgery to 64 +/- 23 mL/min after a median of 34 months. CONCLUSIONS: The results of this contemporary, monocenter experience underline the role of open, elective, nephron-sparing surgery for patients with small renal masses, particularly because benign histologic findings were present in almost one third of patients.

Adenoma↗