A Cross-Sectional Study According to Risk Factors Associated with Erectile Dysfunction in Men

Background: Erectile dysfunction (ED) is a common condition in general population. It has a negative impact on the couple’s quality of life. In 1995, it was estimated that it affected 152 million people worldwide, and that it would affect more than 322 million people in 2025 with a large increase in developing countries. Several studies have suggested a causal link between ED and cardiovascular disease. In the Democratic Republic of Congo, no studies exist on this subject. Nonetheless, we are seeing increased promotion on the management of sexual disorders in our media, which could testify to the extent of this problem. Objective: To assess the extent of cardiovascular risk factors for ED in Kinshasa. Material and Methods: This is a cross-sectional study for analytical purposes. It collected several categories of individuals from May 1 to October 31, 2018. The severity of ED was assessed by the IIEF-5 score and the associated risk factors sought via logistic regression. Results: The mean age of the respondents was 59.9 ± 19.2 years, more than half of the respondents were over the age of 60 years old (60%). The ED proportion was 78.8%, and 75% of respondents had at least moderate ED. This anomaly was significantly elevated among respondents aged over 60 years (94.8%), diabetics (87.5%), hypertensive patients (92.3%) and stroke victims (86%). The independently associated risk factors were: age > 60 years [ORa: 9.87;95% CI: 6.42 - 10.48, p < 0.001], diabetes mellitus [ORa: 2.99;95% CI: 1.80 - 4.95, p = 0.013] and the stroke [ORa: 2.1;95% CI: 1.36 - 3.39;p = 0.012%]. The age threshold predicting ED was 67 years. Conclusion: ED is a frequent disorder in our environment and likely to affect the quality of life of men who suffer from it. There is an ED and cardiovascular risk factors correlation. A proactive attitude of the caregiver in current practice would allow early detection of ED with a view to early and optimal management.

Single incision slings:Are they ready for real life?

AIM: To review of the efficacy and safety outcomes of different single incision slings(SIS) systems, also in comparison with traditional slings.METHODS: A literature search was conducted in Pub Med/MEDLINE database. The research was restricted to randomized and/or prospective trials and retrospective studies, published after 2006, with at least 20 patients with non-neurogenic stress urinary incontinence(SUI). The studies had to assess efficacy and/or safety of the SIS with a minimum follow-up of 12 mo. All the paper assessing the performance of tension free vaginal tape secur were excluded from this review. The final selection included 19 papers fulfilling the aforementioned criteria. Two authors independently reviewed the selected papers.RESULTS: Four different SIS systems were analysed: Ajust&#174;, Ophira&#174;, Altis&#174; and Mini Arc&#174;. The average objective cure rate was 88%. Overall no statistically significant differences were found between SIS and traditional mid-urethral slings(MUS) in terms of objective cure(all P > 0.005). Only one paper showed a statistically lower success rate in Mini Arc&#174; vs Advantage&#174; slings(40% vs 90%) and higher rates of failure in the SIS group. Since there was a great variability in terms of tests performed, it was not possible to compare subjective cure between studies. The vast part of the studies showed no major complications after SIS surgery. We also observed very low reported pain rates in SIS patients. The RCTs on Ajust&#174; and Mini Arc&#174;, showed better outcomes in terms of post-operative pain compared to MUS. None of the patients reported longterm pain complains.CONCLUSION: SIS showed similar efficacy to that of traditional slings but lower short-term pain, complication and failure rates.