Association of Erectile Dysfunction and Hypogonadism with Metabolic Syndrome in Men with Lower Urinary Tract Symptoms of Younger and Older Age Groups

The aim of this study was to evaluate the incidence and severity of erectile dysfunction (ED) and hypogonadism in 193 men presenting with lower urinary tract symptoms (LUTSs) in the younger (20 - 39 years old) and older (40 - 60 years old) age groups depending on the presence of metabolic syndrome (MetS). Triglycerides, glucose and high-density lipoprotein cholesterol, serum total testosterone (TT), sex hormone-binding globulin, prostate-specific antigen, pituitary hormones levels were measured in serum. Standardized criteria (2009) were used to determine the prevalence of MetS. Patients were assessed based on the International Prostate Symptom Score (IPSS) and the IPSS-Quality of Life (IPSS-QoL) for LUTSs and the International Index of Erectile Function (IIEF) for ED. Hypogonadism was determined in accordance with the ISA, ISSAM, EAU, EAA and ASA recommendations. In men with MetS in the younger age group the incidence of ED was 2.4 times higher, and that of low TT level and hypogonadism was 8.4 times higher compared to men without the syndrome. In the older age group, an increased incidence of ED and low TT level in men with MetS compared to men without the syndrome was on the trend level, but the incidence of hypogonadism was for sure higher (by 1.6 times). In conclusion, the study showed that ED and hypogonadism are associated with MetS by a high degree of certainty in young men with LUTSs. In men of the older age group with LUTSs, the presence of MetS is not so clearly associated with ED and hypogonadism due to the fact that the incidence of these urogenital diseases is also high in men without MetS.

The “Kiel Knots” Technique for Treatment of Congenital and Acquired Penile Deviation

Objectives: We propose a surgical correction of the penile curvature applying a technique based on the 16-dot plication technique modified by burying the knots in a shallow trough of incised tunica. We entitle this modification the “Kiel Knots”. Material and methods: 20 patients with a penile deviation, average age 36.8 years (24 - 52) were operated. Follow-up time was 26 months. In 8 patients the deviation was congenital, in 12 patients it was an acquired deviation. The deviation was >30? in all patients. Surgical technique: A circumcising incision was made and the penis was degloved. Buck’s fascia was incised exposing the tunica albuginea opposite the curvature. 8 dots were marked bilaterally on the tunica albugineaand a5 mmincision along the marks was made without cutting into the Corpus cavernosum. Instead of plicating with one suture for 4 dots, our modification uses one suture for two dots with the knot buried in a shallow trough created by a scalpel. Results: The average operation time was 64 minutes. We observed a loss of penile length in 30% of the patients (0.5 - 1 cm). There were no problems with erectile function. In a follow-up of 2 years, 90% of the patients remained without recurrence of deviation. None of patients reported problems with the suture knots. Conclusion: Our technique achieves penile straightening with minimal loss of length and no erectile dysfunction.

The Recollection of Morning Sickness and Their Support System as Documented by Women Post Pregnancy

Nausea during pregnancy affects about ten percent of all pregnant women. The causes of nausea and vomiting during pregnancy are unclear. The condition can lead to dehydration, electrolyte derangement, impaired organ function and lead to serious health issues or even death if left untreated. The treatment conducted today is symptomatic and is not completely satisfactory. Objective: The purpose of the study was to describe women’s experience of morning sickness and their experience of support. Design: Data was collected through a semi-structured questionnaire and analyzed by qualitative content analysis. Participants: Nine women responded to the survey. Results: The result shows that women who suffer from morning sickness during pregnancy feel a loss of control over their lives which has a significant impact on their mental and physical health making it difficult to function normally. Feelings of isolation, loneliness and alienation are common. It is essential that midwives are attentive in order to provide the help and support that these women require. Conclusion: It is essential that the personnel providing the care are knowledgeable about the condition. More research is necessary to find the root cause of the condition in order to develop effective strategies for treatment.

Assessment of Knowledge, Attitudes and Practices Related to Contraceptive Use among Teenagers in High Schools and Colleges in Dakar, Senegal

Introduction: In Senegal, adolescents aged 10 to 19 years represent 22.9% of the total population. The unmet need for contraception in this part of the population remains high despite the health interventions implemented to promote their sexual health. The aim of this study is to analyze the practice of modern contraception in schools in Dakar high schools in Senegal during the year 2018. Methods: A cross-sectional study was conducted in high schools and colleges in Dakar from March 1 to April 30, 2018. This study involved 452 students. This was a self-administration of the questionnaires. After univaried and bivaried analyses, a multivariate logistic analysis identified the factors associated with students’ use of modern contraception. Results: The prevalence of modern contraceptive use among students is 8.84%. Factors associated with the use of modern contraceptive methods among students were age over 18 years (AR: 4.7, 95% CI [1.02 - 22.5]), male sex (AR: 27.8, 95% CI [6.8 - 100.0]), secondary school level (AR: 10.6, 95% CI [2.1 - 53.0]), access to a youth socio-educational home (AR: 3.9, 95% CI [1.1 - 14.9]) and having a child (AR: 25.6, 95% CI [2.2 - 100.0]). Conclusion: Our results concluded that modern contraceptive needs were better met among older male students, those who had an unfortunate experience of unwanted pregnancy and those attending school’s youth socio-educational homes. This suggests shortcomings in the promotion of sexual health among younger students, particularly those in the secondary grades.

Testosterone and Its Analogs as a Male Contraceptive

Male contraception by means of hormonal approach was initiated more than 60 years ago when men became azoospermic with administration of testosterone. The basic principle of male hormonal contraception is suppression of spermatogenesis. Exogenous testosterone/testosterone analogs alone or in combination with progestin have been tested for contraceptive efficacy by inhibiting gonadotropins release from pituitary gland. In this review article, advancement in different testosterone preparation tested alone or in combination for contraceptive efficacy has been focused. Administration of testosterone or testosterone analogs alone failed to provide uniform azoospermia or severe oligospermia (gestin combination has proved better contraceptive efficacy than testosterone alone. Further, long term studies with hormonal regimens and other alternative approaches are required with fewer side effects for development of safe and reversible contraceptive.

Biker’s Nodule: A Perineal Nodular Induration of the Cyclist

A case of “biker’s nodule” in an 80 year-old cyclist is reported. The “biker’s nodule” is caused by repeated microtrauma to the subcutaneous fatty tissue or collageneous tissue on the perineal region resulting in a perineal nodular induration.

Awareness and Factors Associated with Postpartum Modern Contraceptives Use among Women of Reproductive Age in Bukombe District, Geita Region

Introduction: Pregnancies that occur during the first year postpartum are more likely to be unplanned. This leads to an increased risk of adverse maternal and perinatal outcomes. However, modern contraceptive use during this period helps to reduce unplanned pregnancies and its associated adverse outcomes. There is scant data on postpartum contraceptives in pastoral communities in Tanzania. This study aimed to assess awareness and factors associated with postpartum modern contraceptives use among women of reproductive age in Bukombe District, Geita Region. Method: A community based cross-sectional study was conducted in a predominant pastoral community of Bukombe district in Geita region in north-western Tanzania from May-June 2018. A total of 511 postpartum women who were in their first year after child birth were studied. A multistage sampling technique was used to select study participants. Data analysis was performed using SPSS version 21. Multivariable logistic regression analysis was used to determine independent predictors of postpartum modern contraceptive use. Results: Most (97.3%) of the participants were aware about modern contraceptives. The prevalence of postpartum modern contraceptive use was 11.9%. The most frequent used contraceptive method was Implant 6.5%. Majority (75%) of women started to use the contraceptive at the first three months after delivery. Living in urban (AOR = 1.84, 95% CI: 1.20 - 3.79), business women’s (AOR = 2.34, 95% CI: 1.31 - 2.28), having last born aged 3 - 4 months (AOR = 3.30, 95% CI: 1.11 - 9.85) and menses resumption (AOR = 9.23, 95% CI: 3.60 - 23.72) were associated with postpartum modern contraceptive use. Fear of side effects, poor knowledge about contraceptives, husband restrictions, distance to health facility and availability of contraceptive were the barriers for use of contraceptive use. Conclusion: We found low uptake of postpartum modern contraceptive use in this population. Numerous factors were associated with modern contraceptive use. Therefore, health communication targeting this group is warranted to improve modern contraceptive uptake.

Strengthening Weak Healthcare Systems for Maternal and Neonatal Care in Low and Middle Income Countries: The Missing Link

Introduction: Preventable maternal and newborn mortalities still occur in local communities in Kenya since access to maternal and newborn healthcare services remains a big challenge. Barriers to access in resource-constrained settings have not been examined adequately in literature. The World Health Organization (WHO) has 6 building blocks for strengthening healthcare systems that informed this study. This paper examines how user-side and institutional factors influence access and use of Maternal and Newborn Healthcare (MNH) Services in Matayos sub-County-Busia County. Methods: A mixed method approach, with an ethnographic inquiry and a descriptive cross-sectional design, was adopted to assess access to MNH services in Matayos-Busia County, Western Kenya. Postpartum women who had delivered within the previous 12 months and health care providers in the study area were recruited as respondents. A total of 348 postpartum women were selected through stratified systematic random sampling for the survey. Purposive sampling was used to select postpartum women, conventional and traditional health care providers for 16 in-depth interviews and 7 focus group discussions. Data were analyzed using descriptive and inferential statistics. Qualitative data analysis was done thematically. Results: Institutional delivery was low at 68% and family planning at 75% although demand for services was high at 99%. User-side barriers to access included shared beliefs and practices in the community;high direct transport costs from home;and high costs for missing drugs and other supplies in hospitals. Middle (5th-7th) order deliveries occurred at home with traditional birth attendants. The choice of place of delivery in households was influenced by spouses to respondents and communities of residence where respondents lived or were married. All 6 WHO health system building blocks were weak in Matayos sub-County and needed system-wide strengthening involving all pillars. The user-community voice alone was insufficient and the 7th pillar for user-community engagement was absent. The underlying factors were weak governance and underfunding for healthcare. Conclusion: The six WHO building blocks were inadequate due to weak governance and inadequate funding. User-community engagement, the 7th Pillar, was absent in these resource-limited settings. We recommend user-community empowerment, engagement and participation, adoption of a system thinking approach and adequate funding.

Typology and Etiology of Precocious Puberty in Sub-Saharan Africa:Report of 8 Cases in Abidjan,Ivory Coast

Introduction: Early puberty is defined by development of secondary sexual characteristics before the age of 8 years in girls and 9 years in boys. In the West, one in five children out of 100,000 is concerned. Little information on sub-Saharan African patients exists concerning this pathology. Objective: To determine the etiology and clinical characteristics of early puberty in a cohort of Ivorian children. Methods: We conducted a cross-sectional study between 2015 and 2017 in children admitted to early puberty in the unique Endocrinology Service of the country. The epidemiology and clinical characteristics were assessed. Results: The eight patients involved were all females. Their mean age at diagnosis was 7 years and 3 months and the mean age of first symptoms begun at 5 years and 6 months. Seven patients had a central precocious puberty (CPP) including five cases of idiopathic CPP (ICPP) treated by (GnRH agonist) and two cases with secondary precocious puberty (SPP). One of them has a hypothalamic hamartoma and the other a sequelae of encephalopathy. The last case had a peripheral precocious puberty (PPP) causes by ovarian dystrophy. Conclusion: Our results confirm the predominance of idiopathic central precocious puberty particularly in girls.

Sperm Quality and Environment: A Retrospective, Cohort Study among 21,715 Semen Samples in a Southern Province of China

To explore the differences of male semen parameters in different seasons of the year, so as to explore the potential climatic factors affecting spermatogenesis and male reproductive ability, we retrospectively analyzed 21,715 semen analysis data from January 2018 to February 2021, grouped by year and season, and finally the relationships among semen parameters and semen and meteorological parameters were compared. Environmental exposures prior to 3 months were analyzed and correlation analysis was performed.The semen concentration decreased year by year (p < 0.01). However, the Progressive motility (PR) and total PR number had been increased (p < 0.01). There were statistical differences in sperm parameters which include semen volume, sperm concentration, total sperm number, progressive motility (PR), total PR number and total motility in different seasons, winter and spring were better than summer and autumn (p < 0.01). Total sperm number and sperm concentration were positively correlated with PR (R = 0.420, R = 0.440, p < 0.01). There was no correlation between daylight duration and semen parameters. Sperm parameters were positively or negatively correlated with environmental temperature, air pressure or humidity which had an overall effect on semen quality. It is suggested that seasonal factors should be considered when evaluating male reproductive ability. Besides referring to conventional semen parameters, other factors such as season and climate should also be considered.

Sexual Function in Patients with PCOS and/or Obesity before and after Metformin Treatment

The clinical signs of hyperandrogenemia, commonly seen in polycystic ovarian syndrome (PCOS) patients combined with obesity and infertility can cause emotional distress. There are however few data about the psychosocial and sexual function of patients with PCOS. Objectives: The aim of the study was to investigate the sexual function in patients with obesity and/or PCOS using Female sexual function inventory (FSFI) before and after metformin treatment. Design and Methods: In the present study were included 79 patients divided into three groups—group 1 Obese (n = 22);group 2 Lean PCOS (n = 41) and group 3 Obese PCOS (n = 16). All of the subjects completed FSFI questionnaire. In patients who had insulin resistance (OGTT + IRI) metformin treatment was started in dose 1700 - 3000 mg/day. Results: Obese women without PCOS showed significantly higher scores on total FSFI and all domains except from desire compared to lean PCOS subjects. Although the differences do not reach statistical significance, lean PCOS patients have the lowest scores on all domains. FSFI score correlates negatively only with androstendione levels. Women with and without hyperandrogenemia do not show differences in FSFI score. It is interesting to note that LH but not FSH shows moderate positive correlation to all domains of FSFI. FSFI scores do not show correlation to the indices of carbohydrate metabolism (blood glucose and IRI during OGTT), lipid profile, and arterial pressure. After metformin treatment there was an increase in all FSFI domain scores although statistical significance was noted only for the total FSFI score and the domains lubrication and pain, probably because of the small number of patients. Conclusions: Lean PCOS patients have lower scores on FSFI than obese patients with or without PCOS. The hyperandrogenemia is not a determinant for sexual dysfunction in PCOS women. Metformin treatment has a favorable effect on sexual function.

Low Testosterone—An Important Predictor of Low Mineral Bone Density in Young Men—Our Own Experience and a Review of Literature

Urologists and reproductive endocrinologists have become the first contact physicians for young men of reproductive age and have the unique opportunity to positively affect men’s health and quality of life. Growing evidence indicates that a significant proportion of men presenting with infertility or sexual dysfunction are hypogonadal. One hundred ninety nine men were enrolled in our center, and mean total testosterone was = 122, 57%), osteopenia (n = 69, 39%) and osteoporosis (n = 8, 4%). There were no differences in the mean age (p 0.64), height (p 0.99) and weight (p 0.02). Our results indicate that hypogonadism is one of the main risk factors for osteopenia and osteoporosis which can be found in 8% of hypogonadal men younger than 50 years of age. Testosterone replacement therapy may be indicated in most men with hypogonadism and low bone mineral density (BMD);however the benefits of testosterone treatment in eugonadal men are unproven. Selective estradiol and androgen receptor modulators expand our treatment modalities in men of reproductive age when suppression of gonadotropins may interfere with reproductive plans. Early detection of hypogonadism and osteoporosis may lower the risk of hip and vertebral fractures in some men. Further prospective RCTs are needed to prove cost-effectiveness of detection and the best treatment of osteoporosis in hypogonadal men of reproductive age. Urologists have the opportunity to be at the forefront of greater awareness of this clinical problem due to their frequent contact with this population of patients.

Sexual Behaviors in Women with Primary and Secondary Provoked Vestibulodynia: A Controlled Study

Introduction: Provoked vestibulodynia affects 12% of the general female population and more specifically, 21% of women aged less than 30 years. Primary and secondary vestibulodynia are hypothesized to represent the endpoints of different etiologic pathways, although there is still little research addressing potential distinctions between these two groups, particularly with regard to sexuality. Aims: To compare sexual activity and behavior of women with provoked primary vestibulodynia (PVD1) and secondary vestibulodynia (PVD2) against age-matched controls. Methods: Fifty-seven participants (N = 57), mean age 25.72 (18-41) recruited from a gynecology clinic underwent a gynaecological examination and completed a self-report questionnaire: 20 (N = 20) were diagnosed with primary provoked vestibulodynia (PVD1), 19 (N = 19) with secondary provoked vestibulodynia (PVD2), and 18 (N = 18) were medically confirmed as no-pain controls. Main outcome: To verify any differences in the sexual behavior between primary, secondary vestibulodynias and controls. Results: Mean pain duration differed significantly in participants with PVD1 at 73.8 months against those with PVD2 at 37.4 months (p = 0.003). Frequency of sexual activity also differed significantly between the three groups (p = 0.012): the controls were at 27.8% against 0% in primary and secondary vestibulodynias for once or more a day. No significant difference was observed for the sexual arousal time and masturbation frequency. Vaginal penetration was overrepresented in controls (p 0.001) contrary to fellatio frequency (p = 0.016). Pain digital test was significantly different between the three groups in one finger (3.85 vs 0.08), two fingers (4.39 vs 0.06) or three fingers (5.39 vs 0.56) (PVD1 against controls), lubricated inserted fingers for pain verification (p 0.001). Conclusions: Provoked vestibulodynia generates problems in the sexual response and coital activity, this syndrome reflecting absence of pre-existing sexual problems, notably in the masturbatory activity and oral receptive female sex.

The Clinical Outcomes of Mosaic Embryo Transfer in Preimplantation Genetic Testing Cycles

Purpose: We aimed to analyze the pregnancy outcomes and perinatal follow-up of mosaic embryo transfer in the preimplantation genetic testing (PGT) cycles. Method: We retrospectively selected 27 mosaic embryo transfer cycles as the study group and 97 euploid embryo transfer cycles as the control group after propensity score matching, which were performed in the reproductive medicine center of the Sixth Affiliated Hospital, Sun Yat-sen University, from March 2019 to September 2023. The biopsy cells from blastocyst were undertaken next generation sequencing (NGS). Results: No significant difference in pregnancy outcomes compared between the two groups. According to the size of aneuploid, fragment the level of mosaicism or blastocyst morphological gradings, there were no significant difference in mosaic embryo transfers. Conclusion: Mosaic embryo detected in the PGT cycle can lead to clinical pregnancy and live birth of healthy offspring, which can be considerate suitable for transfer.

Tye &Sardi’s Psychological, Psychosocial, and Psychosexual Aspects of Penile Circumcision*

Tye and Sardi recently reviewed the evidence purporting to implicate male circumcision, especially when performed early in infancy, in psychological problems in men. Here we provide a critical evaluation to determine the veracity of their evidence and claims. Missing from their review were critiques pointing out fundamental flaws in key studies. We argue that psychological stress in some men may be caused by anti-circumcision propaganda telling them that they are victims of “genital mutilation”, a term adopted from dissimilar female practices in particular ethnic groups. Sexual dissatisfaction results. We critically discuss claims about foreskin “gliding”, the eccentric foreskin-related sexual practice of “docking”, and the use of lubricant in masturbation. We further find that a study claiming to show numerous differences in socio-affective processing in men circumcised as neonates stem from statistically flawed and one-sided data that has been misinterpreted, and in fact shows the opposite of the hypothesis that psychological problems in some men can be attributed to the pain of their circumcision as newborns. Importantly, since the brain regions responsible for empathy, namely subcortical gray matter and white matter in frontal and parietal regions, were similar in neonatally circumcised and uncircumcised men, the null hypothesis remains null. In conclusion, we find no compelling evidence to support newborn circumcision pain being responsible for psychological problems in neonatally circumcised men. Men who come to believe that they are victims of their infant circumcision are in actual fact likely victims of false claims perpetrated by activist community groups with trenchant opposition to circumcision.

Sexuality of Repartnered Men and Women in France: Sexual Behaviors, Perceptions, Expectations and Sexual Dysfunctions

Introduction. Although many epidemiological studies on sexuality have been published, none have specifically addressed male and female sexuality in repartnered couples. Aim. To investigate men and women’s sexual behaviors, perceptions and expectations, and the frequency of their sexual dysfunctions, with a focus on repartnered couples, i.e, subjects living with a partner in a stable relationship after divorce or widowhood (including both remarried couples and cohabitating unmarried couples). Methods. Analysis of telephone survey data collected from 1,002 French subjects (483 men, 519 women) ≥35years. Of these, 748 were living with their partner as part of a heterosexual couple. For these subjects, the sexuality of 149 repartnered subjects was compared to that of the other 599 subjects. Main Outcome Measures. A 39-item questionnaire assessing subjects' perceptions, expectations, sexual behaviors and dysfunctions. Results. Compared with other subjects, men and women in repartnered couples had more active sexuality and more interest in sexuality (men 93% vs 80%, P < 0.01, women 73% vs 65%, P < 0.05). They were generally more sensitive to feelings and emotions linked to their sexuality, and these feelings seemed to increase steadily with age. Their sexuality was more attuned to their partner’s pleasure (men 79% vs. 59% P < 0.001, women 50% vs. 34% P < 0.01). Concern for the future of the relationship and for sexuality was equally present for both groups, although repartnered couples were more often concerned about potential inadequacy and conflicts between the two partners. Although repartnered men seemed to be less affected by diminished desire, they had slightly higher rates of premature ejaculation and erectile dysfunction, and considered their quality of life to be more affected by these problems. Conclusion. The sexuality of repartnered couples remains poorly studied, but seems to differ from that of non-repartnered couples. Our findings open interesting avenues of research on the diagnosis and management of repartnered couples.

Aphrodisiac Activity of Aqueous Extract of <i>Phoenix dactylifera</i>Pollen in Male Rats

Aim of study: Ancient literature alluded to the use of a number of plants/preparations as sex enhancer. One of such botanicals is Phoenix dactylifera in which the pollen grain has been acclaimed to be used as an aphrodisiac. However, the validity has not been scientifically tested. Dopamine is known to facilitate male sexual function. Therefore, the present study was undertaken to evaluate the effect of aqueous extract of Phoenix dactylifera pollen on the sexual behavior of male rats and to measure of serum Estradiol and Testostrone. Also, dopamine transmission in the nucleus accumbence (NAc) was studied in male rats using in vivo microdialysis. Methods and Materials: sixty male rats were randomized into 6 groups (A-F). Group A received 0.2 ml of Normal Saline mixed with Dimethyl Sulphate (DMSO), while groups B-F were injected same volume containing 35 mg/kg, 70 mg/kg, 105 mg/kg, 140 mg/kg and 350 mg/kg of DPP extract, respectively. Sexual behavioral parameters including mounting, intromission and ejaculation frequencies and latencies were recorded in male rats one hour after injection of extract by mating with a receptive female (1:1). The male serum testosterone and estradiol concentrations were also determined. Results: All doses stimulated male sexual behavior. Extract significantly increased mount, ejaculation, intromission frequencies and ejaculation latency in comparison to controlled ones (p 0.001). Mount and intromission latencies significantly reduced (p 0.001). Maximum effect was observed in dose 140 mg/kg. This extract was found to enhance Testestrone, Estradiol and the orientation of males toward female ones by increasing mounting and ano-genital investigatory behavior. Conclusions: Data from this study identified that the aqueous extract of Phoenix dactylifera pollen grain enhanced sexual behaviour in male rats. The improved sexual appetitive behaviour in male rats may be attributed, to the alkaloids, saponins, and or flavonoids since these phytochemicals has engorgement, androgen enhancing. Also, our findings support the traditional use of this plant as acclaimed aphrodisiac and for the treatment of pre-ejaculation and impotency.

Effect of Intrauterine Laser Therapy at the IVF Success Rate on Infertile Patients with a History of IVF Failure: A Pilot Non-Blinded Study

Backgrounds: While there’s developing proof aimed toward improving embryo implantation thru a focal point on great development, restrained studies have been performed on enhancing endometrial receptivity. Intrauterine Laser Therapy (LT) can be powerful in selling endometrial cell proliferation, therefore enhancing the achievement of assisted reproductive techniques (ART). The contemporary look at aimed to research the effectiveness of effective intrauterine lasers in growing endometrial thickness and the achievement of being pregnant rate. Materials and Methods: In the current clinical randomized trial (RTC) study, the infertile women (20 - 42 years old) referred to the infertility clinic in 2023-2024 who were candidates for IVF treatment with recurrent implantation failure (RIF) history were included. The patients were divided into two main groups: the intervention group;low level laser therapy (LLLT) after hormone administration) (n = 52) and the control group (hormone administration without LT) (n = 52). The IVF success rate and change in endometrial thickness before and after the LT were compared in groups. Results: There was a significant difference between groups (p Conclusion: It appears that the incorporation of Intrauterine LT in the realm of infertility could significantly impact as a novel supplementary treatment in improving endometrial receptivity and pregnancy rate.

Sclerotherapy with Leuprolide and Cefoperazone Sulbactam in the Management of Ovarian Endometriomas under Ultrasound Guidance: A Novel Approach

Endometriosis is an estrogen dependent gynecological disorder, which can occur throughout the reproductive age of women, causing chronic pelvic pain, substantial morbidity, and impaired fertility. It is clinically defined as the presence of ectopic endometrium resulting in sustained inflammatory reaction. In India, about 29,000,000 women suffer from endometriosis. Severe pelvic pain and recurrent endometriomas were observed even after surgery. We have conducted aspirations totally in 110 patients in which most of the patients were suffering from Stage III & Stage IV of endometriosis except for 7 patients for whom we have done as primary therapy for endometriomas. Among 110 patients, 4 patients didn’t turn up for follow up after first aspiration. This pilot study conducted with 110 patients in Ponni Hospital and Fertility Research Centre, Madurai aimed to evaluate pregnancy outcome in 51 infertile patients, and to alleviate pelvic pain, to restore a healthy sexual life and to reduce the recurrence rate of Ovarian Endometriomas (OE) in 59 patients, who did not seek fertility, After using the newer sclerosing agent Leuprolide with Cefoperazone Sulbactam (LCS) under ultrasound guidance. This prospective pilot study resulted in a highly significant achievement in pregnancy where 41 patients conceived out of 51 patients (80.39%) only 6 are in ongoing treatment. Those who didn’t seek fertility were 59 of which 43 have completed family 13 have one child and 3 unmarried girls. 96.61% were relieved of pain and recurrence and restored healthy sexual life, 2 are in ongoing treatment. We have not encountered any adverse effects during this treatment.

Protective Sexual Behaviors and Their Motives, in University Students in the Health Area

Sexually transmitted infections (STIs) and unwanted pregnancy (UP) are becoming a problem that affects significantly the younger segment of the population so, not only in the aspect of health, but in the development of its future life both emotional and school and work. Despite easy access to information, young people still have risky sexual practices. This research highlights protective practices with the aim of developing information and training tools that help them avoid risky behaviors that lead to dangerous situations in health and its future. It was a descriptive study with students who have recently entered of the Faculty of Medicine enrolled in school cycle in 2015 in the bachelor’s degree in Medicine and surgery, Nutrition and dietetics, and Rehabilitation programs who agreed to participate by letter of informed consent to respond to the Instrument for the Evaluation of Psychological Variables and Sexual Risk Behaviors. There were 221 participants, 166 in Medicine and surgery, 28 in Nutrition and dietetics, and 27 in Rehabilitation with an average of 18.6 years, 51% male and 49% female. A protective behavior was not having had sex with penetration (72.3%), due to wanting to have them with whom they are in love and to avoid STIs more frequently in female;another protective behavior was not having had oral sex with occasional partners or unprotected sex workers (15.4%);the reasons were to have wanted to use and that the couple asked him to use it, to avoid sexually transmitted infections because the couple’s sexual history is unknown. Regarding the likelihood of having sexual penetration (SP), participants who have not had it were found that: the men had less possibility to inquire about their partner’s sexual history, to reject the proposal to have SP and to refuse caresses in sensitive areas of the woman’s body;when asked about the likelihood of asking your partner to use a condom in their sexual relations, both men and women agreed that it would be quite likely that they would do so, more frequently in women. It concludes by emphasizing that prevention remains the cheapest, easiest, most reliable and safest tool against STIs and UP.