Repercusiones psicológicas de la disfunción eréctil sobre la autoestima y autoconfianza

Two Birds with One Stone: Regular Use of PDE5 Inhibitors for Treating Male Patients with Erectile Dysfunction and Cardiovascular Diseases

Patients with cardiovascular disease (CVD) frequently have erectile dysfunction (ED) because the two conditions have similar risk factors and potential mechanisms. The therapeutic effect of CVD is strongly dependent upon long-term management of the condition. Patients with CVD tend to have poor medication compliance, and the coexistence of ED often discourages patients with CVD from continuing their long-term CVD management, thus worsening CVD treatment compliance. The two major reasons for poor compliance are that (i) the adverse effects of cardiovascular medications on erectile function drive people to reduce the prescribed dosage or even stop taking the medications to obtain satisfactory sexual arousal and (ii) a worsening mental state due to ED reduces medication compliance. The regular administration of phosphodiesterase-5 inhibitors (PDE5is) guarantees that the prescribed medication dosages are easy to comply with and that they improve the mental status of patients by enhancing their erectile function, resulting in improved long-term management of CVD through medication compliance. PDE5is themselves also play a role in reducing cardiovascular events and improving the prognosis. We recommend prescribing PDE5is for ED and suggest that PDE5i administration is a promising strategy to improve the long-term management of patients with both ED and CVD.

EDO, Delmaschio ACC, Horta ALDM. Sexualidade e qualidade de vida em homens com dificuldades sexuais

O presente estudo teve por objetivo investigar a sexualidade e a qualidade de vida de homens com dificuldades sexuais. Foram selecionados dez homens que procuraram o serviço de sexualidade do CIESEX/UNIFESP. A triagem foi realizada através de uma entrevista estruturada contendo dados sociodemográficos e informações sobre as queixas apresentadas. Optou-se pela utilização dos questionários The Golombok-Rust Inventory of Sexual Satisfaction (GRISS) e Short Form Health Survey 36-item (SF-36), preenchidos pelos próprios entrevistados. Os resultados apontaram que homens com dificuldades sexuais apresentam uma menor qualidade em seu funcionamento sexual, bem como uma diminuição dos aspectos emocionais na qualidade de vida. Tal quadro revela um campo a ser explorado, demonstrando a necessidade de estudos que investiguem a correlação entre as dificuldades sexuais e qualidade de vida.

Evaluation of the impact of the urinary symptoms on quality of life of patients with painful bladder syndrome/chronic pelvic pain and radiation cystitis: EURCIS study

OBJECTIVES

To evaluate the impact of urinary symptoms of Painful Bladder/Pelvic Pain Syndrome and Radiation Cystitis (PBCPPS) on the Quality of Life, and self-esteem of the patient.

MATERIAL AND METHODS

An observational, multicenter, epidemiological and cross-sectional study was performed on patients with Painful Bladder/Chronic Pelvic Pain Syndrome and Radiation Cystitis. Data was recorded on severity of urinary symptoms and QoL impairment using the PUF Score. The patients evaluated the QoL deterioration grade through the King's Health Questionnaire (KHQ), and the level of their anxiety and self-esteem with the Goldberg's Anxiety Scale (GAS) and Rosenberg's Self-Esteem Scale (RSES), respectively. Post-hoc comparisons were performed between the results of the KHQ of this study and a sample of patients with urinary incontinence (UI). Results on RSES were analyzed with data from the general population and from patients with erectile dysfunction.

RESULTS

A total of 530 cases, mostly female patients, who had been diagnosed with PBCPPS, were analyzed. High levels of deterioration in QoL were described: KHQ scores were significantly higher when compared with patients with UI (P<.01). Involvement of self-esteem was higher in patients with RC and men, who obtained scores similar to those of patients with erectile dysfunction.

CONCLUSIONS

Patients with Painful Bladder Syndrome/Chronic Pelvic Pain Syndrome and Radiation Cystitis present high levels of anxiety, and significant reductions in both quality of life and self-esteem. Especially for men, this affectation is similar to that caused by erectile dysfunction.