ERECTILE DYSFUNCTION AFTER TRANSURETHRAL PROSTATE RESECTION (TURP) IN PATIENTS WITH LOWER URINARY TRACT SYMPTOMS AT KOJA HOSPITAL, JAKARTA

Objective: Aim of this study is to identify risk factors associated with erectile dysfunction in post-transurethral prostate resection (TURP) patients for the management of benign prostatic hyperplasia (BPH). Material & Methods: During 2019, 22 patients met the TURP indication criteria in the urology polyclinic of Koja Hospital for symptomatic BPH management. All patients underwent transabdominal ultrasonography to confirm prostate volume and underwent laboratory tests to measure serum prostate-specific antigen (PSA). History of comorbidities such as diabetes mellitus, cardiovascular events, and hypertension was recorded. The patient's sexual function was determined using the International Index of Erectile Function questionnaire (IIEF-5) before surgery and six months postoperatively, where erectile dysfunction was established for scores below 21. Mean comparisons were made to see if there was a significant change in IIEF score six months postoperatively. Results: There were 22 subjects as samples with a mean age of 63 ± 3.8 years, prostate volume 47.64 ± 5.5 mL and a median PSA level of 3.3 [1-47] ng/dL. The comorbidities found in the subjects were diabetes mellitus (22.7%), cardiovascular events (36.4%), and hypertension (27.3%). The mean IIEF-5 score before surgery was 14.55 ± 0.78 and was not significantly different (p= 0.225) with a reevaluation six months after surgery of 14.18 ± 0.76. Conclusion: There was no change in the severity of erectile dysfunction in patients undergoing TURP surgery.

Penile arterial communications and severity of erectile dysfunction, evaluation by color Doppler ultrasound

Objective: The purpose of this study was to evaluate the inflow and outflow communications of the cavernous arteries to the extra cavernous arteries and their association with erectile dysfunction. Materials and methods: An observational, analytical, cross-sectional study was conducted which included 63 patients complaining of erectile dysfunction that had been referred from the urology and andrology services for a penile color Doppler study with a pharmacological test. Severity was classified in accordance with the erection phases evaluated by a Doppler ultrasound and its clinical correlation. Results: There were 63 patients, 22–83 years of age, having variable degrees of erectile dysfunction that were analyzed. In 59 patients (93.6%) some arterial communication was seen. Regardless of the collateral artery involved, we found that with each collateral passing through the tunica albuginea and showing outflow from the cavernous arteries the severity of erectile dysfunction was worsened. prevalence ratio of 1.33 (95% confidence interval 1.13–1.56, value of p=0.001). Conclusions: The helicine arteries seem to participate in the phases of erection and detumescence, and dysfunction of their flow mechanism may be the first step in erectile dysfunction. Hence the importance of exploring new vascular factors that might affect the erectile mechanism and thus propose new lines of treatment. Level of evidence:

Hormone profile and erectile dysfunction in men with vibration disease

Vibration disease (WB) is one of the leading diseases among workers at engineering enterprises, in the metallurgical, mining and construction industries, and in various branches of agriculture. The purpose of the study was to study the state of the hormonal profile and the severity of erectile dysfunction in men with vibrational disease. Violations of interaction in the system of the hypothalamic-pituitary-gonadal system in men with EF from the effects of general vibration, which is a harmful production factor in drivers of heavy vehicles, machine operators of agricultural enterprises, were revealed. The decrease in testosterone does not reach statistically significant changes compared with the control group and does not cause the naturally expected increase in the secretion of follicle-stimulating hormone and luteinizing hormone according to the law of feedback.