Age-Related Correlation Between Erectile Dysfunction and Premature Ejaculation

Background and objectiveTo evaluate the relationship between erectile dysfunction (ED) and premature ejaculation (PE) among men aged 40–79 years and to compare age-related differences between men aged 40–59 years and 60–79 years. Materials and methodsFrom January 2014 to January 2019, records of 892 men aged 40–79 years were analyzed. We performed correlation analysis using the self-reported intravaginal ejaculation latency time (IELT), premature ejaculatory diagnostic tool (PEDT), Male Sexual Health Questionnaire-ejaculation (MSHQ-EjD), and International Index of Erectile Function5 (IIEF5) questionnaires. ResultsThe mean age of the 892 males was 52.8 ± 7.3 years (40–76). All subjects were divided into group 1 (40–59 years old) and group 2 (60–79 years old). The IIEF5 score of group 1 was significantly higher than that of group 2 (18.7 ± 5.5 vs. 17.7 ± 5.7, p = 0.049). Of the total subjects, 71 (8%) had IELT value of less than 1 min. A total of 51 (6.9%) and 20 (13.5%) were in groups 1 and 2, respectively (p = 0.02). The PEDT total score was higher and more subjects were identified as suffering from PE (PEDT ≥ 9) from amongst the ED subjects (IIEF-5 ≤ 21). In both groups 1 and 2, more PE subjects were identified in ED subjects (IIEF-5 ≤ 21) than normal subjects (IIEF-5 > 21) (all p < 0.01). In the total subjects, group 1 and 2, the IIEF-5 and PEDT score showed a weak negative correlation (r = −0.302, r = −0.361, r = −0.248, all p < 0.01). In group 2, the IELT and MSHQ-EjD score also showed a weak positive correlation between the IIEF-5 score (r = 0.166, p = 0.044 and r = 0.164, p = 0.047, respectively). ConclusionMore subjects defined PE value as less than 1 min on the self-reported IELT in the elderly group ≥60 years than those among the 40–59 years age group; moreover, the lower the IIEF5 total score among subjects ≥ 60 years, the higher the PEDT score and the lower the IELT and MSHQ-EjD scores.

A Cross Sectional Examination of HIV, Aging, and Chronic Health Conditions among Gay and Bisexual Men

Purpose The purpose of this study was to evaluate the association between HIV status and the presence of chronic health conditions among gay and bisexual men (gbMSM). Most existing on this topic studies fail to account for behavioral factors—such as smoking and alcohol consumption—or focus on the general population without attention to the unique circumstances of gbMSM. Methods Sexually active gbMSM, aged >16 years, were recruited using respondent-driven sampling (RDS) between February 2012 and February 2015. HIV serology confirmed the HIV status. Chronic health conditions were classified into one of six broader categories (i.e., cardiovascular, cancer, gastrointestinal, respiratory, mental health, and other). Logistic regression models tested whether HIV status was associated with any of the six categories. All these models used an interaction term between HIV status and age, and adjusted for race/ethnicity, annual income, body mass index, daily smoking, and “risky drinking”. Results Overall, 223 HIV-positive gbMSM and 551 HIV-negative gbMSM reported histories of cardiovascular disease (16.1%), cancer (5.1%), gastrointestinal illness (7.2%), respiratory problems (16.1%), mental health conditions (49.2%), and “other” co-/morbidities (13.1%). Compared with older HIV-negative gbMSM, those with HIV were more likely to report cardiovascular (aOR=1.15, 95% CI:1.07, 1.24) and respiratory (aOR = 1.08, 95% CI:1.02, 1.14) disease. There were no differences by HIV status for other co-/morbidities. Conclusion Findings support the need for increased resources focused on aging, HIV, and cardiovascular and respiratory health among gbMSM aging with HIV.

Recommendations for Intervention Content to Enhance HIV Pre-Exposure Prophylaxis Uptake among Men Who have Sex with Men Receiving Care at Sexually Transmitted Disease Clinics

Background and objective Pre-exposure prophylaxis (PrEP) uptake has been suboptimal. Sexually transmitted disease (STD) clinics provide important opportunities to scale PrEP uptake. Material and methods To inform the development of a brief intervention to enhance PrEP uptake in STD clinics, we conducted 32 qualitative interviews to explore barriers and facilitators of PrEP uptake among PrEP eligible, PrEP naïve, and men who have sex with men (MSM) presenting for STD screening services. We also solicited input for intervention components to enhance PrEP uptake at STD clinics. Results Most participants’ self-perceived HIV risks were low despite reporting unprotected anal intercourse. Many were reluctant to take any medications, expressed apprehension about perceived side effects of PrEP, and were unaware of how to obtain PrEP. Participants recommended that interventions focusing on enhancing PrEP uptake in STD clinics should include: culturally tailored educational materials about PrEP, informational graphics indicating PrEP’s relative efficacy in reducing HIV transmission risks, and comprehensive PrEP navigation. Most participants did not feel strongly about gender, race or ethnicity of providers; however, nearly all preferred gay affirming providers. Brief interventions to enhance PrEP uptake among MSM in STD clinics should include efforts to raise self-awareness of HIV risk, provide information about PrEP’s efficacy relative to other interventions, underscore PrEP’s relatively few side effects, and provide culturally tailored messaging.

Febrile Urinary Tract Infection after Radical Cystectomy with Urinary Diversion: Different Characteristics in Patients with Ileal Conduit and Orthotopic Neobladder

Background and ObjectiveTo compare the incidence of febrile urinary tract infection (UTI) and bacterial identification between patients with orthotopic neobladder (ONB) and ileal conduit (IC). Materials and MethodsData of 164 patients who underwent radical cystectomy with ONB and IC for bladder cancer between January 2009 and January 2018 at our institution were analyzed. Febrile UTI observed was listed and subsequently compared. Incidence of febrile UTI, clinicopathological characteristics, and microorganisms identified were reported at 3 months interval; and preoperative predictors of febrile UTI were evaluated with Cox regression analysis. Patients were divided into ONB and IC. ResultsThe study cohort included 52 patients with ONB and 112 patients with IC. Febrile UTI was diagnosed in 49 (29.9%) patients. Compared to IC group, ONB group had significantly higher incidence of young age (p=0.00), lower cancer stage (p=0.013), longer hospital stay (p=0.049), longer operation time (p=0.00), and higher incidence of febrile UTI within the first 3 months after surgery (p=0.006). On univariable and multivariable analysis, factors associated with significantly increased febrile UTI risk were diabetes (odds ratio [OR]: 4.52; p=0.002) and ONB diversion (OR: 1.27; p=0.031). Forty-four (89.8%) patients were culture positive. However, significant difference in microorganisms was not detected between patients who under-went ONB or IC diversion. ConclusionDiabetes and ONB diversion were associated with higher risk symptomatic UTI following radical cystectomy.

Effects of Long-Term and Short-Term Cardiac Rehabilitation Programs on Cardiovascular Risk Factors and Physical Fitness after Percutaneous Coronary Intervention

BackgroundCardiac rehabilitation programs reduce the likelihood of relapse and cardiac arrest in patients with cor-onary artery disease. The goal of this study was to compare and analyze changes in cardiovascular risk factors and physical fitness in patients who participated in short-term (ST) and long-term (LT) cardiac rehabilitation programs following coronary artery percutaneous coronary intervention (PCI). MethodsThis study included 193 men aged ≥45 years who received PCI for coronary artery occlusive disease. The participants were divided into ST program participants (3 months, 108 participants; ST group) and LT program participants (12 months, 85 participants; LT group). Blood lipids analysis, body composition, and physical fitness tests were performed to assess cardiovascular risk factors and physical fitness. Paired t-test and two-way ANOVA with repeated measures were used to investigate the effect of the intervention. ResultsBoth groups had significant improvements after cardiac rehabilitation in body fat, high-density lipoprotein cholesterol, exercise duration, heart rate (HR) at rest, double product peak, VO2 peak, 6-min walking, and sit-to-stand, compared to baseline. The LT group also had significant improvements after cardiac rehabili-tation in waist circumference (WC), total cholesterol (TC), triglyceride (TG), and HR peak. LT group had significantly improved effect than ST group in WC, TC, TG, exercise time, HR peak, and 6-min walking. ConclusionThe cardiac rehabilitation program led to improved cardiovascular risk factors and physical fitness, and the LT program was more effective than the ST program.