Introduction There are three phosphodiesterase type 5 (PDE5) inhibitors marketed, sildenafil, Vardenafil, and tadalafil for oral treatment of erectile dysfunction (ED). Although the treatment is simple and mostly effective, around 50% has ceased to use the medication within 2 years. One recently described way to improve the compliance is to let the patient try all the three PDE5 inhibitors and to prescribe the drug(s) he and his partner desires. Aim To study long-term compliance among patients who were treated according to this “three-drug regime.” Main Outcome Measures Compliance and reasons for discontinuation after >2 years. Methods The men who, during 2003, were enrolled in a treatment regime, where they had the opportunity to test all the three drugs and to chose the one(s) they preferred, were interviewed in 2006 by telephone concerning their ongoing ED treatment and the reason for discontinuation. Results Of the 138 men, mean age 60 years (36–79 years), who had been enrolled and successfully treated with the three-drug regime, 127 (92%) could be reached. The mean follow-up time was 27 months (23–34 months). Of the 127 men, as many as 109 (86%) were still using PDE5 inhibitors. A few (8%) used more than two tablets per week. The majority (44%) used one to two tablets per week or one to two per month (43%), the others (5%) less often. The causes for discontinuation were varying. The most common reason (N=7) was return of a satisfactory non-assisted erection. Seventy-five percent of the men used only one drug; the others switched between a short- and long-acting drug depending on the situation. It was not uncommon (25%) that the preference had changed during the 3 years of PDE5 inhibitor use. Conclusion To let patients with ED test the three available PDE5 inhibitors results in an unusually high compliance even under an extended period of time (>2 years).

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IntroductionTo prospectively evaluate if the inclusion of a clinical sexologist in a penile and sexual rehabilitation program improves sexual function one year after prostate cancer surgery.Material and methodsTwelve months after da Vinci Radical Prostatectomy (dVRP) for prostate cancer, 28 fully potent (IIEF-5 >21) and sexually active men (ages 47-69 years, mean 61) who, in 2008, were enrolled in a prospectively monitored penile rehabilitation program (reference group) were compared with 79 fully potent (IIEF-5 >21) and sexually active men (ages 45-74 years, mean 61) enrolled in 2009 (study group); whose program differed by the inclusion of evaluation and treatment by a clinical sexologist.ResultsTwelve months after dVRP, seventeen patients in the reference group (61%) were sexually active with regular penetrating sexual activity compared to sixty-six (84%) in the study group (p = 0.02). These findings were independent of whether they had undergone a nerve sparing or non-nerve sparing procedure. Almost 94% (74 patients) in the study group had at some time been able to perform penetrating sexual activity; 14 patients required additional visits to the clinical sexologist beyond the routine follow-up, 9 for short-term cognitive behavior therapy.ConclusionsInclusion of a clinical sexologist in a penile and sexual rehabilitation program appears to improve the ability to have regular sexual activity with penetrating sex one year after da Vinci Robotic Radical Prostatectomy.

XXXVI.Von dcr Ffihigkcit des tlautepitheis, ausserhalb des Organismus sein Leben zu behalten, mit Berficksichtigung der Transplantation. t) Yon C. A. L j u n g g r e n . (Mit Tafel VI. VII.) Es ist eine bekannte Thatsache~ dass mit dem Tode des mensehlichen Organismus seine Zellen nieht sogleich absterben. Dies geht u. A. daraus hervor, dass man yon Leiehnamen HautstUcke auf Wundfittchen lebender Menschen hat iiberfUhren kSnnen mit Anheilung und bestehender Hautbildung. Ich erinnere an S w a n o v n a' s und G ir d n e r' s interessante Mittheilungen hierUber. Uebrigens hat die Hauttransplantation an Mensehen gelehrt, dass Hautlappen, die eine Zeitlang ausserhalb des Organismus aufbewahrt sind, mit gntem Erfolg liberftihrbar watch. Es ist W e n t s c h e r gelung'en~ Hautsttieke zu transplantiren~ die 24--48 Stunden in KoehsalzlSsung gelegen hatten. B r e w e r kam bei seinen Transplantationsversuchen yon amputirten Gliedern zu der Auffassung, dass 36 Stunden die tiusserste Zeit der u der Haut sei. G a r t e's histologisehe Untersuehungen tiber den Anheilungsproeess der Transplantation zeigen deutlieh, ,dass ohne naehweisbare Blutcirculation grosse Zelleomplexe durch blosses Ankleben auf einer Wundfiaehc wtthrend mehr als 48 Stunden ihr Leben fristen kSnnen. Mit Transplantationsversuehen besehiiftigt, wurde ieh auf diese Fragen anfmerksam; besonders land ieh es praetiseh wiehtig~ wenigstens anntihernd zu erforsehen, wie lunge Zeit Hautlappen mit Erfolg" flit Transplantation aufbewahrt werden kSnnen. ~oeh mehr anziehend fiir reich war aber die biologisehe Frage, zu untersuehen, l) Diese Arbeit ist fast vollsti~ndig zu den Yerhandlungen des Moskauer Congresses abgeliefert; die Publication wurde durch die Herstellung der Tafel verztigert. Seitdem ist Wentscher's Mittheilung von der Naturforscherversammlung zu Braunschweig erschienen, welche hohes Interesse verdient.

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