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We used magnetic resonance imaging (MRI) to assess lumbar lordosis in 27 patients with low back pain and 19 patients and 10 volunteers with no known back pain. Our study aimed to investigate whether lordosis changes with age and is reduced in those with low back pain. Although our results confirm known observations that lumbar lordosis is more prominent in women (P < 0.01) and those with a higher body mass index (P < 0.04), we were unable to demonstrate any significant variation in lordosis with age. Nor could we demonstrate any difference in the degree of lordosis among women with or without back pain. Men with low back pain tended to have a less prominent lordosis, but this difference did not reach statistical significance. Therefore, a 'reduced lumbar lordosis' should be regarded as a very weak clinical sign.

P < 0.0001). In females there were significant improvements in the ICIQ-SF ( P = 0.0008) and Quality of Life ( P < 0.0001) scores. For each kilogram lost there was a 0.05 improvement in the ICIQ score ( P = 0.03) in females. There were also postoperative improvements in all symptoms of UI and stress incontinence in females but urge incontinence worsened, when adjusted for weight loss. In males there was no improvement in UI with weight loss after LGB. There was no relationship with time and UI in either gender; 83.3% of males reported a degree of ED before LGB. There was improvement in the IIEF score in males post LGB but there was worsening of erectile index ( P = 0.005) and orgasmic function ( P = 0.002) when adjusted for time. More males had started using phosphodiesterase type 5 inhibitors, post-LGB. CONCLUSIONSSurgically induced weight loss by LGB improved overall UI, quality of life and stress incontinence in females but urge incontinence worsened. There was no improvement in UI with weight-loss or overall sexual function after LGB in males. However, erectile index and orgasmic function worsened when adjusted for time. Further evaluation is required by means of larger prospective studies involving urodynamic testing. KEYWORDSobesity, bariatric surgery, laparoscopic gastric banding surgery, urinary incontinence, erectile function, sexual function What's known on the subject? and What does the study add? Obesity is a known risk factor for Urinary Incontinence. Non surgical weight loss has been shown to reduce Urinary Incontinence, but there is only limited evidence for surgically induced weight loss. This study aims to clarify the effects of surgically induced weight loss on urinary and erectile function.Study Type -Symptom prevalence (non-consecutive cohort) Level of Evidence 4 OBJECTIVETo investigate the effects of weight loss and time post laparoscopic gastric banding surgery (LGB) on urinary and sexual function. MATERIALS AND METHODS females and 145 males who underwentLGB over the last 10 years at a single centre in Australia were contacted by post and asked to complete validated questionnaires. RESULTSThe pre-surgery body-mass index (BMI) was higher in males than females (47.3 vs 43.5); 65% of the females and 24% of males previously had some degree of urinary incontinence (UI). There were significant weight and BMI losses in males and females (23.2 kg and 7.51 vs 22.7 kg and 8.28;

BackgroundErdheim-Chester disease (ECD) is a rare multisystem non-Langerhans cell histiocytosis that is characterized histologically by xanthogranulomatous infiltrates and radiologically by symmetrical sclerosis of long bones. The xanthomatous process is characterized by prominent foamy histiocytes staining positive for CD68, occasionally for PS100 and negative for S100 and CD1a. Gastroenterological involvement is exceedingly rare.Case PresentationThis case report describes the case of a 69-year-old man who presented otherwise well to the gastroenterology department with unspecific abdominal symptoms, nausea, vomiting and weight loss. ECD involving the gastrointestinal tract was confirmed clinically, radiologically and histologically.ConclusionGastroenterological manifestation of ECD is rare but should be considered in the differential diagnosis in patients presenting with evidence of multi-organ disease and typical radiological features of Erdheim-Chester disease elsewhere.