Most Read Articles
24 Sep 2017
Women with very low levels of serum testosterone may have an increased likelihood of stress and mixed incontinence, a recent study suggests.
01 Nov 2017
Xerostomia and salivary gland hypofunction appear to be common side effects of elderly medication, particularly those for urinary incontinence, according to a recent study.
29 Oct 2017
Older women with urinary incontinence symptoms exhibit a significant decline in standing balance, which may be associated with coinciding development of sarcopaenia, according to the secondary analysis of the Health, Aging and Body Composition Study.
Dr Jaime Songco, 31 Oct 2017

Erectile dysfunction (ED) is a common condition defined as the persistent inability to achieve or maintain an erection sufficient for satisfactory sexual performance.1 It is one of the most common complaints in men’s sexual medicine, affecting both physical and psychosocial health and having a significant impact on the patient and partner’s quality of life.1 Moreover, ED is commonly associated with other comorbid conditions, including hypertension, dyslipidaemia and diabetes mellitus.1

Evaluation of ED should include a detailed medical and sexual history of the patient. 1 A discussion of the patient and partner’s preference and treatment goals is essential to better tailor treatment and improve patient satisfaction and adherence to treatment.2 Lifestyle modification and management of risk factors should precede pharmacotherapy, while first-line treatment with oral phosphodiesterase type 5 inhibitors (PDE5i) is well established for the management of patients with ED.1

TART screening, fertility counselling underused in congenital adrenal hyperplasia

10 Jan 2018

Testicular adrenal rest tumour (TART) screening and fertility counselling appear to be underutilized in boys with congenital adrenal hyperplasia (CAH), according to a study.

Researchers retrospectively examined 46 paediatric patients with CAH, obtaining data on age and indication for diagnosis, age at first and last documented paediatric endocrinology and urology visit, history of ultrasound examinations, and documentation of fertility counselling.

Of the patients, 38 had 21-hydroxylase deficiency. Patients had a median age of 2 weeks (range, 7 days–10 years) at CAH diagnosis and median age of 14 years (range, 2–42 years) at the most recent paediatric endocrinology clinic visit.

At the time of the study, 29 patients ( 63 percent) were >11 years of age, including 14 who were aged >18 years. There were seven patients (15 percent) who underwent a screening ultrasound at some point in their care (among whom three had TARTs), while six (13 percent) had any mention of fertility in their records.

It was also found that none of the patients underwent biochemical testing or semen analysis to evaluate gonadal function. Likewise, none were offered fertility preservation. There was only one patient who was seen by a paediatric urologist.

Based on the present data, researchers pointed out a need for increased awareness and development of practice guidelines within paediatric urology and endocrinology to address the apparent underutilization of TART screening and fertility counselling in paediatric CAH patients.

“In addition to a screening ultrasound in puberty and consideration of semen analysis after puberty … boys [with CAH] may benefit from seeing a paediatric urologist independently or in an interdisciplinary programme. [The] boys … [along with] their families should be educated about infertility risk and potential interventions, with the goal of improving reproductive outcomes in this population,” researchers said.

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Most Read Articles
24 Sep 2017
Women with very low levels of serum testosterone may have an increased likelihood of stress and mixed incontinence, a recent study suggests.
01 Nov 2017
Xerostomia and salivary gland hypofunction appear to be common side effects of elderly medication, particularly those for urinary incontinence, according to a recent study.
29 Oct 2017
Older women with urinary incontinence symptoms exhibit a significant decline in standing balance, which may be associated with coinciding development of sarcopaenia, according to the secondary analysis of the Health, Aging and Body Composition Study.
Dr Jaime Songco, 31 Oct 2017

Erectile dysfunction (ED) is a common condition defined as the persistent inability to achieve or maintain an erection sufficient for satisfactory sexual performance.1 It is one of the most common complaints in men’s sexual medicine, affecting both physical and psychosocial health and having a significant impact on the patient and partner’s quality of life.1 Moreover, ED is commonly associated with other comorbid conditions, including hypertension, dyslipidaemia and diabetes mellitus.1

Evaluation of ED should include a detailed medical and sexual history of the patient. 1 A discussion of the patient and partner’s preference and treatment goals is essential to better tailor treatment and improve patient satisfaction and adherence to treatment.2 Lifestyle modification and management of risk factors should precede pharmacotherapy, while first-line treatment with oral phosphodiesterase type 5 inhibitors (PDE5i) is well established for the management of patients with ED.1