Biomedical subjects

D Bodner

Publications and source records attributed to D Bodner.

10 recordsLinked to original sources

PubMed2001

Skeletal fracture associated with androgen suppression induced osteoporosis: the clinical incidence and risk factors for patients with prostate cancer.

PURPOSE: Limited information exists regarding the long-term risk of skeletal fracture in men on androgen suppression for prostate cancer. In addition, the clinical risk factors predisposing them to skeletal fracture are incompletely defined. We define the long-term risk and clinical risk factors for skeletal fracture in patients with prostate cancer on chronic androgen suppression. MATERIALS AND METHODS: A total of 181 consecutive patients with prostate cancer on androgen suppression therapy were evaluated. The primary end point was skeletal fracture. Comprehensive demographic information was gathered, and univariate and multivariate analyses were performed to identify associations with skeletal fracture. RESULTS: The proportion of patients who had survived fracture-free at 5 and 10 years on androgen suppression therapy was 96% and 80%, respectively. The black race (p = 0.009) and increased body mass index (p = 0.024) were identified as protective against androgen suppression associated skeletal fractures. A significant correlation was identified between the duration of androgen suppression and risk of skeletal fracture (p = 0.003). CONCLUSIONS: Patients with prostate cancer treated with androgen suppression are at risk for skeletal fracture, and risk increases with the duration of therapy. Slender white men are at greatest risk. Conversely, black men and those with body mass indexes greater than normal (greater than 25 kg/m(2)) are at minimal risk despite a prolonged duration (10 years) of androgen suppression.

Aged↗

PubMed1992

Through the eyes of women: the sexual and psychological responses of women to their partner's treatment with self-injection or external vacuum therapy.

We prospectively delineated and contrasted the sexual, marital and psychological responses of women to their partner's use of 2 treatments for erectile dysfunction: 1) self-injection of papaverine and phentolamine, and 2) vacuum tumescence therapy. The women were assessed at 5 points during a 12-month period with psychometric questionnaires and clinical interviews. Statistical analysis indicated that the women responded equally well to both treatments. They demonstrated significant increases in frequency of intercourse, sexual arousal, coital orgasm and sexual satisfaction. No significant changes were noted on the psychometric questionnaires. The women reported feeling more at ease in their relationships and characterized sex as more leisurely, relaxed and assured. Negative responses focused on the lack of spontaneity and hesitation about initiating sex. Self-injection and vacuum pump therapy restore potency in men and secondarily facilitate improved sexual function in women.

Coitus↗

PubMed1991

Sexual, psychological, and marital impact of self-injection of papaverine and phentolamine: a long-term prospective study.

This prospective study assessed the long-term effects of self-injection of papaverine hydrochloride and phentolamine mesylate along several critical domains for 42 men and 26 partners. Over the course of one year, men were, on average, injecting themselves five times monthly, with 84% of these injections producing satisfactory erections. Treatment resulted in statistically significant improvements in quality of erection, sexual satisfaction, frequency of intercourse, and coital orgasm. The women also demonstrated significant improvement in sexual satisfaction, arousal, frequency of intercourse, and coital orgasm. Decreases in general psychiatric symptomatology were apparent for men but not for partners. The dropout rate was 57%. The common side effects of treatment were development of fibrotic nodules (26%), abnormal liver function values (30%), and bruising (19%). We conclude that self-injection should be considered among the accepted treatments for erectile dysfunction. It does appear to enhance the sexual lives of men and women when the treatment is efficacious and the couple is motivated to utilize it.

Adaptation, Psychological↗

PubMed1990

Treating erectile dysfunction with external vacuum devices: impact upon sexual, psychological and marital functioning.

We evaluated prospectively the medical, sexual and psychosocial outcome of external vacuum devices in the treatment of erectile dysfunction. A total of 29 men regularly used such a device for 6 months and reported statistically significant improvements in erectile quality, frequency of intercourse attempts, frequency of orgasm and sexual satisfaction, as well as decreased psychiatric symptomatology, increased self-esteem and a trend toward improved marital satisfaction. Of the partners 18 reported improved sexual functioning, including increased frequency of orgasm, decreased masturbation and greater sexual satisfaction, with no changes in psychosocial parameters. The vacuum device was effective in producing erections in 89% of the men. Dropout, only 19% within 6 months, was primarily due to insufficient or pivoting erections and bruising. The most frequent adverse effects were blocked ejaculation and physical discomfort. Vacuum devices appear to provide a safe, effective, inexpensive, noninvasive treatment for erectile failure that enjoys high patient and partner acceptance.

Adult↗

PubMed1990

Urologic function after experimental cauda equina compression. Cystometrograms versus cortical-evoked potentials.

Twenty female beagle dogs underwent an L6-7 laminectomy and six dogs each had 25, 50 or 75% constriction of the cauda equina and 2 control dogs had laminectomy only. Cystometrograms were performed pre- and post-operatively and three months after constriction. Cortical evoked potentials were monitored pre- and post-operatively and monthly for three months. After three months of constriction, the cauda equina of these dogs in each group was examined histologically and vascular circulation was examined by latex and India ink injection (Spalteholz technique). The control dogs had normal CMGs and CEPs. Twenty-five percent constriction caused no CMG changes and mild CEP changes. Fifty percent constriction caused no statistically significant CMG changes, major CEP changes and venous congestion of the nerve roots and dorsal root ganglia. Seventy-five percent constriction produced severe CMG changes with detrusor areflexia, increased bladder capacity and clinical incontinence. CEPs also had marked deterioration. Vascular analysis revealed severe arterial narrowing at the level of constriction and venous congestion of the nerve roots and dorsal root ganglia. Blockage of axoplasmic flow and nerve root atrophy was seen in all dogs with 75% constriction. Cortical evoked potentials were the most sensitive predictor of neural compression. CMGs were not sensitive until severe compression was achieved. Bladder dysfunction, i.e., detrusor areflexia, appears to occur with blockage of axoplasmic flow and early sensory changes occur with neurovenous congestion.

Animals↗

PubMed1989

Why do so many people drop out from auto-injection therapy for impotence?

Although intracavernous injection of vasoactive substances has been shown to be a reasonable and reliable method of reversing impotence, studies assessing patient acceptance of this new technology are lacking. By prospectively following patients and willing partners over a 2-year period, this study sought to document patient utilization rates and the reasons why patients decline or discontinue injection therapy. The cumulative dropout rate was 46%, with patients being most at risk for leaving the program after evaluation or during the trial dose phase. Patients decline treatment because they are unable to accept the idea of injecting themselves or because of potential side effects. Patients discontinue treatment because of perceived lack of efficacy. Patient and programatic obstacles to utilization of self-injection therapy are analyzed.

Erectile Dysfunction↗

PubMed1988

Extracorporeal shock wave lithotripsy in traumatic quadriplegic patients: can it be safely performed without anesthesia?

A total of 5 traumatic quadriplegic patients underwent 10 extracorporeal shock wave lithotripsy treatments with either a local (bupivacaine 0.25 per cent) field block or no anesthesia. Significant intraoperative hypertension as determined by the anesthesiologist occurred in 2 patients and responded to intravenous hydralazine. The complete clinical syndrome of autonomic dysreflexia did not occur. Three patients are free of stones and 2 have insignificant residual caliceal fragments. Extracorporeal shock wave lithotripsy may be performed safely in traumatic quadriplegic patients without the added risk of general or regional anesthesia. It is recommended that during therapy these patients should be monitored closely by an anesthesiologist for the signs and symptoms of autonomic dysreflexia.

Adult↗

PubMed1987

Urological problems in the management of quadriplegic women.

During the past 25 years enormous progress has been made in the management of the neuropathic bladder, largely as a result of the adoption of intermittent catheterisation, together with improvements in catheter-related techniques, and the judicious use of antibacterial drugs and sphincter surgery. A few quadriplegic women can be trained to do self-intermittent catheterisation, using a special technique. For the majority of these women, however, there is no practical alternative at present to indwelling catheters. Bladder spasms resulting from the mechanical stimulation of the catheter and/or repeated infections may be difficult to control, and illustrative cases demonstrating some problems encountered are presented. There is an obvious need for an external collecting device for these women. The development in the field of such devices are presented and evaluated.

Adult↗

PubMed1987

Intracavernosal injection in the treatment of impotence: a prospective study of sexual, psychological, and marital functioning.

This study assessed the sexual, psychosocial, and medical impact of intracavernosal injection of papaverine hydrochloride and phentolamine mesylate in the treatment of impotence. Ninety-six percent of patients initially achieved satisfactory erections with injections. Common side effects of self-injections included bruising (26%), nodule development (21%), abnormal liver function tests (7%), and pain (5%). No nodules resulted in penile bending or pain, and no patient discontinued treatment due to nodule development. Dropout rate to date was 35%. Self-injection treatment was associated with increases in erection quality, intercourse frequency, and sexual satisfaction, and decreases in masturbation frequency for patients. Partners also reported increases in intercourse frequency, coital arousal, and satisfaction. Decreases in general psychiatric symptomatology and increases in relationship satisfaction and self-esteem were apparent for patients, but not for partners.

Erectile Dysfunction↗

PubMed1984

Palliative nephrostomy for relief of ureteral obstruction secondary to malignancy.

A mean survival of 7.6 months in 20 patients undergoing nephrostomy for relief of ureteral obstruction from advanced pelvic malignancy was not as dismal as previous reports have indicated. Patients with bilateral ureteral obstruction from direct extension of pelvic malignancy survived considerably longer and appear to be the best candidates for nephrostomy. The physician must be cautious in advising the procedure to patients with bilateral ureteral obstruction from disseminated disease originating outside the pelvis since mean survival in this group (3 patients) was less than one month. Nephrostomies were associated with a significant incidence of perinephric abscess (15 per cent) emphasizing the technical aspect of accurate placement to avoid leakage of potentially infected urine.

Aged↗