Biomedical subjects

Mark Speakman

Publications and source records attributed to Mark Speakman.

4 recordsLinked to original sources

PubMed2004

Randomised controlled trial of pelvic floor muscle exercises and manometric biofeedback for erectile dysfunction.

BACKGROUND: The pelvic floor muscles are active in normal erectile function. Therefore, it was hypothesised that weak pelvic floor muscles could be a cause of erectile dysfunction. AIMS: To compare the efficacy of pelvic floor muscle exercises and manometric biofeedback with lifestyle changes for men with erectile dysfunction. DESIGN OF STUDY: Randomised controlled trial. SETTING: The Somerset Nuffield Hospital, Taunton, United Kingdom. METHOD: Fifty-five men with erectile dysfunction (median age 59.2 years; range 22-78 years) were enrolled from a local urology clinic. Of these, 28 participants were randomised to an intervention group and engaged in pelvic floor exercises, as well as receiving biofeedback and suggestions for lifestyle changes. Twenty-seven controls were solely advised on lifestyle changes. Baseline, 3- and 6-month assessments were: erectile function domain of International Index of Erectile Function (IIEF), Partner's International Index of Erectile Function (PIIEF), Erectile Dysfunction-Effect on Quality of Life (ED-EQoL), anal manometry, digital anal measurements, and clinical assessment by an assessor blind to treatment allocation. After 3 months, the control group were transferred to the active arm. RESULTS: At 3 months, compared with controls, men in the intervention group showed significant mean increases in the erectile function domain of the IIEF (6.74 points, P = 0.004); anal pressure (44.16 cmH(2)O, P <0.001); and digital anal grades (1.5 grades, P <0.001). All showed further improvement in these outcomes at 6 months. Similar benefits were seen in men of the control arm after transfer to active treatment. A total of 22 (40.0%) participants attained normal function, 19 (34.5%) participants had improved erectile function, and 14 (25.5%) participants failed to improve. CONCLUSION: Pelvic floor muscle exercises and biofeedback are an effective treatment for men with erectile dysfunction.

Adult↗

PubMed2004

Pelvic floor exercises for treating post-micturition dribble in men with erectile dysfunction: a randomized controlled trial.

PURPOSE: The purpose of this trial was to compare the efficacy of pelvic floor muscle exercises and manometric biofeedback for post-micturition dribble (PMD) in men with erectile dysfunction. METHODS: Fifty-five men with erectile dysfunction (median age 59.2 years; range 22-78) were enrolled from a local urology clinic. Twenty-eight subjects were randomized to an intervention group and received pelvic floor muscle exercises including a strong post-void "squeeze out" pelvic floor muscle contraction, biofeedback, and suggestions for lifestyle changes. Twenty-seven control subjects were solely advised on lifestyle changes. The PMD status, anal manometry, and digital anal muscle grade were assessed at baseline, 3, and 6 months. After 3 months, the control group received the intervention with pelvic floor muscle exercises and biofeedback. Both groups were followed for an additional 3 months of home exercises. An independent assessor who was blinded to the grouping assessed the PMD status of subjects at 3 and 6 months. RESULTS: Thirty-six (65.5%) of the 55 subjects reported PMD at baseline. At 3 months, there was significant reduction in PMD after intervention (p=0.001) compared to the control subjects (p=0.102). In both groups combined after 3 months of pelvic floor muscle exercises and 3 months of home exercises, 27 (75%) subjects became asymptomatic of PMD, 3 (8.3%) improved, 5 (13.9%) dropped out, and 1 (2.8%) subject still reported PMD. PMD was not correlated to age, erectile function, anal manometric pressure, or digital anal muscle grade. CONCLUSION: Pelvic floor muscle exercises including a post-void "squeeze out" pelvic floor muscle contraction are an effective treatment for post-micturition dribble in men with erectile dysfunction.

Adult↗

PubMed2003

Carcinosarcoma of the ureter: a rare, pleomorphic, aggressive malignancy.

AIM: To examine histological nature and clinical process of ureteral carcinosarcomas. METHODS: We report on a new case of carcinosarcoma of the ureter. The literature was reviewed and histological and clinical features were elucidated. RESULTS: Fourteen cases of ureteral carcinosarcomas have been reported. The nomenclature used for these tumors either in the pathology reports or in literature is confusing. In contrary to obscure tumor biology, prognosis was clearly bad as the majority of the patients died within 2 years after diagnosis. CONCLUSIONS: Terminology confusion is due to the rarity of this entity and lack of its biology knowledge. Patients present after the age of 60 with hematuria and obstruction. Nephroureterectomy is the only hope of cure but, due to tumor aggressiveness, recurrences occur almost always and prognosis is poor.

Aged↗

PubMed2002

Erectile dysfunction and atherosclerosis.

Erectile dysfunction (ED) is a common problem in the United States, with estimates that 30 million men suffer with some degree of ED. Although causes include psychogenic, organic, and mixed forms, in middle-aged and older men one of the most common causes is vascular disease. Endothelial dysfunction, even without definitive arterial stenosis, as well as atherosclerosis with definitive stenosis of blood vessels, contributes to the problem. Endothelial dysfunction and atherosclerosis of blood vessels that supply the penis are associated with the same cardiovascular risk factors that affect the coronary arteries: smoking, lipid abnormalities, hypertension, and diabetes.

Adult↗