Increased Rate of Sexual Dysfunction by Increased Severity of Nasal Obstruction in Patients With Chronic Rhinosinusitis

Objectives: Chronic rhinosinusitis (CRS) is a common chronic respiratory disorder. This study aimed to investigate the relation between nasal obstruction and sexual dysfunction in men with CRS. Methods: In this case-control study, 100 married men aged 19 to 48 years with CRS and 56 healthy married men were selected, consecutively. For assessment of nasal obstruction severity NOSE scale (Nasal Obstruction Symptom Evaluation) was used and IIEF (International Index of Erectile Function) inventory was used to assess sexual function. Results: Mean age of patients with CRS and controls was 33.25 ± 6.5 and 30.58 ± 7.12 years, respectively. Nasal obstruction was moderate in 70% of patients and 95% of patients had some degrees of erectile dysfunction. A significant association was found between nasal obstruction severity and sexual function and by increasing severity of nasal obstruction, sexual function decreased significantly in CRS patients. Sexual function in total (IIEF score) and in its domains, except for sexual desire, were significantly higher in control group ( P < .05). Conclusion: There is significant inverse association between severity of nasal obstruction and sexual function. Sexual function decreases with increasing severity of nasal obstruction in CRS. CRS patients also have lower sexual function scores than healthy control males.

PNEUMATIC CONTACT TRANSURETHRAL ureterOLITHOTRIPSY in emergency urological practice

Relevance. Minimally invasive methods of removing the ureteral calculus in urological practice have steadily taken the leading position. According to the Russian clinical recommendations the indications for endoscopic correction of ureteral calculus are concrements with a low probable passage, constant pain symptomatic on the background of adequate analgesia, the varying degrees of obstruction severity and impaired renal function. The purpose of the work is to assess the efficacy of transurethral pneumatic contact lithotripsy of ureteral calculus in emergency urological practice. The research tasks included the refinement of the endoscopic lithotripsy results, depending on the localization level among men and women. Materials and methods. The results of endoscopic treatment of ureteral calculus among 360 patients of both sexes, hospitalized in a urological hospital with emergency indications of a renal colic diagnosis, are presented. Results. The efficiency of retrograde pneumatic contact ureterolithotripsy reached 91.8 %. The most optimal this method is with the localization of calculus in the lower third of the ureter, regardless of the concrement size and sex. The percentage of the calculus fragmentation of the middle third of the ureter among men and women was 91.6 and 93.4 respectively. The lithotripsy in the upper part of the ureter was 23.6 % more effective among women. Operational complications were registered in 7.5 % cases.

Is Computed Tomography Imaging of Deviated Nasal Septum Justified for Obstruction Confirmation?

Third-party payers request objective confirmation of the nasal septum deviation (NSD) severity by computed tomography (CT) before authorizing financial support for septoplasty. Previous studies have provided contradictory results related to the link between obstruction severity and CT-measured angle of the NSD. The aim of this study was to investigate whether the diverse CT morphology of NSDs (including previously neglected types and shapes) could predict obstruction severity. The study included 225 patients with NSD. The CT morphology of the septum was analyzed using 5 different classifications of NSD that are commonly used in the clinical practice and research. The angle of NSD was also measured. Nasal obstruction was assessed by the Nasal Obstruction Symptom Evaluation (NOSE) questionnaire. A relationship between CT morphology and the angle of the NSD and NOSE scores was analyzed using appropriate regression models. Patients with NSDs located in the anterior part of the septum always have some degree of nasal obstruction, while those with posterior NSDs did not necessarily report obstruction symptoms no matter how complicated NSD they have. Regression analysis did not reveal any causal relationship between NOSE scores and CT morphology and the angle of NSD. The presence of spurs and whether they divide nasal passages have no statistically significant predictive effect on the obstruction severity. The CT morphology and the angle of the NSD could not predict severity of the nasal obstruction. Requesting CT examination just to objectively confirm nasal obstruction is not justified.