Robotic Surgery may reduce impotence

October 24, 2009
‘’Professor Costello’s website says the use of this procedure may reduce impotence and urinary incontinence,'’ professor Chapman said. ‘’The use of the word ‘may’ is very important. Obviously, it may not, either.
The study, published in the Journal of the Amercian Medical Association, has sparked renewed debate over robotically assisted surgery, and over how much surgeons should be obliged to tell patients about their success rates.Evidence suggests that robotic prostate cancer surgery, far from being the saviour of men, is leaving them with more incontinence and impotence than traditional techniques.However, the pioneers of robotic surgery in Australia have defended the procedure, saying the research was flawed.

It found that robotic assistance meant men left hospital a day earlier and they were 10 times less likely to need a blood transfusion.However, more than twice as many (4.7 per cent) suffered ‘’genitourinary'’ complications. Almost a third more (16 per cent) were diagnosed with urinary incontinence, and the rate of erectile dysfunction rose by 40 per cent (to 27 per cent).

Professor Simon Chapman, a public health expert from the University of Sydney, said the study casts strong doubts on the claims made on behalf of the robots by proponents such as the Epworth Hospital’s Tony Costello.The Epworth, in Richmond, pioneered robotic-assisted surgery in Australia in 2003, and now runs two of the country’s five da Vinci robots.

‘’Men are in an enormously vulnerable position. They are not in a position at all to adequately evaluate the claims put to them by a doctor. The issues of urinary incontinence and sexual impotence are really very important for a lot of men, especially now men as young as 40 are being screened [for prostate cancer].'’

The Epworth’s associate professor, David Webb, recently published a paper that found robotic-assisted prostatectomies had completely eliminated ‘’bladder neck'’ problems - previously almost one in 10 prostate surgery patients had experienced a bladder neck contracture.

Neuroscientist Janet Keast, from the University of Sydney, said it was almost impossible to avoid nerve damage during a prostate operation.

‘’I am concerned that people get unrealistic expectations because it is called ‘nerve sparing’ surgery,'’ she said. The skill of the surgeon, rather than use or otherwise of a robot, was a better guide to how likely major nerve damage would be.

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Swine flu H1N1 vaccine gets to metro Detroit

October 22, 2009

Detroit Medical Center has ordered about 35,000 doses of H1N1, but only has 100 or so for pregnant women, said Dr. Michelle Schreiber, chief quality officer. Henry Ford Health System spokesman David Olejarz said their H1N1 vaccine schedule was not available.

The vaccinations are intended for high-risk groups: pregnant women, those ages 6 months to 24, those living with babies 6 months or younger, adults ages 25 to 64 with conditions like asthma, health care workers and first-responders.

Those 10 and older are to get one dose, said Mary Mazur, Wayne County Department of Public Health spokeswoman, and children 6 months to 9 years are to get two doses, spaced one month apart.

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A heart attack can affect your sex life

October 20, 2009

Men with heart disease may experience erectile dysfunction. Erections depend on the arteries that supply blood to the penis, so it makes sense that atherosclerosis is the most common cause of impotence. But high blood pressure, abnormal cholesterol levels, diabetes, and smoking — all leading cardiac risk factors — also increase a man’s risk for impotence.

Although heart attacks during sex are rare, no one wants to be among the unlucky few who die while getting lucky. So if you have cardiovascular disease (CVD), or even if it runs in your family, it’s important to ask your doctor what type of sexual activity is safe. If you’ve just had a heart attack, for instance, you should wait three to four weeks before having intercourse, according to current guidelines.

The link between cardiovascular disease and sexual dysfunction is well established, at least in men. Researchers have known for years that erectile dysfunction (ED) is disproportionately common among men with CVD (and even among those with risk factors for CVD, such as diabetes and high blood pressure). While erectile dysfunction can result from a number of factors, including psychological ones, the majority of cases can be traced to vascular problems.

Research does show that cardiac problems can increase in the hour or two after sexual intercourse, but in reality, the risk is very, very low — even for people who’ve had heart attacks already. It’s about as safe as walking up two flights of stairs. Studies also show that regular exercise markedly reduces the risk for heart attack during or soon after sexual activity.

Some people have angina during sexual activity. If this happens, you should tell your doctor. Doctors often recommend that people in this situation take nitrates before sex to avoid this problem.

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