Chi-Shing Joseph Ng

Factors influencing bladder management in male patients with spinal cord injury: a qualitative study

Study design:Qualitative study using individual in-depth interviews.Objectives:The objective of this study was to explore the factors influencing the choice of bladder management for male patients with spinal cord injury (SCI).Setting:Public hospitals in Malaysia.Methods:Semistructured (one-on-one) interviews of 17 patients with SCI; 7 were in-patients with a recent injury and 10 lived in the community. All had a neurogenic bladder and were on various methods of bladder drainage. Interviews were audio-recorded, transcribed verbatim and analyzed using thematic analyses.Results:The choice of bladder management was influenced by treatment attributes, patients’ physical and psychological attributes, health practitioners’ influences and social attributes. Participants were more likely to choose a treatment option that was perceived to be convenient to execute and helped maintain continence. The influence of potential treatment complications on decision making was more variable. Health professionals’ and peers’ opinions on treatment options had a significant influence on participants’ decision. In addition, patients’ choices depended on their physical ability to carry out the task, the level of family support received and the anticipated level of social activities. Psychological factors such as embarrassment with using urine bags, confidence in self-catheterization and satisfaction with the current method also influenced the choice of bladder management method.Conclusion:The choice of bladder management in people with SCI is influenced by a variety of factors and must be individualized. Health professionals should consider these factors when supporting patients in making decisions about their treatment options.

64 Behind every healthy man, there's a woman: A qualitative inquiry

during the short-term follow-up, with 6 cystic fat nodules. The satisfaction rate for sexual function, morphology and global state were 79.8%, 78.9%, and 91.7%. Conclusions: Our technique shows very effective shortterm outcomes and patient’s satisfaction without serious complications. 62 A case of 47,XXY/46,XY Klinefelter syndrome H. Masuda1, Y. Katsuoka2. 1Aino Hospital, 2 Osaka Medical College, Japan Klinefelter syndrome represents the most commonly found human sex chromosomal abnormality. It is characterized by small, firm testes with hyalinization of the seminiferous tubules, elevated gonadotropins and azoospermia. Males with Klinefelter syndrome may have a 47,XXY or a mosaic 47,XXY/46,XY constitutional karyotype and varying degrees of spermatogenic failure. Mosaicism 47,XXY/46,XX with clinical features suggestive of Klinefelter syndrome is very rare. We report here a case of a mosaic 47,XXY/46,XX infertile male. The patient was a 31-year-old male. Physical examination revealed perfect male-type of genitalia, almost normal penis and bilateral small testicles, being 1.0 × 2.0 × 1.0 cm sized for the right and 1.0 × 2.0 × 1.0 cm for the left. Chromosome analysis by means of culture of peripheral blood lymphocytes revealed twokinds of 46 chromosomes and of 47 chromosomes. The genotype of the former was XX and of the later was XXY, making XX/XXY mosaicism. Testicular sperm extraction was performed, but we could find the sperm in microdissection testicular sperm extraction procedure. Histologically the testicle showed atrophy of seminiferous tubules with hyalinizaition of the canaliculi. No spermatogenesis was observed at all. 63 Coenzyme Q10 treatment for oligoasthenoteratozoospemia in infertile men with varicocele Y. Kobori, H. Okada, G. Arai, S. Soh, H. Yagi. Dokkyo Medical University Koshigaya Hospital, Department of Urology, Japan Objective: To evaluate the effectiveness of coenzyme Q10 treatment in improving semen quality in men who have varicocele with infertility. Patients: Sixty-nine infertile patients (21–51 years of age) with the following baseline sperm selection criteria: concentration 30%. Patients underwent therapy with coenzyme Q10, 30mg/day. We investigated seminograms, background, hormonal analyses. We also investigated the modern ART used to overcome sterility. Results: Coenzyme Q10 and ubiquinol increased significantly sperm concentration, aswell as spermatozoa motility. Intracytoplasmic sperm injection (ICSI) was performed 2 patients, varicocelectomy was performed 1 patient, and total 10 patients are resulted pregnancy. Conclusions:The exogenous administration of coenzyme Q10 increases the level of the same and ubiquinol in semen and is effective in improving sperm kinetic features in patients affected by idiopathic asthenozoospermia with valicocele.