H.M. Tan

Malaysian cultural differences in knowledge, attitudes and practices related to erectile dysfunction: focus group discussions

This qualitative study aimed to examine cultural differences in knowledge, attitudes and practices related to erectile dysfunction (ED) utilizing focus group discussion. Six focus groups consisting of 66 men, 45–70-y-old were conducted—two Malay groups (n=18), two Chinese groups (n=25) and two Indian groups (n=23). Participants were purposively recruited from the general public on a voluntary basis with informed consent. Transcripts were analyzed using qualitative data analysis software ATLASti. The Malay and Chinese traditional remedies for preventing or treating ED are commonly recognized among all races. Many have a negative perception of someone with ED. Malay and Chinese men tended to blame their wife for their problem and thought that the problem might lead to extra-marital affairs, unlike the Indian men who attributed their condition to fate. Malays would prefer traditional medicine for the problem. The Chinese felt they would be more comfortable with a male doctor whilst this is not so with the Malays or Indians. Almost all prefer the doctor to initiate discussion on sexual issues related to their medical condition. There is a need for doctors to consider cultural perspectives in a multicultural society as a lack of understanding of this often contributes to an inadequate consultation.

What Malaysian women believe about Viagra: a qualitative inquiry

This paper highlights womens perceptions of sildenafil citrate (Viagra®, Pfizer). It is based on a qualitative study on perceptions of erectile dysfunction in the Malaysian multicultural society. Six focus groups were conducted, consisting of 69 women, aged between 40 and 70 years, recruited from the general public and who had given informed consent. The findings revealed that the women were aware of erectile dysfunction and Viagra. Due to their concern about the negative aspects of Viagra, the Chinese and Malay traditional methods of treatment were commonly mentioned. The women from three ethnic groups viewed the possibility of their husband starting to take Viagra with lots of suspicion, mistrust and fear. They would prefer their husband discussing with them the issue of resorting to taking Viagra. The Chinese and Indian women perceived that if a man takes Viagra, it will boost his ego and he will feel more manly. Indian women felt that a man taking Viagra is proof of his love for his wife. The Malay women felt that a man would be ashamed and have a low self-esteem if he were to resort to taking Viagra. Although Viagra is meant for the male, understanding of womens perception of it is beneficial for a couples sexual relationship.

How do men perceive erectile dysfunction and its treatment? A qualitative study on opinions of men

Introduction. Erectile dysfunction (ED) is a common medical disorder affecting the aging male. A mans perception of a disease affects his health seeking behaviour. This study aimed to explore perceptions of ED among men with ED and how these perceptions came about. Methods. This qualitative study utilized in-depth interviews involving 17 urban men aged between 40 and 75 years old. Results. Misconceptions existed regarding the definitions of ED. Most men perceived impotence to be more serious than ED. Although most were aware of the medical causes of ED, ‘overuse of penis’ and black magic were mentioned as culturally-related causes. ED was perceived as a serious problem associated with loss of manhood and it had a significant impact on relationships with their partners. However, some adopted an ‘accepting’ view and attributed it to aging and fate. Most men were only familiar with PDE-5 inhibitors and traditional therapies. PDE-5 inhibitors were perceived to be effective but they were concerned about side effects and costs. Conclusions. Identifying mens perceptions of ED and its treatment would help doctors in their consultation, and inform health policy makers in planning appropriate public education and services.

A consensus on men's health status and policy in Asia: a Delphi survey

OBJECTIVE There is currently no documentation on the availability and implementation of policies related to mens health in Asia. This Delphi study aimed to achieve an Asian consensus on mens health policy based on the opinions and recommendations from mens health key opinion leaders. STUDY DESIGN A two-phase Delphi online survey was used to gather information from mens health stakeholders across Asian countries. METHODS All stakeholders were invited to participate in the survey through mens health conferences, personal contacts, recommendations from international mens health organizations and snowballing method. Stakeholders were asked about their concerns on 17 mens health key issues as well as their opinion on the availability and recommendations on mens health policies and programmes in their countries. RESULTS There were a total of 128 stakeholders (policy makers, clinicians, researchers and consumers), from 28 Asian countries, who responded in the survey. Up to 85% of stakeholders were concerned about various mens health issues in Asia and in their respective country, particularly in smoking, ischaemic heart disease and high blood pressure. There is a lack of mens health policies and programmes in Asia (availability = 11.6-43.5%) and up to 92.9% of stakeholders recommended that these should be developed. CONCLUSIONS These findings call for policy change and development, and more importantly a concerted effort to elevate mens health status in Asia.

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.