John R. Gannon

Climacturia after Definitive Treatment of Prostate Cancer

PURPOSE Prostate cancer treatment results in several sexually related side effects beyond the well studied erectile dysfunction. Climacturia (leakage of urine during orgasm) has been reported after prostatectomy but studies have been limited by multiple factors. In this study we examine the prevalence, causes and impact on orgasm function of climacturia after definitive treatment of prostate cancer with surgery or radiation. MATERIALS AND METHODS A total of 906 anonymous surveys were sent to patients with prostate cancer treated with surgery and/or radiation. Respondents were asked about the presence of urinary leakage, climacturia and various elements related to sexual and orgasmic function. We estimated the prevalence of climacturia, evaluated the differences between those with and without climacturia, and assessed the impact of climacturia on orgasmic function. RESULTS Overall 412 surveys were returned and available for analysis, and of these respondents 75.2% were sexually active or experiencing orgasms. Climacturia was reported by 22.6% of these respondents, and by 28.3%, 5.2% and 28.6% of those treated with surgery, radiation, or both, respectively (p <0.001). The use of aides to obtain an erection (OR 2.24, 95% CI 1.08-4.93, p = 0.035) and the presence of urinary incontinence (OR 3.09, 95% CI 1.66-5.88, p <0.001) were also associated with climacturia in a multivariate logistic regression model. Climacturia had no significant impact on orgasmic function and satisfaction. CONCLUSIONS Climacturia is experienced by a substantial proportion of men after undergoing definitive treatment of prostate cancer. We found a complex relationship between stress urinary incontinence and climacturia, and noted that the presence of climacturia does not necessarily negatively impact sexual satisfaction.

A review of the epidemiology and treatment of Peyronie's disease.

Introduction Peyronie’s disease (PD) has significant effect on patients and their partners. We provide a current review of the epidemiology as well as the nonsurgical and surgical treatment of PD. Materials and methods Review of literature pertaining to PD with focus on epidemiology and treatment options. Conclusion PD is common and likely underreported. The availability of new and highly effective treatment options will catalyze patient awareness and subsequently the prevalence of disease.

Use of secondary contraception following vasectomy: insights from the Pregnancy Risk Assessment Monitoring System, 2007–2011

Background To assess postpartum use of secondary contraception with vasectomy within Pregnancy Risk Assessment Monitoring System (PRAMS). Methods Secondary contraception and type of method used were assessed among married women reporting partner vasectomy 4 months after a recent live birth in female residents of 15 US states and New York City who participated in the 2007–2011 PRAMS. Results Between 2007 and 2011, 1,004 married women who had a recent live birth participating in PRAMS reported they and their partners relied on vasectomy for postpartum contraception. Among these couples, 57.8% reported not using additional forms of contraception postpartum. Of those reporting additional contraception, condoms were most commonly used (50.0%), followed by oral contraceptive pills (26.5%), and withdrawal (9.5%). Multivariable modeling showed that use of secondary contraception was twice as high among women reporting a second birth versus women reporting a fourth or higher birth [adjusted prevalence odds ratio (POR) =2.0 (1.1–3.2)]. No other sociodemographic characteristics (maternal age, maternal race, parental education, household income) were significantly associated with use of secondary contraception with vasectomy. Conclusions Most couples within PRAMS reporting partner vasectomy as postpartum contraception did not use secondary contraception in the months immediately after vasectomy, and, of those who did, most relied on less effective methods. Clinicians need to better understand reasons for limited use of secondary contraception with vasectomy to improve counseling strategies for reducing unintended pregnancy.

Localization of topoisomerase 2α and β during the rat spematogenesis cycle

Spermatogenesis involves the processes of germ cell proliferation, meiosis, and maturation. Germ cells at different spermatogenetic developmental stages exist through out the seminiferous tubules. In cross-sections of seminiferous tubules, staging of spermatogenesis is usually performed using PAS-hematoxylin staining, however, most studies also involve immunofluorescence analysis, which can be negatively affected by cell staining. Therefore, finding staging markers compatible with commonly used immunofluorescence techniques could be technically advantageous. In this study rat testis sections were evaluated for immunofluorescence expression profiles of topoisomerase 2 and topoisomerase 2 (Top2 and Top2 ). Stage-specific patterns were seen for both proteins. Topoisomerase 2 was present in the nuclei of the spermatocytes from spermatogenesis stages 7 to 14. Alternatively, topoisomerase 2 was present in the nuclei of elongating and condensing spermatids. It was observed initially as 2-4 small foci in spermiogenesis step 2, then as a single focus near the nuclear membrane of round spermatids from spermiogenesis steps 3 to 8. The Top2 foci were distinct from the chromatoid body and proximal to the Golgi apparatus, which is known to be adjacent to the acrosome. Based on these specific findings we propose that the Top2 locates to the acrosome and that Top2 and Top2 immunofluorescence may be useful staging markers.