16 research outputs found
Impostor phenomenon among urologists in Saudi Arabia
Impostor phenomenon (IP) is the persistent inability to believe that one’s
success is deserved or has been legitimately achieved due to one’s efforts or
skills. It is associated with burnout, anxiety and depression and can negatively
impact the lives of the affected individuals. This study aimed to determine the
prevalence of IP among urologists in Saudi Arabia. A cross-sectional study was
conducted among practicing urologists and urologists-in-training in Saudi Arabia
between November and December 2022. A self-administered questionnaire comprising
questions on the sociodemographic characteristics and the Clance
impostor phenomenon scale (CIPS) was distributed through email to all registered
urologists in the Saudi Commission for Health Specialties database. A total of
155 urologists (143 men and 12 women) were enrolled in this study. The majority
of the urologists (44.5%) were consultants, and the prevalence of the impostor
phenomenon in this study was 27.7%. Nearly half of the urologists (49.7%)
presented moderate levels of the phenomenon, 23.9% of the urologists
demonstrated high levels, and 20.6% presented low levels. Only 5.8% of the
urologists showed intense levels of the phenomenon. The phenomenon was
significantly more prevalent among those in training (p = 0.010) and
less prevalent among those with a subspecialty in endourology (p =
0.016). The prevalence of the impostor phenomenon among urologists was 27.7%. It
was more commonly seen in resident urologists, and those with a subspecialty in
endourology were less likely to be affected by this phenomenon
Association of the modified frailty index with adverse outcomes after penile prosthesis implantation
Obesity is an independent risk factor for low serum testosterone in adult males
Objectives: Obesity and increased weight are recognized risk factors of hypogonadism. This study looked into the relation between body mass index (BMI) and serum testosterone level.
Patients and Methods: This was a prospective study of 664 patients. All patients had BMI calculation and serum Testosterone measurement. Patients with any other possible cause for hypogonadism were excluded from the study.
Results: Statistical analysis of the results showed an inverse correlation between the BMI and serum testosterone.
Conclusion: Increasing BMI is an independent risk factor in lowering serum testosterone
Analysis of the Interobserver Variability in Penile Length Assessment
ABSTRACT
Introduction
Many men seek penile augmentation treatments—a standard tool for their counseling is to inform them of what is “normal.” Although some studies suggest good correlation between stretched and erect penile length, those that have measured stretched and erect length simultaneously have shown significant variability.
Aim
To assess the accuracy of differing penile measurements with multiple observers.
Methods
We recruited 201 adult men (mean age 49.6 years) who achieved full erection using intracavernosal injection.
Main Outcome Measures
Penile measurements were taken by one of seven andrology specialists in a private, temperature-controlled (21°C, 72°F) environment. Stretched flaccid and erect length and circumference were measured. We analyzed the accuracy of each flaccid measurement using the erect measurements as a reference, for the overall patient population and for each observer.
Results
The mean underestimate of length from stretched flaccid to erect was 2.64 cm (21.4%) and girth 2.27 cm (19.5%). Interobserver variability ranged from a mean underestimate of 16–27% (length) and 15–27% (girth).
Conclusions
In this large, multicenter, multi-observer study of penis size, flaccid measurements underestimated erect size. It also seems likely that there is significant interobserver variability. We believe erect penis measurements should be used for men being considered for treatment of small penis anxiety.
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Investigating the risk factors of penile arterial insufficiency and veno‐occlusive dysfunction in patients with erectile dysfunction
Abstract Objective To investigate the risk factors for penile arterial insufficiency (PAI), which is a known cause of erectile dysfunction (ED). Methods Patients who attended our urology clinic complaining of ED for more than 6 months were prospectively enrolled in this study over 1‐year period. Patient consent was taken and ethical committee approval. Complete medical history and thorough general and local examination including body mass index (BMI), Peyronie's disease (PD) and penile size measurements (length and girth) were done for all of them. Laboratory tests included testosterone, lipid profile and glycated haemoglobin (HA1c). A penile duplex ultrasound study (PDU) was done for all patients after intracavernosal injection (ICI) with alprostadil. Peak systolic velocity (PSV) and end‐diastolic velocity (EDV) were measured after 15 min. Statistical analysis was done using SPSS. Results A total of 440 patients were enrolled in this analysis. The mean age was 48(23–81), and the mean BMI was 30 (18–51). Older patients had lower PSV (r = −0.361, P = 0.000) and higher EDV (r = 0.174, P = 0.001), and both correlations were highly statistically significant. Diabetics had lower PSV (r = −0.318, P = 0.000) and higher EDV (r = 0.139, P = 0.008), which were also highly statistically significant. Smokers had lower PSV (r = −0.140, P = 0.008) and higher EDV (r = 0.178, P = 0.001), which were highly statistically significant. Men with larger penises measured skin to tip had lower EDV (r = −0.119, P = 0.024), which was less significant. Interestingly, there was neither a significant correlation between BMI and PSV (0.16, P = 0.745) nor a significant correlation between testosterone and PSV (0.029, P = 0.552). Also, there was no correlation between PSV and both dyslipidaemia and penile PD. Conclusions Ageing, tobacco consumption, DM and hypertension seem to have a negative impact on penile haemodynamics, which was statistically significant. In our patients, there was no statistically significant effect on penile haemodynamics in patients with increased BMI, low testosterone or PD or according to the size of the penis
Peyronie's disease is common in poorly controlled diabetics but is not associated with the Metabolic Syndrome
Clomiphene citrate and human chorionic gonadotropin are both effective in restoring testosterone in hypogonadism: a short-course randomized study.
OBJECTIVES
To compare serum testosterone response and symptom improvement in men with hypogonadism in response to treatment with clomiphene citrate (CC), human chorionic gonadotropin (hCG), or a combination of both therapies.
PATIENTS AND METHODS
A total of 282 men with hypogonadism, wishing to preserve their fertility, were randomized to one of three treatment arms: CC 50 mg (n = 95); 5000 IU hCG injections twice weekly (n = 94); or a combination of both therapies (CC + hCG; n = 94). All participants had complete medical history and had undergone thorough physical examination, including body mass index (BMI) assessment. Laboratory tests included serum total testosterone and glycated haemoglobin (HbA1c) measurements. Quantitative Androgen Deficiency in the Aging Male (qADAM) questionnaire scores were also recorded. Morning samples of total serum testosterone levels were assessed at three time points: baseline, 1 and 3 months.
RESULTS
Testosterone levels increased at 1 and 3 months in all three groups. The mean baseline testosterone level was 2.31 ± 0.66 nmol/L, BMI was 30.8 ± 6.2 kg/m , and qADAM score was 20.5 ± 3.8. Testosterone levels increased in all groups at all time points, with a final mean value of 5.17 ± 1.77 nmol/L (223% increase) with no statistically significant difference among the groups. qADAM scores had increased in all groups at 1 month (CC group: 6.36; hCG group: 5.08; CC + hCG group: 7.26) and at 3 months (CC group: 12.73; hCG group: 11.82; CC + hCG group: 15.13) with a significant difference in intergroup analysis for the CC + hCG group compared with the other two groups (P < 0.01).
CONCLUSIONS
All three treatments were equally effective in restoring testosterone levels. Single-agent CC is simple, cheap and may be used as treatment for hypogonadism when maintenance of fertility is desired. This approach seems to be as effective as either hCG alone or a combination of hCG and CC