Hattat Hospital - Monthly Review

IF YOU ARE CONSIDERING TUMMY TUCK

Cum, 23 Tem 2010 11:45:48 EST

The best candidates for abdominoplasty are men or women who are in relatively good shape but are bothered by a large fat deposit or loose abdominal skin that won't respond to diet or exercise.

The surgery is particularly helpful to women who, through multiple pregnancies, have stretched their abdominal muscles and skin beyond the point where they can return to normal. Loss of skin elasticity in older patients, which frequently occurs with slight obesity, can also be improved.

Patients who intend to lose a lot of weight should postpone the surgery. Also, women who plan future pregnancies should wait, as vertical muscles in the abdomen that are tightened during surgery can separate again during pregnancy.

If you have scarring from previous abdominal surgery, your doctor may recommend against abdominoplasty or may caution you that scars could be unusually prominent.

Abdominoplasty can enhance your appearance and your self-confidence, but it won't necessarily change your looks to match your ideal, or cause other people to treat you differently. Before you decide to have surgery, think carefully about your expectations and discuss them with your surgeon.

Thousands of abdominoplasties are performed successfully each year. When done by a qualified plastic surgeon who is trained in body contouring, the results are generally quite positive. Nevertheless, there are always risks associated with surgery and specific complications associated with this procedure.

Smokers should be advised to stop, as smoking may increase the risk of complications and delay healing. You can reduce your risk of complications by closely following your surgeon's instructions before and after the surgery, especially with regard to when and how you should resume physical activity.

In your initial consultation, your surgeon will evaluate your health, determine the extent of fat deposits in your abdominal region, and carefully assess your skin tone. Be sure to tell your surgeon if you smoke, and if you're taking any medications, vitamins, or other drugs.

If, for example, your fat deposits are limited to the area below the navel, you may require a less complex procedure called a partial abdominoplasty, also know as a mini-tummy tuck, which can often be performed on an outpatient basis. You may, on the other hand, benefit more from partial or complete abdominoplasty done in conjunction with liposuction to remove fat deposits from the hips, for a better body contour. Or maybe liposuction alone would create the best result.

Your surgeon will give you specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking, and taking or avoiding certain vitamins, and medications.

If you smoke, plan to quit at least one to two weeks before your surgery and not to resume for at least two weeks after your surgery. Avoid overexposure to the sun before surgery, especially to your abdomen, and do not go on a stringent diet, as both can inhibit your ability to heal.

Whether your surgery is done on an outpatient or inpatient basis, you should arrange for someone to drive you home after your surgery, and to help you out for a day or two after you leave the hospital, if needed.

Some surgeons perform both partial and complete abdominoplasties in an outpatient surgical center. Many surgeons prefer the hospital, where their patients can stay for one or two days.
Complete abdominoplasty usually takes two to five hours, depending on the extent of work required. Partial abdominoplasty may take an hour or two.

Most commonly, the surgeon will make a long incision from hipbone to hipbone, just above the pubic area. A second incision is made to free the navel from surrounding tissue. With partial abdominoplasty, the incision is much shorter and the navel may not be moved, although it may be pulled into an unnatural shape as the skin is tightened and stitched.

For the first few days, your abdomen will probably be swollen and you're likely to feel some pain and discomfort which can be controlled by medication. Depending on the extent of the surgery, you may be released within a few hours or you may have to remain hospitalized for one to two days.

Your doctor will give you instructions for showering and changing your dressings. And though you may not be able to stand straight at first, you should start walking as soon as possible.

Surface stitches will be removed in five to seven days, and deeper sutures, with ends that protrude through the skin, will come out in two to three weeks. The dressing on your incision may be replaced by a support garment.

It may take you weeks or months to feel like your old self again Exercise will help you heal better. Even people who have never exercised before should begin an exercise program to reduce swelling, lower the chance of blood clots, and tone muscles. Vigorous exercise, however, should be avoided until you can do it comfortably.

Your scars may actually appear to worsen during the first three to six months as they heal, but this is normal. Expect it to take nine months to a year before your scars flatten out and lighten in color. While they'll never disappear completely, abdominal scars will not show under most clothing, even under bathing suits.

Abdominoplasty, whether partial or complete, produces excellent results for patients with weakened abdominal muscles or excess skin. And in most cases, the results are long lasting, if you follow a balanced diet and exercise regularly.

If you're realistic in your expectations and prepared for the consequences of a permanent scar and a lengthy recovery period, abdominoplasty may be just the answer for you.

IF YOU ARE CONSIDERING BREAST LIFT...

Per, 22 Tem 2010 13:14:03 EST

Also known as mastopexy, a breast lift raises and firms the breasts by removing excess skin and tightening the surrounding tissue to reshape and support the new breast contour.

A woman’s breasts often change over time, losing their youthful shape and firmness. These changes and loss of skin elasticity can result from pregnancy, breastfeeding, weight fluctuations, aging, gravity and heredity.

Also known as mastopexy, a breast lift raises and firms the breasts by removing excess skin and tightening the surrounding tissue to reshape and support the new breast contour.

Sometimes the areola becomes enlarged over time, and a breast lift will reduce this as well. A breast lift can rejuvenate your figure with a breast profile that is youthful and uplifted.

A breast lift is a good option for you if you: are physically healthy and maintain a stable weight, have realistic expectations, are bothered by the feeling that your breasts sag, have lost shape and volume, your nipples and areolas point downward, your breasts have a flatter, elongated shape or are pendulous, when unsupported, your nipples fall below the breast crease, you have stretched skin and enlarged areolas or one breast is lower than the other.

Your surgeon may evaluate your general health status and any pre-existing health conditions or risk factors examine your breasts, and may take detailed measurements of their size and shape, skin quality, placement of your nipples and areolas.

Prior to surgery, you may be asked to get a baseline mammogram before surgery stop smoking well in advance of surgery, avoid taking aspirin, anti-inflammatory drugs and herbal supplements.

Breast lift surgery may be performed in an outpatient surgical center, or a hospital. If your breast lift is performed on an outpatient basis, be sure to arrange for someone to drive you to and from surgery and to stay with you for at least the first night following surgery.

Your breast lift surgery can be achieved through a variety of incision patterns and techniques. The appropriate technique for you will be determined based on:breast size and shape, position of your areolas, the degree of breast sagging, skin quality and elasticity as well as the amount of extra skin.

Medications are administered for your comfort during the surgical procedure. The choices include intravenous sedation and general anesthesia. Your doctor will recommend the best choice for you.

There are three common incision patterns: around the areola, around the areola and vertically down from the areola to the breast crease and around the areola, vertically down from the breast crease and horizontally along the breast crease.

After your breasts are reshaped and excess skin is removed, the remaining skin is tightened as the incisions are closed.

Some incision lines resulting from breast lift are concealed in the natural breast contours; however, others are visible on the breast surface. Incision lines are permanent, but in most cases will fade and significantly improve over time.

The results of your breast lift surgery are immediately visible. Over time, post-surgical swelling will resolve and incision lines will fade.

Satisfaction with your new image should continue to grow as you recover and realize the fulfillment of your goal for breasts which have been restored to a more youthful and uplifted position.

The decision to have breast lift surgery is extremely personal and you’ll have to decide if the benefits will achieve your goals and if the risks and potential complications are acceptable.

Breast lift surgery does not normally interfere with pregnancy, but if you are planning to have a baby, your breast skin may stretch and offset the results of mastopexy and you may have more difficulty breastfeeding after this operation.

After your breast lift procedure is completed, dressings or bandages will be applied to the incisions. You’ll need to wear an elastic bandage or support bra to minimize swelling and support your breasts as they heal.

The final results of your breast lift will appear over the next few months as breast shape and position continue to settle. Incision lines are permanent, but will continue to fade over time.

The results of your breast lift surgery will be long-lasting. Over time, your breasts can continue to change due to aging and gravity.

BOTOX

Per, 22 Tem 2010 12:39:10 EST

This drug has been used medically for over two decades to provide relief from muscle spasms; this substance causes a temporary relaxation of the muscles into which it is injected.

Botox is made from the bacterium Clostridium botulinum. When the muscles are paralyzed, the creation of more wrinkles is prevented. The overall effect is a smoother, more serene, more youthful appearance. It's like having a "brow lift" without invasive surgery.

The most commonly treated areas are the foreheads, around the eyes and between the eyebrows. With Botox injections, crow's feet can be softened; the furrow between the brows can be diminished and forehead wrinkles can be lessened. Botox is also used for treating wrinkles in the neck and the lift of brows, which droop in time. However, its most important characteristics is probably its ability to fully cease the aging in the upper part of the face with longer effects in time.

A very small amount of the diluted drug is injected directly into the muscle in the desired treatment area. The procedure is very quick and is performed while you are sitting upright in the treatment room. It is important to remain in an upright position for one to two hours after the treatment so the Botox injection will remain in place in the treated area.

Some people experience stinging while Botox is being injected, but there is rarely any pain following treatment. The application of anesthetic creams to the areas before treatment will decrease the discomfort associated with the injections.

For most people the results last three to six months. Facial muscles that are larger (such as in men) or which are used a lot by facially "expressive" patients may require treatments more frequently. Often the facial muscles become "trained" to not move as much so that, over time, less Botox is needed to keep the facial lines relaxed. As a basic rule, the applications should be made per four months initially, and at each six months following one year.

Since the effects of Botox injections are not permanent, significant side effects are rare. Bruising or redness at the injection sites can occur, and headaches are not uncommon. Pregnant or breastfeeding women should wait to be treated. Anyone with a neuromuscular or bleeding disorder or those with skin disease in the treatment area are not candidates for Botox injections.

Avoid aspirin, aspirin-containing products and non-steroidal anti-inflammatory agents for one week prior to treatment, as these may increase chance of bleeding and or bruising. Avoid alcohol for one day prior to treatment. After Botox injection remain in an upright position for two to three hours.

IF YOU ARE CONSIDERING BREAST AUGMENTATION...

Per, 22 Tem 2010 12:42:29 EST

Breast augmentation, technically known as augmentation mammoplasty, is a surgical procedure to enhance the size and shape of a woman's breast for a number of reasons: to enhance the body contour of a woman who, for personal reasons, feels her breast size is too small. To correct a reduction in breast volume after pregnancy. To balance a difference in breast size. As a reconstructive technique following breast surgery.

The best candidates for breast augmentation are women who are looking for improvement, not perfection, in the way they look. If you're physically healthy and realistic in your expectations, you may be a good candidate.

A breast implant is a silicone shell filled with either silicone gel or a salt-water solution known as saline.

Breast augmentation is relatively straightforward. But as with any operation, there are risks associated with surgery and specific complications associated with this procedure.
The most common problem, capsular contracture, occurs if the scar or capsule around the implant begins to tighten. This squeezing of the soft implant can cause the breast to feel hard. Capsular contracture can be treated in several ways, and sometimes requires either removal or "scoring" of the scar tissue, or perhaps removal or replacement of the implant.

There is no evidence that breast implants will affect fertility, pregnancy, or your ability to nurse.
In your initial consultation, your surgeon will evaluate your health and explain which surgical techniques are most appropriate for you, based on the condition of your breasts and skin tone. If your breasts are sagging, your doctor may also recommend a breast lift.

You may want to ask your surgeon for a copy of the manufacturer's insert that comes with the implant, just so you are fully informed about it.

Breast augmentation operations are generally done under general anesthesia. Occasionally, the surgery may be done as an inpatient in a hospital, in which case you can plan on staying for a day or two.

Your surgeon will give you instructions to prepare for surgery, including guidelines on eating and drinking, smoking, and taking or avoiding certain vitamins and medications.

While making preparations, be sure to arrange for someone to drive you home after your surgery and to help you out for a few days, if needed.

The method of inserting and positioning your implant will depend on your anatomy and your surgeon's recommendation. The incision can be made either in the crease where the breast meets the chest or around the areola (the dark skin surrounding the nipple)..

Every effort will be made to assure that the incision is placed so resulting scars will be as inconspicuous as possible.

Some surgeons believe that putting the implants behind your chest muscle may reduce the potential for capsular contracture.

Drainage tubes may be used for several days following the surgery. This placement may also interfere less with breast examination by mammogram than if the implant is placed directly behind the breast tissue.

Placement behind the muscle however, may be more painful for a few days after surgery than placement directly under the breast tissue.

You'll want to discuss the pros and cons of these alternatives with your doctor before surgery to make sure you fully understand the implications of the procedure.

The surgery usually takes one to two hours to complete. Stitches are used to close the incisions, which may also be taped for greater support. A gauze bandage may be applied over your breasts to help with healing.

You're likely to feel tired and sore for a few days following your surgery, but you'll be up and around in 24 to 48 hours. Most of your discomfort can be controlled by medication prescribed by your doctor.

Within several days, the gauze dressings, if you have them, will be removed, and you may be given a surgical bra. You should wear it as directed by your surgeon. You may also experience a burning sensation in your nipples for about two weeks, but this will subside as bruising fades.
Your stitches will come out in a week to 10 days. You should be able to return to work within a few days, depending on the level of activity required for your job.

Follow your surgeon's advice on when to begin exercises and normal activities. Your breasts will probably be sensitive to direct stimulation for two to three weeks, so you should avoid much physical contact. Your scars will be firm and pink for at least six weeks. Then they may remain the same size for several months, or even appear to widen. After several months, your scars will begin to fade, although they will never disappear completely.

For many women, the result of breast augmentation can be satisfying, even exhilarating, as they learn to appreciate their fuller appearance.

Your decision to have breast augmentation is a highly personal one that not everyone will understand. The important thing is how you feel about it. If you've met your goals, then your surgery is a success.

BREAST RECONSTRUCTION AFTER BREAST CANCER

Per, 22 Tem 2010 12:30:25 EST

The breasts are extremely important for aesthetic and physiologic aspects of women’s lives. So many times the breasts undergo morphological and volumetric modifications. Such modifications might be due to ageing, genetic properties, and changes in the body weights, lactation, pregnancy, breast feeding and menopause.

In contemporary era, the breast that lacks in normal appearance and projection may be the reason for the women to feel uneasy, concerns and even depression that might be adversely influencing the individual’s lifestyle.

To cope with these concerns, the operations for the reconstruction of the breasts are available, which include silicone prosthesis and breast enlargement, breast contouring, breast lift, breast reduction and breast symmetry, i.e., removal of inequality. The problems might be encountered for the nipple and areola, including the non-existence or dent of nipple and areola or displaced nipple.

The operations are also performed for the men who suffer from the feminine type enlargement of the breasts, so called gynecomasty.

Erectile Dysfunction (ED) and the heart

Per, 22 Tem 2010 12:21:32 EST

Erectile Dysfunction (ED) and the heart

What is the connection?

The most common cause of Erectile Dysfunction (ED) is a problem with the circulation to the penis. The lining of the arteries that supply blood to the penis is called the endothelium (endothee-lee-um). This controls the speed with which blood enters the penis and if it fails to operate properly blood does not enter quickly enough or for long enough to get a rigid erection that lasts enough time for satisfactory sexual intercourse. The arteries suffer a narrowing and damaging process known as atheroma which is similar to a pipe furring up.

The link between ED and coronary artery disease (CAD) is that they share the same

endothelium so a problem in one place may be present in another. This is why over 50% of men with CAD have ED. The problem is that over 50% of men with ED may have CAD they don’t know about.

Can ED come before CAD?

The short answer is yes. The arteries to the penis are small in diameter (1-2mm) whereas the coronary arteries to the heart are 3-4mm. This means that a similar problem in the coronary arteries may be silent because the arteries are big enough not to be restricted whereas the smaller penile arteries suffer earlier leading to ED. It takes longer for the bigger arteries to be affected by the narrowing process but if it is allowed to continue a man with ED and no heart complaint may develop a heart complaint in the five-year period after his ED began. This means ED can identify someone at future risk of a heart attack giving a chance for us to prevent it occurring.

What are the risk factors for ED and CAD?

They are the same. High blood pressure, raised cholesterol, cigarette smoking, obesity,

physical inactivity, depression and stress. So it is easy to explain why ED and CAD often coexist – it’s really a matter of which comes first.

What to do if you have ED and no heart disease history

It is very important you see your doctor for a full check-up – you could have a raised blood pressure or high cholesterol for example. Lifestyle issues are important – losing weight if needed and increasing physical activity are the easiest to adopt and benefit both ED and CAD. Heart disease risks can be treated reducing the chances of a problem in the future. You may have had your ED successfully treated by tablets given you by a friend or bought on the internet, but getting your erection back without a check on the heart is asking for trouble.

What is the Take Home Message?

ED may be a warning of an impending heart problem – heed the warning because your life may depend on it – get checked out.

Premature Ejaculation

Cum, 18 Haz 2010 16:16:30 EST

This fact sheet provides some helpful information on premature (or rapid) ejaculation.

What is premature ejaculation?
Premature ejaculation describes the condition where a man ejaculates (or comes) too soon. Sometimes this happens even before any direct stimulation of the penis occurs. Just thinking about a sexually stimulating situation can trigger ejaculation. However it is more common for ejaculation to occur either during or very soon after penetration. Premature ejaculation is one of the most common sexual problems affecting men. Most men will experience premature ejaculation at some time. It can become a problem when this situation is repeated in most sexual situations. Studies have shown that it is highly prevalent across all socio-economic groups and more than 40% of men are affected.

Just how soon is too soon?
Ejaculation often mostly occurs within two minutes of penetration. Some men last much longer and some come much more quickly. The important point to remember is that if ejaculation occurs sooner than the man and/or his partner wishes and this is causing distress in the sexual relationship, then it can be regarded as ‘premature’ or ‘rapid’.

At what age does premature ejaculation occur?
Premature ejaculation can occur at any age and under any situation, but it is more commonly a problem for the younger man. The occurrence of premature ejaculation is more related to the novelty of the sexual experience (new partner or different situation) than to the man's age.

What causes premature ejaculation?
There are some conditions that may interfere with the ejaculatory process, such as changes in the prostate gland, arteriosclerosis, diabetes and neurological disorders, but most cases are caused by failure to control the ejaculatory response. Early pioneers of sexuality studies believed early sexual experiences were important in the shaping of future ejaculatory habits. They thought that because of initial nervousness and haste, unsatisfactory early sexual experiences would 'programme' a pattern of learned rapid ejaculation later on (a form of negative conditioning). Inappropriate venues and circumstances e.g., backseats of cars, fear of discovery and one-night stands may contribute to establishing a pattern of rapid ejaculation.

Psychosocial events that may contribute to premature ejaculation include:

Partner's illness
Occupational stress/financial stress/shift work
Family problems/elderly relatives/bereavement/children
Guilt/Sexual orientation
Lack of experience/opportunity
Poor housing/overcrowding
Performance anxiety/fear of failure/expectations
Lack of sexual/interpersonal skills

A common reason for premature ejaculation is relationship disorders. Some of the components of relationship distress are: sexually demanding partners, unrealistic expectations, discrepant needs and desires in a relationship, dissatisfaction, lack of communication and trust, and affairs, partners who also have a sexual dysfunction, and an excessive desire to please a partner. Derogatory remarks made at the time tend to make matters worse and can lead to a cycle of failure and anxiety.

Current Treatments For Premature Ejaculation

The key aim of therapies for PE should be to improve control over ejaculation. Improvement in control over ejaculation may be associated with improved sexual satisfaction for the man and his partner and/or a reduction in feelings of personal distress or interpersonal difficulty due to timing of ejaculation.

Many men can be helped to delay ejaculation, using self-help methods, but some may require the help of an expert practitioner. Always discuss the problem with your partner first, to find out what their needs and wishes may be. A simple self-help method that can be effective is called the 'stop/start technique'. This can be done either by the man alone or with his partner whichever is preferable.

Step 1:

Gradually start stimulation of the penis, stopping just before you think you are about to ejaculate.

Step 2:

Rest, no stimulation for 30-60 seconds.

Step 3:

Begin stimulation of the penis again, stopping or reducing stimulation until the probability of ejaculation has passed.

Step 4:

Repeat above steps four or five times, until you begin to recognise the point of ejaculation. Allow ejaculation to occur.

This masturbation technique can be modified for your partner and is called the squeeze technique. Your partner masturbates you up to the point of no return, then firmly squeezes the penis where the glans (the knob) joins the shaft using the thumb and forefinger. The sensation of just being about to come will die down. There may be some softening of your erection, until stimulation begins again. This is a bit more difficult to organise and a considerable commitment is required from the couple for these techniques to have any chance of success.

Currently available treatments for PE include behavioural therapy, topical treatments, condoms and some drugs. The most common current treatment for PE is probably the use of behavioural techniques, which are practical exercises designed to teach the patient to control ejaculation based on the idea that responses to sexual excitement and the ejaculatory reflex can be modified. Topical creams or sprays that have an anaesthetic effect are also used and are effective in some men, but impair sensation and may decrease satisfaction with the sexual experience. A number of potential new treatments, both oral and topical, are currently under investigation and may offer new options for men with PE.

Sexual Dysfunction and Diabetes

Cum, 18 Haz 2010 15:42:55 EST

What is the problem?

Unfortunately diabetes can damage the circulation and nervous system. As a man’s erection depends on a healthy circulation and nervous system erectile dysfunction (ED) is common in men with diabetes. ED affects over 50% of people with type 2 diabetes. Importantly people with diabetes are also vulnerable to circulatory problems elsewhere including the coronary arteries to the heart and also the circulation to the kidneys. We now recognise that a person

with diabetes and no heart history is so much at risk of a heart problem that we treat them as if he or she has already had a heart attack.

ED in people with diabetes

As well as being common overall it is now clear that ED occurring before a heart condition can predict an increased risk of future heart problems. A man with ED and type 2 diabetes has a 34% chance of having coronary artery disease he doesn’t know about compared with someone with type 2 diabetic without ED who only has a 4% chance. This means ED occurring in a person with diabetes must be acted on as soon as possible not only to treat the ED but to use

treatment to reduce the risk of heart disease.

Can the ED be treated?

There is no reason not to. All treatments can be used depending on their success. Because diabetes damages both the arteries and nerves to the penis the Viagra, Cialis and Levitra drugs are less successful and should always be used in the top dose (success occurs in about 60% of men) compared with 80% or more in men without diabetes. As well as treating the ED, other treatments will be used to protect the heart, kidneys and circulation from damage

due to the diabetes.

Can female sexual dysfunction (FSD) occur in diabetics?

Sexual dysfunction is common in women with diabetes.However sexual functioning in women with diabetes has been less researched than in men. It appears that the most common sexual dysfunction in women with diabetes is decreased sexual arousal and inadequate lubrication. Women with diabetes may also have decreased sexual desire and more pain on intercourse. Women with more diabetic complications or are having difficulties in coming to terms with their diabetes seem to have more problems.

What can be done?

Both non-hormonal (self-help, psychosexual therapy, vaginal lubricants and moisturizers, clitoral vacuum pumps) or hormonal approaches can be used.

What is the hormonal approach for female sexual dysfunction?

Oestrogens

Oestrogen levels fall after the menopause. Hormone replacement therapy (HRT) can be either given systemically, where they increase levels throughout the whole body or vaginally, without increasing hormone levels throughout the body. Systemic oestrogen (which can be given by tablet, patch or skin gel) will also deal with other menopausal symptoms such as hot flushes. It is probably best to seek specialist advice before taking systemic HRT. Diabetes affects blood lipids (fats) as well as blood sugar, but HRT, especially if delivered through the skin, seems to improve the lipid profile Low dose vaginal oestrogens are very effective and can be given by tablet, ring, creams or pessaries. Long term treatment is required since symptoms return when treatment is stopped. There are no special concerns about giving low dose vaginal oestrogens in women with diabetes.

Testosterone

Testosterone is produced naturally in the female ovaries and adrenal glands and it is linked to female sexual function. The loss of sexual desire can be associated with this testosterone drop. When a woman gets her ovaries surgically removed (o�phorectomy), she experiences an immediate decline in testosterone. Several studies have shown a benefit of testosterone therapy in postmenopausal women but mainly in those using oestrogen. In the UK, the only licensed preparation for women for many years was subcutaneous implants or pellets to be put under the skin using local anaesthetic. Testosterone patches for women are now available. These have the advantage that women can start and stop treatment whenever they want. However testosterone has not been studied in women with diabetes and it is probably best to see a specialist.

Tibolone

Tibolone is often classed as a type of hormone replacement therapy(HRT). It is a synthetic steroid with similar effects to the female hormones, oestrogen and progesterone, as well as testosterone. It can improve menopausal symptoms such as hot flushes and can improve lack of libido. However tibolone has not been studied in women with diabetes and it is probably best to see a specialist.

FurtherWhat is the Take Home Message?

Sexual dysfunction is common in people with diabetes but very treatable. It does identify someone at risk of coronary disease. All people with diabetes with ED or FSD should not delay in discussing their problem with a healthcare professional.

European Sexual Health Alliance

Cum, 18 Haz 2010 15:40:38 EST

Hattat Hospital plays a key role in sexual dysfunction through our strategic partnership with European Sexual Health Alliance, as the co-founder and president of this non profit organisation. ESHA is situated in more than 12 European countries to facilitate counselling, networking and treatment services for patients with sexual dysfunction and their partners.

About ESHA

The European Sexual Health Alliance (ESHA) is an umbrella organisation for patient support groups across Europe. The main role of this patient focused organization is to assist patients suffering from sexual dysfunction, inform them about the solutions available as well as providing awareness and understanding of the condition to their partners, media and other interested parties.

ESHA’s purpose is to help every couple affected by sexual dysfunction to communicate openly about their sexual concerns in order to find a solution that improves the patient’s sexual function and the couple’s quality of life.

Sex & Ageing: Men's Issues

Cum, 18 Haz 2010 15:30:19 EST

Today men and women are living longer, healthier lives. As a result of this improvement in health many older couples now still continue to enjoy intimacy and sexually fulfilling lives. This fact-sheet will help you with some queries that you may have.

Does sex change as you get older?

The issues surrounding mature sexuality are still not openly discussed. Cultural biases have tended to stereotype older people as asexual, devoid of feelings or emotion. Couples who have been in long-term relationships do not necessarily find it any easier than others when it comes to discussing sexual difficulties. Like many activities in life, sexual expression is highly variable. Sexual function may well be different from that of a younger couple but that doesn't mean that it has to be any less pleasurable.

Will I still be able to have sex as I get older?

The ageing process involves many normal physical changes, some of which naturally affect sexual response, but sexuality is much more than a focus on the genital nature of sex. Often couples can find new ways to stimulate each other, such as erotic reading or videos. Partner communication and frank discussion of sexual desires, fantasies and experimentation are important. Some men may notice that they take longer to become aroused and achieve erection, and that their erections do not seem as hard. Just thinking about sex may no longer be enough. More direct physical stimulation of the penis may be required for a longer time. This may be due to reduced sensitivity. Some men may also find that the length of time between erections becomes longer as they age. The sensation of ejaculation may diminish and the man may find that orgasm doesn't feel as powerful as it did and that the amount of semen is reduced. Ejaculation may also take longer to achieve, and this can be a positive side of getting older as it may give more satisfaction to the partner. Some men may notice that their desire for sex may be reduced, but others may remain sexually active throughout life.
If you have found that you are experiencing difficulty obtaining and maintaining your erection, you are not alone. A lot of help that is now available. Your GP may be able to prescribe one of the drugs that now help erectile dysfunction. If, for whatever reason this is not suitable for you, then there are alternatives such as small urethral pellets, penile injections, vacuum aid devices, sex therapy, counselling and surgical implants.

Does illness affect sex?

Yes, it can. As people grow older, they are more likely to experience disabling conditions and illnesses that may affect how they respond sexually. Arthritis, stroke, coronary disease, diabetes, Parkinson's, surgery and the side effects of drugs can all affect how they respond. The psychological effects of illness can also have an impact on sexual function, especially if the diagnosis of a life threatening or life limiting illness has been made, or if the illness affects self-esteem or alters body image drastically. Illness can bring change in the structure of a couple's relationship, as previously independent people become dependent on their partner/carer. One partner may feel it is inappropriate to still have sexual desire if their partner is ill. For many carers the sheer stress and exhaustion of the role may adversely affect desire. Lifestyle can also have an impact how you may see yourself. Retirement and children leaving home is viewed by some as an end of a chapter in their lives, whereas for others it can mean the freeing up of time for each other. Lifestyle factors also have to be taken into consideration, smoking, excessive alcohol, use of recreational drugs, poor diet and lack of exercise can contribute to sexual dysfunction. Talk to your GP if you find that illness is preventing you from enjoying sex with your partner, they may be able to help and offer solutions or put you in touch with a therapist.

I am a widower: is it wrong to look for love again?

We all need to be loved and wanted. These needs do not diminish over time, but you may find you are seeking other forms of attachment than when you were younger. You may just require companionship and someone to share your favourite TV programs with. If you are looking to rekindle your love life you may feel awkward and embarrassed, not knowing where or how to set off. These are perfectly normal feelings, particularly if your partner had a long illness, and you may have profound feelings of guilt and betrayal. It will help to talk to someone about those feelings. To help you to move forward in a new relationship, you may like to speak to your doctor or contact a therapist through the British Association of Sex and Relationship Therapists - address below. When sexuality is affected, it is often a matter of learning to adapt and adjust rather than accepting an end to all forms of sexual expression.

I am embarrassed to seek help: what can I do?

The only person who will find this embarrassing is your self; you have nothing to be afraid of and everything to gain by seeking help. Discussing sexuality in midlife can sometimes be difficult, but there is no reason to think that because you are older, you cannot use all the services that are available to younger people. Sex is not abnormal after middle age, and for many individuals it does not just cease because procreation is no longer possible. Older age should not prevent you from seeking or receiving help from whatever source is most suitable for you.

Hattat Hospital -for the most effective treatment of all your sexual health problems -

Sex & Ageing: Women's Issues

Cum, 18 Haz 2010 16:17:32 EST

Today men and women are living longer, healthier lives. As a result of this improvement in health many older couples continue to enjoy intimacy and sexually fulfilling lives. This fact-sheet will help you with some queries that you may have.

Does sex change as you get older?

Sexuality is a complex issue. It involves the whole experience of self, including relationships with others, feelings about one's self and the functioning of the body. It includes issues of self-esteem and the roles that we take or have been given. Sex often tends to be seen as something that can only be experienced and enjoyed by young people, and if you agree with that notion then you may find difficulty adapting to your sexuality as you age. Like many activities in life, sexual expression is highly variable. Sexual function may well be different from that of a younger couple, but that doesn't mean that it has to be any less pleasurable. While a good sexual relationship is seen as important to quality of life for a majority of older adults, the quality of interpersonal relationships is even more important.
The issues surrounding mature sexuality are still not openly discussed in the public arena. Cultural biases have tended to stereotype older people as asexual, devoid of feelings or emotion. Couples who have been in long-term relationships do not necessarily find it any easier than others when it comes to discussing sexual difficulties.

What changes can I expect, as I get older?

The ageing process involves many normal physical changes, some of which naturally affect the sexual response, but sexuality is much more than a focus on the genital nature of sex. Often couples can find new ways to stimulate each other, such as erotic reading or videos. Partner communication and frank discussion of sexual desires, fantasies and experimentation are important if fulfilling sexual relationships are to be maintained into old age. Some women may find that they take longer to become aroused than when they were young, and this is a normal part of sexual response in older women.
The issues relating to responsiveness are complicated by the fact that each woman is different. A woman's concept of herself as a sexual being may be tied to her ability to reproduce- an ability she loses after the menopause. During menopause, women may experience a wide variety of conditions that may cause changes in sexual function. The drop in oestrogen levels (female hormone) during menopause may account for some (though not all and not exclusively) of the changes in arousal and desire. Changes in lubrication may occur as the walls of the vagina become thinner and less elastic; lubrication is slower and there is less volume in older women. This may cause pain if intercourse is attempted too soon before adequate arousal occurs, the use of additional lubricants such as Senselle and KY jelly are recommended. You may find that the vaginal area and breasts become less sensitive to touch, and that orgasm may take longer. You may require different stimulation than before.

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Can I have good sex without intercourse?

Yes, most definitely. For men and women, sex in later years may change, but can be just as emotionally satisfying as before and perhaps more so. The importance is in learning to communicate in a way that will lead to emotional and physical fulfillment for you.

Does illness affect sex?

Yes, it can. As people grow older they are more likely to experience disabling conditions and illnesses that may affect how they respond sexually. Arthritis, stroke, coronary disease, diabetes, Parkinson's, surgery and the side effects of drugs can all affect how they respond. The psychological effects of illness can also have an impact on sexual function, especially if the diagnosis of a life threatening or life- limiting illness has been made, or if the illness affects self-esteem or alters body image drastically. Illness can bring change in the structure of a couple's relationship, as previously independent people become dependent on their partner/carer. One partner may feel it is inappropriate to still have sexual desire if their partner is ill. For many carers the sheer stress and exhaustion of the role may adversely affect desire. Lifestyle can also have an impact how you may see yourself.
Retirement and children leaving home is viewed by some as an end of a chapter in their lives, whereas for others it can mean the freeing up of time for each other. Lifestyle factors also have to be taken into consideration, smoking, excessive alcohol, use of recreational drugs, poor diet and lack of exercise can contribute to sexual dysfunction. Talk to your GP if you find that illness is preventing you from enjoying sex with your partner; they may be able to help and offer solutions or put you in touch with a therapist.

I am a widow: is it wrong to look for love again?

We all need to be loved and wanted. These needs do not diminish over time, but you may find you are seeking other forms of attachment than when you were younger. You may just require companionship and someone to share your favourite TV programs with. If you are looking to rekindle your love life, you may feel awkward and embarrassed, not knowing where or how to set off. These are perfectly normal feelings, particularly if your partner had a long illness, and you may have profound feelings of guilt and betrayal. It will help to talk to someone about those feelings. To help you to move forward in a new relationship, you may like to speak to your doctor or contact a therapist . When sexuality is affected, it is often a matter of learning to adapt and adjust rather than accepting an end to all forms of sexual expression.

Peyronie�s Disease

Cum, 18 Haz 2010 15:27:50 EST

Why is it called Peyronie’s disease?

Peyronie’s disease was named after Francois Gigot de la Peyronie, who in 1743 first described the characteristic changes in the penis.

What is it?

Peyronie’s disease is a benign fibrous condition of the penis. The fibrous ‘plaques’ are formed in the tunica albuginea, the firm tissue that surrounds the main erectile bodies. As fibrotic tissue does not stretch, any elongation of the penis on erection in someone with this disorder usually results in a penile deformity, with the bend sometimes so marked that sexual intercourse is impossible.

The exact cause is not yet fully understood and many factors may be involved. Twenty-five per cent of patients have Dupuytren’s contracture, a similar fibrotic condition found in the tendons in the palm of the hand causing a progressive clenching of the fingers. There may be a family history in 2% of patients and many patients have vascular diseases such as diabetes, hypertension and heart conditions.

Who can get Peyronie’s disease?

Any man can develop Peyronie’s disease. It commonly presents in men in their forties but can occur in men as young as 18 years old.

What are its main features?

The three main symptoms of Peyronie’s disease are:

1. Penile pain on erection

2. A thickening in the shaft of the penis

3. A curvature of the erect penis.

There may be erectile dysfunction as well. The pain occurs initially as the inflamed plaque is stretched with erection and it usually subsides spontaneously within three– six months. At this stage, the patient may notice a thickening or plaque in the shaft of his penis. As the plaque develops, the penis may become more noticeably curved when erect, commonly towards the abdomen. If this curve increases to a severe angle (greater than 60 degrees), intercourse can become uncomfortable or even impossible. Erectile dysfunction is common because of a combination of physical and psychological factors.

What are the options for treatment?

It is important to remember that many men with Peyronie’s disease do not need any treatment, as the condition usually stabilises over about a year, and any minor deformity does not interfere with sexual function. Many medical treatments have been used, but no single treatment has been shown to work in everyone. This is because despite many years of research, the cause still remains unknown. In the early stages of the disease, various medicines have been used but with variable results. A variety of injections into the plaque may help although more research is needed.

Surgery is only considered if the disease has been present for at least one year and is not increasing. Approximately 20% of patients need surgery, either to straighten the penis if the curvature is severe enough to prevent intercourse, or rarely, to treat the erectile dysfunction. The commonest operation used to straighten the penis is called the Nesbit procedure. A small amount of tissue is removed from the longer side of the penis, or, alternatively, the fibrous plaque can be cut and a graft is put in to lengthen the shorter side. In both operations, there is some loss of length of the penis, more so with the Nesbit procedure. In advanced Peyronie’s disease and where the ability to get an erection is very poor, the insertion of an inflatable prosthesis or rod may be the best solution.

What should I do if I think I have Peyronie’s disease?

Go to see your doctor as soon as you feel any pain or abnormal lumps in your penis. If Peyronie’s disease is diagnosed, ask your doctor to explain the condition and the treatment options that are available. A referral to a consultant with a special interest in male sexual health problems can be arranged. Remember, the disease is not linked to infection or cancer and the main aim of treatment is to prevent and correct the penile deformity.

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