Introdução: Embora a contracepção seja bastante prevalente no Brasil (77%), apenas dois métodos predominam: o contraceptivo hormonal oral e a esterilização cirúrgica (LT). No entanto a LT não é inócua e pode trazer diversas conseqüências para a vida dessas mulheres que se submetem a ela. Dentre estas pode estar a deterioração da função sexual o que seria contraditório visto que a LT objetiva uma vida sexual melhor, menos atemorizada pelo medo da gravidez. O presente estudo teve como objetivo avaliar a função sexual de mulheres submetidas à LT. Métodos: Estudo transversal de 235 casos, representativos de 1826, com dados obtidos através de inquérito da função sexual entre as mulheres laqueadas pelo SUS em Ribeirão Preto(SP) entre 2000 e 2004, utilizando-se o Female Sexual Function Index (FSFI) adaptado para o contexto brasileiro. Resultados: As entrevistadas tinham em média 35,9 anos e foram esterilizadas em média aos 33,3 anos; 89,8% estavam em união marital, 57,9% declararam-se brancas e 66,8%, católicas, tinham em média 6,1 anos de estudo e 76,6% pertenciam às classes C e D; 93,4% referiram ter um bom relacionamento conjugal e 59,5% declararam que o relacionamento não mudou após o procedimento. A média de filhos vivos foi 3,2, resultaram aborto 8,8% das gestações, 71,2% resultaram partos vaginais e 28,8%, cesáreas; 52,3% usaram pílula 6 meses antes da cirurgia; 98,7% responderam estar satisfeita com a cirurgia e 6,8% referiram dor pélvica. Em geral, 32,5% das mulheres apresentaram escores de índice com risco para disfunção sexual medido pelo FSFI. Foi observada associação entre a variável disfunção sexual e categoria de escolaridade, renda per capita, dor pélvica, número de gravidezes, número de partos vaginais e de cesáreas. Observou-se correlação negativa entre o escore de função sexual e o número de filhos vivos e correlação positiva entre o escore e renda familiar, renda per capita e os valores de classificação econômica. Conclusão: A partir dos dados obtidos, pôde-se observar que dentre as mulheres laqueadas do estudo a presença de disfunção sexual estava associada à dor pélvica e maior número de cesarianas, assim como a situações ligadas à vulnerabilidade social (baixa renda e escolaridade e maior número de filhos). / Introduction: Although contraception is high prevalent in Brazil (77%), only two methods prevail: the hormonal pills and the surgical sterilization. However female sterilization is not innocuous and it can bring several consequences for those women\'s life. Among these consequences it can be to deterioration of the sexual function what is contradictory sees that the use of contraceptional methods aims at a better sexual life, less frightened by the fear of pregnancy. The present study had as objective evaluates the women\'s sexual function submitted to LT. Methods: prevalence study of 235 cases, representative of 1826, with data obtained through inquiry of the sexual function among the women sterilized by the public health system in Ribeirão Preto(SP) between 2000 and 2004. There has been used the Sexual Female Function Index (FSFI) adapted for the Brazilian context. Results: The interviewees were 35,9 years old on average and they were sterilized on average to the 33,3 years; 89,8% were in marital union, 57,9% pronounced white and 66,8%, catholic, they had on average of 6,1 years of study and 76,6% belonged to the classes C and D; 93,4% referred to have a good matrimonial relationship and 59,5% declared that the relationship didn\'t change after the procedure. The alive children\'s average was 3,2, 8,8% of the gestations resulted abortion, 71,2% resulted vaginal childbirths and 28,8%, cesarean; 52,3% used pill 6 months before the surgery; 98,7% answered to be satisfied with the surgery and 6,8% referred pelvic pain. In general, 32,5% of the women presented index scores with risk for sexual dysfunction measured by FSFI. Association was observed between the variable sexual dysfunction and education category, per capita income, pelvic pain, number of pregnancies, number of vaginal childbirths and of Cesarean. Negative correlation was observed between the score of sexual function and the number of alive children and positive correlation among the score and surrender family, per capita income and the values of economical classification. Conclusion: Starting from the obtained data, it could be observed that among the sterilized women the presence of sexual dysfunction was associated to the pelvic pain and larger number of cesarean operations, as well as linked situations to the social vulnerability (low income and education and larger number of children).

<p>The purpose of this investigation was to study sexual function in women with neurological disorders at fairly distinct and separate locations. The dissertation comprises descriptive, retrospective, quantitative studies on sexual functioning in women with hypothalamo-pituitary disorders (HPD) (<i>n</i>:48), multiple sclerosis (MS)(<i>n</i>:47), and insulin-dependent diabetes mellitus (IDDM) (<i>n</i>:42). The results werecompared with those in an age-matched control group (C) (<i>n</i>:42), and as reported by representative Swedish women (<i>n</i>:742) in the Swedish sex survey SiS). The studies were based on comprehensive interviews, neurological examinations, incl. Vibration Perception Thresholds (IDDM), concentrations of prolactin and testosterone in serum (HPD), and a checklist on life satisfaction (IDDM, C, and SiS).</p><p>Sexual dysfunction was prevalent in almost all women with HPD and MS, and in 40% of the IDDM group. The problem of insufficient vaginal lubrication was more common in those with neurological disorders than among women in the SiS group. Sexual problems caused by reduced libido and orgasmic difficulties were more commonin the HPD and MS groups than in the SiS group. In the HPD group, women with intrasellar adenomas had better sexual function than women having expansively growing pituitary adenomas with both intra- and suprasellar extension. Normal serum testosterone values correlated to masturbation activity. Amenorrhea and older age werecorrelated with sexual problems in all groups. In the MS group, symptoms of a weak pelvic floor and of bladder and bowel dysfunction were correlated with reduced lubrication and orgasmic ability. In the IDDM group, signs of autonomic neuropathy were correlated with sexual dysfunction. Concerning life satisfaction generally,proportionately fewer women with IDDM were satisfied or very satisfied, though differing significantly from the other two groups in only two domains of life: contacts with friends, and physical health.</p>

<p>The aim of this thesis was to examine different approaches to support the self-care of persons with Type 2 diabetes, with special reference to practical, social, and sexual aspects of women's self-management. The methods to elucidate this comprised: evaluating a new model for diabetes patient education; designing a model to analyse the role of social networks in women's diabetes; conducting individual and focus group interviews for deeper understanding of the social and sexual aspects of diabetes; and collecting questionnaire data as a complement to the above.</p><p>The experience-based educational program led by pharmacists was found to improve participants' subjective control over diabetes and to provide important emotional support and encouragement to continue self-care. Metabolic control as measured by HbA_1c temporarily improved. The social network model elucidated potential mechanism leading to conflict of disease and social demands in women's diabetes. Qualitative analysis of the focus group interviews pointed to the role of guilt, shame, and social taboo in connection with the women's diabetes and sexuality.</p><p>Borderland is the metaphor I have chosen to describe the space between the traditional health care system and the everyday self-care of people with chronic disease. Using Borderland as a framework, a future model for diabetes management, anchored in our own and other's findings, is outlined and the concept of "Disease Manager Role" is introduced. The vision of a self-care support center in Borderland addresses such issues as accessibility, continuity, equitable provider-user relations, shared care plans, and strengthening social support.</p>

The aim of this thesis was to examine different approaches to support the self-care of persons with Type 2 diabetes, with special reference to practical, social, and sexual aspects of women's self-management. The methods to elucidate this comprised: evaluating a new model for diabetes patient education; designing a model to analyse the role of social networks in women's diabetes; conducting individual and focus group interviews for deeper understanding of the social and sexual aspects of diabetes; and collecting questionnaire data as a complement to the above. The experience-based educational program led by pharmacists was found to improve participants' subjective control over diabetes and to provide important emotional support and encouragement to continue self-care. Metabolic control as measured by HbA1c temporarily improved. The social network model elucidated potential mechanism leading to conflict of disease and social demands in women's diabetes. Qualitative analysis of the focus group interviews pointed to the role of guilt, shame, and social taboo in connection with the women's diabetes and sexuality. Borderland is the metaphor I have chosen to describe the space between the traditional health care system and the everyday self-care of people with chronic disease. Using Borderland as a framework, a future model for diabetes management, anchored in our own and other's findings, is outlined and the concept of "Disease Manager Role" is introduced. The vision of a self-care support center in Borderland addresses such issues as accessibility, continuity, equitable provider-user relations, shared care plans, and strengthening social support.

The purpose of this thesis is to explore how men experience living with localized prostate cancer. It includes four substudies carried out between 1997 and 2005. To gather data, the men were interviewed at home and the interviews were recorded. The men (n=27; ages 60-70) who participated in the substudies had a PSA ≤10 ng/ml at the time of diagnosis, and had what is known as low-risk prostate cancer. Seven of the men chose to “wait and see” how the disease would progress after receiving the diagnosis. Twenty men chose curative treatment (10 men external radiation therapy, 10 men radical surgery). The interviews were analyzed using a phenomenological hermeneutical method inspired by the philosophy of Paul Ricoeur, and qualitative content analysis. Men who live with localized prostate cancer perceive the disease as life-threatening, unpredictable, and without early symptoms, which creates a sense of uncertainty, worry, anxiety, despair, and fear of death. Men primarily share perceptions of the disease and treatment with their wives and relatives, as well as with other men in the same situation. They avoid talking about their illness, and keep their innermost thoughts about their disease, prognosis, and the future to themselves. The choice to share their thoughts and feelings only sparingly with others is related in part to the perceived stigmatization of the diagnosis, as well as to consideration for friends and family. The men report that external radiation therapy and radical surgery have negative side effects such as erectile dysfunction, urinary incontinence, and intestinal leakage. They describe the side effects as socially isolating; for example, urinary leakage can require a change of incontinence pads and clothing, and they feel that they smell bad. Men with erectile dysfunction describe themselves as maimed, and their sex lives have changed or disappeared. They report a change in their self-esteem and identity as men and they long for life as it was before the diagnosis, when they felt they had control over their bodily functions. A few men describe a sense of being literally and figuratively “exposed” when they are undressed for examinations or participate in discussions with female doctors and nurses about their erectile dysfunction. They do not describe this perception in the same way with respect to contact with male personnel. In the new situation after treatment, men try to regain a perceived sense of control in their daily lives, over the disease and the effects of treatment. They experience a sense of control over the disease through regular PSA tests; the implications of regular PSA tests can be interpreted as a life preserver in an uncertain world, considering that at the time they were diagnosed they had no symptoms and only had a PSA elevation. The PSA is important for this sense of control, and each PSA test is preceded by tense expectation. The PSA level is described as a reliable expression of the medical condition. The men cannot trust that their own perception of feeling healthy means that the disease is under control. Low and stable PSA levels over a long period of time give a sense of safety, security, and control over the situation. If the PSA climbs, the men feel that despite everything, they have caught it in time for further treatment. Discussions with other men with prostate cancer are also described as a way of having control over the situation. The men's endeavor to reconcile themselves to the new situation can be understood as a process, where they describe various strategies which can be used to forget the “cancer perspective” and achieve a perception of safety and security. Reconciliation with a new situation can be interpreted as a reorientation after the trauma of the cancer diagnosis. The study results show that the men are restrained in communicating their needs to others, which can be interpreted as their having a greater need for support and information than indicated by their signals. Having an internal image of what a man should be like can be an obstacle to showing these needs.

The purpose of this investigation was to study sexual function in women with neurological disorders at fairly distinct and separate locations. The dissertation comprises descriptive, retrospective, quantitative studies on sexual functioning in women with hypothalamo-pituitary disorders (HPD) (n:48), multiple sclerosis (MS)(n:47), and insulin-dependent diabetes mellitus (IDDM) (n:42). The results werecompared with those in an age-matched control group (C) (n:42), and as reported by representative Swedish women (n:742) in the Swedish sex survey SiS). The studies were based on comprehensive interviews, neurological examinations, incl. Vibration Perception Thresholds (IDDM), concentrations of prolactin and testosterone in serum (HPD), and a checklist on life satisfaction (IDDM, C, and SiS). Sexual dysfunction was prevalent in almost all women with HPD and MS, and in 40% of the IDDM group. The problem of insufficient vaginal lubrication was more common in those with neurological disorders than among women in the SiS group. Sexual problems caused by reduced libido and orgasmic difficulties were more commonin the HPD and MS groups than in the SiS group. In the HPD group, women with intrasellar adenomas had better sexual function than women having expansively growing pituitary adenomas with both intra- and suprasellar extension. Normal serum testosterone values correlated to masturbation activity. Amenorrhea and older age werecorrelated with sexual problems in all groups. In the MS group, symptoms of a weak pelvic floor and of bladder and bowel dysfunction were correlated with reduced lubrication and orgasmic ability. In the IDDM group, signs of autonomic neuropathy were correlated with sexual dysfunction. Concerning life satisfaction generally,proportionately fewer women with IDDM were satisfied or very satisfied, though differing significantly from the other two groups in only two domains of life: contacts with friends, and physical health.

Made available in DSpace on 2014-12-17T15:37:05Z (GMT). No. of bitstreams: 1 PauloJFC_DISSERT.pdf: 1001139 bytes, checksum: 32624b3dc04255ae3e75e4e16600e75d (MD5) Previous issue date: 2011-08-08 / A disfun??o sexual corresponde a altera??es em uma ou mais fases da resposta sexual humana e apresenta maior preval?ncia na popula??o feminina. Ademais, a participa??o de alguns fatores como obesidade e n?veis dos horm?nios esteroidais na disfun??o sexual feminina (DSF) permanece incerta. O presente estudo deteve-se na an?lise da ocorr?ncia de DSF numa popula??o de mulheres portadoras de obesidade, cadastradas no Ambulat?rio de Cirurgia Bari?trica do Hospital Universit?rio Onofre Lopes, da Universidade Federal do Rio Grande do Norte, no munic?pio de Natal, RN. O estudo foi realizado em uma amostra composta por trinta e uma mulheres, com idade entre 20 e 50 anos, com ?ndice de massa corp?rea (IMC) > 30 Kg/m2. A todas as pacientes foi aplicado um question?rio composto por uma se??o com dados socio-econ?micos, e outra abordando a sa?de sexual feminina, sendo esta ?ltima correspondente ao Female Sexual Function Index (FSFI), para diagn?stico de DSF. A partir dessa caracteriza??o, as pacientes foram reunidas nos grupos CD (pacientes com disfun??o, n= 9) e SD (sem disfun??o, n= 22). Para a an?lise do efeito da obesidade na DSF, as pacientes foram reunidas nos grupos 1 (6 pacientes com IMC grau I e II: entre 30 e 40 Kg/m2) e 2 (25 com IMC grau III: acima de 40). Para o estudo da participa??o dos horm?nios esteroidais foram determinadas as concentra??es s?ricas de cortisol, estradiol e dehidroepiandrosterona (DHEA) pelo m?todo de quimiluminesc?ncia. A an?lise estat?stica dos dados foi realizada usando os testes ANOVA, MANOVA (Pillai), al?m de an?lise de Cluster. Para identificar as diferen?as entre os dom?nios do FSFI, foi usado o teste T de Student. A signific?ncia considerada para todos os testes foi para p< 0,01. Das pacientes estudadas, 25,8% apresentaram DSF de acordo com o escore total do FSFI. A an?lise estat?stica posterior evidenciou que as diferen?as ocorreram para os dom?nios desejo, excita??o e orgasmo. N?o foi encontrada rela??o da presen?a de DSF com os diferentes graus de obesidade ou com os n?veis hormonais dos ester?ides cortisol, estradiol ou DHEA. Contudo, foi encontrado aumento significativo nos n?veis s?ricos de estradiol para o grupo 1, que corresponde ao de menor ?ndice de IMC. Estes resultados mostram que a preval?ncia de DSF n?o diferiu entre os graus I,II e III de obesidade das pacientes deste estudo mas, quando presente, a disfun??o ocorre nos dom?nios desejo, excita??o e orgasmo. A maior concentra??o de estradiol encontrada nas pacientes de menor ?ndice de IMC sugere uma poss?vel rela??o entre as duas vari?veis que precisa ser investigada em estudos futuros. / Sexual dysfunction corresponds to changes in one or more phases of human sexual response and it has major prevalence in women. At the same time, the participation of some factors such as obesity and levels of steroid hormones in female sexual dysfunction (FSD) remains uncertain. This study analyzed the occurrence of DSF in a population of obese women part of the Bariatric surgery clinic at the Onofre Lopes Academic Hospital of the Federal University of Rio Grande do Norte, Natal, RN. The study was conducted in a sample of thirty-one women, aged between 20 and 50 years with body mass index (BMI) > 30 kg/m2. All patients answered a questionnaire consisting of two sections addressing socioeconomic conditions and female sexual health, the latter corresponding to the Female Sexual Function Index (FSFI) for the diagnosis of FSD. Using this characterization the patients were divided in groups CD (nine patients with dysfunction) and SD (twenty-two patients with no sexual dysfunction). To analyze the effect of obesity on the DSF, the patients were divided in groups 1 (6 patients with obesity grade I and II: BMI between 30 and 40 kg/m2) and 2 (22 patients with obesity grade III: BMI above 40). To investigate the role of steroid hormones, serum levels were determined for cortisol, estradiol, and dehydroepiandrosterone (DHEA), using chemiluminescence method. The statistical analysis was performed using ANOVA, MANOVA (Pillai) and cluster analysis. To identify the differences between the domains of the FSFI, was used the Student t test. The significance level for all tests was p <0.01. Of the patients studied, 25.8% had DSF according to the total FSFI score. The statistical analysis showed that the differences occurred for the domains desire, arousal and orgasm. No relationship was found for the presence of DSF with different degrees of obesity and steroid hormone levels. However, was found significant increase in estradiol serum levels for group 1, which corresponds to the lowest BMI. These results show that the presence of FSD did not differ between grades I, II and III of obesity in this study, but, when present, dysfunction occurs in the domains desire, arousal and orgasm. The highest estradiol concentration found in patients with the lowest BMI suggests a possible relationship between the two variables, and should be investigated in future studies.

Theoretical part Currently accepted new conceptualization of women's sexual dysfunction is based on the model found in the American Psychiatric Association's Diagnostic and Statistical Manual (DSM-IV) and International Classification of Diseases (ICD). These classifications are extended and combined interpersonal, contextual, personalpsychological and biological factors. Recent DSM- IV definitions have focused on absence of sexual fantasies and sexual desireprior to sexual activity and arousal, even though the frequencyof this type of desire is known to vary greatly among women without sexual complaints. DSM-IV definitions also focus on genital swelling and lubrication, entities known to correlate poorly with subjective sexual arousal and pleasure. The structure of the new classification is based on the four categories of DSM-IV: disorders of desire, arousal, orgasm and pain. However these categories are newly assigned to the subjective dimension of satisfaction, stress and the presence of disorders during other sexual activities besides intercourse. The dimension lifetime vs. acquired, generalized vs. situational were added, as well as the etiology is taking into account. For clinical work it is important that these changes highlight the significance and importance of psychological, situational...

Submitted by Luciana Ferreira (lucgeral@gmail.com) on 2016-09-27T11:52:11Z No. of bitstreams: 2 Tese - Márcio Rodrigues Costa - 2016.pdf: 2910843 bytes, checksum: 62ef04b309bbf0cca3a09b8973a910c7 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Approved for entry into archive by Luciana Ferreira (lucgeral@gmail.com) on 2016-09-27T11:52:38Z (GMT) No. of bitstreams: 2 Tese - Márcio Rodrigues Costa - 2016.pdf: 2910843 bytes, checksum: 62ef04b309bbf0cca3a09b8973a910c7 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Made available in DSpace on 2016-09-27T11:52:38Z (GMT). No. of bitstreams: 2 Tese - Márcio Rodrigues Costa - 2016.pdf: 2910843 bytes, checksum: 62ef04b309bbf0cca3a09b8973a910c7 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2016-09-20 / Objective: The objective of this study was to determine the prevalence, severity, factors associated and that influence erectile function in patients with chronic kidney disease on conservative treatment. Methods: This transversal study was developed between May 2013 and December 2015. Male volunteer patients, heterosexual, 18 years of age or older, carriers of chronic renal disease on conservative treatment participated of this study. The patients had follow up in the specific ambulatories of chronic renal disease in two hospitals of Goiânia. The erectile dysfunction of the patients was assessed using the six erectile function domain questions (questions numbers 1 to 5 and 15) of the International Index of Erectile Dysfunction. While the questions of the International Index of Erectile Dysfunction were applied, the researchers reviewed medical records and filled search forms containing lifestyle habits, clinical, laboratory and sociodemographic data. The factors associated with erectile dysfunction in patients with chronic renal disease in conservative treatment were determined by univariate and multivariate logistic regression analysis. The prevalence and degree of erectile dysfunction among patients with chronic renal disease in conservative treatment in stage III versus IV/V were compared with the application of chi-square test. The correlation between glomerular filtration rate and International Index of Erectile Dysfunction score was estimated by Pearson correlation coefficient. Results: Among 245 patients with chronic renal disease on conservative treatment in the study, 71.02% had erectile dysfunction and the sexual disorder was severe in 36.73%. Individual analysis of the variables in these patients, without excluding the influence of one over the other, pointed erectile dysfunction associated with the age more than 50 years, body mass index less than 25, diabetes mellitus, stage IV/V of chronic kidney disease, cardiac arrhythmias and conduction disorders, benign prostatic hyperplasia, present or prior cigarette use, cigarette use for 10 years or more, pack-year cigarette index greater or equal to 20, alcohol usage time equal to or greater than 10 years, albumin less than 3.5 g /100 mL and creatinine clearance levels between 15 and 29 mL/min/1.73 m2. The conjunct analysis of the variables studied in this same group of patients has showed an independent association of erectile dysfunction with diabetes mellitus (P = 0.015). A comparison of patients with chronic renal disease on conservative treatment stage III versus IV/V has demonstrated a higher prevalence of erectile dysfunction in more advanced stages of chronic renal disease (P = 0.001) and similar frequency of severe, moderate, moderate to mild and mild erectile dysfunctions. Glomerular filtration rate has showed a positive correlation with the score of the International Index of Erectile Dysfunction. Conclusions: The prevalence of erectile dysfunction in patients with chronic renal disease in conservative treatment is high. Many factors are associated with erectile dysfunction in chronic renal disease population on conservative treatment. The only factor associated with erectile dysfunction that is not subject to influence from other agents is diabetes mellitus. The prevalence of erectile dysfunction increases with the progression of chronic renal disease on conservative treatment. / Objetivo: O objetivo deste estudo foi determinar a prevalência, gravidade e os fatores associados e influenciadores na função erétil de pacientes portadores de doença renal crônica em tratamento conservador. Material e métodos: Este estudo transversal desenvolveu-se entre maio de 2013 a dezembro de 2015. Participaram do estudo pacientes masculinos, voluntários, heterossexuais, com 18 anos de idade ou mais, portadores de doença renal crônica em tratamento conservador. Os pacientes tinham seguimento em ambulatórios específicos de doença renal crônica de dois hospitais em Goiânia. A disfunção erétil dos pacientes foi avaliada com as seis perguntas do domínio de função erétil (questões números 1 a 5 e 15) do International Index of Erectile Dysfunction. Enquanto as questões do IIEF eram aplicadas, os pesquisadores revisavam prontuários e preenchiam os formulários de pesquisa, que continham hábitos de vida, dados clínicos, laboratoriais e sociodemográficos. Os fatores associados à disfunção erétil nos portadores de doença renal crônica em tratamento conservador foram determinados por análise de regressão logística uni e multivariada. Compararam-se a prevalência e o grau de disfunção erétil entre pacientes com doença renal crônica em tratamento conservador em estágios III versus IV/V, com a aplicação do teste qui-quadrado. A correlação da taxa de filtração glomerular com o IIEF foi estimada pelo coeficiente de correlação de Pearson. Resultados: Dentre os 245 pacientes com doença renal crônica em tratamento conservador que participaram do estudo, 71,02% tinham disfunção erétil e, em 36,73%, o distúrbio sexual era grave. A análise individual das variáveis estudadas nestes pacientes, sem excluir a influência de uma sobre a outra, apontou associação de disfunção erétil com idade superior a 50 anos, índice de massa corpórea inferior a 25, diabetes mellitus, estágios IV/V de doença renal crônica, arritmias cardíacas e distúrbios de condução, hiperplasia prostática benigna, uso atual ou prévio de cigarro, uso de cigarro por 10 anos ou mais, índice maço-ano de cigarro maior ou igual a 20, tempo do uso de álcool igual ou superior a 10 anos, albumina inferior a 3,5 g/100 mL e níveis de depuração da creatinina entre 15 e 29 mL/min/1,73 m2. A análise conjunta das variáveis estudadas nesse mesmo grupo de pacientes apontou associação independente de disfunção erétil com diabetes mellitus (P = 0,015). A comparação entre portadores de doença renal crônica em tratamento conservadores estágios III versus IV/V demonstrou maior prevalência de disfunção erétil nos graus mais avançados de doença renal crônica (P = 0,001) e frequência similar de disfunção erétil grave, moderada, moderada a leve e leve. A taxa de filtração glomerular demonstrou correlação positiva com a pontuação do IIEF. Conclusões: A prevalência de disfunção erétil em portadores de doença renal crônica em tratamento conservador é alta. Muitos fatores associam-se à disfunção erétil na população portadora de doença renal crônica em tratamento conservador. O único fator associado à disfunção erétil que não está sujeito à influência de outros agentes é a diabetes mellitus. A prevalência de disfunção erétil aumenta com a progressão da doença renal crônica em tratamento conservador.

A prostatectomia radical é o método terapêutico mais utilizado no tratamento do câncer de próstata localizado. O objetivo deste estudo é avaliar a readaptação urinária e sexual no período pós- operatório. Método: Foram estudados 46 homens tratados por Prostatectomia Radical à quatro tempos: pré-cirurgia e após três meses; seis meses e um ano após cirurgia, através dos seguintes instrumentos: escala adaptativa operacionalizada redefinida- (EDAO-R); questionário de avaliação da disfunção sexual masculina - (QSM); questionário de incontinência urinária - (ICIQ-SF) e o questionário de comprometimento cognitivo - (MEEM). Em um ano de estudo a análise estatística avaliou quantitativamente a eficácia adaptativa em quatro setores, estruturados nos seguintes pressupostos: Afetivo-Relacional (A-R); Produtividade (Pr); Orgânico (Or) e Socio-Cultural (S-C). Resultados: Encontrou-se diferença significativa nos valores da adequação diagnóstica pela EDAO-R entre o momento 3 (6 meses de PR: G1 8,7%; G2 15,2%; G3 17,4%; G4 28,3%; G5 30,4%) e o momento 4 (1 ano de PR: G1 8,7%, G2 17,4%; G3 23,9%, G4 19,6%; G5 30,4%) em relação ao momento 1(précirurgíco: G1 28,3%; G2 17,4%; G3 26,1%; G4 17,4%, G5 10,9%). E no momento 3 (6 meses de PR: G1 8,7%; G2 15,2%; G3 17,4%; G4 28,3%; G5 30,4%) houve um aumento significativo em relação ao momento 2 (3 meses de PR: G1 10,9%; G2 17,4%; G3 37,0%; G4 17,4%; G5 17,4%). O ICIQ-SF diagnosticou diferenças significativas entre os todos os momentos (p < 0,001). O MEEM resultou no momento 2 (um ano de PR) com valores significativamente maiores que os apresentados no momento 1 pré-cirúrgico (p=0,001). O QS-M revelou no momento pré-cirúrgico que 80,5% dos pacientes se encontravam num escore de bom a excelente em relação ao desempenho sexual e que 19,5% se encontravam num escore de desfavorável a regular. No momento 4 (um ano de PR), os achados foram: 21,7% dos pacientes classificados na categoria de bom a excelente; 54,4%, na categoria de ruim a desfavorável e 23,9%, na categoria de nulo a ruim. Conclusão: Os homens submetidos à PR durante o período do estudo ficaram comprometidos na organização e na readaptação às alterações urinárias e sexuais decorrentes do tratamento / Radical prostatectomy (RP) is the most widely used therapeutic method in the treatment of localized prostate cancer. The aim of this study is to evaluate the urinary and sexual rehabilitation in the postoperative period. Methods: A study was done of 46 men treated with radical prostatectomy at four time intervals: pre-surgery, three months, six months and one year postsurgery. The following instruments were used: Revised Operational Adaptive Diagnostic Scale - (ROADS); questionnaire for the assessment of male sexual dysfunction - (QS -M); International Consultation on Incontinence Questionnaire - Short Form (ICIQ -SF) and the cognitive impairment test (Mini-Mental State Examination - MMSE). In a year of study the statistical analysis quantitatively evaluated the adaptive efficacy in four sectors, structured in the following assumptions: Affective - relational (AR); Productivity (Pr); Organic (Or) and Socio-Cultural (S- C). Results: There was a significant difference in the values of diagnostic suitability for the ROADS between time interval 3 (6 months of RP: G1 8.7%; G2 15.2%; G3 17.4%; G4 28.3%; G5 30.4%) and time interval 4 (1 year RP: G1 8.7%; G2 17.4%; G3 23.9%; G4, 19.6%; G5 30.4%) relative to time interval 1 (pre-surgical: G1 28.3%; G2 17.4%; G3 26.1%; G4 17.4%; G5 10.9%). Additionally at time interval 3 (6 months of RP: G1 8.7%; G2 15.2%; G3 17.4%; G4 28.3%; G5 30.4%) there was a significant increase compared to the second time interval (RP 3 months: G1 10.9%; G2 17.4%; G3 37.0%; G4 17.4%; G5 17.4%). The ICIQ-SF diagnosed significant differences between all four time intervals (p < 0.001). The MMSE resulted in time interval 2 (1year os RP) having significantly higher values than those presented pre-surgery in time interval 1 (p = 0.001). The QS-M revealed that 80.5% of the patients were found to have a good to excellent score in relation to sexual performance and that 19.5% had an unfavorable to regular score prior to surgery. At time interval 4 (one year PR), the findings were: 21.7% of patients were classified as good to excellent; 54.4% were classified as bad to unfavorable and 23.9% were in the null to bad category. Conclusion: The men submitted to PR during the study period were committed to the organization and rehabilitation of the urinary and sexual changes due to treatment