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Erectile Dysfunction (ED) has been defined as a persistent inability to attain or maintain erection adequate to permit satisfactory sexual function (National Institute of Health 1993). It is estimated that a third of men will be affected by ED at some point during their lives (Heidelbaugh 2010). Whilst published figures provide an indication of the prevalence of ED, they are likely to underestimate the true number as many men will not seek help either due to embarrassment or through acceptance that ED is inevitable with advancing age (Hatzimouratidis et al. 2010).

It has been estimated that 0.2% of the UK population identifies as transgender. For those who seek gender reassignment, the pathway can involve the expertise of multiple disciplines, including primary care, psychology, endocrinology and speech and language therapy. A small but significant number of the transgender population will also elect to undergo gender-affirming genital surgery in order to achieve gender congruence. In the UK, very few specialist centres provide genital gender-affirming surgery for trans-men and women. The population accessing these services spans the entire UK, and with such geographical dispersion, trans-patients with uro-genital complications after surgery in both the short and long term are likely to present locally, with initial assessment/management often conducted in a non-specialist setting. This article aims to help familiarise nurses with genital gender reassignment/affirming surgery and the resultant altered anatomy. It explores the urological issues trans-men and women may experience as a consequence of surgery.

BACKGROUND: Most bacteria present in blood components are normal skin flora, particularly Staphylococcus epidermidis and other coagulase-negative staphylococci. Growth patterns of these bacteria and the effects of different methods of component preparation may depend on variations in behavior between different isolates of the same species. STUDY DESIGN AND METHODS: Whole-blood units were inoculated with 19 different coagulase-negative staphylococcus (CNS) isolates at 1 to 10 and 10 to 100 CFUs per mL. After overnight holding at 22°C, the units were processed into components. The components were cultured before inoculation and during processing, including before and after WBC reduction. RESULTS: At low inoculum levels, CNS was detected in 15 (79%) of 19 whole-blood units and in 12 (63%) of 19 RBCs after separation; after filtration, bacteria were detected in 3 (16%) of 19 (p = 0.0069). For platelet concentrates, 6 (32%) of 19 grew bacteria before filtration and 1 of 18 after filtration (difference not statistically significant). Three (16%) of 19 plasmas were positive before and after freezing. At high inoculum levels, 16 (89%) of 18 whole-blood samples and RBCs were positive before filtration; 6 (33%) of 18 RBCs were positive after filtration (p = 0.0002); 8 (44%) of 18 platelets were positive before filtration; 3 (17%) of 18 were positive after filtration (difference not statistically significant), and 7 (37%) of 18 plasma samples were positive before and after freezing. CONCLUSION: The growth characteristics of CNS in blood components vary with differences either in the subtype of bacteria or in the donor blood. Filtration reduces but does not eradicate contamination of RBCs and platelets by CNS. Plasma may act as a reservoir for CNS infection.