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Introduction. Historically chocolate has been reported to exert several effects on human sexuality, mainly acting as an effective aphrodisiac, increasing sexual desire, and improving sexual pleasure. Aim. The aim of our study was to assess whether there is an association between daily chocolate intake and sexual function in a convenience sample of Northern Italian women. Methods. A convenience sample of 163 women (mean +/- SD age: 35.3 +/- 9.2 years; body mass index [BMf]: 22.5 +/- 3.5 kg/m(2)), recruited through advertising, completed an anonymous semistructured interview on recreational habits and questionnaires to assess sexual function (Female Sexual Function Index [FSFI]), sexual distress (Female Sexual Distress Scale), and depression (Beck Depression Inventory and Center for Epidemiological Survey Depression Scale). Results. Complete data were available for 153/163 (93.8%) women. Participants who reported daily chocolate intake (Group 1: 120 women) were significantly younger than those (Group 2: 3 3 women) who did not report to eat chocolate (33.9 +/- 0.8 years vs. 40.4 +/- 1.6 years, respectively) (P= 0.0003), despite a similar BAIL Participants in Group I had significantly higher total (P = 0.002) and desire domain (P = 0.01) FSFI scores than participants in Group 2. No differences between the two groups were observed concerning sexual arousal and satisfaction, sexual distress and depression. Our data also confirm that aging has a high statistically significant impact on women's sexual function. Conclusions. It is alluring to hypothesize that chocolate can have either a psychological or a biological positive impact on women's sexuality. In our sample women reporting chocolate consumption have higher FSFI scores than women who do not eat chocolate. However, when data are adjusted for age FSFI scores are similar, regardless of chocolate consumption.

Background: Recent large, prospective, randomised studies have demonstrated that adjuvant radiotherapy (RT) is a safe and effective procedure for preventing disease recurrence in locally advanced prostate cancer (PCa) patients. However, no study has ever tested the role of adjuvant RT in node-positive patients after radical prostatectomy (RP). Objective: We hypothesised that adjuvant RT with early hormone therapy (HT) might improve long-term outcomes of patients with PCa and nodal metastases treated with RP and extended pelvic lymph node dissection (ePLND). Design, setting, and participants: This retrospective study included 250 consecutive patients with pathologic lymph node invasion. We assessed factors predicting long-term biochemical recurrence (BCR)-free and cancer-specific survival (CSS) in node-positive PCa patients treated with RP, ePLND, and adjuvant treatments between 1988 and 2002 in a tertiary academic centre. Intervention: All patients received adjuvant treatments according to the treating physician after detailed patient information: 129 patients (51.6%) were treated with a combination of RT and HT, while 121 patients (48.4%) received adjuvant HT alone. Measurements: BCR-free survival and CSS in patients with node-positive PCa. Results and limitations: mean follow-up was 95.9 mo (median: 91.2). BCR-free survival and CSS rates at 5, 8, and 10 yr were 72%, 61%, 53% and 89%, 83%, 80%, respectively. In multivariable Cox regression models, adjuvant RT and the number of positive nodes were independent predictors of BCR-free survival (p = 0.002 and p = 0.003, respectively) as well as of CSS (p = 0.009 and p = 0.01, respectively). Moreover, there was significant gain in predictive accuracy when adjuvant RT was included in multivariable models predicting BCR-free survival and CSS (gain: 3.3% and 3%, respectively; all p < 0.001). Conclusions: Our data showed excellent long-term outcome for node-positive PCa patients treated with radical surgery plus adjuvant treatments. This study is the first to report a significant protective role for adjuvant RT in BCR-free survival and CSS of node-positive patients. (C) 2009 European Association of Urology. Published by Elsevier B.V. All rights reserved. Background: Recent large, prospective, randomised studies have demonstrated that adjuvant radiotherapy (RT) is a safe and effective procedure for preventing disease recurrence in locally advanced prostate cancer (PCa) patients. However, no study has ever tested the role of adjuvant RT in node-positive patients after radical prostatectomy (RP). Objective: We hypothesised that adjuvant RT with early hormone therapy (HT) might improve long-term outcomes of patients with PCa and nodal metastases treated with RP and extended pelvic lymph node dissection (ePLND). Design, setting, and participants: This retrospective study included 250 consecutive patients with pathologic lymph node invasion. We assessed factors predicting long-term biochemical recurrence (BCR)-free and cancer-specific survival (CSS) in node-positive PCa patients treated with RP, ePLND, and adjuvant treatments between 1988 and 2002 in a tertiary academic centre. Intervention: All patients received adjuvant treatments according to the treating physician after detailed patient information: 129 patients (51.6%) were treated with a combination of RT and HT, while 121 patients (48.4%) received adjuvant HT alone. Measurements: BCR-free survival and CSS in patients with node-positive PCa. Results and limitations: mean follow-up was 95.9 mo (median: 91.2). BCR-free survival and CSS rates at 5, 8, and 10 yr were 72%, 61%, 53% and 89%, 83%, 80%, respectively. In multivariable Cox regression models, adjuvant RT and the number of positive nodes were independent predictors of BCR-free survival (p = 0.002 and p = 0.003, respectively) as well as of CSS (p = 0.009 and p = 0.01, respectively). Moreover, there was significant gain in predictive accuracy when adjuvant RT was included in multivariable models predicting BCR-free survival and CSS (gain: 3.3% and 3%, respectively; all p < 0.001). Conclusions: Our data showed excellent long-term outcome for node-positive PCa patients treated with radical surgery plus adjuvant treatments. This study is the first to report a significant protective role for adjuvant RT in BCR-free survival and CSS of node-positive patients. (C) 2009 European Association of Urology. Published by Elsevier B.V. All rights reserved.

The advent of phosphodiesterase type 5 inhibitors (PDE5-I) has revolutionized the management of patients with erectile dysfunction (ED) of various causes. Currently, all patients with ED should be assessed with a thorough medical and sexual history, physical examination and selected blood tests, including serum glucose, lipid profile, morning total testosterone and prolactin [ 1]. At the end of this initial assessment phase most patients may be counselled on the different treatment options available and oral drug therapy results as most frequently chosen by current patients [ 2]. Patients who do not respond to oral drug therapy and those who cannot use PDE5-I because of specific contraindications may be given the option to be treated with either intracavernosal or intraurethral medical therapy, or with a vacuum device. Penile implants are usually considered as an option for patients who fail to respond to any kind of non-surgical therapy. Although this group of patients is much smaller than the overall population of patients with ED seeking medical advice, it is also becoming evident that with increasing knowledge of the efficacy and safety of oral drug therapy for ED, there has been a progressive increase of the number of office visits for this medical condition, and the final result includes a proportional increase of the number of those not responding to nonsurgical therapies. Thus the number of potential candidates for a penile implant has certainly increased in the recent past, in the experience of most urologists who work in andrology referral centres. This is the main reason why penile prostheses are important in treating ED. In this article we review the critical aspects of patient selection criteria, types of implants available and criteria leading to a specific choice, preoperative management of the patient, surgical technique, postoperative management, long-term results, and the management of complications. We consider that every resident should be knowledgeable on this list of topics. This review was based on a Medline search for a full-length reports in English, published from January 2000 to April 2004. The key words 'penile implants', 'penile prostheses', and 'erectile dysfunction' were used in the search. Updated information on the various types of implants was collected from the websites of the companies manufacturing these prostheses.