Difference between revisions of "Yuan 2010"

 
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== <span style="font-size:x-large;">Hyperbaric oxygen therapy following urethral reconstruction limited the decrease in erectile function</span> ==
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== <span style="font-size:xx-large;">Hyperbaric oxygen therapy following urethral reconstruction limited the decrease in erectile function</span> ==
  
 
=== <span style="font-size: 14pt;">Clinical bottom line:</span> ===
 
=== <span style="font-size: 14pt;">Clinical bottom line:</span> ===
  
{|
+
{| style="width: 664px;"
 
|-
 
|-
| '''1. Erectile function scores declined less following postoperative HBOT than a sham treatment.'''
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| style="width: 652px;" | '''1. Erectile function scores declined less following postoperative HBOT than a sham treatment.'''
 
|}
 
|}
  
 
'''Citation/s:&nbsp;'''1. Yuan J-B, Yang L-Y, Wang Y-H, Ding T, Chen TD, Lu Q. Hyperbaric oxygen therapy for recovery of erectile function after posterior urethral reconstruction. International Urology Journal 2011; 43:755-761
 
'''Citation/s:&nbsp;'''1. Yuan J-B, Yang L-Y, Wang Y-H, Ding T, Chen TD, Lu Q. Hyperbaric oxygen therapy for recovery of erectile function after posterior urethral reconstruction. International Urology Journal 2011; 43:755-761
  
'''Lead author's name''':'''Yang: yang_louyan@yahoo.cn'''
+
----
  
'''Three-part Clinical Question:''''''Does hyperbaric oxygen promote the recovery of erectile function following posterior urethral reconstruction.''
+
'''Lead author's name''':'''Yang:''' yang_louyan@yahoo.cn
  
'''Search Terms:''''''''''''erectile dysfunction. urethral reconstruction, urethral stricture''
+
'''Three-part Clinical Question: '''Does hyperbaric oxygen promote the recovery of erectile function following posterior urethral reconstruction.
 +
 
 +
'''Search Terms:&nbsp;'''erectile dysfunction. urethral reconstruction, urethral stricture
  
 
&nbsp;
 
&nbsp;
  
 
'''The Study:&nbsp;'''Double blinded, pseudo-randomised trial (alternate allocation) with intention-to-treat.
 
'''The Study:&nbsp;'''Double blinded, pseudo-randomised trial (alternate allocation) with intention-to-treat.
 
&nbsp;
 
  
 
T'''he Study Patients:&nbsp;'''Men with posterior urethral stricture and having operative reconstruction.
 
T'''he Study Patients:&nbsp;'''Men with posterior urethral stricture and having operative reconstruction.
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<span style="line-height: 1.5;">'''Experimental group:'''&nbsp;</span><span style="line-height: 1.5;">(N = 12; 12 analysed): 100% oxygen breathing at 2 ATA for 90 minutes daily postoperatively from the second postoperative day for a total of 14 treatments.</span>
 
<span style="line-height: 1.5;">'''Experimental group:'''&nbsp;</span><span style="line-height: 1.5;">(N = 12; 12 analysed): 100% oxygen breathing at 2 ATA for 90 minutes daily postoperatively from the second postoperative day for a total of 14 treatments.</span>
 
&nbsp;
 
 
&nbsp;
 
  
 
'''The Evidence:'''
 
'''The Evidence:'''
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{| class="Table" style="border:solid windowtext 1.0pt"
 
{| class="Table" style="border:solid windowtext 1.0pt"
 
|-
 
|-
| style="border:solid windowtext 1.0pt" |
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| style="width:153.2pt; border:solid windowtext 1.0pt" width="207" | <p align="center" style="text-align:center; padding:.75pt .75pt .75pt .75pt">'''Measure'''</p>  
<span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Measure</span></span>'''</span>
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| colspan="2" style="width:76.45pt; border:solid windowtext 1.0pt" width="104" | <p align="center" style="text-align:center; padding:.75pt .75pt .75pt .75pt">'''Air Group'''</p>  
 
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| colspan="2" style="width:76.45pt; border:solid windowtext 1.0pt" width="104" | <p align="center" style="text-align:center; padding:.75pt .75pt .75pt .75pt">'''HBOT group'''</p>  
| style="border:solid windowtext 1.0pt; padding:.75pt .75pt .75pt .75pt" | &nbsp;
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| style="width:59.35pt; border:solid windowtext 1.0pt" width="81" | <p align="center" style="text-align:center; padding:.75pt .75pt .75pt .75pt">'''Difference'''</p>  
| style="border:solid windowtext 1.0pt" |
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| style="border:solid windowtext 1.0pt" | <p align="center" style="text-align:center; padding:.75pt .75pt .75pt .75pt">'''95% CI'''</p>  
<span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Air Group</span></span>'''</span>
 
 
 
| style="border:solid windowtext 1.0pt; padding:.75pt .75pt .75pt .75pt" | &nbsp;
 
| style="border:solid windowtext 1.0pt" |
 
<span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">HBOT group</span></span>'''</span>
 
 
 
| style="border:solid windowtext 1.0pt" |
 
<span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Difference</span></span>'''</span>
 
 
 
| style="border:solid windowtext 1.0pt" |  
 
<span style="line-height:normal">'''<span style="font-size:10.0pt"><span style="font-family:">95% CI</span></span>'''</span>
 
 
 
 
|-
 
|-
| style="border:solid windowtext 1.0pt" |
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| style="width:153.2pt; border:solid windowtext 1.0pt; padding:.75pt .75pt .75pt .75pt" width="207" | &nbsp;
<span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">^</span></span></span>
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| style="width:41.0pt; border:solid windowtext 1.0pt" width="57" | <p align="center" style="text-align:center; padding:.75pt .75pt .75pt .75pt">'''Mean'''</p>  
 
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| style="width:33.95pt; border:solid windowtext 1.0pt" width="47" | <p align="center" style="text-align:center; padding:.75pt .75pt .75pt .75pt">'''SD'''</p>  
| style="border:solid windowtext 1.0pt" |
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| style="width:41.05pt; border:solid windowtext 1.0pt" width="57" | <p align="center" style="text-align:center; padding:.75pt .75pt .75pt .75pt">'''Mean'''</p>  
<span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Mean</span></span>'''</span>
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| style="width:33.9pt; border:solid windowtext 1.0pt" width="47" | <p align="center" style="text-align:center; padding:.75pt .75pt .75pt .75pt">'''SD'''</p>  
 
+
| style="width:59.35pt; border:solid windowtext 1.0pt; padding:.75pt .75pt .75pt .75pt" width="81" | &nbsp;
| style="border:solid windowtext 1.0pt" |
 
<span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">SD</span></span>'''</span>
 
 
 
| style="border:solid windowtext 1.0pt" |
 
<span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Mean</span></span>'''</span>
 
 
 
| style="border:solid windowtext 1.0pt" |
 
<span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">SD</span></span>'''</span>
 
 
 
| style="border:solid windowtext 1.0pt; padding:.75pt .75pt .75pt .75pt" | &nbsp;
 
 
| style="border:solid windowtext 1.0pt; padding:.75pt .75pt .75pt .75pt" | &nbsp;
 
| style="border:solid windowtext 1.0pt; padding:.75pt .75pt .75pt .75pt" | &nbsp;
 
|-
 
|-
| style="border:solid windowtext 1.0pt" |
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| style="width:153.2pt; border:solid windowtext 1.0pt" width="207" |
<span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Total IIEF* scores at 3 months (score 0 worst - 70 best)</span></span>'''</span>
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'''Total IIEF* scores at 3 months (score 0 worst - 70 best)'''
 
 
| style="border:solid windowtext 1.0pt" |
 
<span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">52.8</span></span></span>
 
 
 
| style="border:solid windowtext 1.0pt" |
 
<span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">5.2</span></span></span>
 
 
 
| style="border:solid windowtext 1.0pt" |
 
<span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">61.3</span></span></span>
 
 
 
| style="border:solid windowtext 1.0pt" |
 
<span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">4.1</span></span></span>
 
 
 
| style="border:solid windowtext 1.0pt" |
 
<span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">-8.5</span></span></span>
 
 
 
| style="border:solid windowtext 1.0pt" |
 
<span style="line-height:normal"><span style="font-size:10.0pt"><span style="font-family:">-12.4 to -4.6</span></span></span>
 
  
 +
| style="width:41.0pt; border:solid windowtext 1.0pt" width="57" | <p align="center" style="text-align:center; padding:.75pt .75pt .75pt .75pt">52.8</p>
 +
| style="width:33.95pt; border:solid windowtext 1.0pt" width="47" | <p align="center" style="text-align:center; padding:.75pt .75pt .75pt .75pt">5.2</p>
 +
| style="width:41.05pt; border:solid windowtext 1.0pt" width="57" | <p align="center" style="text-align:center; padding:.75pt .75pt .75pt .75pt">61.3</p>
 +
| style="width:33.9pt; border:solid windowtext 1.0pt" width="47" | <p align="center" style="text-align:center; padding:.75pt .75pt .75pt .75pt">4.1</p>
 +
| style="width:59.35pt; border:solid windowtext 1.0pt" width="81" | <p align="center" style="text-align:center; padding:.75pt .75pt .75pt .75pt">-8.5</p>
 +
| style="border:solid windowtext 1.0pt" | <p align="center" style="text-align:center; padding:.75pt .75pt .75pt .75pt">-12.4 to -4.6</p>
 
|-
 
|-
| style="border:solid windowtext 1.0pt" |
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| style="width:153.2pt; border:solid windowtext 1.0pt" width="207" |
<span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Erectile function domain at 3 months (0 - 25)</span></span>'''</span>
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'''Erectile function domain at 3 months (0 - 25)'''
  
| style="border:solid windowtext 1.0pt" |  
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| style="width:41.0pt; border:solid windowtext 1.0pt" width="57" | <p align="center" style="text-align:center; padding:.75pt .75pt .75pt .75pt">19.5</p>
<span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">19.5</span></span></span>
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| style="width:33.95pt; border:solid windowtext 1.0pt" width="47" | <p align="center" style="text-align:center; padding:.75pt .75pt .75pt .75pt">2.9</p>
 +
| style="width:41.05pt; border:solid windowtext 1.0pt" width="57" | <p align="center" style="text-align:center; padding:.75pt .75pt .75pt .75pt">23.8</p>
 +
| style="width:33.9pt; border:solid windowtext 1.0pt" width="47" | <p align="center" style="text-align:center; padding:.75pt .75pt .75pt .75pt">1.9</p>  
 +
| style="width:59.35pt; border:solid windowtext 1.0pt" width="81" | <p align="center" style="text-align:center; padding:.75pt .75pt .75pt .75pt">-4.3</p>  
 +
| style="border:solid windowtext 1.0pt" | <p align="center" style="text-align:center; padding:.75pt .75pt .75pt .75pt">-6.3 to -2.2</p>  
 +
|}
  
| style="border:solid windowtext 1.0pt" |
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*<span style="tab-stops:list 36.0pt">IIEF = International Index of Erectile Function</span>  
<span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">2.9</span></span></span>
 
  
| style="border:solid windowtext 1.0pt" |
 
<span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">23.8</span></span></span>
 
 
| style="border:solid windowtext 1.0pt" |
 
<span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">1.9</span></span></span>
 
 
| style="border:solid windowtext 1.0pt" |
 
<span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">-4.3</span></span></span>
 
 
| style="border:solid windowtext 1.0pt" |
 
<span style="line-height:normal"><span style="font-size:10.0pt"><span style="font-family:">-6.3 to -2.2</span></span></span>
 
 
|}
 
 
*IIEF = International Index of Erectile Function
 
  
 
&nbsp;
 
&nbsp;
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&nbsp;
  
&nbsp;
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'''Appraised by:''''':''''''M Bennett '''m.bennett@unsw.edu.au'''&nbsp;;&nbsp; &nbsp; Friday, 16 January 2015'''
 
 
'''Appraised by''''''''':''''''M Bennett m.bennett@unsw.edu.au&nbsp;; Friday, 16 January 2015'''
 
  
'''<span style="line-height: 1.5;">Kill or Update By:</span>'''<span style="line-height: 1.5;">July 2021</span>
+
'''<span style="line-height: 1.5;">Kill or Update By:</span>'''<span style="line-height: 1.5;">J uly 2021</span>
  
 
[[File:Sumhorsa.gif|center|Sumhorsa.gif]]
 
[[File:Sumhorsa.gif|center|Sumhorsa.gif]]
  
 
<span style="display: block; text-align: center;"><span style="font-size: 230%;">[[Flaps_and_grafts|BACK]]</span></span>
 
<span style="display: block; text-align: center;"><span style="font-size: 230%;">[[Flaps_and_grafts|BACK]]</span></span>

Latest revision as of 03:25, 17 August 2022

Hyperbaric oxygen therapy following urethral reconstruction limited the decrease in erectile function

Clinical bottom line:

1. Erectile function scores declined less following postoperative HBOT than a sham treatment.

Citation/s: 1. Yuan J-B, Yang L-Y, Wang Y-H, Ding T, Chen TD, Lu Q. Hyperbaric oxygen therapy for recovery of erectile function after posterior urethral reconstruction. International Urology Journal 2011; 43:755-761


Lead author's name:Yang: yang_louyan@yahoo.cn

Three-part Clinical Question: Does hyperbaric oxygen promote the recovery of erectile function following posterior urethral reconstruction.

Search Terms: erectile dysfunction. urethral reconstruction, urethral stricture

 

The Study: Double blinded, pseudo-randomised trial (alternate allocation) with intention-to-treat.

The Study Patients: Men with posterior urethral stricture and having operative reconstruction.

Control group: (N = 12; 12 analysed): Placed in chamber and breathing air at 1 ATA on the same schedule as for HBOT group.

Experimental group: (N = 12; 12 analysed): 100% oxygen breathing at 2 ATA for 90 minutes daily postoperatively from the second postoperative day for a total of 14 treatments.

The Evidence:

Measure

Air Group

HBOT group

Difference

95% CI

 

Mean

SD

Mean

SD

   

Total IIEF* scores at 3 months (score 0 worst - 70 best)

52.8

5.2

61.3

4.1

-8.5

-12.4 to -4.6

Erectile function domain at 3 months (0 - 25)

19.5

2.9

23.8

1.9

-4.3

-6.3 to -2.2

  • IIEF = International Index of Erectile Function


 

Comments:

1. Not truly randomized. Alternate allocation following reconstruction.

2. Patients with EF scores less than 22 (any degree of dysfunction) pre-operatively were excluded (2 pts).

3. Erectile function scores were worse in both groups postoperatively, but on comparison, those who received HBOT had better scores.

4. Unpressurized sham - not known if this was effective.

5. Only a three month study. Long term effects not known.

 

Appraised by::'M Bennett m.bennett@unsw.edu.au ;    Friday, 16 January 2015

Kill or Update By:J uly 2021

Sumhorsa.gif

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