Mr Golash has been featured on Channel 5’s Critical Condition television program performing a complex radical nephrectomy (kidney removal) operation for and very large kidney cancer. This type of surgery is very demanding and is safest performed by skilled surgeons at large cancer centres.
Erectile dysfunction (ED) affects about 34 million men in the U.S.A with 9% of men 18 to 39 and up to 70% of men 60 and older. However, in an article by Harte et al published in Journal of Sexual Medicine (2012), men aged 18 to 45 are responsible for the largest increase in the use of Viagra among U.S. adults. From 1998 to 2002, the use by this age category grew 312%. They report a study of 1,207 men with an average age of 22. The men completed an online survey that asked about their sexual functioning in the past four weeks. 72 were recreational (used for perceived enhancement in performance) users of medication used to treat erectile dysfunction, 1111 were non-users and 24 were prescribed theses drugs. They answered questions about their erectile function, orgasm, sexual desire, and their satisfaction with intercourse and overall sex. they also reported their levels of confidence in their ability to get and maintain an erection. Compared to non-users, recreational users reported lower erectile confidence and overall satisfaction.
Although recreational users are a self selected group that may worry more about performance, the authors conclude that recreational use of ED medication reduces sexual confidence, leading to reduced ability and satisfaction.
It has been standard of care to remove the adrenal gland aswell as kidney during radical nephrectomy for suspected renal cancer. However, Finelli et al show that survival is better if it is spared. In an article published in BJUI (2012) they report a study of 1,651 patients with a final pathological diagnosis of T1a RCC, including 490 patients (30%) who had concurrent ipsilateral adrenalectomy. By 10 years, the overall survival was 74.1% with adrenalectomy vs 79.8% when the adrenal was left behind (p<0.001), whilst cancer-specific survival did not differ. In a Cox proportional hazard model, ipsilateral adrenalectomy increased the risk of overall mortality by 23%, but it didn't affect cancer-specific survival.