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Here the path of ?ow observed by us74 and by Sohn et al75 appears to be primarily into the spongiosum. Finally, long run outcomes should be quantita- tively described using life desk evaluation or Kaplan Meier curves76 for each type of vascular procedure and in contrast with prosthetic device ef�cacy. Younger sufferers with pelvic trauma are the most effective however certainly not the one candidates. An essential exception resides in that challenging group of males with aortoiliac illness, notably these with aneurysms or localized internal iliac artery occlu- sions. It is worth re-emphasizing that ends in these older males can typically be superior to these achieved in youthful males present process microvascular reconstructions. Arch Surg 1978; 113: Bulbocavernosus re?ex and evoked potentials in evidently 958�962. TherapiemOglichkeitenE bei der vaskulErE bedingten administration of impotence associated with aortic surgical procedure. Intracavernous injection of papaverine for erectile cavernosometry and cavernosography: Objective evaluation failure (Letter). Br J Pharmacol bypass in the therapy of arteriogenic erectile dysfunction 1986; 87: 494�500. Effects of belly aneurysmectomy, Dysfunction: summary report on the therapy of organic aortoiliac bypass grafting and angioplasty on male sexual erectile dysfunction. Techniques and outcomes of vascular surgical procedure for grafts on postoperative sexual perform: correlation with impotence: giant and small vessel choices. Int J Impot Res 1996; 8: experience with a new approach for penile vascularization. A important evaluation of quick and lengthy-term outcomes surgical procedure for impotence secondary to segmental vascular of penile revascularization (Abstr). Penile revascularization in nonresponders to balloon, for erectile dysfunction as a result of venous leakage. Int J intracavernous injection using a modi�ed microsurgical Impot Res 1996; D129: 154A. Long term outcomes of larization following deep dorsal vein arterialization for penile venous ligation for corporeal venous occlusive dys- vasculogenic impotence. The position of vascular surgical procedure and corrective long run follow up of sufferers present process excision and arteriogenic and venogenic impotence. Futura: Armonk New York, deep dorsal vein resection, with or with out removable 1997, pp 621�640. We hope that this data will give you confidence about addressing any erectile problems you might experience, irrespective of the cause. Either way, don�t really feel that this materials has to be totally absorbed in one sitting. Reviewing the knowledge offered right here together with your doctor or nurse practitioner may make it more specific to your needs. We can be grateful when you might fill out the questionnaire on the finish of the booklet and return it to us together with your suggestions. This will help us make sure that future editions of this booklet handle your questions and issues. The capacity to have an erection requires complex coordination of nerves, blood vessels, muscles, and the brain. After a interval of sexual pleasure/exercise most males experience ejaculation (release of semen from the penis) which is accompanied by orgasm, a sensation of intense pleasure and/or contentment. It is essential to notice that orgasm and ejaculation are separate processes that will happen independently. It is also possible to experience ejaculation and/or orgasm in the absence of penile erection. Decreased sexual desire or libido is common and should happen in the setting of psychological distress (depression/nervousness), stress, and relationship battle. Decreased sexual desire has also been associated with low blood levels of testosterone, the �male hormone. Ejaculation, the discharge of semen throughout sexual exercise, relies on coordinated action of the muscles of the decrease urinary tract and prostate.
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Treatment of intracorporeal injection nonresponse with sildenafil alone or in combination with triple agent intracorporeal injection remedy. Retention and migration of alprostadil cream applied topically to the glans meatus for erectile dysfunction. An integrated analysis of alprostadil topical cream for the therapy of erectile dysfunction in 1732 patients. Penile prosthesis surgical procedure in patients with corporal fibrosis: a state-of-the-art evaluation. Penile prosthesis implantation in the era of medical therapy for erectile dysfunction. Penile prosthesis implantation for the therapy for male erectile dysfunction: medical outcomes and lessons learnt after 955 procedures. A survey of patients with inflatable penile prostheses: evaluation of timing and frequency of intercourse and analysis of implant sturdiness. Penile implantation in Europe: successes and problems with 253 implants in Italy and Germany. Combined inflatable penile prosthesis-synthetic urinary sphincter implantation: no elevated threat of antagonistic occasions in comparison with single or staged system implantation. Comparison of mechanical reliability of authentic and enhanced Mentor Alpha I penile prosthesis. Long-time period infection outcomes after authentic antibiotic impregnated inflatable penile prosthesis implants: up to 7. Long-time period revision rate as a result of infection in hydrophilic-coated inflatable penile prostheses: 11-yr observe-up. National developments in the therapy of penile prosthesis infections by explantation alone vs. An outcomes analysis of over 200 revision surgical procedures for penile prosthesis implantation: a multicenter study. Long-time period outcomes of penile prostheses for the therapy of erectile dysfunction. Prevalence of the grievance of ejaculating prematurely and the 4 untimely ejaculation syndromes: outcomes from the Turkish Society of Andrology Sexual Health Survey. Sexual problems among men and women aged forty-eighty y: prevalence and correlates identified in the Global Study of Sexual Attitudes and Behaviors. Association of sexual problems with social, psychological, and bodily problems in women and men: a cross sectional inhabitants survey. Antibiotic therapy can delay ejaculation in patients with untimely ejaculation and chronic bacterial prostatitis. Ejaculatory abstinence influences intravaginal ejaculatory latency time: outcomes from a potential randomized trial. Self-reported untimely ejaculation and elements of sexual functioning and satisfaction. World Health Organization, International Classification of Diseases and Related Health Problems. An proof-based mostly unified definition of lifelong and acquired untimely ejaculation: report of the second International Society for Sexual Medicine Ad Hoc Committee for the Definition of Premature Ejaculation. Premature ejaculation: psychophysiological concerns in principle, research, and therapy. Prevalence, characteristics and implications of untimely ejaculation/fast ejaculation. Interrelationships among measures of untimely ejaculation: the central position of perceived control. Correlates to the medical analysis of untimely ejaculation: outcomes from a big observational study of males and their partners. Functional and psychological characteristics of belgian males with untimely ejaculation and their partners. Further proof of the reliability and validity of the untimely ejaculation diagnostic device. Premature ejaculation and erectile dysfunction prevalence and attitudes in the Asia-Pacific region. Development and validation of four-merchandise model of Male Sexual Health Questionnaire to assess ejaculatory dysfunction. Assessment of as needed use of pharmacotherapy and the pause-squeeze technique in untimely ejaculation.
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The use of the Sexual Func-- tion questionnaire as a screening tool for ladies with sexual 161. J Jap Soc Sex Science 2008 ; 26:16-26 Clinical Manual of Sexual Medicine Sexual Dysfunctions in Men. Leiblum S, Symonds T, Moore J, Soni P, Steinberg S, Sis-- struct validity of the Changes in Sexual Functioning ques-- son M. M, Rico- Villadermoros F, Banus S: Evaluating modifications in sexual functioning in depressed patients: Sensitivity to 188. J Sex Development and evaluation of an abridged, 5-merchandise version Mar Ther 2000;26:119-131. Althof S, Rosen R, Symonds T, Mundayat R, May K, Abra-- Marital Ther 2007;23:291-304. Patient and companion satisfaction with of self-reported outcome measures for analysis and prac-- Viagra (sildenail citrate) therapy as determined by the tice. Patient Reported Outcome Newsletter 2007;39:1-4 of 4-merchandise version of Male Sexual Health questionnaire to 205. Early conceptual and linguistic improvement of a ated with erectile dysfunction and its therapy. The treat-- form of the psychological and interpersonal relationship ment satisfaction scale: a multidimensional instrument for scales. Int J Impotence Res 2005;18:eighty two-88 the evaluation of therapy for the evaluation of treat-- 207. Psychometric valida-- ment satisfaction for erectile dysfunction patients and their tion of sexual high quality of life questionnaire for use in males partners. The issues with your sexual perform is: (mark one or more) 1 Problems with little or no interest in sex 2 Problems with erection three Problems ejaculating too early throughout sexual activity 4 Problems taking too long, or not with the ability to ejaculate or have orgasm 5 Problems with pain throughout sex 6 Problems with penile curvature throughout erection 7 Other :................................................................................................................................ The issues with your sexual perform is: (mark one or more) 1 Problems with little or no interest in sex 2 Problems with decreased genital sensation (feeling) three Problems with decreased vaginal lubrication (dryness) 4 Problems reaching orgasm 5 Problems with pain throughout sex 6 Other :................................................................................................................................ Sexual activity contains any kind of activity aimed at experiencing sexual satisfaction and pleasure. Has this occurred to you over the past 6 1b) Has this been a private problem for you? A very great problem 2a) Some males ind that they need far more sexual stimulation to achieve an erection than they needed in the past. A very great problem 3a) Some males have dificulties in acquiring and/or primary- taining hard erections lasting long sufficient for sexual activity. Has this occurred to you over the past 6 3b) Has this been a private problem for you? Has this occurred to you over the past 6 4b) Has this been a private problem for you? A very great problem 5a) Some males have dificulty ejaculating or reaching orgasm with sexual activity. A very great problem 6a) Some males are involved about the measurement and/or form of their penis. Has this occurred to you over the past 6 7b) Has this been a private problem for you? Very satisfying 9) Is there anything else you want to inform us with respect to your sexual life? Each query may be answered by circling the condition that greatest characterizes your personal experience. Sexual activity contains any activity aimed at experiencing sexual satisfaction and pleasure. Has this occurred to you over the past 6 2b) Has this been a private problem for you? A very great problem 5a) Some ladies experience genital pain throughout or shortly after sexual activity. Has this occurred to you over the past 6 5b) Has this been a private problem for you? A very great problem 6a) Some ladies experience dificulties permitting vaginal penetration regardless of their wish to do so. A very great problem 7a) Some ladies experience persistent and undesirable genital arousal (tingling, throbbing, pulsating) within the absence of any sexual curiosity.
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Finally, males showed larger conditioning the male between bouts of copulatory exercise. This in unilevel pacing chambers bisected by 1-hole ver-- measure is inversely related to her degree of sexual sus four-hole dividers (Ismail et al. Given that curiosity; for example the timing between intromis-- males take longer to ejaculate in 1-hole chambers, sions increases with successive intromissions, and and require extra intromissions previous to ejaculation, increases dramatically following several ejaculations those information recommend that sexual reward is larger (Pfaus, Smith, & Coopersmith, 1999). To the was paired with a unique unconditioned stimulus: extent that solicitation and pacing relect inversely a the flexibility of females to tempo the copulatory contact. During training, females pacing durations low, may increase desire in wom-- in the paired group received sequential access to en. For example, ovariectomized female rats primed scented males on one facet of the divider or unscent-- with estrogen and progesterone, or estrogen alone, ed males with no divider, on alternate testing days. This drug elevated every female was placed into an open ield with two vaginal arousal in women viewing a female-centric 9 Comittee 7. But Meisel and Sachs� that solicitations in female rats had predictive validity caveat for understanding desire without copula-- as a mannequin of sexual desire in women. Those rats show regular or neurochemical, and neuroanatomical control of lordo-- even elevated rates of anogenital investigation of a sis than some other mammalian sexual conduct (Pfaff, receptive female, and will pursue females if solicited 1980; Pfaff et al. They estrogen, though treating ovariectomized females will even bar-press at excessive rates to acquire second-or-- with estrogen alone produces only a average acti-- der sexual reinforcers (Everitt & Stacey, 1987). These behaviors are also operants in the sense stances may fit on neurochemical substrates nor-- that animals should perform them in order to obtain mally activated by progesterone, or could work by way of the aim of copulatory interplay/sexual stimulation. Several medication are identified to lower mount with every vaginal intromission, main finally to and intromission latencies in sexually naive or slug-- ejaculation. Given the fact that sexually naive males gish male rats, together with the opioid receptor antago-- can present preferences for receptive females, and nist naloxone, (Gessa et al. Although chasing tive females, the irst unconditioned reinforcer in the conduct displayed by male rats in open ields or bi-- cascade of sexual reinforcers could be sex odors. Whalen varied whether males achieved mounts without intromission, intromissions without How will we infer sexual reward in animals? There are ejaculation, or intromissions with ejaculation, with a minimum of three ways. On a inal check, males of operant or instrumental responding for a particular had been allowed to copulate to ejaculation with recep-- sexual reinforcer. In rats, this would come with behaviors like whereas rats that achieved intromissions with or with-- nostril-poking by way of a wire-mesh display screen, navigating out ejaculation had been capable of copulate to ejaculation obstruction boxes or complicated mazes, or bar-pressing usually. During conditioning trials, male Related to penile stimulation is the fact that the male rats copulated with cadaverine-scented females. In distinction, males in the unpaired group cally increases dramatically as the male approaches copulated exclusively with the unscented female, ejaculation, in a pure expression of Larsson�s �En-- regardless of aggressive solicitations and interceptions forced Interval Effect� (Pfaus, Smith, & Coopersmith, by the scented female. This elevated pacing almost always leads to the paired group would approach and chew on a in the male ejaculating. Everitt (1990) reported that wood dowel scented with cadaverine, whereas sexually vigorous male rats given subthreshold neu-- males in the unpaired group, or in a cadaverine- rochemical lesions of the mesolimbic dopamine sys-- alone preexposure group, would avoid contact with tem initiated copulation usually with sexually recep-- the dowel, or would bury the dowel in bedding. However, if the females ing an aversive stimulus with drug reward has been had been handled with the dopamine receptor antagonsit proven previously to induce taste preferences for ini-- lupenthixol (which has the effect of prolonging the tially nonpreferred lavors (e. Thus, it would seem that a cas-- nents of positive sexual experiences for each men cade of reinforcing occasions, from perception of sex and girls (e. Salient the traditional show of appetitive and consummatory cues in the surroundings or on partners could also be as-- sexual responses. However, ejaculation itself may sociated with sexual reward in such a way that they not be the inal endpoint in the cascade of copula-- increase arousal or desire instantly in their presence. In the odor-situation-- Accordingly, the third way to infer sexual reward is to ing research talked about above, the postejaculatory study responses made toward contextual or half-- refractory period was identiied as the required ner-related cues paired with sexual reward. Animals typically show a desire to re-- males had been allowed to be in shut proximity of the main in a context that has been paired consistently odor during the postejaculatory period. During training, the compartments are paired check and ejaculated preferentially with the unscented differentially with unconditional stimuli, (e.
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J Ark Med Disappointing initial outcomes with transurethral Soc 1998;ninety five(three):one hundred-one hundred and one. The effect of doxazosin on sexual perform in patients Ghezzi A, Malvestiti G M, Baldini S et al. Cardiology Review secondary to cavernous adrenergic hypertone: initial outcomes of 2002;19(eleven):32-33. Evaluation of the impact of diabetes on male sexual dysfunction and hypothalamic-pituitary-testicular interplay in diabetic males. Oral phentolamine: an alpha-1, alpha-2 adrenergic antagonist for the treatment of erectile Ginsberg D L. Vardenafil treatment of sertraline-induced sexual Gontero P, Fontana F, Zitella A et al. Sildenafil-dihydrocodeine interplay outcomes after non-nerve sparing radical prostatectomy. Effect of bupropion on sexual deficiency within the etiology and treatment of erectile dysfunction. Endocrine screening for sexual dysfunction utilizing free Arch Ital Urol Androl 2005;seventy seven(4):191-193. Control of penile erection by the melanocortinergic system: Experimental evidences and therapeutic perspectives. Pro-erectile effect of systemic apomorphine: Existence of a spinal web site of action. Randomized trial of sildenafil for the treatment of erectile dysfunction in spinal wire Gray P B, Singh A B, Woodhouse L J et al. Efficacy outcomes and Journal of Clinical Endocrinology & Metabolism high quality-of-life measures in men receiving sildenafil citrate for 2005;90(7):3838-3846. Self intra-cavernous injections as a profitable treatment in pure neurogenic Giuliano Francois, Pena Beatrice, Mishra Avanish et al. Quality of Life Research: An International Journal of and well being-related high quality of life in men with prostate Quality of Life Aspects of Treatment, Care & Rehabilitation most cancers randomly assigned to hormonal medication or 2002;eleven(6):613-670. Penile Prostate Cancer & Prostatic Diseases 2003;6(2):121� prostheses in paraplegic men. Combination of psychological erectile dysfunction due to the presence of psychosexual therapy and intrapenile injections within the macroprolactinemia. Journal of Clinical Endocrinology & treatment of erectile dysfunctions: Rationale and Metabolism 1996;eighty one(7):2512-2514. Annual Meeting of the American Psychiatric Association 1998;Toron to, Ontario, Canada. A possible mechanism for alteration of human erectile perform by digoxin: inhibition of Hatzimouratidis K, Hatzichristou D. Testosterone and corpus cavernosum sodium/potassium adenosine triphosphatase erectile perform: an unresolved enigma. Fluoxetine and untimely ejaculation: a double-blind, crossover, placebo- Hatzimouratidis K, Hatzichristou D G. Natural approaches to promote sexual dysfunction: Characteristics of couples, treatment end result, and performance: Part 1: Viagra versus a pure strategy. Review of new compounds out there in Australia for the treatment of consideration-deficit hyperactivity dysfunction. Evaluation of efficacy and safety of oral sildenafil citrate therapy for men with erectile Hong B, Ji Y H, Hong J H et al. Pharmaceutical Journal of Chinese Peoples crossover examine evaluating the efficacy of korean red Liberation Army 2002;18(4):205-208. Apomorphine: An perform and gonadal hormones in patients taking replace of scientific trial outcomes. Tadalafil has no responses by color Doppler ultrasonography studies detrimental effect on human spermatogenesis or reproductive between sildenafil non-responders and responders. Correlation "Visual field defect and intracerebral hemorrhage associated between voiding and erectile perform in patients with with use of vardenafil (Levitra)": Comment and Reply. Hemodynamic results of sildenafil in men with severe coronary artery Hubler J, Szan to A, Konyves K. Clinical and urinary tract symptoms suggestive of benign prostatic price-effectiveness of new and emerging technologies obstruction.
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The focus of this chapter is and dyspareunia (no broader or extra detailed deini-- on necessities of analysis design and measurement tion for sexual ache syndromes). It suggests some exclusion cri-- teria �to extend the chance of demonstrating a 1. However, the need for an integration are needed to support the opinion that the speciic of that guidance, which additionally incorporates necessary items and instrument are enough and applicable recommendations/corrections from sexual medicine to measure the idea. Some measures meet these standards, the translation processes have been enough to make sure but not all can be found to be used in clinical trials. Thus, Finally, further guidance from other government a sensible commonplace for onset of motion ought to be regulatory agencies was not out there at the time acknowledged as nearer to 1-2 months than 6 months. Three-month extension trials investigation with the variety of publications in-- (following a 12-week acute eficacy trial), relapse creasing 10-fold over the last 30 years. Nevertheless, these necessary to low genital arousal and low orgasmic outcomes present strong proof that validated self perform. Sexual delicate endpoints to detect treatment-induced distress was positively related to depression modifications in ladies�s sexual dysfunction. In an eleven yr, longitudinal sures corresponding to intercourse steroids, speciically androgens, examine of mid-aged ladies utilizing the Short Personal and self-report measures of sexual functioning. Objective and sub-- measures rather than on whether or not the construct is jective measures of domains of sexual perform have comprehensively conceptually applicable to the been the main focus of examine for some a long time. A quantity speciic sexual dysfunction is predicated on a want for of devices which measure the low sexual func-- quantitative behavioral consequence measures. For ex-- tion element have been validated and have been ample, questions about most depth of sexual translated into different languages. Similarly, deinition of profitable and sexual perform and sexual distress) are measured satisfactory sexual events or encounters over time in epidemiological studies, prevalence of sexual dys-- requires a subjective interpretation of sexual experi-- perform is significantly lowered. For instance with in-- and other related outcomes corresponding to orgasm and 1053 comitte 21. Concomi-- psychological factors in genital arousal and orgas-- tant use of self-report measures and clinician evalu-- mic perform, which may must be managed-for in ation might present essentially the most accurate evaluation. Such information seem strating differences between examine drug and placebo to be much more dificult to interpret than numerical in other central nervous system-mediated issues, scores on self-report questionnaires, which have corresponding to major depression and ache issues. In plan-- depend other conceptually applicable events corresponding to ning studies to include companions of women with intercourse-- receptivity to associate method and topic initiation ual issues, care would must be taken to keep away from of sexual exercise. A validated, self-report measure of sexual are often inaccurate; this is significantly true of pa-- functioning to include domains/subscales per diaries that record behavioral events, which may be completed retrospectively without investigator related to phases of the sexual response information, and thus, are subjected to recall bias cycle (speciically sexual want, arousal, which daily diaries are intended to keep away from. Translations of self-report questionnaires must Validated self-report questionnaires have been stan-- be linguistically/culturally validated with cross- dardized in goal populations, and permit privacy cultural construct validation established. Hormonal standing ought to be considered to in-- tom scales: sexual dysfunction evaluation) Struc-- clude separate evaluations/stratiication of tured interviews permit for follow-up questions that premenopausal vs. Secondary endpoints might embody physiologic Female orgasmic Disorder (FoD) (> 50% overlap) measures, satisfying sexual events (this can be [forty six,47,forty eight,49]. Sample selection for clinical subjective line within the sand of what constitutes a trials of candidate treatments for sexual dysfunction criticism versus a dysfunction. Inclusion standards for analysis par-- for the reliability and validity of various diagnoses. Exclusion standards are decided by the require-- ment to make sure security of examine participants and by There is quite a lot of overlap or comorbidity of the need to keep away from clinical trial sampling procedures sexual issues in ladies. In in search of to take action, the tension of balancing inside validity with external Sample Selection within the Context of Clinical Tri-- validity is obvious. Phase I trials at focus at applicable ranges and exclusion of focus on assessing security and tolerability of a examine applicable potential confounders without unduly compound past information obtained in animal studies. Examination of a female sexual dysfunction within a consultant security and tolerability in clinical trials of treatments pattern of those experiencing such dysfunction and of sexual dysfunction in ladies will require healthy who may moderately constitute a treatment goal female participants, whose hormonal standing (e. Following the final principle that associate willingness and doubtlessly associate consent pattern selection is pushed by the speciic aims should be considered. Similarly, with respect to exclusion standards, ladies experiencing Contextual and Interpersonal Factors. Selection of validity might require representation of contextual and participants unlikely to attrit during the course of the interpersonal traits in analysis pattern par-- trial stays a priority.
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Navigational Note: - Spermatic wire obstruction Asymptomatic; medical or Symptomatic; elective Severe signs; invasive - - diagnostic observations only; intervention indicated intervention indicated intervention not indicated Definition: A disorder characterized by blockage of the traditional circulate of the contents of the spermatic wire. Testicular hemorrhage Mild signs; intervention Moderate signs; Transfusion indicated; Life-threatening Death not indicated intervention indicated invasive intervention consequences; pressing indicated; hospitalization intervention indicated Definition: A disorder characterized by bleeding from the testis. Navigational Note: - Uterine fistula Asymptomatic Symptomatic, invasive Invasive intervention Life-threatening Death intervention not indicated indicated consequences; pressing intervention indicated Definition: A disorder characterized by an irregular communication between the uterus and one other organ or anatomic site. Navigational Note: - Uterine obstruction Asymptomatic; medical or Symptomatic; elective Severe signs; invasive - - diagnostic observations only; intervention indicated intervention indicated intervention not indicated Definition: A disorder characterized by blockage of the uterine outlet. Navigational Note: - Vaginal discharge Mild vaginal discharge Moderate to heavy vaginal - - - (larger than baseline for discharge; use of perineal pad patient) or tampon indicated Definition: A disorder characterized by vaginal secretions. Mucus produced by the cervical glands is discharged from the vagina naturally, especially during the childbearing years. Navigational Note: - Vaginal dryness Mild vaginal dryness not Moderate vaginal dryness Severe vaginal dryness - - interfering with sexual interfering with sexual resulting in dyspareunia or function function or inflicting frequent extreme discomfort discomfort Definition: A disorder characterized by an uncomfortable feeling of itching and burning within the vagina. Navigational Note: - Vaginal fistula Asymptomatic Symptomatic, invasive Invasive intervention Life-threatening Death intervention not indicated indicated consequences; pressing intervention indicated Definition: A disorder characterized by an irregular communication between the vagina and one other organ or anatomic site. Navigational Note: - Vaginal hemorrhage Mild signs; intervention Moderate signs; Transfusion indicated; Life-threatening Death not indicated intervention indicated invasive intervention consequences; pressing indicated; hospitalization intervention indicated Definition: A disorder characterized by bleeding from the vagina. Navigational Note: - Vaginal obstruction Asymptomatic; medical or Symptomatic; elective Severe signs; invasive - - diagnostic observations only; intervention indicated intervention indicated intervention not indicated Definition: A disorder characterized by blockage of vaginal canal. Navigational Note: - Vaginal perforation - Invasive intervention not Invasive intervention Life-threatening Death indicated indicated consequences; pressing intervention indicated Definition: A disorder characterized by a rupture within the vaginal wall. Navigational Note: - Vaginal stricture Asymptomatic; mild vaginal Vaginal narrowing and/or Vaginal narrowing and/or - Death shortening or narrowing shortening not interfering shortening interfering with with physical examination the usage of tampons, sexual activity or physical examination Definition: A disorder characterized by a narrowing of the vaginal canal. Navigational Note: - Allergic rhinitis Mild signs; intervention Moderate signs; medical - - - not indicated intervention indicated Definition: A disorder characterized by an inflammation of the nasal mucous membranes attributable to an IgE-mediated response to external allergens. Navigational Note: - Apnea - - Present; medical intervention Life-threatening respiratory Death indicated or hemodynamic compromise; intubation or pressing intervention indicated Definition: A disorder characterized by cessation of breathing. Navigational Note: - Aspiration Asymptomatic; medical or Altered consuming habits; Dyspnea and pneumonia Life-threatening respiratory Death diagnostic observations only; coughing or choking episodes signs (e. Navigational Note: - Bronchial fistula Asymptomatic Symptomatic, invasive Invasive intervention Life-threatening Death intervention not indicated indicated consequences; pressing intervention indicated Definition: A disorder characterized by an irregular communication between the bronchus and one other organ or anatomic site. Navigational Note: - Bronchial stricture Asymptomatic; medical or Symptomatic (e. Navigational Note: - Bronchopleural fistula Asymptomatic Symptomatic, invasive Hospitalization; invasive Life-threatening Death intervention not indicated intervention indicated consequences; pressing intervention indicated Definition: A disorder characterized by an irregular communication between a bronchus and the pleural cavity. Navigational Note: - Bronchopulmonary Mild signs; intervention Moderate signs; invasive Transfusion indicated; Life-threatening Death hemorrhage not indicated intervention not indicated invasive intervention consequences; intubation or indicated; hospitalization pressing intervention indicated Definition: A disorder characterized by bleeding from the bronchial wall and/or lung parenchyma. Navigational Note: - Chylothorax Asymptomatic; medical or Symptomatic; medical Severe signs; elective Life-threatening respiratory Death diagnostic observations only; intervention indicated (e. Navigational Note: - Epistaxis Mild signs; intervention Moderate signs; medical Transfusion; invasive Life-threatening Death not indicated intervention indicated (e. Navigational Note: - Hoarseness Mild or intermittent voice Moderate or persistent voice Severe voice adjustments - - change; fully comprehensible; adjustments; might require including predominantly self-resolves occasional repetition but whispered speech comprehensible on phone; medical analysis indicated Definition: A disorder characterized by harsh and raspy voice arising from or spreading to the larynx. Navigational Note: - Hypoxia - Decreased oxygen saturation Decreased oxygen saturation Life-threatening airway Death with exercise (e. Navigational Note: - Laryngeal fistula Asymptomatic Symptomatic, invasive Invasive intervention Life-threatening Death intervention not indicated indicated consequences; pressing intervention indicated Definition: A disorder characterized by an irregular communication between the larynx and one other organ or anatomic site. Navigational Note: - Laryngeal hemorrhage Mild cough or trace Moderate signs; Transfusion indicated; Life-threatening Death hemoptysis; laryngoscopic intervention indicated invasive intervention consequences; pressing findings indicated; hospitalization intervention indicated (e. Navigational Note: - Laryngeal inflammation Mild sore throat; raspy voice Moderate sore throat; Severe throat pain; - - analgesics indicated endoscopic intervention indicated Definition: A disorder characterized by an inflammation involving the larynx. Navigational Note: - Laryngeal obstruction Asymptomatic; medical or Symptomatic (e. Navigational Note: - Laryngospasm - Transient episode; Recurrent episodes; Persistent or extreme episodes Death intervention not indicated noninvasive intervention related to syncope; indicated (e. Navigational Note: - Mediastinal hemorrhage Mild signs; intervention Moderate signs; Transfusion indicated; Life-threatening Death not indicated; radiologic intervention indicated invasive intervention consequences; pressing proof only indicated; hospitalization intervention indicated Definition: A disorder characterized by bleeding from the mediastinum. Navigational Note: - Nasal congestion Mild signs; intervention Moderate signs; medical Associated with bloody nasal - - not indicated intervention indicated discharge or epistaxis Definition: A disorder characterized by obstruction of the nasal passage due to mucosal edema. Navigational Note: - Oropharyngeal pain Mild pain Moderate pain; altered oral Severe pain; severely altered - - consumption; non-narcotics consuming/swallowing; narcotics initiated; topical analgesics initiated; requires parenteral initiated diet Definition: A disorder characterized by a sensation of marked discomfort within the oropharynx. Navigational Note: - Pharyngeal hemorrhage Mild signs; intervention Moderate signs; Transfusion indicated; Life-threatening Death not indicated intervention indicated invasive intervention consequences; intubation or indicated; hospitalization pressing intervention indicated Definition: A disorder characterized by bleeding from the pharynx.
References:
- http://www.med.umich.edu/asp/pdf/adult_guidelines/Odontogenic_ADULT.pdf
- https://clsi.org/media/1450/m45ed3_sample.pdf
- http://www.innocua.net/web/download-7576/10.1007-s40572-014-0037-5.pdf