***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Study Design . Multicenter , double-blind , placebo-controlled , parallel-group study . Objective . To assess the effect of the oral phosphodiesterase type-5 inhibitor , vardenafil , on ejaculation rates and self-confidence in men with spinal cord injury ( SCI ) . Summary of Background Data . Spinal comm and of male sexual functions is often seriously impaired by traumatic spinal cord injury ( SCI ) . A high proportion of men with SCI can not ejaculate during sexual intercourse . SCI-related ejaculatory disorders are often responsible for male infertility . Sexual dysfunction associated with SCI can also affect men 's self-confidence . Methods . In this 12-week study , 418 men aged ≥18 years with erectile dysfunction > 6 months result ing from a traumatic SCI were r and omized to vardenafil ( n = 207 ) or placebo ( n = 211 ) 10 mg for 4 weeks , then maintained or titrated to 5 or 20 mg at weeks 4 and 8 . Assessment s included questions of the International Index of Erectile Function ( IIEF ) about ejaculation success and orgasmic perception ; the Global Confidence Question ; and quality -of-life scales to measure psychological well-being , self-esteem , depression , and mental health status . Results . Overall per patient ejaculation success rates were significantly greater with vardenafil than placebo over 12 weeks of treatment ( 19 % vs. 10 % ; P < 0.001 ) . At last observation carried forward , the IIEF “ orgasmic function ” score increased from 2.9 at baseline to 4.0 for vardenafil and from 3.0 at baseline to 3.4 for placebo . Sixteen percent of men receiving vardenafil and 8 % receiving placebo felt orgasm “ almost always ” or “ always ” at weeks 8–12 , compared with 4 % and 6 % , respectively , at baseline . Significant improvements in confidence scores were observed with vardenafil compared with placebo ( P < 0.0001 ) . There were no clinical ly significant differences between vardenafil and placebo in the quality -of-life measures at the study endpoint , but these had been in the normal range at baseline . Conclusion . Vardenafil significantly improved ejaculation and self-confidence in men with erectile dysfunction due to SCI Fourteen male patients suffering from Parkinson 's disease , each of whom had been treated with L-DOPA , and in whom additional treatment with oral dopamine agonist ( DA ) was needed , were followed for a period of one year .  Pergolide mesylate ( Permax ) was given to each patient , and titrated to a total daily dose of 3 mg . All of the patients were taking L-DOPA .  The assessment s performed before the start of pergolide treatment consisted of neurological examination , unified Parkinson 's disease rating scale ( UPDRS ) III and IV subscales scoring , mini mental state examination ( MMSE ) scoring , the neuropsychological examination including Zung scale scoring , biochemical and hematological examinations including prolactine serum levels ; and a sexological examination during which the patients filled-in the international index of erectile function ( IIEF ) question naire . These examinations were repeated during the control assessment s at months 1 , 3 , 6 and 12 . ANOVA , non-parametric Friedmann 's ANOVA and Tukey post hoc tests were used for the statistical analysis . There were statistically significant differences between the values of UPDRS III motor subscale and all subscales of IIEF when months 0 and 1 were compared with the results obtained at months 3 , 6 and 12 . Pergolide mesylate , when added to L-DOPA , significantly improved all sexual functions in younger male Parkinsonian patients who were still interested in sexual activities . The treatment with pergolide in these cases might be more beneficial than with short-acting PDE-5 inhibitor sildenafile . Nevertheless , the relationship between pergolide treatment and incidence of restrictive valvular heart disease must be considered Bladder augmentation has revolutionized the care of children with neurogenic bladder but it is associated with certain short- and long-term complications . Using the combination of gastric and ileal segments to balance effects of these segments might be a solution for complications . A total of 39 female Spraque-Dawley rats r and omly divided into four groups : ileocystoplasty ( 11 ) , gastrocystoplasty ( 9 ) , ileogastrocystoplasty ( 11 ) and control ( 8) . Serum/urine electrolytes and pH values , and serum creatinine levels and urine mucus concentration were measured . Kruskal – Wallis non-parametric variance analysis was performed to compare the groups and p < 0.05 was accepted as significant . Metabolic alkalosis with significantly lower urine pH was observed in gastrocystoplasty group . Gastroileal group showed similar results with the ileal group in all parameters . No stone formation was detected in the sham and gastric cystoplasty groups . Metaplastic and hyperplastic changes were observed in all segments surrounding urothelium . In conclusion , combination of gastric and ileal segments does not significantly reduce the rate of metabolic impairments , stone and mucus formation . Besides it is not associated with significant improvement in histological outcome since urine is still in contact with the gastrointestinal mucosa Background Sacral neuromodulation has become a well-established and widely accepted treatment for refractory non-neurogenic lower urinary tract dysfunction , but its value in patients with a neurological cause is unclear . Although there is evidence indicating that sacral neuromodulation may be effective and safe for treating neurogenic lower urinary tract dysfunction , the number of investigated patients is low and there is a lack of r and omized controlled trials . Methods and design This study is a prospect i ve , r and omized , placebo-controlled , double-blind multicenter trial including 4 sacral neuromodulation referral centers in Switzerl and . Patients with refractory neurogenic lower urinary tract dysfunction are enrolled . After minimally invasive bilateral tined lead placement into the sacral foramina S3 and /or S4 , patients undergo prolonged sacral neuromodulation testing for 3–6 weeks . In case of successful ( defined as improvement of at least 50 % in key bladder diary variables ( i.e. number of voids and /or number of leakages , post void residual ) compared to baseline values ) prolonged sacral neuromodulation testing , the neuromodulator is implanted in the upper buttock . After a 2 months post-implantation phase when the neuromodulator is turned ON to optimize the effectiveness of neuromodulation using sub-sensory threshold stimulation , the patients are r and omized in a 1:1 allocation in sacral neuromodulation ON or OFF . At the end of the 2 months double-blind sacral neuromodulation phase , the patients have a neuro-urological re-evaluation , unblinding takes place , and the neuromodulator is turned ON in all patients . The primary outcome measure is success of sacral neuromodulation , secondary outcome measures are adverse events , urodynamic parameters , question naires , and costs of sacral neuromodulation . Discussion It is of utmost importance to know whether the minimally invasive and completely reversible sacral neuromodulation would be a valuable treatment option for patients with refractory neurogenic lower urinary tract dysfunction . If this type of treatment is effective in the neurological population , it would revolutionize the management of neurogenic lower urinary tract dysfunction . Trial registration Trial registration number : http://www . clinical trials.gov ; Identifier : NCT02165774 PURPOSE We assessed the tolerability , safety and efficacy of sildenafil for the treatment of women with sexual dysfunction secondary to multiple sclerosis , as well as the role of somatosensory evoked potential neurophysiological testing . MATERIAL S AND METHODS We performed a double-blind , r and omized , placebo controlled , crossover study investigating the effects of sildenafil in women with multiple sclerosis and sexual dysfunction . Assessment s were done by vali date d question naires . Pudendal and tibial evoked potentials were also recorded . RESULTS A total of 19 women completed the 2 arms of the double-blind phase and 12 completed the optional open label extension phase . Statistically significant improvement following sildenafil was only reported in the lubrication domain of sexual function during the double-blind phase . There was no overall change in quality of life after sildenafil . There was a significant correlation between the latency of tibial and pudendal evoked potentials . CONCLUSIONS Sildenafil only appeared to produce limited benefit in certain individuals with female sexual dysfunction . Some measure of the extent of neurological deficit in these patients could be ascertained from the latency of tibial evoked potentials , which correlated with pudendal evoked potentials . However , it could not predict the extent of sexual dysfunction . Sildenafil is unlikely to help all patients with neurogenic female sexual dysfunction OBJECTIVE To determine the efficacy and safety of tadalafil when taken on dem and by men with erectile dysfunction ( ED ) secondary to traumatic spinal cord injury ( SCI ) . DESIGN AND SETTING Multicenter , r and omized , double-blind , placebo-controlled , flexible dose-titration , parallel-group study in clinical practice s in Europe . Patients Enrolled patients had ED secondary to SCI ( all spinal levels ) and sustained 6 months or longer before visit 1 . INTERVENTIONS After a 4-week run-in period , patients were r and omly assigned to tadalafil , 10 mg , ( n = 142 ) or placebo  ( n = 44 ) for a 12-week , on-dem and treatment period with assessment s at 4-week intervals . The dose of tadalafil was maintained or titrated ( 10 or 20 mg ) at 4 and 8 weeks . MAIN OUTCOME MEASURES Efficacy was measured using the International Index of Erectile Function ( IIEF ) , Sexual Encounter Profile ( SEP ) , and Global Assessment Question ( GAQ ) . Treatment-emergent adverse events and vital signs were collected at each visit . RESULTS Mean age was 38 years .  Mean baseline IIEF erectile function domain score was 13.4 , and following 12 weeks of treatment , 22.6 for tadalafil and 13.6 for placebo ( P < .001 ) . After treatment , the tadalafil group compared with the placebo group was significantly greater ( P < .001 ) in mean per-patient percentage of successful penetration attempts ( SEP question 2 ; 75.4 % vs 41.1 % ) and intercourse attempts ( SEP question 3 ; 47.6 % vs 16.8 % ) ; percentage of improved erections ( GAQ question 1 ; 84.6 % vs 19.5 % ) ; and ejaculatory frequency ( IIEF question 9 ; P = .03 ) . The 2 most common treatment-emergent adverse events in the tadalafil group compared with placebo were headache ( 8.5 % vs 4.5 % ) and urinary tract infection ( 7.7 % vs 6.8 % ) . CONCLUSIONS Tadalafil ( 10 mg and 20 mg ) improved erectile function and was well tolerated by men with ED secondary to traumatic SCI OBJECTIVE To assess the course of sexual function in epilepsy patients treated with lamotrigine .  MATERIAL AND METHODS This open study included 141 patients treated with lamotrigine for a period of 8 months : 79 patients initiated treatment with lamotrigine monotherapy , and 62 were switched to lamotrigine because of lack of efficacy or adverse events to a previous antiepileptic drug ( AED ) . Patients were assessed at baseline and after 4 and 8 months of treatment . In the baseline and final visits the Changes in Sexual Functioning Question naire ( CSFQ ) was applied . Analysis was performed in an intent-to-treat population . RESULTS In women who started treatment with lamotrigine , a significant improvement was observed , both in total CSFQ score ( increase of 5.39 + /- 6.95 points ; p < 0.05 ) , and in the five dimensions of the scale ( desire/frequency , desire/interest , pleasure , arousal/excitement and orgasm ) . In men , a significant improvement was only observed in the pleasure dimension . In the group of patients in whom a previous AED was substituted by lamotrigine , significant improvement was recorded in the dimensions of pleasure and orgasm in men and desire/frequency in women , whilst in women the desire/interest dimension showed a decrease . CONCLUSIONS In this observational study , an improvement in sexual dysfunction was observed in association with lamotrigine . This could have been the result of improvement of the epilepsy , changes in quality of life , elimination of side effects from other AEDs , or a mood-stabilizing effect of lamotrigine INTRODUCTION Lower urinary tract symptoms ( LUTS ) have a profound impact on physical , social , and sexual well-being . Sacral neuromodulation ( SNM ) may have a positive effect on sexuality , though few studies have so far evaluated its impact on female sexual function . AIM To prospect ively assess changes in sexual function , clinical outcome and quality of life after SNM in female patients with overactive bladder ( OAB ) and their possible correlation with improvement in urinary symptoms and quality of life indexes . MAIN OUTCOME MEASURES Correlations between differences in Female Sexual Function Index ( FSFI ) scores and in clinical outcome and correlations between differences in FSFI , SF36 , and IQoL scores were evaluated by Spearman 's coefficient . Comparison between preoperative , midterm follow-up ( MFU ) , and last follow-up ( FFU ) visits were performed by generalized linear model ( 
    Output:
    
The proposed time schedule of investigations as well as the amount and type of investigation were different according to specific neurological lesions .
They depend on the dysfunctional pattern of the lower urinary tract ( LUT ) and its risk profile .
The goal of neuro-urological management is the best possible preservation of upper urinary tract ( UUT ) and LUT function in relation to the individual neurological disorder .