Eric Meuleman

Amsterdam University Medical Center | VUmc · Department of Urology

Background For transgender men choosing to undergo phalloplasty with urethral lengthening, there is a potential for hair growth in the neourethra. Depilation of the urethral donor site may reduce subsequent intraurethral hair growth. Objectives To evaluate the effectiveness of preoperative laser depilation and assess the correlation between urethr...

Context Therapies initiated by urologists, medical as well as surgical, may cause adverse effects in different sexual domains. Sexual domains that are often affected are sexual interest, sexual activity, and erectile functioning. As many elderly men undergo these therapies, it is important to know the prevalence of sexual dysfunction (SD) in these...

Purpose: Urethral reconstruction is performed in patients with urethral strictures or for correction of congenital disorders. In the case of shortage of tissue, engineered tissue may enhance urethral reconstruction. As the corpus spongiosum (CS) is important in supporting the function of the urethra, tissue engineering of the urethra should be com...

Erectile dysfunction is the continuous or recurring inability to get or to maintain an erection rigid enough for sexual activity. Non-urologists will often restrict themselves to counselling, lifestyle advice or the prescription of an erection pill. However, most erection pills are manufactured and traded illegally. The Dutch Institute for Rational...

Since the use of antibiotics, bladder necrosis has become a rare condition. We report a case of bladder necrosis in a 90-year-old man following urinary retention. After insertion of a transurethral catheter (TUC), 2 L of urine was evacuated. In the following days, the TUC became intermittently blocked. Adequate bladder drainage could not be obtaine...

Background: Genital dissatisfaction is an important reason for transmen to undergo genital gender-confirming surgery (GCS; phalloplasty or metoidioplasty). However, little is known about motives for choosing specific techniques, how transmen benefit postoperatively, and whether psychosexual outcomes improve. Aim: To evaluate motivations for and...

Background: The benefits and risks of long-term testosterone administration have been a topic of much scientific and regulatory interest in recent years. Aim: To assess long-term quality of life (QOL) and sexual function benefits of testosterone replacement therapy (TRT) prospectively in a diverse, multinational cohort of men with hypogonadism....

Objectives: To evaluate the effects of testosterone-replacement therapy (TRT) on prostate health indicators in hypogonadal men, including rates of prostate cancer diagnoses, changes in prostate-specific antigen (PSA) levels and lower urinary tract symptoms (LUTS) over time. Patients and methods: The Registry of Hypogonadism in Men (RHYME) is a m...

Objective One of the goals of FtM-SRS is voiding in a standing position, which requires urethral lengthening procedures. Complications after the urethral lengthening procedures occur often. Hence some patients prefer the SRS without urethral lengthening and thus voiding in a sitting position. In the Netherlands FtM transgenders can opt for SRS with...

Botulinum neurotoxin A (BoNT-A) is a highly neurotoxic drug and frequently used in patients. Knowledge on the optimal way of administration of BoNT-A and its subsequent distribution is still rather limited. An accurate method for monitoring these processes might be the use of radiolabelled BoNT-A. In this paper, we report our feasibility study on l...

There has been a longstanding question as to whether testosterone therapy could precipitate or worsen urinary symptoms in aging men. We investigated the effects of 1-year oral testosterone undecanoate (TU) therapy on urinary symptoms in aging, hypogonadal men. A total of 322 men ≥50 years with symptomatic testosterone deficiency participated in a 1...

In the literature hypoactive sexual desire is the most frequently studied entity in the male sexual desire domain. In this chapter it is extensively discussed. Moreover, some facets of male hyperactive sexual desire are discussed. Hypoactive sexual desire is associated with multiple biological and psychological causes Sexual desire is easily distur...

Objectives: The traditional assumption of a linear relationship between serum testosterone and prostate cancer growth has been seriously challenged, as overwhelming evidence contradicts its basic principles. Luteinizing hormone-releasing hormone (LHRH) agonists are known to cause a peak in serum testosterone level in the initial weeks of treatment...

- Peyronie's disease is caused by collagen deposits in the tunica albuginea of the corpus cavernosum following microtrauma.- Symptoms may include a combination of penile curvature, a palpable plaque, painful erections and erectile dysfunction.- Peyronie's disease can have a major impact on the quality of life.- In the course of the disease two phas...

Background Botulinum toxin A (BoNT-A) is a new treatment modality in various causes of bladder dysfunction; like neurogenic detrusor overactivity and overactive bladder. The best technique of administrating BoNT-A in patients is unknown. A validated in vitro model could be used to investigate newer intravesical administration techniques of BoNT-A....

Het Vrije Universiteit Medisch Centrum, Amsterdam, is een van de weinige centra waar de geslachtsaanpassende operatie (GAO) zonder urethraverlenging wordt uitgevoerd.

Lokaal beperkt prostaatcarcinoom wordt op een steeds jongere leeftijd bij seksueel actieve mannen gedetecteerd.

Wij rapporteren de eerste ervaringen in Nederland met betrekking tot de effectiviteit en de veiligheid van de ‘self-anchoring’ adjustable transobturator male sling (ATOMS) voor de behandeling van stress urine-incontinentie (SUI) bij mannen, ontstaan na operatie aan en/of bestraling van de prostaat.

Objective: We investigated the effects of oral testosterone undecanoate (TU) on bone mineral density (BMD), lean body mass (LBM) and body fat mass (BFM) in aging men with symptomatic testosterone deficiency (TD). Methods: Three hundred twenty-two men ≥50 years with TD symptoms and calculated free testosterone <0.26 nmol/L participated in a multi...

Objective: To evaluate the relationship between the body mass index (BMI) and serum testosterone concentrations in men receiving luteinizing hormone-releasing hormone (LHRH) agonist therapy for prostate cancer. Materials and methods: A total of 66 white men were included in the present study. All subjects had received LHRH agonist therapy for ≥...

- After having undergone a radical prostatectomy, 1 out of 5 men is dissatisfied about the functional results particularly because of complications like erectile dysfunction and urinary incontinence; these complications frequently do occur.- During the first postoperative year, patient counselling and guidance are necessary aspects of the managemen...

Purpose: Prostate cells are dependent on androgens for growth and proliferation. Androgen deprivation therapy is the recommended treatment for advanced/metastatic prostate cancer. Under this therapy, prostate cancer will inevitably progress to castration resistant prostate cancer (CRPC). Despite putative castration resistance, testosterone might s...

In 2010 the International Society of Sexual Medicine published its practice guideline for the diagnosis and treatment of premature ejaculation. This guideline was translated and adapted on a number of points by a committee consisting of members of two Dutch sexological societies, the 'WVSD' and the 'NVVS'. The most important subjects in this guidel...

Purpose: To obtain insight into demographical factors, histology and survival rates of females diagnosed with primary urethral cancer and to determine favourable treatment. Methods: Data from 91 females with primary urethral carcinoma, age varying from 15 to 85 years, registered between 1989 and 2008 at the National Cancer Registry of the Nether...

Androgen deprivation therapy by bilateral orchiectomy (surgical castration) or luteinizing hormone-releasing hormone agonist therapy (medical castration) is recommended for advanced or metastatic prostate cancer. Both methods aim at reducing serum testosterone concentrations to a castrate level which is currently defined as less than 50 ng/dl. The...

What's known on the subject? and What does the study add? The male steroid hormone metabolism is an important target in the treatment of prostatic diseases. However, present literature is inconsistent about intraprostatic concentrations of steroid hormones and the role of intraprostatic steroid hormones in the arise and the course of prostatic dise...

Androgen deprivation therapy (ADT) and 5-α-reductase (5AR) inhibition are used in the treatment of men with advanced or metastatic prostate cancer and benign prostatic hyperplasia (BPH), respectively. These drugs exert their effect by lowering androgen levels in the serum and allegedly, the prostate gland. It is, however, unknown whether (increased...

This study evaluated the effects of testosterone replacement therapy (TRT) on insulin resistance, cardiovascular risk factors, and symptoms in hypogonadal men with type 2 diabetes and/or metabolic syndrome (MetS). The efficacy, safety, and tolerability of a novel transdermal 2% testosterone gel was evaluated over 12 months in 220 hypogonadal men wi...

The aim of this article is to provide an overview of the current literature on the impact of the metabolic syndrome on male sexual health and current developments in the management of sexually dysfunctional men with a metabolic syndrome. The increasing prevalence across the world of the metabolic syndrome-a cluster of cardiovascular disease risk fa...

OBJECTIVE This study evaluated the effects of testosterone replacement therapy (TRT) on insulin resistance, cardiovascular risk factors, and symptoms in hypogonadal men with type 2 diabetes and/or metabolic syndrome (MetS).

Addition of testosterone (T) may improve the action of phosphodiesterase type 5 inhibitors (PDE5-Is) in patients with erectile dysfunction not responding to PDE5-Is with low or low-normal T levels. To confirm this add-on effect of T in men optimally treated with PDE5-Is and to specify the baseline T levels at which such an effect becomes significan...

The Committee on "Clinical Evaluation and Scales in Sexual Medicine" of the third International Consultation in Sexual Medicine reviewed current practice and new developments in the field of physiological testing in male erectile dysfunction (ED). To provide an overview of current practice and new developments in the field of diagnostic testing in...

Van alle seksuele responsen is het orgasme het minst goed in kaart gebracht. Orgasme is moeilijk te definiëren, omdat het een subjectieve ervaring is op een moment dat het vermogen tot objectieve observatie sterk verminderd is. Bij de postpuberale man gaat het orgasme normaliter gepaard met ejaculatie. Omdat zo’n duidelijk fenomeen bij de vrouw ont...

Erectiele disfunctie wordt gedefinieerd als het onvermogen een erectie te krijgen en te behouden, voldoende voor bevredigende seksuele activiteit.

Nessuna funzione fisiologica rimane inalterata dal processo di invecchiamento, che determina ineluttabilmente una diminuzione della capacità funzionale e dell’efficacia dei meccanismi regolatori omeostatici. Tutti i sistemi ormonali vengono colpiti in gradi diversi dal fenomeno dell’invecchiamento e l’asse gonadico dell’uomo non fa eccezione, anche...

The challenge in the field of sexual medicine is to develop evidence-based principles for clinical evaluation and create a uniform, widely accepted diagnostic and treatment approach for all sexual problems and dysfunctions, for both genders. To provide recommendations for the broad approach for assessing sexual problems in a medical practice settin...

Lower urinary tract symptoms (LUTS) and erectile dysfunction (ED) are the most commonly presented complaints at a urological outpatient clinic. Both complaints often occur in combination. Population studies have shown an association between LUTS and ED and heart disease, diabetes and hypertension, often referred to as the metabolic syndrome (MetS)....

To investigate the effects of oral testosterone undecanoate (TU) on symptoms associated with late-onset hypogonadism (LOH). Design Multicenter, randomized, double-blind, placebo-controlled. The study was performed in 14 study centers in seven European countries. Men > or =50 years (n=322) with symptoms of hypogonadism and testosterone deficiency (c...

Het terrein van de mannelijke seksuele disfuncties werd het laatste decennium gekenmerkt door snelle en zeer ingrijpende veranderingen in diagnostische en therapeutische mogelijkheden op medisch terrein. Vooral de farmacologische behandelmogelijkheden van problemen met de erectie en met te snel klaarkomen zijn sterk uitgebreid. Daarnaast wordt het...

Transurethral resection syndrome during transurethral resection of the prostate (TURP) results from excessive absorption of electrolyte-free irrigation fluids causing acute hypervolemia and hyponatremia. Neuraxial anesthesia is often recommended for TURP procedures because early signs of neurological deterioration can be detected. However, in patie...

Pathofysiology, impact on sexual function and therapeutic options in men with congenital and acquired penile curvature are discussed.

Objective: To develop a contemporary, evidence-based definition of premature ejaculation (PE). Methods: There are several definitions of PE; the most commonly quoted, the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders - 4th Edition - Text Revision, and other definitions of PE, are all authority-based rat...

The medical literature contains several definitions of premature ejaculation (PE). The most commonly quoted definition, the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition-Text Revision, and other definitions of PE are all authority based rather than evidence based, and have no support from co...

This study was performed to assess spermatogenesis suppression and safety of a new combination of an etonogestrel (ENG) implant combined with testosterone undecanoate (TU) injections for male contraception. This is the first large placebo-controlled study for male hormonal contraception. DESIGN AND STUDY SUBJECTS: In this double-blind, multicenter...

Introduction. The incidence of priapism in adults is higher than in children. Although approximately 50% of all episodes of priapism are thought to be idiopathic, there are a number of known specific causes of this disorder. In adults intracavernous therapy with papaverine, phentolamine, alprostadil or combinations of these agents is the most commo...

IntroductionHypogonadismHyperprolactinemiaRole of other Hormonal Alterations in Sexual Dysfunctions and Men's HealthDHEA therapyMetabolic Diseases and Sexual Dysfunctions

Bij mannen boven de vijftig komen plasklachten en erectiestoornissen vaak in combinatie voor en vormen ze een belangrijke reden voor doktersbezoek. Er zijn aanwijzingen dat een proces van fibrosering van de bekkenorganen de gemeenschappelijke pathofysiologische noemer is. Dit proces is het gevolg van de met ouder worden gepaard gaande atheroscleros...

Les modifications de nombreux systèmes endocriniens au cours du vieillissement entraînent une diminution de la sécrétion de l’hormone de croissance, de la déhydroépiandrostérone et de la testostérone. La variabilité circadienne de la testostérone, présente chez l’homme jeune, est diminuée chez l’homme vieillissant. La diminution des concentrations...

Over the past few decades, female hormonal contraception has been seen to be very successful. However, this has still not resulted in a hormonal contraceptive for men. Certain injectable combinations ofandrogens and progestagens have been found to suppress spermatogenesis. All combinations that have been tested so far suffer from a relative lack of...

In male patients with congenital adrenal hyperplasia (CAH), testicular adrenal rest tumors are frequently found that may interfere with gonadal function. Our objective was to determine steroid-producing features of testicular adrenal rest tumors. The study is descriptive and took place at a university medical center. Eight adult CAH patients with b...

To establish an objective, easy-to-use and comprehensive method to analyze corpus cavernosum electromyographic signals (CC-potentials). CC-potentials were recorded during flaccidity in 23 young healthy volunteers, with surface electrodes placed on the penile shaft bilaterally. Based on the correlation function of Matlab software, an application pro...

In male patients with congenital adrenal hyperplasia (CAH), testicular adrenal rest tumors (TART) are frequently present. These tumors can interfere with testicular function. Intensifying glucocorticoid therapy does not always lead to tumor regression and improvement of testicular function. Recently, testis-sparing surgery was introduced for treatm...

A lack of standardization of the recording techniques of corpus cavernosum electromyography (CC-EMG) and objective criteria to characterize the recorded signals (CC-potentials) are the main difficulties hindering the clinical application of this method. These difficulties have been recently overcome by revising the recording and interpretation meth...

Introduction: The ability of oral phosphodiesterase type 5 (PDE5) inhibitor therapy to restore erectile function to normal is an important attribute to men with erectile dysfunction (ED). Aim: To assess the ability of vardenafil to restore normal erectile function in men with general ED. Methods: In two fixed-dose, parallel-group, double-blind...

Introduction: Although the corpus cavernosum electromyography (CC-EMG) has been studied already for 16 years, doubts regarding its reproducibility have remained. Aim: To assess the reproducibility of CC-EMG under controlled conditions and the influence of confounding factors. Methods: Three CC-EMG recording sessions were performed in 13 health...

Many patients with asymptomatic haematuria are primarily referred to urological examination. To analyse the efficiency of this strategy, we investigated the diagnostic process in 134 patients with asymptomatic haematuria (91 macroscopic and 43 microscopic) who were referred to our urology department. The frequency of diagnostic procedures was urine...

Approximately 35,000 vasectomies were performed in the Netherlands in 2004. Although vasectomy may be looked upon as the most reliable method of contraception (risk of pregnancy in the first year: 0.08-0.15%), realistic preoperative counselling about possible complications such as haemorrhage (5%), wound infection (5%), and haematoma (14%) and long...

Actinobaculum was isolated from urine only after prolonged incubation in 5% CO2 after discrepancy between urine Gram stain and initial culture results was observed. Additional patients were diagnosed using this method. The prevalence of Actinobaculum species in urinary tract infections is underestimated since it is not isolated by routine urine cul...

The introduction of sildenafil put the risk of cardiovascular disease (CVD) among men with erectile dysfunction (ED) on the agenda of physicians. The question arose, Is EDsentinel to CVD? We sought to answer this question in the present study. A historical cohort study was set up using medical records of general practices all over the Netherlands....

Hoewel een circumcisie of besnijdenis wereldwijd tot een van de oudste en meest uitgevoerde operaties behoort, is er weinig literatuur over de gevolgen van een circumcisie op de seksuele beleving. Recent Amerikaans onderzoek betreffende de prevalentie, profylactische effecten en effecten van circumcisie op de seksualiteit, toont aan dat mannen na c...

In Nederland hebben ruim 700.000 mannen een vasectomie ondergaan. Korte-termijn-complicaties zijn wondinfectie en bloedingen. Als lange-termijn-effect zijn scrotale pijnen beschreven. De oorzaak en behandeling van deze klachten, soms verergerend tijdens de samenleving, is onderwerp van meerdere retrospectieve studies.

Bij mannen met een afwijkende semenanalyse komt in 25% van de gevallen een varicokèle voor (3).

De differentiaal diagnose van inguinale massa of inguinale pijn is breed. Denk hierbij aan de gangbare condities als varicokéle, hydrokéle, spermatokéle, inguinale hernia, torsio testis of funiculitis.

De differentiële diagnose van scrotalgie omvat onder meer epididymitis. Een ontsteking van de epididymis wordt gekenmerkt door lokale roodheid, koorts, zwelling en pijn (rubor, calor, tumor, dolor). Een meer chronische vorm van epididymale pijn en zwelling wordt gezien na vasectomie (1).

Vasectomy is a simple and reliable method of contraception. Problems associated with vasectomy include inadequate patient information, complications of the procedure e.g. infection and scrotal bleeding (4-22%), chronic scrotal pain after the procedure (2-5%) and spontaneous recanalisation with return of fertility (0.03-I12%). Later in life a substa...