International Journal of Impotence Research最新文献

Simultaneous stress urinary incontinence (SUI) and erectile dysfunction (ED) are commonly caused by prostate surgery. Penile prosthesis is the gold standard for erectile dysfunction refractory to conservative therapies, fixed male sling and artificial urinary sphincter are recommended in mild and moderate/severe stress urinary incontinence respectively. The implantation of these devices can be simultaneous or delayed. This systematic review analyzes articles on simultaneous implantation of penile prosthesis and anti-incontinence devices. We search on Pubmed/Medline and Scopus: "penile prosthesis" AND "artificial urinary sphincter", "male sling", "Mini-Juppette", "ATOMS", "ProACT", "urethral bulking", "Advance", "Virtue". We have included 21 studies, mostly retrospective. The size of study cohorts is relatively small (2-65 patients) and the main cause of stress urinary incontinence and erectile dysfunction was radical prostatectomy. The average operating time appeared longer (57-218 min), although without evidence of intraoperative complications and an average hospital stay of 1-3 days. The average follow up of the studies ranged from 1 month to 94 months. Studies expressed different outcomes measurements, that could not allow a cumulative analysis. The overall continence outcomes were encouraging, with social continence rates (no more than 1 pad/day) ranging from 72 to 100%. The overall satisfaction for the inflatable penile prosthesis was high (84-100%). The postoperative complication rate did not show an augmented risk for double implants. All studies did not report any technical or surgical implant obstacles in synchronous versus metachronous implantation.

Post-Orgasmic Illness Syndrome (POIS) is a rare and debilitating condition characterized by systemic and cognitive symptoms following ejaculation. As patients increasingly seek health information from artificial intelligence (AI) tools such as ChatGPT, evaluating the accuracy, consistency, and readability of these responses is especially important in the context of underrecognized conditions like POIS, where patients often encounter limited access to specialist care and evidence-based educational resources. This makes generative AI a likely source of health information, underscoring the need to evaluate the accuracy, consistency, and readability of its outputs. This study assessed the performance of ChatGPT version 4o (ChatGPT-4o) in generating patient-directed responses to POIS-related questions. Sixteen real-world questions were selected across four content domains: epidemiology, treatment, treatment risks, and counseling. Each question was submitted to ChatGPT-4o on two different days using separate accounts. Responses were independently graded by three English-speaking urologists with expertise in men's sexual health and andrology using a validated 4-point scale: "correct and comprehensive," "correct but inadequate," "mixed correct and incorrect," and "completely incorrect." Reproducibility was defined by whether the two responses received the same grading category, and Cohen's kappa coefficient (κ) was calculated to measure inter-rater agreement. Readability was assessed using the Gunning Fog Index (GFI). ChatGPT-4o demonstrated high performance in the epidemiology and counseling domains, achieving 100% accuracy and 100% reproducibility (κ = 1.00). However, accuracy dropped to 50% in the treatment and risk domains, with lower reproducibility (κ = 0.25). Readability scores worsened significantly from Day 1 to Day 2 across all domains (p < 0.05), indicating a shift toward more linguistically complex, less accessible language. While ChatGPT-4o shows potential in supporting patient education for rare conditions like POIS, its variability in treatment content and elevated language complexity limit its reliability as a stand-alone medical resource. These findings underscore the need for expert oversight and further model refinement before large language models can be safely integrated into clinical patient communication.

Ischaemic priapism (IP) is a urological emergency that can lead to permanent erectile dysfunction (ED) and penile deformity if not promptly managed. Refractory ischaemic priapism (RIP), defined as IP persisting beyond 48 hours despite conventional interventions, necessitates a paradigm shift in treatment strategy. Early penile prosthesis (PP) implantation offers a proactive approach in surgical management to preserve penile function while minimising complications associated with delayed surgery. This review synthesises current evidence on early PP insertion for RIP, evaluating its advantages over delayed intervention. We examine the pathophysiological progression of IP, emphasising corporal smooth muscle necrosis and penile fibrosis, which render erectile function recovery unlikely even with successful detumescence. Limitations of shunting procedures are also discussed and emerging diagnostic tools highlighted, such as magnetic resonance imaging (MRI), for assessing irreversible corporal damage. Comparative analysis of early versus delayed PP insertion reveals superior patient satisfaction, lower revision rates, reduced penile shortening, and fewer perioperative complications with early implantation. Device selection, operative techniques, and risk mitigation strategies are also explored. Our findings support early PP implantation as the preferred management strategy for RIP, aligning with international guidelines. Further research is warranted to refine surgical protocols and optimise patient outcomes.

Nearly half of the women reaching menopause in the United States (US) experience changes to reproductive health and quality of life. Vaginal estrogen is a widely recognized treatment option for menopausal symptoms. Our study aims to investigate public interest through Google search trends and its comparative prevalence in medical literature for postmenopausal women. A retrospective analysis of Google search trends data for the term "vaginal estrogen" and other related words was conducted, and a time series analysis with a 6-month simple moving average and statistical modeling were employed to evaluate the trends and relationships between these variables. Research volume and relevance were measured through PubMed and Google Scholar, respectively, for post-menopausal symptom management. Our results reveal an increasing search interest in "vaginal estrogen" and the number of articles on this treatment option among post-menopausal women. While this study does not point to causation, it suggests a correlation in growing interest in vaginal estrogen from the public and amongst medical researchers. The data underscore that the medical community's endorsement of vaginal estrogen may be fostering greater awareness and acceptance of this therapy for post-menopausal women, or vice versa. Further research is needed to determine its cost-effectiveness and equal accessibility to all patients.

The Orgasm Rating Scale (ORS) evaluates the subjective orgasm experience (SOE), both in the context of sexual relationships and solitary masturbation. It has been validated in Spain, but to examine the construct in different cultures, this study aimed to analyze its psychometric properties in the Colombian population. A total of 1 097 adults aged 18 to 62 years (mean 27.92 ± 8.54) responded to the ORS and the Arizona Sexual Experience Scale in the contexts of sexual relationships and solitary masturbation separately, during May and October 2024. The four-dimensional structure of the Spanish version is confirmed for both contexts by confirmatory factor analysis. It showed adequate reliability, with McDonald's omega values between 0.74 and 0.94. The ORS scores were significantly correlated between both contexts (r = 0.174 to 0.682), indicating the reciprocity of orgasm between the two domains. In addition, they were significantly associated with measures of sexual functioning (r = -0.097 to -0.641). Finally, through Fisher's ANOVA Bayesian, the results showed that Affective, Sensory and Rewards subscales discriminated between persons with and without orgasm difficulties in sexual relationships and solitary masturbation, but not Intimacy subscale. In conclusion, the ORS has adequate psychometric guarantees in the Colombian population to evaluate the subjective orgasm experience in the contexts of sexual relationships and solitary masturbation from a multidimensional perspective, showing itself as a valuable tool in the field of sexual and couple therapy.