International Journal of Impotence Research最新文献

Postcoital dysphoria (PCD) refers to the experience of inexplicable negative affect following consensual sexual intercourse or general sexual activity. Despite being relatively common, PCD is under-recognized in clinical practice and remains excluded from formal diagnostic classifications. This perspective synthesizes findings from empirical research and theoretical perspectives to explore the psychological, relational, and neurobiological foundations of PCD. It also situates the phenomenon within mythological and historical contexts, arguing for a comprehensive understanding that encompasses both pathological and existential interpretations. We highlight key research gaps and propose directions for clinical integration and future inquiry.

In response to the dynamic societal shifts worldwide, the European Sexual Medicine Network initiated a collective effort to advance sexual health. A team of 6 researchers, grounded in scientific inquiry, clinical practice, and policy advocacy, was tasked with developing a comprehensive research agenda to identify gaps and challenges for future study. This paper explores contemporary influences on sexual health, such as lifestyle changes, technological advancements, and health concerns. Considering the interconnected nature of our lives, we describe the impact of chronic stress, technology, and broader societal factors on sexual well-being. Our research agenda addresses critical concerns like sexual and reproductive health, family planning, and HPV vaccination, emphasizing global recognition and advocating for accessible sexual health education. In addition, we challenge societal norms surrounding female sexuality and sexual pleasure and underscore the relevance of sexual expression and intimacy, even amid conditions like cancer. With this agenda, we advocate for a transdisciplinary approach in clinical practice, recognizing the universal right to have sexual pleasure, with a specific focus on marginalized populations. We conclude with highlighting the importance of collaborative efforts from policy-makers, healthcare professionals, researchers, and community advocates to navigate the complexities of sexual health in contemporary society.

Suturing the corporotomies over the penile implant yields water-tight closure, reducing the risk of hematoma and subsequent infection, though at the risk of needle puncture of the inflatable cylinders. This prospective randomized controlled study evaluates Shaeer's Corporotomy Closure Technique (SCCT); a surgical technique to enhance the ease and safety of suturing the corporotomies closed, by everting the corporotomy edges. The study was performed in a single center, between 2022 and 2025, in Cairo, Egypt. Three-piece inflatable penile prosthesis (iPP) implantation was performed for 32 patients with erectile dysfunction refractory to medical treatment, excluding cases of previous penile surgery, Peyronie's disease, corporal fibrosis or radical prostatectomy, or those receiving anticoagulant therapy. Patients were randomized into two groups. The Control Group had the corporotomies closed by tying the pre-placed stay sutures. SCCT Group had the corporotomies sutured closed with the edges everted using horizontal mattress sutures placed on each side of the intended corporotomy, two on each corpus cavernosum. After corporotomy, the stay sutures were tied, everting the edges. The everted corporotomy edges were then sutured closed in a running fashion. Operative time was 9.5% (5 min) shorter in the Control Group (47.7 ± 5.3 mins vs. 52.7 ± 4.4 mins, p = 0.009). Drain output at 24 h was 78.8% (59.4 cc's) higher for Control Group (75.4 ± 32.8 cc's vs. 16 ± 8.6 cc's, p < 0.001), (Table 1, Fig. 5). Total drain output was 81.5% (77.5 cc's) higher in Control Group (95.1 ± 64.8 cc's vs. 17.6 ± 12 cc's, p < 0.001). For both groups, no intra-operative complications, infections or device mechanical failures were recorded through the follow up period; 14 months ± 4.4. One case in Control Group developed a scrotal hematoma, and two cases developed scrotal tissue induration surrounding the pump, delaying deflation and cycling. SCCT allows safer suturing of the corporotomies.

Erectile dysfunction (ED) is a common male sexual disorder. Vitamin D (VD) deficiency is frequent in ED patients and has been associated with greater disease severity, but its role in predicting treatment response remains unclear. In this prospective cohort study, 202 ED patients were initially enrolled, and after excluding 30 ineligible cases, 172 were included in the final analysis at Chengdu University of TCM Affiliated Hospital (September 2023-August 2024). ED severity was evaluated using the International Index of Erectile Function-5 (IIEF-5) during a 1-month follow-up, with 152 patients (88.4%) reporting symptomatic improvement after daily tadalafil 5 mg treatment. Patients with VD ≥ 20 ng/mL showed faster responses. Multivariate Cox regression demonstrated a significant positive association between baseline VD levels and treatment outcomes (adjusted hazard ratio = 1.60 per 1 ng/mL increase; 95% confidence interval: 1.31-1.95). Restricted Cubic Spline analysis revealed a nonlinear relationship, with the strongest effect observed at VD ≤ 19.6 ng/mL, representing a data-driven inflection point. Interaction analyses further confirmed consistent benefits across all age groups. These findings indicate that baseline VD is an independent prognostic factor for tadalafil efficacy in ED, highlighting its potential clinical utility for risk stratification and individualized treatment decisions in ED.

We performed a randomized-control trial to assess the impact of a video-based educational platform (VEP) on the pre-consult knowledge and post-consult satisfaction of patients presenting for vasectomy consultation. Between December 2022-2023, 39 patients were randomized on an alternating basis to receive either access to a VEP before their vasectomy consult (n = 18) or an in-person consult only (n = 21)(standard of care [SOC]). The VEP was created in partnership with EngagedMD, and consisted of 6 videos (total of 7 min) with mandatory checkpoint questions. A 10-question assessment was given prior to the start of the vasectomy consultation, and custom Likert-scale surveys were given after the consultation. Age, level of education, and marital status were not statistically different between the groups. The VEP group scored higher on the baseline knowledge assessment compared to the SOC group (90% vs 60%, p = <0.001). 100% of patients agreed the VEP helped educate them on the risks and benefits of vasectomy. 94.1% of patients endorsed that the VEP enhanced their ability to converse with the medical team. Compared to the SOC group, the VEP group had higher median composite survey scores regarding comfort with procedure decision-making, clinical expectations, and overall care satisfaction (34 vs 31, p = 0.004).

Testosterone therapy (TTh) is widely used to treat late-onset hypogonadism, aiming to improve quality of life and alleviate symptoms of testosterone deficiency. However, concerns remain regarding its potential association with major adverse cardiovascular events (MACE) and prostate cancer events (PCaE). This systematic review and meta-analysis, registered in PROSPERO (CRD42024603054) and conducted in accordance with PRISMA guidelines, evaluated the risk of MACE, PCaE, and clinically significant prostate cancer (CsPcE) associated with TTh in randomized controlled trials (RCTs). A comprehensive search of PubMed, ClinicalTrials.gov, and Cochrane Central identified 3794 records, of which 41 RCTs (n = 11,161) met inclusion criteria. Pooled odds ratios (OR) were estimated using Mantel-Haenszel or restricted maximum likelihood methods under fixed or random-effects models, based on heterogeneity. Meta-regression explored sources of heterogeneity and effect modifiers, and sensitivity analyses were performed using continuity correction for zero-event trials. TTh was not associated with a statistically significant increase in MACE (OR 0.83; 95% CI: 0.52-1.32; I² = 53.2%), PCaE (OR 0.88; 95% CI: 0.52-1.51; I² = 0.0%), or CsPcE (OR 1.13; 95% CI: 0.39-3.26; I² = 0.0%). Comorbidities contributed to heterogeneity in MACE outcomes. Current evidence supports the short- to mid-term safety of TTh, though long-term data remain necessary. Registry and the Registration No. of the study/trial: CRD42024603054.

Internalized transphobia (IT) is the rejection that transgender and gender non-conforming people (TGNC) feel towards themselves because of the internalization of negative values, prejudices, and/or stereotypes that prevail in society. This study aimed to adapt and validate a Spanish version of the Transgender Identity Survey (TIS) to assess IT in Spanish-speaking TGNC individuals. The sample consisted of 207 TGNC Spanish adults aged between 18 and 63 years (25.11 ± 8.16) who completed the TIS, along with measures of self-esteem and body image. Translation, cross-cultural adaptation, and validation analyses of the TIS were carried out. A reduced version of the original scale composed of 15 items in a one-dimension to assess IT was obtained through Exploratory Factor Analysis (EFA). Validity evidence based on the internal structure was tested through Confirmatory Factor Analysis (CFA). The indices from the CFA showed that the reduced version of the TIS had an acceptable fit: χ² = 250.11, p < 0.001; CFI = 0.86; GFI = 0.96; RMSEA = 0.09 (0.07-0.10); SRMR = 0.06. The scale showed adequate reliability values (α = 0.890; Ω = 0.892). Correlations between TIS, self-esteem and body image reported convergent validity evidence. The Spanish version of the TIS provides a useful, reliable, and valid instrument for both research and clinical areas, supporting interventions aimed at reducing internalized stigma and promoting well-being and self-acceptance in the gender-diverse community.

Vasectomy reversal (VR) has remained the longstanding gold standard for men seeking paternity following a history of vasectomy. Ever since its initial description, numerous innovations have occurred in the field of reproductive urology to optimize perioperative outcomes. Additional considerations such as preoperative patient and patient's partner evaluation, medical optimization, and perioperative surveillance protocols are now a paramount component of caring for patients with obstructive azoospermia undergoing vasectomy reversal. Finally, numerous surgical innovations have been described which may lead to increased duration of patency in the postoperative setting. This review aims to provide a comprehensive update on the management of obstructive azoospermia secondary to vasectomy and all salient considerations including preoperative evaluation, intraoperative decision making, surgical technique, and postoperative surveillance.