International Journal of Impotence Research最新文献

The C-reactive protein-triglyceride glucose index (CTI) is emerging as a novel indicator for comprehensively assessing the severity of both inflammation and insulin resistance. However, the association between CTI and erectile dysfunction (ED) remains largely unexplored. Participant data for this study were sourced from NHANES 2001-2004, with exclusion criteria applied to those lacking information on clinical variables. The CTI was defined as 0.412*Ln (CRP) + ln [T.G. (mg/dL) × FPG (mg/dL)/2]. Weighted univariable and multivariable logistic regression models were utilized to examine the correlation between the CTI and ED, assessing the CTI as both a continuous and categorical variable (quartile). Moreover, subgroup analyses were conducted to pinpoint sensitive populations, and interaction analysis was performed to validate the findings. A total of 1502 participants were included in the final analysis, encompassing 302 with ED and 1200 without ED. After adjusting for potential confounders, the CTI was positively associated with ED incidence (OR = 1.56, 95% CI: 1.27-1.90, P = 0.002). The fourth quartile of the CTI significantly increased the incidence of ED (OR = 2.69, 95% CI: 1.07-6.74, P = 0.04), and the lowest quartile of CTI was used as the reference. The dose-response curve revealed a positive linear relationship between the CTI and the incidence of ED. Subgroup analysis confirmed the consistent positive relationship between the CTI and ED. The interaction test indicated no significant impact on this association. Finally, a sensitivity analysis was performed to verify the significant positive correlation between the CTI and severe ED (OR = 1.44, 95% CI: 1.19-1.76, P = 0.004). Our national data indicate that a greater CTI is positively linked to an increased risk of ED in US men, suggesting its potential for use in clinical practice for ED prevention or early intervention. Additional large-scale prospective studies are warranted to substantiate the causative relationship between CTI and ED.

Traditionally, semen analysis has been viewed solely as a tool for assessing male fertility. However, emerging research suggests that abnormal semen parameters may serve as indicators of broader health issues beyond reproductive function. Studies have revealed significant associations between abnormal semen parameters and an increased risk of chronic diseases such as prostate cancer, diabetes, ischemic heart disease, and metabolic disorders. These findings challenge the conventional understanding and position semen analysis as a potential screening tool for overall male health. The correlation between abnormal semen parameters and conditions like erectile dysfunction further underscores the multifaceted implications of semen quality. This suggests that abnormal semen parameters may be a risk factor for poorer overall health and a higher likelihood of developing comorbidities over time. Given these compelling associations, there is a growing call to integrate semen analysis into routine health assessments for young men, particularly in conjunction with established general health screenings. This proactive approach aligns with a preventative healthcare paradigm, facilitating early detection of underlying health concerns and timely interventions. However, overcoming cultural, logistical, and cost-related barriers is crucial for the successful implementation of this shift in reproductive health.

The evolution in conceptualization of sexual desire has stimulated many attempts to measure it. However measures able to assess multiple expressions of desire in all sexual identities are still lacking. The main aim of the present study was to test the psychometric properties of the Sexual Desire and Erotic Fantasies questionnaire - Part 1 Sexual Desire (SDEF1), developed as a sex-positive measure of different sexual desire expressions. The SDEF1 was assessed in 1773 participants from the Italian general population (1105 women, 645 men, and 23 other genders; ranged between 18-78 years old, mean age 29.31 ± 10.35) on an online survey, together with the Sexual Desire Inventory - 2, the International Index of Erectile Function, the Female Sexual Function Index, and the Marlowe-Crowne Social Desirability Scale-Short Form. Results support a factorial structure of six dimensions, including 28 items and accounting for 58.11% of the total variance: sexual desire, negative feelings to sexual desire, autoerotic desire, regular partner desire, attractive person desire, and responsive desire. The confirmatory factorial analysis showed satisfactory indexes (RMSEA = 0.042 [90% CI = 0.039-0.045]; GFI = 0.97; NFI = .96; and CFI = 0.97). Regression coefficients ranged from 0.39 to 0.94 and were all statistically significant (p < 0.001). The SDEF1 showed good psychometric properties such as internal reliability, construct, and discriminant validity, and to differentiate women and men with and without sexual difficulties. Men reported significantly higher levels of desire than women in all areas except for desire for a regular partner, were no gender difference was detected. Desire for autoerotic activity was the factor accounting for more variance explained among genders (11.7%). The SDEF1 could be a useful measure to assess different areas of sexual desire and its use could be recommended for clinical and research purposes.

Patient out-of-pocket (OOP) cost represents an access barrier to erectile dysfunction (ED) treatment. We determined OOP cost for men with ED covered by Fee-for-Service Medicare. Coverage policies were obtained from the Medicare Coverage Database for treatments recommended by the 2018 American Urological Association (AUA) guidelines. OOP cost was retrieved from the 2023 Centers for Medicare & Medicaid Services Final Rule. OOP cost for treatments without Medicare coverage were extracted from GoodRx® or literature and inflated to 2022 dollars. Annual prescription costs were calculated using the published estimate of 52.2 yearly instances of sexual intercourse. Medicare has coverage for inflatable penile prostheses (IPP; strong recommendation), non-coverage for vacuum erection devices (VED; moderate recommendation) and phosphodiesterase type-5 inhibitors (PDE5i; strong recommendation), and no policies for intracavernosal injections (ICI; moderate recommendation), intraurethral alprostadil (IA; conditional recommendation), or low-intensity extracorporeal shock wave therapy (ESWT; conditional recommendation). Annual IA prescription is most costly ($4022), followed by ICI prescription ($3947), one ESWT course ($3445), IPP ($1600), PDE5i prescription ($696), and one VED ($213). PDE5i and IPP, both strongly recommended by AUA guidelines, are associated with lower OOP cost. Better understanding of patient financial burden may inform healthcare decision-making.