International Journal of Impotence Research最新文献

The incidence of low serum testosterone has been increasing in men of all ages across a period which also corresponds to an increasing prevalence of kidney stones. Currently, the relationship between testosterone and kidney stones is unclear. Using the TriNetX Research Network, we performed a retrospective cohort study to evaluate the risk of developing an initial kidney stone in men based on their total testosterone level. Men aged ≥18 were divided into a low testosterone (<300 ng/dL) and normal testosterone (≥ 300 ng/dL) cohort. Men were excluded if they had a history of a kidney stone encounter diagnosis before testosterone measurement and a history of testosterone therapy prescription at any point. Propensity score matching was employed with an absolute standardized mean difference of less than 0.1 used as an indicator of successful matching. Our main outcome of interest was risk of developing an initial kidney stone in men aged ≥18 and within age-based subgroups. In men 18 and older, low testosterone was associated with a higher risk of one or more kidney stone encounter diagnoses (HR 1.12, 95% CI [1.09-1.15]). When stratified by age, no significant association between low testosterone and kidney stone encounter diagnoses was seen in men aged 18-24 (HR 1.09, 95% CI [0.85-1.39]). The highest risk was observed in men with low testosterone aged 34-44 (HR 1.29, 95% CI [1.17-1.38]). In this study, low serum testosterone was associated with an increased risk of initial kidney stone diagnosis in adult men without testosterone therapy prescriptions at any point in their life. Stratifying by age, the increased risk appears to begin in men aged 25, with the highest observed risk in men aged 33-44.

Despite the widespread use of narrow diameter inflatable penile prosthesis (IPP) cylinders in patients with corporal fibrosis, outcomes data is sparse. We evaluated patients who underwent IPP placement with AMS™ 700 Controlled Expansion Restricted (CXR) cylinders from 2007-2021. Patient characteristics, device details, and surgical outcomes were assessed. A non-validated questionnaire was also distributed to patients to assess satisfaction. Among 982 IPPs placed over the study period at our institution, 49 (5.0%) used CXR cylinders. Indications for narrow cylinders: prior explant for infection (67.3%), ischemic priapism (16.3%), and idiopathic fibrosis (16.3%). Median corporal length was 19 cm (IQR 17-21 cm). Discordant intraoperative corporal measurements (24.5%) and RTE lengths (26.5%) were common. Post-operative complications occurred in 8 patients (16.3%) and included 3 infections (6.1%), 2 cylinder herniations (4.1%), 2 mechanical failures (4.1%), and one case of glans necrosis (2.0%). Five of these (10.2%) required explantation, while 4 (8.2%) were managed with revision. Over the follow-up period, 73.5% of patients reported satisfaction with rigidity. Primary drivers of dissatisfaction were perceived loss of penile length and girth. The AMS™ 700 CXR is a useful tool for challenging corporal fibrosis cases and shows acceptable surgical outcomes with moderate patient acceptability.

The COVID-19 pandemic has markedly influenced people's lifestyle and sexual behaviors, including masturbation patterns. This study delved into how masturbation frequency could impact anxiety levels, sleep quality, and somatic symptoms post-masturbation among Chinese adults during this period. From December 2022 to January 2023, we conducted a cross-sectional survey, gathering data via WenJuanXing, a leading online survey platform in China. This platform facilitated the recruitment of a diverse cohort, spanning various age groups and geographical locations. Masturbation frequency among participants was subjectively categorized into three levels: 'lesser' (a few times over the past year), 'moderate' (once to three times a month), and 'greater' (weekly to almost daily). To assess anxiety levels and sleep quality, we employed the Generalized Anxiety Disorder 7-item (GAD-7) scale and the Pittsburgh Sleep Quality Index (PSQI), respectively. Among 1500 participants, we received 1423 valid responses. Among these, 65% (n = 930) reported engaging in masturbation in the past year, of whom 87.5% reported subjectively experiencing various levels of fatigue post-masturbation. These 930 responses were subsequently analyzed in-depth (e.g., non-parametric test and pathway analysis), with ages ranging from 18 to 54 years (mean age = 30.5, SD = 7.42). Notably, our findings indicate that participants with greater masturbation frequency exhibited higher anxiety levels [GAD-7 median score: 6 (lesser) vs. 4 (moderate) vs. 8 (greater), p < 0.001, Cohen's f = 0.41] and poorer sleep quality [PSQI median score: 5 (lesser) vs. 4 (moderate) vs. 7 (greater), p < 0.001, Cohen's f = 0.46]. A rough positive correlation between masturbation frequency and PSQI score was also observed (β = 0.16, p < 0.001). These results suggest potential mental and sleep benefits at moderate frequencies, especially in contrast to greater frequencies. However, the cross-sectional design and subjective categorization of masturbation frequency in our study limit our ability to draw definitive causal conclusions. These limitations highlight the need for future longitudinal research employing more precise categorizations of masturbation behavior, such as frequency, to delve deeper into these relationships and understand their underlying mechanisms.

Priapism is a rare condition characterized by prolonged and often painful penile erection unrelated to sexual stimulation. Ischemic priapism, the most common subtype, requires immediate attention to prevent irreversible damage to erectile tissue. This narrative review explores the initial management strategies for ischemic priapism. Intracavernosal phenylephrine injection and aspiration with or without irrigation are recommended as first-line treatments, with alternative options available depending on clinical settings and patient factors. While guidelines offer clear recommendations for priapism lasting more than 4 h, management of shorter-duration cases remains challenging due to limited evidence.

Our article outlines a case study assessing the use of low-intensity shock wave therapy (LiSWT) for managing Hard Flaccid Syndrome (HFS). Given the absence of standardized treatments for HFS, LiSWT could serve as an additional tool in the treatment arsenal. The case involved a 36-year-old male presenting HFS, low libido, chronic pain, and erectile dysfunction. Treatment comprised phosphodiesterase type 5 inhibitor (PDE5-I), physical therapy, and LiSWT. Following six sessions, the patient experienced regression of bothersome symptoms and improved erections. A 2-year follow-up revealed sustained symptom relief. LiSWT presents a non-invasive means of inducing mechanical stress and microtrauma in targeted tissues, fostering neovascularization and potentially enhancing blood supply. The integration of LiSWT with PDE5-I and physical therapy suggests a potential avenue for effective HFS management. Nevertheless, further systematic research is essential to validate the therapy's benefits and assess, if any, potential drawbacks.

Solid organ transplant recipients exhibit an elevated incidence of erectile dysfunction, attributed to comorbidities and specific factors associated with organ failure. While treatment mirrors the general population's, response rates are lower, and there is a heightened concern about implanting a penile prosthesis in immunocompromised patients due to the potential occurrence of severe complications. The aim of this study was to assess the safety of penile prostheses in this population. Among fourteen included studies, ten were case reports or series of cases, and four were non randomized case-control studies with non-transplanted patients as controls. Complications affected 34 patients (11.15%), with mechanical device failures in 18 cases (5.9%) and infections in 13 cases (4.26%). Most infections required hospitalization, antibiotic treatment, and prosthesis removal, with two cases of life-threatening Fournier's gangrene. Case-control studies revealed no differences in overall reoperation rates between transplant recipients and controls. However, pelvic organ transplant recipients undergoing three-piece prosthesis implantation showed higher complications rates related to reservoir issues. Despite limited evidence, case-control studies demonstrated a generally low/moderate risk of bias within each specific domain, although overall bias was moderate/severe. As a result, clinicians may mitigate concerns regarding penile prosthesis implantation in solid organ transplant recipients.