Sexual Medicine最新文献_第4页

Differential efficacy of pelvic floor muscle training in primary versus acquired premature ejaculation: an 8-week comparative study using non-invasive biomechanical assessment. 盆底肌肉训练对原发性早泄和获得性早泄的不同疗效：一项为期8周的非侵入性生物力学评估比较研究。

IF 2 3区医学 Q1 MEDICINE, GENERAL & INTERNAL

Sexual Medicine

Pub Date : 2025-10-13 eCollection Date: 2025-10-01 DOI: 10.1093/sexmed/qfaf081

Yinan Lyu, Jiawei Gong, Houdong He, Hongzhe Xu, Huiping Dong, Yue Duan

Background: Premature ejaculation (PE), including lifelong (LPE) and acquired (APE) subtypes, negatively affects men's sexual, psychological, and relational well-being.Aim: This study aimed to investigate pelvic floor muscle function differences between healthy individuals and premature ejaculation patients and evaluate the efficacy of pelvic floor muscle training in improving premature ejaculation subtype symptoms using an innovative assessment approach.Methods: In this 8-week prospective study, 199 men were enrolled (LPE, n = 66; APE, n = 83; healthy controls [HC], n = 50). PE participants received PFMT comprising PFM awareness, biofeedback-based strengthening, and integration into sexual activity. PFM function was measured with a perineometry/biofeedback device; anxiety and depression with 7-item Generalized Anxiety Disorder scale (GAD-7) and 9-item Patient Health Questionnaire (PHQ-9); and intravaginal ejaculatory latency time (IELT) by stopwatch.Outcome: The primary outcomes were improvements in pelvic floor muscle function, ejaculatory latency time, and premature ejaculation symptom severity.Results: After 8 weeks of PFMT, significant improvements were observed in both groups. In the APE group, IELT increased from a median of 120 s to 180 s, and premature ejaculation diagnostic tool (PEDT) scores decreased by 2 points (P < 0.001). In the LPE group, IELT increased from 30 s to 60 s, and PEDT scores decreased by 1.5 points (P < 0.001). Reductions in PHQ-9 (APE: -3.0; LPE: -2.0) and GAD-7 (APE: -3.0; LPE: -1.0) scores were also observed, with APE showing greater overall benefits. No significant baseline differences were found in PFM strength; however, both groups showed post-training increases in maximum contraction pressure and sustained contraction average pressure (all P < 0.001).Clinical implications: Pelvic floor muscle training appears effective in addressing psychological and physical symptoms of premature ejaculation, particularly for acquired premature ejaculation.Strengths and limitations: This study is the first to use a non-invasive biomechanical approach to compare pelvic floor muscle function between healthy individuals and PE patients. It also uniquely examines how PFM training affects different PE subtypes, offering insights for more targeted treatment strategies. However, the research is limited by the absence of sham controls, which are necessary to distinguish placebo effects, and it also lacks long-term follow-up to assess enduring outcomes.Conclusion: Pelvic floor muscle training improves ejaculatory control and psychological outcomes in premature ejaculation patients, with greater efficacy observed in acquired premature ejaculation; further research is needed to explore long-term effects and underlying mechanisms.</p

背景：早泄（PE），包括终身早泄（LPE）和获得性早泄（APE）亚型，对男性的性、心理和关系健康产生负面影响。目的：本研究旨在探讨健康个体和早泄患者盆底肌功能的差异，并采用创新的评估方法评估盆底肌训练对早泄亚型症状的改善效果。方法：在这项为期8周的前瞻性研究中，纳入199名男性（LPE, n = 66； APE, n = 83；健康对照[HC]， n = 50）。体育参与者接受了PFMT，包括PFM意识、基于生物反馈的强化和融入性活动。PFM功能用会阴测量仪/生物反馈仪测量；用7项广泛性焦虑障碍量表（GAD-7）和9项患者健康问卷（PHQ-9）进行焦虑和抑郁；用秒表测量阴道内射精潜伏期（ielts）。结果：主要结果是盆底肌肉功能、射精潜伏期和早泄症状严重程度的改善。结果：PFMT治疗8周后，两组患者均有明显改善。在APE组中，雅思考试中位数从120秒增加到180秒，早泄诊断工具（PEDT）得分下降了2分（P P P）。临床意义：盆底肌肉训练对早泄的心理和生理症状有效，特别是对获得性早泄。优势和局限性：本研究首次采用非侵入性生物力学方法比较健康个体和PE患者的盆底肌肉功能。它还独特地研究了PFM训练如何影响不同的PE亚型，为更有针对性的治疗策略提供见解。然而，由于缺乏区分安慰剂效应所必需的假对照，该研究也缺乏长期随访来评估持久的结果，因此受到限制。结论：盆底肌肉训练可改善早泄患者的射精控制和心理结局，对获得性早泄效果更佳；需要进一步的研究来探索长期影响和潜在的机制。

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引用次数: 0

Yimusake ameliorates corporal endothelial dysfunction by down-regulating the NLRP3 inflammasome-mediated NF-κB signaling pathway and inhibiting oxidative stress. Yimusake通过下调NLRP3炎症小体介导的NF-κB信号通路，抑制氧化应激，改善下体内皮功能障碍。

IF 2 3区医学 Q1 MEDICINE, GENERAL & INTERNAL

Sexual Medicine

Pub Date : 2025-10-13 eCollection Date: 2025-10-01 DOI: 10.1093/sexmed/qfaf079

Chengxia Yang, Rui Zhang, Bingbing Zhu, Lipan Niu, Wenfei Wang, Xiufang Jin, Yulian Liu, Fengxia Liu

Background: Yimusake, a traditional Uyghur medicine, can treat a variety of male diseases, but its effects and mechanisms on diabetes mellitus-induced erectile dysfunction (DMED) remain unclear.Aim: This study was designed to investigate the key cytokines and mechanisms by which Yimusake ameliorates corporal endothelial dysfunction in DMED rats.Methods: Firstly, normal rat penile corpus cavernosum endothelial cells (CCECs) were extracted and cultured in vitro, and the injury model was established after stimulation with 30 mM glucose for 24 hours. Subsequently, the cells were cultured in Yimusake drug-containing serum for 24 hours, and Sh-NLRP3 lentivirus was transfected for 8 hours. Cells were collected for the subsequent experiments. Next, the DM model was established using streptozotocin (45 mg/kg) for 2 consecutive injections, and DMED rats were screened by apomorphine and mating test at weeks 2, 4, 6, and 8, and then, we intervened for a fortnight using Yimusake (Y) and NLRP3 inhibitor (MCC950) drugs, and the penile tissues were taken for the subsequent analyses.Outcomes: Our study demonstrates that Yimusake can downregulate the NLRP3-mediated NF-κB signalling pathway, inhibiting oxidative stress and mitigating the endothelial damage in corpus cavernosum endothelial cells.Results: In the CCEC injury model established by 30 mM glucose, after incubation with Yimusake-containing drug serum and transfection with Sh-NLRP3 lentivirus, the expression of proteins and mRNAs related to the NF-κB signaling pathway mediated by NLRP3 was decreased, the expression of proteins related to oxidative stress was decreased, and the expression of proteins related to the endothelial function was increased. In DMED rats, after Yimusake and MCC950 interventions, the changes in pathway factors, oxidative stress levels, and endothelial function were consistent with the trends of in vitro experiments.Clinical implications: Yimusake may ameliorate endothelial dysfunction in DMED by down-regulating the NLRP3 inflammasome-mediated NF-κB signaling pathway and inhibiting oxidative stress.Strengths and limitations: Although we revealed that Yimusake can facilitate the restoration of the erectile tissue by improving endothelial function through inhibiting inflammation and oxidative stress, the effect was more significant with the combination of drugs, and the exact mechanism of action needs to be further explored.Conclusion: These findings demonstrate that DM exacerbates oxidative stress and endothelial damage in the corpus cavernosum through activation of the NLRP3 inflammasome-mediated NF-κB pathway, whereas Yimusake can inhibit oxidative stress and mitigate endothelial damage by downregulating this pathway, thereby facilitating the restoration of erectile tissue in rats with

背景：依木素是维吾尔族传统药物，可治疗多种男性疾病，但其对糖尿病性勃起功能障碍（DMED）的作用和机制尚不清楚。目的：探讨依木素改善DMED大鼠身体内皮功能障碍的关键细胞因子及其作用机制。方法：首先提取正常大鼠阴茎海绵体内皮细胞（CCECs）体外培养，用30 mM葡萄糖刺激24h后建立损伤模型。随后，细胞在含Yimusake药物的血清中培养24小时，转染Sh-NLRP3慢病毒8小时。收集细胞用于后续实验。然后用链脲佐菌素（45 mg/kg）连续注射2次建立DM模型，在第2周、第4周、第6周和第8周分别用阿波啡和交配试验筛选DMED大鼠，然后用Yimusake (Y)和NLRP3抑制剂（MCC950）药物干预2周，取阴茎组织进行后续分析。结果：我们的研究表明，Yimusake可以下调nlrp3介导的NF-κB信号通路，抑制氧化应激，减轻海绵体内皮细胞的内皮损伤。结果：在30 mM葡萄糖建立的CCEC损伤模型中，经含伊木萨克药物血清孵育并转染Sh-NLRP3慢病毒后，NLRP3介导的NF-κB信号通路相关蛋白和mrna表达降低，氧化应激相关蛋白表达降低，内皮功能相关蛋白表达升高。在DMED大鼠中，Yimusake和MCC950干预后，通路因子、氧化应激水平和内皮功能的变化与体外实验趋势一致。临床意义：Yimusake可能通过下调NLRP3炎症小体介导的NF-κB信号通路，抑制氧化应激，改善DMED的内皮功能障碍。优势与局限性：虽然我们发现Yimusake可以通过抑制炎症和氧化应激来改善内皮功能，促进勃起组织的修复，但与药物联合使用效果更为显著，确切的作用机制有待进一步探索。结论：DM通过激活NLRP3炎症小体介导的NF-κB通路加重海绵体氧化应激和内皮损伤，而Yimusake通过下调该通路抑制氧化应激，减轻内皮损伤，促进DMED大鼠勃起组织的恢复。

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引用次数: 0

Local surgical trauma in the penile tunica albuginea of the rat: a new animal model of Peyronie's disease. 大鼠阴茎白膜局部手术创伤：一种新的佩罗尼病动物模型。

IF 2 3区医学 Q1 MEDICINE, GENERAL & INTERNAL

Sexual Medicine

Pub Date : 2025-10-13 eCollection Date: 2025-10-01 DOI: 10.1093/sexmed/qfaf082

Zitaiyu Li, Hongji Hu, Xiaoping Zheng, Biao Liu, Liangyu Zhao, Zhitao Han, Zihao Zhou, Jiarong Xu, Yinghao Yin, Yuxin Tang

Background: Peyronie's disease (PD) is a relatively common clinical disorder of the penis that causes curvature and erectile dysfunction. However, the pathophysiological processes of PD are not well understood in current animal models and there exists limited clinical treatment options, which significantly impedes translational research.

Aim: This study aimed to develop a novel rat model of PD induced by local surgical tunica albuginea trauma and compare it with the TGF-β-induced model to elucidate the scientific soundness and feasibility of the local surgical tunica albuginea trauma-induced PD model.

Methods: A total of 24 male standard deviation rats were randomly allocated into three groups: sham group, surgical trauma group, and TGF-β group. The sham group received a skin incision only, whereas the surgical trauma group and the TGF-β group underwent PD model establishment via microsurgical tunica albuginea trauma and TGF-β injection, respectively. Six weeks post-modeling, penile blood perfusion, degree of curvature and erectile function were quantified. Penile tissues were subsequently harvested for histological analysis and Western blotting was used to evaluate tunica albuginea fibrosis.

Outcomes: PD model of surgical tunica albuginea trauma was successfully established and exhibited more pronounced fibrotic phenotypes in the penile tunica albuginea.

Results: Compared with TGF-β-induced models, laser speckle imaging revealed significantly reduced penile blood perfusion in surgical trauma group, accompanied by more severe penile curvature with corresponding angular and curvature alterations. HE and Masson's trichrome staining demonstrated marked local thickening and significantly increased collagen deposition in the penile tunica albuginea of rats in the surgical trauma group. Sirius red staining revealed a marked increase in collagen I and collagen III content. Immunofluorescence staining and Western blot analysis revealed that the surgical trauma group exhibited more pronounced alterations in the expression levels of fibrosis-related markers (Fibronectin, α-SMA, Collagen I, and Collagen III) in penile tissue.

Clinical implications: The rat model of tunica albuginea surgical trauma provides a promising option for preclinical PD research.

Strengths and limitations: The tunica albuginea surgical trauma-induced PD model established in our study has been scientifically validated. However, the precise pathogenesis of the model requires further investigation.

Conclusion: The tunica albuginea surgical trauma-induced PD model was successfully established and demonstrates a more pronounced fibrotic phenotype in the penile tunica albuginea, potentially better recapitulating the pathophysiological processes of PD.

背景：佩罗尼氏病（PD）是一种较为常见的阴茎临床疾病，可导致阴茎弯曲和勃起功能障碍。然而，目前的动物模型对PD的病理生理过程知之甚少，临床治疗方案也有限，这极大地阻碍了转化研究。目的：本研究旨在建立手术性局部白膜损伤致PD的新型大鼠模型，并将其与TGF-β诱导的模型进行比较，阐明手术性局部白膜损伤致PD模型的科学性和可行性。方法：选取24只雄性标准差大鼠，随机分为假手术组、手术创伤组、TGF-β组。假手术组只进行皮肤切开，手术创伤组和TGF-β组分别通过显微外科白膜损伤和TGF-β注射建立PD模型。造模后6周，定量测定阴茎血流灌注、弯曲度和勃起功能。随后收集阴茎组织进行组织学分析，并使用Western blotting评估白膜纤维化。结果：成功建立了手术性白膜损伤的PD模型，并在阴茎白膜中表现出更明显的纤维化表型。结果：与TGF-β诱导的模型相比，激光散斑成像显示手术创伤组阴茎血流灌注明显减少，阴茎弯曲更严重，阴茎角度和曲率发生相应改变。HE和Masson三色染色显示手术创伤组大鼠阴茎白膜局部明显增厚，胶原沉积明显增加。天狼星红染色显示胶原I和胶原III含量明显增加。免疫荧光染色和Western blot分析显示，手术创伤组阴茎组织中纤维化相关标志物（纤连蛋白、α-SMA、I型胶原和III型胶原）的表达水平发生了更明显的变化。临床意义：手术创伤大鼠白膜模型为临床前PD研究提供了一个有希望的选择。优势与局限性：本研究建立的白膜外科创伤性PD模型已得到科学验证。然而，该模型的确切发病机制需要进一步研究。结论：成功建立了手术创伤性白蛋白膜PD模型，并在阴茎白蛋白膜中显示出更明显的纤维化表型，可能更好地概括了PD的病理生理过程。

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引用次数: 0

Frequency of lab HIV and self-reported STI history and its predictors among a sexually compulsive clinical sample: a cross-sectional study. 性强迫临床样本中实验室HIV和自我报告性传播感染史的频率及其预测因素：一项横断面研究。

IF 2 3区医学 Q1 MEDICINE, GENERAL & INTERNAL

Sexual Medicine

Pub Date : 2025-10-04 eCollection Date: 2025-10-01 DOI: 10.1093/sexmed/qfaf077

Nisa Regina Bubola Lima, Isabelle Vera Vichr Nisida, Marco de Tubino Scanavino

Background and aims: Individuals with compulsive sexual behavior (CSB) are at increased risk for sexually transmitted infections (STI) and Human Immunodeficiency Virus (HIV).Aim: To investigate the frequency of STIs and HIV in a CSB clinical sample and the associated predictors.Methods: A cross-sectional study was conducted between 2012 and 2021 in a specialized outpatient clinic at a large tertiary hospital in São Paulo, Brazil. We disclosed the study through noticeboards in the institution and advertisements on the official website and social media. Participants underwent a psychiatric interview to assess CSB and exclusion criteria. Individuals who sought treatment for difficulty in controlling sexual impulses and got confirmation of a CSB diagnosis were included. Those who did not were included as controls. Healthy volunteers who sought to participate as controls and did not confirm CSB diagnosis were also included. Comprehensive laboratory tests were requested. We investigated sexual compulsivity, impulsivity, patterns of CSB, condomless anal and vaginal sex and sex under the influence of alcohol/drugs, self-reported STI diagnoses or history, and screening tests. Logistic regression analysis was used.Outcomes: Laboratory results of HIV tests and self-reported STI diagnoses or history.Results: A total of 275 participants (67.5%) met the criteria for CSB, and 132 (32.5%) were eligible as controls. The frequency of HIV in tested participants was 10.8% (n = 23) in the CSB group and 2.4% (n = 2) among controls. Regarding self-reported STI diagnoses or history, 43.9% of CSB outpatients and 17.8% of the control group reported it [χ2 (1) = 25.58, P < .001]. The HIV-positive test was associated with self-identifying as gay or bisexual [OR 31.58, 95% CI 4.09-243.72, P < .05] and sex under the influence of drugs [OR 6.49, 95% CI 1.10-38.35] in the final multivariate analysis model, adjusted for other variables. Sexual compulsivity [OR 1.03, 95% CI 1.00-1.07, P < .05], excessive casual sex [OR 1.84, 95% CI 1.07-3.17, P < .05], and self-identifying as of African descent [OR 0.50, 95% CI 0.29-0.88, P < .05] behave as predictors of self-reported STI.Clinical implications: We suggest incorporating frequent and periodic screening tests for HIV/STI in the management protocols of CSB patients, considering the potential morbidity and social burden of STI.Strengths and limitations: To our knowledge, this is the first study investigating the frequency of HIV in a sexually compulsive clinical sample using laboratory tests, including women and participants of diverse sexual orientations. However, the prolonged data collection time was a limitation and many outpatient CSB participants commonly avoided taking exams and even left before this step. Beca

背景和目的：强迫性行为（CSB）的个体性传播感染（STI）和人类免疫缺陷病毒（HIV）的风险增加。目的：探讨CSB临床样本中性传播感染和HIV的发生频率及其相关预测因素。方法：横断面研究于2012年至2021年在巴西圣保罗一家大型三级医院的专科门诊进行。我们通过机构内的布告板、官网和社交媒体上的广告等方式公开了这项研究。参与者接受精神病学访谈以评估CSB和排除标准。因难以控制性冲动而寻求治疗并被确诊为CSB的个体也包括在内。那些没有被纳入对照的人。作为对照，未确诊CSB的健康志愿者也被纳入研究。要求进行全面的实验室检查。我们调查了性强迫、冲动、CSB模式、无安全套肛交和阴道性行为、酒精/药物影响下的性行为、自我报告的性传播感染诊断或病史，以及筛查测试。采用Logistic回归分析。结果：艾滋病毒检测的实验室结果和自我报告的性传播感染诊断或病史。结果：275人（67.5%）符合CSB标准，132人（32.5%）符合对照。CSB组HIV感染率为10.8% (n = 23)，对照组为2.4% （n = 2）。在自我报告性传播感染诊断或病史方面，43.9%的CSB门诊患者和17.8%的对照组报告了性传播感染[χ2 (1) = 25.58， P P P P P P P P P P P P P P临床意义：考虑到性病的潜在发病率和社会负担，我们建议在CSB患者的管理方案中纳入频繁和定期的艾滋病毒/性传播感染筛查。优势和局限性：据我们所知，这是第一个通过实验室测试调查性强迫性临床样本中艾滋病毒感染频率的研究，其中包括女性和不同性取向的参与者。然而，数据收集时间的延长是一个限制，许多门诊CSB参与者通常避免参加考试，甚至在这一步之前离开。由于缺少许多非艾滋病毒检测，因此首选自我报告的性传播感染史数据。敏感性分析表明，性取向可能对其他预测因子与HIV之间的关系有调节作用，这有待于进一步的研究。结论：考虑到CSB临床样本，目前的研究显示了HIV和STI的不同预测因素，指出了具体的临床护理和预防。

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引用次数: 0

Plasma metabolites mediate the causal relationship between gut microbiota and erectile dysfunction: insights from Mendelian randomization study. 血浆代谢物介导肠道微生物群与勃起功能障碍之间的因果关系：来自孟德尔随机研究的见解。

IF 2 3区医学 Q1 MEDICINE, GENERAL & INTERNAL

Sexual Medicine

Pub Date : 2025-09-30 eCollection Date: 2025-10-01 DOI: 10.1093/sexmed/qfaf076

Wei Wang, Bowen Tang, Sushun Yuan, Hongchen Luan, Tao Qi, Jun Chen

Background: While the relationship between gut microbiota and erectile dysfunction (ED) has been reported, the specific pathways involved remain unclear.

Aim: This study aims to investigate the causal relationship between gut microbiota and ED, and to identify the potential role of plasma metabolites as mediators.

Methods: Utilizing aggregated genome-wide association study (GWAS) data, a comprehensive two-sample Mendelian randomization (MR) analysis was performed involving 196 gut microbiota taxa, 1400 plasma metabolites and ED. Causal relationships between gut microbiota, plasma metabolites and ED were explored. In addition, mediation analysis was applied to identify the pathway from gut microbiota to ED mediated by plasma metabolites.

Outcomes: This study reveals that plasma metabolites act as mediators regulating the influence of gut microbiota on ED.

Results: MR analysis identified causal relationships between six gut microbial taxa and ED, with Butyrivibrio increasing the risk of ED, while Alistipes, Prevotella 9, Dialister, Marvinbryantia, and LachnospiraceaeUCG010 exhibited protective effects. Additionally, 45 plasma metabolites demonstrated causal associations with ED. Finally, mediation analysis revealed four mediation relationships. Sensitivity analysis indicated no heterogeneity or pleiotropy in this study.

Clinical implications: Modulating gut microbiota or targeting specific metabolites may offer new therapeutic approaches for ED, highlighting the potential for microbiome-based interventions.

Strengths and limitations: The MR approach and large-scale GWAS data provide robust causal evidence, but the findings are limited by their focus on European populations and lack of experimental validation. Further studies are needed to confirm these mechanisms in diverse cohorts and functional models.

Conclusion: This study establishes a causal link between gut microbiota, plasma metabolites, and ED, identifying specific microbial taxa and metabolites as key contributors to ED risk. The mediating role of plasma metabolites highlights potential therapeutic strategies, such as probiotics or dietary interventions targeting harmful metabolites.

背景：虽然肠道微生物群与勃起功能障碍（ED）之间的关系已被报道，但涉及的具体途径尚不清楚。目的：本研究旨在探讨肠道微生物群与ED之间的因果关系，并确定血浆代谢物作为介质的潜在作用。方法：利用聚合全基因组关联研究（GWAS）数据，对196个肠道菌群分类群、1400个血浆代谢物与ED进行全面的双样本孟德尔随机化（MR）分析，探讨肠道菌群、血浆代谢物与ED之间的因果关系。此外，我们还通过中介分析来确定血浆代谢物介导的肠道微生物群到ED的途径。结果：本研究表明血浆代谢物是调节肠道微生物群对ED影响的介质。结果：MR分析确定了6种肠道微生物群与ED之间的因果关系，其中丁酸弧菌增加ED的风险，而Alistipes， Prevotella 9, Dialister， Marvinbryantia和LachnospiraceaeUCG010具有保护作用。此外，45种血浆代谢物与ED存在因果关系。最后，中介分析揭示了四种中介关系。敏感性分析显示本研究无异质性或多效性。临床意义：调节肠道微生物群或靶向特定代谢物可能为ED提供新的治疗方法，突出了基于微生物组的干预的潜力。优势和局限性：MR方法和大规模GWAS数据提供了强有力的因果证据，但研究结果受到其对欧洲人群的关注和缺乏实验验证的限制。需要进一步的研究在不同的队列和功能模型中证实这些机制。结论：本研究建立了肠道微生物群、血浆代谢物和ED之间的因果关系，确定了特定的微生物类群和代谢物是ED风险的关键因素。血浆代谢物的调节作用强调了潜在的治疗策略，如益生菌或针对有害代谢物的饮食干预。

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引用次数: 0

Labia majora lifting technique with polydioxanone threads. 聚二氧环酮线提大阴唇技术。

IF 2 3区医学 Q1 MEDICINE, GENERAL & INTERNAL

Sexual Medicine

Pub Date : 2025-09-30 eCollection Date: 2025-10-01 DOI: 10.1093/sexmed/qfaf064

Savas O Aglamis, Selver K Akkaya, Elif O Sahin, Hanifi Sahin

Background: Polydioxanone (PDO) thread is a synthetic absorbable surgical suture used for rejuvenation and lifting.

Aim: The aim of this study is to use PDO threads for rejuvenation and enlargement effect in patients with labium majus hypotrophy.

Methods: Twenty-one patients with labia majora hypotrophy were included in the study. Conventionally, surgery, fat filling or hyaluronic acid filling is used for labia majora rejuvenation. In this study, a different technique, the PDO thread suspension technique, was applied. For PDO thread, Hyundae Meditech Co.Ltd's Secret Line Up product containing 50 mm screw thread with 30 G-38 mm needle tip was used. It was planned to use 10 PDO threads for right and left labia majora. After a total of 20 needles were inserted, the needles were removed one by one and the PDO threads remained in the subcutaneous superficial layer and the procedure was terminated 5 min later. Preoperative and postoperative the Female Genital Self-Image Scale (FGSIS) scores of the patients were compared.

Outcomes: The overall FGSIS total score demonstrated a significant increase following the intervention.

Results: The FGSIS total mean score in the preoperative period was increased in the postoperative period. This difference was statistically significant. Moreover, the mean score calculated for each parameter of FGSIS in the preoperative period increased significantly in the postoperative period.

Clinical implications: These findings indicate a favorable safety profile for the use of PDO threads in this clinical context.

Strengths and limitations: The strength of the study is to introduce a minimally invasive and effective method for labia majora lifting, on the other hand, the small number of patients in the study, limitation of the study.

Conclusion: We would like to point out that in this study, we evaluated labium majus rejuvenation from the same perspective, based on the shaping and enlargement of genital appearance and its positive effect on self-confidence and increase in sexual functions. Unlike many labium majus rejuvenation procedures, this less invasive procedure has achieved similar results. In this context, it is a preferable alternative to surgery.

背景：聚二氧环酮（PDO）线是一种可吸收的合成外科缝线，用于恢复和提升。目的：本研究的目的是利用PDO线对大阴唇萎缩患者的年轻化和扩大效果。方法：选取21例大阴唇萎缩患者作为研究对象。传统上，手术、脂肪填充或透明质酸填充用于大阴唇年轻化。在这项研究中，采用了一种不同的技术，PDO螺纹悬挂技术。PDO螺纹采用了现代Meditech公司的“Secret Line Up”产品，该产品的螺纹长度为50毫米，针尖长度为30 ~ 38毫米。计划使用10个PDO线用于左右大阴唇。共插入20根针后，将针逐一取出，PDO螺纹保留在皮下浅层，5分钟后终止手术。比较患者术前、术后女性生殖器自我形象量表（FGSIS）评分。结果：干预后，FGSIS总分显著提高。结果：术前FGSIS总平均评分在术后有所升高。这一差异具有统计学意义。术前FGSIS各参数的平均评分在术后显著升高。临床意义：这些发现表明PDO螺纹在临床应用中具有良好的安全性。优势与局限性：本研究的优势在于介绍了一种微创有效的大阴唇提升方法，另一方面，本研究患者数量少，研究存在局限性。结论：在本研究中，我们基于生殖器外形的塑造和扩大及其对自信和性功能的积极作用，从相同的角度来评价大阴唇年轻化。与许多大阴唇再生手术不同，这种侵入性较小的手术取得了类似的结果。在这种情况下，它是比手术更好的选择。

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引用次数: 0

The use of tirzepatide to successfully treat persistent genital arousal disorder/genitopelvic dysesthesia: a case report. 使用替西帕肽成功治疗持续性生殖器觉醒障碍/生殖盆腔感觉不良：一例报告。

IF 2 3区医学 Q1 MEDICINE, GENERAL & INTERNAL

Sexual Medicine

Pub Date : 2025-09-24 eCollection Date: 2025-08-01 DOI: 10.1093/sexmed/qfaf073

Eliza Burr, Maya Roytman, Évéline Poirier, Marta Kolbuszewska, James G Pfaus, Barry R Komisaruk, Irwin Goldstein, Rachel Rubin

Introduction: Persistent genital arousal disorder/genitopelvic dysesthesia (PGAD/GPD) is associated with poor quality of life. Due to social stigma and its heterogeneous nature, many patients suffer without treatment.

Aims: This case presents the first example of the successful use of a glucagon-like peptide 1 and glucose-dependent insulinotropic polypeptide receptor agonist (GLP1/GIP RA) medication for the treatment of PGAD/GPD.

Methods: The patient was identified by the Sexual Medicine Research Team, retained as a patient at a sexual medicine clinic, and interviewed for the purposes of this case report.

Results: This case presents a 44-year-old woman with a lifelong history of PGAD/GPD symptoms that caused extreme distress and depression who experienced 95% resolution of her symptoms within 2 days of starting tirzepatide, a GLP1/GIPRA medication, for weight loss.

Conclusion: Increasing benefits of GLP1/GIPRAs are being uncovered, and further studies must investigate the potential for these medications to be used in patients with PGAD/GPD. This study also provides a potential mechanism for decreased arousal resulting from GLP1/GIP receptor activation in attention/reward pathways in the brain.

导语：持续性生殖器觉醒障碍/生殖盆腔感觉障碍（PGAD/GPD）与生活质量差有关。由于社会污名及其异质性，许多患者没有得到治疗。目的：本病例是第一个成功使用胰高血糖素样肽1和葡萄糖依赖性胰岛素性多肽受体激动剂（GLP1/GIP RA）药物治疗PGAD/GPD的例子。方法：患者由性医学研究小组确定，作为性医学诊所的患者保留，并为本病例报告的目的进行访谈。结果：该病例是一名44岁的女性，她一生都有pad /GPD症状史，导致极度痛苦和抑郁，在开始使用替西帕肽（一种GLP1/GIPRA药物）减肥后的2天内，她的症状缓解了95%。结论：GLP1/GIPRAs的益处正在被发现，进一步的研究必须调查这些药物在PGAD/GPD患者中的应用潜力。该研究还提供了大脑中注意/奖励通路中GLP1/GIP受体激活导致觉醒减少的潜在机制。

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引用次数: 0

Effects of pelvic floor muscle training on sexual function of postmenopausal women. A systematic review and meta-analysis. 盆底肌训练对绝经后妇女性功能的影响。系统回顾和荟萃分析。

IF 2 3区医学 Q1 MEDICINE, GENERAL & INTERNAL

Sexual Medicine

Pub Date : 2025-09-19 eCollection Date: 2025-08-01 DOI: 10.1093/sexmed/qfaf067

Raquel García-Laria, Alejandra Alonso-Calvete, Lorenzo Justo-Cousiño, Iria Da Cuña-Carrera, Mercedes Soto-González

Background: During postmenopause, women frequently experience genitourinary symptoms that may result in sexual dysfunctions. Common treatments include hormone replacement therapy or vaginal lubricants. Pelvic floor muscle training (PFMT) has been observed to have beneficial effects on sexual function in other groups of women.

Aim: To evaluate the effect of PFMT on sexual function in postmenopausal women.

Methods: A systematic search was conducted in June 2025, in PubMed, Scopus, Web of Science, Medline, CINAHL databases, and the Google Scholar search engine. Inclusion criteria were randomized clinical trial articles published in English, in which at least one intervention addressed the study objective. A meta-analysis was conducted with a random-effects model.

Results: A total of five studies were selected after applying eligibility criteria. All included articles implemented PFMT interventions, showing improvements in sexual function as assessed by the Female Sexual Function Index. A significant positive effect was shown in the total score of Female Sexual Function Index in experimental group in comparison with control group (P < .001; standard mean difference [SMD] = 1.33; I ² = 92%). A significant positive effect was also demonstrated in orgasm domain (P < .001; SMD = 1.91; I ² = 97%), arousal domain (P < .001; SMD = 1.87; I ² = 96%), and satisfaction domain (P < .001; SMD = 2.16; I ² = 98%). A significant negative effect was found in desire domain (P < .001; SMD = 0.34; I ² = 86%) and lubrication domain (P < .001; SMD = 0.26; I ² = 87%) and finally no significant effects were found in pain domain.

Strengths and limitations: Although this is the first meta-analysis to address this topic in postmenopausal women, the results are heterogeneous and the scientific evidence remains limited.

Conclusion: PFMT appears to have positive effects on sexual function in postmenopausal women, particularly in aspects such as orgasm, arousal, and satisfaction.

背景：绝经后，女性经常出现泌尿生殖系统症状，可能导致性功能障碍。常见的治疗方法包括激素替代疗法或阴道润滑剂。盆底肌肉训练（PFMT）已被观察到对其他组的女性性功能有有益的影响。目的：探讨PFMT对绝经后妇女性功能的影响。方法：于2025年6月在PubMed、Scopus、Web of Science、Medline、CINAHL数据库和谷歌Scholar搜索引擎中进行系统检索。纳入标准是用英文发表的随机临床试验文章，其中至少有一项干预措施符合研究目标。采用随机效应模型进行meta分析。结果：应用入选标准后，共入选5项研究。所有纳入的文章都实施了PFMT干预，通过女性性功能指数评估显示性功能有所改善。试验组女性性功能指数总分较对照组有显著正作用（P < 2 = 92%）。在性高潮领域（pi 2 = 97%）、觉醒领域（pi 2 = 96%）和满意领域（pi 2 = 98%）也表现出显著的积极作用。在欲望域（pi 2 = 86%）和润滑域（pi 2 = 87%）有显著的负作用，而在疼痛域无显著影响。优势和局限性：虽然这是第一个针对绝经后妇女这一主题的荟萃分析，但结果是不一致的，科学证据仍然有限。结论：PFMT似乎对绝经后妇女的性功能有积极的影响，特别是在性高潮、性唤起和满意度方面。

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引用次数: 0

Evaluating a non-pharmacological treatment for primary premature ejaculation patients with low sexual frequency: a retrospective study on vacuum negative pressure hydropneumatic/pneumatic bubble massage. 评价性频率低的原发性早泄患者的非药物治疗：真空负压油气/气泡按摩的回顾性研究。

IF 2 3区医学 Q1 MEDICINE, GENERAL & INTERNAL

Sexual Medicine

Pub Date : 2025-09-16 eCollection Date: 2025-08-01 DOI: 10.1093/sexmed/qfaf069

Qing-Qiang Gao, Chao-Ba He, Bin Wang, Yu-Tian Dai, Bai-Bing Yang, Xiao-Zhi Zhao

Background: Premature ejaculation (PE) is a common male sexual dysfunction with treatment limitations including side effects and partner dependency.

Aim: To evaluate vacuum negative pressure hydropneumatic/pneumatic bubble massage (VNPHP/PBM) efficacy in primary PE (PPE) patients stratified by sexual frequency, focusing on subjective low-frequency (avoidance due to PE) vs objective low-frequency subgroups.

Methods: Retrospective analysis of 42 PPE patients: 22 low-frequency (LF; <4 intercourse/month) including 13 subjective (sub-LF) and 9 objective (ob-LF) vs 20 non-low-frequency (NLF; ≥4/month).

Outcomes: Primary: intravaginal ejaculation latency time (IELT); secondary: Premature Ejaculation Diagnostic Tool (PEDT), Self-Rating Anxiety Scale (SAS) scores, and sexual frequency changes at 4 weeks.

Results: Both groups showed significant improvements in IELT, PEDT, and SAS scores (P < .05). Low-frequency group showed greater improvements than NLF in PEDT reduction (6.36 ± 2.38 vs 7.90 ± 2.02, P = .03), SAS reduction (30.95 ± 9.57 vs 38.45 ± 8.85, P = .01), and sexual frequency increase (0.50 [0.00, 4.00] vs 1.00 [1.00, 2.00], P = .02). Crucially, sub-LF patients exhibited dramatic sexual frequency normalization (6.00 [4.00, 7.50] vs 2.00 [1.00, 2.00], P < .001), while ob-LF unchanged (P = .56). No adverse events.

Clinical implications: Vacuum negative pressure hydropneumatic/pneumatic bubble massage is a partner-independent therapy that not only improves ejaculatory control but also restores sexual activity in patients avoiding intercourse due to PE-related anxiety.

Strengths and limitations: Strengths: First study analyzing subjective vs objective low-frequency PE, standardized protocols. Limitations: Retrospective design, self-reported IELT data, lack of a control group, and the non-blinded nature of the study.

Conclusion: Vacuum negative pressure hydropneumatic/pneumatic bubble massage significantly improves PE symptoms with amplified benefits in low-frequency patients, particularly those with PE-driven sexual avoidance.

背景：早泄（PE）是一种常见的男性性功能障碍，其治疗存在副作用和伴侣依赖性等局限性。目的：评价真空负压油气/气泡按摩（VNPHP/PBM）在按性生活频率分层的原发性PE （PPE）患者中的疗效，重点关注主观低频（因PE而回避）与客观低频亚组。方法：回顾性分析42例PPE患者：22例低频（LF）；结果：主要：阴道内射精潜伏期（雅思）；其次：早泄诊断工具（PEDT），自评焦虑量表（SAS）评分，以及4周的性频率变化。结果：两组在雅思、PEDT、SAS评分上均有显著改善(P P =。03),减少SAS(30.95±9.57 vs 38.45±8.85,P =。性行为频率增加（0.50 [0.00,4.00]vs 1.00 [1.00, 2.00], P = 0.02）。至关重要的是，亚lf患者表现出戏剧性的性频率正常化（6.00 [4.00,7.50]vs 2.00 [1.00, 2.00], P P = 0.56）。无不良事件。临床意义：真空负压油气/气泡按摩是一种与伴侣无关的治疗方法，不仅可以改善射精控制，还可以恢复因pe相关焦虑而避免性交的患者的性活动。优势和局限性：优势：第一个研究分析主观与客观低频PE，标准化方案。局限性：回顾性设计，自我报告的雅思数据，缺乏对照组，以及研究的非盲性。结论：真空负压油气/气泡按摩可显著改善低频率PE患者的PE症状，尤其是PE驱动的性逃避患者。

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引用次数: 0

Morinda officinalis oligosaccharides alleviated mice chronic unpredictable mild stress induced sexual dysfunction. 桑葚低聚糖减轻小鼠慢性不可预测的轻度应激性性功能障碍。

IF 2 3区医学 Q1 MEDICINE, GENERAL & INTERNAL

Sexual Medicine

Pub Date : 2025-09-15 eCollection Date: 2025-08-01 DOI: 10.1093/sexmed/qfaf074

Tingqiao Wang, Zixuan Liu, Mengjie He, You Wu, Zeping Zuo, Hongkai Li, Zhiwei Zhao, Liangyu Lv, Xueling Dai, Chaohua Zhang, Yaxuan Sun

Background: Chronic stress can not only lead to depression-like behavior but also sexual dysfunction. Morinda officinalis oligosaccharides (MOO) is a formula of traditional Chinese medicine commonly used in invigorating the kidney and strengthening Yang, and relieving depression.

Aim: This study was designed to explore the effects and mechanisms of MOO in treating chronic stress-induced depression as well as sexual dysfunction.

Methods: The sucrose preference test, forced swimming test (FST) and novelty-suppressed feeding test (NSFT) were carried out to evaluate the depression status. Sexual behavior was tested on all mice, then the extent of damage to the testicles and epididymis was assessed by H&E staining; Serum sex hormone and neurotransmitters were assessed in the plasma by Enzyme-Linked Immunosorbent Assay. The testicular tissues were applied with the kit for the detection of antioxidant-related indexes and reproductive-related hormones.

Outcomes: The study evaluates the effects of MOO on depression-like behaviors and sexual function levels in CUMS-induced mice by analyzing the behavioral tests, histopathological staining of testis and epididymis, sex hormones, antioxidant capacity, neurotransmitter levels, and sexual behavior abilities of mice in each group.

Results: CUMS led to mice depression and plasma neurotransmitter levels decreased. Accompanying sexual dysfunction in depressed mice was also manifested in many aspects. Compared with the control group, the capture latency and mount latency of male mice in model group were significantly prolonged. HE showed that testicular and epididymal tissues of mice in the CUMS group were severely vacuolated. Testicular marker enzymes, antioxidant indexes and sex hormones were disorganized. The sperm concentration and viability in the epididymis of the mice in model group were significantly reduced. It was suggested that MOO could improve the damage caused by CUMS, and improve the sperm quality of the model mice.

Clinical translation: MOO are promising to be translated into a potential therapeutic drug for clinically improving chronic stress-related depression and sexual dysfunction.

Strengths and limitations: Multi-dimensional verification confirms that MOO can effectively alleviate depressive states and sexual dysfunction in CUMS-induced mice. Future studies should explore the in-depth mechanisms underlying its antidepressant and anti-sexual dysfunction effects based on relevant signaling pathways.

Conclusion: These results suggest that MOO can regulate sexual dysfunction and play a protective role in neurodevelopment during CUMS by regulating sex hormones.

背景：慢性应激不仅会导致抑郁样行为，还会导致性功能障碍。桑椹寡糖（MOO）是一种常用的补肾阳虚、解郁解闷的中药配方。目的：探讨MOO对慢性应激性抑郁、性功能障碍的治疗作用及机制。方法：采用蔗糖偏好试验、强迫游泳试验（FST）和新奇性抑制进食试验（NSFT）评价抑郁状态。对所有小鼠进行性行为测试，然后用H&E染色法评估睾丸和附睾的损伤程度；采用酶联免疫吸附法测定血清性激素和血浆神经递质。应用试剂盒检测睾丸组织抗氧化相关指标和生殖相关激素。结果：本研究通过分析各组小鼠的行为学试验、睾丸和附睾的组织病理学染色、性激素、抗氧化能力、神经递质水平和性行为能力，评价MOO对cms诱导小鼠抑郁样行为和性功能水平的影响。结果：CUMS导致小鼠抑郁，血浆神经递质水平下降。抑郁症小鼠伴发性功能障碍也表现在多个方面。与对照组比较，模型组雄鼠捕获潜伏期和骑鼠潜伏期均明显延长。HE显示，CUMS组小鼠睾丸和附睾组织出现严重空泡。睾丸标记酶、抗氧化指标和性激素紊乱。模型组小鼠附睾精子浓度和活力明显降低。提示MOO可改善CUMS损伤，改善模型小鼠精子质量。临床转化：MOO有望转化为一种潜在的治疗药物，用于临床改善慢性应激相关性抑郁症和性功能障碍。优势与局限性：多维度验证证实MOO能有效缓解cms诱导小鼠的抑郁状态和性功能障碍。未来的研究应基于相关信号通路深入探索其抗抑郁和抗性功能障碍作用的机制。结论：MOO可通过调节性激素调节CUMS期间的性功能障碍，并对神经发育起到保护作用。

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引用次数: 0