Sexual medicine reviews最新文献

Introduction: The use of hyaluronic acid as a nonsurgical treatment for various conditions within urology has been of great interest in recent literature.

Objectives: In this study, we aimed to provide an updated review and analysis of the current state of hyaluronic acid use in urology, characterize its adverse effects, and briefly discuss future directions of research for hyaluronic acid in urology.

Methods: PubMed searches were run utilizing multiple terms, including "hyaluronic acid," "penile," "augmentation," "Peyronie disease," "premature ejaculation," and "cosmetic urology," among other related iterations. Relevant data extracted included International Index of Erectile Function score, intravaginal ejaculatory latency, glans circumference, penile girth, and plaque size. We also included studies which reported on complications of hyaluronic acid injections. Aggregated analysis was performed on studies with complete pre and post injection data at time closest to 6 months postinjection.

Results: A total of 33 studies met our inclusion criteria. Studies had marked heterogeneity in design, but most reported positive results. A total of 16 studies were included in our analysis. Intravaginal ejaculatory latency, penile girth, glans circumference, and International Index of Erectile Function were all increased on a fixed-effects model. Reduction in plaque size was not significant (P = .069). Complications were rare.

Conclusion: Literature on hyaluronic acid for urologic issues demonstrates promising results; however, the quality of studies was variable. Our analysis of these studies largely corroborates these findings; however, the results are limited by the data available. Hyaluronic acid may be promising, but we highly implore standardization of study regimens in randomized controlled trials.

Introduction: Temporomandibular disorders (TMDs) encompass various conditions affecting the temporomandibular joint and surrounding structures, often presenting with pain, limited movement, and functional impairments. TMDs may affect kissing and oral sex, in addition to influencing sexual function, as any other chronic pain condition.

Objective: The study sought to examine the connection between TMDs and sexual function.

Methods: A literature review was conducted, synthesizing evidence from various disciplines, including dentistry, physical therapy, psychology, and sexual medicine. Relevant studies were analyzed to elucidate the multifaceted nature of TMDs and their potential impact on sexual health.

Results: Emerging evidence suggests a complex relationship between TMDs and sexual function, with chronic pain, psychological distress, and physiological factors potentially contributing to sexual dysfunction.

Conclusion: Understanding the interconnectedness of TMDs and sexual function is essential for providing comprehensive care. Further research is needed to assess the association between TMDs and sexual dysfunction, elucidate the underlying mechanisms, and develop targeted interventions that address both TMD symptoms and sexual health concerns.

Introduction: Iontophoresis therapy (IPT) is a noninvasive technique that uses electrical impulses to deliver charged molecules into the skin for controlled and targeted drug delivery. IPT has been explored as a noninvasive treatment option for Peyronie's disease (PD), but the current literature in this regard is still scarce.

Objective: We aimed to systematically review the current literature on the application of IPT in the management of PD to provide a comprehensive evaluation and holistic outlook on the subject.

Method: A comprehensive search strategy was implemented in the following databases to retrieve research articles: PubMed (MEDLINE), Scopus, and Web of Science. Google Scholar was also manually searched. The search results were imported into Rayyan reference management for assessment based on the predefined inclusion criteria. The quality of the articles was evaluated by the proper JBI checklist (ie, per the study design), and the JBI grades of recommendation were used for grading the evidence.

Results: A systematic search yielded 451 publications, 11 of which met the criteria to be included in this systematic review. The results demonstrated that IPT, usually with verapamil and dexamethasone, has shown promising results in treating PD. These methods can reduce pain, plaque size, and penile curvature while improving sexual function and quality of life with no serious adverse events. However, most studies had moderate to low quality, indicating a weak recommendation for a certain health management strategy.

Conclusion: Based on the extant literature, there is currently insufficient evidence to support the use of IPT for the management of PD. Placing it in the forefront of research can facilitate the management choices for PD even further, given its therapeutic potential.

Introduction: Androgens play important roles in regulating the growth and development of the male reproductive system and maintaining libido and erectile function. The specific mechanisms by which androgen deficiency leads to erectile dysfunction (ED) are not yet fully understood.

Objectives: To understand the mechanisms and treatment of androgen deficiency-related ED.

Methods: A literature search in the past 10 years was conducted in PubMed and Google Scholar to determine the effects of androgen deficiency on erectile function and the treatment of androgen deficiency.

Results: Androgen deficiency can be caused by hypothalamic-pituitary lesions and injuries, testicular-related diseases and injuries, endocrine and metabolic disorders, the side effects of medication, and age. Androgen deficiency can lead to ED by inhibiting the NOS/NO/cGMP pathway (nitric oxide synthase/nitric oxide/cyclic guanosine monophosphate) and altering the expression of ion channel proteins, as well as by inducing oxidative stress, death, and fibrosis in penile corpus cavernosum cells. Testosterone replacement therapy is effective at improving the serum testosterone levels and erectile function in patients with androgen deficiency. For patients who need to maintain a low androgenic state, erectile function can be improved by lifestyle changes, treatment with phosphodiesterase type 5 inhibitors, low-intensity extracorporeal shock wave therapy, and stem cell therapy.

Conclusions: Androgen deficiency can affect the structure and function of the penile corpus cavernosum, leading to ED. Areas of further study include how androgen replacement therapy can improve erectile function and how to improve the maintenance of erectile function in patients with hypoandrogenic status.

Introduction: Sexual dysfunction (SD) is highly prevalent and multifactorial; nevertheless, recent research has shed light on a notable phenomenon: male patients with systemic lupus erythematosus (SLE) exhibit an elevated prevalence of sexual function disorders compared with the general population. Despite this recognition, the precise nature and extent of this association remain incompletely understood.

Objectives: This comprehensive review aims to clarify the link by providing an overview of the fundamental components of normal male sexual function, delving into the pathogenesis of male SD and exploring the primary factors predisposing male SLE patients to SD. Additionally, the review offers insights into potential screening, diagnostic, and treatment strategies based on the current body of literature.

Methods: A meticulous search of relevant literature was conducted using the PubMed and Google Scholar databases.

Results: Studies exploring the correlation between SLE and SD in both genders have revealed a nearly 2-fold increased risk of SD among individuals with SLE compared with healthy counterparts. Moreover, these studies suggest that male SLE patients may have a higher susceptibility to SD, with reported prevalence ranging from 12% to 68%, compared with 0% to 22% in healthy individuals. Male patients with SLE are influenced by a spectrum of pathological factors, including pharmacological, psychological, and disease-related determinants, which, through their intricate interplay, elevate the likelihood of developing SD.

Conclusion: Healthcare professionals must remain vigilant in understanding the intricacies of human sexuality and its dysfunction, particularly in males with SLE. The objective is to establish effective and potentially standardized methods for promptly diagnosing and optimally managing SD, recognizing its significant impact on the quality of life for males living with SLE. The pivotal role of rheumatologists in initiating discussions about sexual health, diagnosing SD, investigating causes, and implementing tailored strategies is underscored as crucial in addressing this multifaceted issue.

Introduction: Primary Sjögren's syndrome (pSS) is an inflammatory autoimmune condition affecting the exocrine glands, which can adversely affect the sexual activities of women with pSS.

Objectives: The study sought to evaluate the performance of the Female Sexual Function Index (FSFI) score in women with pSS regarding desire, arousal, orgasm, lubrication, satisfaction, and pain compared with those of healthy individuals.

Methods: A systematic review was conducted by examining studies published up to May 2023 using Embase, Web of Science, Scopus, and PubMed with the search terms "sexual" and "Sjögren's syndrome."

Results: Out of the 228 articles retrieved, 9 met the criteria for inclusion in this systematic review. Six of these studies were cross-sectional, involving 229 women with pSS and 303 control subjects. Results from the meta-analysis showed that women with pSS had significantly lower scores in all 6 FSFI subdomains and the total FSFI score compared with healthy individuals. Lubrication showed the largest decrease, followed by pain. In addition, women with pSS exhibited significantly higher standardized mean differences in depression and in anxiety, as assessed by the Hospital Anxiety and Depression Scale, when compared with control subjects.

Conclusion: This updated meta-analysis underscores the importance of assessing genitourinary atrophy, disease-related psychological changes, and dyspareunia in women with pSS. It also emphasizes the need for customized therapeutic approaches to address these sexual dysfunctions effectively.

Introduction: Female sexual dysfunction (FSD) consists of low libido, sexual arousal problems, anorgasmia, and dyspareunia. Sexual function is an important aspect of life for many women and is closely correlated with overall well-being. FSD is often underrepresented in the academic space when compared with male sexual disorders, such as erectile dysfunction. As FSD spans many fields (eg, urology, gynecology, psychology), bibliometric analyses are an important resource to highlight landmark articles.

Objectives: To identify key articles about FSD by citation number and bibliometric analysis to facilitate future scholarly efforts into more FSD research.

Methods: We searched for articles in the Web of Science Core Collection between 1900 and 2023 using terms specific to FSD. We identified relevant FSD articles and selected the top 50 most cited. A bibliometric analysis was performed to collect and analyze data about title, authorship, publication year, citation number, journal and impact factor, country and institution, study type, citation index, specialty, and conflict of interest.

Results: An overall 6858 results were identified. The top 50 most cited articles were published between 1997 and 2014 in 12 countries, across 32 institutions, and in 20 journals. The United States produced the most articles. The Journal of Sexual Medicine published the most articles. The mean number of citations per article was 351.64. Observational studies were most common. More than half were sponsored. Of all the specialties, most articles were categorized as urology and nephrology. Research about FSD has been much less impactful than research about male sexual dysfunction, possibly owing to stigma and decreased clinical training.

Conclusion: As FSD covers many fields, bibliometric analyses are invaluable to understand the vast body of knowledge. We hope that this research emphasizes the lack of attention that FSD has had and that it provides health care professionals with a valuable tool to understand the trajectory of FSD to guide future education efforts.

Introduction: Erectile dysfunction (ED) and kidney dysfunction share common risk factors linked to conditions involving endothelial impairment, such as coronary artery disease, dyslipidemia, diabetes mellitus, hypertension, smoking, and obesity. Men with chronic kidney disease experience a high incidence and prevalence of ED. While a functional renal graft can alleviate the issue for some patients, a significant portion of recipients still experience ED (20%-50%).

Objectives: This narrative review describes the variety of current treatments modalities on ED in kidney transplant recipients (KTRs) and their clinical outcomes.

Methods: MEDLINE, Web of Science, PubMed, and Google Scholar were used to find eligible articles pertaining to the treatment options of ED in KTRs. A total of 64 articles were evaluated.

Results: In KTRs, ED stems from a multifaceted etiology: anxiety, drug side effects, interference with penile vascularity, or the response of cavernosal muscle to neurotransmitters, along with changes in the endocrine milieu. A diverse range of treatments to restore erectile function has proven to be safe and effective for KTRs. Options include drug therapy, surgical interventions, intracavernosal injection therapies, vacuum erection devices, and extracorporeal shockwave therapy.

Conclusion: The initial treatment approach may involve the use of a phosphodiesterase type 5 inhibitors at a low dosage, especially if testosterone-circulating levels align with the diagnosis of hypogonadism. The consideration of a combination therapy involving testosterone and phosphodiesterase type 5 inhibitors should be contemplated due to the associated beneficial effects. Extracorporeal shockwave therapy has shown positive short-term clinical and physiological effects on erectile function in patients who did not respond to first-line treatments, resulting in spontaneous erections sufficient for sexual penetration in 50% of cases. Penile implants should be considered as third-line options based on specific patient needs and compliance with clinical conditions.

Introduction: First-line treatment options for patients with erectile dysfunction whose medical management has failed include the inflatable penile prosthesis (IPP). Many patients with an IPP require subsequent urologic surgery, during which the reservoir of the IPP can be injured.

Objectives: This review aims to present a summary of current literature related to iatrogenic injuries to the IPP sustained during urologic surgery.

Methods: Two reviewers independently performed a systematic search on PubMed using standardized search terms to identify pertinent articles. After preliminary review, relevant studies were analyzed to identify the presence of perioperative complications resulting in IPP reservoir injury. Results were categorized by surgical procedures.

Results: Among 13 articles included, all were based on urologic surgery. Four studies identified IPP reservoir injury as a result of surgical injury. Of these, injuries occurred during radical prostatectomy (n = 3) and prostatic urethral lift surgery (UroLift, n = 1). Most radical prostatectomy studies without IPP reservoir injuries also described intentional surgical techniques that were employed to prevent reservoir damage, including modulation of reservoir inflation-deflation (n = 3), temporary reservoir repositioning (n = 1), or reservoir capsule dissection to improve visualization (n = 1). Findings from an additional novel case report on IPP injury during a UroLift procedure are presented in this review.

Conclusion: Approximately one-third of studies identified intraoperative IPP reservoir injury as a significant complication of urologic surgery, particularly during radical prostatectomy. Novel case report findings also contribute the only other case of IPP reservoir damage sustained from delivery of UroLift implants. Findings are used to create a standardized surgical checklist that guides perioperative planning measures prior to pursuing surgery in adjacent spaces.

Introduction: Of the approximately 281 million international migrants and 35.3 million refugees around the world, almost half are women. These individuals experience significant stress due to language barriers, financial difficulties, poor living and working conditions, and discrimination. Consequently, concerns related to sexuality may receive lower priority despite their significant impact on overall well-being.

Objectives: This scoping review aims to review the sexual function of migrant and refugee women and identify any knowledge gaps in the field.

Methods: We conducted a scoping review following the PRISMA-ScR guidelines (Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for Scoping Reviews). We searched online databases-Medline, Embase, Emcare, PsycINFO, CINAHL, Scopus, Web of Science, and Cochrane-and gray literature, with no restrictions on year of publication, language, or study design. Utilizing Covidence software, 2 authors screened and extracted data from studies based on predetermined eligibility criteria. A thematic analysis was executed, and findings were reported descriptively.

Results: Initially, we identified 5615 studies; after screening titles, abstracts, and full texts, we ultimately included 12 studies. The review identified a limited body of research with various unvalidated tools. Moreover, these studies yielded heterogeneous results: migrant women reported less sexual knowledge, experience, and liberal attitudes, resulting in lower rates of desire and arousal as compared with nonmigrants. Some studies showed lower sexual function in migrants, while others found no significant differences between migrants and nonmigrants. The assimilation into Western cultures may influence migrants' sexual attitudes and behaviors. Factors such as education and gender role ideology can also significantly affect sexual function among migrant populations.

Conclusion: This review underscores the limitations in previous sexual function research, emphasizing the need for a more inclusive approach. It also offers valuable insights for codesigning programs to address sexual dysfunction among migrant and refugee women, improving their well-being. Future research should prioritize neglected populations and create culturally sensitive interventions to reduce sexual health disparities in migrants.