Sexual medicine reviews最新文献

Introduction: In experimental sex research, attention to sexual stimuli is considered a well-established indicator of sexual interest, with patterns that differ across sexual orientations. While earlier studies primarily focused on heterosexual populations, recent research has increasingly explored attention in sexual minority individuals (SMIs). Building on the incentive motivation and information processing models of sexual response, it can be hypothesized that differences in the appraisal of sexual stimuli contribute to variations in individuals´ sexual responses, raising the possibility that attention to sexual stimuli may be related to individuals' sexual identities.

Objectives: This scoping review aimed to map the existing literature on attention to sexual stimuli among SMIs and to clarify the relationship between attention to sexual stimuli and sexual identity.

Methods: A systematic literature search was conducted using PubMed, EBSCOhost, Web of Science, and ProQuest databases, adhering to the PRISMA guidelines for scoping reviews.

Results: The search resulted in 1107 records, 56 of which were included in the review. Overall, the results highlight patterns of automatic and controlled attention to sexual stimuli in SMIs. These findings are interpreted as reflecting attention-identity relationships in each sexual minority group. The review also suggests several areas for future research.

Conclusion: This review underscores opportunities to improve healthcare for SMIs by clarifying attentional patterns across non-heterosexual orientations and factors related to their sexual self-identification. The findings also offer valuable insights for clinicians in dealing with sexual identity conflicts and advancing sexual minorities´ mental health and well-being.

Background: Compulsive sexual behavior disorder (CSBD) is defined by a persistent inability to regulate sexual impulses, leading to significant distress and impairment. Although it is recognized as a disorder in the International Classification of Diseases-11, the underlying neurobiological mechanisms are not yet fully understood.

Aim: The aim of this systematic review is to summarize recent findings on peripheral biomarkers in individuals with CSBD and to provide a comprehensive overview of the current state of the field.

Methods: We searched articles published in the last 10 years in PubMed, Scopus, and Web of Science following The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement. Eligible studies included adult participants formally diagnosed with CSBD, hypersexual disorder, or sexual addiction, and that assessed peripheral biomarkers. Exclusion criteria comprised studies focused on neurological comorbidities, neuroimaging alone, or animal models. A total of 10 articles met the inclusion criteria.

Outcomes: The primary outcomes were associations between peripheral biomarkers and clinical or psychological variables in CSBD, including hormone levels, epigenetic patterns, and immune markers.

Results: The reviewed studies investigated neuroendocrine, epigenetic, and immunological biomarkers in individuals with CSBD. Altered DNA methylation was identified in stress-related genes (e.g., CRH, CRHR1, FKBP5, NR3C1), often associated with HPA axis dysregulation and non-suppression in the dexamethasone suppression test (DST). Specific microRNAs (e.g., MIR4456, MIR708) showed differential methylation and expression patterns. Neuroendocrine findings included elevated post-DST cortisol and ACTH levels, increased plasma oxytocin and LH levels, and associations between salivary testosterone and CSBD symptoms in men. Immunological alterations included increased TNF-α and decreased IL-6.

Clinical implications: These preliminary findings suggest biological alterations related to stress, hormonal regulation, and inflammation in CSBD, but clinical application remains limited.

Strengths and limitations: This is the first systematic review focused on peripheral biomarkers in CSBD. However, limited sample diversity, cohort overlap, and lack of replication restrict generalizability.

Conclusion: Evidence supports a multifactorial biological profile in CSBD. Future longitudinal, multimodal studies in diverse populations are essential to clarify the diagnostic and clinical relevance of these biomarkers.

Introduction: Treatment of erectile dysfunction is based on pharmacotherapy for most patients.

Aim: To review the current data on pharmacotherapy for erectile dysfunction based on efficacy, psychosocial outcomes, and safety outcomes.

Methods: A review of the literature was undertaken by the committee members. All related articles were critically analyzed and discussed, and consensus statements were developed after presentation at the 2024 ICSM.

Results: Eight recommendations are provided with the corresponding level of evidence and grade of recommendation.

Conclusions: The management of erectile dysfunction should be personalized to address the psychosocial needs and expectations of both the patient and their partner. PDE5 inhibitors remain the first-line treatment for most men, while intracavernosal injections, vacuum erection devices, and penile prostheses serve as second-line options, with treatment decisions guided by patient preferences. Key recommendations are summarized in table 1.

Introduction: As the field of sexual medicine continues to grow, there has been increasing attention on methodological integrity and rigor of sexual medicine research, including an emphasis on guidelines for quantitative research design and standards for assessing clinical trial outcomes. However, qualitative research (QR) methodology has garnered relatively scant attention in comparison.

Objectives: To clarify the value of QR and provide recommendations for improving implementation of QR methods in sexual medicine research.

Methods: A PubMed review was conducted. Expert opinion was based on a process of literature review and expert consensus.

Results: An essential goal of QR is to describe and explain unknown or insufficiently understood phenomena through detailed investigation of subjective human experience. Results from QR allow for generating hypotheses that may then be tested. More recently, mixed-methods research, ie, research integrating both qualitative and quantitative methods, is being increasingly used across domains of biomedical and health science research. While there remain differences of opinion regarding use of qualitative methodology in sexual medicine, best-practice models of QR underscore the principle of trustworthiness and include ethics and transparency in protocols for data collection and analysis. It is recommended that established QR frameworks for developing a research question are utilized and that consolidated criteria for reporting research results are employed. Furthermore, authors and reviewers need training in both QR methods and qualitative reporting frameworks to be able to adequately report and review this type of research. Specific areas in sexual medicine that would ideally benefit from QR methods are suggested.

Conclusion: As the field of sexual medicine continues to expand, qualitative methodologies including mixed-methods research, offer significant value for understanding domains of inquiry that have not been thoroughly investigated. To achieve these targets, training of authors and reviewers on QR is needed.

Introduction: Erectile dysfunction (ED) is a common and debilitating condition that can have significant impacts on quality of life. Peripheral electrical stimulation (PES) has emerged as a potential alternative therapy for ED, as it aims to improve penile hemodynamics and neuromuscular function. However, the clinical evidence on the effectiveness of PES for managing ED remains unclear.

Objective: To conduct a comprehensive systematic review evaluating the effectiveness of PES for the management of ED in adult male patients.

Methods: PubMed, Embase, Scopus, Web of Science, and Google Scholar were searched from inception to April 2024 using relevant keywords. Studies evaluating the use of any form of PES for the management of ED in adult male patients were included. Two independent reviewers screened titles and abstracts, retrieved full-text articles, and extracted data using a standardized form. Methodological quality was assessed using the appropriate Joanna Briggs Institute (JBI) checklists. A meta-analysis was conducted using RevMan 5.4.1 software.

Results: A total of 13 studies [6 randomized controlled trials (RCTs) and 7 quasi-experimental studies], published from 1998 to 2024, satisfied the inclusion criteria. Studies reported on using different PES techniques, including transcutaneous electrical nerve stimulation (TENS), percutaneous electrical nerve stimulation (PENS), functional electrical stimulation (FES), and transanal pelvic plexus stimulation (TPPS). Six studies were eligible for the meta-analysis. The first analysis, evaluating the before-and-after results of PES on ED, showed a mean difference in International Index of Erectile Function (IIEF) scores of 3.09 (95% CI: -2.19 to 8.38; I2 = 99%), indicating a non-significant improvement in erectile function following PES. The second analysis, comparing the intervention group with a control group, showed a significantly higher mean difference of 6.27 (95% CI: 4.30 to 8.27; I2 = 79%), suggesting a positive effect of PES on erectile function compared to the control group, though moderate heterogeneity was observed. All the studies were of low to moderate quality, and the certainty of the evidence was weak.

Conclusion: Limited and low-quality research suggested the potential benefits of PES for treating ED. However, the current evidence is weak and cannot support routine administration. More high-quality research is needed to establish PES optimization.

Introduction: Persons with physical disabilities (PWD) are a health care disparity group who face both difficulties accessing and inequalities in care. Although their sexual health is impacted by their disability and important to them, they often receive no or inadequate sexual health care. To address this gap, we sought to summarize evidence-based recommendations for culturally sensitive sexual health care for PWD.

Objectives: The aim of this scoping review was to identify patient-reported preferences for culturally sensitive sexual health care for people with Parkinson's Disease, Multiple Sclerosis, Spinal Cord Injury, Spina Bifida, and Cerebral Palsy.

Methods: Utilizing PubMed and Embase, we identified all primary research studies published from 1/1/2005-1/6/2024 that included PWD-reported preferences for delivery of sexual health care. After determining eligibility, two authors extracted and subsequently summarized the data utilizing standard scoping review methods.

Results: 6575 articles were identified, of which 32 met eligibility criteria, which included 13 reviews, nine cross- sectional studies, nine cohort studies, and one quasi-experimental studies. Sexual health generally goes unaddressed in the care of PWD despite its importance to the individuals. While there is a paucity of research, existing evidence suggests that preferences are highly individual and may vary by sociocultural, health, disability, relationship, and personal factors. Health care providers should ask each person about their preferences for the timing and context of sexual health conversations, such as who is present and how to make the person comfortable during the clinic visit. Validated questionnaires and educational tools may help facilitate conversations. Sexual health conversations should be ongoing.

Conclusions: Providing culturally sensitive sexual health care for PWD and their partners is both critical and feasible. Additional research is needed to further explore preferences for care and how preferences are impacted by the intersectionality of sociocultural, disability, and other factors.

Introduction: The mental health concerns associated with infertility, encompassing conditions such as anxiety, depression, and stress, are of paramount importance. However, bibliometric analyses employing tools like CiteSpace and VOSviewer to study this domain have been notably lacking.

Objectives: This research aims to fill this gap by employing these tools to analyze the current state, hotspots, and trends in infertility psychology, thereby offering a comprehensive review to assist researchers in navigating the research landscape.

Methods: Using Web of Science Core Collection as the data source, search for articles on psychological research on infertility patients from 2014 to 2024, and conduct bibliometric analysis using Microsoft Office Excel 2019, VOSviewer software, and CiteSpace. And draw tables and trend charts, generate network maps, cluster maps, etc., to evaluate relevant literature information, such as authors, countries, institutions, and keywords. In addition, use Price's law to calculate the number of core authors.

Results: A total of 324 articles related to the research on infertility psychology were retrieved. We observed that the number of publications has increased with fluctuations. The United States ranks first in terms of the overall research strength in this field. Review literature has the highest number of citations, and most of the research topics in the cited literature are related to stress, depression, anxiety, and so on. Keywords and clustering analysis indicate that, in the past decade, research has gradually been carried out on multiple dimensions around the psychological conditions of this group, such as group psychological interventions, birth cohort studies, the relationship between couples, measurement tools, and so on.

Conclusion: The results of this study provide a scientific and comprehensive overview of the development of psychological research on infertility patients, enabling relevant authors and research teams to understand the current research status in this field. At the same time, the mental health of infertile patients is closely related to the sexual function of both spouses, and it is particularly important to use the Internet to intervene. Exploring hot topics and cutting-edge directions can also guide researchers to seek new perspectives and directions, such as groups, couples, interdisciplinary intersections, and so on.

Introduction: In recent years, the field of sexual medicine has undergone major transformations brought about by the internet and concern with genital performance and aesthetics. On the other hand, economic transformations have increased barriers to better care and sexual education.

Methods: Given the emerging knowledge of this topic, we conducted a narrative review of the extant literature through wide searches in PubMed and Google and on global websites relevant to this topic, such as the World Health Organization, the United Nations, and others. The content of this paper was reviewed by all the authors, discussed where disagreements occurred, or additional perspectives were needed, and further literature was incorporated.

Results: The Internet has made valuable contributions to the dissemination of sexual health education, but it has also promoted non-evidence-based information that can contribute to sexual dysfunctions and has contributed to sexual exploitation and cyberbullying. Of concern is the rise of an Internet-based industry that promotes and dispenses dietary supplements. Liberal, unfettered marketing has brought the dissemination of products that, at best, do not deliver the desired result, and at worst, are adulterated and become a threat to individual and public health. In the context of false advertising, men's anxiety about penis size has been exploited. Advertising of techniques that would produce penis enlargement preys on these anxieties without evidence to support efficacy of these techniques. Economic barriers have impeded men's ability to access sexual healthcare. The lack of coverage by health plans, the lack of trained professionals, and the costs of exams and treatments impede access to sexual healthcare in many parts of the world.

Conclusions: We recommend that doctors inform patients of the risks of non-evidence-based practices and that the International Society of Sexual Medicine produce evidence-based information accessible to the general public and seek to work toward finding solutions to existing economic barriers.

Introduction: Female sexology is the scientific and scholarly study of human sexuality a multidisciplinary research area influenced by visual arts which, comprise all non-textual media, prioritizing moving images (film and video), photography, and the installation art context.

Objectives: The review aims to improve doctors' understanding of intersection of female sexology and visual arts. Thereby providing a framework for analyzing representations of female sexuality in art, by highlighting key themes and debates.

Methods: A comprehensive search approach was utilized to get research papers from the following databases: PubMed (MEDLINE), Scopus, and Web of Science. Google Scholar was also manually searched. The search results were imported into Rayyan reference management and evaluated against the established inclusion criteria. The articles' quality was appraised using the appropriate JBI checklist (ie, in accordance with the study design), and the evidence was graded using the JBI grades of recommendation.

Results: Through scholarly writings, a contemporary artistic research project, and finished visual artworks, the goal is to consider how the visual arts and visual art practices can respond to or engage with female sexology. Academic perspective offers up thoughts on definitions, positions, and considerations within this interdisciplinary field. Artistic perspective opens up space for wondering, questioning, and reflecting on other potential considerations, protocols, and positions within this field. Finally, finished artworks offer one potential approach to the visual art practice's engagement with female sexology. Through scholarly writings, artistic research process, and finished visual artworks, the intersection of female sexology and visual arts has begun to be explored.

Conclusions: visual arts has an imperative role in female sexology. The study suggests an interdisciplinary approach to managing female sexology, integrating visual arts.

Introduction: The intersection of culture, history, religion, traditions, laws, political trends, and evolving attitudes affects sexual expression and acceptance or rejection of sexual practices. Clinicians and clinical care are affected by these factors as well, although clinicians are not always aware of the way in which their training, their own experiences and attitudes influence the way in which they approach patients. In this paper, we contextualize and then describe 2 areas of sexual practices and 1 area of sexual difficulty that sexual medicine clinicians encounter in their practice, namely, the practice of female genital mutilation/cutting, penile circumcision, and the experience of unconsummated marriages.

Materials and methods: Given the emerging knowledge of the socio-cultural aspects of sexual medicine, we conducted a narrative review of the extant literature through wide searches in PubMed, Google, and on global websites relevant to this topic, such as the World Health Organization, the United Nations, and others. The content of this paper was reviewed by all the authors, discussed where disagreements occurred, or additional perspectives were needed, and further literature was incorporated.

Results: We describe known practices of female genital cutting/mutilation and penile circumcision, their perceived benefits, and harms, but also with a view to the importance of patient empowerment and respect for self-determination. We discuss unconsummated marriages as the result of often culturally determined insufficient sex education and guidance, as well as clinical resources.

Discussion: We recommend that clinicians approach patients with both curiosity and cultural humility and that the International Society for Sexual Medicine (ISSM) adopt a strong ethical perspective as a part of the ongoing discourse on these practices and experiences.