Sexual medicine reviews最新文献

Introduction: By offering a historical analysis that moves from the early modern period to the present, this essay examines the various factors that have shaped female genital self-image (FGSI) and sexual attitudes. Four main categories are identified as being particularly influential.

Objectives: The review aims to improve doctors' understanding of the impact of social media on FGSI thereby promoting a comprehensive and holistic approach.

Methods: A comprehensive search technique was used to obtain 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 assessed using the established inclusion criteria. The quality of the articles was assessed using the appropriate JBI checklist (ie, according to the study design), and the JBI grades of recommendation were used to grade the evidence.

Results: First, the review considers anatomical texts to determine how cultural beliefs about the female capacity for sexual enjoyment influenced perceptions of the female genitals as early as the 17th century. Next, the review engages with medical discourses-ranging from the scientific to the social-to establish 19th-century attitudes toward the connection between female genital anatomy and psychological state. Third, the review explores the application of psychoanalytic theory to uncover the internalization of societal norms in the construction of a similarly negative genital self-image in the early- to mid-20th century. Fourth, the review provides insights from the sexual liberation movement, with a particular focus on the importance of communication in the enhancement of female self-image.

Conclusions: In conclusion, there is an association between increased time spent on social media platforms and heightened FGSI, alongside its interacting effect on multiple areas of self-perception and functioning in women.

Introduction: Low-intensity pulsed ultrasound (LIPUS) is a type of specific ultrasound that is delivered at low intensity and generated in pulsed wave mode. Previous studies have demonstrated the therapeutic applications of LIPUS in the healing or regeneration of several tissues. However, research on LIPUS therapy for erectile dysfunction (ED) is still limited.

Objectives: This literature review aims to summarize the clinical trials, clinical applications, and the molecular mechanisms of LIPUS in ameliorating ED.

Methods: A comprehensive literature search was conducted in PubMed and MEDLINE using the keywords: "low-intensity pulsed ultrasound," "erectile dysfunction," "treatment," "clinical trials," and "mechanism."

Results: LIPUS significantly improved erectile function in patients with mild-to-moderate ED in all of the clinical trials. Notably, no adverse events were reported in any of the studies. In addition, LIPUS was shown to promote erectile function mainly via the regeneration of cavernous nerves, the corpus cavernosum endothelium or smooth muscles, as well as via the activation of stem cells.

Conclusion: LIPUS has demonstrated safety and efficacy in the treatment of ED based on clinical trials, and the mechanisms that are involved in these effects have been elucidated via basic studies. Although most clinical studies have lacked placebo-controlled groups and have included limited sample sizes, LIPUS therapy is still a promising area in ED research. However, it should be noted that the studies were conducted in China, which may limit the generalizability of the findings.

Introduction: Male hypogonadism is a clinical condition combining low circulating testosterone (T) and specific signs and symptoms associated with impaired hormone production.

Objectives: To provide the 5th International Consultation for Sexual Medicine consensus paper with recommendations concerning management strategies for hypogonadism.

Outcomes: A narrative review combined with expert opinions on major topics concerning diagnosis of male hypogonadism; treatment options; T impact toward cardiovascular, metabolic, sexual, and reproductive health; and prostate cancer (PCa).

Methods: A consensus panel was held with leading Sexual Medicine experts during the 5th ICSM. Relevant English-language peer-reviewed literature was reviewed with a focus on research from but not limited to the last 10 years. The quality of each individual study was judged with Oxford levels of evidence (LOEs) criteria, but overall LOEs were not used as a systematic review was not performed. The expert panel generated recommendations based on the quality of evidence and criteria of Grading of Recommendations Assessment, Development and Evaluation.

Results: This manuscript reports a narrative reappraisal combined with authoritative expert opinion on the physiological role of T throughout the male aging process, with emphasis on the critical interpretation of the hypogonadal conditions associated with sexual dysfunction and male factor infertility. Likewise, particular attention was paid to relevant everyday clinical topics including cardiovascular health, metabolism and bone safety, and PCa survivorship. Clinically effective recommendations were given for 14 categories concerning hypogonadism diagnosis and 15 categories on testosterone therapy.

Strengths and limitations: The combined main strength and limitation is the narrative profile of this literature review, which was intentionally devoted to addressing the critical clinical aspects of male hypogonadism, while neither provides a systematic review nor a meta-analysis of the most updated published data.

Conclusions: This manuscript discusses relevant clinical aspects and management recommendations of the 5th ICSM committee on male hypogonadism.

Introduction: Evidence-based clinical practice guidelines focused on sexual (dys)function for the LGBTQIA+ (ie, lesbian, gay, bisexual, transgender, queer/questioning, intersex, and asexual) community, including before and after gender-affirming surgery, are still scarce.

Objectives: To provide an overview and recommendations for sexual (dys)function among individuals with diverse sexual orientations, transgender and gender-diverse individuals, and intersex individuals/individuals with differences of sexual development (DSD).

Methods: A committee of experts conducted a comprehensive review of the literature, focusing on scientific publications since the last consultation, for the fifth International Consultation on Sexual Medicine.

Results: Researches that considered populations with diverse sexual orientations were reviewed and largely focused on sexual satisfaction/pleasure, sexual functioning, and sexual difficulties. Additional topics included relationship and psychological dimensions, sexual functioning during receptive anal sex, chemsex, minority stress, asexuality, and sexuality in older adulthood. The main challenges are related to small sample sizes and mostly cross-sectional study designs that limit the generalization of findings. Research focused on sexual (dys)function among transgender and gender-diverse individuals tends to focus on a medical perspective of sexual function and is often based on cisgender models or methodology. Research has also focused attention on the relationship between medical interventions for gender-affirming care (eg, hormone therapy, surgery) and has often included cross-sectional designs or short-term follow-up. Current research also highlights the unique facets of sexual (dys)function that appear important to gender-diverse individuals, such as relational and body image factors. Fewer articles focused on individuals with intersex traits/DSD, and these included a diverse approach to the samples studied and methodology used. Much of this research focused on the impact of medical interventions (eg, hormone therapy, surgery) on sexual satisfaction and function. Across populations, there were limited validated measures of sexual (dys)function.

Conclusion: Overall, the main challenges in the field are related to methodological gaps, as acknowledged in this review, and a summary of the literature is provided. Diversity, equity, and inclusion, as well as ethical considerations, are addressed, and clinical recommendations for supporting the sexual well-being of individuals with diverse sexual orientations, transgender and gender-diverse individuals, and intersex individuals/individuals with DSD are presented.

Introduction: Blue balls is a mundane complaint that generates substantive popular lore but has little coverage in the sexual medicine literature.

Objectives: To draft a first medical history of relevant nosology and etiology.

Methods: The Latin, French, German, Dutch, Italian, and English literature was mined.

Results: As expected from a period of not only widespread scaremongering concerning masturbation and "semen loss" but also "overly rigid continence," scrotal pain reminiscent of blue balls was well covered between the 1820s and 1920s, under variably inclusive nosologic headings: "hernia seminalis," "orchioncus," "simple spermatocele," "epididymis distensa," "irritable testis," "testicular epilepsy," "testicular neuralgia," "spermatic colic," "stone-ache," "epididymitis sympathica," "epididymitis erotica," "epididymitis antiperistaltica," "paradidymitis erotica acuta," and "epididymo-deferential colic." Even an analogical "ovaralgia erotica" was hypothesized. Observations had the radical potential of supporting poena naturalis (natural punishment) arguments against "too strict" continence and even pro masturbation. This historical push toward concepts of normal and habitual sexuality was fortified by equally tendentious concepts of "constitutional" or "temperamental" predisposition in some men. Yet the clear potential of the diagnosis to moderate strong prevailing sentiments against masturbation remained poorly realized until well into the early 20th century.

Conclusion: Discomfort of the blue balls variety widely animated clinical sexual discourse from the early 18th century onward. It specifically informed interlocking, gendered ideas about sexual entitlement expressed in normative frames for sexual habits, eroto-sexual constitution, and behavioral health.

Introduction: Sexual satisfaction is a key component of individual and relational well-being and is defined as the subjective perception of enjoyment and fulfillment in sexual life. For individuals and couples belonging to sexual orientation and gender diversities (SOGDs), this satisfaction may be influenced by unique factors related to the experience of their sexual orientation and gender identity. However, the scientific literature exploring sexual satisfaction in these groups remains scarce. The present work analyzes the growth and characteristics of scientific production in this field of study.

Objectives: Mapping scientific articles indexed in Scopus and Web of Science on the scientific production of sexual satisfaction in SOGD individuals and couples and identifying the production growth, sources, authors, countries and affiliations, relevant terms, and collaborative networks.

Methods: A bibliometric analysis of 333 articles published in scientific journals was performed. The selected studies included terms related to the SOGD population and sexual satisfaction in the title, abstract and keywords. The articles covered the period 1976-2023 and were analyzed in terms of temporal production; authors, countries and institutions; relevant terms; trend topics; co-occurrence; and collaborations, using R-bibliometrix and VOSviewer.

Results: The analysis revealed a progressive growth in scientific production, especially in the last decade. The main journals that published on the subject include The Journal of Sexual Medicine, Archives of Sexual Behavior, and The Journal of Sex Research. The studies were mainly concentrated in North American and European countries. Recurring terms such as HIV and relationship satisfaction were identified, while some SOGD collectives remained underrepresented. Additionally, limited intellectual collaboration networks were observed.

Conclusions: This analysis highlights the need to expand research on sexual satisfaction in SOGD populations to include underrepresented regions and groups. A more inclusive and collaborative approach is recommended, addressing experiences of sexual satisfaction from affirmative and multicultural perspectives.

Introduction: Erectile dysfunction (ED) and cardiovascular disease (CVD) share common pathophysiological mechanisms and molecular pathways, with ED serving as an independent risk factor and prognostic marker for CVD.

Objectives: This review aims to explore the relationship between ED and CVD, analyze their shared pathophysiological mechanisms, and discuss the implications of these findings for clinical practice.

Methods: A comprehensive literature review was conducted using PubMed, MEDLINE, and Web of Science databases, with keywords including "erectile dysfunction," "cardiovascular disease," "endothelial dysfunction," "inflammation," "oxidative stress," "NO/cGMP/PKG signaling pathway," "RhoA/ROCK pathway," and "testosterone deficiency."

Results: The study found a positive correlation between ED and the incidence rate and severity of CVD, with shared mechanisms such as endothelial dysfunction, oxidative stress, and systemic inflammation. Mendelian randomization studies provided evidence of a causal relationship between genetically predicted CVD and ED risk, although reverse causality remains less clear. Early detection of ED may help prevent and manage CVD, with ED serving as a sentinel marker for asymptomatic coronary artery disease. The review also highlighted the potential of combining treatments like phosphodiesterase type 5 inhibitors with rho-associated protein kinase inhibitors or glucagon-like peptide-1 receptor agonists with testosterone therapy to optimize both cardiovascular and sexual outcomes.

Conclusions: Understanding the association between ED and CVD is crucial for improving patients' quality of life and cardiovascular prognosis. Future research should focus on elucidating the mechanistic pathways underlying ED and CVD, validating causal relationships through long-term, multimodal studies, and developing standardized risk algorithms for early intervention. For clinical practice, proactive ED screening in high-risk populations and interdisciplinary collaboration between cardiologists and urologists are essential to prevent CVD progression and enhance patient quality of life.

Introduction: Erectile dysfunction (ED) is a common male sexual disorder that diminishes quality of life significantly. Despite extensive research, little is known about the complex physiological mechanisms of ED, in part owing to disparities between animal and human physiology. Comprehensive and objective assessment methods for animal models are crucial to bridge this translational gap.

Objectives: Various experimental approaches for evaluating erectile function in rodent models are explored.

Methods: A search of the medical literature was carried out in PubMed and Medline, focusing on original research and systematic reviews of original research on the evaluation of erectile function in experimental animals. Studies without erectile assessment methods or insufficient data, editorials, letters, commentaries, and non-English articles were excluded.

Results: The ICP-to-mean arterial pressure ratio remains a valuable indicator for evaluating erectile function. Furthermore, laser speckle blood perfusion imaging technology offers an approach for assessing changes in cavernous blood flow, whereas infrared thermal imaging technology enables real-time temperature monitoring during erectile responses. Microscopic ultrasound and magnetic resonance imaging allow high-resolution observation of hemodynamic and histological changes in the rat model penis, real-time assessment of blood flow, and detailed anatomical information. Human-rat homologous marker detection using blood tests has high clinical relevance and translational potential. In addition, wearable adaptive penile rigidity monitoring (WARM) dynamically monitors erectile function by accurately and continuously detecting changes in the girth of the rat penis in a non-invasive manner. Utilizing ex vivo models of cavernous tissue, such as the cavernous artery and smooth muscle, can provide valuable insights into the mechanisms underlying ED and the pharmacological effects and efficacy of drugs.

Conclusion: This comprehensive review covers diverse approaches, including new technologies, for assessing erectile function in rodent models, including new technologies. By addressing the limitations of the existing methodologies and providing a framework for accurate and reliable evaluations, this review provides a basis for further research on the pathophysiology of ED and potential therapeutic interventions.

Background: The labia minora, an essential yet understudied component of female genital anatomy, has been hypothesized to play a role in the female sexual function. Despite its potential importance, empirical evidence linking the labia minora's anatomical characteristics to sexual function remains limited.

Aim: Through critically assessing the current literature on the labia minora, this scoping review aims to consolidate existing research on the labia minora's anatomy, vascularization, innervation, and its role in female sexual function.

Methods: Scoping review methods according to (PRISMA-ScR) were followed. A comprehensive literature search was conducted across multiple databases, including PubMed, Web of Science, and Scopus, from database inception to March 31, 2024. Studies were screened for original research on anatomy, vascularization, innervation, and sexual function of the labia minora, and data were extracted from those meeting the inclusion criteria. The quality of the studies was assessed using the Oxford Centre for Evidence-Based Medicine Levels of Evidence and the JBI Critical Appraisal Tool.

Results: Of the 480 studies identified, a total of 27 studies met the inclusion criteria, with the majority (56%) rated as "good" quality evidence. The labia minora was consistently found to have rich vascularization and a high density of nerve endings, suggesting a role in sexual arousal and engorgement. However, significant variations in labial morphology were noted, and the impact of these variations on sexual function remains unclear. Additionally, the role of hormonal influences, particularly androgens, on labial anatomy and function is poorly understood.Conclusion: The labia minora likely plays a critical role in female sexual function, yet many aspects of its anatomy and function are not well understood. Future research should prioritize detailed studies of its vascular and neural structures and the effects of hormonal changes to improve clinical outcomes and therapeutic interventions for vulvar-related conditions.

Introduction: Sexual dysfunction in men and women is an important clinical issue; infection and inflammation can cause social, medical, and psychological problems that have a profound impact on sexual and reproductive health worldwide.

Objectives: We set out to identify sexual dysfunctions in men and women that arise from infection and inflammation and propose meaningful interventions, as evaluated by the Fifth International Consultation on Sexual Medicine (ICSM) held in June 2024 in Madrid (Spain).

Methods: We searched MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL) for published peer-reviewed journal articles and ClinicalTrials.gov and the World Health Organization's (WHO's) International Clinical Trials Registry Platform for prospective trials. This manuscript represents the opinions of 10 experts from 6 countries developed in a consensus process after completing the literature review, which produced a list of recommendations graded as weak or strong. This document was presented for peer review and debate in a public forum, and revisions were made based on the recommendations of chairpersons of the 5th ICSM.

Results: Infections, and in particular sexually transmitted infections (STIs), dramatically affect the sexual and reproductive health of individuals and couples, irrespective of sexual orientation and gender. Similarly, non-communicable chronic diseases (NCDs), through the common pathogenetic mechanism of inflammation, can directly impair the ability to copulate, reproduce, and enjoy sexual life.

Conclusions: This expert consensus recommends prioritizing early detection, comprehensive treatment approaches, and preventive measures to mitigate the effects of infection and inflammation on sexual health, both for the patient and the couple. These insights provide a foundation for improving patient outcomes and fostering global awareness of the interconnections between infection, inflammation, and sexual dysfunction.