Patience Castleton, Salima Meherali, Zahid Memon, Zohra S Lassi
Introduction: Adolescence is a crucial stage of physical and sexual maturation and development and a period in which understanding sexual and reproductive health (SRH) is important. SRH interventions and toolkits provide a range of valuable resources and information to young people, educators, and members of the community on numerous topics, including contraception and puberty.
Objectives: The usefulness and reliability of these available toolkits have not been previously studied, thus limiting our understanding of their appropriateness and contents. Hence, this scoping review aimed to synthesize the available toolkits aimed at the SRH of adolescents and young adults to understand the contents, design, and information gaps.
Methods: A systematic search was conducted of 6 medical databases and 12 gray literature sites. Sixteen toolkits published globally before May 2023 were included in our review.
Results: The majority of toolkits (n = 12) contained information related to general SRH knowledge and contraception, whereas only 3 contained information on teenage pregnancy. We found that aiming the toolkits toward educators and health care workers was a favorable design over targeting adolescents and young adults directly and that vulnerable youth-including LGBTQI+ (lesbian, gay, bisexual, transgender, queer or questioning, asexual or allied, intersex, and additional identities) and youth from humanitarian settings-were not well represented.
Conclusion: We identified key gaps in the inclusion of information in a range of SRH topics, such as LGBTQI+ sexuality, teenage pregnancy, and safe abortion, in the currently available SRH toolkits and their lack of applicability in a global context. Furthermore, we provide recommendations for areas of improvement to encourage adolescents' agency in their SRH education.
{"title":"Understanding the contents and gaps in sexual and reproductive health toolkits designed for adolescence and young adults: a scoping review.","authors":"Patience Castleton, Salima Meherali, Zahid Memon, Zohra S Lassi","doi":"10.1093/sxmrev/qeae032","DOIUrl":"10.1093/sxmrev/qeae032","url":null,"abstract":"<p><strong>Introduction: </strong>Adolescence is a crucial stage of physical and sexual maturation and development and a period in which understanding sexual and reproductive health (SRH) is important. SRH interventions and toolkits provide a range of valuable resources and information to young people, educators, and members of the community on numerous topics, including contraception and puberty.</p><p><strong>Objectives: </strong>The usefulness and reliability of these available toolkits have not been previously studied, thus limiting our understanding of their appropriateness and contents. Hence, this scoping review aimed to synthesize the available toolkits aimed at the SRH of adolescents and young adults to understand the contents, design, and information gaps.</p><p><strong>Methods: </strong>A systematic search was conducted of 6 medical databases and 12 gray literature sites. Sixteen toolkits published globally before May 2023 were included in our review.</p><p><strong>Results: </strong>The majority of toolkits (n = 12) contained information related to general SRH knowledge and contraception, whereas only 3 contained information on teenage pregnancy. We found that aiming the toolkits toward educators and health care workers was a favorable design over targeting adolescents and young adults directly and that vulnerable youth-including LGBTQI+ (lesbian, gay, bisexual, transgender, queer or questioning, asexual or allied, intersex, and additional identities) and youth from humanitarian settings-were not well represented.</p><p><strong>Conclusion: </strong>We identified key gaps in the inclusion of information in a range of SRH topics, such as LGBTQI+ sexuality, teenage pregnancy, and safe abortion, in the currently available SRH toolkits and their lack of applicability in a global context. Furthermore, we provide recommendations for areas of improvement to encourage adolescents' agency in their SRH education.</p>","PeriodicalId":21813,"journal":{"name":"Sexual medicine reviews","volume":" ","pages":"387-400"},"PeriodicalIF":3.6,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140912663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Seyed Sajjad Tabei, Rhea Kataria, Sean Hou, Armaan Singh, Hasan Al Hameedi, Doaa Hasan, Mike Hsieh, Omer A Raheem
INTRODUCTION Patients with long-term chronic illnesses frequently present with hypogonadism, which is primarily managed through exogenous testosterone. These same patients also experience a high degree of cachexia, a loss of skeletal muscle and adipose tissue. OBJECTIVE To perform a contemporary review of the literature to assess the effectiveness of testosterone replacement therapy (TRT) for managing chronic disease-associated cachexia. METHODS We performed a PubMed literature search using MeSH terms to identify studies from 2000 to 2022 on TRT and the following cachexia-related chronic medical diseases: cancer, COPD, HIV/AIDS, and liver cirrhosis. RESULTS From the literature, 11 primary studies and 1 meta-analysis were selected. Among these studies, 3 evaluated TRT on cancer-associated cachexia, 3 on chronic obstructive pulmonary disease, 4 on HIV and AIDS, and 2 on liver cirrhosis. TRT showed mixed results favoring clinical improvement on each disease. CONCLUSIONS Cachexia is commonly observed in chronic disease states. Its occurrence with hypogonadism, alongside the shared symptoms of these 2 conditions, points toward the management of cachexia through the administration of exogenous testosterone. Robust data in the literature support the use of testosterone in increasing lean body mass, improving energy levels, and enhancing the quality of life for patients with chronic disease. However, the data are variable, and further studies are warranted on the long-term efficacy of TRT in patients with cachexia.
简介：长期慢性病患者经常出现性腺功能减退症，主要通过外源性睾酮进行治疗。目的对当代文献进行回顾，评估睾酮替代疗法（TRT）在控制慢性疾病相关恶病质方面的有效性。方法我们使用 MeSH 术语进行了 PubMed 文献检索，以确定 2000 年至 2022 年期间有关 TRT 和以下与恶病质相关的慢性疾病的研究：癌症、慢性阻塞性肺病、艾滋病毒/艾滋病和肝硬化。其中，3 项研究评估了 TRT 对癌症相关恶病质的治疗效果，3 项研究评估了 TRT 对慢性阻塞性肺病的治疗效果，4 项研究评估了 TRT 对艾滋病的治疗效果，2 项研究评估了 TRT 对肝硬化的治疗效果。TRT对每种疾病的临床改善效果不一。它与性腺功能减退症同时出现，加上这两种疾病的共同症状，表明可以通过施用外源性睾酮来治疗恶病质。大量文献数据支持使用睾酮来增加瘦体重、改善能量水平和提高慢性病患者的生活质量。然而，这些数据并不稳定，因此需要进一步研究 TRT 对恶病质患者的长期疗效。
{"title":"Testosterone replacement therapy in patients with cachexia: a contemporary review of the literature.","authors":"Seyed Sajjad Tabei, Rhea Kataria, Sean Hou, Armaan Singh, Hasan Al Hameedi, Doaa Hasan, Mike Hsieh, Omer A Raheem","doi":"10.1093/sxmrev/qeae031","DOIUrl":"https://doi.org/10.1093/sxmrev/qeae031","url":null,"abstract":"INTRODUCTION\u0000Patients with long-term chronic illnesses frequently present with hypogonadism, which is primarily managed through exogenous testosterone. These same patients also experience a high degree of cachexia, a loss of skeletal muscle and adipose tissue.\u0000\u0000\u0000OBJECTIVE\u0000To perform a contemporary review of the literature to assess the effectiveness of testosterone replacement therapy (TRT) for managing chronic disease-associated cachexia.\u0000\u0000\u0000METHODS\u0000We performed a PubMed literature search using MeSH terms to identify studies from 2000 to 2022 on TRT and the following cachexia-related chronic medical diseases: cancer, COPD, HIV/AIDS, and liver cirrhosis.\u0000\u0000\u0000RESULTS\u0000From the literature, 11 primary studies and 1 meta-analysis were selected. Among these studies, 3 evaluated TRT on cancer-associated cachexia, 3 on chronic obstructive pulmonary disease, 4 on HIV and AIDS, and 2 on liver cirrhosis. TRT showed mixed results favoring clinical improvement on each disease.\u0000\u0000\u0000CONCLUSIONS\u0000Cachexia is commonly observed in chronic disease states. Its occurrence with hypogonadism, alongside the shared symptoms of these 2 conditions, points toward the management of cachexia through the administration of exogenous testosterone. Robust data in the literature support the use of testosterone in increasing lean body mass, improving energy levels, and enhancing the quality of life for patients with chronic disease. However, the data are variable, and further studies are warranted on the long-term efficacy of TRT in patients with cachexia.","PeriodicalId":21813,"journal":{"name":"Sexual medicine reviews","volume":"5 7","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140963315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Perelmuter, Ramzy Burns, Katie Shearer, Raeven Grant, A. Soogoor, Soyoun Jun, Janine Alexis Meurer, Jill Krapf, Rachel Rubin
BACKGROUND The genitourinary syndrome of menopause (GSM) is a well-documented condition characterized by a range of genitourinary symptoms in peri- and postmenopausal women. As with GSM, postpartum lactating women experience reduced estrogen and androgen levels. However, there is limited research on the impact of symptoms during the postpartum breastfeeding period. OBJECTIVES The aim was to review the literature for genitourinary health in the postpartum breastfeeding population and summarize key findings and potential treatments. METHODS We performed a comprehensive literature review in PubMed, Google Scholar, and Scopus from inception of database to November 2023 using the following keywords individually and in combination: "physiology of postpartum" or "physiology of lactogenesis" or "vulvovaginal health" or "vaginal atrophy" or "vaginal dryness" or "dyspareunia" or "urinary incontinence" or "lactation" or "breastfeeding" or "vaginal estrogen." All identified articles published in English were considered. Relevant studies were extracted, evaluated, and analyzed. The work presented in this article represents a summative review of the identified literature. RESULTS During lactation, high levels of prolactin inhibit estrogen and androgen secretion via negative feedback, which leads to an increased prevalence of vulvovaginal atrophy, vaginal dryness, dyspareunia, and urinary incontinence in lactating postpartum women. Despite these highly prevalent and potentially devastating symptoms, there is a lack of consistent screening at postpartum visits and no treatment guidelines available to health care providers. CONCLUSION Postpartum breastfeeding women experience similar physiology and symptoms to the postmenopausal phase, as seen in GSM. We propose the introduction of a novel term to describe the genitourinary changes seen in postpartum breastfeeding individuals: genitourinary syndrome of lactation. The diagnostic use of genitourinary syndrome of lactation will equip health care providers with an all-encompassing term to bring awareness to the symptoms experienced by postpartum breastfeeding individuals and lead to improved screening and treatment for the high numbers of individuals experiencing these genitourinary changes.
{"title":"Genitourinary syndrome of lactation: a new perspective on postpartum and lactation-related genitourinary symptoms.","authors":"S. Perelmuter, Ramzy Burns, Katie Shearer, Raeven Grant, A. Soogoor, Soyoun Jun, Janine Alexis Meurer, Jill Krapf, Rachel Rubin","doi":"10.1093/sxmrev/qeae034","DOIUrl":"https://doi.org/10.1093/sxmrev/qeae034","url":null,"abstract":"BACKGROUND\u0000The genitourinary syndrome of menopause (GSM) is a well-documented condition characterized by a range of genitourinary symptoms in peri- and postmenopausal women. As with GSM, postpartum lactating women experience reduced estrogen and androgen levels. However, there is limited research on the impact of symptoms during the postpartum breastfeeding period.\u0000\u0000\u0000OBJECTIVES\u0000The aim was to review the literature for genitourinary health in the postpartum breastfeeding population and summarize key findings and potential treatments.\u0000\u0000\u0000METHODS\u0000We performed a comprehensive literature review in PubMed, Google Scholar, and Scopus from inception of database to November 2023 using the following keywords individually and in combination: \"physiology of postpartum\" or \"physiology of lactogenesis\" or \"vulvovaginal health\" or \"vaginal atrophy\" or \"vaginal dryness\" or \"dyspareunia\" or \"urinary incontinence\" or \"lactation\" or \"breastfeeding\" or \"vaginal estrogen.\" All identified articles published in English were considered. Relevant studies were extracted, evaluated, and analyzed. The work presented in this article represents a summative review of the identified literature.\u0000\u0000\u0000RESULTS\u0000During lactation, high levels of prolactin inhibit estrogen and androgen secretion via negative feedback, which leads to an increased prevalence of vulvovaginal atrophy, vaginal dryness, dyspareunia, and urinary incontinence in lactating postpartum women. Despite these highly prevalent and potentially devastating symptoms, there is a lack of consistent screening at postpartum visits and no treatment guidelines available to health care providers.\u0000\u0000\u0000CONCLUSION\u0000Postpartum breastfeeding women experience similar physiology and symptoms to the postmenopausal phase, as seen in GSM. We propose the introduction of a novel term to describe the genitourinary changes seen in postpartum breastfeeding individuals: genitourinary syndrome of lactation. The diagnostic use of genitourinary syndrome of lactation will equip health care providers with an all-encompassing term to bring awareness to the symptoms experienced by postpartum breastfeeding individuals and lead to improved screening and treatment for the high numbers of individuals experiencing these genitourinary changes.","PeriodicalId":21813,"journal":{"name":"Sexual medicine reviews","volume":"17 21","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140966680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Matthew Loria, C. Van Dorn, A. Bobrow, Aishwarya Gautam, E. Fraiman, Megan Mcnamara, Shubham Gupta, Kirtishri Mishra
INTRODUCTION For transmasculine spectrum individuals, there is a lack of validated surveys to assess sexual well-being (SWB) post-genital gender-affirming surgery. Currently, either providers are designing their own SWB surveys or surveys designed for cisgender men are being used. OBJECTIVE This study investigated the applicability of SWB surveys validated for cisgender men to transmasculine spectrum individuals post-genital gender-affirming surgery (TMSX). Recognizing the paucity of validated tools for assessing SWB in transmasculine individuals post-genital gender-affirming surgery (TMSX), we evaluated current surveys for their inclusiveness and relevance to this population. METHODS Our methodology involved analyzing surveys validated in English-speaking North American cisgender men. We conducted a systematic review, yielding 31 surveys, out of which 12 met our inclusion criteria. These were then assessed against the 10 domains of holistic SWB as identified by Özer et al. Each survey was scored based on its reflection of these domains, thus generating an SWB score. Additionally, we performed a thematic analysis to identify areas needing modification for better applicability to TMSX. RESULTS Our findings indicate an average SWB score of 5.17 out of 10 across the surveys. The surveys predominantly addressed sexual function, with a marked underrepresentation of domains like quality of life, sexuality, and sexual pleasure. This underscores the tendency of these surveys to focus more on the biological mechanisms of sex, rather than on a nuanced biopsychosocial understanding. Thematic analysis revealed significant gaps, such as the irrelevance of questions about erections and ejaculations for TMSX, and the need for greater emphasis on psychosocial factors. CONCLUSION Given these gaps and the inadequacy of most cisnormative surveys, we recommend the creation of a novel, validated SWB survey specifically for TMSX. This should be developed in collaboration with a multidisciplinary panel and TMSX community advisory board, ensuring a tool that truly reflects the unique SWB needs of this population.
{"title":"Are cisnormative surveys adequate to assess sexual well-being in trans men post-genital gender-affirming surgery?","authors":"Matthew Loria, C. Van Dorn, A. Bobrow, Aishwarya Gautam, E. Fraiman, Megan Mcnamara, Shubham Gupta, Kirtishri Mishra","doi":"10.1093/sxmrev/qeae023","DOIUrl":"https://doi.org/10.1093/sxmrev/qeae023","url":null,"abstract":"INTRODUCTION\u0000For transmasculine spectrum individuals, there is a lack of validated surveys to assess sexual well-being (SWB) post-genital gender-affirming surgery. Currently, either providers are designing their own SWB surveys or surveys designed for cisgender men are being used.\u0000\u0000\u0000OBJECTIVE\u0000This study investigated the applicability of SWB surveys validated for cisgender men to transmasculine spectrum individuals post-genital gender-affirming surgery (TMSX). Recognizing the paucity of validated tools for assessing SWB in transmasculine individuals post-genital gender-affirming surgery (TMSX), we evaluated current surveys for their inclusiveness and relevance to this population.\u0000\u0000\u0000METHODS\u0000Our methodology involved analyzing surveys validated in English-speaking North American cisgender men. We conducted a systematic review, yielding 31 surveys, out of which 12 met our inclusion criteria. These were then assessed against the 10 domains of holistic SWB as identified by Özer et al. Each survey was scored based on its reflection of these domains, thus generating an SWB score. Additionally, we performed a thematic analysis to identify areas needing modification for better applicability to TMSX.\u0000\u0000\u0000RESULTS\u0000Our findings indicate an average SWB score of 5.17 out of 10 across the surveys. The surveys predominantly addressed sexual function, with a marked underrepresentation of domains like quality of life, sexuality, and sexual pleasure. This underscores the tendency of these surveys to focus more on the biological mechanisms of sex, rather than on a nuanced biopsychosocial understanding. Thematic analysis revealed significant gaps, such as the irrelevance of questions about erections and ejaculations for TMSX, and the need for greater emphasis on psychosocial factors.\u0000\u0000\u0000CONCLUSION\u0000Given these gaps and the inadequacy of most cisnormative surveys, we recommend the creation of a novel, validated SWB survey specifically for TMSX. This should be developed in collaboration with a multidisciplinary panel and TMSX community advisory board, ensuring a tool that truly reflects the unique SWB needs of this population.","PeriodicalId":21813,"journal":{"name":"Sexual medicine reviews","volume":"57 10","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140671002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
INTRODUCTION Peyronie's disease (PD) is a common penile disorder characterized by the formation of fibrous noncompliant hard nodules in the tunica albuginea of the penis. Collagenase Clostridium histolyticum (CCH) is an injectable drug that treats PD by enzymatically degrading plaque interstitial collagen. CCH has been used in patients with varying curvature, as well as in the acute and stable phases of the disease, through a variety of treatment regimens and combinations. We carried out a systematic review and meta-analysis to assess the efficacy of CCH combination therapies for PD. METHODS We selected 4 observational comparative studies and 3 randomized controlled trials including 532 participants from the PubMed, Embase, and Cochrane databases (until December 2023) to evaluate the efficacy of CCH combination therapies for PD. The primary outcome was clinical efficacy as evaluated by improvement in penile curvature and penile length, as well as by scores on the Peyronie's Disease Questionnaire (PDQ) for symptom bother, penile pain, and psychological symptoms. Continuous data were represented by mean difference (MD) and 95% CI. All data were analyzed by Review Manager version 5.3. RESULTS For penile length (MD, 0.81 cm; 95% CI, 0.17-1.45; P = .01), PDQ symptom bother (MD, -1.02; 95% CI, -1.83 to -0.21; P = .01), and PDQ penile pain (MD, -0.93; 95% CI, -1.50 to -0.36; P = .001), CCH combination therapy showed significantly greater improvements vs CCH monotherapy. However, in the other indicators, penile curvature and PDQ psychological symptoms, there was no significant difference between the therapies. CONCLUSION This meta-analysis supports that CCH combination therapies can partially increase penile length and ameliorate symptom bother and penile pain to some extent. However, CCH combination therapies still need to be evaluated through more high-quality research.
{"title":"Efficacy of collagenase Clostridium histolyticum combination therapies for Peyronie's disease: a systematic review and meta-analysis.","authors":"Yicheng Guo, Yingying Yang, Qiancheng Mao, Hongquan Liu, Tianqi Wang, Fengze Sun, Jitao Wu, Yuanshan Cui","doi":"10.1093/sxmrev/qeae025","DOIUrl":"https://doi.org/10.1093/sxmrev/qeae025","url":null,"abstract":"INTRODUCTION\u0000Peyronie's disease (PD) is a common penile disorder characterized by the formation of fibrous noncompliant hard nodules in the tunica albuginea of the penis. Collagenase Clostridium histolyticum (CCH) is an injectable drug that treats PD by enzymatically degrading plaque interstitial collagen. CCH has been used in patients with varying curvature, as well as in the acute and stable phases of the disease, through a variety of treatment regimens and combinations. We carried out a systematic review and meta-analysis to assess the efficacy of CCH combination therapies for PD.\u0000\u0000\u0000METHODS\u0000We selected 4 observational comparative studies and 3 randomized controlled trials including 532 participants from the PubMed, Embase, and Cochrane databases (until December 2023) to evaluate the efficacy of CCH combination therapies for PD. The primary outcome was clinical efficacy as evaluated by improvement in penile curvature and penile length, as well as by scores on the Peyronie's Disease Questionnaire (PDQ) for symptom bother, penile pain, and psychological symptoms. Continuous data were represented by mean difference (MD) and 95% CI. All data were analyzed by Review Manager version 5.3.\u0000\u0000\u0000RESULTS\u0000For penile length (MD, 0.81 cm; 95% CI, 0.17-1.45; P = .01), PDQ symptom bother (MD, -1.02; 95% CI, -1.83 to -0.21; P = .01), and PDQ penile pain (MD, -0.93; 95% CI, -1.50 to -0.36; P = .001), CCH combination therapy showed significantly greater improvements vs CCH monotherapy. However, in the other indicators, penile curvature and PDQ psychological symptoms, there was no significant difference between the therapies.\u0000\u0000\u0000CONCLUSION\u0000This meta-analysis supports that CCH combination therapies can partially increase penile length and ameliorate symptom bother and penile pain to some extent. However, CCH combination therapies still need to be evaluated through more high-quality research.","PeriodicalId":21813,"journal":{"name":"Sexual medicine reviews","volume":"07 5","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140676543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hartmut Porst, Ronald Lewis, Ronald Virag, Irwin Goldstein
INTRODUCTION Although oral phosphodiesterase 5 inhibitors represent a first choice and long-term option for about half of all patients with erectile dysfunction (ED), self-injection therapy with vasoactive drugs remains a viable alternative for all those who are not reacting or cannot tolerate oral drug therapy. This current injection therapy has an interesting history beginning in 1982. OBJECTIVES To provide a comprehensive history of self-injection therapy from the very beginnings in 1982 by contemporary witnesses and some members of the International Society for Sexual Medicine's History Committee, a complete history of injection therapy is prepared from eyewitness accounts and review of the published literature on the subject, as well as an update of the current status of self-injection therapy. METHODS Published data on injection therapy, as a diagnostic and therapeutic tool for ED, were reviewed thoroughly by PubMed and Medline research from 1982 until June 2023. Early pioneers and witnesses added firsthand details to this historical review. Therapeutic reports of injection therapy were reviewed, and results of side effects and complications were thoroughly reviewed. RESULTS The pioneers of the first hours were Ronal Virag (1982) for papaverine, Giles Brindley (1983) for cavernosal alpha-blockade (phentolamine and phenoxybenzamine), Adrian Zorgniotti (1985) for papaverine/phentolamine, and Ganesan Adaikan and N. Ishii (1986) for prostaglandin E1. Moxisylyte (thymoxamine) was originally marketed but later withdrawn. The most common side effect is priapism, with the greatest risk of this from papaverine, which has modified its use for therapy. Currently, prostaglandin E1 and trimixes continue to be the agents of choice for diagnostic and therapeutic use in ED. A recent agent is a mixture of a vasoactive intestinal polypeptide (aviptadil) and phentolamine. CONCLUSIONS After 40 years, self-injection therapy represents the medication with the highest efficacy and reliability rates and remains a viable option for many couples with ED. The history of this therapy is rich.
简介尽管口服磷酸二酯酶 5 抑制剂是约半数勃起功能障碍（ED）患者的首选和长期治疗方案，但对于所有对口服药物治疗无反应或无法耐受口服药物治疗的患者来说，血管活性药物自我注射疗法仍然是一种可行的替代疗法。为了全面介绍自我注射疗法从 1982 年开始的历史，当代见证人和国际性医学会历史委员会的一些成员根据目击者的描述和已发表的相关文献编写了完整的注射疗法历史，并对自我注射疗法的现状进行了更新。早期的先驱者和见证者为这一历史回顾提供了第一手细节。结果最初几个小时的先驱者分别是：Ronal Virag（1982 年）治疗罂粟碱；Giles Brindley（1983 年）治疗海绵体α-受体阻滞剂（酚妥拉明和酚氧苄胺）；Adrian Zorgniotti（1985 年）治疗罂粟碱/酚妥拉明；Ganesan Adaikan 和 N. Ishii（1986 年）治疗前列腺素 E1。Moxisylyte（胸腺氧胺）最初在市场上销售，但后来撤消了。最常见的副作用是前列腺增生，其中最大的风险来自罂粟碱，这也改变了罂粟碱的治疗用途。目前，前列腺素 E1 和三羟色胺仍是诊断和治疗 ED 的首选药物。结论经过 40 年的发展，自我注射疗法是疗效和可靠率最高的药物，仍然是许多 ED 患者的可行选择。这种疗法的历史悠久。
{"title":"A comprehensive history of injection therapy for erectile dysfunction, 1982-2023.","authors":"Hartmut Porst, Ronald Lewis, Ronald Virag, Irwin Goldstein","doi":"10.1093/sxmrev/qeae020","DOIUrl":"https://doi.org/10.1093/sxmrev/qeae020","url":null,"abstract":"INTRODUCTION\u0000Although oral phosphodiesterase 5 inhibitors represent a first choice and long-term option for about half of all patients with erectile dysfunction (ED), self-injection therapy with vasoactive drugs remains a viable alternative for all those who are not reacting or cannot tolerate oral drug therapy. This current injection therapy has an interesting history beginning in 1982.\u0000\u0000\u0000OBJECTIVES\u0000To provide a comprehensive history of self-injection therapy from the very beginnings in 1982 by contemporary witnesses and some members of the International Society for Sexual Medicine's History Committee, a complete history of injection therapy is prepared from eyewitness accounts and review of the published literature on the subject, as well as an update of the current status of self-injection therapy.\u0000\u0000\u0000METHODS\u0000Published data on injection therapy, as a diagnostic and therapeutic tool for ED, were reviewed thoroughly by PubMed and Medline research from 1982 until June 2023. Early pioneers and witnesses added firsthand details to this historical review. Therapeutic reports of injection therapy were reviewed, and results of side effects and complications were thoroughly reviewed.\u0000\u0000\u0000RESULTS\u0000The pioneers of the first hours were Ronal Virag (1982) for papaverine, Giles Brindley (1983) for cavernosal alpha-blockade (phentolamine and phenoxybenzamine), Adrian Zorgniotti (1985) for papaverine/phentolamine, and Ganesan Adaikan and N. Ishii (1986) for prostaglandin E1. Moxisylyte (thymoxamine) was originally marketed but later withdrawn. The most common side effect is priapism, with the greatest risk of this from papaverine, which has modified its use for therapy. Currently, prostaglandin E1 and trimixes continue to be the agents of choice for diagnostic and therapeutic use in ED. A recent agent is a mixture of a vasoactive intestinal polypeptide (aviptadil) and phentolamine.\u0000\u0000\u0000CONCLUSIONS\u0000After 40 years, self-injection therapy represents the medication with the highest efficacy and reliability rates and remains a viable option for many couples with ED. The history of this therapy is rich.","PeriodicalId":21813,"journal":{"name":"Sexual medicine reviews","volume":"104 32","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140679006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Erectile dysfunction (ED) is one of the most common male sexual dysfunctions and is related to many pathogenic factors. However, first-line treatment, represented by phosphodiesterase 5 inhibitors, is unable to maintain long-term efficacy. Extracellular vesicles (EVs) have recently attracted the attention of researchers in the fields of cardiovascular disease, neurologic disease, and regenerative medicine and may become a treatment for ED. This article reviews recent applications of EVs in the treatment of ED from the aspects of the source, the therapeutic mechanism, and the strategies to enhance therapeutic efficacy. These research advances lay the foundation for further research and provide references for in-depth understanding of the therapeutic mechanism and possible clinical application of EVs in ED.
勃起功能障碍（ED）是最常见的男性性功能障碍之一，与许多致病因素有关。然而，以磷酸二酯酶 5 抑制剂为代表的一线治疗无法维持长期疗效。最近，细胞外囊泡（EVs）引起了心血管疾病、神经系统疾病和再生医学领域研究人员的关注，并有可能成为治疗 ED 的一种方法。本文从EVs的来源、治疗机制和提高疗效的策略等方面综述了EVs在ED治疗中的最新应用。这些研究进展为进一步的研究奠定了基础，并为深入了解EVs在ED中的治疗机制和可能的临床应用提供了参考。
{"title":"Research progress on the therapeutic application of extracellular vesicles in erectile dysfunction.","authors":"Xiaolin Zhang, Mengbo Yang, Xinda Chen, Mujun Lu","doi":"10.1093/sxmrev/qeae022","DOIUrl":"https://doi.org/10.1093/sxmrev/qeae022","url":null,"abstract":"Erectile dysfunction (ED) is one of the most common male sexual dysfunctions and is related to many pathogenic factors. However, first-line treatment, represented by phosphodiesterase 5 inhibitors, is unable to maintain long-term efficacy. Extracellular vesicles (EVs) have recently attracted the attention of researchers in the fields of cardiovascular disease, neurologic disease, and regenerative medicine and may become a treatment for ED. This article reviews recent applications of EVs in the treatment of ED from the aspects of the source, the therapeutic mechanism, and the strategies to enhance therapeutic efficacy. These research advances lay the foundation for further research and provide references for in-depth understanding of the therapeutic mechanism and possible clinical application of EVs in ED.","PeriodicalId":21813,"journal":{"name":"Sexual medicine reviews","volume":"21 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140693839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
INTRODUCTION The penis serves as a vital receptor in men, playing a significant role in sexual intercourse. While there are discernible disparities between the glans penis and the penile shaft, a comprehensive and detailed analysis of these distinctions is currently lacking. OBJECTIVES This study aimed to review the existing literature on the variances between the glans penis and the penile shaft, providing a systematic examination of their anatomical and histological dissimilarities. METHODS Our investigation encompassed a thorough search of the published literature, including original articles, reviews, letters to the editor, and case reports focused on the penis. We conducted a comprehensive review of the anatomical and histological dissimilarities between the glans penis and the penile shaft. RESULTS The following key differences were identified. First, regarding innervation, the glans penis and the penile shaft possess distinct neural pathways. The glans penis exhibits a 3-dimensional structure, while the penile shaft exhibits a 2-dimensional distribution. Notably, the nerves of the penile shaft extend penetrating branches into the corpus cavernosum. Furthermore, there are variations in nerve-specific antibodies between the 2 regions. Second, regarding composition, the glans penis and the penile shaft consist of dissimilar cavernous bodies. The glans penis contains unique epithelial structures and receptors, setting it apart from the penile shaft. Third, regarding the veins, there are disparities in the venous systems of the glans penis and the penile shaft. Fourth, regarding biothesiometry, variances in biothesiometry research have been observed between the 2 regions. CONCLUSION There are differences between the glans and the shaft. To further advance our understanding, future research should delve deeper into the discrepancies between the glans penis and the penile shaft. Additionally, a more specialized subdivision of the glans penis and the penile shaft would facilitate more precise and tailored treatments.
{"title":"Differences between the glans and shaft of the penis: a review.","authors":"Letian Wei, Lei Zheng, Hui Jiang, T. Jiang","doi":"10.1093/sxmrev/qeae019","DOIUrl":"https://doi.org/10.1093/sxmrev/qeae019","url":null,"abstract":"INTRODUCTION\u0000The penis serves as a vital receptor in men, playing a significant role in sexual intercourse. While there are discernible disparities between the glans penis and the penile shaft, a comprehensive and detailed analysis of these distinctions is currently lacking.\u0000\u0000\u0000OBJECTIVES\u0000This study aimed to review the existing literature on the variances between the glans penis and the penile shaft, providing a systematic examination of their anatomical and histological dissimilarities.\u0000\u0000\u0000METHODS\u0000Our investigation encompassed a thorough search of the published literature, including original articles, reviews, letters to the editor, and case reports focused on the penis. We conducted a comprehensive review of the anatomical and histological dissimilarities between the glans penis and the penile shaft.\u0000\u0000\u0000RESULTS\u0000The following key differences were identified. First, regarding innervation, the glans penis and the penile shaft possess distinct neural pathways. The glans penis exhibits a 3-dimensional structure, while the penile shaft exhibits a 2-dimensional distribution. Notably, the nerves of the penile shaft extend penetrating branches into the corpus cavernosum. Furthermore, there are variations in nerve-specific antibodies between the 2 regions. Second, regarding composition, the glans penis and the penile shaft consist of dissimilar cavernous bodies. The glans penis contains unique epithelial structures and receptors, setting it apart from the penile shaft. Third, regarding the veins, there are disparities in the venous systems of the glans penis and the penile shaft. Fourth, regarding biothesiometry, variances in biothesiometry research have been observed between the 2 regions.\u0000\u0000\u0000CONCLUSION\u0000There are differences between the glans and the shaft. To further advance our understanding, future research should delve deeper into the discrepancies between the glans penis and the penile shaft. Additionally, a more specialized subdivision of the glans penis and the penile shaft would facilitate more precise and tailored treatments.","PeriodicalId":21813,"journal":{"name":"Sexual medicine reviews","volume":"337 2","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140719474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
F. Barbagallo, R. Cannarella, R. Condorelli, L. Cucinella, S. La Vignera, R. E. Nappi, A. E. Calogero
INTRODUCTION Female sexual dysfunctions (FSDs) have received little attention in the context of thyroid diseases, despite the high prevalence of both conditions. OBJECTIVES This review aims to update and summarize the state of knowledge on the association between thyroid diseases and FSDs and to investigate the complex mechanisms through which thyroid hormone imbalance can impact female sexual health in the context of the biopsychosocial model. METHODS A comprehensive literature search was performed through the PubMed, MEDLINE, and Scopus databases, using the following keywords: "female sexual function," "sexual dysfunction," "hypoactive sexual desire disorder," "thyroid disease," "thyroiditis," "hypothyroidism," and "hyperthyroidism." RESULTS To date, well-designed studies that describe the relationship between FSDs and thyroid disorders are lacking. However, despite the limitations on available studies, current data indicate that sexual alterations are frequently associated with thyroid diseases in women. A complex interplay of direct and indirect hormonal and nonhormonal mechanisms has been hypothesized, including hormonal changes, neurotransmitter imbalance, reduced nitric oxide release, mood disorders, and other systemic consequences of both hypothyroidism and hyperthyroidism. Thyroid hormone receptors have also been identified in the genitourinary system. CONCLUSIONS In a clinical setting, physicians should investigate the sexuality of patients consulting for thyroid disease. At the same time, an evaluation of thyroid function should be performed in patients presenting with FSD, especially after menopause, when the risk of thyroid diseases and FSDs increases strongly.
{"title":"Thyroid diseases and female sexual dysfunctions.","authors":"F. Barbagallo, R. Cannarella, R. Condorelli, L. Cucinella, S. La Vignera, R. E. Nappi, A. E. Calogero","doi":"10.1093/sxmrev/qeae021","DOIUrl":"https://doi.org/10.1093/sxmrev/qeae021","url":null,"abstract":"INTRODUCTION\u0000Female sexual dysfunctions (FSDs) have received little attention in the context of thyroid diseases, despite the high prevalence of both conditions.\u0000\u0000\u0000OBJECTIVES\u0000This review aims to update and summarize the state of knowledge on the association between thyroid diseases and FSDs and to investigate the complex mechanisms through which thyroid hormone imbalance can impact female sexual health in the context of the biopsychosocial model.\u0000\u0000\u0000METHODS\u0000A comprehensive literature search was performed through the PubMed, MEDLINE, and Scopus databases, using the following keywords: \"female sexual function,\" \"sexual dysfunction,\" \"hypoactive sexual desire disorder,\" \"thyroid disease,\" \"thyroiditis,\" \"hypothyroidism,\" and \"hyperthyroidism.\"\u0000\u0000\u0000RESULTS\u0000To date, well-designed studies that describe the relationship between FSDs and thyroid disorders are lacking. However, despite the limitations on available studies, current data indicate that sexual alterations are frequently associated with thyroid diseases in women. A complex interplay of direct and indirect hormonal and nonhormonal mechanisms has been hypothesized, including hormonal changes, neurotransmitter imbalance, reduced nitric oxide release, mood disorders, and other systemic consequences of both hypothyroidism and hyperthyroidism. Thyroid hormone receptors have also been identified in the genitourinary system.\u0000\u0000\u0000CONCLUSIONS\u0000In a clinical setting, physicians should investigate the sexuality of patients consulting for thyroid disease. At the same time, an evaluation of thyroid function should be performed in patients presenting with FSD, especially after menopause, when the risk of thyroid diseases and FSDs increases strongly.","PeriodicalId":21813,"journal":{"name":"Sexual medicine reviews","volume":"90 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140718028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mostafa Deabes, Mohammad Ghassab Deameh, Baha' Aldeen Bani Irshid, Ali Hasan Al Darraji, Ibrahim Serag, Nereen A Almosilhy, Ahmed Dwidar, Mohamed A Aldemerdash, Hatim Nasruldin Shahin
INTRODUCTION Platelet-rich plasma (PRP) is rich in factors that play a role in stem cell recruitment, inflammation modulation, and angiogenesis. With numerous preclinical and clinical studies exploring PRP as a potential treatment for erectile dysfunction (ED), this study focused on assessing the effectiveness of intracorporeal PRP injection for ED patients based on randomized controlled trials (RCTs). OBJECTIVES The study sought to evaluate the efficacy and safety of intracorporeal injection of PRP in treating ED through a systematic review and meta-analysis of RCTs. METHODS This study adhered to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. A comprehensive search was conducted on online databases (PubMed, Scopus, and ScienceDirect) to identify RCTs comparing PRP with a placebo for ED treatment. The primary outcomes assessed were the proportion of patients achieving the minimal clinically important difference in the International Index of Erectile Function (IIEF) domain and the change in the IIEF domain from baseline. The results were combined as a standardized mean difference between the PRP and placebo groups. RESULTS Three RCTs comprising 230 patients were included. The overall effect favored PRP over placebo: total patients attaining minimal clinically important difference in the IIEF domain (odds ratio [OR], 5.64; 95% confidence interval [CI], 2.05 to 15.55; P = .0008), IIEF change from baseline (mean difference [MD], 2.99; 95% CI, 1.74 to 4.24; P = .00001), PSV (MD, 9.34; 95% CI, 0.84 to 17.84; P = .03), end-diastolic volume (standardized MD, 0.50; 95% CI, 0.17 to 0.83; P = .003), Sexual Encounter Profile question 3 (standardized MD, 0.78; 95% CI, 0.45 to 1.12; P = .00001), and visual analog scale score (MD, -0.30; 95% CI, -0.53 to -0.08; P = .008). CONCLUSION PRP appears to be a safe and effective treatment for mild-to-moderate ED. However, further support from high-quality RCTs is needed to strengthen these findings.
{"title":"Evaluating the efficacy and safety of platelet-rich plasma injection for erectile dysfunction: a systematic review and meta-analysis of randomized controlled trials.","authors":"Mostafa Deabes, Mohammad Ghassab Deameh, Baha' Aldeen Bani Irshid, Ali Hasan Al Darraji, Ibrahim Serag, Nereen A Almosilhy, Ahmed Dwidar, Mohamed A Aldemerdash, Hatim Nasruldin Shahin","doi":"10.1093/sxmrev/qeae018","DOIUrl":"https://doi.org/10.1093/sxmrev/qeae018","url":null,"abstract":"INTRODUCTION\u0000Platelet-rich plasma (PRP) is rich in factors that play a role in stem cell recruitment, inflammation modulation, and angiogenesis. With numerous preclinical and clinical studies exploring PRP as a potential treatment for erectile dysfunction (ED), this study focused on assessing the effectiveness of intracorporeal PRP injection for ED patients based on randomized controlled trials (RCTs).\u0000\u0000\u0000OBJECTIVES\u0000The study sought to evaluate the efficacy and safety of intracorporeal injection of PRP in treating ED through a systematic review and meta-analysis of RCTs.\u0000\u0000\u0000METHODS\u0000This study adhered to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. A comprehensive search was conducted on online databases (PubMed, Scopus, and ScienceDirect) to identify RCTs comparing PRP with a placebo for ED treatment. The primary outcomes assessed were the proportion of patients achieving the minimal clinically important difference in the International Index of Erectile Function (IIEF) domain and the change in the IIEF domain from baseline. The results were combined as a standardized mean difference between the PRP and placebo groups.\u0000\u0000\u0000RESULTS\u0000Three RCTs comprising 230 patients were included. The overall effect favored PRP over placebo: total patients attaining minimal clinically important difference in the IIEF domain (odds ratio [OR], 5.64; 95% confidence interval [CI], 2.05 to 15.55; P = .0008), IIEF change from baseline (mean difference [MD], 2.99; 95% CI, 1.74 to 4.24; P = .00001), PSV (MD, 9.34; 95% CI, 0.84 to 17.84; P = .03), end-diastolic volume (standardized MD, 0.50; 95% CI, 0.17 to 0.83; P = .003), Sexual Encounter Profile question 3 (standardized MD, 0.78; 95% CI, 0.45 to 1.12; P = .00001), and visual analog scale score (MD, -0.30; 95% CI, -0.53 to -0.08; P = .008).\u0000\u0000\u0000CONCLUSION\u0000PRP appears to be a safe and effective treatment for mild-to-moderate ED. However, further support from high-quality RCTs is needed to strengthen these findings.","PeriodicalId":21813,"journal":{"name":"Sexual medicine reviews","volume":"29 S1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140732366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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