Pub Date : 2024-03-01DOI: 10.1093/jsxmed/qdae002.226
O. Kaabia, A. Belkahla
Cervical cancer is the fourth cancer in women. Its incidence is particularly high in developing countries. The increase in cases among young women in low- and middle-income countries may be due to changes in sexual behaviors and an increased risk of HPV infection and the absence of vaccination programs. The mortality and morbidity rates of cervical cancer are very high if diagnosed at an advanced stage. It is a preventable Human Papilloma Virus (HPV) related cancer. Cervical cancer patients are often stigmatized because of the idea that this cancer is associated with early-onset sexuality. Furthermore, the treatments for such cancer are mutilating for women often causing definitive infertility and sexual and/or couple dysfunctions. This study aims to describe the changes in sexuality and fertility among young women diagnosed and treated for cervical cancer It is a monocentric cross-sectional study based on a phone survey. We included and contacted all young women (under 40) when they were diagnosed with and/or treated for cervical cancer in our institution for 11 years from January 2010 to December 2020. We excluded all patients with a history of chronic disease other than cervical cancer. The study took place from January To May 2022. We developed an 8-item questionnaire in the local dialect and used the validated translation of the Female Sexual Function Index (FSFI) to evaluate the participants' sexual function. We included 23 cases of cervical cancer in young women, i.e. a response rate of 4.6%. The average age of our sample was 34.7 years (±4.7). The median age of first sexual intercourse was 21.5 years [20–25.25]. The abortion rate was 2 [0.25–2.75] per participant. The median age of the first pregnancy was 21 years [21–27]. The most common symptom leading to the cancer diagnosis was post-coital metrorrhagia in 12 (52.2%) of cases. The first Pap smear led to a cervical cancer diagnosis in 13 cases (56.5%). Five patients had a tumor size ≤ 40 mm and 4 patients were metastatic at the time of the diagnosis. Eighteen patients underwent surgical treatment of whom 5 had a fertility-sparing technique. All patients got radiation. The average duration of follow-up was 5.72 years ±0.3.247. The average survival is 9.7 years (±0.9 years; 95% CI 7.9 – 11.5 years). The 3-year survival rate is 82.6%, and the 5-year survival rate is 82.6%. Five patients expressed a desire for pregnancy after the treatment, one got pregnant after 5 years. Five patients expressed that there was an impact on their sexuality after the treatment with sexual disorders with pain, in particular dyspareunia and vulvodynia, and a decrease in female desire associated with a guilty feeling. All patients had pathological FSFI scores regarding all the domains of female sexual function Sexuality and fertility are taboo among young cervical cancer survivors. The sexual stigma of cervical cancer as a sexually transmitted disease is present in our populatio
{"title":"(263) Sexuality and Fertility among Young Women Treated for Cervical Cancer","authors":"O. Kaabia, A. Belkahla","doi":"10.1093/jsxmed/qdae002.226","DOIUrl":"https://doi.org/10.1093/jsxmed/qdae002.226","url":null,"abstract":"\u0000 \u0000 \u0000 Cervical cancer is the fourth cancer in women. Its incidence is particularly high in developing countries. The increase in cases among young women in low- and middle-income countries may be due to changes in sexual behaviors and an increased risk of HPV infection and the absence of vaccination programs. The mortality and morbidity rates of cervical cancer are very high if diagnosed at an advanced stage. It is a preventable Human Papilloma Virus (HPV) related cancer. Cervical cancer patients are often stigmatized because of the idea that this cancer is associated with early-onset sexuality. Furthermore, the treatments for such cancer are mutilating for women often causing definitive infertility and sexual and/or couple dysfunctions.\u0000 \u0000 \u0000 \u0000 This study aims to describe the changes in sexuality and fertility among young women diagnosed and treated for cervical cancer\u0000 \u0000 \u0000 \u0000 It is a monocentric cross-sectional study based on a phone survey. We included and contacted all young women (under 40) when they were diagnosed with and/or treated for cervical cancer in our institution for 11 years from January 2010 to December 2020. We excluded all patients with a history of chronic disease other than cervical cancer. The study took place from January To May 2022. We developed an 8-item questionnaire in the local dialect and used the validated translation of the Female Sexual Function Index (FSFI) to evaluate the participants' sexual function.\u0000 \u0000 \u0000 \u0000 We included 23 cases of cervical cancer in young women, i.e. a response rate of 4.6%. The average age of our sample was 34.7 years (±4.7). The median age of first sexual intercourse was 21.5 years [20–25.25]. The abortion rate was 2 [0.25–2.75] per participant. The median age of the first pregnancy was 21 years [21–27]. The most common symptom leading to the cancer diagnosis was post-coital metrorrhagia in 12 (52.2%) of cases. The first Pap smear led to a cervical cancer diagnosis in 13 cases (56.5%). Five patients had a tumor size ≤ 40 mm and 4 patients were metastatic at the time of the diagnosis. Eighteen patients underwent surgical treatment of whom 5 had a fertility-sparing technique. All patients got radiation. The average duration of follow-up was 5.72 years ±0.3.247. The average survival is 9.7 years (±0.9 years; 95% CI 7.9 – 11.5 years). The 3-year survival rate is 82.6%, and the 5-year survival rate is 82.6%. Five patients expressed a desire for pregnancy after the treatment, one got pregnant after 5 years. Five patients expressed that there was an impact on their sexuality after the treatment with sexual disorders with pain, in particular dyspareunia and vulvodynia, and a decrease in female desire associated with a guilty feeling. All patients had pathological FSFI scores regarding all the domains of female sexual function\u0000 \u0000 \u0000 \u0000 Sexuality and fertility are taboo among young cervical cancer survivors. The sexual stigma of cervical cancer as a sexually transmitted disease is present in our populatio","PeriodicalId":377411,"journal":{"name":"The Journal of Sexual Medicine","volume":"128 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140279025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01DOI: 10.1093/jsxmed/qdae002.180
A. Ammar, A. E. El-Mohamady, H. Abdo, A. El-Shahid
Semen analysis is an essential component of infertility evaluation, but it may still fail to detect subtle sperm defects present in patients with male factor infertility. Although estimates vary, approximately 15% of patients with male factor infertility have normal spermiograms It is necessary to identify diagnostic measures for male infertility that are easy to perform, inexpensive, and provide an accurate diagnosis. Tests that assess sperm quality should not only identify the ability of spermatozoa to reach the oocyte but also their ability to fertilize the oocyte and activate embryo growth. The estimation of sperm DNA damage fills the above need in the diagnosis of male infertility Abnormalities in the male genome characterized by damaged sperm DNA may be indicative for male subfertility regardless of routine semen parameters, and these parameters do not reveal sperm DNA defects Men with normal semen analysis may also have a high degree of DNA fragmentation, which can be a major cause of undiagnosed/unexplained infertility. Sperm DNA fragmentation may result from aberrant chromatin packaging during spermatogenesis, defective apoptosis before ejaculation or excessive production of reactive oxygen species (ROS) in the ejaculate. To study the impact of cigarette smoking on sperm chromatin integrity in infertile patients. The present study included eighty infertile male patients recruited from the Andrology Outpatient Clinic at Al-Azhar University Hospitals The patients were divided into two groups: - Group I: forty nonsmoker infertile males. (Control Group). Group II: forty cigarette smoker infertile males. (Study Group) The current study revealed that smoking increases the abnormality of sperm chromatin integrity in sperms of smokers. This is evident by the positive correlation of increased head stainability of sperms in smokers compared to nonsmokers. The value of partially stained sperm heads using aniline blue is calculated from the total staining score formula, this score was found to increase significantly among smokers in comparison to nonsmokers. In the present study, the increased severity of smoking (smoking index), was not correlated with the degree of sperm head stainability. This mean that, smoking insult on sperm chromatin integrity is crucial regardless the duration or the amount of the consumed cigarettes There is a significant increase of sperm chromatin damage in smoker infertile patients than nonsmoker infertile patients and these damages may affect the quality of the ejaculated spermatozoa and decrease their fertility potential. Not only semen parameters but also sperm chromatin condensation is affected significantly by smoking. Aniline blue staining is an effective and inexpensive tool for assessment of the fertilization potentiality of infertile patients. A significant correlation was found between the percentage of spermatozoa with normal sperm chromatin condensation and normal morphology.
精液分析是不育症评估的重要组成部分，但仍可能无法检测出男性因素不育患者精子中存在的细微缺陷。因此，有必要确定易于操作、价格低廉并能提供准确诊断的男性不育诊断方法。评估精子质量的试验不仅要确定精子到达卵母细胞的能力，还要确定精子使卵母细胞受精和激活胚胎生长的能力。精子 DNA 损伤的评估满足了上述诊断男性不育症的需要。 无论精液常规参数如何，以精子 DNA 损伤为特征的男性基因组异常都可能是男性不育症的指征，而这些参数并不能揭示精子 DNA 缺陷。 精液分析正常的男性也可能存在高度的 DNA 碎片，这可能是导致无法诊断/无法解释的不育症的主要原因。精子DNA碎片可能是由于精子发生过程中染色质包装异常、射精前凋亡缺陷或射精中活性氧（ROS）产生过多造成的。 为了研究吸烟对不育患者精子染色质完整性的影响。 本研究纳入了从爱资哈尔大学医院（Al-Azhar University Hospitals）雄性学门诊部招募的 80 名不育男性患者，将患者分为两组： - 第一组：40 名不吸烟的不育男性（对照组）。(对照组）。第二组：40 名吸烟的不育男性（研究组）。(目前的研究表明，吸烟会增加吸烟者精子染色质完整性的异常。与不吸烟者相比，吸烟者精子头部染色性增加的正相关性证明了这一点。使用苯胺蓝对精子头部进行部分染色的数值是通过染色总分公式计算得出的，与非吸烟者相比，吸烟者的染色总分明显增加。在本研究中，吸烟严重程度（吸烟指数）的增加与精子头部染色程度无关。这意味着，无论吸烟时间长短或数量多少，吸烟对精子染色质完整性的影响都是至关重要的。与不吸烟的不育患者相比，吸烟不育患者的精子染色质损伤显著增加，这些损伤可能会影响射出精子的质量并降低其生育潜力。吸烟不仅会影响精液参数，还会严重影响精子染色质的凝集。苯胺蓝染色法是评估不育患者受精潜能的一种有效而廉价的工具。研究发现，精子染色质凝集正常的精子比例与形态正常的精子比例之间存在明显的相关性。吸烟可能会对精子质量和DNA完整性产生负面影响。因此，男性最好戒烟，以免生育能力下降。 不
{"title":"(203) Impact of Smoking on Sperm Chromatin Integrity","authors":"A. Ammar, A. E. El-Mohamady, H. Abdo, A. El-Shahid","doi":"10.1093/jsxmed/qdae002.180","DOIUrl":"https://doi.org/10.1093/jsxmed/qdae002.180","url":null,"abstract":"\u0000 \u0000 \u0000 Semen analysis is an essential component of infertility evaluation, but it may still fail to detect subtle sperm defects present in patients with male factor infertility. Although estimates vary, approximately 15% of patients with male factor infertility have normal spermiograms It is necessary to identify diagnostic measures for male infertility that are easy to perform, inexpensive, and provide an accurate diagnosis. Tests that assess sperm quality should not only identify the ability of spermatozoa to reach the oocyte but also their ability to fertilize the oocyte and activate embryo growth. The estimation of sperm DNA damage fills the above need in the diagnosis of male infertility Abnormalities in the male genome characterized by damaged sperm DNA may be indicative for male subfertility regardless of routine semen parameters, and these parameters do not reveal sperm DNA defects Men with normal semen analysis may also have a high degree of DNA fragmentation, which can be a major cause of undiagnosed/unexplained infertility. Sperm DNA fragmentation may result from aberrant chromatin packaging during spermatogenesis, defective apoptosis before ejaculation or excessive production of reactive oxygen species (ROS) in the ejaculate.\u0000 \u0000 \u0000 \u0000 To study the impact of cigarette smoking on sperm chromatin integrity in infertile patients.\u0000 \u0000 \u0000 \u0000 The present study included eighty infertile male patients recruited from the Andrology Outpatient Clinic at Al-Azhar University Hospitals The patients were divided into two groups: - Group I: forty nonsmoker infertile males. (Control Group). Group II: forty cigarette smoker infertile males. (Study Group)\u0000 \u0000 \u0000 \u0000 The current study revealed that smoking increases the abnormality of sperm chromatin integrity in sperms of smokers. This is evident by the positive correlation of increased head stainability of sperms in smokers compared to nonsmokers. The value of partially stained sperm heads using aniline blue is calculated from the total staining score formula, this score was found to increase significantly among smokers in comparison to nonsmokers. In the present study, the increased severity of smoking (smoking index), was not correlated with the degree of sperm head stainability. This mean that, smoking insult on sperm chromatin integrity is crucial regardless the duration or the amount of the consumed cigarettes\u0000 \u0000 \u0000 \u0000 There is a significant increase of sperm chromatin damage in smoker infertile patients than nonsmoker infertile patients and these damages may affect the quality of the ejaculated spermatozoa and decrease their fertility potential. Not only semen parameters but also sperm chromatin condensation is affected significantly by smoking. Aniline blue staining is an effective and inexpensive tool for assessment of the fertilization potentiality of infertile patients. A significant correlation was found between the percentage of spermatozoa with normal sperm chromatin condensation and normal morphology.","PeriodicalId":377411,"journal":{"name":"The Journal of Sexual Medicine","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140084183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01DOI: 10.1093/jsxmed/qdae002.038
P. M. Pascoal, T. Forte, A. A. Manão, A. A. Manão, S. A. Carvalho
Transgender people’s health and healthcare have become one of the most important challenges in healthcare settings and policy making. The perspectives of transgender consumers are important to inform policymaking and the development of measures to diminish barriers to accessing and maintaining health care. However, the perspective of healthcare providers, namely clinicians, is less known and is important to take a comprehensive and collaborative stance to deliver the best healthcare. To highlight the perspective of sexual medicine practitioners/sexologists involved in transgender healthcare on the challenges faced in providing transgender healthcare. Following an initiative by the Portuguese Society for Clinical Sexology, we used a participatory research design involving experienced sexual medicine clinicians/sexologists and activists for transgender care to develop a study to collect sexologists' perceptions of the challenges they faced when providing health care to transgender people. After IRB approval, we used a cross-sectional qualitative design and disseminated an online survey among professional associations (e.g., the Portuguese Society of Andrology, Sexual Medicine and Reproduction). A total of 25 complete answers were collected from clinicians who act in transgender healthcare and whose professional background included: Clinical Psychology, Pediatric Psychiatry, Psychiatry, Endocrinology, Urology, Gynecology and Anesthesiology. Participants were, on average, 46 years old (SD = 12.38), had an average of 13 years (SD = 11.25) experience in Sexual Medicine/Clinical sexology and 11 years on average (SD = 10.38) of experience with transgender healthcare. Sociodemographic data was collected between January and June 2023, and four open questions were presented. The current study will report preliminary content analysis concerning the open question: “Which challenges have you encountered in your experience as a health professional acting clinically with transgender people?”. The preliminary content analysis revealed 6 main categories, each representing distinct and interrelated subcategories aggregating different codes. The main categories were: 1. Formal Institutional Challenges (e.g., lack of formal education concerning transgender care, lack of specific guidelines for primary care; long waiting lists); 2. Informal Institutional Challenges (e.g., lack of updated knowledge from other clinicians not directly involved in transgender care; non-responsiveness from colleagues, translating policies and international guidelines into practices); 3. Social Challenges (e.g., family stigma; social discrimination); 4. Patient’s Challenges (e.g., lack of compliance; hostility or negative expectations towards health professionals); 5. Personal limits (e.g., perseverative thinking about the timing and patients’ internalisation of information about surgery risks; feelings of strangeness towards non-binary bodies); 6. Clinical Challe
{"title":"(039) Challenges in Transgender Care Through a Qualitative Lens: Provisional Results About Sexual Medicine Professionals´ Opinions","authors":"P. M. Pascoal, T. Forte, A. A. Manão, A. A. Manão, S. A. Carvalho","doi":"10.1093/jsxmed/qdae002.038","DOIUrl":"https://doi.org/10.1093/jsxmed/qdae002.038","url":null,"abstract":"\u0000 \u0000 \u0000 Transgender people’s health and healthcare have become one of the most important challenges in healthcare settings and policy making. The perspectives of transgender consumers are important to inform policymaking and the development of measures to diminish barriers to accessing and maintaining health care. However, the perspective of healthcare providers, namely clinicians, is less known and is important to take a comprehensive and collaborative stance to deliver the best healthcare.\u0000 \u0000 \u0000 \u0000 To highlight the perspective of sexual medicine practitioners/sexologists involved in transgender healthcare on the challenges faced in providing transgender healthcare.\u0000 \u0000 \u0000 \u0000 Following an initiative by the Portuguese Society for Clinical Sexology, we used a participatory research design involving experienced sexual medicine clinicians/sexologists and activists for transgender care to develop a study to collect sexologists' perceptions of the challenges they faced when providing health care to transgender people. After IRB approval, we used a cross-sectional qualitative design and disseminated an online survey among professional associations (e.g., the Portuguese Society of Andrology, Sexual Medicine and Reproduction). A total of 25 complete answers were collected from clinicians who act in transgender healthcare and whose professional background included: Clinical Psychology, Pediatric Psychiatry, Psychiatry, Endocrinology, Urology, Gynecology and Anesthesiology. Participants were, on average, 46 years old (SD = 12.38), had an average of 13 years (SD = 11.25) experience in Sexual Medicine/Clinical sexology and 11 years on average (SD = 10.38) of experience with transgender healthcare. Sociodemographic data was collected between January and June 2023, and four open questions were presented. The current study will report preliminary content analysis concerning the open question: “Which challenges have you encountered in your experience as a health professional acting clinically with transgender people?”.\u0000 \u0000 \u0000 \u0000 The preliminary content analysis revealed 6 main categories, each representing distinct and interrelated subcategories aggregating different codes. The main categories were: 1. Formal Institutional Challenges (e.g., lack of formal education concerning transgender care, lack of specific guidelines for primary care; long waiting lists); 2. Informal Institutional Challenges (e.g., lack of updated knowledge from other clinicians not directly involved in transgender care; non-responsiveness from colleagues, translating policies and international guidelines into practices); 3. Social Challenges (e.g., family stigma; social discrimination); 4. Patient’s Challenges (e.g., lack of compliance; hostility or negative expectations towards health professionals); 5. Personal limits (e.g., perseverative thinking about the timing and patients’ internalisation of information about surgery risks; feelings of strangeness towards non-binary bodies); 6. Clinical Challe","PeriodicalId":377411,"journal":{"name":"The Journal of Sexual Medicine","volume":"10 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140269492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01DOI: 10.1093/jsxmed/qdae002.002
G. Bhat, A. Shastry
Hypoactive Sexual Desire Dysfunction (HSDD) in women is of multifactorial etiology with the best possible response on identifying modifiable factors and addressing them. With sexual boredom being one such factor in women with HSDD in a monogamous heterosexual relationship, the factors that improve boredom are expected to improve sexual desire in these women. To evaluate sexual novelty as a therapeutic strategy to treat HSDD in women in monogamous heterosexual relationships using a prospective randomized study design. The study was initiated following institutional review board approval. The participants, who expressed sexual boredom during our initial survey on sexual boredom in women in monogamous heterosexual relationships, female outpatients (in monogamous heterosexual relationships) with non-sexual complaints, and female partners of male patients with non-sexual complaints who agreed to participate in the study voluntarily were included. The exclusion was based on an evaluation of the participants by qualified medical specialists who diagnosed sexual, psychological, medical as well as gynecological conditions affecting sexual desire. Included participants attributing reduced sexual desire to sexual boredom on initial screening with Decreased Sexual Desire Screener (DSDS) were administered the Sexual Boredom Scale (SBS), to record the degree of sexual boredom in these women at the time of entry into the study. The participants were divided into two groups based on the computer-generated random numbers. The participants in group A received psychotherapy (included behavior therapy and/or cognitive behavior therapy and/or mindfulness) alone and group B received psychotherapy and a sexual novelty package (included any novelty related to sexuality other than trying a new sexual partner) as their planned intervention for a period of 6 months. The participants in both groups were administered the Elements of Desire Questionnaire (EDQ) at the beginning and at the end of the study to assess their sexual desire status. Mean and standard deviation was calculated for categorical variables, namely, age, period of monogamy, SBS score, and EDQ scores. The linear and multiple regression analysis was done to assess the effect of the age of the participant, and period of monogamy on boredom, and to know any influence of age, period of monogamy, and boredom level on the degree of improvement in sexual desire following treatment. A p-value of ≤ 0.05 was considered statistically significant. The study was conducted from January 2019 to May 2023 with a sample size of 398. There was no statistically significant difference between the groups as far as the age (36.5±10.8 years Vs 36.4±10.7 years), period of monogamy (10.9±7.7 years Vs 11.7.9±8.5 years), SBS score (71.8±30.8 Vs 73.1±43.9), and baseline EDQ score (1.5±0.6 Vs 1.4±0.6) were concerned. However, post-intervention, the sexual novelty group showed better improvement in EDQ score, wh
女性性欲减退症（HSDD）的病因是多因素的，最好的办法是找出可改变的因素并加以解决。在一夫一妻制异性恋关系中，性厌倦是导致女性性欲减退的因素之一，因此改善性厌倦的因素有望改善这些女性的性欲。 采用前瞻性随机研究设计，评估性新奇感作为治疗一夫一妻制异性性关系中女性 HSDD 的一种治疗策略。 该研究在获得机构审查委员会批准后启动。研究对象包括：在我们对一夫一妻制异性性关系中女性的性厌倦进行初步调查时表示出性厌倦的参与者、有非性主诉的女性门诊患者（一夫一妻制异性性关系中），以及有非性主诉的男性患者的女性伴侣（自愿同意参与研究）。排除的依据是由合格的医学专家对参与者进行的评估，他们对影响性欲的性、心理、医学和妇科疾病进行了诊断。在使用性欲减退筛查器（DSDS）进行初步筛查时，将性欲减退归因于性厌倦的受试者被纳入研究，并被施用性厌倦量表（SBS），以记录这些女性在进入研究时的性厌倦程度。根据计算机生成的随机数字，参与者被分为两组。A 组参与者只接受心理治疗（包括行为治疗和/或认知行为治疗和/或正念），B 组参与者接受心理治疗和性新奇套餐（包括除尝试新的性伴侣之外的任何与性有关的新奇事物），作为其计划的干预措施，为期 6 个月。两组参与者在研究开始和结束时都接受了欲望要素问卷调查（EDQ），以评估他们的性欲状况。计算了年龄、一夫一妻制时间、SBS 评分和 EDQ 评分等分类变量的平均值和标准差。研究人员进行了线性和多元回归分析，以评估受试者的年龄和一夫一妻制时间对厌烦程度的影响，并了解年龄、一夫一妻制时间和厌烦程度对治疗后性欲改善程度的影响。P值≤0.05为具有统计学意义。 研究时间为 2019 年 1 月至 2023 年 5 月，样本量为 398 个。在年龄（36.5±10.8 岁 Vs 36.4±10.7岁）、一夫一妻制时间（10.9±7.7 年 Vs 11.7.9±8.5年）、SBS评分（71.8±30.8 Vs 73.1±43.9）和基线EDQ评分（1.5±0.6 Vs 1.4±0.6）方面，组间差异无统计学意义。然而，干预后，性新奇感组的 EDQ 得分有了更好的改善，这在统计学上有显著意义。在多元回归模型中，受试者年龄较低和一夫一妻制时间较长对性欲有不利影响。 作为一种新颖的治疗策略，性新奇感成功地治疗了我们的研究参与者，他们在一夫一妻制异性恋关系中将性欲减退归因于性厌倦。 不
{"title":"(002) Evaluation of Efficacy of Sexual Novelty as a Novel Therapeutic Strategy to Treat Hypoactive Sexual Desire Dysfunction in Women in Monogamous Heterosexual Relationships Attributing Reduced Sexual Desire to Sexual Boredom: A Prospective Randomized Study","authors":"G. Bhat, A. Shastry","doi":"10.1093/jsxmed/qdae002.002","DOIUrl":"https://doi.org/10.1093/jsxmed/qdae002.002","url":null,"abstract":"\u0000 \u0000 \u0000 Hypoactive Sexual Desire Dysfunction (HSDD) in women is of multifactorial etiology with the best possible response on identifying modifiable factors and addressing them. With sexual boredom being one such factor in women with HSDD in a monogamous heterosexual relationship, the factors that improve boredom are expected to improve sexual desire in these women.\u0000 \u0000 \u0000 \u0000 To evaluate sexual novelty as a therapeutic strategy to treat HSDD in women in monogamous heterosexual relationships using a prospective randomized study design.\u0000 \u0000 \u0000 \u0000 The study was initiated following institutional review board approval. The participants, who expressed sexual boredom during our initial survey on sexual boredom in women in monogamous heterosexual relationships, female outpatients (in monogamous heterosexual relationships) with non-sexual complaints, and female partners of male patients with non-sexual complaints who agreed to participate in the study voluntarily were included. The exclusion was based on an evaluation of the participants by qualified medical specialists who diagnosed sexual, psychological, medical as well as gynecological conditions affecting sexual desire. Included participants attributing reduced sexual desire to sexual boredom on initial screening with Decreased Sexual Desire Screener (DSDS) were administered the Sexual Boredom Scale (SBS), to record the degree of sexual boredom in these women at the time of entry into the study. The participants were divided into two groups based on the computer-generated random numbers. The participants in group A received psychotherapy (included behavior therapy and/or cognitive behavior therapy and/or mindfulness) alone and group B received psychotherapy and a sexual novelty package (included any novelty related to sexuality other than trying a new sexual partner) as their planned intervention for a period of 6 months. The participants in both groups were administered the Elements of Desire Questionnaire (EDQ) at the beginning and at the end of the study to assess their sexual desire status. Mean and standard deviation was calculated for categorical variables, namely, age, period of monogamy, SBS score, and EDQ scores. The linear and multiple regression analysis was done to assess the effect of the age of the participant, and period of monogamy on boredom, and to know any influence of age, period of monogamy, and boredom level on the degree of improvement in sexual desire following treatment. A p-value of ≤ 0.05 was considered statistically significant.\u0000 \u0000 \u0000 \u0000 The study was conducted from January 2019 to May 2023 with a sample size of 398. There was no statistically significant difference between the groups as far as the age (36.5±10.8 years Vs 36.4±10.7 years), period of monogamy (10.9±7.7 years Vs 11.7.9±8.5 years), SBS score (71.8±30.8 Vs 73.1±43.9), and baseline EDQ score (1.5±0.6 Vs 1.4±0.6) were concerned. However, post-intervention, the sexual novelty group showed better improvement in EDQ score, wh","PeriodicalId":377411,"journal":{"name":"The Journal of Sexual Medicine","volume":"4 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140400275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01DOI: 10.1093/jsxmed/qdae002.066
L. Wei, L. Zheng, T. Jiang
Ejaculation is what we can see whereas orgasm is what we feel. Hence, the presence of ejaculate does not indicate the ability to experience orgasm. Having orgasm without ejaculate may be due to anejaculation (AE) or retrograde ejaculation (RE). Retrograde ejaculation is usually diagnosed by finding sperm in a urine sample after orgasm. However, it can be difficult to differentiate in cases of very low semen volume, previous vasectomy, ejaculatory duct obstruction, or azoospermia. This study aims to explore the use of transrectal dynamic ultrasonographic (US) to observe the process of ejaculation, direction of seminal flow, and changes in seminal vesicles, ejaculatory ducts, and bladder neck during orgasm, providing visual differentiation between AE and RE. US observations were conducted on 11 patients who experienced orgasm without ejaculate. Among the 11 patients (7 with diabetes, 1 with congenital megacolon surgery, 1 with urethral stricture), 3 patients had unsuccessful examinations due to discomfort or technical issues with the transrectal ultrasound probe. Successful observations were made in 8 patients, where 5 patients showed contraction of the seminal vesicles and incomplete closure of the bladder neck during orgasm, leading to RE. In 3 cases, no changes in the seminal vesicles or bladder neck were observed, and no seminal flow was seen, leading to AE. Dynamic ultrasonographic allows for the observation of the ejaculation process and understanding of the changes in seminal vesicles and bladder neck during orgasm, enabling differentiation between AE and RE. No.
{"title":"(073) A Novel Method——Identifying Anejaculation or Retrograde Ejaculation by Transrectal Dynamic Ultrasound (Report of 11 Cases)","authors":"L. Wei, L. Zheng, T. Jiang","doi":"10.1093/jsxmed/qdae002.066","DOIUrl":"https://doi.org/10.1093/jsxmed/qdae002.066","url":null,"abstract":"\u0000 \u0000 \u0000 Ejaculation is what we can see whereas orgasm is what we feel. Hence, the presence of ejaculate does not indicate the ability to experience orgasm. Having orgasm without ejaculate may be due to anejaculation (AE) or retrograde ejaculation (RE). Retrograde ejaculation is usually diagnosed by finding sperm in a urine sample after orgasm. However, it can be difficult to differentiate in cases of very low semen volume, previous vasectomy, ejaculatory duct obstruction, or azoospermia.\u0000 \u0000 \u0000 \u0000 This study aims to explore the use of transrectal dynamic ultrasonographic (US) to observe the process of ejaculation, direction of seminal flow, and changes in seminal vesicles, ejaculatory ducts, and bladder neck during orgasm, providing visual differentiation between AE and RE.\u0000 \u0000 \u0000 \u0000 US observations were conducted on 11 patients who experienced orgasm without ejaculate.\u0000 \u0000 \u0000 \u0000 Among the 11 patients (7 with diabetes, 1 with congenital megacolon surgery, 1 with urethral stricture), 3 patients had unsuccessful examinations due to discomfort or technical issues with the transrectal ultrasound probe. Successful observations were made in 8 patients, where 5 patients showed contraction of the seminal vesicles and incomplete closure of the bladder neck during orgasm, leading to RE. In 3 cases, no changes in the seminal vesicles or bladder neck were observed, and no seminal flow was seen, leading to AE.\u0000 \u0000 \u0000 \u0000 Dynamic ultrasonographic allows for the observation of the ejaculation process and understanding of the changes in seminal vesicles and bladder neck during orgasm, enabling differentiation between AE and RE.\u0000 \u0000 \u0000 \u0000 No.\u0000","PeriodicalId":377411,"journal":{"name":"The Journal of Sexual Medicine","volume":"46 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140283180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01DOI: 10.1093/jsxmed/qdae002.106
M. Savira, W. Atmoko
Erectile dysfunction (ED) is common health issues among men with increasing prevalence along with age. With the advancement of technology, the aim of therapy for ED is start to shift in reversing the pathology and not only relieving the symptoms. Platelet-rich plasma (PRP) are one of the regenerative modalities that has gained popularity in many medical disciplines. Many studies have been conducted that favour PRP in improving erectile function. However, no relevant meta-analysis of PRP have been performed to date. A single-arm meta-analysis were conducted to evaluate the outcome of PRP for the treatment of ED based on the data before and after the procedures. We systematically searched PubMed, Embase, Scopus in June 2023 to find the relevant articles based on the Preferred Reporting Items for Systematic Review and Meta-analysis statement. All randomized controlled trials (RCTs), observational, and case control studies in English with 10 or more subjects and a minimum of 1 month follow-up after PRP treatment reporting International Index of Erectile Function-Erectile Function (IIEF-EF) score were included. Pooled analysis on outcomes that were reported in at least 2 studies were performed using RevMan 5.4 and STATA18 with 95% confidence intervals (CIs). We also conduct heterogeneity test and a leave-one-out sensitivity analysis. A total of three RCTs, three observational studies and one case-control study, comprising 236 patients, were included from 183 studies identified. The pooled analysis showed that PRP injection significantly increased the IIEF-EF score by 3.87 (95% CI: 2.92, 4.83, p<0.00001), 3.01 (95% CI: 2.27, 3.74, p<0.0001), 3.29 (95% CI: 2.26, 4.32, p<0.00001), at 1, 3, and 6, months follow-up. Subgroup analysis of IIEF-EF based on the use of PDE5i in the protocol or during follow-up period also found the same finding result. The proportion of patient who met MCID after 6 months of follow of was 70% (95% CI: 59%, 80%). In term of penile hemodynamic, a significant improvement was found in peak systolic velocity and end diastolic velocity at the end-point of follow-up. On contrary, there was no significant improvement were found for IIEF score of intercourse satisfaction and overall satisfaction domain. The most common complication reported were transient subcutaneous bruising. Two cases reported a formation of painless plaque but no other major adverse events were reported. Consistent result was found after a leave-one-out sensitivity analysis. PRP is a promising restorative modality for ED with improvement in IIEF-EF score and penile hemodynamic. However, further studies and human trials are required to confirm the efficacy and durability of this novel treatment as well as to find out the best protocol of administration. No.
{"title":"(117) Is Platelet-Rich Plasma Effective and Safe for Managing Erectile Dysfunction? A Meta-Analysis of Before-After Data from Clinical Studies","authors":"M. Savira, W. Atmoko","doi":"10.1093/jsxmed/qdae002.106","DOIUrl":"https://doi.org/10.1093/jsxmed/qdae002.106","url":null,"abstract":"\u0000 \u0000 \u0000 Erectile dysfunction (ED) is common health issues among men with increasing prevalence along with age. With the advancement of technology, the aim of therapy for ED is start to shift in reversing the pathology and not only relieving the symptoms. Platelet-rich plasma (PRP) are one of the regenerative modalities that has gained popularity in many medical disciplines. Many studies have been conducted that favour PRP in improving erectile function. However, no relevant meta-analysis of PRP have been performed to date.\u0000 \u0000 \u0000 \u0000 A single-arm meta-analysis were conducted to evaluate the outcome of PRP for the treatment of ED based on the data before and after the procedures.\u0000 \u0000 \u0000 \u0000 We systematically searched PubMed, Embase, Scopus in June 2023 to find the relevant articles based on the Preferred Reporting Items for Systematic Review and Meta-analysis statement. All randomized controlled trials (RCTs), observational, and case control studies in English with 10 or more subjects and a minimum of 1 month follow-up after PRP treatment reporting International Index of Erectile Function-Erectile Function (IIEF-EF) score were included. Pooled analysis on outcomes that were reported in at least 2 studies were performed using RevMan 5.4 and STATA18 with 95% confidence intervals (CIs). We also conduct heterogeneity test and a leave-one-out sensitivity analysis.\u0000 \u0000 \u0000 \u0000 A total of three RCTs, three observational studies and one case-control study, comprising 236 patients, were included from 183 studies identified. The pooled analysis showed that PRP injection significantly increased the IIEF-EF score by 3.87 (95% CI: 2.92, 4.83, p<0.00001), 3.01 (95% CI: 2.27, 3.74, p<0.0001), 3.29 (95% CI: 2.26, 4.32, p<0.00001), at 1, 3, and 6, months follow-up. Subgroup analysis of IIEF-EF based on the use of PDE5i in the protocol or during follow-up period also found the same finding result. The proportion of patient who met MCID after 6 months of follow of was 70% (95% CI: 59%, 80%). In term of penile hemodynamic, a significant improvement was found in peak systolic velocity and end diastolic velocity at the end-point of follow-up. On contrary, there was no significant improvement were found for IIEF score of intercourse satisfaction and overall satisfaction domain. The most common complication reported were transient subcutaneous bruising. Two cases reported a formation of painless plaque but no other major adverse events were reported. Consistent result was found after a leave-one-out sensitivity analysis.\u0000 \u0000 \u0000 \u0000 PRP is a promising restorative modality for ED with improvement in IIEF-EF score and penile hemodynamic. However, further studies and human trials are required to confirm the efficacy and durability of this novel treatment as well as to find out the best protocol of administration.\u0000 \u0000 \u0000 \u0000 No.\u0000","PeriodicalId":377411,"journal":{"name":"The Journal of Sexual Medicine","volume":"28 13","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140269169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01DOI: 10.1093/jsxmed/qdae002.025
M. Mahdi, A. Albakr, K. Khalafalla, A. Suliman, A. Majzoub
Infection is a devastating complication of penile prosthesis implantation ranging from 0.33 to 11.4%. 1 Although a salvage procedure is an option in case of infection, the rule of thumb is to remove all device components. 2 Special considerations and pre-operative planning are essential for better outcome in the management of such condition. We are presenting a video case presentation demonstrating the use of laparoscopic assisted approach to aid in the extraction of the reservoir of an infected penile prosthesis from a patient who had ipsilateral inguinal hernia mesh implant To demonstrate the feasibility and efficacy laparoscopic assisted approach in the removal of difficult to extract inflatable penile prosthesis (IPP) reservoir. A 72-year-old gentleman with past medical history of Diabetes and hypertension presented to our clinic 3 weeks after an IPP insertion that was done in another center. He was complaining of right inguinal bulge and scrotal pain. The bulge developed suddenly without any preceding event. Examination confirmed a prosthesis reservoir herniation in to the right groin. Plan CT abdomen& pelvis confirmed the diagnosis. In three days, the herniated reservoir was managed by inguinal exploration, repositioning of the same reservoir in the right Retzius space and posterior inguinal canal wall repair using a mesh. The patient was discharged on post-operative day 1 in a stable condition, but unfortunately, he developed persistent scrotal pain that progressed into an overt scrotal infection over the early follow up period. During the examination, a scrotal collection was observed, swap was taken from the draining pus and results showed moderate growth of pseudomonas aeruginosa. On the other hand, the inguinal scar showed good healing with no tenderness, indicating the presence of an intact and non-infected inguinal mesh. Therefore, the decision was made to remove all components of the prosthesis without removing the mesh. Considering the anticipated challenges associated with removing the reservoir of the IPP through a scrotal approach, a decision was made to incorporate an additional laparoscopic-assisted abdominal approach for reservoir removal. Removal of the IPP cylinders and pump was performed through a scrotal incision, then a laparoscopic assisted abdominal approach was used successfully to remove the reservoir. After the IPP explant procedure, patient had an uneventful smooth recovery at the two and four weeks follow up visits, he was advised to use Vacuum erection device (VED) to alleviate possible penile fibrosis/shortening. A penile prosthesis reimplantation procedure was planned in a 6 months period Laparoscopic assisted approach for penile prosthesis reservoir extraction is a feasible and safe technique that can be used in anticipated cases of difficult reservoir extraction. Pre-operative assessment, planning and counselling are crucial in obtaining a favorable outcome in such complex ca
{"title":"(025) Laparoscopic Assisted Reservoir Removal of an Infected Inflatable Penile Prosthesis in a Patient with Ipsilateral Inguinal Hernia Mesh Implant","authors":"M. Mahdi, A. Albakr, K. Khalafalla, A. Suliman, A. Majzoub","doi":"10.1093/jsxmed/qdae002.025","DOIUrl":"https://doi.org/10.1093/jsxmed/qdae002.025","url":null,"abstract":"\u0000 \u0000 \u0000 Infection is a devastating complication of penile prosthesis implantation ranging from 0.33 to 11.4%. 1 Although a salvage procedure is an option in case of infection, the rule of thumb is to remove all device components. 2 Special considerations and pre-operative planning are essential for better outcome in the management of such condition. We are presenting a video case presentation demonstrating the use of laparoscopic assisted approach to aid in the extraction of the reservoir of an infected penile prosthesis from a patient who had ipsilateral inguinal hernia mesh implant\u0000 \u0000 \u0000 \u0000 To demonstrate the feasibility and efficacy laparoscopic assisted approach in the removal of difficult to extract inflatable penile prosthesis (IPP) reservoir.\u0000 \u0000 \u0000 \u0000 A 72-year-old gentleman with past medical history of Diabetes and hypertension presented to our clinic 3 weeks after an IPP insertion that was done in another center. He was complaining of right inguinal bulge and scrotal pain. The bulge developed suddenly without any preceding event. Examination confirmed a prosthesis reservoir herniation in to the right groin. Plan CT abdomen& pelvis confirmed the diagnosis. In three days, the herniated reservoir was managed by inguinal exploration, repositioning of the same reservoir in the right Retzius space and posterior inguinal canal wall repair using a mesh. The patient was discharged on post-operative day 1 in a stable condition, but unfortunately, he developed persistent scrotal pain that progressed into an overt scrotal infection over the early follow up period. During the examination, a scrotal collection was observed, swap was taken from the draining pus and results showed moderate growth of pseudomonas aeruginosa. On the other hand, the inguinal scar showed good healing with no tenderness, indicating the presence of an intact and non-infected inguinal mesh. Therefore, the decision was made to remove all components of the prosthesis without removing the mesh. Considering the anticipated challenges associated with removing the reservoir of the IPP through a scrotal approach, a decision was made to incorporate an additional laparoscopic-assisted abdominal approach for reservoir removal.\u0000 \u0000 \u0000 \u0000 Removal of the IPP cylinders and pump was performed through a scrotal incision, then a laparoscopic assisted abdominal approach was used successfully to remove the reservoir. After the IPP explant procedure, patient had an uneventful smooth recovery at the two and four weeks follow up visits, he was advised to use Vacuum erection device (VED) to alleviate possible penile fibrosis/shortening. A penile prosthesis reimplantation procedure was planned in a 6 months period\u0000 \u0000 \u0000 \u0000 Laparoscopic assisted approach for penile prosthesis reservoir extraction is a feasible and safe technique that can be used in anticipated cases of difficult reservoir extraction. Pre-operative assessment, planning and counselling are crucial in obtaining a favorable outcome in such complex ca","PeriodicalId":377411,"journal":{"name":"The Journal of Sexual Medicine","volume":"54 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140272238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01DOI: 10.1093/jsxmed/qdae002.086
P. Shoureshi, K. Dallas, L. Harper, A. Dubinskaya, M. Krychman, K. Eilber
Female sexual dysfunction (FSD) can be a direct result of hormonal changes in a woman’s lifetime, including the use of birth control, postpartum, or menopausal. The FSFI (Female Sexual Function Index) measures sexual function based on six domains: desire, arousal, lubrication, orgasm, satisfaction and pain. Studies have shown that vaginal lubrication can be affected by hormonal changes; however, it is unclear how lubrication relates to sexual desire among women with hormonal changes of varied etiology. The objective of this study is to evaluate the relationship between vaginal lubrication and sexual desire among women who are on birth control, postpartum, or menopausal. A post-market analysis was performed of all women who had utilized the sexual wellness application Rosy between February 2022 and November 2022. Application users had previously filled out the FSFI short form (6-item) and the desire and lubrication domain results were analyzed. We utilized multivariable linear regression models to determine significant effects between lubrication score and desire score controlling for whether the patient was on birth control, postpartum, or menopausal. A total of 11,407 women met the study criteria. 2,599 were menopausal, 3,394 were postpartum, and 8,013 were on birth control. The median age was 34.2 (range 17–80) years old. The mean FSFI short form scores for lubrication were as follows based on category: birth control = 3.03, postpartum = 2.0, and menopausal = 1.94. Mean FSFI short scores for desire were birth control = 2.44, postpartum = 2.23, and menopausal = 1.80. Regression modeling revealed a significant association between lubrication score and desire score (mean of 0.36 increase in desire score per point increase in lubrication score, 95% CI 0.35, 0.36, p<0.001). With women on birth control as a baseline, a menopausal status was associated with an increased desire (estimate 0.33, p<0.001). The interaction term between lubrication score and menopausal status was positive (0.06, p<0.001). Iatrogenic or physiologic hormonal changes such as birth control, postpartum, or menopause can alter vaginal lubrication scores. Among these women, those with better vaginal lubrication have an associated increase in sexual desire. Improvements in lubrication can positively affect sexual desire in menopausal women. Our findings of a significant positive interaction between lubrication scores and menopausal status is interpreted as the magnified effect that increase lubrication has on sexual desire in this population. Furthermore, these findings reinforce that among this cohort, menopausal women are most effected by hormonal changes that can alter lubrication and ultimately sexual desire. While this data demonstrates interesting findings, potential confounders include users of Rosy who may have underlying sexual dysfunction, which may alter these results. Further studies are needed on this topic among the general population
{"title":"(095) Vaginal Lubrication Improves Sexual Desire among Menopausal Women","authors":"P. Shoureshi, K. Dallas, L. Harper, A. Dubinskaya, M. Krychman, K. Eilber","doi":"10.1093/jsxmed/qdae002.086","DOIUrl":"https://doi.org/10.1093/jsxmed/qdae002.086","url":null,"abstract":"\u0000 \u0000 \u0000 Female sexual dysfunction (FSD) can be a direct result of hormonal changes in a woman’s lifetime, including the use of birth control, postpartum, or menopausal. The FSFI (Female Sexual Function Index) measures sexual function based on six domains: desire, arousal, lubrication, orgasm, satisfaction and pain. Studies have shown that vaginal lubrication can be affected by hormonal changes; however, it is unclear how lubrication relates to sexual desire among women with hormonal changes of varied etiology.\u0000 \u0000 \u0000 \u0000 The objective of this study is to evaluate the relationship between vaginal lubrication and sexual desire among women who are on birth control, postpartum, or menopausal.\u0000 \u0000 \u0000 \u0000 A post-market analysis was performed of all women who had utilized the sexual wellness application Rosy between February 2022 and November 2022. Application users had previously filled out the FSFI short form (6-item) and the desire and lubrication domain results were analyzed. We utilized multivariable linear regression models to determine significant effects between lubrication score and desire score controlling for whether the patient was on birth control, postpartum, or menopausal.\u0000 \u0000 \u0000 \u0000 A total of 11,407 women met the study criteria. 2,599 were menopausal, 3,394 were postpartum, and 8,013 were on birth control. The median age was 34.2 (range 17–80) years old. The mean FSFI short form scores for lubrication were as follows based on category: birth control = 3.03, postpartum = 2.0, and menopausal = 1.94. Mean FSFI short scores for desire were birth control = 2.44, postpartum = 2.23, and menopausal = 1.80. Regression modeling revealed a significant association between lubrication score and desire score (mean of 0.36 increase in desire score per point increase in lubrication score, 95% CI 0.35, 0.36, p<0.001). With women on birth control as a baseline, a menopausal status was associated with an increased desire (estimate 0.33, p<0.001). The interaction term between lubrication score and menopausal status was positive (0.06, p<0.001).\u0000 \u0000 \u0000 \u0000 Iatrogenic or physiologic hormonal changes such as birth control, postpartum, or menopause can alter vaginal lubrication scores. Among these women, those with better vaginal lubrication have an associated increase in sexual desire. Improvements in lubrication can positively affect sexual desire in menopausal women. Our findings of a significant positive interaction between lubrication scores and menopausal status is interpreted as the magnified effect that increase lubrication has on sexual desire in this population. Furthermore, these findings reinforce that among this cohort, menopausal women are most effected by hormonal changes that can alter lubrication and ultimately sexual desire. While this data demonstrates interesting findings, potential confounders include users of Rosy who may have underlying sexual dysfunction, which may alter these results. Further studies are needed on this topic among the general population","PeriodicalId":377411,"journal":{"name":"The Journal of Sexual Medicine","volume":"745 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140273223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01DOI: 10.1093/jsxmed/qdae002.111
W. Kinnaird, M. Kirby, P. Schartau, V. Jenkins, S. Allen, H. Payne
The physical and psychological health benefits of sexual activity are well documented. However, sexual needs in people with disabilities are often unrecognised and they are less likely to access professional support when problems arise. Almost all prostate cancer (PCa) treatments are associated with sexual side effects that can have negative effects on sexual well-being. To explore the impact disability has on PCa patients' experiences of sexual dysfunction and accessing support. An anonymous online survey was distributed to men with PCa in collaboration with the charity Prostate Cancer UK. Questions focused on participants’ experience of sexual dysfunction and the level of support they received. The focus of the current sub-analysis was on participants who self-reported any kind of disability. Chi-square testing was used for categorical variable analysis. 654 out of 893 adult participants (73.2%) reported having a diagnosis of prostate cancer. Of those 95 (14.5%) self-reported having a disability, 553 (84.6%) reported not having a disability, and 6 (0.9%) said they would ‘prefer not to say’. Physical and psychological sexual problems were common among men with self-reported disabilities, with more than 50% reporting sexual dysfunction in 9 out of 13 domains. They were more likely to report sexual dysfunction than men with no disability in 11 out of those 13 domains, reaching the level of significance in five of those (p<.05). [Fig 1] Sexual activity was rated as ‘fairly/very important’ by 77.9% (n=74) of men with a disability. Further, 60.0% (n=57) reported ‘sexual problems’ to be in their top three current concerns, the highest ranked concern from a list of 15 categories. There was no significant difference in these two results when compared with those for men who did not self-report a disability (p=.90 & p=.68). Despite this, men with a disability were significantly less likely to have discussed the sexual side effects of PCa treatment with a healthcare professional (HCP) (44.2% vs 65.3%, p<.05). Of the men who did discuss sexual side effects, only a minority in both groups were offered a referral on to a specialist clinic, with no significant difference between the groups (27.6% vs 29.9%, p=.71). Men with a disability reported lower levels of satisfaction in each of five statements assessing satisfaction with support for sexual side effects, reaching the level of significance in four (p<0.05) [Fig 2]. This study is the first to report on disability and men’s experience of sexual dysfunction associated with PCa. Our findings suggest wide-ranging physical and psychological sexual side effects are common and distressing among men with disabilities. Sexual activity is equally as important to men with disabilities but they are less likely to access support through HCPs. This results in high levels of dissatisfaction with care. The results suggest men with disabilities face additional barriers to accessing sexual s
{"title":"(122) Disability and Men’s Experience of Sexual Dysfunction Associated with Prostate Cancer","authors":"W. Kinnaird, M. Kirby, P. Schartau, V. Jenkins, S. Allen, H. Payne","doi":"10.1093/jsxmed/qdae002.111","DOIUrl":"https://doi.org/10.1093/jsxmed/qdae002.111","url":null,"abstract":"\u0000 \u0000 \u0000 The physical and psychological health benefits of sexual activity are well documented. However, sexual needs in people with disabilities are often unrecognised and they are less likely to access professional support when problems arise. Almost all prostate cancer (PCa) treatments are associated with sexual side effects that can have negative effects on sexual well-being.\u0000 \u0000 \u0000 \u0000 To explore the impact disability has on PCa patients' experiences of sexual dysfunction and accessing support.\u0000 \u0000 \u0000 \u0000 An anonymous online survey was distributed to men with PCa in collaboration with the charity Prostate Cancer UK. Questions focused on participants’ experience of sexual dysfunction and the level of support they received. The focus of the current sub-analysis was on participants who self-reported any kind of disability. Chi-square testing was used for categorical variable analysis.\u0000 \u0000 \u0000 \u0000 654 out of 893 adult participants (73.2%) reported having a diagnosis of prostate cancer. Of those 95 (14.5%) self-reported having a disability, 553 (84.6%) reported not having a disability, and 6 (0.9%) said they would ‘prefer not to say’. Physical and psychological sexual problems were common among men with self-reported disabilities, with more than 50% reporting sexual dysfunction in 9 out of 13 domains. They were more likely to report sexual dysfunction than men with no disability in 11 out of those 13 domains, reaching the level of significance in five of those (p<.05). [Fig 1] Sexual activity was rated as ‘fairly/very important’ by 77.9% (n=74) of men with a disability. Further, 60.0% (n=57) reported ‘sexual problems’ to be in their top three current concerns, the highest ranked concern from a list of 15 categories. There was no significant difference in these two results when compared with those for men who did not self-report a disability (p=.90 & p=.68). Despite this, men with a disability were significantly less likely to have discussed the sexual side effects of PCa treatment with a healthcare professional (HCP) (44.2% vs 65.3%, p<.05). Of the men who did discuss sexual side effects, only a minority in both groups were offered a referral on to a specialist clinic, with no significant difference between the groups (27.6% vs 29.9%, p=.71). Men with a disability reported lower levels of satisfaction in each of five statements assessing satisfaction with support for sexual side effects, reaching the level of significance in four (p<0.05) [Fig 2].\u0000 \u0000 \u0000 \u0000 This study is the first to report on disability and men’s experience of sexual dysfunction associated with PCa. Our findings suggest wide-ranging physical and psychological sexual side effects are common and distressing among men with disabilities. Sexual activity is equally as important to men with disabilities but they are less likely to access support through HCPs. This results in high levels of dissatisfaction with care. The results suggest men with disabilities face additional barriers to accessing sexual s","PeriodicalId":377411,"journal":{"name":"The Journal of Sexual Medicine","volume":"123 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140276358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01DOI: 10.1093/jsxmed/qdae002.245
S. Jang
Many physicians have tried to develop the surgical techniques to make safer and more effective results in penile enhancement surgery. To accomplish better results of penile enhancement surgery, We aim to introduce newly developed more effective surgical techniques and safer processes in penile enhancement surgery. 2023 Patients underwent penile enhancement surgeries. All patients adopted pre-pubic minimal skin incision with newly developed retractors. Allogenic dermal graft was fixed for girth enhancement. And midline fixation between penile skin inner surface and midline site of dermal graft was performed with surgifit 3.0. to accelerate the attachment of skin and graft. We use newly developed dissection technique with curved iris scissors and electro-cutting to dissect surgical plain between dartos and buck’s fascias. To perform lengthening procedure, fundiform ligament was dissected and pre-pubic dead space was approximated by multi-layer transverse suturing. Mean operation time was 46 min and mean incision length was 3.3 cm. Postoperative penile length after 3 months was elongated on average 2.7 cm. postoperative inflammation rate was 1.2% and no garfts failure was observed. For more effective and safer penile enhancement and lengthening, multi-layer dissection technique, multi-layer suturing lengthening and mid-line fixation technique with minimal pre-pubic incision (4m penile surgery) are very useful. No.
{"title":"(283) Report of Newly Developed Penile Enhancement Surgery Using Midline Fixation Technique of Dermal Garft, Multi-layer Dissection Method, Multilayer Suture Lengthening and Minimal Skin Incision","authors":"S. Jang","doi":"10.1093/jsxmed/qdae002.245","DOIUrl":"https://doi.org/10.1093/jsxmed/qdae002.245","url":null,"abstract":"\u0000 \u0000 \u0000 Many physicians have tried to develop the surgical techniques to make safer and more effective results in penile enhancement surgery.\u0000 \u0000 \u0000 \u0000 To accomplish better results of penile enhancement surgery, We aim to introduce newly developed more effective surgical techniques and safer processes in penile enhancement surgery.\u0000 \u0000 \u0000 \u0000 2023 Patients underwent penile enhancement surgeries. All patients adopted pre-pubic minimal skin incision with newly developed retractors. Allogenic dermal graft was fixed for girth enhancement. And midline fixation between penile skin inner surface and midline site of dermal graft was performed with surgifit 3.0. to accelerate the attachment of skin and graft. We use newly developed dissection technique with curved iris scissors and electro-cutting to dissect surgical plain between dartos and buck’s fascias. To perform lengthening procedure, fundiform ligament was dissected and pre-pubic dead space was approximated by multi-layer transverse suturing.\u0000 \u0000 \u0000 \u0000 Mean operation time was 46 min and mean incision length was 3.3 cm. Postoperative penile length after 3 months was elongated on average 2.7 cm. postoperative inflammation rate was 1.2% and no garfts failure was observed.\u0000 \u0000 \u0000 \u0000 For more effective and safer penile enhancement and lengthening, multi-layer dissection technique, multi-layer suturing lengthening and mid-line fixation technique with minimal pre-pubic incision (4m penile surgery) are very useful.\u0000 \u0000 \u0000 \u0000 No.\u0000","PeriodicalId":377411,"journal":{"name":"The Journal of Sexual Medicine","volume":"85 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140278778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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