Pub Date : 2024-03-01DOI: 10.1093/jsxmed/qdae002.017
K. Khalaf Alla, M. Mahdi, J. Mehr, O. Westney, R. Wang
Artificial urinary sphincter (AUS) and bulbourethral male sling are used frequently in the management of post prostatectomy urinary incontinence (UI) in men. Some surgeons used to combine an inflatable Penile Prosthesis (IPP) procedure at the same setting to treat concurrent erectile dysfunction (ED). Recent clinical trials have aimed to determine the comparative effectiveness between the male sling and the artificial urinary sphincter (AUS) in men with urodynamic stress urinary incontinence (SUI) after prostate surgery, focusing on non-inferiority. We aim to compare continence control and complications rates in patients who underwent bulbourethral slings or AUS during IPP surgery via perineal approach. A retrospective chart review was done in a large tertiary center. Post prostatectomy patients who underwent perineal dual implantation IPP and AUS or bulbourethral sling for ED and UI purposes, between 2014 and 2022 were included. Clinical data, patients’ demographics were retrieved. Post-operative outcomes with regards to IPP complication rates, revision rates for IPP/ AUS / Male sling, and continence control at 6 weeks, 6 months and 1 year were collected and included in the analysis. Continence control rates were assessed by the number of pads used per day on subsequent follow up visits for both groups. A total of 32 patients met the inclusion criteria. 16 Patients underwent synchronous IPP and AUS insertion, whereas another 16 patients underwent IPP with bulbourethral sling procedure. Patient demographics, median follow up & complication rates are summarized below in Table 1. In both groups the procedure was done through a perineal approach. There was no significant difference in baseline data among groups. Complication rates between AUS devices and bulbourethral slings showed no statistically significant differences (12.5% vs 6.25% p= 0.22 respectively). Infection rates and need for revision also did not show any statistically significant differences. With regards to post-operative continence rates, both groups had comparable outcome with no significant differences (P = 0.81). Upon the 6 months follow up visit, the AUS group, 56% were pad free, 19% used 1 pad per day, 19% used 2 pads per day, and 6% used 3 pads or more per day, while in the sling group, 50% were pad free, 25% used 1 pad per day, 19% used 2 pads per day, and 6% used 3 pads or more per day. Patients were followed for a total of 1 year after the surgery. The combined insertion of IPP with either AUS or sling procedures has comparable outcomes with regards to continence rate and device- related complications. Each incontinence surgery should be chosen according to surgeon experience and specific patient indications. Further prospective studies on a larger sample of patients with longer follow up period are needed to solidify these findings and will guide patient's decision and preference for incontinence surgeries along with IPP once indicated.
{"title":"(017) Comparing Complication Rates and Continence Control in Concurrent Dual Implantation of Inflatable Penile Prosthesis/Artificial Urinary Sphincter vs. Inflatable Penile Prosthesis/Male Sling: An Updated Comparative Pilot Study","authors":"K. Khalaf Alla, M. Mahdi, J. Mehr, O. Westney, R. Wang","doi":"10.1093/jsxmed/qdae002.017","DOIUrl":"https://doi.org/10.1093/jsxmed/qdae002.017","url":null,"abstract":"\u0000 \u0000 \u0000 Artificial urinary sphincter (AUS) and bulbourethral male sling are used frequently in the management of post prostatectomy urinary incontinence (UI) in men. Some surgeons used to combine an inflatable Penile Prosthesis (IPP) procedure at the same setting to treat concurrent erectile dysfunction (ED). Recent clinical trials have aimed to determine the comparative effectiveness between the male sling and the artificial urinary sphincter (AUS) in men with urodynamic stress urinary incontinence (SUI) after prostate surgery, focusing on non-inferiority.\u0000 \u0000 \u0000 \u0000 We aim to compare continence control and complications rates in patients who underwent bulbourethral slings or AUS during IPP surgery via perineal approach.\u0000 \u0000 \u0000 \u0000 A retrospective chart review was done in a large tertiary center. Post prostatectomy patients who underwent perineal dual implantation IPP and AUS or bulbourethral sling for ED and UI purposes, between 2014 and 2022 were included. Clinical data, patients’ demographics were retrieved. Post-operative outcomes with regards to IPP complication rates, revision rates for IPP/ AUS / Male sling, and continence control at 6 weeks, 6 months and 1 year were collected and included in the analysis. Continence control rates were assessed by the number of pads used per day on subsequent follow up visits for both groups.\u0000 \u0000 \u0000 \u0000 A total of 32 patients met the inclusion criteria. 16 Patients underwent synchronous IPP and AUS insertion, whereas another 16 patients underwent IPP with bulbourethral sling procedure. Patient demographics, median follow up & complication rates are summarized below in Table 1. In both groups the procedure was done through a perineal approach. There was no significant difference in baseline data among groups. Complication rates between AUS devices and bulbourethral slings showed no statistically significant differences (12.5% vs 6.25% p= 0.22 respectively). Infection rates and need for revision also did not show any statistically significant differences. With regards to post-operative continence rates, both groups had comparable outcome with no significant differences (P = 0.81). Upon the 6 months follow up visit, the AUS group, 56% were pad free, 19% used 1 pad per day, 19% used 2 pads per day, and 6% used 3 pads or more per day, while in the sling group, 50% were pad free, 25% used 1 pad per day, 19% used 2 pads per day, and 6% used 3 pads or more per day. Patients were followed for a total of 1 year after the surgery.\u0000 \u0000 \u0000 \u0000 The combined insertion of IPP with either AUS or sling procedures has comparable outcomes with regards to continence rate and device- related complications. Each incontinence surgery should be chosen according to surgeon experience and specific patient indications. Further prospective studies on a larger sample of patients with longer follow up period are needed to solidify these findings and will guide patient's decision and preference for incontinence surgeries along with IPP once indicated.\u0000 \u0000","PeriodicalId":377411,"journal":{"name":"The Journal of Sexual Medicine","volume":"21 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140269363","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/qdae002.007
G. Seijas, S. G. Comerma Steffensen, A. Gomez Del Val, G. Wegener, U. Simonsen
Female sexual behavior animal translation data do not translate to acute results and neither current synchronization invasive models (ovariectomy+Estrogen “E2”+Progesterone “P4”) guarantee hormonal physiological values. Therefore, our study investigated the effect of non-invasive oestrus synchronization on sexual behavior. Methods: Twelve week old Sprague Dawley intact rats were synchronized and randomly divided into three groups each of n=8-10. Each group received a dose of prostaglandin F2α “PGF2α” (75, 125 and 250 μg) at days 0 and 3, and 1 mg of progesterone at day four. Vaginal cytology was performed to determine the point of the cycle and the animals underwent an incentive test. To investigate the sexual behavior, the synchronized female rats were paired with trained male rats, and behavior recorded. The videos were quantified by trained operators. Sexual behavior was quantified as paracopulatory (hops, darts, ear wiggling, sniffing from male and from female) or copulatory (male mounting female, thrusting from male, intromission, ejaculation, female for sniffing position, lordosis, orgasm, female mounting on male, female rotation in her axis and female licking itself), E2 and Follicle Stimulating hormone (FSH) in plasma and E2 in vaginal fluid were quantified by immune assay. Based on the vaginal cytology, the proportion of animals in proestrus (p), estrus (e) or metestrus (m) was calculated with values of 0.5 (p), 0.25 (e) and 0.25 (m) for the group which received 0.75 μg PGF2α; 0.4 (p), and 0.6 (e) for the group which received 0.125 μg PGF2α; 0.2 (p), 0.5 (e), and 0.3 (m) for the group which received 250 μg PGF2α. The numbers of hops was higher in the proestrus compared to the metestrus, and of mounts higher in the estrus compared to the metestrus phase. The sexual encounter profile and E2 levels were unchanged with the different PGF2α doses, but in the high-dose group no hops were observed. The levels of sexual behavior was comparable to previous studies of hormone substituted ovariectomized rats, but E2 and FSH plasma levels were in a physiological range. In summary, the non-invasive synchronization protocol could substitute the state-of-the-art used ovariectomized+hormone (E2) model. Our findings suggest the largest part of rats were synchronized in the oestrus phase with 125 μg PGF2α. but the 250 μg had also a positive profile. Any of the authors act as a consultant, employee or shareholder of an industry for: Initiator Pharma A/S.
{"title":"(007) Impact of Non-Invasive Oestrus Synchronization on Sexual Behavior in Intact Sprague Dawley Rats","authors":"G. Seijas, S. G. Comerma Steffensen, A. Gomez Del Val, G. Wegener, U. Simonsen","doi":"10.1093/jsxmed/qdae002.007","DOIUrl":"https://doi.org/10.1093/jsxmed/qdae002.007","url":null,"abstract":"\u0000 \u0000 \u0000 Female sexual behavior animal translation data do not translate to acute results and neither current synchronization invasive models (ovariectomy+Estrogen “E2”+Progesterone “P4”) guarantee hormonal physiological values.\u0000 \u0000 \u0000 \u0000 Therefore, our study investigated the effect of non-invasive oestrus synchronization on sexual behavior.\u0000 \u0000 \u0000 \u0000 Methods: Twelve week old Sprague Dawley intact rats were synchronized and randomly divided into three groups each of n=8-10. Each group received a dose of prostaglandin F2α “PGF2α” (75, 125 and 250 μg) at days 0 and 3, and 1 mg of progesterone at day four. Vaginal cytology was performed to determine the point of the cycle and the animals underwent an incentive test. To investigate the sexual behavior, the synchronized female rats were paired with trained male rats, and behavior recorded. The videos were quantified by trained operators. Sexual behavior was quantified as paracopulatory (hops, darts, ear wiggling, sniffing from male and from female) or copulatory (male mounting female, thrusting from male, intromission, ejaculation, female for sniffing position, lordosis, orgasm, female mounting on male, female rotation in her axis and female licking itself), E2 and Follicle Stimulating hormone (FSH) in plasma and E2 in vaginal fluid were quantified by immune assay.\u0000 \u0000 \u0000 \u0000 Based on the vaginal cytology, the proportion of animals in proestrus (p), estrus (e) or metestrus (m) was calculated with values of 0.5 (p), 0.25 (e) and 0.25 (m) for the group which received 0.75 μg PGF2α; 0.4 (p), and 0.6 (e) for the group which received 0.125 μg PGF2α; 0.2 (p), 0.5 (e), and 0.3 (m) for the group which received 250 μg PGF2α. The numbers of hops was higher in the proestrus compared to the metestrus, and of mounts higher in the estrus compared to the metestrus phase. The sexual encounter profile and E2 levels were unchanged with the different PGF2α doses, but in the high-dose group no hops were observed. The levels of sexual behavior was comparable to previous studies of hormone substituted ovariectomized rats, but E2 and FSH plasma levels were in a physiological range.\u0000 \u0000 \u0000 \u0000 In summary, the non-invasive synchronization protocol could substitute the state-of-the-art used ovariectomized+hormone (E2) model. Our findings suggest the largest part of rats were synchronized in the oestrus phase with 125 μg PGF2α. but the 250 μg had also a positive profile.\u0000 \u0000 \u0000 \u0000 Any of the authors act as a consultant, employee or shareholder of an industry for: Initiator Pharma A/S.\u0000","PeriodicalId":377411,"journal":{"name":"The Journal of Sexual Medicine","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140270633","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/qdae002.048
O. Kaabia, K. Dimassi
Assuming that the Obstetrician and Gynecologist (ObGyn) is the natural and first interlocutor for sexual questions in women, particular attention should be paid to their specific training in sexual health and clinical sexology. However, it turns out that the latter is neglected with little attention given to the development or implementation of specific curricular programs within the gynecologists’ residency programs. This study aims to: - Identify and analyze the specific needs of the ObGyn residents in terms of education and training in Sexual Health and Clinical Sexology. - Discuss the methods of integrating a specific sexology training into their residency program to be adapted to the needs thus identified. It is a knowledge, attitudes, and practices cross-sectional online study that took place over 5 weeks starting May 1st, 2021. All the ObGyn residents registered at the National College of Gynecology and Obstetrics were contacted through the College’s social media groups. The online questionnaire was a 9-item Google form elaborated in concertation with the Frequency, Gravity Problem (FGP) grid leading to 33 questions. With a response rate of 34 %, 94 residents participated in the survey. The participants were representative of the local population of ObGyn residents with an equal proportion of participants from the 5 years of the program. According to 69% of the participants, complaints or sexual disorders are rarely encountered during the ObGyn residency program courses. This finding was not correlated with the participants' residency level (R= 0.258, p> 0.05). The most frequently encountered sexual disorders during the clinical consultations were sexual disorders with pain (44.68%) and in particular vaginismus (75%). Regardless of the frequency of the disorders, the difficulties reported were primarily in the domain of knowledge (67.5%); then in the domain of know-how or practices (68%), and often in the domain of interpersonal skills (42.2%). Following the application of the rating system of the FGP grid, the main problems identified concerned sexual disorders with pain, in particular, vaginismus and then a decrease in female desire. Following the analysis of these results and a review of the literature, we were able to propose the outline of a project to implement basic academic education and training in clinical sexology for the ObGyn residents. No.
{"title":"(052) Sexual Health and Clinical Sexology Specific Training Needs of Residents in Gynecology and Obstetrics","authors":"O. Kaabia, K. Dimassi","doi":"10.1093/jsxmed/qdae002.048","DOIUrl":"https://doi.org/10.1093/jsxmed/qdae002.048","url":null,"abstract":"\u0000 \u0000 \u0000 Assuming that the Obstetrician and Gynecologist (ObGyn) is the natural and first interlocutor for sexual questions in women, particular attention should be paid to their specific training in sexual health and clinical sexology. However, it turns out that the latter is neglected with little attention given to the development or implementation of specific curricular programs within the gynecologists’ residency programs.\u0000 \u0000 \u0000 \u0000 This study aims to: - Identify and analyze the specific needs of the ObGyn residents in terms of education and training in Sexual Health and Clinical Sexology. - Discuss the methods of integrating a specific sexology training into their residency program to be adapted to the needs thus identified.\u0000 \u0000 \u0000 \u0000 It is a knowledge, attitudes, and practices cross-sectional online study that took place over 5 weeks starting May 1st, 2021. All the ObGyn residents registered at the National College of Gynecology and Obstetrics were contacted through the College’s social media groups. The online questionnaire was a 9-item Google form elaborated in concertation with the Frequency, Gravity Problem (FGP) grid leading to 33 questions.\u0000 \u0000 \u0000 \u0000 With a response rate of 34 %, 94 residents participated in the survey. The participants were representative of the local population of ObGyn residents with an equal proportion of participants from the 5 years of the program. According to 69% of the participants, complaints or sexual disorders are rarely encountered during the ObGyn residency program courses. This finding was not correlated with the participants' residency level (R= 0.258, p> 0.05). The most frequently encountered sexual disorders during the clinical consultations were sexual disorders with pain (44.68%) and in particular vaginismus (75%). Regardless of the frequency of the disorders, the difficulties reported were primarily in the domain of knowledge (67.5%); then in the domain of know-how or practices (68%), and often in the domain of interpersonal skills (42.2%). Following the application of the rating system of the FGP grid, the main problems identified concerned sexual disorders with pain, in particular, vaginismus and then a decrease in female desire.\u0000 \u0000 \u0000 \u0000 Following the analysis of these results and a review of the literature, we were able to propose the outline of a project to implement basic academic education and training in clinical sexology for the ObGyn residents.\u0000 \u0000 \u0000 \u0000 No.\u0000","PeriodicalId":377411,"journal":{"name":"The Journal of Sexual Medicine","volume":"149 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140279622","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/qdae002.122
A. R. Cintra, B. L. Linhares, E. L. Da Rocha, M. M. F. Monteiro, K. M. Da Trindade, M. S. R. Lopes, J. Linhares-Filho, M. J. Da Silva, H. T. Palmeira, J. Bessa Jr, E. P. Miranda, R. Reges
Androgen deprivation therapy (ADT) is considered one of the mainstays in the treatment of prostate cancer. ADT slows cancer progression, alleviates cancer-related symptoms, and is associated with survival gains. Despite these proven benefits, this treatment is related to several side effects, such as increased cardiovascular risk, changes in body composition and various metabolic changes. Although the well-established association between circulating testosterone level and endothelial integrity, the direct effects of ADT on endothelial function remain controversial. This study aimed to investigate the impact of ADT on endothelial function, through the analysis of vascular parameters of the brachial artery and measurement of serum inflammatory markers. It was also our aim to evaluate the early impact of ADT on body composition and metabolic parameters. We prospectively evaluated men with moderate to high-risk prostate cancer treated with ADT from January to December 2022 at our institution. Smokers and those who quit smoking less than five years ago, decompensated diabetics (glycated hemoglobin > 9%) and those who had already had a cardiovascular event were excluded. High-resolution B-mode ultrasound was used to assess vascular diameter and endothelium-dependent flow-mediated vasodilation (FMD) of the brachial artery. Our metabolic and inflammatory profile included measurement of serum total cholesterol and fractions, triglycerides, fasting glucose, glycated hemoglobin, basal insulin, C-reactive protein and assessment of body fat distribution through bioelectrical impedance. Subjects were evaluated at baseline and 3 months after starting ADT with goserelin acetate 10.80 mg. A total of 32 men were included. The mean age was 69 years and the prevalence of diabetes was 31.25%. FMD demonstrated a worsening trend after ADT, which did not reach statistical significance after 3 months (mean 3.39 ± 6.83 vs 1.16 ± 7.65; p = 0.14) (figure 1). Baseline brachial artery diameter also showed a tendency to worsen with ADT compared to baseline (0.44 ± 0.06 vs 0.42 ± 0.06; p = 0.06). With regard to the metabolic profile, ADT significantly increased insulin resistance: fasting glucose (mean 104.10 ± 18.96 vs 110.60 ± 25.29; p = 0.01), fasting insulin levels (mean 13.05 ± 8.76 vs 16.82 ± 11.36; p = 0.003), glycated hemoglobin (mean 5.89% ± 0.46 vs 6.15% ± 0.67; p = 0.008) and homeostatic model assessment insulin resistance (mean 3.47 ± 2.55 vs 5.05 ± 4.50; p = 0.005) increased significantly after 3 months. Triglycerides concentrations (mean 142.30 ± 69.66 vs 165.50 ± 93.04; p = 0.03) were higher after 3 months of ADT. Abdominal circumference (mean 98.66 ± 10.16 vs 99.76 ± 9.39; p = 0.02) and body mass index (mean 27.46 ± 4.06 vs 27.76 ± 3.89; p = 0.02) also increased after ADT. Although not statistically significant, the present study demonstrated a trend towards a decrease in brachial artery FMD. We also observed an important and su
{"title":"(134) Early Impact of Androgen Deprivation Therapy on Endothelial Function and Metabolic Parameters in Prostate Cancer Patients: A Prospective Study","authors":"A. R. Cintra, B. L. Linhares, E. L. Da Rocha, M. M. F. Monteiro, K. M. Da Trindade, M. S. R. Lopes, J. Linhares-Filho, M. J. Da Silva, H. T. Palmeira, J. Bessa Jr, E. P. Miranda, R. Reges","doi":"10.1093/jsxmed/qdae002.122","DOIUrl":"https://doi.org/10.1093/jsxmed/qdae002.122","url":null,"abstract":"\u0000 \u0000 \u0000 Androgen deprivation therapy (ADT) is considered one of the mainstays in the treatment of prostate cancer. ADT slows cancer progression, alleviates cancer-related symptoms, and is associated with survival gains. Despite these proven benefits, this treatment is related to several side effects, such as increased cardiovascular risk, changes in body composition and various metabolic changes. Although the well-established association between circulating testosterone level and endothelial integrity, the direct effects of ADT on endothelial function remain controversial.\u0000 \u0000 \u0000 \u0000 This study aimed to investigate the impact of ADT on endothelial function, through the analysis of vascular parameters of the brachial artery and measurement of serum inflammatory markers. It was also our aim to evaluate the early impact of ADT on body composition and metabolic parameters.\u0000 \u0000 \u0000 \u0000 We prospectively evaluated men with moderate to high-risk prostate cancer treated with ADT from January to December 2022 at our institution. Smokers and those who quit smoking less than five years ago, decompensated diabetics (glycated hemoglobin > 9%) and those who had already had a cardiovascular event were excluded. High-resolution B-mode ultrasound was used to assess vascular diameter and endothelium-dependent flow-mediated vasodilation (FMD) of the brachial artery. Our metabolic and inflammatory profile included measurement of serum total cholesterol and fractions, triglycerides, fasting glucose, glycated hemoglobin, basal insulin, C-reactive protein and assessment of body fat distribution through bioelectrical impedance. Subjects were evaluated at baseline and 3 months after starting ADT with goserelin acetate 10.80 mg.\u0000 \u0000 \u0000 \u0000 A total of 32 men were included. The mean age was 69 years and the prevalence of diabetes was 31.25%. FMD demonstrated a worsening trend after ADT, which did not reach statistical significance after 3 months (mean 3.39 ± 6.83 vs 1.16 ± 7.65; p = 0.14) (figure 1). Baseline brachial artery diameter also showed a tendency to worsen with ADT compared to baseline (0.44 ± 0.06 vs 0.42 ± 0.06; p = 0.06). With regard to the metabolic profile, ADT significantly increased insulin resistance: fasting glucose (mean 104.10 ± 18.96 vs 110.60 ± 25.29; p = 0.01), fasting insulin levels (mean 13.05 ± 8.76 vs 16.82 ± 11.36; p = 0.003), glycated hemoglobin (mean 5.89% ± 0.46 vs 6.15% ± 0.67; p = 0.008) and homeostatic model assessment insulin resistance (mean 3.47 ± 2.55 vs 5.05 ± 4.50; p = 0.005) increased significantly after 3 months. Triglycerides concentrations (mean 142.30 ± 69.66 vs 165.50 ± 93.04; p = 0.03) were higher after 3 months of ADT. Abdominal circumference (mean 98.66 ± 10.16 vs 99.76 ± 9.39; p = 0.02) and body mass index (mean 27.46 ± 4.06 vs 27.76 ± 3.89; p = 0.02) also increased after ADT.\u0000 \u0000 \u0000 \u0000 Although not statistically significant, the present study demonstrated a trend towards a decrease in brachial artery FMD. We also observed an important and su","PeriodicalId":377411,"journal":{"name":"The Journal of Sexual Medicine","volume":"507 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140273754","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/qdae002.113
K. Drasa, E. Bylykbashi
In healthy men, the average duration of sexual intercourse ranges from nine to ten minutes. However, duration of erection has been shown to be shorter in men with Erectile Dysfunction (ED) and even shorter for men with ED plus associated underlying conditions. Furthermore, duration of Penis erection is most important for sexual couple. The aim of this study was to assess two herbal supplements: HILTI gold (Hg) vs Epimedyumlu Macun (EM) efficacy in terms of duration of erection and (i) Its correlation with other efficacy end points and male and female sexual quality of life (QoL) and (ii) Its impact on intercourse duration. A double-blind, controlled trial randomized men (18–65 years of age) with ED for more than six months, to receive fixed-dose either Hg, 1 capsule or EM, 1 tea spoon (60 minutes prior intercourse) for 12 weeks in 52 patients with ED, after four-week without medication. Primary efficacy end points were stopwatch-assessed duration of erection (min) at any attempt and when leading to successful intercourse, and the erectile function domain of the International Index of Erectile Function (EF-IIEF) score was assessed at week 12/ last observation carried forward (LOCF). Secondary end points were Sexual Encounter Profile question three (SEP3) response rate and male sexual QoL. End points in participating women were stopwatch-assessed duration of intercourse and sexual QoL. 52 men included. 42% had moderate ED. 58% had severe ED at baseline. At week 12 / LOCF, patients taking Hg had longer duration of erections vs EM group (least square mean ± standard error 10.3±0.8 minutes vs. 7.7±0.7 minutes, and 10.3±0.8 vs. 7.8 ±1.0 minutes, respectively), and significant increases in EF-IIEF scores, the SEP3 response, and all sexual QoL items. An increased duration of intercourse was also observed. Female sexual QoL improved significantly. Both duration end points strongly correlated with EF-IIEF scores, and the three end points correlated well with SEP3 response. Correlation was good with sexual QoL scores in men and women and with duration of intercourse, with difference between groups only for duration end points. Safety was better in Hg than in EM group. The results indicate that duration of erection represents a novel efficacy measures for evaluating those herbal supplements (HS), and could be used as a predictor or efficacy measure of sexual performance in couples affected by ED. With regard to the method of measuring duration, stopwatch method was shown to be reliable and capable of complementing traditional self-assessment efficacy methods for evaluating the efficacy of HS. Hg is the best to significantly improve: Duration of erection in men with ED and Sexual QoL, in both members of a couple affected by ED than EM Absolutely, Hg and EM: Increase duration of erection; Improve sexual pleasure. And, thereby improving the sexual QoL of the COUPLE. And, most important is that sexual couples don’t risk to be un
健康男性的平均性交时间为九到十分钟。然而，事实证明，患有勃起功能障碍（ED）的男性勃起持续时间较短，而患有 ED 和相关潜在疾病的男性勃起持续时间更短。此外，阴茎勃起的持续时间对于性伴侣来说是最重要的。 本研究旨在评估两种草药补充剂：HILTI gold (Hg) 与 Epimedyumlu Macun (EM) 在阴茎勃起持续时间方面的疗效，以及 (i) 与其他疗效终点、男性和女性性生活质量 (QoL) 的相关性和 (ii) 对性交持续时间的影响。 一项双盲对照试验将患有 ED 超过 6 个月的男性（18-65 岁）随机分为两种剂量，一种是固定剂量的 Hg（1 粒胶囊），另一种是固定剂量的 EM（1 茶匙，性交前 60 分钟），52 名 ED 患者在未服药 4 周后接受了为期 12 周的试验。主要疗效终点为秒表评估的任何尝试和成功性交时的勃起持续时间（分钟），以及在第12周/最后一次观察结转（LOCF）时评估的国际勃起功能指数（EF-IIEF）勃起功能领域得分。次要终点是性接触档案问题三（SEP3）应答率和男性性生活质量。参与女性的终点为秒表评估的性交持续时间和性生活质量。 共纳入 52 名男性。42%患有中度ED。58%的基线值为重度 ED。在第 12 周/LOCF，服用 Hg 的患者与 EM 组相比，勃起持续时间更长（最小平方均值 ± 标准误差分别为 10.3±0.8 分钟 vs. 7.7±0.7 分钟和 10.3±0.8 分钟 vs. 7.8 ±1.0 分钟），EF-IIEF 评分、SEP3 反应和所有性生活 QoL 项目均显著增加。此外，还观察到性交持续时间延长。女性的性生活质量明显提高。两个持续时间终点都与 EF-IIEF 分数密切相关，三个终点都与 SEP3 反应密切相关。男性和女性的性生活质量评分与性交持续时间的相关性良好，仅在持续时间终点上存在组间差异。Hg 组的安全性优于 EM 组。 研究结果表明，勃起持续时间是评估草药补充剂（HS）的一种新型疗效指标，可用作受 ED 影响的夫妇性功能的预测指标或疗效指标。在测量持续时间的方法方面，秒表法被证明是可靠的，能够补充传统的自我评估疗效方法，用于评价中草药补充剂的疗效。Hg的改善效果最好：与 EM 绝对相比，Hg 和 EM 能够：延长勃起时间；提高性快感。从而提高夫妻双方的性生活质量。最重要的是，性伴侣不会有不忠的风险。 不
{"title":"(125) Efficacy of Hilti Gold vs. Epimedyumlu Macun in Duration of Erection and Its Correlation with Partners ´Sexual Quality of Life","authors":"K. Drasa, E. Bylykbashi","doi":"10.1093/jsxmed/qdae002.113","DOIUrl":"https://doi.org/10.1093/jsxmed/qdae002.113","url":null,"abstract":"\u0000 \u0000 \u0000 In healthy men, the average duration of sexual intercourse ranges from nine to ten minutes. However, duration of erection has been shown to be shorter in men with Erectile Dysfunction (ED) and even shorter for men with ED plus associated underlying conditions. Furthermore, duration of Penis erection is most important for sexual couple.\u0000 \u0000 \u0000 \u0000 The aim of this study was to assess two herbal supplements: HILTI gold (Hg) vs Epimedyumlu Macun (EM) efficacy in terms of duration of erection and (i) Its correlation with other efficacy end points and male and female sexual quality of life (QoL) and (ii) Its impact on intercourse duration.\u0000 \u0000 \u0000 \u0000 A double-blind, controlled trial randomized men (18–65 years of age) with ED for more than six months, to receive fixed-dose either Hg, 1 capsule or EM, 1 tea spoon (60 minutes prior intercourse) for 12 weeks in 52 patients with ED, after four-week without medication. Primary efficacy end points were stopwatch-assessed duration of erection (min) at any attempt and when leading to successful intercourse, and the erectile function domain of the International Index of Erectile Function (EF-IIEF) score was assessed at week 12/ last observation carried forward (LOCF). Secondary end points were Sexual Encounter Profile question three (SEP3) response rate and male sexual QoL. End points in participating women were stopwatch-assessed duration of intercourse and sexual QoL.\u0000 \u0000 \u0000 \u0000 52 men included. 42% had moderate ED. 58% had severe ED at baseline. At week 12 / LOCF, patients taking Hg had longer duration of erections vs EM group (least square mean ± standard error 10.3±0.8 minutes vs. 7.7±0.7 minutes, and 10.3±0.8 vs. 7.8 ±1.0 minutes, respectively), and significant increases in EF-IIEF scores, the SEP3 response, and all sexual QoL items. An increased duration of intercourse was also observed. Female sexual QoL improved significantly. Both duration end points strongly correlated with EF-IIEF scores, and the three end points correlated well with SEP3 response. Correlation was good with sexual QoL scores in men and women and with duration of intercourse, with difference between groups only for duration end points. Safety was better in Hg than in EM group.\u0000 \u0000 \u0000 \u0000 The results indicate that duration of erection represents a novel efficacy measures for evaluating those herbal supplements (HS), and could be used as a predictor or efficacy measure of sexual performance in couples affected by ED. With regard to the method of measuring duration, stopwatch method was shown to be reliable and capable of complementing traditional self-assessment efficacy methods for evaluating the efficacy of HS. Hg is the best to significantly improve: Duration of erection in men with ED and Sexual QoL, in both members of a couple affected by ED than EM Absolutely, Hg and EM: Increase duration of erection; Improve sexual pleasure. And, thereby improving the sexual QoL of the COUPLE. And, most important is that sexual couples don’t risk to be un","PeriodicalId":377411,"journal":{"name":"The Journal of Sexual Medicine","volume":"46 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140279280","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/qdae002.138
O. Knigavko
The venous leakage is one of the most often reason of erectile dysfunction (ED) in young and middle age men. The main reason of venous leakage or veno-occlusive Erectile Dysfunction (VOED) is the insufficiency venous obstruction under tunica albuginea of corpora cavernosa. Accordingly all types of veno-occlusive operations have particular and short term effect up to renovation of venous leakage in half year. Conservative treatment of VOED with PDE-5 has a low or mild effectiveness. Evermore young patients deny penile prosthesis implantation for psychological reason. We want to stimulate growth of endothelial valves under tunica albuginea with injections autological mesenchymal stem cells (ASC) and autological VEGF (Vascular endothelial growth factor) and combine it with veno-occlusive surgeries. 2012–2022 we treated 178 patients with VOED. The average patient age is 36.5 +4.1 years. Patients with prostatitis or depression/anxiety were excluded from the investigation or treated previously. We embolizated deep dorsal and Santorini plexus veins for patients with distal form of VOED–47 patients -Group 1. We ligated deep dorsal and penile veins for proximal form of VOED – 68 patients – Group 2. And we made both methods together for 65 patients –Group 3 with combination of proximal and distal leak. Patients with only surgical methods created subgroup A – 105 men. For improving of veno-occlusive mechanism for 73 patients (subgroup B) we injected to each corpus cavernosa 1 mln of autological stem cells 6 times (2 times before, during surgery and 3 times after surgery) each month and we performed 15 microinjections of VEGF each 10 days. Then we compared short (2 months) and long term (10 months) results. The efficacy of surgical treatment according to subjective data (questionnaires on IIEF-5) in 2 months was almost equal (16.7+3.1 and 16.9+3.0), but in 10 months significantly higher in SubGroup B(14.3+3.2 and 19.6+3.4). According to Doppler Penile Ultrasound in 10 months adding microinjections ASC and VEGF to surgery significantly improves Erectile function (absence of venous leakage) 56.4% - subgroup A and 87.4% - subgroup B. Only 6.8% patients subgroup B (opposite to 35.9% subgroup A) have to take PDE-5 inhibitors for maintain erectile function. Half year injections of ASC and VEGF improve of veno-occlusive mechanism and increases effectiveness and long term result of veno-occlusive operations for treatment of VOED. Combine occlusive method (embolisation and ligation of veins) has the highest effectiveness and should be used in different types of leakage. No.
{"title":"(152) Efficiency Improvement Veno-Occlusive Surgeries for Treatment of Venous Leak with Autologous Stem Cell, VEGF and PRP","authors":"O. Knigavko","doi":"10.1093/jsxmed/qdae002.138","DOIUrl":"https://doi.org/10.1093/jsxmed/qdae002.138","url":null,"abstract":"\u0000 \u0000 \u0000 The venous leakage is one of the most often reason of erectile dysfunction (ED) in young and middle age men. The main reason of venous leakage or veno-occlusive Erectile Dysfunction (VOED) is the insufficiency venous obstruction under tunica albuginea of corpora cavernosa. Accordingly all types of veno-occlusive operations have particular and short term effect up to renovation of venous leakage in half year. Conservative treatment of VOED with PDE-5 has a low or mild effectiveness. Evermore young patients deny penile prosthesis implantation for psychological reason.\u0000 \u0000 \u0000 \u0000 We want to stimulate growth of endothelial valves under tunica albuginea with injections autological mesenchymal stem cells (ASC) and autological VEGF (Vascular endothelial growth factor) and combine it with veno-occlusive surgeries.\u0000 \u0000 \u0000 \u0000 2012–2022 we treated 178 patients with VOED. The average patient age is 36.5 +4.1 years. Patients with prostatitis or depression/anxiety were excluded from the investigation or treated previously. We embolizated deep dorsal and Santorini plexus veins for patients with distal form of VOED–47 patients -Group 1. We ligated deep dorsal and penile veins for proximal form of VOED – 68 patients – Group 2. And we made both methods together for 65 patients –Group 3 with combination of proximal and distal leak. Patients with only surgical methods created subgroup A – 105 men. For improving of veno-occlusive mechanism for 73 patients (subgroup B) we injected to each corpus cavernosa 1 mln of autological stem cells 6 times (2 times before, during surgery and 3 times after surgery) each month and we performed 15 microinjections of VEGF each 10 days. Then we compared short (2 months) and long term (10 months) results.\u0000 \u0000 \u0000 \u0000 The efficacy of surgical treatment according to subjective data (questionnaires on IIEF-5) in 2 months was almost equal (16.7+3.1 and 16.9+3.0), but in 10 months significantly higher in SubGroup B(14.3+3.2 and 19.6+3.4). According to Doppler Penile Ultrasound in 10 months adding microinjections ASC and VEGF to surgery significantly improves Erectile function (absence of venous leakage) 56.4% - subgroup A and 87.4% - subgroup B. Only 6.8% patients subgroup B (opposite to 35.9% subgroup A) have to take PDE-5 inhibitors for maintain erectile function.\u0000 \u0000 \u0000 \u0000 Half year injections of ASC and VEGF improve of veno-occlusive mechanism and increases effectiveness and long term result of veno-occlusive operations for treatment of VOED. Combine occlusive method (embolisation and ligation of veins) has the highest effectiveness and should be used in different types of leakage.\u0000 \u0000 \u0000 \u0000 No.\u0000 \u0000","PeriodicalId":377411,"journal":{"name":"The Journal of Sexual Medicine","volume":"354 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140280256","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/qdae002.158
B. T. Aujo, N. Nakasujja, A. Turiho, J. L. Gumikiriza, O. Kakaire
Sexual dysfunction is a significant problem among women, and it is associated with maladaptive coping mechanisms that can further worsen the situation. In African regions, the prevalence of female sexual dysfunction (FSD) is highly linked to hormonal contraceptives (HCs), a popular method of birth control. Uganda has a relatively high prevalence of HC use among women of reproductive age. However, there is limited research on sexual dysfunction and coping mechanisms among women who use HCs in Kawempe Hospital. This study aimed to (1) estimate the prevalence of sexual dysfunction among women who use hormonal contraceptives, (2) describe the coping mechanisms used by women who use hormonal contraceptives, and (3) identify the sociodemographic and clinical characteristics associated with sexual dysfunction among women using hormonal contraceptives at Kawempe Hospital. This was a cross-sectional study where sexually active adult females who were on hormonal contraceptives and gave informed consent were consecutively sampled. The female sexual function index and the SexFlex scale were used to assess sexual dysfunction and coping mechanisms of women using hormonal contraceptives. Means, proportions, chi squares and logistic regression were used to describe the population and determine characteristics associated with sexual dysfunction. Of the 401 participants recruited for the study, 386 were analyzed due to 15 incomplete questionnaires. The average age of participants was 29.4 years. Of the participants, almost half 46.6% used implants. The prevalence of FSD was 74.6%. Participants with FSD reported more reflexive 82 (28.47%) and less approach coping 62 (21.53%) than participants without FSD. Factors associated with FSD were relationship dissatisfaction (OR=3.78, 95% CI: 1.68, 8.5), psychological distress (OR=2.12, 95% CI: 1.17, 3.86), finding sex important (OR=0.22, 95%CI: 0.05, 0.88) and approach coping mechanisms (OR=0.49, 95%CI: 0.26, 0.95). FSD was not significantly associated with HCs This study found that women HCs have a high prevalence of FSD that is associated with psychological factors such as relationship dissatisfaction and psychological distress. The study suggests that women using HCs should be regularly screened for FSD and that clinicians should help them find solutions to the underlying causes. No.
{"title":"(174) Sexual Dysfunction and Coping Mechanisms among Women Using Hormonal Contraceptives at Kawempe Hospital - A Cross-Sectional Study","authors":"B. T. Aujo, N. Nakasujja, A. Turiho, J. L. Gumikiriza, O. Kakaire","doi":"10.1093/jsxmed/qdae002.158","DOIUrl":"https://doi.org/10.1093/jsxmed/qdae002.158","url":null,"abstract":"\u0000 \u0000 \u0000 Sexual dysfunction is a significant problem among women, and it is associated with maladaptive coping mechanisms that can further worsen the situation. In African regions, the prevalence of female sexual dysfunction (FSD) is highly linked to hormonal contraceptives (HCs), a popular method of birth control. Uganda has a relatively high prevalence of HC use among women of reproductive age. However, there is limited research on sexual dysfunction and coping mechanisms among women who use HCs in Kawempe Hospital.\u0000 \u0000 \u0000 \u0000 This study aimed to (1) estimate the prevalence of sexual dysfunction among women who use hormonal contraceptives, (2) describe the coping mechanisms used by women who use hormonal contraceptives, and (3) identify the sociodemographic and clinical characteristics associated with sexual dysfunction among women using hormonal contraceptives at Kawempe Hospital.\u0000 \u0000 \u0000 \u0000 This was a cross-sectional study where sexually active adult females who were on hormonal contraceptives and gave informed consent were consecutively sampled. The female sexual function index and the SexFlex scale were used to assess sexual dysfunction and coping mechanisms of women using hormonal contraceptives. Means, proportions, chi squares and logistic regression were used to describe the population and determine characteristics associated with sexual dysfunction.\u0000 \u0000 \u0000 \u0000 Of the 401 participants recruited for the study, 386 were analyzed due to 15 incomplete questionnaires. The average age of participants was 29.4 years. Of the participants, almost half 46.6% used implants. The prevalence of FSD was 74.6%. Participants with FSD reported more reflexive 82 (28.47%) and less approach coping 62 (21.53%) than participants without FSD. Factors associated with FSD were relationship dissatisfaction (OR=3.78, 95% CI: 1.68, 8.5), psychological distress (OR=2.12, 95% CI: 1.17, 3.86), finding sex important (OR=0.22, 95%CI: 0.05, 0.88) and approach coping mechanisms (OR=0.49, 95%CI: 0.26, 0.95). FSD was not significantly associated with HCs\u0000 \u0000 \u0000 \u0000 This study found that women HCs have a high prevalence of FSD that is associated with psychological factors such as relationship dissatisfaction and psychological distress. The study suggests that women using HCs should be regularly screened for FSD and that clinicians should help them find solutions to the underlying causes.\u0000 \u0000 \u0000 \u0000 No.\u0000","PeriodicalId":377411,"journal":{"name":"The Journal of Sexual Medicine","volume":"282 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140280447","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/qdae002.082
N. Thi Huyen Trang, H. Pham Thi My, T. Nguyen Thi Thu, K. Nguyen Thanh, H. Pham Van
Infertility is a significant issue that affects many couples worldwide. Depression is one of the most common psychiatric disorders among infertile patients. This study aims to determine the prevalence of depression and its determinant factors among infertile patients in the Andrology and Fertility Hospital of Hanoi based on the PHQ-9. The study was conducted among 360 infertile patients who visited the Andrology and Fertility Hospital of Hanoi between August 2022 and January 2023. Depression was measured using the Patient Health Questionnaire-9 (PHQ-9). The relationships between depression and demographic/fertility characteristics were explored using univariate and multiple logistic regression with an odds ratio (OR) and 95% confidence interval (CI). The mean total PHQ-9 score was 4.47 (SD = 4.14). Using a cut-off value of 10, the prevalence of depression was 11.7%. Depression was significantly associated with being age over 35 years old (OR = 2.24, 95% CI =1.05 – 4.76), having an income per month of less than 10 million VND (OR=2.01; 95%CI (1.01 – 4.72), husbands feeling pressured to have children (OR = 2.26, 95%CI = 1.08 – 4.72), feeling uncomfortable when others find out about infertility (OR=2.78, 95%CI = 1.36 – 5.67), not receiving support from the workplace (OR=2.55, 95%CI = 1.25 – 5.20) and believing they can be happy without children (OR=4.41, 95%CI = 1.37 – 14.18). The high prevalence of depression among infertile patients in this study highlights the need for healthcare providers to screen and provide psychological support to this population. The finding that female aged above 35, low income, with husbands pressuring them to have kids, feeling uncomfortable when others know about their infertility, and lacking support from their workplace was found to be significant risk factors for depression are significant determinants of depression among infertile patients suggests that interventions should be targeted toward these groups. No.
{"title":"(090) Depression Among Infertile Women: Prevalence and Risk Factors","authors":"N. Thi Huyen Trang, H. Pham Thi My, T. Nguyen Thi Thu, K. Nguyen Thanh, H. Pham Van","doi":"10.1093/jsxmed/qdae002.082","DOIUrl":"https://doi.org/10.1093/jsxmed/qdae002.082","url":null,"abstract":"\u0000 \u0000 \u0000 Infertility is a significant issue that affects many couples worldwide. Depression is one of the most common psychiatric disorders among infertile patients.\u0000 \u0000 \u0000 \u0000 This study aims to determine the prevalence of depression and its determinant factors among infertile patients in the Andrology and Fertility Hospital of Hanoi based on the PHQ-9.\u0000 \u0000 \u0000 \u0000 The study was conducted among 360 infertile patients who visited the Andrology and Fertility Hospital of Hanoi between August 2022 and January 2023. Depression was measured using the Patient Health Questionnaire-9 (PHQ-9). The relationships between depression and demographic/fertility characteristics were explored using univariate and multiple logistic regression with an odds ratio (OR) and 95% confidence interval (CI).\u0000 \u0000 \u0000 \u0000 The mean total PHQ-9 score was 4.47 (SD = 4.14). Using a cut-off value of 10, the prevalence of depression was 11.7%. Depression was significantly associated with being age over 35 years old (OR = 2.24, 95% CI =1.05 – 4.76), having an income per month of less than 10 million VND (OR=2.01; 95%CI (1.01 – 4.72), husbands feeling pressured to have children (OR = 2.26, 95%CI = 1.08 – 4.72), feeling uncomfortable when others find out about infertility (OR=2.78, 95%CI = 1.36 – 5.67), not receiving support from the workplace (OR=2.55, 95%CI = 1.25 – 5.20) and believing they can be happy without children (OR=4.41, 95%CI = 1.37 – 14.18).\u0000 \u0000 \u0000 \u0000 The high prevalence of depression among infertile patients in this study highlights the need for healthcare providers to screen and provide psychological support to this population. The finding that female aged above 35, low income, with husbands pressuring them to have kids, feeling uncomfortable when others know about their infertility, and lacking support from their workplace was found to be significant risk factors for depression are significant determinants of depression among infertile patients suggests that interventions should be targeted toward these groups.\u0000 \u0000 \u0000 \u0000 No.\u0000","PeriodicalId":377411,"journal":{"name":"The Journal of Sexual Medicine","volume":"203 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140280759","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/qdae002.250
M. Lu, Y. Huang
To compare the efficacy and safety of daily use PDE5i and PDE5i combined with linear low-intensity shockwave therapy (Li-SWT) in the treatment of acute phase of Peyronie disease (PD). 68 patients with acute PD within 6 month onset were collected. The patients were 26–56 years old with an average of 42.3 years. The patients were randomly divided into two groups, 35 of which were orally administered with 5 mg of tadalafil every night for 3 months; the other 33 received 4 times of Li-SWT with daily PDE5i. Li-SWT uses the Renova shock wave therapy device with an energy density of 0.09mJ/mm2, each time 3200 times in the penile plaque, 900 times in the left and right penile shaft, and once a week for 4 consecutive treatments as a cycle. All patients underwent ultrasound or MRI, penile bending angle measurement, improvement of subjective symptoms, and IIEF-5 scale before and after treatment. 68 patients with acute PD within 6 month onset were collected. The patients were 26–56 years old with an average of 42.3 years. The patients were randomly divided into two groups, 35 of which were orally administered with 5 mg of tadalafil every night for 3 months; the other 33 received 4 times of Li-SWT with daily PDE5i. Li-SWT uses the Renova shock wave therapy device with an energy density of 0.09mJ/mm2, each time 3200 times in the penile plaque, 900 times in the left and right penile shaft, and once a week for 4 consecutive treatments as a cycle. All patients underwent ultrasound or MRI, penile bending angle measurement, improvement of subjective symptoms, and IIEF-5 scale before and after treatment. In the PDE5i group, the pain symptom relieve were improved in 80% patients (28 of 35 cases), while the combined group (PDE5i+Li-SWT) were improved in 90.9% patients (30 of 33 cases). The IIEF5 score in the PDE5i group improved from 13.8±7.9 to 19.5±8.1 and from 13.4±7.6 to 21.3±9.2 in the combined group, with both improvement between two groups. The plaque size were shrinkage 5 cases in PDE5i group and 12 cases in combined group, but penile curvature did not change significantly in both groups. In the PDE5i group, 5 patients had mild dizziness and back pain, while 3 patients had mild dizziness and back pain in combined group. There was no obvious adverse reaction observed for Li-SWT treatment. Both the daily use PDE5i and the PDE5i combined with Li-SWT can improve the symptoms of acute PD patients, mainly to relieve pain and improve erectile function in some patients. The combined group had a better pain symptom relieve rate and more improvement for sexual function. The two methods can reduce PD plaque size in some cases, while both groups did not significantly change penile curvature. Both methods have good safety in the treatment of acute phase PD. No.
{"title":"(289) Combined Therapy with Low-intensity Shockwave Therapy and Daily PDE5i Showed Better Pain Relieve and Sexual Function Improvement in Acute Phase of Peyronie Disease","authors":"M. Lu, Y. Huang","doi":"10.1093/jsxmed/qdae002.250","DOIUrl":"https://doi.org/10.1093/jsxmed/qdae002.250","url":null,"abstract":"\u0000 \u0000 \u0000 To compare the efficacy and safety of daily use PDE5i and PDE5i combined with linear low-intensity shockwave therapy (Li-SWT) in the treatment of acute phase of Peyronie disease (PD).\u0000 \u0000 \u0000 \u0000 68 patients with acute PD within 6 month onset were collected. The patients were 26–56 years old with an average of 42.3 years. The patients were randomly divided into two groups, 35 of which were orally administered with 5 mg of tadalafil every night for 3 months; the other 33 received 4 times of Li-SWT with daily PDE5i. Li-SWT uses the Renova shock wave therapy device with an energy density of 0.09mJ/mm2, each time 3200 times in the penile plaque, 900 times in the left and right penile shaft, and once a week for 4 consecutive treatments as a cycle. All patients underwent ultrasound or MRI, penile bending angle measurement, improvement of subjective symptoms, and IIEF-5 scale before and after treatment.\u0000 \u0000 \u0000 \u0000 68 patients with acute PD within 6 month onset were collected. The patients were 26–56 years old with an average of 42.3 years. The patients were randomly divided into two groups, 35 of which were orally administered with 5 mg of tadalafil every night for 3 months; the other 33 received 4 times of Li-SWT with daily PDE5i. Li-SWT uses the Renova shock wave therapy device with an energy density of 0.09mJ/mm2, each time 3200 times in the penile plaque, 900 times in the left and right penile shaft, and once a week for 4 consecutive treatments as a cycle. All patients underwent ultrasound or MRI, penile bending angle measurement, improvement of subjective symptoms, and IIEF-5 scale before and after treatment.\u0000 \u0000 \u0000 \u0000 In the PDE5i group, the pain symptom relieve were improved in 80% patients (28 of 35 cases), while the combined group (PDE5i+Li-SWT) were improved in 90.9% patients (30 of 33 cases). The IIEF5 score in the PDE5i group improved from 13.8±7.9 to 19.5±8.1 and from 13.4±7.6 to 21.3±9.2 in the combined group, with both improvement between two groups. The plaque size were shrinkage 5 cases in PDE5i group and 12 cases in combined group, but penile curvature did not change significantly in both groups. In the PDE5i group, 5 patients had mild dizziness and back pain, while 3 patients had mild dizziness and back pain in combined group. There was no obvious adverse reaction observed for Li-SWT treatment.\u0000 \u0000 \u0000 \u0000 Both the daily use PDE5i and the PDE5i combined with Li-SWT can improve the symptoms of acute PD patients, mainly to relieve pain and improve erectile function in some patients. The combined group had a better pain symptom relieve rate and more improvement for sexual function. The two methods can reduce PD plaque size in some cases, while both groups did not significantly change penile curvature. Both methods have good safety in the treatment of acute phase PD.\u0000 \u0000 \u0000 \u0000 No.\u0000","PeriodicalId":377411,"journal":{"name":"The Journal of Sexual Medicine","volume":"37 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140082632","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}
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