Journal of Sexual Medicine最新文献

Introduction: Platelet-rich therapies (PRTs), including platelet-rich plasma and platelet-rich fibrin matrix, have drawn attention as treatments for erectile dysfunction (ED). However, evidence regarding their effectiveness remains limited.

Objectives: To determine the efficacy of PRTs in the treatment of ED.

Methods: We performed a systematic search of PubMed, Embase, and Cochrane Library in April 2025 for studies comparing PRT with placebo in patients with ED. Pooled risk ratios, mean differences, and standardized mean differences with 95% CIs were calculated. We used the Grading of Recommendations Assessment, Development, and Evaluation tool to assess the certainty of evidence and strength of recommendations. The outcomes of interest were the mean change in the erectile function domain of the International Index of Erectile Function (IIEF) score, the rate of men achieving minimum clinically important difference (MCID) in the IIEF-EF score, peak systolic velocity (PSV), end diastolic velocity (EDV), and visual analogue scale (VAS) pain score after injection.

Results: We included seven randomized controlled trials (RCTs) comprising 479 patients, of whom 239 (49.9%) were randomized to PRTs. There were no differences between PRTs and placebo in the combined IIEF score at 1, 3, and 6 months of follow-up. There was no difference between groups in terms of the rate of men achieving MCID in IIEF-EF at 1 month, and at 3 months. PRTs showed a significantly higher rate of men achieving MCID in IIEF-EF at 6 months; however, it is noteworthy that only 3 studies provided data for this outcome, which may limit the robustness and generalizability of this result, thus should be interpreted with caution. There were no differences between groups in the PSV, EDV, and VAS pain score after injection.

Conclusion: This meta-analysis of RCTs provides low-to-moderate certainty evidence that PRTs do not confer superior efficacy over placebo in improving sexual function in men with ED. However, the small number of patients restricts the generalizability of our conclusions. Additional high-quality studies are required to clarify the clinical role of PRTs in the management of ED.

Background: The psychosexual characteristics of women who report experiencing squirting (Sq)-ie, the copious expulsion of fluid during sexual stimulation, typically coincident with female orgasm, and distinct from other forms of periorgasmic fluids (POF)-have been scarcely investigated.

Aim: To delineate the psychological and sexual functioning profile of women who report the ability to squirt, through the integration of clinical data of enrolled women as well as validated psychosexual assessments and biochemical analysis of POF samples.

Methods: This single-center, cross-sectional, case-control study involved 13 selected women who self-reported the production of POF. Participants completed a comprehensive battery of validated psychometric instruments, including the Female Sexual Function Index (FSFI), Orgasmometer-F, Body Uneasiness Test (BUT), Middlesex Hospital Questionnaire, Attachment Style Questionnaire, and the Sexual Inhibition/Sexual Excitation Scale (SIS/SES). Each participant provided POF samples collected at home, which were subjected to biochemical analysis to distinguish Sq from other potential types of POF.

Outcomes: The psychosexual characteristics of the women able to produce Sq were compared with those of a sample of age-matched women unable to produce Sq.

Results: Among the 13 individuals from whom POF samples were obtained, 8 were classified as Sq producers, 4 as exhibiting coital incontinence (CI), and 1 as displaying female ejaculation (FE). Compared to controls, women in the Sq group demonstrated significantly higher scores on the FSFI Total (P < .001), as well as in the Desire (P = .044), Arousal (P < .001), and Lubrication (P = .013) subdomains. Additionally, they reported higher scores on the Orgasmometer (P = 0.008) and the SES scale (P = .017), alongside significantly lower scores on the BUT (P = .018) and the Discomfort with Closeness subscale (P = .017).

Clinical implications: These findings suggest that women who report Sq may exhibit better overall sexual functioning, more positive body image, and more secure relational attachment. Encouraging open, evidence-based discussions within clinical settings may facilitate more personalized care and contribute to improved sexual well-being.

Strengths and limitations: The use of validated psychometric instruments and the inclusion of a control group enhance the reliability of the findings. However, the small sample size and reliance on self-reported data limit the generalizability of the results.

Conclusion: Women who report Sq appear to exhibit more active psychosexual characteristics than those who do not. Further research with larger and more diverse samples is warranted to validate and expand upon these findings.