Journal of Sexual Medicine最新文献

Introduction: Penile prosthesis implantation (PPI) is the definitive treatment for men with severe erectile dysfunction refractory to medical therapy. Conventional technique for cavernosal dilation at time of PPI often involves serial cavernosal dilation (CD), which may compromise residual erectile tissue and vascular integrity. In contrast, cavernous sparing (CS) aims to preserve cavernosal artery function, spontaneous penile tumescence, and penile girth.

Objectives: This study systematically compared perioperative and postoperative outcomes between CS and CD technique at time of PPI.

Methods: A comprehensive literature search was conducted across PubMed, Scopus, Web of Science, and Cochrane databases. Randomized controlled trials and prospective studies comparing CS versus CD techniques at time of PPI were included. Primary outcomes assessed were cavernosal artery preservation, residual tumescence, and postoperative penile girth. Secondary outcomes included complication rates and patient satisfaction.

Results: Four randomized studies involving 193 patients met inclusion criteria. Cavernosal artery preservation was significantly higher in the CS group (OR = 95.92 [24.33-377.70], P < .0001). Residual tumescence occurred in 86.6%-89.13% of CS versus 6.6%-15.2% in CD group (P < .001). Penile girth gains were consistently greater in the CS, with mean increases ranging from 0.55 to 1.81 cm. Complication rates were statistically similar between the two techniques.

Conclusion: Cavernous tissue-sparing techniques offer superior functional outcomes without increasing complication risk. Proper surgical approach for CD at time of PPI should be selectively tailored to corpora cavernosal anatomy including intra-corporal fibrosis severity and complexity.

Introduction: Female sexual dysfunction (FSD) is a common issue, but currently only a few studies have evaluated the problem in breast cancer survivors.

Objectives: We aim to systematically evaluate the prevalence and risk factors of FSD among breast cancer survivors globally.

Methods: We searched PubMed, Embase, Web of Science, Cochrane Library, Scopus, CNKI, SinoMed, WanFang, and VIP databases from January 1, 2014 to October 10, 2025, to identify studies on the prevalence and risk factors of FSD in breast cancer survivors. Two researchers independently screened the literature, extracted data, and assessed the risk of bias. Finally, a meta-analysis was conducted using Stata 17.

Results: A total of 36 studies were included, involving 9749 breast cancer survivors. The meta-analysis showed that the pooled prevalence of FSD among global breast cancer survivors was 70% (95% CI, [64%-76%]), and the prevalence of sexual distress was 57% (95% CI, [29%-86%]). There were significant differences in the prevalence of FSD among different educational levels, economic development levels, pathological stages, surgical methods, and first post-operative sexual intercourse time. Mastectomy, adjuvant therapies, dissatisfaction with body image, and lack of sexual counseling were all risk factors for FSD in breast cancer survivors.

Conclusion: Female sexual dysfunction is a common issue among breast cancer survivors, disease-related factors and the lack of sexual counseling are significantly associated with FSD, and sexual health assessment should be incorporated into the routine diagnosis and treatment of breast cancer in the future.