Journal of Sexual Medicine最新文献

英文中文

Erectile dysfunction in the young and restless: rethinking the rise of erectile dysfunction in young men: Perspective on "Erectile dysfunction prevalence in the United States: report from the 2021 National Survey of Sexual Wellbeing". 年轻人和躁动不安的勃起功能障碍：重新思考年轻男性勃起功能障碍的上升：对“美国勃起功能障碍患病率：来自2021年全国性健康调查报告”的看法。

IF 3.3 3区医学 Q1 UROLOGY & NEPHROLOGY

Journal of Sexual Medicine

Pub Date : 2026-01-07 DOI: 10.1093/jsxmed/qdaf394

Laura N Oscar, Karen Zhang, Run Wang

引用次数: 0

Response to Letter to the Editor on "A novel algorithm-based risk classification for vascular damage in men with erectile dysfunction". 关于“一种新的基于算法的男性勃起功能障碍血管损伤风险分类”的致编辑信的回复。

IF 3.3 3区医学 Q1 UROLOGY & NEPHROLOGY

Journal of Sexual Medicine

Pub Date : 2026-01-07 DOI: 10.1093/jsxmed/qdaf386

Federico Belladelli, Francesco Cei, Edoardo Pozzi, Alessandro Bertini, Christian Corsini, Massimiliano Raffo, Fausto Negri, Giacomo Musso, Riccardo Ramadani, Francesco Cattafi, Luigi Candela, Luca Boeri, Alessia d'Arma, Francesco Montorsi, Andrea Salonia

引用次数: 0

Gender-affirming orchiectomy with or without scrotectomy? Patients' perspectives and surgical outcomes. 性别确认睾丸切除术加还是不加阴囊切除术？患者的观点和手术结果。

IF 3.3 3区医学 Q1 UROLOGY & NEPHROLOGY

Journal of Sexual Medicine

Pub Date : 2026-01-07 DOI: 10.1093/jsxmed/qdaf401

Yulia Wilk Goldsher, Dayana Davoudi, Katherine Lajkosz, Emily MacLeod, Lauren Pickel, Olivia Drodge, Emery Potter, Ethan D Grober, Yonah Krakowsky, Alexandra L Millman

引用次数: 0

Health disparities among LGBTQ+ adults aged 33-35 in northern Finland: findings from the NFBC1986 cohort. 芬兰北部33-35岁LGBTQ+成年人的健康差异：来自NFBC1986队列的研究结果

IF 3.3 3区医学 Q1 UROLOGY & NEPHROLOGY

Journal of Sexual Medicine

Pub Date : 2026-01-07 DOI: 10.1093/jsxmed/qdaf366

Elo Kuuluvainen, Marja Kaila-Vanhatalo, Tanja Nordström, Terhi T Piltonen, Pekka Pinola

Background: Lesbian, gay, bisexual, transgender, queer, and other sexual and gender minority (LGBTQ+) individuals experience elevated health-related risks and a higher prevalence of physical diseases, often attributed to minority stress resulting from discrimination and victimization related to their minority status.Aim: This cross-sectional study examined health-related risk factors (socioeconomic status, obesity, substance abuse, and physical inactivity), self-rated health, functional limitations, and physical morbidity among LGBTQ+ participants aged 33-35 in the population-based Northern Finland Birth Cohort 1986 (NFBC1986).Methods: Data were drawn from NFBC1986 and were entirely self-reported. Assessed health parameters included sociodemographic and behavioral factors considered as health-related risk factors (current marital status, socioeconomic status, body mass index (BMI), smoking, alcohol use, physical activity), current self-rated health, functional limitations due to medical conditions in the past 6 months, and lifetime physical morbidity. Independent samples' t-tests, Mann-Whitney U-tests for non-normal distributions, and binary logistic regression were used to compare outcomes between LGBTQ+ and cisgender heterosexual participants. The study population comprised 2841 participants: 2721 (95.8%) cisgender heterosexual and 120 LGBTQ+ participants. Among the cisgender heterosexual participants, 1720 (63.2%) were women and 1001 men. Of the LGBTQ+ group, 103 (85.8%) belonged to cisgender sexual minority group, and 17 belonged to gender minority group.Outcomes: LGBTQ+ participants experience poorer health outcomes than cisgender heterosexual participants, which may be linked to minority stress related to stigma, discrimination, and victimization.Results: LGBTQ+ participants reported significantly poorer self-rated health than cisgender heterosexual participants in both assigned female at birth (AFAB; P < .001), and assigned male at birth (AMAB; P = .030) groups, and were more often unpartnered (AFAB: P = .003; AMAB P < .001). AFAB LGBTQ+ participants also had lower socioeconomic status (P = .012), higher BMI (P = .006), and greater functional limitations (P = .022). AMAB LGBTQ+ participants were more likely non-smokers compared to cisgender heterosexual participants (P = .026). No significant differences were observed in physical morbidity between the groups.Clinical implications: This study highlights the need for further consideration of the health of LGBTQ+ population and the implementation of healthcare interventions aimed at improving the health of this specific group.Strengths and limitations: This study's main strength is the rich lifelong health data from the NFBC1986 cohort, while its limitation lies in the moderate sub-sample sizes.Conclusion: A

背景：女同性恋、男同性恋、双性恋、变性人、酷儿和其他性少数和性别少数群体（LGBTQ+）的健康相关风险更高，身体疾病患病率更高，这通常归因于与他们的少数群体身份相关的歧视和受害所造成的少数群体压力。目的：本横断面研究在以人口为基础的1986年芬兰北部出生队列（NFBC1986）中，检查了年龄在33-35岁的LGBTQ+参与者的健康相关风险因素（社会经济地位、肥胖、药物滥用和缺乏身体活动）、自评健康、功能限制和身体发病率。方法：数据来自NFBC1986，完全由患者自我报告。评估的健康参数包括被认为是健康相关危险因素的社会人口和行为因素（目前的婚姻状况、社会经济状况、身体质量指数（BMI）、吸烟、饮酒、体育活动）、目前的自我评估健康、过去6个月因医疗条件造成的功能限制以及终生身体发病率。采用独立样本t检验、非正态分布的Mann-Whitney u检验和二元logistic回归比较LGBTQ+和异性恋参与者的结果。研究人群包括2841名参与者：2721名（95.8%）顺性别异性恋者和120名LGBTQ+参与者。在异性恋者中，女性1720人（63.2%），男性1001人。LGBTQ+群体中，103人（85.8%）属于顺性少数群体，17人属于性别少数群体。结果：LGBTQ+参与者的健康状况比顺性异性恋参与者差，这可能与与耻辱、歧视和受害相关的少数群体压力有关。结果：LGBTQ+被试的自评健康状况显著低于顺性异性恋被试（AFAB）；临床意义：本研究强调需要进一步考虑LGBTQ+人群的健康状况，并实施旨在改善这一特定群体健康的医疗干预措施。优势和局限性：本研究的主要优势是来自NFBC1986队列的丰富的终身健康数据，而其局限性在于亚样本量适中。结论：在33-35岁时，LGBTQ+参与者面临较低的社会经济地位、较高的单身可能性、较高的BMI、较差的自评健康和更大的功能限制，尽管与顺性异性恋参与者相比，身体发病率没有差异。

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引用次数: 0

Penile implants after phalloplasty in transgender individuals: a consensus-based surgical clinical protocol concerning pre-, peri-, and postoperative care. 变性人阴茎成形术后阴茎植入：一项基于共识的手术临床方案，涉及术前、围手术期和术后护理。

IF 3.3 3区医学 Q1 UROLOGY & NEPHROLOGY

Journal of Sexual Medicine

Pub Date : 2026-01-07 DOI: 10.1093/jsxmed/qdaf365

Maya Levy, Marco Falcone, Julia Bohr, Wai Gin Lee, Nicolas Morel-Journel, Saskia Morgenstern, David Ralph, Garry Pigot

Background: Individuals undergoing phalloplasty as part of their gender-affirming medical transition are subsequently able to undergo insertion of a penile implant to achieve rigidity in the neophallus for penetrative intercourse. These procedures require specific knowledge and surgical skills, as the anatomy of the neophallus differs from that of the native penis. Currently, there is no universally accepted guideline for preoperative assessment, surgical technique, or postoperative care.

Aim: To address this gap, we developed consensus-based protocol informed by expert opinions to standardize peri-surgical care delivery and facilitate valid scientific evaluation.

Methods: A Delphi approach was used to develop and reach a consensus on a clinical protocol for pre-, peri-, and postoperative care related to penile prosthesis implantation surgery after phalloplasty. Surgeons who perform this procedure regularly were recruited to participate in the expert panel. The process included two rounds of voting by the expert panel to achieve maximum level of consensus on the protocol items.

Outcomes: Consensus ratings were obtained for each recommendation, culminating in a final set of items to be included in the final version of the clinical protocol.

Results: Twenty-one experts agreed to participate in the study, with 17/21 (81%) partaking in the first voting round and 16/21 (76%) in the second. In the first voting round, 65 items were presented to the expert panel, and consensus was reached on the inclusion of 27 (42%) of them. In the second round, 29 items were presented, and consensus was reached on 26 (90%) of them.

Clinical implications: This protocol can be used by physicians worldwide to enhance global clinical outcomes and facilitate scientific research by promoting consistency.

Strengths and limitations: Strengths of this protocol include its consolidation of expert opinions in a niche surgical field to create consensus-backed recommendations for care in this clinical context. However, limitations stem from the overrepresentation of certain geographical areas, which may hinder its applicability in regions with differing resources and care protocols.

Conclusion: Consensus was successfully reached on recommended practices for penile implant insertion in transgender and gender diverse individuals with phalloplasty.

背景：个体接受阴茎成形术作为其性别确认医学转变的一部分，随后能够进行插入阴茎植入物，以实现阴茎的刚性，以进行插入性交。这些手术需要特殊的知识和手术技巧，因为新阴茎的解剖结构与天然阴茎不同。目前，对于术前评估、手术技术或术后护理尚无普遍接受的指南。目的：为了解决这一差距，我们制定了基于共识的协议，并告知专家意见，以规范围手术期护理服务，促进有效的科学评估。方法：采用德尔菲法对阴茎成形术后阴茎假体植入手术的术前、围手术期和术后护理制定临床方案并达成共识。定期进行该手术的外科医生被招募参加专家小组。该进程包括由专家小组进行的两轮投票，以就议定书项目达成最大程度的协商一致意见。结果：对每项建议获得一致的评分，最终形成一组最终项目，纳入临床方案的最终版本。结果：21位专家同意参与研究，其中17/21（81%）参加了第一轮投票，16/21（76%）参加了第二轮投票。在第一轮投票中，向专家小组提交了65个项目，其中27个项目（42%）获得了共识。第二轮共提出29个议题，其中26个（90%）达成共识。临床意义：该方案可被世界各地的医生使用，通过促进一致性来提高全球临床结果和促进科学研究。优点和局限性：该方案的优点包括巩固了利基外科领域的专家意见，为临床背景下的护理提供了共识支持的建议。然而，某些地理区域的代表性过高造成了局限性，这可能妨碍其在具有不同资源和护理方案的区域的适用性。结论：跨性别及性别差异患者阴茎成形术中阴茎植入的推荐做法已成功达成共识。

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引用次数: 0

Effects of glucagon-like peptide-1 receptor agonists on male reproductive hormones, semen parameters, and metabolic outcomes: a systematic review. 胰高血糖素样肽-1受体激动剂对男性生殖激素、精液参数和代谢结果的影响：系统综述。

IF 3.3 3区医学 Q1 UROLOGY & NEPHROLOGY

Journal of Sexual Medicine

Pub Date : 2026-01-07 DOI: 10.1093/jsxmed/qdaf381

Mohammad Ghassab Deameh, Mohamed Ramez, Rashed Rowaiee, Baha' Aldeen Bani Irshid, Hamza Mohamed, Abdelrahman Abdelshafi, Mohammad Ali Al-Osoufi, Tarek Mohamed, Safa Botros Hegazin, Omer Raheem

Introduction: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are antidiabetic agents that also induce weight loss. Their widespread use has prompted investigation of potential benefits beyond glycemic control, including effects on male sexual and reproductive function. Emerging evidence suggests that they may improve male reproductive parameters, particularly in men with metabolic dysfunction.

Objectives: To systematically evaluate the effects of GLP-1RAs (liraglutide, semaglutide, dulaglutide, and exenatide) on male reproductive hormones, semen parameters, and metabolic outcomes.

Methods: We conducted a systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched in PubMed, Embase, Scopus, and Web of Science up to April 2025. Eligible studies included randomized controlled trials (RCTs) and cohort studies evaluating the effects of GLP-1RAs in adult men. Assessed the risk of bias with the risk of bias 2 tool for RCT and the Risk Of Bias In Non-Randomized Studies of Interventions (ROBINS-I) tool for observational studies.

Results: Ten studies involving a total of 639 men were included. GLP-1RAs were consistently associated with increased total testosterone, particularly in men with obesity, type 2 diabetes, or functional hypogonadism. Free testosterone changes were inconsistent, often offset by concurrent rises in sex hormone-binding globulin. Luteinizing hormone and follicle-stimulating hormone levels were preserved or increased with GLP-1RA use, in contrast to the suppression observed in testosterone therapy comparator groups. Improvements in semen parameters were reported in obese or hypogonadal men; however, no significant changes were found in healthy individuals.

Conclusion: GLP-1RAs may improve testosterone levels and potentially enhance semen quality in men with metabolic issues, while maintaining gonadotropin function. They could serve as fertility-sparing alternatives to testosterone therapy in some obesity-related hypogonadism cases. More long-term, controlled studies with standardized fertility measures are needed to confirm their role in male reproductive health.

简介：胰高血糖素样肽-1受体激动剂（GLP-1RAs）是一种抗糖尿病药物，也可诱导体重减轻。它们的广泛使用促使了对血糖控制之外的潜在益处的研究，包括对男性性功能和生殖功能的影响。新出现的证据表明，它们可以改善男性生殖参数，特别是对有代谢功能障碍的男性。目的：系统评价GLP-1RAs（利拉鲁肽、西马鲁肽、杜拉鲁肽和艾塞那肽）对男性生殖激素、精液参数和代谢结果的影响。方法：我们按照系统评价和荟萃分析指南的首选报告项目进行了系统评价。我们在PubMed， Embase， Scopus和Web of Science中检索到2025年4月。符合条件的研究包括评估GLP-1RAs对成年男性影响的随机对照试验（rct）和队列研究。使用RCT的偏倚风险2工具和观察性研究的非随机干预研究的偏倚风险（ROBINS-I）工具评估偏倚风险。结果：10项研究共纳入639名男性。GLP-1RAs始终与总睾酮增加有关，特别是在肥胖、2型糖尿病或功能性性腺功能减退的男性中。游离睾酮的变化是不一致的，经常被性激素结合球蛋白的同时升高所抵消。使用GLP-1RA时，黄体生成素和卵泡刺激素水平保持或升高，与睾酮治疗比较组观察到的抑制相反。据报道，在肥胖或性腺功能低下的男性中，精液参数有所改善；然而，在健康个体中没有发现明显的变化。结论：GLP-1RAs可能在维持促性腺激素功能的同时，提高代谢问题男性的睾丸激素水平，并可能提高精液质量。在一些与肥胖相关的性腺功能减退病例中，它们可以作为睾酮治疗的生育保护替代方案。需要对标准化生育措施进行更长期的对照研究，以确认它们在男性生殖健康中的作用。

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引用次数: 0

Response to Letter to the Editor on "Renal health and erectile dysfunction in adult men: insights from the National Health and Nutrition Examination Survey data". 关于“成年男性肾脏健康与勃起功能障碍：来自国家健康与营养检查调查数据的见解”的致编辑信的回复。

IF 3.3 3区医学 Q1 UROLOGY & NEPHROLOGY

Journal of Sexual Medicine

Pub Date : 2026-01-07 DOI: 10.1093/jsxmed/qdaf377

Renjie Huang, Miao Huang, Rui Zhang

引用次数: 0

Letter to the Editor on "Improved health-related quality of life and gender congruence after gender-affirming mastectomy: a prospective cohort study". 致编辑的信：“性别确认乳房切除术后健康相关生活质量的改善和性别一致性：一项前瞻性队列研究”。

IF 3.3 3区医学 Q1 UROLOGY & NEPHROLOGY

Journal of Sexual Medicine

Pub Date : 2026-01-07 DOI: 10.1093/jsxmed/qdaf380

Shyam Sundar Sah, Abhishek Kumbhalwar

引用次数: 0

Letter to the Editor on "The association between dietary vitamin E intake and erectile dysfunction in adults: analyses of NHANES and Mendelian randomization". 致编辑的信“膳食维生素E摄入量与成人勃起功能障碍之间的关系：NHANES和孟德尔随机化的分析”。

IF 3.3 3区医学 Q1 UROLOGY & NEPHROLOGY

Journal of Sexual Medicine

Pub Date : 2026-01-07 DOI: 10.1093/jsxmed/qdaf393

Jianguo Xu, Zhongyan Chen, Weiwei Lai

引用次数: 0

Peyronie's-like changes in the tunica albuginea were identified in reconstruction patients. 在重建患者中发现了白膜的佩罗尼样改变。

IF 3.3 3区医学 Q1 UROLOGY & NEPHROLOGY

Journal of Sexual Medicine

Pub Date : 2026-01-07 DOI: 10.1093/jsxmed/qdaf387

Alberto Colombo, Jiangping Deng, Ervin Kocjancic, Omer Acar, Daniel A Harrington, Kevin T McVary, Carol A Podlasek

Background: Tunica albuginea plays a critical role in the biomechanics of the penis, as the main bearer of mechanical forces during erection; collagen is central to changes that occur in the tunica of Peyronie's patients; however, our understanding of tunica collagen composition remains poorly understood.Aim: To quantify collagen abundance and subtypes in tunica and corpora cavernosa of reconstruction patients treated with 0-25 years of 17β-estradiol and Spironolactone.Methods: Tunica and corpora cavernosa (n = 25) were obtained from patients undergoing penectomy with reconstruction surgery. Collagen was quantified and evaluated with 17β-estradiol treatment, age, antiandrogen, and testosterone concentration. Immunohistochemistry (IHC) for collagen I-IV was performed with ImageJ quantification. Primary tunica cell cultures were established and characterized for P4HB (fibroblast), α-ACTIN (smooth muscle), and CD31 (endothelium). Fibroblast growth with Sonic hedgehog (SHH), BMP4, and GREM1 treatment were quantified.Outcomes: Hydroxyproline, IHC, and cell culture were performed.Results: Collagen abundance did not correlate with duration of 17β-estradiol and antiandrogen treatment, age, and testosterone level. Collagen III was more abundant in the corpora cavernosa than the tunica, and collagen III increased 35.4% (P = .05) in tunica of patients treated with 17β-estradiol and antiandrogen, mimicking the increased collagen III observed in Peyronie's patients. Collagen I was 12.1% higher in the corpora cavernosa than the tunica (P = .049) and was unchanged in tunica (P = .34) and corpora cavernosa (P = .41) with 17β-estradiol and antiandrogen treatment. Collagen IV increased 26.6% in corpora cavernosa with 17β-estradiol and antiandrogen treatment (P = .005). P4HB staining fibroblasts were isolated from patient tunica; fibroblasts increased growth with GREM1 and decreased growth with BMP4.Clinical implications: Reconstruction patients develop Peyronie's-like changes in collagen subtypes (collagen III) in the tunica that offer a unique opportunity to study how collagen signaling becomes dysfunctional and provide novel insight into early-stage collagen changes.Strengths and limitations: Collagen III increased in tunica of reconstruction patients. It is of interest that tunica of reconstruction patients, which do not display a plaque as in Peyronie's patients, show a similar change in collagen III abundance. It is unclear how changes in collagen subtype impact erectile function.Conclusion: In addition to 17β-estradiol and antiandrogen treatment, reconstruction patients practice aggressive taping and compression of their tissue, which may induce Peyronie's-like collagen changes from the repeated microtrauma and/or ischemia; reconstruction patient tunica may provide a novel

背景：白膜在阴茎的生物力学中起着至关重要的作用，是勃起过程中机械力的主要承载体；胶原蛋白是Peyronie患者的膜发生变化的核心；然而，我们对膜胶原组成的了解仍然很少。目的：定量观察17β-雌二醇和螺内酯治疗0 ~ 25年重建患者的膜和海绵体胶原蛋白的丰度和亚型。方法：25例阴茎切除术合并重建术患者的鞘膜和海绵体。胶原蛋白通过17β-雌二醇治疗、年龄、抗雄激素和睾酮浓度进行定量和评估。对I-IV型胶原进行免疫组化（IHC），采用ImageJ定量。培养原代膜细胞P4HB（成纤维细胞）、α-ACTIN（平滑肌）和CD31（内皮细胞）。对Sonic hedgehog （SHH）、BMP4和GREM1处理的成纤维细胞生长进行量化。结果：羟脯氨酸、免疫组化和细胞培养。结果：胶原蛋白丰度与17β-雌二醇和抗雄激素治疗时间、年龄和睾酮水平无关。海绵体中III型胶原含量高于膜层，17β-雌二醇和抗雄激素治疗组膜层中III型胶原含量增加35.4% (P = 0.05)，与Peyronie患者III型胶原含量增加相似。17β-雌二醇和抗雄激素治疗后，海绵体中I型胶原蛋白的含量比膜层高12.1% (P = 0.049)，而膜层（P = 0.34）和海绵体中I型胶原蛋白的含量没有变化（P = 0.41）。17β-雌二醇和抗雄激素组海绵体IV型胶原增加26.6% （P = 0.005）。从患者膜中分离P4HB染色成纤维细胞；GREM1组成纤维细胞生长增加，BMP4组成纤维细胞生长减少。临床意义：重建患者在被膜中胶原亚型（胶原III）发生Peyronie样变化，这为研究胶原信号如何变得功能障碍提供了独特的机会，并为早期胶原变化提供了新的见解。优势与局限性：重建患者膜内III型胶原增加。令人感兴趣的是，重建患者的膜没有像Peyronie患者那样出现斑块，但胶原蛋白III丰度也出现了类似的变化。目前尚不清楚胶原蛋白亚型的变化如何影响勃起功能。结论：除17β-雌二醇和抗雄激素治疗外，重建术患者对组织进行积极贴敷和压迫，可引起反复微创伤和/或缺血引起的Peyronie样胶原改变；重建患者膜可能为研究胶原信号的变化提供了一种新的模型，并对Peyronie的膜结构变化的发展提供了新的见解。意义声明：重建患者会出现类似Peyronie的情况，被膜中胶原蛋白III增加，这为研究胶原信号如何功能失调提供了独特的机会，并为早期Peyronie的胶原蛋白变化提供了新的见解。

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