International Journal of Impotence Research最新文献

{"title":"Intraoperative frozen section examination for penile cancer surgery: a systematic review.","authors":"Mohammad Z Yunis, Karl H Pang, Asif Muneer, Hussain M Alnajjar","doi":"10.1038/s41443-025-01024-7","DOIUrl":"https://doi.org/10.1038/s41443-025-01024-7","url":null,"abstract":"<p><p>Penile cancer (PeCa) is rare but aggressive and life changing. Penile-preserving surgery (PPS) allows length preservation for sexual activity and normal voiding. Intraoperative frozen section examination (FSE) of resection margins helps to decide on how much penile tissue is excised. Oncological outcomes and diagnostic accuracy of FSE to date, however, are not well documented. The objective of this systematic review was to evaluate the efficacy of FSE in the treatment of PeCa and its impact on oncological outcomes. A systematic review was conducted with reference to the PRISMA statement. Studies published from 2009 to 2024 were identified through a search conducted between 1975 and 2024. The search yielded 7 studies involving 574 patients. Intraoperative FSE had a high percentage of accuracy, with a mean accuracy of 95.4% and a range of 92.9-99.4%. The mean values of sensitivity, specificity, positive predictive value, and negative predictive values were 71.4%, 99.9%, 98.8%, and 96.5%, respectively. Functional outcomes with PPS were encouraging, especially in terms of sexual function. The average local recurrence rate was 7.9%. There is a paucity of data on PeCa FSE in the literature. However, it appears that FSE is accurate and can be helpful in guiding surgeons intraoperatively when performing PPS.</p>","PeriodicalId":14068,"journal":{"name":"International Journal of Impotence Research","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143398975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Individualised shockwave therapy for erectile dysfunction: importance of establishing precise therapeutic range.","authors":"Romeq Bm Giezen, Eric Chung, Ranjith Ramasamy","doi":"10.1038/s41443-025-01028-3","DOIUrl":"https://doi.org/10.1038/s41443-025-01028-3","url":null,"abstract":"","PeriodicalId":14068,"journal":{"name":"International Journal of Impotence Research","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of the urologist in managing high flow priapism.","authors":"Murat Dursun, Arif Kalkanlı, Seyfettin Anıl Tantekin, Ahmet Halil Sevinç, Turgay Kaçan, Celal Caner Ercan, Ateş Kadıoğlu","doi":"10.1038/s41443-025-01017-6","DOIUrl":"https://doi.org/10.1038/s41443-025-01017-6","url":null,"abstract":"<p><p>High-flow priapism (arterial) is a prolonged erection caused by irregular cavernous arterial flow, often resulting from blunt perineal or penile trauma, or iatrogenic needle injury. This condition leads to the formation of an arteriolacunar fistula, causing unregulated arterial blood flow into the sinusoidal spaces of the penis. Unlike low-flow priapism, high-flow priapism typically presents with a partially erect, non-painful penis. The diagnosis is confirmed through characteristic findings on color Doppler ultrasound, which reveals turbulent high-velocity flow pinpointing the fistula's location. Blood gas analysis typically reflects arterial values, helping to differentiate high-flow priapism from its low-flow counterpart. Although high-flow priapism was historically considered non-urgent, recent evidence suggests that delayed treatment may increase the risk of erectile dysfunction. Therefore, prompt intervention by urologists is crucial. The primary goal is to close the fistula, and the treatment plan should be individualized based on the severity and duration of the condition. Urologists play a critical role in managing this condition, offering a range of therapeutic options. These include conservative approaches, such as observation and compression, medical therapy, arterial embolization, and, in some cases, surgical intervention. The choice of treatment depends on the patient's condition, the fistula's location, and the resources available. By ensuring timely and appropriate management, urologists can minimize complications and preserve erectile function.</p>","PeriodicalId":14068,"journal":{"name":"International Journal of Impotence Research","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adherence to american urological association (AUA) vasectomy guidelines: a systematic review of current practice among healthcare providers.","authors":"Mohammed Mahdi, Muhammed A M Hammad, Elia Abou Chawareb, Mana Almuhaideb, Faysal A Yafi","doi":"10.1038/s41443-025-01023-8","DOIUrl":"https://doi.org/10.1038/s41443-025-01023-8","url":null,"abstract":"<p><p>Vasectomy, a common male sterilization procedure, has seen a surge in popularity following the 2022 reversal of Roe v. Wade. The American Urological Association (AUA) vasectomy guidelines provide essential guidance for providers, outlining best practices for the procedure. We reviewed studies that examined adherence to the AUA vasectomy guidelines with regard to pre-procedure counseling, surgical technique, and post vasectomy semen analysis (PVSA) practice, as well as studies evaluating the impact of these guidelines on urology and non-urology practices. A total of five studies were identified that assessed adherence to the guidelines. Only one of these studies evaluated adherence to all three aspects of the guidelines. The remaining four studies focused solely on the practice of PVSA. Overall, urologists exhibited greater adherence to the guidelines compared to other healthcare providers. However, the adherence rates were still suboptimal. Five additional studies were included that evaluated the use of home-based PVSA, which is not part of the AUA guidelines. Conflicting results were found regarding the test compliance. While the studies evaluating home-based PVSA may raise the question of including this approach in the guidelines panel discussion, it is important to consider the potential benefits and drawbacks before incorporating it as an option in future guidelines.</p>","PeriodicalId":14068,"journal":{"name":"International Journal of Impotence Research","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing vasectomy techniques, recovery and complications: tips and tricks.","authors":"Joseph A Borrell, Catherine Gu, Nancy Ye, Jesse N Mills, Juan J Andino","doi":"10.1038/s41443-025-01018-5","DOIUrl":"https://doi.org/10.1038/s41443-025-01018-5","url":null,"abstract":"<p><p>Vasectomies are safe and effective, achieving up to 99.7% in sterilization, with complication rates around 1-2%. As vasectomy uptake rises, physicians should stay informed about counseling, isolation and occlusion techniques, post-op recovery, and associated risks and complications. Historically, pre-vasectomy counseling has been performed in-person, but recent literature has shown that telehealth is a viable alternative, and a physical exam may not be necessitated. With regard to vas isolation and occlusion, current international guidelines support a minimally invasive approach such as no-scalpel vasectomy with mucosal cautery and fascial interposition, as they are the most effective in achieving vasectomy success and have the lowest complication rates. After a vasectomy, patients should undergo a post-vasectomy semen analysis 8-16 weeks after the procedure to ensure severe non-motile oligozoospermia (≤100,000 non-motile sperm/mL) or azoospermia. While risks and complications from vas isolation and occlusion are rare, patients should be informed about the potential for hematomas, infections, postoperative pain, and vas recanalization. In the U.S, vasectomies have increased in utilization from previous years, likely in the setting of increased access to telehealth and restricted female reproductive access. This trend raises questions about future fertility options such as vasectomy reversals and highlights the need for informed decision-making.</p>","PeriodicalId":14068,"journal":{"name":"International Journal of Impotence Research","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cisgender men and women report different patterns of sexual arousal and orgasm during masturbation and sexual relationships.","authors":"Itziar Adell-Peña, Juan Carlos Sierra, Carlos Pérez-Amorós, Pablo Mangas","doi":"10.1038/s41443-025-01020-x","DOIUrl":"https://doi.org/10.1038/s41443-025-01020-x","url":null,"abstract":"<p><p>Studies comparing sexual function between the contexts of masturbation and sexual relationships are scarce. This investigation analyzed the effects of sex (male vs. female), sexual context (solitary masturbation vs. sexual relationships), and the interaction effect between both variables on sexual arousal and orgasm. From October 2023 to May 2024, the Arizona Sexual Experience Scale (ASEX) was used to evaluate the sexual arousal and orgasm of one thousand heterosexual cisgender Spanish adults (433 men and 567 women), aged 18-77 years, in both contexts. A multivariate analysis of covariance (MANCOVA) and an analysis of variance (ANOVA) were conducted. Men reported better sexual function as measured by the ASEX questions than women did (p values between < 0.001 and 0.021). With respect to sexual context, men's arousal and ability to reach orgasm varied, with greater arousal in sexual relationships (p < 0.042) and a greater ability to reach orgasm during masturbation (p < 0.022). Finally, the sex x sexual context interaction was significant (p < 0.001), so men and women presented different patterns in arousal, penile erection/vaginal lubrication, ability to reach orgasm and satisfaction with orgasm (p values between < 0.001 and 0.034) when the contexts of solitary masturbation and sexual relationships were compared. This study highlights the importance of attending to sex and sexual context when assessing sexual function in both clinical and research settings.</p>","PeriodicalId":14068,"journal":{"name":"International Journal of Impotence Research","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Androgen deprivation therapy does not increase rates for reintervention, complication, or infection in primary penile implant or artificial urinary sphincter surgery: a retrospective cohort study from the TriNetX network.","authors":"Zachary J Prebay, David Fu, Aaron R Hochberg, Paul H Chung","doi":"10.1038/s41443-025-01015-8","DOIUrl":"https://doi.org/10.1038/s41443-025-01015-8","url":null,"abstract":"<p><p>Prostate cancer treatment-related erectile dysfunction and stress urinary incontinence are commonly treated with inflatable penile prosthesis (IPP) or artificial urinary sphincter (AUS). Given the association with androgens and penile/urethral health, we aim to evaluate whether patients on androgen deprivation therapy (ADT) undergoing IPP or AUS surgery are at increased risk for reintervention, complication, or infection. We queried the TriNetX database for adult males receiving IPP or AUS. The ADT cohort included those on ADT 3 months before or any time after surgery. We performed sub-analysis for leuprolide and bicalutamide. Cohorts and outcomes were defined by Current Procedural Terminology and International Classification of Diseases codes. Propensity score matching was performed using age, prostate cancer, history of prostatectomy, and history of radiation. Outcomes were reintervention (revision, removal, or replacement), infection, and complication. Analytics were performed in March 2024. 13,432 patients received an IPP and 5676 received an AUS, 465 and 745 of whom were on ADT, respectively. The only significant AUS analysis was for patients on abiraterone having fewer reinterventions (10.5% vs 20.8%, RR = 0.50 [0.29, 0.88]). Patients receiving an IPP with ADT had fewer reinterventions (7.2% vs 12%, RR = 0.60 [0.39, 0.92]) and complications (12.7% vs 18.5%, RR = 0.68 [0.49, 0.95]). Those on a GnRH agonist had fewer reinterventions (7.4% vs 11.7%, RR = 0.63 [0.41, 0.98]) for IPP. Patients receiving an IPP on bicalutamide had fewer reinterventions ( <5.2%* vs 10.8%, RR = 0.48 [0.23, 0.99]) and on leuprolide had fewer complications (12.2% vs 19.3%, RR = 0.63 [0.43, 0.91]). The remainder of analyses showed no significant differences. Patients with IPP or AUS do not fare worse on ADT. Further evaluation into the duration of ADT may provide clinical context, but based on these results, ADT should not limit implant surgery.</p>","PeriodicalId":14068,"journal":{"name":"International Journal of Impotence Research","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness and patient satisfaction with the new sildenafil oral suspension formulation compared to sildenafil oro-dispersible film: a real-life study.","authors":"Luca Boeri, Giorgio Graps, Ester Zino, Agnese Zago, Andrea Li Puma, Fabio Ciamarra, Antonio Cimmino, Valentina Parolin, Michela Piccoli, Franco Gadda, Emanuele Montanari, Giancarlo Albo","doi":"10.1038/s41443-025-01019-4","DOIUrl":"https://doi.org/10.1038/s41443-025-01019-4","url":null,"abstract":"<p><p>Sildenafil is one of the most used phosphodiesterase type 5 inhibitor (PDE5i) for the treatment of erectile dysfunction (ED) in clinical practice. A new oral suspension formulation (OSF) of sildenafil has been introduced to overcome the drawbacks of previous formulations. We assess the efficacy and patients' experience with sildenafil 50 mg OSF in men with ED who were taking the sildenafil oro-dispersible film (ODF). Demographics and clinical data from 70 consecutive men with mild-moderate ED were analysed. Patients were treated with sildenafil 50 mg ODF for 12 weeks (follow-up 1), then, after 2-week washout, were administered sildenafil 50 mg OSF for 12 weeks (follow-up 2). At each follow-up, patients completed the International Index of Erectile Function (IIEF), the Patient Global Impression of Improvement (PGI-I), and the Psychological and Interpersonal Relationship Scales-Short Form (PAIRS-SF) questionnaires. Descriptive statistics described the whole cohort. The Wilcoxon Signed Rank Test assessed potential differences in psychometric scores at different follow-up assessments. Logistic regression analyses tested the associations between study variables and satisfaction after sildenafil OSF treatment. Overall, median age was 56 (51-62) years, and median IIEF-EF score was 14 (12-17). Compared to baseline, IIEF-EF scores significantly improved after sildenafil ODF and OSF treatment (all p < 0.01) with no differences between the two formulations. IIEF-overall satisfaction (OS) was higher after sildenafil OSF than ODF (p < 0.001). Similarly, median PGI-I score were better after sildenafil OSF than ODF (p < 0.001). The PAIRS-SF spontaneity scores were significantly higher after OSF than ODF (p < 0.01). At multivariable logistic regression analysis, younger age (p = 0.02) and lower baseline IIEF-EF scores (p = 0.01) were independent predictors of improved satisfaction with OSF compared to ODF. The sildenafil OSF and ODF had similar efficacy, however the new OSF provides higher satisfaction and spontaneity scores compared to the oro-dispersible film.</p>","PeriodicalId":14068,"journal":{"name":"International Journal of Impotence Research","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Botulinum toxin-A is ineffective in premature ejaculation treatment: insights from a meta-analysis of randomised controlled trials.","authors":"Mohamed Mubarak, Qasim Isa, Vaibhav Modgil, Ian Pearce","doi":"10.1038/s41443-025-01022-9","DOIUrl":"https://doi.org/10.1038/s41443-025-01022-9","url":null,"abstract":"<p><p>The ejaculatory reflex consists of emission and expulsion, with the latter involving rhythmic muscular contractions that propel seminal fluid. Botulinum toxin, through its inhibitory effects, has been hypothesized to improve premature ejaculation (PE). This study evaluates high-quality evidence on botulinum toxin-A injections into the bulbospongiosal muscle as a treatment for PE. We conducted a systematic review and meta-analysis of randomised-controlled trials (RCTs) following PRISMA guidelines. Outcomes included intravaginal ejaculatory latency time (IELT), Premature Ejaculation Profile (PEP) scores, and complications. Data were analysed using Microsoft Excel and R. ROB-2, Eggers test, and GRADE assessed risk of bias, publication bias, and certainty of evidence (CoE). Three RCTs were eligible, and covered data from 228 patients with (1:1) randomisation into intervention and control arms (100 units of botulinum toxin-A in 10 mLs versus 10 mLs of 0.9% NaCl). IELT increases were noted with averages of 39.6, 11.5, and 2.4 s at 1, 3, and 6 months of follow up, respectively. Likewise, PEP scores demonstrated improvements of 1.54, 1.08, and 0.36 units at the same follow up intervals. however, statistical significance was not achieved in both outcomes of interest. Post-procedural complications were recorded in 11 patients (9.6%) with 10 in the intervention group. The majority of patients had voiding difficulties (n = 5) & mild erectile dysfunction (n = 4), however, all adverse events (AEs) were self-resolving and did not require active treatment. Given our findings, current high-quality evidence does not support using Botulinum Toxin-A in the management of PE. Larger scale & standardised RCTs are recommended to conclusively outline its clinical benefits.</p>","PeriodicalId":14068,"journal":{"name":"International Journal of Impotence Research","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sildenafil oral suspension formulation for erectile dysfunction: is it love at first sight?","authors":"Luca Boeri, Fabrizio Palumbo, Tommaso Cai, Carlos Miacola, Carlo Ceruti, Marco Bitelli, Danilo Di Trapani, Emilio Italiano, Giorgio Piubello, Chiara Polito, Alessandro Palmieri","doi":"10.1038/s41443-025-01016-7","DOIUrl":"https://doi.org/10.1038/s41443-025-01016-7","url":null,"abstract":"","PeriodicalId":14068,"journal":{"name":"International Journal of Impotence Research","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143038430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}