International Journal of Impotence Research最新文献

{"title":"Transmasculine patients' perspective before and after genital gender-affirming surgery.","authors":"Lorenzo Cirigliano, Marco Falcone, Liliana Guadagni, Ilaria Ferro, Mirko Preto, Matilde Braida, Natalia Plamadeala, Martina Scavone, Emanuele Zupo, Paolo Gontero","doi":"10.1038/s41443-026-01331-7","DOIUrl":"https://doi.org/10.1038/s41443-026-01331-7","url":null,"abstract":"<p><p>Gender-affirming care aims to reduce gender-related distress. Informational needs regarding masculinizing genital gender-affirming surgery (GGAS) remain poorly understood. We conducted a cross-sectional survey, inviting transmasculine individuals who had undergone phalloplasty or metoidioplasty. Participants rated the importance of specific topics on a 1-5 Likert scale before, during, and after surgery, reported the information they received and identified sources and preferred delivery formats. Forty-four patients were included (response rate 48.4%). Before surgery, the topics deemed of high importance (4 or 5) were possible complications, preparation of the donor site, long-term follow-up and complications and differences between surgical techniques (all 100%); written materials were the preferred format (87.5%). Participants reported important informative gaps (% importance high - %coverage), particularly regarding the management of ischemic complications (62.0%), urethral fistula (33.0%) or stenosis (32.0%), financial costs (35.0%), and the need for a structured support plan after surgery (22.0%). During hospitalization, respectful communication (95.4%), nursing experience with GGAS (100%), and clear instructions for self-care at discharge (97.7%) were deemed to be of high importance (4 or 5). In follow-up, patients emphasized guidance on prevention of injury to the neophallus (97.7%) and criteria for unscheduled visits (93.2%). These findings highlight the need for comprehensive, written, team-based counselling, and structured continuity of care to align surgical services with patient priorities.</p>","PeriodicalId":14068,"journal":{"name":"International Journal of Impotence Research","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148578640","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 effect of stress on testosterone and sexual function.","authors":"Ethan McGonagle, Joshua Thomas, Ivan Marrufo, Mohit Khera","doi":"10.1038/s41443-026-01279-8","DOIUrl":"10.1038/s41443-026-01279-8","url":null,"abstract":"<p><p>Stress influences male reproductive and sexual health through physiological and psychological pathways, each with distinct mechanisms, durations, and downstream effects. This narrative review investigates how acute physiological stress and chronic psychological stress affect testosterone levels and sexual function. Acute physiological stress induces predictable, transient reductions in testosterone and temporary impairments in sexual function, primarily driven by sympathetic nervous system activation, hypothalamic-pituitary-adrenal axis engagement, and energy imbalance. In contrast, chronic psychological stress, conceptualized through accumulations in allostatic load, leads to sustained endocrine dysregulation, often linked indirectly to testosterone suppression via its association with metabolic dysregulation. Chronic stress is further correlated to long-term declines in sexual health, including diminished sperm quality, erectile dysfunction, and reduced sexual desire. Together, these findings highlight the importance of distinguishing between stress types to better understand their individual and cumulative effects on male endocrine and sexual health.</p>","PeriodicalId":14068,"journal":{"name":"International Journal of Impotence Research","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148535838","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":"Comment on: Association of erectile dysfunction with all-cause and cardiovascular mortality in US men: findings from NHANES 2001-2004 with 16-Year follow-up.","authors":"Massimiliano Raffo, Edoardo Pozzi, Fausto Negri, Francesco Montorsi, Andrea Salonia","doi":"10.1038/s41443-026-01306-8","DOIUrl":"https://doi.org/10.1038/s41443-026-01306-8","url":null,"abstract":"","PeriodicalId":14068,"journal":{"name":"International Journal of Impotence Research","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148535898","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":"Beyond symptomatic treatment: PDE5 inhibitors as initiators, enablers, and sustainers of erectile function.","authors":"Dimitris Hatzichristou","doi":"10.1038/s41443-026-01329-1","DOIUrl":"https://doi.org/10.1038/s41443-026-01329-1","url":null,"abstract":"<p><p>Phosphodiesterase type-5 inhibitors (PDE5i) are widely used as first-line therapy for erectile dysfunction (ED). Traditionally, they have been viewed primarily as symptomatic agents that facilitate erections during sexual activity. However, extensive clinical experience suggests that their role in erectile medicine extends beyond simple pharmacologic facilitation of erection. In everyday practice, the response to PDE5i provides valuable physiological information about the erectile system. The magnitude and quality of erectile response often reflect underlying penile hemodynamics, cavernosal smooth muscle function, and the integrity of the veno-occlusive mechanism. Thus, the clinical response to PDE5i may function as a practical indicator of erectile reserve, initiating the diagnostic process in ED. Furthermore, PDE5i appear to enhance responsiveness to other therapeutic modalities and support cavernosal tissue oxygenation during chronic use. Based on these clinical observations, PDE5i may be conceptualized as fulfilling three complementary roles: initiators of erectile activity, enablers of multimodal therapy, and sustainers of cavernosal tissue health. This conceptual framework aims to integrate pharmacologic action with clinical interpretation and therapeutic strategy in sexual medicine.</p>","PeriodicalId":14068,"journal":{"name":"International Journal of Impotence Research","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148535906","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":"Top ten surgical tricks-penile prosthesis with corporal fibrosis.","authors":"Osama Shaeer, Kamal O K M Shaeer, Kamal Shaeer","doi":"10.1038/s41443-026-01327-3","DOIUrl":"https://doi.org/10.1038/s41443-026-01327-3","url":null,"abstract":"<p><p>Penile prosthesis implantation in cases of corporal fibrosis is the ultimate challenge in prosthetic urology. This report describes the top ten tips and tricks based on literature review and the authors' experience for such cases. PubMed search was conducted for the terms \"penile prosthesis\" and (\"scarred\" or \"scarring\" or \"fibrosis\" or \"cavernotome\"), up to February 2026 with no start date. Contemporary classic surgical techniques were classified into the more invasive \"open techniques\" and the less invasive \"closed techniques\". The authors' preferred techniques are described, as well as the proactive measures against corporal fibrosis. Tips and tricks cover patient counseling, problem-oriented patient evaluation, tips for tailored cylinder selection, optimal use of rear-tip extenders, size enhancement procedures, and advice for post-operative care. In conclusion, there is no consensus on the optimal management of corporal fibrosis during implantation. It is the authors' experience that whenever feasible, closed techniques are preferred to open techniques. The tips -detailed herein- may enhance safety and outcome.</p>","PeriodicalId":14068,"journal":{"name":"International Journal of Impotence Research","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148535840","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":"Comment on: Targeting the acute phase of Peyronie's disease: preliminary experience with Perovial®, a novel hyaluronic acid formulation.","authors":"Bailey B Carter, Martin S Gross, Britney L Atwater","doi":"10.1038/s41443-026-01320-w","DOIUrl":"10.1038/s41443-026-01320-w","url":null,"abstract":"","PeriodicalId":14068,"journal":{"name":"International Journal of Impotence Research","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148535852","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":"Development and validation of the arabic-modified erectile dysfunction inventory of treatment satisfaction (AM-EDITS) for assessing patient and partner satisfaction following malleable penile prosthesis implantation.","authors":"Ahmed Ragheb, Ahmed Abdelbary, Ahmed Gamal Mohamed, Mahmoud Abdallah, Ahmed Elbatanony, Ahmed Abdullatif, Ossama Mahmoud, Mohamed A Youssef, Amr M Lofty","doi":"10.1038/s41443-026-01318-4","DOIUrl":"https://doi.org/10.1038/s41443-026-01318-4","url":null,"abstract":"<p><p>The Modified Erectile Dysfunction Inventory of Treatment Satisfaction is a validated English questionnaire designed to evaluate satisfaction after penile prosthesis implantation. However, no culturally adapted Arabic version currently exists. The objectives were to develop and validate the Arabic-Modified Erectile Dysfunction Inventory of Treatment Satisfaction for assessing patient and partner satisfaction following malleable penile prosthesis implantation. A prospective single-center validation study was conducted between August 2020 and July 2024. A total of 120 men with medication-refractory erectile dysfunction and their partners were enrolled. The Arabic-Modified Erectile Dysfunction Inventory of Treatment Satisfaction was created using a standardized forward-back translation and expert consensus process, followed by linguistic validation and pilot testing. Internal consistency and reliability were evaluated using Cronbach's α and the intraclass correlation coefficient. Participants completed structured telephone or online surveys at 1, 3, and 6 months postoperatively. Reduction of anxiety after preoperative counseling was evaluated through a direct binary response (\"decreased\" vs \"unchanged\"), while satisfaction domains were rated on 4-point Likert scales. The Arabic-Modified Erectile Dysfunction Inventory of Treatment Satisfaction demonstrated excellent psychometric properties (Cronbach's α = 0.979 for males; 0.951 for partners; intraclass correlation coefficient = 0.978 and 0.942, respectively). Preoperative counseling reduced anxiety in 82.5% of patients. At 1 month, 96.0% reported a \"positive surgical experience\" (defined as postoperative recovery being better or similar to expectations). At 3 months, 82.5% of patients were satisfied, 80.0% described erections as natural, and 92.5% of partners were satisfied (78.5% highly satisfied). By 6 months, patient satisfaction increased to 90.8%, whereas partner satisfaction declined to 84.2% (p < 0.001), suggesting emotional and psychosocial influences over time. Therefore, the Arabic-Modified Erectile Dysfunction Inventory of Treatment Satisfaction is a valid and reliable tool for evaluating satisfaction among Arabic-speaking patients and partners after malleable penile prosthesis. The findings highlight the importance of culturally sensitive counseling that involves both partners throughout the perioperative period.</p>","PeriodicalId":14068,"journal":{"name":"International Journal of Impotence Research","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148535887","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":"Comment on: Outcomes of the Hamdan Extrainguinal Sub-Oblique (HESO) technique for reservoir placement in inflatable penile prosthesis implantation.","authors":"Rashed Rowaiee, Omer Raheem","doi":"10.1038/s41443-026-01332-6","DOIUrl":"https://doi.org/10.1038/s41443-026-01332-6","url":null,"abstract":"","PeriodicalId":14068,"journal":{"name":"International Journal of Impotence Research","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148535835","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":"Infection rates in primary inflatable penile prosthesis: a systematic review and meta-analysis of antibiotic-coated versus non-coated devices.","authors":"Nilson Marquardt Filho, Lucas Uglione Da Ros, João Pedro Uglione Da Ros, Gustavo Franco Carvalhal, Carlos Teodósio Da Ros, Alejandro Carvajal","doi":"10.1038/s41443-026-01314-8","DOIUrl":"https://doi.org/10.1038/s41443-026-01314-8","url":null,"abstract":"<p><p>Our aim was to conduct a systematic review with meta-analysis comparing primary inflatable penile prosthesis with and without antibiotic coverage, determining infection rates and identifying the most effective prophylaxis to prevent infectious complications. We conducted a systematic search of the PubMed, EMBASE, MEDLINE, and LILACS databases. The search and selection process followed PRISMA guidelines, and the selected studies were evaluated for quality using the ROBINS-I tool. Predefined inclusion and exclusion criteria were used to filter the results, and a meta-analysis was later performed using the R Statistical Software. After removing duplicate studies, 50 studies were selected for full-text analysis, and 29 were included for further examination. Of those, 11 observational studies comprising 102,572 patients who underwent primary penile prosthesis implantation, with or without antibiotic-coated or non-coated prostheses, were included in the meta-analysis. Our analysis revealed a significant decline in infection rates among those using coated prostheses (HR = 0.38; CI 0.28 to 0.51; p < 0.01; I² = 85.5%). We also meta-analyzed studies comparing the two major prosthesis brands on the market, Boston Scientific and Coloplast, and found no difference in infection rates between them (HR = 1.02; CI 0.17 to 6.02; p = 0.98; I² = 88.7%). Antibiotic-coated inflatable penile prosthesis demonstrated a significant decline in infection rates compared to non-coated devices. These findings are based on observational studies, and further research is warranted to better understand the role of different prophylaxis strategies in preventing infections.</p>","PeriodicalId":14068,"journal":{"name":"International Journal of Impotence Research","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148535875","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":"SAPOC technique for length restoration in complex Peyronie's disease and erectile dysfunction at the time of penile prosthesis placement.","authors":"Jonathan Clavell-Hernández, Maria F Miguel Lithgow, Kareim Khalafalla","doi":"10.1038/s41443-026-01321-9","DOIUrl":"10.1038/s41443-026-01321-9","url":null,"abstract":"<p><p>Severe Peyronie's disease with concomitant erectile dysfunction remains surgically challenging, particularly in patients with significant curvature and penile shortening undergoing inflatable penile prosthesis implantation. We describe the SAPOC (Slices Around the Point of maximal Curvature) technique, a modification of the Multiple-Slit Technique, designed to permit length restoration while limiting large tunical defects and potentially reducing the need for structural grafting. Between October 2018 and December 2023, 64 patients with medically refractory erectile dysfunction and severe Peyronie's disease underwent inflatable penile prosthesis placement with SAPOC reconstruction by a single surgeon at a single academic center. Mean preoperative curvature was 72.0° ± 20.8° and mean stretched penile length increased from 14.2 ± 1.36 cm to 15.3 ± 1.2 cm (mean gain 1.05 ± 0.62 cm; p < 0.001). Complete intraoperative curvature correction was achieved in 73.4% of cases, with residual curvature <20° (mean postoperative curvature 3.3°) in the remainder. At median follow-up of 13.5 months (IQR: 9-22 months), 96.9% had no functionally significant curvature. Structural grafting (Cadaveric Pericardium) was required in only 7.8% of cases. Complications included one infection and no cases of glans necrosis. These findings suggest that SAPOC may represent a feasible reconstructive adjunct during inflatable penile prosthesis implantation that preserves tunical integrity while facilitating length restoration in selected patients. Further multicenter and comparative studies are needed to better define its safety profile and reproducibility.</p>","PeriodicalId":14068,"journal":{"name":"International Journal of Impotence Research","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148455879","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}