Sexual Medicine最新文献

{"title":"The efficacy of combination therapy with Ningmitai capsule and sildenafil in men with chronic prostatitis/chronic pelvic pain syndrome and erectile dysfunction: a prospective, multicenter, randomized controlled trial.","authors":"Daosheng Luo, Jintao Guo, Tongwen Chen, Guihua Liu, Peng Luo, Zhiquan Deng, Yu Xin Tang, Yongbin Liao, Chunhua Deng","doi":"10.1093/sexmed/qfaf024","DOIUrl":"10.1093/sexmed/qfaf024","url":null,"abstract":"<p><strong>Background: </strong>A high proportion of men with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) present with comorbid erectile dysfunction (ED), but evidence-based therapeutic interventions specifically targeting this patient population remain understudied in clinical trials.</p><p><strong>Aim: </strong>To assess the efficacy of Ningmitai capsule (NMT), an oral traditional Chinese herbal formulation, combined with sildenafil versus monotherapy in alleviating symptoms among a cohort of participants with CP/CPPS and ED.</p><p><strong>Methods: </strong>A multi-center, randomized clinical trial was conducted from March 2019 to December 2022 at six tertiary hospitals in China. A total of 214 participants diagnosed with CP/CPPS and ED were randomized 1:2:2 to receive orally sildenafil (25 mg, q.n.), NMT (0.38 g × 4 capsules, t.i.d.), or a combination of both for 4 weeks. Validated Chinese version of the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI), the International Index of Erectile Function-5 (IIEF-5) and the Erection Hardness Score (EHS) questionnaires were administered at baseline, week 2, and week 4.</p><p><strong>Outcomes: </strong>The primary endpoint was the reduction in NIH-CPSI pain domain scores from baseline to week 4.</p><p><strong>Results: </strong>All treatment groups exhibited statistically significant decreases in NIH-CPSI total, pain, urinary and quality of life (QoL) domain scores within 2 weeks, with improvements sustained until the end of the treatment. The combination group demonstrated superior pain score reductions versus sildenafil monotherapy at both timepoints (week 2: mean difference [MD] -2.82 ± 3.27 vs. -1.26 ± 3.45, <i>P</i> = 0.043; week 4, MD -3.57 ± 3.50 vs. -1.07 ± 2.94, <i>P</i> = 0.009). Notably, combination therapy achieved greater IIEF-5 score enhancements compared to NMT alone (<i>P <</i> 0.05) and higher responder rates than either sildenafil or NMT monotherapy (<i>P <</i> 0.05). No significant differences were found among the three arms concerning EHS. No adverse events were reported.</p><p><strong>Clinical implications: </strong>NMT-sildenafil combination therapy may serve as a viable alternative to α-blocker-based regimens for CP/CPPS-ED patients, potentially circumventing the orthostatic hypotension risk associated with the concurrent use of phosphodiesterase 5 inhibitors (PDE5i) and α-blockers.</p><p><strong>Strengths and limitations: </strong>Strengths include a prospective randomized design, which is well controlled. Limitations encompass the absence of placebo control and long-term follow-up.</p><p><strong>Conclusion: </strong>NMT-sildenafil combination therapy demonstrates significantly greater benefits of ameliorating pain symptoms and improving erectile function in men with CP/CPPS and ED compared to either monotherapy, with favorable tolerability profiles.</p><p><strong>Registration: </strong>The study protocol was reviewed and approved by the in","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"13 2","pages":"qfaf024"},"PeriodicalIF":2.6,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12074575/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144046278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Addressing unmet needs for patients with erectile dysfunction: a narrative review of topical therapies.","authors":"Gerald B Brock, Wayne J G Hellstrom, Annamaria Giraldi, Stanton Honig","doi":"10.1093/sexmed/qfaf021","DOIUrl":"https://doi.org/10.1093/sexmed/qfaf021","url":null,"abstract":"<p><strong>Background: </strong>Treatment of patients with erectile dysfunction (ED) was revolutionized by the development and approval of phosphodiesterase type 5 inhibitors (PDE5is), which have been repeatedly shown to be safe and effective in men with this condition. However, some patients do not respond to these agents and others may prefer an alternative therapy.</p><p><strong>Aim: </strong>The objective of this paper is to evaluate topical therapies for ED used in clinical studies, either as single agents or in combination with a PDE5i, and consequently determine which topical therapies meet the criteria of an 'ideal medication for ED.'</p><p><strong>Methods: </strong>The PubMed database was searched to identify clinical studies of topical agents that have been evaluated in men with ED. This review was supplemented by a search of presentations at the 2024 annual meetings of the American Urological Association and Sexual Medicine Society of North America.</p><p><strong>Results: </strong>The literature review and subsequent screening resulted in 39 clinical studies and 5 meeting abstracts for review. The studies demonstrated efficacy for intraurethral and topical alprostadil, topical prostaglandin E₁ ethyl ester, nitric oxide donors, testosterone (in selected patients), and a non-medicated hydro-alcoholic gel. The studies reviewed also demonstrated a significant benefit of adding topical alprostadil to therapy in patients with inadequate responses to PDE5is. An effective topical therapy delivered to its site of action with a rapid onset could improve patients' and partners' satisfaction with and acceptance of treatment. These actions have been demonstrated by a new over-the-counter agent, MED3000, authorized by the United States Food and Drug Administration, and for topical alprostadil, which is available with a prescription in the European Union.</p><p><strong>Clinical translation: </strong>The availability of safe and effective topical ED therapy is an important addition to current treatment options for men with this condition.</p><p><strong>Strengths and limitations: </strong>This study provides results from a comprehensive search strategy by including a wide range of search criteria. However, the heterogeneity of studies evaluated creates difficulties in directly comparing results from different studies.</p><p><strong>Conclusion: </strong>The results of this analysis show that current topical therapies can provide statistically and clinically significant improvements in erectile function in men with ED and may provide an effective alternative to PDE5i in men who require or prefer an alternative therapy.</p>","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"13 2","pages":"qfaf021"},"PeriodicalIF":2.6,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12066416/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144046259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brazilian version of the Brief Male Sexual Function Inventory (BSFI) in adult men: cultural adaptation and measurement properties.","authors":"Erisvan Vieira da Silva, Guilherme Tavares de Arruda, Eduarda Brollo Berni, Amanda Dos Santos Candido, Hedioneia Maria Foletto Pivetta, Melissa Medeiros Braz","doi":"10.1093/sexmed/qfaf029","DOIUrl":"https://doi.org/10.1093/sexmed/qfaf029","url":null,"abstract":"<p><strong>Background: </strong>There is a need for a more comprehensive tool for assessing male sexual function that is inclusive of diverse gender identities and sexual orientations.</p><p><strong>Aim: </strong>Culturally adapt the Brazilian version of the Brief male Sexual Function Inventory (BSFI) and evaluate its measurement properties in adult men.</p><p><strong>Methods: </strong>We conducted an online survey with 727 Brazilian men over 18 years of age (31.73 ± 10.88 years). According to COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN), we translated and evaluated the content validity, structural validity, internal consistency, construct validity, test-retest reliability, measurement error, and minimum and maximum effects of the BSFI.</p><p><strong>Outcomes: </strong>The final Brazilian version of the BSFI consisted of 10 items and was found to be relevant, comprehensive, and comprehensible.</p><p><strong>Results: </strong>Although it showed good content validity and reliability, the BSFI showed inadequate structural validity and insufficient internal consistency for at least one factor.</p><p><strong>Clinical implications: </strong>The Brazilian version of the BSFI can be used in adult males in community samples, pending evaluation in clinical samples.</p><p><strong>Strengths and limitations: </strong>The sampling bias associated with online recruitment may have excluded individuals without access to the Internet, thereby compromising the representativeness of the sample. This may limit generalizability. However, COSMIN guidelines were followed to ensure methodological rigor. The BSFI adaptation provides a Patient-Reported Outcome Measure for assessing male sexual function, but has limitations in structural validity and internal consistency.</p><p><strong>Conclusion: </strong>The Brazilian version of the BSFI showed sufficient validity (content validity and hypothesis testing for construct validity) in adult men and sufficient test-retest reliability.</p>","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"13 2","pages":"qfaf029"},"PeriodicalIF":2.6,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12068470/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144037840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>Corynanthe pachyceras</i> K. Schum (Rubiaceae) boosts sexual behavior, improves sexual hormones/semen quality and, modulates oxidative stress in a rat model of age-induced hypogonadism: an experimental study.","authors":"Aubrile Julie Ndomgang, Henderson Herris Karl Ngombeu Zeugang, Yannick Baudouin Tchatat Petnga, Georges Romeo Bonsou Fozin, Aimé Césaire Tetsatsi Momo, Modeste Wankeu-Nya, Esther Ngadjui, Pierre Watcho","doi":"10.1093/sexmed/qfaf033","DOIUrl":"https://doi.org/10.1093/sexmed/qfaf033","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Hypogonadism refers to a condition where the body does not produce enough testosterone. It is an important cause of male sexual dysfunctions and infertility. &lt;i&gt;Corynanthe pachyceras&lt;/i&gt; is a medicinal plant with a claimed powerful aphrodisiac potential.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;This study investigated the capacities of &lt;i&gt;C. pachyceras&lt;/i&gt; in boosting the sexual performance of age-related hypogonadic rat.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Thirty-six aged (17-19-months-old) male Wistar rats (n = 6/group) were randomly distributed into six groups and orally treated with either distilled water (10 mg/kg), Viagra (5 mg/kg), aqueous or ethanolic extracts of &lt;i&gt;C. pachyceras&lt;/i&gt; (8 mg/kg or 50 mg/kg) within two weeks. The copulatory activity was tested on days 0, 7, and 14 using receptive females. Body and sex organ weights, sperm parameters, sex hormones, oxidative stress markers, and penile nitric oxide (NO) were measured.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes: &lt;/strong&gt;The main outcome of this work is the confirmed efficacy of &lt;i&gt;C. pachyceras&lt;/i&gt; in improving the reproductive performance of age-related hypogonadic rats.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The copulatory activity of the untreated hypogonadic aged rats (distilled water group) was low and marked by a significant increase in the sexual motivation (latencies and post-ejaculatory interval) and a decrease in the sexual performance (frequencies). Malondialdehyde level was increased, whereas the activities of superoxide dismutase and glutathione were decreased. Treatment of aged rats with the aqueous or ethanolic extracts of &lt;i&gt;C. pachyceras&lt;/i&gt; brought important changes, shown by the significant decrease in the motivation parameters and the increase in the ejaculation frequency. Sperm count and motility (&lt;i&gt;P&lt;/i&gt; &lt; .01-.001), LH (&lt;i&gt;P&lt;/i&gt; &lt; .01), FSH (&lt;i&gt;P&lt;/i&gt; &lt; .01-.001), testosterone (&lt;i&gt;P&lt;/i&gt; &lt; .01), and NO (&lt;i&gt;P&lt;/i&gt; &lt; .05) levels that were altered in the untreated aged rats were increased in those receiving &lt;i&gt;C. pachyceras&lt;/i&gt; extracts. The plant extracts also significantly (&lt;i&gt;P&lt;/i&gt; &lt; .05-.01) improved the antioxidant status by reducing the level of MDA and increasing that of SOD (&lt;i&gt;P&lt;/i&gt; &lt; .05-.01) and glutathione.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Clinical translation: &lt;/strong&gt;&lt;i&gt;C. pachyceras&lt;/i&gt; may serve as a potential therapeutic agent for improving the sexual health of androgen-deficient subjects such as aged men.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Strengths and limitations: &lt;/strong&gt;&lt;i&gt;C. pachyceras&lt;/i&gt; has androgenic, aphrodisiac, and antioxidant properties. However, its molecular mechanism is not yet determined. A well-structured clinical study needs also to be carried to confirm the effects of &lt;i&gt;C. pachyceras&lt;/i&gt; on humans.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Present findings showed that &lt;i&gt;C. pachyceras&lt;/i&gt; can boost the reproductive conditions of age-induced hypogonadism rats through its androgenic, aphrodisiac, and antioxidant potentials. However, further studies are still needed to gain more ","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"13 2","pages":"qfaf033"},"PeriodicalIF":2.6,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12053115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143993479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effectiveness and safety of intracavernosal botulinum toxin injections in the management of erectile dysfunction: a systematic review and meta-analysis of clinical studies.","authors":"Karl H Pang","doi":"10.1093/sexmed/qfaf034","DOIUrl":"https://doi.org/10.1093/sexmed/qfaf034","url":null,"abstract":"<p><strong>Background: </strong>Patients with erectile dysfunction (ED) are often left with limited nonsurgical options when conventional pharmacotherapies become ineffective. Botulinum neurotoxin serotype A (BoNT-A) intracavernosal injections (ICIs) have been demonstrated in a few clinical studies to be effective and safe in managing ED and may serve as a first- or second-line option.</p><p><strong>Aim: </strong>To perform a systematic review and meta-analysis on the effectiveness and safety of BoNT-A ICI in managing ED with a focus on human studies.</p><p><strong>Methods: </strong>A systematic review and meta-analysis of clinical studies was performed in accordance with the PRISMA 2020 statement. Adult men with ED who received BoNT-A were included in the study. The risk of bias assessment of included studies was performed using the JBI assessment checklists.</p><p><strong>Outcomes: </strong>The effectiveness and safety of BoNT-A ICI. Measures of effectiveness included the increase or change in International Index for Erectile Function (IIEF-EF) score/Sexual Health Inventory for Men (SHIM) score/Erection Hardness Score (EHS) or change in Doppler ultrasound parameters and the percentage of patients achieving the minimal clinically important difference (MCID) score.</p><p><strong>Results: </strong>The search retrieved 61 articles, and 2 randomized controlled trials (RCTs) and 4 retrospective studies met the inclusion criteria. Three types of BoNT-A were evaluated: onaBoNT-A, aboBoNT-A, and incoBoNT-A. At least 40% of the patients achieved the MCID (2-7 points increase in the IIEF-EF/SHIM score) depending on the severity of ED) at ≥1 month. When directly comparing all 3 BoNT-A, the overall response rate was 77.5%, with no statistically difference between the 3 types. For aboBoNT-A, 500 U appeared to sustain the effectiveness longer compared to 250 U. OnaBoNT-A improved peak systolic velocity on Doppler ultrasound compared with saline. Meta-analysis of the 2 RCTs demonstrated a mean difference of 4.35 (<i>P</i> = .008) in the SHIM score at 12 weeks in favor of onaBoNT-A over normal saline. No systemic side effects have been reported, and the only infrequent local side effect was transient penile pain. Only one case of priapism was reported.</p><p><strong>Strengths and limitations: </strong>This is the first systematic review summarizing data from human studies on ED and BoNT-A ICI. The inclusion criteria and outcomes of the included studies varied, which limited the number of studies included and parameters assessed in the meta-analysis.</p><p><strong>Conclusion: </strong>BoNT-A may become an acceptable non-surgical option. However, there is a lack of clinical randomized or observational studies on this topic, and more randomized studies with standardized reporting are required to replicate current results and investigate the long-term benefits of BoNT-A as a monotherapy or adjunct therapy in the management of ED.</p>","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"13 2","pages":"qfaf034"},"PeriodicalIF":2.6,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12053099/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144024218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors affecting complications and outcomes in penile fractures: a decade of surgical experience from a single center.","authors":"Murat Sambel, Abdullah Erdogan, Sahin Kilic, Eren Erdi Aksaray, Batuhan Furkan Berk, Asuman Arslan Onuk, Mutlu Ates","doi":"10.1093/sexmed/qfaf030","DOIUrl":"https://doi.org/10.1093/sexmed/qfaf030","url":null,"abstract":"<p><strong>Background: </strong>Penile fracture (PF) is a urological emergency that can lead to significant complications if not treated promptly and understanding the factors influencing complications and outcomes in PFs is crucial for improving patient management.</p><p><strong>Aim: </strong>This study aims to evaluate the impact of various factors on postoperative complications and outcomes in patients with PFs based on 10 years of experience at a single center.</p><p><strong>Methods: </strong>In this retrospective study, we analyzed data from 106 patients who underwent surgical treatment for PFs between 2013 and 2023 at our institution. Patient demographics, fracture characteristics, and postoperative outcomes were analyzed. Factors affecting complications including the timing of surgery, defect size were evaluated.</p><p><strong>Outcomes: </strong>The study revealed that early surgical intervention significantly reduced the risk of complications. Factors such as larger defect size and delayed surgery were associated with higher rates of postoperative complications.</p><p><strong>Results: </strong>The mean age of the participants was 46.3 ± 13.9 years. The primary causes of PFs were sexual intercourse (62.3%), masturbation (19.8%), forced penile bending (11.3%), rolling over in bed (4.7%), and falling from bed (1.8%). The mean time from trauma to surgery was 10.5 ± 8 hours, with a mean defect size of 12.7 ± 5.5 mm. Postoperative complications included penile curvature, palpable plaques, and painful erections, with rates of 10.4%, 39.6%, and 23.6%, respectively. International Index of Erectile Function (IIEF-5) scores significantly decreased from preoperative (21.36 ± 2.9) to postoperative values at 6 months (19.48 ± 3.7) (<i>P</i> < 0.001). The time from trauma to surgery significantly correlated with the change in IIEF-5 scores between preoperative and postoperative values (<i>P</i> = 0.007, <i>R</i> ² = 0.067). The group experiencing complications exhibited a mean defect size of 14.54 ± 6 mm, whereas the non-complication group had a mean defect size of 11.07 ± 4.5 mm (<i>P</i> < 0.001).</p><p><strong>Clinical implications: </strong>The findings suggest that timely surgical intervention and careful assessment of defect size are critical in managing PFs and these insights can guide urologists in optimizing treatment strategies and improving patient outcomes.</p><p><strong>Strengths and limitations: </strong>This study benefits from a substantial sample size and a decade of surgical experience at a single center. However, the study's retrospective design and unknown patient history with erectogenic drugs are limitations.</p><p><strong>Conclusion: </strong>The timing of surgery significantly impacts IIEF-5 scores, while the size of the defect was associated with other postoperative complications; understanding the factors influencing complications in PFs can improve surgical outcomes.</p>","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"13 2","pages":"qfaf030"},"PeriodicalIF":2.6,"publicationDate":"2025-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12050032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"South Asian Society for Sexual Medicine School, Bangladesh: a multidisciplinary training initiative in an under-resourced country.","authors":"Mohammad Shamsul Ahsan, Leuza Mubassara, A K M Anwarul Islam, Md Mahbubul Hasan, Shahjada Selim, Rubaiya Ali, Mohtasham Hasan, Md Kamrul Hossain","doi":"10.1093/sexmed/qfaf028","DOIUrl":"https://doi.org/10.1093/sexmed/qfaf028","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The yearly courses conducted by the South Asian Society for Sexual Medicine (SASSM) in Bangladesh establish a collaborative training paradigm designed to increase healthcare professionals' comfort with sexual medicine and develop skills for giving the best treatment possible to individuals with sexual health issues and dysfunctions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;The study assessed the impact of course completion on SASSM School Bangladesh participants.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A pretest-posttest of 116 (57%) SASSM participants was conducted, comprising data on knowledge acquisition following the 3-day program in 2017, 2018, 2019, and 2021. A paired &lt;i&gt;t&lt;/i&gt;-test was applied to compare the difference between pretest and posttest performance. Logistic regression was conducted to assess the influence of socio-demographic variables.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes: &lt;/strong&gt;The study demonstrates that the SASSM School Bangladesh program significantly improves participants' knowledge of sexual medicine, with a 12.7-unit increase in test scores, irrespective of socio-demographic factors.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Majority (102, or 75% of those polled) of the participants were men. Psychiatrists were the most common respondents (39%), followed by dermatologists (32%), urologists (12%), and gynecologists (8%) who completed both surveys. There was a significant difference (&lt;i&gt;P&lt;/i&gt;-value &lt; .01) in mean pretest (49.6 ± 17.1) and posttest (62.3 ± 15.5) scores. The socio-demographic factors (gender, location, age, and experience) do not have any significant influence on gain of knowledge through the SASSM training program as the &lt;i&gt;P&lt;/i&gt;-value of odds ratio or adjusted odds ratio from logistic regression is &lt;i&gt;P&lt;/i&gt; &gt; .05.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Clinical implications: &lt;/strong&gt;The study highlights the clinical importance of structured training in sexual medicine, ensuring that healthcare professionals across various specialties are better equipped to diagnose and manage sexual health issues effectively.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Strengths and limitations: &lt;/strong&gt;The study used a pretest-posttest design to measure actual knowledge improvement. Paired &lt;i&gt;t&lt;/i&gt;-test and logistic regression were applied to ensure robust analysis. Diverse professionals from psychiatry, dermatology, urology, and gynecology participated in the study, making the findings relevant across specialties. This study evaluates the only structured sexual medicine training program in Bangladesh, contributing new insights into medical education.However, the findings may not be generalizable beyond Bangladesh. The study could not assess whether knowledge retention and clinical practice improved over time. Participants voluntarily enrolled in the study, which can possibly represent a group already interested in sexual medicine. The study focused only on knowledge improvement, not on changes in clinical practice or patient outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Specialists o","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"13 2","pages":"qfaf028"},"PeriodicalIF":2.6,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12041646/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144046262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sexual dysfunctions in patients with well-compensated chronic liver disease: role of etiology, Mediterranean diet and quality of life in an observational cross-sectional study.","authors":"Lorenzo Romano, Mariano Fonticelli, Filomena Morisco, Kateryna Priadko, Alba Rocco, Gerardo Nardone, Luisa Ranieri, Luigi Napolitano, Felice Crocetto, Biagio Barone, Davide Arcaniolo, Lorenzo Spirito, Celeste Manfredi, Antonietta Gerarda Gravina, Carmine Sciorio, Antonio Tufano, Antonio Cioffi, Ferdinando Fusco, Marco Romano, Marco De Sio","doi":"10.1093/sexmed/qfaf025","DOIUrl":"https://doi.org/10.1093/sexmed/qfaf025","url":null,"abstract":"<p><strong>Background: </strong>Sexual dysfunctions (SD) are highly prevalent in Chronic Liver Diseases (CLD). Whether Metabolic dysfunction-Associated Steatotic Liver Disease (MASLD) carries a higher risk of SD is unknown as is the role of dietary patterns or quality of Life (QoL).</p><p><strong>Aim: </strong>to assess (1) prevalence of SD in CLD; (2) whether MASLD is a risk factor for SD; (3) the role of adherence to Mediterranean Diet (MD) or QoL.</p><p><strong>Methods: </strong>Observational, cross-sectional study, 207 CLD patients (84 females and 123 males), median age 57 years (IQR:46-63); 96 (46.4%) MASLD; and 111 (53.6%) nonMASLD.</p><p><strong>Outcomes: </strong>SD were assessed through Female Sexual Function Index (FSFI) and International Index of Erectile Function (IIEF) questionnaires. Adherence to MD was evaluated by the MD Score, QoL by SFHS-12 questionnaire evaluating physical [(ie, Physical Component Summary (PCS)] and mental [(ie, Mental Component Summary (MCS)] health. Multivariate analysis identified predictors of SD.</p><p><strong>Results: </strong>(1) SD prevalence in CLD was 157/207 (75.8%); 80.9% females were at risk for SD, altered sexual desire/arousal and dyspareunia being the most common complaints, whereas 72.3% males had erectile dysfunction (ED); (2) prevalence of SD was higher in MASLD (89%) than in nonMASLD (64%) (<i>P</i> < 0.001); (3) in females, at univariate analysis, a negative correlation was found between FSFI and age, hypertension, or MASLD; (4) in males, at univariate analysis, IIEF-ED negatively correlated with age, DM2, or MASLD, whereas positively correlated with PCS and MCS; (5) in females, at multivariate analysis BMI (OR = 0.779,CI 95% = 0.640-0.948) and MCS (OR = 0.840,CI 95% = 0.741-0.953) were protective against SD, whereas age (OR = 1.115,CI 95% = 1.040-1.263) and DM2 (OR = 120.894,CI 95% = 1.396-10 741) were predictive of SD; (6) in males, at multivariate analysis, age (OR = 1088,CI 95% = 1032-1.148) and MASLD (OR = 4.075,CI 95% = 1.120-14.828) were risk factors for, whereas PCS (OR = 0,928,CI 95% = 0,865-0,995), and disease duration (OR = 0.393,CI 95% = 0.187-0.822) were protective against SD; 7) MD adherence, while higher in nonMASLD vs MASLD (<i>P =</i> 0.004), was not an independent protective factor against SD.</p><p><strong>Clinical implications: </strong>SD should not be underestimated in CLD patients, in particular those with MASLD.</p><p><strong>Strengths and limitations: </strong>Comprehensive study evaluating SD in a large cohort of CLD patients of both sexes, comparing MASLD vs nonMASLD. Due to its cross-sectional design, no conclusions can be drawn about cause and effect.</p><p><strong>Conclusions: </strong>(1) CLD, in particular MASLD, have a high prevalence of SD which is not affected by MD adherence, whereas QoL seems to play a role; (2) CLD patients should be evaluated for SD, for early diagnosis and treatment.</p>","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"13 2","pages":"qfaf025"},"PeriodicalIF":2.6,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12018302/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144007524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AI-assisted transcription of YouTube videos on penile enlargement: analysis of their text quality and readability.","authors":"Mehmet Fatih Şahin, Erdem Can Topkaç, Çağrı Doğan, Serkan Şeramet, Furkan Batuhan Tuncer, Muhammed Sencer Köroğlu, Onur Orbeği, Cenk Murat Yazici","doi":"10.1093/sexmed/qfaf023","DOIUrl":"https://doi.org/10.1093/sexmed/qfaf023","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Patients dealing with sensitive issues like penile enlargement (PE) might benefit from YouTube videos. Therefore, it is essential that the textual content of these videos is clear, trustworthy, and of high quality.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;Are the AI-assisted acquired texts' qualities and comprehensibilities of YouTube videos about PE enough and suitable for the patients?&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;On October 25, 2024, Google Trends analysis identified the 25 most searched phrases for \"Penile enlargement.\" Non-related terms were excluded, and the relevant keywords were searched on YouTube. Only content about PE included; excluding duplicates, non-English videos, YouTube shorts, those under 30 seconds, silent, and music-only videos. Videos were transcribed using Whisper AI, and their quality was assessed by M.F.Ş, E.C.T., and Ç.D. using the GQS (global quality scale) and DISCERN, the readability was evaluated via Flesch-Kincaid (FKGL and FKRE) measures. High assessor agreement was noted (Pearson r = 0.912). Videos were categorized by uploader, and metrics such as views, likes, comments, and duration were recorded. The Chi-square test was used for categorical variable comparisons; the Kruskal-Wallis H-Test was applied when normality and homoscedasticity were not met, with Bonferroni post hoc correction for multiple comparisons.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes: &lt;/strong&gt;The mean DISCERN and GQS scores were 51.23 ± 13.1 and 3.32 ± 0.9, respectively. FKRE and FKGL scores were 73.12 ± 11.7 and 5.85 ± 2.1. Physicians (n = 67) produced the most videos, while academic institutions (n = 2) produced the least. No significant differences in text quality were found between groups (&lt;i&gt;P&lt;/i&gt; = 0.067 and &lt;i&gt;P&lt;/i&gt; = 0.051). Health-related websites exhibited lower FKRE compared to non-healthcare videos (&lt;i&gt;P&lt;/i&gt; = &lt;b&gt;0.002&lt;/b&gt;), with a significant difference in FKGL as well (&lt;i&gt;P&lt;/i&gt; = &lt;b&gt;0.019&lt;/b&gt;).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The video exhibited a high level of readability (indicating comprehensibility for almost a 6th-grade student). Text quality, view and like count of the videos uploaded by academic institutions was the highest.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Clinical implications: &lt;/strong&gt;In PE, YouTube video's health information needs to be better quality and more trustworthy, according to our research. The language used in videos should be easier to understand.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Strengths and limitations: &lt;/strong&gt;This study is the first scientific analysis of YouTube video transcripts on PE using AI, focusing specifically on English content, which limits its applicability to non-English speakers and other platforms. Exclusions of silent and shorter videos may result in the omission of valuable information.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The need for better quality and trustworthiness in health-related YouTube information, especially for PE is essential. Content makers should stress clear, accessible language and minimize disinformation.","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"13 2","pages":"qfaf023"},"PeriodicalIF":2.6,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12011079/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Methods, practices, and complications related to the use of artificial penile nodules within the French Guiana penitentiary.","authors":"Jeremy Vergez, Anaïs Baudot, Loïc Epelboin, Sébastien Rabier, Evelyn Vienrendeels, Mathieu Nacher, Aude Lucarelli, Timothee Bonifay","doi":"10.1093/sexmed/qfaf022","DOIUrl":"https://doi.org/10.1093/sexmed/qfaf022","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Artificial penile nodules (APNs) are small, handmade objects inserted under the penile skin, a practice deeply rooted in the prison environment of French Guiana, raising significant concerns related to sexual health, including complications and an increased risk of sexually transmitted infections (STIs).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;The primary objective of the current study was to investigate APN practices, methods, and complications in prison and to identify risk factors for complications among APN users and their sexual partners.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This cross-sectional study was conducted among adult male detainees in June 2023 at the French Guiana Penitentiary (FGP). Eligible participants completed an anonymous 47-question survey addressing sociodemographic data, APN practices, and sexual health. Facilitators played a critical role in distributing and collecting the questionnaires, which were available in five languages to accommodate the prison's population ethnogeographic diversity. Data analysis was conducted using logistic regression to identify risk factors associated with complications.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes: &lt;/strong&gt;Outcomes included the prevalence of APN use among detainees, the proportion of individuals experiencing complications, the association between APN characteristics (number and placement) and partner-related complications, as well as the rates of condom breakage and self-reported STI history.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Among 779 eligible detainees, 132 participated (17%). The majority were under 35 years old (67%), and 69% reported having APNs, with a median of 5.2 nodules per user (range: 1-22). The main motivation for APN use was enhancing partner satisfaction (60%), while 5% cited intent to harm. Complications were reported by 25%, including pain (52%), bleeding (41%), and infections (35%). Partner-related complications (pain or bleeding) were significantly associated with having five or more APNs and placement in the foreskin of the penis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Clinical implications: &lt;/strong&gt;Given the high prevalence of APNs in the prison setting and their associated health risks, targeted health education and harm reduction strategies are essential to mitigate complications and promote informed decision-making among detainees.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Strengths and limitations: &lt;/strong&gt;The main limitation of this study was its reliance on self-reported questionnaires completed in cells, which may have affected confidentiality, response accuracy, and participation due to prison dynamics and literacy barriers. However, the approach provided valuable insight into a stigmatized topic, and collaboration with facilitators and staff helped achieve meaningful participation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;APNs are deeply rooted in prison culture in French Guiana but pose significant health risks. Findings underscore the need for targeted health education to address these risks, particularly f","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"13 2","pages":"qfaf022"},"PeriodicalIF":2.6,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12011078/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}