Sexual Medicine最新文献

{"title":"Analysis of the psychometric evidence of the Female Sexual Function Index (FSFI) & measurement invariance across relationship status & age generations in a Chilean sample.","authors":"Gonzalo R Quintana, Fernando P Ponce, J Francisco Santibáñez-Palma, Javier Escudero-Pastén, Carolina P Aguayo-Zuñiga, Mercedes Carrasco-Portiño, Marcela Cid-Aguayo, Mauricio González-Arias, Paola Ilabaca, Rodrigo Jarpa-Schäcker, Claudio López-Labarca, Marco A Marrodán, Nadia Ramos, Leonardo Reyes-Torres, Valeria Rosales-Pincetti, María T Solis-Soto, Anna Wlodarczyk, Jaime Barrientos","doi":"10.1093/sexmed/qfaf010","DOIUrl":"10.1093/sexmed/qfaf010","url":null,"abstract":"<p><strong>Background: </strong>Inconsistencies in the Female Sexual Function Index (FSFI) factor structure and current research and clinical guidelines highlight the need for continued exploration of its psychometric evidence. Furthermore, only one study has assessed its measurement invariance (MI), while the only FSFI psychometric study conducted in Chile lacks quality and representativity.</p><p><strong>Aim: </strong>Therefore, this study aimed to evaluate the psychometric properties of the FSFI (ie, structural and convergent validity, and reliability) in a Chilean sample of women, while also examining MI across relationship status and age groups.</p><p><strong>Method: </strong>A sample of 2595 sexually active adult women (<i>M</i> <sub>age</sub> = 32.10, <i>SD</i> <sub>age</sub> = 10) was derived from a broader Chilean study (Chilean National Sex and Sexuality Study). We used a confirmatory factor analysis to determine its structural validity, sexual satisfaction (SS) dimensions to establish its convergent validity, and Cronbach's alpha and McDonald's omega to assess the reliability of its scores.</p><p><strong>Outcomes: </strong>Measures of goodness-of-fit.</p><p><strong>Results: </strong>Confirmatory factor analysis supported a six-factor structure. Internal consistency indices for all FSFI dimensions ranged from good to excellent. MI was achieved across socio-demographic variables at the factor covariance level. Convergent validity indicated modest-to-moderate effects in satisfaction differences based on relationship status. Among other findings, Chilean women in a relationship had significantly higher satisfaction with their sexual communication and compatibility than those who were single, which is consistent with previous findings. Meanwhile, women at risk of experiencing sexual problems scored significantly lower across all SS dimensions than those not at risk.</p><p><strong>Clinical implications: </strong>This study provides evidence that the FSFI is a valid, reliable, and invariant tool for the clinical practice in the sexual health of Spanish-speaking Latino Americans, especially that of Chilean women's sexual function (SF) and problems.</p><p><strong>Strengths & limitations: </strong>This study provided a comprehensive analysis of the FSFI's psychometric validity evidence, demonstrating its reliability and validity across diverse Chilean women while also offering its first assessment of MI and confirming its suitability for clinical and research use in Spanish-speaking Latino women. Conversely, this study's main caveat lies in having a predominantly younger, cisgender, and heterosexual sample.</p><p><strong>Conclusion: </strong>Nevertheless, this study's findings support the FSFI as a valuable research tool for female SF and well-being, particularly within the Chilean population. This study significantly expands the applicability of the FSFI and underscores its MI across sociodemographic factors, as well as its applicability in the","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"13 1","pages":"qfaf010"},"PeriodicalIF":2.6,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11879574/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557714","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 conserved molecular mechanism of erectile dysfunction in type 2 diabetes rats and mice by cross-species transcriptomic comparisons.","authors":"Ming Xiao, Huanqing Zeng, Yanghua Xu, Jiarong Xu, Xiaoli Tan, Yuxin Tang","doi":"10.1093/sexmed/qfaf007","DOIUrl":"10.1093/sexmed/qfaf007","url":null,"abstract":"<p><strong>Background: </strong>The poor clinical situation of type 2 diabetes-induced erectile dysfunction (T2DMED) creates an urgent need for new therapeutic targets.</p><p><strong>Aim: </strong>To reveal the conserved molecular mechanism of T2DMED across species.</p><p><strong>Methods: </strong>T2DMED rat and mouse models were constructed to extract mRNA from corpus cavernosum for high-throughput sequencing. The differentially expressed genes (DEGs) were analyzed and the Kyoto Encyclopedia of Genes and Genomes (KEGG), Gene Ontology (GO), and Protein-Protein Interaction Networks were performed by bioinformatics methods. Immunohistochemistry, immunofluorescence, hematoxylin- eosin and Masson staining were used for subsequent verification.</p><p><strong>Outcomes: </strong>Cross-species transcriptomics of T2DMED rats and mice were analyzed and validated.</p><p><strong>Results: </strong>Gene expression patterns in normal corpus cavernosum of mice and rats showed a strong correlation (r = 0.75, <i>P</i> < 2.2 × 10^-16), with a total of 15 691 homologous genes identified. In both species, 553 homologous down-regulated DEGs were identified, mainly enriched in pathways related to smooth muscle and mitochondrial functions, as revealed by KEGG and GO analyses. Immunohistochemistry and immunofluorescence confirmed the decreased expression of α-smooth muscle actin and <i>Uqcr10</i> in cavernosum tissues of T2DMED mice and rats. Additionally, 239 homologous up-regulated DEGs were identified, which were enriched in the <i>Wnt</i> signaling pathway and extracellular matrix composition. Subsequent experiments confirmed increased β-catenin expression and significant collagen accumulation, indicating fibrosis in T2DMED.</p><p><strong>Clinical implications: </strong>To provide a new direction for improving the erectile ability of patients with T2DMED.</p><p><strong>Strengths and limitations: </strong>The main strength is that cross-species transcriptomic sequencing has revealed the conserved molecular mechanisms of T2DMED. The main limitation is the lack of further validation in the T2DMED patients.</p><p><strong>Conclusions: </strong>Cross-species transcriptomic comparisons may offer a novel strategy for uncovering the underlying mechanisms and identifying therapeutic targets for T2DMED.</p>","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"13 1","pages":"qfaf007"},"PeriodicalIF":2.6,"publicationDate":"2025-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11879191/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557924","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":"Application of International Society for the Study of Women's Sexual Health consensus algorithm for persistent genital arousal disorder/genito-pelvic dysesthesia to 10 cases and use of epidural spinal injections as long term management.","authors":"Hannah Ahrendt, Salim Hayek, Sheryl Kingsberg, Anna Myers, Rachel Pope","doi":"10.1093/sexmed/qfaf008","DOIUrl":"10.1093/sexmed/qfaf008","url":null,"abstract":"<p><strong>Introduction: </strong>Persistent genital arousal disorder/genito-pelvic dysesthesia (PGAD/GPD) is a debilitating, but poorly understood disorder. To address the lack of knowledge regarding mechanism and treatments, the International Society for the Study of Women's Sexual Health (ISSWSH) consensus statement proposed a region-based approach for management of PGAD/GPD, including possible etiologies. Annular tears of the lumbar intervertebral disc are a recently acknowledged etiology of PGAD/GPD, and current evidence suggests that management of symptomatic tears resistant to non-invasive treatment may require lumbar endoscopic spinal surgery.</p><p><strong>Aim: </strong>This case series offers 10 cases of PGAD/GPD symptoms, in order to describe resource efficient management, including use of epidural spinal injections to reduce barriers to care for this debilitating condition.</p><p><strong>Methods: </strong>Individuals were identified by investigators in clinical practice. Electronic medical record notes and relevant imaging from the past 3 years were reviewed.</p><p><strong>Results: </strong>Half of the patients tried three or more treatments before finding any symptomatic relief. Two patients, with annular tears evident on magnetic resonance imaging (MRI), found complete relief with epidural spinal injections. A patient with hypertonic pelvic floor found total relief with pelvic floor physical therapy. Two patients found alleviation of symptoms with discontinuation of triggering medications, and four patients had palliation of symptoms with gabapentin and/or pregabalin.</p><p><strong>Conclusion: </strong>These cases demonstrate the utility of the ISSWSH consensus algorithm in guiding initial diagnosis and treatment of PGAD/GPD. However, flexibility is important in management to choose the appropriate treatment pathway to provide the most effective symptom management. Current evidence suggests the use of epidural spinal injections for temporary symptom relief, however, this case series suggests its use for long term management.</p>","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"13 1","pages":"qfaf008"},"PeriodicalIF":2.6,"publicationDate":"2025-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11879244/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557855","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":"Different temporal relationship between sex hormones and sleep status in midlife women: a longitudinal cohort study.","authors":"Dongyuan Ma, Tong Zhang","doi":"10.1093/sexmed/qfaf009","DOIUrl":"10.1093/sexmed/qfaf009","url":null,"abstract":"<p><strong>Background: </strong>Fluctuation in sex hormones and the occurrence of sleep disturbance are 2 major health challenges among midlife women. However, the temporal relationship between them remains unclear.</p><p><strong>Methods: </strong>This study included 2488 females (mean ± SD age, 49.0 ± 2.70 years) with an average follow-up of 6.95 years. We constructed a composite score by summing items related to sleep problems to reflect the comprehensive sleep status of the participants in the Study of Women's Health Across the Nation. Cross-lagged path analysis was used to examine the temporal relationship between sex hormones and sleep status. Sensitivity analyses were conducted in nonoverweight and overweight groups and adjusted for vasomotor symptoms in the main model.</p><p><strong>Aim: </strong>In this study, we aimed to examine the temporal relationship between sex hormones and sleep status in midlife women using cross-lagged path analysis.</p><p><strong>Outcomes: </strong>The primary outcomes included results of the cross-lagged path analysis between sex hormones and sleep status.</p><p><strong>Results: </strong>After adjusting for age, race, income, menopausal status, body mass index, hormone therapy use, smoking, and drinking, the cross-lagged path coefficients from baseline follicle-stimulating hormone (FSH) and estradiol (E2) to follow-up sleep status were 0.054 (<i>P</i> = .017) and -0.054 (<i>P</i> = .016), respectively. The path coefficient from baseline sleep to follow-up dehydroepiandrosterone sulfate (DHAS) was 0.042 (<i>P</i> = .017). The path coefficients between testosterone and sleep were not statistically significant. In the nonoverweight group, the patterns of the temporal relationship between sex hormones and sleep were the same as the total sample, and the point estimates were larger. However, the temporal relationships in the overweight group were nonsignificant. After adjustment for vasomotor symptoms in the main model, results were basically consistent.</p><p><strong>Clinical implications: </strong>Given the temporal relationship between sex hormones and sleep, our findings will provide scientific perspectives to benefit health management in the transition of menopause.</p><p><strong>Strengths and limitations: </strong>This study used a longitudinal theoretical model to distinguish the temporal relationship between sex hormones and sleep status in midlife women. Limitations include limited causal evidence in observational studies, unknown confounders, and careful extrapolation.</p><p><strong>Conclusion: </strong>There were distinct patterns in the unidirectional temporal relationship between (1) FSH, E2, and DHAS and (2) sleep. Changes in FSH and E2 occurred earlier than the change of sleep, while the change of DHAS was later. In contrast, there was no temporal relationship between testosterone and sleep.</p>","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"13 1","pages":"qfaf009"},"PeriodicalIF":2.6,"publicationDate":"2025-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11879248/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557922","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":"A Maltese Perspective of Sex: a Maltese cross-sectional study.","authors":"Matthew Bartolo, Vincent Marmara, Danica Cassar, Arianna Miclet","doi":"10.1093/sexmed/qfae095","DOIUrl":"10.1093/sexmed/qfae095","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;This research constitutes a pioneering cross-sectional investigation into sexual behaviors within the Maltese population, centered on the examination of meaning of sex, sex frequency, sex duration, sexual satisfaction, and discussions about sex.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;The aim of this study is to explore how the Maltese define the term \"sex\" and with whom they discuss sexual matters while testing the hypotheses that the frequency and duration of sexual activity, as well as the discussion of sexual matters, influence sexual satisfaction.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Data were collected via a computer-assisted telephone interview method, using a randomized sample of 400 Maltese adults aged 18 and above. The questionnaire included 33 items addressing various aspects of sexual behavior. The responses were analyzed using SPSS, applying Mann-Whitney &lt;i&gt;U&lt;/i&gt;, Kruskal-Wallis, and chi-square tests to assess relationships between variables.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes: &lt;/strong&gt;To gauge participants' sexual satisfaction, respondents were tasked with rating their contentment with their sexual lives on a scale from 1 to 5.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Results revealed that 26.9% of respondents defined sex as a \"sexual act between two persons,\" while 26.8% linked it to \"an act of love.\" Few participants associated sex with pleasure or intimacy, reflecting possible conservative cultural influences. A majority (61.7%) felt comfortable discussing sexual matters with their partners, while only 26.6% were comfortable doing so with friends. The average sexual frequency was 5.69 times per month. Sexual satisfaction was positively correlated with frequency as individuals reporting more frequent sex were generally more satisfied with their sex lives. However, no significant association was found between the duration of sexual activity and sexual satisfaction.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Clinical translation: &lt;/strong&gt;The study's clinical implications provide valuable insights for healthcare professionals, policymakers, and researchers grappling with sexual health concerns within the Maltese population.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Strengths and limitations: &lt;/strong&gt;This pioneering study provides new insights into sexual behaviors in Malta, with stratified sampling enhancing the sample's representativeness. However, social desirability and recall bias may affect the accuracy of self-reported data, and the focus on age, gender, and relationship status overlooks other factors, such as cultural or religious influences, that may offer a deeper understanding of sexual behaviors.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The Maltese population demonstrates a diverse understanding of \"sex\" while also revealing that most individuals feel comfortable discussing sexual matters with partners but not with friends; additionally, the population reports an average sexual frequency of 5 times per month, lasting between 26 and 45 minutes, with the majority expressing overall satisf","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"13 1","pages":"qfae095"},"PeriodicalIF":2.6,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11843095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484007","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 assessment of the sexuality of patients with a borderline personality disorders based on their 2D:4D digit ratio.","authors":"Justyna Holka-Pokorska, Adam Kucharski","doi":"10.1093/sexmed/qfaf006","DOIUrl":"10.1093/sexmed/qfaf006","url":null,"abstract":"<p><strong>Background: </strong>The hormonal composition of amniotic fluid during prenatal development, particularly the androgen-to-estrogen ratio, may influence neuronal differentiation related to sexual response patterns and the capacity to control impulsive sexual behaviors in later life.</p><p><strong>Aim: </strong>This study aims to assess sexual behaviors and characterize sexual responses in women with borderline personality disorder (BPD) compared to a control group.</p><p><strong>Methods: </strong>The study included 33 women diagnosed with BPD and 56 women in a control group. BPD diagnoses were based on clinical psychiatric evaluation and the Structured Clinical Interview for DSM-IV. Elements of sexual response were measured using the Arizona Sexual Experience Scale (ASEX). The digit ratio (2D:4D) served as a biomarker for testosterone and estrogen exposure during early prenatal development.</p><p><strong>Main outcomes: </strong>ASEX results were analyzed in the categories of \"desire,\" \"arousal,\" and \"vaginal lubrication\" subscales, along with the 2D:4D digit ratio for both hands.</p><p><strong>Results: </strong>Lower values for the right-hand digit ratio were observed in the BPD group compared to the control group (0.989, SD = 0.034 vs. 1.016, SD = 0.039; <i>P</i> = 0.0014), potentially indicating higher prenatal testosterone levels. Significant correlations were found in the BPD group between the right-hand digit ratio and scores on the ASEX subscales, specifically \"sexual arousal\" (<i>r</i> = 0.406, <i>P</i> = 0.019) and \"vaginal lubrication\" (<i>r</i> = 0.362, <i>P</i> = 0.038).</p><p><strong>Clinical implications: </strong>These results may support biological hypotheses regarding the origins of sexual dysfunction in women with BPD.</p><p><strong>Strengths and limitations: </strong>This study is a pioneering attempt to explore the indirect impact of early amniotic hormone composition on the neurobiological conditioning of sexual response and behavior in women with BPD. Limitations include the preliminary nature of the findings, a small sample size, and results that may not be generalizable across all genders.</p><p><strong>Conclusions: </strong>Physiological aspects of sexual response, such as arousal and vaginal lubrication, in women with BPD appear to be significantly correlated with prenatal testosterone levels, as indicated by the 2D:4D digit ratio.</p>","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"13 1","pages":"qfaf006"},"PeriodicalIF":2.6,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11828702/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433711","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":"A cross-sectional survey on the sexual health status of Chinese men in Guinea.","authors":"Yun-Hua Lin, Xian-Tao Song, Jun-Sheng Wang, Ning Zhang","doi":"10.1093/sexmed/qfaf005","DOIUrl":"10.1093/sexmed/qfaf005","url":null,"abstract":"<p><strong>Background: </strong>Sexual health among Chinese men living and working in Guinea has not been adequately studied.</p><p><strong>Aim: </strong>To assess sexual health issues and related factors among Chinese men in Guinea.</p><p><strong>Methods: </strong>A cross-sectional study was conducted using an anonymous questionnaire, with 258 Chinese male respondents living and working in Guinea. The survey collected data on demographics, lifestyle habits, sexual activity, condom use, and knowledge of sexually transmitted diseases (STDs).</p><p><strong>Outcomes: </strong>The primary outcomes included levels of sexual activity, condom use, and STD awareness.</p><p><strong>Results: </strong>Of the respondents, 89.1% reported sexual needs, but only 11.6% were sexually active during their stay. Younger age, urban residence, and non-smoking were positively associated with sexual activity. Among those who were sexually active, 80% had multiple sexual partners, and 60% consistently used condoms, while 13.3% never used them. Condom use was found to be lower among older, married, and less educated individuals. Awareness of STDs was generally low, with an average score of 8.03 out of 12. Younger respondents, those with higher education, those who were sexually active and those who considered themselves familiar with STD knowledge had a relatively higher level of awareness. Most respondents (93%) believed that promoting sexual health education is necessary.</p><p><strong>Clinical implications: </strong>Findings suggest a need for targeted sexual health education and intervention programs, especially among high-risk groups.</p><p><strong>Strengths & limitations: </strong>The study provides valuable data on a previously unexamined population; however, its cross-sectional design and reliance on self-reported data may limit the ability to establish causal relationships.</p><p><strong>Conclusion: </strong>The study highlights unmet sexual health needs and knowledge gaps among Chinese men in Guinea, suggesting the importance of health education and preventive measures in this population.</p>","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"13 1","pages":"qfaf005"},"PeriodicalIF":2.6,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11803080/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143382997","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":"Evaluate the knowledge, attitudes, and practices of emergency medicine physicians in managing priapism cases-a cross section study.","authors":"Sameh Saad Aziz, Walaa Adel Siam, Yasser Salem N Saleh, Asmaa A Hashem, Altaf Bandy, Saleh Salem Bahaj, Amany Ali Essa Elshemally","doi":"10.1093/sexmed/qfaf004","DOIUrl":"10.1093/sexmed/qfaf004","url":null,"abstract":"<p><strong>Introduction: </strong>Priapism is an emergency condition treated by emergency medicine (EM) physicians and urologists/andrologists. EM physicians are the first-line healthcare providers for this condition, and their knowledge, attitudes, and practices regarding priapism remain unclear.</p><p><strong>Aim: </strong>The aim of this study was to understand emergency physicians' perspectives regarding priapism to help re-structure EM programs.</p><p><strong>Methods: </strong>This cross-sectional study on knowledge, attitude, and practice (KAP) surveyed emergency physicians from a university and other hospitals in the Ismailia governorate, Egypt. A validated questionnaire was sent via an online e-survey following the CHEERIES guidelines. Bivariate analysis of demographic characteristics and KAP was performed using by odds ratios and 95% confidence intervals. Spearman's rho was used to measure the correlation between knowledge, attitude, and practice. A <i>P</i> <0.05 was considered statistically significant.</p><p><strong>Main outcome measure: </strong>Emergency physicians completed an e-survey of their knowledge, attitudes, and practices regarding priapism.</p><p><strong>Results: </strong>A total of 149 participants were surveyed. 140 (93%) of EM physicians believed priapism was a medical emergency. 139 (93%) respondents were aware of the long-term complications of priapism. Further, 136 (91.3%) respondents strongly supported the multidisciplinary approach. Of these, 79 (53%) gave intra-cavernous sympathomimetic therapy and 75 (50.3%) did aspiration with irrigation. EM physicians <30 years of age had significantly better knowledge about priapism (OR = 2.47 (1.23-4.96); <i>P</i> = 0.01). Similarly, young physicians had better attitudes (OR = 3.24 (1.31-8.02); <i>P</i> = 0.01) and female physicians demonstrated better practice (OR = 3.36 (1.65-6.82); <i>P</i> = 0.001) toward priapism. A significant positive correlation was observed between knowledge and attitude (r = 0.487), and knowledge and practice (r = 0.281) at <i>P</i> <0.001.</p><p><strong>Clinical implications: </strong>EM physicians agreed that EM-based therapy is appropriate for straightforward cases of acute ischemic priapism. Existing educational programs for EM physicians may not adequately equip them in handling priapism in practice.</p><p><strong>Strengths and limitations: </strong>This study is the first to investigate EM knowledge, attitude, and practice (KAP) for priapism handling. The study identified areas for improvement in this regard. However, the cross-sectional design, single governorate setting, and self-administered questionnaire limit its generalizability.</p><p><strong>Conclusion: </strong>Despite the satisfactory knowledge and attitudes of EM physicians regarding priapism and infection control, this study identified potential areas for improvement in the use of guidelines on invasive treatment.</p>","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"13 1","pages":"qfaf004"},"PeriodicalIF":2.6,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11798673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143365864","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":"Exploring sexual and romantic functioning as early risk factors of schizophrenia: a narrative review.","authors":"Paula Dospělová, Petra Šustová, Ellen Zakreski, Renáta Androvičová","doi":"10.1093/sexmed/qfaf002","DOIUrl":"10.1093/sexmed/qfaf002","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Patients with schizophrenia frequently encounter challenges related to sexuality and intimacy; however, the underlying causes of these difficulties remain unknown and unexplored.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;This narrative review aims to explore how the biological/hormonal and psychological/behavioral developmental trajectories in schizophrenia patients deviate from the normal course and to examine their connection to difficulties in sexual and romantic functioning.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A comprehensive literature search was conducted using PubMed and Google Scholar, with key terms related to schizophrenia and sexual development without restriction on publication year. Articles discussing behavioral, sexual, or psychological/behavioral development before the onset of schizophrenia were included. Articles were divided into biological/hormonal and psychological/behavioral precursor categories. Additional searches were conducted to explore the broader sociocognitive context of schizophrenia, such as deficits in empathy, emotional processing, and theory of mind.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes: &lt;/strong&gt;The review highlights deviations in both biological/hormonal and psychological/behavioral development in schizophrenia that contribute to difficulties in romantic and sexual relationships.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;This narrative review addresses the extent to which biological, psychological, and social factors in schizophrenia may be closely intertwined. Abnormalities in the hypothalamic-pituitary-gonadal and hypothalamic-pituitary-adrenal axes have been documented in individuals with schizophrenia, potentially impairing sociosexual competencies and leading to behavioral challenges in forming sexual relationships. Deficits in theory of mind, emotional processing, and empathy may further hinder the ability to form and sustain intimate relationships, amplifying the social difficulties associated with schizophrenia. Additionally, early life traumas, especially sexual abuse, can contribute to sexual difficulties and worsen the disorder.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Clinical translation: &lt;/strong&gt;Understanding the deviations from the normal developmental course in schizophrenia patients may offer valuable insights for potential intervention strategies and remediation approaches and contribute to improvements in sexual/romantic functioning and overall sexual health in schizophrenia patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Strengths and limitations: &lt;/strong&gt;This review provides an overview of the developmental precursors of schizophrenia-related sexual/romantic difficulties. Further research is needed to elucidate the specific mechanisms underlying these difficulties, particularly in determining the emotional and motivational salience of sexual stimuli and the capacity to engage in and maintain communication of sexual interest. The reader should bear in mind that narrative reviews lack systematic methods for selecting and evaluating studies, which ca","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"13 1","pages":"qfaf002"},"PeriodicalIF":2.6,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11798675/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143365867","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":"Benefits of movement-based Behaviors on improving erectile function in American men: a nationwide survey study.","authors":"Yiming Chen, Qianfeng Zhuang, Wei Xia, Naiyuan Shao, Bo Zhang, Xingliang Feng","doi":"10.1093/sexmed/qfaf003","DOIUrl":"10.1093/sexmed/qfaf003","url":null,"abstract":"<p><strong>Background: </strong>Erectile dysfunction (ED) is a prevalent condition with significant psychological and physiological impacts. Recently, a new concept called movement-based behaviors (MBB) has been proposed, which includes four types of PA: vigorous PA (VPA), moderate-intensity PA (MPA), walking/cycling, and muscle-strengthening activities (MSA), and uses an MBB index (range 0-4) to estimate the combined effects of these activities on health outcomes.</p><p><strong>Aim: </strong>This study aims to evaluate the relationship between different types of physical activities (PA) and ED using the MBB index in a nationally representative sample of U.S. men.</p><p><strong>Methods: </strong>We analyzed data from the National Health and Nutrition Examination Survey (NHANES) 2001-2004, including 3435 male participants. Multivariate logistic regressions were performed to explore the associations, supplemented with subgroup analysis and sensitivity analysis.</p><p><strong>Outcomes: </strong>The assessment of PA in this study is based on four self-reported questions from the NHANES Mobile Examination Center interview, including VPA, MPA, walking/cycling, and MSA. The MBB index, ranging from 0 to 4, was used to assess combined PA types. ED was evaluated using a single-question self-assessment.</p><p><strong>Results: </strong>Higher MBB index values were associated with lower ED risk. Participants with an MBB index of 2 had a significantly lower risk of ED in Model 3 (OR = 0.65, 95% CI: 0.43-0.97, P = 0.04). Those with an MBB index of 3 or 4 had the lowest risk of ED across all models, with OR_Model1 = 0.29 (95% CI: 0.21-0.40, P < 0.0001), OR_Model2 = 0.52 (95% CI: 0.37-0.73, P < 0.001), and OR_Model3 = 0.61 (95% CI: 0.41-0.90, P = 0.02). However, this relationship was not significant in subgroups with severe ED or comorbid conditions.</p><p><strong>Clinical implications: </strong>Our findings can provide clinicians with guidance to help patients personalize their selection of different exercise combinations.</p><p><strong>Strengths and limitations: </strong>We explored the impact of different exercise combinations on reducing ED risk and innovatively proposed the MBB index for a comprehensive assessment of exercise benefits, supported by a large sample size and multivariable adjustments. However, the limitations of cross-sectional design and recall bias cannot be overlooked.</p><p><strong>Conclusion: </strong>The MBB index effectively demonstrates that combined PA can reduce ED risk, supporting tailored exercise recommendations for patients.</p>","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"13 1","pages":"qfaf003"},"PeriodicalIF":2.6,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11788418/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190559","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}