Sexual Medicine最新文献

{"title":"Utilization and prospects of artificial intelligence in the diagnosis, prediction, and treatment of erectile dysfunction.","authors":"Bo Zhang, Hui Wang, Zitong Wang, Ziqi Zhu, Xinyi Wang, Xiancheng Du, Ming Chen, Chunhui Liu, Chao Sun","doi":"10.1093/sexmed/qfaf104","DOIUrl":"10.1093/sexmed/qfaf104","url":null,"abstract":"<p><strong>Introduction: </strong>Erectile dysfunction (ED) represents a significant global public health challenge in men's health, with its prevalence exacerbated by population aging. Given the rapid advancement of artificial intelligence (AI) in healthcare, there is growing interest in its novel applications for ED diagnosis and treatment.</p><p><strong>Objectives: </strong>This systematic review synthesizes existing research on AI's role in ED management, examining its current development, application in diagnosis and treatment, and key benefits and challenges.</p><p><strong>Methods: </strong>We executed a PRISMA-guided systematic review across PubMed, Web of Science, and Chinese databases (CNKI/Wanfang) through June 19, 2025. Analysis targeted three domains: (1) the technological evolution of AI tools specific to ED, (2) applications in clinical diagnosis, prediction, and personalized treatment, and (3) the emerging role of large language models (LLMs).</p><p><strong>Results: </strong>The review identified major milestones in AI's technological evolution for ED and highlighted its significant clinical advantages, particularly through intelligent questionnaires and wearable devices enabling precise diagnosis, alongside efficacy in developing personalized treatments and predicting disease progression. While AI, particularly LLMs, demonstrates emerging potential, critical challenges persist.</p><p><strong>Conclusion: </strong>This review establishes a critical theoretical and technical foundation for implementing AI in men's healthcare, demonstrating its significant potential to transform the management of ED through improved diagnostics, personalized treatment, and predictive capabilities. While the interpretive nature of the synthesis presents an inherent limitation, cross-validation among researchers enhanced the reliability of the findings. However, clinical adoption remains contingent upon addressing key challenges related to data privacy, ethical considerations, and interoperability.</p>","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"14 2","pages":"qfaf104"},"PeriodicalIF":2.4,"publicationDate":"2026-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12910163/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146221378","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":"Perception of aesthetic procedures applied to the vulva in the context of the medical specialty of gynecology and obstetrics.","authors":"Vera Lúcia Mota da Fonseca, Jorge Artur Peçanha de Miranda Coelho, Gustavo Henrique Silva de Souza, Emanuel Duarte de Almeida Cordeiro, José Humberto Belmino Chaves, Rui Manuel Lopes Nunes","doi":"10.1093/sexmed/qfag003","DOIUrl":"10.1093/sexmed/qfag003","url":null,"abstract":"<p><strong>Background: </strong>Female genital cosmetic surgery (FGCS), particularly labiaplasty, has gained increasing visibility and demand in clinical practice.</p><p><strong>Aim: </strong>To examine the perceptions of gynecology physicians and residents regarding ethical aspects and knowledge related to FGCS, with a focus on labiaplasty.</p><p><strong>Methods: </strong>A cross-sectional study was conducted with 404 physicians, including 327 (80.9%) women and 77 (19.1%) men. Participants completed a structured questionnaire assessing their ethical perspectives on vulvovaginal cosmetic procedures and their specific knowledge of interventions such as labiaplasty, hymenoplasty, clitoroplasty, and others.</p><p><strong>Outcomes: </strong>Differences in ethical views and knowledge levels between experienced physicians and residents were evaluated.</p><p><strong>Results: </strong>The findings revealed no significant differences between physicians and residents in ethical perceptions of labiaplasty. However, more experienced physicians reported greater exposure to patients seeking these procedures and demonstrated higher levels of knowledge regarding specific techniques.</p><p><strong>Clinical implications: </strong>Despite greater clinical exposure, ethical perspectives seem to be shaped early during academic training, underscoring the importance of formal education on FGCS.</p><p><strong>Strengths and limitations: </strong>This study provides insights into a relatively underexplored topic in medical education. However, the use of self-reported measures and a cross-sectional design may limit causal interpretations.</p><p><strong>Conclusion: </strong>Ethical perceptions of FGCS are consistent across levels of clinical experience, suggesting a strong influence of medical training and reinforcing the need for structured discussions on the topic in educational curricula.</p>","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"14 1","pages":"qfag003"},"PeriodicalIF":2.4,"publicationDate":"2026-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12907013/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146213670","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 the temporal relationship between psychosocial risk factors and recurrent ischemic priapism.","authors":"Devin M Dishong, Mark Essien, Yuezhou Jing, Arthur L Burnett","doi":"10.1093/sexmed/qfag005","DOIUrl":"10.1093/sexmed/qfag005","url":null,"abstract":"<p><strong>Background: </strong>The development of recurrent ischemic priapism (RIP) is associated with mental health disorders, psychiatric medications, and substance use, but the temporal relationship between the onset of RIP and the development of these risk factors is poorly understood.</p><p><strong>Aim: </strong>This study aimed to investigate the chronology of psychosocial and substance use risk factors relative to the initial clinical presentation of RIP.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of 73 adult patients diagnosed with RIP at a single academic center, identified via manual chart review of the electronic health record. Patients presenting with RIP between 2004 and 2020 were included, with data collection extending to 2025 to ensure a minimum follow-up of nearly 5 years for all participants to minimize censoring bias and capture delayed risk factor onset.</p><p><strong>Outcomes: </strong>The date of the first RIP presentation (index event) was compared to the first documented date of several risk factors, including anxiety, depression, psychiatric medication use, and substance use.</p><p><strong>Results: </strong>In the overall cohort, there was no statistically significant difference in the proportion of any risk factor developing before versus after the onset of RIP. Further, in a sub-analysis of 35 patients with sickle cell disease (SCD), a higher proportion of patients initiated psychiatric medication after the onset of RIP, although this was not statistically significant (<i>P</i> = .0522). No other factors reached statistical significance in the SCD sub-analysis.</p><p><strong>Clinical implications: </strong>The findings suggest that RIP may be a psychologically traumatic event that contributes to the development of the same psychosocial risk factors it is associated with.</p><p><strong>Strengths and limitations: </strong>The primary strength of this study is its novel investigation into the temporal relationship between RIP and psychosocial risk factors, supported by a design that ensured a minimum follow-up period of over 4 years for all participants. Limitations are primarily related to its retrospective, single-center chart-review design.</p><p><strong>Conclusion: </strong>Our findings suggest a complex, potentially bidirectional relationship that highlights the need for integrated mental health screening for all patients with RIP, particularly for the high-risk SCD population.</p>","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"14 1","pages":"qfag005"},"PeriodicalIF":2.4,"publicationDate":"2026-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12907015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146214125","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":"Non-pharmacological interventions for sexual health in multiple sclerosis: a systematic review and meta-analysis.","authors":"Hikmat Hadoush PhD, Abdallah Al Hassoun MSc, Mohammad Al-Wardat PhD, Mohammad Etoom PhD, Alham Al-Sharman PhD","doi":"10.1093/sexmed/qfaf102","DOIUrl":"10.1093/sexmed/qfaf102","url":null,"abstract":"<p><strong>Background: </strong>Multiple sclerosis (MS), a neurodegenerative disease, frequently causes sexual dysfunction (SD) besides the well-known motor impairment, which significantly reduces patients' quality of life (QOL).</p><p><strong>Aim: </strong>This meta-analysis evaluates the effectiveness of non-pharmacological interventions for MS-related SD.</p><p><strong>Methods: </strong>Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a systematic search of PubMed, ScienceDirect, CINAHL, and Cochrane databases identified randomized and clinical trials; data were extracted, the risk of bias was assessed, and meta-analyses were conducted.</p><p><strong>Outcomes: </strong>The primary outcomes were changes in sexual function, satisfaction, and QOL.</p><p><strong>Results: </strong>A total of 34 studies were included and eligible for meta-analysis. Pooled analyses revealed that yoga did not significantly improve sexual function standardized mean difference (SMD = -0.18, <i>P</i> = .84). However, structured exercise protocols (treadmill, aerobic, and aquatic exercises) showed significant improvements in sexual function (SMD = 2.88, <i>P</i> = .04), with aquatic exercise being particularly effective (SMD = 14.76, <i>P</i> = .0001). Mindfulness interventions also enhanced sexual function (SMD = 4.40, <i>P</i> < .0001). While psychoeducational programs did not significantly improve overall sexual QOL (SMD = 16.40, <i>P</i> = .18), they significantly improved sexual function (SMD = 3.46, <i>P</i> = .004) and satisfaction (SMD = 7.73, <i>P</i> = .028).</p><p><strong>Clinical implication: </strong>Tailored exercise and psychoeducational interventions can be recommended to improve sexual function and satisfaction in patients with MS.</p><p><strong>Strengths and limitations: </strong>Strengths include adherence to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and comprehensive analysis; limitations are the heterogeneity of interventions and the short-term nature of the included studies.</p><p><strong>Conclusion: </strong>Tailored exercise and psychoeducation significantly benefit sexual function in MS, while other therapies like yoga require refinement; future research should investigate long-term outcomes and patient-specific factors.</p>","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"14 1","pages":"qfaf102"},"PeriodicalIF":2.0,"publicationDate":"2026-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12879193/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146143466","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":"Baseline sexual function of patients receiving gender-affirming hysterectomies.","authors":"Allison J de Moya, Katarina Q Watson, Tami S Rowen","doi":"10.1093/sexmed/qfag001","DOIUrl":"10.1093/sexmed/qfag001","url":null,"abstract":"<p><strong>Background: </strong>While there are data showing the effects of gender-affirming hormone therapy on sexual satisfaction in transgender and gender-diverse individuals, there is no research on sexual function in patients seeking or undergoing gender-affirming hysterectomy (GAH).</p><p><strong>Aim: </strong>This project is a descriptive study of baseline characteristics (pre-hysterectomy) in patients seeking GAH.</p><p><strong>Methods: </strong>Twenty participants at a single tertiary care center were surveyed on orgasm satisfaction (Orgasm Rating Scale), and sexual function (Transmasculine Sexual Functioning Index).</p><p><strong>Results: </strong>The study sample (<i>n</i> = 20) was largely white, college-educated, between the ages of 21 and 35 years old. Most participants identified as transmasculine/transgender men and 75% were on testosterone therapy. No significant differences were observed in Orgasm Rating Scale subscales. The median Transmasculine Sexual Functioning Index sexual function score (20) corresponded with \"moderate\" sexual function.</p><p><strong>Conclusion: </strong>This study should be replicated in a larger, more diverse sample, with stratification across hormone therapy use, and longitudinal follow-up to assess for change in sexual function over time.</p>","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"14 1","pages":"qfag001"},"PeriodicalIF":2.4,"publicationDate":"2026-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12860200/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146107123","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":"Clinical characterization and management of persistent genital arousal disorder/genito-pelvic dysesthesia (PGAD/GPD): a registry study.","authors":"Franziska Maxi Lisa Marie Kümpers, Sophie Köhne, Tillmann H C Krüger","doi":"10.1093/sexmed/qfaf106","DOIUrl":"10.1093/sexmed/qfaf106","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Persistent genital arousal disorder (PGAD)/genito-pelvic dysesthesia (GPD) is a disabling disease, where patients perceive prolonged genital arousal without sexual desire. The condition mainly occurs in women. Etiopathological considerations reach from peripheral to central nervous system mechanisms.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;To clinically and anamnestically characterize patients with PGAD/GPD using data from a dedicated patient registry.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This study comprises a detailed description of 92 patients with PGAD/GPD from a registry data bank. Investigations included clinical characterization of PGAD/GPD-symptoms, assessment of sexual, urogynecological, somatic, and psychiatric history as well as clinical examination and treatments.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes: &lt;/strong&gt;The primary outcome was to identify common clinical features, symptom patterns, trigger and relieving factors, comorbidities, and therapeutic strategies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Persistent genital arousal disorder symptoms were mostly characterized as tingling and were almost permanently present. In over 80%, PGAD symptoms were located in the clitoris (women) or in the glans penis (men); 50% reported extragenital manifestations. Thirty-four percent described symptoms such as GPD. PGAD presented with high rates of swelling of the genitals (46%), spontaneous orgasms (30%), and extraordinary lubrication (27%). Most frequent trigger factors were mental stress, sitting, wearing tight clothes, and vibration. Relieving factors were mainly distraction, physical exercise, and warmth. Half of the patients stated increased urinary urge. More than 40% stated symptoms of overactive bladder syndrome. About one third reported restless legs symptoms. Almost 70% had comorbid psychiatric diseases, mainly depressive disorders. In most cases, those occurred after the onset of PGAD/GPD symptoms. Further diagnostic procedures covered urogynecological and neurological examinations as well as magnetic resonance imaging of brain, spinal cord, and pelvis. Non-pharmacological therapeutic approaches included among others physiotherapy, psychotherapy, transcutaneous electrical nerve stimulation, neurosurgical procedures, or pudendal block. In the majority, a clear somatic correlate for PGAD/GPD was not found.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Clinical implications: &lt;/strong&gt;The findings highlight the complex and multifactorial nature of PGAD/GPD, advocating interdisciplinary diagnostics and individualized treatments due to high psychiatric comorbidity and the absence of consistent somatic findings.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Strengths and limitations: &lt;/strong&gt;The study's strength lies in its large sample size and comprehensive clinical profiling of PGAD/GPD patients; however, its retrospective registry-based design and the absence of a control group represent significant limitations.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This first registry-based study of PGAD/GPD in a larger cohort","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"14 1","pages":"qfaf106"},"PeriodicalIF":2.0,"publicationDate":"2026-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12860204/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146107036","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":"Diagnostic value of multi-modal ultrasound combined with intracavernosal injection testing for concurrent erectile dysfunction and penile curvature.","authors":"Muyi Mao, Jiahui Peng, Lujing Li, Senbao Tan, Huitong Lin, Zuofeng Xu","doi":"10.1093/sexmed/qfag002","DOIUrl":"10.1093/sexmed/qfag002","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The combination of Intracavernosal Injection (ICI) and Color Doppler Duplex Ultrasonography (CDDU) has emerged as a novel approach for evaluating erectile dysfunction (ED) in recent years.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;To evaluate the diagnostic value of multi-modal ultrasound integrated with ICI in patients with ED concomitant with penile curvature.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Eighty-two ED patients were prospectively enrolled in this observational study between April 2021 and February 2025. Multimodal ultrasound, including high frequency ultrasound, CDDU, and shear wave elastography were used to evaluate the penile hemodynamic and structural parameters pre- and post-ICI of Papaverine Hydrochloride. The peak systolic velocity (PSV), end diastolic velocity (EDV), and resistance index (RI) of the corpus cavernosum artery and SWE-derived Young's modulus values (YM) of the corpus cavernosum were examined. Participants were stratified by curvature presence, with subgroup analyses by different angle (&lt;15°, 15-30°, 31-60°, &gt;60°) and different direction (ventral/lateral, left/right).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes: &lt;/strong&gt;The differences of penile hemodynamic and structural parameters pre- and post-ICI of all ED patients, and different subgroups of patients with penile curvature were evaluated.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;(1) Eighty-two men with a median age of 34 (21-67) years were evaluated, including 34 patients (41.46%) diagnosed as ED with penile curvature and 48 patients (58.54%) diagnosed as ED without penile curvature. (2) Using High-frequency ultrasound, Peyronie's disease was detected in 8 patients (9.76%). (3) Following ICI, compared to pre-ICI measurements, both groups exhibited significant increases in PSV (&lt;i&gt;P&lt;/i&gt; &lt; .001) and EDV (&lt;i&gt;P&lt;/i&gt; = .012) of cavernous artery and a reduction in YM (&lt;i&gt;P&lt;/i&gt; &lt; .001). (4) Patients in moderate/severe curvature group showed higher EDV (&lt;i&gt;P&lt;/i&gt; = .01) and lower RI (&lt;i&gt;P&lt;/i&gt; = .02) than no/mild curvature groups, with Significant differences. (5) Significant differences in pre-ICI YM were observed among patients categorized by penile curvature direction (&lt;i&gt;P&lt;/i&gt; = .03).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Clinical implications: &lt;/strong&gt;We provide a non-invasive, reproducible method for the integrated assessment of ED complicated with penile curvature by multi-modal ultrasound combined with ICI, and correlate pre-intervention biomechanical and vascular profiles with post-erection anatomical outcomes in ED patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Strengths & limitations: &lt;/strong&gt;The strength of the study lies in its unique approach to evaluate patients with ED concomitant with penile curvature, making the clinical evaluation more complete and precise. However, the limited sample size restricts generalizability and further research.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Multi-modal ultrasound combined with ICI provides a non-invasive, reproducible method for the integrated assessment of ED complicated with penile","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"14 1","pages":"qfag002"},"PeriodicalIF":2.0,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12856951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146107055","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":"Lack of sustained improvements in erectile function following low-intensity extracorporeal shockwave therapy correlate with decreases in corporal brain-derived neurotropic factor: a pilot study and prospective clinical trial.","authors":"Skye Coffey, Vy Nguyen, Ashley N Matthew, Bridget S Kastelberg, Maria E Teves, Mina Ghatas, Adam P Klausner, Ryan P Smith, Sarah C Krzastek","doi":"10.1093/sexmed/qfaf107","DOIUrl":"10.1093/sexmed/qfaf107","url":null,"abstract":"<p><strong>Background: </strong>Low-intensity extracorporeal shockwave therapy (Li-ESWT) is thought to treat erectile dysfunction (ED) by stimulating neovascularization and nerve regeneration as demonstrated in animal models by histologically increased angiogenesis and neuronal-related growth factors, though corresponding human studies are limited.</p><p><strong>Aim: </strong>We hypothesized that Li-ESWT results in appreciable increases in growth factors in human tissues, and in this proof-of-concept study we aimed to determine whether markers for neovascularization and nerve regeneration can be detected in the corporal blood of men following Li-ESWT treatment.</p><p><strong>Methods: </strong>Patients were prospectively enrolled in a clinical trial of Li-ESWT for ED. Patients received 12 bi-weekly Li-ESWT treatments of 0.2 mJ/mm² at 5 Hz, 1500 shocks delivered per treatment, with follow up at 1-2 weeks, 4-6 weeks, 3 months, and 6 months post-treatment. Cavernosal penile blood samples were obtained prior to treatment and at each visit post-treatment. The concentrations of endothelial nitric oxide synthase (eNOS), neuronal nitric oxide synthase (nNOS), vascular endothelial growth factor (VEGF), and brain-derived neurotropic factor (BDNF) in penile plasma samples were measured using enzyme-linked immunosorbent assay with specific commercial kits, following the protocols provided by the manufacturer.</p><p><strong>Outcomes: </strong>eNOS, nNOS, VEGF, and BDNF were detectable and demonstrated changes in cavernosal plasma samples following Li-ESWT treatment.</p><p><strong>Results: </strong>Twenty-five patients completed all five study visits. Mean patient age was 63. Mean baseline International Index of Erectile Function-Erectile Function score prior to treatment was 14.24 (±1.21). Corporal plasma samples were analyzed for eNOS, nNOS, VEGF, and BDNF using the enzyme-linked immunosorbent assay. Levels of eNOS, nNOS, and VEGF showed an upward trend following treatment but did not reach significance. BDNF levels were noted to decrease.</p><p><strong>Clinical implication: </strong>Corporal blood aspirates may function as surrogates for histological studies to understand effects of Li-ESWT at the tissue level in humans.</p><p><strong>Strengths and limitations: </strong>To our knowledge, this is first the molecular study in human tissues to attempt to quantify neurogenesis and neovascularization in penile tissue following Li-ESWT for ED. Although our sample size is small, we believe this represents a promising first step in understanding the effect of Li-ESWT at a tissue level in men.</p><p><strong>Conclusion: </strong>The clinical significance of our findings is currently unknown, but markers of neovascularization and neurogenesis are detectable in corporal plasma and may change following Li-ESWT. ClinicalTrials.gov  <b>ID</b> NCT04720755.</p>","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"13 6","pages":"qfaf107"},"PeriodicalIF":2.0,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12825299/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146053622","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":"Repeatability in measuring curvature in Peyronie's disease.","authors":"Majken H Wiborg, Rasmus Krøijer, Else B Kallestrup, Birgitte S Laursen, Gabriele Berg-Beckhoff, Lars Lund","doi":"10.1093/sexmed/qfaf105","DOIUrl":"10.1093/sexmed/qfaf105","url":null,"abstract":"<p><strong>Background: </strong>Despite guideline recommendations to assess Peyronie's disease (PD) curvature during an intracavernous injection-induced erection, no standardized measurement protocol exists, and considerable interobserver variability remains.</p><p><strong>Aim: </strong>To evaluate the interobserver reliability of penile curvature measurements in patients with PD and to determine if image annotation enhances measurement consistency.</p><p><strong>Methods: </strong>In this study, 4 experienced urologists independently assessed erect penile curvature in 22 male patients enrolled in a prospective PD clinical trial. Two image sets per patient were analyzed: 1 consisting of self-captured photographs taken at home and the other obtained in the clinic after intracavernosal injection of alprostadil. Each image set included standardized lateral and dorsal views. The potential impact of an assisting line on photographic measurements was also evaluated.</p><p><strong>Outcomes: </strong>Interobserver agreement in curvature measurement, the effect of line annotation on measurement accuracy, and the comparison of measurement consistency between home-acquired and clinic-induced erection images.</p><p><strong>Results: </strong>Interobserver agreement was high, with Intraclass Correlation Coefficient values ranging from 0.77 to 0.88 across assessments. No statistically significant improvement in repeatability was observed with the addition of assisting lines. Furthermore, no meaningful difference in reproducibility was detected between home-based and pharmacologically induced image sets.</p><p><strong>Clinical implications: </strong>Accurate measurement of penile curvature is crucial for comparing studies and evaluating treatment results. Variations in measurement techniques can lead to inconsistent data interpretation and reduce generalizability.</p><p><strong>Strengths and limitations: </strong>This study highlights the need to standardize PD curvature assessment. While using multiple expert raters increases reliability, the small sample size and subjective interpretation of curvature may limit its broader use.</p><p><strong>Conclusion: </strong>Penile curvature measurements in PD show high interobserver reliability, regardless of photographic conditions or the use of assisting lines.</p>","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"13 6","pages":"qfaf105"},"PeriodicalIF":2.4,"publicationDate":"2025-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12728819/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145834689","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":"Effect of PLISSIT model-based counseling on solving sexual dysfunction in women using contraception: 1-year outcomes.","authors":"Özlem Bakan Demirel, Hatice Yıldız","doi":"10.1093/sexmed/qfaf099","DOIUrl":"10.1093/sexmed/qfaf099","url":null,"abstract":"<p><strong>Background: </strong>The PLISSIT model has a significant impact on alleviating sexual dysfunction and enhancing sex life.</p><p><strong>Aim: </strong>This study aimed to investigate the 1-year outcomes of the effect of sexual training-counseling based on the PLISSIT model on the resolution of sexual dysfunction among women using contraceptive methods.</p><p><strong>Methods: </strong>The study was designed prospective, randomized controlled, and experimental, and carried out in 2 stages. In the first stage, 352 women were included in the study. The Female Sexual Function Index (FSFI) was administered to these women, and their sexual dysfunction status was assessed according to the FSFI cut-off point (≤26.55). And then, 100 women who detected sexual dysfunction were randomized and divided into 2 groups (study group-SG; n = 49 and control group-CG; n = 51). Sexual education-counseling based on the PLISSIT model was implemented only for the SG. At 1-year follow-up, the sexual functions of women in both groups were evaluated with FSFI.</p><p><strong>Outcomes: </strong>The rate of sexual dysfunction in women using contraceptive methods is important, and PLISSIT-based sexual counseling is effective in reducing this problem.</p><p><strong>Results: </strong>The sexual dysfunction rate was found to be 28.4% (n = 100). After PLISSIT-based sexual counseling, the sexual functions of the women in the SG improved starting from the third month and the FSFI levels were higher than the CG women at the third month, sixth month, and first year (<i>P</i> < .001). The effect size of PLISSIT-based counseling on the total FSFI score was 37.6%. While in the first assessment, sexual dysfunction rates were 100% in both groups; after 6 months, this rate decreased to 38.8% and 42.9% after 1 year in the SG (in CG, respectively; 94.1% and 80.4%) and the difference was significant (<i>P</i> < .001).</p><p><strong>Clinical implications: </strong>The results show the importance of sexual function assessment and sexual counseling in women using contraceptive methods, the FSFI can be used in the assessment, and PLISSIT-based sexual counseling was effective in reducing sexual dysfunction.</p><p><strong>Strengths and limitations: </strong>The limitations of this research are its cross-sectional nature and the fact that it was conducted only with women who use contraceptive methods.</p><p><strong>Conclusion: </strong>Study results showed that the rate of sexual dysfunction was high in women using contraceptive methods and PLISSIT-based sexual counseling was effective in reducing or resolving sexual dysfunction experienced during contraceptive use.</p>","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"13 6","pages":"qfaf099"},"PeriodicalIF":2.4,"publicationDate":"2025-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12717947/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145805440","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}