Sexual Medicine最新文献

{"title":"The value of audiovisual sexual stimulation with virtual reality in diagnosing erectile dysfunction.","authors":"Yan-Ping Huang, Tao Jing, Kai-Feng Liu, Wei Liu, Ming Zhang, Da-Chuan Zhong, Yi-Dong Liu, Shi-Ran Xu, Mu-Jun Lu","doi":"10.1093/sexmed/qfae014","DOIUrl":"10.1093/sexmed/qfae014","url":null,"abstract":"<p><strong>Background: </strong>The traditional audiovisual sexual stimulation (AVSS) test may experience limitations including low erectile response rate and lack of unified diagnostic criteria.</p><p><strong>Aim: </strong>We aimed to explore the clinical value of AVSS with virtual reality (VR-AVSS) test in assessing erectile function and diagnosing erectile dysfunction (ED).</p><p><strong>Methods: </strong>Participants 18 to 60 years of age were screened for analysis in 3 clinical centers from June 2020 to March 2022. Demographic data, 5-item International Index of Erectile Function (IIEF-5), erectile hardness score (EHS), and self-reported symptom questions were collected. The ED patients and control patients were confirmed according to the IIEF-5 and EHS. All subjects watched a 60-minute erotic video by VR device during RigiScan recording. The parameters including tip average rigidity, tip effective erectile duration (duration of rigidity ≥60%, tip effective erectile duration), base average rigidity, and base effective erectile duration were evaluated.</p><p><strong>Outcomes: </strong>The main outcome of interest was the application of VR immersion technology to improve the traditional AVSS test.</p><p><strong>Results: </strong>A total of 301 ED cases and 100 eligible control patients were included for final analysis. Compared with control patients, ED cases had significantly lower IIEF-5 scores, EHS, positive response rate, and erectile rigidity and duration. The positive response rate of ED and control patients were 75.5% and 90.9%, respectively. The cutoff points of tip average rigidity, tip effective erectile duration, base average rigidity, and base effective erectile duration were 40.5% (sensitivity: 77.6%, specificity: 70.2%; <i>P</i> < .001), 4.75 minutes (sensitivity: 75.9%, specificity: 75.4%; <i>P</i> < .001), 48.5% (sensitivity: 77.6%, specificity: 75.1%; <i>P</i> < .001), and 7.75 minutes (sensitivity: 79.3%, specificity: 75.7%; <i>P</i> < .001).</p><p><strong>Clinical implications: </strong>The technological superiority of VR will enable the VR-AVSS immersion test to be a more accurate detection than traditional AVSS modes.</p><p><strong>Strengths and limitations: </strong>Our study applied VR immersion technology to establish the standard operation procedure for the AVSS test, which could effectively reduce the interference of adverse factors and minimize the detecting errors. However, the test data only included positive response subjects, so the true erectile status of men with a negative response to the AVSS test cannot be obtained.</p><p><strong>Conclusions: </strong>The VR-AVSS test can effectively improve the diagnostic accuracy of ED. The average rigidity and effective erectile duration were the optimal diagnostic parameters for excluding ED.</p>","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"12 1","pages":"qfae014"},"PeriodicalIF":2.6,"publicationDate":"2024-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10944820/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140158954","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":"Safety, tolerability, and pharmacokinetics of aildenafil citrate tablets, a novel oral PDE5 inhibitor, in healthy Chinese volunteers after multiple-dose administration.","authors":"Ran Xie, Bo Jia, Lu Cheng, Nan Zhao, Xu He, Xia Wang, Xia Zhao, Yimin Cui","doi":"10.1093/sexmed/qfae008","DOIUrl":"10.1093/sexmed/qfae008","url":null,"abstract":"<p><strong>Background: </strong>Aildenafil citrate is a potent and selective inhibitor of cyclic guanosine monophosphate-specific phosphodiesterase type 5, developed for the treatment of erectile dysfunction (ED).</p><p><strong>Aim: </strong>This study aimed to assess the pharmacokinetics, safety, and tolerability of aildenafil citrate tablets after multiple doses in healthy Chinese males.</p><p><strong>Methods: </strong>Twenty participants were divided into 2 groups, 10 participants each. Participants were administered multiple doses of aildenafil citrate tablets at 30 and 60 mg.</p><p><strong>Outcomes: </strong>The safety evaluation was based on clinical symptoms and adverse events. Concentrations of aildenafil and its key metabolites (M1, M5, and M12) in human serum were measured by liquid chromatography-tandem mass spectrometry.</p><p><strong>Results: </strong>Pharmacokinetic analysis showed rapid absorption and elimination of aildenafil, with a median time to maximum serum concentration of 1 hour and mean terminal half-lives of 2.75 and 3.26 hours in the respective dose groups. The mean maximum concentration was proportional to the aildenafil dose in the range of 30 to 60 mg, although the area under the curve was not proportional for serum concentration vs time 0 to the last measurable time point (24 hours). Multiple doses of aildenafil were well tolerated, with 60.0% of men experiencing treatment-emergent adverse events, notably myalgia and fatigue, particularly in the 60-mg group.</p><p><strong>Clinical implications: </strong>Aildenafil citrate tablets demonstrated favorable tolerability with once-daily administration over the clinical dose range. The occurrence of myalgia and fatigue was more prevalent in the 60-mg group. From a pharmacokinetic perspective, optimal administration of aildenafil citrate tablets appears to be 1 hour before sexual intercourse in men with ED.</p><p><strong>Strengths and limitations: </strong>This study presents robust safety and pharmacokinetic data at expected therapeutic doses, unaffected by clinical factors. The efficacy of aildenafil citrate tablets warrants further validation in individuals with ED.</p><p><strong>Conclusion: </strong>Aildenafil citrate tablets exhibited good tolerability in healthy Chinese males following multiple doses at 30 and 60 mg. The 60-mg group showed an increased incidence of myalgia and fatigue, suggesting the need for heightened clinical vigilance. The mean maximum concentration, but not the area under the curve, displayed dose proportionality within the 30- to 60-mg dose range, and no significant drug accumulation was observed with repeated daily administration.</p><p><strong>Clinical trial registration: </strong>CTR20192473 (http://www.chinadrugtrials.org.cn).</p>","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"12 1","pages":"qfae008"},"PeriodicalIF":2.6,"publicationDate":"2024-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10937897/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140132469","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":"Why compulsive sexual behavior is not a form of addiction like drug addiction.","authors":"Morten Hesse","doi":"10.1093/sexmed/qfae006","DOIUrl":"10.1093/sexmed/qfae006","url":null,"abstract":"","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"12 1","pages":"qfae006"},"PeriodicalIF":2.6,"publicationDate":"2024-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10915579/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140050363","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":"Compulsive sexual behavior disorder in an inpatient sample with substance use disorder.","authors":"Sarah Golder, Bertram Walter, Isabel Bengesser, Dietmar Kramer, Christian Muhl, Nadja Tahmassebi, Florian Storz, Charlotte Markert, Rudolf Stark","doi":"10.1093/sexmed/qfae003","DOIUrl":"10.1093/sexmed/qfae003","url":null,"abstract":"<p><strong>Background: </strong>Several studies indicate that compulsive sexual behavior disorder (CSBD) shares core elements with substance use disorder (SUD). These findings support the assumption of common mechanisms in addiction, which may lead to a higher tendency in patients with SUD to have comorbid CSBD. Nevertheless, this relationship between CSBD and SUD is poorly understood to date.</p><p><strong>Aim: </strong>This study aimed to compare the prevalence of CSBD and its subtype pornography use disorder (PUD) between a SUD group and a matched control group. Herein, we aimed to test whether patients with SUD are more likely to have a comorbid CSBD/PUD. We further hypothesized that a higher CSBD/PUD prevalence in patients with SUD is accompanied by more pronounced CSBD- and PUD-related personal characteristics.</p><p><strong>Methods: </strong>We assessed CSBD, PUD, and related personal characteristics in an inpatient SUD sample (<i>N</i> = 92) and a healthy control sample matched by age, gender, and educational level.</p><p><strong>Outcomes: </strong>Primary outcomes were the diagnoses of CSBD/PUD as assessed by questionnaires. CSBD/PUD-related personal characteristics were the early onset of problematic pornography consumption, relationship status as a single person, a high sexual motivation, a high level of time spent watching pornography, and a high degree of problematic pornography consumption (Problematic Pornography Consumption Scale, short version).</p><p><strong>Results: </strong>There was no significant difference between groups regarding CSBD prevalence (SUD sample, 3.3%; control sample, 7.6%) and PUD prevalence (SUD sample, 2.2%; control sample, 6.5%). We found relationship status as a single person and the sexual motivation dimension of importance of sex to be the only CSBD-related personal characteristics that were more pronounced in the SUD sample than the matched control group.</p><p><strong>Clinical implications: </strong>Results indicate no higher tendency for patients with SUD to develop comorbid CSBD/PUD, yet important vulnerabilities (eg, emotional dysregulation) should be considered when treating addictive disorder to prevent possible symptom displacement.</p><p><strong>Strengths and limitations: </strong>A strength of the study is that we compared a sample of patients with SUD with a matched control sample and used an instrument based on <i>ICD-11</i> criteria for CSBD. Possible limitations are significant differences between the groups because of the restrictions in an inpatient clinic that may have influenced responses (eg, roommates) and that the control group was not screened for SUD. Therefore, the results should be interpreted with some caution.</p><p><strong>Conclusion: </strong>We found no evidence of an overcomorbidity of SUD and CSBD/PUD. However, a higher rate of vulnerability factors for CSBD/PUD in the SUD sample might suggest some similarities between SUD and CSBD/PUD.</p>","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"12 1","pages":"qfae003"},"PeriodicalIF":2.6,"publicationDate":"2024-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10915581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140050360","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":"Prospective evaluation of sexual health following radical cystectomy due to bladder cancer.","authors":"Julia Nolting, Romy Nitzsche, Bernhard Kiss, Oliver W Hakenberg, Laila Schneidewind","doi":"10.1093/sexmed/qfae005","DOIUrl":"10.1093/sexmed/qfae005","url":null,"abstract":"<p><strong>Background: </strong>There is a lack of data concerning sexual health following open radical cystectomy (RC), especially in elderly patients and women.</p><p><strong>Aim: </strong>To describe sexual health and its impact on general health as well as survival in patients undergoing standard open RC for the treatment of bladder cancer (BC). Due to limited data, subgroup analysis for elderly patients and women was performed.</p><p><strong>Methods: </strong>A prospective noninterventional clinical study was performed evaluating sexual health in RC with any kind of urinary diversion due to BC with a follow-up of 12 months after RC. The study was approved by the local ethics review board (A 2021-0175) and was registered at the German Clinical Trial Register (DRKS00026255). Assessment of sexual health was done with the following validated questionnaires: EORTC QLQ-C30 (for quality of life; European Organisation for Research and Treatment of Cancer), EORTC SH22 (for sexual health), and IIEF-5 (5-item International Index of Erectile Function).</p><p><strong>Outcomes: </strong>The standard measurements of EORTC QLQ-C30, EORTC SH22, and IIEF-5 as well as overall survival.</p><p><strong>Results: </strong>Thirty-two patients participated in the study with a mean age of 71.5 years (SD, 9.7): 25 (78.1%) were male and 7 (21.9%) were female. Overall there is a heterogenic picture for sexual health in the study population, but sexual satisfaction is significantly higher prior to surgery while the importance of a sex life stays high and stable. Interestingly, the general health score is significantly correlated to sexual satisfaction (Pearson's correlation; <i>r</i> = 0.522, <i>P</i> = .002) preoperatively but not following surgery: <i>r</i> = 0.103 (<i>P</i> = .665) after 3 months, <i>r</i> = 0.478 (<i>P</i> = .052) after 6 months, <i>r</i> = 0.276 (<i>P</i> = .302) after 9 months, and <i>r</i> = 0.337 (<i>P</i> = .202) after 12 months. The importance of a sex life is still essential for the patients, especially when recovering from RC; nearly the same can be reported for elderly patients. Unfortunately, the data for women are too limited to report robust results.</p><p><strong>Clinical implications: </strong>Evaluation, advice, and monitoring of sexual health must be integrated into clinical practice, particularly in women.</p><p><strong>Strengths and limitations: </strong>At least to our knowledge, this is the first systematic prospective evaluation of sexual health in patients with BC receiving RC. Due to the small sample size, there is a risk of selection bias.</p><p><strong>Conclusion: </strong>Sexual health is important for patients with BC receiving RC, and it is an essential part of quality of life, especially in elderly patients.</p>","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"12 1","pages":"qfae005"},"PeriodicalIF":2.6,"publicationDate":"2024-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10915580/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140050361","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":"Reply on \"Why compulsive sexual behavior is not a form of addiction like drug addiction\".","authors":"Rudolf Stark, Bertram Walter, Isabel Bengesser, Dietmar Kramer, Christian Muhl, Nadja Tahmassebi, Said Khatib, Florian Storz, Charlotte Markert, Sarah Golder","doi":"10.1093/sexmed/qfae007","DOIUrl":"10.1093/sexmed/qfae007","url":null,"abstract":"","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"12 1","pages":"qfae007"},"PeriodicalIF":2.6,"publicationDate":"2024-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10915578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140050362","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 COVID-19 on sexual function and activities among reproductive-age women in Ibadan, South-West Nigeria.","authors":"Rukiyat Adeola Abdus-Salam, Oluwasegun Caleb Idowu, Fatimat Motunrayo Akinlusi, Yusuf Bello, Imran Oludare Morhason-Bello","doi":"10.1093/sexmed/qfae004","DOIUrl":"10.1093/sexmed/qfae004","url":null,"abstract":"<p><strong>Background: </strong>Since the outbreak of COVID-19 disease, the environment, families, individuals, and their ways of living have been affected. Social distancing was one of the strategies for the prevention of SARS-CoV-2 infection. It led to limited social interactions for fear of contracting the infection, which ultimately affected relationships, among which is sexual health.</p><p><strong>Aim: </strong>To determine the risk of female sexual dysfunction and the effect of the COVID-19 pandemic on sexual function and activities among women of reproductive age in Ibadan, South-West Nigeria.</p><p><strong>Methods: </strong>This cross-sectional study of 218 reproductive-age women evaluated the sexual function before, during, and after the COVID-19 disease pandemic and lockdown. Pretested semistructured self-administered questionnaires with the Female Sexual Function Index (FSFI) were used for data collection. Information collected included sociodemographic and gynecologic characteristics and COVID-19 experiences, as well as sexual history and function before, during, and after the COVID-19 pandemic lockdown. The level of significance was set at <i>P</i> < .05.</p><p><strong>Outcomes: </strong>Respondents were aged 20 to 50 years (95%) with a mean ± SD age of 34.82 ± 8.52 years; the majority were married (75.58%); one-fifth (21.9%) tested positive for COVID-19 infection; and participants who tested positive for COVID-19 infections were mostly health care workers.</p><p><strong>Results: </strong>An absence of sexual activity was reported in 9.18% of participants during lockdown, 7.73% before lockdown, and 4.18% after lockdown. The risk of female sexual dysfunction was prevalent among participants, especially those who tested positive for COVID-19 infection. The prevalence was worse during the pandemic lockdown (53.57%) than before (48.39%) or after (51.61%), and a similar pattern was seen among those who tested negative. There was no statistically significant difference in risk of developing sexual dysfunction during the COVID-19 pandemic between those who tested positive and negative to COVID-19. The arousal and desire domains contributed the highest proportion of low FSFI scores.</p><p><strong>Clinical implications: </strong>Nationwide lockdowns, which may be a method of control for pandemics, may result in psychosocial complications such as female sexual dysfunction.</p><p><strong>Strength and limitations: </strong>Most respondents had tertiary education and were able to respond to self-administered questionnaires, yet the risk of recall bias remains a concern whereas the pandemic met the world unprepared and baseline FSFI prior the pandemic was not available for participants. There are no local validation studies for the FSFI in Nigeria, which could have aided interpretation of results.</p><p><strong>Conclusion: </strong>A low FSFI score is prevalent in Ibadan, South-West Nigeria, with a higher incidence reported during the COVID-19 pa","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"12 1","pages":"qfae004"},"PeriodicalIF":2.6,"publicationDate":"2024-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10881290/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139932776","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":"Causal associations between prostate diseases, renal diseases, renal function, and erectile dysfunction risk: a 2-sample Mendelian randomization study.","authors":"Diliyaer Dilixiati, Kaisaierjiang Kadier, Jian-De Lu, Shiping Xie, Baihetiya Azhati, Reyihan Xilifu, Mulati Rexiati","doi":"10.1093/sexmed/qfae002","DOIUrl":"10.1093/sexmed/qfae002","url":null,"abstract":"<p><strong>Background: </strong>Previous observational studies have found a potential link between prostate disease, particularly prostate cancer (PCa), and kidney disease, specifically chronic renal disease (CKD), in relation to erectile dysfunction (ED), yet the causal relationship between these factors remains uncertain.</p><p><strong>Aim: </strong>The study sought to explore the potential causal association between prostate diseases, renal diseases, renal function, and risk of ED.</p><p><strong>Methods: </strong>In this study, 5 analytical approaches were employed to explore the causal relationships between various prostate diseases (PCa and benign prostatic hyperplasia), renal diseases (CKD, immunoglobulin A nephropathy, membranous nephropathy, nephrotic syndrome, and kidney ureter calculi), as well as 8 renal function parameters, with regard to ED. All data pertaining to exposure and outcome factors were acquired from publicly accessible genome-wide association studies. The methods used encompassed inverse variance weighting, MR-Egger, weighted median, simple mode, and weighted mode residual sum and outlier techniques. The MR-Egger intercept test was utilized to assess pleiotropy, while Cochran's Q statistic was employed to measure heterogeneity.</p><p><strong>Outcomes: </strong>We employed inverse variance weighting MR as the primary statistical method to assess the causal relationship between exposure factors and ED.</p><p><strong>Results: </strong>Genetically predicted PCa demonstrated a causal association with an elevated risk of ED (odds ratio, 1.125; 95% confidence interval, 1.066-1.186; <i>P <</i> .0001). However, no compelling evidence was found to support associations between genetically determined benign prostatic hyperplasia, CKD, immunoglobulin A nephropathy, membranous nephropathy, nephrotic syndrome, kidney ureter calculi, and the renal function parameters investigated, and the risk of ED.</p><p><strong>Clinical implications: </strong>The risk of ED is considerably amplified in patients diagnosed with PCa, thereby highlighting the importance of addressing ED as a significant concern for clinicians treating individuals with PCa.</p><p><strong>Strengths and limitations: </strong>This study's strength lies in validating the PCa-ED association using genetic analysis, while its limitation is the heterogeneity in study results.</p><p><strong>Conclusion: </strong>The results of this study suggest a potential link between PCa and a higher risk of ED.</p>","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"12 1","pages":"qfae002"},"PeriodicalIF":2.6,"publicationDate":"2024-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10859556/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139723965","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":"Access to inflatable penile prosthesis surgery as indicated by distances traveled among US men with Medicare.","authors":"Sirikan Rojanasarot, Kathryn Morris, Tristan Nicholson, Thomas Walsh","doi":"10.1093/sexmed/qfad073","DOIUrl":"10.1093/sexmed/qfad073","url":null,"abstract":"<p><strong>Background: </strong>The significance of geographic barriers to receiving inflatable penile prosthesis (IPP) treatment is uncertain according to the existing medical literature.</p><p><strong>Aim: </strong>To describe the travel patterns of men with erectile dysfunction (ED) in the United States who underwent IPP surgery.</p><p><strong>Methods: </strong>This retrospective cohort study utilized data from the 100% Medicare Standard Analytical Files. Men aged ≥65 years with an ED diagnosis who underwent IPP surgery between January 2016 and December 2021 were identified from the database. Federal Information Processing Series codes from the National Bureau of Economic Research's County Distance Database were used to determine geographic distances from patients' homes to the facilities at which surgery was performed.</p><p><strong>Outcomes: </strong>Evaluations included the proportions of men who traveled outside their county of residence or state for IPP treatment and the average distances in miles traveled.</p><p><strong>Results: </strong>Among 15 954 men with ED undergoing IPP treatment, 56.4% received care out of their county for IPP, at a mean distance of 125.6 miles (range, 3.8-4935.0). Although patients aged ≥80 years were less likely to travel outside their county as compared with men aged 65 to 69 years (48.1% vs 57.1%, <i>P</i> < .001), if they traveled, they were likely to travel farther (mean, 171.8 vs 117.7 miles; <i>P</i> < .001). South Dakota had the highest proportion of men traveling outside their county for IPP treatment (91.3%; mean, 514.2 miles), while Vermont had the highest proportion traveling outside their home state (73.7%).</p><p><strong>Clinical implications: </strong>By unveiling disparities in access, this study will potentially lead to tailored interventions that enhance patient care and health outcomes.</p><p><strong>Strengths and limitations: </strong>Strengths include the uniqueness in (1) evaluating the proportions of patients who travel out of their county of residence or home state for IPP treatment and (2) quantifying the average distances that patients traveled. An additional strength is the large sample size due to the retrospective design and database used. The analysis did not capture all Medicare enrollees; however, it did encompass all traditional Medicare enrollees, representing approximately half of all men in the US aged ≥65 years. Limitations include not being generalizable to entire population of the US, as the study examined only Medicare enrollees. In addition, the study period includes the pandemic, which could have affected travel patterns. Furthermore, the coding and accuracy of the data are limitations of using administrative claims data for research.</p><p><strong>Conclusion: </strong>Study findings showed that many men with Medicare and ED traveled from their home geographic location for IPP treatment.</p>","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"12 1","pages":"qfad073"},"PeriodicalIF":2.6,"publicationDate":"2024-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10859555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139723964","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":"Cell therapy for male sexual dysfunctions: systematic review and position statements from the European Society for Sexual Medicine.","authors":"Celeste Manfredi, Luca Boeri, Ioannis Sokolakis, Nicolò Schifano, Nikolaos Pyrgidis, Esaú Fernández-Pascual, Andrea Sansone, Borja García-Gómez, Maarten Albersen, Giovanni Corona, Javier Romero-Otero, Mikkel Fode","doi":"10.1093/sexmed/qfad071","DOIUrl":"https://doi.org/10.1093/sexmed/qfad071","url":null,"abstract":"<p><strong>Background: </strong>Cell therapy (CT) is a form of regenerative medicine under investigation for the management of male sexual dysfunction (MSD).</p><p><strong>Aim: </strong>We sought to perform a systematic review of published information on CT for MSD and provide an official position statements for the European Society for Sexual Medicine.</p><p><strong>Methods: </strong>A comprehensive bibliographic search on the MEDLINE, Web of Science, Scopus, and Cochrane Library databases was conducted in February 2023. Articles were selected based on the Population, Intervention, Comparator, Outcome, Study design (PICOS) model if they included male patients (P) undergoing CT (I) with or without comparison with other treatments (C) and evaluated the impact of CT on sexual function (O). Quantitative data were reported as found in the original studies (S). Level of evidence and grade of recommendation according to the Oxford Centre for Evidence-Based Medicine were assigned to each statement.</p><p><strong>Outcomes: </strong>Outcomes were determined based on assessment of erectile function, ejaculatory function, orgasmic function, sexual desire, and penile curvature.</p><p><strong>Results: </strong>A total of 19 studies and 421 patients were included. Most articles (n = 12, 63%) were case series, whereas a minority of papers (n = 6, 32%) had a comparative group; only 2 articles reported randomized controlled trials (RCTs) and 1 article reported a post hoc analysis of RCTs. Most articles (16, 84%) investigated patients with erectile dysfunction (ED). Improvements in the International Index of Erectile Function-Erectile Function Domain (IIEF-EF) or the IIEF 5-item version (IIEF-5) were found in 11/15 (73%) studies, with mean increases in IIEF-EF, mean IIEF-5, and median IIEF-EF between 8 and 14 points, 2 and 9 points, and 4.5 and 6 points, respectively. Two papers (20%) evaluated men with Peyronie's disease (PD). In both ot these articles penile curvature improvement and plaque volume reduction were described in all patients (n = 16, 100%). Objective measurements were performed in 1 study, which showed 10°-120° (15%-100%) curvature improvement and 90%-100% plaque reduction. Mild transient adverse events at the donor or administration sites were found in 7/16 (44%) papers on ED. Priapism was reported in one case (20%) and mild penile skin complications were reported in the majority of patients after CT for PD. No severe adverse events were described.</p><p><strong>Clinical implications: </strong>Although high-quality evidence is lacking, CT appears to have potential benefits from application in patients with ED or PD.</p><p><strong>Strengths and limitations: </strong>This report is to our knowledge the most comprehensive and up-to-date systematic review on the topic of CT for the management of MSD, including the position statements of the European Society for Sexual Medicine. Overall the assessment of available studies demonstrated low quality and si","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"12 1","pages":"qfad071"},"PeriodicalIF":2.6,"publicationDate":"2024-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10857898/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139723966","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}