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A real-world pilot study assessing treatment satisfaction with avanafil in patients with erectile dysfunction. 一项真实试验研究,评估勃起功能障碍患者对阿伐那非治疗的满意度。
IF 2.6 3区 医学
Sexual Medicine Pub Date : 2024-02-07 eCollection Date: 2024-02-01 DOI: 10.1093/sexmed/qfae001
Ping-Ju Tsai, Shih-Ya Hung, Tsung-Hsi Lee, Bang-Ping Jiann
{"title":"A real-world pilot study assessing treatment satisfaction with avanafil in patients with erectile dysfunction.","authors":"Ping-Ju Tsai, Shih-Ya Hung, Tsung-Hsi Lee, Bang-Ping Jiann","doi":"10.1093/sexmed/qfae001","DOIUrl":"10.1093/sexmed/qfae001","url":null,"abstract":"<p><strong>Background: </strong>Avanafil is a second-generation phosphodiesterase type 5 (PDE5) inhibitor, and offers a rapid onset of action (15 minutes). Its real-world data, including treatment satisfaction, are still lacking.</p><p><strong>Aim: </strong>The study sought to investigate the treatment outcomes of avanafil and the factors impacting treatment satisfaction in a real-world setting.</p><p><strong>Methods: </strong>Between November 2021 and February 2023, erectile dysfunction (ED) patients prescribed avanafil were consecutively enrolled in this phase 4, open-label, cross-sectional, observational study. At each follow-up visit (4-week intervals), participants completed a questionnaire for assessing the use and treatment-emergent adverse events of avanafil, ED severity, and treatment satisfaction.</p><p><strong>Outcomes: </strong>The outcome measures included the Sexual Health Inventory for Men (SHIM), and Erectile Dysfunction Inventory of Treatment Satisfaction.</p><p><strong>Results: </strong>Among 234 patients enrolled, 112 (47.9%) patients had follow-up visits and answered the questionnaire. Treatment with avanafil significantly improved the mean SHIM total score from 10.2 ± 5.6 at baseline to 17.5 ± 6.2 (<i>P</i> < .001). Of the patients treated with avanafil, 71.4% (n = 80 of 112) reported a >4-point improvement in the SHIM total score, and 33.1% (n = 37 of 112) reported normal erectile function. The proportion of patients satisfied with avanafil treatment (defined as Erectile Dysfunction Inventory of Treatment Satisfaction index score ≥60) was 87.5%. Several physical factors (younger age, lower waist circumference, and lower level of low-density lipoprotein), and sexual function factors (shorter duration of ED, higher SHIM total score at baseline, PDE5 inhibitor treatment naive, and acquired premature ejaculation) tended to contribute to satisfaction with avanafil treatment. Treatment-emergent adverse events occurred in 41.1% of patients, and all were mild in severity.</p><p><strong>Clinical implications: </strong>This study identifies the factors associated with treatment satisfaction of avanafil, which may ultimately lead to better treatment outcomes.</p><p><strong>Strengths and limitations: </strong>This is the first study to provide real-world evidence of avanafil for ED treatment, and validated questionnaires were used to assess erectile function and treatment satisfaction. However, the limitations of this study include single-center observational study design, small sample size, and short-term follow-up.</p><p><strong>Conclusion: </strong>Avanafil is an effective treatment for ED, and satisfaction rate is high in an outpatient setting. The awareness of identified factors related to patient satisfaction may improve treatment outcomes.</p>","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"12 1","pages":"qfae001"},"PeriodicalIF":2.6,"publicationDate":"2024-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10849181/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139703368","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}
引用次数: 0
Association between testosterone levels and RigiScan parameters of patients with erectile dysfunction. 勃起功能障碍患者的睾酮水平与 RigiScan 参数之间的关系。
IF 2.6 3区 医学
Sexual Medicine Pub Date : 2024-02-04 eCollection Date: 2024-02-01 DOI: 10.1093/sexmed/qfad072
Fu Yuli, Zhang Qi, Yu Haojie, Liao Zedong, Huang Wenjie, Xu Runnana, Shi Tianhao, Feng Yanfei, Lv Bodong
{"title":"Association between testosterone levels and RigiScan parameters of patients with erectile dysfunction.","authors":"Fu Yuli, Zhang Qi, Yu Haojie, Liao Zedong, Huang Wenjie, Xu Runnana, Shi Tianhao, Feng Yanfei, Lv Bodong","doi":"10.1093/sexmed/qfad072","DOIUrl":"10.1093/sexmed/qfad072","url":null,"abstract":"<p><strong>Background: </strong>It is difficult to diagnose hypogonadism because of the lack of objective assessments of erectile dysfunction (ED), which is caused by hypogonadism.</p><p><strong>Aim: </strong>To provide a new approach for diagnosing hypogonadism, this study evaluated the efficacy of nocturnal penile tumescence and rigidity (NPTR) testing with RigiScan for patients with ED with and without hypogonadism.</p><p><strong>Methods: </strong>From June 2021 to February 2023, 133 patients with ED (62 with hypogonadism and 71 without) underwent NPTR testing at the Department of Andrology. A detailed history of all participants was obtained. All participants also underwent a physical examination, sex hormone testing, and ultrasound examination of the cavernous vessels of the penis.</p><p><strong>Outcomes: </strong>Patient characteristics, sex hormone serum levels, and RigiScan Plus data of NPTR testing of patients with ED were obtained and evaluated.</p><p><strong>Results: </strong>Between the groups, there were no significant differences in age, body mass index, or erectile function score or in the prevalence of smoking, drinking, diabetes, hypertension, and hyperlipidemia. RigiScan data revealed differences in erection episodes per night, average event rigidity, erection durations, and percentage of tumescence greater than baseline, which were significantly lower in the testosterone-deficient group than in the normal testosterone group. The average event rigidity of the tip displayed the largest area under the curve value, with a sensitivity of 67.6%, a specificity of 85.5%, and a cutoff value of 52.50.</p><p><strong>Clinical implications: </strong>Our findings may allow appropriate patients to receive testosterone replacement therapy, which has been shown to be an effective treatment for hypogonadism.</p><p><strong>Strengths and limitations: </strong>This is the first study of its kind to perform a comprehensive review of the association between hypogonadism and RigiScan parameters. This study was limited by its small sample size.</p><p><strong>Conclusion: </strong>RigiScan parameters of patients with ED and testosterone deficiency were significantly lower than those of patients with normal testosterone; therefore, RigiScan is useful for the differential diagnosis of patients with ED caused by hypogonadism.</p>","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"12 1","pages":"qfad072"},"PeriodicalIF":2.6,"publicationDate":"2024-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10839424/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139698234","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}
引用次数: 0
Relationship between inflammatory bowel disease and erectile dysfunction: a 2-sample Mendelian randomization study. 炎症性肠病与勃起功能障碍的关系:双样本孟德尔随机研究。
IF 2.6 3区 医学
Sexual Medicine Pub Date : 2024-01-23 eCollection Date: 2023-12-01 DOI: 10.1093/sexmed/qfad067
Dawei Gao, Cheng Chen, Ziliang Wu, Huakang Li, Bo Tang
{"title":"Relationship between inflammatory bowel disease and erectile dysfunction: a 2-sample Mendelian randomization study.","authors":"Dawei Gao, Cheng Chen, Ziliang Wu, Huakang Li, Bo Tang","doi":"10.1093/sexmed/qfad067","DOIUrl":"10.1093/sexmed/qfad067","url":null,"abstract":"<p><strong>Background: </strong>Observational studies have indicated a high prevalence of erectile dysfunction (ED) among patients with inflammatory bowel disease (IBD), but a definitive causal relationship remains unestablished.</p><p><strong>Aim: </strong>The primary aim of this study was to assess the potential causal relationship between IBD and ED using Mendelian randomization (MR) analysis.</p><p><strong>Methods: </strong>We obtained statistical data for 2 subtypes of IBD, ulcerative colitis (UC) and Crohn's disease (CD), as well as for ED, from publicly available genome-wide association studies (GWASs). Subsequently, a 2-sample MR analysis was conducted using these datasets. The primary MR analysis utilized the inverse variance-weighted (IVW) method, complemented by secondary analyses employing MR-Egger and weighted median methods. Furthermore, we assessed heterogeneity using Cochran's Q test and evaluated pleiotropy with the MR-Egger intercept test. To identify potential influential single nucleotide polymorphisms, we employed a leave-one-out analysis. Additionally, outliers were identified using the MR-PRESSO method.</p><p><strong>Outcomes: </strong>The study outcomes encompassed results from 3 MR analyses, namely IVW, MR-Egger, and weighted median, along with sensitivity analyses involving Cochran's Q test, the MR-Egger intercept test, leave-one-out analysis, and the MR-PRESSO method.</p><p><strong>Results: </strong>There was no causal effect of UC and CD on ED in the MR analysis (IVW <i>P</i> > .05). Results of complementary methods were consistent with those of the IVW method. The results of sensitivity analyses supported our conclusion, and no directional pleiotropy was found.</p><p><strong>Clinical implications: </strong>Genetically, despite the absence of a causal link between IBD and ED according to MR analysis, we must emphasize the elevated ED prevalence among IBD patients in observational studies, with particular consideration for the influence of negative emotions on erectile function.</p><p><strong>Strengths & limitations: </strong>This study is the inaugural application of a 2-sample MR analysis using extensive GWAS datasets to evaluate the causal relationship between IBD and ED, effectively mitigating biases stemming from confounding factors and reverse causality often present in observational studies. Nevertheless, it is imperative to exercise caution when drawing conclusions due to inherent limitations in GWAS data, encompassing factors like samples overlap, gender categorization, population ancestry, and the persistent ambiguity surrounding the precise functionality of specific single nucleotide polymorphisms.</p><p><strong>Conclusions: </strong>MR analysis did not provide genetic-level evidence supporting a direct causal relationship between IBD (UC and CD) and ED.</p>","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"11 6","pages":"qfad067"},"PeriodicalIF":2.6,"publicationDate":"2024-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10805346/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139542873","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}
引用次数: 0
"Normal vulva" based on the first national Labiagram design in adult Iranian women not seeking female genital cosmetic surgery: a pilot study. 基于首个国家阴唇图设计的 "正常外阴 "在不寻求女性生殖器整容手术的伊朗成年女性中的应用:一项试点研究。
IF 2.6 3区 医学
Sexual Medicine Pub Date : 2024-01-19 eCollection Date: 2023-12-01 DOI: 10.1093/sexmed/qfad070
Zinat Ghanbari, Maryam Kazemi, Nasim Eshraghi, Sina Shiri Hamedani, Azam Zafarbakhsh
{"title":"\"Normal vulva\" based on the first national Labiagram design in adult Iranian women not seeking female genital cosmetic surgery: a pilot study.","authors":"Zinat Ghanbari, Maryam Kazemi, Nasim Eshraghi, Sina Shiri Hamedani, Azam Zafarbakhsh","doi":"10.1093/sexmed/qfad070","DOIUrl":"10.1093/sexmed/qfad070","url":null,"abstract":"<p><strong>Background: </strong>Several studies have been published to present normal values of female genitalia in different age and racial groups.</p><p><strong>Aim: </strong>The primary objective of our study was to measure the parameters of the external genitalia in adult Iranian women, record the data using the Labiagram system (the first national Labiagram design in Iran), and establish a preliminary database.</p><p><strong>Methods: </strong>A descriptive study was conducted from March 2022 to December 2022, involving 220 nonpregnant adult women who presented to the gynecology clinic. Women who met the inclusion criteria for the study underwent a comprehensive examination of the external genitalia. The data collected during the examinations were recorded in electronic files and the Labiagram system.</p><p><strong>Outcomes: </strong>The data showed the diversity of external genital parameters of nonpregnant adult Iranian women.</p><p><strong>Results: </strong>In this descriptive study, the mean ± SD age of the participants was 51.5 ± 13.44 years, ranging from 15 to 84 years. A total of 192 women (87.3%) had a history of vaginal delivery. There was no statistically significant difference observed in the average measurements of the vulva among the 4 age groups (<i>P</i> < .05). The Pearson correlation coefficient test indicated a statistically weak correlation between body mass index and perineum length (<i>r</i> = 0.174, <i>P</i> = .010). Additionally, a weak correlation was found between body mass index and the width of the labia minora at the left-lower point (<i>r</i> = 0.143, <i>P</i> = .030) and the right-middle point (<i>r</i> = 0.146, <i>P</i> = .031). Furthermore, the results demonstrated that women with a history of vaginal delivery had a significantly longer introitus (49.3 vs 44.3 mm, <i>P</i> = .037), longer labia majora (91.3 vs 87.3 mm, <i>P</i> = .046), and longer labia minora (56.8 vs 50.9 mm, <i>P</i> = .008) when compared with women without prior labor experience.</p><p><strong>Clinical implications: </strong>The data will be used as a basis for future studies.</p><p><strong>Strengths and limitations: </strong>The use of simple tools for the measuring, data recording, and digital drawing of female external genital anatomy, along with privacy protection, is one of the strengths of this research. The weakness is the small sample size, which is the reason for piloting the Labiagram chart for more extensive studies.</p><p><strong>Conclusion: </strong>Increasing age and the number of births had no statistically significant effect on the size of external genital parameters among Iranian women. Despite the considerable diversity in these parameters, it has not resulted in a significant demand among Iranian women for female cosmetic surgery.</p>","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"11 6","pages":"qfad070"},"PeriodicalIF":2.6,"publicationDate":"2024-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10799718/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139512873","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}
引用次数: 0
Can atherogenic indices and the triglyceride-glucose index be used to predict erectile dysfunction? 致动脉粥样硬化指数和甘油三酯-葡萄糖指数能否用于预测勃起功能障碍?
IF 2.6 3区 医学
Sexual Medicine Pub Date : 2024-01-19 eCollection Date: 2023-12-01 DOI: 10.1093/sexmed/qfad069
Murat Sambel, Abdullah Erdogan, Volkan Caglayan, Sinan Avci, Sahin Kilic, Halil Emre Yildiz, Ercument Keskin
{"title":"Can atherogenic indices and the triglyceride-glucose index be used to predict erectile dysfunction?","authors":"Murat Sambel, Abdullah Erdogan, Volkan Caglayan, Sinan Avci, Sahin Kilic, Halil Emre Yildiz, Ercument Keskin","doi":"10.1093/sexmed/qfad069","DOIUrl":"10.1093/sexmed/qfad069","url":null,"abstract":"<p><strong>Background: </strong>Atherosclerosis and insulin resistance play an important role in the development of erectile dysfunction (ED), and few studies have comprehensively evaluated more specific indicators like atherogenic indices and the triglyceride-glucose (TyG) index in the assessment of ED.</p><p><strong>Aim: </strong>This study aimed to reveal the role of atherogenic indices (atherogenic index of plasma [AIP], Castelli risk index-1/2 [CRI-1/2], and atherogenic coefficient [AC]) based on plasma lipid ratios, which have been used as more sensitive indicators of atherosclerosis in recent years, and the TyG index, a practical indicator of insulin resistance, in predicting vasculogenic ED.</p><p><strong>Methods: </strong>The study included a total of 199 patients who met the inclusion criteria and a total of 51 control subjects without ED complaints according to the International Index of Erectile Function (IIEF-5) scores (>21) between May 2021 and October 2022. For all participants, the demographic and biochemical parameters were evaluated, and atherogenic indices, namely CRI-1 (total cholesterol/high-density lipoprotein [HDL]), CRI-2 (LDL/HDL) AIP [log10(triglycerides/HDL)], and AC (non-HDL/HDL), as well as the TyG index [Ln {fasting triglycerides (mg/dL) × fasting glucose (mg/dL)/2}] were calculated.</p><p><strong>Outcomes: </strong>The TyG index, which is an indicator of insulin resistance, and atherogenic indices such as CRI-1, AIP, and AC were significantly associated with ED, and especially AIP and the TyG index seem to be more important in the evaluation of ED.</p><p><strong>Results: </strong>According to the univariate analysis, the patient group had significantly higher CRI-1 (5.3 ± 1.4 vs 4.7 ± 1.3; <i>P</i> = .005), AIP (0.31 ± 0.26 vs 0.13 ± 0.2; <i>P</i> < .001), AC (4.1 ± 1.4 vs 3.70 ± 1.2; <i>P</i> = .026), and TyG (9.16 ± 0.71 vs 8.77 ± 0.52; <i>P</i> < .001) values compared with the control group. In the correlation analysis, a significant negative correlation was found between the AIP and TyG index and the IIEF-5 scores (r<sup>2</sup> = 0.120, <i>P</i> < .001 between AIP and IIEF-5; r<sup>2</sup> = 0.091, <i>P</i> < .001 between TyG index and IIEF-5). The multivariate analysis revealed AIP and the TyG index as independent predictive factors for ED.</p><p><strong>Clinical implications: </strong>The use of atherogenic indices and TyG index in daily urology practice can help physicians in the diagnosis and follow-up of ED.</p><p><strong>Strengths and limitations: </strong>The lack of sex hormone-binding globulin and free testosterone levels represents a limitation of our study. Another limitation is that the severity of ED was determined using the IIEF-5 scores, rather than a more objective method, such as penile artery ultrasound.</p><p><strong>Conclusion: </strong>Atherogenic indices and the TyG index can be used as inexpensive and practical markers to predict the severity of arteriogenic ED.</p>","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"11 6","pages":"qfad069"},"PeriodicalIF":2.6,"publicationDate":"2024-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10799712/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139512882","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}
引用次数: 0
Clinical characteristics, allergic response to autologous semen, and desensitization in patients with postorgasmic illness syndrome. 性高潮后疾病综合征患者的临床特征、对自体精液的过敏反应和脱敏。
IF 2.6 3区 医学
Sexual Medicine Pub Date : 2024-01-17 eCollection Date: 2023-12-01 DOI: 10.1093/sexmed/qfad068
Guang-Peng Xi, Ruo-Xuan Yang, Jing Zhang, Yue-Mei Ma, Xiao-Yan Zhong
{"title":"Clinical characteristics, allergic response to autologous semen, and desensitization in patients with postorgasmic illness syndrome.","authors":"Guang-Peng Xi, Ruo-Xuan Yang, Jing Zhang, Yue-Mei Ma, Xiao-Yan Zhong","doi":"10.1093/sexmed/qfad068","DOIUrl":"10.1093/sexmed/qfad068","url":null,"abstract":"<p><strong>Introduction: </strong>Postorgasmic illness syndrome (POIS) is rare and includes a cluster of physical and cognitive symptoms that occur after ejaculation. The pathogenesis and effective treatments remain unclear.</p><p><strong>Aim: </strong>This study aimed to characterize the symptomatology of POIS, study the allergic response of autologous semen in patients and controls, and evaluate the effects of desensitization therapy.</p><p><strong>Methods: </strong>The clinical characteristics of 24 Chinese patients with POIS were analyzed. Skin prick tests, intracutaneous tests, and specific IgE detection were performed with autologous semen. Five patients were desensitized via subcutaneous injections of autologous semen.</p><p><strong>Outcomes: </strong>Evaluated outcomes included the clinical features of POIS; scores of the Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS), and visual analog scale (VAS) of symptoms; skin reactions; desensitization with diluted autologous seminal fluid; and the IgE reactivity patterns of immunoblotting and enzyme-linked immunosorbent assay in vitro.</p><p><strong>Results: </strong>The most common symptom cluster was the general cluster, and the most prevalent symptoms were extreme fatigue and inattention. A total of 66.67% (14/21) of the patients had no symptoms or milder symptoms after nocturnal emission than after intercourse or masturbation. Of the patients, 87.5% (21/24) had psychiatric symptoms and 53.85% (7/13) had abnormal sex hormone levels. The SAS and SDS scores of the high and low VAS groups were significantly higher than those of the control group. Pearson analysis showed that the correlation coefficient between the SAS and VAS was 0.607 (<i>P</i> < .01) and that between the SDS and VAS was 0.490 (<i>P</i> < .05). The patients and healthy donors all had positive intracutaneous test results with their own semen, negative skin prick test results, and no IgE specific to autologous semen. Most patients (4/5) did not achieve ideal therapeutic effects with desensitization.</p><p><strong>Clinical implications: </strong>Allergy is not the main pathogenesis of POIS, and desensitization with autologous semen is not effective for most patients.</p><p><strong>Strengths and limitations: </strong>This project included the largest number of patients with POIS in China and assessed the allergic response to autologous semen and the effect of desensitization therapy. There is no objective method for evaluating the efficacy of desensitization with autologous semen.</p><p><strong>Conclusions: </strong>IgE-mediated semen allergy is not the main pathogenesis of POIS, and there is a positive chance that POIS is related to psychological factors. Most patients do not respond to desensitization with autologous semen, and POIS treatment should be individualized, especially in cases with uncertain causes.</p>","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"11 6","pages":"qfad068"},"PeriodicalIF":2.6,"publicationDate":"2024-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10795926/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139492001","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}
引用次数: 0
First-time orgasm in a young man with lifelong anorgasmia after flibanserin use: a case report. 一名使用氟班色林后终生性高潮障碍的年轻人首次达到性高潮:病例报告。
IF 2.6 3区 医学
Sexual Medicine Pub Date : 2024-01-11 eCollection Date: 2023-12-01 DOI: 10.1093/sexmed/qfad066
Gal Saffati, Taher Naeem, Basil Kaaki, Mohit Khera
{"title":"First-time orgasm in a young man with lifelong anorgasmia after flibanserin use: a case report.","authors":"Gal Saffati, Taher Naeem, Basil Kaaki, Mohit Khera","doi":"10.1093/sexmed/qfad066","DOIUrl":"10.1093/sexmed/qfad066","url":null,"abstract":"<p><strong>Introduction: </strong>Anorgasmia is a poorly understood phenomenon defined as either a lifelong or acquired consistent inability to achieve ejaculation. Despite the prevalence of anorgasmia, there is currently no established treatment for the condition.</p><p><strong>Aims: </strong>To report a unique case of a patient with lifelong anorgasmia who was able to achieve his first orgasm with off-label use of flibanserin.</p><p><strong>Methods: </strong>The present case study relies on the patient's self-report and a review of the relevant literature. The patient provided written informed consent.</p><p><strong>Results: </strong>A 28-year-old male presented to our office with complaints of lifelong anorgasmia, without any signs of erectile dysfunction. He reported good libido and energy levels and denied any urinary symptoms or history of depression. The patient failed medical management with numerous off-label medications, including bupropion and bremelanotide. Despite having received 4 or 5 sex therapy sessions over 3 months, the patient reported that this treatment approach was not effective. Off-label use of flibanserin was then initiated, and after 28 to 32 doses over 4 weeks, he achieved his first orgasm. Notably, the patient experienced nocturia and insomnia. The follow-up International Index of Erectile Function score marginally improved by 2 points without any improvement in the overall satisfaction subdomain.</p><p><strong>Conclusion: </strong>This case highlights the challenges of managing anorgasmia and anejaculation in a young male patient. A stepwise approach involving pharmacotherapy and sex therapy was not successful. However, the off-label use of flibanserin ultimately resulted in the patient achieving his first orgasm, albeit with some side effects. Further studies are needed to evaluate the efficacy and safety of flibanserin in men for this indication.</p>","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"11 6","pages":"qfad066"},"PeriodicalIF":2.6,"publicationDate":"2024-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10786674/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139466999","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}
引用次数: 0
Adaptation and validation of the Chinese version of the New Sexual Satisfaction Scale-Short Form in a sample of Chinese women. 新性满足量表-简表中文版在中国女性样本中的改编和验证。
IF 2.6 3区 医学
Sexual Medicine Pub Date : 2023-12-29 eCollection Date: 2023-12-01 DOI: 10.1093/sexmed/qfad065
Chanchan Wu, Edmond Pui Hang Choi, Pui Hing Chau, Aleksandar Štulhofer
{"title":"Adaptation and validation of the Chinese version of the New Sexual Satisfaction Scale-Short Form in a sample of Chinese women.","authors":"Chanchan Wu, Edmond Pui Hang Choi, Pui Hing Chau, Aleksandar Štulhofer","doi":"10.1093/sexmed/qfad065","DOIUrl":"10.1093/sexmed/qfad065","url":null,"abstract":"<p><strong>Background: </strong>Existing research on sexual satisfaction has been carried out primarily in Western samples, lacking insights from less sexually permissive cultures such as China, particularly in the case of heterosexual and sexual minority women.</p><p><strong>Aim: </strong>This study aimed to culturally adapt and validate the New Sexual Satisfaction Scale-Short Form (NSSS-S) in a sample of Chinese women with diverse sexual identities.</p><p><strong>Methods: </strong>The standard forward-backward translation procedure and cognitive debriefing were conducted to translate the NSSS-S into Mandarin Chinese (NSSS-SC). The psychometric properties of the NSSS-SC were assessed in this cross-sectional survey.</p><p><strong>Outcomes: </strong>The primary outcome measure was the NSSS-S. The World Health Organization Quality of Life-Abbreviated Form, the Positive Sexuality Scale, the Female Sexual Function Index, and a single-item measure of sexual satisfaction were used to test the measure's validity.</p><p><strong>Results: </strong>A total of 336 Chinese women were recruited, with an average age of 26.82 years (SD, 6.03; range, 18-56). The 1-dimensional model had a good fit to the data and was invariant across 2 sexual identity groups (cisgender heterosexual and sexual minority women) and age. The NSSS-SC had good reliability; no significant floor and ceiling effects were observed. We found moderate to strong correlations between the NSSS-SC scores and the sexual satisfaction, sexual function, positive sexuality, and quality-of-life indicators. On average, cisgender heterosexual women were characterized by higher sexual satisfaction scores when compared with sexual minority women.</p><p><strong>Clinical translation: </strong>The NSSS-SC can be used as a reliable and culturally appropriate measure of sexual satisfaction in women of different ages and sexual identities, which could be used in future sex-related surveys.</p><p><strong>Strengths and limitations: </strong>This study is the first to translate the NSSS-S into Chinese and validate the NSSS-SC in a sample of Chinese women with varied sexual identities. However, this study recruited only female participants; future studies should also validate the NSSS-SC in Chinese men.</p><p><strong>Conclusion: </strong>The NSSS-SC is linguistically equivalent to the original scale and has solid psychometric properties, which can be used to assess sexual satisfaction levels in diverse samples of Chinese women.</p>","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"11 6","pages":"qfad065"},"PeriodicalIF":2.6,"publicationDate":"2023-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10756855/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139074980","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}
引用次数: 0
Will you go the distance? A satisfaction survey of telemedicine in sexual medicine. 您愿意走得更远吗?性医学远程医疗满意度调查。
IF 2.6 3区 医学
Sexual Medicine Pub Date : 2023-12-18 eCollection Date: 2023-12-01 DOI: 10.1093/sexmed/qfad060
Gal Saffati, Taher Naeem, Jordan Kassab, Daniela Orozco Rendon, Charles Green, Larry I Liphsultz, Mohit Khera
{"title":"Will you go the distance? A satisfaction survey of telemedicine in sexual medicine.","authors":"Gal Saffati, Taher Naeem, Jordan Kassab, Daniela Orozco Rendon, Charles Green, Larry I Liphsultz, Mohit Khera","doi":"10.1093/sexmed/qfad060","DOIUrl":"https://doi.org/10.1093/sexmed/qfad060","url":null,"abstract":"<p><strong>Background: </strong>The success of telemedicine depends on patient satisfaction with the care that they receive, which is impacted by the ease of use of the technology, quality of the connection, and perceived effectiveness of care.</p><p><strong>Aim: </strong>The study sought to evaluate patient satisfaction with telemedicine services in a high-volume andrology clinic.</p><p><strong>Methods: </strong>We included all patients who had a telemedicine appointment between January 1, 2020, and August 22, 2022. Demographic information was gathered, and a satisfaction survey was conducted using REDCap software. Data were grouped into 2 age categories, with ≥50 years as the cutoff (19-50 years; >50 years). The data were analyzed according to age, distance from the patient's home to our center, and survey responses. Pearson's chi-square test and ordinal logistic regression analyses were performed.</p><p><strong>Outcomes: </strong>The main outcome is satisfaction with telemedicine in a men's sexual health context.</p><p><strong>Results: </strong>A total of 4071 patients were identified based on attending a telemedicine visit. Hypogonadism was the most common diagnosis. Other diagnoses included erectile dysfunction, varicocele, Peyronie's disease, vasectomy, and infertility. In total, 613 patients completed the survey, with a mean age of 56.6 years. Older patients were less likely to prefer telemedicine (odds ratio [OR], 0.55; 95% confidence interval [CI], 0.36-0.80; <i>P</i> < .001), less likely to agree to a video visit because of privacy concerns (OR, 0.51; 95% CI, 0.35-0.75; <i>P</i> < .001), and less likely to recommend a telemedicine visit compared with their younger counterparts (OR, 0.37; 95% CI, 0.27-0.51; <i>P</i> < .001). The median distance was 22.4 (interquartile range, 7.5-57.5) miles. However, there was no significant association between distance and patients' likelihood of preferring telehealth visits, including reviews of outside laboratories and imaging (OR, 1; 95% CI, 0.99-1; <i>P</i> = .35), belief in the quality of care provided via video visits (OR, 0.99, CI 0.99-1; <i>P</i> = .25), and overall preference for telehealth visits (OR, 0.99; 95% CI, 0.99-1; <i>P</i> = .35).</p><p><strong>Clinical implications: </strong>Healthcare providers should consider the age of patients when deciding to offer telemedicine while addressing privacy concerns to provide adequate reassurance to patients who may have concerns about the quality of care provided through telemedicine.</p><p><strong>Strengths and limitations: </strong>Our study achieved a substantial sample size that reached statistical significance. Conducted at a single academic center, our study was constrained, possibly introducing biases related to the institution's advanced telemedicine system. Geographic and diagnostic limitations could lead to regional biases, affecting the generalizability of the findings.</p><p><strong>Conclusion: </strong>Older patients exhibited a lower ","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"11 6","pages":"qfad060"},"PeriodicalIF":2.6,"publicationDate":"2023-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10727694/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138809400","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}
引用次数: 0
Sexual experiences of postmenopausal women in China: a qualitative study. 中国绝经后妇女的性经历:一项定性研究。
IF 2.6 3区 医学
Sexual Medicine Pub Date : 2023-12-04 eCollection Date: 2023-12-01 DOI: 10.1093/sexmed/qfad062
Jie Chen, Haina Zhai, Hongyun Jin, Xiang Li, Pan Zhang, Rong Chen
{"title":"Sexual experiences of postmenopausal women in China: a qualitative study.","authors":"Jie Chen, Haina Zhai, Hongyun Jin, Xiang Li, Pan Zhang, Rong Chen","doi":"10.1093/sexmed/qfad062","DOIUrl":"10.1093/sexmed/qfad062","url":null,"abstract":"<p><strong>Background: </strong>Sexual dysfunction is common among postmenopausal women and can have a significant negative impact on quality of life.</p><p><strong>Aim: </strong>This study aimed to explore perceptions, experiences, and coping strategies related to sex among postmenopausal women in China.</p><p><strong>Methods: </strong>We used phenomenologic qualitative methods in this study. On the basis of purposive sampling and the data saturation principle, 21 volunteers from a community cohort study were selected for semistructured interviews. The data were analyzed and themes were extracted.</p><p><strong>Outcomes: </strong>Thematic codes pertaining to sexual experiences and coping strategies were defined and assessed in this study.</p><p><strong>Results: </strong>Four themes and 12 subthemes were extracted from the interview data. The sexual concepts were relatively conservative for most of the Chinese women; the majority experienced physical and psychological distress with respect to sex, although negative and positive psychological experiences were described. The women often passively accepted and adapted to negative changes to their sex lives during the postmenopause period.</p><p><strong>Clinical implications: </strong>This study highlights the importance of and need for effective dissemination of sexual health-related knowledge and the opening of appropriate communication channels.</p><p><strong>Strengths and limitations: </strong>By using a qualitative approach, this study provides individuals with the opportunity to describe their cognition and attitudes toward sexuality. Limitations include limited generalizability, as is true for most qualitative research. Additionally, the study is based solely on the female perspective and cannot fully reflect the sex life of couples.</p><p><strong>Conclusion: </strong>The sexual experiences of our respondents exhibited distinct Chinese cultural characteristics. The interviews show the importance of paying attention to postmenopausal women's sexual health and providing relevant professional support and guidance to improve women's overall health-related quality of life.</p>","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"11 6","pages":"qfad062"},"PeriodicalIF":2.6,"publicationDate":"2023-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10696166/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138499418","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}
引用次数: 0
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