Sexual MedicinePub Date : 2025-02-06eCollection Date: 2025-02-01DOI: 10.1093/sexmed/qfaf004
Sameh Saad Aziz, Walaa Adel Siam, Yasser Salem N Saleh, Asmaa A Hashem, Altaf Bandy, Saleh Salem Bahaj, Amany Ali Essa Elshemally
{"title":"Evaluate the knowledge, attitudes, and practices of emergency medicine physicians in managing priapism cases-a cross section study.","authors":"Sameh Saad Aziz, Walaa Adel Siam, Yasser Salem N Saleh, Asmaa A Hashem, Altaf Bandy, Saleh Salem Bahaj, Amany Ali Essa Elshemally","doi":"10.1093/sexmed/qfaf004","DOIUrl":"10.1093/sexmed/qfaf004","url":null,"abstract":"<p><strong>Introduction: </strong>Priapism is an emergency condition treated by emergency medicine (EM) physicians and urologists/andrologists. EM physicians are the first-line healthcare providers for this condition, and their knowledge, attitudes, and practices regarding priapism remain unclear.</p><p><strong>Aim: </strong>The aim of this study was to understand emergency physicians' perspectives regarding priapism to help re-structure EM programs.</p><p><strong>Methods: </strong>This cross-sectional study on knowledge, attitude, and practice (KAP) surveyed emergency physicians from a university and other hospitals in the Ismailia governorate, Egypt. A validated questionnaire was sent via an online e-survey following the CHEERIES guidelines. Bivariate analysis of demographic characteristics and KAP was performed using by odds ratios and 95% confidence intervals. Spearman's rho was used to measure the correlation between knowledge, attitude, and practice. A <i>P</i> <0.05 was considered statistically significant.</p><p><strong>Main outcome measure: </strong>Emergency physicians completed an e-survey of their knowledge, attitudes, and practices regarding priapism.</p><p><strong>Results: </strong>A total of 149 participants were surveyed. 140 (93%) of EM physicians believed priapism was a medical emergency. 139 (93%) respondents were aware of the long-term complications of priapism. Further, 136 (91.3%) respondents strongly supported the multidisciplinary approach. Of these, 79 (53%) gave intra-cavernous sympathomimetic therapy and 75 (50.3%) did aspiration with irrigation. EM physicians <30 years of age had significantly better knowledge about priapism (OR = 2.47 (1.23-4.96); <i>P</i> = 0.01). Similarly, young physicians had better attitudes (OR = 3.24 (1.31-8.02); <i>P</i> = 0.01) and female physicians demonstrated better practice (OR = 3.36 (1.65-6.82); <i>P</i> = 0.001) toward priapism. A significant positive correlation was observed between knowledge and attitude (r = 0.487), and knowledge and practice (r = 0.281) at <i>P</i> <0.001.</p><p><strong>Clinical implications: </strong>EM physicians agreed that EM-based therapy is appropriate for straightforward cases of acute ischemic priapism. Existing educational programs for EM physicians may not adequately equip them in handling priapism in practice.</p><p><strong>Strengths and limitations: </strong>This study is the first to investigate EM knowledge, attitude, and practice (KAP) for priapism handling. The study identified areas for improvement in this regard. However, the cross-sectional design, single governorate setting, and self-administered questionnaire limit its generalizability.</p><p><strong>Conclusion: </strong>Despite the satisfactory knowledge and attitudes of EM physicians regarding priapism and infection control, this study identified potential areas for improvement in the use of guidelines on invasive treatment.</p>","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"13 1","pages":"qfaf004"},"PeriodicalIF":2.6,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11798673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143365864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sexual MedicinePub Date : 2025-02-06eCollection Date: 2025-02-01DOI: 10.1093/sexmed/qfaf002
Paula Dospělová, Petra Šustová, Ellen Zakreski, Renáta Androvičová
{"title":"Exploring sexual and romantic functioning as early risk factors of schizophrenia: a narrative review.","authors":"Paula Dospělová, Petra Šustová, Ellen Zakreski, Renáta Androvičová","doi":"10.1093/sexmed/qfaf002","DOIUrl":"10.1093/sexmed/qfaf002","url":null,"abstract":"<p><strong>Background: </strong>Patients with schizophrenia frequently encounter challenges related to sexuality and intimacy; however, the underlying causes of these difficulties remain unknown and unexplored.</p><p><strong>Aim: </strong>This narrative review aims to explore how the biological/hormonal and psychological/behavioral developmental trajectories in schizophrenia patients deviate from the normal course and to examine their connection to difficulties in sexual and romantic functioning.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted using PubMed and Google Scholar, with key terms related to schizophrenia and sexual development without restriction on publication year. Articles discussing behavioral, sexual, or psychological/behavioral development before the onset of schizophrenia were included. Articles were divided into biological/hormonal and psychological/behavioral precursor categories. Additional searches were conducted to explore the broader sociocognitive context of schizophrenia, such as deficits in empathy, emotional processing, and theory of mind.</p><p><strong>Outcomes: </strong>The review highlights deviations in both biological/hormonal and psychological/behavioral development in schizophrenia that contribute to difficulties in romantic and sexual relationships.</p><p><strong>Results: </strong>This narrative review addresses the extent to which biological, psychological, and social factors in schizophrenia may be closely intertwined. Abnormalities in the hypothalamic-pituitary-gonadal and hypothalamic-pituitary-adrenal axes have been documented in individuals with schizophrenia, potentially impairing sociosexual competencies and leading to behavioral challenges in forming sexual relationships. Deficits in theory of mind, emotional processing, and empathy may further hinder the ability to form and sustain intimate relationships, amplifying the social difficulties associated with schizophrenia. Additionally, early life traumas, especially sexual abuse, can contribute to sexual difficulties and worsen the disorder.</p><p><strong>Clinical translation: </strong>Understanding the deviations from the normal developmental course in schizophrenia patients may offer valuable insights for potential intervention strategies and remediation approaches and contribute to improvements in sexual/romantic functioning and overall sexual health in schizophrenia patients.</p><p><strong>Strengths and limitations: </strong>This review provides an overview of the developmental precursors of schizophrenia-related sexual/romantic difficulties. Further research is needed to elucidate the specific mechanisms underlying these difficulties, particularly in determining the emotional and motivational salience of sexual stimuli and the capacity to engage in and maintain communication of sexual interest. The reader should bear in mind that narrative reviews lack systematic methods for selecting and evaluating studies, which ca","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"13 1","pages":"qfaf002"},"PeriodicalIF":2.6,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11798675/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143365867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Benefits of movement-based Behaviors on improving erectile function in American men: a nationwide survey study.","authors":"Yiming Chen, Qianfeng Zhuang, Wei Xia, Naiyuan Shao, Bo Zhang, Xingliang Feng","doi":"10.1093/sexmed/qfaf003","DOIUrl":"10.1093/sexmed/qfaf003","url":null,"abstract":"<p><strong>Background: </strong>Erectile dysfunction (ED) is a prevalent condition with significant psychological and physiological impacts. Recently, a new concept called movement-based behaviors (MBB) has been proposed, which includes four types of PA: vigorous PA (VPA), moderate-intensity PA (MPA), walking/cycling, and muscle-strengthening activities (MSA), and uses an MBB index (range 0-4) to estimate the combined effects of these activities on health outcomes.</p><p><strong>Aim: </strong>This study aims to evaluate the relationship between different types of physical activities (PA) and ED using the MBB index in a nationally representative sample of U.S. men.</p><p><strong>Methods: </strong>We analyzed data from the National Health and Nutrition Examination Survey (NHANES) 2001-2004, including 3435 male participants. Multivariate logistic regressions were performed to explore the associations, supplemented with subgroup analysis and sensitivity analysis.</p><p><strong>Outcomes: </strong>The assessment of PA in this study is based on four self-reported questions from the NHANES Mobile Examination Center interview, including VPA, MPA, walking/cycling, and MSA. The MBB index, ranging from 0 to 4, was used to assess combined PA types. ED was evaluated using a single-question self-assessment.</p><p><strong>Results: </strong>Higher MBB index values were associated with lower ED risk. Participants with an MBB index of 2 had a significantly lower risk of ED in Model 3 (OR = 0.65, 95% CI: 0.43-0.97, P = 0.04). Those with an MBB index of 3 or 4 had the lowest risk of ED across all models, with OR_Model1 = 0.29 (95% CI: 0.21-0.40, P < 0.0001), OR_Model2 = 0.52 (95% CI: 0.37-0.73, P < 0.001), and OR_Model3 = 0.61 (95% CI: 0.41-0.90, P = 0.02). However, this relationship was not significant in subgroups with severe ED or comorbid conditions.</p><p><strong>Clinical implications: </strong>Our findings can provide clinicians with guidance to help patients personalize their selection of different exercise combinations.</p><p><strong>Strengths and limitations: </strong>We explored the impact of different exercise combinations on reducing ED risk and innovatively proposed the MBB index for a comprehensive assessment of exercise benefits, supported by a large sample size and multivariable adjustments. However, the limitations of cross-sectional design and recall bias cannot be overlooked.</p><p><strong>Conclusion: </strong>The MBB index effectively demonstrates that combined PA can reduce ED risk, supporting tailored exercise recommendations for patients.</p>","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"13 1","pages":"qfaf003"},"PeriodicalIF":2.6,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11788418/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sexual MedicinePub Date : 2025-01-23eCollection Date: 2024-12-01DOI: 10.1093/sexmed/qfae094
Amandine Degraeve, Lorenzo Tosco, Bertrand Tombal, Thierry Roumeguere, Jeanne Beirnaert, Robin Hamal, Céline Bugli, Marco Cosentino, Lee Wai Gin Don, Marta Skrodzka, Maarten Albersen, Koenraad van Renterghem, Maxime Sempels, David Penning, Mikkel Fode, Antoine Faix, Marjan Waterloos, Borja Garcia Gomez, Damien Carnicelli, Jean-Pierre Graziana, Afonso Morgado, Kathleen D'Hauwers, Ege Serefoglu, Celeste Manfredi, Emmanuel Weyne, Jack Beck, Daniar Osmonov, Chris Roller, Ludovic Ferreti, Giogio Russo, Faysal A Yafi, Beatrice Cuzin, François-Xavier Madec, Geoffroy Vanoverschelde, François Hervé, Eric Chung, Ulla Nordström, Andrea Cocci, Rawad Abou Zahr, François Triffaux, Minhas Suks, Hussain Alnajjar, Julien Van Damme, Sam Ward
{"title":"Definition of a European pre-vasectomy scoring system to identify patients at risk of vasectomy regret.","authors":"Amandine Degraeve, Lorenzo Tosco, Bertrand Tombal, Thierry Roumeguere, Jeanne Beirnaert, Robin Hamal, Céline Bugli, Marco Cosentino, Lee Wai Gin Don, Marta Skrodzka, Maarten Albersen, Koenraad van Renterghem, Maxime Sempels, David Penning, Mikkel Fode, Antoine Faix, Marjan Waterloos, Borja Garcia Gomez, Damien Carnicelli, Jean-Pierre Graziana, Afonso Morgado, Kathleen D'Hauwers, Ege Serefoglu, Celeste Manfredi, Emmanuel Weyne, Jack Beck, Daniar Osmonov, Chris Roller, Ludovic Ferreti, Giogio Russo, Faysal A Yafi, Beatrice Cuzin, François-Xavier Madec, Geoffroy Vanoverschelde, François Hervé, Eric Chung, Ulla Nordström, Andrea Cocci, Rawad Abou Zahr, François Triffaux, Minhas Suks, Hussain Alnajjar, Julien Van Damme, Sam Ward","doi":"10.1093/sexmed/qfae094","DOIUrl":"10.1093/sexmed/qfae094","url":null,"abstract":"<p><strong>Introduction: </strong>Vasectomy is a widely used, safe, effective method of permanent contraception and contributes to healthy sexuality.</p><p><strong>Aims: </strong>We have conducted a 3-step observational clinical study to develop a vasectomy regret risk score and guide patients and clinicians when discussing a vasectomy.</p><p><strong>Methods: </strong>A 3-step approach has been followed. First, experts involved in male health have proposed risk factors for regret (remorse) after vasectomy, defined by a vasectomy reversal surgery or medically assisted reproduction. The selected factors were evaluated in 1200 patients vasectomized in the last 15 years. Finally, the expert panel has constructed a score for predicting regret after vasectomy.</p><p><strong>Results: </strong>Fifty-two international experts identified 17 risk factors for vasectomy regret. Five of the risk factors were significant: an age <35 years old, a high Barrat Impulsivity Score, a low level of education, and a patient who didn't understand that the vasectomy might not be reversible or for whom the contraception responsibility is ideally feminine, or no responsible partner. On multivariate analysis, 3 risk factors and 2 \"sine qua non\" conditions were used to build the decision algorithm. A risk score ≥ 4 required information on sperm cryopreservation before vasectomy, and those with a risk score ≥ 7 required extra time for reflection. The scoring system was proposed to 52 international experts and accepted with 86.7% strongly agreeing. The model's sensitivity and specificity were 0.98 and 0.53, respectively.</p><p><strong>Conclusion: </strong>A decisional algorithm was established to identify patients requiring information on sperm cryopreservation before vasectomy or additional time for reflection to reduce the risk of vasectomy regret. The algorithm contains 3 risk factors and 2 \"<i>sine qua non</i>\" conditions.</p>","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"12 6","pages":"qfae094"},"PeriodicalIF":2.6,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11757006/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029573","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}
Sexual MedicinePub Date : 2025-01-21eCollection Date: 2024-12-01DOI: 10.1093/sexmed/qfaf001
Theodore C Crisostomo-Wynne, Alexandria M Hertz, Monica G Ferrini, Timothy C Brand, Shashikumar K Salgar
{"title":"Nutraceutical and low energy shockwave treatments improved sexual function recovery in a rat pelvic neurovascular injury model.","authors":"Theodore C Crisostomo-Wynne, Alexandria M Hertz, Monica G Ferrini, Timothy C Brand, Shashikumar K Salgar","doi":"10.1093/sexmed/qfaf001","DOIUrl":"10.1093/sexmed/qfaf001","url":null,"abstract":"<p><strong>Background: </strong>Pelvic trauma can have long-lasting debilitating effects, including severe erectile dysfunction (ED) in men. While there are effective treatments for ED, these treat the symptoms not the cause. Those who suffer from an acute traumatic injury to the neurovascular supply of penis, may benefit from regenerative therapy. COMP4 is an all-natural herbal compound (Muira puama, <i>Paullinia cupana</i>, Ginger, and L-Citrulline) has potential to enhance penile vascular/smooth muscle/neuronal regeneration via Nitric Oxide synthesis. Low energy shockwave (LESW) therapy promotes nerve regeneration/angiogenesis by activating stem/progenitor cells.</p><p><strong>Aim: </strong>To investigate the effects of the COMP4 and LESW for the treatment of ED in a rat pelvic trauma model.</p><p><strong>Methods: </strong>The experimental design included five groups (Lewis rats aged 10-12 weeks; n = 8/group): (1) Sham, (2) Injury control, (3) Peanut Butter (PNB; Vehicle) Control, (4) COMP4, and (5) COMP4 + LESW. Pelvic neurovascular injury (PNVI) was induced by performing bilateral cavernous nerve crush injury and internal pudendal bundle ligation under general anesthesia. One week after PNVI rats received COMP4 (45 mg/kg b.wt./day) orally via PNB and/or LESW (1000 pulses at 0.06 mJ/mm2, 3 Hz, three times per week to the pelvis around penis) for 6 weeks. After 1 week of washout period, erectile function (EF) was assessed via intracavernous pressure (ICP; mmHg) measurements; rats euthanized, penile tissues collected for analyses.</p><p><strong>Outcomes: </strong>COMP4 and LESW treatments improved EF recovery.</p><p><strong>Results: </strong>There was a significant (<i>P</i> < .01) improvement in EF (ICP) with COMP4 (153.6 ± 26.6) and COMP4 + LESW (174.1 ± 38.2) treatments compared to vehicle (PNB) control (109.4 ± 32.6). COMP4 + LESW treatment enhanced EF compared to COMP4 alone. The base level ICP before treatments (Group 2) was 117.3 ± 6 and was lower (<i>P</i> < .01) than sham (165 ± 43.8) and COMP4 & COMP4 + LESW treated rats. Masson's trichrome staining of corpus cavernosum penis demonstrated reduced (<i>P</i> < .001) smooth muscle-to-collagen (SM:C) ratio in injury and PNB controls compared to sham. COMP4 treatment following PNVI showed an increase (<i>P</i> < .05) in SM:C ratio. Adding LESW and COMP4 enhanced (<i>P</i> < .01) the SM:C ratio, suggesting a reduction in fibrosis. Western blot analysis revealed a significant increase in Endothelial Nitric Oxide Synthase and α-Smooth Muscle Actin (α-SMA) in the corpus cavernosum with COMP4 and COMP4 + LESW treatments compared to PNB control.</p><p><strong>Clinical implications: </strong>COMP4 and/or LESW can serve as an adjunct therapy to mitigate ED.</p><p><strong>Strengths and limitations: </strong>Identified novel treatment option to improve EF recovery. Unable to address in-depth cellular/molecular mechanisms.</p><p><strong>Conclusions: </strong>COMP4 and LESW treatments appear to be pro","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"12 6","pages":"qfaf001"},"PeriodicalIF":2.6,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11750428/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143024424","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}
Sexual MedicinePub Date : 2025-01-15eCollection Date: 2024-12-01DOI: 10.1093/sexmed/qfae083
Jannis Engel, Antonia Waechter, Maria Veit, Jonas Kneer, Christopher Sinke, Matthias Brand, Tillmann H C Krueger
{"title":"Masked liking of pornography: implicit associations in men with compulsive sexual behavior.","authors":"Jannis Engel, Antonia Waechter, Maria Veit, Jonas Kneer, Christopher Sinke, Matthias Brand, Tillmann H C Krueger","doi":"10.1093/sexmed/qfae083","DOIUrl":"10.1093/sexmed/qfae083","url":null,"abstract":"<p><strong>Background: </strong>Compulsive Sexual Behavior Disorder is a new category in the 11th version of the International Classification of Diseases and is showing neuropsychological similarities to substance dependencies and behavioral addictions.</p><p><strong>Aims: </strong>This experimental study aims to further our knowledge on implicit associations in Compulsive Sexual Behavior (CSB) with a clinical sample.</p><p><strong>Methods: </strong>Participants completed an Implicit Association Test modified with pornographic pictures. In addition, problematic sexual behavior and sensitivity toward sexual excitation were assessed.</p><p><strong>Outcomes: </strong>We collected data on implicit associations from 47 heterosexual men with CSB (age, M = 36.51, SD = 11.47) and a control group of 38 men without the condition (age: M = 37.92, SD = 12.33).</p><p><strong>Results: </strong>Results show significantly more positive relationships between implicit associations of pornographic pictures with positive emotions, as well as with problematic sexual behavior and sensitivity toward sexual excitation, in men with CSB vs. men without CSB. Furthermore, implicit associations, sexual excitation, and sexual inhibition due to threat of performance consequences differentiated significantly between groups using a binary stepwise logistic regression analysis. The findings are in line with those of previous subclinical investigations and support the assumption of pronounced positive implicit associations in CSB. Moreover, as suggested by the I-PACE model of addictive behaviors, implicit associations may be crucial to the maintenance of behavioral addictions.</p><p><strong>Clinical implications: </strong>Implicit associations could be addressed in therapy to illustrate cognitive processes of those affected and as an outcome measure in research on treatment efficiency.</p><p><strong>Strengths & limitations: </strong>The present study is the first to investigate implicit associations in CSB in a clinical sample. Findings are limited to heterosexual men.</p><p><strong>Conclusion: </strong>Findings can be seen in accordance with a proposed classification of CSB as a behavioral addiction.</p>","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"12 6","pages":"qfae083"},"PeriodicalIF":2.6,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11733629/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143011120","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":"Impact of bladder management methods and other factors on sexual activity in women with chronic spinal cord injury/disease.","authors":"Jasmin Lea Mahler, Salome Schneider, Jens Wöllner, Jürgen Pannek, Jörg Krebs","doi":"10.1093/sexmed/qfae087","DOIUrl":"https://doi.org/10.1093/sexmed/qfae087","url":null,"abstract":"<p><strong>Background: </strong>Spinal cord injury/disease (SCI/D) profoundly affects both sexuality and urinary function. Catheterization is often necessary to manage bladder voiding and it can interfere with sexual activity.</p><p><strong>Aim: </strong>We aim to investigate the effect of the bladder evacuation method on sexual activity in women with chronic SCI/D.</p><p><strong>Methods: </strong>This cross-sectional study at a specialized SCI/D rehabilitation center recruited women ≥18 years with chronic SCI/D using intermittent or suprapubic catheterization. We assessed sexual activity and sexual function with the German version of the Sexual Behaviour Questionnaire and the Female Sexual Function Index (FSFI) and a study-specific questionnaire.</p><p><strong>Outcomes: </strong>The primary outcome was sexual activity and secondary outcomes included factors influencing sexual activity, such as age and SCI/D characteristics.</p><p><strong>Results: </strong>Around half of the evaluated women were sexually active, regardless of bladder evacuation method. However, significantly (<i>P</i> = .018) more women using intermittent catheterization (IC) (66.7%, 20/30) were sexually active compared to those with a suprapubic catheter (SPC) (29.4%, 5/17). The main concern for women using IC was urinary incontinence during sex (43.3%, 13/30), while those with a SPC struggled with self-image due to the catheter (58.8%, 10/17). Not having a partner was the most common reason for sexual inactivity in both groups (59.1%). The median FSFI total score was significantly (<i>P</i> = .049) greater in the IC group (median 26.4, lower quartiles [LQ] 8.9/upper quartiles [UQ] 28.8) compared to the SPC group (median 11.5, LQ 5.4/UQ 25.5), which represents a lower grade of sexual dysfunction in women using IC.</p><p><strong>Clinical translation: </strong>Sexual education is crucial and should be adapted to the different types of bladder management.</p><p><strong>Strength & limitations: </strong>This study shows first data on the effect of catheter on sexual activity in women. Limitation of our study is the small sample size and response bias by the high rejection rate of women with SPC.</p><p><strong>Conclusions: </strong>Few women with SPC remain sexually active after SCI/D, while the majority of women using IC do, highlighting issues around self-image and urinary incontinence.</p>","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"12 6","pages":"qfae087"},"PeriodicalIF":2.6,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732754/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143011115","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}
Sexual MedicinePub Date : 2025-01-13eCollection Date: 2024-12-01DOI: 10.1093/sexmed/qfae070
Hayat Ali Yousefzai, Siti Irma Fadhilah Ismail, Sana Hussain, Aishah Siddiqah Alimuddin
{"title":"Unveiling intimacy: sexual dysfunction and marital satisfaction among Pakistani males in Karachi.","authors":"Hayat Ali Yousefzai, Siti Irma Fadhilah Ismail, Sana Hussain, Aishah Siddiqah Alimuddin","doi":"10.1093/sexmed/qfae070","DOIUrl":"10.1093/sexmed/qfae070","url":null,"abstract":"<p><strong>Background: </strong>In Asian countries, discussing sex-related issues remains a taboo. Sexual dysfunction is not even considered a serious disorder in Pakistan.</p><p><strong>Aim: </strong>To explore sexual dysfunction and marital satisfaction within the Pakistani context to develop supportive intervention programs.</p><p><strong>Methods: </strong>This study entailed a mixed method approach and was carried out in Karachi, Pakistan. The sample comprised 28 married men, and data were gathered by in-depth interviews. Subsequently, data were analyzed through content analysis.</p><p><strong>Outcomes: </strong>There is a strong relationship between marital dissatisfaction and sexual dysfunction in adult married males aged 25 to 40 years in Pakistan.</p><p><strong>Results: </strong>The analysis of participants' perspectives revealed 5 themes: psychosocial issues, rationale of openness in marital life, insufficient sexual knowledge, lack of sexual health service, and individual consequences.</p><p><strong>Clinical implications: </strong>The results of this study suggest that it is an important suggestion to the government of Pakistan to introduce sexual health counseling and premarital counseling programs at the university level. The Ministry of Health and Higher Education needs to promote awareness about sexual health, sexual dysfunctions, and marital satisfaction, which will enable men to understand their sexual problems and effectively cope with them.</p><p><strong>Strengths and limitations: </strong>The results of this study highlight the biopsychosocial dimensions of human sexuality. In this context, the psychosocial aspects associated with sexual dysfunctions are influenced by cultural and societal norms, where open discussions about sexual issues between male and female partners may be limited due to concerns about maintaining harmony in marital relationships. The limitation of this study is that the sample is not generalized; it is also not a demographic representation of all socioeconomic groups in Pakistan. Participants in low and middle classes reported an inability to seek help from professionals due to the high costs of treatments. Therefore, the results cannot to be extended to all Pakistani males.</p><p><strong>Conclusion: </strong>In this study, male sexual dysfunction strongly affects marital satisfaction within the couple. As such, marital counseling and psychotherapeutic strategies play an important role to help individuals and couples manage their sexual dysfunctions and enhance their marital satisfaction.</p>","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"12 6","pages":"qfae070"},"PeriodicalIF":2.6,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11725952/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142979622","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}
Sexual MedicinePub Date : 2025-01-13eCollection Date: 2024-12-01DOI: 10.1093/sexmed/qfae088
Majken Højrup Wiborg, Rasmus Krøijer, Birgitte Schantz Laursen, Lars Lund
{"title":"Effects of therapy in experimental models of Peyronie's disease: a scoping review.","authors":"Majken Højrup Wiborg, Rasmus Krøijer, Birgitte Schantz Laursen, Lars Lund","doi":"10.1093/sexmed/qfae088","DOIUrl":"10.1093/sexmed/qfae088","url":null,"abstract":"<p><strong>Background: </strong>Peyronie's disease (PD) is a fibrotic disorder affecting the penile tunica albugínea, with unclear pathophysiology despite centuries of recognition.</p><p><strong>Aim: </strong>This scoping review maps the effects of interventions in basic PD research, synthesizing evidence from in vivo and in vitro studies to guide future investigation.</p><p><strong>Methods: </strong>In October-November 2023, a systematic search was conducted across PubMed, Embase (Ovid), Science of Web, and Scopus, following SRYCLE's guidelines. Relevant studies were screened for data on interventions targeting PD in vivo and in vitro, with no language or time restrictions.</p><p><strong>Outcomes: </strong>Primary outcomes included changes in extracellular matrix (ECM) proteins, myofibroblast activity, and plaque size.</p><p><strong>Results: </strong>Of 683 articles screened, 40 studies were included. Key interventions such as phosphodiesterase inhibitors and stem cell therapies reduced ECM proteins and myofibroblast activity, particularly in early-stage PD models. However, none of the studies adhered to the ARRIVE guidelines, highlighting a gap in reporting standards.</p><p><strong>Clinical translation: </strong>Findings suggest potential benefits of early and multimodal treatment strategies, but further human trials are needed to bridge the gap in clinical practice.</p><p><strong>Strengths and limitations: </strong>This review systematically synthesizes animal and cellular research on PD, highlighting significant preclinical findings. However, the lack of standardized reporting and limited human studies restricts direct clinical applicability.</p><p><strong>Conclusion: </strong>Further research should prioritize adherence to reporting standards, optimize treatment timing, and explore combination therapies to advance PD management.</p>","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"12 6","pages":"qfae088"},"PeriodicalIF":2.6,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11726063/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142979690","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}
Sexual MedicinePub Date : 2025-01-13eCollection Date: 2024-12-01DOI: 10.1093/sexmed/qfae086
Zhimin Chen, Xiansheng Zhang
{"title":"The value of 5-HT, leptin, and NE in the classification of premature ejaculation.","authors":"Zhimin Chen, Xiansheng Zhang","doi":"10.1093/sexmed/qfae086","DOIUrl":"10.1093/sexmed/qfae086","url":null,"abstract":"<p><strong>Background: </strong>While premature ejaculation (PE) can be divided into lifelong PE (LPE), acquired PE, natural variable PE (NPE), and subjective PE (SPE), there is no objective method to classify PE.</p><p><strong>Aim: </strong>To determine the value of serum serotonin (5-HT), leptin, and norepinephrine (NE) levels in the classification of PE.</p><p><strong>Methods: </strong>From July 2023 to July 2024, we recruited 150 participants and divided them into 4 groups: LPE (43 cases), NPE (32 cases), SPE (35 cases), and non-PE (40 cases) groups. All participants' baseline data, premature ejaculation diagnostic tool score, and intravaginal ejaculation latency time were investigated. In addition, all participants' serum 5-HT, leptin, and NE levels were measured.</p><p><strong>Outcome: </strong>Serum 5-HT, NE, and leptin levels were compared among all groups.</p><p><strong>Results: </strong>Serum 5-HT levels were lower and NE and leptin levels were higher in the LPE group compared to the SPE, NPE, and non-PE groups (<i>P</i> < .05). However, serum 5-HT, leptin, and NE levels were not significantly different among the non-PE, NPE, and SPE groups (<i>P</i> < .05). In addition, serum 5-HT <95.0 ng/mL, NE >543.0 ng/L, and leptin >19.8 ng/mL may be predictive indicators of LPE.</p><p><strong>Clinical significance: </strong>Based on serum 5-HT, NE, and leptin levels, LPE can be distinguished from SPE and NPE, which provides an objective basis for the treatment of PE.</p><p><strong>Strengths and limitations: </strong>There is no effective method to classify PE. The main limitation of this study is the limited sample size.</p><p><strong>Conclusion: </strong>The serum 5-HT, leptin, and NE levels in PE patients may contribute to the classification of PE.</p>","PeriodicalId":21782,"journal":{"name":"Sexual Medicine","volume":"12 6","pages":"qfae086"},"PeriodicalIF":2.6,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11725958/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142979692","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}