Sexual medicine reviews最新文献

{"title":"The evolving landscape of AI in publishing.","authors":"Annamaria Giraldi, Landon Trost, Giovanni Corona","doi":"10.1093/sxmrev/qeag060","DOIUrl":"https://doi.org/10.1093/sxmrev/qeag060","url":null,"abstract":"","PeriodicalId":21813,"journal":{"name":"Sexual medicine reviews","volume":"14 4","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149114852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peptides in urology and sexual medicine: clinical effectiveness, dosing, indications, and safety: a narrative review.","authors":"Valeriia Vasylieva, Annette West, Edward Karpman","doi":"10.1093/sxmrev/qeag078","DOIUrl":"https://doi.org/10.1093/sxmrev/qeag078","url":null,"abstract":"<p><strong>Introduction: </strong>Peptide-based therapies are increasingly used in urology and sexual medicine, although adoption is often influenced by off-label prescribing, direct-to-consumer promotion, and limited long-term safety data. We review mechanisms, clinical evidence, dosing, safety, and regulatory status of these agents.</p><p><strong>Methods: </strong>A structured search of PubMed, Scopus, and Google Scholar identified studies of peptide-based therapies in sexual medicine. Search terms included Bremelanotide, Melanotan II, Kisspeptin, Oxytocin, PnPP-19, Gonadorelin and growth hormone secretagogues, including GHRP-2, GHRP-6, Ibutamoren, Ipamorelin, Tesamorelin, Sermorelin, and CJC-1295. Of 725 records, 76 studies met inclusion criteria. Findings were synthesized narratively given heterogeneity across studies.</p><p><strong>Results: </strong>Peptides reviewed act through diverse mechanisms, including central modulation of desire and arousal, stimulation of the hypothalamic-pituitary-gonadal and growth hormone axes, and nitric oxide-mediated effects on erectile physiology. Bremelanotide and Tesamorelin are the most clinically established agents, with defined dosing and regulatory approval for selected indications. Kisspeptin shows early promise but remains investigational. Growth hormone secretagogues reliably increase growth hormone and insulin-like growth factor 1 concentrations; however, evidence for improved sexual function, physical performance, or quality of life remains limited. Melanotan II, Ibutamoren, CJC-1295, and related agents remain accessible through unregulated markets, raising concerns about product quality, dosing variability, and incompletely characterized adverse effects. Oxytocin has biologic plausibility but limited efficacy data, whereas PnPP-19 remains preclinical. Gonadorelin was Food and Drug Administration approved but is no longer manufactured. Across peptide classes, safety data are limited by short follow-up, small samples, and incomplete assessment of cardiovascular, metabolic, and oncologic outcomes.</p><p><strong>Discussion: </strong>Peptide-based therapies in urology and sexual medicine show selective therapeutic potential, but most remain insufficiently validated for clinical use. Clinicians should distinguish approved therapies from investigational and nonregulated compounds and counsel patients regarding uncertain benefit, potential harm, and risks of unsupervised use. Randomized trials with standardized dosing and long-term safety assessment are needed before broader adoption.</p>","PeriodicalId":21813,"journal":{"name":"Sexual medicine reviews","volume":"14 4","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149171189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Orgasm-associated urinary incontinence (climacturia) after radical prostatectomy: current concepts in pathophysiology and management.","authors":"Mesut Berkan Duran, Muhammet Volkan Bulbul, Ege Can Serefoglu","doi":"10.1093/sxmrev/qeag077","DOIUrl":"https://doi.org/10.1093/sxmrev/qeag077","url":null,"abstract":"<p><strong>Introduction: </strong>Radical prostatectomy (RP) for prostate cancer commonly results in sexual dysfunction and stress urinary incontinence, including climacturia-orgasm-associated urinary incontinence. Prevalence estimates range widely (20%-93%, averaging closer to 30%), and the condition is likely underreported despite its substantial psychosocial impact, including embarrassment, relationship strain, and avoidance of sexual activity. This review summarizes its pathophysiology, prevalence, and management following RP.</p><p><strong>Methods: </strong>A narrative review of the literature was performed, synthesizing data on epidemiology, proposed pathophysiological mechanisms, and conservative, medical, and surgical treatment options, drawing on case series, observational cohorts, randomized trials, and systematic reviews/meta-analyses.</p><p><strong>Results: </strong>Proposed mechanisms include loss of the internal urethral sphincter and bladder neck closure mechanism, intrinsic sphincter deficiency, loss of the prostatic urethral segment with reduction in functional urethral length, pudendal nerve injury, and periurethral fibrosis, though no single mechanism is established. Shorter preoperative urethral length and lower urinary tract symptoms predict higher risk. Conservative management-pre-coital voiding, condom use, pelvic floor physical therapy, and penile occlusion devices-provides benefit in many patients, though pelvic floor therapy data are mixed, with no significant advantage over controls in a 12-month meta-analysis. Pharmacologic options remain largely empirical, lacking condition-specific evidence. Surgical interventions-artificial urinary sphincter, male urethral slings, and the Mini-Jupette sling and its modifications performed with inflatable penile prosthesis placement-show high rates of improvement or resolution (complete resolution 65%-93% across pooled series), though evidence derives from small, retrospective, non-comparative studies.</p><p><strong>Discussion: </strong>Climacturia remains an underrecognized complication of RP with meaningful effects on patient and partner quality of life. While conservative measures and surgical options offer effective relief for many men, the evidence base is limited by small samples, retrospective design, and scarce randomized data directly evaluating climacturia. Further high-quality, comparative, longer-term studies are needed to clarify pathophysiology, validate predictive factors, and refine treatment algorithms for this distressing but treatable condition.</p>","PeriodicalId":21813,"journal":{"name":"Sexual medicine reviews","volume":"14 4","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149114877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond libido: the multifaceted role of testosterone in women.","authors":"Beatriz S Hernandez, Alexis Covarrubias, Paulo G Perez-Grego, Peyton J Coady, Arnaav Walia, Kelly Casperson, Louise Newson, Gabrielle Lyon, Mohit Khera","doi":"10.1093/sxmrev/qeag072","DOIUrl":"https://doi.org/10.1093/sxmrev/qeag072","url":null,"abstract":"<p><strong>Introduction: </strong>Testosterone physiology in women remains poorly understood despite more than 80 years of clinical knowledge. Longstanding gender biases and the misconception that testosterone is primarily a male hormone have contributed to its underrecognition in women. Testosterone is, however, the most abundant biologically active sex steroid in women and plays important roles across multiple physiological systems throughout the lifespan.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted in PubMed and Scopus for studies published from January 1974 to December 2025. Three authors independently screened articles using predefined inclusion and exclusion criteria. This narrative review included experimental, observational, and clinical studies evaluating endogenous testosterone production, regulation, and physiological functions in women, with emphasis on musculoskeletal, metabolic, cardiovascular, neurological, reproductive, genitourinary, and sexual health.</p><p><strong>Results: </strong>Endogenous testosterone in women arises from ovarian, adrenal, neural, and peripheral conversion pathways and persists after menopause. Physiologic testosterone levels contribute to bone maintenance, muscle mass, metabolic homeostasis, endothelial function, cognition, mood regulation, sexual function, and reproductive physiology. Testosterone concentrations vary with age, reproductive status, hormonal milieu, and other physiologic factors, complicating the interpretation of circulating levels and their relationship with clinical outcomes. Emerging evidence also suggests potential roles in neuroprotection, immune modulation, pelvic floor integrity, and fertility, although the strength of evidence varies across physiologic domains.</p><p><strong>Discussion: </strong>Testosterone is an important yet underrecognized component of female physiology, with effects extending beyond sexual function. A broader understanding of endogenous androgen physiology provides important context for female sexual and reproductive health and highlights the interconnected nature of androgen signaling across physiologic systems. Further research is needed to better characterize testosterone physiology in women, standardize its assessment, and clarify the clinical significance of alterations in endogenous androgen levels.</p>","PeriodicalId":21813,"journal":{"name":"Sexual medicine reviews","volume":"14 4","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contemporary consensus and emerging directions in premature and delayed ejaculation: recommendations from the 5th International Consultation on Sexual Medicine.","authors":"Ege C Serefoglu, Alan W Shindel, Yan Zhang, Eelke Snoeren, Gajanan Bhat, Mohamed Arafa, Stanley Althof, Amr El-Meliegy","doi":"10.1093/sxmrev/qeag068","DOIUrl":"10.1093/sxmrev/qeag068","url":null,"abstract":"<p><strong>Introduction: </strong>Disorders of ejaculation, including premature ejaculation (PE) and delayed ejaculation (DE), are common conditions with a substantial impact on men's quality of life and their relationships. This review synthesizes the latest findings on their etiology, epidemiology, evaluation, and management. This study aims to present evidence-based recommendations for the definition, classification, and treatment of PE and DE, developed under the guidance of the Fifth International Consultation on Sexual Medicine.</p><p><strong>Methods: </strong>A multidisciplinary panel conducted a narrative review of global literature and utilized a modified Delphi method to develop consensus recommendations. Evidence was graded using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system.</p><p><strong>Results: </strong>Premature ejaculation is the most frequently reported male sexual complaint, classified into lifelong, acquired, variable, and subjective subtypes. Evidence-based management includes medical therapies such as selective serotonin reuptake inhibitors, topical anesthetics, and psychotherapeutic approaches. Although less common, DE remains under-researched, with limited pharmacological and behavioral treatment options. Definitions for both disorders have evolved to incorporate timing, distress, and control criteria.</p><p><strong>Conclusion: </strong>Understanding the pathophysiology and adopting individualized approaches to managing PE and DE can improve patient outcomes. Further research is needed to enhance the evidence-based therapies, particularly for DE.</p>","PeriodicalId":21813,"journal":{"name":"Sexual medicine reviews","volume":"14 4","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149148548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mapping supportive sociopsychosexual healthcare for patients with prostate cancer: a scoping review.","authors":"Duo Zhang, Juan Liu, Haoyang Zheng, Ting Yang, Qiuxia Qin, Yanrong Zhou, Fan Yang","doi":"10.1093/sxmrev/qeag074","DOIUrl":"https://doi.org/10.1093/sxmrev/qeag074","url":null,"abstract":"<p><strong>Introduction: </strong>Sexual health is a core component of long-term care for patients with prostate cancer, yet treatment-related sexual dysfunction remains common and existing interventions vary considerably in their definition and delivery. This scoping review aimed to map intervention content, delivery modalities, provider involvement, tailoring approaches, and outcome assessment of sexual health care interventions for patients with prostate cancer, and to identify priorities for future development.</p><p><strong>Methods: </strong>A scoping review was conducted using Joanna Briggs Institute methodology. PubMed, Web of Science, Scopus, Embase, APA PsycINFO, the Cochrane Library, ProQuest, China National Knowledge Infrastructure (CNKI), Wanfang Data, and Chinese Scientific Journal Database (VIP) were searched from inception to August 30, 2025. Studies were screened against prespecified criteria, and relevant data were charted and synthesized descriptively.</p><p><strong>Results: </strong>Thirty-one studies published between 2003 and 2025 were included. Most were randomized controlled trials, and the largest number came from the United States and China. Intervention content mainly covered education, psychological support, sexual rehabilitation, symptom management, supportive safeguards, and relationship support. Face-to-face delivery, particularly in individual or dyadic formats, was predominant, although remote and digital approaches were also reported. Intervention delivery commonly involved mental health or psychosexual practitioners, nurses, and physicians. Tailoring was commonly based on patient problems, goals, preferences, psychological status, and clinical or behavioral characteristics. Outcome assessment focused mainly on sexual function and multidimensional prostate cancer-specific measures.</p><p><strong>Conclusion: </strong>Sexual health care interventions for patients with prostate cancer have developed into multidimensional approaches, but relational support, adaptive procedures, and implementation pathways remain variably specified. Future progress should focus on earlier integration of sexual health care into prostate cancer care and on implementation-oriented evidence to support sustainable service delivery.</p>","PeriodicalId":21813,"journal":{"name":"Sexual medicine reviews","volume":"14 4","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149148351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ethics of male circumcision in minors: a scoping review of parental authority, adolescent involvement, and implications for sexual medicine practice and policy.","authors":"Cennikon Pakpahan, Natasha Susanto Utomo, Markus Christian Hartanto, Andri Rezano, Bac Hoai Nguyen","doi":"10.1093/sxmrev/qeag075","DOIUrl":"https://doi.org/10.1093/sxmrev/qeag075","url":null,"abstract":"<p><strong>Introduction: </strong>Male circumcision in minors remains widely practiced in many regions of the world, although its prevalence varies considerably across cultural, religious, and geographic contexts. Beyond its medical dimensions, circumcision is closely linked to religion, culture, masculinity, family identity, and public health agendas. Ethical debates commonly involve tensions between parental authority, bodily autonomy, assent, and children's rights, particularly because minors are often minimally involved in decision-making processes.</p><p><strong>Methods: </strong>A scoping review was conducted to examine ethical, sociocultural, legal, and decision-making dimensions related to circumcision in minors. Literature searches were performed across MEDLINE, Web of Science, Scopus, ProQuest, SpringerLink, CINAHL/EBSCO, SAGE, and Taylor & Francis. Thirty-one eligible studies were included and analyzed using narrative and thematic synthesis approaches.</p><p><strong>Results: </strong>Ethical dilemmas surrounding circumcision in minors were found to be highly context-dependent and not ethically interchangeable across all forms of circumcision. Five major contextual typologies were identified: religious circumcision, traditional or rite-of-passage circumcision, therapeutic circumcision, public-health-driven voluntary medical male circumcision (VMMC), and elective or family-preference circumcision. Six major thematic frameworks emerged, including parental authority, constrained adolescent agency, public health versus bodily autonomy, masculinity formation, moral conflict and regret, and healthcare and legal systems as ethical gatekeepers. Circumcision decision-making was shaped by multilayered interactions involving family structures, sociocultural norms, healthcare systems, and public health priorities.</p><p><strong>Conclusion: </strong>Ethical interpretations of circumcision in minors cannot be reduced to a simple binary distinction between ethical and unethical practices. Greater recognition of contextual differences and developmentally appropriate assent may support more ethically responsive and culturally sensitive circumcision practices. Policies and clinical guidelines should avoid applying uniform ethical approaches across all circumcision contexts. More context-sensitive frameworks incorporating assent procedures, adolescent involvement, culturally sensitive counseling, and safeguards against coercion may strengthen ethical governance in circumcision practices involving minors.</p><p><strong>Trial registration: </strong>This study was registered in the PROSPERO database (CRD420251074798). URL: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251074798. Date of registration: September 26, 2025.</p>","PeriodicalId":21813,"journal":{"name":"Sexual medicine reviews","volume":"14 4","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149169783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Korean red ginseng and male sexual function: reality or myth?","authors":"Wajid Zaman, Mozaniel Santana de Oliveira, Adnan Amin","doi":"10.1093/sxmrev/qeag043","DOIUrl":"https://doi.org/10.1093/sxmrev/qeag043","url":null,"abstract":"","PeriodicalId":21813,"journal":{"name":"Sexual medicine reviews","volume":"14 3","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148424070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The NLRP3 inflammasome in the pathogenesis of erectile dysfunction: mechanistic insights and therapeutic potential.","authors":"Feng Yin, Hongming Chen, Hongtai Tu, Hao Zhong, Yunqi Mo, Tianxiang Xie, Zhubinyun Lai, Junrong Zou, Rihai Xiao","doi":"10.1093/sxmrev/qeag054","DOIUrl":"https://doi.org/10.1093/sxmrev/qeag054","url":null,"abstract":"<p><strong>Introduction: </strong>The NLRP3 inflammasome is a critical innate immune sensor that drives inflammatory responses and has been implicated in various chronic diseases. However, its specific role in erectile dysfunction (ED) remains incompletely understood, and the evidence supporting its clinical relevance has not been systematically evaluated.</p><p><strong>Methods: </strong>This narrative review followed a structured literature search in PubMed, Web of Science, and Scopus from inception to 2026, using predefined keyword combinations covering NLRP3 inflammasome, pyroptosis, oxidative stress, endothelial dysfunction, neuroinflammation, endocrine dysregulation, and targeted inhibitors. Inclusion criteria comprised original studies, systematic reviews, and meta-analyses reporting NLRP3-related mechanisms or interventions in ED, without restriction to animal or human studies. The retrieved evidence was critically appraised, and the level of evidence was graded according to the Oxford Centre for Evidence-Based Medicine (OCEBM 2011) classification.</p><p><strong>Results: </strong>Preclinical studies, predominantly in rodent models of diabetic, hypertensive, and hyperuricaemic ED, consistently show NLRP3 upregulation/activation in penile tissues and improvement of erectile function after NLRP3-targeting interventions. Mechanistically, NLRP3 contributes to ED through three interrelated pathways: (1) endothelial dysfunction via pyroptosis and reduced nitric oxide bioavailability; (2) neuroinflammation affecting both peripheral autonomic nerves and central regulatory circuits; and (3) endocrine dysregulation, particularly impairment of Leydig cell steroidogenesis and testosterone production. Pharmacological inhibitors (MCC950, CY-09), IL-1 receptor antagonists, caspase-1 inhibitors, and natural products (curcumin, resveratrol) have shown efficacy in animal models; however, human data are limited to biomarker analyses, and no clinical trials have been reported for ED.</p><p><strong>Conclusions: </strong>Current evidence supports a functional association and causal plausibility of NLRP3 inflammasome in ED pathogenesis, but direct causality in humans remains unconfirmed. Future research should prioritize rigorous causal validation, on-target specificity verification, and clinically aligned endpoints to facilitate translation of NLRP3-targeted strategies into ED therapeutics.</p>","PeriodicalId":21813,"journal":{"name":"Sexual medicine reviews","volume":"14 3","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148685792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A call for the universal implementation of a person-centered gynecological examination.","authors":"Mijal Luria","doi":"10.1093/sxmrev/qeag053","DOIUrl":"https://doi.org/10.1093/sxmrev/qeag053","url":null,"abstract":"","PeriodicalId":21813,"journal":{"name":"Sexual medicine reviews","volume":"14 3","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148621540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}