Sexual medicine reviews最新文献

{"title":"Vacuum erectile devices for erectile dysfunction: recommendations from the 5th international consultation on sexual medicine.","authors":"Run Wang, Francisco E Martins, David Ralph, Georgios Hatzichristodoulou, Daniar Osmonov, Justin Parker, Sung Hun Sean Park, Ignacio Moncada, Carlo Bettocchi, Ricardo Munarriz, Tobias Köhler","doi":"10.1093/sxmrev/qeaf002","DOIUrl":"10.1093/sxmrev/qeaf002","url":null,"abstract":"<p><strong>Introduction: </strong>Vacuum erectile device (VED) is 1 of the main approved therapies for erectile dysfunction (ED). The introduction of phosphodiesterase type 5 inhibitor (PDE5i) for ED significantly changed the roles of VED in contemporary sexual medicine.</p><p><strong>Objective: </strong>To provide updated clinical evidence to inform health care providers on best practices with VED.</p><p><strong>Methods: </strong>A consensus panel was held with leading sexual medicine experts during the 5th International Consultation on Sexual Medicine (ICSM). Relevant peer-reviewed literature was reviewed with focus on research from the last 10 years, but not limited to the last 10 years. The expert panel generated consensus statements based on the quality of evidence and criteria of Grading of Recommendations Assessment, Development and Evaluation.</p><p><strong>Results: </strong>As a primary or combination therapy for ED, VED has been shown to be successful in all populations studied, including difficult to treat cohorts, such as diabetes mellitus, spinal cord injury, and post-radical prostatectomy (RP), but long-term attrition rates are high. Available evidence has shown that VED can preserve or restore penile size for patients after RP, after incision and grafting surgery for Peyronie's disease, before and after penile prosthesis, and after other post pelvic surgeries. However, it has not demonstrated a more rapid recovery of spontaneous erectile function after RP. VED does not increase penile length for subjective short penis. Studies with female specific VED for female sexual dysfunction are very limited.</p><p><strong>Conclusions: </strong>Since the prior 4th ICSM, more evidence is available to support the new roles of VED in contemporary sexual medicine. Research into the penile pathophysiologic changes with VED therapy and clinical outcomes for various conditions are ongoing. We encourage sexual medicine clinicians to follow the 5th ICSM recommendations, but providers should also use their own judgement and adopt shared decision making with their patients/partners when considering VED for a specific disorder.</p>","PeriodicalId":21813,"journal":{"name":"Sexual medicine reviews","volume":" ","pages":"172-183"},"PeriodicalIF":3.6,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433823","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 theoretical model for sexual performance anxiety (SPA) and a clinical approach for its remediation (SPA-R).","authors":"David L Rowland, Paraskevi-Sofia Kirana","doi":"10.1093/sxmrev/qeaf012","DOIUrl":"10.1093/sxmrev/qeaf012","url":null,"abstract":"<p><strong>Introduction: </strong>Anxiety, and more specifically performance anxiety, is commonly associated with sexual problems both by health professionals and clients alike. Yet, despite its strong association with sexual dysfunctions, the conceptualization and understanding of performance anxiety are seldom provided in a comprehensive and detailed manner that imparts utility for its remediation.</p><p><strong>Objectives: </strong>Here, we offer a theoretical model for sexual performance anxiety that directly informs a clinical approach for its remediation, with the goal of better preparing clinicians who routinely work with, counsel, and treat men and women experiencing a sexual problem.</p><p><strong>Method: </strong>We first lay a groundwork that explains the general characteristics of anxiety as a psychological construct and emotion and briefly summarize 2 overarching models that relate anxiety to performance. Then we present a theoretical model that provides a heuristic for understanding sexual performance anxiety (SPA) and review factors purported to moderate and mediate anxiety in sexual performance situations. Finally, we present a clinical approach for its remediation (SPA-R) that is directly tied to the theoretical model (SPA), specifically demonstrating how consideration of various targets in the flow chart can serve as a roadmap for addressing performance anxiety within a psychotherapeutic context.</p><p><strong>Results: </strong>We highlight and explain each aspect of the model and delineate the connection between the model and its application, summarizing a number of key principles inherent to the therapeutic process.</p><p><strong>Conclusion: </strong>We offer both this theoretical model and remedial clinical application not necessarily as the only or even best solution for dealing with clients suffering from sexual performance anxiety but as a challenge to stimulate both critique and further discussion, elaboration, and research on this critically important, though somewhat neglected, topic.</p>","PeriodicalId":21813,"journal":{"name":"Sexual medicine reviews","volume":" ","pages":"184-201"},"PeriodicalIF":3.6,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731352","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":"Perspective on \"Sexual health in the era of artificial intelligence: a scoping review of the literature\".","authors":"Joana Carvalho, Samuel Silva","doi":"10.1093/sxmrev/qeaf008","DOIUrl":"10.1093/sxmrev/qeaf008","url":null,"abstract":"","PeriodicalId":21813,"journal":{"name":"Sexual medicine reviews","volume":" ","pages":"280-281"},"PeriodicalIF":3.6,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693295","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":"Application of nitrates and NO-donors as a transdermal therapy for erectile dysfunction: a comprehensive review.","authors":"Fatemeh Khorasanian, Maryam Shami, Mohammad Amin Langarizadeh, Marziye Ranjbar Tavakoli, Hojjat Rezaiezadeh, Hamid Forootanfar","doi":"10.1093/sxmrev/qeaf005","DOIUrl":"10.1093/sxmrev/qeaf005","url":null,"abstract":"<p><strong>Introduction: </strong>Erectile dysfunction (ED) is among the most prevalent urologic issues affecting men globally, with a notably high incidence rate. It significantly impacts the quality of life of patients and their sexual partners.</p><p><strong>Objectives: </strong>Given the increasing prevalence of ED among men in recent years, numerous pharmacotherapies have been developed to address these conditions. However, systemic drug therapies for ED are often associated with significant challenges, including drug interactions and contraindications across a wide range of medical conditions. This has prompted researchers to focus on designing drugs and dosage forms that maintain efficacy while reducing side effects, interactions, and contraindications.</p><p><strong>Methods: </strong>Building on previous studies, this article investigates nitrates and NO-donors with a focus on their transdermal impact, strategies for enhancing therapeutic efficiency, potential local side effects, and the evaluation of various formulations.</p><p><strong>Results: </strong>In this regard, organic nitrates such as nitroglycerin and isosorbide dinitrate and NO donors comprising volatile alkyl nitrites, linsidomine, sodium nitroprusside, and L-arginine are among good candidates for transdermal formulations of ED treatment. In the current article, the topical effects of these compounds, both alone and in combination with other drugs, have been thoroughly examined, including aspects such as their mechanism of action, effectiveness, side effects, and contraindications.</p><p><strong>Conclusion: </strong>Based on these findings, it appears that novel formulations with enhanced absorption of these compounds could play a significant role in the treatment of ED, either as a standalone therapy or as an adjunctive treatment. Currently, most of the data are from preclinical studies and future clinical research can reveal the precise efficacy of such transdermal formulations.</p>","PeriodicalId":21813,"journal":{"name":"Sexual medicine reviews","volume":" ","pages":"211-228"},"PeriodicalIF":3.6,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383205","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":"Correction to: Newer formulations of oral testosterone undecanoate: development and liver side effects.","authors":"","doi":"10.1093/sxmrev/qeaf007","DOIUrl":"10.1093/sxmrev/qeaf007","url":null,"abstract":"","PeriodicalId":21813,"journal":{"name":"Sexual medicine reviews","volume":" ","pages":"282"},"PeriodicalIF":3.6,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143067998","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":"Management of hematocrit levels for testosterone replacement patients, a narrative review.","authors":"Julius Fink, Kirk Bentzen, Shigeo Horie","doi":"10.1093/sxmrev/qeaf013","DOIUrl":"10.1093/sxmrev/qeaf013","url":null,"abstract":"<p><strong>Introduction: </strong>Testosterone replacement therapy is gaining more and more popularity among hypogonadal men. The positive effects on body composition, metabolic functions, and mental well-being can improve the quality of life of many men. However, testosterone can also trigger several side effects, including increases in hematocrit and hemoglobin levels. Exogenous testosterone tends to increase erythropoiesis. The testosterone-induced increase in red blood cells can increase performance via improved transport of oxygen to the body. However, red blood cell overproduction can cause blood clots and severe sequelae such as heart attack, stroke, or pulmonary embolism. These side effects need to be closely monitored in testosterone replacement therapy (TRT) patients. Traditionally, cessation of TRT was recommended for patients with severe polycythemia. However, cessation of TRT can lead to the recurrence of symptoms experienced before TRT. Fortunately, recent innovations in testosterone preparations allow a treatment with less side effects on hematocrit levels.</p><p><strong>Objectives: </strong>This review focuses on highlighting novel methods to treat hypogonadism while minimizing side effects related to hematocrit levels.</p><p><strong>Methods: </strong>We identified relevant articles using PubMed and Google Scholar searching for specific terms from 2000-2024.</p><p><strong>Results: </strong>Elevations in hematocrit levels triggered by testosterone therapy seem to be controversial, some studies advocate noninferior effects as compared to placebo while others found adverse side effects on cardiovascular health. However, the way of administration of testosterone seems to strongly influence the extent of hematocrit increases and can therefore be minimized by choosing the right testosterone preparation.</p><p><strong>Conclusion: </strong>Depending on the route of administration, testosterone replacement therapy can lead to significant increases in hematocrit and potential cardiovascular incidents. On the other hand, for hypogonadal patients with anemia, testosterone replacement therapy might be beneficial not only for restoring healthy testosterone levels but also red blood cells.</p>","PeriodicalId":21813,"journal":{"name":"Sexual medicine reviews","volume":" ","pages":"229-236"},"PeriodicalIF":3.6,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701673","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":"Surgical techniques in chondrolaryngoplasty: a narrative review.","authors":"Rodolfo B S de Almeida, Claudiney C Costa, Hugo V L Ramos, Pauliana L E Silva Duarte, Leandro C Velasco, Onivaldo Cervantes","doi":"10.1093/sxmrev/qeaf003","DOIUrl":"10.1093/sxmrev/qeaf003","url":null,"abstract":"<p><strong>Introduction: </strong>Chondrolaryngoplasty, also known as \"Adam's apple\" reduction, is a surgical procedure that diminishes the prominence of the thyroid cartilage. Primarily sought by transgender women, the procedure is performed for esthetic reasons to align with their identified gender. It can also be done for cisgender individuals seeking reduced prominence. Despite its safety, there are risks due to the proximity to vocal cords, and variations may impact results.</p><p><strong>Objective: </strong>To identify the main techniques available in the literature for performing chondrolaryngoplasty, as well as the differences in the results of each technique applied.</p><p><strong>Methods: </strong>Research utilized databases (MEDLINE, PubMed, and Scopus) from inception to March 2023, focusing on randomized clinical trials, prospective and retrospective studies, and case series published in English, Spanish, French, or Portuguese. Selected studies provided results including satisfaction rates, surgical time, and/or details on complications.</p><p><strong>Results: </strong>21 eligible results, four of which were excluded because the full text was not available and four because they did not meet the research objectives. Thus, 13 articles were included in the analysis, eight of which reported on external approach surgical procedures (via surgical incision) and five on transoral procedures, totaling 355 living patients evaluated, as well as 11 cadavers. The complications reported are considered mild and transient, and do not contraindicate the procedure. Among the factors that most interfere with patient satisfaction is the apparent scar, which is avoided with the transoral surgical approach, which has been reported more recently.</p><p><strong>Conclusion: </strong>Chondrolaryngoplasty is an esthetic surgical procedure that aims to reduce the prominence of the thyroid cartilage and is most commonly performed on transgender women. Studies show that it is a safe procedure, with rare complications that are generally transient. The main drawback of the surgery is the apparent scar which can be avoided by a transoral approach.</p>","PeriodicalId":21813,"journal":{"name":"Sexual medicine reviews","volume":" ","pages":"237-245"},"PeriodicalIF":3.6,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426331","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":"Effectiveness of physiotherapy and its impact on the quality of life of patients compared to other therapeutic approaches in the management of female sexual dysfunction in non-menopausal adult population: a systematic review.","authors":"Laia Blanco-Ratto, Inés Ramírez-García, Stephanie Kauffmann, Montserrat Girabent Farrés","doi":"10.1093/sxmrev/qeaf022","DOIUrl":"https://doi.org/10.1093/sxmrev/qeaf022","url":null,"abstract":"<p><strong>Introduction: </strong>Female sexual dysfunction (FSD) affects quality of life, presenting as reduced sexual desire, arousal issues, pain, and orgasm difficulties. Its multifactorial causes include physical and psychological factors, with about 43% of women in the United States affected.</p><p><strong>Objective: </strong>To evaluate the efficacy of physiotherapy compared to other treatments (medical, psychological, pharmacological) in improving sexual function and quality of life in adult women with sexual dysfunction, excluding menopausal women. It synthesizes evidence on physiotherapeutic treatments, such as pelvic floor exercises, manual therapy, biofeedback, electrotherapy, and pelvic function education.</p><p><strong>Methods: </strong>Following PRISMA guidelines, a comprehensive search was conducted in PubMed, Scopus, and Web of Science. Inclusion criteria encompassed studies evaluating the effectiveness of physiotherapy in adult women with sexual dysfunction, excluding postmenopausal. Data extraction and quality assessment were performed using standardized tools.</p><p><strong>Results: </strong>Of the 708 identified studies, 8 met the inclusion criteria. The studies demonstrated significant improvements in Female Sexual Function Index (FSFI) domains following physiotherapeutic interventions, notably reducing pain and enhancing desire and arousal. However, heterogeneity among studies precluded meta-analysis, necessitating qualitative synthesis.</p><p><strong>Discussion: </strong>Physiotherapy, particularly pelvic floor muscle training and multimodal approaches, proved effective in enhancing sexual function and reducing pain. While physiotherapy offers a non-invasive alternative with fewer side effects compared to surgical options, variability in intervention protocols indicates the need for standardization. Psychological and emotional factors are key in sexual dysfunction, highlighting the value of integrated treatments. Capacitive resistive monopolar radiofrequency with manual therapy improved sexual function in women with dyspareunia, though benefits were short-lived, underscoring the need for maintenance strategies.</p><p><strong>Conclusions: </strong>Physiotherapy is an effective intervention for FSD, significantly improving quality of life. Incorporating physiotherapy into clinical rehabilitation programs is recommended. Further research with standardized protocols and long-term follow-ups is necessary to consolidate evidence and optimize treatment strategies.</p>","PeriodicalId":21813,"journal":{"name":"Sexual medicine reviews","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049313","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":"Blue balls: a brief history.","authors":"Diederik F Janssen","doi":"10.1093/sxmrev/qeaf015","DOIUrl":"https://doi.org/10.1093/sxmrev/qeaf015","url":null,"abstract":"<p><strong>Introduction: </strong>Blue balls is a mundane complaint that generates substantive popular lore but has little coverage in the sexual medicine literature.</p><p><strong>Objectives: </strong>To draft a first medical history of relevant nosology and etiology.</p><p><strong>Methods: </strong>The Latin, French, German, Dutch, Italian, and English literature was mined.</p><p><strong>Results: </strong>As expected from a period of not only widespread scaremongering concerning masturbation and \"semen loss\" but also \"overly rigid continence,\" scrotal pain reminiscent of blue balls was well covered between the 1820s and 1920s, under variably inclusive nosologic headings: \"hernia seminalis,\" \"orchioncus,\" \"simple spermatocele,\" \"epididymis distensa,\" \"irritable testis,\" \"testicular epilepsy,\" \"testicular neuralgia,\" \"spermatic colic,\" \"stone-ache,\" \"epididymitis sympathica,\" \"epididymitis erotica,\" \"epididymitis antiperistaltica,\" \"paradidymitis erotica acuta,\" and \"epididymo-deferential colic.\" Even an analogical \"ovaralgia erotica\" was hypothesized. Observations had the radical potential of supporting poena naturalis (natural punishment) arguments against \"too strict\" continence and even pro masturbation. This historical push toward concepts of normal and habitual sexuality was fortified by equally tendentious concepts of \"constitutional\" or \"temperamental\" predisposition in some men. Yet the clear potential of the diagnosis to moderate strong prevailing sentiments against masturbation remained poorly realized until well into the early 20th century.</p><p><strong>Conclusion: </strong>Discomfort of the blue balls variety widely animated clinical sexual discourse from the early 18th century onward. It specifically informed interlocking, gendered ideas about sexual entitlement expressed in normative frames for sexual habits, eroto-sexual constitution, and behavioral health.</p>","PeriodicalId":21813,"journal":{"name":"Sexual medicine reviews","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144064385","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":"Review of recent data on disorders of ejaculation and orgasm in men: recommendations from the Fifth International Consultation on Sexual Medicine.","authors":"Alan W Shindel, Ege Can Serefoglu, Stanley Althof, Mohamed Arafa, Gajanan Bhat, Eelke Snoeren, Yan Zhang, Amr El-Meliegy","doi":"10.1093/sxmrev/qeaf016","DOIUrl":"https://doi.org/10.1093/sxmrev/qeaf016","url":null,"abstract":"<p><strong>Introduction: </strong>Disorders of ejaculation and orgasm (DEO) in men are poorly understood and can pose a substantial burden to men and their sexual partners.</p><p><strong>Objectives: </strong>Under the aegis of the International Consultation on Sexual Medicine, a multinational, multidisciplinary panel of experts was convened to review the world literature and generate a consensus on management of DEO in men. This document represents a summary of the panel's report on physiology of ejaculation and orgasm, mental health conditions, and specific DEO that are not related to the timing of climax (ie, premature and delayed ejaculation).</p><p><strong>Methods: </strong>Narrative review of existing literature and consensus recommendations from the expert panel.</p><p><strong>Results: </strong>The processes of ejaculation and orgasm are complex and include neuronal and hormonal factors as well as psychological and interpersonal dynamics. Care of the patient presenting with a potential DEO centers on sensitive history taking and selective testing. Declines in semen volume may occur naturally with age and can be seen in the context of medical or surgical therapies. Pain with ejaculation/orgasm has a myriad of potential etiologies and may be part of a complex chronic pelvic pain syndrome; assessment for related diagnoses that may be contributory is warranted. Hematospermia can be distressing but is often benign; management when indicated is geared toward detecting potentially reversible etiologies. Climacturia is a troublesome condition of urine loss common after prostate surgeries; Behavioral and physical therapy and surgical intervention may be of value in these cases. Management strategies for anhedonic orgasm and post-orgasmic illness syndrome are not well established. Dhat is a complex syndrome oftentimes centered around pathological fear of semen loss that is best managed with a sensitive and culturally appropriate focus.</p><p><strong>Conclusions: </strong>An understanding of the processes of ejaculation and what is known about DEO can aid clinicians and researchers in providing optimal care.</p>","PeriodicalId":21813,"journal":{"name":"Sexual medicine reviews","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796303","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}