Sexual medicine reviews最新文献

{"title":"Clitoral reconstructive surgery in patients with vulvar (pre)malignancies: what can we learn from female genital mutilation/cutting? A scoping review.","authors":"Guus Veldmate, Renée M F Ebisch, Karlijn Cornel, Tim Nijhuis, Joanne A de Hullu, Mieke L G Ten Eikelder","doi":"10.1093/sxmrev/qeag026","DOIUrl":"10.1093/sxmrev/qeag026","url":null,"abstract":"<p><strong>Introduction: </strong>Tumors located near the clitoris in vulvar (pre)malignancies represent a distinct clinical category. Achieving tumor-free surgical margins often requires removal of a significant portion of the clitoris, potentially causing profound psychological and sexual impact. Clitoral reconstruction, used in patients with female genital mutilation/cutting (FGM/C), has shown positive outcomes in restoring sexual function and reducing pain.</p><p><strong>Objectives: </strong>This scoping review presents an overview of the literature on clitoral reconstruction after treatment for vulvar (pre) malignancies, incorporating insights from FGM/C-related women.</p><p><strong>Methods: </strong>A systematic search of PubMed, EMBASE, Web of Science, and the Cochrane Library was conducted up to July 13, 2025. Studies were included if they reported on clitoral reconstructive surgery in patients with vulvar (pre)malignancies or FGM/C.</p><p><strong>Results: </strong>Seventeen studies met the inclusion criteria: two addressed clitoral reconstruction in vulvar (pre)malignancies and fifteen in FGM/C, encompassing 3304 women. The Foldès technique was used in 11 of the 15 FGM/C studies. Sexual outcomes were evaluated in 16 studies and psychological well-being in 12. Most reported improved sexual function, body image and reduced genital pain. Complications were reported in 11 studies and included infection, hematoma and delayed healing, with low overall morbidity.</p><p><strong>Conclusion: </strong>Evidence on clitoral reconstruction for patients with vulvar (pre)malignant lesions is limited. Data from FGM/C indicate the procedure is feasible and safe and may improve sexual function, body image and quality of life. Adapting FGM/C reconstructive techniques has the potential to improve outcomes for oncological patients, but further research is needed to assess its potential integration into standard care.</p>","PeriodicalId":21813,"journal":{"name":"Sexual medicine reviews","volume":"14 2","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147949629","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 association between ejaculatory dysfunction and lumbosacral disorders: a systematic review of an underrecognized clinical link.","authors":"Dawei Gao, Wenxiu Zhang, Chuyu Li, Yihan Jin, Xudong Hu, Shanshan Tong, Shuyi Huang, Sijia Sun, Zhou Zhao, Dalin Sun, Baofang Jin","doi":"10.1093/sxmrev/qeag039","DOIUrl":"https://doi.org/10.1093/sxmrev/qeag039","url":null,"abstract":"<p><strong>Introduction: </strong>Lumbosacral disorders commonly cause neurological symptoms such as low back pain and radiculopathy, their contribution to ejaculatory dysfunction (EjD) remains underrecognized.</p><p><strong>Objectives: </strong>To summarize neuroanatomical and neurophysiological mechanisms linking the lumbosacral spine to ejaculation, synthesize clinical evidence of EjD in lumbosacral disorders, identify diagnostic challenges, and discuss implications for clinical evaluation and multidisciplinary management.</p><p><strong>Methods: </strong>A comprehensive literature search was performed in PubMed, Web of Science, Embase, and Scopus from inception to December 31, 2025, using keywords covering lumbosacral pathologies and ejaculation. Eligible studies reported original clinical data on males with confirmed lumbosacral disorders and documented ejaculatory outcomes. Observational studies and case reports were included; reviews, guidelines, conference abstracts, and non-human studies were excluded.</p><p><strong>Result: </strong>Twenty-four studies met the inclusion criteria. EjD was associated with lumbar disc herniation, cauda equina syndrome, lumbar spinal stenosis, Tarlov cysts, spina bifida, ankylosing spondylitis, and pudendal nerve entrapment. EjD phenotypes included premature ejaculation, delayed ejaculation, anejaculation, retrograde ejaculation, weak ejaculation, and anorgasmia. Lumbosacral lesions may impair ejaculation by disrupting afferent, sympathetic (T10-L2), or somatic pudendal pathways (S2-S4). Ejaculatory function often improved after treating the underlying spinal disorder. However, evidence was limited by small sample sizes, heterogeneous outcomes, and low-level study designs.</p><p><strong>Conclusion: </strong>Lumbosacral disorders represent a potentially underrecognized cause of EjD. While a clear causal link between specific pathologies and EjD phenotypes remains unproven, neuroanatomical plausibility and clinical observations support a meaningful association in selected patients. Increased clinical awareness and multidisciplinary evaluation can improve diagnosis and management, especially in patients with concurrent lumbosacral or neurological symptoms. Future prospective studies with standardized tools are needed to clarify mechanisms and identify subgroups likely to benefit from targeted interventions.This study was registered in PROSPERO: CRD420261372301.</p>","PeriodicalId":21813,"journal":{"name":"Sexual medicine reviews","volume":"14 2","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148333071","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":"Sexual health framing sexual medicine: toward a more humanistic framework.","authors":"Faysal El Kak, Annamaria Giraldi","doi":"10.1093/sxmrev/qeag016","DOIUrl":"10.1093/sxmrev/qeag016","url":null,"abstract":"<p><p>Sexual medicine has advanced substantially through pharmacological, hormonal, and surgical innovation, enhancing the management of sexual dysfunction. Yet its clinical paradigm remains predominantly biomedical, often privileging physiological restoration over holistic well-being. This editorial argues that sexual medicine should be explicitly grounded in a sexual health framework informed by justice, rights, and pleasure. Drawing on the World Health Organization's multidimensional definition of sexual health and contemporary transdisciplinary scholarship, we propose a shift from a pathology-centered \"repair model\" to a patient-centered model of flourishing. Justice necessitates equitable, culturally responsive care across gender, orientation, identity, and socioeconomic contexts. Rights affirm sexuality as integral to autonomy and human dignity. Pleasure, long marginalized in clinical discourse, should be recognized as a legitimate and measurable health outcome. Integrating these principles into education, clinical metrics, and practice standards is essential for achieving comprehensive, ethically grounded sexual care aligned with contemporary public health and human rights frameworks.</p>","PeriodicalId":21813,"journal":{"name":"Sexual medicine reviews","volume":"14 2","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147610080","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":"Toward a biopsychosocial tipping point framework: insights from sexual medicine.","authors":"Michael A Perelman","doi":"10.1093/sxmrev/qeag034","DOIUrl":"https://doi.org/10.1093/sxmrev/qeag034","url":null,"abstract":"","PeriodicalId":21813,"journal":{"name":"Sexual medicine reviews","volume":"14 2","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148199919","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":"Industry advisory board: a case of success.","authors":"Sidney Glina, Ira D Sharlip, Ronald W Lewis","doi":"10.1093/sxmrev/qeag033","DOIUrl":"https://doi.org/10.1093/sxmrev/qeag033","url":null,"abstract":"","PeriodicalId":21813,"journal":{"name":"Sexual medicine reviews","volume":"14 2","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148219896","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":"Efficacy and safety of acupuncture for erectile dysfunction: a systematic review and meta-analysis of randomized controlled trials.","authors":"Mingxi Yan, Tao Zhu, Kaiyang Xue, Zhihui Zhang, Chunxia Lu, Caihong Xiao, Pingyu Ge, Jin Cui","doi":"10.1093/sxmrev/qeag042","DOIUrl":"10.1093/sxmrev/qeag042","url":null,"abstract":"<p><strong>Introduction: </strong>Acupuncture, a key component of traditional Chinese medicine, has emerged as a potential non-pharmacological option for erectile dysfunction (ED) management, yet high-level evidence regarding its efficacy and safety remains limited.</p><p><strong>Objective: </strong>This systematic review and meta-analysis aimed to evaluate the clinical effectiveness and safety of acupuncture for the treatment of ED.</p><p><strong>Methods: </strong>A comprehensive search of 8 Chinese and English databases was conducted from inception to May 20, 2025, eligible randomized controlled trials (RCTs). Risk of bias was assessed using the Cochrane Risk of Bias tool (RoB 2.0). Meta-analyses were performed using RevMan 5.4, while sensitivity and publication bias analyses were conducted with STATA 17.0. Trial Sequential Analysis (TSA) was applied to evaluate cumulative evidence reliability, and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to assess evidence certainty.</p><p><strong>Results: </strong>A total of 21 RCTs were included. Meta-analysis showed that acupuncture significantly improved International Erectile Function Index-5 (IIEF-5) scores (MD = 3.28, 95% CI, 2.47-4.09), Erectile Hardness Score (EHS) (MD = 0.75, 95% CI, 0.59-0.91), serum testosterone levels (MD = 0.79, 95% CI, 0.14-1.44), and reduced TCM symptom scores (MD = -4.82, 95% CI -6.49 to -3.15), anxiety state assessment (SMD = -0.86, 95% CI, -1.50 to -0.22), and depression state assessment (SMD = -0.85, 95% CI, -1.52 to -0.17). The clinical efficacy rate (CEr) was also significantly higher in the acupuncture group (RR = 1.24, 95% CI, 1.17-1.32). According to GRADE, evidence quality ranged from very low to moderate. TSA confirmed the robustness of findings for IIEF-5 and CEr. No significant differences in adverse events were found.</p><p><strong>Conclusions: </strong>The certainty of evidence for acupuncture in ED is very low to moderate. Although improvements were observed, the weak evidence precludes definitive conclusions and underscores the need for high-quality trials.</p>","PeriodicalId":21813,"journal":{"name":"Sexual medicine reviews","volume":"14 2","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148340449","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":"Historical perspectives in contemporary body image counseling: a clinical framework for contextualizing masculine body dysmorphic concerns.","authors":"Or Friedman, Yuval Paniri, Miri Mizrahi Reuveni, Eitan Lavon, Arnon Afek, David Maiershon","doi":"10.1093/sxmrev/qeag018","DOIUrl":"10.1093/sxmrev/qeag018","url":null,"abstract":"<p><strong>Introduction: </strong>Male body dysmorphic disorder (BDD) focused on genital concerns remains significantly under-recognized despite affecting 2.5% of adults and up to 15% in appearance-focused medical settings. Contemporary therapeutic approaches often fail to address the cultural construction of masculine body ideals, potentially leading to frequent misdiagnosis and inappropriate treatment.</p><p><strong>Objectives: </strong>To develop an evidence-informed clinical framework integrating historical morphometric data from Western sculpture with contemporary body image counseling approaches for men with genital size anxiety.</p><p><strong>Methods: </strong>We synthesized historical morphometric evidence from 24 museum-quality sculptures (600 BCE-1822 CE), contemporary prevalence data on male BDD and genital size anxiety, current treatment guidelines, and theoretical frameworks from medical anthropology and cultural psychology. Digital morphometric measurements were conducted using ImageJ software following established clinical protocols.</p><p><strong>Results: </strong>Historical sculptures demonstrate mean phallus-to-height ratios of 0.0285 ± 0.0061, significantly smaller than contemporary measurements (0.0403-0.0567). This 29%-50% proportional difference provides quantitative evidence consistent with the cultural relativity of masculine ideals. We present preliminary considerations for integrating historical psychoeducation within established cognitive-behavioral therapy frameworks.</p><p><strong>Conclusions: </strong>Historical contextualization offers a pragmatic perspective requiring empirical validation through controlled trials before clinical implementation. The morphometric findings document substantial variation in masculine representation across historical periods, which may be relevant for understanding contemporary body image concerns.</p>","PeriodicalId":21813,"journal":{"name":"Sexual medicine reviews","volume":"14 2","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147610107","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: Erectile dysfunction in patients with Peyronie's disease treated with different grafts: a systematic review.","authors":"","doi":"10.1093/sxmrev/qeag035","DOIUrl":"https://doi.org/10.1093/sxmrev/qeag035","url":null,"abstract":"","PeriodicalId":21813,"journal":{"name":"Sexual medicine reviews","volume":"14 2","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148035337","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":"Genitopelvic pain in racially/ethnically, sexually, and gender/sex minoritized samples in Canada and the United States: a scoping review.","authors":"Caroline F Pukall, Olivia R Adams, Melody Garas, Trinda Penniston, Gillian Akenson, Sophie Bergeron","doi":"10.1093/sxmrev/qeag038","DOIUrl":"10.1093/sxmrev/qeag038","url":null,"abstract":"<p><strong>Introduction: </strong>Very little research exists on genitopelvic pain in racially/ethnically, sexually, and gender/sex minoritized samples despite its high prevalence among these groups. Existing frameworks of genitopelvic pain are based largely on White, heterosexual, cisgender women samples; applying these frameworks to minoritized samples may be prone to inaccuracies, as they do not account for minority stress and strength, social safety, and broader social determinants of health that structure exposure to pain, access to care, and health outcomes among marginalized populations.</p><p><strong>Objective: </strong>The main purpose of this scoping review was to synthesize findings of genitopelvic pain research published on racially/ethnically, sexually, and gender/sex minoritized samples in Canada and the United States.</p><p><strong>Methods: </strong>After removal of duplicates, the abstracts of 1330 articles were independently screened for eligibility for full-text review, of which 974 were excluded. Of the remaining 356, 59 studies were included for data extraction and synthesis. Results were organized according to the underrepresented sample of interest (racially/ethnically, sexually, or gender/sex minoritized) and subcategorized according to study aims focusing on prevalence, pain characteristics and experiences, minority stressors and strengths (eg, stigma, coping, resilience), social safety (eg, relational and healthcare contexts), and social determinants of health.</p><p><strong>Results: </strong>Results indicated that genitopelvic pain is prevalent, there are similarities and differences in pain characteristics and experiences, and variables related to minority stress and strength, social safety, and social determinants of health-when examined-were associated with pain prevalence, severity, coping, and care trajectories in racially/ethnically, sexually, and gender/sex minoritized samples.</p><p><strong>Conclusion: </strong>Genitopelvic pain is common in racially/ethnically, sexually, and gender/sex minoritized individuals and is meaningfully shaped by minority stress processes, minority strength adaptations, social safety, and social determinants of health, underscoring the need for theory-informed and equity-oriented pain frameworks.</p>","PeriodicalId":21813,"journal":{"name":"Sexual medicine reviews","volume":"14 2","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13293372/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148319159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of erectile dysfunction in men with lower urinary tract symptoms/benign prostatic hyperplasia: a systematic review and meta-analysis.","authors":"Sedrick Bukyana, Paul Clement Fillie, Jackson Kakooza, Catherine R Lewis, Enock Mukiibi, Prosper Akankwasa, Mumbere V Bienfait, John Turyagumanawe, Eunice Inomu, Ahmed Kiswezi Kazigo, Eltahir Ahmed Eltahir, Irene Kimala Guweddeko, Theoneste Hakizimana, Abraha Demoz, Emeka Godson Anyanwu, Joshua Muhumuza, Micheal Mugenyi","doi":"10.1093/sxmrev/qeag029","DOIUrl":"10.1093/sxmrev/qeag029","url":null,"abstract":"<p><strong>Introduction: </strong>Erectile dysfunction (ED) and benign prostatic hyperplasia (BPH) commonly coexist in aging men through shared vascular and neuroregulatory pathways, yet prevalence estimates vary widely across income settings.</p><p><strong>Objectives: </strong>The objective of this study was to estimate the pooled prevalence of ED in men presenting with lower urinary tract symptoms (LUTS)/BPH across clinical settings in high-income countries (HICs) and low- and middle-income countries (LMICs), and to narratively describe associated clinical and demographic factors reported within the included studies.</p><p><strong>Methods: </strong>Following PRISMA guidelines, we searched 4 sources (Scopus, PubMed, Web of Science, and Lens.org) for English-language observational studies published between 2010 and 2025 reporting ED prevalence in men with LUTS/BPH. Two reviewers independently screened titles/abstracts and full texts, extracted data, and assessed risk of bias. A random-effects meta-analysis with logit-transformed prevalence estimates was conducted, with subgroup and sensitivity analyses used to explore heterogeneity.</p><p><strong>Results: </strong>Eleven studies (n = 1254 men with LUTS/BPH) from 9 LMICs and 2 HICs yielded a pooled ED prevalence of 79.53% (95% confidence interval [CI], 71.63%-85.74%; I2 = 51.51%, P = .014), ranging from 60.0% (Morocco) to 98.7% (Bosnia and Herzegovina). LMICs showed higher rates (78.7%) than HICs (70.9%), though CIs overlapped. Tests of funnel-plot asymmetry suggested possible small-study effects, but these findings were interpreted cautiously given the limited number of studies. Narrative evidence suggested that age >60 years, LUTS, and cardiometabolic comorbidity were commonly reported correlates of ED. Conclusion: ED is highly prevalent among men with LUTS/BPH presenting in hospital- or clinic-based settings. These findings support routine consideration of sexual health assessment in men presenting with LUTS/BPH, while underscoring the need for prospective studies using standardized diagnostic criteria and broader sampling frames.</p><p><strong>Registration: </strong>PROSPERO CRD420251145482 https://www.crd.york.ac.uk/PROSPERO/view/CRD420251145482.</p>","PeriodicalId":21813,"journal":{"name":"Sexual medicine reviews","volume":"14 2","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147875590","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}