Journal of Sexual Medicine最新文献

{"title":"Multimodal electrostimulation in erectile dysfunction: preliminary experience with the NeuroEstimulación Ecoguiada Percutánea Transcavernosa del Pudendo technique.","authors":"Álvaro Navas Mosqueda, Giuseppe Maiolino, Gracia Gallego Sendarrubias, Borja García-Gómez, Juan Ignacio Martínez-Salamanca, Enrique Lledó Garcia, Eldiberto Manuel Fernández Fernández, Javier Romero Otero, Eduardo Cimadevilla Fernández-Pola, Roi Fernández Dios, Juan Hernández Lougedo, Esaú Fernández-Pascual","doi":"10.1093/jsxmed/qdaf400","DOIUrl":"https://doi.org/10.1093/jsxmed/qdaf400","url":null,"abstract":"","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":"23 3","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146777050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clitoral reconstructive surgery in vulvar cancer patients: a qualitative study about motives, experiences, and outcomes.","authors":"Guus Veldmate, Carolien Blaauw, Tim Nijhuis, Renée M F Ebisch, Rosella P M G Hermens, Joanne A de Hullu, Mieke L G Ten Eikelder","doi":"10.1093/jsxmed/qdag036","DOIUrl":"https://doi.org/10.1093/jsxmed/qdag036","url":null,"abstract":"<p><strong>Background: </strong>Vulvar cancer involving the clitoral region often requires radical excision, including (partial) resection of the clitoris, which can impair quality of life and sexual function, and although reconstructive flap surgery has long been used in patients with vulvar carcinoma to restore anatomy and overall function, clitoral-specific reconstructive procedures remain poorly described.</p><p><strong>Aim: </strong>To evaluate patient motives, experiences, and outcomes following clitoral reconstruction in women with vulvar cancer.</p><p><strong>Methods: </strong>Semi-structured interviews were conducted with vulvar cancer patients who underwent clitoral reconstructive (CR) surgery between 2019 and 2023 in a Dutch university medical center until data saturation was reached.</p><p><strong>Outcomes: </strong>Motives, experiences, and outcomes as psychosexual functioning were analyzed using open coding.</p><p><strong>Results: </strong>A total of 12 women participated in the study. Five principal themes were identified: preoperative motivation, the decision-making process, surgical outcomes, postoperative experiences, and the psychosocial impact. The primary motive for undergoing clitoral reconstruction was functional recovery. The majority, 10 out of 12 women, experienced functional recovery. The procedure contributed to an improved sense of femininity, which emphasizes the psychosocial impact of vulvar cancer surgery. Overall, the experiences with pre- and postoperative guidance were considered adequate, with the availability of written information and attention to open communication postoperatively on sexual functioning cited as areas for improvement.</p><p><strong>Clinical implications: </strong>These findings underscore the importance of addressing potential improvements for sexual health concerns in women diagnosed with vulvar cancer.</p><p><strong>Strength and limitations: </strong>A key strength of this study is its qualitative design, which enabled a nuanced exploration of patient motives, experiences, and functional outcomes following CR surgery. A limitation is that we did not include women who did not undergo clitoral reconstruction, preventing comparison of functional and psychosocial outcomes between groups.</p><p><strong>Conclusion: </strong>Clitoral reconstructive surgery for women with vulvar cancer appears meaningful and has the potential to improve sexual function and overall well-being. These findings underscore the need for prospective studies to refine techniques and long-term outcomes.</p>","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":"23 3","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146259998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A clinically oriented algorithm for cylinder and extender selection in the penoscrotal approach: the Canguven penile prosthesis calculator.","authors":"Onder Canguven","doi":"10.1093/jsxmed/qdag038","DOIUrl":"https://doi.org/10.1093/jsxmed/qdag038","url":null,"abstract":"","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":"23 3","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147277739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychological therapies for female sexual function: a systematic review and network meta-analysis.","authors":"Liu Qiangzhao, Lian Qiong, Guo Bohong, Li Qingyi, Hao Youcheng, Li Yintao, Gong Tao","doi":"10.1093/jsxmed/qdag040","DOIUrl":"https://doi.org/10.1093/jsxmed/qdag040","url":null,"abstract":"<p><strong>Introduction: </strong>Various clinical trials have evaluated psychological interventions for female sexual function; however, their comparative effectiveness remains insufficiently defined. To date, no network meta-analysis (NMA) has systematically synthesized and ranked these interventions to guide evidence-based clinical decision-making in the management of female sexual function.</p><p><strong>Objectives: </strong>To compare the efficacy of various psychological interventions for female sexual function using network meta-analysis and to establish a hierarchy of therapeutic strategies to inform clinical practice.</p><p><strong>Methods: </strong>A systematic review and NMA were conducted to assess all psychological interventions evaluated for female sexual function. Comprehensive literature searches were conducted in the Web of Science, PubMed, and Embase, and statistical analyses were performed using Stata version 18.0.</p><p><strong>Results: </strong>A total of 45 studies encompassing 4726 women met the inclusion criteria. The NMA demonstrated that sex education, cognitive behavioral therapy (CBT), mindfulness-based interventions (MBI), PLISSIT model-based sexual counseling, and general sexual counseling significantly improved Female Sexual Function Index scores compared with usual care or control groups (P < .05). According to surface under the cumulative ranking curve values, the PLISSIT model showed the greatest improvement in Female Sexual Function Index, followed by CBT, general sexual counseling, MBI, and sex education. Regarding Female Sexual Distress Scale outcomes, CBT, MBI, and sex education were associated with significant reductions in sexual distress relative to usual care or control (P < .05). MBI ranked highest for reducing Female Sexual Distress Scale, followed by sex education and CBT.</p><p><strong>Conclusion: </strong>The available evidence indicates that MBI is the most effective approach for alleviating sexual distress, whereas the PLISSIT model appears to offer the greatest benefit for improving sexual function. However, the limited number of trials for certain interventions and the heterogeneity of psychological approaches suggest that the current evidence base remains incomplete and warrants further investigation.</p>","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":"23 3","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146259974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronotype is associated with acquired premature ejaculation: evidence from moderated mediation analysis.","authors":"Zhi Cao, Tianle Zhu, Yunlong Ge, Peng Yang, Yukuai Ma, Pan Gao, Hui Jiang, Xiansheng Zhang","doi":"10.1093/jsxmed/qdag050","DOIUrl":"https://doi.org/10.1093/jsxmed/qdag050","url":null,"abstract":"<p><strong>Background: </strong>Acquired premature ejaculation (APE) is a prevalent male sexual dysfunction that significantly impairs quality of life. Although APE is associated with various risk factors, its underlying etiology remains poorly understood.</p><p><strong>Aim: </strong>This research investigates the potential connection between chronotype and APE. Particular emphasis is placed on the mediating associations involving health-promoting lifestyle (HPL) -self-initiated activities that maintain or improve health-and the moderating role of illness perception.</p><p><strong>Methods: </strong>A total of 516 men diagnosed with APE and 495 healthy controls were recruited from our hospital for this study. Participants completed paper-based questionnaires, including sociodemographic information, the Premature Ejaculation Diagnostic Tool, the Health-Promoting Lifestyle Profile II, and the Morningness-Eveningness Questionnaire. Furthermore, patients with APE completed the Brief Illness Perception Questionnaire. Among APE patients, moderated mediation analysis was conducted to explore the underlying mechanisms.</p><p><strong>Outcomes: </strong>The main finding was that an evening chronotype was associated with both the presence and greater severity of APE, and the association between chronotype and APE severity was partly mediated by HPL and further moderated by illness perception.</p><p><strong>Results: </strong>Chronotype was associated with the presence of APE (adjusted odds ratio = 0.99, 95% confidence interval [CI], 0.98-1.00, P < .001). Among men with APE, chronotype was associated with APE severity (β = -0.42, P < .01), with HPL mediating this association (β = -0.46, P < .01). Illness perception significantly moderated both the association between chronotype and HPL (β = -0.18, 95% CI, -0.24 to -0.11) and the link between HPL and APE (β = 0.11, 95% CI, 0.03-0.20).</p><p><strong>Clinical implications: </strong>These findings suggest that considering chronotype, HPL, and illness perception may inform clinical approaches to improving ejaculatory regulation in individuals with APE.</p><p><strong>Strengths and limitations: </strong>This study is the first to investigate the association between chronotype and APE, providing new insights that may inform future clinical considerations. However, the single-center design may limit the generalizability of the results.</p><p><strong>Conclusion: </strong>Chronotype was associated with both the presence and severity of APE, with the chronotype-severity link partly mediated by HPL and further moderated by illness perception. Integrating chronotype, lifestyle patterns, and illness perception into clinical assessment may improve understanding of ejaculatory control in men with APE.</p>","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":"23 3","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147312370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inflatable penile prostheses long-term revision and removal rates compared to semi-rigid penile prostheses: a real-world analysis from a global electronic health record (EHR) database.","authors":"Sarah Kohl, Clara Goebel, Angelina Kuzina, Benjamin Rubin, Jacob Bleau, Travis Mann-Gow, Mohammad Mohaghegh, Richard Grunert","doi":"10.1093/jsxmed/qdag034","DOIUrl":"https://doi.org/10.1093/jsxmed/qdag034","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Reoperation rates following penile prosthesis implantation are influenced by patient- and device-related factors. While previous studies from high-volume centers have reported 5 to 10-year reoperation rates of 11%-16%, these findings may not fully capture outcomes in broader, real-world populations.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;This study aimed to assess long-term complication and reoperation rates for penile prostheses using a global electronic health records database.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a retrospective observational analysis using electronic health records and insurance claims from the TriNetX Global Health Research Network, covering May 2005 to May 2025. Men aged 18-90 who underwent initial implantation of either an inflatable or semi-rigid penile prosthesis (SRPP) were included. Statistical comparisons between cohorts used two-sample Z-tests, with significance set at P &lt; .05.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes: &lt;/strong&gt;Outcomes included device revision or reimplantation, explantation, infection, mechanical failure, and displacement.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Among 29 385 men, 18 749 received inflatable prostheses and 10 636 received semi-rigid devices. At 5 years, the revision/removal rate was not significantly lower for inflatable devices (13.9%) compared to semi-rigid implants (13.7%; P &lt; .77). Total explantation rates were lower for inflatable prostheses at 5 years (6.5% vs. 8.4%, P &lt; .00001). Mechanical breakdown was more common in the inflatable cohort at 5 years (9.1% vs. 6.7%; P ≤ .0001). There was also a significantly higher rate of device displacement for inflatable prostheses at 5 years (2.3% vs. 1.6%; P = .002). There were no differences in infection rates between devices over time.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Clinical implications: &lt;/strong&gt;This analysis found that inflatable penile prostheses (IPPs) are associated with similar long-term revision and lower explantation rates compared to semi-rigid devices, but more prone to mechanical breakdown and displacement. These findings support the use of inflatable prostheses in appropriate patients seeking lower rates of device removal and underscore the importance of real-world data in surgical decision-making.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Strengths & limitations: &lt;/strong&gt;The strengths of this study include its large sample size, applicability, and the use of a global clinical dataset integrating claims and electronic health record data to reduce missing information. However, several limitations should be acknowledged. TriNetX does not account for variation in surgical technique, device manufacturer, or surgeon experience. In addition, reliance on administrative codes may underreport complications or omit clinical nuances. Retrospective and observational studies are also limited by inherent biases, incomplete data, and inability to establish causality, which constrain the interpretation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;In this large-scale, real-world analysis, ","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":"23 3","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146214767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The etiology of sexual pain in American Christian women: associations of sexual debut, maternal teachings on sex, and abuse history with pain severity.","authors":"Joanna Sawatsky, Lori Mize, Keith Gregoire, Arielle Leonard Hodges, Rebecca Lindenbach, Sheila Wray Gregoire","doi":"10.1093/jsxmed/qdag020","DOIUrl":"https://doi.org/10.1093/jsxmed/qdag020","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Sexual pain (SP) affects a significant proportion of women, with lifetime prevalence ranging from 7% to 46%, but is poorly understood. While conservative religious affiliation has been identified as a potential risk factor since the 1970s, the mechanisms underpinning this association remain insufficiently characterized.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;To investigate the etiological factors contributing to SP among Christian women in the United States who attended church frequently in adolescence, with a focus on the roles of sexual debut timing, maternal explanations of sex and abuse history. The study also explores variation in SP presentation by severity, distinguishing cases by the presence or absence of obstructed penetration (OP).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Data were drawn from the Sexual Satisfaction and Function Survey (SSFS), a cross-sectional survey of American Christian women. Multinomial and binary logistic regression analyses were used to examine associations between SP and key psychosocial variables, including sexual debut (pre-marital vs post-marital), satisfaction with maternal sexual explanations, and abuse history (sexual and non-sexual). Analyses controlled for demographic covariates and evangelical self-identification. We estimated lifetime odds of SP-with and without OP- using multinomial and binary logistic regression.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes: &lt;/strong&gt;Lifetime odds of developing SP by OP status were evaluated based on sexual debut, abuse history, and maternal sex communication while controlling for demographics and evangelical self-identification.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Post-marital sexual debut was significantly associated with higher odds of SP with OP. In contrast, a history of abuse (sexual, non-sexual, or both) was associated with increased odds of SP without OP in all models and SP with OP in the full model only except for non-sexual abuse. Maternal sexual explanations were not significantly associated with SP outcomes except in SP with OP which satisfaction with maternal sex explanations was a risk factor for SP OP in a univariate model but was protective in the full model.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Clinical implications: &lt;/strong&gt;Findings highlight the importance of integrating sociocultural and religious context into the assessment and management of SP. Clinicians should incorporate routine assessment of psychosocial contributors-such as sexual scripts in addition to abuse history-when developing care plans.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Strengths and limitations: &lt;/strong&gt;This is the largest known dataset examining SP in Christian women, offering unique insights into underexplored psychosocial contributors. Limitations include non-probabilistic sampling and a racially homogeneous cohort, limiting generalizability.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;SP among Christian women is differentially associated with psychosocial and religious factors depending on symptom severity. These findings extend prior res","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":"23 3","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146259912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Histomorphometry of the human dorsal nerve of the penis: analysis and clinical considerations.","authors":"Peter C Ferrin, Maria Uloko, Lindsey Burnett, Daniel A Hunter, Blair R Peters","doi":"10.1093/jsxmed/qdag039","DOIUrl":"10.1093/jsxmed/qdag039","url":null,"abstract":"<p><strong>Background: </strong>Little has been published on the histomorphometry of the human dorsal nerve of the penis (DNP), despite its growing importance in peripheral nerve surgeries aimed at restoring lost penile sensation or erectile function, and in gender-affirming surgeries which rely on the glans penis to reconstruct the neoclitoris with minimal histomorphometric data currently available to inform technique.</p><p><strong>Aim: </strong>To quantify the number of axons in the human DNP and discuss potential clinical implications.</p><p><strong>Methods: </strong>Bilateral DNP samples were obtained from 12 fresh frozen cadavers at the level of the inferior aspect of the pubic symphysis. Specimens were fixed and stained using validated techniques. Histomorphometric evaluation was performed at 1000× magnification using image analysis software to obtain myelinated nerve fiber count, fascicle number, and density.</p><p><strong>Outcomes: </strong>Primary outcomes included myelinated axon count, fascicle number, and nerve fiber density of the DNP.</p><p><strong>Results: </strong>Twenty-three DNP samples were analyzed. The mean axon count was 3634 (SD = 1575) with a range of 6299. Accounting for the bilaterality of the DNP, the mean total number of axons innervating the human glans penis was 7076 axons (SD = 2634 axons). The total myelinated axon count, fascicle number, and nerve density did not differ significantly by laterally, nor did these parameters differ significantly between individuals. Myelinated axon counts of the DNP were on average less than previously reported axon counts for the dorsal nerve of clitoris using identical methodology, despite the much larger size of the glans penis. The axon counts of the DNP varied more between individuals than demonstrated in our prior work on the dorsal nerve of clitoris.</p><p><strong>Clinical implications: </strong>These findings may suggest that variability in DNP axon composition may be one factor giving rise to outcome variability in nerve-based reconstructive and sensory restoration procedures and inform techniques in neoclitoris construction in gender-affirming genital surgery.</p><p><strong>Strengths and limitations: </strong>Unmyelinated axons are not counted using the technique employed. Samples were obtained from fresh frozen cadavers which may introduce heterogeneity into the tissue samples obtained.</p><p><strong>Conclusion: </strong>This study reports axon count, fascicle number, and nerve density of the human DNP and discusses the clinical relevance therein.</p>","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":"23 3","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146198182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A prospective multicenter study on plasma metabolomics and machine learning for diagnosing premature ejaculation and predicting dapoxetine treatment response.","authors":"Jiaochen Luan, Wenchuan Shao, Chunlu Xu, Yuehua Yang, Qijie Zhang, Yutian Dai, Jiadong Xia, Ninghong Song","doi":"10.1093/jsxmed/qdag026","DOIUrl":"https://doi.org/10.1093/jsxmed/qdag026","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Premature ejaculation is a prevalent sexual dysfunction, yet the variable patient response to first-line dapoxetine treatment poses a major clinical challenge, highlighting the unmet need for biomarkers to guide diagnosis and therapy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;This study aimed to investigate the distinct plasma metabolic profile of primary premature ejaculation (PPE) patients, and to develop machine learning-based diagnostic and therapeutic response prediction models.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A multicenter cohort comprising 69 patients with PPE and 51 healthy control (HC) subjects was enrolled. Plasma samples underwent untargeted metabolomic analysis. Differentially expressed metabolites were identified, and pathway enrichment analyses were conducted using Small Molecule Pathway Database and Kyoto Encyclopedia of Genes and Genomes. Three machine learning algorithms-Support Vector Machine, Random Forest, and Least Absolute Shrinkage and Selection Operator regression-were employed to screen biomarkers. Subsequently, targeted metabolomics analysis was used to quantify neurotransmitter levels.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes: &lt;/strong&gt;The primary outcomes included the Premature Ejaculation Diagnostic Tool, the intravaginal ejaculation latency time, and the Clinical Global Impression of Change scale score after a 4-week observation period of on-demand dapoxetine treatment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Multivariate analysis revealed clear separations in metabolic profiles between the PPE and HC groups, and between dapoxetine treatment (DT)-Response and DT-No response groups. Pathway analysis indicated significant enrichment in amino acid metabolism pathways for PPE-related differentially expressed metabolites (DEMs). Additionally, DT-Response-related DEMs were associated with D-Amino acid metabolism and Arginine biosynthesis. Machine learning identified a panel of 4 consensus metabolites for diagnosing PPE, achieving an area under the curve (AUC) of 0.995 in the train cohort and 0.917 in the test cohort. For predicting DT response, three metabolites were selected, forming a model with an AUC of 0.905 (train) and 0.811 (test). It is important to note that these promising initial results require further validation in larger, independent cohorts to confirm their generalizability. Furthermore, targeted metabolomics analysis confirmed significant dysregulation of multiple neurotransmitters in the PPE group.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Clinical implications: &lt;/strong&gt;The machine learning-based models we established show robust performance in diagnostic and dapoxetine treatment response prediction.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Strengths & limitations: &lt;/strong&gt;The establishment of the machine learning-based diagnostic and predictive models represents a key strength, though their clinical translation requires further validation in larger cohorts.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This study delineates distinct metabolic profiles in PPE, establishes robu","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":"23 3","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146259614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"America's secret nightlife: the hidden prevalence and patterns of sexual dreams.","authors":"Emmanuel Eroume A Egom, Elijah-Bill Christopher Nguem Nguem, Bernadette Sandrine Lema","doi":"10.1093/jsxmed/qdag032","DOIUrl":"https://doi.org/10.1093/jsxmed/qdag032","url":null,"abstract":"","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":"23 3","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146214803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}