Journal of Sexual Medicine最新文献

{"title":"Impact of vaginectomy technique on the outcomes of transmasculine gender affirming surgery.","authors":"Patrick Ho, Emily Schmidt-Beuchat, Michaela Sljivich, Ethan Nyein, Miroslav Djordjevic, Ann Tran, Rajveer S Purohit","doi":"10.1093/jsxmed/qdaf148","DOIUrl":"https://doi.org/10.1093/jsxmed/qdaf148","url":null,"abstract":"<p><strong>Background: </strong>The optimal approach for vaginectomy in transmasculinizing surgery is not well-defined, with options for sharp excision of vaginal epithelium or electrocautery fulguration of the vaginal mucosa.</p><p><strong>Aim: </strong>This study compares the outcomes of excisional and fulguration vaginectomy approaches.</p><p><strong>Methods: </strong>A retrospective review of patients who underwent transmasculine surgery from 2021 to 2023 at a single institution was performed. All patients had vaginectomy with metoidioplasty.</p><p><strong>Outcomes: </strong>Post-operative complications, estimated blood loss (EBL), and operating room (OR) time were compared between excision and fulguration techniques.</p><p><strong>Results: </strong>Of 70 patients, 50 (71%) had epithelial excision and 20 (29%) had fulguration. Both groups had identical rates of post-operative vagino-cutaneous fistulae (10%). Vaginal remnant recurrence occurred in four patients (8%) in the excision group and one patient (5%) in the fulguration group (P = 0.67). Repeat vaginectomy was required in 2% of the excision group and 5% of the fulguration group (P = 0.50). In patients without hysterectomy, mean EBL was 254 mL in the excision group vs. 88 mL in the fulguration group (P < 0.01). Mean OR time was 290 minutes for excision compared to 183 minutes for fulguration (P < 0.01).</p><p><strong>Clinical implications: </strong>This study identifies a safe and effective approach to vaginectomy technique that is not standardized in transmasculine surgery.</p><p><strong>Strengths and limitations: </strong>A strength of our study is that it directly compares outcomes of the excisional approach and fulguration approach to vaginectomy. Limitations include its retrospective nature and that surgical technique was determined by surgeon preference.</p><p><strong>Conclusion: </strong>Our data suggest that a complete fulguration approach, when compared to an epithelial excision approach, reduces blood loss and OR time without compromising rates of vagino-cutaneous fistulae or vaginal remnants requiring re-operation.</p>","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144509324","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 effects of diaphragmatic breathing exercises on individuals with premature ejaculation: a randomized controlled trial.","authors":"Umit Erkut, Dilber Karagozoglu Coskunsu, Kubra Erkut, Ali Veysel Ozden","doi":"10.1093/jsxmed/qdaf107","DOIUrl":"https://doi.org/10.1093/jsxmed/qdaf107","url":null,"abstract":"<p><strong>Background: </strong>There are no standardized, evidence-based rehabilitation protocols for premature ejaculation (PE) which hinders effective management, the development of validated patient-reported outcomes, regulatory oversight, and the potential benefits of targeted interventions.</p><p><strong>Aim: </strong>To investigate the effect of diaphragmatic breathing exercises (DBE) on PE.</p><p><strong>Methods: </strong>Sixty-two participants with PE were randomly assigned to Group I (n = 31) or Group II (n = 31). Both groups received behavioral therapy (BT) and pelvic floor muscle training (PFMT) twice daily, three days a week, for eight weeks. Additionally, Group I recieved DBE twice daily, every day, for eight weeks. Intravaginal ejaculation latency time (IELT) was calculated with a stopwatch, at the end of the 8th week (post-treatment), and at 1-year follow-up. Pelvic floor muscle (PFM) strength and endurance were evaluated with ultrasound, and changes in the in the autonomic nerves system (ANS) parameters (including the root mean square of successive differences [RMSSD], proportion of NN50 [PNN50], low-frequency [LF] power, and high-frequency [HF] power) were evaluated with an Elite HRV device at pre-treatment and post-treatment by a blinded assessor.</p><p><strong>Outcomes: </strong>Primary outcome measurements were IELT, PFM strength and endurance, and changes in ANS paramaters.</p><p><strong>Results: </strong>The study was completed by 29 participants (mean age = 31.4 ± 6.5 years) in Group I and 30 (mean age = 31.3 ± 7.6 years) in Group II. At post-treatment, all outcome measures showed significant improvements in both groups (P <.001 for all). Compared to Gropu II, Group I showed significantly greater improvements in IELT(P=0.12), RMSDD (P<.001), PNN50 (P=.003), LF Power (P<.001), HF Power (P=.003), strength(P<.001), and endurance (P<.001). The median IELT increase from baseline to post-treatment was 283 seconds (range: 84-870; 900%) in Group I and 204 seconds (range: 44- 581; 690%) in Group II. While IELT declined significantly from post-treatment to 1-year follow-up in Group II, no statistically significant change was found in Group I.</p><p><strong>Clinical implications: </strong>The effect of DBE on the ANS may help regulate the ejaculatory reflex.</p><p><strong>Strengths and limitations: </strong>This is the first study to apply breathing exercises with BT and PFMT in men with PE. Limitations include the lack of exercise adherence records beyond 8 weeks and the estimation-based IELT measurement at baseline.</p><p><strong>Conclusion: </strong>Adding DBE, to BT and PFMT, yields better results in IELT (at 8 weeks and 1 year) and inreases PFM strength and endurance of PFM (at 8 weeks) in men with PE.</p>","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530984","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":"Increased body mass index is associated with recurrence and complications following repair for adult acquired buried penis.","authors":"Connor Chestnut, George Koch, Aaron Stewart, Jonathan Wingate, Catalina Hwang, Christopher Loftus, John Paul Giliberto, Hunter Wessells, Jeffrey Friedrich, Judith C Hagedorn, Alexander J Skokan","doi":"10.1093/jsxmed/qdaf149","DOIUrl":"https://doi.org/10.1093/jsxmed/qdaf149","url":null,"abstract":"<p><strong>Background: </strong>Adult Acquired Buried (AABP) is an increasingly common condition which negatively affects sexual and urinary health and often requires surgical repair.</p><p><strong>Aim: </strong>To examine risk factors for recurrence and complications following surgical repair AABP.</p><p><strong>Methods: </strong>We conducted a retrospective review of 76 consecutive patients who underwent repair at a single referral center from 2013 to 2022 with documented follow-up of at least 60 days. Patient charts were reviewed for patient-specific factors including body mass index (BMI), diabetes, and smoking status. Outcomes examined included recurrence, defined as re-burying of penis for which repeat repair was offered, and surgical complications.</p><p><strong>Outcomes: </strong>Determination of risk factors which increase the odds of recurrence and complication following repair of AABP.</p><p><strong>Results: </strong>There were 17 (22%) cases of recurrent concealment at an average 436 days follow-up. Twenty-three patients (30%) experienced a complication, with wound cellulitis being the most common (n = 11). A BMI cutoff of 40 kg/m2 was associated with a 12.7-fold increase in the odds of recurrence on logistic regression (P = 0.03), and a BMI cutoff of 38 kg/m2 was associated with a 6.7-fold increase in the odds of developing any complication (P = 0.02) after adjusting for comorbidities. Multivariable analysis showed an increase in 1 BMI point to increase the odds or recurrence by 12% and complication by 11%.</p><p><strong>Clinical implications: </strong>Patients can be counseled regarding their individual risk for recurrence or complication following AABP repair as well as over the potential benefits of pre-operative weight loss.</p><p><strong>Strengths & limitations: </strong>Limitations include retrospective nature of review and potential loss-to-follow-up for patients with AABP recurrence.</p><p><strong>Conclusion: </strong>Increased BMI is associated with increased risk of recurrence and complication following surgical repair of AABP.</p>","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530982","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":"Correction to: Known limitations and shared prioritization of sexual wellbeing: Response to Letter to the Editor.","authors":"","doi":"10.1093/jsxmed/qdaf158","DOIUrl":"10.1093/jsxmed/qdaf158","url":null,"abstract":"","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486835","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":"Evaluation of sexual dysfunction among women with primary Sjögren's syndrome using a Female Sexual Function Index: a systematic review and meta-analysis.","authors":"Settimio D'Andrea, Antonio Vinci, Luca Navarini, Andrea Sansone, Annalisa Marino, Dorian Bardhi, Alessandra Bruno, Francesco Rosiello, Camilla Lombardo, Edoardo Agostini, Fabio Ingravalle, Susanna Gentili, Massimo Maurici, Antonella Berardicurti, Emmanuele A Jannini, Roberto Giacomelli, Onorina Berardicurti","doi":"10.1093/jsxmed/qdaf110","DOIUrl":"https://doi.org/10.1093/jsxmed/qdaf110","url":null,"abstract":"<p><strong>Background: </strong>Only a few studies have assessed sexual dysfunction in women with primary Sjögren's syndrome (pSS).</p><p><strong>Aim: </strong>We aimed to confirm the higher prevalence of sexual dysfunction in these women and identify the most impaired domain of sexual function and the risk factors associated with it.</p><p><strong>Methods: </strong>We conducted a systematic review and meta-analysis to investigate the risk of sexual dysfunction in women with pSS according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. The study protocol has been registered in the \"PROSPERO international prospective register of systematic reviews\" with the registration number CRD42022298525.</p><p><strong>Outcomes: </strong>We aimed to compare sexual dysfunction among women with pSS compared to healthy subjects and which domain of the Female Sexual Function Index (FSFI) was most impaired.</p><p><strong>Results: </strong>In the analysis involving 16 studies, pSS is associated with 5-fold higher odds of reporting sexual dysfunction compared to the control group. Additionally, differences in FSFI scores between pSS and healthy controls were found to be statistically significant. All FSFI item sub-scores were affected by pSS more than the control group.</p><p><strong>Clinical implications: </strong>Sexual dysfunction is common in pSS and needs to be evaluated in all women with pSS.</p><p><strong>Strengths and limitations: </strong>This is the first meta-analysis that emphasized that sexual dysfunction in women with pSS should be evaluated regardless vaginal dryness. Nevertheless, caution is required when interpreting results due to the poor quality of the selected studies.</p><p><strong>Conclusion: </strong>The sexual dysfunction was a common issue in pSS with various causes and should be addressed by healthcare providers.</p>","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144509323","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":"Multicenter examination of contemporary penile prosthesis surgery infection prophylaxis practices.","authors":"Elia Abou Chawareb, David W Barham, Muhammad A M Hammad, Supanut Lumbiganon, Jake A Miller, Sean R North, James M Hotaling, Jay Simhan, Martin S Gross, Faysal A Yafi","doi":"10.1093/jsxmed/qdaf145","DOIUrl":"https://doi.org/10.1093/jsxmed/qdaf145","url":null,"abstract":"","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144509326","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":"Diversity matters in Peyronie's disease clinical trials-a systematic review.","authors":"Marcelo Mass Lindenbaum, Bernardita M Ljubetic, Navid Leelani, Prajit Khooblall, Raevti Bole, Scott D Lundy, Petar Bajic","doi":"10.1093/jsxmed/qdaf134","DOIUrl":"https://doi.org/10.1093/jsxmed/qdaf134","url":null,"abstract":"<p><strong>Introduction: </strong>Recent studies have demonstrated a distressing lack of diversity in urology clinical trials. Diversity is important to ensure that trial outcomes accurately represent the gamut of patients with a condition. We aimed to assess the current literature landscape of ethnic and racial diversity on clinical trials for Peyronie's disease (PD).</p><p><strong>Objective: </strong>Investigate the representation of different racial and ethnic groups in PD clinical trials.</p><p><strong>Methods: </strong>In September 2024, a systematic review of Peyronie's disease clinical trials in the published English literature was performed using the Ovid, Embase, and Medline/PubMed databases. Articles were included if they were in English, relevant to Peyronie's disease, and specified clinical trial in the title or abstract. Articles were excluded if they included patients with congenital penile curvature, pooled analyses, abstracts with incomplete information, and/or ongoing incomplete clinical trials.</p><p><strong>Results: </strong>The initial search yielded 494 studies. After screening, and full-text review, 75 articles met the inclusion criteria. Of the 75 articles included in this systematic review, only 10 (13.3%) reported participant race and ethnicity with a pooled population totaling 1948 men. All 10 studies reported enrollment of Caucasian men, with Caucasian men making up 95.6% of the enrolled population. Enrollment of Black men was reported in 6 of the 10 studies and constituted 4% of included patients. Enrollment of Asian men was reported in 2 (2.6%) studies and comprised 0.1% of included patients. Enrollment of American Indian/Native American men was reported in only 1 (1.4%) study and comprised 0.05% of patients. Hispanic ethnicity was the only ethnicity reported and was available in 5 (8.1%) studies with 3.8% of men reported as Hispanic.Five of the 10 studies that reported race enrolled patients exclusively from the United States.The 5 US-based studies showed a significant disparity in representation compared to the 2020 US Census (P < .001). Caucasian men were overrepresented, while all other racial and ethnic groups were underrepresented.</p><p><strong>Conclusions: </strong>There is an over-representation of Caucasian men and an underrepresentation of other races, along with a lack of representation of racial and ethnic minorities with PD. This may lead to clinical trial outcomes being non-generalizable. Further studies with diverse populations are needed.</p>","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512769","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":"Sexual satisfaction and dysfunction in transgender adults following puberty suppression treatment during adolescence.","authors":"Isabelle S van der Meulen, Marijn Arnoldussen, Anna I R van der Miesen, Sabine E Hannema, Thomas D Steensma, Annelou L C de Vries, Baudewijntje P C Kreukels","doi":"10.1093/jsxmed/qdaf095","DOIUrl":"https://doi.org/10.1093/jsxmed/qdaf095","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Sexual satisfaction and dysfunction in transgender and gender-diverse (TGD) individuals following treatment with puberty suppression (PS) have not yet been studied and remain a topic of clinical and academic concerns.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;This study explores the long-term effects of (early) PS treatment on sexual satisfaction and dysfunction in TGD individuals.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This retrospective cohort study included 50 transmasculine and 20 transfeminine individuals treated with PS and gender-affirming hormones (GAH). Fifty-seven percent underwent genital gender-affirming surgery. All gender-related medical treatment (GRMT) was performed at the Center of Expertise on Gender Dysphoria in Amsterdam, the Netherlands, between 1998 and 2011. PS treatment was, on average, initiated 14 years prior to study participation. Sexual experiences were assessed using a self-developed questionnaire at least 9 years after GAH and compared between early and late PS treatment groups. Findings were compared with data of a transgender cohort that started GRMT at an adult age.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes: &lt;/strong&gt;The primary outcomes included sexual satisfaction and various sexual dysfunctions, defined as the presence of a sexual problem accompanied by distress.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Sexual satisfaction was reported by 52% of transmasculine and 40% of transfeminine individuals, with similar outcomes between early and late PS groups. Among transmasculine individuals, 58% reported at least one sexual dysfunction, most commonly difficulty with initiating sexual contact (34%), with similar frequencies in PS groups. In transfeminine individuals, 50% experienced at least one sexual dysfunction, with difficulty achieving orgasm (35%) being most common, with similar reports across PS groups. The prevalence of sexual dysfunctions was comparable to that of transgender individuals who began GRMT in adulthood.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Clinical implications: &lt;/strong&gt;These findings enable healthcare professionals to provide accurate and personalized information regarding the anticipated effects of early endocrine GRMT.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Strengths and limitations: &lt;/strong&gt;This is the first study to assess sexual satisfaction and dysfunction in TGD individuals treated with early and late PS. The small sample size precluded inferential statistical analyses.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;In this study, the majority of transgender individuals treated with PS did not experience difficulties with desire, arousal, or achieving orgasm in adulthood. Outcomes were similar for early and late PS treatment and comparable to previous findings in those who started GRMT in adulthood. Sexual satisfaction is comparable to the general population. These results may alleviate concerns about long-term effects on sexual satisfaction and dysfunction in TGD individuals who do not undergo (full) endogenous puberty. However, attention for sexual counseling","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512770","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":"Comparative study of vancomycin/gentamicin versus 0.05% chlorhexidine gluconate solution dip and irrigation in hydrophilic coated penile implants.","authors":"Edward Karpman, Ryan Griggs, Carolyn Twomey, Gerard D Henry","doi":"10.1093/jsxmed/qdaf142","DOIUrl":"https://doi.org/10.1093/jsxmed/qdaf142","url":null,"abstract":"","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303500","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":"Patient perspectives on phalloplasty: a social media sentiment analysis.","authors":"Joyce J Zhu, Payton Kotlarz, Carson Bair, Jenna Stoehr, Brielle Weinstein","doi":"10.1093/jsxmed/qdaf141","DOIUrl":"https://doi.org/10.1093/jsxmed/qdaf141","url":null,"abstract":"","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303504","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}