Journal of Sexual Medicine最新文献

{"title":"Chlorhexidine gluconate application, diabetes, revision surgery, and extended operative time increase risk for penile implant infection.","authors":"Sevann Helo, Milad Bonakdar Hashemi, Matthew J Ziegelmann, Daniel T Lybbert, Javier Piraino, Andres H Guillen Lozoya, Tobias S Köhler","doi":"10.1093/jsxmed/qdaf009","DOIUrl":"https://doi.org/10.1093/jsxmed/qdaf009","url":null,"abstract":"<p><strong>Background: </strong>Chlorhexidine gluconate (CHG) (0.05%) has recently been suggested as a dip and irrigation solution at time of inflatable penile prosthesis (IPP) surgery.</p><p><strong>Aim: </strong>This study evaluated infection rates before and after implementing CHG protocol while investigating concurrent risk factors contributing to post operative infections.</p><p><strong>Methods: </strong>A retrospective, consecutive cohort study was performed that included patients who underwent insertion of a Coloplast Titan IPP including both virgin and revision cases between 2021 and 2024. Cases performed from January 2021 to August 2022 utilized rifampin/gentamicin for dip and vancomycin/gentamicin for irrigation (ABX), whereas those from October 2022 to May 2024 utilized CHG for both dip and irrigation. Perioperative risk factors including dip and irrigation solution used at time of surgery were compared between groups.</p><p><strong>Outcomes: </strong>We defined the incidence of postoperative infection and risk factors associated with infection in each group.</p><p><strong>Results: </strong>The incidence of infection was significantly higher in the 0.05% CHG group (13/377) compared to the ABX group (0/320) (P < .001). When analyzed separately by subgroup, virgin cases treated with CHG for dip and irrigation demonstrated a significantly higher infection rate (7/315) compared to those in the ABX group (0/280) (P = .012). Similarly, in revision cases, the CHG group also exhibited a significantly higher infection rate (0/40) than the ABX group (6/62) (P = .043).Univariable analysis of the CHG cohort identified three significant risk factors for infection: diabetes mellitus (DM), extended operative time (OP), and revision surgery (P = .003, .001, and < .001, respectively). Multivariable regression analysis revealed that patients with DM had a 5.7-fold increased risk of infection (OR: 5.70, P = .004), while those undergoing revision surgery faced a 5.3-fold higher risk (OR: 5.26, P = .004). Additionally, each minute increase in OP was associated with a 1% higher infection risk (OR: 1.01 per minute, P = .007). These associations remained significant after adjusting for all variables in the model.</p><p><strong>Clinical implications: </strong>Prosthetic surgeons should be cautious about adopting 0.05% CHG for both dip and irrigation in the absence of strong clinical evidence demonstrating its non-inferiority to antibiotic solutions.</p><p><strong>Strengths and limitations: </strong>This is the first clinical study reporting infection rates after IPP surgery using 0.05% CHG for both dip and irrigation. While retrospective and non-randomized, we present a relatively large sample size of patients.</p><p><strong>Conclusions: </strong>Our findings identify four risk factors for penile prosthesis infection: usage of the 0.05% CHG solution for dip and irrigation solution of Coloplast hydrophilic-coated devices, DM, revision surgery, and extended OP.<","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366444","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 dysfunction in female patients with multiple sclerosis: relationship with functional status, fatigue, depression, sleep quality, and quality of life.","authors":"Kübra Yeni, Zeliha Tulek, Murat Terzi","doi":"10.1093/jsxmed/qdaf015","DOIUrl":"https://doi.org/10.1093/jsxmed/qdaf015","url":null,"abstract":"<p><strong>Background: </strong>Although sexual dysfunction is one of the most common symptoms in patients with multiple sclerosis (MS), there are relatively few studies on this topic.</p><p><strong>Aim: </strong>The aim of this study was to assess sexual function in female MS patients and investigate its association with functional state, fatigue, depression, sleep, and quality of life.</p><p><strong>Methods: </strong>This descriptive cross-sectional study was conducted between May and November 2019 with MS patients attending an MS outpatient clinic at a university hospital. Patients' sexual function was assessed using the Female Sexual Function Index (FSFI). Expanded Disability Status Scale (EDSS), Fatigue Severity Scale (FSS), Beck Depression Inventory (BDI), Pittsburgh Sleep Quality Index (PSQI), and Multiple Sclerosis Quality of Life Scale (MSQoL-54) were used to determine their relationship to sexual function.</p><p><strong>Outcomes: </strong>Sexual function, functional status, depression, sleep quality, and quality of life.</p><p><strong>Results: </strong>The mean age of the 83 patients included in the study was 41.8 (±8.5) years, and all were married. The mean FSFI score of the patients was 21.1 (±8.9) and 26.55, 72.3% of patients were found to have sexual dysfunction. FSFI scores were found to have a negative correlation with age (r = -0.398, P = .001), duration of diagnosis (r = -0.338, P = .001), and EDSS scores (r = -0.326, P = 0.040). Patients taking symptomatic medication (P = .032) and antidepressants (P = .012) had lower mean FSFI scores. Additionally, the FSFI score showed a significant negative correlation with the FSS (r = -0.368, P = .001), the BDI (r = -0.423, P < .001), the PSQI (r = -0.314, P = .004), and the MSQoL-54 (physical health: r = 0.509, P < .001 and mental health: r = 0.431, P < .001).</p><p><strong>Clinical implications: </strong>A comprehensive evaluation of sexual dysfunction and the development of tailored treatment plans, taking into account associated factors, will be beneficial for female patients with MS.</p><p><strong>Strengths and limitations: </strong>Small sample size and assessment of sexual function by a generic scale are the limitations of this study.</p><p><strong>Conclusion: </strong>Considering the multifactorial nature of sexual dysfunction in female MS patients, it is recommended that patients be assessed multidimensionally during outpatient follow-up visits.</p>","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366472","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":"Cross-sectional and prospective associations between self-compassion and sexual distress in couples coping with sexual interest/arousal disorder.","authors":"Maude Massé-Pfister, Natalie O Rosen, Noémie Bigras, Alice Girouard, Delphine Perrier-Léonard, Sophie Bergeron","doi":"10.1093/jsxmed/qdaf007","DOIUrl":"https://doi.org/10.1093/jsxmed/qdaf007","url":null,"abstract":"<p><strong>Background: </strong>When an individual in a relationship is coping with low desire/arousal, both partners experience difficulties, including higher levels of sexual distress. Effective emotional regulation strategies, such as self-compassion, could have individual and interpersonal benefits for couples with sexual interest/arousal disorder (SIAD).</p><p><strong>Aim: </strong>Using a dyadic design, we examined the role of self-compassion in the sexual distress of couples coping with SIAD, accounting for overall relationship satisfaction. The associations were analyzed cross-sectionally and prospectively. We also explored the moderating roles of having at least one member identify as sexually or gender diverse within the couple in the potential associations between self-compassion and sexual distress.</p><p><strong>Methods: </strong>Individuals with SIAD and their partners (N = 263 couples) completed online measures at baseline and 6 months later.</p><p><strong>Outcomes: </strong>Individuals with SIAD and their partners completed the Sexual Distress Scale-Short Form and the Couples Satisfaction Index.</p><p><strong>Results: </strong>Controlling for relationship satisfaction, when individuals coping with SIAD and their partners reported greater self-compassion at baseline, they also reported lower sexual distress. For partners only, greater self-compassion was associated with the person with SIAD's lower levels of sexual distress at baseline. No statistically significant prospective associations were found between levels of self-compassion and sexual distress 6 months later. Belonging to a sexually diverse couple was a significant moderator of the cross-sectional associations between partners' level of self-compassion and their own level of sexual distress at baseline, such that the link between greater self-compassion and lower sexual distress was observed only in partners belonging to a sexually diverse couple. Belonging to a gender diverse couple did not moderate any of the associations.</p><p><strong>Clinical implications: </strong>Findings indicate that self-compassion could be a promising tool to reduce sexual distress in couples coping with SIAD.</p><p><strong>Strengths & limitations: </strong>Strengths of this study include the large, diverse sample of couples coping with SIAD, the use of a cross-sectional and prospective design, and the examination of the moderating role of belonging to a gender or sexually diverse couple. However, the possible lack of statistical power to measure moderation based on belonging to a gender diverse couple and the recall bias due to the use of self-report questionnaires should be considered when interpreting the results.</p><p><strong>Conclusion: </strong>Greater self-compassion is associated with lower sexual distress in both partners of couples coping with SIAD. Self-compassion may be particularly beneficial for partners of individuals with SIAD belonging to a sexually diverse couple.</p>","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366446","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":"Penile rehabilitation after radical prostatectomy using low-intensity shockwave therapy for erectile function: late results findings from a randomized clinical trial.","authors":"Pedro Fernandes Lessa, Willy Baccaglini, Matheus Pascotto de Salles, Reuli Cordeiro da Silva, Cristiano Linck Pazeto, Leonardo Seligra Lopes, Sidney Glina","doi":"10.1093/jsxmed/qdaf012","DOIUrl":"https://doi.org/10.1093/jsxmed/qdaf012","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;There is still few evidence to support the use of low-intensity extracorporeal shockwave therapy (LiESWT) in rehabilitation of erectile function after radical prostatectomy (RP).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;The aim of this study is to assess the long-term results of LiWEST as a penile rehabilitation method in patients who underwent RP.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This is an assessment of the late results outcomes of our previous clinical trial registered in ReBEC (ensaiosclinicos.gov.br) RBR-85HGCG. Patients were randomized in two groups with two parallel arms and an allocation ratio of 1:1. The control group received tadalafil 5 mg/day, while the experimental group received tadalafil 5 mg/day and were submitted to 2400 shocks/session-week distributed on four different penile regions across 8 weeks of treatment. Both groups started the penile rehabilitation after the removal of the transurethral catheter. Sexual function was assessed by International Index of Erectile Function (IIEF-5) score.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes: &lt;/strong&gt;A difference in IIEF-5 without statistical significance between the experimental and control groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Among 77 patients included in our previous analysis, 35 patients were reassessed after a median follow-up of 45 months (95% CI, 42-50 months). Seventeen of them had to be excluded from the analysis for biochemical recurrence and/or new interventions. Remaining 7 and 11 patients in the experimental and control group, respectively. The final mean IIEF-5 score between experimental and control groups showed a difference in favor of the LiWEST group, not statistically significant (18.85, SD 5.66, 95% CI, 13.61-24.1 x 16.63, SD 5.48, 95%CI, 12.9- 20.31; respectively; P = 0.42). Subgroup analysis in patients still using IPDE5 there is a higher difference between mean IIEF5, however not statistically significantly (18.5, SD 6.12, 95%CI 12.07-24.92 x 15.85, SD 3.62, 95% CI, 12.50-19.20, P = 0.35).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Clinical implications: &lt;/strong&gt;This study highlights that LiESWT may offer limited long-term benefit for erectile function recovery after RP.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Strengths & limitations: &lt;/strong&gt;This study provides valuable long-term data on the use of LiESWT as a penile rehabilitation method after RP. The randomized design and parallel group structure strengthen the reliability Journal of Sexual Medicine Journal of Sexual Medicine For Peer Review of findings, with clear intervention protocols. However, limitations include a small final sample size due to patient exclusions, which likely impacted statistical power and the generalizability of results. Additionally, while differences in IIEF-5 scores favored the LiESWT group, the lack of statistical significance limits the ability to draw definitive conclusions about its effectiveness.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The LiESWT showed no impact on long-term results of penile rehabilitation in patients submitted to ","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191161","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":"Icariin improves erectile function in spontaneously hypertensive rats by downregulating GRK2 in penile cavernous tissue.","authors":"Yanke Li, Jun Jiang, Rui Jiang","doi":"10.1093/jsxmed/qdaf014","DOIUrl":"https://doi.org/10.1093/jsxmed/qdaf014","url":null,"abstract":"<p><strong>Background: </strong>Hypertension is an independent risk factor for erectile dysfunction (ED). Icariin can improve erectile function of spontaneous hypertensive rats (SHRs). GRK2 is closely related to the phosphorylation of eNOS and endothelial function.</p><p><strong>Aim: </strong>To explore whether icariin can improve erectile function in SHRs by regulating the expression of GRK2 in penile cavernous tissue.</p><p><strong>Methods: </strong>Eight-week-old WKY and SHR rats were randomly divided into four groups (n = 6 per group) as follows: WKY, WKY + icariin, SHR and SHR + icariin. The WKY + icariin and SHR + icariin groups were treated with 10 mg/kg/day icariin. After 4 weeks, the ICPmax/mean arterial pressure (MAP), serum testosterone, the levels of GRK2, p-AKT/AKT, p-eNOS/eNOS, and caspase-3; the protein interaction between GRK2 and AKT; the levels of nitric oxide (NO), superoxide dismutase (SOD), and malondialdehyde (MDA); and the level of apoptosis in rat penile cavernous tissue were measured.</p><p><strong>Outcome: </strong>The expression of GRK2 in penile cavernous tissue of SHR was significantly higher than that in WKY rats, resulting in the inhibition of the AKT/eNOS/NO pathway, increased levels of oxidative stress and apoptosis, and the impairment of erectile function.</p><p><strong>Results: </strong>The ICPmax/MAP ratio in the SHR group was significantly lower than those in WKY and SHR + icariin groups (P < .01). In the SHR + icariin group, the expression levels of GRK2 and caspase-3, the interaction between GRK2 and AKT, the level of MDA and the rate of apoptosis in the penile cavernous tissue were significantly lower, and the levels of p-AKT and p-eNOS, the p-AKT/AKT and p-eNOS/eNOS ratios, and NO and SOD were significantly greater than those in the SHR group (P < .01).</p><p><strong>Clinical implications: </strong>Icariin may improve the erectile function of hypertension by downregulating GRK2 expression in penile cavernous tissue.</p><p><strong>Strengths and limitations: </strong>The specific mechanism via which icariin downregulates GRK2 needs to be further elucidated.</p><p><strong>Conclusion: </strong>Icariin downregulates the expression of GRK2 in the penile cavernous tissue of SHRs, upregulates the AKT/eNOS/NO pathway, decreases oxidative stress and apoptosis, and ultimately improves erectile function.</p>","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191157","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":"Testosterone replacement therapy in men on active surveillance for prostate cancer.","authors":"James Applewhite, Jacob McCarter, Gal Saffati, Shane Kronstedt, David Hinojosa-Gonzalez, Troy La, Rioke M Diejomaoh, Larry I Lipshultz, Mohit Khera","doi":"10.1093/jsxmed/qdaf003","DOIUrl":"https://doi.org/10.1093/jsxmed/qdaf003","url":null,"abstract":"<p><strong>Background: </strong>While the use of testosterone replacement therapy (TRT) in men undergoing active surveillance (AS) for prostate cancer (PCa) has been historically contraindicated, recent studies have contributed to a paradigm shift to this approach.</p><p><strong>Aim: </strong>To examine the impact of testosterone on prostate-specific antigen (PSA) levels and prostate biopsy progression in men with low testosterone on AS for PCa.</p><p><strong>Methods: </strong>A retrospective single-center analysis was conducted on men undergoing AS for PCa who subsequently underwent TRT. Men previously treated for PCa were excluded. PSA and testosterone levels were recorded at regular intervals one year before and after the initiation of testosterone. ANOVA was used to analyze variance in PSA and testosterone levels, and paired t-tests and linear regression analysis were performed. Baseline and surveillance biopsies were documented.</p><p><strong>Outcomes: </strong>The primary outcomes were changes in PSA levels and biopsy progression following initiation of testosterone therapy.</p><p><strong>Results: </strong>Forty-three men met the inclusion criteria. Median (IQR) testosterone level before testosterone therapy was 272 (221.5-333.5) ng/dL and 578.5 (354.5-846.5) ng/dL after therapy (P < 0.01). No significant variation in mean PSA levels was observed (P = 0.87). Baseline biopsies were available for 27 patients, showing Gleason 3 + 3 = 6 in no more than three cores. Fifteen (55.6%) patients had one or more surveillance biopsies after starting testosterone therapy. Of these, 12 (80.0%) had no disease progression in biopsies over a mean of 44.3 months on testosterone. Three patients (20.0%) had a Gleason score 7 on biopsy after a mean of 79.5 months on testosterone therapy. No patients developed metastatic disease.</p><p><strong>Clinical implications: </strong>Testosterone therapy did not result in statistically significant changes in PSA levels in men with low testosterone on AS. Pathology changes were inconclusive, but the available data showed no apparent increase in PCa progression or disease worsening in the cohort.</p><p><strong>Strengths and limitations: </strong>The study's strengths include a longitudinal follow-up design and use of multiple statistical analyses. Limitations include the retrospective design, small sample size which may limit generalizability, and lack of control group.</p><p><strong>Conclusion: </strong>No significant change in PSA level was observed after initiating testosterone therapy, despite an increase in testosterone levels. Despite limited biopsy data, our findings suggest similar rates of disease progression compared to the general AS population.</p>","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081909","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":"New insights into the goals of transgender male versus non-binary individuals considering metoidioplasty and phalloplasty gender-affirming surgery.","authors":"Lee K Brown, Rebecca L Butcher, Linda M Kinney, John F Nigriny, Rachel A Moses","doi":"10.1093/jsxmed/qdae193","DOIUrl":"https://doi.org/10.1093/jsxmed/qdae193","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Understanding patient goals for metoidioplasty and phalloplasty gender-affirming surgery (MaPGAS) is paramount to achieving satisfactory, preference-sensitive outcomes, yet there is a lack of understanding of MaPGAS priorities and how these may vary between transgender men and non-binary individuals assigned female at birth (AFAB).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;To understand the surgical goals of transgender men and non-binary individuals AFAB considering MaPGAS.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;An online survey was created following literature review and qualitative interviews and distributed via social media and a community health center to participants AFAB aged ≥18 years who had considered but not yet undergone MaPGAS. We collected demographics, surgical history, Likert ratings of importance of 14 possible MaPGAS goals, and selection of the 5 most important goals. Differences in goal importance ratings were compared using the Mann-Whitney U test. Responses to an open-ended question on additional MaPGAS goal considerations were thematically analyzed by 2 reviewers.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes: &lt;/strong&gt;A total of 248 eligible participants completed the survey; participants included transgender men (64%) and non-binary individuals (36%).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Both groups rated maintaining tactile and erogenous sensations as top priorities. Significant differences emerged in half of the goals, with transgender men more likely to place importance on being seen as male, public restroom comfort, peeing through the tip of the penis, standing urination through the fly, and resolution of gender dysphoria. Non-binary individuals were more likely to place importance on retaining a vaginal canal to receive penetration and for gender identity affirmation. These differences in goal prioritization between the 2 groups were most apparent when individuals provided their top 5 goals. In open-ended responses, aesthetics was a major consideration for transgender men, sexual pleasure was a consideration for non-binary individuals, and complications were cited as major concerns by both groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Clinical implications: &lt;/strong&gt;Individual MaPGAS goals should be incorporated into preoperative counseling and may vary by gender identity.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Strengths and limitations: &lt;/strong&gt;This is the largest study to our knowledge evaluating patient MaPGAS goals and comparing gender identity cohorts. Our results incorporate qualitative open-ended feedback and underscore the importance of understanding patient-specific MaPGAS goals to better facilitate personalized preoperative counseling. Results will be used to guide decision support tool development. Limitations include the cross-sectional study design and reduced socioeconomic diversity.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;While maintaining tactile and erogenous sensation and minimizing surgical complications were universally important goals, significant variations emerge","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143054202","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":"Preservation of sexual function with Optilume-a novel treatment for lower urinary tract symptoms secondary to benign prostatic hyperplasia.","authors":"Olivia Copelan, Jared Moss, Sheldon Freedman, Karl Coutinho, Dean Elterman, Jeffrey Marotte, Osvaldo Padron, Neal Shore, Jeffrey Spier, Jed Kaminetsky, Brian Mazzarella, Alexis Te, Steven A Kaplan, Kevin T McVary","doi":"10.1093/jsxmed/qdae206","DOIUrl":"https://doi.org/10.1093/jsxmed/qdae206","url":null,"abstract":"<p><strong>Background: </strong>The Optilume benign prostatic hyperplasia (BPH) catheter system is a novel minimally invasive paclitaxel-coated dilation system that has demonstrated substantial and durable results in urinary flow and symptoms.</p><p><strong>Aim: </strong>We now assess the impact of Optilume BPH procedure on sexual function.</p><p><strong>Methods: </strong>Prior published results have described the methods of data collection during the PINNACLE study, which demonstrated durable improvement in urinary symptoms. Follow-up assessments for the current study included IIEF-EF and Male Sexual Health Questionnaire for Ejaculatory Dysfunction (MSHQ-EjD). Semen quality was also examined.</p><p><strong>Outcomes: </strong>IIEF-EF and MSHQ-EjD scores in the Optilume BPH group were not different from the sham group at 3 months, 6 months, or 12 months.</p><p><strong>Results: </strong>A total of 148 men were randomized to receive the procedure (100) or a sham surgical procedure (48). Subjects in both groups had similar rates of erectile dysfunction (ED) previously diagnosed at baseline (56% vs 54.2%, P = .83) and those men who were sexually active. IIEF-EF and MSHQ-EjD scores in the Optilume BPH group were not different from the sham group at 3, 6, or 12 months. Change in IIEF-EF scores remained consistent across all levels of baseline ED severity after Optilume BPH procedure. No clear trend was seen after treatment with Optilume BPH for semen volume, sperm motility, progressive motility, or sperm morphology.</p><p><strong>Clinical implications: </strong>The Optilume BPH catheter system provides patients with a durable improvement in lower urinary tract symptoms while preserving sexual function.</p><p><strong>Strengths and limitations: </strong>This study uses validated questionnaires to assess patients' sexual function at baseline and regularly for 1 year after the procedure. Given exclusion criteria regarding patient age and prostate size, the results may not be applicable to all BPH phenotypes.</p><p><strong>Conclusion: </strong>Optilume appears to provide clinical benefit with a high degree of patient satisfaction and minimal impact on sexual function.</p>","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015825","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":"Profiles of testosterone and pre-androgens and sexual function in premenopausal women.","authors":"Marlene A Werner, Caspar J Van Lissa, Stephanie Both, Marina A Skiba, Robin J Bell, Susan R Davis","doi":"10.1093/jsxmed/qdae195","DOIUrl":"https://doi.org/10.1093/jsxmed/qdae195","url":null,"abstract":"<p><strong>Background: </strong>There is inconsistent evidence as to the role of testosterone and pre-androgens in premenopausal female sexual function, and reported associations between blood concentrations of these hormones and female sexual function vary in strength.</p><p><strong>Aim: </strong>To examine the patterns of testosterone and pre-androgen concentrations and variations in sexual function in premenopausal eumenorrheic women.</p><p><strong>Methods: </strong>This was a secondary analysis of a sample of 588 premenopausal eumenorrheic women from the Grollo-Ruzzene Foundation Young Women's Health Study. Socio-demographics, health information, and questionnaire data were collected using online surveys. Eligible women were invited to provide a blood sample. We ran latent profile analysis (LPA) and subsequent analyses in R using RStudio.</p><p><strong>Outcomes: </strong>Indicator variables in the LPA included sexual arousal and desire domains of the Profile of Female Sexual Function and testosterone, dehydroepiandrosterone (DHEA), and androstenedione, measured by liquid chromatography-tandem mass spectrometry.</p><p><strong>Results: </strong>Analyses resulted in a pattern of 3 latent classes. Classes reporting relatively lower and higher sexual arousal (LPA-derived means and 95% CIs: -0.79 [-1.24; -0.34] and 0.62 [0.51; 0.72]) did not differ significantly in sex steroid concentrations (testosterone: -0.21 [-0.38; -0.03] and -0.33 [-0.47; -0.20]; DHEA: -0.47 [-0.57; -0.37] and -0.26 [-0.39; -0.13]; androstenedione: -0.36 [-0.50; -0.22] and -0.39 [-0.49; -0.29]), while the class reporting relatively medium arousal (-0.11 [-0.31; 0.08]) showed the highest testosterone, DHEA, and androstenedione concentrations (testosterone: 0.8 [0.60; 1.01]; DHEA: 0.99 [0.76; 1.23]; androstenedione: 1.08 [0.88; 1.29]). There were no significant differences in sexual desire between classes (-0.08 [-0.23; 0.06]; 0.00 [-0.13; 0.14]; 0.10 [-0.09; 0.30]) differing significantly in sex steroid concentrations (-0.69 [-0.80; -0.58], -0.04 [-0.15; 0.07], 0.94 [0.71; 1.16] for testosterone) nor associations between the sex steroid concentrations and degrees of sexual desire.</p><p><strong>Clinical implications: </strong>These findings cast further doubt on the utility of measuring sex steroids for diagnosing female sexual dysfunction in premenopausal eumenorrheic women, even when considered in combination.</p><p><strong>Strengths and limitations: </strong>We analyzed a large community sample and controlled for potentially biasing factors. We analyzed sex steroid concentrations determined with gold-standard methodology. Excluding women with early menopause and menstrual dysfunction might have resulted in finding 3, rather than more, latent classes.</p><p><strong>Conclusion: </strong>Testosterone and pre-androgen profiles do not clearly identify premenopausal eumenorrheic women with low sexual arousal and desire.</p>","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015801","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":"Penile regenerative and aesthetic procedure trends among Sexual Medicine Society of North America members.","authors":"Catherine S Nam, Shinnosuke Kuroda, Jared M Bieniek, Joshua A Halpern, Joel Hillelsohn, Tung-Chin Hsieh, Kevin J Campbell, Kirtshri Mishra, Carolyn A Salter, Alyssa Yee, Scott D Lundy, Petar Bajic, Helen L Bernie","doi":"10.1093/jsxmed/qdae202","DOIUrl":"https://doi.org/10.1093/jsxmed/qdae202","url":null,"abstract":"","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985746","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}