Journal of Sexual Medicine最新文献

{"title":"Cognitive behavioural therapy for sexual concerns during menopause: evaluation of a four session protocol.","authors":"Sheryl M Green, Melissa Furtado, Alison K Shea, Elena C Ballantyne, David L Streiner, Benicio N Frey, Randi E McCabe","doi":"10.1093/jsxmed/qdaf085","DOIUrl":"https://doi.org/10.1093/jsxmed/qdaf085","url":null,"abstract":"<p><strong>Background: </strong>Sexual concerns are reported by 43%-82.5% of peri- and post-menopausal women and negatively impact physical and emotional well-being. Despite the high prevalence and negative impact, treatment options are limited, particularly those which are non-pharmacological.</p><p><strong>Aim: </strong>The primary objective of this pilot trial was to evaluate the effectiveness of a novel four-session individual Cognitive Behavioural Therapy protocol for improving sexual functioning (CBT-SC-Meno) during peri- and post-menopause. Secondary objectives included assessing body image, relationship satisfaction, and common menopause symptoms (eg, vasomotor), depression, anxiety, and self-reported health.</p><p><strong>Methods: </strong>Participants (n = 32) were peri- or post-menopausal women experiencing primary sexual concerns and reporting a score of 26.55 or lower on the Female Sexual Function Index (FSFI), indicating impaired sexual functioning. Eligible participants were assigned to a waitlist control condition for 4 weeks, after which they were reassessed and then completed the CBT protocol.</p><p><strong>Outcomes: </strong>Measures assessing sexual functioning, satisfaction, distress, and desire, as well as body image, relationship satisfaction, common menopause symptoms (eg, vasomotor), depression, anxiety, and self-reported health were completed at baseline, post-waitlist, and post-treatment. Treatment satisfaction was captured with the Client Satisfaction Questionnaire along with qualitative data.</p><p><strong>Results: </strong>During the waitlist period, no significant changes were observed across measures, apart from the FSDQ concern subscale and GCS physical subscale. Following CBT-SC-Meno, participants experienced a significant improvement in overall sexual functioning (eg, desire, arousal, reduced pain, satisfaction), a decrease in symptoms of sexual distress, concern, and resistance, menopausal symptoms, symptoms of depression and anxiety, as well as improved body image, couple satisfaction, and overall health (P < 0.001). All participants endorsed high treatment satisfaction and indicated that treatment helped them better cope with their symptoms more effectively.</p><p><strong>Clinical implications: </strong>To our knowledge, this is the first study examining the effectiveness of a CBT protocol specifically designed to target sexual concerns experienced during peri- and post-menopause. Results suggest that CBT-SC-Meno leads to significant improvements in sexual functioning across several important sexual concern domains and related areas (eg, body image), in addition to several other commonly comorbid menopausal symptoms (eg, vasomotor), depression, anxiety, and self-reported overall health.</p><p><strong>Strengths and limitations: </strong>Although CBT-SC-Meno appears to be a promising treatment for sexual concerns, the sample was small and homogeneous.</p><p><strong>Conclusions: </strong>This study provides prel","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095637","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":"Association of the Inflammatory Burden Index with erectile dysfunction in United States adult men: evidence from NHANES 2001-2004.","authors":"Shengyi Chen, Yuekun Fang, Chenxiao Huang, Bin Cheng","doi":"10.1093/jsxmed/qdaf118","DOIUrl":"https://doi.org/10.1093/jsxmed/qdaf118","url":null,"abstract":"","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095632","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":"Depression, selective serotonin reuptake inhibitors, and sexual wellbeing in assigned females: exploring the moderating role of sexual flexibility.","authors":"Finnoula I O'Neill-King, Robyn A Jackowich, Caroline F Pukall","doi":"10.1093/jsxmed/qdaf097","DOIUrl":"https://doi.org/10.1093/jsxmed/qdaf097","url":null,"abstract":"<p><strong>Background: </strong>Depression often causes sexual dysfunction, including reduced desire and pleasure, and selective serotonin reuptake inhibitors (SSRIs), commonly used to treat depression, can worsen these issues, leading to treatment discontinuation.</p><p><strong>Aim: </strong>To examine sexual wellbeing differences across depression and SSRI groups, how depression, SSRI use, and sexual flexibility predict sexual outcomes, and whether sexual flexibility moderates the relationship between sexual functioning, distress, and pleasure.</p><p><strong>Methods: </strong>Participants (N = 357, mean age 26.8 years) assigned female sex at birth were recruited for an online cross-sectional study. Participants were grouped by SSRI use and depression severity: SSRIs-low depression (n = 86), SSRIs-high depression (n = 117), no SSRIs-low depression (n = 81), and no SSRIs-high depression (n = 73).</p><p><strong>Outcomes: </strong>Validated measures of depression, sexual function, sexual distress, sexual flexibility, and sexual pleasure were used.</p><p><strong>Results: </strong>Analyses of variance (ANOVAs) and multiple regressions examined relationships between depression, SSRI use, and sexual wellbeing. Moderation analyses tested whether sexual flexibility moderated the link between sexual functioning, distress, and pleasure. The SSRIs-high depression group reported the poorest sexual wellbeing, while the No SSRIs-low depression group reported the highest. Depression and SSRI use predicted increased sexual distress and decreased functioning, pleasure, and flexibility, explaining 21%-26% of variance. Sexual flexibility moderated the relationship between functioning and pleasure, with stronger effects at lower flexibility levels.</p><p><strong>Clinical implications: </strong>Sexual flexibility may improve sexual functioning and pleasure, providing a positive, adaptable framework for therapy; thus, psychosexual and educational interventions focusing on flexibility could enhance sexual pleasure and reduce distress, fostering sexual resilience and improving relationship dynamics.</p><p><strong>Strengths and limitations: </strong>Strengths include a nuanced analysis of depression severity and SSRI use, offering a comprehensive view of sexual wellbeing. Limitations include reliance on self-reported medication use, inability to assess specific SSRIs, and potential confounding from concurrent antidepressant use.</p><p><strong>Conclusion: </strong>SSRIs and depression each uniquely affect sexual functioning, distress, and pleasure, such that those with moderate to severe depression and SSRI use report significantly poorer sexual outcomes.</p>","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081875","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":"Histopathological findings in the genital organs of assigned female at birth transgender people undergoing genital gender-affirming surgery.","authors":"Chiara Ferraguti, Alessandra Lami, Laura Cocchi, Veronica Amati, Renato Seracchioli, Maria Cristina Meriggiola","doi":"10.1093/jsxmed/qdaf087","DOIUrl":"https://doi.org/10.1093/jsxmed/qdaf087","url":null,"abstract":"","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081878","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":"Association between lower urinary tract symptoms and female sexual function: results from the GENitourinary syndrome of menopause in JApanese women (GENJA) study.","authors":"Yumi Ozaki, Hikaru Tomoe, Mayuka Shimomura, Noriko Ninomiya, Yuki Sekiguchi, Yoshikazu Sato, Yoshimitsu Takahashi, Satoru Takahashi","doi":"10.1093/jsxmed/qdaf080","DOIUrl":"https://doi.org/10.1093/jsxmed/qdaf080","url":null,"abstract":"<p><strong>Background: </strong>Female sexual dysfunction (FSD) is highly prevalent in women with lower urinary tract symptoms (LUTS); however, few studies have assessed the association between specific LUTS and FSD.</p><p><strong>Aim: </strong>To identify which specific LUTS are associated with which domains of female sexual function in Japanese women.</p><p><strong>Methods: </strong>Data from 1337 sexually active women aged 40-79 years who participated in the GENitourinary syndrome of menopause in JApanese women (GENJA) study were analyzed. All participants answered web-based questionnaires including the Core Lower Urinary Tract Symptom Score, Female Sexual Function Index (FSFI), and Vulvovaginal Symptoms Questionnaire. We used multivariable regression to assess the association between LUTS and FSFI domain scores, adjusted for age, menstrual status, hormone therapy, hypertension, dyslipidemia, diabetes mellitus, and depression.</p><p><strong>Outcomes: </strong>FSFI domain and total scores associated with LUTS.</p><p><strong>Results: </strong>The mean age of participants was 54.0 ± 10.7 years. Women with LUTS were more likely to have lower total FSFI scores than those without, except for increased daytime urinary frequency. The multivariate analysis revealed that nocturia was associated with lower orgasm scores (coefficient: -0.23; 95% confidence interval [CI]: -0.45 to -0.01; P = .044), urgency with lower pain scores (coefficient: -0.62; CI: -1.09 to -0.14; P = .011), stress urinary incontinence (coefficient: -0.51; CI: -0.90 to -0.12; P = .011), and vaginal bulge/lump sensations (coefficient: -0.42; CI: -0.81 to -0.04; P = .031) with lower satisfaction scores.</p><p><strong>Clinical implications: </strong>This study highlights the need to include routine assessments of sexual function in women with LUTS.</p><p><strong>Strengths and limitations: </strong>This is the first study to comprehensively examine the association between specific LUTS and FSFI domain scores using validated questionnaires in a nationwide epidemiological survey among sexually active Japanese women. Limitations include non-random participant selection and reliance on self-reported data, which represent subjective symptoms.</p><p><strong>Conclusion: </strong>LUTS, including nocturia, urgency, stress urinary incontinence, as well as vaginal bulge/lump sensations, were associated with FSD regardless of age, menstrual status, lifestyle-related diseases, or depression.</p>","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144008337","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":"Comparison of Enzian and rASRM classifications in predicting symptoms of sexual dysfunction in endometriosis.","authors":"Paula Norinho, Rosa Zulmira Vaz de Macedo, Mariana M Martins, Hélder Ferreira","doi":"10.1093/jsxmed/qdaf086","DOIUrl":"https://doi.org/10.1093/jsxmed/qdaf086","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Endometriosis is known to negatively impact sexual function; however, limited research has explored whether classification systems can help pinpoint specific anatomical locations associated with sexual dysfunction. This study was necessitated by the paucity of literature on classification systems that allow clinicians to associate specific symptoms of sexual dysfunction with particular locations of deep infiltrating endometriosis (DIE).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;This study aimed to investigate whether the Enzian and revised American Society for Reproductive Medicine (rASRM) classification systems can predict sexual dysfunction based on the localization and extent of DIE.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A clinical study was conducted with 77 women with histologically confirmed DIE. Data were collected from gynecological consultations and surgical reports classified using the rASRM and Enzian systems. Sexual function was assessed using the Female Sexual Function Index. Statistical analyses included Fisher's exact test, Mann-Whitney test, and Student's t-test.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes: &lt;/strong&gt;The primary outcome was to examine the relationship between endometriosis localization, disease extent, and sexual dysfunction as indicated by the two classification systems under investigation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A possible association was identified between sexual dysfunction and Enzian B classification (p = 0.013*), implicating involvement of the sacrouterine ligaments, cardinal ligaments, or pelvic sidewall. No significant association was found between sexual dysfunction and rASRM scores. A correlation between the number of endometriosis locations and the presence of sexual dysfunction was also observed (p = 0.015*). However, it is important to note that patients classified as Enzian B may have had additional, undocumented lesions in other locations not identified through available medical records, imaging, or surgical reports. These unidentified lesions could have influenced their sexual dysfunction, representing a potential confounding factor in our analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Clinical implications: &lt;/strong&gt;These findings suggest that the localization of DIE may contribute to sexual dysfunction, but further validation is required before drawing clinical conclusions regarding surgical interventions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Strengths & limitations: &lt;/strong&gt;This is the first study to explore the ability of a classification system to pinpoint sexual dysfunction in endometriosis to a particular anatomical location, providing novel insights into DIE's impact on sexual health. However, variability in referral sources, the potential for undocumented lesions, and a small sample size for cases of sexual dysfunction may limit the generalizability of these findings.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Disease localization, particularly in the uterosacral ligaments and pelvic sidewall, may contribute to sexual dysfunction, offering po","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144043622","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":"Bone morphogenetic protein 2 rescues neurogenic abnormalities and angiogenic factors in mice with bilateral cavernous nerve injury.","authors":"Jong Won Kim, Doo Yong Chung, Fang-Yuan Liu, Yan Huang, Fitri Rahma Fridayana, Minh Nhat Vo, Kang Su Cho, Ji-Kan Ryu, Mi-Hye Kwon, Guo Nan Yin","doi":"10.1093/jsxmed/qdaf091","DOIUrl":"https://doi.org/10.1093/jsxmed/qdaf091","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Bone morphogenetic protein 2 (BMP2), a key isoform within the bone morphogenetic protein family, plays a critical role in promoting angiogenesis and peripheral nerve regeneration, but its specific role in neurogenic erectile dysfunction (ED) remains unclear.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;This study aimed to explore the therapeutic efficacy of exogenous recombinant BMP2 protein administration in restoring erectile function in a mouse model of cavernous nerve injury (CNI)-induced ED.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Twelve-week-old male C57BL/6 mice were used to evaluate BMP2 expression and erectile function following CNI. Western blotting and immunofluorescence staining were employed to assess BMP2 levels in corpus cavernosum tissues from both sham-operated and CNI-induced ED mice. Erectile function was measured through electrical stimulation of bilateral cavernous nerves, with subsequent intracavernous pressure parameter recordings. Mechanistic investigations included immunofluorescence staining, terminal deoxynucleotidyl transferase dUTP nick-end labeling assay, and western blot analysis. Additionally, ex vivo neurite outgrowth assays were conducted using dorsal root ganglia (DRG) and major pelvic ganglia (MPG) tissues.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes: &lt;/strong&gt;In vivo intracavernous pressure, neurovascular regeneration, proliferation, apoptosis, ex vivo neurite sprouting, and survival signaling were measured.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Bone morphogenetic protein 2 expression was significantly decreased in the corpus cavernosum of CNI mice. Exogenous administration of recombinant BMP2 protein effectively enhanced erectile function in CNI mice, likely through the restoration of endothelial cells, smooth muscle cells, pericytes, and neuronal cells within the corpus cavernosum. Immunofluorescence staining and western blot analysis demonstrated that BMP2 treatment promoted angiogenesis by increasing endothelial cell proliferation and reducing apoptosis in the corpus cavernosum. Furthermore, ex vivo assays revealed that BMP2 promoted neurite sprouting in DRG and MPG tissues exposed to lipopolysaccharide. Mechanistic studies further indicated that BMP2 increased the expression of neurotrophic factors and VEGF, activating the AKT/eNOS signaling pathway.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Clinical implications: &lt;/strong&gt;Bone morphogenetic protein 2 may be used as a strategy to treat neurogenic ED or other neurovascular diseases.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Strengths and limitations: &lt;/strong&gt;Bone morphogenetic protein 2 has dual roles in vascular and neuronal development. Our study focused on broadly evaluating the role of BMP2 in neurogenic ED. Future studies will evaluate the nerve regeneration effects and novel signaling pathways of BMP2 in a sciatic nerve injury mouse model. In view of its properties as an angiogenic factor, its dose concentration should be strictly controlled to avoid potential side effects.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The exogenous ","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059035","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 association between depression and anxiety with female sexual function in young women with polycystic ovary syndrome.","authors":"Meral Cevik Dogan, Tevfik Yoldemir","doi":"10.1093/jsxmed/qdaf050","DOIUrl":"10.1093/jsxmed/qdaf050","url":null,"abstract":"<p><strong>Background: </strong>PCOS and its associated symptoms might be related to anxiety and depressive symptoms which may influence sexual function.</p><p><strong>Aim: </strong>To investigate the association between depression and anxiety with female sexual function among women with polycystic ovary syndrome (PCOS) during reproductive age.</p><p><strong>Methods: </strong>The study group included 268 women with PCOS and 158 women without PCOS between the ages of 18 and 35 years. Serum testosterone, androstenedione, dehydroepiandrostenedione sulfate (DHEA-S), fasting glucose, sex-hormone binding globulin, and fasting insulin levels were analyzed. The McCoy Female Sexual Questionnaire (MFSQ), and Beck Anxiety and Depression Inventories (BAI and BDI) were distributed to women with PCOS and controls.</p><p><strong>Outcomes: </strong>MFSQ, BDI, and BAI scores were compared between women with PCOS and controls.</p><p><strong>Results: </strong>There was a significant difference between the PCOS and non-PCOS groups when BDI (18.92 ± 11.09 vs 10.20 ± 8.66, p = 0.001) and BAI (12.45 ± 9.67 vs 8.08 ± 8.90, p = 0.001) subgroups were compared. A weak negative correlation was present between McCoy's sexuality domain (r = -0.304), McCoy's Sexual partner domain (r = -0.215), and BAI score among PCOS women. A moderate negative correlation between McCoy's sexuality domain (r = -0.515), and a weak correlation between McCoy's Sexual partner domain (r = -0.271) and BDI score among PCOS women were found.</p><p><strong>Clinical implications: </strong>Women with PCOS report more severe depression, anxiety, and sexual dysfunction than non-PCOS women.</p><p><strong>Strengths & limitations: </strong>Socio-cultural identity, awareness, perceptions of body image, and interpersonal relations were not investigated in the current study. These play a role in the interactions between sexual dysfunction and mood disorder. The strength of our study was that the prevalence of PCOS features was different between the various depression and anxiety subgroups.</p><p><strong>Conclusion: </strong>The women with PCOS were more likely to have moderate-severe anxiety and moderate-severe depression while their mean total scores of the two domains of MFSQ were lower when compared to non-PCOS women.</p>","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":"859-868"},"PeriodicalIF":3.3,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755730","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 impact of overactive bladder on sexual health in women with diabetes.","authors":"Cansu Polat Dunya, Arzu Erkoc, Medine Yucesoy, Mehmet Gokhan Culha, Mine Adas","doi":"10.1093/jsxmed/qdaf052","DOIUrl":"10.1093/jsxmed/qdaf052","url":null,"abstract":"<p><strong>Background: </strong>The prevalence of overactive bladder symptoms and sexual dysfunction is increased in women with type 2 diabetes, and this can negatively impact their quality of life.</p><p><strong>Aim: </strong>To evaluate the effects of overactive bladder on sexual function and the quality of sexual life in women with and without type 2 diabetes.</p><p><strong>Methods: </strong>This cross-sectional study included 168 women who were assigned to 4 groups: healthy women (n = 42), women with overactive bladder (n = 42), women with diabetes but without overactive bladder (n = 42), and women with both diabetes and overactive bladder (n = 42). Data were collected using the Overactive Bladder 8-Question Awareness Tool, the Female Sexual Function Index, and the Sexual Quality of Life-Female questionnaire. The variables assessed with these tools were analyzed using the Kruskal-Wallis test.</p><p><strong>Outcomes: </strong>The levels of overactive bladder symptoms, sexual function, and sexual quality of life in women were evaluated.</p><p><strong>Results: </strong>The overactive bladder and sexual function scores of women with overactive bladder and women with both diabetes and overactive bladder were significantly worse compared to those of healthy women (P ˂ .001). In particular, women with both diabetes and overactive bladder had lower levels of sexual quality of life compared to women with overactive bladder and healthy women (P ˂ .001).</p><p><strong>Clinical implications: </strong>The study reveals that overactive bladder symptoms and diabetes severely affect women's quality of sexual life, emphasizing that these problems should be a routine part of clinical assessment.</p><p><strong>Strengths and limitations: </strong>The strength of the study lies in its unique approach as the first to comprehensively examine the effect of diabetes and overactive bladder on sexuality through a comparison of 4 distinct groups of women. Collecting data using valid and reliable scales and applying the STROBE checklist increases methodological rigor. However, the limited sample size restricts generalizability, and causal relationships cannot be established due to the cross-sectional design. In addition, self-reported data may increase the risk of bias.</p><p><strong>Conclusion: </strong>This study highlights that diabetes and overactive bladder symptoms negatively affect women's sexual function and sexual quality of life and that comprehensive and individualized treatment plans should be developed.</p>","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":"739-745"},"PeriodicalIF":3.3,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755733","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":"Association between surgeon procedure volume and reoperation rates for penile prosthesis implantation.","authors":"Juan J Andino, Navid Leelani, Ryoko Sato, Young Shin, Sirikan Rojanasarot, Thiago Furtado, Helen L Bernie, Petar Bajic, Carolyn A Salter, Joshua A Halpern","doi":"10.1093/jsxmed/qdaf064","DOIUrl":"10.1093/jsxmed/qdaf064","url":null,"abstract":"<p><strong>Background: </strong>Prior studies have examined patient-specific predictors of reoperation following penile prosthesis (PP) insertion at the local and regional level, but little is known about patient factors and volume-outcome relationships at the national level.</p><p><strong>Aim: </strong>To assess the impact of patient characteristics and surgeon volume on reoperation rates following PP placement in a Medicare population.</p><p><strong>Methods: </strong>We utilized the 100% Medicare Standard Analytical Files to identify men aged ≥65 years who underwent PP implantation between 2018 and 2021. Surgeon volume data were obtained from the Atlas All-Payor Claims dataset, and quartiles were calculated. Multivariable logistic regression was used to evaluate associations between reoperation rates, patient characteristics, and surgeon volume.</p><p><strong>Outcomes: </strong>The reoperation rate at 1-year post-implantation, the cause of reoperation, and factors associated with a higher reoperation rate.</p><p><strong>Results: </strong>Among 8343 patients, 2.3% required reoperation at 90 days and 6.3% at 1 year. The most common comorbidities were diabetes (35.2%), cardiovascular disease (23.9%), Peyronie's disease (15.4%), and obesity (11.5%). Surgeon volume quartiles were calculated, with the highest-volume surgeons performing >31 cases annually versus <6 for the lowest quartile. Lower surgeon volume, older patient age, and smoking were associated with higher reoperation rates. Patients treated by top-quartile surgeons had 25%-28% lower odds of reoperation at 1 year [OR 0.72; 95% CI 0.56-0.93; OR 0.75; 95% CI 0.59-0.97].</p><p><strong>Clinical implications: </strong>While higher surgeon volume was associated with lower reoperation rates, PP surgery remained safe across all volume levels.</p><p><strong>Strengths and limitations: </strong>Strengths include the use of a nationally representative Medicare dataset and All-Payor volume-outcome analysis. Limitations include accuracy of claims data, inability to fully characterize reoperations, and lack of data for procedures performed in ambulatory surgery centers.</p><p><strong>Conclusion: </strong>In a nationally representative Medicare cohort, PP reoperation rates were low (6.3%), with mechanical complications accounting for 41% of reoperations (2.6% of the cohort). Higher-volume surgeons had lower reoperation rates, but outcomes remained acceptable across all volume levels, reinforcing the overall safety of the procedure.</p>","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":"916-923"},"PeriodicalIF":3.3,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143773624","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}