Journal of Sexual Medicine最新文献

{"title":"Do indicators for DSM-5 sexual dysfunction and somatic symptom disorder overlap? Evidence from the Hamburg City Health Study population-based sample.","authors":"Thula U Koops, Natalie Uhlenbusch, Bernd Löwe, Martin Härter, Volker Harth, Peer Briken","doi":"10.1093/jsxmed/qdae113","DOIUrl":"https://doi.org/10.1093/jsxmed/qdae113","url":null,"abstract":"<p><strong>Background: </strong>Symptoms of sexual dysfunction and somatic symptom disorder may resemble each other in their presentation as lasting and distressing alterations of expected bodily \"functioning\"; their co-occurrence has not yet been studied in nonclinical settings or by DSM-5 criteria (Diagnostic and Statistical Manual of Mental Disorders, fifth edition).</p><p><strong>Aim: </strong>To investigate (1) the association of indicators consistent with DSM-5 sexual dysfunction and somatic symptom disorder diagnoses, (2) whether individuals with different sexual dysfunction diagnoses differ in somatic symptoms and their perception, and (3) whether distress from sexual difficulties is related to somatic symptoms and symptom perception.</p><p><strong>Methods: </strong>We examined links among sexual dysfunctions/distress from sexual difficulties (Brief Questionnaire on Sexuality), somatic symptom severity (Patient Health Questionnaire-15 [PHQ-15]), and symptom perception (Somatic Symptom Disorder-B Criteria Scale) in 9333 participants of the Hamburg City Health Study aged 45 to 74 years. For a sensitivity analysis, we repeated all analyses after excluding an item on sexual difficulties from the PHQ-15 score.</p><p><strong>Outcomes: </strong>Outcomes included scores on the Brief Questionnaire on Sexuality indicating sexual difficulties and dysfunction according to DSM-5, PHQ-15 for somatic symptom severity, and Somatic Symptom Disorder-B Criteria Scale for symptom perception.</p><p><strong>Results: </strong>Indicators consistent with DSM-5 sexual dysfunction and somatic symptom disorder diagnoses were linked (P = .24) before the sensitivity analysis but not after. Individuals with different sexual dysfunction diagnoses did not differ in their somatic symptom severity or their symptom perception. Distress from sexual difficulties was weakly correlated with somatic symptom severity (after sensitivity analysis: ρ = .19, P = .01) and symptom perception (ρ = .21, P = .01). Both correlations were stronger for men than for women.</p><p><strong>Clinical implications: </strong>Our results convey that it is worth exploring sexual difficulties and somatic symptom disorder in patients presenting with either complaint but also that sexual difficulties should still be regarded as an independent phenomenon.</p><p><strong>Strengths and limitations: </strong>Our sample consisted of participants from one metropolitan region who were >45 years of age and thus does not demographically represent the general population. Assessing via self-report questionnaires may have influenced the reporting of symptoms, as may have prevailing shame around experiencing sexual dysfunction. The final sample size was reduced by missing values from some questionnaires. Despite these limitations, sample sizes for all analyses were large and offer meaningful new observations on the subject.</p><p><strong>Conclusion: </strong>Our data suggest that indicators for sexual dysfunction and ","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142300245","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":"It's not all that bad: associations among pain characteristics and sexual well-being in people living with chronic pain.","authors":"Pablo Santos-Iglesias, Justine L Estey, Lyndsay Crump, Diane L LaChapelle, E Sandra Byers","doi":"10.1093/jsxmed/qdae120","DOIUrl":"https://doi.org/10.1093/jsxmed/qdae120","url":null,"abstract":"<p><strong>Background: </strong>Individuals experiencing chronic pain often report adverse effects on their sexual functioning. However, other important aspects of sexual well-being (SWB), such as sexual distress and sexual self-esteem, have received little attention. This is an important omission because a SWB involves more than just good sexual function. Similarly, past research has not examined how chronic pain characteristics affect the different aspects of SWB.</p><p><strong>Aim: </strong>The goal of this cross-sectional study was to examine the SWB of individuals living with chronic pain and to examine the extent to which SWB is associated with different chronic pain characteristics.</p><p><strong>Methods: </strong>A total of 310 individuals (28.1% men, 70.6% women, 1.3% transgender men) with ages between 21 and 50 (M = 31.96, SD = 6.13) who were in a romantic relationship and with self-reported chronic pain for three months or longer completed an online survey.</p><p><strong>Outcomes: </strong>The following indicators of SWB were included in the study: frequency of genital sexual activity, sexual satisfaction, sexual self-esteem, sexual desire, sexual function, genital pain, and sexual distress.</p><p><strong>Results: </strong>The results show that most individuals with chronic pain maintain an active and satisfying sexual life and feel positive about themselves as a sexual partner. Slightly more than a fourth reported experiencing at least one sexual functioning difficulty and almost three-fourths of them found those difficulties sexually distressing. A first canonical correlation showed that more negative pain characteristics were associated with poorer SWB. The second canonical correlation showed that greater perceived partner support can offset the negative relationship between pain and some aspects of SWB.</p><p><strong>Clinical implications: </strong>These findings show that individuals living with chronic pain can experience positive SWB. Furthermore, the buffering effect of partner support suggests it is important to involve romantic partners in interventions aimed at improving the SWB of people living with chronic pain.</p><p><strong>Strengths and limitations: </strong>The study examined a large number of indicators of SWB using a sample of individuals with different types of chronic pain. Limitations include potential self-selection bias and a sample that was predominantly white and highly educated.</p><p><strong>Conclusions: </strong>The results paint a more positive picture of the SWB of individuals living with pain and show that individuals living with chronic pain can experience positive SWB. These findings can help for researchers, educators, and clinicians about how to conceptualize, understand, and improve the SWB of individuals living with chronic pain.</p>","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142300249","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":"Minocycline-rifampin-impregnated penile prosthesis surfaces retain antimicrobial activity following irrigation with 0.05% chlorhexidine gluconate and antibiotic solutions.","authors":"Brian H Im, Analyse Giordano, Sohan Shah, Samone Guillame, Rachel Evans, Noreen J Hickok, Paul H Chung","doi":"10.1093/jsxmed/qdae093","DOIUrl":"10.1093/jsxmed/qdae093","url":null,"abstract":"<p><strong>Background: </strong>0.05% Chlorhexidine gluconate (CHG; Irrisept [IrriMax]) is a commercial wound irrigation solution approved by the Food and Drug Administration that has seen recent adoption in the field of prosthetic urology; however, no study has evaluated whether 0.05% CHG is compatible with the minocycline-rifampin-impregnated surface (InhibiZone) of the AMS 700 penile prosthesis (Boston Scientific).</p><p><strong>Aim: </strong>To evaluate whether 0.05% CHG alters the antibiotic efficacy of the minocycline-rifampin-impregnated penile prosthesis surface.</p><p><strong>Methods: </strong>Discs (8 mm) were taken by a punch biopsy (Sklar) from sterile penile prosthesis reservoirs whose surfaces had been impregnated with rifampin and minocycline. Discs (n = 10) were suspended in 0.05% CHG, vancomycin and gentamicin, or normal saline for 2 minutes to simulate intraoperative irrigation. Discs were then rinsed in normal saline to remove any unbound solution and incubated with methicillin-sensitive Staphylococcus aureus for 48 hours. Adherent surface bacteria were suspended by shaking in a 0.3% Tween 20 solution, serially diluted, plated onto 3M PetriFilms, and counted. Kirby-Bauer disc diffusion assays were conducted to generalize findings across various organisms.</p><p><strong>Outcomes: </strong>Outcomes included (1) bacterial adherence to the implant surface measured as bacterial counts (in colony-forming units per milliliter) and (2) bacterial growth reduction measured as zones of inhibitions (in millimeters).</p><p><strong>Results: </strong>Incubation of implant surfaces in 0.05% CHG did not alter recovered bacterial counts as compared with normal saline and vancomycin/gentamycin. Similarly, within a single bacterial species, 0.05% CHG and vancomycin/gentamycin did not alter zone-of-inhibition measurements in Kirby-Bauer disc diffusion studies.</p><p><strong>Clinical translation: </strong>This study demonstrates in vitro that 0.05% CHG may be used directly on the minocycline-rifampin-impregnated surface without altering the antibiotic efficacy of the coating.</p><p><strong>Strengths and limitations: </strong>Strengths include that this is the first study to evaluate if 0.05% CHG affected the minocycline-rifampin-impregnated surface. Limitations include the use of in vitro studies, which serve as a proxy for in vivo practices and may not be entirely accurate or translatable in a clinical setting.</p><p><strong>Conclusion: </strong>0.05% CHG does not alter the antimicrobial activity of the minocycline-rifampin-impregnated surface as compared with vancomycin/gentamycin and normal saline in vitro; however, its efficacy in clinical practice remains to be evaluated.</p>","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141857079","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":"What is the validity of the Federal Adverse Event Reporting System in contemporary clinical research?","authors":"Albert Ha, Ashkan P Langroudi, Michael L Eisenberg","doi":"10.1093/jsxmed/qdae072","DOIUrl":"https://doi.org/10.1093/jsxmed/qdae072","url":null,"abstract":"","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142127260","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":"Pain with orgasm in endometriosis: potential etiologic factors and clinical correlates.","authors":"Avrilynn Ding, Heather Noga, Katrina N Bouchard, Mohamed A Bedaiwy, Caroline Lee, Catherine Allaire, Natasha L Orr, Paul J Yong","doi":"10.1093/jsxmed/qdae084","DOIUrl":"10.1093/jsxmed/qdae084","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Pelvic pain worsened by orgasm is a poorly understood symptom in patients with endometriosis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;To assess the prevalence of pelvic pain worsened by orgasm in patients with endometriosis and explore its association with potential etiologic factors, including pelvic floor myalgia, uterine tenderness and adenomyosis, and central nervous system sensitization.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;An analysis was done of a prospective data registry based at a tertiary referral center for endometriosis. Eligible participants were patients aged 18 to 50 years who were referred between January 1, 2018, and December 31, 2019, diagnosed with endometriosis, and subsequently underwent surgery at the center. Clinical features were compared between participants reporting worsening pelvic pain with orgasm and those without worsening pain with orgasm, including patient-reported variables, physical examination findings, and anatomic phenotyping at the time of surgery. Pelvic floor myalgia and uterine tenderness were assessed by palpation on pelvic examination, adenomyosis by ultrasound, and central nervous system sensitization via the Central Sensitization Inventory (range, 0-100).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes: &lt;/strong&gt;Outcomes included pelvic or lower abdominal pain in the last 3 months that worsened with orgasm (yes/no).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Among 358 participants with endometriosis, 14% (49/358) reported pain worsened by orgasm while 86% (309/358) did not. Pain with orgasm was significantly associated with pelvic floor myalgia (55% [27/49] vs 35% [109/309]; Cohen's h = 0.40, P = .01) and higher scores on the Central Sensitization Inventory (mean ± SD, 53.3 ± 17.0 vs 42.7 ± 18.2; Cohen's d = 0.60, P &lt; .001) but not with uterine tenderness or adenomyosis. Other clinical features associated with pain with orgasm were poorer sexual health (higher scores: deep dyspareunia, Cohen's h = 0.60; superficial dyspareunia, Cohen's h = 0.34; and Female Sexual Distress Scale-Revised, Cohen's d = 0.68; all P &lt; .05) and poorer mental health (higher scores: Patient Health Questionnaire-9, 12.9 ± 6.7 vs 9.1 ± 6.3, Cohen's d = 0.59, P &lt; .001; Generalized Anxiety Disorder-7, 9.4 ± 5.6 vs 6.8 ± 5.5, Cohen's d = 0.48, P = .002). Anatomic findings at the time of surgery did not significantly differ between the groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Clinical implications: &lt;/strong&gt;Interventions targeting pelvic floor myalgia and central nervous system sensitization may help alleviate pain worsened by orgasm in patients with endometriosis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Strengths and limitations: &lt;/strong&gt;A strength is that pain worsened by orgasm was differentiated from dyspareunia. However, pain with orgasm was assessed by only a binary question (yes/no). Also, the study is limited to a single center, and there were limited data on sexual function.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Pelvic pain exacerbated by orgasm in people with endometriosis may be related ","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11372072/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141749596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety of topical sildenafil cream, 3.6% in a randomized, placebo-controlled trial for the treatment of female sexual arousal disorder.","authors":"Andrea R Thurman, Isabella Johnson, Katherine A Cornell, Jessica Hatheway, Noel N Kim, Sharon J Parish, Clint Dart, David R Friend, Andrew Goldstein","doi":"10.1093/jsxmed/qdae089","DOIUrl":"10.1093/jsxmed/qdae089","url":null,"abstract":"<p><strong>Background: </strong>There are currently no Food and Drug Administration-approved treatments for female sexual arousal disorder (FSAD), which is physiologically analogous to male erectile dysfunction.</p><p><strong>Aims: </strong>The study sought to test the systemic and local genital safety of topical sildenafil cream, 3.6% (sildenafil cream) among healthy premenopausal women with FSAD and their sexual partners over a 12-week treatment period.</p><p><strong>Methods: </strong>This was a phase 2b, exploratory, randomized, placebo-controlled, double-blind study of sildenafil cream among healthy premenopausal women with FSAD. Safety was assessed by the frequency and incidence of treatment-emergent adverse events (TEAEs) among participants and their sexual partners. Participants recorded the incidence of TEAEs in a daily eDiary (electronic diary). Sexual partners were contacted within 72 hours of each sexual event in which investigational product was used. All participants used placebo cream for 1 month, during a single-blind run-in period, and then if eligible, were randomized 1:1 to sildenafil cream or placebo cream. Participants used their assigned investigational product over a 12-week double-blind dosing period. They attended monthly follow-up visits, in which their eDiary TEAE data were reviewed by the study staff and graded for severity and relationship to study product.</p><p><strong>Outcomes: </strong>The frequency and incidence of TEAEs among participants and their sexual partners.</p><p><strong>Results: </strong>During the 12-week double-blind dosing period, there were 78 TEAEs reported by 29 of 99 sildenafil-assigned participants and 65 TEAEs reported by 28 of 94 placebo-assigned participants (P = .76). All TEAEs were mild or moderate in severity. The most common treatment-related TEAE among active and placebo-assigned participants was application site discomfort. There were no differences in the number of treatment-related TEAEs among sildenafil cream vs placebo cream users (P > .99). Four sildenafil cream participants and 3 placebo cream participants discontinued the study due to TEAEs involving application site discomfort (P > .99). There were 9 TEAEs reported by 7 of 91 sexual partners exposed to sildenafil cream vs 4 TEAEs reported by 4 of 84 sexual partners exposed to placebo cream (P = .54).</p><p><strong>Clinical implications: </strong>These data support further clinical development of topical sildenafil cream for the treatment of FSAD.</p><p><strong>Strengths and limitations: </strong>Safety was assessed among participants and their sexual partners after 1357 and 1160 sexual experiences in which sildenafil cream or placebo cream were used, respectively. The phase 2b study was powered for the primary objectives of efficacy, rather than safety.</p><p><strong>Conclusion: </strong>These data demonstrate that topically applied sildenafil cream was safe and well tolerated by exposed users and their sexual partners.</p>","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141857080","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":"Individually customized gender affirming genital procedures: techniques and considerations.","authors":"Mona Ascha, Siri Rigsby, Maia Shoham, Arya Andre Akhavan, Marco Swanson, Carl G Streed, Anandev Gurjala, Shane D Morrison, John Henry Pang, Thomas Satterwhite","doi":"10.1093/jsxmed/qdae075","DOIUrl":"https://doi.org/10.1093/jsxmed/qdae075","url":null,"abstract":"<p><strong>Purpose: </strong>Gender-affirming surgery is being increasingly performed for transgender and gender-diverse individuals diagnosed with gender dysphoria. However, there is a group of patients who may seek outcomes that are either a combination of or altogether different from those of binary procedures such as penile inversion vaginoplasty or phalloplasty.</p><p><strong>Methods: </strong>We describe surgical techniques for less commonly performed gender-affirming genital procedures, in order to introduce these procedures to the medical and surgical community.</p><p><strong>Results: </strong>Operative techniques for phallus-preserving vaginoplasty, vagina-preserving phalloplasty, and removal of genitalia with creation of perineal urethrostomy are described. Demographic characteristics and complications of these procedures in 16 patients are reported.</p><p><strong>Conclusion: </strong>Individually customized gender-affirming genital procedures, such as phallus-preserving vaginoplasty, vaginal-preserving phalloplasty, and removal of genitalia and creation of perineal urethrostomy, may better affirm the identities of some gender-diverse patients, and may also preserve desired sexual function of natal genitalia.</p>","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142127257","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":"Psychiatric morbidity across the life course and provoked vulvodynia: is it dependent upon the presence of non-stress-related immune dysfunction?","authors":"Bernard L Harlow, Hanna Mühlrad, Jane Yan, Evelina Linnros, Donghao Lu, Matthew P Fox, Nina Bohm-Starke","doi":"10.1093/jsxmed/qdae082","DOIUrl":"10.1093/jsxmed/qdae082","url":null,"abstract":"<p><strong>Background: </strong>Vulvodynia impacts up to 8% of women by age 40, and these women may have a more compromised immune system than women with no vulvar pain history.</p><p><strong>Aim: </strong>Given that psychiatric morbidity is associated with vulvodynia and is known to activate immune inflammatory pathways in the brain and systemically, we sought to determine whether the association between psychiatric morbidity and vulvar pain was independent of or dependent upon the presence of immune-related conditions.</p><p><strong>Methods: </strong>Women born in Sweden between 1973 and 1996 with localized provoked vulvodynia (N76.3) and/or vaginismus (N94.2 or F52.5) diagnosed between 2001 and 2018 were matched to two women from the same birth year with no vulvar pain. International Statistical Classification of Diseases and Related Health Problems (ICD-9 or -10 codes) were used to identify women with a history of depression, anxiety, attempted suicide, neurotic disorders, stress-related disorders, behavioral syndromes, personality disorders, psychotic disorders, or chemical dependencies, as well as a spectrum of immune-related conditions. The Swedish National Prescribed Drug Register was used to identify women with filled prescriptions of antidepressants or anxiolytics.</p><p><strong>Outcomes: </strong>Vulvodynia, vaginismus, or both were outcomes assessed in relation to psychiatric morbidity.</p><p><strong>Results: </strong>Women with vulvodynia, vaginismus, or both, relative to those without vulvar pain, had adjusted odds ratios between 1.4 and 2.3, with CIs highly compatible with harmful effects. When we assessed women with and those without a lifetime history of immune-related conditions separately, we also observed elevated odds ratios in both groups for mood, anxiety, and neurotic and stress disorders.</p><p><strong>Clinical implications: </strong>Documenting psychiatric impairment as a cause or consequence of vulvodynia is critical in clinical practice because psychiatric conditions may impact treatment efficacy.</p><p><strong>Strengths and limitations: </strong>Strengths of this study include a data source that represents the entire population of women in Sweden that is known to be highly accurate because Sweden provides universal healthcare. Limitations include difficulty in making an accurate assessment of temporality between psychiatric morbidity and the first onset of vulvar pain. In addition, because Swedish registry data have limited information on lifestyle, behavioral, and anthropomorphic factors such as smoking, diet, physical activity, and obesity, these conditions could not be assessed as confounders of psychiatric morbidity and vulvar pain.</p><p><strong>Conclusions: </strong>Immune pathways by which women with psychiatric conditions increase their risk of vulvar pain could be independent from other immune pathways.</p>","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11372066/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141735600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antibiotic dip and irrigation solutions confer increased antimicrobial efficacy of inflatable penile prosthesis hydrophilic surfaces compared with 0.05% chlorhexidine gluconate.","authors":"Rishabh Simhal, Brian H Im, Sohan Shah, Samone Guillame, Carlos Perez Kerkvliet, Rachel Evans, Noreen J Hickok, Paul H Chung","doi":"10.1093/jsxmed/qdae073","DOIUrl":"10.1093/jsxmed/qdae073","url":null,"abstract":"<p><strong>Background: </strong>Chlorhexidine gluconate (CHG) (0.05%) has recently been suggested as both a dip for the hydrophilic surface and an irrigation solution in the setting of penile prosthesis (PP) surgery.</p><p><strong>Aim: </strong>The study sought to compare the antimicrobial efficacy of 0.05% CHG with vancomycin and gentamicin (VG) antibiotics as dip and/or irrigation solutions in the setting of a hydrophilic PP surface in vitro.</p><p><strong>Methods: </strong>Sterile PPs with a hydrophilic coating were obtained. A series of experiments were performed to evaluate the efficacy of normal saline (NS), 0.05% CHG, or VG as dip and/or irrigation solutions to reduce methicillin-sensitive Staphylococcus aureus adhesion to PP surfaces. The 8-mm discs from PPs were incubated in 105 colony-forming units/mL of methicillin-sensitive S aureus for 48 hours, plated, and counted. Disc-diffusion tests were conducted by suspending 6-mm discs for 2 minutes in NS, 0.05% CHG, or VG, then placing them coated side down onto plates streaked with the following organisms: methicillin-sensitive S aureus, S epidermidis, Enterococcus, and Escherichia coli. After 24 hours of growth, zones of inhibition were measured.</p><p><strong>Outcomes: </strong>We found average bacterial counts (colony-forming units/mL) and zones of inhibition (mm) following a series of treatment protocols of PP discs.</p><p><strong>Results: </strong>PP discs dipped in VG reduced bacterial adhesion to the implant surface >0.05% CHG (~5.5 log vs ~1.5 log; P < .01). Discs irrigated with either 0.05% CHG or NS removed all dip solution adsorbed to the hydrophilic surface, allowing bacterial growth. VG irrigation adsorbed to the hydrophilic surface even after 0.05% CHG or NS dips, reducing bacterial adherence (~3 log). Dipping and irrigating discs with VG was most effective in reducing adherent bacteria (~5.5 log) and was the only irrigation that showed antimicrobial activity.</p><p><strong>Clinical translation: </strong>VG, when used both as a prophylactic dip and as an intraoperative irrigation solution for hydrophilic penile implant surfaces, has improved efficacy to 0.05% CHG and NS.</p><p><strong>Strengths and limitations: </strong>This is the first study to compare the use of VG, 0.05% CHG, and NS as prophylactic dips and intraoperative irrigations for hydrophilic penile implant surfaces. Limitations include the use of in vitro studies, which serve as a proxy for in vivo practices and may not be entirely accurate nor translatable clinically.</p><p><strong>Conclusion: </strong>We demonstrated the superior efficacy of VG as a combined dip and irrigation solution for hydrophilic penile implant surfaces compared with 0.05% CHG.</p>","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141560292","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":"Heparin-binding epidermal growth factor-like growth factor improves erectile function in streptozotocin-induced diabetic mice.","authors":"Fitri Rahma Fridayana, Jiyeon Ock, Fang-Yuan Liu, Lashkari Niloofar, Minh Nhat Vo, Yan Huang, Guo Nan Yin, Ji-Kan Ryu","doi":"10.1093/jsxmed/qdae079","DOIUrl":"10.1093/jsxmed/qdae079","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Heparin-binding epidermal growth factor-like growth factor (HB-EGF) serves as a pro-angiogenic factor; however, there is to our knowledge currently no reported research on the relationship between HB-EGF and diabetic erectile dysfunction (ED).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;In this study we aimed to determine whether HB-EGF can improve the erectile function of streptozotocin-induced diabetic mice and to explore the related mechanisms.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Eight-week-old male C57BL/6 mice were used for diabetes induction. Diabetes mellitus (DM) was induced by low-dose injections of streptozotocin (50 mg/kg) for 5 consecutive days. Eight weeks after streptozotocin injections, DM was determined by measuring blood glucose and body weight. Diabetic mice were treated with two intracavernous administrations of phosphate-buffered saline (20 μL) or various doses of HB-EGF (days -3 and 0; 1, 5, and 10 μg in 20 μL of phosphate-buffered saline). The angiogenesis effect of HB-EGF was confirmed by tube formation and migration assays in mouse cavernous endothelial cells and mouse cavernous pericytes under high-glucose conditions. Erectile function was measured by electrical stimulation of the cavernous nerve, as well as histological examination and Western blot analysis for mechanism assessment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes: &lt;/strong&gt;In vitro angiogenesis, cell proliferation, in vivo intracavernous pressure, neurovascular regeneration, cavernous permeability, and survival signaling were the outcomes measured.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Expression of HB-EGF was reduced under diabetic conditions. Exogenous HB-EGF induced angiogenesis in mouse cavernous endothelial cells and mouse cavernous pericytes under high-glucose conditions. Erectile function was decreased in the DM group, whereas administration of HB-EGF resulted in a significant improvement of erectile function (91% of the age-matched control group) in association with increased neurovascular content, including cavernous endothelial cells, pericytes, and neuronal cells. Histological and Western blot analyses revealed a significant increase in the permeability of the corpus cavernosum in DM mice, which was attenuated by HB-EGF treatment. The protein expression of phospho-Akt Ser473 and phosphorylated endothelial nitric oxide synthase Ser1177 increased after HB-EGF treatment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Clinical implications: &lt;/strong&gt;The use of HB-EGF may be an effective strategy to treat ED associated with DM or other neurovascular diseases.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Strengths and limitations: &lt;/strong&gt;Similarly to other pro-angiogenic factors, HB-EGF has dual roles in vascular and neuronal development. Our study focused on broadly evaluating the role of HB-EGF in diabetic ED. In view of the properties of HB-EGF 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;Conclusion: &lt;/strong&gt;In the diabetic ED mouse model in this","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141735599","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}