Journal of Sexual Medicine最新文献

{"title":"Patient satisfaction study for the new Rigicon Infla10 inflatable penile prosthesis including single surgeon safety and outcomes data.","authors":"Naci Burak Cinar, Ali Saribacak, Britney L Atwater, Martin S Gross, Steven K Wilson, Melih Culha","doi":"10.1093/jsxmed/qdae168","DOIUrl":"10.1093/jsxmed/qdae168","url":null,"abstract":"<p><strong>Background: </strong>Rigicon is a newer inflatable penile prostheses (IPP) manufacturer that has produced the Infla10 IPP for countries outside the United States (US) since 2019, with Food and Drug Administration studies for approval of Infla10 in the US presently underway.</p><p><strong>Aim: </strong>This study aims to report the first patient satisfaction, efficacy, and safety from revision data for the newly available Rigicon Infla10 IPP.</p><p><strong>Methods: </strong>A single surgeon's first 58 patients who underwent Rigicon Infla10 IPP implantation between 2019 and 2023 were included. Most patients (70%) received the Infla10 X (girth expansion) cylinder, and 30% received the Infla10 AX (length and girth expansion) model. Follow-up ranged from 4 to 42 months (median 19 months).</p><p><strong>Outcomes: </strong>Outcomes measured were intraoperative and postoperative complications as well as patient-reported satisfaction.</p><p><strong>Results: </strong>Reoperation was required in 5 patients (8.6%). Complication rates were 1.7% urethral erosion (n = 1), 1.7% infection requiring explant (n = 1), and 5% mechanical malfunction due to tubing breakage at pump junction (n = 3). The tubing issue was addressed by the manufacturer, resulting in no additional mechanical concerns. Kaplan-Meier analysis demonstrated rates of cumulative survival of the device at 12, 24, and 36 months were 96.6%, 93.8%, and 78.2%, respectively. Overall, 53 patients (91.4%) were satisfied at 6 months postoperatively and would recommend the procedure. Diminished satisfaction was due to perceived penile shortening in 3 patients (5.1%) and difficulty learning pump cycling in 2 patients (3.4%).</p><p><strong>Clinical implications: </strong>This single surgeon series demonstrates high rates of patient satisfaction with appropriate early safety from revision.</p><p><strong>Strengths and limitations: </strong>Limitations include the retrospective nature of this study and short-term follow-up. Additional prospective studies incorporating a larger number of patients are warranted.</p><p><strong>Conclusion: </strong>While very new in the marketplace, the Infla10 IPP shows promising early satisfaction, efficacy, and safety from revision.</p>","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":"344-348"},"PeriodicalIF":3.3,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142808489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A detailed analysis of the penile fibro-vascular assembly.","authors":"Geng-Long Hsu, Hong-Chiang Chang, Eugen Molodysky, Chih-Yuan Hsu, Mang-Hung Tsai, Jue-Hawn Yin, Ming-Tsun Chen","doi":"10.1093/jsxmed/qdae177","DOIUrl":"10.1093/jsxmed/qdae177","url":null,"abstract":"<p><strong>Background: </strong>Although various compartments of the human cardiovascular system have been thoroughly elucidated, the penile fibrovascular assembly remains an exception that has yet to be fully explored; therefore, this gap in our understanding prompts us to conduct further investigations.</p><p><strong>Aim: </strong>This study revisits the penile-fibro-vascular assembly to determine whether it constitutes an independent vascular compartment within the human body.</p><p><strong>Methods: </strong>The penile-fibro-vascular assembly was meticulously examined in 23 male human cadavers. The loupe-assisted observation was used to compare the size of bilateral penile arteries, conspicuously addressed at the hilum, and to isolate erection-related vascular channels meticulously with a loupe, as extensively as possible. Additionally, a comprehensive library was analyzed, including 801 cadaveric images, 1001 sets of dual cavernosographies, 11 spongiosographies, 7 Magnetic Resonance Imaging (MRI)/computed tomography (CT) cavernosographies, 61 Doppler's sonographies, and 15 selective internal pudendal arteriographies. Hemodynamic phenomena were observed both intra-corporeally and extra-corporeally in patients who underwent penile venous stripping (n = 501), coil embolization (n = 6), and pudendal arterial stenting (n = 5).</p><p><strong>Outcomes: </strong>This study confirms the existence of an independent penile fibro-vascular hydraulic environment within the human cardiovascular system.</p><p><strong>Results: </strong>The human penis contains an independent bi-layered fibrovascular assembly. Anatomical symmetry of bilateral arteries is rare on the arterial side. On the venous drainage side, there is one deep dorsal vein (DDV), two cavernosal veins, and four para-arterial veins, contrary to the conventional understanding of only a single DDV between the tunica albuginea and Buck's fascia. The penile venous drainage blood ultimately returns to pulmonary circulation.</p><p><strong>Clinical implications: </strong>Penile vascular surgery, particularly penile venous stripping, is shown to be the most physiologically appropriate method for restoring erectile function; contrarily, erection-related arterial stents, or venous embolization do not offer similar benefits.</p><p><strong>Strengths and limitations: </strong>This study's strength lies in its extensive analysis of a large repository of anatomical, physiological, radiographic imaging, and clinical vascular data; however, its retrospective nature represents a limitation.</p><p><strong>Conclusion: </strong>This study demonstrates that the penile fibro-vascular assembly functions as an independent vascular system, substantially making it the last vascular compartment to be disclosed in the human body.</p>","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":"225-234"},"PeriodicalIF":3.3,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814907","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 function and related predictors in male with multiple sclerosis and neuromyelitis optica spectrum disorder: a case-control study.","authors":"Saeed Vaheb, Mohammad Yazdan Panah, Mohammad Mohammadi, Mohammad Amin Sadri, Narges Ebrahimi, Sarina Loghmani, Marjan Beigi, Vahid Shaygannejad, Omid Mirmosayyeb","doi":"10.1093/jsxmed/qdae188","DOIUrl":"10.1093/jsxmed/qdae188","url":null,"abstract":"<p><strong>Background: </strong>Sexual dysfunction (SF) is a prevalent and distressing comorbidity in males with multiple sclerosis (MwMS) and neuromyelitis optica spectrum disorder (MwNMOSD).</p><p><strong>Aims: </strong>This study aimed to assess the SF in MwMS and MwNMOSD in comparison to male healthy controls (HCs) and identify its associated predictors.</p><p><strong>Methods: </strong>This case-control study was conducted from February 2023 to January 2024 at the MS clinic of Kashani Hospital, Isfahan, Iran. Participants included 49 MwMS, 27 MwNMOSD, and 40 HCs. Demographic, clinical, and psychological data were collected, and SF was evaluated by the International Index of Erectile Function (IIEF). Linear regression was used to assess relationships between variables.</p><p><strong>Outcomes: </strong>SF was significantly worse in the MwMS and MwNMOSD compared to the HCs.</p><p><strong>Results: </strong>SF was significantly lower in MwMS and MwNMOSD compared to HCs. In MwMS, significant independent predictors of SF included partner's education (B = -2.7, P = .003), anxiety (B = -0.6, P = .003), and depression (B = -0.3, P = .026). In MwNMOSD, significant independent predictors of SF were EDSS (B = -5.7, P = .007) and anxiety (B = -1, P = .002).</p><p><strong>Clinical implications: </strong>Controlling risk factors such as depression and anxiety can improve SF of MwMS to a significant extent.</p><p><strong>Strengths and limitations: </strong>Despite limitations like the cross-sectional design and exclusion of certain variables, our study identifies significant associations between sexual dysfunction and various risk factors in MwMS and MwNMOSD, emphasizing the need for future longitudinal research.</p><p><strong>Conclusion: </strong>MwMS and MwNMOSD exhibited worse SF than HCs. Multiple factors have been identified as independent predictors of SF within these patient groups.</p>","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":"274-281"},"PeriodicalIF":3.3,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958493","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 role of interoceptive sensibility on central sensitization to pain in vulvodynia.","authors":"Federica Scarpina, Maria Elena Navarra, Giorgia Varallo, Roberto Bernorio","doi":"10.1093/jsxmed/qdae203","DOIUrl":"https://doi.org/10.1093/jsxmed/qdae203","url":null,"abstract":"<p><strong>Background: </strong>Interoception may be linked to central sensitization in chronic pain.</p><p><strong>Aim: </strong>We aimed to provide evidence about the role of interoceptive sensibility on central sensitization in vulvodynia.</p><p><strong>Methods: </strong>In this cross-sectional study, a sample of females who received a diagnosis of vulvodynia filled out validated questionnaires relative to the individual level of interoceptive sensibility and the symptoms of central sensitization.</p><p><strong>Outcomes: </strong>Interoceptive sensibility and symptoms of central sensitization were measured with the Multidimensional Assessment of Interoceptive Awareness and the Central Sensitization Inventory, respectively.</p><p><strong>Results: </strong>A lower level of trust and a higher level of emotional awareness predicted a higher number of central sensitization symptoms in our sample.</p><p><strong>Clinical implications: </strong>Our evidence may increase the researchers' and physicians' attention toward the involvement of the central nervous system in pain phenomenology in vulvodynia.</p><p><strong>Strengths and limitations: </strong>No ad-hoc control sample was collected. No behavioral assessments about interoception were performed.</p><p><strong>Conclusion: </strong>As registered in other chronic pain conditions, interoceptive sensibility may play a crucial role in the expressions of symptoms of central sensitization in vulvodynia.</p>","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increased walking pace reduces the rate of erectile dysfunction: results from a multivariable Mendelian randomization study.","authors":"Yuekun Fang, Shengyi Chen, Chenxiao Huang, Xinmin Deng, Rui Lai, Xiaofeng Lv, Bin Cheng","doi":"10.1093/jsxmed/qdae178","DOIUrl":"10.1093/jsxmed/qdae178","url":null,"abstract":"<p><strong>Background: </strong>Previous observational studies have identified a potential association between walking and the risk of erectile dysfunction (ED); however, the causal relationship between them remains unclear.</p><p><strong>Aim: </strong>This study aims to explore the causal relationship between walking and ED using Mendelian randomization (MR).</p><p><strong>Methods: </strong>MR analysis was conducted using genome-wide association study (GWAS) data related to walking pace. The inverse variance weighted (IVW) method was used as the primary MR analysis method. To supplement the IVW results, two additional MR methods were used: MR-Egger and weighted median (WM). Sensitivity analyses were performed to assess heterogeneity and pleiotropy. Furthermore, multivariable MR (MVMR) analysis was employed to evaluate the causal relationship after adjusting for potential confounding factors.</p><p><strong>Outcomes: </strong>The moderating effects of different walking phenotypes on ED.</p><p><strong>Results: </strong>According to the IVW method, genetically predicted walking pace was found to have a reverse causal relationship with the risk of ED (OR: 0.24; 95% CI: 0.12-0.51). Similar causal effects were observed using the other two MR methods, with statistical significance found in the WM method and validation through sensitivity analyses. Furthermore, MVMR analysis confirmed that the protective effect of increased walking pace on reducing the risk of ED remained significant even after adjusting for potential confounders.</p><p><strong>Clinical implications: </strong>Encouraging men to engage in brisk walking could be an effective strategy for reducing the incidence of ED.</p><p><strong>Strengths and limitations: </strong>This study utilized large-scale GWAS summary data on walking and ED and employed a two-sample, multivariable MR design to minimize confounding factors and reverse causation, enabling the derivation of credible causal effects. It is essential to obtain GWAS data from other populations and replicate this MR analysis to validate the results, as well as conduct further research to explore the underlying mechanisms.</p><p><strong>Conclusion: </strong>The results of this study suggest that there is an inverse causal relationship between walking pace and ED risk, and brisk walking may be an independent protective factor against ED.</p>","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":"298-306"},"PeriodicalIF":3.3,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814913","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":"Spinal cord epidural stimulation for male sexual function in spinal cord injured rats.","authors":"Natasha Lorraine Wilkins, Kyle Beasley, Betsy Perez De Corcho Vazquez, Daniel Medina-Aguinaga, Charles H Hubscher","doi":"10.1093/jsxmed/qdae190","DOIUrl":"10.1093/jsxmed/qdae190","url":null,"abstract":"<p><strong>Background: </strong>95% of men with spinal cord injuries exhibit difficulties with sexual function, including erectile dysfunction, anejaculation, retrograde ejaculation, poor ejaculatory force, and poor sperm quality.</p><p><strong>Aim: </strong>The primary goal is to determine if well-established interventions, such as spinal cord epidural stimulation, are a feasible treatment for sexual dysfunction and if locomotor recovery training can be used to improve ejaculatory function in a rodent model of spinal cord injury (SCI).</p><p><strong>Methods: </strong>Male Wistar rats underwent thoracic laminectomies (shams), spinal cord transections, or moderate spinal cord contusion injuries. In urethane-anesthetized rodents, terminal spinal cord epidural stimulation was performed to target the mid-lumbar level spinal generator for ejaculation (SGE) in animals with transection spinal cord injuries at 3-, 14-, or 70-days post-injury and in animals with sham surgeries and spinal cord contusions at 70 days post-injury. The impact of locomotor training frequency was examined in two groups of rats with spinal cord contusion, which underwent 1-hr of assisted plantar stepping on a treadmill, training two or five times weekly for 6 weeks. Terminal experiments in all groups were followed by measures of sperm concentration and post-mortem testicular weight and morphology.</p><p><strong>Outcomes: </strong>Spinal cord epidural stimulation consistently induced the expulsion phase of ejaculation, and occasionally the emission phase of ejaculation in rats with chronic SCI.</p><p><strong>Results: </strong>All animals were most responsive to spinal cord epidural stimulation combined with manual stimulation to induce ejaculation, with chronic injury resulting in the most consistent responses. Locomotor training improved response rates to spinal cord epidural stimulation, with intermittent training resulting in the most consistent induction of both the emission and expulsion phases of ejaculation. Sperm concentration was impacted by injury completeness and time-post injury, which was lowest in the chronic complete transection group of rats. Locomotor training resulted in an overall increase in sperm concentration, with 2 days per week of training resulting in a significant improvement of sperm motility.</p><p><strong>Clinical implications: </strong>Spinal cord epidural stimulation combined with locomotor training is a feasible intervention for individuals with SCI who seek to regain sexual function.</p><p><strong>Strengths and limitations: </strong>Although we have anecdotal reports of non-targeted L3 spinal cord epidural stimulation inducing ejaculation in humans having spinal cord injuries, the current outcomes may be underestimated as stimulation was carried out in anesthetized animals.</p><p><strong>Conclusion: </strong>Spinal cord epidural stimulation to target the SGE is a feasible intervention for sexual dysfunction following SCI.</p>","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":"235-249"},"PeriodicalIF":3.3,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142900153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A novel algorithm-based risk classification for vascular damage in men with erectile dysfunction.","authors":"Federico Belladelli, Francesco Cei, Edoardo Pozzi, Alessandro Bertini, Christian Corsini, Massimiliano Raffo, Fausto Negri, Giacomo Musso, Riccardo Ramadani, Francesco Cattafi, Luigi Candela, Luca Boeri, Alessia d'Arma, Francesco Montorsi, Andrea Salonia","doi":"10.1093/jsxmed/qdae176","DOIUrl":"10.1093/jsxmed/qdae176","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Penile dynamic color doppler duplex ultrasound (CDDU) is a relevant tool in assessing men with suspected vasculogenic erectile dysfunction (V-ED).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;To investigate (1) factors potentially associated with V-ED to define risk classes useful in predicting V-ED; (2) the response to phosphodiesterase type 5 inhibitors (PDE5i); and (3) the onset of incident major cardiovascular (CV) events.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A cohort of men with ED and without known concomitant CVD was grouped into: patients undergoing CDDU (N. 301) and patients not undergoing CDDU but prospectively monitored for incident major CV events after initiating PDE5i (N. 127). Logistic regression and Chi-square Automatic Interaction Detectors (CHAID) methodology were employed to identify potential predictors and develop a novel risk classification system. Receiver operating characteristic (ROC) curves and decision curve analysis was performed to assess its accuracy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes: &lt;/strong&gt;Factors associated with V-ED useful to develop a novel risk classification system predicting incident major CV events and PDE5i response.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The new classification defines patients as follows: Very Low Risk [age &lt; 53, body mass index (BMI) &lt; 25 Kg/m2], Low Risk (age &lt; 53, BMI &gt; 25 Kg/m2, non-smokers), Moderate Risk (age &gt; 53, non-smokers), High Risk (age &lt; 53, BMI &gt; 25 Kg/m2, smokers), and Very High Risk (age &gt; 53, smokers). Multivariable logistic regression analysis highlighted age, BMI, and smoking as significant predictors of V-ED. CHAID methodology yielded a risk classification system with an accuracy of 0.79. Notably, \"Very High Risk\" class was associated with a significantly increased risk of incident major CV events [odds ratio (OR) 4.00, 95% confidence interval (CI) 1.06-15.08, P &lt; .05]. Moreover, patients belonging to \"Very High Risk\" and \"High Risk\" classes were also associated with diminished PDE5i response. At Kaplan-Meier analysis, men belonging to \"Very High Risk\" class depicted a notable risk of incident major CV events (P = .03).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Clinical implications: &lt;/strong&gt;We propose a novel risk classification system which may have some clinical value in tailoring patients at significantly higher risk of V-ED. Although preliminary, current findings also suggest that the novel risk classification system could help tailoring men at potential increased risk of incident major CV events and those not responding to PDE5i.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Strengths and limitations: &lt;/strong&gt;This study introduces a novel user-friendly risk stratification tool for V-ED, emphasizing the need for CV screening and alternative therapies for higher-risk groups. A limited number of events in the cohort with follow-up for major CV events and response to PDE5is constrains the interpretation of the results. Current findings need an external validation cohort.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Patients with ED catego","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":"291-297"},"PeriodicalIF":3.3,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824816","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":"Effect of pelvic arterial stenosis on erectile function: determining the severity threshold for erectile dysfunction.","authors":"Wei-Lun Huang, Sheng-Yung Tung, Chi-Shin Tseng, Tzung-Dau Wang, Wen-Jeng Lee, Jyh-Horng Chen, Yann-Ron Su, Hong-Chiang Chang, Yi-Kai Chang","doi":"10.1093/jsxmed/qdae172","DOIUrl":"10.1093/jsxmed/qdae172","url":null,"abstract":"<p><strong>Background: </strong>Pelvic arterial (PLA) stenosis is associated with arterial insufficiency of the penis and erectile dysfunction (ED), but the effect of different severities of PLA stenosis on ED remains unclear.</p><p><strong>Aim: </strong>To investigate how different severities of PLA stenosis affect erectile function.</p><p><strong>Methods: </strong>We included patients who visited our clinic for ED and underwent computed tomography angiography (CTA) and dynamic duplex sonography (DUS). The erectile hardness score (EHS), simplified International Index of Erectile Function (IIEF-5), DUS and CTA results, and flow index (FI) calculated from the peak systolic velocity (PSV) and PLA stenosis percentages were analyzed. EHS < 3 was defined as significant ED. PLA stenosis was analyzed by the mean PLA (average of the right and left PLA) and unilateral or bilateral stenoses. According to severity, stenosis was classified as mild, moderate, or severe.</p><p><strong>Outcomes: </strong>Subjective and objective parameters, including the IIEF-5 score, EHS, PSV, and FI, in relation to different severities of PLA stenosis.</p><p><strong>Results: </strong>The study included 182 patients. Vascular parameters such as the mean PSV, PLA stenosis, and FI correlated with EHS and IIEF-5 scores. Receiver operating characteristic analyses for predicting EHS ≥ 3 showed that all vascular parameters had acceptable discriminatory ability. During the analysis performed using the mean PSA stenosis, EHS decreased in patients with mild and severe mean PLA stenosis, although a PSV drop was noted only in severe cases. The proportion achieving EHS 3 significantly dropped in patients with at least mild mean PLA stenosis. Using unilateral or bilateral PLA stenosis, the EHS significantly dropped in patients with severe unilateral and bilateral PLA stenosis, with PSV decreasing on the affected side in severe unilateral stenosis. However, the mean PSV did not drop despite different unilateral stenosis severities. The proportion achieving EHS 3 significantly dropped among patients with at least moderate unilateral PLA stenosis and bilateral PLA stenosis but not in mild unilateral cases.</p><p><strong>Clinical implications: </strong>The severity of PLA stenosis is correlated with the risk of ED.</p><p><strong>Strengths & limitations: </strong>The strength of this study lies in its analysis of the effect of PLA stenosis on erectile function from various perspectives, including unilateral, bilateral, and mean stenosis. However, the absence of validation regarding the outcomes of endovascular therapy is a limitation.</p><p><strong>Conclusion: </strong>Mild mean PLA stenosis and moderate unilateral PLA stenosis are associated with increased risks of ED; however, mild unilateral PLA stenosis does not affect erectile function.</p>","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":"282-290"},"PeriodicalIF":3.3,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142808486","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":"Prevalence of detransition in persons seeking gender-affirming hormonal treatments: a systematic review.","authors":"Eva Feigerlova","doi":"10.1093/jsxmed/qdae186","DOIUrl":"10.1093/jsxmed/qdae186","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Despite recent evidence of the benefits of gender-affirming medical procedures, data in the literature indicate emerging demands of detransition and regrets while suggesting potential sources of bias in different datasets, including a nonconsensual definition of detransition.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;The present systematic review aims to summarize the existing research regarding the prevalence of detransition in transgender persons who requested or started receiving gonadotrophin-releasing hormone analogs (GnRHa) and/or gender-affirming hormonal therapy (GAHT).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A systematic literature search (CINAHL Plus, Cochrane Library, Google Scholar, MEDLINE, Web of Science, Sage Journals, Science Direct, Scopus) for quantitative studies was conducted up to May 2024. All eligible studies were assessed using the Strengthening the Reporting of Observational Studies in Epidemiology statement. The risk of bias was assessed using the National Institute of Health quality assessment tool. The present analysis follows the PRISMA statement for systematic review articles and the synthesis without meta-analysis recommendations.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes: &lt;/strong&gt;The primary outcome was the point-prevalence proportion of detransition events as a percentage in the population of transgender persons who were considered eligible for treatment or had initiated GnRHa and/or GAHT.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Fifteen observational studies involving 3804 children and adolescents and 3270 adult participants were included in the 3212 screened studies. Five studies reported a change in request before starting GnRHa, five studies reported GnRHa discontinuation, and nine studies reported GAHT discontinuation. The point-prevalence proportions of shifts in requests before any treatment ranged from 0.8-7.4%. The point-prevalence proportions of GnRHa discontinuation ranged from 1-7.6%. The point-prevalence proportions of GAHT discontinuation ranged from 1.6-9.8%. All of the included studies were heterogeneous regarding definitions of detransition used and the study design: their numbers were too small to be statistically relevant, their time frame was insufficient, they did not use patient-level data, or they did not consider confounding factors.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Clinical implications: &lt;/strong&gt;Quality measurement tools are needed, as are monitoring standards, and both are important for health outcomes and guarantee the attention of health care providers and policy-makers.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Strengths and limitations: &lt;/strong&gt;The unique features of this analysis are its restrictive inclusion criteria compared with those of previous reviews, such as a strict definition of detransition and a focus on empirical studies only. However, most of the studies were retrospective and unblinded, and most were not sufficiently powered to detect detransition rates.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Taken together, the results of the presen","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":"356-368"},"PeriodicalIF":3.3,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142900152","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":"Impulse control and its association with ejaculation time in men with premature ejaculation.","authors":"Tarık Sağlam, Uğur Takım, Yasin Kavla, Demirhan Örsan Demir, Şenol Turan","doi":"10.1093/jsxmed/qdae169","DOIUrl":"10.1093/jsxmed/qdae169","url":null,"abstract":"<p><strong>Background: </strong>The relationship between impulse control and premature ejaculation (PE), the most common sexual dysfunction in men, is not yet well understood.</p><p><strong>Aim: </strong>To assess the association between impulse control issues and the severity of PE in men with a lifelong diagnosis of this condition.</p><p><strong>Methods: </strong>A cross-sectional observational study was designed to evaluate patients who presented to the clinic with complaints of PE between March 2023 and March 2024. The final study sample comprised 40 men with lifelong PE and 40 healthy control subjects.</p><p><strong>Outcomes: </strong>Impulse control was evaluated with the UPPS Impulsive Behavior Scale and the Barratt Impulsivity Scale-11 (BIS-11), while depression and anxiety levels were measured using the Beck Depression Inventory (BDI) and the Beck Anxiety Inventory (BAI). The severity of PE was assessed using the Arabic Index of PE (AIPE).</p><p><strong>Results: </strong>The mean AIPE score was 15.13 ± 3.33 in the PE group and 32.05 ± 2.06 in the control group (P ˂ 0.001). Compared to the control group, the PE group had significantly higher UPSS Impulsive Behavior Scale scores in all subscales (P ˂ 0.001 for planning, urgency, and lack of perseverance; P = 0. 001 for sensation seeking) and total scores (P ˂ 0.001). The BIS-11 scores were also significantly higher in the PE group compared to the control group for all subscales (P ˂ 0.001 for all). The patients in the PE group also had higher levels of anxiety and depression (P ˂ 0.001 for all).</p><p><strong>Clinical implications: </strong>A clinician's quantitative assessment of ejaculation time and the severity of PE among men presenting to the clinic with complaints of PE may reveal accompanying comorbid conditions more effectively.</p><p><strong>Strength and limitations: </strong>The current study is a novel investigation that quantitatively evaluates PE in terms of intravaginal ejaculatory latency time and severity, aiming to identify comorbid conditions. As a limitation, the necessity for patients and their partners to measure the time to ejaculation limited the sample size, making it challenging to generalize the findings.</p><p><strong>Conclusion: </strong>Our findings suggest that impulse control plays a significant role in lifelong PE. It is important for clinicians to assess impulse control and consider therapeutic interventions for men presenting with PE complaints, particularly in those classified as severe.</p>","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":"250-257"},"PeriodicalIF":3.3,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830795","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}