Journal of Sexual Medicine最新文献

{"title":"Sexspan: a comprehensive framework for sustaining lifelong sexual health and vitality.","authors":"Gal Saffati, Mohit Khera","doi":"10.1093/jsxmed/qdae144","DOIUrl":"https://doi.org/10.1093/jsxmed/qdae144","url":null,"abstract":"","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":"22 1","pages":"4-6"},"PeriodicalIF":3.3,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142924006","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":"Psychological modalities for the treatment of localized provoked vulvodynia: a scoping review of literature from 2010 to 2023.","authors":"Gabrielle S Logan, Diana L Gustafson, Michelle Swab, Alex Rains, Michelle E Miller, Victoria A Jackman, Krisztina Bajzak","doi":"10.1093/jsxmed/qdae163","DOIUrl":"10.1093/jsxmed/qdae163","url":null,"abstract":"<p><strong>Introduction: </strong>Localized provoked vulvodynia is a common sexual health condition for which there is a lack of consensus on effective management, even though it can have a significant negative impact on psychological wellbeing, sexual functioning, and quality of life for women and their partners.</p><p><strong>Aim: </strong>To map the research landscape related to the effectiveness/efficacy of psychological treatments for localized provoked vulvodynia, identify gaps, and make recommendations for future research.</p><p><strong>Methods: </strong>We used Arksey and O'Malley's approach to conducting a scoping review to identify, organize, and summarize research published between 2010 and 2023 that investigated the efficacy or effectiveness of interventions in the management of localized provoked vulvodynia. Inclusion and exclusion criteria and the search strategy were developed by subject experts in collaboration with a health sciences librarian. A PubMed search used controlled vocabulary and keyword terms relating to vulvodynia, which were then translated into other databases. Studies not published in English or French were excluded. We did not consider other subsets of vulvodynia.Articles were uploaded to Covidence, duplicates removed, and titles and abstracts screened. The remaining articles were subject to a 2-person, independent full-text review followed by a hand search of eligible articles. All intervention studies were included regardless of the study design. Study details were reported narratively and analyzed.</p><p><strong>Main outcome measures: </strong>Of the 88 included articles published between January 2010 and March 2023, 15 reported on the efficacy/effectiveness of psychological treatments for localized provoked vulvodynia, including group educational seminars, cognitive behavioral therapy, acceptance and commitment therapy, and somatocognitive therapy.</p><p><strong>Results: </strong>Cognitive behavioral therapy was the most common form of psychological treatment studied (n = 7) with interventions for both individuals and couples. Education about the condition and the therapeutic process was a component of many interventions. Psychological therapies may be of some benefit, but only 1 RCT evaluating the efficacy of acceptance and commitment therapy appeared adequately powered to demonstrate improvement in dyspareunia. Studies sampled homogenous patient populations, primarily consisting of White, urban-dwelling, educated, partnered, heterosexual cis-women.</p><p><strong>Conclusion: </strong>Evidence of efficacy/effectiveness, drawn mainly from small studies, is promising and highlights opportunities for more robust studies with heterogeneous populations, more research on the role of education in treatment success, and greater attention to assessing patient-driven outcomes in partnered and unpartnered women.</p>","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":"132-155"},"PeriodicalIF":3.3,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Penile length after penile implant surgery is determined by stretched penile length before surgery.","authors":"Koenraad van Renterghem, Helene De Bruyn, Cedric Jorissen, Andries Van Huele, Maurizio D'Anna, Josep Torremadé, Juan I Martinez-Salamanca, Laura Prieto Matienzo, Ignacio Moncada","doi":"10.1093/jsxmed/qdae153","DOIUrl":"10.1093/jsxmed/qdae153","url":null,"abstract":"<p><strong>Background: </strong>While various treatment modalities exist, penile prosthesis (PP) implantation offers a permanent solution for patients that do not respond to or are not suitable for other treatment options for erectile dysfunction.</p><p><strong>Aim: </strong>The aim of this study was to establish stretched penile length before surgery as a reliable determining factor of penile length after penile implant surgery.</p><p><strong>Methods: </strong>For this study, data on penile length before and after PP surgery from three European centers was analyzed. Penile length measurements were conducted preoperatively and postoperatively in different conditions using standardized techniques. Only virgin cases were included and a complete case analysis was performed.</p><p><strong>Outcome: </strong>The outcome of this study was the comparison of stretched penile length before and the inflated penile length after PP surgery.</p><p><strong>Results: </strong>Data on penile length before and after PP of 361 patients was analyzed. Preoperative stretched penile length was equal to postoperative inflated penile length in 33% of patients. The absolute mean difference between pre-surgery stretched and postoperative inflated lengths was 1.1 cm. No correlation was found between implanted cylinder length and postoperative penile length. Additionally, the choice of implant type did not significantly affect postoperative penile length outcomes.</p><p><strong>Clinical implications: </strong>Our findings confirm the reliability of preoperative stretched penile length as a tool for proper patient counseling before PP surgery.</p><p><strong>Strengths & limitations: </strong>Although our study is overpowered, our results show that preoperative stretched penile length serves as a reliable predictor of postoperative penile length outcomes after PP surgery. By providing clinicians with a tool for patient counseling, our findings contribute to enhancing satisfaction and quality of life outcomes in patients undergoing PP implantation.</p><p><strong>Conclusion: </strong>Preoperative stretched penile length serves as a reliable predictor of postoperative penile length outcomes after PP surgery.</p>","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":"165-169"},"PeriodicalIF":3.3,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632182","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":"Response to Letter to the Editor on \"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/qdae165","DOIUrl":"10.1093/jsxmed/qdae165","url":null,"abstract":"","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":"209-211"},"PeriodicalIF":3.3,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142645062","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":"Adenosine relaxes vagina smooth muscle through the cyclic guanosine monophosphate- and cyclic guanosine monophosphate-dependent pathways.","authors":"Ilaria Cellai, Sandra Filippi, Paolo Comeglio, Giulia Guarnieri, Gabriele Acciai, Chiara Cancedda, Sarah Cipriani, Elisa Maseroli, Giulia Rastrelli, Annamaria Morelli, Mario Maggi, Linda Vignozzi","doi":"10.1093/jsxmed/qdae150","DOIUrl":"10.1093/jsxmed/qdae150","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;In males, adenosine (ADO) is known to relax penile smooth muscles, although its role in the vagina is not yet fully elucidated.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;This study investigated the effect of ADO on vagina smooth muscle activity, using a validated female Sprague-Dawley rat model.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Contractility studies, using noradrenaline-precontracted vaginal strips, tested the effects of ADORA1/3 antagonists and ADORA2A/2B antagonists and agonists. Increasing doses of ADO were tested after in vivo or in vitro treatment with Nω-nitro-L-arginine-methyl-ester hydrochloride (L-NAME) or with guanylate or adenylate cyclase inhibitors. Immunopositivity for ADORA2A and ADORA2B was assessed, and messenger RNA (mRNA) analysis was performed. Cyclic ADO monophosphate (cAMP) and cyclic guanosine monophosphate (cGMP) were quantified both in rat vagina smooth muscle cells (rvSMCs) and in vaginal tissues with increasing doses of ADO.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes: &lt;/strong&gt;Demonstrating ADO's role in the relaxing/contractile mechanism in distal vagina smooth muscle.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;All ADO receptors mRNAs were expressed in vaginal tissue, with a prevalent content of ADORA2B. A high expression of genes regulating ADO catabolism (ADK) and de novo synthesis (NT5E) was found. In vaginal strips, ADO induced relaxation with IC50 = 144.7 μM and a flat pseudo-Hill coefficient value = -0.42, indicating an activity on heterogeneous receptors. Blocking ADORA1/3 shifted ADO response to the left and with a steeper slope. ADORA2A/2B agonists showed a higher potency than ADO in inducing relaxation. Immunolocalization confirmed the presence of ADORA2A/2B in vaginal musculature, in the blood vessels endothelium, and in the epithelium. ADO stimulation of vagina tissues induced a significant increase in cAMP and cGMP contents. Experiments on rvSMCs confirmed that ADO time- and dose-dependently stimulated cAMP production in these cells. However, ADORA2A/2B antagonists, although reducing the ADO-induced relaxation, did not completely block it. A similar inhibition was obtained by blocking adenylate cyclase. Overall, these findings suggest that ADO relaxation involves other pathways, eg, nitric oxide (NO)/cGMP. Accordingly, blocking NO formation through L-NAME substantially blunted ADO responsiveness, as it does the block of cGMP formation through 1H-[1,2,4]oxadiazolo-[4,3-a]quinoxalin-1-one. Simultaneous incubation with cGMP and cAMP blockers completely inhibited ADO responsiveness.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Clinical translation: &lt;/strong&gt;The study highlights ADO's role in regulating vaginal smooth muscle activity, suggesting its potential effect on the vagina.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Strengths and limitations: &lt;/strong&gt;This is the first study on ADO in the vagina, although the results are preliminary and limited to the rat model.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;These results show that ADO acts as a vaginal relaxing modulator through selectiv","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":"14-25"},"PeriodicalIF":3.3,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142752258","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":"Pelvic floor muscle activation amplitude at rest, during voluntary contraction, and during Valsalva maneuver-a comparison between those with and without provoked vestibulodynia.","authors":"Linda McLean, Flavia Ignacio Antonio, Marina Petter Rodrigues, Caroline Pukall","doi":"10.1093/jsxmed/qdae170","DOIUrl":"https://doi.org/10.1093/jsxmed/qdae170","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The neuromuscular contribution to increased tone of the pelvic floor muscles (PFMs) observed among those with provoked vestibulodynia (PVD) is unclear.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;To determine if PFM activity differs between those with provoked PVD and pain free controls, and if the extent of PFM activation at rest or during activities is associated with pain sensitivity at the vulvar vestibule, psychological, and/or psychosexual outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This observational case-control study included forty-two volunteers with PVD and 43 controls with no history of vulvar pain. Participants completed a series of questionnaires to evaluate pain, pain catastrophizing, depression, anxiety and stress, and sexual function, then underwent a single laboratory-based assessment to determine their pressure pain threshold at the vulvar vestibule and electromyographic (EMG) signal amplitudes recorded from three PFMs (pubovisceralis, bulbocavernosus, and external anal sphincter).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes: &lt;/strong&gt;EMG signal amplitude recorded at rest, during maximum voluntary contraction (MVC), and during maximal effort Valsalva maneuver, pressure pain threshold at the vulvar vestibule, and patient-reported psychological (stress, anxiety, pain catastrophizing, central sensitization) and psychosexual (sexual function) outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Participants with PVD had higher activation compared to controls in all PFMs studied when at rest and during Valsalva maneuver. There were no group differences in EMG amplitude recorded from the pubovisceralis during MVC (Cohen's d = 0.11), but greater activation was recorded from the bulbocavernosus (d = 0.67) and the external anal sphincter(d = 0.54) among those with PVD. When EMG amplitudes at rest and on Valsalva were normalized to activation during MVC, group differences were no longer evident, except at the pubovisceralis, where tonic EMG amplitude was higher among those with PVD (d = 0.42). While those with PVD had lower vulvar pressure pain thresholds than controls, there were no associations between PFM EMG amplitude and vulvar pain sensitivity nor psychological or psychosexual problems.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Clinical implications: &lt;/strong&gt;Women with PVD demonstrate evidence of PFM overactivity, yet the extent of EMG activation is not associated with vulvar pressure pain sensitivity nor psychological/psychosexual outcomes. Interventions aimed at reducing excitatory neural drive to these muscles may be important for successful intervention.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Strengths and limitations: &lt;/strong&gt;This study includes a robust analysis of PFM EMG. The analysis of multiple outcomes may have increased the risk statistical error, however the results of hypothesis testing were consistent across the three PFMs studied. The findings are generalizable to those with PVD without vaginismus.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Those with PVD demonstrate higher PFM activity in ","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830798","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":"Pelvic floor muscle activation in response to pressure stimuli applied to the vulvar vestibule: an observational study comparing women with and without provoked vestibulodynia.","authors":"Linda McLean, Flavia Ignacio Antonio, Marina Petter Rodrigues, Caroline Pukall","doi":"10.1093/jsxmed/qdae171","DOIUrl":"https://doi.org/10.1093/jsxmed/qdae171","url":null,"abstract":"<p><strong>Background: </strong>The nature of pelvic floor muscle (PFM) involvement in provoked vestibulodynia (PVD) is poorly understood.</p><p><strong>Aim: </strong>We aimed to determine if PFM electromyographic (EMG) activity in anticipation of or response to pressure applied to the posterior vaginal fourchette differs between those with and without PVD, and if the magnitude of PFM response is associated with pressure pain sensitivity, psychological or psychosexual function.</p><p><strong>Methods: </strong>This was an observational case-control study. Forty-two volunteers with PVD and 43 controls with no vulvar pain participated. Five on-line questionnaires were completed, then participants underwent a laboratory-based evaluation of vulvar pain sensitivity. EMG activation of the PFMs, hip adductor, and upper trapezius muscles was measured before, during, and after pressure stimuli (low, moderate) were applied, in random order, to the posterior vaginal fourchette and the posterior thigh (control site).</p><p><strong>Outcomes: </strong>EMG amplitude of the pubovisceralis (PV), bulbocavernosus (BC), and external anal sphincter (EAS) muscles. Secondary outcomes were EMG activation of the hip adductor brevis and upper trapezius muscles, questionnaire scores reflecting psychological/psychosexual outcomes, pressure pain threshold (PPT) at the vulvar vestibule, pain reported on a tampon test, and heart rate/heart rate variability.</p><p><strong>Results: </strong>Compared to controls, EMG activation of the PV and EAS, but not the BC, was higher in anticipation of the pressure applied to the vaginal fourchette, was higher in all PFMs while the pressure was applied, and remained higher than baseline after the pressure was removed among those with PVD. EMG response amplitudes were modulated by the intensity of the pressure applied, with the largest responses reaching over 40% MVC in the EAS among those with PVD. PFM EMG amplitudes were associated with greater pain sensitivity and lower sexual function, but not with pain catastrophizing, central sensitization, depression, anxiety, or stress.</p><p><strong>Clinical implications: </strong>While some anticipatory activation was observed, EMG responses were primarily observed during and after the application of the pressure. Among those with PVD, digital assessment of PFM tone might reflect PFM responses to pain at the vulvar vestibule, and interventions to reduce local pain sensitivity may be an important first step to successful improvements in vaginal function.</p><p><strong>Strengths and limitations: </strong>This study includes a robust analysis of EMG activation. However, the cross-sectional design precludes the determination of causal relationships.</p><p><strong>Conclusions: </strong>Those with PVD demonstrate higher PFM responses and a higher prevalence of anticipatory activation in the PV and EAS muscles than controls in response to pressure applied at the vulvar vestibule.</p>","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830799","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 effect of puboperiurethral suspension stitch placement on climacturia after robot-assisted laparoscopic radical prostatectomy.","authors":"Selman Unal, Musab Ali Kutluhan, Halil Uzundal, Turker Soydas, Emrah Okulu, Asim Ozayar, Onder Kayigil","doi":"10.1093/jsxmed/qdae130","DOIUrl":"10.1093/jsxmed/qdae130","url":null,"abstract":"<p><strong>Background: </strong>Climacturia is defined as urine leakage associated with orgasm and can negatively affect patients' quality of life. The high prevalence of climacturia after radical prostatectomy (RP) has led to continued efforts to reduce climacturia rates. It has been shown that puboperiurethral suspension stitch placement during RP assists in the recovery of urinary continence.</p><p><strong>Aim: </strong>To evaluate the impact of puboperiurethral suspension stitch placement during RP on post-RP climacturia.</p><p><strong>Methods: </strong>We conducted a retrospective study of patients who underwent nerve-sparing robot-assisted laparoscopic RP (RALP) at our institution between 2016 and 2023. The patients were categorized into 2 groups: Group 1 (n = 32) that underwent nerve-sparing RALP with puboperiurethral suspension stitch placement and Group 2 (n = 62) that underwent nerve-sparing RALP alone. Patients who were not able to achieve penetration at the last follow-up visit were excluded from the study. The clinical history, parameters of prostate cancer, details of medical and surgical treatments, and follow-up data were evaluated.</p><p><strong>Outcomes: </strong>Differences in sexual and urinary function, climacturia rates, and complications between nerve-sparing RP with and without puboperiurethral suspension stitch placement.</p><p><strong>Results: </strong>There were no significant differences between the groups in terms of surgical complications. The mean follow-up time was 14.62 ± 3.55 months in Group 1 and 14.43 ± 4.44 months in Group 2 (P = .42). Postoperative erectile functions were similar between the groups. At the last follow-up visit, climacturia was present in 4 patients (12.5%) in Group 1 and 24 patients (38.7%) in Group 2 (P = .016). The long-term stress urinary incontinence rates were similar between the groups.</p><p><strong>Clinical implications: </strong>This study provides comparative results on postoperative climacturia rates between nerve-sparing RALP groups with and without puboperiurethral suspension stitch placement. These results show that puboperiurethral suspension stitch can help to prevent postoperative climacturia after RP.</p><p><strong>Strength and limitations: </strong>This is the first study in the literature that evaluates the effect of puboperiurethral suspension stitch on climacturia. The limitations include the single-center, retrospective design with potential selection bias, possible inaccuracies in the recorded medical data, and challenges in controlling confounding variables.</p><p><strong>Conclusion: </strong>Our study demonstrated that puboperiurethral suspension stitch was a feasible option for the prevention of climacturia after RALP without an increased risk of complications.</p>","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":"1193-1200"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331910","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":"Niclosamide attenuates erectile dysfunction and corporal fibrosis via reversal of Smad signaling in diabetic rat model.","authors":"Seçkin Engin, Elif Nur Barut, Yeşim Kaya Yaşar, Semanur Işık, Gökçen Kerimoğlu, Arthur L Burnett, Sena F Sezen","doi":"10.1093/jsxmed/qdae129","DOIUrl":"10.1093/jsxmed/qdae129","url":null,"abstract":"<p><strong>Background: </strong>Diabetes mellitus-induced erectile dysfunction (DMED) is a common urological complication of diabetes, and current drugs often fail to provide an effective treatment. Smad2/3 signaling-mediated corporal fibrosis has a critical role in the molecular basis of DMED.</p><p><strong>Aim: </strong>We investigated the effect of Niclosamide (Nic), an antihelmintic drug with antifibrotic effects, on erectile function in a rat DMED model.</p><p><strong>Methods: </strong>Male Sprague Dawley rats were injected intraperitoneally (i.p) with streptozotocin (75 mg/kg) to induce diabetes. At week 8, both diabetic and nondiabetic rats were treated with Nic (10 mg·kg-1/day; i.p) or vehicle for 4 weeks. At week 12, erectile function was evaluated as intracavernous pressure (ICP) response to the electrical stimulation of the cavernous nerve (CN). Penile tissues were harvested for Masson's trichrome staining or western blotting to determine corporal fibrosis and Smad2/3 pathway-related protein expression, respectively.</p><p><strong>Outcomes: </strong>At the end of the experimental protocol, in vivo erectile function was assessed by measuring the ratio of ICP/ mean arterial pressure (MAP) and total ICP following CN stimulation. Smooth muscle content and collagen fibers were evaluated by Masson's trichrome staining of the penile tissues. The expressions of fibrosis-related proteins (Smad2, Smad3, fibronectin) were determined using western blotting in the penile tissues.</p><p><strong>Results: </strong>Erectile function, as determined by the maximum ICP/MAP and total ICP/MAP ratios, was drastically decreased in diabetic rats. Corporal tissues of diabetic rats were severely fibrotic with a significant increase in collagen fibers and a marked reduction in smooth muscle content. Also, the protein expressions of phosphorylated (p-)Smad2, p-Smad3 and fibronectin were significantly increased in the penis of diabetic rats. Both functional and molecular alterations in DMED were effectively reversed by Nic-treated diabetic rats without a glycemic alteration.</p><p><strong>Clinical implications: </strong>Nic could be a promising candidate for the treatment of DMED due to its antifibrotic effects.</p><p><strong>Strengths and limitations: </strong>The present study provides the first evidence that Nic has beneficial effect on erectile dysfunction by attenuating corporal fibrosis in a rat model of DMED. The effect of Nic on penile endothelial function and the other potential underlying mechanisms needs to be further elucidated.</p><p><strong>Conclusions: </strong>Nic improved erectile function in DMED rats possibly suppressing penile fibrosis by inhibiting Smad2/3 signaling. These results suggest a potential therapeutic repurposing of Nic as an adjuvant treatment in DMED.</p>","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":"1111-1119"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142480198","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":"Predictors of duty sex frequency in women.","authors":"Kate B Metcalfe, Chelsea D Kilimnik, Cindy M Meston","doi":"10.1093/jsxmed/qdae137","DOIUrl":"10.1093/jsxmed/qdae137","url":null,"abstract":"<p><strong>Background: </strong>Duty Sex-the act of engaging in sex out of a sense of duty or obligation to a partner-is a commonly reported reason why women have sex, with studies indicating associations between Duty Sex and sexual dysfunction, as well as nonconsensual sexual experiences (NSEs).</p><p><strong>Aim: </strong>This study sought to examine the associations between Duty Sex frequency, sexual function, and NSEs using comprehensive, validated measures of sexual function and NSE histories in a large community sample of women.</p><p><strong>Methods: </strong>Six hundred and fifty-eight women with (n = 293) and without (n = 365) NSE histories completed measures of sexual function and sexual motivations.</p><p><strong>Results: </strong>Women with NSE histories reported more sexual pain, lower sexual satisfaction, and more frequent Duty Sex. The relation between NSE history and Duty Sex remained after controlling for the variance in sexual function. The type of NSE behavior, but not the timing of the first NSE nor the perceived impact of the experience, predicted Duty Sex frequency.</p><p><strong>Clinical implications: </strong>Clinicians should consider sexual motivations, particularly Duty Sex, when treating women with NSE histories or who experience sexual dysfunction.</p><p><strong>Strengths and limitations: </strong>To our knowledge, this was the first study to examine how NSEs relate to all domains of sexual function and sexual motives, revealing a link between NSEs, sexual function, and Duty Sex. However, we were unable to account for what percentage of sexual encounters are considered Duty Sex. Therefore, our measurement of Duty Sex lacks specificity, which may explain the relatively low variance accounted for by the models in our analyses.</p><p><strong>Conclusions: </strong>There are consequences of NSEs, including difficulties with communicating sexual boundaries and impairment of sexual function, that may contribute to the increased likelihood of engaging in Duty Sex.</p>","PeriodicalId":51100,"journal":{"name":"Journal of Sexual Medicine","volume":" ","pages":"1120-1130"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11643303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142570120","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}