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Sexual Medicine Reviews Jun 2024One of the changes caused by pelvic cancers is the decrease in patients' sexual function, which influences their quality of life (QoL) during and after treatment. Sexual...
INTRODUCTION
One of the changes caused by pelvic cancers is the decrease in patients' sexual function, which influences their quality of life (QoL) during and after treatment. Sexual dysfunction (SD) is associated with severe ejaculatory dysfunction, sexual dissatisfaction, reduced libido and sexual desire, decreased intensity of orgasm, difficulty in erection, and lower sexual frequency.
OBJECTIVES
This systematic review investigated the effectiveness of conservative treatments (nonsurgical and nonpharmacologic) for SD in males with pelvic cancer.
METHODS
Systematic searches were performed in the Cochrane Library, PubMed, CINAHL, PEDro, Embase, and VHL databases in September 2023 by using MeSH terms related to population, study design, intervention, and outcome.
RESULTS
Only prostate cancer studies were included due to a lack of studies in other treatments. Studies used pelvic floor muscle training (8 studies); biofeedback (1 study); a penile vibrator (1 study); electrostimulation (2 studies); shock wave therapy (2 studies); aerobic, resistance, and flexibility exercises (2 studies); and a vacuum erection device (1 study). All articles assessed sexual function and reported improvements in the intervention group, including 5 with no differences between the groups. Articles involving shock wave therapy described improvements in SD but were not clinically relevant. Studies evaluating QoL reported benefits in the experimental groups. Adverse effects of a vacuum erection device and penile vibrator were reported.
CONCLUSION
Conservative treatments are more effective than others in treating SD in men with prostate cancer. Further studies are needed to assess the unwanted effects of these treatments. In this study, we found evidence that this type of therapy improves sexual function and QoL in this population.
PubMed: 38936816
DOI: 10.1093/sxmrev/qeae045 -
Aktuelle Urologie Jun 2024Integrity, control and regulation of the urinary tract are subject to a complex neuronal regulation, in which portions of the sympathetic, parasympathetic and somatic...
Integrity, control and regulation of the urinary tract are subject to a complex neuronal regulation, in which portions of the sympathetic, parasympathetic and somatic nervous system are involved. The spinal cord plays a central role in regulation and serves as a transmitter for the motor and sensory pathways. Bladder dysfunction followed by renal dysfunction was the most frequent cause of death in patients with spinal cord injuries/diseases (paraplegia) as recently as half a decade ago. Thanks mainly to diagnostic and therapeutic advances made in neuro-urology, urological problems are no longer life-limiting. A vital role is played not only by the actual function of the urinary tract but also by the complex interactions in patients living with paraplegia. Issues such undertreated hyperactivity of the detrusor muscle with autonomous dysregulation, incontinence with secondary skin changes, or insufficient hand function to perform intermittent catheterisation must be evaluated in an interdisciplinary approach. Spinal cord injury/disease implies numerous functional disorders and secondary impairments of the organism. In addition to bladder function, sexual dysfunction also plays a crucial role. Especially in younger patients who sustain paraplegia before or during the family planning phase, this disruption and limitation is an essential reason for reduced quality of life. Neurogenic intestinal function plays an additional crucial role with regard to quality of life and management of everyday life. In recent years, the range of neuro-urological topics has expanded significantly. The focus of our work shifted from being merely on the urinary tract and urodynamics. In particular, the diagnostic investigation and treatment of neurogenic intestinal dysfunction is increasingly in the hands of neuro-urologists. The complex presentation of paraplegia involves an interaction of bladder, intestinal and sexual dysfunction in a way that these influence one another. Therefore, the sustained care and re-integration of these patients essentially includes lifelong and regular neuro-urological care in a paraplegia centre. Last but not least, it is exactly these neuro-urological topics such as urinary tract infections, urinary and intestinal incontinence and faecal impaction, which most commonly lead to re-hospitalisation.
PubMed: 38936415
DOI: 10.1055/a-2252-0323 -
Drug and Alcohol Dependence Jun 2024Substance use is highly prevalent among women experiencing intimate partner violence (IPV) and has been associated with dysfunction of the hypothalamic-pituitary-adrenal...
INTRODUCTION
Substance use is highly prevalent among women experiencing intimate partner violence (IPV) and has been associated with dysfunction of the hypothalamic-pituitary-adrenal (HPA) axis and resulting cortisol response. Posttraumatic stress disorder (PTSD) symptoms may play an important role in exacerbating the association between cortisol levels and substance use behaviors.
PURPOSE
This study examined the role of PTSD symptoms in the relation between cortisol and past month substance use behaviors. The current study used hair cortisol as an index of past 30-day HPA-axis functioning and ecological momentary assessment (EMA) to characterize substance use behaviors more accurately over a 30-day period.
METHOD
Participants were 90 community women who had experienced physical or sexual IPV in the past 30 days by their current male partner and used any amount of alcohol or drugs (M age = 40.71; 54.4 % white). Participants completed (a) a baseline interview, (b) EMA for 30-days, and (c) a follow up interview where they were asked to provide a hair sample for cortisol analyses. Data collection took place from 2018 to 2020.
RESULTS
PTSD severity moderated the relations between cortisol and days of drinking and binge drinking. In the context of high PTSD symptomology, women with high cortisol levels spent, on average, an additional 7.4 days drinking and 8.1 days binge drinking in the past 30 days compared to women with low cortisol levels, in a model adjusted for age.
CONCLUSIONS
Results highlight the prominent role of PTSD symptoms in the association between cortisol and alcohol use among women experiencing IPV.
PubMed: 38936182
DOI: 10.1016/j.drugalcdep.2024.111378 -
JAMA Network Open Jun 2024
Topics: Humans; Female; United States; Adult; Male; Adolescent; Minors; Prevalence; Young Adult; Child; Transgender Persons; Middle Aged; Sex Reassignment Surgery; Cross-Sectional Studies; Gender Dysphoria
PubMed: 38935380
DOI: 10.1001/jamanetworkopen.2024.18814 -
Archivio Italiano Di Urologia,... Jun 2024Erectile dysfunction can cause self-withdrawal and decreased quality of life. Patients who do not respond to pharmacological therapy and other conservative treatments... (Comparative Study)
Comparative Study Meta-Analysis
INTRODUCTION
Erectile dysfunction can cause self-withdrawal and decreased quality of life. Patients who do not respond to pharmacological therapy and other conservative treatments are urged to undergo penile prosthesis implantation. Malleable penile prosthesis was the first prosthesis developed, but then inflatable penile prosthesis was developed to give a more natural erection. There is no meta-analysis comparing inflatable and malleable penile prostheses in terms of safety and efficacy. This study is conducted to evaluate patient and partner satisfaction, ease of use, mechanical failure, and infection rate in patients who underwent penile prosthesis implantation.
METHOD
This meta-analysis followed Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) protocols. Five eligible studies were included from Pubmed, Scopus, ScienceDirect, and SemanticScholar databases.
RESULT
In this study, patient and partner satisfaction are significantly better (OR 3.39, 95% CI 1.66-6.93, p = 0.0008) (OR 2.32, 95% CI 1.75-3.08, p < 0.00001). Mechanical failure is also significantly higher in inflatable penile prostheses (OR 5.60, 95% CI 2.02-15.53, p = 0.0009). There is no significant difference in terms of ease of use and infection rate in inflatable or malleable penile prostheses.
CONCLUSIONS
This study concluded that inflatable penile prosthesis is better in terms of patient and partner satisfaction, but mechanical failures occur more frequently in this type of prosthesis.
Topics: Humans; Male; Erectile Dysfunction; Penile Prosthesis; Patient Satisfaction; Prosthesis Design; Penile Implantation; Treatment Outcome; Quality of Life; Prosthesis Failure
PubMed: 38934528
DOI: 10.4081/aiua.2024.12353 -
Current Opinion in Obstetrics &... Aug 2024Hysterectomy is the most common gynecologic surgical procedure performed on women in the United States. While there are data supporting that hysterectomy for benign... (Review)
Review
PURPOSE OF REVIEW
Hysterectomy is the most common gynecologic surgical procedure performed on women in the United States. While there are data supporting that hysterectomy for benign indication often does not reduce sexual function and may in fact improve sexual function as fibroids and endometriosis are resected, it remains unclear if there are factors within the perioperative period that affect sexual function in the years following surgery. To date, there is no consensus on what factors can optimize patients' sexual function after hysterectomy.
RECENT FINDINGS
We present the current literature that assesses factors which may contribute to sexual function after hysterectomy. Preoperative demographic factors, including increasing age, pelvic pain, and preoperative sexual dysfunction, play a large role in postoperative sexual function. Perioperatively, there is a growing amount of data suggesting that premenopausal salpingo-oophorectomy at the time of hysterectomy may increase the risk of sexual dysfunction after hysterectomy, and no conclusive evidence that subtotal hysterectomy improves sexual function. The route of hysterectomy and technique of cuff closure can impact sexual function after hysterectomy due to the risk of shortening the vaginal length.
SUMMARY
There is a lack of high-quality evidence that can provide a consensus on factors to optimize sexual function after hysterectomy. A growing area of research in the excision of endometriosis procedures is the consideration of nerve-sparing surgery. Considering the many variables that exist when counseling a patient on benign hysterectomy and its effects on sexual function, it is critical to understand the current research that exists with regards to these factors.
Topics: Humans; Female; Hysterectomy; Sexual Dysfunction, Physiological; Risk Factors; Endometriosis; Postoperative Complications; Pelvic Pain; Salpingo-oophorectomy
PubMed: 38934105
DOI: 10.1097/GCO.0000000000000959 -
Journal of Diabetes and Metabolic... Jun 2024fluctuation in serum levels of thyroid hormones or thyroid-associated dysfunction can negatively affect the sexual behaviors or performance, and disruption in couples`... (Review)
Review
INTRODUCTION
fluctuation in serum levels of thyroid hormones or thyroid-associated dysfunction can negatively affect the sexual behaviors or performance, and disruption in couples` relationship or satisfaction. Thus, this systematic review and meta-analysis study was aimed to investigate the global prevalence of sexual dysfunction in men with thyroid gland disorders (TGD).
METHODS
this systematic review and meta-analysis study conducted based on PRISMA statement criteria regarding the available evidences representing the prevalence of sexual dysfunction in men with TGD. The initial searching process was applied on July, 2023. In this era, the main keywords of "Prevalence", "Sexual disorders", "Sexual disorder", "Sexual dysfunction", "Male sexual dysfunction", "Erectile dysfunction", "Males", "Men", "Thyroid disorders", "Thyroid diseases", "Hyperthyroidism", "Thyroid", and "Thyroiditis" were hired. Also, "AND" and "OR" operators were used for keywords combination. All intended studies were searched using the databases of Web of Science, Google Scholar, Scopus, ScienceDirect, PubMed, and Embase. Random effects model was used to perform the analysis and the heterogeneity of the studies was assessed through I index. Data analysis was applied with CMA software (v.2).
RESULTS
following the assessment of 17 eligible studies with a sample size of 501 individuals, the global prevalence of male sexual dysfunction with TGD was found 51.5% (95% CI:38.7-64). Also, the prevalence of male sexual dysfunction in hypothyroidism and hyperthyroidism cases was 59.1% (95% CI:37.2-77.8) and 41.5% (95% CI:25.9-59.1), respectively. The meta-regression analysis showed that following incremental trend in sample size, the global prevalence of male sexual dysfunction with TGD decreases. This assessment also revealed that the prevalence of male sexual dysfunction increases with the year of study conduction, significantly ( < 0.05).
CONCLUSION
the global prevalence of sexual dysfunction in men with TGD was found relatively high. also, the highest prevalence of sexual disorders was reported in hypothyroid cases. Thus, health policymakers are suggested to inform the individuals prone to this pathology regarding the negative effects of TGD on sexual dysfunction. Besides, TGD-affected cases can prevent sexual disorders and unpleasant consequences through timely medical treatments.
PubMed: 38932831
DOI: 10.1007/s40200-024-01408-4 -
Journal of Clinical Medicine Jun 2024: The COVID-19 pandemic brought significant changes to daily life in Poland, with restrictions affecting various sectors, including entertainment, education, and travel....
: The COVID-19 pandemic brought significant changes to daily life in Poland, with restrictions affecting various sectors, including entertainment, education, and travel. The pandemic's impact extended to intimate aspects of life. This study aimed to compare the sexual functioning of young adults in Poland before and during the pandemic, using the Changes in Sexual Functioning Questionnaire (CSFQ-14). : The research involved an online survey with demographic questions, the CSFQ-14 for pre-pandemic sexual functioning, and modified CSFQ-14 questions for the pandemic period. Sexual dysfunction was determined using predefined cutoff scores. : Overall, the study found no significant difference in the sexual functioning of young Poles during the COVID-19 pandemic compared to before. However, there were gender-specific trends. Women reported enhanced pleasure, satisfaction, and orgasm during lockdown, while men faced challenges with erection and ejaculation. A higher proportion of women experienced overall sexual dysfunction compared to men, both before and during the pandemic. This research provides insights into the impact of the COVID-19 pandemic on the sexual lives of young Poles. While overall sexual functioning remained relatively stable, specific aspects varied by gender. : The study emphasizes the need to consider demographic factors, such as age and gender, when assessing the effects of external stressors like a pandemic on sexual health. Further research is essential to fully grasp these complexities and their potential long-term consequences.
PubMed: 38929899
DOI: 10.3390/jcm13123370 -
Journal of Personalized Medicine Jun 2024Inflatable penile prosthesis (IPP) surgery is an effective treatment for erectile dysfunction (ED), but infections pose a significant threat to its success. Current... (Review)
Review
Inflatable penile prosthesis (IPP) surgery is an effective treatment for erectile dysfunction (ED), but infections pose a significant threat to its success. Current guidelines lack antifungal recommendations, despite rising fungal infection rates post-IPP surgery. This review examines epidemiology, risk factors (including diabetes mellitus, immunosuppression, and obesity), and pathogenesis, highlighting the role of biofilm formation in device contamination. Clinical manifestations vary from acute to delayed, with fungal biofilms presenting challenges in diagnosis. Prophylactic strategies, including broad-spectrum antibiotics and antifungals, are crucial, with evidence suggesting a 92% reduction in infections. With fungal infections showing lower salvage rates, management involves culture-guided treatment, irrigation, and oral antibiotics. Future research aims to understand biofilm mechanisms and develop biomaterials to reduce infection rates. Implementing antifungal therapy, along with standard practices like the no-touch technique and antibiotic dips, is crucial in preventing IPP infections.
PubMed: 38929865
DOI: 10.3390/jpm14060644 -
Cancers Jun 2024We aimed to report sexual and reproductive outcomes following post-chemotherapy robot-assisted retroperitoneal unilateral lymph node dissection (PC-rRPLND) for...
We aimed to report sexual and reproductive outcomes following post-chemotherapy robot-assisted retroperitoneal unilateral lymph node dissection (PC-rRPLND) for non-seminomatous germ cell tumors (NSGCTs) at a high-volume cancer center. We collected records regarding sexual and reproductive outcomes of patients undergoing unilateral PC-rRPLND for stage II NSGCTs from January 2018 to November 2021. Preoperative and postoperative (at 12 months) ejaculatory function as well as erectile function, based on the International Index of Erectile Function-5 (IIEF-5) and Erection Hardness Score (EHS), were assessed. Only patients with a pre-operative IIEF-5 of ≥22 and EHS of ≥3 were included in this analysis. Overall, 22 patients undergoing unilateral PC-rRPLND met the inclusion criteria. Of these, seven (31.8%) patients presented an andrological disorder of any type after PC-rRPLND. Specifically, retrograde ejaculation was present in three (13.6%) patients and hypospermia was present in one (4.5%) patient. Moreover, three (13.6%) patients yielded erectile dysfunction (IIEF-5 < 22 and/or EHS < 3). Lastly, two (9.1%) succeeded in naturally conceiving a child after PC-rRPLND. Retrograde ejaculation is confirmed to be one of the most common complications of PC-rRPLND. Moreover, a non-negligible number of patients experience erectile dysfunction.
PubMed: 38927936
DOI: 10.3390/cancers16122231