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The Journal of Sexual Medicine Jul 2023No conclusions have been reached on whether female stress urinary incontinence (SUI) and related treatments affect male partners' sexual function. (Meta-Analysis)
Meta-Analysis
BACKGROUND
No conclusions have been reached on whether female stress urinary incontinence (SUI) and related treatments affect male partners' sexual function.
AIM
To assess the effects of female SUI and related treatments on male partners' sexual function.
METHODS
A comprehensive search of the PubMed, Embase, Web of Science, Cochrane, and Scopus databases was performed up to September 6, 2022. Studies were included that investigated the effect of female SUI and related treatments on male partners' sexual function.
OUTCOME
Male partners' sexual function.
RESULTS
Of the 2294 citations identified, 18 studies with 1350 participants were included. Two studies assessed the effect of female SUI without treatment on male partners' sexual function, finding that partners had more erectile dysfunction, more sexual dissatisfaction, and less sexual frequency than partners of women without urinary incontinence. Seven studies directly assessed the effect of female SUI treatments on male partners' sexual function by surveying the male partners. Among these, 4 assessed transobturator suburethral tape (TOT) surgery; 1 assessed TOT and tension-free vaginal tape obturator surgery; and the remaining 2 assessed pulsed magnetic stimulation and laser treatment. Among the 4 TOT studies, 3 used the International Index of Erectile Function (IIEF). TOT surgery significantly improved the total IIEF score (mean difference [MD] = 9.74, P < .00001), along with erectile function (MD = 1.49, P < .00001), orgasmic function (MD = 0.35, P = .001), sexual desire (MD = 2.08, P < .00001), intercourse satisfaction (MD = 2.36, P < .00001), and overall satisfaction (MD = 3.46, P < .00001). However, the improvements in IIEF items may be of unclear clinical significance, as 4 points in the erectile function domain of the IIEF are typically defined as the minimal clinically important difference. In addition, 9 studies indirectly assessed the effect of female SUI surgery on male partners' sexual function by surveying patients with the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire. The results demonstrated no significant differences in erectile function (MD = 0.08, P = .40) or premature ejaculation (MD = 0.07, P = .54).
CLINICAL IMPLICATIONS
The effects of female SUI and related treatments on male partners' sexual function were summarized for the first time, providing a reference for future clinical practice and scientific research.
STRENGTHS AND LIMITATIONS
A limited number of studies that used various scales met the standardized eligibility criteria.
CONCLUSION
Female SUI may affect male partners' sexual function, and female patients' anti-incontinence surgery does not appear to have a clinically significant improvement on the sexual function of their partners.
Topics: Female; Humans; Male; Urinary Incontinence, Stress; Erectile Dysfunction; Sexual Behavior; Coitus; Libido; Suburethral Slings; Treatment Outcome
PubMed: 37291077
DOI: 10.1093/jsxmed/qdad070 -
The Journal of Sexual Medicine Jun 2023Sexual dysfunction is thought to be highly prevalent in patients with psychiatric disorders. Factors such as the use of psychotropic substances (ie,...
BACKGROUND
Sexual dysfunction is thought to be highly prevalent in patients with psychiatric disorders. Factors such as the use of psychotropic substances (ie, psychopharmaceuticals and drugs), age, or somatic diseases may contribute to sexual problems, but the extent to which psychopathology itself affects sexual functioning is not well understood.
AIM
The study sought to provide an overview of the literature on the prevalence of sexual dysfunction in psychotropic-free and somatic disease-free psychiatric patients.
METHOD
A systematic review (PRISMA [Preferred Reporting Items for Systematic Reviews and Meta-Analyses]) was conducted by 2 authors (TH and AWMP) independently, with the review process being monitored by a third author. Relevant articles on the relationship between sexual dysfunctions and psychopathology were searched in PubMed, Web of Science, and PsycINFO from inception until June 16, 2022. The study methods were entered in the international register of systematic reviews PROSPERO (2021, CRD42021223410).
OUTCOMES
The main outcome measures were sexual dysfunction and sexual satisfaction.
RESULTS
Twenty-four studies were identified, including a total of 1199 patients. These studies focused on depressive disorders (n = 9 studies), anxiety disorders (n = 7), obsessive- compulsive disorder (OCD) (n = 5), schizophrenia (n = 4), and posttraumatic stress disorder (n = 2). No studies on bipolar disorder were found. Reported prevalence rates of sexual dysfunction in psychiatric disorders were 45% to 93% for depressive disorders, 33% to 75% for anxiety disorders, 25% to 81% for OCD, and 25% for schizophrenia. The most affected phase of the sexual response cycle was sexual desire, in both men and women with depressive disorders, posttraumatic stress disorder, and schizophrenia. Patients with OCD and anxiety disorders most frequently reported dysfunction in the orgasm phase, 24% to 44% and 7% to 48%, respectively.
CLINICAL IMPLICATIONS
The high prevalence of sexual dysfunction requires more clinical attention by means of psychoeducation, clinical guidance, sexual anamnesis, and additional sexological treatment.
STRENGTHS AND LIMITATIONS
This is the first systematic review on sexual dysfunction in psychotropic-free and somatic disease-free psychiatric patients. Limitations include the small number of studies, small sample sizes, the use of multiple questionnaires (some not validated), which may contribute to bias.
CONCLUSION
A limited number of studies identified a high prevalence of sexual dysfunction in patients with a psychiatric disorder, with substantial variation between patient groups in frequency and phase of reported sexual dysfunction.
Topics: Male; Humans; Female; Sexual Dysfunction, Physiological; Sexual Behavior; Schizophrenia; Libido; Stress Disorders, Post-Traumatic
PubMed: 37279603
DOI: 10.1093/jsxmed/qdad074 -
Journal of Sex & Marital Therapy 2023Determining the true incidence and identifying the risk factors of low sexual desire (LSD) and hypoactive sexual desire disorder (HSDD) are essential to prevent sexual... (Meta-Analysis)
Meta-Analysis
Determining the true incidence and identifying the risk factors of low sexual desire (LSD) and hypoactive sexual desire disorder (HSDD) are essential to prevent sexual dysfunctions and provide adequate treatment resources. This systematic review and meta-analysis were performed on research articles reporting women with LSD and HSDD in PsycArticles, Scopus, MEDLINE, Web of Science databases, and reference lists till October 2021. All cross-sectional studies published in English that assessed both sexual desire and sexual distress were included. Of 891 full-text articles identified, 24 were eligible, all of which had a low risk of overall bias. We did separate random-effects meta-analyses for LSD and HSDD outcomes. The incidence of LSD and HSDD were 29% and 12%, respectively. Studies that used the convenience sampling method reported a higher incidence of HSDD than studies that used the probability sampling method. No differences were found between the assessment method and across cultures in LSD and HSDD. A majority of studies reviewed addressed demographic (e.g. age, education), physiological (e. g. menopausal status, body mass index), psychological (e.g. depression, daily internal stress), relational (e.g. relationship length, relationship satisfaction), and sexual predictors (e.g. sexual activity, sexual pleasure) between LSD and HSDD. This systematic review may inform researchers, guideline developers, and policy-makers about LSD associated with distress and help health professionals to identify women most at risk.
Topics: Female; Humans; Cross-Sectional Studies; Incidence; Sexual Dysfunctions, Psychological; Sexual Behavior; Libido
PubMed: 37158079
DOI: 10.1080/0092623X.2023.2208564 -
BMC Women's Health Dec 2022To provide an understanding of the changes in sexual function in women with genital warts. (Review)
Review
PURPOSE
To provide an understanding of the changes in sexual function in women with genital warts.
METHODS
In this review study, databases searched included: PubMed, Science Direct, Scopus, Web of Science, Cochrane Library of Systematic Reviews, Google Scholar, ProQuest, Wiley, and Highwire Press. No study design limitations were applied to the initial search, and qualitative and quantitative studies published between 2005 and 2021 were included.
RESULTS
19 articles were selected and analyzed narratively. The quality of the studies was almost good. The findings were classified into three groups: The prevalence of sexual dysfunction in women with genital warts (GWs) and Human Papillomavirus (HPV); Types of sexual dysfunction in women with genital warts, and associated factors; Psychosexual effects of genital warts.
CONCLUSION
This study provides up-to-date evidence of the changes in sexual function in women with genital warts. Although the results of most studies showed that women with genital warts experienced sexual dysfunction in almost all dimensions, differences in study design and study population made it difficult to determine the specific type of disorder such as libido, or arousal disorders in these women. Based on the findings of this review, more research in this field is recommended for the future.
SYSTEMATIC REVIEW REGISTRATION
(PROSPERO: CRD42020188584, https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=188584 ).
Topics: Humans; Female; Condylomata Acuminata; Prevalence
PubMed: 36503516
DOI: 10.1186/s12905-022-02073-6 -
Radiotherapy and Oncology : Journal of... Jan 2023Patients with anal squamous cell carcinoma (SCC) are treated with sphincter-preserving radiation therapy and concurrent chemotherapy, achieving excellent oncologic... (Review)
Review
BACKGROUND AND PURPOSE
Patients with anal squamous cell carcinoma (SCC) are treated with sphincter-preserving radiation therapy and concurrent chemotherapy, achieving excellent oncologic outcomes. Patients, however, may experience treatment-related morbidity including sexual dysfunction. The objective of this systematic review was to review the literature on sexual dysfunction in female patients treated for anal cancer and to identify knowledge gaps.
MATERIALS AND METHODS
This systematic review was registered in PROSPERO prior to initiation. Databases searched included MEDLINE, Embase, PubMed, Cochrane, and Google Scholar. There were no restrictions on the study time period. Studies were limited to English. All study designs were included except review articles, letters to the editor, and case reports with less than ten patients.
RESULTS
In total, 1801 studies were retrieved and 19 met the inclusion criteria, including: 13 cross-sectional surveys, 3 prospective studies, 1 longitudinal intervention study, 1 retrospective chart review, 1 case control study. Sexual function was assessed using the female sexual functioning index (FSFI), EORTC-QLQ-CR30 and -CR38; response rates were low (<50 % in most studies). Sexual dysfunction was reported by up to 85 % of women; the most common symptoms being dyspareunia (17-65 %), vaginal dryness (22-88 %), and loss of libido (38-95 %). Gastrointestinal issues, such as bowel problems, and body image concerns additionally affected sexual function and quality of life.
CONCLUSION
Sexual dysfunction is a common issue affecting most female patients treated for anal cancer and there is a paucity of evidence on the management of this important survivorship issue. There is additionally a lack of ethnic, economic, and educational diversity and there are no studies addressing the unique needs of LGBTQ individuals - future studies should make a concerted effort to include a diverse patient population.
Topics: Humans; Female; Quality of Life; Case-Control Studies; Retrospective Studies; Cross-Sectional Studies; Prospective Studies; Anus Neoplasms; Sexual Dysfunction, Physiological
PubMed: 36481383
DOI: 10.1016/j.radonc.2022.109437 -
Revista Brasileira de Ginecologia E... Oct 2022To explore the main sexuality complaints of gynecologic cancer survivors after treatment and to identify the care strategies provided.
OBJECTIVE
To explore the main sexuality complaints of gynecologic cancer survivors after treatment and to identify the care strategies provided.
DATA SOURCE
Searches were conducted in six electronic databases: Scopus, Web of Science, LILACS, MEDLINE, PsychINFO, and EMBASE.
STUDY SELECTION
Articles published between 2010 and 2020 were selected and the following descriptors were used in the English language: and . The methodological quality of the studies used the Mixed Methods Appraisal Tool (MMAT).
DATA COLLECTION
The primary data extracted were: names of the authors, year of publication, country of origin, objective and type of study, data collection instrument, sample size and age range, types of cancer, and symptoms affected with the strategies adopted.
DATA SUMMARY
A total of 34 out of 2,536 screened articles were included. The main strategies found for patient care were patient-clinician communication, practices for sexuality care, individualized care plan, multiprofessional team support, and development of rehabilitation programs. For sexuality care, the most common practices are pelvic physiotherapy sessions and the use of vaginal gels and moisturizers.
CONCLUSION
The main complaints identified in the scientific literature were low libido and lack of interest in sexual activity, vaginal dryness, pain during sexual intercourse, and stenosis. Different care strategies may be adopted, such as follow-up with a multidisciplinary health team and sexual health rehabilitation programs, which could minimize these symptoms and ensure the quality of life of patients.
Topics: Female; Humans; Quality of Life; Sexuality; Sexual Behavior; Genital Neoplasms, Female; Survivors
PubMed: 36174653
DOI: 10.1055/s-0042-1756312 -
Medicina (Kaunas, Lithuania) Sep 2022: Cervical cancer is a leading cause of mortality among women. Chemo-radiation followed by interventional radiotherapy (IRT) is the standard of care for stage IB-IVA... (Review)
Review
: Cervical cancer is a leading cause of mortality among women. Chemo-radiation followed by interventional radiotherapy (IRT) is the standard of care for stage IB-IVA FIGO. Several studies have shown that image-guided adaptive IRT resulted in excellent local and pelvic control, but it is associated with vaginal toxicity and intercourse problems. The purpose of this review is to evaluate the dysfunctions of the sexual sphere in patients with cervical cancer undergoing different cervix cancer treatments. : We performed a comprehensive literature search using Pub med, Scopus and Cochrane to identify all the full articles evaluating the dysfunctions of the sexual sphere. ClinicalTrials.gov was searched for ongoing or recently completed trials, and PROSPERO was searched for ongoing or recently completed systematic reviews. : One thousand three hundred fifty-six women included in five studies published from 2016 to 2022 were analyzed. The median age was 50 years (range 46-56 years). The median follow-up was 12 months (range 0-60). Cervical cancer diagnosis and treatment (radiotherapy, chemotherapy and surgery) negatively affected sexual intercourse. Sexual symptoms such as fibrosis, strictures, decreased elasticity and depth and mucosal atrophy promote sexual dysfunction by causing frigidity, lack of lubrication, arousal, orgasm and libido and dyspareunia. : Physical, physiological and social factors all contribute to the modification of the sexual sphere. Cervical cancer survivors who were irradiated have lower sexual and vaginal function than the normal population. Although there are cures for reducing discomfort, effective communication about sexual dysfunctions following treatment is essential.
Topics: Dyspareunia; Female; Humans; Middle Aged; Orgasm; Sexual Dysfunction, Physiological; Sexual Dysfunctions, Psychological; Uterine Cervical Neoplasms
PubMed: 36143900
DOI: 10.3390/medicina58091223 -
Best Practice & Research. Clinical... Sep 2022Anabolic-androgenic steroid (AAS) have widespread and growing illicit use as image and performance enhancing drugs (IPED), predominantly in young men. Users trying to... (Review)
Review
Anabolic-androgenic steroid (AAS) have widespread and growing illicit use as image and performance enhancing drugs (IPED), predominantly in young men. Users trying to stop AAS are prone to distressing withdrawal symptoms which may trigger relapse in use. It is important to develop therapies to support AAS withdrawal. The illicit nature of AAS use has impeded the robust characterisation of its clinical withdrawal syndrome within any single study. Therefore, we conducted a systematic review summarising the available clinical studies describing symptoms associated with non-medically indicated AAS use, and AAS withdrawal. Reported clinical features of AAS withdrawal include headache, fatigue, myalgia, restlessness, insomnia, low mood and libido, anorexia, suicidal ideation, body image dissatisfaction, and steroid cravings; novel therapies for AAS withdrawal would need evaluation against these symptoms.
Topics: Anabolic Agents; Androgens; Humans; Male; Performance-Enhancing Substances; Steroids; Testosterone Congeners
PubMed: 35999138
DOI: 10.1016/j.beem.2022.101691 -
Archives of Physical Medicine and... Jan 2023To systematically review how sexuality is experienced by lesbian, gay, bisexual, transgender, queer or questioning, intersex plus (other gender identifies and sexual... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To systematically review how sexuality is experienced by lesbian, gay, bisexual, transgender, queer or questioning, intersex plus (other gender identifies and sexual orientations) (LGBTQI+) persons living with chronic disease.
DATA SOURCES
PsycINFO, Embase, MEDLINE, Scopus, Cumulative Index to Nursing and Allied Health, and Web of Science were searched from date of inception to November 2021 for English language publications. Reference lists of relevant publications were also searched.
STUDY SELECTION
Eligible studies reported on sexuality among LGBTQI+ persons living with chronic disease. The search yielded 12,626 records; 665 full texts were assessed for eligibility and 63 documents included (59 unique studies). Study quality was rated using the Mixed Methods Appraisal Tool.
DATA EXTRACTION
Characteristics of included studies were recorded independently by 2 authors. Differences were resolved through discussion or with a third author.
DATA SYNTHESIS
A sequential, exploratory mixed-studies approach was used for synthesis. Pooled analysis indicated that among gay and bisexual men living with prostate cancer, 68.3% experienced erectile dysfunction and 62.9% had insufficient quality of erection to engage in anal sex. Among gay and bisexual men living with HIV or AIDS, 29.3% experienced loss of libido and 25.3% experienced erectile dysfunction. Although sexual dysfunction was common, LGBTQI+ persons had difficulty accessing appropriate sexual counseling and identified negative attitudes and heteronormative assumptions by health care providers as significant barriers to sexual health. Interventions to address sexuality focused entirely on reduction of risky sexual behavior among men living with HIV or AIDS. Women, transgender persons, and intersex persons were largely excluded from the research studies.
CONCLUSIONS
Current understandings of the effect of chronic disease on LGBTQI+ sexuality are limited and mostly focus on the male sexual response. LGBTQI+ persons who experience difficulty with sexuality struggle to identify appropriate services, and there is an absence of evidence-based interventions to promote sexual health and well-being in this population.
Topics: Adult; Female; Humans; Male; Acquired Immunodeficiency Syndrome; Erectile Dysfunction; Sexual and Gender Minorities; Sexuality; Chronic Disease; Sexual Dysfunction, Physiological
PubMed: 35973583
DOI: 10.1016/j.apmr.2022.07.018 -
Journal of Evidence-based Medicine Jun 2022To conduct the first systematic review critically examining evidence on whether early male circumcision has short- and long-term adverse psychological effects.
OBJECTIVE
To conduct the first systematic review critically examining evidence on whether early male circumcision has short- and long-term adverse psychological effects.
METHODS
We searched PubMed, EMBASE, SCOPUS, Cochrane Library, and Google Scholar.
RESULTS
Twenty-four studies with original data met the inclusion criteria. These comprised 11,173 total males, 4340 circumcised in infancy and 6908 uncircumcised. Nineteen were rated 1+, 2++ or 2+, and 5 were rated 2- by SIGN criteria. Neonatal circumcision, particularly without anesthetic, increased vaccination pain response, but had little effect on breastfeeding or cognitive ability. Studies reporting associations with sudden infant death syndrome, autism, alexithymia and impaired sexual function and pleasure had design flaws and were rated 2-. Sexual arousal, touch, pain, and warmth thresholds measured by quantitative sensory testing were not diminished in neonatally circumcised men. Neonatal circumcision was not associated with empathy in men, contradicting the hypothesis that procedural pain causes central nervous system changes. After correcting all associations with socioaffective processing parameters for multiple testing only higher sociosexual desire, dyadic sexual libido/drive, and stress remained significant. The relatively greater sexual activity found in circumcised men might reflect reduced sexual activity in uncircumcised men overall owing to pain and psychological aversion in those with foreskin-related medical conditions (reverse causality). Most studies employed case-control designs with limited follow-up. Studies beyond childhood were prone to confounding.
CONCLUSION
The highest quality evidence suggest that neonatal and later circumcision has limited or no short-term or long-term adverse psychological effects.
Topics: Case-Control Studies; Circumcision, Male; HIV Infections; Humans; Infant, Newborn; Male; Pain; Sexual Behavior
PubMed: 35785439
DOI: 10.1111/jebm.12482