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SEXUALITY (59 journals)

Showing 1 - 59 of 59 Journals sorted alphabetically
AIDS and Behavior     Hybrid Journal   (Followers: 18)
AIDS Research and Therapy     Open Access   (Followers: 15)
Archives of Sexual Behavior     Hybrid Journal   (Followers: 13)
Bagoas - Estudos gays: gêneros e sexualidades     Open Access  
BMJ Sexual & Reproductive Health     Hybrid Journal   (Followers: 2)
Cadernos de Gênero e Diversidade     Open Access   (Followers: 2)
Cadernos Pagu     Open Access  
Cuadernos Kóre     Open Access  
Culture, Health & Sexuality: An International Journal for Research, Intervention and Care     Hybrid Journal   (Followers: 17)
European Journal of Politics and Gender     Hybrid Journal   (Followers: 3)
Gay and Lesbian Law Journal     Full-text available via subscription   (Followers: 2)
Genre, sexualité & société     Open Access   (Followers: 5)
HIV/AIDS - Research and Palliative Care     Open Access   (Followers: 20)
Human Reproduction Update     Hybrid Journal   (Followers: 18)
International Journal of Sexuality and Gender Studies     Hybrid Journal   (Followers: 26)
International Journal of Transgender Health     Hybrid Journal   (Followers: 6)
Journal of Bisexuality     Hybrid Journal   (Followers: 8)
Journal of Black Sexuality and Relationships     Full-text available via subscription   (Followers: 2)
Journal of Gay & Lesbian Issues in Education     Hybrid Journal   (Followers: 9)
Journal of Gay & Lesbian Psychotherapy     Partially Free   (Followers: 10)
Journal of Gay & Lesbian Social Services     Hybrid Journal   (Followers: 5)
Journal of Gender and Power     Open Access   (Followers: 1)
Journal of GLBT Family Studies     Hybrid Journal   (Followers: 3)
Journal of Homosexuality     Hybrid Journal   (Followers: 13)
Journal of Lesbian Studies     Hybrid Journal   (Followers: 5)
Journal of LGBT Health Research     Hybrid Journal   (Followers: 10)
Journal of LGBT Issues in Counseling     Hybrid Journal   (Followers: 10)
Journal of LGBT Youth     Hybrid Journal   (Followers: 14)
Journal of Psychosexual Health     Open Access  
Journal of Sex & Marital Therapy     Hybrid Journal   (Followers: 8)
Journal of Sex Research     Hybrid Journal   (Followers: 14)
Journal of Sexual & Reproductive Medicine     Full-text available via subscription   (Followers: 2)
Journal of the Gay and Lesbian Medical Association     Hybrid Journal   (Followers: 3)
Mandrágora     Open Access  
Psychology & Sexuality     Hybrid Journal   (Followers: 16)
Psychology of Sexual Orientation and Gender Diversity     Full-text available via subscription   (Followers: 13)
QED : A Journal in GLBTQ Worldmaking     Full-text available via subscription   (Followers: 2)
Queer Cats Journal of LGBTQ Studies     Open Access   (Followers: 4)
Queer Studies in Media & Popular Culture     Hybrid Journal   (Followers: 2)
Raheema     Open Access   (Followers: 1)
Religion and Gender     Open Access   (Followers: 14)
Revista Periódicus     Open Access  
Screen Bodies : An Interdisciplinary Journal of Experience, Perception, and Display     Full-text available via subscription   (Followers: 1)
Seksuologia Polska     Full-text available via subscription  
Sex Roles     Hybrid Journal   (Followers: 18)
Sexes     Open Access  
Sexual Addiction & Compulsivity: The Journal of Treatment & Prevention     Hybrid Journal   (Followers: 4)
Sexual and Relationship Therapy     Hybrid Journal   (Followers: 4)
Sexual Medicine     Open Access   (Followers: 1)
Sexualities     Hybrid Journal   (Followers: 16)
Sexuality & Culture     Hybrid Journal   (Followers: 21)
Sexuality and Disability     Hybrid Journal   (Followers: 18)
Sexuality Research and Social Policy     Hybrid Journal   (Followers: 8)
Sexualization, Media, & Society     Open Access   (Followers: 3)
SQS - Suomen Queer-tutkimuksen Seuran lehti     Open Access  
Theology & Sexuality     Hybrid Journal   (Followers: 7)
Transgender Health     Open Access   (Followers: 3)
Whatever : A Transdisciplinary Journal of Queer Theories and Studies     Open Access   (Followers: 4)
Zeitschrift für Sexualforschung     Hybrid Journal  
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Sexual Medicine
Journal Prestige (SJR): 0.575
Citation Impact (citeScore): 2
Number of Followers: 1  

  This is an Open Access Journal Open Access journal
ISSN (Online) 2050-1161
Published by Elsevier Homepage  [3305 journals]
  • Twenty Years of Plaque Incision and Grafting for Peyronie’s Disease:
           A Review of Literature

    • Abstract: Publication date: Available online 16 March 2019Source: Sexual MedicineAuthor(s): Patrick G. Rice, Bhaskar K. Somani, Rowland W. Rees IntroductionPlaque incision and grafting (PIG) is indicated for men with complex or severe penile curvature and, despite a multitude of incision types and grafting materials having been used, no individual technique has proven superiority.AimTo assess outcomes following PIG and to understand the operative technique.MethodsA systematic review was performed to find all relevant studies reporting on use of the PIG technique to correct curvature resulting from Peyronie’s disease. Studies were included if they had>40 participants, were written in the English language, and no penile prosthesis was implanted.Main Outcome MeasuresPrimary outcome measures included deformity correction, erectile dysfunction, and degree of penile lengthening/shortening. Secondary outcome measures included satisfaction, reoperation rate, and complications.ResultsTwelve studies were included in the quantitative synthesis, which overall report on the results of 1,025 patients. Careful patient selection was critical, with erectile function requiring assessment with the International Index of Erectile Function (IIEF), subjective patient reports, and consideration of whether erections are pharmacologically aided. There was no evidence of superiority in favor of any particular incision type or grafting material, and absorbable sutures were clearly favored. Postoperatively, 4.6%–67.4% required pharmacologically aided erections and 0–11.8% were completely unable to achieve erections. Successful straightening occurred in 80.0%–96.4%, although there was no consistent definition of success. Penile length was unchanged in 44.2%–95.0%; 88.0%–92.0% of the patients were satisfied, and .7%–4.7% required reoperation. Altered sensation occurred in 2.0%–22.5% of patients, of which 80.0%–100.0% was only a transient loss. All outcomes were heterogeneously reported. There are no clear predictive factors for erectile dysfunction following PIG surgery. No single incision type or grafting material has proven superiority.ConclusionPIG is an effective and safe technique for correction of complex or severe penile curvature in terms of satisfaction, length change, straightening, and complications.Rice PG, Somani BK, Rees RW. Twenty Years of Plaque Incision and Grafting for Peyronie’s Disease: A Review of Literature. Sex Med 2019;XX:XX–XX.
       
  • Impact Of Vulvovaginal Atrophy Of Menopause In Spanish Women: Prevalence
           And Symptoms According To The EVES Study

    • Abstract: Publication date: Available online 16 March 2019Source: Sexual MedicineAuthor(s): Santiago Palacios, Silvia P. González, Micaela Fernández-Abellán, Montserrat Manubens, Pascual García-Alfaro, C.Argudo Prieto, L.Baquedano Mainar, J.Calleja Abu-Amshah, M.J.Cancelo Hidalgo, C. Castelo-Branco i Flores, P.Coronado Martin, M.Correa Rancel, M.Fernández Abellán, J.M.Fernández Moya, P.García Alfaro, M.González Fernández, S.González Rodríguez, E.Iglesias Bravo, P.Llaneza Coto, M.Manubens Grau IntroductionThe prevalence of menopausal women with confirmed vulvovaginal atrophy (VVA) oscillates between 67–98%.AimTo assess the prevalence of postmenopausal women with VVA confirmed by gynecologic clinical assessment among all women attending menopause centers in Spain, as well as to describe the impact of VVA on quality of life and sexual functioning.MethodsWomen aged 45–75 years old with the last menstrual period>12 months before were included in a cross-sectional study.Main Outcome MeasuresWomen with ≥1 VVA symptoms filled out a number of questionnaires, including EuroQoL, Day-to-Day Impact of Vaginal Aging, Female Sexual Function Index, and Female Sexual Distress Scale-revised. A gynecologic examination was performed to confirm diagnosis.Results1,177 evaluable patients were included. VVA was confirmed in 87.3% of the patients. Almost 80% of women who acknowledged being sexually active (n = 717) presented pain during intercourse. As compared with patients without confirmed VVA (n = 66), patients with confirmed VVA (n = 1,028) were significantly older (P < .0001), had lower rates of sexual activity (P < .05), and used more VVA treatments (P < .05). Severe vaginal atrophy and severe vulvar atrophy were more prevalent in VVA-confirmed women (P < .0001, in both cases). No differences regarding the confirmation of VVA were observed for EuroQoL and Day-to-Day Impact of Vaginal Aging quality-of-life questionnaires. Sexual function measured through the Female Sexual Function Index score was significantly reduced in sexually-active patients with confirmed VVA (P < .05).ConclusionVVA signs and symptoms are highly prevalent in Spanish postmenopausal women. Confirmation of VVA diagnosis was associated with impaired sexual function. The early recognition of VVA symptoms should be actively promoted in medical practice, instead of waiting until signs appear to exclude other reasons for VVA and to manage treatment effectively.Palacios S, González SP, Fernández-Abellán M, et al. Impact of Vulvovaginal Atrophy of Menopause in Spanish Women: Prevalence and Symptoms According to the EVES Study. Sex Med 2019;XX:XXX–XXX.
       
  • What Patients and Partners Want in Interventions That Support Sexual
           Recovery After Prostate Cancer Treatment: An Exploratory Convergent Mixed
           Methods Study

    • Abstract: Publication date: Available online 2 March 2019Source: Sexual MedicineAuthor(s): Akanksha Mehta, Craig Evan Pollack, Theresa W. Gillespie, Ashley Duby, Caroline Carter, Steve Thelen-Perry, Daniela Witmann IntroductionMen treated for prostate cancer suffer from treatment-related sexual side effects that adversely affect their relationships and quality of life.AimTo investigate what prostate cancer survivors and their partners want from a sexual recovery intervention, and whether they consider an online tool acceptable for use in promoting sexual recovery.MethodsThis mixed-methods study included focus groups and interviews with both heterosexual and gay cancer survivors, as well as their partners. Focus groups and interviews probed experiences with treatment, side effects, and support received/needed for sexual recovery. Participants responded to proposed web-based intervention content. Interviews were analyzed with thematic content analysis. Their sexual function was assessed with validated measures.Main Outcome MeasuresAcceptability of online tools for promoting sexual recovery was evaluated.ResultsParticipants included 14 patients and 10 partners (2 male). Patient and partner median age was 62 and 62.5 years, respectively. Treatment ranged from surgery alone to combined radiation and hormonal therapy. Qualitative data analysis yielded 5 main intervention needs: (i) pretreatment discussion of sexual side effects, rehabilitation, emotional impact and realistic expectations, (ii) improved sexual communication within couples, (iii) strategies for promoting sexual intimacy beyond penetrative intercourse, (iv) attentiveness to partners' needs, and (v) access to peer support. Gay men specifically expressed the need for improved provider understanding of their sexuality and experiences. Most considered a web-based approach to be acceptable.ConclusionPatients and partners value both pretreatment preparation for sexual recovery and support for sexual recovery for both after treatment. A web-based approach may help mitigate barriers to access to these support services.Mehta A, Pollack CE, Gillespie T. What Patients and Partners Want in Interventions That Support Sexual Recovery After Prostate Cancer Treatment: An Exploratory Convergent Mixed Methods Study. Sex Med 2019;XX:XXX–XXX.
       
  • Perceptions of Anal Intercourse Among Heterosexual Women: A Pilot
           Qualitative Study

    • Abstract: Publication date: Available online 2 March 2019Source: Sexual MedicineAuthor(s): Lyndsey S. Benson, Kelly C. Gilmore, Elizabeth A. Micks, Erin McCoy, Sarah W. Prager IntroductionMore than one-third of women in the U.S. have engaged in heterosexual anal intercourse (HAI), but little is known regarding women’s perceptions of HAI and motivations for engaging in this sexual behavior.AimThis study aimed to explore U.S. women’s motivations for engaging in HAI and to investigate how they navigate HAI in the context of sexual relationships.MethodsSemi-structured interviews were conducted with 20 women, ages 18–50 years old, who had engaged in anal intercourse with a male partner within the past 3 months. The interview guide was developed utilizing a conceptual framework based on the Theory of Planned Behavior.Main Outcome MeasureThematic content analysis was performed, and salient themes were identified.ResultsSalient themes were identified in all key components of the construct, including attitudes toward the behavior, subjective norms, and perceived behavioral control. Women’s intent to engage in HAI was influenced by their attitudes toward HAI and level of control and trust with their partners. Primary motivators were partner and personal pleasure and sexual curiosity and experimentation.ConclusionThe Theory of Planned Behavior construct was well suited to explore factors influencing women’s intent to engage in HAI. Most women perceive negative societal norms toward HAI. Although this does not appear to affect intention to engage in HAI, it does affect disclosure of this sexual activity with friends and healthcare providers. It is important for healthcare providers to provide open, non-judgmental counseling regarding HAI to decrease stigma, enhance communication, and improve sexual health.Benson LS, Gilmore KC, Micks EA, et al. Perceptions of Anal Intercourse Among Heterosexual Women: A Pilot Qualitative Study. Sex Med 2019;XX:XXX–XXX.
       
  • Degree of Planning of Sexual Intercourse Among Men From China, Japan, and
           Taiwan Taking Medication for Erectile Dysfunction: Findings of an
           Observational, Cross-Sectional Survey

    • Abstract: Publication date: March 2019Source: Sexual Medicine, Volume 7, Issue 1Author(s): Bang-Ping Jiann, Koichi Nakajima, Sonali Dighe, Chad D. Harshman-Smith, Tarek A. Hassan IntroductionManagement of erectile dysfunction (ED) is beset with assumptions around spontaneity of sexual intercourse, requiring candor between the physician and patient if appropriate treatment is to be implemented.AimTo evaluate the degree to which men who take ED medications plan for and have sex.MethodsMen from China, Japan, and Taiwan aged 40–70 years who had taken ED medications within the past 3 months were invited to participate anonymously in an online, self-administered survey that enquired about frequency and advance planning of sex, time between taking ED medication and intercourse, and treatment satisfaction. Data were analyzed using descriptive statistics.Main Outcome MeasureFrequency of planning of sexual intercourse, planning and ED medication dosing interval, and frequency of ED medication use.ResultsData from 604 respondents (mean age 50.8 years) from China (n = 254), Japan (n = 250), and Taiwan (n = 100) were collected. Men used ED medications a median of ≤4 times per month in all 3 territories. 76% who used ED medication during the past 3 months planned for sex on specific occasions, with 59% and 52% agreeing that they plan for sex on specific days of the week and times of the day, respectively. Most commonly, men planned for sex up to several hours to a day beforehand, with 94% taking ED medication within 4 hours of sex. Satisfaction with ED medication was generally high and related to erection rigidity, speed of onset, and safety.ConclusionKnowledge of the degree to which individuals with ED plan for sex may have important implications for the appropriate prescription of ED medication. The high degree of planning around sexual activities exhibited by men taking ED medication suggests there is a need for appropriate counseling to ensure that treatment is aligned with patient behavior.Jiann B-P, Nakajima K, Dighe S, et al. Degree of planning of sexual intercourse among men from China, Japan, and Taiwan taking medication for erectile dysfunction: Findings of an observational, cross-sectional survey. Sex Med 2019;7:54–60.
       
  • Combined Plaque Incision, Buccal Mucosa Grafting, and Additional Tunica
           Albuginea Plication for Peyronie’s Disease

    • Abstract: Publication date: March 2019Source: Sexual Medicine, Volume 7, Issue 1Author(s): Luigi Cormio, Vito Mancini, Paolo Massenio, Nicola d’Altilia, Oscar Selvaggio, Giuseppe Di Fino, Gennaro Selvaggi, Giuseppe Carrieri IntroductionSurgery remains the gold standard for treatment in stable patients with penile deformity associated to Peyronie’s disease (PD).AimTo evaluate the long-term results of plaque incision and buccal mucosa grafting (BMG), with or without additional tunica albuginea plication (TAP), in the correction of severe penile curvatures secondary to PD.Methods72 patients with severe curvature caused by PD, normal erections, and stable disease entered this prospective study. Preoperatively, they underwent penile duplex ultrasounds with measurement of curvature and length of affected side. All procedures were carried out by 1 surgeon. Patients were seen at 1, 3, 6, and 12 months postoperatively, then yearly. Subjective outcome was assessed by the Sexual Encounter Profile (SEP) questionnaire, and objective outcome was assessed by an intracavernous injection (ICI) test performed within the first year for evaluating penile rigidity, straightness, and length.Main Outcome MeasureLong-term outcomes include penile straightening, penile shortening, and sexual satisfaction.ResultsMean curvature was 71.32 ± 17.6° (range 40–110); 33 (45.8%) patients had a 2-sided curvature with a mean second curvature of 33.79 ± 12.2° (range 10–60). Additional TAP was needed in 60% of patients for complete straightening or graft stretching. All patients resumed unassisted intercourse 1 month after surgery; 4 (5.5%) refused follow-up, claiming excessive penile shortening. In the remaining 68, the ICI test showed no recurvature, shortening, or de novo erectile dysfunction. At mean follow-up of 62.01 ± 34.3 months (range 12–135), all were able to obtain an erection (SEP-1), 97.1% to penetrate (SEP-2), and 89.7% to successfully complete intercourse (SEP-3); 80.9% of them were satisfied with erection hardness (SEP-4) and 86.8% were overall satisfied (SEP-5), with the main reason for dissatisfaction being expectation of better length and rigidity.ConclusionBMG, with or without TAP, provides excellent long-term results and is safe and reproducible, representing a valuable treatment option for PD, but great care should be taken in patient counseling to avoid unrealistic expectations.Cormio L, Mancini V, Massenio P. Combined Plaque Incision, Buccal Mucosa Grafting, and Additional Tunica Albuginea Plication for Peyronie’s Disease. Sex Med 2019;7:48–53.
       
  • Endothelial Dysfunction in Patients With Erectile Dysfunction: A
           Double-Blind, Randomized-Control Trial Using Tadalafil

    • Abstract: Publication date: March 2019Source: Sexual Medicine, Volume 7, Issue 1Author(s): Smita Pattanaik, Pawan Kaundal, Ravimohan S. Mavuduru, Shrawan K. Singh, Arup K. Mandal ObjectiveTo assess whether tadalafil improves endothelial dysfunction(EnD) in a placebo-controlled randomized-control trial.MethodsErectile dysfunction and EnD were assessed by the International Index of Erectile Function (IIEF-5) and flow-mediated dilation (FMD) of the brachial artery respectively, at baseline and 4 weeks by blinded observer. Patients with FMD of < 15% were randomized in 1:1 ratio to receive either placebo or tadalafil. Both placebo and tadalafil in similar-appearing capsules but coded separately, were dispensed by a blinded co-investigator. Compliance and drug-related events were recorded. The randomization codes were then decoded and appropriate statistical tests applied.Results89 patients were randomized and 82 completed the study. Both groups were comparable. Posttreatment, there were significant improvements in IIEF-5 score (pre- vs posttreatment; tadalafil: 11.432 vs 15.937, P < .001 and placebo 11.232 vs 14.935, P < .00) and FMD% pre- vs posttreatment; tadalafil: 11.222 vs 13.827, P < .001 and placebo: 11.617 vs 14.027, P < .001). Intergroup comparison did not show any significant difference in IIEF scores (mean change in tadalafil vs placebo group: 3.719 vs 4.433, P = .223) and FMD% (mean change tadalafil vs placebo group: 2.426 and 2.829, P = .528). The adverse events were significantly more in the tadalafil group (tadalafil vs placebo 14 adverse reactions [ADR] vs 5 ADR, P < .001).ConclusionThe response of low-dose tadalafil on IIEF and FMD is largely similar to placebo; however, the utility of FMD% in young patients and placebo effect needs to be studied further.Pattanaik S, Kaundal P, Mavuduru RS, et al. Endothelial Dysfunction in Patients With Erectile Dysfunction: A Double-Blind, Randomized-Control Trial Using Tadalafil. Sex Med 2019;7:41–47.
       
  • Erectile Dysfunction in 45-Year-Old Heterosexual German Men and Associated
           Lifestyle Risk Factors and Comorbidities: Results From the German Male Sex
           Study

    • Abstract: Publication date: March 2019Source: Sexual Medicine, Volume 7, Issue 1Author(s): Jacqueline Hallanzy, Martina Kron, Veronika E. Goethe, Frank-Michael Köhn, Maximilian Schmautz, Christian Arsov, Boris Hadaschik, Florian Imkamp, Jürgen E. Gschwend, Kathleen Herkommer BackgroundErectile dysfunction (ED) is a common public health issue with a significant impact on quality of life. The associations between ED and several risk factors have been reported previously. The continuously increasing incidence of these factors is contributing to the increasing prevalence of ED.AimTo assess ED prevalence and severity in a representative sample of 45-year-old German men and to analyze the association with risk factors (lifestyle risk factors/comorbidities).MethodsData were collected within the German Male Sex-Study. Randomly selected 45-year-old men were invited. A total of 10,135 Caucasian, heterosexual, sexually active men were included in this analysis. The self-reported prevalence of ED was assessed using the Erectile Function domain of the International Index of Erectile Function. Risk factors for ED were ascertained using self-report questionnaires. An anamnesis interview and a short physical examination were performed.Main Outcome MeasureED prevalence and severity were evaluated in a cross-sectional design. The associations of ED with comorbidities (eg, depression, diabetes, hypertension, lower urinary tract symptoms) and lifestyle factors (ie, smoking, obesity, central obesity, physical inactivity, and poor self-perceived health-status) were analyzed by logistic regression.ResultsThe overall prevalence of ED was 25.2% (severe, 3.1%; moderate, 9.2%; mild to moderate, 4.2%; mild, 8.7%). Among the men with ED, 48.8% had moderate or severe symptoms. ED prevalence increased with the number of risk factors, to as high as 68.7% in men with 5–8 risk factors. In multiple logistic regression with backward elimination, the strongest associations with ED were found for depression (odds ratio [OR] = 1.87), poor self-perceived health status (OR = 1.72), lower urinary tract symptoms (OR = 1.68), and diabetes (OR = 1.38).ConclusionOne out of 4 men already had symptoms of ED at age 45. Almost one-half of the men with ED had moderate to severe symptoms. ED was strongly associated with each analyzed risk factor, and the prevalence and severity of ED increased with an increasing number of risk factors.Hallanzy J, Kron M, Goethe VE, et al. Erectile Dysfunction in 45-Year-Old Heterosexual German Men and Associated Lifestyle Risk Factors and Comorbidities: Results From the German Male Sex Study. Sex Med 2019;7:26–34.
       
  • Intratunical Injection of Human Adipose Tissue–Derived Stem Cells
           Restores Collagen III/I Ratio in a Rat Model of Chronic Peyronie’s
           Disease

    • Abstract: Publication date: March 2019Source: Sexual Medicine, Volume 7, Issue 1Author(s): Fabio Castiglione, Petter Hedlund, Emanuel Weyne, Lukman Hakim, Francesco Montorsi, Trinity J. Bivalacqua, Dirk De Ridder, Uros Milenkovic, David Ralph, Giulio Garaffa, Asif Muneer, Steven Joniau, Maarten Albersen, Trauma and Reconstructive Urology Working Party of the European Association of Urology Young Academic Urologists IntroductionPrevious studies have shown that the injection of adipose tissue–derived stem cells (ADSCs) into the tunica albuginea (TA) during the active phase of Peyronie’s disease (PD) prevents the development of fibrosis.AimTo investigate, using an animal model, whether local injection of human ADSCs (hADSCs) can alter the degree of fibrosis in the chronic phase of PD.Methods27 male, 12-week-old rats were divided into 3 equal groups: sham, PD without treatment, and PD treated with hADSCs 1 month after disease induction. Sham rats underwent 2 injections of vehicle into the TA 1 month apart. PD rats underwent transforming growth factor β1 (TGFβ1) injection and injection of vehicle 1 month later. PD-hADSC rats underwent TGFβ1 injection followed by 1 million hADSCs 1 month later. 1 week after treatment, n = 3 animals/group were euthanized, and the penises were harvested for quantitative polymerase chain reaction. 1 month after treatment, the other animals, n = 6 per group, underwent measurement of intracavernous pressure (ICP) and mean arterial pressure (MAP) during electrostimulation of the cavernous nerve. After euthanasia, penises were again harvested for histology and Western blot.Main Outcome MeasureThe primary outcome measures included (a) gene expression at one week post-injection; (b) measurement of ICP/MAP upon cavernous nerve stimulation as a measure of erectile function; (c) elastin, collagen I and III protein expression; and (d) Histomorphometric analysis of the penis. Means where compared by analysis of variance (ANOVA) followed by a Student-Newman-Keuls test for post hoc comparisons or Mann-Whitney test when applicable.ResultsNo significant difference was noted in ICP or ICP/MAP in response to cavernous nerve electrostimulation between the 3 groups at 2.5, 5, and 7.5 V (P> .05 for all voltages). PD animals developed tunical and subtunical areas of fibrosis with a significant upregulation of collagen III protein. The collagen III/I ratio was higher in the PD (4.6 ± 0.92) group compared with sham (0.66 ± 0.18) and PD-hADSC (0.86 ± 0.06) groups (P < .05) These fibrotic changes were prevented when treated with hADSCs. Compared with PD rats, PD-hADSC rats demonstrated a decreased expression of several fibrosis-related genes.ConclusionInjection of hADSCs reduces collagen III expression in a rat model of chronic PD.Castiglione F, Hedlund P, Weyne E, et al. Intratunical Injection of Human Adipose Tissue–Derived Stem Cells Restores Collagen III/I Ratio in a Rat Model of Chronic Peyronie’s Disease. Sex Med 2019;7:94–103.
       
  • Needs and Expectations of Patients with Erectile Dysfunction: An Update on
           Pharmacological Innovations in Phosphodiesterase Type 5 Inhibition with
           Focus on Sildenafil

    • Abstract: Publication date: March 2019Source: Sexual Medicine, Volume 7, Issue 1Author(s): Emmanuele A. Jannini, Stéphane Droupy IntroductionPhosphodiesterase type 5 inhibitors (PDE5-Is) have an excellent efficacy and tolerability profile and remain the first-line choice for the treatment of erectile dysfunction (ED). However, ED is still an underdiagnosed and undertreated condition, and many men prematurely discontinue therapy with conventional dosage formulations despite successful intercourse.AimTo review the unmet needs and expectations of patients with ED and describe the latest pharmaceutical innovations in the field of PDE5-I formulations designed to address these needs, with particular reference to a new orodispersible film (ODF) formulation of the PDE5-I, sildenafil.MethodsOnline literature search in PubMed and the Cochrane Library.Main Outcome MeasureTo identify English-language publications relevant to the aims of the present review.ResultsImproved recognition and management of ED would enable the early diagnosis of underlying and comorbid conditions that contribute to ED, leading to improved patient health and health-related quality of life. To ensure successful outcomes and patient and partner satisfaction, the complex and personal issues that influence the patient’s needs and expectations regarding treatment for ED must be considered along with their personal experiences and preferences. Innovative drug delivery systems, including orally disintegrating formulations, have been developed as alternatives to conventional dosage forms with the aim of improving patient convenience and acceptability and enhancing compliance. These alternative formulations include the sildenafil ODF, which is designed to improve acceptance and compliance over conventional solid dosage forms and extend the treatment options for men with ED by offering a convenient and discrete dosage form of a drug with proven efficacy.ConclusionThe sildenafil ODF is an example of an innovative dosage formulation for ED that can be used interchangeably with the conventional film-coated formulation to better address the needs and expectations of men with ED.Jannini EA, Droupy S. Needs and Expectations of Patients with Erectile Dysfunction: An Update on Pharmacological Innovations in Phosphodiesterase Type 5 Inhibition with Focus on Sildenafil. Sex Med 2019;7:1–10.
       
  • Society Page

    • Abstract: Publication date: March 2019Source: Sexual Medicine, Volume 7, Issue 1Author(s):
       
  • Combination High Flow Priapism With Low Flow Priapism: Case Report

    • Abstract: Publication date: March 2019Source: Sexual Medicine, Volume 7, Issue 1Author(s): Alejandro Carvajal, Johana Andrea Benavides IntroductionPriapism is defined as a persistent penile erection lasting longer than 4 hours and unrelated to sexual activity. It is one of the most common emergencies treated by urologists. Advances in understanding the pathophysiology of various types of priapism have led to targeted management strategies according to type of priapism.AimThe aims of this article is report the case of a 24-year-old man who was presented in the emergency department with a combination of high flow priapism with low flow priapism.MethodsThis case report documents the case of a patient who presented in the emergency department with a high flow priapism that then became to a ischemic priapism.ConclusionPriapism is one of the most common emergencies treated by urologists. Advances in understanding the pathophysiology of various types of priapism have led to targeted management strategies as was shown in our case.Carvajal A, Benavides JA. Combination High Flow Priapism With Low Flow Priapism: Case Report. Sex Med 2019;7:111–113.
       
  • Age-Related Differences for Male-to-Female Transgender Patients Undergoing
           Gender-Affirming Surgery

    • Abstract: Publication date: March 2019Source: Sexual Medicine, Volume 7, Issue 1Author(s): Dmitry Zavlin, Richard J. Wassersug, Vishwanath Chegireddy, Jürgen Schaff, Nikolaos A. Papadopulos IntroductionIt has been theorized that there are 2 subgroups within the male-to-female (MtF) transgender population: individuals who are predominantly androphilic and those who are predominantly gynephylic or interested in both male and female partners.AimTo explore the role of a dichotomous distribution of age at dysphoria onset in individuals diagnosed with MtF gender dysphoria.Methods40 patients who presented to a surgical clinic in Germany for gender-affirming surgery (GAS) were included in this study. Their age distribution was plotted as a histogram and the population was then divided at the median self-reported age of onset of gender dysphoria—that is, those 17 years and younger and those 18 years and older. The 2 groups were then compared with regard to demographic data, partnership history, various quality of life parameters, as well as sexual orientation and sexual history.Main Outcome MeasureSelf-designed questionnaires for demographics and sexuality, Questions on Life Satisfaction and Body Image (FLZM), Freiburg Personality Inventory, Rosenberg Self-Esteem Scale, and Patient Health Questionnaire were used.ResultsEarly-onset, gender-dysphoric MtF patients underwent GAS at a much younger age (mean 32.7 vs 43.8 years, P = .004), but had similar characteristics regarding weight, height, body mass index, marital status, and living situation to individuals who reported later onset of gender dysphoria. Preoperatively, they showed greater depressive symptoms (4.6 vs 3.3 points, P = .045), which disappeared after GAS. Following surgery, the younger MtFs were predominantly attracted to men (52.6%), whereas individuals who were diagnosed with late-onset of gender dysphoria preferred women or both men and women (85.7%) as sexual partners (P = .010). Younger trans individuals were more frequently sexually active (73.7% vs 42.9%, P = .049).ConclusionOur findings suggest that there are 2 MtF populations that differ in age of dysphoria onset, sexual history, and multiple personal details including sexual orientation. These data may be used to improve care to transgender individuals by providing treatment reflecting their sexual interests.Zavlin D, Wassersug RJ, Chegireddy V, et al. Age-Related Differences for Male-to-Female Transgender Patients Undergoing Gender-Affirming Surgery. Sex Med 2019;7:86–93.
       
  • Hydro-Jet Dissection of the Cavernous Nerves Preserves Erection Function
           in a Radical Prostatectomy Animal Model

    • Abstract: Publication date: March 2019Source: Sexual Medicine, Volume 7, Issue 1Author(s): Jeffrey D. Campbell, Husain Alenezi, Ling X. DeYoung, Gerald B. Brock, Stephen E. Pautler BackgroundPostoperative erectile dysfunction (ED) remains a prevalent consequence of radical prostatectomy (RP) that significantly impacts patient quality of life. Water-jet technology is widely used for dissection in neurosurgical procedures but novel to urologic surgery.AimTo establish the impact of hydro-jet dissection (HJD) of the cavernous nerves (CN) on postoperative erectile function in an animal model of RP-induced ED.Methods32 male Sprague-Dawley rats were randomized to 4 groups: Sham surgery (n = 8), bilateral HJD of CN (n = 8), blunt CN injury (n = 8), or stretch CN injury (n = 8). After 4 weeks, erectile function was assessed by measuring intracavernous pressure (ICP), and penile tissues were harvested for immunohistologic studies.Main Outcome MeasureThe peak ICP and the area under the curve were calculated for each group. Immunohistologic studies were performed for α-smooth muscle actin and neuronal nitric oxide synthase on cross-sections of penile tissue.ResultsRats in the HJD group demonstrate a significantly higher mean peak ICP and area under the curve compared with both CN injury groups (P = .001). Postoperative erectile function in the HJD group returned to baseline function. Preservation of α-smooth muscle actin and neuronal nitric oxide synthase was observed in the HJD group compared with the other surgical trauma groups.Clinical ImplicationsHydro-jet dissection used in an RP animal model maintains erectile function and offers a potential benefit that warrants further human studies.Strengths & LimitationsThis is a novel animal study comparing a new technology to established CN dissection techniques. This study uses an animal model, which may not completely translate to post-RP ED in humans.ConclusionHydro-jet dissection of the CN during RP in an animal model is associated with significantly better postoperative erectile function when compared with other CN injury. Clinical studies are needed to further investigate the putative benefit of HJD on erectile function in patients undergoing RP.Campbell JD, Alenezi H, DeYoung LX, et al. Hydrojet Dissection of the Cavernous Nerves Preserves Erection Function in a Radical Prostatectomy Animal Model. Sex Med 2019;7:104–110.
       
  • Testosterone Insufficiency in Human Immunodeficiency Virus–Infected
           Women: A Cross-Sectional Study

    • Abstract: Publication date: March 2019Source: Sexual Medicine, Volume 7, Issue 1Author(s): Ellen T.M. Laan, Jan M. Prins, Rik H.W. van Lunsen, Pythia T. Nieuwkerk, Marian A.F. Nievaard-Boon IntroductionNow that HIV infection has become a chronic disease, optimizing health status is an important goal of care for HIV-infected patients. Testosterone insufficiency (TI) can compromise health status, but little is known about the prevalence of TI and possible related factors in HIV-infected women.AimTo investigate the prevalence of TI among HIV-infected women attending our HIV outpatient clinic, and to study the relationship between TI and sexual function, fatigue, health status, and depression.Methods56 HIV-infected women aged ≥18 years who attended the HIV outpatient clinic of the Amsterdam University Medical Center, The Netherlands, were included. Blood samples were taken for endocrinologic testing and patients filled out 6 validated questionnaires measuring sexual function, fatigue, health, and depression.Main Outcome MeasureTI, the Female Sexual Function Index, the Female Sexual Distress Scale-Revised, the Multidimensional Fatigue Inventory, the Medical Outcomes Studies Short Form 36-item health survey, and the Beck Depression Inventory were assessed.ResultsA relatively high prevalence of TI, 37%, was found. Plasma viral load and CD4 cell count did not differ between women with or without TI. Clinical fatigue, physical fatigue, and impaired cognitive function were significantly more prevalent in women with TI. Women with TI also tended to report decreased sexual desire, reduced physical activity, increased mental fatigue, reduced physical function, increased health distress, and clinical depression.ConclusionWe recommend that in all HIV-positive women with complaints typical for TI, testosterone is measured, and that in women with TI, testosterone replacement be considered as a treatment option. However, given that complaints are also prevalent in HIV-positive women without TI, the approach to women with these complaints should include sexual and psychological evaluation.Laan ETM, Prins JM, van Lunsen RHW, et al. Testosterone Insufficiency in Human Immunodeficiency Virus–Infected Women: A Cross-Sectional Study. Sex Med 2019;7:72–79.
       
  • Age of Onset and Its Correlates in Men with Sexual Interest in Children

    • Abstract: Publication date: March 2019Source: Sexual Medicine, Volume 7, Issue 1Author(s): Safiye Tozdan, Peer Briken IntroductionCurrent discussions in the field of sex research concern the age at which sexual interest in children occurred or awareness emerged.AimTo investigate the age of onset (AOO) and its correlates in men with sexual interest in children.MethodsUsing 2 samples (study 1, patients from an outpatient treatment center, n = 26; study 2, an online survey using 3 recruitment paths, n = 94), we assessed self-reported AOO of sexual interest in children, its flexibility, its exclusiveness, and individuals’ motivation to change it. We further examined the interrelation between these variables.Main Outcome MeasureAOO as the self-reported age at which participants retrospectively felt sexually attracted to children for the first time.ResultsWe found broad ranges in AOO (study 1: mean 20.0 ± 10.7; study 2: mean 17.0 ± 8.7), flexibility, and exclusiveness (in studies 1 and 2, 7.7% and 22.3%, respectively, reported that their sexual interest is exclusively in children). The earlier participants felt sexually attracted to children for the first time, the more they were attracted exclusively in children and the less they perceived it to be flexible. Participants who reported rather exclusive sexual interest in children were less likely to perceive it as flexible. The more participants reported on flexibility, the more they were motivated to change it. The earlier participants of study 2 felt sexually attracted to children for the first time, the less they were motivated to change.Clinical ImplicationsThe variety of our results indicates the contradiction of overall rules for individuals with sexual interest in children.Strength & LimitationsWe included individuals with sexual interest in children from different contexts (eg, forensic vs non-forensic). Our results are in line with previous findings. However, both studies included rather small samples, limiting generalizability. There is not yet consent about how to operationalize AOO.ConclusionWe recommend a differentiated perspective on individuals with sexual interest in children and on different forms of pedophilia in the diagnostic construct.Tozdan S, Briken P. Age of Onset and Its Correlates in Men with Sexual Interest in Children. Sex Med 2019;7:61–71.
       
  • Sexual Activity is Associated with Greater Enjoyment of Life in Older
           Adults

    • Abstract: Publication date: March 2019Source: Sexual Medicine, Volume 7, Issue 1Author(s): Lee Smith, Lin Yang, Nicola Veronese, Pinar Soysal, Brendon Stubbs, Sarah E. Jackson BackgroundRelationships among sexual activity, problems and concerns, and well-being among older adults have not been fully explored.AimTo investigate associations among sexual activity, problems and concerns, and experienced well-being in a representative sample of older adults.MethodsIn this cross-sectional analysis from the English Longitudinal Study of Ageing, sexual behavior, problems, and concerns were assessed via a self-completed questionnaire. Covariates included age, partnership status, socioeconomic status, smoking status, alcohol intake, limiting long-standing illness, and depressive symptoms. Data were analyzed using 1-way independent analysis of variance.Main Outcome MeasureEnjoyment of life was assessed with the pleasure subscale of the CASP-19 (Control, Autonomy, Self-realization, and Pleasure), a validated measure of quality of life specific to older age.ResultsData on sexual activity and enjoyment of life were available for a total of 3,045 men and 3,834 women (mean age 64.4 years in men and 65.3 years in women). Men and women who reported any sexual activity in the past year had significantly higher mean enjoyment of life scores compared with those who were not sexually active (men, 9.75 vs 9.44 [P < .001]; women, 9.86 vs 9.67 [P = .003]). Among sexually active men, frequent (≥2 times a month) sexual intercourse (P < .001) and frequent kissing, petting, or fondling (P < .001) were associated with greater enjoyment of life. Among sexually active women, frequent kissing, petting, or fondling was also associated with greater enjoyment of life (P < .001), but there was no significant association with frequent intercourse (P = .101). Concerns about one’s sex life and problems with sexual function were strongly associated with lower levels of enjoyment of life in men and to a lesser extent in women.ConclusionThis is among the first studies to show that well-being is higher among older adults when they are sexually active. Preferences regarding the expression of sexual activity differed between the sexes. Further longitudinal research is needed to confirm a causal association between sexual activity and well-being.Smith L, Yang L, Veronese N, et al. Sexual Activity is Associated with Greater Enjoyment of Life in Older Adults. Sex Med 2019;7:11–18.
       
  • Compromised Sexual Health Among Male Patients With Implantable
           Cardioverter Defibrillator: A Cross-Sectional Questionnaire Study

    • Abstract: Publication date: Available online 21 January 2019Source: Sexual MedicineAuthor(s): Pernille Palm, Ann-Dorthe Zwisler, Jesper Hastrup Svendsen, Annamaria Giraldi, Marianne Linnet Rasmussen, Selina Kikkenborg Berg IntroductionIn cardiac patients with implantable cardioverter defibrillator (ICD), sexual function is sparsely described.AimTo determine the prevalence and distribution of sexual dysfunction, and to describe whether primary or secondary prophylactic ICD indication and antitachycardia pacing (ATP) or shock is associated with sexual function.MethodsA cross-sectional survey of men with an implanted ICD was conducted at 2 university hospitals in Denmark. Inclusion criteria were men over the age of 18 with an ICD. Exclusion criterion was no partner.Main Outcome MeasureSexual function was assessed by the International Index of Erectile Function questionnaire and data on implantation indication (primary/secondary prevention) and therapy such as ATP and shock (both appropriate and inappropriate) was obtained from the Danish ICD Register.ResultsData from 415 questionnaires were analyzed (response rate 50.2%). Patients had a mean age of 63.9±12.1 years. Erectile dysfunction (ED) was present in 70% of patients, orgasmic dysfunction was present in 57.9% of patients, 82.8% had reduced sexual desire, 85.8% had intercourse satisfaction problems, and 76.9% experienced overall satisfaction problems (non-validated metric except for ED). Patients with an ICD on primary prophylactic indication had more sexual dysfunction and ED compared with patients with an ICD on secondary prophylactic indication. ATP therapy, but not shock, was associated with more ED.ConclusionSexual dysfunction is common in patients with ICD and is not limited to ED, but also orgasmic function, desire, intercourse, and overall satisfaction are affected. Primary prophylactic ICD indication and ATP, but not shock therapy, is associated with compromised sexual function.Palm P, Zwisler A-D, Svendsen JH. Compromised Sexual Health Among Male Patients With Implantable Cardioverter Defibrillator: A Cross-Sectional Questionnaire Study. Sex Med 2018;XX:XXX–XXX.
       
  • Sexual Activity the Night Before Exercise Does Not Affect Various Measures
           of Physical Exercise Performance

    • Abstract: Publication date: Available online 21 January 2019Source: Sexual MedicineAuthor(s): Gerald S. Zavorsky, Eleftherios Vouyoukas, James G. Pfaus IntroductionThe idea that sexual activity can affect athletic performance has been a matter of conjecture for the past several decades.AimTo provide preliminary data on whether sexual activity the evening before several physical exercise performance tests affects performance the next day.MethodsEight participants (mean age, 28 ± 5 years) underwent several physical exercise performance tests on 3 different mornings, under 3 conditions: (i) no sexual intercourse the night before the tests (control), (ii) sexual intercourse the night before the tests, and (iii) yoga the night before the tests (randomized, single-blinded).Main Outcome MeasuresPhysical work capacity, lower body muscular power (standing vertical jump), upper body strength (handgrip strength), reaction time, and upper body musculoskeletal endurance (number of push-ups completed).ResultsAll participants experienced orgasm through intercourse. The more pleasurable the orgasm, the lower the systolic blood pressure (SBP) on the day after intercourse (Spearman’s rho = -0.86; P = .007). For every 2% increase in the total orgasm score, SBP decreased by 1 mmHg. Intercourse lasted 13 minutes; mean heart rate (HR) and caloric expenditure ranged from 88 to 145 beats/minute and from 53 to 190 kcal, respectively. There were no significant differences in the physical working capacity that elicited an HR of 170 beats/minute, number of push-ups completed, vertical jump height, grip strength, or reaction time across the 3 conditions.ConclusionOrgasm through sexual activity on the night before physical exercise may reduce SBP; however, we were unable to demonstrate a statistically significant difference in physical exercise performance in any of the 3 conditions.Zavorsky GS, Vouyoukas E, Pfaus JG. Sexual Activity the Night Before Exercise Does Not Affect Various Measures of Physical Exercise Performance. Sex Med 2019;XX:XXX–XXX.
       
  • Association Between Alcohol Use and Female Sexual Dysfunction From the
           Data Registry on Experiences of Aging, Menopause, and Sexuality (DREAMS)

    • Abstract: Publication date: Available online 21 January 2019Source: Sexual MedicineAuthor(s): Juliana M. Kling, Kimran Sidhu, Jordan Rullo, Kristin C. Mara, Karla S. Frohmader Hilsaca, Ekta Kapoor, Stephanie S. Faubion IntroductionSexual dysfunction is a common problem in women and the nature of its association with alcohol use remains unclear.AimTo explore the association between alcohol use and female sexual dysfunction (FSD).MethodsAssociations between self-reported drinking and sexual function were evaluated in 2,253 women presenting for consultation to a women’s health specialty clinic. A short version of the Alcohol Use Disorders Identification Test (AUDIT-C) was used to evaluate alcohol use. Women with an AUDIT-C ≥3 were considered at risk for hazardous drinking. Multivariable regression, controlling for depression, anxiety, and abuse (childhood and recent), was used to assess the association between alcohol consumption and FSD (defined as a Female Sexual Function Index [FSFI] ≤26.55 and Female Sexual Distress Scale [FSDS] ≥11) in sexually active women.Main Outcome MeasureThe main study outcome measure was the presence of FSD as defined by a score ≤26.55 on the FSFI and ≥11 on the FSDS.Results57% of the 1,649 sexually active women were classified as having FSD; 80% reported any alcohol use and 38% reported drinking patterns with the potential to be hazardous. The women at risk for hazardous drinking had significantly higher FSFI domain scores indicating better sexual function (P ≤ .001). However, in multivariable analyses, there was no significant difference in the rates of FSD across alcohol use categories in women.ConclusionIn women presenting for consultation to a women’s health specialty clinic, an association between alcohol use and FSFI scores was seen, in which greater risk of hazardous drinking was associated with better sexual function scores. However, when sexual distress was included to define sexual dysfunction, those with FSD were not at higher risk of hazardous drinking. Given the complex nature of FSD, additional study is needed to further clarify these relationships.Kling JM, Sidhu K, Rullo J, et al. Association Between Alcohol Use and Female Sexual Dysfunction From the Data Registry on Experiences of Aging, Menopause, and Sexuality (DREAMS). Sex Med 2018;XX:XX–XX.
       
  • Verteporfin as a Medical Treatment in Peyronie’s Disease

    • Abstract: Publication date: December 2018Source: Sexual Medicine, Volume 6, Issue 4Author(s): Daan C.J. Mohede, Igle Jan de Jong, Ruud A. Bank, Mels F. van Driel IntroductionIn Europe and the United States, verteporfin (Visudyne; VP) is registered and used in treating macular degeneration. Research showed that VP decreased expression of fibrotic genes in fibroblasts collected from nodules of patients suffering from Dupuytren’s disease, plausibly by de-activating transcription in the Yes Activated Protein (YAP) pathway.AimTo analyze the effect of VP on myofibroblasts cultured from Peyronie’s disease (PD) plaques.MethodsAt surgery for PD we took biopsies from the plaques of 5 patients. By immunostaining, the presence of the pathologic myofibroblasts was determined. After culturing cells, VP was dispensed in starvation medium for 24 and 48 hours and messenger(m)RNA levels of COL1A1, ACTA2, COL5A1, EDA-FN, LOXL2, CCN2, SERPINH1, PLOD2, and YAP were quantified and compared with controls with real-time polymerase chain reaction.Main Outcome MeasuremRNA-levels of COL1A1, ACTA2, COL5A1, EDA-FN, LOXL2, CCN2, SERPINH1, PLOD2, and YAP.ResultsThe pathologic phenotype of cells isolated from PD plaques was confirmed with baseline immunofluorescent stainings that showed considerable levels of α-smooth muscle actin, being a marker for the presence of myofibroblasts. The mRNA ratios of all the genes related to fibrosis (COL1A1, etc.) except YAP decreased significantly after treatment with VP within 24 and 48 hours. These results suggest inhibition of fibrosis in the YAP cascade, downstream of YAP.ConclusionIn our opinion, urologists must move the focus to disease before deformity, and the search for new oral or intralesional agents, well-tolerated and effective in both the acute and chronic phase of PD must continue. VP blocked the expression of genes related to fibrosis in the YAP cascade in myofibroblasts derived from PD plaque.Mohede DCJ, de Jong IJ, Bank RA, et al. Verteporfin as a medical treatment in Peyronie’s disease. Sex Med 2018;6:302–308.
       
  • Oral L-citrulline and Transresveratrol Supplementation Improves Erectile
           Function in Men With Phosphodiesterase 5 Inhibitors: A Randomized,
           Double-Blind, Placebo-Controlled Crossover Pilot Study

    • Abstract: Publication date: December 2018Source: Sexual Medicine, Volume 6, Issue 4Author(s): Masato Shirai, Ippei Hiramatsu, Yusuke Aoki, Hirofumi Shimoyama, Taiki Mizuno, Taiji Nozaki, Shinichiro Fukuhara, Atsushi Iwasa, Shinji Kageyama, Akira Tsujimura IntroductionPhosphodiesterase type 5 inhibitors (PDE5i) are first-line therapy for most men with erectile dysfunction (ED). If ineffective, vacuum erection devices, intracavernous injections, and penile prosthesis implantation are suitable as second- or third-line therapies. However, very few patients select these therapies. It is critically important to improve erectile function with oral administration of effective agents. Administration of L-citrulline or transresveratrol in animal experiments has been reported to improve erectile function, but few such experiments have been performed on humans with ED.AimWe aimed to investigate the efficacy of combination therapy of L-citrulline and transresveratrol in patients with ED despite their use of PDE5i.MethodsIn this randomized, double-blind, placebo-controlled crossover pilot study, men with ED (Sexual Health Inventory for Men [SHIM] score below 16) despite on-demand use of PDE5i received a placebo for 1 month or the active treatment (L-citrulline 800 mg/day and transresveratrol 300 mg/day) for another month. Patients continued on-demand use of PDE5i.Main Outcome MeasureThe SHIM score, Erection Hardness Score (EHS), Aging Male Symptoms Scale-sexual domain (AMS-SD), and adverse events were examined.Results20 patients ages 29–78 years were enrolled, and after 6 men withdrew, 13 concluded the study without adverse events. Mean SHIM score for the active treatment increased significantly (10.96 ± 1.21) compared with baseline (8.32 ± 1.21) and placebo (8.31 ± 1.23) (both P < .05). Mean EHS score for the active treatment (2.56 ± 0.26) also increased from baseline (2.31 ± 0.26), but not significantly (P = .79). Mean AMS-SD score was not significantly different in either group.ConclusionTo our knowledge, this is the first study to show that combination therapy of L-citrulline and transresveratrol is effective for ED treatment in men with added on-demand use of PDE5i. This combination supplement may be added if PDE5i is insufficient.Shirai M, Hiramatsu I, Aoki Y, et al. Oral L-citrulline and Transresveratrol Supplementation Improves Erectile Function in Men With Phosphodiesterase 5 Inhibitors: A Randomized, Double-Blind, Placebo-Controlled Crossover Pilot Study. Sex Med 2018;6:291–296.
       
  • Concordance and Discordance of Sexual Identity, Sexual Experience, and
           Current Sexual Behavior in 45-Year-Old Men: Results From the German Male
           Sex-Study

    • Abstract: Publication date: December 2018Source: Sexual Medicine, Volume 6, Issue 4Author(s): Veronika E. Goethe, Hannes Angerer, Andreas Dinkel, Christian Arsov, Boris Hadaschik, Florian Imkamp, Jürgen E. Gschwend, Kathleen Herkommer IntroductionDiscordance of various aspects of sexual orientation has been mostly studied in young adults or in small samples of heterosexual men. Studies focusing on concordance and discordance of aspects of sexual orientation in representative samples of middle-aged men including homosexual men are scarce.AimTo investigate concordant and discordant sexual behavior in 45-year-old German men with a special focus on homosexual identified men.MethodsData for this cross-sectional study were collected within the German Male Sex-Study. Participants were 45-year-old Caucasian males from the general population. Men self-reported on sexual identity, sexual experience, and current sexual behavior. Associations between sexual identity, experience, and behavior were analyzed using the chi-square test.Main Outcome MeasureAssociations of sexual identity with sexual experience and behavior in a community-based sample of men, and discordance of sexual identity and behavior especially in the subgroup of homosexual men.Results12,354 men were included in the study. 95.1% (n = 11.749) self-identified as heterosexual, 3.8% (n = 471) as homosexual, and 1.1% (n = 134) as bisexual. Sexual identity was significantly associated with sexual experience and behavior. 85.5% of all men had recently been sexually active, but prevalence of sexual practices varied. In hetero- and bisexuals, vaginal intercourse was the most common sexual practice, whereas oral sex was the most common in homosexuals. A discordance of sexual identity was especially found in homosexual men: 5.5% of homosexuals only had sexual experiences with women, and 10.3% of homosexuals recently had vaginal intercourse. In this latter subgroup, only one-quarter ever had sexual experience with a man, and three-quarters had only engaged in sexual activity with a woman.ConclusionSexual identity is associated with differences in sexual experience and behavior in German middle-aged men. A considerable proportion of homosexual identified men live a heterosexual life.Goethe VE, Angerer H, Dinkel A, et al. Concordance and Discordance of Sexual Identity, Sexual Experience, and Current Sexual Behavior in 45-Year-Old-Men: Results From the German Male Sex-Study. Sex Med 201;6:282–290.
       
  • Association Between Childhood and Adolescent Sexual Abuse Experiences and
           High-Risk Sexual Behaviors Among Chinese Youth

    • Abstract: Publication date: December 2018Source: Sexual Medicine, Volume 6, Issue 4Author(s): Ruoxi Ding, Xu Wen, Ping He, Chao Guo, Yanan Luo, Xinming Song, Xiaoying Zheng IntroductionAdolescents are at high risk for negative health outcomes associated with high-risk sexual behaviors (HRSBs), and researchers have attempted to identify factors that influence such behavior so that meaningful prevention and intervention programs may be developed.AimTo investigate the associations between CSA experience and HRSBs in Chinese youth aged 15-24 years old.MethodsData were from the Survey of Youth Access to Reproductive Health in China, a national sample survey conducted in 2009. The following behaviors were classified as HRSBs: condom non-use during the first sexual experience, having sex with multiple partners, taking part in casual sex, engaging in commercial sex, taking part in anal sex, and condom non-use during the most recent sexual encounter. Differences in HRSBs between the sexes were examined. The χ2 test and binary logistic regression were used to estimate the association between CSA experience and HRSBs.Main Outcome MeasureThe sexual behaviors of condom non-use during the first sexual experience, sexual activity with multiple partners, taking part in casual sex, engaging in commercial sex (defined as paying or receiving money/gifts in exchange for sex), taking part in anal sex, and condom non-using during the most recent sexual intercourse were classified as HRSBs.Results4,974 Sexually active youth were included in this study, 150 respondents (3.0%) reported CSA experience, and 3,950 (79.4%) sexually active youth had engaged in at least 1 type of HRSBs. The odds of having sex with multiple partners (odds ratio [OR] 4.31, 95% CI 3.07–6.07), casual sex (OR 3.65, 95% CI 2.55–5.24), commercial sex (OR 7.43, 95% CI 5.13–10.77), anal copulation (OR 2.54, 95% CI 1.57–4.12), or any of these HRSBs (OR 5.02, 95% CI 2.33–10.80) were significantly higher among those who had experienced CSA. There was a gender-specific difference in the associations of CSA with different types of HRSBs.ConclusionSexual abuse experience in childhood is highly correlated with HRSBs among Chinese youth, and the pattern of this association differs between males and females. Public knowledge and social assistance systems needs to be improved for children and youth in China. Gender-specific counter-measures may be more efficient for interventions.Ding R, Wen X, He P, et al. Association Between Childhood and Adolescent Sexual Abuse Experiences and High-Risk Sexual Behaviors Among Chinese Youth. Sex Med 2018;6:273–281.
       
  • Attitudes Toward Penile Transplantation Among Urologists and Health
           Professionals

    • Abstract: Publication date: December 2018Source: Sexual Medicine, Volume 6, Issue 4Author(s): Bobby Najari, Ryan Flannigan, Jackson Hobgood, Darius Paduch IntroductionPenile transplantation, in its infancy, has the potential to reestablish functional outcomes for men with penile loss and disfigurement. However, significant bioethical considerations are pertinent, and systematic discussions are necessary to safely progress implementation.AimTo determine the attitude of health practitioners toward the penile transplant and identify the key aspects of concern pertinent to the operation and clinical care.MethodsHealth care professionals from the United States responded to either email invitation, web link, or social media post on Facebook to complete a questionnaire investigating perceptions and attitudes toward penile transplantation.Main Outcome MeasuresRespondents' attitude toward penile transplantation, their own perceived important functions of the penis, and concerns about performing a penile transplantation. Respondents' previous exposure to visceral transplants, to penile disfigurement, and information about penile transplants were used as independent factors in analysis.ResultsAmong 412 health care professionals who responded to the questionnaire, 95.9% were in favor of visceral organ transplant, but only 64.3% were in favor of penile transplantation. The results showed that 61.3% of respondents first learned about the penile transplant from mass media, whereas only 37.5% had been exposed through a scientific journal, formal lecture, or a professional colleague. Younger health professionals and those exposed through professional forums surrounding penile transplantation were more likely to be in favor of the procedure (P < .001). The most important functions of the penis were identified by respondents as being sexual function (role in sexual activity) and gender identity (being a man) with rates of 86.4% and 85.3%, respectively (P < .001). Barriers identified by respondents included the use of immunosuppression and the potential subsequent effect on healthcare resource utilization. Reading an excerpt about penile trauma in war during the questionnaire improved acceptance of penile transplantation (P = .05).ConclusionPenile transplantation is accepted by most health professionals surveyed. Younger respondents and those informed through professional outlets are more favorable toward penile transplantation. Anticipated limitations include the risk of immunosuppression, lack of available donors, and the effect on healthcare utilization.Najari B, Flannigan R, Hobgood J, et al. Attitudes Toward Penile Transplantation Among Urologists and Health Professionals. Sex Med 2018;6:316–323.
       
  • miR-137 Affects Vaginal Lubrication in Female Sexual Dysfunction by
           Targeting Aquaporin-2

    • Abstract: Publication date: December 2018Source: Sexual Medicine, Volume 6, Issue 4Author(s): Hepeng Zhang, Tianjiao Liu, Ziyun Zhou, Aixia Zhang, Yuan Zhu, Jing Zhang, Lianjun Pan, Jiehua Ma IntroductionFemale sexual dysfunction (FSD) is a common disease with serious potential hazards, but it has not received much attention. The pathogenesis of FSD is urgently needed for the diagnosis and treatment of FSD.AimTo investigate the role of microribonucleic acid (mRNA, miR)-137 in FSD.MethodsVaginal epithelium tissues from 15 women with lubrication disorder and 15 women with normal function were collected for this study. The expression level of miR-137 in lubrication disorder and normal function women were measured by microarray analysis and Real-time Quantitative Polymerase Chain Reaction (PCR, qPCR). miR-137 was overexpressed in vaginal epithelial cells VK2/E6E7 by lentivirus infection. The cell water permeability was measured using the calcein-quenching method. Cell apoptosis was analyzed by flow cytometry. The potential target of miR-137 was predicted by bioinformatic analysis, then verified by luciferase reporter assays.Main Outcome MeasureThe expression level of miR-137 and aquaporin-2 (AQP2), cell water permeability, cell apoptosis, and luciferase reporter assays were examined.ResultsmiR-137 was found to be highly expressed in vaginal epithelial tissues of women with lubrication disorder. Additionally, functional in vitro studies suggested that overexpression of miR-137 leads to a decrease in cell permeability. By combining target prediction and examination, we identified AQP2 as the direct mechanistic target of miR-137 that affected the water permeability of vaginal epithelial cells.ConclusionOur results point to a novel role for miR-137 and its downstream effector AQP2 in vaginal lubrication, which can be manipulated as therapeutic targets against lubrication disorder and its related disorders.Zhang H, Liu T, Zhou Z. miR-137 affects vaginal lubrication in female sexual dysfunction by targeting Aquaporin-2. Sex Med 2018;6:339–347.
       
  • Sexual Dysfunction and Satisfaction in Japanese Couples During Pregnancy
           and Postpartum

    • Abstract: Publication date: December 2018Source: Sexual Medicine, Volume 6, Issue 4Author(s): Tomoko Tanaka Saotome, Keiko Yonezawa, Nobuhiko Suganuma IntroductionSexual function and frequency can change between couples during pregnancy and postpartum, with a decline in sexual function in women.AimTo investigate sexual function in couples during pregnancy and postpartum.MethodsThis questionnaire-based cross-sectional descriptive study solicited data from 551 couples, 127 (23%) of whom responded: 15 during the first trimester; 26 during the second trimester; and 21, 22, 21, and 22 at 1, 3, 6, and 12 months postpartum, respectively. The Female Sexual Function Index (FSFI) and International Index for Erectile Function (IIEF) questionnaires were used for female and male participants, respectively, and included questions about delivery, breastfeeding, partner’s contribution to housework, and desire to have more children for women, and about aspects of their partner’s pregnancy and postpartum life for men. Data about maternal/paternal age, parity, body mass index, and mode of delivery were also collected.Main Outcome MeasureFSFI and IIEF total and subcategory scores with attributable factors.ResultsThe total and subcategory scores related to female and male sexual functions were lowest at 1 and 3 months postpartum, with 79 women reporting female sexual dysfunction (score
       
  • Successful Use of an Inflatable Penile Prosthesis for the Treatment of
           Distal Deficiency of the Tunica Albuginea and Cavernous Tissue

    • Abstract: Publication date: December 2018Source: Sexual Medicine, Volume 6, Issue 4Author(s): Nahid Punjani, Patrick McGarry, Gerald Brock IntroductionCongenital hypoplasia of the distal half of the tunica albuginea has not been previously described.AimTo review a patient presenting with erectile dysfunction secondary to congenital penile hypoplasia.MethodsHistory, physical exam and penile Doppler ultrasound of the patient, followed by a discussed of treatment options and definitive management.ResultsSuccessful operative treatment of our patient with insertion of an inflatable penile prosthesis.ConclusionWe present a case of congenital hypoplasia of the distal tunica albuginea and a successful treatment strategy. We highlight the need for further study of penile embryology.Punjani N, McGarry P, Brock G. Successful Use of an Inflatable Penile Prosthesis for the Treatment of Distal Deficiency of the Tunica Albuginea and Cavernous Tissue. Sex Med 2018;6:356–359.
       
  • Society Page

    • Abstract: Publication date: December 2018Source: Sexual Medicine, Volume 6, Issue 4Author(s):
       
  • Reviewer Acknowledgment

    • Abstract: Publication date: December 2018Source: Sexual Medicine, Volume 6, Issue 4Author(s):
       
  • Letter to the Editor on the article “Sexual Health During Postgraduate
           Training—European Survey Across Medical Specialties”

    • Abstract: Publication date: December 2018Source: Sexual Medicine, Volume 6, Issue 4Author(s): Lorena A. Grondhuis Palacios, Esmée M. Krouwel, Henk W. Elzevier
       
 
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