BACKGROUND End-stage renal disease(ESRD)is associated with a multitude of physical,psychological,and social health challenges,including a profound impact on sexual and reproductive health.Among males with ESRD,erectil...BACKGROUND End-stage renal disease(ESRD)is associated with a multitude of physical,psychological,and social health challenges,including a profound impact on sexual and reproductive health.Among males with ESRD,erectile dysfunction(ED)is highly prevalent due to factors such as underlying comorbidities,including diabetes and hypertension,and the physiological effects of long-term dialysis.Kidney transplantation(KTx)has been proposed as a potential intervention to mitigate the effects of ED by restoring renal function and improving hormonal balance.However,the evidence surrounding the effectiveness of KTx in improving sexual function,specifically erectile function(EF),remains inconclusive.This systematic review and meta-analysis aim to evaluate the effects of KTx on sexual dysfunction(SexDys),particularly ED,in male ESRD patients.AIM To evaluate the benefits and potential harms of KTx compared to other forms of renal replacement therapy in improving EF in adult males with ESRD,assessed using the international index of EF(IIEF),to survey the prevalence of SexDys in this population,and to assess the correlation between various factors and SexDys through regression analysis.METHODS A systematic search of PubMed,EMBASE,Cochrane Library,Scopus,Clinical-Trials.gov,and Google Scholar was conducted,following the PRISMA 2020 guidelines.Prospective and retrospective cohort studies,as well as cross-sectional studies assessing EF pre-and post-transplantation,were included.These studies used validated tools such as the IIEF to measure EF.Meta-analyses were performed using a random-effects model to estimate standardized mean differences(SMD)and hazard ratios(HR)with 95%confidence intervals(CI).Heterogeneity was assessed using the I²statistic,and publication bias was evaluated with a funnel plot and the Egger’s test.RESULTS A total of 2419 studies were identified,with 362 abstracts screened and 193 full-text articles reviewed.Ultimately,11 studies were included for qualitative analysis and 7 for quantitative synthesis.The random effects model for SMD yielded a combined estimate of 0.43(95%CI:-0.20-1.07),indicating a small but non-significant improvement in EF post-transplantation.The heterogeneity across studies was substantial(I²=90%),reflecting significant variability in outcomes.Subgroup analysis showed greater improvements in EF among living-donor transplant recipients compared to those receiving organs from deceased donors.Despite this trend,the overall result for changes in EF was not statistically significant(P=0.15).Additionally,the combined HR from the meta-analysis was 2.87(95%CI:1.76-4.69),suggesting that KTx significantly increases the likelihood of improved EF,though variability between studies persisted(I²=63%).CONCLUSION While KTx offers some promise for improving EF in male ESRD patients,the overall evidence remains inconclusive due to high heterogeneity between studies and a lack of statistical significance in the combined results.Despite this,individual studies suggest that KTx may lead to significant improvements in EF for certain subgroups,particularly living-donor recipients.Future research should focus on larger,well-designed cohort studies with standardized outcome measures to provide more definitive conclusions.Addressing SexDys as part of routine care for ESRD patients undergoing KTx is crucial to improving their overall quality of life.However,adjunct therapies such as phosphodiesterase type 5 inhibitors may be necessary for those who do not experience adequate improvements post-transplantation.展开更多
Aim： To investigate how erectile dysfunction （ED） medications affect morning erection in patients with ED and how they respond to the return of morning erection. Methods： This study was conducted in 120 patients w...Aim： To investigate how erectile dysfunction （ED） medications affect morning erection in patients with ED and how they respond to the return of morning erection. Methods： This study was conducted in 120 patients who experienced successful intercourse with either tadalafil or sildenafil. Using a random face-to-face interview and a questionnaire （about the quality and number of days getting morning erection after using the two medications）, the impact of the medications on the morning erections was investigated, and the participants were asked about their feelings on regaining morning erection. Results： Of the respondents, 81% （68% of those with sildenafil and 99% of those with tadalafil） experienced morning erections after taking an oral ED medication. The men who took tadalafil mainly for 2 days with one dose, while those who took sildenafil experienced morning erections mainly for 1 day. The major sentiment upon regaining a morning erection was, ＂having more confidence as a man＂ （74%）. Among the 96 respondents who experienced morning erections with tadalafil, 52% preferred tadalafil over sildenafil, not only because of freedom from concerns about a specific time to have relations, but also regaining morning erection. Conclusion： Regaining a morning erection affects the recovery of confidence as a man and influences the preference for tadalafil over sildenafil.展开更多
Objective To investigate the female sexual dysfunction(FSD)in type 2 diabetes patients,by comparing the sexual function between type 2 diabetic women and non-diabetic women with Female Sexual Function Index(FSFI).Meth...Objective To investigate the female sexual dysfunction(FSD)in type 2 diabetes patients,by comparing the sexual function between type 2 diabetic women and non-diabetic women with Female Sexual Function Index(FSFI).Methods 215 type 2 diabetic women and 107 age-matched non-diabetes women were enrolled with similar backgrounds.Their sexual functions were evaluated with FSFI.Metabolic parameters such as body mass index,blood lipid profile,hemoglobin AlC,plasma glucose were also collected.Results Total score of FSFI of the type 2 diabetic women were significantly lower than that of the non-diabetic controls(18.27±8.96 vs.23.02±5.78,P=0.000).Scores of the FSFI domains(desire,arousal,lubrication,orgasm,satisfaction,pain)of the type 2 diabetic group were also lower than those of the control group.According to the FSD criterion(FSFI〈25)available in China,the percentage of FSD in the type 2 diabetic group was significantly higher than that of the control group(79.2%vs.55.0%,P〈0.001).These trends seemed more prominent in pre-menopause subgroups.The logistic regression analysis indicated that age and diabetes were independent risk factors of FSD.Body Mass Index(BMI)also had influence in the diabetes group.Conclusion Findings from this study showed that there are more FDS in Chinese type 2 diabetic women than in their non-diabetic counterparts,especially in pre-menopause participants.展开更多
Late-onset hypogonadism （LOH） has been considered the most common form of male hypogonadism with a prevalence of approximately 1 in 100 men. Diagnosis of LOH should be made in symptomatic men with unequivocally low ...Late-onset hypogonadism （LOH） has been considered the most common form of male hypogonadism with a prevalence of approximately 1 in 100 men. Diagnosis of LOH should be made in symptomatic men with unequivocally low serum testosterone （T） levels. However, its clinical presentation is often insidious and difficult to recognize because it is characterized by nonspecific symptoms that make differential diagnosis with physiological ageing problematic. Sexual dysfunction is the most important determinant for medical consultation and the most specific symptom associated with low T. We therefore analysed a consecutive series of 1734 subjects who attended our unit for sexual dysfunction to investigate the associations between low T （different thresholds）, sexual parameters, medical history data （delayed puberty, pituitary disease or cryptorchidism） and their physical exam results. Metabolic parameters, in particular waist circumference, display the greatest accuracy in detecting low T. We found that only the association of several symptoms and signs could significantly raise the clinical suspicion of low T. Structured inventories, which cluster together symptoms and signs of hypogonadism, can help clinicians suspect androgen deficiency. In particular, structured interviews, such as ANDROTEST, have been demonstrated to have a greater accuracy when compared to self reported questionnaires in detecting low T levels.展开更多
The impact of sexual dysfunction （SD） is distressing to many male patients with pituitary adenomas which affect both physical and psychological health. The research explored to identify risk factors affecting sexual...The impact of sexual dysfunction （SD） is distressing to many male patients with pituitary adenomas which affect both physical and psychological health. The research explored to identify risk factors affecting sexual function and the prognosis of male patients with pituitary adenomas. Two hundred and fifty-four male patients, who aged between 18 and 60 （mean ± s.d. ： 44.16 ± 10.14） years and diagnosed with pituitary adenomas, were retrospectively analyzed. One hundred and fifty-nine patients （62.6%） complained of SD prior to surgery. The mean International Index of Erectile Function （IIEF-5） in patients with giant adenomas was 16.13 ± 2.51, much smaller than those with microadenomas or macroadenomas （P 〈 0.05）. All the patients showed significant improvement in terms of erectile dysfunction （ED） following surgery （P 〈 0.05）. In addition, complete resection achieved a higher degree of SD relief than partial resection. The incidence of SD in functioning pituitary adenomas （FPAs） was much higher than that in nonfunctioning pituitary adenomas （NFPAs） （P 〈 0.05）. In addition, compared with NFPAs, males with prolactinomas （82.8%） had the higher prevalence of SD and significantly improvement following surgical intervention （P 〈 0.05）. An inverse relationship was identified between decreasing testosterone levels and increasing incidence of SD before surgery （P 〈 0.05）. There was no significant difference between 6 months and 12 months after surgery in serum testosterone level （P〉 0.05）. Our results indicated that surgical therapy could be optimized for improvements in SD and that testosterone levels can be used as a sensitive indicator to predict the recovery rate of sexual function in patients with pituitary adenomas following surgery and the serum testosterone level will stay stable in 6 months after surgery.展开更多
The impact of erectile dysfunction is distressing to both males and their female partners, but less attention has been paid to identify female partners＇ preferred treatment and sexual quality of life outcomes. The pr...The impact of erectile dysfunction is distressing to both males and their female partners, but less attention has been paid to identify female partners＇ preferred treatment and sexual quality of life outcomes. The present analysis explores female partners＇ treatment preference for erectile dysfunction in Chinese Men. This was a phase 4, randomized, open-label, multicenter, crossover study in Chinese men with erectile dysfunction who were na＇fve to phosphodiesterase type 5 inhibitor treatments. Eligible patients were randomized to sequential 20-mg tadalafil/100-mg sildenafil or lO0-mg sildenafil/20-mg tadalafil for 8 weeks each. Of 418 patients, female partners of 64 patients agreed to enter the study; of 64 patients who entered the study with female partners, 63 were randomized, and 62 completed the study. Baseline demographics and disease characteristics were comparable between treatment groups. Significantly more couples preferred tadalafil compared with sildenafil overall （75.4% vs 24.6%; P〈 0.001）, and irrespective of erectile dysfunction severity at baseline （P 〈 0.005）. Significant improvements in sexual quality of life scores were reported at endpoint （Visit 8） in male patients and female partners in both tadalafil and sildenafil treatment groups （P 〈 0.001）. Significantly higher mean changes from baseline were observed for male patients in the tadalafil group compared with the sildenafil group for the erectile function （P = 0.013） and overall satisfaction （P = 0.019） International Index for Erectile Function domains and the spontaneity domain （P〈 0.001） of the Psychological and Interpersonal Relationship Scale. No major safety concerns were reported during the study. Though both treatments were effective, safe, and tolerable, more couples preferred tadalafil compared with sildenafil.展开更多
Objective:To observe the clinical therapeutic effect of electroacupuncture on postpartum sexual dysfunction associated with urinary incontinence.Methods:The prospective case-series study was adopted.A total of 36 pati...Objective:To observe the clinical therapeutic effect of electroacupuncture on postpartum sexual dysfunction associated with urinary incontinence.Methods:The prospective case-series study was adopted.A total of 36 patients with postpartum sexual dysfunction associated with urinary incontinence were included consecutively.Electroacupuncture was applied to Shènshū(肾俞BL23),Huìyáng(会阳BL35),Pángguāngshū(膀胱俞BL28),Shíqīzhuī(十七椎EX-B8),Cìliáo(次髎BL32),Zhōngliáo(中髎BL33),Qìhǎi(气海CV6),Guānyuán(关元CV4),Zhōngjí(中极CV3),Qūgǔ(曲骨CV2),Shuǐdào(水道ST28),Zǐgōng(子宫EX-CA1),ZXsānlǐ(足三里ST36) and Sānyīnjiāo(三阴交SP6),once daily,6 times a week.The treatment for 2 weeks was as one phase and it should be completed in one menstrual cycle.For the cases without menstrual cycle recovery,the treatment should be given for any two weeks in one menstrual cycle and for those with menstrual cycle recovery,the treatment should avoid the menstrual period.Totally,the treatment lasted for 3 menstrual cycles.Before and after treatment,the scores of postpartum female sexual dysfunction diagnostic scale(PFSDDS),sexual intercourse pain assessment scale(SIPAS) and pelvic floor muscle strength test(PFMST),as well as the results of urodynamic examination(UE) were observed before and after treatment in the patients.Results:After treatment,the scores of PFSDDS,SIPAS and PFMST were all increased as compared with those before treatment separately,presenting the statistical significance(all P <0.05).Regarding UE,after treatment,the maximum bladder capacity,detrusor pressure at maximum flow,maximum flow rate and maximal urethral closure pressure were increased and postvoiding residual urine volume was reduced obviously as compared with the values before treatment,respectively,indicating the statistical differences(all P <0.05).Conclusion:Electroacupuncture has the significant effect on postpartum sexual dysfunction associated with urinary incontinence.展开更多
Background and goals Sexual dysfunction is a well-documented complication of rectal cancer surgery, with a reported incidence of 18% - 59%. The objective of this study is to evaluate the incidence of sexual dysfunctio...Background and goals Sexual dysfunction is a well-documented complication of rectal cancer surgery, with a reported incidence of 18% - 59%. The objective of this study is to evaluate the incidence of sexual dysfunction (SD) in males after radical resection for rectal cancer and to compare the outcome of open versus laparoscopic rectal resection for different age groups. Patients and methods This prospective randomized study assessed outcomes in male patients that underwent rectal resection for rectal cancer from January 2012 until March 2015 at two large tertiary hospitals in Cairo, Egypt. The patients were randomly allocated into two groups (laparoscopic and open technique) of 40 patients each using the odd number policy for patient allocation. Patients included in each group were further subdivided into two groups according to the type of rectal resection either anterior resection (AR) or abdominoperineal resection (APR). Erectile function was evaluated preoperatively and postoperatively at 3 and 6 months using the International Index of Erectile Function (IIEF) questionnaire. Results There was no significant difference between the laparoscopic and open total mesorectal excision (TME) groups when comparing IIEF score preoperatively. At 3 months postoperatively, the laparoscopic arm showed better results over the open arm (abnormal IIEF in 57.5% vs. 67.5%). The study demonstrated dramatic improvement in SD in both groups at 6 months postoperatively (abnormal IIEF score of 40% in the laparoscopic vs. 42.5% in the open arm) with no significant difference in IIEF score between the two groups (p-value 0.876). At 3 and 6 months postoperatively, younger patients showed significant improvement in SD compared to older patients in both groups with more significant improvement in the laparoscopic group (16.7% vs. 40%). Patients with APR show more SD compared with AR patients whether laparoscopic or open as seen by the abnormal IIEF scores for the the two groups [the laparoscopic group APR patients showed 62.5% abnormal IIEF at 3 months that decreased to 50% after 6 months compared to 56.3% and 37.5% at 3 and 6 months respectively for lap. AR patients, and in the open group APR patients also showed higher abnormal IIEF of 71.4% and improved to 42.9% at 3 and 6 months respectively compared to 66.7% and 42.3% at 3 and 6 months respectively for open AR), which shows that APR whether laparoscopic or open causes more sexual dysfunction than AR. Conclusion In this randomized prospective study, there was no significant difference between the laparoscopic and open TME when we compared IIEF scores. In patients younger than 30 years, the significant improvement in the laparoscopic arm adds to the favorable outcome of laparoscopic TME as regards postoperative complications, postoperative pain, hospital stay, the return of bowel functions and cosmetic results.展开更多
Multiple sclerosis （MS） is a chronic inflammatory demyelinating disorder of the central nervous system characterized by episodic and progressive neurologic dysfunction resulting from inflammatory and autoimmune reac...Multiple sclerosis （MS） is a chronic inflammatory demyelinating disorder of the central nervous system characterized by episodic and progressive neurologic dysfunction resulting from inflammatory and autoimmune reactions. The underlying pathogenesis of MS remains largely unclear. However, it is currently accepted as a T cell-mediated autoimmune disease. Among other clinical manifestations, sexual dysfunction （SD） is a painful but still underreported and underdiagnosed symptom of the disorder. SD in MS patients may result from a complex set of conditions and may be associated with multiple anatomic, physiologic, biologic, medical and psychological factors. SD arises primarily from lesions affecting the neural pathways involved in physiologic function. In addition, psychological factors, the side effects of medications and physical symptoms such as fatigue, muscular weakness, menstrual changes, pain and concerns about bladder and bowel incontinence may also be involved. Since MS primarily affects young people, SD secondary to MS may have a great impact on quality of life. Thus, maintaining a healthy sexual life with MS is an important priority. The treatment of SD requires multidisciDlinarv teamwork and coooeration amone specialists,individual patients, partners and the society.展开更多
This study aimed to estimate the prevalence of and identify the factors influencing female sexual dysfunction （FSD） among Chinese nurses. A cross-sectional survey was conducted from March 2013 to May 2014 among 6 ho...This study aimed to estimate the prevalence of and identify the factors influencing female sexual dysfunction （FSD） among Chinese nurses. A cross-sectional survey was conducted from March 2013 to May 2014 among 6 hospitals in Suzhou, China. In total, 2,030 married female nurses were included in the analysis.展开更多
Pelvic organ prolapsed is a common problem today, and it has been gradually increasing because of the longevity of women. Pelvic organ prolapse can result in negative psychological feelings that affect on women’s sex...Pelvic organ prolapsed is a common problem today, and it has been gradually increasing because of the longevity of women. Pelvic organ prolapse can result in negative psychological feelings that affect on women’s sexual activity. Methods: There is a cross-sectional study on sexual dysfunction in 296 women with pelvic organ prolapse grade II and III followed up at gynecological-pelvic floor unit of Hung Vuong hospital from 09/2017 to 06/2018. Results: The prevalence of female sexual dysfunction in PISQ-12 was 76.4% and 95% CI [71.6 - 81.2]. The rate of female sexual dysfunction in turn is: 1) Behavioral-Emotional: 93.6% 95% CI [90.8 - 96.4]. 2) Physiology: 62.2% CI 95% [56.7 - 67.7]. 3) Relationship to partner: 89.5% 95% CI [86.0 - 93.0]. Factor related to sexual dysfunction in women with pelvic organs (p < 0.05) is general sexual dysfunction: 1) Age group: women over age 55 increased generally the risk of sexual dysfunction, OR = 5.89, 95% CI [1.38 - 25.20]. 2) Diabetes mellitus increased the risk of sexual dysfunction with OR = 5.03, 95% CI [1.42 - 17.82]. 3) Patients with previous abortions reduced the risk of sexual dysfunction with OR = 0.49 95% CI [0.27 - 0.90]. Conclusion: Research on quality of life in pelvic organ prolapse should be considered more in the future.展开更多
Objectives: to evaluate the effectiveness of a natural compound made of Ecklonia bicyclis Seaweed, Tribulus terrestris and water-soluble chitosan oligosaccharide, in the male sexual asthenia with mild or mild-moderate...Objectives: to evaluate the effectiveness of a natural compound made of Ecklonia bicyclis Seaweed, Tribulus terrestris and water-soluble chitosan oligosaccharide, in the male sexual asthenia with mild or mild-moderate erectile dysfunction and serum testosterone levels between 280 and 350 ng/dl. Materials and Methods: 84 male patients affected by reduced libido and serum testosterone levels at the lower limit of normal, were recruited. We have separated patients in three different age groups: group A (18 - 45 years), group B (45 - 59 years), group C (>60 years). All subjects answered the International index of erectile function questionnaire (IIEF-5) and underwent determination of serum total testosterone before and after 30 days of treatment. Results: Before treatment, the group A showed mean (± standard deviation) total testosterone 321.9 ± 19.2 ng/dl and mean IIEF-5 18.6 ± 1.97, in the group B it was 318.5 ± 18.1 ng/dl and 16.3 ± 2.66, and finally in the group C it was 305.4 ± 13.1 ng/dl and 14.2 ± 1.95 respectively. After treatment mean total testosterone and mean IIEF-5 were respectively: group A (448 ± 111.46 ng/dl and 21.84 ± 3.41);group B (453.8 ± 105.23 ng/dl and 20.4 ± 3.81);group C (385.8 ± 87.29 ng/dl and 16.7 ± 3.84). Conclusions: The treatment with Ecklonia bicyclis, Tribulus terrestris and water-soluble chitosan oligosaccharide might represent a safe and effective option on the improvement of libido and erectile function in man with testosterone level at the lower limit of normal.展开更多
Female sexual dysfunction (FSD) affects 40% of the world’s females, most of which are disorders linked to desire or interest/excitement. Whilst all types of therapy that attempt to improve female sexual desire have l...Female sexual dysfunction (FSD) affects 40% of the world’s females, most of which are disorders linked to desire or interest/excitement. Whilst all types of therapy that attempt to improve female sexual desire have long been established, the results are contradictory. Objective: To analyze all available evidence to validate the effectiveness of natural therapies in the treatment of FSD. Method: The study was registered at http://www.prospero.org (CRD42019127700). We searched the Institute for Scientific Information Web of Knowledge, MEDLINE, Pubmed, Scopus and Cochrane databases for all articles published in peer- reviewed journals in April 2019 (in any language). The PICOS standard is women with FSD;(intervention) of any type of Natural therapy;(outcome) primary outcome: frequency of changes, severity, and average mean scores on sexual symptoms measured with a validated instrument, secondary outcome: quality of life;(study design) and randomized clinical trial (RCT). Results: The literature search strategy identified 95 articles, 81 of which were excluded at the different search stages. Finally, we systematically reviewed 15 RCTs, 11 of which referred to primary FSD, and four of which analyzed women with drug-induced FSD (DFSD). Most of them analyzed hypoactive sexual desire disorder. Although differences related to placebo were found in most people, the majority of the studies are considered to be of poor quality and low external effectiveness. Conclusion: Although the quality of the evidence is not high, most natural product interventions appear to improve FSD, particularly hypoactive sexual desire disorders including those categorized as primary and drug-induced.展开更多
Objective:To evaluate the effect of Quercetin (QT) on erectile dysfunction and oxidative stress in penile tissue of streptozotocin-induced diabetic rats.Methods: Two weeks after diabetes induction, QT was treated to n...Objective:To evaluate the effect of Quercetin (QT) on erectile dysfunction and oxidative stress in penile tissue of streptozotocin-induced diabetic rats.Methods: Two weeks after diabetes induction, QT was treated to normal and diabetic rats for 5 wk. Sexual behavioral parameters including mount latency, intromission latency, ejaculation latency, post-ejaculatory interval, mount frequency and intromission frequency, were observed against stimulus females. Sperm count and their motility and viability were recorded. Serum glucose and testosterone levels were estimated. In penile tissue levels of cyclic guanosine monophosphate, thiobarbituric acid reactive substances and glutathione, and enzymatic activities of superoxide dismutase and catalase were measured. Histopathological changes were evaluated in a cross-section of penile tissue.Results:Sexual behavioral ejaculation latency, post-ejaculatory interval, mount latency and intromission latency were significantly increased while mount frequency and intromission frequency were decreased in diabetic rats. Treatment with QT corrected the male sexual behavioral levels and also enhanced the inhibited sperm count, motility and viability in diabetic rats. Serum testosterone and penile cyclic guanosine monophosphate levels were significantly increased in QT treated diabetic rats compared to untreated diabetic animals. Penile oxidative stress biomarkers were corrected by the QT treatments in diabetic rats. Histopathological evaluation revealed damaged penile tissues in diabetic rats, which was protected following QT treatment.Conclusions: QT eliminated the diabetic-induced sexual impairment and showed significant antioxidant effects in penile tissue. Further experimental studies are recommended for QT therapeutically usage.展开更多
Penile fracture is a rare urological emergency that may cause erectile dysfunction(ED).We analyzed the factors affecting erectile function in patients who underwent surgical repair for the management of penile fractur...Penile fracture is a rare urological emergency that may cause erectile dysfunction(ED).We analyzed the factors affecting erectile function in patients who underwent surgical repair for the management of penile fractures.Eighty-two patients who underwent penile fracture surgery in the Department of Urology,University of Gaziantep(Gaziantep,Türkiye)between January 2012 and January 2023 were evaluated.Age,body mass index,time elapsed from the incident of penile fracture to surgery,size,laterality,level of the defect,causes of fracture,presenting signs and symptoms,and relevant complications were recorded.Erectile function of the patients was evaluated preoperatively and at postoperative 3rd and 6th months according to the International Index of Erectile Function-5(IIEF-5)scoring system.The factors decreasing the erection quality of the patients after surgical repair of penile fractures were investigated using IIEF-5 scoring system.Only age,defect size,and time elapsed from fracture onset to surgery were found to be effective on the occurrence of ED(P=0.005,P<0.001,and P<0.001,respectively).In the receiver operating characteristic(ROC)analysis,the cut-off values were 12.5 mm for defect size(P<0.001),8.5 h for the time elapsed from fracture onset to surgery(P=0.036),and 40.5 years for the age of the patients(P=0.005).Delayed surgery,defect size,and advanced age had significant and negative effects on erectile function in cases of penile fracture.Before repair of the defect,patients should be given appropriate counseling about the possibility of ED,and early penile rehabilitation should be initiated.展开更多
Background: Diabetes is amongst the most researched diseases worldwide due to its debilitating effects on patients. Diabetics have a higher risk of developing erectile dysfunction. Evidence has linked erectile dysfunc...Background: Diabetes is amongst the most researched diseases worldwide due to its debilitating effects on patients. Diabetics have a higher risk of developing erectile dysfunction. Evidence has linked erectile dysfunction severity to increased age, duration of diabetes, the metabolic syndrome and hypogonadism. However, the role of inflammatory markers in the pathogenesis of SD is still unclear. The contributions of hormonal parameters and adipokines to both macro and micro vascular complications are still poorly understood. This study was conducted to provide some evidence of an association between SD, the metabolic syndrome and inflammatory hormones. Method: A total of 130 diabetic males participated in this study. All participants were at least 18 years and were actively engaged in a stable heterosexual relationship for a minimum of two years before they were recruited for this study. The Diabetic men were evaluated using the Golombok Rust Inventory of Sexual Satisfaction for males (GRISS-M). The NCEP-ATP III, IDF and WHO criteria were used to assess the metabolic syndrome. Blood samples were taken for biochemical and hormonal assays. Results: Participants with raised Triglyceride levels showed significantly higher leptin levels for NCEP-ATP III and IDF criteria. Participants with impotence showed significantly lower leptin/adiponectin ratio (p = 0.0184) whilst participant with non-sensuality showed significantly higher values of leptin/adiponectin ratio (p = 0.0103). A significantly higher levels of insulin (p = 0.0265) was recorded in participants with Dissatisfaction problems. Participants with Non communication problems showed significantly higher levels of insulin (p = 0.0419) and lower levels of adiponectin (p = 0.0438) whilst participants with infrequency showed significantly lower levels of adiponectin (p = 0.0042). Conclusion: The relative balance between pro inflammatory and anti-inflammatory mediators of endothelial dysfunction could possibly be essential for the progression of diabetes to SD and the MetS thus a longitudinal study which measures a range of both pro and anti-inflammatory hormones and adipokines as risk factors for SD and the MetS could potentially aid in improvements in assessing the risk of developing these conditions among diabetics.展开更多
Objective: To compare sexual function between primiparous women who underwent cesarean section (CS) and those who delivered vaginally. Methods: This cross-sectional study was conducted from October 2011 to April 2012 ...Objective: To compare sexual function between primiparous women who underwent cesarean section (CS) and those who delivered vaginally. Methods: This cross-sectional study was conducted from October 2011 to April 2012 in Beijing, China. The target population included women aged 18 - 45 years who had given birth only once at least 6 months prior. The questionnaire was self-administered including female sexual function measured using the Female Sexual Function Index (FSFI). Data were analyzed using R software with the significance level of 0.05. Results: A total of 1456 participants were included and 102 women (7.0%) declined. The median age of the participants was 35 years. The median time interval after childbirth was 6 years. The median FSFI score was 26.9 and prevalence of female sexual dysfunction (FSD) was 34.2%. Both the FSFI scores and the proportions of individuals with sexual disorders were similar between women undergoing CS and those having vaginal delivery for both individual domains and the full scale. Conclusion: There were insignificant differences in female sexual function scores and FSD prevalence between women undergoing CS versus vaginal delivery.展开更多
Low testosterone(T)is frequent in men with chronic illnesses.The clinical features of T deficiency(TD)overlap with those of chronic diseases.The aim of this study is to evaluate the relative contribution of chronic di...Low testosterone(T)is frequent in men with chronic illnesses.The clinical features of T deficiency(TD)overlap with those of chronic diseases.The aim of this study is to evaluate the relative contribution of chronic disease score(CDS)and low T to the presenee of TD symptoms.A consecutive series of 3862 men(aged 52.1±13.1 years)consulting for sexual dysfunction were studied.Several clinical and biochemical parameters were collected,in eluding the structured interview,ANDROTEST,for the assessme nt of TD symptoms.Penile color Doppler ultrasound(PCDU)was also performed.Based on the medications taken,the CDS was calculated.For a subset of 1687 men,information on mortality was collected(follow-up of 4.3±2.6 years).Higher CDS was associated with lower free and total T(TT)as well as with higher ANDROTEST score.When introducing CDS and TT in multivariable models adjusted for age,severe erectile dysfunctio n and impaired morning erectio ns were associated with both CDS(odds ratio and 95%confide nee interaval,OR[95%Cl]=1.25[1.13;1.37]and 1.38[1.29;1.48],respectively)and low TT(OR[95%Cl]=1.11[1.00;1.23]and 1.13[1.06;1.21],respectively).Similar results were obtained for PCDU parameters.Hypoactive sexual desire was associated with low TT(OR[95%Cl]=1.21[1.13;1.30]),whereas it was inversely related with CDS(OR[95%Cl]=0.91[0.84;0.97]).When considering mortality for major cardiovascular events,TT<8 nmol I1,but not CDS,was a significant predictor(hazard ratio[95%Cl]=5.57[1.51;20.63]).Chronic illnesses are associated with an overt TD.Both chronic diseases and low T can be invoIved in determining symptoms present in subjects complaining for sexual dysfunction.This should be considered in the diagnostic workup for TD.展开更多
Introduction: female sexual dysfunction (FSD) is a complex and poorly understood condition that affects females of all ages. Female sexual dysfunction has been a cyclic rather than a linear process that emphasizes bio...Introduction: female sexual dysfunction (FSD) is a complex and poorly understood condition that affects females of all ages. Female sexual dysfunction has been a cyclic rather than a linear process that emphasizes biologic, psychological, social, hormonal, and environmental factors. Female sexual dysfunction is a high prevalent disorder reaching up to 60% of females with reported higher levels in postmenopausal. Aim of the work: was to estimate prevalence of FSD and its related factors in Elfayoum city. Subject and Method: This study was a cross sectional descriptive study conducted in Elfayoum city included 508 married females (above 21 years old) during the period from September 2016 to March 2017. Results: The prevalence of FSD among studied group was 61.2% versus 38.8% had normal sexual function, desire dysfunction was 42.3%, arousal dysfunction was 39.2%, lubrication dysfunction was 25%, orgasm dysfunction was 58.5%, satisfaction dysfunction was 58.1% and pain was 43.3%. There was statistically significant negative correlation between Female Sexual Function Index (FSFI) score and each of female and husband age, duration of marriage, and number of children. Low mean of FSFI score was found among females with irregular menstrual cycle, using contraceptive, not pregnant, mutilated and females who’s their husband had erectile or ejaculation disorders. Conclusion and recommendation: High prevalence of FSD among females in Elfayoum governorate. Many factors are found to affect FSD as FGM, each of female and husband age, duration of marriage, and number of children.展开更多
Sexual dysfunction(SD)is a prevalent but very commonly ignored aspect in the treatment of liver diseases and cirrhosis.The etiology of SD is multifactorial and therefore treatment strategies are complex,especially in ...Sexual dysfunction(SD)is a prevalent but very commonly ignored aspect in the treatment of liver diseases and cirrhosis.The etiology of SD is multifactorial and therefore treatment strategies are complex,especially in females.Phosphodiesterase inhibitors are useful and effective in erectile dysfunction in males but in females,no single drug is available for SD,therefore multimodal treatment is required depending upon the cause.The foremost and fundamental requirement in both genders is to be stress-free and have adequate control of liver diseases.Improved quality of life is helpful in improving SD and vice versa is also true.Therefore,patients suffering from liver diseases should come forward and ask for treatment for SD,and physicians should actively enquire about SD while history taking and evaluating these patients.SD results in deterioration of quality of life,and both are modifiable and treatable aspects of liver diseases,which are never addressed actively,due to social taboos and fears of SD treatment in the presence of liver diseases.The diagnosis of SD does not require costly investigations,as the diagnosis can be established based on validated questionnaires available for both genders,therefore detailed targeted history taking using questionnaires is essential.Data are emerging in this area but is still at an early stage.More studies should be dedicated to SD in liver diseases.展开更多
文摘BACKGROUND End-stage renal disease(ESRD)is associated with a multitude of physical,psychological,and social health challenges,including a profound impact on sexual and reproductive health.Among males with ESRD,erectile dysfunction(ED)is highly prevalent due to factors such as underlying comorbidities,including diabetes and hypertension,and the physiological effects of long-term dialysis.Kidney transplantation(KTx)has been proposed as a potential intervention to mitigate the effects of ED by restoring renal function and improving hormonal balance.However,the evidence surrounding the effectiveness of KTx in improving sexual function,specifically erectile function(EF),remains inconclusive.This systematic review and meta-analysis aim to evaluate the effects of KTx on sexual dysfunction(SexDys),particularly ED,in male ESRD patients.AIM To evaluate the benefits and potential harms of KTx compared to other forms of renal replacement therapy in improving EF in adult males with ESRD,assessed using the international index of EF(IIEF),to survey the prevalence of SexDys in this population,and to assess the correlation between various factors and SexDys through regression analysis.METHODS A systematic search of PubMed,EMBASE,Cochrane Library,Scopus,Clinical-Trials.gov,and Google Scholar was conducted,following the PRISMA 2020 guidelines.Prospective and retrospective cohort studies,as well as cross-sectional studies assessing EF pre-and post-transplantation,were included.These studies used validated tools such as the IIEF to measure EF.Meta-analyses were performed using a random-effects model to estimate standardized mean differences(SMD)and hazard ratios(HR)with 95%confidence intervals(CI).Heterogeneity was assessed using the I²statistic,and publication bias was evaluated with a funnel plot and the Egger’s test.RESULTS A total of 2419 studies were identified,with 362 abstracts screened and 193 full-text articles reviewed.Ultimately,11 studies were included for qualitative analysis and 7 for quantitative synthesis.The random effects model for SMD yielded a combined estimate of 0.43(95%CI:-0.20-1.07),indicating a small but non-significant improvement in EF post-transplantation.The heterogeneity across studies was substantial(I²=90%),reflecting significant variability in outcomes.Subgroup analysis showed greater improvements in EF among living-donor transplant recipients compared to those receiving organs from deceased donors.Despite this trend,the overall result for changes in EF was not statistically significant(P=0.15).Additionally,the combined HR from the meta-analysis was 2.87(95%CI:1.76-4.69),suggesting that KTx significantly increases the likelihood of improved EF,though variability between studies persisted(I²=63%).CONCLUSION While KTx offers some promise for improving EF in male ESRD patients,the overall evidence remains inconclusive due to high heterogeneity between studies and a lack of statistical significance in the combined results.Despite this,individual studies suggest that KTx may lead to significant improvements in EF for certain subgroups,particularly living-donor recipients.Future research should focus on larger,well-designed cohort studies with standardized outcome measures to provide more definitive conclusions.Addressing SexDys as part of routine care for ESRD patients undergoing KTx is crucial to improving their overall quality of life.However,adjunct therapies such as phosphodiesterase type 5 inhibitors may be necessary for those who do not experience adequate improvements post-transplantation.
文摘Aim： To investigate how erectile dysfunction （ED） medications affect morning erection in patients with ED and how they respond to the return of morning erection. Methods： This study was conducted in 120 patients who experienced successful intercourse with either tadalafil or sildenafil. Using a random face-to-face interview and a questionnaire （about the quality and number of days getting morning erection after using the two medications）, the impact of the medications on the morning erections was investigated, and the participants were asked about their feelings on regaining morning erection. Results： Of the respondents, 81% （68% of those with sildenafil and 99% of those with tadalafil） experienced morning erections after taking an oral ED medication. The men who took tadalafil mainly for 2 days with one dose, while those who took sildenafil experienced morning erections mainly for 1 day. The major sentiment upon regaining a morning erection was, ＂having more confidence as a man＂ （74%）. Among the 96 respondents who experienced morning erections with tadalafil, 52% preferred tadalafil over sildenafil, not only because of freedom from concerns about a specific time to have relations, but also regaining morning erection. Conclusion： Regaining a morning erection affects the recovery of confidence as a man and influences the preference for tadalafil over sildenafil.
基金supported by the Research Fund from Zhejiang Health Department,2009A119
文摘Objective To investigate the female sexual dysfunction(FSD)in type 2 diabetes patients,by comparing the sexual function between type 2 diabetic women and non-diabetic women with Female Sexual Function Index(FSFI).Methods 215 type 2 diabetic women and 107 age-matched non-diabetes women were enrolled with similar backgrounds.Their sexual functions were evaluated with FSFI.Metabolic parameters such as body mass index,blood lipid profile,hemoglobin AlC,plasma glucose were also collected.Results Total score of FSFI of the type 2 diabetic women were significantly lower than that of the non-diabetic controls(18.27±8.96 vs.23.02±5.78,P=0.000).Scores of the FSFI domains(desire,arousal,lubrication,orgasm,satisfaction,pain)of the type 2 diabetic group were also lower than those of the control group.According to the FSD criterion(FSFI〈25)available in China,the percentage of FSD in the type 2 diabetic group was significantly higher than that of the control group(79.2%vs.55.0%,P〈0.001).These trends seemed more prominent in pre-menopause subgroups.The logistic regression analysis indicated that age and diabetes were independent risk factors of FSD.Body Mass Index(BMI)also had influence in the diabetes group.Conclusion Findings from this study showed that there are more FDS in Chinese type 2 diabetic women than in their non-diabetic counterparts,especially in pre-menopause participants.
文摘Late-onset hypogonadism （LOH） has been considered the most common form of male hypogonadism with a prevalence of approximately 1 in 100 men. Diagnosis of LOH should be made in symptomatic men with unequivocally low serum testosterone （T） levels. However, its clinical presentation is often insidious and difficult to recognize because it is characterized by nonspecific symptoms that make differential diagnosis with physiological ageing problematic. Sexual dysfunction is the most important determinant for medical consultation and the most specific symptom associated with low T. We therefore analysed a consecutive series of 1734 subjects who attended our unit for sexual dysfunction to investigate the associations between low T （different thresholds）, sexual parameters, medical history data （delayed puberty, pituitary disease or cryptorchidism） and their physical exam results. Metabolic parameters, in particular waist circumference, display the greatest accuracy in detecting low T. We found that only the association of several symptoms and signs could significantly raise the clinical suspicion of low T. Structured inventories, which cluster together symptoms and signs of hypogonadism, can help clinicians suspect androgen deficiency. In particular, structured interviews, such as ANDROTEST, have been demonstrated to have a greater accuracy when compared to self reported questionnaires in detecting low T levels.
文摘The impact of sexual dysfunction （SD） is distressing to many male patients with pituitary adenomas which affect both physical and psychological health. The research explored to identify risk factors affecting sexual function and the prognosis of male patients with pituitary adenomas. Two hundred and fifty-four male patients, who aged between 18 and 60 （mean ± s.d. ： 44.16 ± 10.14） years and diagnosed with pituitary adenomas, were retrospectively analyzed. One hundred and fifty-nine patients （62.6%） complained of SD prior to surgery. The mean International Index of Erectile Function （IIEF-5） in patients with giant adenomas was 16.13 ± 2.51, much smaller than those with microadenomas or macroadenomas （P 〈 0.05）. All the patients showed significant improvement in terms of erectile dysfunction （ED） following surgery （P 〈 0.05）. In addition, complete resection achieved a higher degree of SD relief than partial resection. The incidence of SD in functioning pituitary adenomas （FPAs） was much higher than that in nonfunctioning pituitary adenomas （NFPAs） （P 〈 0.05）. In addition, compared with NFPAs, males with prolactinomas （82.8%） had the higher prevalence of SD and significantly improvement following surgical intervention （P 〈 0.05）. An inverse relationship was identified between decreasing testosterone levels and increasing incidence of SD before surgery （P 〈 0.05）. There was no significant difference between 6 months and 12 months after surgery in serum testosterone level （P〉 0.05）. Our results indicated that surgical therapy could be optimized for improvements in SD and that testosterone levels can be used as a sensitive indicator to predict the recovery rate of sexual function in patients with pituitary adenomas following surgery and the serum testosterone level will stay stable in 6 months after surgery.
文摘The impact of erectile dysfunction is distressing to both males and their female partners, but less attention has been paid to identify female partners＇ preferred treatment and sexual quality of life outcomes. The present analysis explores female partners＇ treatment preference for erectile dysfunction in Chinese Men. This was a phase 4, randomized, open-label, multicenter, crossover study in Chinese men with erectile dysfunction who were na＇fve to phosphodiesterase type 5 inhibitor treatments. Eligible patients were randomized to sequential 20-mg tadalafil/100-mg sildenafil or lO0-mg sildenafil/20-mg tadalafil for 8 weeks each. Of 418 patients, female partners of 64 patients agreed to enter the study; of 64 patients who entered the study with female partners, 63 were randomized, and 62 completed the study. Baseline demographics and disease characteristics were comparable between treatment groups. Significantly more couples preferred tadalafil compared with sildenafil overall （75.4% vs 24.6%; P〈 0.001）, and irrespective of erectile dysfunction severity at baseline （P 〈 0.005）. Significant improvements in sexual quality of life scores were reported at endpoint （Visit 8） in male patients and female partners in both tadalafil and sildenafil treatment groups （P 〈 0.001）. Significantly higher mean changes from baseline were observed for male patients in the tadalafil group compared with the sildenafil group for the erectile function （P = 0.013） and overall satisfaction （P = 0.019） International Index for Erectile Function domains and the spontaneity domain （P〈 0.001） of the Psychological and Interpersonal Relationship Scale. No major safety concerns were reported during the study. Though both treatments were effective, safe, and tolerable, more couples preferred tadalafil compared with sildenafil.
文摘Objective:To observe the clinical therapeutic effect of electroacupuncture on postpartum sexual dysfunction associated with urinary incontinence.Methods:The prospective case-series study was adopted.A total of 36 patients with postpartum sexual dysfunction associated with urinary incontinence were included consecutively.Electroacupuncture was applied to Shènshū(肾俞BL23),Huìyáng(会阳BL35),Pángguāngshū(膀胱俞BL28),Shíqīzhuī(十七椎EX-B8),Cìliáo(次髎BL32),Zhōngliáo(中髎BL33),Qìhǎi(气海CV6),Guānyuán(关元CV4),Zhōngjí(中极CV3),Qūgǔ(曲骨CV2),Shuǐdào(水道ST28),Zǐgōng(子宫EX-CA1),ZXsānlǐ(足三里ST36) and Sānyīnjiāo(三阴交SP6),once daily,6 times a week.The treatment for 2 weeks was as one phase and it should be completed in one menstrual cycle.For the cases without menstrual cycle recovery,the treatment should be given for any two weeks in one menstrual cycle and for those with menstrual cycle recovery,the treatment should avoid the menstrual period.Totally,the treatment lasted for 3 menstrual cycles.Before and after treatment,the scores of postpartum female sexual dysfunction diagnostic scale(PFSDDS),sexual intercourse pain assessment scale(SIPAS) and pelvic floor muscle strength test(PFMST),as well as the results of urodynamic examination(UE) were observed before and after treatment in the patients.Results:After treatment,the scores of PFSDDS,SIPAS and PFMST were all increased as compared with those before treatment separately,presenting the statistical significance(all P <0.05).Regarding UE,after treatment,the maximum bladder capacity,detrusor pressure at maximum flow,maximum flow rate and maximal urethral closure pressure were increased and postvoiding residual urine volume was reduced obviously as compared with the values before treatment,respectively,indicating the statistical differences(all P <0.05).Conclusion:Electroacupuncture has the significant effect on postpartum sexual dysfunction associated with urinary incontinence.
文摘Background and goals Sexual dysfunction is a well-documented complication of rectal cancer surgery, with a reported incidence of 18% - 59%. The objective of this study is to evaluate the incidence of sexual dysfunction (SD) in males after radical resection for rectal cancer and to compare the outcome of open versus laparoscopic rectal resection for different age groups. Patients and methods This prospective randomized study assessed outcomes in male patients that underwent rectal resection for rectal cancer from January 2012 until March 2015 at two large tertiary hospitals in Cairo, Egypt. The patients were randomly allocated into two groups (laparoscopic and open technique) of 40 patients each using the odd number policy for patient allocation. Patients included in each group were further subdivided into two groups according to the type of rectal resection either anterior resection (AR) or abdominoperineal resection (APR). Erectile function was evaluated preoperatively and postoperatively at 3 and 6 months using the International Index of Erectile Function (IIEF) questionnaire. Results There was no significant difference between the laparoscopic and open total mesorectal excision (TME) groups when comparing IIEF score preoperatively. At 3 months postoperatively, the laparoscopic arm showed better results over the open arm (abnormal IIEF in 57.5% vs. 67.5%). The study demonstrated dramatic improvement in SD in both groups at 6 months postoperatively (abnormal IIEF score of 40% in the laparoscopic vs. 42.5% in the open arm) with no significant difference in IIEF score between the two groups (p-value 0.876). At 3 and 6 months postoperatively, younger patients showed significant improvement in SD compared to older patients in both groups with more significant improvement in the laparoscopic group (16.7% vs. 40%). Patients with APR show more SD compared with AR patients whether laparoscopic or open as seen by the abnormal IIEF scores for the the two groups [the laparoscopic group APR patients showed 62.5% abnormal IIEF at 3 months that decreased to 50% after 6 months compared to 56.3% and 37.5% at 3 and 6 months respectively for lap. AR patients, and in the open group APR patients also showed higher abnormal IIEF of 71.4% and improved to 42.9% at 3 and 6 months respectively compared to 66.7% and 42.3% at 3 and 6 months respectively for open AR), which shows that APR whether laparoscopic or open causes more sexual dysfunction than AR. Conclusion In this randomized prospective study, there was no significant difference between the laparoscopic and open TME when we compared IIEF scores. In patients younger than 30 years, the significant improvement in the laparoscopic arm adds to the favorable outcome of laparoscopic TME as regards postoperative complications, postoperative pain, hospital stay, the return of bowel functions and cosmetic results.
文摘Multiple sclerosis （MS） is a chronic inflammatory demyelinating disorder of the central nervous system characterized by episodic and progressive neurologic dysfunction resulting from inflammatory and autoimmune reactions. The underlying pathogenesis of MS remains largely unclear. However, it is currently accepted as a T cell-mediated autoimmune disease. Among other clinical manifestations, sexual dysfunction （SD） is a painful but still underreported and underdiagnosed symptom of the disorder. SD in MS patients may result from a complex set of conditions and may be associated with multiple anatomic, physiologic, biologic, medical and psychological factors. SD arises primarily from lesions affecting the neural pathways involved in physiologic function. In addition, psychological factors, the side effects of medications and physical symptoms such as fatigue, muscular weakness, menstrual changes, pain and concerns about bladder and bowel incontinence may also be involved. Since MS primarily affects young people, SD secondary to MS may have a great impact on quality of life. Thus, maintaining a healthy sexual life with MS is an important priority. The treatment of SD requires multidisciDlinarv teamwork and coooeration amone specialists,individual patients, partners and the society.
文摘This study aimed to estimate the prevalence of and identify the factors influencing female sexual dysfunction （FSD） among Chinese nurses. A cross-sectional survey was conducted from March 2013 to May 2014 among 6 hospitals in Suzhou, China. In total, 2,030 married female nurses were included in the analysis.
文摘Pelvic organ prolapsed is a common problem today, and it has been gradually increasing because of the longevity of women. Pelvic organ prolapse can result in negative psychological feelings that affect on women’s sexual activity. Methods: There is a cross-sectional study on sexual dysfunction in 296 women with pelvic organ prolapse grade II and III followed up at gynecological-pelvic floor unit of Hung Vuong hospital from 09/2017 to 06/2018. Results: The prevalence of female sexual dysfunction in PISQ-12 was 76.4% and 95% CI [71.6 - 81.2]. The rate of female sexual dysfunction in turn is: 1) Behavioral-Emotional: 93.6% 95% CI [90.8 - 96.4]. 2) Physiology: 62.2% CI 95% [56.7 - 67.7]. 3) Relationship to partner: 89.5% 95% CI [86.0 - 93.0]. Factor related to sexual dysfunction in women with pelvic organs (p < 0.05) is general sexual dysfunction: 1) Age group: women over age 55 increased generally the risk of sexual dysfunction, OR = 5.89, 95% CI [1.38 - 25.20]. 2) Diabetes mellitus increased the risk of sexual dysfunction with OR = 5.03, 95% CI [1.42 - 17.82]. 3) Patients with previous abortions reduced the risk of sexual dysfunction with OR = 0.49 95% CI [0.27 - 0.90]. Conclusion: Research on quality of life in pelvic organ prolapse should be considered more in the future.
文摘Objectives: to evaluate the effectiveness of a natural compound made of Ecklonia bicyclis Seaweed, Tribulus terrestris and water-soluble chitosan oligosaccharide, in the male sexual asthenia with mild or mild-moderate erectile dysfunction and serum testosterone levels between 280 and 350 ng/dl. Materials and Methods: 84 male patients affected by reduced libido and serum testosterone levels at the lower limit of normal, were recruited. We have separated patients in three different age groups: group A (18 - 45 years), group B (45 - 59 years), group C (>60 years). All subjects answered the International index of erectile function questionnaire (IIEF-5) and underwent determination of serum total testosterone before and after 30 days of treatment. Results: Before treatment, the group A showed mean (± standard deviation) total testosterone 321.9 ± 19.2 ng/dl and mean IIEF-5 18.6 ± 1.97, in the group B it was 318.5 ± 18.1 ng/dl and 16.3 ± 2.66, and finally in the group C it was 305.4 ± 13.1 ng/dl and 14.2 ± 1.95 respectively. After treatment mean total testosterone and mean IIEF-5 were respectively: group A (448 ± 111.46 ng/dl and 21.84 ± 3.41);group B (453.8 ± 105.23 ng/dl and 20.4 ± 3.81);group C (385.8 ± 87.29 ng/dl and 16.7 ± 3.84). Conclusions: The treatment with Ecklonia bicyclis, Tribulus terrestris and water-soluble chitosan oligosaccharide might represent a safe and effective option on the improvement of libido and erectile function in man with testosterone level at the lower limit of normal.
文摘Female sexual dysfunction (FSD) affects 40% of the world’s females, most of which are disorders linked to desire or interest/excitement. Whilst all types of therapy that attempt to improve female sexual desire have long been established, the results are contradictory. Objective: To analyze all available evidence to validate the effectiveness of natural therapies in the treatment of FSD. Method: The study was registered at http://www.prospero.org (CRD42019127700). We searched the Institute for Scientific Information Web of Knowledge, MEDLINE, Pubmed, Scopus and Cochrane databases for all articles published in peer- reviewed journals in April 2019 (in any language). The PICOS standard is women with FSD;(intervention) of any type of Natural therapy;(outcome) primary outcome: frequency of changes, severity, and average mean scores on sexual symptoms measured with a validated instrument, secondary outcome: quality of life;(study design) and randomized clinical trial (RCT). Results: The literature search strategy identified 95 articles, 81 of which were excluded at the different search stages. Finally, we systematically reviewed 15 RCTs, 11 of which referred to primary FSD, and four of which analyzed women with drug-induced FSD (DFSD). Most of them analyzed hypoactive sexual desire disorder. Although differences related to placebo were found in most people, the majority of the studies are considered to be of poor quality and low external effectiveness. Conclusion: Although the quality of the evidence is not high, most natural product interventions appear to improve FSD, particularly hypoactive sexual desire disorders including those categorized as primary and drug-induced.
文摘Objective:To evaluate the effect of Quercetin (QT) on erectile dysfunction and oxidative stress in penile tissue of streptozotocin-induced diabetic rats.Methods: Two weeks after diabetes induction, QT was treated to normal and diabetic rats for 5 wk. Sexual behavioral parameters including mount latency, intromission latency, ejaculation latency, post-ejaculatory interval, mount frequency and intromission frequency, were observed against stimulus females. Sperm count and their motility and viability were recorded. Serum glucose and testosterone levels were estimated. In penile tissue levels of cyclic guanosine monophosphate, thiobarbituric acid reactive substances and glutathione, and enzymatic activities of superoxide dismutase and catalase were measured. Histopathological changes were evaluated in a cross-section of penile tissue.Results:Sexual behavioral ejaculation latency, post-ejaculatory interval, mount latency and intromission latency were significantly increased while mount frequency and intromission frequency were decreased in diabetic rats. Treatment with QT corrected the male sexual behavioral levels and also enhanced the inhibited sperm count, motility and viability in diabetic rats. Serum testosterone and penile cyclic guanosine monophosphate levels were significantly increased in QT treated diabetic rats compared to untreated diabetic animals. Penile oxidative stress biomarkers were corrected by the QT treatments in diabetic rats. Histopathological evaluation revealed damaged penile tissues in diabetic rats, which was protected following QT treatment.Conclusions: QT eliminated the diabetic-induced sexual impairment and showed significant antioxidant effects in penile tissue. Further experimental studies are recommended for QT therapeutically usage.
文摘Penile fracture is a rare urological emergency that may cause erectile dysfunction(ED).We analyzed the factors affecting erectile function in patients who underwent surgical repair for the management of penile fractures.Eighty-two patients who underwent penile fracture surgery in the Department of Urology,University of Gaziantep(Gaziantep,Türkiye)between January 2012 and January 2023 were evaluated.Age,body mass index,time elapsed from the incident of penile fracture to surgery,size,laterality,level of the defect,causes of fracture,presenting signs and symptoms,and relevant complications were recorded.Erectile function of the patients was evaluated preoperatively and at postoperative 3rd and 6th months according to the International Index of Erectile Function-5(IIEF-5)scoring system.The factors decreasing the erection quality of the patients after surgical repair of penile fractures were investigated using IIEF-5 scoring system.Only age,defect size,and time elapsed from fracture onset to surgery were found to be effective on the occurrence of ED(P=0.005,P<0.001,and P<0.001,respectively).In the receiver operating characteristic(ROC)analysis,the cut-off values were 12.5 mm for defect size(P<0.001),8.5 h for the time elapsed from fracture onset to surgery(P=0.036),and 40.5 years for the age of the patients(P=0.005).Delayed surgery,defect size,and advanced age had significant and negative effects on erectile function in cases of penile fracture.Before repair of the defect,patients should be given appropriate counseling about the possibility of ED,and early penile rehabilitation should be initiated.
文摘Background: Diabetes is amongst the most researched diseases worldwide due to its debilitating effects on patients. Diabetics have a higher risk of developing erectile dysfunction. Evidence has linked erectile dysfunction severity to increased age, duration of diabetes, the metabolic syndrome and hypogonadism. However, the role of inflammatory markers in the pathogenesis of SD is still unclear. The contributions of hormonal parameters and adipokines to both macro and micro vascular complications are still poorly understood. This study was conducted to provide some evidence of an association between SD, the metabolic syndrome and inflammatory hormones. Method: A total of 130 diabetic males participated in this study. All participants were at least 18 years and were actively engaged in a stable heterosexual relationship for a minimum of two years before they were recruited for this study. The Diabetic men were evaluated using the Golombok Rust Inventory of Sexual Satisfaction for males (GRISS-M). The NCEP-ATP III, IDF and WHO criteria were used to assess the metabolic syndrome. Blood samples were taken for biochemical and hormonal assays. Results: Participants with raised Triglyceride levels showed significantly higher leptin levels for NCEP-ATP III and IDF criteria. Participants with impotence showed significantly lower leptin/adiponectin ratio (p = 0.0184) whilst participant with non-sensuality showed significantly higher values of leptin/adiponectin ratio (p = 0.0103). A significantly higher levels of insulin (p = 0.0265) was recorded in participants with Dissatisfaction problems. Participants with Non communication problems showed significantly higher levels of insulin (p = 0.0419) and lower levels of adiponectin (p = 0.0438) whilst participants with infrequency showed significantly lower levels of adiponectin (p = 0.0042). Conclusion: The relative balance between pro inflammatory and anti-inflammatory mediators of endothelial dysfunction could possibly be essential for the progression of diabetes to SD and the MetS thus a longitudinal study which measures a range of both pro and anti-inflammatory hormones and adipokines as risk factors for SD and the MetS could potentially aid in improvements in assessing the risk of developing these conditions among diabetics.
文摘Objective: To compare sexual function between primiparous women who underwent cesarean section (CS) and those who delivered vaginally. Methods: This cross-sectional study was conducted from October 2011 to April 2012 in Beijing, China. The target population included women aged 18 - 45 years who had given birth only once at least 6 months prior. The questionnaire was self-administered including female sexual function measured using the Female Sexual Function Index (FSFI). Data were analyzed using R software with the significance level of 0.05. Results: A total of 1456 participants were included and 102 women (7.0%) declined. The median age of the participants was 35 years. The median time interval after childbirth was 6 years. The median FSFI score was 26.9 and prevalence of female sexual dysfunction (FSD) was 34.2%. Both the FSFI scores and the proportions of individuals with sexual disorders were similar between women undergoing CS and those having vaginal delivery for both individual domains and the full scale. Conclusion: There were insignificant differences in female sexual function scores and FSD prevalence between women undergoing CS versus vaginal delivery.
文摘Low testosterone(T)is frequent in men with chronic illnesses.The clinical features of T deficiency(TD)overlap with those of chronic diseases.The aim of this study is to evaluate the relative contribution of chronic disease score(CDS)and low T to the presenee of TD symptoms.A consecutive series of 3862 men(aged 52.1±13.1 years)consulting for sexual dysfunction were studied.Several clinical and biochemical parameters were collected,in eluding the structured interview,ANDROTEST,for the assessme nt of TD symptoms.Penile color Doppler ultrasound(PCDU)was also performed.Based on the medications taken,the CDS was calculated.For a subset of 1687 men,information on mortality was collected(follow-up of 4.3±2.6 years).Higher CDS was associated with lower free and total T(TT)as well as with higher ANDROTEST score.When introducing CDS and TT in multivariable models adjusted for age,severe erectile dysfunctio n and impaired morning erectio ns were associated with both CDS(odds ratio and 95%confide nee interaval,OR[95%Cl]=1.25[1.13;1.37]and 1.38[1.29;1.48],respectively)and low TT(OR[95%Cl]=1.11[1.00;1.23]and 1.13[1.06;1.21],respectively).Similar results were obtained for PCDU parameters.Hypoactive sexual desire was associated with low TT(OR[95%Cl]=1.21[1.13;1.30]),whereas it was inversely related with CDS(OR[95%Cl]=0.91[0.84;0.97]).When considering mortality for major cardiovascular events,TT<8 nmol I1,but not CDS,was a significant predictor(hazard ratio[95%Cl]=5.57[1.51;20.63]).Chronic illnesses are associated with an overt TD.Both chronic diseases and low T can be invoIved in determining symptoms present in subjects complaining for sexual dysfunction.This should be considered in the diagnostic workup for TD.
文摘Introduction: female sexual dysfunction (FSD) is a complex and poorly understood condition that affects females of all ages. Female sexual dysfunction has been a cyclic rather than a linear process that emphasizes biologic, psychological, social, hormonal, and environmental factors. Female sexual dysfunction is a high prevalent disorder reaching up to 60% of females with reported higher levels in postmenopausal. Aim of the work: was to estimate prevalence of FSD and its related factors in Elfayoum city. Subject and Method: This study was a cross sectional descriptive study conducted in Elfayoum city included 508 married females (above 21 years old) during the period from September 2016 to March 2017. Results: The prevalence of FSD among studied group was 61.2% versus 38.8% had normal sexual function, desire dysfunction was 42.3%, arousal dysfunction was 39.2%, lubrication dysfunction was 25%, orgasm dysfunction was 58.5%, satisfaction dysfunction was 58.1% and pain was 43.3%. There was statistically significant negative correlation between Female Sexual Function Index (FSFI) score and each of female and husband age, duration of marriage, and number of children. Low mean of FSFI score was found among females with irregular menstrual cycle, using contraceptive, not pregnant, mutilated and females who’s their husband had erectile or ejaculation disorders. Conclusion and recommendation: High prevalence of FSD among females in Elfayoum governorate. Many factors are found to affect FSD as FGM, each of female and husband age, duration of marriage, and number of children.
文摘Sexual dysfunction(SD)is a prevalent but very commonly ignored aspect in the treatment of liver diseases and cirrhosis.The etiology of SD is multifactorial and therefore treatment strategies are complex,especially in females.Phosphodiesterase inhibitors are useful and effective in erectile dysfunction in males but in females,no single drug is available for SD,therefore multimodal treatment is required depending upon the cause.The foremost and fundamental requirement in both genders is to be stress-free and have adequate control of liver diseases.Improved quality of life is helpful in improving SD and vice versa is also true.Therefore,patients suffering from liver diseases should come forward and ask for treatment for SD,and physicians should actively enquire about SD while history taking and evaluating these patients.SD results in deterioration of quality of life,and both are modifiable and treatable aspects of liver diseases,which are never addressed actively,due to social taboos and fears of SD treatment in the presence of liver diseases.The diagnosis of SD does not require costly investigations,as the diagnosis can be established based on validated questionnaires available for both genders,therefore detailed targeted history taking using questionnaires is essential.Data are emerging in this area but is still at an early stage.More studies should be dedicated to SD in liver diseases.
