Sexual Medicine

BACKGROUND: The ongoing quest to surgically create the (nearly) ideal neophallus in transgender men has led to the continuous development of transgender medicine and the proposed introduction of penis transplantation. However, both technical and ethical issues arise when developing this treatment. AIM: We sought to extract ethical considerations among different stakeholder groups regarding penile transplantation surgery in transgender men and to define preliminary clinical recommendations...

BACKGROUND: Although approximately 41% of women experience sexual dysfunction, limited education on female sexual medicine (FSM) in medical school results in underpreparedness among physicians when addressing these bothersome conditions. AIM: This study aims to evaluate the extent to which FSM is represented in medical education by examining current preclinical and clinical curricula. METHODS: Preclinical curriculum materials on female sexual anatomy, physiology, and pathology, as well as obstetrics and gynecology clinical materials (syllabi, lecture materials, and supplemental resources), were collected from medical schools in the Chicago area...

BACKGROUND: Physicians often report low levels of confidence in diagnosing and treating female sexual dysfunction (FSD), which may stem from inadequate education and exposure to the topic. AIM: The study sought to determine the extent to which FSD is covered in undergraduate medical education and evaluate student comfort with the topic and familiarity with treatments. METHODS: We created a novel, 50-question survey to be administered online to any current U...

BACKGROUND: Erectile dysfunction (ED) occurs in an increasing number of patients after radical prostatectomy and cystectomy, and the phenotypic modulation of corpus cavernosum smooth muscle cells is closely related to ED. AIM: To determine whether endoplasmic reticulum stress (ERS) is implicated in the phenotypic modulation of ED induced by bilateral cavernous nerve injury (BCNI). METHODS: In total, 36 Sprague-Dawley rats were randomly divided into 3 groups: sham, in which rats received sham surgery with bilateral cavernous nerve exposure plus phosphate-buffered saline; control, in which rats received BCNI plus phosphate-buffered saline; and experimental, in which rats received BCNI plus 4-phenylbutyric acid...

BACKGROUND: Chronic pain can occur in the vulva, one of the primary pleasure centers of the body; however, the associations between pleasurable vulvar experiences and chronic vulvar pain have not yet been explored. AIM: The aim of this study was to investigate associations between vulvar pleasure and pain experiences in patients with chronic vulvar pain. METHODS: This was a prospective cross-sectional study of 547 patients (aged ≥17 years) presenting over 10 months to 2 urban outpatient gynecology clinics specializing in vulvar pain...

BACKGROUND: Penile fractures can lead to many functional complications, especially erectile dysfunction (ED). Few studies have evaluated the factors that predict late complications of an immediately repaired penile fracture. AIM: To identify the potential predictors of long-term poor functional outcomes following immediate surgical intervention for penile fractures. METHODS: Sixty-eight consecutive patients with suspected penile fracture between 2003 and 2022 were retrospectively reviewed...

BACKGROUND: Inflammation is a key risk factor for heart disease and has also been linked to erectile dysfunction (ED). Sildenafil is a phosphodiesterase type 5 inhibitor with a strong antioxidant effect. Interleukin (IL)-18 is a proinflammatory factor. Excessive production and release of IL-18 disrupt the balance between IL-18 and IL-18 binding proteins in certain inflammatory diseases, leading to the occurrence of pathological inflammation. AIM: We evaluated the effects of sildenafil on erectile function in a rat model of high-fat diet-induced ED...

BACKGROUND: The loop electrosurgical excision procedure (LEEP) to treat cervical dysplasia (CD) is known to alter the cervical microbiota, the community of bacteria that play a central role in female genital health. Perturbations to the microbiota of the female urogenital tract (FUT), including the urethra, vagina, and cervix, have been linked with symptoms of sexual dysfunction (SD), though correlations among LEEP, the microenvironment, and SD have not yet been described. AIMS: To characterize the FUT microbiota before and after LEEP and investigate possible associations with SD...

BACKGROUND: The association of inflammatory biomarkers with erectile dysfunction (ED) is still largely unknown. AIM: The study sought to explore the association of inflammatory biomarkers with ED in U.S. adults. METHODS: Participant data for this study were extracted from the National Health and Nutrition Examination Survey, and individuals that lacked information on clinical variables were excluded. Dose-response curve analysis was applied to explore the association of inflammatory biomarkers with ED prevalence...

BACKGROUND: Endothelial dysfunction caused by low androgen levels in penile tissue can lead to erectile dysfunction. The exact mechanism of endothelial dysfunction has not been thoroughly studied. OBJECTIVE: The study sought to verify whether low androgen levels induce ferroptosis of endothelial cells in rat penile tissue. METHODS: Rat penile cavernous endothelial cells (CP-R133) were divided into a no-androgen group (Dihydrotestosterone (DHT): 0 nmol/L), very low-androgen group (DHT: 0...

INTRODUCTION: Animal models are frequently used for translational research in Peyronie's disease (PD). However, due to lack of availability of guidelines, there is some heterogeneity in study design, data reporting, and outcome measures. AIM: This European Society for Sexual Medicine consensus statement aims to provide guidance in utilization of animal models in PD research in a standardized and uniform fashion. METHODS: PubMed was searched for studies using animal models for PD...

BACKGROUND: Delayed ejaculation (DE) is a disorder that can cause significant distress for sexually active men. The etiology of DE is largely idiopathic, with even less being known about clinical factors associated with the condition. AIM: We sought to use data mining techniques to examine a broad group of health conditions and pharmaceutical treatments to identify factors associated with DE. METHODS: Using an insurance claims database, we evaluated all men with a diagnosis of DE and matched them to a cohort (1:1) of men with other male sexual disorders of urologic origin (ie, erectile dysfunction [ED] and Peyronie's disease [PD])...

BACKGROUND: Due to the sensitivity and potential embarrassment of discussing erectile dysfunction (ED) in person, men are seeking treatment online. AIMS: We sought to compare offerings of direct-to-consumer (DTC) platforms for ED treatment with respect to consultation, pricing, services, and privacy policy. METHODS: Google was queried to identify DTC platforms offering ED treatment with the keywords: "telehealth erectile dysfunction," "telemedicine erectile dysfunction," and "online erectile dysfunction...

BACKGROUND: Increased carotid artery intima-media thickness (CIMT) has been shown to be associated with erectile dysfunction (ED), but studies evaluating the efficacy of CIMT in predicting drug response are lacking in the literature. AIM: We aimed to evaluate the efficacy of CIMT in predicting the response to phosphodiesterase-5 inhibitors (PDE5-I). METHODS: A total of 274 subjects were divided into two groups: ED patients ( n  = 150) and controls ( n  = 124)...

BACKGROUND: The relationship between erectile dysfunction (ED) and physical activity has been established in several previous studies, but there is little information on the specific forms of activity that affect ED. AIM: The objective of this study was to evaluate the relationship of 4 exercise categories and 2 activity intensities with ED in US men. METHODS: We used data sets from the National Health and Nutrition Examination Survey, 2001-2004...

BACKGROUND: Mindfulness facets can be trained with structured mindfulness interventions, but little is known regarding application on a broader level within sex therapy (e.g. men, partners and different sexual dysfunctions). AIM: To evaluate the feasibility and preliminary efficacy of an 8-week intervention-specifically, mindfulness for sex and intimacy in relationships (MSIR)-as a supplement to treatment as usual (TAU) as compared with only TAU in a clinical sample of men and women referred for sexual difficulties with or without a partner...

BACKGROUND: Sexual dysfunction frequencies and diagnostic indicators among older populations are relevant for public health measures, but evidence from large population-based studies is still scarce. AIM: To determine sexual dysfunction frequencies for women and men according to the Diagnostic and Statistical Manual of Mental Disorders (fifth edition; DSM-5 ) among 45- to 74-year-old participants of the population-based Hamburg City Health Study and the factors associated with sexual dysfunction diagnoses...

BACKGROUND: Sexual history-taking competence in medical students is an essential skill that they need to acquire. It requires them to learn to develop comfort in using sexuality-related language and raising the subject with patients. Sexual history exploration skills are inadequately taught in a significant number of medical schools. AIM: We studied comfort levels in using sexuality-related language in medical students who had no training yet in history taking. METHODS: First-year medical students in a South African university engaged in an exercise in pairs-a dyad-alternating the role of interviewer and interviewee...

BACKGROUND: Although the use of the Web has brought major advances in every step of the research process, this also comes with several methodological challenges. AIM: The article presents the European Society for Sexual Medicine's position statements on key methodological concerns relative to Web-based research in sexual medicine. METHODS: The authors conducted a systematic scoping review of articles using Web-based research methods in sexual medicine...

BACKGROUND: Menopause with anatomical, physiological, and psychological changes can affect sexual satisfaction and consequently the quality of life. AIMS: The study sought to evaluate the effects of mindfulness-based counseling on sexual self-efficacy and sexual satisfaction among Iranian postmenopausal women. METHODS: This quasi-experimental study was conducted on 110 women who were assigned to an intervention group (n = 55) and a control group (n = 55)...