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Sexual Medicine Reviews

Amanda R Ingram, Stephanie A Stillings, Lawrence C Jenkins
INTRODUCTION: Non-ischemic or high-flow priapism is derived from unregulated arterial inflow within the penis, which is significantly less common and, therefore, less well characterized than ischemic or low-flow priapism. AIM: We collected the most recent available data and summarized the findings. METHODS: All literature related to non-ischemic priapism from 2000-2018 from several databases was reviewed, and 105 articles, including any relevant referenced articles, were ultimately included...
April 12, 2019: Sexual Medicine Reviews
Michael J Butcher, Tricia Zubert, Kristin Christiansen, Alejandro Carranza, Paul Pawlicki, Stacey Seibel
INTRODUCTION: Premature ejaculation (PE) is among the most common sexual dysfunctions that affect men. Currently, topical medications are considered a first-line treatment option for PE, with no specific medication having market approval in the United States specifically for the treatment of PE. Topical agents for PE include eutectic mixture of local anesthetics cream, topical eutectic mixture for premature ejaculation spray, severance secret-cream, resiniferatoxin, and an assortment of over-the-counter treatments, including medicated condoms, sprays, and wipes...
April 12, 2019: Sexual Medicine Reviews
Yuji Hotta, Tomoya Kataoka, Kazunori Kimura
INTRODUCTION: Testosterone deficiency is known to induce endothelial dysfunction, which can lead to erectile dysfunction and/or vascular dysfunction. In some basic and clinical reports, testosterone has been shown to regulate the nitric oxide (NO)/cyclic guanosine monophosphate (cGMP) pathway and thereby influence endothelial function and endothelial progenitor cells (EPCs), which are key for the endothelial repair system. AIM: To review the association between testosterone and endothelial dysfunction focusing on NO and EPCs...
April 12, 2019: Sexual Medicine Reviews
Uros Milenkovic, Marcus M Ilg, Selim Cellek, Maarten Albersen
INTRODUCTION: Peyronie's disease (PD) is a debilitating affliction for the male population, causing severe curvatures to the erect penis and erectile dysfunction in about 50% of men. This deviation of the penis significantly impairs sexual intercourse and causes depression and strains in the relationship. As of today, medical treatment options are few and far between, with surgery remaining as the sole reliable treatment. AIM: To give a general overview regarding fibrosis and the specific role of extracellular matrix, macrophages, and myofibroblasts in PD...
April 5, 2019: Sexual Medicine Reviews
Natasha Orr, Kate Wahl, Angela Joannou, Dee Hartmann, Lisa Valle, Paul Yong
INTRODUCTION: Dyspareunia has been traditionally divided into superficial (introital) dyspareunia and deep dyspareunia (pain with deep penetration). While deep dyspareunia can coexist with a variety of conditions, recent work in endometriosis has demonstrated that coexistence does not necessarily imply causation. Therefore, a reconsideration of the literature is required to clarify the pathophysiology of deep dyspareunia. AIMS: To review the pathophysiology of deep dyspareunia, and to propose future research priorities...
March 27, 2019: Sexual Medicine Reviews
Jordan R Krieger, Paul J Rizk, Taylor P Kohn, Alexander Pastuszak
INTRODUCTION: Peyronie's disease is an acquired condition of the connective tissue of the penis that affects 0.5-20.3% of the male population and is marked by fibrotic plaques in the tunica albuginea. It can result in penile curvature/deviation, painful erections, and sexual dysfunction. Several treatment modalities have been proposed, with studies from the past decade investigating extracorporeal shockwave therapy's (ESWT) potential efficacy in Peyronie's management. AIMS: To investigate the effects of ESWT on Peyronie's disease parameters such as penile curvature, plaque size, erectile function, and penile pain...
March 26, 2019: Sexual Medicine Reviews
David K Twitchell, Daniela A Wittmann, James M Hotaling, Alexander W Pastuszak
INTRODUCTION: A common negative sequela of cancer treatment in men is sexual dysfunction, which can have a significant psychological impact and can contribute to feelings of depression, anxiety, and other mental health issues. Management of cancer survivors' psychological and mental well-being plays an important role in the treatment and recovery process. AIM: To identify how sexual dysfunction impacts the lives of male cancer survivors and to provide clinicians with treatment recommendations specific to this patient population...
March 26, 2019: Sexual Medicine Reviews
Carola S König, Stavroula Balabani, Geoffrey I Hackett, Richard C Strange, Sudarshan Ramachandran
INTRODUCTION: Clinical guidelines indicate that hematocrit should be monitored during testosterone replacement therapy (TTh), with action taken if a level of 0.54 is exceeded. AIM: To consider the extent of changes in hematocrit and putative effects on viscosity, blood flow, and mortality rates after TTh. METHODS: We focused on literature describing benefits and possible pitfalls of TTh, including increased hematocrit. We used data from the BLAST RCT to determine change in hematocrit after 30 weeks of TTh and describe a clinical case showing the need for monitoring...
March 26, 2019: Sexual Medicine Reviews
Marco Capece, Roberto La Rocca, Vincenzo Mirone, Trinity J Bivalacqua, Fabio Castiglione, Maarten Albersen, David J Ralph, Asif Muneer, Giulio Garaffa
INTRODUCTION: Ischemic priapism (IP) is the most common form of priapism. In cases of priapism persisting for >36 hours, conservative management usually fails, and the patients' erectile tissue will be inevitably compromised, resulting in corporal fibrosis, shortening of the penis, and refractory erectile dysfunction. In this subset of patients, early implantation of a penile prosthesis (PP) could be a solution for both the priapic episode and the erectile dysfunction. AIM: To analyze the current literature with regard to the correlation between refractory ischemic priapism and immediate implantation of PP...
March 19, 2019: Sexual Medicine Reviews
Maya V Epifanova, Badri R Gvasalia, Maksim A Durashov, Sergey A Artemenko
INTRODUCTION: Platelet-rich plasma (PRP) found its use in treating different conditions and diseases, because concentrated plasma PRP consists of many growth factors. Their interaction with surrounding cells, intracellular matrix, and mediators at the site of injection leads to tissue regeneration. Angiogenic, vasculogenic, and regenerative effects of PRP may be used for erectile dysfunction (ED) and Peyronie's disease (PD) treatment. AIM: To present a current data review of preclinical and clinical trials on PRP use for treating ED and PD...
March 19, 2019: Sexual Medicine Reviews
Kirtishri Mishra, Aram Loeb, Laura Bukavina, Adam Baumgarten, Jonathan Beilan, Melissa Mendez, Lorenzo DiGiorgio, Liying Fu, Rafael Carrion
INTRODUCTION: Current management of ischemic priapism revolves around 3 principles: resolving the acute event, preserving erectile function, and reducing the risk of future recurrences. Although more conservative management options, such as aspiration, irrigation, and surgical shunts, are effective in many patients, those who are refractory to these interventions or have prolonged priapism may benefit from placement of a penile prosthesis (PP). AIM: To provide a comprehensive overview of priapism management, highlight the current literature on the utility of penile implants for refractory priapism, and provide insight from a high-volume center on surgical decision making and technique...
March 19, 2019: Sexual Medicine Reviews
Dorota J Hawksworth, Arthur L Burnett
INTRODUCTION: Nonalcoholic fatty liver disease (NAFLD) is considered a hallmark of metabolic syndrome (MetS) and a significant contributor to cardiovascular disease (CVD). With the alarming rates of obesity in the United States and worldwide, efforts at understanding, preventing, and treating MetS and its components are being increasingly undertaken by scientists and clinicians. A strong association between MetS and male sexual problems is already well established. More recent animal and human studies have further evaluated the relationship of NAFLD with male sexual problems and infertility...
March 19, 2019: Sexual Medicine Reviews
Luca Boeri, Paolo Capogrosso, Eugenio Ventimiglia, Nicolò Schifano, Emanuele Montanari, Francesco Montorsi, Andrea Salonia
INTRODUCTION: Previous studies have shown a strong association between diabetes mellitus (DM) and the frequency and severity of some aspects of male sexual dysfunction (SD). The same relationship with prediabetes (preDM) has been less well investigated. AIM: To systematically review the current literature on the association between preDM and SD, focusing on erectile dysfunction (ED), sex steroid hormone alterations, and premature ejaculation (PE). METHODS: The present review was conducted in accordance with the PRISMA declaration standards for systematic reviews...
March 6, 2019: Sexual Medicine Reviews
Susan Scott, Matthew Roberts, Eric Chung
BACKGROUND: Platelet-rich plasma (PRP) injections have recently been marketed as a form of autologous cell therapy under the banner of regenerative medicine despite limited scientific evidence on its use for treating erectile dysfunction (ED). AIM: To evaluate the evidence on PRP treatment for ED and determine the current trends in provision of this treatment. METHODS: A critical review of the literature on PRP using the PubMed and Embase databases...
March 1, 2019: Sexual Medicine Reviews
Sheryl A Kingsberg, Susan L McElroy, Anita H Clayton
INTRODUCTION: Flibanserin, a multifunctional serotonin agonist and antagonist, is approved by the U.S. Food and Drug Administration (FDA) for treatment of acquired, generalized hypoactive sexual desire disorder in premenopausal women. During the FDA's review of flibanserin, concerns were raised about the risks of hypotension, syncope, and sedation-related adverse events, which increase with alcohol use. Based on the results of an alcohol challenge study, the FDA required a boxed warning and alcohol contraindication in the flibanserin prescribing information, as part of a risk evaluation and mitigation strategy program...
February 22, 2019: Sexual Medicine Reviews
Filippo Maria Nimbi, Francesca Tripodi, Roberta Rossi, Felipe Navarro-Cremades, Chiara Simonelli
INTRODUCTION: The literature showed the need for a better understanding of the male sexual response, which has historically been considered as simpler and more mechanistic compared with that in women. AIM: To examine the literature on biopsychosocial factors associated with the level of sexual desire in men and discuss some interesting directions for future research. METHODS: A systematic literature review was conducted. MAIN OUTCOME MEASURES: 169 articles published in Google Scholar, Web of Science, Scopus, EBSCO, and Cochrane Library about male sexual desire and related biopsychosocial factors...
February 22, 2019: Sexual Medicine Reviews
Giulia Rastrelli, Federica Guaraldi, Yacov Reismann, Alessandra Sforza, Andrea M Isidori, Mario Maggi, Giovanni Corona
BACKGROUND: Several data have clearly shown that the endocrine system-and androgens in particular-play a pivotal role in regulating all the steps involved in the male sexual response cycle. Accordingly, testosterone (T) replacement therapy (TRT) represents a cornerstone of pharmacologic management of hypogonadal subjects with erectile dysfunction. AIM: The aim of this review is to summarize all the available evidence supporting the role of T in the regulation of male sexual function and to provide a comprehensive summary regarding the sexual outcomes of TRT in patients complaining of sexual dysfunction...
February 22, 2019: Sexual Medicine Reviews
Geoffrey Hackett
INTRODUCTION: Up to 40% of men with type 2 diabetes (T2DM) and metabolic syndrome (MetS) have hypogonadotrophic hypogonadism (HH). Men with HH are at increased risk of cardiovascular (CV) and all-cause mortality, as well as of the development of incident T2DM. AIM: To review the current literature on the metabolic effects of testosterone therapy (TTh) in men with T2DM and MetS. METHODS: We searched MEDLINE, Embase, and Cochrane Reviews for articles on T2DM, HH, testosterone deficiency, and CV and all-cause mortality published between May 2005 and July 2018, yielding 1817 articles, including 54 clinical trials and 32 randomized controlled trials (RCTs)...
February 22, 2019: Sexual Medicine Reviews
Jonathan Clavell-Hernández, Anuj Shah, Run Wang
INTRODUCTION: Inflatable penile prosthesis (IPP) surgery offers a high satisfaction rate and low rate of complications when performed by experienced surgeons. However, reservoir placement, either in the space of Retzius (SOR), or alternative/ectopic locations, may lead to an array of serious complications that may require revision surgery. AIM: To review the prevalence and management options for non-infectious intraoperative and postoperative complications related to prosthetic reservoirs...
February 18, 2019: Sexual Medicine Reviews
Nicolai Egholt Munk, Jakob Schöllhammer Knudsen, Simon Comerma-Steffensen, Ulf Simonsen
INTRODUCTION: On-demand phosphodiesterase type 5 inhibitor (PDE5i) monotherapy is a first-line treatment for erectile dysfunction (ED), but 30%-40% of patients exhibit little or no response. The success rate of alprostadil therapy is high in these patients, but this treatment requires painful intracavernosal injection. AIM: To systematically review the efficacy and safety of second-line oral pharmacologic combination therapies of ED when PDE5i monotherapy fails...
January 30, 2019: Sexual Medicine Reviews
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