The challenges for prostate cancer survivors include the surveillance of prostate cancer recurrence and management of physical, cognitive, sexual, and socioeconomic quality of life issues. Sexual ...function remains an important issue in men, who often continue to be interested in sex after prostate cancer treatment. The various post‐prostate cancer treatment‐related sexual dysfunctions are penile deformities and erectile dysfunction (ED); sexual desire and mental health; ejaculatory and orgasmic dysfunctions; and changes in partner relationship and dynamics.
The aim of this study is to provide state of art review of the various male sexual dysfunctions in prostate cancer survivors and the management strategies in sexual rehabilitation.
A literature search for English language original and review articles either published or e‐published was performed using PubMed database. Keywords included prostate cancer, prostate cancer treatment, prostate prostatectomy (RP), sexual dysfunction, erectile dysfunction (ED), sexual desire, mental health, ejaculation, orgasmic, climacturia, and relationship.
There has been considerable volume of publication in recent years on prostate cancer‐related male sexual dysfunction. Penile deformities and ED shared similar pathophysiology and that penile smooth muscle fibrosis ultimately results in structural alterations and end‐organ failure. Penile rehabilitation using oral phosphodiesterase type 5 (PDE5) inhibitors is considered the standard of care especially in patients who received nerve‐sparing RP and should be instituted as soon as possible to protect and prevent corporal endothelial and smooth muscle damage. However, there is no consensus on the exact timing, dose, and duration of PDE5 inhibitors and its impact in non‐nerve‐sparing RP and other forms of prostate cancer treatment modalities. Current literature on hypoactive sexual desire, ejaculatory, and orgasmic dysfunctions in patients who received prostate cancer treatment is limited. Psychological and sexual counseling play an important role in rehabilitation and treatment of various forms of male sexual dysfunctions.
While several preventive and treatment strategies for the preservation and recovery of sexual function are available, no specific recommendation or consensus guidelines exist regarding the optimal rehabilitation or treatment protocol. While medical and surgical therapies are effective in erectile function recovery and/or preservation, psychological and sexual counseling are equally important in sexual rehabilitation. Chung E and Brock G. Sexual rehabilitation and cancer survivorship: A state of art review of current literature and management strategies in male sexual dysfunction among prostate cancer survivors. J Sex Med 2013;10(suppl 1):102–111.
Little is known about problems in sexual functioning among young people, despite the high rates found in adult samples. It is unclear which problems are most prevalent or how common sexual distress ...is for young people experiencing problems.
This study aims to assess the prevalence, range, and correlates of sexual problems and distress among a sample of adolescents (16–21 years).
Participants (mean age 19.2) were recruited from community and area high schools. Male adolescents (n = 114) completed online the International Index of Erectile Function (IIEF) and Premature Ejaculation Diagnostic Tool (PEDT). Female adolescents (n = 144) completed the Female Sexual Function Index (FSFI). Both completed the Female Sexual Distress Scale (FSDS) and the measures of background, relationship characteristics, and sexual histories.
Clinical cutoff scores on the IIEF, PEDT, FSFI, and FSDS were used to determine whether there was a significant sexual problem.
Adolescents reported extensive sexual experience, most in relationship contexts. Half of the sample (51.1%) reported a sexual problem; 50.0% reported clinically significant levels of distress associated with it. Similar rates of problems and distress were found among male and female adolescents. For the most part, adolescent characteristics, backgrounds, and experience were not associated with adolescents' sexual problems.
Sexual problems are clearly prevalent among adolescents, and distressing to many who experience them, emphasizing a strong need to develop programs to address this issue. O'Sullivan LF, Brotto LA, Byers ES, Majerovich JA, and Wuest JA. Prevalence and characteristics of sexual functioning among sexually experienced middle to late adolescents. J Sex Med 2014;11:630–641.
The aim of this study was to investigate the incidence of erectile dysfunction (ED) in nonmuscle-invasive bladder cancer (NMIBC) patients before and after transurethral resection (TUR) in China. ...Clinical data from 165 male patients with NMIBC who received adjuvant intravesical chemotherapy after TUR in Neijiang First People's Hospital (Neijiang, China) between January 2010 and June 2019 were retrospectively reviewed. The sexual function of these patients was evaluated before and 1.5 years after initial TUR by the International Index of Erectile Function-5 (IIEF-5). An age-specific subanalysis was performed among the patients: <45 years old (Group 1, n = 19) and ≥45 years old (Group 2, n = 146). Before and 1.5 years after TUR, the incidence rates of ED in Group 1 were 15.8% and 52.6%, and those in Group 2 were 54.1% and 61.0%, respectively. The difference between groups was statistically significant at the preoperative stage (15.8% vs 54.1%, P = 0.002) but not at the postoperative stage (52.6% vs 61.0%, P = 0.562). Compared with the preoperative stage, the incidence of ED at the postoperative stage was increased significantly in Group 1 (15.8% vs 52.6%, P = 0.017) but not in Group 2 (54.1% vs 61.0%, P = 0.345). In conclusion, the incidence of ED increased in male NMIBC patients under the age of 45 years after TUR in China. These patients should be offered professional counseling during the follow-up period.
Several models have been used to describe men's and women's sexual responses. These models have been conceptualized as linear or circular models. The circular models were proposed to describe women's ...sexual function best.
This study aims to determine whether men and women thought that current theoretical models of sexual responses accurately reflected their own sexual experience and to what extent this was influenced by sexual dysfunction.
A cross‐sectional study of a large, broadly sampled, nonclinical population, cohort of Danish men and women. The Female Sexual Function Index, Female Sexual Distress Scale, and the International Index of Erectile Function were used to describe sexual function. Also, participants completed questionnaires with written descriptions of different sexual responses to describe their most experienced sexual response.
For women, we measured desire, arousal, lubrication, orgasm, sexual satisfaction, pain during sexual activity, sexual distress, and satisfaction with sexual life. For men, we measured erectile function, orgasm, desire, intercourse satisfaction, overall satisfaction, and satisfaction with sexual life.
A total of 499 men and 573 women participated. We only analyzed responses from sexually active participants with a partner (401 men and 429 women). The majority of men endorsed the Masters & Johnson model (48.5%) or the Kaplan model (38.3%); only 5.4% endorsed the Basson model, and 7.3% endorsed none of the models. Among women, 34% endorsed the Kaplan model, 28% the Masters & Johnson model, 25.6% the Basson model, and 12.5% none of the models. Among women, sexual dysfunction and distress were significantly (P = 0.01) related to endorsement of the Basson model or none of the models. Among men, erectile dysfunction and dissatisfaction with sexual life were significantly related to endorsement of the Basson model or none of the models (P = 0.01).
No single model of sexual response could describe men's and women's sexual responses. The majority of men and women with no sexual dysfunction that were satisfied with their sexual life endorsed the linear models. Giraldi A, Kristensen E, and Sand M. Endorsement of models describing sexual response of men and women with a sexual partner: An online survey in a population sample of Danish adults ages 20–65 years. J Sex Med 2015;12:116–128.
Purpose of Review
What is the goal of your paper? What questions did you seek to answer? Digital health is an emerging discipline that utilizes hardware and software tools to improve healthcare ...delivery efficiency and accessibility. Technologies that fall under the digital health umbrella include mobile phone applications, telemedicine, and social media networks. The goal of this review is to highlight two mobile phone applications that were developed for premature ejaculation and Peyronie’s disease.
Recent Findings
Summarize the latest research on your topic. Through the course of our review, we aim to highlight how these applications were conceived, the manner in which users interface with these tools and future directions for these software solutions. We identified that patients and practitioners alike are creating digital health solutions based upon personal and clinical experiences.
Summary
What answers did you find? What are the major takeaways/conclusions of your examination? What’s the impact on future research? The major takeaway of our examination is that digital health is an emerging area of innovation and investigation. Existing solutions however need further real-world evaluation to assess their clinical validity.
Purpose of Review
Recent social, legal, and medical advances have significantly increased transgender visibility and the need for widely available access to care for these patients.
Recent Findings
...The past decade has seen an increase in the literature providing insight into the demographics, access to care, and surgical techniques related to transgender care.
Summary
This review attempts to offer a basic overview of male-to-female transgender surgery, with insights into the major complications that may occur intraoperatively or postoperatively. Overall, the field of transgender reconstructive surgery is relatively nascent, and with increasing advances in surgical techniques and postoperative management, some of these complications may be addressed and avoided.
Diabetes mellitus (DM) is a widespread chronic disease with a prevalence that is expected to further increase in the near future. The classical management of DM includes the normalization of the ...glycometabolic profile and the evaluation of cardiac and cerebral vascular health by the intervention of an array of different specialists. However, so far, sexual dysfunctions are still a neglected complication in patients with DM, although there is an elevated prevalence of this long-term complication in male and female patients. Furthermore, some of them may represent a sign of vascular alteration and/or hypogonadism and require timely management to prevent the onset of major adverse cardiac events. This narrative review briefly summarizes the current evidence on epidemiology, pathogenesis, diagnosis, and therapy of erectile dysfunction in male patients with DM to support diabetologists in clinical practice.
To investigate satisfaction with a vacuum constriction device for middle-aged and older male Veterans with erectile dysfunction and their female partners.
Patients (N = 57; mean age = 64.28 years; ...SD = 8.7) received comprehensive education and training and ongoing follow-up of device use, which included a semi-structured interview. Female partners (n = 41) also rated their satisfaction with the device.
Over 96% of patients (n = 53/56 responses) endorsed the ability to maintain an erection with the device and 100% (n = 56/56 responses) indicated they would recommend the device to others. Female partners generally rated sex as better with the device (83.8%; n = 31/37 responses). Physical discomfort using the device was reported among 23% of patients (n = 16), and often due to difficulty or pain with the constriction bands. Difficulty obtaining erections with the device, though infrequently reported, was more common with older age.
The majority of male patients and their female partners receiving comprehensive training for vacuum constriction device use reported satisfaction with the device.
Vacuum constriction devices can be highly effective in improving the sexual health and intimacy of Veterans of all ages experiencing erectile dysfunction.
Summary
Male sexual dysfunction is a common disorder that appears to be a consequence of a wide range of physical and psychological conditions. Due to mental stress, insufficient physical exercise ...and various aetiological factors, human being's life is becoming less pleasant, which leads to incapability to have sexual pleasure. The allopathic drugs used for sexual dysfunction are believed to produce a variety of side effects and affect other physiological processes and, ultimately, general health. Therefore, the search for natural supplement from medicinal plants is being intensified probably because of less side effects availability and affordability. Ethnobotanical surveys have indicated a large number of plants traditionally used as aphrodisiacs but only few of them are scientifically validated for the management and treatment of male sexual dysfunction. This article has summarised the medicinal plants traditionally recommended and scientifically validated for the management and treatment of male sexual dysfunction.
Purpose of Review
Hormonal and surgical treatments for transgender individuals can severely impact reproductive potential. In this review, we discuss the role of fertility preservation in both ...male-to-female and female-to-male transgender patients. We focus on the effects of hormone replacement therapy on the gonads and discuss current methods and techniques available for fertility preservation. Moreover, we review the current literature on patient attitudes toward fertility preservation and existing barriers to care.
Recent Findings
The literature supports the notion that feminizing therapy negatively impacts spermatogenesis, as evidenced by impaired semen parameters. The degree of such decline lies on a spectrum and can be somewhat unpredictable. Similarly, masculinizing therapy with testosterone has variable effects on ovarian function, gynecologic organs, and future fertility potential. Further research is required to better elucidate the long-term effects of such therapies. Optimal timing for fertility preservation is in the postpubertal period prior to initiation of hormonal therapy. This is however not always possible. A multitude of barriers to pursuing fertility preservation exist, including lack of appropriate counseling, the potentially invasive nature of some fertility preservation methods, and the financial burden placed on the patients.
Summary
Fertility preservation in the transgender population remains poorly utilized. For transgender women, cryopreservation of sperm ideally is performed prior to initiation of hormone replacement therapy. Nonetheless, studies have shown that a degree of spermatogenesis is seen in some individuals without discontinuation of hormonal therapy. This could allow for less disruption, both physically and emotionally. Fertility preservation in transgender men remains invasive with oocyte retrieval as the main technique. Cessation of therapy, ovarian stimulation, and invasive testing has potential to be traumatic and enhance dysphoria. The possibility of fertility preservation at the time of gonadectomy is promising. Prepubertal fertility preservation is also on the horizon, though still experimental. Cost of preservation techniques and storage is currently prohibitive for many patients. Recent changes to state insurance mandates may soon make fertility preservation more accessible. Future research may demonstrate that fertility preservation is possible at the time of gender confirmation surgery, with the goal of being both effective and nontraumatic to the patient.
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