Virtual reality in the management of male sexual dysfunction: an updated narrative review of the literature.

Male sexual dysfunctions manifested by disorders of sexual desire (hypoactive and hyperactive), disorders of erection (erectile dysfunction), disorders of ejaculation (premature, absent/delayed and painful ejaculation, disorders of orgasm, and failure of detumescence). Conventional medicine is the knowledge, skills, and practice of holistic health care and recognized and accepted for its role in the maintenance of health and the treatment of diseases. It is based on indigenous theories, beliefs, and experiences that are handed down from generation to generation. Conventional medicine is practiced in many countries; it has always been part of the cultural and religious life of Indian people. Herbal treatments are the most popular forms of traditional medicine and are highly lucrative in the international marketplace. Today, more than 80% population of the developing countries depends on plants for their medical needs. Therefore, the increasing search for medicinal plants used in the treatment and management of male sexual dysfunction has necessitated. There are many herbal drugs that have been used for the treatment and management of male sexual dysfunction with varying degrees of success such as Tribulus terrestris, Withania somnifera, Eurycoma longifolia, Ginkgo biloba, and Myristica fragrans. Based on historical experience in traditional system of medicines, herbal medicinal plants are recommended for the treatment and management of male sexual dysfunction, and few of them have been scientifically validated. Recently, preclinical screening models including use of small animals such as rats and mice have been developed for better assessment of the pharmacological potential of medicinal plants against male sexual dysfunction. The present article has summarized the preclinical screening parameters with their significance including mating performance analysis, changes in reproductive organs index, reproductive hormonal estimations, sperm analysis, and histoarchitecture investigations.

PHYSIOLOGY OF MALE SEXUAL FUNCTION. The History of the Penis: Images, Worship, and Practices. Male Sexual Anatomy. Normal Male Sexual Response Cycle. Functional Neuroanatomy of Sexual Arousal. Neuroendocrine Control of Male Erectile Function. Sex Hormones and Male Sexual Behavior. Cardiovascular Response to Sexual Activity in the Male. Psychological and Social Influences on Male Sexual Function. Male Circumcision. PATHOPHYSIOLOGY OF MALE SEXUAL DYSFUNCTION. Disorders of The Male Sexual Response Cycle. Comparing Male and Female Sexual Function and Dysfunctions. Psychological Factors in Male Sexual Dysfunction. Impact of Systemic Disease on Male Sexual Function. Sexual Dysfunction in Males with Diabetes. Neurological Causes of Male Sexual Dysfunction and Neurological Sequelae of Sexual Activity. Cancer and Sexual Dysfunction. Peyronie's Disease and Trabecular Smooth Muscle Dysfunction. Priapism. Pharmacological Agents Causing Male Sexual Dysfunction. Effects of Chemotherapy and Radiotherapy on Male Sexual Function. The Effect of Male Genital Tract Infections and Sexually Transmitted Diseases on Male Sexual Function. INVESTIGATION OF MALE SEXUAL DYSFUNCTION. Clinical Assessment of the Male Presenting with Sexual Dysfunction. Use of Nocturnal and Daytime Penile Tumescence and Rigidity Monitoring for Evaluation of Male Sexual Dysfunction. Evaluation of Psychological Functioning in Men with Sexual Dysfunction. Investigation of Vascular and Structural Abnormalities of the Penis. Neurological Investigations of Males with Sexual Dysfunction. TREATMENT OF MALE SEXUAL DYSFUNCTION. Psychological and Behavioral Counseling in the Treatment of Male Sexual Dysfunction. Couple Therapy for Premature Ejaculation. Systemic Drug Therapy for Male Sexual Dysfunction. Local Drug Therapy for Male Sexual Dysfunction. The Use of Complementary or Alternative Medicine in the Treatment of Male Sexual Dysfunction. Nonsurgical Devices for the Treatment of Male Sexual Dysfunction. Surgical Treatment of Male Sexual Dysfunction. Advances in the Treatment of Peyronie's Disease. Androgen Treatment of Male Hypogonadism. Treatment of Erectile Dysfunction in Men with Heart Disease. Treatment of Sexual Dysfunction in Patients with Prostate Cancer. Treatment of Sexual Dysfunction in Males with Spinal Cord Injury and Other Neurologic Disabling Diseases. Treatment of Sexual Dysfunction in Male Cancer Survivors. Penile Arterial Reconstruction. Advances in Phallic Reconstruction. Tissue and Molecular Engineering in the Treatment of Male Sexual Dysfunction. Effect of Sexual Dysfunction and Its Treatment on Quality of Life of Affected Men.

Extended-Reality Technologies: An Overview of Emerging Applications in Medical Education and Clinical Care.

Primary school students often find it difficult to differentiate two dimensional and three-dimensional geometric shapes. Taking advantage of the ability of Virtual Reality (VR) and Augmented Reality (AR) to visualize 3D objects, we evaluate the potential of VR and AR technologies for teaching the lesson of geometric solids to primary school children. To the best of our knowledge there are no previous cases in the literature describing a comparative evaluation of VR and AR technologies in education, and more specifically in the field of mathematics for primary school children. An experimental evaluation was staged to test the following hypothesis: Hypothesis 1: VR and AR applications make the teaching of mathematics more interactive and interesting and they also contribute to a more efficient learning and understanding of mathematical concepts. Hypothesis 2: The use of VR applications is more effective when compared to AR applications for mathematics teaching activities. For the needs of the experimental evaluation, we designed a lesson plan comprised of three activities: Classification of shapes into solid or plane shapes, identification of solid shapes appearing in a typical city environment, and classification of solid shapes. The lesson plan was implemented based on the traditional method that utilizes printed material, three related VR and three AR applications. The developed VR and AR applications for the current research do not require specialized equipment. For the AR applications, the users only need to use their mobile device or tablet and for VR applications they only need to use a mobile phone and low-cost virtual reality glasses. As part of the study 30 fourth, fifth and sixth class primary school students were divided equally into the control group who used the traditional teaching method, and the AR and VR groups who used AR and VR applications respectively. Participants were provided with questionnaires before (pre-test) and after the test (post-test) to measure factors such as user attention, presence, enjoyment, science knowledge, auditory knowledge, and visual knowledge. According to the results, new technologies in education in the form of virtual and augmented reality improve interactivity and student interest in mathematics education, contributing to more efficient learning and understanding of mathematical concepts when compared to traditional teaching methods. No significant difference was observed between virtual and augmented reality technologies with regards to the efficiency of the methods that contribute to the learning of mathematics, suggesting that both virtual and augmented reality display similar potential for educational activities in Mathematics. Based on statistical evidence Hypothesis 1 was accepted and Hypothesis 2 was rejected. The current research is one of the first attempts ever to compare VR and AR technologies for Mathematics teaching activities in primary school. The findings of our research can provide valuable feedback to educators and developers who plan to use or develop VR or AR technologies for educational activities. Given that these days VR and AR applications, like the ones used in the experimental evaluation, do not require highly specialized equipment, the introduction of AR and VR based activities both for in-class and extra curriculum activities provide a promising way for more efficient Mathematics training activities.

Male sexual dysfunction is a series of conditions, most notably including erectile dysfunction (ED), Peyronie’s disease (PD), and premature ejaculation (PE), defined by impaired sexual functioning. The prevalence of male sexual dysfunction increases with age and is relatively high with greater than 50% of men aged 40 to 70 describing some degree of erectile dysfunction. Risk factors for male sexual dysfunction include age, diabetes mellitus (DM), cancer, stroke, hypertension, penile trauma, depression, anxiety, and disturbance in central serotonin neurotransmission and 5-HT postsynaptic receptor functioning. Sexual questionnaires including the International Index of Erectile Dysfunction, Sexual Health Inventory for Men, and the Premature Ejaculation Diagnostic Tool are useful in screening for these disorders. Focused history and physical can establish diagnoses. For a condition to be diagnosed as male sexual dysfunction, the patient or their partner must view their sexual functioning as impaired. Treatment of male sexual dysfunction is etiology dependent. For ED, first-line therapy is a phosphodiesterase-5 inhibitor or mental health care for psychogenic ED. More complicated cases may be treated with injections, surgery, or shockwave therapy. PD is either treated with medications for pain management, collagenase clostridium histolyticum injection, corpoplasty, plication, or shockwave therapy. PE may be treated behaviorally or with SSRIs as first line medication.

The Application of Virtual Reality in Art Design: A New Approach

ABSTRACTIntroduction: The prevalence of sexual dysfunctions has increased over the last decades; despite a number of available treatments for erectile dysfunction (ED), premature ejaculation (PE), and Peyronie’s disease (PD), still several unmet therapeutic needs deserve to be fulfilled. The aim of this review is to detail on phase I and II clinical trials investigating novel medical treatments for ED, PE, and PD.Areas covered: We conducted a systematic review of the literature including both published and ongoing phase I and II registered trials focused on medical treatment of ED, PE, and PD during the last 5 years. A total of 35 trials have been identified. Most studies (63%) investigated ED treatments and 26% were still ongoing. Stem cells (SCs) therapy was assessed in 28% of trials.Expert opinion: SCs therapy represent a promising treatment for ED although only few patients have been treated to date. Likewise, the oral selective oxytocin receptor antagonists for treating PE showed excellent safety profile and deserve further investigations in phase III trials. Preliminary results of novel topical treatments for PD with fibrinolytic and antiinflammatory drugs are encouraging, but urgently need to be confirmed in large placebo-controlled trials.

Male sexual dysfunctions (SDs) like erectile dysfunction (ED), premature ejaculation (PE), and Peyronie's disease (PD) are highly prevalent conditions affecting the quality of life of men and their partners. Botulinum toxin (BTX) is emerging as a promising injectable therapy to treat male SDs. To systematically review the current evidence on the use of BTX in the treatment of male SDs. PubMed, Cochrane, and EMBASE databases were queried for all published studies indexed up to October 2024 using predefined keywords. Of 108 identified articles, 9 (6 on ED, 2 on PE, and only 1 on PD) met our inclusion criteria. In ED, BTX improved International Index of Erectile Function-Erectile Function domain (IIEF-EF) scores in 41%-57.4% of patients, with benefits lasting up to 6 months. In PE, BTX increased ejaculation latency and subjective satisfaction at 1-3 months, but the effects diminished by 6 months. In PD, a single study showed a significant reduction in penile curvature (-7.9°), plaque thickness, and penile pain. Adverse effects were mild and local, reported in less than 10% of cases. BTX injections demonstrate promising improvements in erectile function, ejaculation latency, and penile curvature with a favourable safety profile. However, current evidence is limited by small, heterogeneous studies and the absence of large randomized controlled trials. Further research is needed to establish optimal dosing, timing, and patient selection.

The rapid development of virtual and augmented reality technologies is currently taking place in almost all spheres of activity. Elements of virtual and augmented reality are used in such areas as education, medicine, transport, gaming, tourism and others. The active spread of these technologies causes the emergence of special competencies in the IT labor market and, as a result, the formation of new professions.Many Russian universities are training students in IT training areas. Specialization in the development of computer games and virtual reality applications has begun recently. The provision of practical classes is accompanied by specific tasks, which gives students the opportunity to improve the use of software and technical devices.The relevance of the research is determined by the current demand for the use of the latest technologies by IT developers in the field of creating computer games. Today, technologies that provide a player’s immersion in virtual reality are becoming more and more popular. One of these technologies is a suit with wearable sensors that track a person’s position in space in real time. However, there are quite a few real described projects in the literature and on the Internet. This study examines the process of developing a task for creating a game application using virtual reality technology: a suit with wearable sensors for teaching students.Materials and methods of research. Timely identification of the needs of the IT market in personnel training allows educational organizations to form new training programs of different levels of training. This approach makes it possible to target the educational and methodological materials being developed to use the latest achievements in the development of the field under study.Using a systematic approach, the study characterizes virtual reality suits and sensors for monitoring the position in the user’s space. Thus, the goal of the task was to ensure the immersiveness and convenience of interaction between the player and the game environment.Based on materials on software, position sensors in space, the approach of pedagogical design was applied and the procedure was formed for a practical task, reflecting the relevant competencies.Results. The study was conducted on the basis in the framework of laboratory and practical work of students, as well as at a real enterprise. Training in the new profile of the direction of training “Applied informatics” is fully equipped with all the latest technologies in this field. As a result of the work, the content of the practical task was developed.Real development of virtual and augmented reality applications is conducted jointly with students. Almost all projects used a suit with body sensors.Conclusion. Our study examines in detail the process of developing an application using a suit with wearable sensors for further training of students. Based on the results, work can be carried out on real projects for any field. Based on the research materials, it is planned to issue a textbook for students with the profile of developing computer games and virtual / augmented reality applications.

Sexual function is essential to good health and well-being in men. The relationship between male sexual function, pelvic floor function, and pelvic pain is complex and only beginning to be appreciated. The objectives of the current review are to examine these complex relationships, and to demonstrate how pelvic floor physical therapy can potentially improve the treatment of various male sexual dysfunctions, including erectile dysfunction and dysfunction of ejaculation and orgasm. Contemporary data on pelvic floor anatomy and function as they relate to the treatment of various male sexual dysfunctions were reviewed. Examination of evidence supporting the association between the male pelvic floor and erectile dysfunction, ejaculatory/orgasmic dysfunction, and chronic prostatitis/chronic pelvic pain syndrome, respectively. Evidence suggests a close relationship between the pelvic floor and male sexual dysfunction and a potential therapeutic benefit from pelvic floor therapy for men who suffer from these conditions. Pelvic floor physical therapy is a necessary tool in a more comprehensive bio-neuromusculoskeletal-psychosocial approach to the treatment of male sexual dysfunction and pelvic pain.

Stem cell therapy using stromal vascular fraction (SVF) is a promising treatment modality. SVF is comprised of a mixture of adipose-derived stem cells, endothelial precursor cells, and immune modulatory cells that act synergistically to facilitate angiogenesis and epithelial cell differentiation. This makes SVF an attractive option for men's sexual disorders that require reconstitution of vasculature and endothelial lining, namely erectile dysfunction (ED) and Peyronie's disease (PD). The objective of this study was to compare and contrast the available literature regarding the use of SVF in the treatment of male sexual dysfunction. A literature review was performed in PubMed with the keywords "stromal vascular fraction" and/or "erectile dysfunction" and/or "Peyronie's disease" and/or "sexual dysfunction." The main outcome measure for preclinical studies was erectile function, as measured by changes in intracavernous pressures, and results of histopathologic analysis of corporal tissue. Clinical endpoint analysis in humans included various patient questionnaires. For ED, there were 5 preclinical studies included in the analysis, with 1 Phase 1 clinical trial in humans. Major limitations of both the preclinical and clinical studies included the absence of SVF component analysis, and short duration of follow-up. Despite a paucity of preclinical studies, there was a single clinical study assessing the efficacy of combination SVF and shock wave therapy in the treatment of PD. Limitations of this study included an absence of a control group and the use of subjective data. Preclinical and clinical data in the use of SVF for the treatment of male sexual dysfunction is deficient. Even though multiple medicinal disciplines are studying the use of SVF on a myriad of pathologies, further investigative work elucidating the mechanism and potential adverse effects of SVF need to be performed before clinical trials are undertaken. Haney NM, Gabrielson A, Kohn TP, Hellstrom WJG. The Use of Stromal Vascular Fraction in the Treatment of Male Sexual Dysfunction: A Review of Preclinical and Clinical Studies. Sex Med Rev 2019;7:313-320.

This paper includes a research review in five bibliographic databases on using the application of virtual reality (VR) and augmented reality (AR) in physical and occupational therapy (POT). This literature review addresses five research questions and two sub‐research questions. A total of 36 relevant studies were selected in the review based on the defined keywords and inclusion‐exclusion criteria. The primary motivation for using the application of VR and AR in POT is that it is accurate, involves higher patient participation, and requires less therapy recovery time. The standard software tool used is the Unity 3D game engine, and the common device used is the Oculus Rift HMD. Various applications of VR and AR consist of different VR environments and AR contents used in POT. Post‐stroke rehabilitation, rehabilitation exercises, pain management, mental and behavioral disorders, and autism in children are the main aspects addressed through the VR and AR environments. Literature review indicates that questionnaires, interviews, and observation are the primary metrics for measuring therapy's effectiveness. The study's findings show positive results such as reduced treatment time, nervousness, pain, hospitalization period, making therapy enjoyable and encouraging, improved quality of life, and focus on using the application of VR and AR in POT. This review will be relevant to researchers, VR and AR application designers, doctors, and patients using the application of VR and AR in POT. Further research addressing multiple participants with clinical trials, adding new VR environments and AR content in VR and AR applications, including follow‐up sessions, and increasing training sessions while using the application of VR and AR in POT are recommended.

The study describes a therapeutic approach using psycho-dynamic psychotherapy integrating virtual environment (VE) for resolving impotence or better erectile dysfunction (ED) of presumably psychological or mixed origin and premature ejaculation (PE). The plan for therapy consists of 12 sessions (15 if a sexual partner was involved) over a 25-week period on the ontogenetic development of male sexual identity, and the methods involved the use of a laptop PC, joystick, Virtual Reality (VR) helmet with miniature television screen showing a new specially-designed CD-ROM programs using Virtools with Windows 2000 and an audio CD. This study was composed of 30 patients, 15 (10 suffering from ED and 5 PE) plus 15 control patients (10 ED and 5 PE), that underwent the same therapeutic protocol but used an old VR helmet to interact with the old VE using a PC Pentium 133 16Mb RAM. We also compared this study with another study we carried out on 160 men affected by sexual disorders, underwent the same therapeutic protocol, but treated using a VE created (in Superscape VRT 5.6) using always Windows 2000 with portable tools. Comparing the groups of patients affected by ED and PE, there emerged a significant positive results value without any important differences among the different VE used. However, we had a % increase of undesirable physical reactions during the more realistic 15-minute VR experience using Virtools development kit. Psychotherapy alone normally requires long periods of treatment in order to resolve sexual dysfunctions. Considering the particular way in which full-immersion VR involves the subject who experiences it (he is totally unobserved and in complete privacy), we hypothesise that this methodological approach might speed up the therapeutic psycho-dynamic process, which eludes cognitive defences and directly stimulates the subconscious, and that better results could be obtained in the treatment of these sexual disorders. This method can be used by any psychotherapist and it can be used alone or associated with pharmacotherapy prescribed by the urologist/andrologist as part of a therapeutic alliance.

The evaluation and treatment of male sexual dysfunction has developed considerably since the release of sildenafil (Viagra®) as a treatment for erectile dysfunction in 1998.1 There is a societal perception that it is important for men to preserve their sexual function and optimize their sexual performance. This perception, coupled with perpetual innovation in male sexual medicine, has led to many treatment options for male sexual dysfunction, including oral therapies for erectile dysfunction, multiple vehicles for hormonal replacement, shockwave therapy, and penile implants for refractory erectile dysfunction. There are fellowships throughout Canada dedicated to the medical and surgical management of male sexual dysfunction. Medical students and residents across many disciplines are routinely exposed to the evaluation and treatment of men with sexual dysfunction. Unfortunately, despite robust clinical and academic interest in male sexual dysfunction, women with sexual complaints have been largely overlooked.2 There have been limited treatment options, few Canadian role models who specialize in female sexual medicine, and little academic activity in the area of female sexual function. Fortunately, over the past decade there has been an increase in the clinical and academic interest in female sexual function. The times appear to be changing. The International Society for the Study of Women’s Sexual Health (ISSWSH) was established in 2001 to serve as a multidisciplinary international community dedicated to advancing the study of female sexuality. There are published guidelines and position papers that reinforce the practical aspects of female sexual dysfunction (FSD) evaluation and management.3 There has been an important increase in research regarding the impact of cancer and its treatment on female sexual function.4 And finally, there are now U.S. FDA-approved therapies for both low desire and sexual pain that will possibly be available in Canada in the future.5–7 The increase in attention to female sexual function over the past decade can be attributed to a number of factors, including the establishment of ISSWSH, new treatments offering hope, an increase in female sexuality research, and broader societal forces promoting equity in medical practice and research. This review provides a practical, evidence-based guide to the evaluation and management of FSD that is adaptable for clinical practice in Canada. For the purpose of this review, the classification of FSD have been divided into four broad categories: sexual pain, low desire, low arousal, and orgasmic dysfunction. These closely mirror the DSM V classifications of FSD, compromised of: genito-pelvic pain/penetration disorder (sexual pain), female sexual interest/arousal disorder (low desire and low arousal), and female orgasmic disorder (orgasmic dysfunction). 8 These classifications have been chosen instead of the DSM classifications, as many patients will not meet strict criteria but will still benefit from evaluation and management. A symptom-based approach is the most effective means to organize the initial medical evaluation and treatment of women with sexual complaints to encourage collaboration and communication between healthcare providers.

This scoping review examines the extent and focus of scientometric studies on male infertility and male sexual dysfunctions (MSDs) while assessing gaps in the current research. It highlights contributions from leading countries, institutions, and authors and identifies important emerging areas of research in male infertility and MSDs. A literature search was performed using Web of Science Core Collection (WoSCC), Scopus, and PubMed following the methodological framework of a scoping review. Bibliometric/scientometric studies on male infertility and sexual dysfunctions were included in this review. A total of 2,525 articles were assessed for eligibility, with 36 studies included in this review. Through a detailed analysis of the articles, this study identifies significant contributions from countries such as the USA, China, and Italy, with leading institutions and authors playing a crucial role in advancing research on oxidative stress (OS), sperm DNA fragmentation (SDF), varicocele, and assisted reproductive technologies. Notably, OS and SDF have emerged as critical areas influencing both infertility diagnosis and treatment outcomes, while varicocele research remains centered on surgical interventions and their reproductive implications. In the domain of MSDs, erectile dysfunction (ED), especially diabetes-related ED, has seen a surge in research attention, with innovative treatments showing promise for future clinical applications. Despite progress in these areas, the review identifies significant gaps in research on premature ejaculation, Peyronie's disease, and other MSDs. This review underscores the value of scientometric analysis in andrology, providing a comprehensive overview of current research trends, key contributors, and emerging areas in male infertility and sexual dysfunctions. While significant advancements have been made in several key areas of male infertility and ED, notable gaps remain in underexplored MSDs conditions. By identifying these gaps and regional contributions, this analysis serves as a foundation for guiding future research efforts. Utilizing scientometric insights can foster innovation, improve treatment strategies, and propel advancements in male reproductive and sexual health research.