Assessment Of Sexual Dysfunction Research Articles

Association of hirsutism and anthropometric profiles with sexual dysfunction and anxiety levels in infertile Indonesian women with polycystic ovarian syndrome

BackgroundHyperandrogenism is frequently found in polycystic ovary syndrome (PCOS) and contributes to physical manifestations like hirsutism and obesity, along with infertility. This condition can result in anxiety, depression, and body image disorders, potentially leading to sexual dysfunction. The objective of this investigation was to assess the correlation among hirsutism, anthropometric characteristics, sexual dysfunction, and anxiety levels among infertile Indonesian women diagnosed with PCOS.MethodsFrom December 2021 to December 2022, a cross-sectional study was undertaken involving 71 infertile women diagnosed with PCOS at Yasmin Clinic, Dr. Cipto Mangunkusumo General Hospital in Jakarta, Indonesia. Hirsutism was assessed using the modified Ferriman-Gallwey (mFG) score; the anthropometric profile was assessed using BMI and waist-to-hip ratio. The assessment of sexual dysfunction was conducted using the Female Sexual Function Index (FSFI) questionnaire, while the evaluation of anxiety levels utilized the HAM-A questionnaires.ResultsIn this study, it was discovered that 53.3% of subjects experienced sexual dysfunction. However, there was no statistically significant relationship between hirsutism, anthropometric profile, and sexual dysfunction score in infertile women with PCOS (p > 0.05). Analysis of the overall FSFI domain score revealed that lubrication and satisfaction were lower in obese patients (p = 0.02 and p = 0.03), but this did not contribute to an overall sexual dysfunction score. Also, we found that subjects who experienced sexual dysfunction had a higher anxiety score (p < 0.005), with correlation analysis showing that Ferriman-Gallwey (FG) scores have a significant positive correlation with anxiety.ConclusionThere is no correlation between hirsutism, anthropometric profile, and sexual dysfunction in infertile Indonesian women diagnosed with PCOS. However, hirsutism could play a role in causing anxiety in Indonesian PCOS women. Additional investigation is required, as female sexual function is an intricate subject.

(038) Health-Related Quality of Life after Gender-Affirming Pelvic Surgery: A Systematic Review and Meta-Analysis

Abstract Introduction Various validated questionnaires have been designed to evaluate sexual dysfunction as it relates to specific phases of the sexual response cycle, which include desire, arousal, orgasm, and resolution. Although there is a breadth of data on the surgical and aesthetic outcomes of patients who have undergone gender-affirming pelvic surgery (GAPS), there are limited data on sexual outcomes as they relate to the sexual response cycle after GAPS. Questionnaires are a crucial tool for research and clinical assessment of sexual dysfunction. However, many of the validated questionnaires for sexual dysfunction were not created for use in transgender patients after GAPS. To date, there is not a validated questionnaire specifically for patients who have undergone GAPS. Objective We sought to review the most commonly used sexual function questionnaires and assess their inclusivity as it relates to transgender patients who have undergone GAPS. Methods A PubMed and PsycINFO search was carried out using the keywords: “Validated questionnaires” AND “sexual dysfunction” OR “arousal” OR “desire” OR “libido” OR “satisfaction” OR “quality of life”. We then reviewed the most commonly used validated sexual dysfunction questionnaires and graded them on the metrics of medical applicability of patients who had undergone vaginoplasty, metoidioplasty, or phalloplasty, affirming language, and inclusion of identities beyond fully binary transgender people. The validated questionaries were reviewed by a comprehensive sexual health expert and a gender-affirming surgeon. Results Of the 13 questionnaires reviewed, only 5 met all metrics for inclusiveness. 4/13 of the validated questionnaires used exclusionary gendered language (female vs male), 6/13 were not physiologically applicable to patients who had undergone GAS (vaginal lubrication, ejaculation etc) and 2/13 assumed heterosexual orientation. Conclusions The current clinical and research tools used to define sexual dysfunction are not inclusive of people who have undergone gender-affirming surgery. Validated questionnaires are needed to optimally assess the sexual outcomes of patients who have undergone GAS. Disclosure No.

Isotretinoin: establishing baseline prescribing practices in Ireland and assessing compliance and satisfaction with current guidelines.

Our article discusses current challenges of prescribing isotretinoin as well as reflecting on results of a recent survey of Irish dermatologists to assess baseline prescribing practice in relation to pregnancy prevention compliance, psychiatric assessment and assessment of sexual dysfunction. It highlights compliance and satisfaction with current Irish guidance and a need for further studies in key prescribing areas.

Skin-Related Sexual Life Questionnaire (SRSLQ): Creation and Validation of the Questionnaire.

Background and Objectives: The assessment of sexual dysfunction among psoriatic patients still remains a great diagnostic difficulty due to its subjective and embarrassing character. Various questionnaires have been used to assess sexual dysfunctions associated with skin conditions; however, none of them have been approved as a gold standard. The aim of our study was to create and validate the Skin-Related Sexual Life Questionnaire (SRSLQ) for the assessment of possible sexual dysfunction and related psychological burdens in patients with skin diseases. Materials and Methods: A total of 109 patients, including 45 women and 64 men (1:1.4) suffering from psoriasis and aged between 18 and 73 years (mean 48.0 ± 13.4 years), were included in the study. All subjects completed the 11-item SRSLQ and the Dermatology Life Quality Index (DLQI). In addition, all men were asked to fulfil the five-item version of the International Index of Erectile Dysfunction (IIEF-5) at the time of examination and 7 days after enrollment. The disease severity was assessed via the PASI scale. Results: The statistical analysis of internal consistency of SRSLQ showed very good integrity, with a Cronbach α coefficient of 0.94. The reproducibility level assessed with intraclass correlation coefficient (ICC) amounted to 0.96. A significant correlation between the total score of the 11-item SRSDQ and the DLQI (r = 0.39; p < 0.001) was found, confirming congruent validity. Conclusions: The validated 11-item Skin-Related Sexual Life Questionnaire can be successfully implemented in daily clinical practice as well as in clinical research.

The Influence of Chronic Prostatitis and Chronic Pelvic Pain Syndrome on Sexual Function in Iraqi Men

Background: Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a bothersome disease that affects men and is associated with adverse impacts on their sexual activity and quality of life. Objective: Assessment of sexual dysfunction in Iraqi men with chronic prostatitis. Methods: This study comprised two groups: the first included 112 patients with CP/CPPS, and the second involved 64 healthy volunteers. Assessment of prostatitis symptoms was done using the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI). Sexual dysfunction was addressed using the International Index of Erectile Function-5 (IIEF-5) questionnaire for assessment of erectile dysfunction severity, the Premature Ejaculation Diagnostic Tool Questionnaire (PEDT) for premature ejaculation, and two questions from the Ejaculatory Function Questionnaire, questions 3 (EjQ3) and 4 (EjQ4), for painful ejaculation and satisfaction of ejaculation. Results: The mean score of the NIH-CPSI for CP/CPPS patients was higher than for the control group, and the pain or discomfort symptom was the most predominant. ED was reported in 46% of CP/CPPS patients, compared to 39% in the control group. PE was recorded in 49% of the patients versus 25% of the control group. Painful ejaculation was found in 65% of the studied patients with CP/CPPS and in 11% of the healthy control group. Ejaculatory dissatisfaction was evident in 67% and 17% of the patients and control groups, respectively. Conclusion: CP/CPPS is associated with distressing sexual dysfunction in the form of erectile dysfunction, premature ejaculation, and ejaculatory dysfunction that affects men's sexual activity.

Perceptions and experiences of Forensic Medicine Department service recipients and providers during male sexual dysfunction assessment following filing for divorce: a qualitative study in Iran

Background: In the current era, divorce has become quite commonplace. One of the significant reasons for divorce is sexual dysfunction. the aim of this study was to explore the perceptions and experience of Forensic Medicine Department service recipients and providers during male sexual dysfunction assessment following filing for divorce. Methods: This study was a qualitative study that was analyzed through a content analysis approach. Individual interviews were used for data collection. The data were collected through in-depth semi-structured interviews with Twenty service recipients and nine service providers of Forensic Medicine Department in Tehran from Jan 2022 and ended in March 2022. Results: The analysis of the data led to the extraction of two main categories, including: existing challenges of the forensic medical system in the sexual assessment process with 3 sub-categories (Absence of the plaintiff during the assessment process, sharing a common room with other clients, The psychosocial pressure associated with a Rigi Scan test) and features of desirable evaluation services with 5 Sub-categories (Service delivery to couples, Service delivery by observing ethical principles, confidentiality and human dignity, Comprehensive physical-psychological-communicative assessment, Service delivery that emphasizes informing couples about the road ahead, Provision of services if the authenticity of the sexual problem is proven). Conclusion: Based on the results of the present study, Service recipients expected the claimant to be present throughout the evaluation process and to cover the expenses too. Moreover, they expected a better atmosphere to be available for these individuals and that human dignity and ethical principles be safeguarded. Furthermore, based on their opinions, a comprehensive physical-psychological-communicative assessment was necessary and couples should be informed and aware of the process when they enter it –particularly when the complaint is proven to be unreal, and all evaluations should be performed on both spouses, not just one.

Validation of Qualisex questionnaire to evaluate sexual dysfunction in women affected by fibromyalgia.

Fibromyalgia (FM) may have consequences on sexual life. The objective was to validate the Qualisex questionnaire in the assessment of sexual dysfunction in women affected by FM. We consecutively enrolled FM women (American College of Rheumatology-ACR 2016) referring to our Fibromyalgia Clinic, from 2020 to 2022. Demographic, clinical data and evaluation of FM symptoms severity (Revised Fibromyalgia Impact Questionnaire (R-FIQ), Symptoms Severity Scale-SSS, Widespread Pain Index-WPI) were assessed. Hospital Anxiety and Depression Scale (HADS) and Qualisex questionnaire were anonymously administered. Qualisex includes 10 questions on different items of sexual life with higher scores suggestive of greater negative impact of the disease on sexuality. The cohort was composed by 373 FM women. Cronbach's alpha test was used to validate Qualisex questionnaire (0.878). Moreover, we observed higher values of Qualisex in married women (p<0.001), in women with lower grade of education (p=0.002) and with lower sexual feeling with partner (p<0.001). Higher values of Qualisex Total score showed a positive correlation with HADS-A/D (p<0.001 r=0.312; p<0.001 r=0.542 respectively), VAS pain, VAS fatigue, VAS dryness (p<0.001 r=0,438; p<0.001 r=0.375; p<0.001 r=0.370 respectively) and relationship duration (p<0.001 r=0.202). Multivariate analysis revealed a significant influence of relationship duration, VAS pain, fatigue, dryness, HADS-A/D, R-FIQ and all Qualisex items, on Qualisex Total score corrected for patients' age (p<0.001). This study validated Qualisex questionnaire as a good test for the sexual disorders' evaluation in FM women. Its use allows the assessment of different factors associated with sexual dysfunction, showing an impact of FM on sexuality. Moreover, due to demotivation feelings, sexual dysfunction contributes to worsen patients' quality of life.

(351) Cross Cultural Adaptation and Psychometric Validation of The Arizona Sexual Experiences Scale (ASEX) into Bangla

Abstract Introduction Sexual Dysfunction affecting all age groups. We need standard tool for proper assessment and management of patient with Sexual Dysfunctions. However, there is severe scarcity of validated tool in Bangla to assess Sexual Dysfunctions in our cultural context. The Arizona Sexual Experience Scale is widely used validated tool to screen and assess severity of Sexual Dysfunctions for clinical management and research. Objective To develop a culturally adapted and validated Bangla version of The Arizona Sexual Experience Scale (ASEX) to assess Sexual Dysfunctions. Methods This was a cross sectional validation study conducted from June, 2019 to Mar, 2021. After receiving the approval from original author of The Arizona Sexual Experience Scale (ASEX), it was forward and backward translated followed by the expert committee review the initial Bangla version of the scale was developed. Afterward this scale was applied on 56 patients with Sexual Dysfunctions and evaluated validity (Content validity, Face validity and Construct validity) and reliability (Internal consistency). Data analysis performed by Statistical Package for Social Science (SPSS) version- 24. Results The Bangla Arizona Sexual Experience Scale (ASEX) showed very good psychometric property with a Cronbach’s alpha value of 0.756. The Factor analysis based one the Eigen value revealed the Bangla version has one component. Conclusions The study commented the Bangla version of the ASEX (ASEX- Bangla) can be used for assessment of Sexual Dysfunctions in Bangladesh and it will help in further management of the sexual dysfunction in the country and will also help in future research in this area. Disclosure No

Quality of life, voiding & sexual dysfunction following robot-assisted vesicovaginal fistula repair: a tertiary care centre experience.

Robot-assisted VVF (RA-VVF) repair has the advantage of small cystotomy, precise dissection and minimal surrounding tissue trauma. Translation of this to better functional outcomes is not studied so far. This study aims to evaluate the quality of life, voiding, and sexual dysfunction following robot-assisted VVF repair. Women with successful RA-VVF repair were screened using UDI-6, IIQ-7, FSFI, and WHOQOL-BREF questionnaires. The preoperative assessment was done in the prospective cohort only. Of the 75 women who underwent RA-VVF repair, 47 were enrolled, 33 in retrospective, and 14 in a prospective cohort. Overall, 28 (60%) women had urinary complaints with a median UDI-6 total score of 4 (0-100) and IIQ-7 score(0-23) in 5 (10%) women. However, UDS (15 women) showed no DO with cystometric capacity (352 ± 98.12) ml and normal compliance in 14 (93%) women. Mean BOOI and DCI were 11.90 ± 7.01 and 44.25 ± 8.60 respectively, with PdetQmax ranging from 17 to 44. None had difficulty in voiding (Qmax 13.85 ± 4.90). Twenty (43%) women were sexually active, and 2 had sexual dysfunction (FSFI score < 26.55). Quality of life was "good" to "very good" in all domains (score > 90) except for the social domain. The prospective cohort showed significant improvement in UDI-6 score (p < 0.05), IIQ-7 score (p < 0.05), and quality of life (p < 0.05) postoperatively. RA-VVF repair results in minimal voiding dysfunction and significant improvement in overall quality of life. For sexual dysfunction assessment, a longer follow-up is required.

Risk Factors of Quality-Of-Life and Sexual Function Impairment in Chronic Spontaneous Urticaria Patients: Cross-Sectional Study

Background: Chronic spontaneous urticaria (CSU) has been associated with poor quality of life and mood disturbances. However, factors associated with these dimensions have not been properly assessed. Moreover, there is a lack of studies regarding sexual dysfunction (SxD) and CSU. Therefore, the aims of this study were to assess quality of life associated factors and to evaluate the prevalence and potential impact of SxD in patients with CSU. Method: Cross-sectional study of patients suffering from CSU. Sociodemographic and disease activity variables, quality of life, sleep, SxD, anxiety, and depression were collected using validated questionnaires. Results: Seventy-five patients were included, with a female-to-male ratio of 2.40. Female sex, worse disease control, and sexual dysfunction were associated with poor quality-of-life indexes (p < 0.001). SxD was detected in 52% of female and 63% of male patients. SxD was associated with poor disease control (p < 0.001). Female SxD, but not male, was associated with poorer quality of life (p = 0.02) and an increased risk for anxiety 85% and depression 90% (p < 0.05). Conclusions: Female patients and those with an inadequate control of CSU are in higher risk of having poorer quality of life. SxD seems to be frequent in patients with CSU. Moreover, female SxD seems to have a more profound impact on quality of life and mood disturbances when compared to males. Assessment of SxD in Urticaria Clinic might be of benefit to identify patients at a higher risk of poor quality of life.

Brief Sexual Symptom Scale for Women (BSSS–W): Scale Development and Psychometric Validation

Brief Sexual Symptom Scale for women (BSSS –W). This questionnaire is designed for assessment of sexual dysfunctions in medical or psychiatric women patients and healthy women. In addition, this questionnaire is designed to the measurement of sexual symptoms before and after the intake of medicines in psychotropic substances. This self-report questionnaire can be either administered by a clinician or self-administered. The measure assesses nine user-friendly items; each item explores a particular aspect of sexuality: 1- Sexual desire 2- Sexual Interesting 3- Sexual arousal 4- vaginal lubrication 5-ability to reach orgasm 6- pain during or after intercourse 7- Sexual activity 8- Intercourse Satisfaction 9- Sexual satisfaction in general. The total possible scores range from 9 to 45, with the highest scores indicating more sexual dysfunction Data were collected from March to December 2020 among 200 Arabian psychiatric patients attending Mutmaena medical center in Riyadh city, compared to 150 control subjects. All subjects women aged from18 to 45years. Demographic characteristics for subjects are involved. (BSSS –W) was examined for sensitivity, specificity, reliability, and construct validity This questionnaire provides A high degree of internal consistency was observed for each of the nine domains and for the total scale (Cronbach's alpha values of 0.86 and higher and 0.91 and higher, respectively) in the populations studied. Correlation (at intervals of 2 and 3 weeks) r = 0.85 and r = 0.94, respectively). The BSSS –W demonstrated adequate construct validity, and all ten domains showed a high degree of sensitivity and specificity Significant (P <0.001). Tests of convergent and divergent validity, including correlations with standardized scales for depression (Beck Depression Inventory), sexual function ( (Female Sexual Function Index (FSFI), confirmed the criterion validity of the new measure. This new instrument has excellent psychometric properties and is well suited for use in clinical and research settings we have no conflicts of interest to disclose

Evaluation of Disparity in Physician Assessment of Sexual Dysfunction in Women vs. Men Receiving Brachytherapy for Genitourinary Cancers

<h3>Purpose/Objective(s)</h3> Brachytherapy is an integral component of treatment for genitourinary cancers, but comes with long-term risk of sexual dysfunction, with 90% of women and 50% of men experiencing sexual dysfunction after brachytherapy for gynecologic malignancies and prostate cancer, respectively. We hypothesized that women's sexual health was not being assessed in clinic at the same rate as their male counterparts receiving prostate brachytherapy. We similarly hypothesized that our institutional data would be representative of clinical investigators nationally, with lower rates of sexual function assessment in women compared to men enrolled on clinical trials. <h3>Materials/Methods</h3> Patients with cervical or prostate cancer evaluated for brachytherapy between 2010 and 2021 at a single academic institution were included in this retrospective analysis. Consult notes were reviewed to assess if patients were asked about baseline sexual function with or without patient-reported outcomes (PRO). Chi-square test was used to determine statistically significant differences between the two groups (p<0.05). For a more robust national comparison, we also queried the NIH Clinical Trials Database to determine the proportion of clinical trials assessing sexual function as a primary or secondary endpoint after brachytherapy for prostate or cervical cancer. <h3>Results</h3> We analyzed 126 female and 75 male patients who were evaluated for cervical and prostate cancer brachytherapy, respectively. More men than women were asked about sexual function at time of consult, even though the female cohort was younger (Table 1). Rates of assessment of sexual function were similar in men who were and were not offered ADT [45 (88%) vs. 22 (92%); p=0.65]. Prostate cancer brachytherapy trials were also more likely to assess sexual function compared to those in cervical cancer. <h3>Conclusion</h3> We demonstrate a significant difference between men and women in the ascertainment of sexual function both in our clinic and on brachytherapy clinical trials nationwide. We have previously shown that 79% of women believed that sexual function was an important component of their overall health. Even though brachytherapy has a highly deleterious impact on sexual function, women are not being evaluated for this important functional outcome at the same rate as men. Further studies are warranted to fulfill this unmet need and to understand the barriers to assessing and treating sexual dysfunction in women receiving brachytherapy as part of treatment.

FEATURES OF SEXUAL DYSFUNCTIONS IN PATIENTS WITH NEUROTIC DISORDERS

Deterioration of mental health is an extremely important risk factor for sexual dysfunction. The aim is to investigate sexual dysfunction in patients with neurotic mental disorders. Material. Peculiarities of sexual dysfunctions in 256 patients (120 men and 136 women) were analyzed. Research. Assessment of sexual dysfunctions was performed on the basis of individual interviews and questionnaires of each patient. Intimate disorders such as perversion, anorgasmia, deactualization, hypoaesthesia, hyperesthesia, decreased libido, alibidemia, decreased sexual activity, abstinence, decreased erection, premature ejaculation, and pain during sex were evaluated. Conclusions. The issue of sexual disorders in various forms of neurosis is an extremely relevant topic, as these disorders cause significant disharmony in different areas of life of patients. Not only does it not lose its relevance, but it is gaining more and more medical and social significance.

Assessment of sexual dysfunction in patients with multiple sclerosis: a perspective from neurologist

BackgroundSexual dysfunction (SD) is a common comorbidity in people with multiple sclerosis (pwMS). It affects the quality of life and remains an overlooked condition. The objective of this study was to describe how Colombian neurologists assess and treat SD and explore the barriers during sexual function evaluation.MethodsIn this observational cross-sectional study we developed a questionnaire for neurologists with 4 sections (demographic data, evaluation and treatment of SD, and possible reasons for not discussing sexual dysfunction.) It was sent via email to 326 Colombian neurologists. We grouped the answers according to the type of consultation (neurologists from a MS program or no MS program). We described through absolute frequencies and proportions.ResultsFifty neurologists answered the survey. 64% stated that they usually study sexual dysfunction in neurological disorders. The main methods employed were private reading (86%) and attending conferences (14%). 5/50 participants have never attend pwMS; the Sect. 2–4 was not answered by them. 29% work in a MS program, all of them asked their patients about sexual function, but 18.75% of physicians working outside an MS program have never asked about it. Main reasons for not talking about sexual dysfunction were lack of knowledge (65.1%), presence of a companion (65.1%) and lack of time (55.8%). 91% of the neurologists reported that their patients usually and frequently ask about sexual function. Neurologists use informal questions to assess sexual function (80%), although 64.4% said that they are aware of SD questionnaires. When sexual dysfunction is detected, 91% of neurologists refer patients to another specialist and 87% do not start any treatment.ConclusionsColombian neurologists are concerned with sexual function in pwMS, however it remains an underdiagnosed an undertreated condition. It is necessary to strengthen knowledge about the diagnosis and treatment of sexual dysfunction in pwMS, for neurologists and patients. It is also imperative to eliminate barriers around the topic and include sexual function evaluation and treatment as the routine care of pwMS.

Assessment of Sexual Dysfunction in Cervical Cancer Patients after Different Treatment Modality: A Systematic Review.

Background and Objectives: Cervical cancer is a leading cause of mortality among women. Chemo-radiation followed by interventional radiotherapy (IRT) is the standard of care for stage IB–IVA FIGO. Several studies have shown that image-guided adaptive IRT resulted in excellent local and pelvic control, but it is associated with vaginal toxicity and intercourse problems. The purpose of this review is to evaluate the dysfunctions of the sexual sphere in patients with cervical cancer undergoing different cervix cancer treatments. Materials and Methods: We performed a comprehensive literature search using Pub med, Scopus and Cochrane to identify all the full articles evaluating the dysfunctions of the sexual sphere. ClinicalTrials.gov was searched for ongoing or recently completed trials, and PROSPERO was searched for ongoing or recently completed systematic reviews. Results: One thousand three hundred fifty-six women included in five studies published from 2016 to 2022 were analyzed. The median age was 50 years (range 46–56 years). The median follow-up was 12 months (range 0–60). Cervical cancer diagnosis and treatment (radiotherapy, chemotherapy and surgery) negatively affected sexual intercourse. Sexual symptoms such as fibrosis, strictures, decreased elasticity and depth and mucosal atrophy promote sexual dysfunction by causing frigidity, lack of lubrication, arousal, orgasm and libido and dyspareunia. Conclusions: Physical, physiological and social factors all contribute to the modification of the sexual sphere. Cervical cancer survivors who were irradiated have lower sexual and vaginal function than the normal population. Although there are cures for reducing discomfort, effective communication about sexual dysfunctions following treatment is essential.

Discrimination of clinical and nonclinical conditions of the digital application S-ONapp for the assessment and testing of sexual dysfunctions

Objective: The current study aims to evaluate the diagnostic validity of the scales included in the S-ONapp application. Methods: This cross-sectional study was conducted between February 28, 2022, and April 30, 2022, on subjects from the USA, Europe, Canada and Asia. A clinical group of 430 subjects and a non-clinical control group of 420 subjects were drawn. Results: Multiple comparisons were made between the two groups, the S-ONapp application proving its discriminatory capacity between the clinical and non-clinical groups. Conclusions: The S-ONapp application, includes sexual dysfunction assessment and testing tools that present a clinical robustness in the diagnosis of sexual dysfunctions.

MP18-20 EVALUATION OF QUALITY OF LIFE, VOIDING, AND SEXUAL DYSFUNCTION IN PATIENTS FOLLOWING ROBOT-ASSISTED VESICOVAGINAL FISTULA REPAIR

You have accessJournal of UrologyCME1 May 2022MP18-20 EVALUATION OF QUALITY OF LIFE, VOIDING, AND SEXUAL DYSFUNCTION IN PATIENTS FOLLOWING ROBOT-ASSISTED VESICOVAGINAL FISTULA REPAIR Pawan Kaundal, Ravimohan Mavuduru, Girdhar Bora, and Shrawan K. Singh Pawan KaundalPawan Kaundal More articles by this author , Ravimohan MavuduruRavimohan Mavuduru More articles by this author , Girdhar BoraGirdhar Bora More articles by this author , and Shrawan K. SinghShrawan K. Singh More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002551.20AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Robot-assisted VVF repair has the advantage of minimal surrounding tissue trauma, small cystotomy, and precise dissection, leading to a better outcome. This study aims to evaluate the quality of life, voiding, and sexual dysfunction following robot-assisted VVF repair. METHODS: Women with successful RA-VVF repair from December 2014 to June 2020 were screened using Urinary distress inventory-6(UDI-6),Incontinence impact questionnaire-7(IIQ-7), Female sexual function index(FSFI), World Health Organization quality of life(WHOQOL-BREF) questionnaires in an ambispective cohort study at 3 months of repair.Those with recto-vaginal, malignant, radiation fistulae, failed robotic repair, non-consenting, undergoing open abdominal/vaginal VVF repair and incompletely filled questionnaire were excluded.Those with urinary dysfunction were subjected to urodynamic evaluation. Appropriate Statistical test were applied using SPSS version 23.0. RESULTS: 75 women underwemt RA-VVF repair. Of these 47 were enrolled(33 in retrospective and 14 in prospective cohort). Overall, 28 (60%) women had urinary complaints. The median UDI-6 score was 4 (0-100), IIQ score 0.00 (0-23). 5 (10%) women had affect on day-to-day activity and only one patient had moderate bother. However, UDS (15 women) showed normal cystometric capacity (352 ± 98.12) ml and compliance in 14 (93%) womenwith no detrusor overactivity. Mean BOOI and DCI were 11.90 ± 7.01 and 44.25 ± 8.60 respectively. 20 (43%) women were sexually active, only 2 had sexual dysfunction (FSFI score < 26.55). Quality of life was “good” to “very good” in all domains (score >90) except for the social domain (Table1). Prospective cohort showed significant improvement in UDI-6 score (p<0.05), IIQ-7 score (p<0.5) and quality of life (p<0.5) postoperatively. CONCLUSIONS: RA-VVF repair results in minimal voiding dysfunction and significant improvement in overall quality of life. For sexual dysfunction assessment, longer follow-up is required. Source of Funding: None © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e304 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Pawan Kaundal More articles by this author Ravimohan Mavuduru More articles by this author Girdhar Bora More articles by this author Shrawan K. Singh More articles by this author Expand All Advertisement PDF DownloadLoading ...

Erectile and sexual dysfunction in male and female patients with celiac disease: A cross-sectional observational study.

IntroductionSexual function is often impaired in patients with chronic illnesses. Several patients with chronic gastrointestinal and liver disorders have been shown to suffer from sexual dysfunction, and celiac disease is a highly prevalent gastroenterological disorder.AimThe aim of this study was to investigate the sexual function incidence and the risk factors for sexual dysfunction in both male and female celiac disease patients.MethodsTwo hundred and eighty‐four patients (170 females, 114 males) participated in this cross‐sectional observational study in an anonymous manner. Female sexual function was assessed through the Female Sexual Function Index questionnaire. Male sexual function was assessed through the International Index of Erectile Function‐5 questionnaire. Clinical‐demographic variables were recorded. We investigated differences in the patient‐reported outcomes among the different subgroups and whether there were clinical‐demographic predictors of sexual dysfunction in our setting.Main outcome measuresPrevalence and assessment of sexual dysfunction in celiac disease patients.ResultsIn the female group, 85 subjects (50%) had a total score compatible with sexual dysfunction: 43 (61.42%) showed low desire, 79 (46.47%) showed arousal disorder, 66 (38.82%) lubrication disorder, and 84 (49.41%) inability of obtaining an orgasm. Also, a large proportion of our female patients, 161 (94.70%), showed sexual discomfort during intercourse. In the male group, 79 patients (62.2%) showed scores compatible with normal erectile function, eight (7.01%) had mild erectile dysfunction, 24 (21.05%) mild to moderate erectile dysfunction, and three (2.63%) presented severe erectile dysfunction. Altered body mass index was significantly associated with sexual dysfunction both in male and female patients. Early age at diagnosis was a significant predictor of sexual dysfunction in male celiac disease patients.ConclusionsA significant proportion of celiac disease patients present sexual dysfunction. Early age at diagnosis and high body mass index seem to predict sexual dysfunction in this clinical setting. Assessment of sexual function should be part of the initial evaluation of celiac disease patients in order to establish a prompt diagnosis and early treatment.

Sexual Health in breast cancer patients in Poland

Introduction. Breast cancer is the most common malignancy among women in Poland and in the world, with a mor­tality rate second only to that of lung cancer. Breasts are one of the most important symbols of femininity and sexuality. Cancer surgery, but also systemic therapy (chemotherapy and hormone therapy) cause a change in the perception of one’s body. The aim of the survey proposed by us was to assess interest in sex by breast cancer patients during and after oncological treatment, as well as to identify ways to improve the quality of patients’ sex lives. Materials and methods. The proposed survey consisted of 3 parts: the first part included questions about the demo­graphic, in the second part there were the author’s questions about sexual dysfunction (12 questions), in the third part there was the Female Sexual Function Index (FSFI) form assessing the sexual functioning of women. The questionna­ires were made available online from October 13, 2020 to December 20, 2020 through the social networks of patient organizations involved in breast cancer care. 287 women diagnosed with breast cancer were included in the survey. Results. Before the disease almost all patients were sexually active and had a partner (95.5%; n = 274); at the time of filling the questionnaire only slightly more than half of the patients remained sexually active ( 57.1%; n = 164). About 30.7% (n = 88) stated that the disease was the main reason for not being sexually active. More than 60% of patients (60.9%; n = 137) used products to improve the comfort of sexual intercourse, mainly lubricants (39.7%; n = 114). Only about 1/3 of the patients (32.1%; n = 92) were satisfied with their sex life, 48.1% (n = 138) stated they were not satisfied with their sex life, 19.9% (n = 57) did not answer this question. The main reasons for lack of satisfaction with sex life included: decreased libido (65.9%; n = 189), vaginal dryness (55.1%; n = 158). The mean score of forms filled out by the respondents was 24.50 in FSFI form. Conclusions. Assessment of sexual dysfunction in patients with breast cancer should be performed on a routine basis before treatment and regularly during treatment.

Prevalence of Sexual Dysfunction in Women With Depressive Disorder at a Tertiary Hospital

Background: Sexual dysfunction in female with depressive disorder is highly prevalent and strikingly understudied. Epidemiological and clinical studies have shown association between depression and impairments of sexual function. Despite high prevalence, there are limited studies regarding the prevalence of sexual dysfunction among female with depressive disorder in Nepal. Aims: This study was conducted to find out the prevalence of sexual dysfunction in female with depressive disorder in Nepal, their association with treatment status, and the level of psychological distress caused by it. Methods: A descriptive cross-sectional study was carried out among female with depression at Tribhuvan University Teaching Hospital, Nepal. The participants were grouped as drug naïve and under medication. Data were collected using semi-structured proforma, Beck Depression Inventory, Kessler 6+ Psychological Distress Scale, and Female Sexual Function Index. Data were tabulated and analyzed using Statistical Package for Social Sciences version 23. Results: The prevalence of sexual dysfunction was 58.82%, being 60.78% in drug-naïve cases and 56.86% in females suffering from depression and receiving medications. This study showed statistically significant association between sexual dysfunction and psychological distress but not with age, duration of marriage, number of children, occupational, and financial status. Conclusions: The study reported high prevalence of sexual dysfunction among female with depression. All domains of sexual function were affected and showed significant association with psychological distress. Therefore, assessment of sexual dysfunction in every female with depression is required to address the problem timely and efficiently.