Assessment Of Sexual Function Research Articles

Cross-Cultural Adaptation and Face Validation of the Chilean Version of the Operated Male to Female Sexual Function Index.

Transgender and gender-diverse people often experience discrimination or even outright exclusion when undergoing medical attention. It has been shown that gender-affirming treatments improve quality of life in transgender patients, and genital-affirming surgery (GAS) is increasingly spreading worldwide. Sexual function after male-to-female GAS has long been evaluated by using tools designed for assigned female at birth (AFAB), resulting in suboptimal assessments. Currently, the operated Male to Female Sexual Function Index (oMtFSFI) is the only validated questionnaire to assess the sexual function of operated transgender women. The current study was aimed at performing cross-cultural adaptation and to test the face validity of the Chilean version of the oMtFSFI. We carried out an observational descriptive study. The questionnaire was translated into Spanish, adapted, and face validated in five phases with eight participants. The study was approved by the Universidad del Desarrollo Scientific Ethics Committee. According to participants, the questionnaire was shown to both pertinently and exhaustively evaluate the sexual function of post-feminizing genitoplasty transgender women. The questionnaire was well understood by the participants, except for a difficulty in understanding certain terms. Some participants criticized the perspective of the instrument in terms of the assumption of having a partner or having penetrative intercourse via the neovagina. The amendments to the Italian version of the questionnaire were discussed until an agreement on adaptation considering the patient´s perspective was reached. The present preliminary data support the face validity of the Chilean version of the oMtFSFI in the assessment of sexual function in operated transgender women. This adapted questionnaire could be a valuable tool for clinicians and researchers.

Laser and Pelvic Floor Muscle Training for Urinary Incontinence: A Randomized Clinical Trial.

Pelvic floor muscle training (PFMT) is considered the first option as a conservative treatment for female stress urinary incontinence (SUI). However, there is still debate whether energy-based devices are effective for treating SUI. The objective of this study was to assess whether PFMT and fractional CO2 laser therapy may improve symptoms in women with SUI. A parallel, randomized, nonblinded, noninferiority trial included 94 of 144 women 18 years or older with SUI randomized into 2 groups. The CO2 laser group (n = 47) received 3 vaginal applications at monthly intervals. The PFMT group (n = 47) underwent 2 weekly sessions. Primary outcome was the mean difference of International Consultation on Incontinence Questionnaire-Urinary Incontinence Short-Form (ICIQ-UI-SF) total scores between groups after 3 and 6 months. Main secondary outcomes were questionnaires for assessment of pelvic floor symptoms (Pelvic Floor Impact Questionnaire-Short Form 7 [PFIQ-7]), sexual function (Female Sexual Function Index [FSFI]), and improvement after treatment (Patient Global Impression of Improvement [PGI-I]). A reduction in the ICIQ-UI-SF total score, PFIQ total score, and the Urinary Impact Questionnaire score was perceived between baseline and 3-6 months in both groups. CO2 laser did not reach the noninferiority margin when compared with PFMT in both follow-up periods and analyses. Pelvic floor muscle training has improved the FSFI desire domain between baseline and 3-6 months, whereas CO2 laser improved the FSFI orgasm, pain, and total score after 3 months and FSFI orgasm and total score after 6 months. PGI-I assessment has shown an improvement in both groups. Fractional CO2 laser therapy was noninferior to PFMT after 3-6 months of treatment. Both groups presented a reduction in the ICIQ-UI-SF scores, and both methods could be considered for women with SUI.

Anxiety, depression, urinary continence, and sexuality in patients undergoing radical prostatectomy: preliminary findings.

Evaluate the relationship between psychological distress, namely anxiety and depression, with urinary continence and recovery of erectile function in patients undergoing radical prostatectomy (RP). We retrospectively analyzed data from 33 consecutive patients who underwent RP in a single tertiary-referral academy between 01/2018 to 01/2019. We used the International Index of Erectile Function (IIEF-15), the Sexual Complaints Screener for Men (SCS-M), and the Hospital Anxiety and Depression Scale (HADS), validated questionnaires for the assessment of sexual function, anxiety, and depression experiences, respectively. These questionnaires were administered at the pre-surgical visit, after surgery, and at intermediate follow-ups (three, six, and twelve months). The analysis of the questionnaires completed during follow-up shows that erectile function is the most affected, with 90% erectile dysfunction (ED) at three months after surgery. In terms of emotional states, anxiety prevails in the first months following surgery and is statistically significantly associated with incontinence (p = 0.02). Depressive symptoms, on the other hand, appear later and prevail over anxiety at six months after surgery, although not statistically significant. In the early post-surgical phase anxiety and ED are the most frequently detected components, while depressive experiences and decreased desire, typical of later stages, have not yet fully emerged.

Post-stroke sexual dysfunction in males

IntroductionSexual dysfunction (SD) is a commonly overlooked issue following ischemic stroke (IS), influenced by various risk factors including social, psychological, and biological factors. This study aims to investigate the prevalence and risk factors associated with SD in adult male patients who have experienced an IS. MethodsA descriptive observational cross-sectional study was conducted in Bogotá, Colombia, involving adult male IS patients. Sociodemographic, medical history, pharmacological history, substances consumption, and time since stroke data were collected. Clinical assessments were performed using the NIHSS score, modified Rankin score (mRankin), pain score, and mood evaluation (Beck inventories). The Arizona Sexual Experience (ASEX) scale and the frequency of sexual encounters were used to assess SD. Results50 males included, mean age 63.2 (±9.7) years. The most prevalent medical comorbidities were arterial hypertension (84%) and type 2 diabetes mellitus (DM) (46%). Anxiety or depression were identified in 48%. The mean scores for the NIHSS, mRankin, and pain were 6, 1, and 1, respectively. The average time from IS to clinical assessment was 6.5 months. Sexual dysfunction was observed in 18 (36%) subjects. Age (OR 1.12, 95% CI: 1.02–1.247) and location of the IS in the cortico-subcortical region of the parietal, temporal, or occipital lobes (OR 13.59, 95% CI: 1.58–405.784) were associated with SD. ConclusionSD affects more than one-third of male patients with IS, age, and IS location identified as key risk factors. Comprehensive assessment of sexual function should be incorporated into this patients.

Ejaculation sparing of classic and minimally invasive surgical treatments of LUTS/BPH.

The surgical landscape for Lower Urinary Tract Symptoms (LUTS) and Benign Prostatic Hyperplasia (BPH) has evolved with the introduction of Minimally Invasive Surgical Therapies (MISTs), recognizing the impact of sexual function on patients' well-being, and prioritizing ejaculation-sparing approaches. This systematic review explored ejaculation sparing after classic endoscopic procedures and MISTs (iTind, Rezūm, Urolift, Aquablation, and TPLA) and a literature search yielded 41 studies. While all procedures demonstrated efficacy in improving LUTS/BPH symptoms (IPSS, QoL, Qmax), a subset of studies evaluated ejaculatory function. Positive outcomes were noted, challenging the historical association of BPH surgeries with ejaculatory dysfunction. Variations in study design, patient cohorts, and limited long-term data present challenges. Notably, the lack of baseline specificity, use of alpha-blockers, and non-specific sexual function assessments underscore potential biases. Despite limitations, the review tentatively concluded that MISTs, including iTind, Rezūm, Urolift, Aquablation, and TPLA, appear comparable in sparing ejaculation. Long-term studies are essential to validate sustainability, and comparative research should assess trade-offs between MISTs and traditional surgeries. Incorporating patient-reported outcomes and quality of life assessments will enhance future investigations, refining MISTs as standard therapeutic options for LUTS/BPH.

Female Sexual Function Index Adaptation for Breast Cancer Patients (FSFI-BC): Brazilian Portuguese Translation and Cultural Adaptation

BackgroundThe assessment of female sexual function after diagnosis and treatment of breast cancer is relevant, as cancer can negatively affect sexuality and, therefore, quality of life. Instruments assessing female sexuality can be useful in clinical practice. However, there are few validated instruments available for this purpose. This study aimed to translate the Female Sexual Function Index Adaptation for Breast Cancer Patients (FSFI-BC) into Brazilian Portuguese and culturally adapt it for use in Brazil. Patients and MethodsTranslation and cross-cultural adaptation followed the linguistic validation process, according to international guidelines. The instrument was translated and back-translated by independent translators. Sixty women aged 25 to 70 years who had been diagnosed and surgically treated for breast cancer at least 6 months previously participated in the cultural adaptation process. Participants were stratified into sexually active or inactive. Internal consistency was analyzed using Cronbach's alpha coefficient. ResultsMean participant age was 52.5 years. For sexually active women, reliability analysis (Cronbach's alpha) showed excellent internal consistency between the items of the subscales ‘Desire/Arousal’ (α = 0.912) and ‘Orgasm’ (α = 0.904), and good internal consistency for ‘Lubrication’ (α = 0.814) and ‘Pain’ (α = 0.839). For sexually inactive women, excellent internal consistency was observed between the items of the subscale ‘Reason for Inactivity – difficulty lubricating’ (α = 0.930), and good internal consistency for the other subscales. The instrument had face and content validity. ConclusionsFSFI-BC was translated and culturally adapted to the context of the Brazilian population.

(246) Sexual Functioning of Women with Affective Disorders in the Light of Ego-Resiliency and their Quality of Life

Abstract Introduction Sexuality is a complex and multidimensional issue. Human sexuality is important for psychological functioning, as it is related to the satisfaction of basic needs, such as the need for security or acceptance. The assessment of sexual functioning, which is associated with sexual satisfaction, may be an important factor that affects the quality of life, and may also translate into the assessment of the fulfillment of basic psychosocial needs. Objective The aim of the study was to assess the relationships between sexual functioning, quality of life and ego-resiliency among women diagnosed with affective disorders. The aim of the study was to assess the prevalence of the risk of sexual dysfunction in this group of patients. Methods 23 sexually active women diagnosed with affective disorders, who were hospitalized in a psychiatric ward, were qualified for the study. The mean age of the patients was 45.36±16.15 years. The study used a self-designed sociodemographic questionnaire as well as Polish adaptations of standardized questionnaires: FSFI (Female Sexual Function Index), ER89-R12 (Ego-Resiliency Scale) and WHOQOL-Bref (The World Health Organization Quality of Life). As part of statistical procedures, descriptive statistics of variables were estimated. Spearman’s rank correlation coefficient was also used. Results Positive and moderate correlations were found between ego-resiliency (p=0.498), its optimal regulation subscale (p=0.497) and sexual functioning. A positive relationship also connected the assessment of the sexual functioning of the respondents with the social domain of their quality of life (p=0.498). Conclusions Ego-resiliency, including optimal regulation may be important factors for improving the self-assessment of sexual functioning among women suffering from affective disorders. The assessment of sexual functioning may also play an important role in relation to the social sphere of quality of life. Disclosure No.

(103) Predictors of Sexual Arousal in Women: A Secondary Data Analysis

Abstract Introduction Low sexual desire and lack of arousal are highly prevalent sexual problems in women. Despite high prevalence, sexual arousal difficulties have not been a priority focus of assessment and treatment of women at midlife. Relationship satisfaction and importance of sex are key to healthy sexual function at midlife. Psychosocial variables, including relationship satisfaction, communication with one’s partner, and importance of sex are associated with overall sexual satisfaction. Rosemary Basson’s intimacy-based model of female sexual response incorporates the need for intimacy and emotional satisfaction and acknowledges the impact of sexual arousal on responsive sexual desire and physical satisfaction. Better understanding of the impacts of emotional satisfaction in female sexual response and function is needed to direct improvements in assessment and treatment of sexual problems in midlife women. Objective To explore the associations of emotional satisfaction, sexual desire, importance of sex and ability to climax with frequency of arousal during sexual activity in menopausal women. Methods A secondary data analysis of the Study of Women’s Health Across the Nation (SWAN), USA, 2006-2008 (Visit 10) dataset was completed utilizing multiple linear regression to assess variables associated with frequency of sexual arousal in menopausal women. A total of 2,245 women between the ages of 51-63 years were included. The mean age was 56 years. Results Multiple linear regression results demonstrated that 19% of the variability in frequency of arousal in our study population was explained by emotional satisfaction (F (1,1163) = 271.039, p<.001). Further analyses revealed that 56% of the variability in frequency of arousal was explained by emotional satisfaction, sexual desire, importance of sex, and ability to climax (F (6,1014) = 215.461, p<.001). Conclusions Interventions designed to enhance emotional satisfaction with a partner may positively impact female sexual arousal. Emotional satisfaction with a partner is strongly associated with frequency of sexual arousal in menopausal women. Additionally, sexual desire, importance of sex and ability to climax are also strongly associated with frequency of sexual arousal. These findings are clinically relevant and reinforce the need for biopsychosocial assessment of sexuality and sexual function, as well as thorough assessment of dyadic and interpersonal factors. Further research is needed to better understand the impacts and interplay of psychosocial variables on female sexual response and function. Disclosure No.

(001) Top 50 Most Cited Articles About Female Sexual Dysfunction: A Bibliometric Analysis

Abstract Introduction Female sexual dysfunction (FSD), as recognized by the American Foundation for Urologic Disease, consists of low libido, problems with sexual arousal, inability to achieve orgasm, and dyspareunia. Sexual function is an important aspect of life for many women and is closely correlated with overall well-being. This dysfunction is often underrepresented in the academic space when compared to male sexual disorders, such as erectile dysfunction (ED). As FSD spans the fields of Urology, Gynecology, Psychology, and Endocrinology, bibliometric analyses are an important resource to understand the vast body of knowledge by highlighting landmark papers. Objective The objective of this study was to identify key articles about FSD using citation number and bibliometric analysis to facilitate future scholarly efforts into more research on FSD through a multidisciplinary perspective. Methods We searched for articles in the Web of Science Core Collection between 1900 to 2023 using terms specific to FSD. We identified relevant FSD articles and selected the top 50 most cited (T50). A bibliometric analysis was performed to collect and analyze data about title, authorship, publication year, citation number, journal and impact factor, country and institution, study type, citation index, specialty, and conflict of interest. Citation index was calculated as citations/years since publication to determine citations per year. Results 6,858 results were identified and T50 articles were published between 1997-2014 in 12 countries, across 32 different institutions, and in 20 journals. Most articles were published in 2007 while most citations occurred in articles published in 1999. The most cited article (4020 citations), The Female Sexual Function Index (FSFI): A multidimensional self-report instrument for the assessment of female sexual function by R. Rosen, also had the most citations per year (174.78 citation/year). The USA produced the most articles, specifically through University of Medicine and Dentistry of New Jersey. Journal of Sexual Medicine published the most articles. The mean number of citations per article was 351.64. Observational studies were most common while reviews were least common. Less than half were sponsored. Of all the specialties that FSD spans, most articles were published in Urology & Nephrology, then Psychology, then Obstetrics and Gynecology. Research about FSD has been less impactful and influential than research about male sexual dysfunction, which is evidenced in the lower median citation number (209.00 vs. 364.00 citations, respectively) and total number of articles in WoS (6,858 vs 24,941 articles, respectively) for FSD compared to ED. Since FSD and male sexual dysfunction have about equal prevalence, this disparity may be due to the reluctance of female patients to discuss sexual issues due to shame. Conclusions This is the first bibliometric analysis to identify the characteristics of T50 articles in FSD. This list emphasizes the lack of attention that FSD has had in medical research and underscores the obvious discrepancy between research into FSD and male sexual dysfunction. We hope to provide healthcare professionals with a valuable resource to understand the vast body of knowledge and trajectory of FSD to guide future research and education. Disclosure No.

P500 Systematic review of sexual function measurement instruments in the context of pelvic and perineal surgery for Inflammatory Bowel Disease

Abstract Background Sexual dysfunction after Inflammatory Bowel Disease (IBD), pelvic and perineal surgery is common but poorly discussed, investigated and treated in the peri-operative period. There remains no standardised measurement tool to assess sexual function in routine use for patients undergoing benign pelvic colorectal surgery. The necessity for open dialogue regarding sexual dysfunction was evidenced in a patient-led study conducted by Dames et al. Our primary objective was to undertake a systematic review of sexual function measurement instruments, to identify the need for a novel sexual function patient-reported outcome measure (sex-PROM) that may be used in the context of pelvic and perineal surgery for IBD e.g. fistula surgery, defunctioning ostomy formation, ileo-anal pouch formation and proctectomy. Methods We performed a systematic review according to Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) criteria (Prospero registration: CRD42023403396). Embase, Medline and PubMed Databases were searched for previously validated patient-reported outcome measures that could be used in the assessment of sexual function. These instruments were evaluated for their psychometric properties, in addition to their overall quality, utility and suitability in the context of IBD and other benign surgery. A global rating was attained according to COSMIN criteria. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) checklist was applied to evaluate the quality of evidence. In addition, patient involvement in instrument development was assessed. Results Some 2331 articles were screened, 305 full-text studies were assessed for eligibility and 56 measurement instruments were identified and evaluated. All studies showed limited psychometric validation. The Female Sexual Function Index and the International Index of Erectile Function were among the highest-scoring instruments, however conveyed significant limitations, including an anatomical focus, limited exploration of quality of life and relationship satisfaction, and a lack of significant patient involvement in their development. All identified measurement instruments carried limited specific clinical utility for patients after IBD surgery. Conclusion Sexual dysfunction after pelvic surgery for inflammatory bowel pathology is multi-factorial. It can result from anatomical nerve damage but can also occur secondary to the psychological impact of altered body image, sexual self-esteem, and relationships and intimacy. We recommend the development of a novel patient-centred sexual function measurement instrument that may be used after benign pelvic/perineal colorectal surgery to be used in the clinical and research settings.

The effect of drug holidays on sexual dysfunction in men treated with selective serotonin reuptake inhibitors (SSRIs) other than fluoxetine: an 8-week open-label randomized clinical trial

IntroductionSelective serotonin reuptake inhibitors (SSRIs) are widely used for the treatment of various mental disorders. Sexual dysfunction is one of the most common side effects of SSRIs, and often leads to poor adherence and treatment discontinuation. While several strategies have been employed to manage SSRI-induced sexual dysfunction, drug holidays has not been extensively studied for this purpose. This clinical trial aims to assess the effect of drug holidays on sexual dysfunction in married men under treatment with SSRIs other than fluoxetine (as its long half-life makes drug holidays ineffective).MethodsThis 8-week double-center, randomized, open-label, controlled trial was conducted in the outpatient clinics of Iran Psychiatric Hospital and Tehran Institute of Psychiatry, from January 2022 to March 2023. We included married men aged between18 and 50 years who had experienced sexual dysfunction during treatment with SSRIs, other than fluoxetine. The Male Sexual Health Questionnaire (MSHQ) and the 28-Question General Health Questionnaire (GHQ-28) were used for the assessment of sexual function and mental health status. The drug holidays group was instructed not to take their medications on the weekends. The control group was asked to continue their regular medication regimen without any changes. Both groups were assessed at baseline, and weeks 4 and 8.ResultsSixty-three patients were included and randomly assigned to the drug holidays group (N = 32) or the control group (N = 31). Fifty patients (25 in each group) completed the trial. Drug holidays significantly improved erection, ejaculation, satisfaction, and the overall sexual health of the participants (P < 0.001). No significant change was observed in their mental health status. No major side effects were recorded.ConclusionsDrug holidays significantly improved the MSHQ scores in ‘erection’, ‘ejaculation’, ‘satisfaction’ and ‘total’ in married men with sexual dysfunction induced by SSRIs, other than fluoxetine, without causing any significant changes in their mental health status. Further research is needed to reach a certain conclusion.Trial registrationThe trial was registered at the Iranian Registry of Clinical Trials on 2021.10.25 (www.irct.ir; IRCT ID: IRCT20170123032145N6) before the trial.

Sexual and Reproductive Health Care after Gonadotoxic Treatment in Females at a Tertiary Pediatric Hospital

Study ObjectivesRecommendations from the Children's Oncology Group Long-Term Follow-Up (COG-LTFU) Guidelines for Survivors of Childhood, Adolescent, and Young Adult Cancer emphasize the importance of reproductive health care, yet little is known regarding adherence to these recommendations and non-fertility-related sexual and reproductive health (SRH) outcomes. MethodsFollow-up of outcomes on the basis of the COG-LTFU guidelines was assessed in female patients who underwent fertility preservation consultation before gonadotoxic therapy between 2016 and 2022 at a single institution and were at least 6 months from treatment completion. ResultsWe included 140 patients, with a mean time of 2.7 years from treatment completion. Eighty-six patients were 12 years old or older, of whom sexual activity was recorded in 59 (68.7%), and 12 of 31 (38.7%) sexually active patients underwent sexual function assessment. The 57 (66.3%) patients at high risk of premature ovarian insufficiency (POI) at diagnosis were more likely than minimal-risk counterparts (29, 33.7%) to have abnormal uterine bleeding (42.1% vs 17.2%, P = .03), to be diagnosed with POI (29.8% vs 0%, P = .01), and to have sexual activity recorded (77.2% vs 51.7%, P = .03). Of 17 patients with POI, 82.4% were on hormone replacement therapy, and 58.8% had undergone bone mineral density testing. ConclusionThis study adds to the limited literature regarding non-fertility-related SRH outcomes after gonadotoxic therapy and illustrates opportunities to improve adherence to the COG-LTFU guidelines. Increased attention to SRH guidelines may increase detection and treatment of SRH conditions, improving the health and quality of life of female cancer survivors.

War-Time Stress and Sexual Well-Being in Israel

Objective This study explored the relationship between war-related stressors and sexual well-being among a civilian population during the 2023 Israel–Hamas War, emphasizing a comprehensive assessment of sexual satisfaction, function, and distress. We aimed to investigate how direct exposure, media exposure, and acute stress symptoms during the war contribute to various dimensions of sexual well-being using a quasi-longitudinal online survey method. Methods An online survey with a convenience sample of 1033 Israeli adults, utilizing measures of direct and media exposure to war stress, acute stress symptoms, and various aspects of sexual well-being, both pre-war and present was distributed. Data analysis involved Pearson correlations and hierarchical regression. Results There were significant associations between stress-related variables and sexual well-being, highlighting the differential contribution of direct exposure, media exposure, and acute stress symptoms. Direct exposure to stress was uniquely associated with sexual dysfunction, while media exposure and acute stress symptoms contributed significantly to predicting various aspects of sexual well-being. Conclusions Recognizing the multifaceted impact of stress during wartime on sexual well-being is crucial for developing comprehensive mental health interventions that address individual and societal factors. This study contributes valuable insights into the relationships between stress-related variables and sexual well-being during wartime, emphasizing the need for holistic approaches in addressing the intimate challenges individuals face during times of conflict.

Assessment of sexual function before medically assisted procreation: A mixed-methods study among a sample of infertile women and men cared for in a fertility center

A mixed-methods study was conducted to investigate sexual function among infertile patients undergoing medically assisted procreation for the first time. The study employed an interview and content analysis approach, involving 45 infertile patients prior to their medically assisted procreation procedures. The findings revealed that infertile patients are a group at risk for sexual distress. Furthermore, patients with sexual dysfunctions exhibited lower levels of sexual activity, potentially diminishing their chances of achieving pregnancy. Participants faced challenges in openly discussing their sexual problems and demonstrated limited knowledge of sexual functioning. Among infertile women with sexual dysfunctions, the most frequently reported issues were sexual interest/arousal disorders, with a majority also experiencing pain during sexual activity and associated genital-pelvic pain disorders. In contrast, delayed ejaculation and erectile disorder seem to be more common in infertile men, while sexual desire and excitement disorders and premature ejaculation disorders appeared to be as common as in the general population. While the relationship between infertility and sexuality is complex, our study suggests that sexual dysfunctions or the absence of sexual activity may explain infertility. Therefore, it is imperative for clinicians to evaluate the sexual functioning of both men and women undergoing medically assisted procreation treatment, to increase their chances of procreation and offer them sexological support if needed. Future studies should expand their scope to include a larger sample size and delve into the potential etiological factors associated with sexual dysfunctions.

Feasibility and safety of hybrid transvaginal natural orifice transluminal endoscopic surgery for colon cancer: Protocol for a multicenter, single-arm, phase II trial (vNOTESCA)

IntroductionIt has been a decade since the first patient with colon cancer underwent colectomy by hybrid transvaginal natural orifice transluminal endoscopic surgery (hvNOTES). However, the efficacy and safety of this procedure is not well established. MethodsThis study is an open-label, multicenter, single-arm, phase 2 trial undertaken at six centers in China. Female patients aged over 18 years and below 80 years old with an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1, with pathologically proven, resectable, cT1-3N0-2M0 disease who have previously untreated colon cancer are eligible for inclusion. The primary endpoint is a composite of major intraoperative and postoperative complications (greater than grade III, the Common Terminology Criteria for Adverse Events [CTCAE], version 5.0). Secondary endpoints include conversion to laparoscopic or open surgery, postoperative concentration of C-Reactive Protein and procalcitonine, complete pathological assessment of complete mesocolic excision specimens, postoperative pain, amount of narcotic pain medication administered, time to first flatus after surgery, number of harvested lymph nodes, R0 resection rate, length of hospital stay, sexual function assessment, quality of recovery, satisfaction with surgical scars, quality of life, postoperative recurrence patterns, relapse-free survival, and overall survival. Ethics and disseminationThe study was approved by the Research Ethics Committee, Renmin Hospital of Wuhan University, China, number: WDRY2022-K053. All patients will receive written information of the trial and provide informed consent before enrollment. The results of this trial will be disseminated in academic conferences and peer-reviewed medical journals.Trial registration number NCT04048421.

International Urogynecology consultation chapter 2 committee 3: the clinical evaluation of pelvic organ prolapse including investigations into associated morbidity/pelvic floor dysfunction

Introduction and hypothesisThis manuscript from Chapter 2 of the International Urogynecology Consultation (IUC) on Pelvic Organ Prolapse (POP) reviews the literature involving the clinical evaluation of a patient with POP and associated bladder and bowel dysfunction.MethodsAn international group of 11 clinicians performed a search of the literature using pre-specified search MESH terms in PubMed and Embase databases (January 2000 to August 2020). Publications were eliminated if not relevant to the clinical evaluation of patients or did not include clear definitions of POP. The titles and abstracts were reviewed using the Covidence database to determine whether they met the inclusion criteria. The manuscripts were reviewed for suitability using the Specialist Unit for Review Evidence checklists. The data from full-text manuscripts were extracted and then reviewed.ResultsThe search strategy found 11,242 abstracts, of which 220 articles were used to inform this narrative review. The main themes of this manuscript were the clinical examination, and the evaluation of comorbid conditions including the urinary tract (LUTS), gastrointestinal tract (GIT), pain, and sexual function. The physical examination of patients with pelvic organ prolapse (POP) should include a reproducible method of describing and quantifying the degree of POP and only the Pelvic Organ Quantification (POP-Q) system or the Simplified Pelvic Organ Prolapse Quantification (S-POP) system have enough reproducibility to be recommended. POP examination should be done with an empty bladder and patients can be supine but should be upright if the prolapse cannot be reproduced. No other parameters of the examination aid in describing and quantifying POP. Post-void residual urine volume >100 ml is commonly used to assess for voiding difficulty. Prolapse reduction can be used to predict the possibility of postoperative persistence of voiding difficulty. There is no benefit of urodynamic testing for assessment of detrusor overactivity as it does not change the management. In women with POP and stress urinary incontinence (SUI), the cough stress test should be performed with a bladder volume of at least 200 ml and with the prolapse reduced either with a speculum or by a pessary. The urodynamic assessment only changes management when SUI and voiding dysfunction co-exist. Demonstration of preoperative occult SUI has a positive predictive value for de novo SUI of 40% but most useful is its absence, which has a negative predictive value of 91%. The routine addition of radiographic or physiological testing of the GIT currently has no additional value for a physical examination. In subjects with GIT symptoms further radiological but not physiological testing appears to aid in diagnosing enteroceles, sigmoidoceles, and intussusception, but there are no data on how this affects outcomes. There were no articles in the search on the evaluation of the co-morbid conditions of pain or sexual dysfunction in women with POP.ConclusionsThe clinical pelvic examination remains the central tool for evaluation of POP and a system such as the POP-Q or S-POP should be used to describe and quantify. The value of investigation for urinary tract dysfunction was discussed and findings presented. The routine addition of GI radiographic or physiological testing is currently not recommended. There are no data on the role of the routine assessment of pain or sexual function, and this area needs more study. Imaging studies alone cannot replace clinical examination for the assessment of POP.

Investigation of the relationship between sexual and pelvic floor dysfunction in female patients with fibromyalgia syndrome

ABSTRACT The aim of the study was to examine the relationship between pelvic floor functions and sexual functions in women with fibromyalgia. The study included 204 women with fibromyalgia, mean aged 43.43 ± 8.61 years. All patients who met the inclusion criteria and applied to the rheumatology outpatient clinic were included in the study. The study was conducted between September 2020 and June 2022. The Female Sexual Function Scale (FSFI) was used to evaluate sexual function, Pelvic Floor Distress Scale-20 (PFDI-20), Pelvic Floor Impact Questionnaire (PFIQ-7) and Pelvic Organ Prolapse/Incontinence Sexual Function Assessment (PSIQ-12) were used to evaluate pelvic floor problems. The relationship between sexual dysfunction and other parameters was analyzed using Spearman correlation analysis. There was a weak negative correlation between many sub-parameters of FSFI and scores of PFDI-20, PFIQ-7, PSIQ-12 (r:−0.165–−0.377 p: 0.02–0.00). According to the results of this study, sexual dysfunction was negatively affected by pelvic floor dysfunction and symptoms related to bladder, bowel, and pelvic organs in women with fibromyalgia. These results may suggest that sexual function and pelvic floor problems in women with fibromyalgia should be considered together and an approach should be planned for such problems in treatment programs.

Sexual function assessment in patients with SAPHO syndrome: a cross-sectional study

IntroductionSAPHO syndrome is a group of special syndromes characterized by synovitis, acne, pustulosis, hyperostosis and osteitis. Skin lesions and joint damage are the main clinical manifestations. Among them, females mostly present with palm toe pustulosis, while males have severe acne as the main external manifestation. The bone and joint damage characterized by bone hypertrophy and osteitis is the core manifestation of SAPHO and affects all parts of the body. SAPHO syndrome causes great physical and mental suffering to patients, and it also brings a huge financial burden to the family. The purpose of this study is to explore the impact of SAPHO on the quality of sexual life of patients.MethodsWe screened and included 249 SAPHO patients (169 women and 80 men) from Peking Union Medical College Hospital (Beijing, China). First, we recorded the basic situation of the patient through questionnaires (including gender, age, SAPHO duration, BMI, smoking, drinking, marital status, educational level, occupational status and work status.). Then, the patient needed to fill in the Short Form-36 quality of life questionnaire (SF-36 QoL) to record the quality of life. For Sexual dysfunction (SD), female patients needed to fill in the Female Sexual Function Index (FSFI) to assess the quality of sexual life; while the International Index of Erectile Function (IIEF) was used to assess the SD of male patients. At the same time, we used self-esteem and relationship questionnaire (SEAR) to analyze the psychological state of SAPHO patients. Finally, we performed statistical analysis on the data obtained, and then explored the connection between SAPHO and SD.ResultsIn this cross-sectional study, a total of 249 patients completed the questionnaire and constituted the study population. We found that among 169 female patients, 124 patients had FSD (73.4%); while 45 patients did not have FSD (26.6%); and among 80 male patients, 45 (56.3%) had ED; However, 35 patients did not have ED (43.7%). The results of the quality of life and mental state assessment showed that female patients with SD showed lower scores in terms of mental state. Among all male participants, we found no significant difference in quality of life and mental state among participants with or without SD. In addition, there was no significant difference in the duration of SAPHO between female and male participants with or without SD.ConclusionThis study is the first to evaluate the SD of SAPHO patients. The incidence of SD in female SAPHO patients is higher than that in male patients; the cause of female SD may be mainly psychological factors. These results prove that it is particularly important to focus on regulating their psychological state while diagnosing and treating SAPHO patients in clinical practice.

P-597 Sexual function in women with Polycystic Ovary Syndrome: an updated systematic review and meta-analysis

Abstract Study question To present a comprehensive review of the evidence on sexual function in women with polycystic ovary syndrome (PCOS) compared to women without PCOS. Summary answer Women with PCOS report lower sexual function and sexual satisfaction compared to women without PCOS. What is known already Research focusing on the psychosocial aspects of PCOS or sexual function is fairly recent and data are limited. Data are often contradicting with studies reporting no differences in sexual function in women with PCOS and studies reporting more sexual problems in women with PCOS. A meta-analysis from our group in 2018 reported lower sexual function and lower sexual satisfaction in women with PCOS compared to women without PCOS. Study design, size, duration A systematic review and meta-analysis of the published literature was conducted. Participants/materials, setting, methods Eight databases were searched from inception to August 24th 2022. Two authors independently screened articles based on pre-defined inclusion (e.g. adequate PCOS diagnosis) and exclusion criteria (e.g. hyperandrogenism caused by other diseases),assessed their quality and graded the certainty of the evidence. Review Manager was used to perform all analyses. Main results and the role of chance Twenty-seven articles were included, of which 23 used questionnaires and four used visual analogue scales (VAS). Pooling FSFI scores showed worse sexual function across most domains in women with PCOS, including arousal (weighted mean difference [WMD]== -0.37, P= 0.002), lubrication (WMD= -0.53, P &amp;lt;0.001), and orgasm (WMD= -0.32, P &amp;lt;0.001). Total sexual function (WMD= -2.47, P &amp;lt;0.001) and sexual satisfaction (WMD= -0.42, P &amp;lt;0.001) were also significantly lower. Selection on fertility status did not change the direction of results. VAS results were not pooled in meta-analysis due to using the same control group across the included studies. However, effects within individual VAS studies demonstrated the negative impact of excess body hair on sexuality, lower sexual attractiveness and lower sexual satisfaction in women with PCOS compared with controls, with no differences in the perceived importance of a satisfying sex life. Certainty of evidence was graded low for all included studies. Conclusion: Women with PCOS place similar importance on sexual satisfaction as women without PCOS, yet have lower sexual function and sexual satisfaction. Distress was not assessed. Sexual function assessment, and, psychosexual counseling should be considered as part of standard care in women with PCOS. Limitations, reasons for caution Sexual distress was not assessed. Hence, prevalence of sexual dysfunction which requires both lower sexual function and sexual distress, remains unkown. Certainty of evidence was graded low for all included studies. Wider implications of the findings Sexual function assessment, and, psychosexual counseling should be considered as part of standard care in women with PCOS. Findings from this review have directly informed the international PCOS guideline on sexual function assessment and management. Trial registration number NA

(422) Sexual Function of 18-50 Year Old Women With Normal Weight, Overweight and Obese

Abstract Introduction Female sexual dysfunctions (FSD) can influence mental and physical health, causing limitations in the ability to respond to or enjoy sexual pleasure. Obesity is related to diseases such as type II diabetes, heart disease and some types of cancer, for example, but investigations into its relationship with problems related to sexuality have not yet been well defined. of FSD, but the evidence found, including in this study, is still contradictory Objective To investigate and compare the sexual function of, obese, overweight and normal weight 18 to 50 year old women. Materials and methods This study was carried out between June 2020 and October 2021, it is observational and comparative. A questionnaire link was sent via social networks, social networks like facebook, whatsapp and also email, to women between 18 and 50 years old, sexually active in the last four weeks before answering the questionnaire, after having agreed to participate in the study and signed the consent form, they filled out a form with demographic data and the questionnaire Female Sexual Function Index (FSFI), postmenopausal women were excluded from the survey. This study was approved by the ethics and research committee under opinion number: 4.229.411. Results 325 women participated in the study, with a mean age of 28 years, where 186 (49.60%) were classified according to the body mass index (BMI) with normal weight, 109 with overweight (29.07%) and 80 as obese (21.33% most were married or in a stable relationship (50.13%) or single (42.93%). In the total score of the FSFI questionnaire (median), non-obese participants obtained 16.4 points, overweight women scored 16.4 points and obese women scored 17.1 points, it was not statistically significant when comparing the FSD according to the BMI classification (p=0.887). Conclusions There was no difference in the assessment of sexual function between normal weight, overweight and obese women aged 18 and 50 years. Disclosure No