General Sexual Satisfaction Research Articles

A New Approach to the Assessment of Erectile Dysfunction Based on Vasomotion Monitored by the Flow-Mediated Skin Fluorescence (FMSF) Technique-A Preliminary Study.

Background: Erectile dysfunction (ED) most often has vascular etiology and usually is the earliest symptom of vascular dysfunction. The aim of this study was to evaluate vascular dysfunction with the use of the Flow-Mediated Skin Fluorescence (FMSF) technique in men with and without ED. Methods: Included were 39 men (median age 53) with ED and 40 men (median age 41.5) without ED. Medical interview, physical examination, and anthropometrical measurements were performed for all participants. The serum total testosterone, LH, and SHBG determinations were performed in patients with ED, and the Free Testosterone Index (FTI) was calculated. The FMSF technique was used to measure the microcirculatory oscillations at the baseline and to determine the flowmotion (FM) and vasomotion (VM) parameters. The Normoxia Oscillatory Index (NOI) was calculated, which represents the contribution of the endothelial (ENDO) and neurogenic (NEURO) oscillations relative to all oscillations detected at low-frequency intervals (<0.15 Hz): NOI = (ENDO + NEURO)/(ENDO + NEURO + VM). Results: In men with ED were found significantly lower FM and VM parameters, but the NOI was significantly higher in comparison to men without ED. VM and FM correlated significantly positively with erectile function, orgasmic function, and general sexual satisfaction in the whole group and the FTI in the ED group. The thresholds of 53.5 FM (AUC = 0.7) and 8.4 VM (AUC = 0.7) were predictive values for discriminating men with ED. Conclusions: It was shown that the FMSF diagnostic technique may be helpful in the early diagnosis of microcirculation dysfunction due to impaired vasomotion caused by decreased testosterone activity.

(550) Sexual Arousal in Premenopausal Breast Cancer Patients on Antihormonal Treatment

Abstract Introduction Breast Cancer is the most common cancer in women and is associated with a severe impairment of general life quality, body-related self-esteem and sexual function and satisfaction. Sexual satisfaction has been shown to have a significant impact on general health and well-being. Nevertheless, research aiming at understanding sexual function in breast cancer patients is very scarce, no vaginal plethysmography data measuring vaginal blood flow on breast cancer patients currently exists. A better understanding of the interplay of the physiological sexual response and subjective sexual arousal in breast cancer survivors could help develop new strategies for treating this specific target group and contributing to improve their health and life quality. Objective The aim of this study is to collect preliminary data on psychophysiological aspects of the sex.al function of premenopausal breast cancer patients on antihormonal therapy and compare them with healthy controls. Specifically, we hypothesized that (1) genital arousal following visual stimuli is less in breast cancer patients than in healthy controls, (2) genital arousal following tactile stimuli is the same in breast cancer patients and healthy controls, (3) genital arousal following tactile stimuli is greater than following visual stimuli in both breast cancer patients and healthy controls. Serum sex hormone levels and self-reported sexual function are analyzed as moderators. Methods Breast cancer survivors (n=60) treated with antihormonal therapy for breast cancer, who are in complete remission for at least one year and healthy controls (n=20), undergo vaginal plethysmography while sexual stimuli (visual, tactile, visual + tactile) are presented. Subjective arousal and genital arousal are recorded continuously. Hormone serum levels, self-reported sexual function, sexual self-esteem, and quality of life measures are analyzed as potential moderators. Results Intraindividual differences (subjective and genital arousal) and interindividual differences (breast cancer patients, healthy controls) are analyzed based on a 2-level mixed effect models for each outcome variable. Pearson correlations are calculated to assess the relationships between subjective arousal and genital arousal for each group. Conclusions This study is the first to provide data on genital and subjective arousal in premenopausal women with breast cancer on antihormonal treatment compared to healthy controls and explore the data in connection with serum hormone levels. Overall, it will give a further insight in sexual function of breast cancer survivors to reveal targets to improve sexual function in this target group. Disclosure Yes, this is sponsored by industry/sponsor: WOW Tech™ Group. Clarification Industry funding only - investigator initiated and executed study.

The Longer it is, the Closer One Feels: Perception of Emotional Closeness to the Partner, Relationship Duration, Sexual Activity, and Satisfaction in Married and Cohabiting Persons in Norway

This study explores the connection between relationship duration and feelings of closeness in Norwegian men and women, and the association with sexual satisfaction and activity. A sample of 4160 Norwegians aged 18–89 years was enrolled from a randomly selected web panel of 11,685 Norwegians. This study focused on participants who were married or cohabiting (1432 men, 1207 women). Closeness was the highest for men and women who had been with their partner for 0−6 years. However, among those who had been with their partner for 31 years or longer, men felt closer to their partners than women. Irrespective of relationship duration, the most important factor for both men and women’s perceived closeness with their partner was general sexual satisfaction. Among men who had lived with their partner for 7−20 years and 31 years or longer, having been monogamous in life was significantly associated with “inclusion of others in the self” (IOS). Further, closeness was associated with higher intercourse frequency, lower masturbation frequency, and satisfaction with genital appearance in men who had been with their partners for 31 years or more. Intercourse frequency was significantly associated with IOS in women who had been with their partner for 0−6 years. Furthermore, in women who had been with their partner for 31 years or more, satisfaction with their own weight was important for IOS. In conclusion, men and women reported similar degrees and patterns of IOS up to the point where they had been in their relationship for more than 30 years. Thereafter, women reported feeling less close to their partners, while men’s feelings of closeness increased. This may be related to physiological, psychological, and social changes in the lives of aging men and women.

Gender Affirming Medical Treatment Desire and Treatment Motives in Binary and Non-Binary Transgender Individuals

BackgroundIt is currently unknown whether there are differences in desire for gender affirming medical treatment (GAMT) between binary and non-binary transgender individuals, although the latter seek treatment less prevalently. AimTo investigate differences between binary and non-binary individuals on received GAMT, desire for GAMT, and motives for (not) wanting GAMT, and to explore the association between having an unfulfilled treatment desire and general and sexual well-being. MethodsWe conducted an online questionnaire in a community sample of 125 transgender men, 72 transgender women, and 62 non-binary transgender individuals (age: M = 30.4, SD = 11.31, range 18-69). Outcome measuresUndergone GAMT, GAMT desire, motives for (not) wanting (further) GAMT, Utrecht Gender Dysphoria Scale, Satisfaction With Life Scale, Hospital Anxiety and Depression Scale, Global Measure of Sexual Satisfaction, transgender-specific body image worries, and sexual self-concept discrepancies. ResultsBinary transgender participants reported having undergone more GAMT procedures than non-binary transgender participants (P < .001 for both gender affirming hormone treatment (GAHT) and gender affirming surgery (GAS)). While binary participants reported a stronger desire for GAHT compared to non-binary participants (X2(1, N = 93) = 32.63, P < .001), the groups did not differ in their desire for GAS (X2(1, N = 247) = 0.68, P = .411). Binary and non-binary participants reported similar reasons for wanting treatment, mostly related to body and/or gender incongruence and gender affirmation. In terms of not wanting treatment, the non-binary group reported their gender identity as the most important reason, while the binary group mostly mentioned possible medical complications. The majority of both groups had an unfulfilled treatment desire (69% of binary participants and 64.5% of non-binary participants), which was related to lower levels of general life satisfaction (P < .001) and sexual satisfaction (P = .005), more anxiety (P = .006) and transgender-specific body image worries (P < .001), and larger sexual self-concept discrepancies (P < .001 for actual and/or ideal, P < .001 for actual and/or ought). Clinical implicationsSystemic barriers to GAMT (especially GAS) should be removed not only for binary but also for non-binary identifying transgender individuals to decrease the discrepancy between treatment desire and actually seeking treatment. Strengths & limitationsThis study was the first to systematically investigate differences in treatment desire motives between binary and non-binary transgender individuals, while also showing the possible negative consequences of an unfulfilled treatment desire. Given the online character of the study, results may not generalize to the broader transgender community. ConclusionSimilarly to binary transgender individuals, many non-binary transgender individuals have a desire for GAMT, and not being able to receive GAMT has a negative effect on their mental and sexual health. Further efforts should be made to make GAMT accessible for all transgender individuals, regardless of gender identity.Kennis M, Duecker F, T'Sjoen G, et al. Gender Affirming Medical Treatment Desire and Treatment Motives in Binary and Non-Binary Transgender Individuals. J Sex Med 2022;19:1173–1184.

Satisfaction with Sex Life Scale: New Psychometric Evidence in a Portuguese Population

Introduction: In recent years, greater attention has been paid to research on sexual satisfaction because of its association with general well-being and increased interest in sexual and public health issues. Objectives: The objective of this study was to evaluate the psychometric properties of the Satisfaction with Sex Life Scale (SWSLS). Methods: 2,154 Portuguese individuals (M = 34.67 years, SD = 17.18) participated. Confirmatory factor analysis (CFA) and item response theory (IRT) were used. Specifically, the internal structure, reliability and factor invariance of the SWSLS were evaluated by sex and age, as well as the characteristics and performance of the items based on the IRT analysis. Results: The SWSLS Confirmatory Factor Analysis confirmed that a one-dimensional model fit the data well, both for the total sample and for each sex and age group. Furthermore, the SWSLS has adequate reliability for internal consistency. Factor invariance across sex and age was supported by confirmatory multigroup factor analysis. The graduated response model showed a good fit for the one-dimensional model, while the item and test information curves indicated that the SWSLS is more informative to identify high levels of sexual satisfaction. Conclusion: The SWSLS has adequate psychometric properties to measure general sexual satisfaction in the Portuguese population regardless of age and sex.

Single and Multiple Orgasm Experience Among Women in Heterosexual Partnerships. Results of the German Health and Sexuality Survey (GeSiD)

Orgasm occurrence plays an important role in general sexual satisfaction for women. Until now, only few studies have focused on examining a broad spectrum of sexuality- and relationship-specific factors associated with orgasm in heterosexual women currently in a long-term relationship or on differences between the overall experience of orgasm and multiple orgasms. The present study aims to understand how various sexuality- and relationship-associated factors are related to experiencing partnered orgasm among heterosexual women having stable relationships in Germany. Moreover, the study aims to differentiate between the overall experience of orgasm and the experience of multiple orgasms and shed light on their impact on general sexual satisfaction. Within the nationwide representative survey GeSiD (German Health and Sexuality Survey), n=1,641 sexually active women aged between 18 and 75 years in heterosexual relationships reported their experience of orgasm during the latest sexual encounter. Data on the type of sexual practices, frequency of sexual activity and of masturbation, relationship satisfaction, feelings of love, closeness, and general sexual satisfaction were analyzed. The overall experience of orgasm, the experience of multiple orgasms, and associations between experiencing orgasm and sexual satisfaction. Frequency of sexual activity, relationship satisfaction, feelings of love and closeness were moderately to strongly positively correlated with each other and each showed positive associations with the likelihood of orgasm. Greater number of sexual practices and frequency of sexual activity were associated with an increased likelihood of experiencing multiple orgasms, which in turn was correlated with higher sexual satisfaction. In clinical and therapeutic work with women who have difficulty achieving orgasm, central issues should be the perceived relationship quality as well as regular sexual activity with the partner. The present population-representative study is the first in Germany to identify significant factors associated with the experience of orgasm among heterosexual women in relationships. Further studies ought to include the frequency of orgasms in partnered sex over a longer period of time as well as the experience of orgasm during masturbation. The experience of orgasm for women is related to a variety of complex interpersonal mechanisms and to be associated with sexual satisfaction. Cerwenka S, Dekker A, Pietras L, et al. Single and Multiple Orgasm Experience Among Women in Heterosexual Partnerships. Results of the German Health and Sexuality Survey (GeSiD). J Sex Med 2021;18:2028-2038.

Development and Validation of the Couple Sexual Satisfaction Scale for HIV and Sexual Health Research.

Sexual satisfaction is an important dimension of relationship quality with implications for sexual and reproductive health (SRH), and HIV prevention, care, and treatment. We developed and validated the Couple Sexual Satisfaction Scale (CSSS) with heterosexual couples in sub-Saharan Africa.Using data from qualitative interviews with 94 partnered women and men in Swaziland and Malawi, we generated a 22-item scale and administered it to 211 couples with at least one partner living with HIV in Malawi. We performed an exploratory factor analysis (EFA) to identify and confirmatory factor analysis (CFA) to test the factor structure. To assess validity, we tested for associations between the CSSS and relationship quality, consistent condom use, and intimate partner violence (IPV) using generalized estimating equations. The EFA yielded two factors, general sexual satisfaction (13-item CSSS-Gen subscale, e.g., "I am satisfied with the sweetness of sex in our relationship") and HIV-specific sexual satisfaction (4-item CSSS-HIV subscale, e.g., "My appetite for sex has gone down due to HIV"), accounting for 78% of the shared variance. The CFA supported the two-factor solution: χ2(118) = 203.60; CFI = 0.909; SRMR = 0.057; RMSEA = 0.058. Participants with higher CSSS-Gen scores reported higher coital frequency and relationship quality (intimacy, trust, unity, equality, relationship satisfaction, commitment, partner social support), and less consistent condom use, physical IPV, and emotional IPV. Participants with higher CSSS-HIV scores reported higher coital frequency and relationship quality (trust, partner support), and less consistent condom use, and sexual IPV. The CSSS demonstrated good psychometric properties and provides new opportunities to study sexual reproductive health and HIV-related health behaviors among couples in sub-Saharan Africa.

Impact of COVID-19 Pandemic on the Sexual Function of Health Professionals From an Epicenter in Brazil.

IntroductionThe pandemic caused by the COVID-19 resulted in worldwide social isolation and leading to significant personal distress, particularly among health professionals on the front lines. Those factors' relevance and their impact on sexual function in this population have not yet been established.AimTo evaluate the impact of the pandemic on sexual function in healthcare professionals and medical students at a reference center in the treatment of COVID-19 in Brazil.MethodsA cross-sectional analysis with online questionnaires about sexual function was sent to health professionals and medical students from the HC-FMUSP medical complex. The questionnaire evaluated Total Sexual and Masturbatory Frequency prior and during the pandemic, libido and sexual satisfaction changes with a detailed inquire about demographics and personal factors. An objective assessment of sexual function was also made using the validated sexual quotient questionnaires.Main Outcome MeasuresDifferences in intercourse frequency, libido, and overall sexual satisfaction, in a sample of healthcare professionals particularly vulnerable to the pandemic effects.ResultsA total of 1,314 responses were available with a mean age of 37 years. Worsening of sexual satisfaction was reported by 44.5% of the participants, with the following associated factors: Lower libido, missing Nightlife, Higher Masturbatory Frequency, and isolation from the partner. Remaning sexualy actively and having higher sexual frequency appear to decrease the chance of worsening sexual function. Worsening of Libido was reported by 37% and had several associated factors, including missing of Nightlife, older age, isolation from the partner among others. Being male and sexually active was associated with a smaller chance of reporting lower libido.ConclusionWe were able to observe a sharp drop in Libido and General Sexual Satisfaction. Although an increase in pornography consumption and masturbatory frequency did occur, these factors were not associated with greater sexual satisfaction. The impact of COVID-19 on this population's sexual health is not to be underestimated and should be further studied in the follow-up of the pandemic. Neto RP, Nascimento BCG, Carvalho dos Anjos Silva G, et al. Impact of COVID-19 Pandemic on the Sexual Function of Health Professionals From an Epicenter in Brazil. Sex Med 2021;9:100408

Sexual health after vaginoplasty: A systematic review.

Vaginoplasty is a gender-affirming procedure for transgender and gender diverse (TGD) patients who experience gender incongruence. This procedure reduces mental health concerns and enhances patients' quality of life. A systematic review investigating the sexual health outcomes of vaginoplasty has not been performed. To investigate sexual health after gender-affirming vaginoplasty for TGD patients. MEDLINE/PubMed, Embase, Scopus, and PsycINFO databases were searched, unrestricted by dates or study design. We included primary literature that incorporated TGD patients, reported sexual health outcomes after vaginoplasty intervention and were available in English. Outcomes included at least one of these sexual health parameters: sexual desire, arousal, sensation, activity, secretions, satisfaction, pleasure, orgasm, interferences, or aids. Our search yielded 140 studies with 12 different vaginoplasty surgical techniques and 6,953 patients. The majority of these studies were cross-section or retrospective cohort observational studies (66%). 17.4%-100% (median 79.7%) of patients (n=2,384) were able to orgasm postoperatively regardless of revision or primary vaginoplasty techniques. Female Sexual Function Index was the most used standardized questionnaire (17 studies, ranging from 16.9 to 28.6). 64%-98% (median 81%) of patients were satisfied with their general sexual satisfaction. The most common interference of sexual activity was dyspareunia. The heterogenous methods of measuring sexual outcomes reflect the difficulty in comparing single-center surgical outcomes, encouraging the need for a standardized and validated metric for reporting sexual health after vaginoplasty for TGD patients. The most common sexual health parameter reported is sexual activity while therapeutic aids and pleasure were the least reported parameters. Future studies are needed to improve and expand methods of measuring sexual health, including prospective studies, validated questionnaires, and inclusive metrics. Systematic review registration number: PROSPERO 01/01/2021: CRD42021224014.

Sexuality after stroke with hemiplegia. II. With special regard to partnership adjustment and to fulfilment

Aspects of sexual function, partnership responsiveness and fulfilment after stroke were, together with sexually performance orientated and stigmatic attitudes, investigated in 51 subjects. Erectile and orgastic spectatoring were frequent after stroke and were in the males significantly associated. Retarded ejaculation occurred for no males before but for 15% after the stroke. Marked decreases in different kinds of caressive behaviour were followed by discontentment and up to and about half the subjects felt that sexual partnership responsiveness had deteriorated. After the stroke the commonly occurring reduction in general sexual satisfaction was significantly associated with symptoms of increased sexual dysfunction, disturbed partnership responsiveness and reduced sexual fulfilment. The high prevalence of sexual maladjustment in stroke victims appears mostly to be psychogenic. Important precipitating factors are performance orientation and sexual stigmatism. Moreover, lack of sexual information and counselling may contribute to deterioration of partnership sexuality.

Sexual Intimacy in First-time Mothers: Associations with Sexual and Relationship Satisfaction Across Three Waves.

New mothers often experience significant declines in their sexual and relationship satisfaction compared to pre-pregnancy, yet there has been limited research examining protective factors. Intimacy-defined as the degree of disclosure and perceived partner responsiveness in a relationship-has been identified as contributing to the positive adjustment of individuals coping with novel life stressors, as well as to general sexual and relationship satisfaction. However, it is unknown whether sexual disclosure and/or partner responsiveness are reciprocally related to sexual and relationship satisfaction. This study examined the longitudinal associations between sexual intimacy-that is, intimacy in the context of sex-and sexual and relationship satisfaction in first-time mothers. First-time mothers (N = 171) completed online measures assessing disclosure and perceived partner responsiveness specific to their sexual relationship, sexual satisfaction, and relationship satisfaction at 3, 6, and 12months postpartum. Analyses were conducted with path analysis using a longitudinal panel mediation model. Greater perceived partner responsiveness in relation to sex at a prior wave predicted increases in both sexual and relationship satisfaction at the subsequent wave. Sexual disclosure did not contribute to sexual or relationship satisfaction over time; the results did not support a reciprocal model of sexual disclosure and perceived partner responsiveness, nor indirect effects of these variables on outcomes. Perceived partner responsiveness in relation to sex is positively related, and temporally precedes sexual and relationship satisfaction in first-time mothers.

A Double-Blind, Placebo-Controlled Study of the Effectiveness of Mate Endurance TM Dietary Supplement on Sexual Satisfaction, Ejaculatory Control, and Distress in Men with Premature Ejaculation

Background: To assess the efficacy of the dietary supplement Mate Endurance on sexual satisfaction, ejaculatory control, and sexually related personal distress in patients with premature ejaculation. Methods: In a double-blind, randomized, placebo-controlled study, 68 patients between 21 and 60 years old with premature ejaculation were randomized to receive either Mate Endurance or placebo treatment for three months. The patients were provided a questionnaire at the start of the study and again three months post commencement of the study. The questionnaires were comprised of the Index of Premature Ejaculation (IPE) and the PE Diagnostic Tool (PEDT). Results: Participants in the treatment group experienced a significant improvement in symptoms often associated with premature ejaculation versus those in the placebo group. The treatment was widely used with limited adverse effects. Conclusions: The results of the study demonstrate the effectiveness of the dietary supplement Mate Endurance in improving symptoms associated with premature ejaculation, including general sexual satisfaction and distress associated with sexual encounters.

Factors Associated with General Sexual Functioning and Sexual Satisfaction among People Living with HIV: A Systematic Review

ABSTRACT Sexual difficulties, experienced by half of the people living with HIV (PLWH), not only affect quality of life but have been associated with lower adherence to antiretroviral medication. This systematic review synthesizes studies published since 1997 which used statistical methods to investigate factors associated with general sexual functioning or sexual satisfaction of PLWH. We searched Medline, PsycINFO, Embase, Cinahl and Scopus with terms: HIV AND sexual dysfunction AND factors. Of 5552 records, 26 studies met selection criteria. Twenty-one studies on general sexual function, and five studies on sexual satisfaction. Two researchers separately extracted data and applied standardized quality assessment criteria. (Registration: CRD42018094146.) Regarding general sexual dysfunction, older age, general physical health, depression, body image and psychological distress were the most relevant factors. There was inconsistent evidence for: CD4, viral load, HIV symptom severity, HIV disease progression and time since diagnosis. From limited available evidence on sexual satisfaction, age, unemployment, and psychosocial factors were significant. Overall, anxiety and relational factors were under-researched, treatment center studies were over-represented and non-validated measurement of outcomes was common. Future research is required to build theoretical models of sexual well-being specific to PLWH to guide effective research and intervention to promote sexual quality of life of PLWH.

A Systematic Review of Sexual Satisfaction in Prostate Cancer Patients.

Prostate cancer (PCa) treatment has a significant negative impact on sexual function. Because research to this date has mostly focused on the impact of PCa on erectile function, very little is known about the impact of PCa on other relevant sexual outcomes, such as sexual satisfaction. To conduct a literature review of studies that have examined sexual satisfaction in men diagnosed with and treated for PCa. A systematic review was conducted using Scopus and PubMed databases to identify studies that had assessed sexual satisfaction in men with PCa. The main characteristics of each study and results regarding the impact of PCa on sexual satisfaction were extracted and examined. The main outcome measure was studies that assessed general sexual satisfaction in men with PCa. Thirty-eight articles were found regarding sexual satisfaction in PCa. Most studies did not focus on sexual satisfaction specifically, and methodologic limitations produced very mixed results. Overall, PCa treatments had a low to moderate impact on sexual satisfaction, and psychosocial interventions were more successful at improving sexual satisfaction than medical interventions. Sexual satisfaction was correlated to a large number of sexual, relational, psychological, and medical variables. This literature review shows very mixed results about the sexual satisfaction in men with PCa. Differences in research designs, methodologic limitations, and studies conducted atheoretically limit our understanding of the mechanisms that impact sexual satisfaction in men with PCa. We propose an alternative way of conducting research on sexual satisfaction by using solid theoretical models of sexual satisfaction. Santos-Iglesias P, Rana M, Walker L. A Systematic Review of Sexual Satisfaction in Prostate Cancer Patients. Sex Med Rev 2020;8:450-465.

Short-term and long-term outcomes of robotic rectal surgery\u2014from the real word data of 1145 consecutive cases in China

BackgroundDue to a limited patient sample size, substantial data on robotic rectal resection (RRR) is lacking. Here, we reported a large consecutive cases from the real word data to assess the safety and efficacy of RRR.MethodsFrom September 2010 to June 2017, a total of 1145 consecutive RRR procedures were performed in patients with stage I–IV disease. We conducted an analysis based on information from a prospectively designed database to evaluate surgical outcomes, urogenital function, and long-term oncological outcomes.ResultsOf three types of RRR performed, 227 (24.2%) were abdominoperineal resections, 865 (75.5%) were anterior resections, and 3 (0.3%) were Hartmann. Conversion to an open procedure occurred in 5.9% of patients. The overall positive circumferential margin rate was 1.3%. Surgical complication rate and mortality were 16.2% and 0.8% within 30 days of surgery, respectively. Mean hospital stay after surgery and hospital cost were 6.3 ± 2.9 days and 10442.5 ± 3321.5 US dollars, respectively. Risk factors for surgical complications included male gender, tumor location (mid-low rectum), combined organ resection, and clinical T category (cT3–4). Urinary function and general sexual satisfaction decreased significantly 1 month after surgery for both sexes. Subsequently, both parameters increased progressively, and the values 1 year after surgery were comparable to those measured before surgery. At a median follow-up of 34.6 months, local recurrence and distant metastases occurred in 2.3% and 21.1% of patients, respectively.ConclusionsRobotic rectal resection was safe with preserved urogenital function and arrived equivalent oncological outcomes in a nonselected group of patients with rectal cancer.

Comparison of preoperative and postoperative sexual function in patients with deeply infiltrating endometriosis with and without bowel resection

ObjectiveTo analyze preoperative and postoperative sexual function following surgery for deeply infiltrating endometriosis (DIE) with and without bowel involvement. Study designPatients with DIE who underwent surgery between 2001 and 2011 with segmental bowel resection (WB) or without segmental bowel resection (WOB) were surveyed using the German version of the Massachusetts General Hospital Sexual Functioning Questionnaire (KFSP). Responses were given on a six-point scale for the items sexual interest, sexual arousal, orgasm, lubrication, and general sexual satisfaction. As there are no cut-off values for the existence of sexual function disorders, a control group with no history of endometriosis was evaluated. Differences between the preoperative and postoperative results, as well as between WB, WOB, and a control group, were compared using the Wilcoxon test, Mann–Whitney U test, and Fisher’s exact test. ResultsEighty-nine patients without bowel resection (mean age 34.3 years; mean follow-up 63.2 months), 87 patients with bowel resection (mean age 37.7 years; mean follow-up 69.6 months), and 100 control patients aged 21–58 years (mean age 35.0 years) were evaluated. Preoperatively, both treatment groups had significantly poorer scores in all categories in comparison with the control group. The WOB group improved significantly in all categories postoperatively, with no further significant differences from the control group. No significant postoperative improvement was observed in the WB group, and the group had significantly poorer scores in comparison with the control group. The number of previous operations is associated with significantly poorer postoperative KFSP results. Sterility and age > 40 years are associated with significantly less improvement in the KFSP, although with lower initial values. ConclusionsPatients with DIE with or without bowel involvement have significantly impaired sexual function preoperatively. Complete resection of endometriosis in the WOB group was able to improve sexual function, as the women had sexual scores similar to those in the healthy control group postoperatively. Possible explanations for the lack of postoperative improvement of sexual function after segmental bowel resection include the type of surgery carried out, or injury to the affected nerves resulting from the endometriosis.

Abstract P1-12-04: Preliminary evaluation of a mind-body intervention to improve body and/or self-image: A phase II randomized trial

Abstract Background: The number of cancer survivors is growing and expected to be 18.9 million by 2024. Addressing survivorship issues, such as sexual health, are a critical part of health promotion. Women diagnosed with breast or gynecologic cancer can experience distressing changes in their self and/or body image, which affects their sexual health. This study evaluates hypnosis compared to progressive muscle relaxation (PMR) to improve self/body image in order to improve sexuality. Methods: Women with a history of breast or gynecologic cancer, who also report negative body image changes, were randomized in a 2:1 fashion to a 6-week intervention of hypnotic relaxation or PMR. Both intervention arms consisted of three 30-minute sessions delivered face-to-face by a trained therapist, one every two weeks, along with home practice using a CD. The primary outcome was impact of treatment on body image using the Impact of Treatment Scale (ITS). Secondary outcomes included mood (Positive/Negative Affect Scale-PANAS), sexual satisfaction (PROMIS satisfaction), and perceived change (Global Impression of Change Scale -GCIS). Outcomes were measured at baseline and 6 weeks except for the GCIS measured only at 6 weeks. A series of independent samples t-tests were used to compare changes in outcome measures between arms. The intention-to-treat principle was applied. Results: The final randomized sample consisted of 87 women. There was no statistically significant difference (p=.15) in the change in ITS between groups at 6 weeks, with both groups significantly improving (within group effect size Cohen's d .49 - .75). There were non-significant differences between groups on secondary outcomes. Change from baseline for positive affect (PANAS) was 1.7 in the hypnosis group and 3.8 in the PMR group while negative affect change was very similar being about 2.8 in both groups. Change from baseline for the PROMIS general sexual satisfaction scale was 1.5 in the hypnosis group and 1.3 in the PMR group. On the GCIS at 6 weeks, 42% of the hypnosis group reported moderate to very much improvement on self/body image (GCIS) while only 32% of the PMR group reported this level of improvement; and 36% of the hypnosis group versus 11% of the PMR group reported moderate to very much improvement in their sexuality. Implications: The stress relieving strategies applied in this study may contribute substantially to decreasing the distress of the cancer experience related to altered self/body image and sexuality. The variable improvement across domains suggests that hypnosis and PMR may work in different ways, mechanistically. Further mechanistic studies of interventions to optimally promote survivorship health are warranted. Citation Format: Barton D, Brooks T, Cieslak A, Elkins G, Clark P, Baydoun M, Smith A, VanPoznak C. Preliminary evaluation of a mind-body intervention to improve body and/or self-image: A phase II randomized trial [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P1-12-04.

The effect of urethroplasty surgery on erectile and orgasmic functions: a prospective study.

ABSTRACTObjectives:to examine the effects of urethroplasty surgery on sexual functions by taking into account age, location of stenosis, length of stenosis and surgical technique parameters.Materials and Methods:The prospective study was conducted between January 2015 and August 2017 with 60 cases. Patients were categorized according to age groups (19-65 / 65-75 years), surgery technique and stricture localization and length. Before the urethroplasty operation and postoperative 6th month follow-up, the international index of erectile function (IIEF) form (15 questions), was filled, the relevant domains of sexual function; erectile function (Q1,2,3,4,5,15), orgasmic function (Q9,10) and overall satisfaction (Q13,14) were assessed.Results:The mean age of the cases is 54 ± 13. However, preoperative IIEF, sexual satisfaction and orgasmic function averages of patients with a stenosis segment length of 1-3 cm was found to be significantly higher than that of patients with a stenosis segment length of 4-7 cm. Between stenosis segment length groups, there was no statistical difference in terms of preoperative and postoperative sexual functions. And also, there was no statistically significant change in patients’ preoperative and postoperative sexual function scores in terms of localization of stricture and surgery techniques. However, there were statistically significant change in the postoperative IIEF and sexual satisfaction averages according to preoperative averages.Conclusion:Our study suggests that urethroplasty surgery itself does not significantly affect erectile function, orgasmic function, and general sexual satisfaction regardless of the type of surgery, localization and length of stenosis. Besides, there was a significant decrease in erectile function in senior adults.

Sexual distress and quality of life among women with bipolar disorder

BackgroundInformation on the association between bipolar disorder (BD), sexual satisfaction, sexual function, sexual distress and quality of life (QoL) is sparse. This study aims, in women with BD, to (i) investigate sexual dysfunction, sexual distress, general sexual satisfaction and QoL; (ii) explore whether sexual distress was related to affective symptoms and (iii) investigate whether QoL was associated with sexual distress. The study is a questionnaire survey in an outpatient cohort of women with BD using: Changes in Sexual Functioning Questionnaire, Female Sexual Distress Scale, Altman Self-Rating Mania Scale (ASRM), Major Depression Inventory (MDI) and The World Health Organisation Quality of Life-Brief.ResultsIn total, 61 women (age range 19–63, mean 33.7 years) were recruited. Overall, 54% reported sexual distress (n = 33) and 39% were not satisfied with their sexual life (n = 24). Women with BD were significantly more sexually distressed in comparison with Danish women from the background population but they did not have a higher prevalence of impaired sexual function. Better sexual function was positively associated with ASRM scores while MDI scores were associated with more distress. Finally, the group of non-sexually distressed women with BD reported higher QoL scores compared with the sexually distressed group.ConclusionsWomen with BD exhibited a high prevalence of sexual distress and their sexual function seemed associated with their actual mood symptoms and perception of QoL.

Time for love: Partners’ time perspectives predict relationship satisfaction in romantic heterosexual couples

The aim of the present research was to explore the role of individual differences in time perspective (TP) in predicting two relationship quality indicators: general relationship satisfaction and sexual satisfaction, in romantic heterosexual couples. A total amount of 100 dyads took part in the study. Our study revealed that relationship satisfaction indices are predicted by partners’ time perspectives; both actor and partner effects proved significant. For instance, past-negative was related to lower general relationship satisfaction, whereas past-positive proved detrimental to sexual satisfaction. Higher relationship (but not sexual) satisfaction was related to a more balanced time perspective. Moreover, we demonstrated that the role of some time perspective dimensions may change with relationship length, e.g., a relationship between future-positive (FP) time perspective and females’ relationship satisfaction proved to change across relationship course from significantly negative to strongly positive. Contrary to our hypotheses, we found no evidence for assortative mating effects for time perspective dimensions. The present results provide evidence for the role of psychological temporality in relationship functioning and suggests potential utility of time perspective theories in practical interventions aimed to improve romantic relationships’ quality.