Higher Rates Of Sexual Dysfunction Research Articles

Assessing the influence of recurrent urinary tract infections on sexual function: a case-control study.

Urinary tract infections (UTIs) significantly impact quality of life and can also lead to changes in sexual function. This study aims to assess the symptoms associated with recurrent urinary tract infections (rUTIs) and their influence on both quality of life and sexual activity. A case-control study was conducted, involving 383 patients with rUTIs and 161 healthy controls. The Acute Cystitis Symptom Score (ACSS) and Female Sexual Function Index (FSFI) questionnaires were utilized, with all surveys completed online through Google Forms. The ACSS and FSFI were collected using online surveys designed through Google Forms. A higher prevalence of constipation was observed in the rUTI group compared to controls (37.6% vs 31.7%). rUTIs caused moderate to severe interference with work activities in 55.5% of cases, while 59% reported interference with social life. Sexual life assessment revealed that all FSFI domains were significantly affected in patients with rUTIs. Sexual desire was rated as low or very low in 61.9% of rUTI cases compared to 48.1% of controls (P< .001). Additionally, 35.3% of rUTI patients reported low or very low confidence in becoming sexually aroused, compared to 7.5% of controls (P< .001). Difficulty reaching orgasm was reported by 29.6% of rUTI patients versus 20.7% of controls (P< .001). Pain or discomfort following vaginal penetration was reported more than half the time by 43.9% of rUTI patients, compared to 19.6% of controls (P< .001). Dissatisfaction with sexual intercourse was noted in 53.6% of rUTI patients versus 15.8% of controls (P< .001). The assessment of sexual health should be integrated into the management of patients with rUTIs. Interventions targeting UTI management must also address strategies to improve sexual function and satisfaction. This study provides insight into the impact of rUTIs on sexual function across both pre- and post-menopausal women, allowing for an evaluation of how sexual perceptions evolve with age. However, the study's limitations include the lack of assessment of sexual practices, which may influence the risk of rUTIs and affect FSFI results. Women with rUTIs report significantly lower sexual satisfaction and higher rates of sexual dysfunction. It is essential to evaluate the sexual function of patients with rUTIs, and management strategies must consider ways to improve sexual health as part of the overall treatment plan.

The effect of breastfeeding on postpartum sexual function: an observational cohort study.

Postpartum women commonly experience sexual dysfunction; however, little is known regarding the effect of breastfeeding on sexual function and postpartum women's interest in treatment. We aimed to evaluate sexual function and genitourinary symptoms based on infant-feeding status and assess desire for treatment. Cross-sectional observational study of women 5-6months postpartum following singleton delivery was performed. Participants were grouped based on self-reported infant-feeding status: (1) primarily breastfeeding (BF) and (2) primarily formula feeding (FF). Female Sexual Function Index (FSFI) and Day-to-day Impact on Vaginal Aging (DIVA) questionnaires and interest in treatment were compared. In total, 125 women were included with 61 (49%) breastfeeding and 64 (51%) formula feeding. Compared to FF women, BF women were less likely to identify as African American (47% vs 79%; SD 0.8) or have Medicaid (28% vs 66%; SD 0.9). No other large differences were noted. BF women had significantly lower FSFI score indicating poorer sexual function (20.8 (IQR 10, 24) BF vs 24.5 (IQR 19.5, 27.8) FF, p = 0.009). Both cohorts reported low bother from vaginal symptoms and low interest in treatment of symptoms with BF cohort reporting higher interest in use of vaginal lubricants (69% BF vs 30% FF, SD 0.8). Factors associated with lower FSFI score were BF, perineal laceration, use of progesterone long-acting reversible contraception, and single relationship status. Both breastfeeding and formula feeding women experienced high rates of sexual dysfunction but low bother from vaginal symptoms and low interest in treatment. Further research is needed to explore these findings and assess postpartum sexual health.

Association of Sexual Dysfunctions and Sociodemographic Characteristics among Married Couples

Background: Sexual dysfunction is a prevalent issue that affects the quality of life and marital satisfaction among couples. This study aims to explore the association of sexual dysfunction with various sociodemographic characteristics among married couples in Bangladesh.Methods: This cross-sectional study was conducted in Shaheed Monsur Ali Medical College Hospital, Dhaka, Bangladesh during the period from January 2015 to 31st August 2015. A total of 49 married patients with substance use disorder were selected using purposive sampling. Data were collected using a structured questionnaire, DSM-5 criteria for substance use disorder, and the Bangla version of the Arizona Sexual Experience Scale (ASEX). Statistical analyses were performed using SPSS version 25.Results: The study found that sexual dysfunction was significantly associated with age, gender, education, and occupation. Specifically, 22.22% of participants under 25 years, 44.44% of those between 25 to 40 years, and 33.33% of those over 40 years reported sexual dysfunction (p=0.025). Males reported a higher incidence (83.33%) compared to females (0%) (p=0.04). Sexual dysfunction was more common among illiterate participants (16.67%) compared to those with higher education levels (p=0.04). Farmers reported higher rates of sexual dysfunction (33.33%) compared to other occupations, though this was not statistically significant (p=0.18). Income, habitat, and family history of psychiatric illness did not show significant associations with sexual dysfunction.Conclusion: The study underscores the significant impact of sociodemographic factors on sexual dysfunction among married couples in Bangladesh. Targeted interventions addressing these specific factors are essential for improving sexual health outcomes. Further research should aim to deepen the understanding of these associations and develop culturally appropriate strategies for prevention and management.

Comparative study on sexual dysfunction in alopecia areata: prevalence and associated factors.

Alopecia areata (AA) impairs quality of life. However, there is no evidence on the impact of this disease in terms of sexual dysfunction (SD). The aim of the present study was to assess the prevalence of SD and possible associated factors in a cohort of patients with AA. A cross-sectional study was conducted in a cohort of AA patients matched with healthy controls. Sexual function was assessed using a numerical scale and gender-specific questionnaires. A total of 60 patients with AA and 60 healthy controls were included. The prevalence of SD was higher in women with AA than in healthy controls and in men with AA (p<0.05). Female SD was associated with younger age, shorter duration of illness and higher rates of anxiety and depression (p<0.05). Male SD was associated with older age and greater severity of AA (p<0.05). Women with AA appear to have higher rates of SD than healthy controls and men with AA. Similarly, the factors associated with SD differ between men and women, with mood disturbance being of greater relevance in women, whereas disease severity seems to play a key role in men.

Sexual Activity, Function, and Satisfaction in Reproductive-Aged Females Living with Chronic Kidney Disease.

Up to 80% of women living with chronic kidney disease (CKD) experience sexual dysfunction, though its link with sexual activity and sexual satisfaction is not well understood. Among older women with CKD treated with hemodialysis, the majority report sexual inactivity, though few describe sexual difficulty and most report high sexual satisfaction. Whether this applies to reproductive-aged females living with CKD is yet unknown. This study aimed to assess the sexual activity, function, and satisfaction of reproductive-aged females living with CKD. Self-identified females aged 18-51 years with CKD were recruited from nephrology clinics in Calgary, Canada. Sexual activity, function, and satisfaction were assessed with a modified version of the Female Sexual Function Index. Fifty-seven participants were recruited (35% CKD without kidney replacement therapy, 44% CKD treated with hemodialysis, 9% CKD treated with peritoneal dialysis, 12% CKD treated with kidney transplant) and nearly half (47%) reported sexual activity. Among sexually active participants, there was a high prevalence of sexual dysfunction (67%) and only 25% of participants reported sexual satisfaction. A strong relationship between sexual function and satisfaction was identified. Reproductive-aged females living with CKD are sexually active, though experience high rates of sexual dysfunction and dissatisfaction. These findings emphasize the importance of recognition and management of sexual dysfunction in this important population.

Association of Sexual Dysfunctions and Sociodemographic Characteristics among Married Couples

Background: Sexual dysfunction is a prevalent issue that affects the quality of life and marital satisfaction among couples. This study aims to explore the association of sexual dysfunction with various sociodemographic characteristics among married couples in Bangladesh. Methods: This cross-sectional study was conducted in Shaheed Monsur Ali Medical College Hospital, Dhaka, Bangladesh during the period from January 2015 to 31st August 2015. A total of 49 married patients with substance use disorder were selected using purposive sampling. Data were collected using a structured questionnaire, DSM-5 criteria for substance use disorder, and the Bangla version of the Arizona Sexual Experience Scale (ASEX). Statistical analyses were performed using SPSS version 25. Results: The study found that sexual dysfunction was significantly associated with age, gender, education, and occupation. Specifically, 22.22% of participants under 25 years, 44.44% of those between 25 to 40 years, and 33.33% of those over 40 years reported sexual dysfunction (p=0.025). Males reported a higher incidence (83.33%) compared to females (0%) (p=0.04). Sexual dysfunction was more common among illiterate participants (16.67%) compared to those with higher education levels (p=0.04). Farmers reported higher rates of sexual dysfunction (33.33%) compared to other occupations, though this was not statistically significant (p=0.18). Income, habitat, and family history of psychiatric illness did not show significant associations with sexual dysfunction. Conclusion: The study underscores the significant impact of sociodemographic factors on sexual dysfunction among married couples in Bangladesh. Targeted interventions addressing these specific factors are essential for improving sexual health outcomes. Further research should aim to deepen the understanding of these associations and develop culturally appropriate strategies for prevention and management.

(058) HAVING SEX OUT OF A SENSE OF DUTY: THE INFLUENCE OF NONCONSENSUAL SEXUAL EXPERIENCES AND SEXUAL FUNCTIONING

Abstract Introduction Pleasure and emotional bonding are two motives for why women have sex that are commonly discussed in the literature. Less commonly reported, but frequently endorsed by women, is the motive “duty sex,” in which an individual engages in sex out of a sense of obligation to maintain a relationship or their partner’s feelings towards them, to ensure their partner will not leave them, or to avoid conflict. Engaging in duty sex can yield negative outcomes such as emotional discomfort and lower relationship satisfaction, although there have been some reports of positive outcomes, including feelings of closeness (O’Sullivan &amp; Allgeier, 1998). Women with a history of nonconsensual sexual experiences (NSEs) show high rates of sexual dysfunction (Pulverman et al., 2018), and sexual dysfunction in women has been linked to a higher tendency to engage in duty sex (Meston &amp; Stanton, 2017). Objective This study aimed to investigate the potential connections between sexual dysfunction and the frequency of duty sex in women with NSE histories. Methods Women (N = 820; mean age = 35.36, SD = 11.32) completed the Nonconsensual Sexual Experiences Inventory (NSEI; Kilimnik &amp; Meston, 2017), the Female Sexual Function Index (FSFI; Rosen et al., 2000), items indicative of duty sex from the Sexual Motivations Scale (Cooper et al., 1998), as well as other measures not reported here. Results Women were categorized as either having NSE history (n = 465) or not (n = 355) based on the NSEI. FSFI total scores predicted duty sex such that women with lower sexual functioning reported engaging in more duty sex, R2 = .18, F(1, 654) = 147.30, p &amp;lt; .01, and higher levels of duty sex predicted lower sexual satisfaction, R2 = .057, F(1, 807) = 50.13, p &amp;lt; .01. Results from a multiple linear regression revealed that NSE history significantly predicted engagement in duty sex after controlling for sexual function, R2 = .19, F(2, 653) = 77.06, p &amp;lt; .01. Conclusions The results suggest that women with NSE histories endorse a higher frequency of duty sex motives compared to women without NSE histories that cannot be explained by variability in sexual functioning. That is, women with NSE histories were more likely to engage in sex out of fear that their partner would love them less, be angry with them, or leave them if they refused to engage in sex, and this effect was over and above the relationship of these motives with sexual dysfunction. As engaging in these duty sex motives was linked to overall sexual dissatisfaction, future research that examines the cognitive mechanisms by which having a history of NSE leads women to feel obligated to have sex out of a sense of duty would help enhance the sex lives of women with NSE histories. Disclosure No.

(301) GENDER SENSITIVITY IN THE TREATMENT OF SEXUAL (DYS)FUNCTION: A CRITICAL REVIEW AND FUTURE DIRECTIONS

Abstract Introduction To ensure effective and evidence-based care in sexual health, treatment must account for diverse gender identities and experiences. One-size-fits-all treatments fail to account for the diverse sociocultural determinants that influence sexual health outcomes. Today science recognizes the necessity of culturally sensitive treatments that consider sociocultural determinants such as ethnicity, religion, language, socioeconomic status and, critically, gender. Gender, as a key sociocultural determinant, significantly impacts the experience and treatment of sexual dysfunction, necessitating gender-sensitive approaches. Objective The aim of this study is to critically review literature on gender sensitivity in the treatment of sexual dysfunction, identify gaps, and propose recommendations for developing culturally and gender-sensitive clinical practices. Methods A systematic literature review of studies addressing gender differences in the treatment of sexual dysfunction was conducted. We combined and searched MeSH terms using databases including PubMed, Web of Science, Scielo and PsycINFO. We focused on treatment modalities, patient outcomes, sociocultural determinants, and gender-sensitivity in clinical practice. Results Significant gender disparities exist in the prevalence, diagnosis, and treatment of sexual dysfunctions. Men more frequently report erectile dysfunction, while women report higher rates of desire and arousal disorders. Transgender and non-binary individuals often face higher rates of sexual dysfunction due to minority stress and inadequate healthcare. Regarding treatment approaches and outcomes based on gender, men frequently receive pharmacological treatments, such as PDE5 inhibitors for erectile dysfunction, whereas women are often prescribed hormonal therapies or referred to psychosexual counseling for issues such as desire and arousal disorders. Transgender and non-binary individuals face unique challenges, including minority stress, provider bias, and inadequate healthcare access. Regarding therapy, psychological interventions for men may focus on performance anxiety, relationship issues, and psychological causes of erectile dysfunction while for women, therapy often addresses broader issues like body image, past trauma, emotional intimacy, and relationship dynamics, which can significantly impact desire and arousal. Also, when it comes to male sexual (dys)function, social stigma around discussing ED can lead to underreporting, but there is generally a higher public awareness and more direct marketing of treatments. While with women there is often less public awareness and more stigma surrounding female sexual dysfunction, leading to underdiagnosis and undertreatment. Sociocultural expectations around women’s sexual roles and behaviors also influence their experiences and treatment-seeking behaviors. Most treatment protocols reviewed lack customization based on gender-specific needs and broader sociocultural contexts. Conclusions This review highlights the critical need for integrating gender sensitivity into the treatment of sexual dysfunction. The significant gender disparities in prevalence, diagnosis, and treatment underscore the inadequacy of one-size-fits-all approaches. Our findings emphasize that treatment protocols must be customized to address the specific needs of different gender identities and consider broader sociocultural contexts. Culturally sensitive treatments that incorporate factors such as ethnicity, socioeconomic status, and gender are essential for improving patient outcomes. Future research should focus on developing and validating gender-sensitive treatment protocols and training healthcare providers to deliver inclusive and effective care. By addressing these gaps, sexual medicine can better serve diverse populations, ultimately promoting holistic sexual health and well-being. Disclosure No.

Sexual Dysfunctions among Diabetic and Non-diabetic People Attending in Tribhuvan University Teaching Hospital, Kathmandu Nepal.

Sexual dysfunctions including erectile dysfunction among men, a widespread sexual health issue, pose challenges to sexual satisfaction. This cross-sectional study aimed to assess the prevalence and determinants of sexual dysfunctions in both diabetic and non-diabetic individuals aged 30-70. A study at Tribhuvan University Teaching Hospital in Kathmandu, Nepal, surveyed 350 participants (176 men, 174 women), aged 30-70, with 52.6% having diabetes. The structured interviews and validated questionnaires like IIEF-5 for men and FSFI-6 for women to assess the prevalence and factors associated with erectile dysfunction were used. Statistical tools were employed to measure the associations of different variables with Sexual dysfunctions. Overall, the prevalence of sexual dysfunction was 73.7% (95% CI: 72.4- 73.7) with higher rates in men 83.9% (95% CI: 83.1- 84.7) than women 63.6% (95% CI: 62.0 - 65.2). Individuals with diabetes experienced an 81.5% prevalence of sexual dysfunction (95% CI: 80.6-82.4), whereas non-diabetic individuals exhibited a 65.1% prevalence (95% CI: 63.5-66.7). In the diabetic male population, the prevalence of sexual dysfunction was 97.5% (95% CI: 97.4-97.6), while diabetic females had a prevalence of 68.9% (95% CI: 67.5-70.3). Among non-diabetic men, the percentage of erectile dysfunction was 72% (95% CI: 70.7-73.3), and among non-diabetic women, sexual dysfunction remained 56.2% (95% CI: 54.4-58.0). Among individuals with diabetes, those who used tobacco exhibited a sexual dysfunction prevalence of 93.8% (95% CI: 93.5-94.1), while non-tobacco users had a prevalence of 74.8% (95% CI: 73.6-76.0). In non-diabetic individuals, obesity was associated with a higher prevalence of sexual dysfunctions, reaching 84.6% (95% CI: 83.8-84.6). High blood pressure showed a strong association with sexual dysfunctions in both diabetic (83% with 95% CI: 81.9-83.4) and non-diabetic (70% with 95% CI: 67.7-70.1) groups. Individuals with diabetes for more than five years had a higher rate of sexual dysfunction as 87.8% (95% CI: 86.6-89.0) with 100% in men and 79% in women. However, there was no significant difference in the prevalence of sexual dysfunctions related to obesity and alcohol consumption between diabetics and non-diabetics. The research highlights a noteworthy association of sexual dysfunctions with individuals with diabetes, male sex, tobacco use, and hypertension. The observed high prevalence of sexual dysfunctions in both diabetic and non diabetic people is a public health concern, emphasizing the need for culturally tailored approaches to address the sexual health of the affected individuals.

(179) Sexual Dysfunctions in Infertile Tunisian Women

Abstract Introduction Once perceived as a source of pleasure and enjoyment, sexuality has evolved for infertile couples, focusing primarily on a purely procreative objective. Infertility has a direct impact on a woman's sex life, calling into question her femininity and causing significant alterations in the components of her sexual response. Objective The aims of our study were to assess the frequency of sexual dysfunction in Tunisian women facing infertility and to identify the aspects of their sexuality most affected. Methods This was a prospective, cross-sectional, and descriptive study, including a sample of 200 Tunisian infertile women, followed up in a Tunisian Assisted reproduction center over a three-month period, from November 24, 2022 to February 24, 2023. To assess the different dimensions of sexuality in infertile women, we used the Arabic version of the FSFI (female sexual function index) Results The mean age of our women was 30 ± 4 years. The majority had a university educational level (80%), an urban origin (87%), an average socio-economic level (63%), and no medical or gynecological surgery history (62%). Most partners (67%) had no sexual dysfunction (SD). The most frequent male SD was premature ejaculation, observed in 14% of cases. As regards the etiology of infertility, most cases were classified as unexplained (28%), while the remainder were linked to female causes, dominated by PCOS (40%). The majority of women had initially discussed the subject of sexuality (72%) with their partners. In our sample, the mean FSFI score was 20.74, with extremes ranging from 2 to 35.4. The prevalence of female sexual dysfunction (FSD) was 82%. The areas most affected were sexual satisfaction (50%), reaching orgasm (45%), as well as lubrication (44%) and arousal (44%). Lower educational level, secondary infertility, contraceptive use, and a long history of fertility treatment as well as the presence of sexual dysfunction in the male partner, were found to be associated with sexual dysfunction in women suffering from infertility, yet no significant correlation was established. Conclusions Infertility is associated with high rates of sexual dysfunction. Thorough counseling and continuing support of infertile women is therefore indicated. Disclosure No.

A psychoeducational intervention to improve sexual functioning in male rectal and anal cancer patients: A pilot randomized controlled trial study.

Male rectal and anal cancer patients demonstrate high rates of sexual dysfunction. This pilot randomized controlled trial tested a psychoeducational intervention designed to improve psychosexual adjustment. Rectal or anal cancer patients were randomized to a Sexual Health Intervention for Men (intervention) or to a referral and information control (control). The intervention included control activities plus 4 sexual health intervention sessions every 4-6 weeks and 3 brief telephone calls timed between these sessions. Assessments were completed pre-intervention (baseline) and 3 months (follow-up 1) and 8 months (follow-up 2) post-intervention. Differences were assessed with statistical significance and Cohen's d effect sizes (d = 0.2, small effect; d = 0.5, moderate effect; d = 0.8, large effect). Ninety subjects enrolled. Forty-three participants completed at least 1 follow-up assessment (intervention, n = 14; control n = 29). At follow-up 1, men in intervention, compared to control, improved on all domains of the International Index of Erectile Function (IIEF) (p < 0.001 to p < 0.05) and demonstrated large effects (d = 0.8 to d = 1.5). Similarly, at follow-up 2, changes in all domains of the IIEF except the orgasm domain were either statistically significant or marginally statistically significant (p = 0.01 to p = 0.08) and demonstrated moderate to large treatment effects for intervention versus control (d = 0.5 to d = 0.8). Men in the intervention, compared to control, demonstrated decreased sexual bother at follow-up 1 (p = 0.009, d = 1.1), while Self-Esteem and Relationship (SEAR) total scores and the SEAR sexual relationship subscale demonstrated moderate increases for intervention versus control (d = 0.4 to d = 0.6). This study provides initial evidence for combining a psychoeducational intervention with medical interventions to address sexual dysfunction following rectal and anal cancer. Trials register number: NCT00712751 (date of registration: 7/10/2008).

Sexual function in patients with bipolar disorder type I evaluated in symptomatic remission: a cross-sectional study.

Bipolar disorder (BD) is a chronic pathology that is associated with several impairments throughout a patient's life, including decreased sexual function. Despite the importance in quality of life (QoL), functionality and medication adherence, it is still little investigated in these patients. To compare the sexual function of patients with Bipolar Disorder type I (BD-I), in remission, with healthy controls (HC) and to investigate the clinical and socio-demographic characteristics associated with sexual function in these individuals. Also, to assess the QoL in patients with and without sexual dysfunction (SD). Cross-sectional study with 132 patients with BD-I in euthymic phase and 61 HCs from an outpatient clinic. All the participants were evaluated through the Arizona Sexual Scale (ASEX) and the brief version of the World Health Organization Quality of Life Assessment (WHOQoL-BREF). The patients with BD-I were compared with the HCs. The patients were divided into two groups: the ones diagnosed with SD and the ones without it. The patients with BD-I had higher rates of SD (42.4%) compared to the HCs (16.4%) (OR 3.67, 95% CI 1.55 - 8.67; p=0.003). SD in patients was associated with being women (p=0.001), older age (p=0.003) and having a longer duration of untreated illness (p=0.010). Patients with SD had worse QoL scores compared to those without SD. Patients with BD-I have a high prevalence of SD and this was associated with worse QoL scores in all domains.

Relationship of insomnia to sexual function and sexual satisfaction: Findings from the sleep and sex survey II

ObjectiveResearch suggests that healthy sleep is a key component of sexual function. When evaluating sexual function, however, poor sleep is often overlooked as a contributing factor. This cross-sectional survey expands prior work by exploring relationships among insomnia severity, sexual satisfaction, and sexual function with an updated battery of measures for the Sleep and Sex Survey. MethodThe sample (N = 1266) consisted of 618 men, 648 women recruited via Prolific, an online survey platform. The Sleep and Sex Survey II included measures addressing insomnia, fear of sleep, nightmares, sexual function, sexual satisfaction, sexual activity, depression, anxiety, posttraumatic stress, and alcohol use. ResultsRecent sexual activity was correlated with better sleep, lower anxiety, and lower scores on a posttraumatic stress disorder screener. Insomnia severity was negatively correlated with sexual satisfaction (r = 0.22, p < .001) and the presence of insomnia was associated with higher rates of sexual dysfunction in women (53.8% vs. 31.8%; p < .001) and men (22.7% vs. 12.5%; p = .036). In regression analyses, after accounting for depression and anxiety, insomnia had a statistically significant association with sexual function for women (β = 0.12; p < .01) but not men (β = 0.11; p = .60). ConclusionFindings support a relationship of insomnia to sexual function and satisfaction with some gender differences. Future work may be enhanced by assessing these relationships in a gender diverse population including objective sleep measures and addressing contributing mechanisms. Clinically, findings support the assessment of sleep when evaluating patients for sexual dysfunction.

Sexuality in Postmenopausal Women with Genital Prolapse.

One of the most common complaints among menopausal women concerns changes in sexual function. This is attributed to various factors, including anatomical defects in the genital tract, with pelvic organ prolapse (POP) being one of the most prevalent problems affecting women during this stage of their lives. Additionally, symptoms resulting from gonadal hypofunction can also contribute to the development of sexual dysfunction during menopause. This research aimed to explore the way in which postmenopausal patients with POP experienced their sexuality in our setting. To achieve the proposed objective, we conducted a descriptive, cross-sectional study involving a total of 133 postmenopausal women with POP. The results of our series are consistent with the scarce literature available in our setting and suggest a high rate of sexual dysfunction in postmenopausal patients with POP. We can conclude that POP is associated with the presence of female sexual dysfunction.

Association Between Opioid Use and Risk of Sexual Dysfunction: A Systematic Review

Opioid use disorder (OUD) is defined by negative effects on oneself despite numerous efforts to stop it. Chronic opioid users have sexual dysfunctions such as erectile dysfunction, delayed ejaculation decreased libido, and sexual performance. To explore the association between the use of opioids and the risk of sexual dysfunction. This review was conducted from March 2023 to June 2023, and comprised of search on PsycINFO, MEDLINE, EMBASE, Google Scholar, OvidSP Science Direct, PubMed, Clinical Trials.gov, and Web of Science databases for experimental studies and randomized controlled trials related to OUDs published in peer-reviewed English-language journals between 2013 and 2023 (10 years). Of the 314 studies initially identified, 41(13%) were subjected to full-text assessment, and 10 were reviewed and analyzed (Figure). There were 2(20%) each study done in Egypt and Istanbul and 1(10) each in Germany, Canada, Spain, China, Poland, and Malaysia. All 10 (100%) studies were baes on opioid use and sexual dysfunction. Prospective studies showed that the occurrence of any sexual dysfunction ranged from 40% to 90% of opioid dependence. The most commonly studied observed sexual dysfunction is a lack of desire, erectile dysfunction, erectile dysfunction, and poor satisfaction. Our findings suggest that there is a significant link between opioid use and sexual dysfunction and that people who use opioids have higher rates of sexual dysfunction. Nevertheless, opioids have mind-altering properties that negatively affect various stages of the sexual cycle.

(174) Sexual Health in Young Adult Survivors of Childhood Cancer: A Project REACH Study

Abstract Introduction Sexual health, a key component of general well-being, relies on the successful interplay of physical, psychological, and social development. Although we know cancer treatment early in life disrupts many of these processes, it remains unclear exactly how treatment leads to sexual dysfunction in young adult childhood cancer survivors (YACCS). Our previous research found that approximately one third of YACCS report two or more sexual dysfunction symptoms using five sexual health items on a larger health-related quality of life survey. This research suggests that sexual dysfunction is related to late effects (e.g., fatigue) but not specific cancer treatments (e.g., chemotherapy). However, additional research using validated sexual health measures is required to understand these relationships more fully. Objective To build on previous research by examining the relationship between cancer treatment and sexual dysfunction in YACCS using validated sexual health measures. Methods 252 YACCS enrolled in Project REACH, a prospective cohort study, completed self-report measures on sexual functioning, psychological distress, and physical functioning. To examine proportion of participants experiencing clinically significant sexual dysfunction, participants were classified as a sexual dysfunction “case” if they scored ≥ 19 on the Female Sexual Function Index (FSFI-6) or ≥ 24 on the International Index of Erectile Function (IIEF). Relationships between sexual dysfunction, cancer type, cancer treatment, psychological distress (Brief Symptom Inventory-18; BSI-18), and health-related quality of life (i.e., Short Form-12; SF-12) were examined. Results Almost half (43%) of participants were classified as a sexual dysfunction case, with females significantly more likely (51%) to be a case than males (34%, p=.007). Brain tumor survivors were significantly more likely to be a case (53%) than participants with other types of cancers (36%, p=.009). Participants with a history of bone marrow transplant (BMT) were more likely to be a case (61%) than those without (41%, p=0.061), although this finding was only marginally significant. There were no significant differences in case vs. non-case by age, time since diagnosis, chemotherapy, radiation, or surgery. Sexual dysfunction cases reported significantly worse anxiety and depression (BSI-18) and overall mental and physical health (SF-12) than non-cases. Conclusions Our findings extend previous research by confirming that YACCS, particularly female YACCS, have significant sexual dysfunction according to validated sexual health measures. Findings also confirm strong ties between sexual dysfunction and other common late-effects (e.g., anxiety). Unlike previous research, our current findings link a history of brain cancer and BMT to more significant sexual dysfunction. Additional research is required to understand whether higher rates of sexual dysfunction are related to the more significant disruptions to physical, psychological, and social development during treatment in these two groups. Nevertheless, findings suggest that sexual health screening and treatment is clearly warranted in YACCS, particularly with those who have experienced brain cancer or BMT. Disclosure No

(191) A Systematic Review of Sexual Health Consequences among Women with Vulvar Lichen Sclerosus

Abstract Introduction Lichen Sclerosus (LS) is a chronic, inflammatory skin condition that predominantly affects the vulva. This condition often leads to scarring involving the clitoris, labia minora, vaginal introitus, and perineum, leading to clitoral phimosis and introital stenosis. Women with LS are less likely to be sexually active than those without the condition. Studies have shown a high rate of sexual dysfunction in vulvar LS; however, the sexual effects of the condition are still poorly acknowledged. Objective To identify sexual health consequences of vulvar lichen sclerosus among women with vulvar lichen sclerosus through systematic review of available literature. Methods A systematic review of the literature was conducted on sexual health consequences of lichen sclerosus among women with lichen sclerosus. PubMed, MEDLINE, and Scopus were queried and results were screened using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Included studies are observational studies evaluating women of premenopausal or postmenopausal status with clinical or biopsy confirmed lichen sclerosus and sexual health, or randomized controlled trials or comparative studies utilizing a validated sexual function measure to evaluate sexual health prior to intervention among the same population. Manuscripts included must have been written in English from January 1991 to April 2022. Selection of studies was done by three independent reviewers and conflicts were resolved by discussion. Systemic reviews and committee guidelines were identified for references review. Results The search produced 683 references for title and abstract screening. Of these, 32 articles met criteria for full-text review. After full-text review, 20 studies met inclusion criteria and were evaluated. Three systematic reviews and three committee guidelines were identified and all references had been identified in the initial search. Eight publications yielded qualitative data regarding sexual health consequences of LS. A negative impact of sexual dysfunction was reported in 16-60% of affected women, and dyspareunia reported by 22-56.7%. LS is also associated with decreased sexual frequency and satisfaction, a negative impact on romantic relationships, and feelings of inadequacy as a sexual partner. Eight publications evaluated the Female Sexual Function Index (FSFI), and all demonstrated a central tendency less than 26.55 among those with LS. Four publications evaluated the Female Sexual Distress Scale (FSDS), and all demonstrated a score greater than 12 among women with LS. Two publications evaluated Female Genital Self-Image Scale (FGSIS) scores in women with LS, and both found decreased FGSIS scores compared to controls. Four publications evaluated the Dermatology Quality of Life Index (DQLI), with LS causing a small to very large impact on quality of life. The subcategory with the greatest impact of quality of life is sexual difficulties. One publication evaluated the Vulval Quality of Life Index (VQLI) in women LS, and found sexuality to be the second highest scoring subgroup. Conclusions The sexual health consequences of LS include sexual pain symptoms, all facets of female sexual function, sexual distress, negative genital self-image, and negative impact on romantic relationships. Women with LS experience a significant impact on quality of life, particularly in relation to sexual functioning. Disclosure No

Ablative minimally invasive surgical therapies for benign prostatic hyperplasia: A review of Aquablation, Rezum, and transperineal laser prostate ablation.

Benign prostatic hyperplasia (BPH) is one of the most common diseases affecting men and can present with bothersome lower urinary tract symptoms (LUTS). Historically, transurethral resection of the prostate (TURP) has been considered the gold standard in the treatment of LUTS due to BPH. However, TURP and other traditional options for the surgical management of LUTS secondary to BPH are associated with high rates of sexual dysfunction. In the past decade, several novel technologies, including Aquablation therapy, convective water vapor therapy (Rezum), and transperineal prostate laser ablation (TPLA), have demonstrated promising evidence to be safe and effective while preserving sexual function. In this review, we discuss three ablative minimally invasive surgeries: Aquablation, Rezum, and TPLA. We review their techniques, safety, as well as perioperative and functional outcomes. We go into further detail regarding sexual function after these ablative minimally invasive surgical therapies. Aquablation is a surgeon-guided, robot-executed, heat-free ablative waterjet procedure with sustained functional outcomes at 5 years while having no effect on sexual activity. Rezum is an innovative office-based, minimally invasive surgical option for BPH that delivers convective water vapor energy into prostate adenoma to ablate obstructing tissue. Rezum leads to significant improvements in Qmax, IPSS while preserving sexual function. TPLA is another office-based technology which uses a diode laser source to produce thermoablation. It leads to improvement in Qmax, IPSS, and QoL while preserving ejaculatory function. Overall, ablative minimally invasive surgical therapies have demonstrated excellent safety and efficacy profiles while preserving sexual function. These modalities should be discussed with patients to ensure informed and shared decision-making. Ablative minimally invasive surgical therapies may be particularly interesting to patients who value the preservation of their sexual function.

Aquablation Treatment for Benign Prostatic Obstruction

Aquablation Treatment for Benign Prostatic Obstruction Abstract: The surgical BPH treatment is one of the most common urological procedures. With our reference methods: transurethral resection of the prostate (TUR-P), open surgical adenomenucleation over a transabdominal access, and also modern laser procedures. Various effective surgical options are available. However, the quality of the surgical outcome is highly dependent on the surgeons' experience. At the same time, all of the above-mentioned reference methods are associated with a high rate of sexual dysfunction, especially postoperative anejaculation, a symptom complex which is relevant for men, regardless of age [1]. Robotic Aquablation® was developed with the goal to reduce the dependency of the surgical outcome on the expertise of the surgeon, but at the same time achieving a comparable outcome and reduced morbidity. After the "first in human treatment" by Peter Gilling in 2013, the Aquabeam® robot has been used in its current form in clinical studies since 2015 (Water, Water II and Open Water Study) and finally was introduced in clinical routine in August 2017 by Thorsten Bach in Hamburg. The safety and effectiveness of Aquablation® therapy has been proven in various studies and in everyday clinical practice.

A systematic review of sexual health consequences among women with lichen sclerosus

Abstract Introduction Lichen sclerosus (LS) is a chronic inflammatory skin condition predominantly affecting the vulva. Studies have shown high rates of sexual dysfunction in patients with LS; however, the sexual effects of the condition are poorly acknowledged. Objectives We sought to identify sexual health consequences among women with vulvar LS through systematic review of available literature. Methods A systematic review of the literature was conducted to find reports on sexual health consequences among women with LS. PubMed, MEDLINE, and Scopus were queried. Included articles were observational studies evaluating women with LS and their sexual health and randomized controlled trials or comparative studies utilizing a validated sexual health measure before intervention among the same population. Articles must have been written in English and published from January 1991 to April 2022. Results The search produced 683 references, including 32 articles that met criteria for full-text review and 20 reported studies that met inclusion criteria. Two studies investigated the impact of LS on interpersonal relationships, 6 studies evaluated sexual symptoms, 16%-60% reported sexual dysfunction, and 22%-56.7% reported dyspareunia. Also described were decreased sexual frequency and satisfaction, negative impact on sexual relationships, and feelings of inadequacy. Eight publications evaluated the Female Sexual Function Index (FSFI); all described studies that demonstrated a central tendency less than 26.55. Four publications evaluated the Female Sexual Distress Scale (FSDS); all demonstrated average scores greater than 12. Two publications evaluated the Female Genital Self-Image Scale (FGSIS), both found decreased scores compared to controls. Four publications evaluated the Dermatology Life Quality Index (DLQI); impact on quality of life was small to very large, with sexual difficulties affecting most study patients. One publication evaluated the Vulvar Quality of Life Index (VQLI); sexuality was the second highest-scoring subgroup. Conclusions Sexual health consequences of LS include sexual pain, dysfunction, and distress; negative genital self-image; and negative impact on sexual relationships. Women with LS experience a negative impact on quality of life, particularly related to sexual functioning.