Male Sexual Health Questionnaire Ejaculatory Research Articles

Partner Satisfaction in Labiaplasty Patients.

Labiaplasty operation, which has become increasingly popular in recent years, is frequently preferred by women for cosmetic and functional reasons. It creates significant changes on female sexuality with high satsfaction rates. But there is limited data on its effects on male sexual response. To investigate the effects of labiaplasty on partners. Partners of 49 patients who underwent labiaplasty between January 2020 and May 2023 were included in the study. Male Sexual Health Questionnaire Ejaculatory Dysfunction (MSHQ-EjD), Golombok Rust Sexual Satisfaction Scale and New Sexual Satisfaction Scale (NSSS) questionnaires were administered to the partners preoperatively and 6 months postoperatively. There was no significant difference between preoperative and postoperative results in the MSHQ-EjD questionnaire applied to the partners included in the study. The postoperative increase in the new sexual satisfaction scale compared to the preoperative sexual satisfaction score was statistically significant. In the Golombok Rust sexual satisfaction scale, statistically significant, positive changes were observed in the categories of frequency of intercourse, communication, satisfaction, and nature of sexual intercourse in postoperative results. Labiaplasty operation had positive effects onmale sexual response, but had no effect on ejaculation function and difficulty.

An Innovative Technique for Ejaculation-Sparing Prostatic Enucleation with Thulium:YAG Laser.

Purpose: We report our experience with 100 patients who underwent an innovative prostate enucleation technique that spares the complete urethral-plate from the veru montanum to the bladder neck using a low-energy thulium laser emission. The aim of our study was to evaluate the short-term effects of this procedure on ejaculation preservation and urinary obstruction. Materials and Methods: The International Prostate Symptom Index (IPSS), quality of life (QoL), and Male Sexual Health Questionnaire Ejaculatory Dysfunction (MSHQ-EJD) Short Form were used as validated instruments to quantify ejaculatory dysfunction before and 6 months after the surgery. Results: The median IPSS score pre- and postoperatively was 20 and 5, respectively (p < 0.0001); QoL dropped from a median of 4-1 (p < 0.0001); and the mean preoperative maximal flow rate improved significantly (8.5 vs 21.2 mL/min) (p < 0.0001). Furthermore, there was significant reduction in postvoid residual postoperatively (p < 0.0001). Postoperative ejaculatory function was preserved in 92/100 patients (92%). According to the MSHQ-EJD score, patients reported a slight nonsignificant decrease in frequency of ejaculation (item 1), force of expulsion (item 2) and reduction in semen volume during ejaculation (item 3), with the exception of ejaculation discomfort (item 4). Conclusion: According to our results, complete removal of the apical tissue, which has been advocated as an integral part of the so called ejaculatory hood, does not interfere with ejaculation if the ventral lissosphincter remains intact.

Preservation of Erectile and Ejaculatory Functions After Tetramodal Bladder-Sparing Therapy Incorporating Consolidative Partial Cystectomy Against Muscle Invasive Bladder Cancer.

To cross-sectionally assess erectile and ejaculatory functions after tetramodal bladder-sparing therapy consisting of transurethral resection, chemoradiotherapy, and consolidative partial cystectomy in patients with muscle invasive bladder cancer. Among 72 enrolled male patients who underwent tetramodal bladder-sparing therapy from 2006 to 2019, 42 who visited the outpatient clinic from February to October 2020 received questionnaires. Erectile function, ejaculatory function, and quality of life were assessed using the International Index of Erectile Function short form, the Male Sexual Health Questionnaire Ejaculatory Dysfunction short form, and the Functional Assessment of Cancer Therapy. Among the 42 patients, 9 were excluded because of incomplete responses and 33 were eligible for analyses. The median (range) age at survey and the time from treatment completion to responding to the questionnaires was 70 (50-87) years and 4.2 (0.4-14.0) years, respectively. The median International Index of Erectile Function short form-5 score was 11 (5-25), and 3 (9.1%) and 9 (27.3%) patients had no and mild erectile dysfunction, respectively. The Male Sexual Health Questionnaire Ejaculatory Dysfunction short form results showed that 23 (69.7%) patients responded that they could ejaculate. Patients with higher Male Sexual Health Questionnaire Ejaculatory Dysfunction short form scores had better erectile function and quality of life than those with lower Male Sexual Health Questionnaire Ejaculatory Dysfunction short form scores. Preservation of erectile and ejaculatory functions was demonstrated in muscle invasive bladder cancer patients treated with tetramodal bladder-sparing therapy. In addition to lower urinary tract function, preservation of male sexual function, especially ejaculatory function, in bladder-sparing therapy can be an advantage over radical cystectomy.

Assessment of erectile and ejaculatory functions after bladder-sparing therapy against muscle-invasive bladder cancer

ABSTRACT Introduction Radical cystectomy (RC) is still gold standard for muscle invasive bladder cancer (MIBC). Whereas, bladder-sparing therapy with transurethral resection of bladder tumor (TUR) and chemoradiation therapy (CRT) has been recognized as an alternative treatment to RC for selected patients with MIBC. We have developed and implemented tetra-modality bladder-sparing therapy (TeMT) incorporating partial cystectomy (PC) in addition to maximal TUR and induction CRT to overcome local recurrence after bladder-sparing therapy (Kageyama et al. Am J Clin Oncol 2003, Koga et al. BJU Int 2012, Kijima et al. BJU Int 2019). There are few studies on erectile and ejaculatory functions after bladder-sparing therapy. Objective To cross-sectionally survey erectile and ejaculatory functions after TeMT in patients with MIBC. Methods Of the total 117 male patients with MIBC who completed TeMT between 2006 and 2019, 70 patients were set as the target to distribute the questionnaires after excluding patients lost to follow up as of February 2020, patients with local recurrence of MIBC or additional prostate cancer treatment. Erectile function was assessed using the International Index of Erectile Function short form (IIEF-5), and ejaculatory function using Male Sexual Health Questionnaire Ejaculatory Dysfunction short form (MSHQ-EjD-SF). Attending physicians handed the questionnaires to the patients at the first regular outpatient visit after February 2020 and had the patients complete them outside the office. Results Of 44 patients received the questionnaires between February and August 2020, 35 completed the questionnaires. The median age (range) of the eligible patients was 70 (50-87) years old, and the median time from the date of PC to the date of response was 5.2 (0.35-14) years. The results of IIEF-5 showed that 3 (9%) had no erectile dysfunction (ED) (22-25 points), 9 (26%) had mild ED (17-21 points), 4 (11%) had mild to moderate ED (12-16 points), 4 (11%) had moderate ED (8-11 points), and 15 (43%) had severe ED (5-7 points). Based on the results of MSHQ-EjD-SF, 23 patients (66%) responded that they could ejaculate. Of those, 5 patients (14%) scored 4 or higher on all questions 1-3 of MSHQ-EjD-SF, suggesting that they did not have ejaculatory dysfunction. Conclusions Preservation of erectile and ejaculatory functions was observed in MIBC patients treated with bladder-sparing therapy. Along with that of lower urinary tract function, preservation of male sexual function in bladder-sparing therapy, especially ejaculatory function which is inevitably lost by RC, is considered to be an advantage over RC. Disclosure Work supported by industry: no.

Ejaculation profiles in men after irreversible electroporation for prostate cancer

ABSTRACT Introduction Irreversible Electroporation (IRE) is an evolving strategy for the management of localized prostate cancer. Little data exists on sexual function, in particular ejaculation, in such patients. Objective We aimed to report the ejaculatory function in patients undergoing IRE. Methods Patients undergoing IRE with ≥1-year follow-up were evaluated. These patients were selected for focal therapy and consented to participate in a prospective registry. Eligibility criteria: Gleason score 3+4, PSA &amp;lt;20, no evidence of extracapsular extension, seminal vesicle invasion or lymph node involvement on standard imaging. The Gleason score 3+4 prostate cancer was allowed up to a maximum of two adjacent sextants within the prostate gland. Concomitant Gleason score 6 was untreated and monitored on active surveillance. They completed the Male Sexual Health Questionnaire ejaculation domain short form (MSHQ-EFD-SF) at 6 weeks, 3 months, 6 months, and 12 months post-IRE. This questionnaire has 4 questions: 3 questions sum scores (range 1-15), where lower scores indicate worse ejaculatory function, and the MSHQ-Bother question score (ranges 0-5), with higher scores indicating higher bother associated with ejaculatory difficulties. Comorbidities, demographics, and pathology parameters were recorded. Results 20 men have been evaluated to date with a mean age of 64.3 ± 4.8 years. Baseline testosterone and PSA were 536.3 ± 267.6 ng/dL and 6.2 ± 2.7 ng/mL. Mean prostate volume was 45.6 ± 11.9 cc. Median baseline score of MSHQ-EJD-SF was 13.5 (IQR 10, 14), and post-procedure median scores were 11 at 6 weeks; 12.5 at 3 months; 12 at 6 months; and 11.5 at 12 months (p-value =0.036). Scores for ejaculation strength and seminal volume ejaculated decreased significantly, and bother scores increased significantly between baseline and 1-year post-IRE. The ability to ejaculate during sexual activity did not change over time. Conclusions In our cohort of patients with prostate cancer who underwent IRE there was a significant difference in ejaculatory profiles between baseline and 1-year post-IRE. Disclosure Work supported by industry: no.

Ejaculation Profiles in Men after Irreversible Electroporation for Prostate Cancer

ABSTRACT Introduction Irreversible Electroporation (IRE) is an evolving strategy for the management of localized prostate cancer. Little data exists on sexual function, in particular ejaculation, in such patients. Objective We aimed to report the ejaculatory function in patients undergoing IRE. Methods Patients undergoing IRE with ≥1-year follow-up were evaluated. These patients were selected for focal therapy and consented to participate in a prospective registry. Eligibility criteria: Gleason score 3+4, PSA &amp;lt;20, no evidence of extracapsular extension, seminal vesicle invasion or lymph node involvement on standard imaging. The Gleason score 3+4 prostate cancer was allowed up to a maximum of two adjacent sextants within the prostate gland. Concomitant Gleason score 6 was untreated and monitored on active surveillance. They completed the Male Sexual Health Questionnaire ejaculation domain short form (MSHQ-EFD-SF) at 6 weeks, 3 months, 6 months, and 12 months post-IRE. This questionnaire has 4 questions: 3 questions sum scores (range 1-15), where lower scores indicate worse ejaculatory function, and the MSHQ-Bother question score (ranges 0-5), with higher scores indicating higher bother associated with ejaculatory difficulties. Comorbidities, demographics, and pathology parameters were recorded. Results 20 men have been evaluated to date with a mean age of 64.3 ± 4.8 years. Baseline testosterone and PSA were 536.3 ± 267.6 ng/dL and 6.2 ± 2.7 ng/mL. Mean prostate volume was 45.6 ± 11.9 cc. Median baseline score of MSHQ-EJD-SF was 13.5 (IQR 10, 14), and post-procedure median scores were 11 at 6 weeks; 12.5 at 3 months; 12 at 6 months; and 11.5 at 12 months (p-value =0.036). Scores for ejaculation strength and seminal volume ejaculated decreased significantly, and bother scores increased significantly between baseline and 1-year post-IRE. The ability to ejaculate during sexual activity did not change over time. Conclusions In our cohort of patients with prostate cancer who underwent IRE there was a significant difference in ejaculatory profiles between baseline and 1-year post-IRE. Disclosure No

MP56-16 ONE-STAGE URETHROPLASTY USING DORSAL-VENTRAL BUCCAL MUCOSAL GRAFT: LONG-TERM, VALIDATED PATIENT REPORTED OUTCOMES

You have accessJournal of UrologyTrauma/Reconstruction/Diversion: Urethral Reconstruction (including Stricture, Diverticulum) III (MP56)1 Sep 2021MP56-16 ONE-STAGE URETHROPLASTY USING DORSAL-VENTRAL BUCCAL MUCOSAL GRAFT: LONG-TERM, VALIDATED PATIENT REPORTED OUTCOMES John Barnard, and Joel Gelman John BarnardJohn Barnard More articles by this author , and Joel GelmanJoel Gelman More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002086.16AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The dorsal-ventral or "double face" buccal mucosa graft urethroplasty (BMG-U) via a dorsal approach was first described in a series of 18 patients in 2014. When the corpus spongiosum is intact, this surgery is appropriate for a 1-stage reconstruction where there is obliteration or near obliteration of a segment too long for anastomotic or augmented anastomotic urethroplasty (AAU). This technique is also a non-transecting alternative to AAU for shorter strictures unsuitable for onlay repair alone. Our objective was to provide global, validated and urethroplasty specific patient reported outcomes (PROMs) with this technique with up to 21 year follow up. METHODS: Patients were prospectively enrolled in our IRB approved urethroplasty outcomes study from 1998 to present. Anatomic success was assessed by cystoscopy >4 months after surgery. Long-term outcomes were assessed using the International Prostate Symptom Score (IPSS) and a 6Q-LUTS urethroplasty specific PROM, the Sexual Health Inventory for Men (SHIM), and the Male Sexual Health Questionnaire Ejaculatory Dysfunction Short Form (MSHQ-EjD-SF). A Student’s t-test evaluated differences in means for the PROMs with significance at p < 0.05. RESULTS: 38 patients underwent BMG-U. Mean age at surgery was 50.5 years (19.2-77.5). Mean follow-up was 78 months (13.4-262.4). The anatomic success rate was 97.2%, and the long-term functional success was 97.4%. Significant improvement was observed in IPSS (including quality of life metric) and 6Q-LUTS post-operatively, and this difference was sustained. No difference in SHIM or MSHQ-EjD-SF was observed. Overall satisfaction was 97.4%, and 91.9% stated they would undergo surgery again knowing their outcome. CONCLUSIONS: The dorsal-ventral BMG-U via a dorsal approach is associated with high patient satisfaction, and validated PROMs demonstrate lasting effect with no significant detriment to erectile and ejaculatory function. It was recently reported that for bulbar strictures, AAU was an independent risk factor for recurrence. Although we did not perform a comparative study, we speculate that the absence of urethral transection may be a factor contributing to a successful outcome that is comparable to the published results for strictures amenable to dorsal onlay substitution urethroplasty. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e975-e975 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information John Barnard More articles by this author Joel Gelman More articles by this author Expand All Advertisement Loading ...

Efficacy of a combination of dutasteride, tadalafil, and solifenacin in the treatment of previously unsuccessful patients

ObjectiveTo evaluate the efficacy and safety of simultaneous administration of dutasteride, tadalafil and solifenacin in the treatment of benign prostatic hyperplasia (BPH) with overactive bladder symptoms and lower urinary tract obstruction in previously unsuccessfully treated men. MethodsPatients in Group A (n=97) received dutasteride 0.5 mg/day, tadalafil 2.5 mg/day, and solifenacin 2.5 mg/day; Group B (n=95) received dutasteride 0.5 mg/day, tadalafil 5 mg/day, and solifenacin 5 mg/day; Group C (n=103) received dutasteride 0.5 mg/day, tadalafil 20 mg/day, and solifenacin 10 mg/day. The functional status of the lower urinary tract was assessed using the International Prostate Symptom Score (I-PSS), Overactive Bladder Questionnaire (OABq), International Index of Erectile Function (IIEF), and Male Sexual Health Questionnaire Ejaculatory Dysfunction (MSHQ-EjD) as well as uroflowmetry. ResultsThe total score of the sexual function remained unchanged in Group B of patients 81.3 points vs. 80.2 points (p>0.05) according to MSHQ-EjD, 61.4 points vs. 51.2 points (p>0.05) according to IIEF data. The total assessment of symptoms of hyperactivity significantly decreased in Group C according to OABq data after the 4th week of the study (17.5 points vs. 26.1 points, p<0.05) and remained below the baseline until the end of the study (15.2 points). ConclusionsThe simultaneous administration of standard doses of dutasteride, solifenacin, and tadalafil for 3 months is safe, effective, and can be recommended for patients with BPH to reduce symptoms of obstruction and hyperactivity of the bladder and maintain sexual function.

Review of Sexual Preservation After Novel Benign Prostatic Hyperplasia Surgical Treatment Modalities From Food and Drug Administration Clinical Trials.

Traditional benign prostatic hyperplasia treatment options, such as transurethral resection of the prostate and laser, have focused on addressing urinary symptoms for men; however, these options are associated with a high risk of sexual dysfunction. The objective of this study was to assess newer technologies (Aquablation therapy, UroLift, and Rezum) for the treatment of benign prostatic hyperplasia and the impact of preserving sexual function compared with transurethral resection of the prostate. A comprehensive review of Food and Drug Administration randomized studies from each of the technologies was carried out. A comparison of 3-year outcomes for International Index of Erectile Function-5 and Male Sexual Health Questionnaire Ejaculatory Function domain short form was analyzed. Aquablation and prostatic urethral lift were the only therapies to show permanent sexual function preservation in both Male Sexual Health Questionnaire Ejaculatory Function domain short form (ejaculatory function) and International Index of Erectile Function-5 (erectile function) at 3 years after treatment. For prostates less than 80 cc, Aquablation and prostatic urethral lift were able to demonstrate permanent sexual function preservation in both Male Sexual Health Questionnaire Ejaculatory Function domain short form (ejaculatory function) and International Index of Erectile Function-5 (erectile function) at 3 years after treatment. Bhojani N, Yafi FA, Misrai V, etal. Review of Sexual Preservation After Novel Benign Prostatic Hyperplasia Surgical Treatment Modalities From Food and Drug Administration Clinical Trials. Sex Med Rev 2021;9:169-173.

Retrograde ejaculation after holmium laser enucleation of the prostate (HoLEP)-Impact on sexual function and evaluation of patient bother using validated questionnaires.

A vast body of literature has focused on erectile function after Holmium Laser Enucleation of the Prostate (HoLEP). Interestingly, retrograde ejaculation (RE), despite its frequency has sparsely been investigated. To study patient perception and impact of RE on sexuality following HoLEP. We retrospectively analyzed 2,131 patients undergoing HoLEP 2006-2015 at our institution. Patients were followed via standardized questionnaires namely International Index of Erectile Function (IIEF) as well as Male Sexual Health Questionnaire Ejaculatory Short Form (MSHQ-EjD-SF). Exclusion criteria were missing/follow-up <6months, missing data on MSHQ-EjD-SF and IIEF score, resulting in 535 assessable patients. Multivariable logistic regression was employed to identify independent predictors of satisfaction with overall sex life (IIEF question 13). Median follow-up was 50months (IQR: 30-78). Overall, 495 (92.5%) patients reported RE. Patients differed significantly with respect to age (P=.036), IPSS at follow-up (P=.01), and erectile function (P<.001), whereas no other statistically significant differences were observed. In multivariable logistic regression analyses, presence of RE was not independently associated with satisfaction with overall sex life (OR: 2.7, 95% CI: 0.70-10.5, P=.1). However, in the cohort of patients exhibiting RE, patients who stated "feeling bothered by RE" had lower satisfaction with overall sex life (OR: 0.23, 95% CI: 0.13-0.38, P<.001). Bother by RE varied according to erectile function and did not impact overall satisfaction in men with superior erectile function. RE is a very common event after HoLEP but in this retrospective analysis was not associated with overall satisfaction with sex life. Contrary, satisfaction with sex life is impaired in patients who feel bothered by RE. Proper patient selection will pose key to identify patients in which RE bother will offset the benefits of LUTS relief.

Ejaculatory Dysfunction in Patients Presenting to a Men's Health Clinic: A Retrospective Cohort Study.

IntroductionPrevalence and bother of ejaculatory dysfunction (EjD) has yet to be evaluated in a men's health referral population.AimTo evaluate the prevalence and associated risk factors of EjD in men presenting to a men's health clinic.MethodsA retrospective review examined patients presenting to an outpatient men's health clinic who completed the Sexual Health Inventory for Men and the Male Sexual Health Questionnaire Ejaculatory Dysfunction (MSHQ-EjD) Short Form. Patient factors including demographics, comorbidities, and medication were examined. Descriptive statistics and multivariable logistic regression were used.Main Outcome MeasuresThe main outcomes of this study are Sexual Health Inventory for Men and MSHQ-EjD scores.ResultsA total of 63 (24%) of patients presenting to the urology clinic were characterized as having EjD based on questionnaire responses. The mean age for men with EjD was 53.8 years, while those without was 42.6 years (P < .001). Of men with EjD, 74.6% were at least moderately bothered (MSHQ-EjD ≥3). Men with EjD were more likely to have erectile dysfunction (77.8%) compared with those without (21%, P < .001) as well as a history of a pelvic cancer (20.6% vs 6%, P = .001). On multivariable regression, erectile dysfunction (odds ratio: 15.04, 95% confidence interval: 6.76–35.92, P < .0001) and alpha inhibitor prescription (odds ratio: 6.82, 95% confidence interval: 1.57–30.16, P = .01) were associated with a higher odds of EjD. ED was found to be a mediator of the relationship between EjD and age, as the age association was lost in the ED population on multivariable regression compared with the non-ED population where it remained significant.ConclusionsEjD is common among patients presenting to a men's health clinic and may present at varying ages, though it is more common in those aged 50 years or older; it is independent of age and race. EjD is associated with erectile dysfunction, pelvic cancer history, and use of alpha inhibitors, presenting a population that could be considered for screening.Kasman AM, Bhambhvani HP, Eisenberg ML. Ejaculatory Dysfunction in Patients Presenting to a Men's Health Clinic: A Retrospective Cohort Study. J Sex Med 2020;8:454–460.

AGE-RELATED CORRELATION BETWEEN ERECTILE DYSFUNCTION AND PREMATURE EJACULATION

Background and objectiveTo evaluate the relationship between erectile dysfunction (ED) and premature ejaculation (PE) among men aged 40–79 years and to compare age-related differences between men aged 40–59 years and 60–79 years. Materials and methodsFrom January 2014 to January 2019, records of 892 men aged 40–79 years were analyzed. We performed correlation analysis using the self-reported intravaginal ejaculation latency time (IELT), premature ejaculatory diagnostic tool (PEDT), Male Sexual Health Questionnaire-ejaculation (MSHQ-EjD), and International Index of Erectile Function5 (IIEF5) questionnaires. ResultsThe mean age of the 892 males was 52.8 ± 7.3 years (40–76). All subjects were divided into group 1 (40–59 years old) and group 2 (60–79 years old). The IIEF5 score of group 1 was significantly higher than that of group 2 (18.7 ± 5.5 vs. 17.7 ± 5.7, p = 0.049). Of the total subjects, 71 (8%) had IELT value of less than 1 min. A total of 51 (6.9%) and 20 (13.5%) were in groups 1 and 2, respectively (p = 0.02). The PEDT total score was higher and more subjects were identified as suffering from PE (PEDT ≥ 9) from amongst the ED subjects (IIEF-5 ≤ 21). In both groups 1 and 2, more PE subjects were identified in ED subjects (IIEF-5 ≤ 21) than normal subjects (IIEF-5 &gt; 21) (all p &lt; 0.01). In the total subjects, group 1 and 2, the IIEF-5 and PEDT score showed a weak negative correlation (r = −0.302, r = −0.361, r = −0.248, all p &lt; 0.01). In group 2, the IELT and MSHQ-EjD score also showed a weak positive correlation between the IIEF-5 score (r = 0.166, p = 0.044 and r = 0.164, p = 0.047, respectively). ConclusionMore subjects defined PE value as less than 1 min on the self-reported IELT in the elderly group ≥60 years than those among the 40–59 years age group; moreover, the lower the IIEF5 total score among subjects ≥ 60 years, the higher the PEDT score and the lower the IELT and MSHQ-EjD scores.

ASSOCIATION OF ERECTILE DYSFUNCTION AND PREMATURE EJACULATION IN MEN WITH CHRONIC PROSTATITIS

Background and objective Although several studies have reported that sexual dysfunction is associated with chronic prostatitis (CP), specific differences in self-reported questionnaires and correlation with CP are not well-known. This study aimed to evaluate the prevalence and correlation of sexual dysfunction in men with CP. Material and methodsThis cross-sectional study included 892 men who visited our health care center, who were then divided into two groups. In Group 1, subjects are characterized with National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) pain score ≥4, and Group 2 subjects are characterized with NIH-CPSI<4. Intravaginal Ejaculation Latency Time, Premature Ejaculatory Diagnostic Tool (PEDT), Male Sexual Health Questionnaire-ejaculation, International Index of Erectile Function (IIEF), and IIEF-5 were self-reported by participants. Total testosterone (TT) level was also checked. Data obtained were compared between the groups and the relationships identified. ResultsThe mean age was 52.8±7.3 years, and CP was prevalent in 136 (15.2%) of the 892 participants. All questionnaire scores showed worse results in Group 1 compared to those in Group 2 (p<0.05). In total, the prevalence of erectile dysfunction (IIEF-5≤21) and premature ejaculation (PEDT≥9) were 508 (56.3%) and 290 (32.5%), respectively. A higher prevalence of erectile dysfunction (71.3% vs. 53.6%, p<0.001) and premature ejaculation (44.8% vs. 30.3%, p=0.001) was identified in Group 1 than in Group 2. By correlation analysis, IIEF-5 (r=−0.208, p=0.015) and TT (r=−0.331, p=0.011) showed correlation with NIH-CPSI pain score in Group 1. ConclusionThe prevalence and severity of erectile dysfunction and premature ejaculation were higher in Group 1. Moreover, the IIEF-5 showed correlation with NIH-CPSI pain score. These results indicate that screening for erectile dysfunction and premature ejaculation in men with CP is useful for early detection of comorbidities.

Ejaculatory disorders after prostatic artery embolization: a reassessment of two prospective clinical trials

PurposeThis study aims to specify and explain the previous findings of unexpectedly high rates of ejaculatory disorders, i.e. 56%, found after prostatic artery embolization (PAE) in a randomized controlled trial comparing safety and efficacy of PAE and transurethral resection of the prostate (TURP).Patients and methodsCase report forms of the randomized controlled trial were analyzed to specify the grade of postoperative ejaculatory dysfunction 3 months postoperatively.In addition, study participants with assessable ejaculation were asked to complete the four-item Male Sexual Health Questionnaire-Ejaculation Dysfunction Short Form (MSHQ-EjD) referring to their ejaculatory function at present, as well as before treatment and 3 months after. Potential explanations for ejaculatory disorders after PAE were derived from histological examination of five radical prostatectomy specimens of patients that underwent PAE 6 weeks before radical prostatectomy within a proof-of-concept trial at the study site, St. Gallen Cantonal Hospital. An experienced uropathologist systematically examined the whole-gland embedded tissue with focus on structures that are involved into ejaculation.ResultsWhile patients after TURP predominantly suffered from anejaculation (52%), diminished ejaculation was found more often after PAE (40%). Significantly higher MSHQ-EjD scores were found 3 months after PAE and at a median follow-up of 31 months.Histological examination showed marked changes of structures involved into ejaculation (e.g., prostatic glands, seminal vesicles, ejaculatory ducts) after PAE.ConclusionAlthough anejaculation occurs less frequently after PAE (16%) compared to TURP (52%), patients have to be informed about the relevant risk of ejaculatory disorders, especially diminished ejaculation.

Troubles de l’éjaculation et sclérose en plaques : étude prospective de 44 patients

To analyze in a descriptive way the ejaculation disorders during MS and to study the correlations between dysejaculations, other sexual, urinary and anorectal disorders. Prospective, monocentric, non-interventional study. Ejaculation disorders were assessed by Premature Ejaculation Profile (PEP) scores, intravaginal latency, and the Male Sexual Health Questionnaire - Ejaculation (MSHQ-Ej). The sexual disorders were evaluated by the International Index of Erectile Function (IIEF15) and the Sclerosis Intimacy and Sexuality Questionnaire-19 (MSISQ). Forty-four men of mean age 46.8 (±10.3) years, with an average EDSS of 5.0 (±1.5) were included. According to the MSHQ-Ej score, ejaculation disorders were present in 28 out of 44 patients included (64%); 26/44 (59%) had an orgasm disorder, 23/44 (52%) a delay in ejaculation, 26/44 (59%) a decrease in ejaculation flow, 24/44 (55%) decreased ejaculated volume, 18/44 (41%) decreased ejaculation frequency, 15/44 (33%) ejaculatory pain and 11 34 (25%) showed systematic non ejaculation. The PEP score showed premature ejaculation in 14 patients (32%). The intra-vaginal latency time was less than 1minute in 6 patients (13.6%). There was a statistically significant correlation between ejaculation disorders and erectile dysfunction (P<0.05, correlation coefficient at 0.53) but no statistically significant correlation between ejaculation disorders and urinary or ano-rectal disorders. Dysejaculation was present in 64% of MS. These disorders were mainly characterized by a decrease in the volume of the ejaculation, the strength of ejaculation and the delay in ejaculation. 4.

Urethroplasty and Quality of Life: Psychometric Validation of a Dutch Version of the Urethral Stricture Surgery Patient Reported Outcome Measures

Purpose: The study aimed to translate the Urethral Stricture Surgery Patient Reported Outcome Measures (USS-PROM) questionnaire in Dutch. To validate this translated questionnaire, the study evaluates its psychometric properties in a different population, a different environment, and a different health care system. Questions about urinary incontinence and sexual functioning were added. Materials and Methods: Between December 2014 and January 2017, Dutch-speaking adult men scheduled for urethroplasty at Ghent University Hospital were prospectively enrolled in this study. Patients completed the USS-PROM before surgery, 3-6 months after surgery, and 1 year after surgery. Psychometric criteria included content validity, criterion validity, internal consistency, reproducibility, responsiveness, and floor and ceiling effects. (EC/2014/0438). Results: A total of 100 patients were included, 39 patients completed both the preoperative and the postoperative questionnaire, and 30 patients completed the USS-PROM twice within a short period of time in order to evaluate test-retest reliability. Pearson correlation coefficients showed no statistical significant correlation between lower urinary tract symptoms (LUTS) scores and maximum flow rates. Cronbach's α was 0.81 and 0.89, respectively, for the LUTS score and the summative Male Sexual Health Questionnaire Ejaculatory Dysfunction short form (MSHQ-EjD short form) score. The intraclass correlation coefficients ranged from 0.72 to 0.94. Significant changes were observed in all items except the MSHQ-EjD short form scores. All values exceeded the predefined thresholds. Conclusions: The Dutch version of the USS-PROM has adequate psychometric properties and is a valid instrument to assess patient-reported outcome measures in men undergoing urethroplasty.

Editorial Comment

This is a multicenter collaborative study about sexual and ejaculatory function after staged penile urethroplasty. As Patel et al 1 Patel D.P. Elliott S.P. Voelzke B.B. et al. Patient-reported sexual function after staged penile urethroplasty. Urology. 2015; 86: 395-400 Abstract Full Text Full Text PDF Scopus (24) Google Scholar note, surgical success following staged penile urethroplasty with oral mucosa grafts has been well described; however, little is known about how the surgery affects sexual function. Patient-Reported Sexual Function After Staged Penile UrethroplastyUrologyVol. 86Issue 2PreviewTo evaluate sexual function after staged penile urethroplasty with oral mucosal graft (OMG). Full-Text PDF ReplyUrologyVol. 86Issue 2PreviewWe thank Dr. Buckley1 for her thoughtful editorial comments. Our analyses are likely underpowered to detect a change in preoperative vs postoperative Sexual Health Inventory for Men (SHIM) and Male Sexual Health Questionnaire Ejaculatory Domain (MSHQ-EjD) scores, given the small sample size and limited questionnaire completion. However, our results do add to the current literature to help guide reconstructive urologists when counseling patients considering staged penile urethroplasty. Importantly, a significant percentage of patients reported a change in penile curvature, length, and/or sensitivity on our nonvalidated posturethoplasty questionnaire. Full-Text PDF

Patient-Reported Sexual Function After Staged Penile Urethroplasty

To evaluate sexual function after staged penile urethroplasty with oral mucosal graft (OMG). We identified men with completed staged penile urethroplasty with OMG from the Trauma and Urologic Reconstruction Network of Surgeons database between January 1, 2010 and May 1, 2014. Our primary outcome was change in total Sexual Health Inventory for Men (SHIM) and total Male Sexual Health Questionnaire Ejaculatory Domain (MSHQ-EjD) Short Form at baseline vs after the second stage of the procedure. Second, we assessed subjective changes in penile curvature, length, and sensation. Thirty-three patients were included with a mean age of 45years and mean body mass index of 27.6kg/m(2). Urethral strictures arose from failed hypospadias repair in 52% and lichen sclerosus in 27%. Fifty-two percent of patients reported a previous urethroplasty. The median follow-up time between the second stage procedure and postoperative questionnaires was 6.3months (interquartile range: 3.5-13.3). There was no significant change in the total SHIM (Δ0.64, 95% confidence interval [CI]:-3.00∼1.72) and MSHQ-EjD (Δ1.55, 95% CI:-1.53∼4.63) scores preoperatively vs postoperatively. In addition, 32% reported improved and 52% no change in satisfaction with sexual intercourse (SHIM Q5). Forty percent of patients reported reduced and 45% no change in bother with ejaculation after surgery (MSHQ-EjD Q4). Men reported new penile curvature (23%), loss of penile length (55%), and altered penile sensitivity (45%) after surgery. Patients undergoing staged penile urethroplasty with OMG are likely to have minimal changes in erectile and ejaculatory function postoperatively, although many may experience new penile curvature, reduced penile length, and/or reduced penile sensitivity.

Efficacy of Long-Term Daily Dosage of Alfuzosin 10 mg upon Sexual Function of Benign Prostatic Hypertrophy Patients: Two-Year Prospective Observational Study

PurposeTo identify sexual function improvement associated with alfuzosin (10 mg daily for 2 years).Materials and MethodsWe enrolled 30 men with lower urinary tract symptom (LUTS) who visited Gyeongsang National University Hospital between 2010 and 2012. At first visit, urinalysis, prostate specific antigen, transrectal ultrasound, and uroflowmetry were performed. The nternational Prostate Symptom Score (IPSS), quality of life (QoL), International Index of Erectile Function (IIEF), and Male Sexual Health Questionnaire Ejaculation Function Domain (MSHQ-EjFD) questionnaires were administered, and the subjects answered the same questionnaires at 1 month, 6 months, 1 year, and 2 years of follow-up.ResultsTwelve men completed of the entire study. After administration of alfuzosin, the median IPSS at first visit, 1 month, 6 months, 1 year, and 2 years was 18.00 (interquatile range [IQR]: 14.00~29.75), 20.00 (IQR: 11.50~30.00), 15.50 (IQR: 8.50~25.25), 14.50 (IQR: 9.25~19.50), and 11.50 (IQR: 5.00~17.75), respectively, which showed an improvement. The median QoL at the same times was 4.50 (IQR: 4.00~5.00), 4.50 (IQR: 4.00~5.00), 3.00 (IQR: 2.00~4.00), 3.50 (IQR: 2.25~4.00), and 3.00 (IQR: 1.00~3.00), respectively, and also showed improvement. Likewise, the median IIEF was 36.50 (IQR: 24.50~46.75), 37.50 (IQR: 26.75~47.25), 45.50 (IQR: 35.00~59.75), 48.50 (IQR: 34.75~62.75), and 47.50 (IQR: 43.25~61.00), while the median MSHQ-EjFD was 19.00 (IQR: 12.0~24.75), 19.50 (IQR: 13.50~27.75), 23.00 (IQR: 19.25~32.25), 26.50 (IQR: 18.25~34.50), 27.00 (IQR: 21.50~32.50), respectively, with both showing improvement.ConclusionsAfter administration of alfuzosin (10 mg daily for 2 years), the IPSS, QoL, IIEF, and MSHQ-EjFD all improved significantly. This means long-term administration of 10 mg of alfuzosin daily would be effective not only for LUTS but also erectile function and ejaculation.

Sexuality and Management of Benign Prostatic Hyperplasia with Alfuzosin: SAMBA Thailand

Benign prostatic hyperplasia (BPH) is a common condition among elderly men. The aim of therapy is to improve lower urinary tract symptoms (LUTS) and quality of life (QoL) and to prevent complications. The primary objective was to assess the effect on ejaculatory dysfunction (EjD) of 6 months treatment with alfuzosin (XATRAL) 10 mg once daily (OD) in men with LUTS suggestive of BPH in Thailand. Secondary objectives were to evaluate the efficacy of alfuzosin on LUTS, bother score (International Prostate Symptom Score [IPSS] 8th question), erectile dysfunction (ED), onset of action, and tolerability. Overall, 99 men with moderate to severe LUTS suggestive of BPH (mean IPSS 18.9, bother score 4.3) were enrolled in an open-label study. Sexual function was evaluated at baseline and after 6 months treatment, using the International Index of Erectile Function-5 and the Male Sexual Health Questionnaire (MSHQ) ejaculation score, a new validated questionnaire assessing seven EjD symptoms. The main outcome measure is mean change from baseline to the end of treatment in the MSHQ Ejaculation score. MHSQ ejaculation score significantly improved from 23.09 at baseline to 21.54 at 6 months (P=0.022). Overall, 70% of patients perceived an improvement in LUTS within 1 week (36.3% within 3 days). IPSS total score significantly improved from 18.93 at baseline to 9.59 at 6 months (P<0.001). IPSS voiding and irritative subscores also significantly improved. The percentage of patients with moderate or severe ED decreased from 35.3% at baseline to 21.8% at 6 months. Most adverse events were dizziness (3%) and orthostatic hypotension (1%) with minor intensity. No significant change in blood pressure and heart rate was observed. Alfuzosin 10 mg OD administered for 6 months provides a marked and rapid (within 1 week) improvement in LUTS and bother score while improving both ED and EjD.