Sexual Dysfunction In Patients Research Articles

Sexual dysfunction in patients with focal dystonia

Sexual dysfunction in patients with focal dystonia

Sex and the veins. A cross-sectional analysis on sexual dysfunction in patients with Chronic Venous Disease

BackgroundThis study aimed to investigate the presence of sexual dysfunction (SD) in patients with Chronic Venous Disease (CVD) and if CVD treatments may have an impact on SD evolution in these patients. MethodsInclusion criteria were patients of both sexes and genders, with minimum age of 18, with first diagnosis of CVD. Exclusion criteria were presence of known sexual dysfunction of organic origin, arterial system diseases, malignancies and endocrine system diseases. Included patients were administered the ASEX (Arizona Sexual Experience) questionnaire that was administered at the moment of study inclusion (T0), and for patients that resulted affected from sexual dysfunction, were administered also, after CVD treatments at 6 months (T1) and after 12 months (T2). ResultsA total of 649 patients with CVD were recruited. After the administration of the ASEX questionnaire, 122 patients (18.8 %) resulted affected from SD. Female sex, C3–C6 clinical stages, and the presence of Coronary Artery Disease (CAD), hypertension, and hyperlipidemia were more associated with the presence of SD. SD improved in all patients’ population, especially after CVD treatment at T2. ConclusionsCVD patients may experience SD, especially in female sex, in more advanced disease stages. SD in CVD patients appears to improve after adequate CVD treatment.

Male sexual dysfunction in patients with chronic kidney disease: a cross-sectional study

Sexual dysfunction is common in males with chronic kidney disease (CKD), but yet the prevalence and specific relationship between CKD and sexual dysfunction, especially premature ejaculation (PE), remain to be investigated in China; This study aims to examine the prevalence and association between CKD and sexual dysfunction in male patients in China; In this cross-sectional, non-interventional, observational study conducted at a single center. 72 male patients with CKD were enrolled. Data collection included socio-demographic information, assessments via the 5-item version of the International Index of Erectile Function (IIEF-5), the Chinese version of the Premature Ejaculation Diagnostic Tool, the Patient Health Quentionnnaire-9 and the General Anxiety Disorder-7. Data analysis was performed using R version 3.5.2 and SPSS software version 25.0; Among the 72 CKD patients, 56.9% experienced erectile dysfunction and 29.2% had PE. Various factors including estimated Glomerular Filtration Rate, Albumin-to-Creatinine Ratio, psychological aspects, medication use were found to be associated with sexual dysfunction in these CKD patients; Sexual dysfunction is prevalent in males with CKD and is, influenced by multiple factors. It is important for clinicians to focus on sexual dysfunction in this patient group and further investigate its underlying mechanisms.

Exploring sexual function in adrenal insufficiency: findings from the Dual RElease hydrocortisone versus conventionAl glucocorticoid replaceMent therapy in hypocortisolism (DREAM) trial.

Data on sexual function in patients with adrenal insufficiency are scarce and largely controversial. To investigate sexual dysfunction in patients with primary and secondary adrenal insufficiency and the effects of switching to once-daily dual-release hydrocortisone on sexual function in outcome assessors blinded, randomized, multicenter, active comparator clinical trial. Eighty-nine adrenal insufficiency patients on conventional, multiple daily doses of glucocorticoid replacement, enrolled in the Dual RElease hydrocortisone versus conventionAl glucocorticoid replaceMent in hypocortisolism (DREAM) trial, were randomly assigned to continue their therapy or to switch to an equivalent dose of dual-release hydrocortisone. Sixty-three patients (34 women) consented to sex steroid measurements and questionnaires completion for quality of life (Addison's disease-specific quality-of-life questionnaire) and sexual function evaluation (female sexual function index for women, International Index of Erectile Function-Erectile Function for men) at baseline and 24weeks after randomization. At baseline, sexual dysfunction was observed in 41% of women and 59% of men with adrenal insufficiency. In both sexes, no associations were found between sexual function and hormone levels, whereas Addison's disease-specific quality-of-life questionnaire total and fatigue domain scores positively correlated with total female sexual function index and International Index of Erectile Function-Erectile Function scores. At 24weeks, there was no significant difference either in sexual function or sex steroid levels between study groups. In the dual-release hydrocortisone group, the variation in the female sexual function index desire domain score was positively associated with the change in Addison's disease-specific quality-of-life questionnaire's symptom domain score (ρ=0.478, p=0.045). Sexual dysfunction is common in adrenal insufficiency patients and is likely explained by multiple factors. dual-release hydrocortisone treatment is not directly associated with sexual function improvement, but an indirect effect mediated by quality-of-life amelioration cannot be excluded.

THE ROLE AND CORRECTION OF SEXUAL DYSFUNCTION AS A COMPONENT OF THE QUALITY OF LIFE IN PATIENTS OPERATED ON FOR CEREBRAL ANEURYSM RUPTURE

Introduction. Hemorrhagic stroke due to the rupture of the intracranial aneurysm (IA) is a typical clinical manifestation of the disease and one of the main causes of disability, affecting the quality of life in operated patients.
 The aim. To determine the feasibility and safety of implementing protocols for diabetes mellitus (DM) treatment as part of rehabilitation interventions in patients who have undergone surgery for the rupture of intracranial aneurysm (IA) in the brain.
 Materials and methods. To determine the effectiveness and safety of implementing diabetes mellitus (DM) treatment protocols in individually developed rehabilitation interventions following surgery for the rupture of intracranial aneurysm (IA) in the brain, a retrospective cohort study was conducted in parallel groups.
 Results. Sexual dysfunctions (SD) resulting from the rupture of IA are multifactorial. The causes of SD can be categorized as primary, secondary, and tertiary. Primary causes include damage to brain structures by hemorrhagic stroke or vascular ischemic events affecting sexual functioning, pre-existing medical conditions, and side effects related to medication therapy during treatment. Secondary causes encompass persistent sensorimotor disturbances due to a prior stroke. Issues related to cognitive, behavioral, and psychosocial adaptation constitute tertiary causes of SD. The effective and prompt correction of sexual dysfunction in patients following the rupture of cerebral blood vessel aneurysms largely depended on the proper administration of anesthesia during surgical interventions and intensive therapy in the perioperative period. This includes preoperative preparation and patient analgesia, the administration of anesthesia, and adequate postoperative care.
 Conclusions. The application of SD correction in men as part of rehabilitation measures from the 6th to the 24th month after surgical treatment of intracranial aneurysm (IA) has a positive impact, reducing SD regression from 88.9% (n=56/63) to 34.9% (n=22/63).

Sexual quality of life and postoperative deep dyspareunia after vNOTES benign adnexal procedures.

This study aimed to investigate the impact of vNOTES on postoperative sexual dysfunction in patients undergoing adnexal procedures. We analyzed data from patients who underwent vNOTES adnexal surgeries for benign conditions between May 2020 and May 2023. The primary outcome was the presence of new postoperative deep dyspareunia (DD) or other sexual dysfunctions, which were assessed through a phone survey conducted 6 to 24 months after surgery. Secondary outcomes included surgical feasibility, operative times, complications rate, and postoperative pain evaluation. We included 103 patients for primary and secondary outcomes and 111 patients for secondary outcomes analysis only. Newly postoperative DD was reported by three patients (2.9%), remained present at 12 postoperative months in one case (1.0%), and spontaneously disappeared in two cases (1.9%) after four and 10 postoperative months, respectively. In the remaining 100 patients (97.1%), no new DD or other sexual function disorders were reported after surgery. vNOTES procedures were successfully performed in all cases, with a mean operative time of 38.2 ± 19.6 min and a conversion rate to conventional laparoscopy of 0.9%. No significant complication was observed. This study suggests a very limited risk of developing postoperative sexual dysfunction after vNOTES benign adnexal procedures.

(220) Sexual Dysfunction in Krabbe Disease Patients - A Scoping Review

Abstract Introduction Krabbe Disease (KD) or globoid cell leukodystrophy is a rare autosomal recessive lysosomal storage disorder affecting approximately 1 in 100,000 people worldwide. GALC gene mutations associated with KD involve a galactosylceramidase deficiency, which damages the oligodendrocytes and Schwann cells. Therefore, nervous system demyelination is a hallmark of KD. While only a few infants survive beyond two years in early-onset Krabbe disease, patients with late-onset Krabbe Disease exhibit a milder phenotype and longer life expectancy. Late-onset KD symptoms include progressive muscle weakness and stiffness, developmental regression, behavioral changes, dementia, hearing loss, vision problems, and seizures. Only a few cases of sexual dysfunction associated with KD have been reported in literature but they highlight the wide-ranging impact of this condition on young adults and adults. Objective This review aims to examine sexual dysfunction in KD, as reported in literature. We employ a broad definition of sexual dysfunction (erectile dysfunction, dyspareunia, orgasmic disorder, muscle weakness, etc.) and its incidence in both sexes with KD. A comprehensive review of this topic has not yet been conducted, and we offer here preliminary information for healthcare providers when addressing sexual concerns in patients with lysosomal storage disorders. Methods A literature search was conducted by two separate investigators who independently screened studies and abstracted data. Data sources included peer reviewed publications from the following databases: PubMed, Scopus, Web of Science, EMBASE, Cochrane, Google Scholar and Clinical trials.gov. There were no restrictions on language nor date of publication. The search algorithm utilized to generate the review list was: (Globoid cell leukodystrophy OR Galactosylcerebrosidase deficiency OR Galactosylceramidase deficiency OR Krabbe disease OR Late-onset Krabbe disease OR GALC mutation). Results were further filtered by article type, restricting articles to Case Reports, Clinical Trials, Reviews, and Systematic Reviews. Results were then screened for reports containing data on sexual dysfunction in patients with KD. Results A total of four case reports and one review paper contained reports of sexual dysfunction in KD patients. All cases involved late-onset Krabbe disease, characterized by a milder and more insidious presentation. Genitourinary symptoms reported included urinary incontinence (N=3) and erectile dysfunction (N=2), however, there were no reports (N=0) of symptoms related to female sexual dysfunction. Other symptoms commonly reported in late-onset KD that might be linked to sexual function were ataxia, spasticity and weakness of lower limbs (N=3), and sensory dysfunction due to peripheral neuropathy (N=4). Conclusions This pioneering review reveals that patients with KD experience symptoms of sexual dysfunction. While the rarity of KD makes it challenging to study it clinically, sexual dysfunction may be consistent with the known pathophysiology of late-onset KD. This review also highlights that sexual dysfunction in female patients with KD is an under-investigated component of the disease presentation. Future clinical research into this important comorbidity, especially in female patients where the literature is lacking, may improve the care of patients with KD. Disclosure No.

(012) Sexual Dysfunction in Men After Failed Hypospadias Repair

Abstract Introduction Hypospadias is commonly treated in childhood, and future sexual function of such patients is sometimes overlooked. Some published reports reveal excellent sexual function following hypospadias repair at long term, while other authors state high prevalence of sexual dysfunction which depends on original position of urethral meatus. Patients with complications of primary hypospadias repair are one of the most difficult subpopulations to evaluate. This is a unique subset of patients who should be described separately from men who underwent successful hypospadias repair. Objective To describe the spectrum of sexual dysfunction in patients with sequelae of failed hypospadias repair and our experience in its management. Methods We evaluated 112 patients with a history of failed hypospadias repair, defined as presence of voiding symptoms or cosmetic problems remaining despite previous surgery or caused by it. Patients’ median age was 29.5 years (range: 18–62). There were no intersex cases. Only 9.8% (11/112) underwent single attempt at surgical reconstruction, the median number of attempts was 3.5 (range: 1–9). Patients with IIEF-EF score ≤ 25 were considered to have erectile dysfunction; those with IIEF-EF ≤ 16 underwent penile doppler ultrasound, penile electromyography and endocrine assessment. Results 64.2% of patients (72/112) were dissatisfied with penile appearance, 40.2% (45/112) had ED, 71.4% (80/112) had ejaculation disorders. Psychogenic ED was diagnosed in 21 patients with preserved non-coital erections and no evidence of organic ED. Median IIEF-EF in ED patients was 20 (range: 8–25). Asthenic ejaculation, delayed ejaculation and anejaculation were present in 63.4% (71/112), 7.1% (8/112) and 3.5% (4/112) patients, respectively. Premature ejaculation was present in 28.6% (32/112) patients, but its association with hypospadias or previous surgery is unlikely. On univariate analysis only the number of previous attempts at surgical repair was a significant predictor of sexual dysfunction following definitive surgery (p = 0.033). Rate of normal sexual function was 37.5%, 23.5% and 9.1% among patients with history of ≤ 3, 4–6 and ≥ 7 procedures, respectively. Conclusions Failed hypospadias repair may lead to a wide spectrum of sexual dysfunction, involving sexual desire, erection and ejaculation. Repeated surgery leads to increased risk of sexual dysfunction which may be devastating for patient’s quality of life. Disclosure No.

(113) Investigating the Prevalence of Erectile Dysfunction in Patients with Non-Alcoholic Fatty Liver and Its Relationship with the Severity of Fatty Liver

Abstract Introduction Today, the relationship between erectile dysfunction in men and the pathogenesis process in the field of metabolic syndrome is of interest. Non-alcoholic fatty liver disease is one of the diseases related to metabolic syndrome, which has a high prevalence. This study was conducted with the aim of evaluating the prevalence of erectile dysfunction in men with non-alcoholic fatty liver disease and investigating the relationship between its severity and the grading of liver complications. Objective In this research, the frequency of erectile dysfunction and decreased libido and sexual satisfaction in patients with non-alcoholic fatty liver disease have been investigated and compared with the control group. Also, the relationship between the severity of sexual dysfunction and fatty liver grading has been investigated. Methods In this study, 1200 patients with non-alcoholic fatty liver disease were randomly selected and participated in this study between 2019 and 2022. In order to investigate sexual disorders, the standard male sexual performance questionnaire was used along with the demographic questionnaire. Results The results of this study showed that the indicators of male sexual dysfunction in patients with non-alcoholic fatty liver have a high prevalence (44.5%). Also, the severity of erectile dysfunction has a significant relationship with the severity of non-alcoholic fatty liver disease (pv=0.002). Conclusions A holistic view of the health category requires that in the treatment of medical disorders, the effective factors and consequences of the disorder should be considered. Paying attention to the diagnosis and treatment of sexual disorders in the treatment process will be one of the most important aspects of the patient's health; Because erectile dysfunction in men, apart from the effect on sexual relations, will have destructive consequences on their psychological indicators and quality of life. On the other hand, it is possible to improve the quality of patients' health by modifying the lifestyle and interdisciplinary cooperation. Disclosure No.

(027) The Prevalence of Female Sexual Dysfunction in Patients with Irritable Bowel Syndrome (IBS)

Abstract Introduction Irritable bowel syndrome is a functional disorder in the digestive system that is defined by specific intestinal-gastric symptoms. A combination of psychological and organic causes are involved in its creation and continuation. A wide range of psychological disorders and personality traits have been reported in patients with irritable bowel syndrome; But one of the consequences and complications of this syndrome can be the effect on sexual performance. Objective In this study, the frequency of each of women's sexual dysfunction, including hypo active sexual desire and arousal disorder, orgasm dysfunction and pain during sex, and the level of satisfaction in sex were compared with the control group. The relationship between the severity of each of these sexual disorders and the severity of symptoms of irritable bowel syndrome has been investigated. Methods In this study 300 patients with irritable bowel syndrome presentation has compared with control group by using FSFI (Female Sexual Function-Index) standard questionnaire which its validity and reliability were assessed and demographic questionnaire. Results Examining the dimensions of sexual desire in two groups showed that the frequency and intensity of sexual stimulation and satisfaction with it in women with irritable bowel syndrome is significantly lower than the control group. The number of orgasms and intensity of orgasm experienced and satisfaction with it in women with irritable bowel syndrome is significantly lower than in the control group. Examining the dimensions of sexual satisfaction in two groups showed that the level of closeness with a sexual partner in women with irritable bowel syndrome is significantly lower than in the control group. Based on the results, there is a significant relationship between the score of sexual pleasure and sexual satisfaction and the severity of irritable bowel syndrome symptoms. Conclusions The results of this research showed that symptoms of irritable bowel syndrome can have significant effects on sexual performance and relationship satisfaction in women. Since women are exposed to more psychological stressors compared to men, and on the other hand, psychological factors can aggravate the symptoms of irritable bowel syndrome, the doctor's attention to sexual problems in women can improve the health and quality of life of affected patients. Disclosure No.

251P Sexual dysfunction in patients with lung cancer: Interim analysis of the LUDICAS study

251P Sexual dysfunction in patients with lung cancer: Interim analysis of the LUDICAS study

Factors associated with sexual dysfunction in patients with colorectal cancer in Iran: a cross-sectional study

Sexual dysfunction is a prevalent issue among individuals diagnosed with colorectal cancer (CRC), significantly impacting their quality of life. However, limited research has explored the factors associated with sexual dysfunction in CRC patients in Iran. This cross-sectional study aimed to identify the demographic factors that may contribute to sexual dysfunction in this population. A cross-sectional study involving CRC patients was conducted from April 1, 2022, to May 1, 2022, in Tabriz, Iran. Ethical approvals were obtained, and convenience sampling was employed at outpatient chemotherapy centers in five Tabriz hospitals. Validated questionnaires, including participants characteristics form, the Female Sexual Function Index (FSFI) for females and International Index of Erectile Function (IIEF) for males, were utilized. Data were analyzed using IBM SPSS Statistics version 24, employing descriptive statistics and stepwise linear regression to assess association between mentioned factors and sexual function. Among 256 participants, 50.4% were males, 49.6% were females, and 80.5% were married. The predominant age range was 50–60 years. The study findings revealed a high prevalence of sexual dysfunction among both female (Mean ± SD: 10.91 ± 8.67, Min–Max: 3.20–33.00) and male (Mean ± SD: 27.64 ± 16.28, Min–Max: 11–62) CRC patients. Factors such as the presence of a colostomy for FSFI (P < 0.001), type of treatment received for both FSFI and IIEF (P < 0.001), type of housing for both FSFI and IIEF (P < 0.001), occupation for FSFI (P < 0.001), presence of other diseases for FSFI (P = 0.047), and time since the last chemotherapy session for FSFI (P = 0.018), Education for IIEF (P = 0.026), and Age for IIEF (P = 0.002) were identified as significant factors of sexual dysfunction. These demographic factors demonstrated varying effects on sexual function, underscoring the complexity of this issue. The results underscore the significance of addressing sexual health concerns in CRC patients and highlight the necessity for tailored interventions to enhance their overall well-being. Healthcare providers should recognize the influence of demographic factors on sexual function and contemplate integrating sexual health assessments and interventions into the care of CRC patients. Further research is needed to comprehend better the underlying mechanisms and devise effective strategies for managing sexual dysfunction in this population.

Sexual dysfunction in patients with diabetes: association between remnant cholesterol and erectile dysfunction

BackgroundErectile dysfunction (ED) is closely associated with dyslipidemia; however, it is yet unknown how ED and remnant cholesterol (RC) are related. As such, this research sought to explore the correlation between RC and ED among individuals with diagnosed with diabetes.MethodsThis cross-sectional study used information from 215 males from National Health and Nutrition Examination Survey (NHANES) from 2001 to 2004. RC was calculated as follows: the values of high-density lipoprotein cholesterol (HDL-c) and low-density lipoprotein cholesterol (LDL-c) were subtracted from the total cholesterol (TC) value, while ED diagnoses were based on self-reports. Weighted logistic regression analyses using both univariate and multivariate approaches were conducted to assess the correlation between RC and ED.ResultsAfter comprehensive adjustment, multivariable logistic regression models revealed a strong correlation between RC and ED in subjects with diabetes (with an odds ratio (OR) of 7.49 and a 95% confidence interval (CI) of 1.98–28.37; P = 0.004). On categorizing RC into 3 grades (T1-T3), the OR corresponding to higher RC grade increased. Despite the results not reaching statistical significance upon categorization, a consistent and statistically significant trend (P for trend < 0.05) was observed.ConclusionThis study indicated a correlation between increased RC levels and a higher prevalence of ED in diabetic males. RC may serve as a promising predictor of ED in individuals with diabetes. However, additional studies are required to confirm these findings.

Factors associated with sexual dysfunctions in Nairobi, Kenya.

Background: Sexual dysfunctions are associated with comorbidities, which can be the cause or theresult of the dysfunctions. Little research has been done to document comorbidities in Kenya. This studydocumented comorbidities associated with sexual dysfunctions in patients treated at the Sexology Clinicin Nairobi.Objective: To provide health service providers with evidence on what to investigate when patientspresent with sexual dysfunctions so that treatment is directed to the root causes.Methods: Quantitative retrospective analysis of records of patients presenting with sexual dysfunctionswas performed at the Sexology Clinic in Nairobi. Records analysis of patients’ files seen at the clinic for12 months were analyzed. A total of 396 files were reviewed (362 males and 34 females) using astandard tool. Biopsychosocial factors and treatment correlations were performed.Results: The commonest comorbidities in male sexual dysfunctions were metabolic diseases comprisinghypertension (19%), hyperlipidemia (17%), diabetes (14%), and obesity (9%). Hormonal disorders werealso common, with testosterone deficiency being the leading factor at 16% followed byhyperprolactinemia and thyroid hormone disorders each at 2% of all male dysfunctions. Medicines usedin treating metabolic disorders also adversely affect sexual function in males. Conversely, the mostcommon comorbidities in female sexual dysfunction were menopause and female genital cutting. In bothmales and females, comorbidities included infertility, cancer and its treatment, and psychological orpsychiatric problems. Sleep deprivation, alcohol and drug abuse, stressful lifestyles, and relationshipdisharmony were associated with sexual dysfunction in both sexes.Conclusions: Lifestyle diseases are commonly associated with sexual dysfunctions, which could beindicators for lifestyle diseases.Recommendations: Service providers should use sexual dysfunctions as an entry point for full patientassessment for commonly associated disease conditions.

Impact of peritoneal vaginoplasty combined with radical hysterectomy on the quality of sexual life for patients with early-stage cervical cancer: trial protocol for a multi-center superiority randomized controlled trial.

Radical hysterectomy (RH) is commonly used to treat early-stage cervical cancer in women of childbearing age and sexual dysfunction due to postoperative vaginal shortening is a major concern. The impact of intraoperative vaginoplasty on prognosis and quality of sexual life in patients with early-stage cervical cancer remains controversial and lacks high-level evidence. However, there are few reports on vaginoplasty after RH to lengthen vagina in patients. This prospective, multi-center, randomized controlled trial aims to explore the impact of peritoneal vaginoplasty with or without ovarian transposition after laparoscopic RH on sexual dysfunction in patients with early-stage cervical cancer. Eligible patients will be randomly assigned (1:1) to receive peritoneal vaginoplasty or not. The primary evaluation indicators are female sexual function index (FSFI) and male sexual satisfaction scale. The secondary evaluation indicators include EORTC QLQ-CX24, 2-year overall survival (OS), 5-year OS, 2-year progression-free survival (PFS), 5-year PFS and surgery-related complications. The trial will enroll 368 patients from 6 hospitals in China over a 3-year period and follow up for 5 years. Chinese Clinical Trial Registry Identifier: ChiCTR2000040610.

Sexual Dysfunction after Clipping of Ruptured Intracranial Aneurysms.

Sexual dysfunction significantly affects interpersonal relationships and overall quality of life. It remains a matter of concern for risk assessment and counseling in patients with ruptured intracranial aneurysms. To assess the sexual dysfunctions in patients undergoing clipping for ruptured intracranial aneurysms and comparative evaluation among different anterior circulation aneurysms. We prospectively included 40 male patients of ruptured intracranial aneurysms of anterior circulation (age range: 20-60 years; sexually active preoperatively), managed with craniotomy and clipping. We evaluated the sexual outcome in patients with excellent Glasgow outcome score (GOS) five at a minimum one year of follow-up. Patients with GOS-5 status at follow-up were broadly classified into two groups: Anterior communicating artery aneurysm (Acom), and non-Acom) aneurysms. We valued sexual outcome with Subjective Sexual Arousal Scale for Men at follow-up, and compared in the two groups. Mean age of patients was 44.78 ± 9.51 years. Besides 20 Acom aneurysms, other groups included 11 middle cerebral artery aneurysms, five internal carotid artery aneurysms, three posterior communicating artery aneurysms, and one distal anterior cerebral artery aneurysm. The mean follow-up was 24.45 ± 13.58 months. Patients with non-Acom aneurysms had an overall better outcome in the sexual performance domain "P = 0.015," mental satisfaction domain "P = 0.009," and sexual assertiveness domain "P = 0.007." However, there was no statistical difference in partner communication domain "P = 0.593," and partner relationship domain "P = 0.378." Overall, the sexual outcome was inferior in patients treated for Acom aneurysms compared to other anterior circulation aneurysms. In cases of aneurysmal subarachnoid hemorrhage, sexual dysfunctions are common even after good clinical outcomes. The study revealed prominent differences in outcomes on the sexual quality of life in patients harboring Acom aneurysms as compared to anterior circulation aneurysms located off-midline.

Sexual Dysfunction and Dyspareunia in the Setting of the Genitourinary Syndrome of Menopause.

Sexual dysfunction is a common consequence of the genitourinary syndrome of menopause (GSM). In this book chapter, we discuss the pathophysiology, prevalence, evaluation, and evidence-based management of sexual dysfunction in patients affected by GSM. Additionally, we present an algorithm to guide clinicians in the management and treatment of sexual dysfunction in this setting based on available evidence and best practices.

Scientific Evaluation of A Unani Pharmacopoeia-Based Formulation on BPH in Animal Model

BPH (Benign prostatic hyperplasia) is a common problem of the prostate gland that affects elderly men with age and major cause of lower urinary tract symptoms (LUTS) like urgency of urination, frequency of micturition, dysuria, nocturia, dribbling, and burning of urine. If left untreated, the condition can lead to severe urinary retention, recurrent UTI, and, in severe cases, renal failure, etc. Alpha-blockers and 5-alpha reductase inhibitors (5-ARIs) are two main classes of drugs that are used in conventional therapy to treat BPH. These phytochemical therapies are extremely effective, but standard control methods have unfavorable side effects too. Conversely, evidence, though limited, has shown that alternative medicines are safer and have the potential to improve LUTS and quality of life, in addition to improving sexual dysfunction in patients with BPH. The purpose of the study is to assess the efficacy of 50% hydroalcoholic UPBF extract on BPH in TP-induced rats, and the effects of the drug were compared between the treated and untreated groups. The experimental design for anti-BPH activity was carried out following the Bhavin model. 48 Wistar rats were divided into 6 groups, with 8 rats in each group. Group 1, plane control (untreated rats), group 2, negative control (treated with TP 5 mg/kg), group 3, negative control (treated with TP+ finasteride 1 mg/kg), and groups 4,5 and 6 served as tests controls (A, B, and C) treated with TP+ UPBF extract 100 mg/kg, 150 mg/kg, and 200 mg/kg as low, medium, and high doses, respectively. BPH was induced in rats by administration of testosterone propionate (TP) in arachis oil, and treatment was done orally with a standard drug (finasteride) and a test drug (UPBF) once a day for 28 consecutive days. Before and after initiating the study, each rat was weighed and documented, and after 28 days, the collection of blood samples and the prostate gland was done under light anesthesia. The parameters of the study were accessed, like prostate weight, prostate-to-body weight ratio, histopathological investigation of the prostate, percentage of inhibition, percentage of recovery, and determination of ST and STP levels. Data from the results were expressed as the mean ± standard error of the mean (SEM). Evaluation between group results was carried out with the one-way ANOVA test followed by Tukey’s test, and the significant value of p was &lt;0.05. Both histopathological and biochemical parameter results showed significant improvements in rats treated with finasteride and UPBF extract at a dose of 200 mg/kg (p&lt;0.001). In addition, ST and STP levels showed a significant reduction in comparison with the BPH group. It can be concluded from the findings of the results in both biochemicals and histopathological parameters that the test drug (UPBF) possesses significant effects against the TP-induced BPH in rats. The findings suggested that the test drug can be used independently in the management of BPH as well as for lower urinary tract symptoms.

Sexual Dysfunction in Female Patients with Type 2 Diabetes Mellitus—Sneak Peek on an Important Quality of Life Determinant

Type 2 diabetes mellitus (T2DM) is a multisystemic disease with a high global burden and chronic complications. Sexual dysfunction (SD) in patients with T2DM is an often-overlooked complication, despite its high impact on quality of life (QoL). Female sexual disorders can affect women of reproductive age as well as menopausal women. Proposed mechanisms are intertwining a variety of physiological, neurological, vascular, hormonal, and psychological variables. The impairment of sexual function has been linked to hyperglycemia, insulin resistance, chronic low-grade inflammation, endothelial dysfunction, neuropathy, and hormonal abnormalities. There are many different manifestations of female sexual dysfunction, such as insufficient sexual desire, diminished arousal, difficulty in eliciting orgasm, and pain during sexual engagement. Numerous studies have shown that the QoL of patients living with diabetes mellitus (DM) is lower than that of those without DM. SD in women with T2DM leads to deteriorated QoL. Treatment must be individualized based on the diagnosis and the sexual dysfunction as well as underlying medical, psychological, and interpersonal issues. The goal of modern medical care for patients living with diabetes is not to delay death but to improve their health and QoL. The present review article aimed to raise awareness about female sexual dysfunction in patients with T2DM and to provide an overview of its impact on QoL.

Sexual dysfunction in patients with cancer, a challenge in oncology practice: results of the CLARIFY project.

Sexual dysfunction (SD) associated with oncological treatment is a common and understudied disorder. Our aim was to characterize SD in a cohort of Spanish patients. Analytic observational study in patients included in the CLARIFY H2020 project at the Hospital Universitario Puerta de Hierro. Clinical variables and validated measures of sexual function were collected from October 2020 to May 2022. Frequency and quality of sexual activity were assessed. Descriptive, trend associations, and logistic regression analyses were performed. A total of 383 patients were included: breast cancer 68.14% (261), lung cancer 26.37% (101), and lymphoma 5.50% (21). Mean age was 56.5 years (range 33-88). 19.58% (75) were men and 80.42% (308) were women. 69% and 31% of men and women, respectively, reported being sexually active. The absolute frequency of overall sexual dissatisfaction was 76% in women and 24% in men. Women with breast cancer were most likely to have severe sexual dysfunction. Those with early disease had resolved complaints after 5 years. In multinomial logistic regression, significant associations were found in women with metastatic breast cancer and severe disorders of arousal (p 0.000), lubrication (p 0.002), orgasm (p 0.000), as well as dissatisfaction with sexual performance (p 0.000) and global sexual dissatisfaction (p 0.000). Women with lung cancer have severe arousal dysfunction (p 0.016) and global sexual dissatisfaction (p 0.044). Our population has a high prevalence of SD, which supports the need to increase awareness of this disorder among the medical oncology team and the importance of including sexual health assessment in oncological patient follow-up.