Sexual Dysfunction Patients Research Articles

Development of a new digital sexual health assessment tool to help patients better understand the factors involved in their sexual disorders – “The Sexual Dysfunction Evaluation Tool” (SEXDET)

IntroductionA visual digital tool called SEXual Dysfunction Evaluation Tool (SEX-DET) was created for assessing the causes of sexual dysfunction, based on a biopsychosocialsexual and relational schema, to assist patients in understanding the relative influence of the various factors contributing to their sexual dysfunction. The aim of this study was to evaluate satisfaction of this tool in sexual dysfunction patients and practitioners. MethodsA satisfaction study of the SEX-DET was performed in 50 patients (20 F, 30 M) consulting for a sexual trouble and 3 practitioners. The main reasons for consultation were erectile dysfunction (36%) and desire disorder (30%). ResultsAll the participants agreed that the SEX-DET helped them to understand the origin their trouble (46% strongly, 42% moderately, 12% somewhat), the various factors involved (56% strongly, 22% moderately and 18% somewhat) and the management of their trouble (6% strongly, 47% moderately, 33% somewhat). Overall, 94% of participants found that the SEX-DET was easy to use (58% strongly, 16% moderately and 20% somewhat). Practitioners acknowledged the user-friendly interface, its critical role in improving patients’ understanding and providing a comprehensive visualization of the dimensions associated with sexual dysfunction, even if one practitioner threatened the tool's intrinsic inclination to oversimplify complex data. ConclusionSEX-DET enabled to improve patients’ understanding of their trouble and helped practitioners in structuring better communication during consultations communication regarding sexual dysfunction. The shortcomings of this study was its focus on short-term outcomes, self-reported data, and the absence of control group.

Prevalence and Predictors of Sexual Dysfunction (SD) after Treatment of Localized Rectal and Anal Cancer (LRAC)

SD is possible after treatment of LRAC and is associated with distress and impaired quality of life. We report the prevalence of SD in our LRAC patients treated with curative intent. We also evaluate patient/treatment-related factors associated with SD. LRAC patients from 2010-2022 were identified. Consented patients were surveyed and patient/treatment factors were collated from medical records. Sexual function (SF) was measured using the Female Sexual Function Index (FSFI) and the International Index of Erectile Function (IIEF). The impact of disease/treatment on SF since treatment was measured using the SF Questionnaire Medical Impact Scale (SFQ-MIS). FSFI ≤ 19.2 and IIEF ≤ 32.2 were considered SD based on the mean scores of SD patients in the primary literature. SFQ-MIS ≥ 15.5 was used to dichotomize responses into "at least some impact" versus "at least no impact." Spearman rank correlations examined correlations between FSFI/IIEF and factors. Comparisons involving componential domains and factors were based on a two-sided Mann-Whitney test. RT dose, surgery, the extent of lymphadenectomy, T stage, and time since treatment were factors assessed in all patients. In females, dilator use during RT, tumor distance (TD) from the anterior vaginal wall and whole vagina, and V25Gy, V45Gy, and mean dose to the anterior vaginal wall and whole vagina were other factors assessed. In males, TD from the neurovascular bundle (NVB), V25Gy, V45Gy, and mean dose to NVB was used. Forty-five patients (13.5% response rate) completed study surveys (62% males; 80% white; 71% rectal cancer patients). The median age and time since treatment were 63 and 4 yrs. respectively. RT doses ranged from 25 - 54Gy. The overall prevalence of SD was 58% (71% in females; 50% in males). The proportion of patients who reported at least some SF impact was 56% (53% in females; 57% in males). There was a marginal association between higher total IIEF and receipt of surgery (p = 0.059). A correlation of 0.44 was seen between total IIEF and TD from upper NVB-the strongest among all comparisons. In the domains of IIEF, statistically significant associations were found between intercourse satisfaction (ISAT) and TD from upper NVB (p = 0.004), overall satisfaction (OSAT) and TD from lower NVB (p = 0.040), and ISAT and T stage (p = 0.047). There were marginal associations between TD from upper NVB and OSAT (p = 0.052), orgasm (p = 0.063), and erectile dysfunction (p = 0.097). There was a marginal association between V25Gy to the anterior vaginal wall and pain during penetrative sex (p = 0.095). No other association with FSFI or its domains was significant. SD is prevalent in a large majority of patients studied (58%). In males, higher TD from NVB was associated with better overall SF, better intercourse, and overall satisfaction. While a higher proportion of females had SD, no significant associations were found in females likely due to their small sample size.

Management of Sexual Dysfunction in Gastrointestinal Disorders.

Patients with gastrointestinal (GI) disorders are at increased risk of sexual dysfunction (SD) due to a combination of biomedical, psychological, social, and interpersonal factors. While most patients desire information on the impact of their GI disorder on sexual function, few providers initiate this conversation. GI providers should routinely assess their patients for SD, validate these concerns, and provide brief education and a referral for evaluation and/or treatment. Treatment of sexual concerns is often multidisciplinary and may involve a sexual medicine physician, pelvic floor physical therapists, and sex therapists.

The early definitive internal fixation of Complex Pelvic Fracture and its outcome: our experience in level 1 trauma care centre.

<p><strong>Background:</strong> Complex pelvic fractures have high mortality and morbidity hence required urgent resuscitation, haemodynamic stabilization and fracture fixation. Keeping in mind the various schools of thought regarding definitive management, there is need to study the outcomes of complex pelvic fractures after internal fixation surgery.</p><p><strong>Methods:</strong> Twenty patients with complex pelvic fractures treated with internal fixation surgery in between 1<sup>st</sup> June 2018-31<sup>st</sup> December 2019 with at least 12 months follow-up were included. Clinical and functional outcome of these patients was studied and evaluated using Majeed and Hannover scoring systems.</p><p><strong>Results:</strong> Of 20 patients, 19 had closed while 1 had open pelvic fracture while 11 had tile type B and 9 had tile type C fracture. After 12 months of follow up, 72% patients of tile B fractures and 55.6% in tile C had excellent Majeed score with rest having good score. Hannover score was very good in 36.4% tile B cases and 22.2% tile C cases and good in 63.6% tile B cases and 77.8% tile C cases. Type of fracture (type B or type C) had a statistically significant co-relation with chronic pain (p=0.016). It was also found that urogenital injury and sexual dysfunction (p=0.007) had a significant co-relation.</p><p><strong>Conclusions:</strong> Early definitive internal fixation in patients with complex pelvic fracture had very good clinical and functional outcome. Most common associated injuries in complex pelvic fractures are urogenital injuries due to close proximity. In the outcomes chronic pain and sexual dysfunction are major issues. The sexual dysfunction patients usually associated fracture of pubic rami or pubic diastasis.</p>

Sexual Dysfunction in Chronically Medicated Male Inpatients With Schizophrenia: Prevalence, Risk Factors, Clinical Manifestations, and Response to Sexual Arousal.

BackgroundSexual dysfunction is a common symptom in patients with schizophrenia, especially in chronically medicated patients. However, the relationship between sexual dysfunction and emotional response to sexual arousal in male patients with schizophrenia remains unclear. This study aimed to assess the incidence, risk factors of sexual dysfunction in males, and their clinical correlations to sexual arousal in male patients with schizophrenia in China.MethodsA total of 162 male patients, aged 18–50 years, with schizophrenia were recruited from a psychiatric hospital in Ganzhou. The clinical symptoms were assessed by the Positive and Negative Syndrome Scale (PANSS). The Arizona Sexual Experience Scale was utilized to evaluate sexual dysfunction. Erotic images were selected from International Affective Picture System (IAPS). Sixty-eight out of the 162 subjects completed the erotic pictures reactivity task.ResultsOverall, 48 (29.6%) patients were measured as having global sexual dysfunction, 72 (44.4%) patients as having strength of sex drive dysfunction, 51 (31.5%) patients as having sexual arousal dysfunction, 55 (34.0%) patients as having penile erection dysfunction, 60 (37.0%) patients as having reached orgasm dysfunction, and 60 (37.0%) patients as having satisfaction with orgasm dysfunction. The sexual dysfunction patients had significantly higher scores on the negative symptoms of the PANSS. The only important predictor of sexual dysfunction was the severity of PANSS negative factor. The sense of pleasure and arousal post viewing erotic images in the sexual dysfunction group were lower compared to the non-sexual dysfunction group. The sense of pleasure and approach motivation were significantly negatively correlated with the severity of sexual dysfunction.ConclusionsThis study shows that nearly one-third of young and middle-aged chronically medicated male inpatients with schizophrenia suffer from sexual dysfunction. The negative factor of the PANSS can be regarded as the risk factor of sexual dysfunction. Schizophrenia patients with sexual dysfunction experienced lower pleasure and higher avoidance motivation than non-sexual dysfunction patients when exposed to erotic stimuli.

Comparative analysis of postoperative sexual dysfunction and quality of life in type a aortic dissection patients of different ages

BackgroundTo compare postoperative sexual dysfunction (SD) and quality of life (QOL) in Type A Aortic Dissection (AAD) Patients of Different Ages.MethodsFrom January 2018 to December 2019, 204 AAD postoperative survivors in Union Hospital of Fujian Medical University were selected and were divided into young group (less than 50 years old) and elderly group (more than 50 years old). We evaluated SD according to the male International Erectile Dysfunction Index (IIEF-5) and female sexual function index (FSFI). The Short Form 12 Health Survey Questionnaire (SF-12) and Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q) were used to investigate the QOL, Quick Inventory Depressive Symptomatology-Self Report (QIDS-SR) and the Beck Depression Inventory-II (BDI-II) to investigate depressive symptoms.ResultsOne hundred seventy-five patients completed all the questionnaire (85.8%). The total SD prevalence rate was 38.9% (68 cases), with 27.4% of the young (20 cases) and 47.1% of the elderly (48 cases). The age of non-SD and SD patients was 49.0 ± 11.5 and 56.9 ± 10.8 years, respectively (P = 0.03). Compared with non-SD patients, the total physical health of SD patients was significantly worse (P = 0.04), however, the mental health was not significantly worse (P = 0.77); the depressive symptoms did not expressed a significant difference between the SD and non-SD groups (QIDS-SR P = 0.15, BDI-II P = 0.06). Total physical health scores in the young SD group did not show significant better than elderly SD group (P = 0.24), however, total mental health scores showed significantly worse (P = 0.04), depressive symptoms scores were significantly higher (QIDS-SR P = 0.03, BDI-II P = 0.04).ConclusionThe postoperative AAD SD prevalence of elderly is higher than that of young, and the total physical health of SD patients is poorer than those without SD patients. The young SD patients did not show a significant higher physical health scores than the elderly SD patients, instead, the young SD patients were more psychologically affected than the elderly SD patients, whose mental health was worse, and depression symptoms were more obvious, suggesting that the factors affecting the QOL of postoperative SD patients are related to physical factors, but the young postoperative SD patients mainly affected by psychological factors.

Sexual Function in Young Individuals With Multiple Sclerosis: Does Disability Matter?

Studies on the prevalence of sexual dysfunction (SD) in multiple sclerosis (MS) have shown that 40% to 80% of women and 50% to 90% of men have had sexual complaints. Sexual function is often disregarded during consultation with healthcare professionals, and SD is frequently underdiagnosed. The aim of this study was to investigate the prevalence of SD and its relationship to sociodemographic and disease-related factors, with regard to disability state, in a hospital cohort of MS patients, by using a semistructured interview. Of 130 screened outpatients, 87 met the inclusion criteria and completed the study. The mean age of the participants was 39.3 ± 8.3 years, with a disease duration of 8.3 ± 5.4 years and a mean Expanded Disability Status Scale (EDSS) score of 2.04 ± 0.19. Sexual function was evaluated by means of a semistructured interview, investigating a patient's 3 main life areas: sociodemographic information, illness perception, and sexuality. Approximately 70% of the patients complained at least 1 SD (decreased libido, erectile dysfunction, premature or retarded ejaculation, painful penetration), and 22% of them reported the disorder as frequent. The disease duration was associated with lower satisfaction in sexual function, and lack of sexual interest was the most common problem having a negative correlation with EDSS. Healthcare professionals involved in MS, should assess patients for SD. Further studies should be fostered to better quantify SD etiology, the degree of sexual impairment, and its impact on patients' quality of life to "overcome" this problem.

Sexual dysfunction as a determinant of cardiovascular outcome in patients undergoing chronic hemodialysis.

Sexual dysfunction (SD) is common in men and women with chronic kidney disease (CKD) and is considered as an early marker for cardiovascular (CV) disease. We hypothesized that patients with SD have higher risk for vascular damage of the large arteries, accelerated vascular aging, and consequently higher CV mortality than other end-stage renal disease (ESRD) patients. In this study, the International Index of Erectile Function (IIEF) questionnaire and the Female Sexual Function Index (FSFI) questionnaire were applied in men and women, respectively. Ambulatory blood pressure monitoring (ABPM), arterial stiffness, and ankle-brachial index (ABI) were performed in all patients. Pulse wave velocity (PWV) was significantly slower in non-SD patients (10.5 vs. 8.8 m/s; p < 0.001) with significantly lower number of non-SD patients with PWV > 10 m/s compared to SD patients (p < 0.001). Only 57% of the patients with prior CV event had PWV > 10 m/s. No difference in AIx was observed. Non-SD patients had better values of ABI (0.83 vs. 1.09; p < 0.05) with significantly lower number of non-SD patients with ABI < 0.9 compared to SD patients (p = 0.001) as well as smaller percentage of LVH (57.5% vs. 80.7%; p = 0.01). There were no differences in hemodynamic parameters when patients with SD were divided by sex. Pulse wave velocity was the strongest predictor of lower IIEF and FSFI scores. Mean survival time was longer in non-SD patients than in SD patients (11.6 vs. 10.5 months, p = 0.019). The higher incidence of prior CV events and CV mortality found in SD patients on hemodialysis (HD) is a consequence of accelerated vascular aging. Sexual dysfunction in HD patients should also be considered a marker of subclinical organ damage and future CV events. Our study confirms the predictive role of PWV in HD patients.

The Arizona Sexual Experiences Scale: A Validity and Reliability Assessment of the Thai Translation (ASEX-Thai) in Parkinson's Disease

Cultural sensitivities tend to limit assessments of sexual dysfunction (SD) in Parkinson's disease (PD). To assess the validity and reliability of the Thai translation (ASEX-Thai) of the Arizona Sexual Experiences Scale (ASEX). The validity and reliability of ASEX-Thai were assessed with a random sample of 40 PD patients. Back translation and cross-cultural modifications assured content validity. Criterion validity used DSM-IV-TR criteria and receiver operating characteristics (ROC) analysis was calculated for cutoff points plus sensitivity and specificity. Internal consistency was assessed with Cronbach's alpha coefficient. Test-retest reliability was assessed by Pearson's correlation at baseline and at a 2-month follow-up. Criterion validity was conducted with a positive correlation between the clinical diagnosis of SD and DSM-IV-TR (r = 0.601; p < 0.001). The ROC analysis differentiated between SD and non-SD patients (p < 0.001). The cutoff point of ASEX-Thai at ≥16 points effectively screened for SD (sensitivity 96.2%, specificity 92.9%). Reliability was documented with the Cronbach's alpha of all items at baseline and at a 2-month follow-up with values of 0.948 and 0.962 respectively. The Pearson's correlation also showed highly significant test-retest reliability [Item 1 (r = 0.959, p < 0.001), Item 2 (r = 0.914, p < 0.001), Item 3 (r = 0.944, p < 0.001), Item 4 (r = 0.992, p < 0.001), Item 5 (r = 0.930, p < 0.001), and total ASEX-Thai score (r = 0.883, p < 0.001)]. ASEX-Thai is a valid and reliable instrument for the assessment of sexual dysfunction in Thai PD patients.

Sexuality in Advanced Age in Jewish Thought and Law

Judaism has a positive attitude to sexual relations within a marriage, and views such sexual relations as important not only for procreation but also as part of the framework of marriage. This is true for any age group, and sexuality is seen as an essential element of marriage for couples of advanced age. In this article, the authors present the views of Jewish law and thought regarding sexuality among older couples. The authors illustrate this using 3 case studies of couples who sought guidance in the area of sexuality. In addition, this area of counseling benefits greatly from an ongoing relationship and dialogue between expert rabbis in the field and therapists treating older Orthodox Jewish patients for sexual dysfunction. The triad relationship of couple, therapist, and rabbi enhances the ability to treat and assist such couples to seek treatment and overcome their difficulties.

Which patients with sexual dysfunction are suitable for testosterone replacement therapy?

According to all the consensus and statements of the major societies, hypogonadism should be considered a medical problem, termed late onset hypogonadism (LOH) or testosterone deficiency syndrome (TDS), only when symptoms are present. One of the most common symptoms of LOH/TDS is sexual dysfunction (SD). The main purpose of this review is to discuss the role of testosterone (T) in men's sexual function, including epidemiology, pathophysiology, diagnostic procedures, and treatment efficacy in patients affected by erectile dysfunction (ED). The prevalence of hypogonadism in men with ED ranges from 1.7% to 35%. In ED patients, hypogonadism is often associated with reduced sexual desire and nocturnal penile erections, while association with sex-induced erection is less evident. This is because T regulates not only cyclic guanosine monophosphate (cGMP) formation, through nitric oxide synthase (NOS) stimulation, but also its catabolism, through phosphodiesterase-5 (PDE5) activity. The androgen-dependent PDE5 expression could explain the reduced effectiveness of PDE5 inhibitors (PDE5i) in the treatment of erectile dysfunction in hypogonadal patients. Accordingly, T substitution in these subjects restores responsiveness to PDE5i. Recognising hypogonadism in patients with ED is essential in order to appropriately treat the disease. However, suspecting LOH/TDS in SD patients is not an easy task. Recently published structured inventories, such as ANDROTEST, might help physicians to recognize hypogonadism and to further pursue its appropriate diagnosis and treatment.

Sexual Functioning After Renal Transplantation

Sexual dysfunction (SD) is common among end-stage renal disease (ESRD patients). Studies about SD in the posttransplantation period have reported various results. The aim of this study was to investigate SD prevalence and relationship to sociodemographic and clinical variables. Sexual functioning was measured using the Arizona Sexual Experiences Scale (ASEX), and depression by the Beck Depression Inventory (BDI) in 98 patients. We observed that 68 patients (69.4%) had SD; the prevalence rates were 56.9% for men and 93.4% for women. ASEX item scores among single patients were higher than those among married patients. Subjects with SD were more depressed ( P < .001) and less educated (for female patients, P = .02). These findings showed that SD is common in Turkish patients, especially women. SD patients should be integrated into routine examination throughout the transplant, process, and when needed, their treatment management should include education regarding sexual life complaints.

A preliminary examination of the pornography experience of sex offenders, paraphiliacs, sexual dysfunction patients, and controls based on Meese Commission recommendations.

The Meese Commission Report claims exposure to pornography leads to sex offenses and states it is important to examine the developmental patterns of offenders, in particular age of first masturbatory experience, role of pornography in that experience, age of first exposure to pornography, age of commission of the deviant behavior, and long-term use of pornography and length of duration of deviancy. This study found the frequency of use of pornography, age of exposure to pornography, age of first masturbation experience, and use of pornography during first masturbation experience, for sex offenders, paraphiliacs, sexual dysfunction patients, and controls were not significantly different.

Bem sex role inventory undifferentiated score: A comparison of sexual dysfunction patients with sexual offenders

Bem sex role inventory undifferentiated score: A comparison of sexual dysfunction patients with sexual offenders