Differentiated thyroid carcinoma (DTC) is the most common endocrine malignancy, disproportionately affecting women. Despite excellent survival outcomes, DTC treatment, particularly long-term thyrotropin (TSH) suppression therapy, has been associated with differences in psychological well-being and sexual function. Although the association between thyroid dysfunction and female sexual dysfunction (FSD) is well-established, limited data exist regarding FSD in premenopausal women with DTC. To investigate the presence and severity of depressive symptoms and FSD in premenopausal women with DTC and examine their association with thyroid hormone levels and thyroid autoimmunity. This cross-sectional study included 110 premenopausal women with DTC on stable TSH suppression therapy, stratified into three groups by TSH level (<0.1, 0.1-0.5, and 0.5-2.5 mIU/mL), and 40 healthy controls. Sexual function and depressive symptoms were assessed using the Female Sexual Function Index (FSFI) and Beck Depression Inventory-II (BDI-II), respectively. Thyroid function tests, thyroid antibodies, and sex hormones were evaluated. Correlation and logistic regression analyses were performed. Women with DTC showed higher rates of sexual dysfunction and depressive symptoms than controls (FSD 53.6% vs. 10%; depressive symptoms 65.5% vs. 15%), with the greatest impairment under stronger TSH suppression. Increased BDI-II scores were inversely correlated with FSFI total and subdomain scores (desire, satisfaction, pain). TSH levels were positively associated with FSFI scores, while free thyroxine and free triiodothyronine showed inverse correlations with satisfaction and lubrication. Elevated thyroglobulin antibody levels were associated with higher depression scores. Multivariable models were adjusted for age. Covariates included body mass index, risk of recurrence, disease duration, TSH, free thyroxine, free triiodothyronine, thyroglobulin antibody, total testosterone, prolactin, and BDI-II. Logistic regression analysis showed that suppressed TSH and higher BDI-II scores were independently associated with higher odds of FSD. Sexual dysfunction and depressive symptoms were more frequent in women with DTC than in healthy controls; moreover, among women with DTC, the greatest deterioration was seen in those receiving stronger TSH suppression. These findings highlighted the need for comprehensive care that includes psychological and sexual health assessment in the long-term management of women with DTC.

Navigating the complexities of rectal cancer management: Shared decision-making and patient perspectives in critical choices.

Outcome assessment after urethral stricture surgery remains inconsistent, with success traditionally defined by anatomical patency or absence of reintervention. Growing recognition of discordance between objective findings and patient experience has made it necessary to re-evaluate how outcomes are measured. This review explores contemporary approaches to defining success and highlights the need for standardized, patient-centered endpoints. Current literature shows that anatomical and objective functional measures alone fail to capture the complexity of postoperative recovery. Patient-reported outcome measures have gained increasing importance, revealing persistent urinary symptoms, sexual dysfunction, and quality-of-life impairment despite technically successful reconstruction. Functional outcomes such as storage symptoms, ejaculatory changes, and perceived penile alterations are increasingly recognized as key determinants of satisfaction. Emerging composite outcomes aim to integrate anatomical, functional, and patient-reported domains into a unified framework. Outcome evaluation in urethral stricture surgery is shifting toward multidimensional assessment that prioritizes patient perception alongside traditional metrics. Standardized composite endpoints may improve comparability across studies, support shared decision-making, and better align surgical success with patient expectations.

Post-Finasteride Syndrome: Survey of Dermatologists From the Spanish Hair and Nail Disorders Group.

Consumer-directed female technology ("femtech") is rapidly expanding into pelvic floor and sexual health, yet clinicians have limited guidance on the safety, efficacy, and appropriate use of these products. The objective of this review is to summarize currently marketed female technology products relevant to pelvic floor disorders, sexual function, and vaginal health, and to highlight key evidence, limitations, and implications for clinical practice. This is a narrative review of commercially available technologies for urinary incontinence, sexual dysfunction, and vaginal health. Product categories include external and intravaginal pelvic floor muscle training devices, vibrators, and dilators for sexual function and pain, regenerative medicine interventions such as platelet-rich plasma injections, sexual wellness applications, and direct-to-consumer vaginal microbiome testing platforms. Pelvic floor devices and in-office energy therapies offer nonsurgical options for urinary incontinence, but high-quality, independent long-term data are scarce, and costs are often substantial. Sexual wellness devices, including vibrators and dilators, are increasingly recognized as therapeutic tools but are variably supported by clinical research. Early studies of platelet-rich plasma suggest potential benefit for sexual function, yet protocols and outcomes remain heterogeneous. Digital applications and microbiome tests expand access and patient engagement but frequently lack rigorous validation and may raise concerns regarding privacy, equity, and interpretation of results. Female technology offers novel opportunities to address pelvic floor and sexual health outside traditional care pathways. Urogynecologists should be familiar with these products, provide balanced counseling on benefits, risks, and cost, and advocate for independent trials to define their role within evidence-based care.

Premature ejaculation (PE) is one of the most prevalent sexual dysfunctions in males. Repetitive transcranial magnetic stimulation (TMS) demonstrates potential modulatory effects on ejaculatory function, however, the effects of different stimulation frequencies remain unclear. To investigate the effects of low-frequency and high-frequency rTMS in a rat model of rapid ejaculation and compare these outcome with dapoxetine, a standard pharmacological intervention. Male rats exhibiting rapid ejaculation were identified based on sexual behavior parameters, then randomly allocated into four groups: 1-Hz rTMS, 10-Hz rTMS, dapoxetine control, and sham control groups. Ejaculatory behavior, hippocampal 5-hydroxytryptamine (5-HT) levels, brain-derived neurotrophic factor (BDNF) expression, and activation of the BDNF-receptor tyrosine kinase receptor B (TrkB) pathway were investigated before and after 2 weeks of treatment. Following 2 weeks of intervention, we found that all rTMS and dapoxetine groups showed significant improvements in ejaculation latency compared with controls, with the 10-Hz rTMS group showing the most substantial effect. While dapoxetine slightly outperformed 10-Hz rTMS in increasing 5-HT levels, 10-Hz rTMS induced a greater upregulation of BDNF and TrkB expression. Correlation analysis revealed that BDNF levels were positively associated with EL (r = 0.8817, p < 0.001) and negatively associated with ejaculation frequency (r = -0.8702, p < 0.001). rTMS exhibited frequency-dependent therapeutic efficacy in rapid ejaculation rat models, with high-frequency protocols demonstrating superior benefits compared with low-frequency interventions. These effects are mediated through activation of the BDNF-TrkB pathway and enhanced serotonergic signaling, suggesting high-frequency rTMS as a promising non-pharmacological therapy for PE.

Many people with cancer (PWC) continue to experience persistent biopsychosocial and existential challenges across the cancer care continuum. Symptoms such as anxiety, depression, cancer-related fatigue and pain, sleep disturbance, fear of cancer recurrence, cognitive impairment, and reduced quality of life remain highly prevalent during and after treatment, underscoring the need for interventions that address both psychological and physiological dimensions of distress. Mind-body interventions encompass a diverse group of practices that explicitly target the bidirectional relationship between mental and physical processes and are increasingly incorporated into integrative oncology as adjuncts to standard care. This narrative review synthesizes current evidence on mind-body interventions for improving biopsychosocial outcomes in adult PWC. We review guideline-recommended interventions including mindfulness-based interventions, yoga, tai chi and qigong, relaxation therapies, hypnosis, music therapy, acupuncture, acupressure, massage, reflexology, and aromatherapy; as well as emerging modalities such as psychedelic-assisted therapy, biofield therapies, nature-based interventions, and mindfulness-based approaches for sexual dysfunction. For each intervention, we summarize target symptoms, treatment-phase considerations, and the quality and limitations of the supporting evidence. Finally, we discuss future directions with an emphasis on improving methodological rigor, elucidating mechanisms of action, expanding implementation and access, and extending research across diverse populations and all stages of cancer care, including survivorship and end-of-life contexts.

Rape is one of the silent savagely violent sexual offences in Bangladesh. Without being affected by strong laws against it, the ill rape continues to uprising. Growing trend of the cruel sexual offence (rape) represents a major psychological sexual disorder and public health problem and headway of the country. But sometimes silence is thus symbolic of powerlessness in our society. For that reason, not be surprising that rape survivors often on a regular basis silent about their experiences and lifestyle. The goal of this study was to improve condition the pattern of all charged victims in the rural area of Bangladesh with the aim of create public awareness about the brutal crime. Here the retrospective study was conducted on 294 sexually alleged rape victims' report forms and reported from Faridpur Medical College, Bangladesh during the period of 2019 to 2021 for medical examination. Within the study subject maximum number (70.0%) of alleged rape cases were below the age of 20 years. Here More than two-thirds (75.15%) of the assailants were known to there victims, greater portion of the incidents (52.04%) occurred in the victims' houses and near places. This study also revealed that minimum number of victims (12.24%) reported within 24 hours for medical examination. Almost one fourth of the rape victims were gang raped and there were no positive finding in favour of sexual intercourse was found in about three fourth (72.40%) of cases. We need to raise public awareness about this rape which would be effective to report in right time with preserve the evidence of the crime and modern method like DNA analysis may be help to identify the assailant. Now we can expect women to break the silence about the exhausted experience used to support the lack of capacity.

Erectile dysfunction (ED) is a common but under-discussed complication among men living with diabetes (MLWD), particularly in African contexts where sexual health is culturally sensitive. Despite major psychosocial and relational consequences, ED is often inadequately addressed within routine diabetes care. This study explored perceptions, impacts, and management practices related to sexual weakness among MLWD, alongside healthcare providers' experiences managing the condition in Ghana. We conducted an exploratory qualitative study across five public healthcare facilities in four regions of Ghana. In-depth interviews were conducted with 26 MLWD and 14 healthcare providers involved in diabetes care. Participants were purposively recruited, and data were analysed using thematic analysis supported by ATLAS.ti. Participants attributed sexual weakness to multiple causes, including diabetes-related complications, medication effects, and spiritual factors. Divergent explanatory models between patients and providers shaped management decisions and care-seeking. Many men reported using herbal remedies, aphrodisiacs, energy drinks, and spiritual interventions, often delaying biomedical care. Sexual weakness was associated with distress, reduced confidence, and relationship strain, and disclosure was selective, shaped by stigma, secrecy, and trust. Providers expressed concern about misconceptions, unregulated treatment use, and structural constraints within overcrowded diabetes clinics that limited meaningful engagement on sexual health.

Sexual interest/arousal disorder (SIAD) is the most common sexual dysfunction among women, often leading to psychological and relationship difficulties for affected individuals and their partners. Although interpersonal dynamics are widely recognized as central to the etiology and maintenance of SIAD, dyadic studies are rare. 1 cross-sectional study found that women with SIAD experience lower levels of self-expansion in their relationships (new and broadening experiences), despite it being associated with improved sexual and relationship outcomes. However, single-time-point studies cannot capture meaningful within-person fluctuations or explain the mechanisms underlying how relational self-expansion is linked to better outcomes, such as partner responsiveness. This study investigated whether within-person fluctuations in self-expansion-daily and longitudinally-were linked to changes in perceived partner responsiveness (PPR), and in turn, sexual desire, satisfaction, and distress. Individuals with SIAD and their partners (n = 263; Mage = 34.67; SD = 10.26) completed daily surveys over 56 days (n = 228) and assessments at baseline, 6-, and 12-month follow-ups. On days when either partner reported more self-expansion than usual, both reported greater PPR, which was, in turn, linked to higher sexual desire and satisfaction, and lower sexual distress for both partners. Longitudinally, greater self-expansion than usual was associated with higher sexual desire and lower sexual distress for individuals with SIAD via their own PPR, and greater sexual satisfaction for both partners via partners' PPR. Findings support interpersonal models of SIAD and suggest that enhancing self-expansion and PPR could be valuable therapeutic targets for couples coping with SIAD. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Chronic pain conditions can have a pronounced negative impact on sexual function. Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), in particular, can cause severe pelvic pain, which can interfere with numerous functions such as urination, sexuality, and overall quality of life. This study aims to determine the impact of CP/CPPS on sexual function and its association with the patient's symptom burden, the full version of the International Index of Erectile Function (IIEF) and Sexual Function Index (SFI) questionnaires and the UPOINT(S) classification. 174 patients with CP/CPPS and predominantly type IIIB prostatitis (87.4%) were prospectively enrolled and received a comprehensive andrological work-up. In addition to laboratory chemical analyses, microbiological processing and semen analysis, a detailed assessment of sexual function and symptom burden was carried out using the International Prostate Symptom Score (IPSS), National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI), IIEF and SFI questionnaires. The NIH-CPSI total score showed a moderate symptom burden with a median of 28 points, while the median IIEF score of 26 points was within the normal range, and the SFI score of 28 points indicated slightly impaired sexual function. In addition, 62.6% of the subjects showed an affected sexual domain in the UPOINT(S) classification. Univariate analysis revealed a significant association (p< 0.05) between IIEF scores and (i) CPSI total score, (ii) the SFI score, (iii) the number of affected UPOINT(S) domains - particularly (iv) the sexual domain (S), and (v) marital status. Multivariate analysis revealed significant associations between IIEF scores and (i) the SFI score, (ii) the UPOINTS total score and (iii) the UPOINTS sexual domain. However, the results of microbiology and inflammatory seminal parameters showed no association with items of sexual function in respective questionnaires. The prevalence of sexual problems was high in CP/CPPS patients in our cohort and it was shown a statistically significant association with (i) the IIEF scores, (ii) the SFI score, (iii) and the NIH-CPSI total score, so routine assessment of sexual function in patients with CP/CPPS seems reasonable.

Premature ejaculation (PE) is one of the most common male sexual disorders and is influenced by both psychological and biological factors. Despite available treatments, including psychosexual therapy and pharmacological interventions, no definitive cure exists. In addition, various interventional approaches have been investigated for lifelong PE, such as glandular filler injections, partial dorsal nerve neurectomy, and frenulectomy. This pilot study evaluated the effect of glandular frenulectomy in 25 married men with lifelong PE who had not responded to conventional treatments for at least six months. Participants underwent glandular frenulectomy and were assessed before surgery and three months postoperatively using Intravaginal Ejaculatory Latency Time (IELT) and the Arabic Index of Premature Ejaculation (AIPE) scores. No statistically significant improvement was observed in IELT or AIPE scores after surgery. The mean IELT and AIPE scores before and three months postoperatively yielded P-values of 0.058 and 0.090, respectively. In this pilot study, glandular frenulectomy did not result in significant short-term improvement in men with lifelong PE unresponsive to conventional therapy. Larger studies with longer follow-up are needed to further evaluate its therapeutic role.

Objectives This study examines the development and institutionalization of clinical sexology training in Morocco, Egypt, and Lebanon. It explores how political, socio-cultural, and academic contexts influence the recognition of this field within health and education systems. Methods A mixed-methods approach was used, combining a review of academic literature and policy documents on sexual health education, a mapping of existing clinical sexology training programs, and semi-structured interviews with key stakeholders, including clinical sexologists, trainers in sexual and reproductive health, and experts in sexual health education, research, and advocacy. The analysis was informed by critical perspectives on the medicalization of sexuality and the institutionalization of sexual medicine within health systems. Results We reveal a lack of formal recognition of clinical sexology in national health strategies and higher education policies across the three countries. Existing initiatives are limited, fragmented, and mainly driven by individual academics or civil society organizations rather than embedded in national frameworks. Sexology training is largely situated within medical faculties and clinical specialties such as psychiatry, gynecology, and reproductive medicine, reinforcing a biomedical and therapeutic approach focused on sexual dysfunctions, diagnosis, and treatment. While sexual medicine remains dominant in institutional settings, broader sexual health perspectives grounded in public health, psychosocial, gender, and human rights approaches are weakly institutionalized. Key barriers include socio-cultural taboos, religious sensitivities, institutional resistance, lack of regulatory frameworks, shortage of trained professionals, and limited political prioritization. Nevertheless, emerging opportunities include increased civil society engagement, feminist advocacy for sexual rights, development of flexible training initiatives, and growing interest among young professionals in rights-based approaches. Conclusions Strengthening policy support, developing interdisciplinary training, and fostering collaboration between medical, psychosocial, public health, and civil society actors are essential to better integrate clinical sexology into health and education systems and to improve access to comprehensive, rights-based sexual health services in the MENA region.

To conduct a scoping review of the prevalence, risk factors, neurobiological mechanisms, and clinical management of antidepressant-induced sexual dysfunction (AISD) in adults, including emerging evidence on post-SSRI sexual dysfunction (PSSD) and potential strategies for mitigation. A targeted scoping review with narrative synthesis was conducted using PubMed to identify English-language studies published from 2000 to 2025. A total of 65 studies were reviewed. Outcomes assessed included the frequency and severity of AISD, associated patient-related and drug-related predictors, and the reported effectiveness of pharmacologic and behavioral interventions. AISD appears to be a common and potentially under-recognized adverse effect of antidepressants, particularly with SSRIs and serotonin-norepinephrine reuptake inhibitors (SNRIs). Reported risk factors have been associated with higher antidepressant dose, male sex, older age, pre-existing sexual dysfunction, and greater depressive severity. Mechanistic contributors have been proposed and include serotonergic overactivation (notably 5-HT₂A/₂C receptors), dopaminergic and nitric oxide suppression, prolactin elevation, and possible epigenetic modulation, especially in cases of persistent dysfunction such as PSSD. Bupropion, mirtazapine, and agomelatine have been associated in several studies with more favorable sexual side effect profiles. Management strategies with supporting evidence have included dose reduction, switching to lower-risk agents, and augmentation with PDE5 inhibitors or bupropion. Nonpharmacologic interventions, such as exercise, psychotherapy, and mindfulness-based strategies, have shown preliminary benefit in selected studies and may serve as adjunctive options. AISD is a multifactorial adverse effect of antidepressant therapy that may persist in some individuals and can adversely affect quality of life and treatment adherence. Systematic assessment and individualized intervention may help mitigate impact, though optimal strategies remain incompletely defined. Increased recognition of PSSD highlights the need for further methodologically rigorous research into its pathophysiology, prevalence, and treatment.

Pelvic floor dysfunction (PFD) is a highly prevalent health problem, encompassing urinary incontinence, emptying disorders of the bladder, fecal incontinence, emptying disorders of the bowel, pelvic organ prolapse, sexual dysfunction, and chronic pelvic pain. Mobile health (mHealth) interventions delivered through apps can provide remote health services to improve patient compliance and enhance treatment effectiveness. Although apps for preventing and managing PFD have been developed and used, the features and quality of these apps in China have not been systematically examined. This study aimed to systematically summarize the functions and evaluate the quality of the existing mHealth apps for preventing and managing all kinds of PFD, such as urinary incontinence, fecal incontinence, and chronic pelvic pain. We systematically searched for potential PFD apps on the Apple App Store, Huawei AppGallery, and VIVO App Store. Apps were included if they were free, designed for preventing or managing PFD, in the Chinese language, could be downloaded and run on Android, Harmony, or iOS operating systems (OS), and incorporated elements of preventing and managing PFD. We excluded apps that were intended for use by health care providers and not relevant to PFD. Apps that met the inclusion criteria were downloaded and included for final analysis. The user version of the Mobile App Rating Scale (uMARS) was used to assess the apps' quality and summarize the apps' functionality according to guidelines. Of the 3897 apps screened, 46 apps that met the inclusion criteria were included in the final analysis. All apps were developed by corporations. More than half of the apps had download counts exceeding 10,000, and 24 (52.2%) apps scored 4 or higher in app stores. Furthermore, nearly half of the apps (n=21, 45.7%) had been updated within the past month at the time of retrieval. The overall uMARS scores ranged from 2.29 to 4.50, with a mean uMARS score of 3.46 (SD 0.50), which is considered acceptable quality. Based on uMARS scores, 15.2% (n=7) were rated as poor quality, 65.2% (n=30) as acceptable, and 19.6% (n=9) as good quality. More than half of the apps provided the functions of exercise (n=44, 95.7%), personal information recording (n=31, 67.4%), and health education (n=28, 60.9%). Only 5 apps provided 5 or more functions. The apps for PFD revealed acceptable quality, and the majority provided exercise, personal information recording, and health education functions. However, many apps lacked comprehensive functionalities and did not provide immediate feedback or high-quality educational information. Health care providers should follow international guidelines to create high-quality, evidence-based, multifunctional apps for PFD. Future studies should explore the effects of the apps and real-world user feedback data in clinical settings.

This study aimed to summarize and pool the existing observational evidence on sexual dysfunction (SD) in patients with migraine and to explore sex-specific associations. SD appears to be more common in patients with migraine, yet the available data are heterogeneous and scattered, with most research focused on women. A comprehensive synthesis across both sexes has been lacking. This systematic review and meta-analysis of observational studies identified relevant studies reporting data on SD published between July 1987 and July 2025 were identified through searches in PubMed, Scopus, Embase, the Cochrane Library, and Google Scholar. Twenty-one studies including 1692 patients with migraine and 741 controls were identified; nine studies were qualified for quantitative analysis. Reported SD prevalence ranged from 41.8% to 91.0% among women and from 46.6% to 80.0% among men. Across controlled studies, patients with migraine showed a higher likelihood of experiencing SD compared with healthy controls (odds ratio [OR], 6.13; 95% confidence interval [CI], 1.59-23.60). In women, the likelihood of SD was more than three times higher (OR, 3.65; 95% CI, 1.22-10.9). Data for men were limited to two small, controlled studies, both indicating higher SD rates among male patients with migraine (OR, 164.85; 95% CI, 21.09-1288.89). When studies with extreme values were excluded, the association between migraine and SD remained still elevated. SD is common among patients with migraine, affecting both sexes, although the evidence base remains substantially richer for women. Although pooled data confirm an elevated risk of SD in women, findings in men rely on limited evidence. These results underline the need to routinely address sexual health in migraine care and highlight the urgent need for well-designed, sex-inclusive studies.

Male sexual dysfunction (MSD) is a multifactorial condition in which traditional models focusing on vascular, endocrine, and psychogenic factors are insufficient. Emerging evidence highlights dysregulated crosstalk between the nervous and immune systems-the neuroimmune axis-as a potential unifying pathological substrate. This review synthesizes fragmented yet compelling evidence linking neural injury, chronic inflammation (both systemic and neurogenic), and immune dysregulation to the pathogenesis of MSD. We propose a novel integrative framework in which disruption of the neuro-immune axis serves as a convergent pathway for diverse etiologies, ranging from diabetic neuropathy to chronic pelvic pain. Central to this framework is the concept that immune-mediated processes exacerbate neural and vascular damage, creating a self-perpetuating cycle of dysfunction. Building on this mechanistic perspective, we explore the translational potential of neurosurgical and neuromodulatory strategies-such as sacral neuromodulation and vagus nerve stimulation-to restore neuroimmune homeostasis. Although direct clinical evidence in MSD remains limited, insights from related fields, including chronic pain and autoimmune disorders, provide a strong rationale for further investigation. This review aims to bridge mechanistic insights with therapeutic innovation, charting a course for future research into precision neuromodulation as a promising frontier for refractory MSD.

Deciphering the molecular mechanisms of fluoxetine-induced sexual dysfunction: Evidence from pharmacovigilance, network toxicology, and molecular docking.

Sexual dysfunction in chronic kidney disease (CKD) is frequently underrecognized and underreported worldwide, despite its well-established association with depression and reduced quality of life (QoL). This study estimated the pooled global prevalence of sexual dysfunction among individuals with CKD and evaluated its impact on psychosocial well-being. A systematic review and meta-analysis of published studies examining sexual dysfunction in CKD was conducted following PRISMA 2020 guidelines (PROSPERO: CRD42024508777). Pooled prevalence estimates were calculated using a DerSimonian-Laird random-effects model with Freeman-Tukey double arcsine transformation, and correlation coefficients were pooled following Fisher's Z transformation. Forty-four eligible studies, involving 10,672 participants from 18 countries, were included. The overall pooled prevalence of sexual dysfunction was 71.2% (95% CI: 65.9-76.3%, I²= 96.8%), with no significant difference across geographical regions (p = 0.87) or between males (71.5%, 95% CI: 65.5-77.3%) and females (67.3%, 95% CI: 52.6-80.5%) (p = 0.61). Prevalence was significantly higher among patients on hemodialysis (77.6%) and those in predialysis stage (76.7%) compared with post-kidney transplant recipients (56.9%), with a significant difference across patient groups (p = 0.01). Sexual dysfunction was significantly correlated with poorer mental (r ≈ 0.36, 95% CI: 0.27-0.45, p < 0.001) and physical (r ≈ 0.39, 95% CI: 0.29-0.48, p < 0.001) health-related quality of life, as well as greater depression severity as measured by the IIEF (r = -0.34, p < 0.001) and FSFI (r = -0.42, p < 0.001). No significant publication bias was observed on Begg's test (p = 0.48) or Egger's test (p = 0.16). Sexual dysfunction is highly prevalent among individuals with CKD, affecting more than two-thirds of patients and varying by treatment modality, with lower prevalence observed after kidney transplantation. It is significantly associated with poorer quality of life and depression severity. These findings underscore the need for routine screening and integrated psychological and sexual health interventions in CKD care.

Sexual dysfunction is common following pelvic pouch surgery for ulcerative colitis. Despite this, little work has been done to explore the degree of sexual distress this causes in patients. To determine the proportion of patients with ulcerative colitis who experience sexual distress following pelvic pouch surgery and to explore the effects of social demographics, age, bowel function, anxiety, and depression on sexual distress. A cross-sectional survey that was emailed to patients. A large tertiary care teaching hospital. Patients who underwent pelvic pouch surgery for ulcerative colitis from 1980-2022. Validated questionnaires included the 13-item Sexual Distress Scale, Hospital Anxiety and Depression Scale, and Colorectal Functional Outcome questionnaire. The primary outcome was the proportion of patients meeting established thresholds for sexual distress. Multivariable regression was used to evaluate associations between sexual distress and operative factors, age, sex, income, education, ethnicity, sexual orientation, and relationship status. Of 1830 eligible patients, 497 responded and were included in the analysis. Overall, 194 patients (39%) screened positive for sexual distress. Women were disproportionately affected, with more than half reporting clinically significant distress (141/243, 57.8%). Female gender was the only independent preoperative predictor of sexual distress on multivariable analysis (odds ratio = 4.796, 95% CI: 3.119, 7.374, p < 0.001). Poor bowel function, anxiety, and depression were all significantly more prevalent among patients with sexual distress (all p < 0.001). Cross-sectional design limits causal inference. Selection and response bias are possible. Sexual distress is common following pelvic pouch surgery for ulcerative colitis, particularly among women, and is strongly associated with bowel dysfunction, anxiety, and depression. These findings highlight the importance of holistic pre- and postoperative counselling and consideration of psychological screening in follow-up care. Further research is needed to elucidate underlying mechanisms and develop targeted interventions. See Video.