Index Of Sexual Functioning For Women Research Articles

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.

Reliability, validity and distribution of the Spanish female sexual function index in women with relapsing multiple sclerosis

BackgroundThe Female Sexual Function Index (FSFI) is a widely recognized tool for assessing sexual dysfunction (SD). However, its validation for Spanish women suffering from multiple sclerosis (MS) has not yet been conducted.AimThe study aimed to examine the psychometric properties of the 19-item Spanish version of the FSFI (svFSFI) in women with relapsing MS.MethodA total of 137 women with relapsing MS from three Spanish centers participated in the study and completed the svFSFI. The psychometric properties of the questionnaire were evaluated. The prevalence of SD in the study cohort was determined, and its association with clinical and sociodemographic variables was analyzed using bi- and multivariate regression analyses.ResultsThe svFSFI demonstrated excellent test-retest reliability and substantial-to-excellent internal consistency in the context of relapsing MS. There was significant convergent validity in the intercorrelations of domains. Discriminant validity showed differences in SD between women with high and low neurological disability, as measured by the Expanded Disability Status Scale (EDSS) scores. An exploratory factor analysis indicated a five-factor structure for the svFSFI. The prevalence of SD in the MS cohort was found to be 42.6%, with the ‘desire’ and ‘arousal’ domains being the most affected. Factors such as EDSS score, fatigue, depression, and having a stable partner were found to influence the total svFSFI score.ConclusionThe study validates the svFSFI as a reliable and valid instrument for evaluating sexual dysfunction in Spanish women with MS.

Assessing Sexual Functioning with the Female Sexual Function Index in Women Suffering from Genito-Pelvic Pain Penetration Disorder Undergoing a Therapeutic Educational Program

Genito-Pelvic Pain/Penetration Disorder is a common sexual disorder that affects an individual’s sexual health and overall well-being. Education is a therapeutic resource that presents several advantages, and it can potentially generate improvements both in pain and sexual functioning-related outcomes in patients suffering from this affliction. The objective of this study was to assess if a therapeutic educational program produced improvements in the different domains of the Female Sexual Function Index in participants suffering from Genito-Pelvic Pain Penetration Disorder. Participants were randomized into a group that received a face-to-face therapeutic educational program, a group that received the same program but online, or a control group. The Female Sexual Function Index was assessed, and analysis of the change in the domains for every group was performed using multiple t-tests. Improvements were found in the face-to-face intervention group, but only the “Pain” domain showed significant improvements (−1.1 points, p < 0.05). Improvements were also found in the online group, but they were only significant in the “Pain” and “Satisfaction” domains (−0.8 points, p < 0.05 for both). A therapeutic educational program improves pain-related outcomes, and it shows a positive tendency to also improve sexual functioning-related outcomes in patients suffering from Genito-Pelvic Pain/Penetration Disorder. Registration: Clinical Trials (NCT05114473).

P-558 The importance of sexual desire for the sexual health of infertile women and men starting their fertility clinic journey

Abstract Study question Is the sexual desire of infertile women and men correlated with their intercourse frequency and sexual satisfaction? Summary answer Both partner’s sexual desire is moderately correlated to intercourse frequency and their own sexual satisfaction and weakly correlated to the sexual satisfaction of their partner. What is known already Reviews showed that infertile couples have worse sexual health than the general population. Qualitative studies explained that infertile patients feel less attractive and consider intercourse a ‘duty’, associated with failure. Fertility clinics offer diagnosis and treatments but have yet to start caring for sexual health. The Pleasure&amp;Pregnancy-programme, combining psychosexual education with communication, mindfulness and sensate focus exercises, recently proved to increase the sexual desire of infertile women pursuing natural conception. Whether improving sexual desire can be expected to increase the intercourse frequency and sexual satisfaction of women and men about to start fertility treatment had yet to be explored. Study design, size, duration A cross-sectional cohort of 140 heterosexual couples (n = 280; response rate 51%) was surveyed between 2019 and 2022. Couples filled out a package questioning their sexual health over the past four weeks at a chosen moment between their first fertility clinic consultation and the end of their diagnostic workup. This package included a questionnaire to be filled out by each partner individually and a couple questionnaire. Non-responders received were reminded. Participants/materials, setting, methods Sexual desire and satisfaction of women and men was assessed with subscales of the following valid and reliable questionnaires: Female Sexual Function Index in women (FSFI; the higher, the better) or International Index of Erectile Function in men (IIEF; the higher, the better). Intercourse frequency of couples was assessed with a sexual activity event log. Spearman rho’s correlations assessed associations between sexual desire, sexual satisfaction and coital frequency. Main results and the role of chance Responding women and men were in their early thirties and had tried to conceive naturally for 18.2 months, on average. The sexual desire of women (and of men was not correlated (r = 0.116, p = 0.178). Couples had sexual intercourse seven times per month (7.12±4.03), on average. The sexual desire of both women and men was moderately correlated to couple’s intercourse frequency (♀: r = 0.402, p &amp;lt; 0.001; ♂: r = 0.426, p &amp;lt; 0.001). The sexual desire of women was also moderately correlated to their own sexual satisfaction (r = 0.481, p &amp;lt; 0.001) and weakly correlated to the sexual satisfaction of their male partner (r = 0.270, p = 0.001). The sexual desire of men was significantly but weakly correlated to their own sexual satisfaction (r = 0.361, p &amp;lt; 0.001) and the sexual satisfaction of their female partner (r = 0.239, p = 0.005). Limitations, reasons for caution The sexual health of the included couples is currently followed-up during fertility treatment. Linear mixed models, taking account of dyads and of multiple assessments, would allow analysing the impact over time of women’s sexual desire whilst taking account of the sexual desire of her male partner and vice-versa. Wider implications of the findings Sexual desire seems important for a couple’s coital frequency and both partner’s sexual satisfaction. Examining whether a six-month sexual health programme that improves women’s sexual desire, could in the longer term improve intercourse frequency and especially sexual satisfaction or prevent the deterioration thereof would be interesting. Trial registration number not applicable

Effects of Flibanserin on Subdomain Scores of the Female Sexual Function Index in Women With Hypoactive Sexual Desire Disorder.

Flibanserin treatment increases sexual desire and satisfying sexual events while decreasing distress in certain women diagnosed with acquired, generalized hypoactive sexual desire disorder (HSDD). Additional aspects of sexual function and the time course of response have not been fully characterized. To evaluate changes in sexual function assessed by the subdomains of the Female Sexual Function Index (FSFI) in women with HSDD treated with flibanserin. FSFI data pooled from 3 pivotal flibanserin trials in premenopausal women (flibanserin=1,165; placebo=1,203) and FSFI data from one complete flibanserin trial in postmenopausal women (flibanserin=432; placebo=463) were subjected to post-hoc analyses. For each FSFI subdomain, least squares mean change from baseline was calculated at each assessment visit (treatment weeks 4, 8, 16, 24) and treatment groups were compared using analysis of covariance. Standardized effect size (Cohen's d) was also determined for each FSFI subdomain. Changes from baseline in FSFI subdomains. Compared to placebo, both premenopausal (P < .02) and postmenopausal (P < .045) patients in the flibanserin group reported significantly greater increases over baseline in the FSFI subdomain scores of desire, arousal, lubrication, orgasm, and satisfaction. In premenopausal patients, significant improvements were observed at the first assessment of response (week 4) and were maintained through week 24. In postmenopausal patients, significant improvements were observed at week 4 for desire and arousal, while significant improvements in lubrication, orgasm, and satisfaction were observed at week 8. At week 24, excluding the pain subdomain, standardized effect sizes ranged from 0.18 to 0.28 in the premenopausal cohort and 0.12 to 0.29 in the postmenopausal cohort. In both pre- and postmenopausal patients, improvements in pain were smaller and largely undifferentiated between treatment groups. While variations in time to response should be taken into consideration, on average, the beneficial impact of flibanserin on overall sexual function occurs within the first month of treatment. The data also suggest that the response to flibanserin is sustained for the duration of treatment. Sexual function assessments were performed in a large cohort of 2,368 premenopausal women and 895 postmenopausal women. However, the FSFI assesses changes over a 1-month period and time points earlier than 4 weeks could not be assessed. These analyses suggest that assessment of benefit of flibanserin in HSDD should include improvements across all domains of sexual function, not only desire. Simon JA, Clayton AH, Goldstein I, et al. Effects of Flibanserin on Subdomain Scores of the Female Sexual Function Index in Women With Hypoactive Sexual Desire Disorder. Sex Med 2022;10:100570.

The effect of systemic lupus erythematosus on sexual function in women: an updated meta-analysis based on cross-sectional studies

BackgroundSystemic lupus erythematosus (SLE), a chronic systemic autoimmune disease, often affects different organs and tissues. It can be effectively managed using drugs; however, attention should be paid to the patient’s quality of life. This study aimed to evaluate the effect of SLE on female sexual function based on current literature.MethodsThe PubMed, Embase, and Cochrane Library databases were searched for eligible studies published up to November 9, 2021. This review included all English studies that compared the sexual function between women with SLE and healthy women. A meta-analysis was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.ResultsA total of 367 records were retrieved from 3 electronic databases. Five studies that involved 710 women with SLE and 2059 healthy women were finally included in this meta-analysis. The result indicated a significant decrease (mean difference = − 1.74, 95% confidence interval − 3.14 to − 0.34, p = 0.02) in the total scores of the Female Sexual Function Index in women with SLE, implying that healthy women had better sexual function than those with SLE.ConclusionThe results of our study indicated that SLE could negatively affect the quality of sexual life in terms of desire, arousal, and pain. Thus, close attention should be paid to the sexual function of women with SLE.Trial registration: This study was registered in the International Prospective Register of Systematic Reviews (registration number: CRD42021290439).

Rehabilitation of People With Chronic Spinal Cord Injury Using a Laparoscopically Implanted Neurostimulator: Impact on Mobility and Urinary, Anorectal, and Sexual Functions

ObjectivesThis study aimed to assess the impact of the laparoscopic implantation of neuromodulation electrodes (Possover-LION procedure) on mobility and on sexual, urinary, and anorectal functions of people with chronic spinal cord injury (SCI). Material and MethodsLongitudinal analysis of 30 patients with chronic SCI (21 ASIA impairment scale (AIS) A, eight AIS B, and one AIS C) submitted to the Possover-LION procedure for bilateral neuromodulation of femoral, sciatic, and pudendal nerves. Assessments were performed before the surgical procedure and at 3, 6, and 12 months postoperatively. The primary outcome was evolution in walking, measured by the Walking Index for Spinal Cord Injury score, preoperatively and at 12 months. Secondary outcomes were changes in overall mobility (Mobility Assessment Tool for Evaluation of Rehabilitation score), urinary function and quality of life (Qualiveen questionnaire), and bowel (time for bowel emptying proceedings and Wexner’s Fecal Incontinence Severity Index [FISI]) and sexual functions (International Index of Erectile Function for men and Female Sexual Function Index for women). Surgical time, intraoperative bleeding, and perioperative complications were also recorded. ResultsQualitatively, 18 of 25 (72%) patients with thoracic injury and 3 of 5 (60%) patients with cervical injury managed to establish a walker-assisted gait at one-year follow-up (p < 0.0001). A total of 11 (47.8%) have improved in their urinary incontinence (p < 0.0001), and seven (30.4%) improved their enuresis (p = 0.0156). The FISI improved from a median of 9 points preoperatively to 5.5 at 12 months (p = 0.0056). Of note, 20 of 28 (71.4%) patients reported an improvement on genital sensitivity at 12 months postoperatively (p < 0.0001), but this was not reflected in sexual quality-of-life questionnaires. ConclusionsPatients experienced improved mobility and genital sensitivity and a reduction in the number of urinary and fecal incontinence episodes. By demonstrating reproducible outcomes and safety, this study helps establish the Possover-LION procedure as an addition to the therapeutic armamentarium for the rehabilitation of patients with chronic SCI. Clinical Trial RegistrationThis study was registered at the WHO Clinical Trials Database through the Brazilian Registry of Clinical Trials—REBEC (Universal Tracking Number: U1111-1261-4428).

A psychometric evaluation of the Female Sexual Function Index in women treated for breast cancer.

BackgroundWe aimed to determine the psychometric properties and factor structure of the 19‐item Female Sexual Function Index (FSFI) in 132 sexually active women previously treated for breast cancer.MethodsConfirmatory factor analysis explored three models: (a) second‐order six‐factor, (b) six‐factor, and (c) five‐factor models combining the desire and arousal subscales.ResultsResults revealed excellent reliability for the total score (Cronbach's α = 0.94), and domain scores (all Cronbach's αs > 0.90), and good convergent and discriminant validity. The six‐factor model provided the best fit of the models assessed, but a marginal overall fit (Tucker–Lewis index = 0.91, comparative fit index = 0.93, root mean square error of approximation = 0.09). Exploratory factor analyses (EFA) supported a four‐factor structure, revealing an arousal/orgasm factor alongside the original pain, lubrication, and satisfaction domains.ConclusionThe arousal/orgasm factor suggests a “sexual response” construct, potentially arising from an underlying latent factor involving physical and mental stimulation in conceptualizations of arousal and orgasm in women treated for breast cancer. Finally, the EFA failed to capture an underlying desire factor, potentially due to measurement error associated with the small number of items (two) in this domain. Despite evidence that the FSFI has sound psychometric properties, our results suggest that the current conceptualizations of the FSFI might not accurately represent sexual functioning in women previously treated for breast cancer. Further research is required to elucidate the factors that influence desire, arousal, and orgasm in sexually active women in this population, and the reasons underlying sexual inactivity. Practical and theoretical implications for FSFI use in this population are discussed.

The Multiple Sclerosis Intimacy and Sexuality Questionnaire (MSISQ-15): Validation and Cross-cultural Adaptation of the Greek Version in MS Patients

Sexuality and intimate relationships are a significant part of life and well-being. The presence of a physical illness such as multiple sclerosis (MS) has the potential to complicate the lifelong course of sexual development and the ways in which one defines and expresses one’s sexuality. The objective of this study was to develop a cross-cultural adaptation and validation of the MSISQ-15 so that it can be used as a tool to evaluate SD in Greek patients with MS. A total of 127 individuals, 68 Greek MS patients and 59 healthy persons for the control group who visited urology department of the National Rehabilitation Centre of Athens completed the Greek version of MSISQ-15 along with Female Sexual Function Index for women and International Index of Erection Function at baseline (test) and 3 weeks later for the MS patients, (retest). Data were analyzed for measurement properties. Content validity was adequate. The Greek version of MSISQ-15 showed a good internal consistency with Cronbach’s a > 70 for total score and the three scales of MSISQ-15 for the test and retest. In the MS patient group, no floor or ceiling effects were seen for the total score, primary, secondary and tertiary symptoms. A test–retest reliability shows that for primary symptoms and measurements 3 weeks after, correlation was r = .94, for secondary was r = .88, while for tertiary was r = .89. All correlations were significant at p < .001. In conclusion, this Greek version of MSISQ-15 was tested following well-established guidelines on measurement properties and showed good validity and reliability. It is reproducible, reliable and valid for the Greek population and may be used as a tool for assessing the impact of sexual dysfunction in patients with MS.

Multiple Sclerosis and Female Sexual Dysfunction: Impact of Disease Severity and Duration

Despite a lot of studies of sexual dysfunction there are still no consistent data about the prevalence and characteristics of sexual dysfunction among women with MS, especially it terms of multiple sclerosis severity and duration. The objective: was to determine the prevalence of various SD symptoms among female MS patients, depending on the age and severity of the disease, and evaluate SD impact on quality of life. Materials and methods. The study population includes 116 female patients with MS (McDonald’s criteria, 2010). Health – related quality of life was measured by the Multiple Sclerosis Quality of Life Questionnaire (MSQOL-54). Sexual dysfunction was assessed with the Sexual Function Index for Women with Multiple Sclerosis Questionnaire. Results. A direct average correlation between satisfaction with sexual life and relationships; sexual activity and arousal; discomfort and pain during sexual intercourse; direct impact of multiple sclerosis on sexual life and total quality of life, physical health component, mental health component was established (р&lt;0.05). The prevalence of sexual dysfunction increases with the age and disease duration. Conclusions. Our data confirm that SD is common symptom in women with MS and significantly affect their quality of life. Key words: multiple sclerosis, female sexual dysfunction.

Effect of psychiatric symptoms and male sexual function of couples on the success of treatment for vaginismus.

The study was performed on 110 women diagnosed with vaginismus and their partners. The women underwent cognitive behavioural therapy (CBT), and couples were divided into two groups: successful and unsuccessful therapy. Sexual function in couples was evaluated using the Golombok Rust Index of Sexual Satisfaction (GRISS) in men and the Female Sexual Function Index in women. The psychopathological symptoms of participants were evaluated using the Symptom Check List-90-Revised (SCL-90-R). Of the 110 women in this study, 98 completed CBT and treatment was successful for 59 (60.2%). GRISS scores pertaining to the subscales of infrequency (66.7% and 39.0%), non-communication (56.4% and 22.0%), avoidance (76.9% and 52.5%), impotence (56.4% and 33.9%) and premature ejaculation (64.1% and 32.2%) before treatment were significantly lower in the successful than unsuccessful treatment group (P < 0.05). Furthermore, there was a positive correlation between complaints of impotence and premature ejaculation in men and symptoms of depression and anxiety in men. In the successful treatment group, pretreatment values were lower for the SCL-90-R subscales of anxiety and depression in men and anxiety, depression, phobic anxiety and obsessive compulsiveness in women than in the unsuccessful treatment group. The psychiatric symptoms and sexual functions of couples were found to affect the success of treatment for vaginismus. As such, treatments should be administered in accordance with other symptoms present in couples.

Urological, Sexual, and Quality of Life Evaluation of Adult Patients With Exstrophy-Epispadias Complex: Long-term Results From a Dutch Cohort

To assess urological function, sexual function, and quality of life in patients with exstrophy or epispadias. Little is known regarding these outcomes in adult patients; our aim is to determine where improvements are needed for long-term management. The study population comprised adult (>18 years) patients. Demographic data were gathered and patients were asked to fill out 4 validated questionnaires: (1) International Consultation on Incontinence Questionnaire urinary incontinence form (ICIQ-UI) regarding continence; (2) International Prostate Symptom Score (IPSS) for men and International Consultation on Incontinence Questionnaire-Female Lower Urinary Tract Symptoms (ICIQ-FLUTS) for women regarding lower urinary tract symptoms; (3) 12-Item Short Form Health Survey regarding quality of life; (4) International Index of Erectile Function for men and Female Sexual Function Index for women regarding sexual function. Seventeen patients were included (9 men and 8 women) with a median age of 36 years (range 19-73). Median score on ICIQ-UI was 5/21. Median IPSS score was 7/35 and median quality of life score was 1 (=pleased). Median scores per domain within ICIQ-FLUTS were 7 for storage, 0 for voiding, and 6 for urinary incontinence with bother scores of 4, 0, and 2.8, respectively. Scores for 12-Item Short Form Health Survey in the study population were comparable with those of the Dutch population, except for Physical Component Summary in women. For sexual function, no difference was found between those in the general population and our participants except for the domain "pain" in Female Sexual Function Index. Adult patients with exstrophy or epispadias have a high rate of incontinence and lower urinary tract symptoms with relatively low to some degree of bother. When compared with the general population, quality of life, and sexual function of our patients were more or less similar.

Digestive and genitourinary sequelae in rectal cancer survivors and their impact on health-related quality of life: Outcome of a high-resolution population-based study

BackgroundWith the rising number of rectal cancer survivors, more patients with sphincter-preserving surgery are having to live with a potentially impaired quality of life. The survey aimed to assess bowel and genitourinary sequelae and their impact on quality of life in an unselected registry-based population of rectal cancer survivors. MethodsThis cross-sectional cohort survey (registered at ClinicalTrials.gov; ID: NCT03459235) included patients with rectal cancer who underwent curative surgery with sphincter-preserving surgery from January 1, 2007 to January 31, 2015. Patients with recurrent disease, intestinal stoma, or cognitive disorders were excluded. Validated scoring system included the Urinary Symptom Profile in women and the International Prostate Symptom Score in men for urinary function, International Index for Erectile Function 5 in men and Female Sexual Function Index in women for sexual function, and Core 30/ Colo Rectal 29 questionnaires for quality of life and Low Anterior Resection Syndrome score for bowel function. The impact of functional sequelae on global quality of life was evaluated by multiple linear regression. ResultsResponders (45.3%, 92/203 patients) and nonresponders were comparable according to sex, age, tumor stage, and neoadjuvant chemoradiation. With a mean follow-up of 6.5 years, 65.2% of the rectal cancer survivors had bowel dysfunction, of whom 41.3% experienced major Low Anterior Resection Syndrome and 80% of rectal cancer survivors experienced genitourinary dysfunction. In multiple linear regression, poor bowel function was a significant predictor of global quality of life in men (P = .04) and women (P = .0003). ConclusionThis survey highlights the importance of sexual and bowel dysfunction in rectal cancer survivors and the strong correlation between high Low Anterior Resection Syndrome score and inferior quality of life. Further studies are needed to improve knowledge on how to predict bowel dysfunction and how to best support patients with bowel dysfunction.

Survey of Sexual Function and Pornography.

We aimed to explore and describe the pornography habits of young men and women. Given recent upward trends in pornography use and erectile dysfunction, along with a plausible pathophysiology, we hypothesized that pornography use would correlate with sexual dysfunction. Institutional Review Board approval was obtained. Surveys were distributed to 20-40 year old men and women presenting to a urology clinic. Information was collected on demographics and medical history. Sexual function was evaluated with the International Index of Erectile Function (IIEF) in men and the Female Sexual Function Index in women. Extent of potential addiction to pornography was measured with the pornography craving questionnaire and the obsessive passion scale. Pornography use was measured based on both frequency and duration, and analyzed relative to sexual dysfunction. Men used pornography significantly more frequently than women (81.1% vs. 39%). Computer and cellular phone image viewing were the most popular modalities in both sexes. There was no association between IIEF and craving for, or obsessive passion for, pornography. Preference for pornography with masturbation was found to be significantly associated with erectile dysfunction (p = 0.001). Rates of erectile dysfunction were lowest in those preferring partnered sex without pornography (22.3%) and increased significantly when pornography was preferred over partnered sex (78%). No correlation was found between any variables and female sexual dysfunction. Pornography and sexual dysfunction are common among young people. No clear relationship exists between extent of addiction to pornography and sexual dysfunction in either gender. However, men who prefer masturbation with pornography to partnered sex have a significantly increased risk of sexual dysfunction. Given sexual dysfunction may be associated with mental health concerns, further evaluation of its causes and impact on military operational readiness are warranted.

EPA-0124 - Sexual function in schizophrenia

This study surveys patients with schizophrenia or schizoaffective disorder, to understand the relationship between sexual function and treatment with antipsychotic medication. The study compares patients on single versus multiple antipsychotics as well differences between first and second generation agents. Patients diagnosed with schizophrenia or schizoaffective disorder at Beth Israel Medical Center are eligible. Once patients are evaluated to ensure they meet enrollment criteria and are consented, they are administered the Positive and Negative Syndrome Scale (PANSS), Abnormal Involuntary Movement Scale (AIMS), and either the International Index of Erectile Function for men, or the Female Sexual Function Index for women. Inclusion criteria include age 18-65, able to participate in a structured interview, fulfill DSM-IV criteria for Schizophrenia or Schizoaffective disorder, and on stable doses of one or more antipsychotic medications for at least six weeks. Exclusion Criteria include patients taking Selective Serotonin Reuptake Inhibitors (SSRIs), and inability to provide informed consent. Presently, data suggests sexual function is impaired secondary to antipsychotic use. Further extrapolation of data is pending further enrollment. Preliminary results point to better sexual function with certain second generation antipsychotics. It also appears that patients on single antipsychotic may have better sexual function than patients on multiple agents.

Long-term Results After Restorative Proctocolectomy With Ileal Pouch-Anal Anastomosis at a Young Age

Restorative proctocolectomy with IPAA is an optimal surgical treatment for patients with familial adenomatous polyposis and therapy resistant ulcerative colitis, few data are available on long-term results in patients who have undergone this operation at a young age. The aim of this study was to investigate long-term functional outcome, quality of life, body image, and sexual function after restorative proctocolectomy with IPAA in young patients with familial adenomatous polyposis or ulcerative colitis. The study consisted of a retrospective review of medical records and questionnaire follow-up of 26 consecutive patients with familial adenomatous polyposis or ulcerative colitis who had undergone surgery between January 1992 and October 2008 at the Maastricht University Medical Center, were aged 10 to 24 years at the time of surgery, and had at least 1 year of follow-up after surgery. We reviewed medical records from an institutional database regarding surgical procedures and short- and long-term complications. At the end of 2009, validated questionnaires covering bowel function (Colorectal Functional Outcome Questionnaire), quality of life (Short Form-36 and Gastrointestinal Quality of Life Index), body image and cosmesis (Body Image Questionnaire), and sexual function (International Index of Erectile Function for men and Female Sexual Function Index for women) were mailed to patients. Median age at surgery was 18 years, and median follow-up was 12.5 (range, 2-18) years. Long-term colorectal complications occurred in 23 patients (88%), and were directly related to the surgery in 20 patients (77%). Five patients needed pouch excision. The questionnaire response rate was 88%. Bowel function, quality-of-life, and body image and cosmesis scores were all lower in patients than in historical normal control populations. Men did not report impotence or retrograde ejaculation, but 50% of women reported sexual dysfunction. This was a retrospective study in a small number of patients from a single institution with no comparison groups. Restorative proctocolectomy with IPAA can be performed in young patients with an acceptable functional outcome, but at the cost of relatively high complication rates, poor body image and cosmesis, and a high rate of sexual dysfunction in women. Because young patients undergoing this surgical procedure may experience negative long-term effects, surgeons should be aware of all potential consequences, inform patients as to what to expect, and ensure long-term follow-up to deal with long-term complications.

Does conventional or single port laparoscopically assisted vaginal hysterectomy affect female sexual function?

To investigate the effects of conventional and single port laparoscopically assisted vaginal hysterectomy (LAVH) on sexual function in premenopausal women. A prospective case-control study. University teaching hospital. Population. A total of 95 premenopausal women having LAVH from January 2009 to December 2009. Comparison of 47 premenopausal women who had single port LAVH using trans-umbilical GelPort access (SP-LAVH group) and 48 premenopausal women who had conventional multiport LAVH (conventional LAVH group). Evaluation of sexual function was done prior to and six months after surgery using a validated tool, the female sexual function index (FSFI). In terms of women's demographic characteristics and operative results, there was no significant difference between the two study groups, or between pre- and postoperative individual domain scores or total female sexual function index in women who underwent either conventional or single port LAVH. Neither conventional nor single port LAVH affects sexual function in premenopausal women. Women can be counseled that this type of surgery is unlikely to alter sexual function.

Association of Sexual Functioning and Quality of Partnership in Patients in Cardiovascular Rehabilitation—A Gender Perspective

In the general population, studies indicate a strong association between sexual dysfunction and partnership quality. Despite a high prevalence of sexual problems in patients with cardiovascular diseases, this association has not yet been examined in this sample. The central task of this paper is to determine the association between sexual dysfunction and quality of partnership under a gender-specific view. A written survey was handed out to all newly admitted patients in five participating inpatient rehabilitation centers for cardiovascular diseases in Germany. The survey included a gender-specific questionnaire to assess sexual functioning (International Index of Erectile Function for men, and Female Sexual Function Index for women), and a Partnership Questionnaire. Correlations were calculated between sexual function and relationship satisfaction, and differences between groups (cardiovascular diseased men and women with and without sexual problems) were tested using covariance analyses. Overall, 44.3% of 98 female participants and 52.7% of 395 male participants stated to have at least one sexual problem. Patients with sexual problems showed significantly more quarrelling (P = 0.001), significantly less tenderness (P < 0.001), communication (P < 0.001), as well as significantly lower overall quality of partnership (P < 0.001), compared with cardiac men and women without sexual problems. Suffering from a sexual problem impaired partnership quality for women to a significantly greater extent than for men. Possible shortcomings of our study are selection bias, i.e., it is unknown whether all newly admitted patients received the questionnaire by their physician, as well as an overall low response rate, probably because of the private character of questions. This study suggests for the first time that men and women who suffer from cardiovascular diseases and sexual problems show a significantly decreased partnership satisfaction compared with those without sexual dysfunction. Further longitudinal studies might confirm the causal nature of found correlations.

A Prospective Evaluation of Sexual Function and Quality of Life After Ileal Pouch-Anal Anastomosis

This study was designed to assess the effect of ileal pouch-anal anastomosis on sexual function and quality of life in men and women. Sexual function of patients undergoing ileal pouch-anal anastomosis from February 2005 to June 2006 was prospectively evaluated using the International Index of Erectile Function in men and Female Sexual Function Index in women. Quality of life was assessed using the Short Inflammatory Bowel Disease Questionnaire. Preoperative scores were compared with scores at 6 and 12 months postoperatively. Of 110 patients eligible for inclusion, 59 (53.6 percent) agreed to participate. Male sexual function and erectile function scores remained high 12 months after surgery (mean International Index of Erectile Function score 51.7 preoperative vs. 58.3 at 12 months postoperative; P = not significant (NS)). Abnormal sexual function decreased from 33.3 percent before surgery to 22.7 percent 12 months after surgery (P = NS). Female sexual function improved 12 months after surgery (mean Female Sexual Function Index score 19.2 preoperative vs. 27 at 12 months postoperative; P = 0.031). Abnormal sexual function decreased from 73.1 percent before surgery to 25 percent 12 months after surgery (P = 0.001). Quality of life significantly improved after ileal pouch-anal anastomosis in both sexes. In men, ileal pouch-anal anastomosis does not have an adverse effect on sexual function, whereas sexual function in women seems to improve 12 months after surgery.

Validation of the Female Sexual Function Index in Women with Chronic Pelvic Pain

Chronic pelvic pain (CPP) is a common gynecological problem that is also associated with sexual dysfunction. The purpose of this research was to investigate the validity and reliability of Female Sexual Function Index (FSFI) in women with CPP. One hundred women with CPP and 100 age-matched subjects without CPP were compared in the study. Sexual function was assessed by FSFI. Internal consistency (Cronbach's alpha values = 0.91-0.97) was high for all scales. There were significant differences between women with and without CPP for each of the FSFI domain and total scores with very large effect sizes (1.29-2.56) (P < 0.0001, for all). Interdomain correlations of FSFI in the CPP group corresponded well to each other (P < 0.0001, for all). Moreover, test-retest reliability (r = 0.79-0.90) was also within acceptable ranges for this population. We concluded that the FSFI showed good ability to discriminate between women with and without sexual dysfunctions in the CPP population.