Sexual Intercourse Satisfaction Research Articles

(217) Report of Surgical Treatment Using Allogenic Dermal Graft Penoplasty to Treat Premature Ejaculation

Abstract Introduction Premature ejaculation is the major factor that causes low satisfaction of sexual intercourse. Ejaculation time is determined by various factors including such as psychological, habitual and physical factors, sensitive penile shaft and glans. Objective This study aimed to report the effectiveness and the safety of newly adopted surgical treatment using allogenic dermal graft. Methods We had performed Dermal graft surgery for treating premature ejaculation in 56 men who have short time ejaculatory problems within 5 minutes on average. We adopted a pre-pubic minimal incision and dissected penile shaft and pre-pubic space. Inserted graft materials were Allograft dermis which were fixed at the Buck's fascia. Glans sulcus was dissected from 8 o’clock to 4 o’clock and the thin strip shaped graft was fixed at the dissected space of glans sulcus. Vibratory sense of glans and penile shaft was estimated by biothesiometry and ejaculatory time was surveyed at both preoperative and postoperative status (5month~18month). Results 48 patients answered that their ejaculatory time was considerably delayed. And 7 patients slightly delayed. Among them, 1 man answered that there was no surgical effects despite of slightly being reduced penis sense. Following being asked raising their frequency of sexual intercourse, 1 man with no surgical effect was considerably improved in delaying the ejaculatory time. Among 136 cases, the inflammation on wound site occurred in 2 patients fully recovered in 2 weeks. No other complication occurred. Conclusions The surgical treatment using allogenic dermal graft is very effective in treating premature ejaculation. And this surgical procedure is very safe without no series complication. Disclosure No.

Erectile function and androgen and estrogen beta receptor gene polymorphisms in acromegalic men

PurposeSexual dysfunctions are often experienced by male patients with acromegaly, due to a combination of hypogonadism and other comorbidities, but are a scarcely investigated complication. Erectile dysfunction is also closely related to cardiovascular diseases through endothelial dysfunction. Therefore, this project aimed to assess the prevalence of erectile dysfunction in a population of acromegalic men and evaluate its association with cardio-metabolic disorders, also exploring associations with androgen and estrogen receptor gene polymorphisms.MethodsSexually active men aged 18–65 with previous diagnosis of acromegaly were recruited. Clinical and laboratory data were retrospectively collected. Each patient also provided a blood sample for AR and ERβ gene polymorphisms analyses and filled out the IIEF-15 questionnaire.ResultsTwenty men with previous diagnosis of acromegaly (mean age 48.4 ± 10.0 years) were recruited. 13/20 subjects (65%) had erectile dysfunction, but only four had a concurrent biochemical hypogonadism, with no significant correlation with IIEF-15 scores. Total testosterone negatively correlated with sexual intercourse satisfaction domain (ρ = − 0.595; p = 0.019) and general satisfaction domain (ρ = − 0.651; p = 0.009). IGF-1 levels negatively correlated with biochemical hypogonadism (ρ = − 0.585; p = 0.028). The number of CAG and CA repeats in AR and ERβ receptors genes was not significantly associated with IIEF-15 scores or with GH/IGF-1 levels, but a negative correlation between CA repeats and the presence of cardiomyopathy (ρ = − 0.846; p = 0.002) was present.ConclusionsMen with acromegaly have a high prevalence of erectile dysfunction, but it does not appear to be correlated with treatments, testosterone levels and AR/ER-beta signaling. Nonetheless, a shorter CA polymorphic trait (ERbeta) is associated with the presence of cardiomyopathy. If confirmed, these data may suggest an association between an incorrect hormonal balance and increased cardiovascular risk in acromegaly subjects.

Correlation between age and curative effects of selective dorsal neurectomy for primary premature ejaculation.

The use of selective dorsal neurectomy (SDN) as a surgical treatment of premature ejaculation (PE) has increased for many years in Asian countries. To investigate the correlation between age and curative effects of SDN in primary premature ejaculation (PPE) in mainland China. From September 2016 to September 2020, 65 patients with PPE treated with SDN were selected for study. All of the patients were followed up from 12 to 56 (30.07 ±13.48) months. They were divided into 3 groups according to age: group A (22-30 years, n = 23), group B (31-37 years, n = 20) and group C (38-45 years, n = 22). The 5-item version of the International Index of Erectile Function (IIEF-5) and Premature Ejaculation Diagnostic Tool (PEDT) results, erectile rigidity grade, intravaginal ejaculation latency time (IELT), ejaculation control abilities (ECA) scores, and sexual intercourse satisfaction (SIS) scores were assessed in the 3 groups before and after operation to evaluate the clinical efficacy of surgery. Fifty-nine patients were finally followed up. The IIEF-5 scores and erectile rigidity grade of group A was significantly higher than that of groups B and C, both before and after surgery. The change of PEDT scores in group A was significantly higher than in groups B and C; the difference was statistically significant (p < 0.05). The IELT, ECA and SIS scores in group A were significantly higher than in groups B and C (p < 0.05). Operational efficiency ratio in groups B and C (65%, 70%) was significantly lower than in group A (95.24%). The SDN as a treatment of PPE in different age groups allowed to achieve certain results. The highest surgical efficiency (95.24%) was observed in the 22-30 years age group and the lowest (65%) in the 38-45 years age group. Therefore, we believe that the best time for surgery is between 22 and 30 years of age.

THE EFFECT OF BLADDER PAIN SYNDROME/INTERSTITIAL CYSTITIS ON PARTNER SEXUAL FUNCTIONS

Objective: Bladder pain syndrome/Interstitial cystitis (BPS/IC) negatively affects both women’s social life and sexual functions. The study researched if this situation can negatively affect the sexual functions of the male partners of these women. Material and Method: The husbands of fifty female patients, who were treated for BPS/IC in our clinic, were contacted by telephone. The international index of erectile function-5 (IIEF-5), premature ejaculation diagnostic tool (PEDT), orgasmic function, sexual desire, sexual intercourse satisfaction and total satisfaction scores were used for the survey (Group 1). The same questionnaire was also used with fifty men whose wives did not have IC/BPS but who had applied to the urology outpatient clinic (Group 2). The scores of the participants were recorded and then the groups were compared. Results: The median IIEF-5 score was 23 (22-24) in both groups (p=0.899). Both groups had a median orgasmic score of 8 (7-9) (p=0.980). While the Median PEDT score was 7.00 (4.00-12.25) in Group 1, it was 4.50 (3.00-6.00) in Group 2 (p=0.002). The men in Group 2 were significantly more advantageous than Group 1 in terms of sexual desire, sexual intercourse satisfaction and total satisfaction scores, (p=0.003, p=0.0001 and p=0.003, respectively). Conclusion: Although BPS/IC does not have a significant effect on the IIEF-5 score of the husbands of women, it negatively affects the scores of sexual desire, sexual intercourse satisfaction, total satisfaction and premature ejaculation.

THE EFFECT OF BLADDER PAIN SYNDROME/INTERSTITIAL CYSTITIS ON PARTNER SEXUAL FUNCTIONS

Objective: Bladder pain syndrome/Interstitial cystitis (BPS/IC) negatively affects both women’s social life and sexual functions. The study researched if this situation can negatively affect the sexual functions of the male partners of these women. Material and Method: The husbands of fifty female patients, who were treated for BPS/IC in our clinic, were contacted by telephone. The international index of erectile function-5 (IIEF-5), premature ejaculation diagnostic tool (PEDT), orgasmic function, sexual desire, sexual intercourse satisfaction and total satisfaction scores were used for the survey (Group 1). The same questionnaire was also used with fifty men whose wives did not have IC/BPS but who had applied to the urology outpatient clinic (Group 2). The scores of the participants were recorded and then the groups were compared. Results: The median IIEF-5 score was 23 (22-24) in both groups (p=0.899). Both groups had a median orgasmic score of 8 (7-9) (p=0.980). While the Median PEDT score was 7.00 (4.00-12.25) in Group 1, it was 4.50 (3.00-6.00) in Group 2 (p=0.002). The men in Group 2 were significantly more advantageous than Group 1 in terms of sexual desire, sexual intercourse satisfaction and total satisfaction scores, (p=0.003, p=0.0001 and p=0.003, respectively). Conclusion: Although BPS/IC does not have a significant effect on the IIEF-5 score of the husbands of women, it negatively affects the scores of sexual desire, sexual intercourse satisfaction, total satisfaction and premature ejaculation.

Male sexual functions and behaviors in the age of COVID-19: Evaluation of mid-term effects with online cross-sectional survey study.

To evaluate the long-term effects of the coronavirus disease 2019 (COVID-19) pandemic on sexual functions and behavior in men with heterosexual partners. A total of 602 participants completed an online questionnaire, shared via social networks, between November 20 and December 20, 2020. Pre-pandemic sexual intercourse frequency, International Erectile Dysfunction Index (IIEF-15) score, intravaginal ejaculatory latency time (IELT), premature ejaculation diagnostic tool (PEDT) score, and activities during sexual intercourse were compared to the ones during the pandemic. In addition, the effects of various variables on participants' sexual functions were evaluated and analyzed according to age groups. The mean number of weekly sexual intercourse during the pandemic was 1.7+1.7, which was significantly lower than in the pre-pandemic period (p < 0.001). The ED score was significantly lower during the pandemic (p < 0.001) compared to the pre-pandemic period, however orgasmic function (p = 0.016), sexual intercourse satisfaction (p < 0.001), general satisfaction (p < 0.001), and PEDT scores (p = 0.004) were significantly higher. There was no significant difference in IELT before and during the pandemic (p = 0.391). Full-time employment and low education level were risk factors for developing ED and PE. The negative affect of the pandemic on sexual life was most prominent in the > 65 age group. Although kissing, oral and anal sex, and face-to-face sex positions decreased during the pandemic in all age groups, kissing and face-to-face sex positions remained the most preferred sexual behavior pattern (p = 0.002). There was no reduction in risky sexual behavior in the majority of the participants. At the end of one year with COVID-19, a decrease in erectile function and an increase in PE incidence were observed in men. Despite this, there was an increase in sexual desire and satisfaction. Although there were some changes in sexual behavior, the majority of pre-pandemic habits continued.

Sexual function assessment in men with PTSD

IntroductionExposure to extreme traumatic events can lead to post-traumatic stress disorder (PTSD). This disorder affects emotional, social and professional functioning. Recent studies suggest that it can lead to sexual dysfunction.ObjectivesThe aim of this study is to compare the level of sexual dysfunction between men with PTSD and control subjects.MethodsA total of 30 male PTSD patients and 30 controls were included in this study. We used the Post-Traumatic Stress Disorder Check Scale (PCLS) to assess the intensity of PTSD symptoms and the International Erectile Function Index (IIEF15) to assess sexual dysfunction of both patients and controls.ResultsThe mean IIEF-15 score was 51.16 ± 6.82 in patients followed for PTSD versus 77.33 ± 2.02 in healthy controls with a non-significant difference (p = 0.26). Three patients (10%) had an alteration of desire while the control reported only dysfunction but there was no significant difference between the mean scores of IIEF-SD (p = 0.22). No patient or control had erectile dysfunction and there was no significant difference between the IIEF-EF sub-scores in the 2 groups (p = 0.20). The mean sexual intercourse satisfaction (SD) score in the patients was 5.13 ± 1.10 versus 8.86 ± 0.40 with a non-significant difference (p = 0.09). Altered satisfaction with intercourse was noted in 15% (n = 5) of subjects with PTSD versus a single control.ConclusionsIt is important that practitioners address the subject of sexuality in patients followed for PTSD and refer their patients, if necessary, to a sexology consultation.

The Use of Delphi Method and Analytical Hierarchy Process in the Establishment of Assessment Tools in Premature Ejaculation: The Scoring System for Premature Ejaculation Treatment Outcomes.

There is a lack of objective tools to comprehensively evaluate premature ejaculation (PE) treatment results clinically. We aimed to describe the development of a novel scoring system for PE treatment results as an example of using the Delphi method and an analytical hierarchy process for complex decision-making in the field of sexual medicine. A Delphi question survey was adopted to collect expert opinions from 47 Chinese specialists in andrology/urology on the assessment of PE treatment outcomes based on four primary properties, that is, the improvement in intravaginal ejaculation latency time, a couple’s mental status, the ability to control ejaculation, and sexual intercourse satisfaction. Different weights on those primary properties were assigned to create a mathematical hierarchy matrix and then perform an analysis. The scores were assigned according to the calculated weights. The ratio among the combined weights of the four primary properties was 1:3:2:3. The total numerical score was 36. Scores above 27, between 26 and 18, and below 17 indicated significant improvement, moderate improvement, and no improvement in PE, respectively, with selected treatments. The scoring system with 36 points can be used by physicians, patients, and their sexual partners to comprehensively and objectively assess quantitative PE treatment results.

The Testosterone Effect on Metabolic and Urologic Outcomes in Patients with Nonfunctioning Pituitary Macroadenomas and Hypogonadotropic Hypogonadism.

Objective To evaluate cardiovascular risk, metabolic profile, low urinary tract symptoms (LUTS), and sexual function in patients with nonfunctional pituitary macroadenoma (NFPMA) and hypogonadotropic hypogonadism with testosterone therapy (TTh). Methods A retrospective clinical study at a tertiary care center was performed in 101 men with NFPMA, HH, and TTh; metabolic profile, cardiovascular risk, International Prostate Symptoms Score (IPSS), and International Index of Erectile Function 5 (IIEF-5) scores were evaluated before initiation of TTh and at the last checkup with TTh. Results Age was 49.3 ± 8.8 years; T before TTh was 195 ng/mL (101–259) vs. 574 (423–774) at the last checkup. The time of TTh administration was 34 months (12–72). An increase in triglyceride levels (200 (153–294) vs. 174 (134–233) mg/dL; p=0.03), dyslipidemia (40% vs. 52%; p=0.03), and MetS (25% vs. 34%; p=0.05) was corroborated. A statistical difference in the Globorisk score and cardiovascular (CV) risk stratification was not found. IIEF-5 score was 15.5 ± 6.5 vs. 17.8 ± 5.3 (p=0.11). An improvement in penetration quality (2.0 ± 1.5 vs. 2.6 ± 1.3; p=0.05), erection after penetration (1.8 ± 1.2 vs. 2.5 ± 1.6; p=0.02), completion of intercourse (1.8 ± 1.2 vs. 2.4 ± 1.3; p=0.03), and satisfaction of sexual intercourse (1.8 ± 1.3 vs. 2.5 ± 1.5; p=0.01) was evidenced. IPSS score was 6 (IQR 2–10) vs. 7 (IQR 4–12); p=0.30. A lower rate of intermittency (14% vs. 3%; p=0.02), urgency (39% vs. 16%; p=0.01), and episodes of nocturia (18% vs. 4%; p=0.02) was found. An increase of hematocrit (44.1 ± 4.4 vs. 47.3 ± 4.4%; p=0.001), hemoglobin (14.9 ± 1.4 vs. 15.9 ± 1.4 g/dL; p=0.001), and prostatic specific antigen (0.59 (0.43–1.19) vs. 0.82 (0.45–1.4) ng/mL; p=0.02) was evidenced during TTh. Conclusion TTh in young men with NFPMA improves LUTS, sexual function, and some metabolic parameters, and it is relatively safe in the prostatic context.

Effect of Bariatric Surgery on Male Sexual Function: A Meta-Analysis and Systematic Review.

IntroductionObesity is a worldwide public health issue with serious psychological and social impacts. Erectile dysfunction is also a common clinical condition, and obesity is one of its main risk factors.ObjectiveThe objective of this study was to systematically evaluate the effect of bariatric surgery on male sexual function.MethodsA systematical research was carried out in Medline via PubMed, EMBASE, Cochrane Library, and Web of Science up to March 16, 2019, to identify published articles related to bariatric surgery and male sexual function in men. Two reviewers screened literature, extracted data, and assessed the quality of included studies. I2 index was applied to estimate the heterogeneity. All analyses were done using RevMan5.3 and Stata14.ResultsA total of 12 studies involving 420 participants were included. Analysis showed that bariatric surgery significantly reduced body mass index in morbidly obese patients (mean difference [MD] = -13.73; 95% CI -17.23 to -10.22; P < .00001). From 10 studies that reported the International Index of Erectile Function (IIEF) score, bariatric surgery led to a significant increase in IIEF-total score (MD = 8.2; 95% CI = 5.52−10.88; P < .00001), and erectile function score (MD = 3.76; 95% CI = 2.34−5.19; P < .00001), sexual desire (MD = 0.93; 95% CI = 0.55−1.32; P < .00001), sexual intercourse satisfaction (MD = 1.73; 95% CI = 0.43−3.03; P < .01), and total satisfaction (MD = 1.28; 95% CI = 0.56−2.00; P = .0005) were also significantly improved. However, bariatric surgery did not affect orgasm function (MD = 0.26; 95% CI = -0.15 to 0.68; P = .21). Three studies that reported the IIEF-5 score also showed a significant improvement of erectile function (MD = 5.45; 95% CI = 3.38−7.52; P < .00001).ConclusionsBariatric surgery could improve the erectile function, sexual desire, sexual intercourse satisfaction, and total satisfaction in morbidly obese men. Due to limited data on body mass index and hormone levels, our meta-analysis had some limitations. More clinical studies are needed to further explore the relationship between bariatric surgery and male sexual function.Xu J, Wu Q, Zhang Y, et al. Effect of Bariatric Surgery on Male Sexual Function: A Meta-Analysis and Systematic Review. Sex Med 2019;7:270–281.

MP52-01 THE EFFECT OF BUSPIRONE ON REFRACTORY NEUROGENIC RETROGRADE EJACULATION TO PSEUDOEPHEDRINE

INTRODUCTION AND OBJECTIVES:The treatment of retrograde ejaculation (RE) is important not only for fertility but also for satisfaction of sexual intercourse. Ideally, the goal of treatment is to es...

Selection of method of treatment in secondary premature ejaculation

Premature ejaculation (PE) – a persistent attack of orgasm and ejaculation in a man before the onset of orgasm in a woman – a fairly common disease, which according to different authors suffers from 25% to 40% of men, mostly young. Despite such a wide spread of premature ejaculation, there are still no clear guidelines for its treatment in Ukraine, especially the secondary (acquired) form, which manifested itself sometime after a successful sexual life.The objective: to determine the most common causes of secondary premature ejaculation (SPE) and the effectiveness of various methods of its treatment.Materials and methods. In 2007–2017 in the andrological department of the KZOZ «RCCUN them. V.I. Shapoval», 906 patients with premature ejaculation were examined. In this sample, the results of diagnosis and treatment of 379 patients with secondary PE with an Intravaginal ejaculation latency time (IELT) were evaluated for less than 2 minutes. Based on penile biothesiometry, sexual history, study of urological complaints, doppler ultrasound examination of the prostate and scrotum, analyzes for sexually transmitted infections, and the use of the scale of autonomic dysfunction and the Hamilton scale (HRDS), there are suggestions for the most likely cause of PE. This allowed the patients to be divided into 4 groups. Group 1 – 124 patients with normal penile sensitivity without deviations in the psychoneurological status with diagnosed chronic prostatitis (CP), who underwent antibacterial treatment according to the sensitivity of the isolated infectious agents; Group 2 consisted of 84 patients with CP and the presence of varicocele, which, in addition to antibiotic therapy, were underwent Marmara surgery; Group 3 – 77 patients with CP, who along with antibacterial therapy were additionally assigned prostatoprotector (Vitaprost); Group 4 – 94 patients with neurological complaints and high anxiety HRDS &gt;14, whose treatment consisted in the appointment of a selective serotonin reuptake inhibitor (SSRI) sertraline by a course of 6 months at a dose of 50 mg per day.Results. After 1 and 7 months, the effectiveness of the treatment was determined by the lengthening of the intravaginal ejaculatory latent time (IELT), the satisfaction of sexual intercourse on the Rosen scale, the number of patients satisfied with the results of treatment and the absence of the need to take the drugs in the future. In group 1, the duration of IELT increased by 1,85 times, eradication of the disease reached 78,3%, high results were observed in the absence of complaints in 91,2% of patients, but in respect of the SPE, the efficacy was not high – only 56,2%. In the 2nd group, high eradication cure was noted – 87,3%, almost complete absence of complaints and high efficiency with respect to the SPE – 79,7%, increase in IELT – by 2,54 times. In the third group, eradication cure reached 89,4%, almost no complaints and high efficiency with respect to the SPE – 83,1%, increased by 2,72 times. In the fourth group of patients receiving sertraline, the average increase in IELT was 2,36 times, the efficacy with respect to SPE was 64,5%.Conclusions. 1. The cause of SPE is most often chronic prostatitis and prostatevisculitis (78%).2. The appointment of SSRI in case of SPE is rational only in the presence of neurological symptoms (HRDS &gt;14) and absence of CP.3. Varicocele (especially bilateral) is a comorbid factor of CP, causing venous hyperemia of the prostate, and may be one of the causes of SPE.4. Operation Marmar reduces venous hyperemia of the prostate, reduces the score of IPSS, improves IELT in patients with comorbid pathology (varicocele + CP).5. Antibacterial therapy of CP allows to cure SPE in 56%, the addition of prostatotropic drugs (Vitaprost) improves the effectiveness of treatment of SPE to 83%.

Обґрунтування удосконалення діагностики сексуальних розладів у хворих соматичного профілю на прикладі виразкової хвороби шлунка та дванадцятипалої кишки

The objective: The study and improvement of diagnosis of sexual disorders in patients of somatic profile, with ulcerative disease of the stomach (UDS) and peptic ulcer disease duodenal ulcer (DU). Patients and methods. For 3 years carried out a comprehensive examination and treatment of 130 patients with DU in remission and UDS in remission, which is observed sexual disorders; the first was 76 (58.5±4.3%) patients, second – 54 (41.5±4.3%); p&lt;0.05. They represented the main group. The comparison group included 100 male patients with DU and UDS, which were also in remission, but did not complain of sexual disorders; accordingly, they were of 66.0±4.7% and 34.0±3.3%; p&lt;0.05. Also was used a reference group (control) of 20 healthy men. All groups were matched for age (average age in the major groups – 34.0±1.7 years in the control to 32.0±4.0 years), and the first two – and duration of ulcer (average period in the history of 6.9±0.7 years). Results. The frequency of manifestations of depression in patients with DU and UDS with sexual disorders identified parameters, among which reliably allocated to mental anxiety (85.4±3.1%), depressive mood (73.1±3.8%), somatic anxiety (66.1±4.3%), reduced efficiency and activity (64.6±4.1 percent). Their combination in various embodiments burdened the situation. Exclusively in patients with peptic ulcer disease was most prevalent somatic anxiety (32.0±4.6%), depressive mood (28.0±4.5%), capacity and activity (24.0±4.2%). The majority of patients with DU and UDS with sexual disorders (60,8±4,2%) recorded a high level of personal anxiety and almost equally often low to moderate (19,2±3,4% and 20.0±3.4%, respectively). However, 93.0% of patients only with peptic ulcer were also noted its low level of expression. At the same time, among the first significantly more often observed the average level of situational anxiety (62.3±4.2%), every third - low (28.5±3.9%) and others (10.0 per cent), whereas among second - frequency dominated low level (63.0±4.9% vs 31.0±4.9% of the average and 6.0±2.3% - high). Conclusion. Justified the principle of improving the early identification of sexual disorders in men with chronic somatic diseases, for example peptic ulcer disease, the essence of which is to be included in the anamnestic and diagnostic method of two key issues, namely: the satisfaction of sexual intercourse and satisfaction with sexual life in General. Key words: gastric ulcer and duodenal ulcer, sexual dysfunction, diagnosis.

Особливості депресивного стану чоловіків з виразковою хворобою шлунка та дванадцятипалої кишки, які мають сексуальні розлади

The objective: the evaluation of depressive state in men with peptic ulcer of stomach and duodenum, which have sexual disorders. Patients and methods. The study is based on the generalization of the results of complex examination and treatment of 130 patients with peptic ulcer disease duodenal ulcer in remission and gastric ulcer in remission who have sexual disorders; the first were 76 (58.5±4.3%) patients, the second – 54 (41.5±4.3%); p&lt;0.05. They entered the main group. The comparison group consisted of 100 men with peptic ulcer disease duodenal ulcer and gastric ulcer that also in remission who did not complain of sexual disorders; accordingly, they were of 66.0±4.7% and 34.0±3.3%; p&lt;0.05. The creation of this group are motivated by the need to determine the characteristics of changes in the quality of life, psychological status between patients with these somatic diseases, but if not combined with sexual disorders. For this purpose was used the referential group consisted of 20 healthy men, the survey results of which complements the existing normalized values most approximate to this population. All groups were matched for age, and the first two – for the duration of peptic ulcer disease. Results. It is determined that the frequency of manifestations of depression in patients with peptic ulcer disease duodenal ulcer and gastric ulcer with sexual disorders identified parameters, among which stood out significantly mental anxiety (85.4±3.1%), depressive mood (73.1±3.8%), somatic anxiety (66.1±4.3%), reduced efficiency and activity (64.6±4.1 percent). Their combination in various embodiments burdened the situation. Exclusively in patients with peptic ulcer disease were most prevalent somatic anxiety (32.0±4.6%), depressive mood (28,0±4,5%), capacity and activity (24.0±4.2%). It is revealed that most duodenal ulcer and gastric ulcer with sexual disorders (60.8±4.2%) characterized by a high level of personal anxiety and almost equally often low to moderate (19.2±3.4% and 20.0±3.4%, respectively). However, 93.0% of patients only with peptic ulcer were also noted its low level of expression. At the same time, among the first significantly more often observed the average level of situational anxiety (62.3±4.2%), every third – low (28.5±3.9%) and others (10.0 %) – high, whereas among second – frequency dominated low level (63.0±4.9% vs 31.0±4.9% of the average and 6.0±2.3% – high). Conclusion. It was confirmed the hypothesis of dependence between the presence of in patients with peptic ulcer disease various intensities of depression, mental tension, mainly situational anxiety and the development of sexual dysfunctions, as evidenced by the discovery in 14% of cases of erectile dysfunction. It was proven the principle of improving the early identification of sexual disorders in men with chronic somatic diseases, for example peptic ulcer disease, the essence of which – a mandatory inclusion in the medical history, as diagnostic method of two key parameters: the satisfaction of sexual intercourse and satisfaction with sexual life in General. Key words: gastric ulcer and duodenal ulcers, sexual function disorders, psychological disorders, and depression.

Male sexual function after total mesorectal excision: a comparison between laparoscopic and open surgery during the learning curve period.

This study assessed male sexual function using a specific and validated questionnaire, the International Index of Erectile Function (IIEF), in patients subjected to open total mesorectal excision (OTME) and laparoscopic total mesorectal excision (LTME) and compared it with a control group. The inclusion criteria consisted of male patients with an active sexual life before surgery subjected to OTME or LTME at the Coloproctological Unit of the Clinics Hospital, Minas Gerais Federal University, between January 2005 and September 2009. The IIEF questionnaire was used. The control group comprised 30 randomly selected men (older than 35 y of age) without previous pelvic or abdominal surgery and without any genitourinary complaints. Between January 2005 and September 2009, 77 male patients were subjected to total mesorectal excision, with 26 meeting the inclusion criteria and answering the questionnaire: 13 in the OTME group and 13 in the LTME group. When the 3 groups were compared in each IIEF domain, there were significant differences in erectile function (P=0.05), orgasm and ejaculation (P=0.009), sexual intercourse satisfaction (P=0.01), and overall satisfaction (P=0.025), favoring the LTME and control groups. No difference was found in sexual desire (P=0.285). LTME may have the benefit of preserving male sexual function compared with OTME, even in the learning curve period.

Investigation of sexual function and health status of offsprings in male kidney transplantation recipients

Objective The researchers sought to investigate and evaluate sexual function in male kidney transplantation recipients and their offsprings' health condition. Methods 90 male kidney trans-plantation recipients who had a normal sex life before their kidney failure and had good renal graft function after transplantation fell into the inclusion criterion. The method of questionnaire survey was used to investi-gated and evaluate the time of first spermatorrhea, viability of sex activities, frequency and sexual intercourse satisfaction of sex activities, procreation status, growth and intelligence status of the offsprings. Semen routine tests before and after the transplantation were needed. Results Hyposexuality or sexual function declina-tion was found in all of the 90 cases of recipients. And after surgery, sexual function of the recipients im-proved obviously, following the graft function gradually regained. 81 patients had spermatorrhea in the first 1 to 3 months post transplantation, and other 9 cases did not have spermatorrhea because of sexual life. Postoperative 84 male patients began to have sex in 2 to 4 months with 92.86% rate of satisfaction, except for the other 6 refusing to have sex because of worrying about graft damage by sex. 100 children were born by 90 recipients postoperatively, growth and intelligence status of them showed no significant difference com-paring with the children of the same age. No transplant graft failure or rejection was found after the recipients gave birth to children. Conclusions After kidney transplantation, male recipients' sexual function could re-turn to normal. It's safe that male recipients could give birth to children under their doctor's the guidance, and the growth and intelligence status of their offsprings were normal. Key words: Kidney transplantation; Male; Sexual function; Children

The prevalence of premature ejaculation and its clinical characteristics in Korean men according to different definitions

This study compared the prevalence of premature ejaculation (PE) diagnosed by the PE diagnostic tool (PEDT) score, self-reporting and stopwatch-recorded intravaginal ejaculation latency time (IELT). It examined the characteristics of males diagnosed with PE by each criterion. A questionnaire survey enrolled 2081 subjects from March to October, 2010. Stopwatch-recorded IELT was measured in 1035 of the 2081 subjects. We aimed to determine whether PE has an influence on the frequency and satisfaction of sexual intercourse, the degree of libido/erectile function and the satisfaction. These factors were evaluated according to different definitions of PE to assess whether the definition used yielded differences in the data. The prevalence of PE, based on a PEDT score of ≥11, self-reporting and stopwatch-recorded IELT of ≤1 min was 11.3%, 19.5% and 3%, respectively. The prevalence of PE diagnoses based on PEDT score and self-reporting increased with age, but stopwatch-recorded IELT-based diagnoses did not. Males experiencing PE showed lower levels of libido, erectile function and frequency and satisfaction of sexual intercourse compared with non-PE males. PE males felt that they did not satisfy their partners in terms of the partners' sexual satisfaction and frequency of orgasm, in comparison with non-PE males. PE is a highly prevalent sexual dysfunction in males. Regardless of whether the PE diagnosis was made on the basis of self-reporting, PEDT score or stopwatch-recorded IELT, subjective symptoms were similar among PE males.

COMPARISON OF SEXUAL FUNCTION IN FEMALES RECEIVING HAEMODIALYSIS AND AFTER RENAL TRANSPLANTATION

The aim of this study is to compare the sexual function of kidney transplant recipients and end-stage renal disease (ESRD) patients receiving haemodialysis (HD) in female patients. In the sample population of this study, there were 72 women in the transplant group and 40 women in the HD group. To test the differences in the quantitative variables between these two groups, an independent sample Student's t-test was performed. Sexual relationship, sexual function, sexual frequency and sexual fear in the renal transplant patients are significantly better than HD patients. Sexual intercourse satisfaction was apparently higher in the kidney recipients than in the HD patients. Twenty-one patients in transplanted group described number was 6 (15%) (p = 0.03). This study indicated that female kidney transplant recipients experienced a significantly better sexual relationship compared with the ESRD patients receiving HD.

ORIGINAL RESEARCH—SURGERY: Sexual Function after Loop Electrosurgical Excision Procedure for Cervical Dysplasia

ABSTRACT Introduction Loop electrosurgical excision procedure (LEEP) is an effective tool for management of cervical dysplasia. However, removal of a part of the cervix might have a negative impact on sexual function. Aim To examine the effect of LEEP on overall sexual satisfaction and other specific aspects of sexual function in women with cervical dysplasia. Methods Eighty-nine premenopausal women with cervical dysplasia who had undergone LEEP at least 3 months previously were interviewed once on post-LEEP follow-up visits with a questionnaire on pre- and post-procedural sexual function. Data on frequency of sexual intercourse, the presence of dysmenorrhea, dyspareunia, and postcoital bleeding were compared using the McNemar test. Data on specific aspects of sexual function rated by the 6-point Likert scale were analyzed using Wilcoxon signed ranks test. Main Outcome Measure The main outcome is the overall sexual intercourse satisfaction. Results The mean age was 41.7 years. The median interval from LEEP to the time of interview was 29.3 weeks. The time of resumption of sexual intercourse after LEEP was 8.1 weeks on the average. The changes in the frequency of sexual intercourse, dysmenorrhea, and dyspareunia after LEEP were not statistically significant. The changes in overall satisfaction, vaginal elasticity, and orgasmic satisfaction appeared statistically significant (P &amp;lt;0.05). Conclusion Having LEEP done along with other “non-surgical” parts of cervical pre-cancer management is associated with small but statistically significant decreases in overall sexual satisfaction, vaginal elasticity, and orgasmic satisfaction when interviewed near to the procedure at 29.3 weeks post-operation. However, the changes on other aspects of sexual function are insignificant. The LEEP procedure itself appears to have a minimal, if any, clinically important adverse effect on sexual function.

Behavioral Dichotomy In Sexuality During Pregnancy And Effect Of Birth-Week Intercourse On Pregnancy Outcomes In An Iranian Population.

Background: Sexuality in pregnancy is extensively investigated in European, American and some eastern Asian countries but not well studied in some Middle East countries like Iran. The aim of this study was to determine the pattern of sexuality in a given Iranian population and to investigate possible association between sexual activity pattern during pregnancy and some maternity and fetal health outcomes. Methods: In this pregnancy cohort study, 74 pregnant women receiving prenatal care form Asadabadi and Alzahra university hospital prenatal care units were enrolled. They were studied for their sexuality in pregnancy, their attitudes toward it and effect of birth-week intercourse on maternity and child health. Results: Having an intercourse during the last week of pregnancy was observed in 24.3 percent of women with a mean of 1.4 times among these subjects. Cumulative number of previous intercourses, intercourse at a prior week and husband educational level were the three independent predictors of having intercourse birth week in multivariate regression analysis. Although women with lower educational level and women who had higher satisfaction score during the previous intercourse showed higher percentage of birth-week intercourse, but the results were not statistically significant in multivariate analysis. Desire for and satisfaction of sexual intercourse had less trend variation throughout the pregnancy. Having more than two intercourses during the birth week significantly increased the chance of developing prom(P<0.01). Having Apgar score equal to seven versus higher Apgar scores was significantly more likely among women with more than one intercourse during the birth-week. Conclusion: The results of this study confirmed the existence of a behavioral dichotomy in sexuality during pregnancy in an Iranian population: One substantially conservative behavior and one relatively non-cautious sexual behavior.