Sexual Dysfunction Research Articles

Efficiency of Early Penile Rehabilitation on Erectile Function Recovery after Open Radical Prostatectomy

Prostate cancer (PC) is one of the most commonly diagnosed malignancies worldwide and the second leading cause of mortality among men (1). Nowadays, radical prostatectomy is considered the primary therapeutic modality for treating patients with localized PC (stage pT2), providing a five-year survival rate of nearly 100% (2). Sexual dysfunction in men associated with PC treatment encompasses three distinct entities: erectile dysfunction (ED) and penile shortening; ejaculatory and orgasmic dysfunction; and psychosexual dysfunction, which pertains to sexual desire, intimacy, and mental health (3). Penile rehabilitation (PR) is defined as the use of any intervention or combination of procedures aimed not only at achieving an erection sufficient for satisfactory sexual intercourse but also at restoring erectile function to its preoperative level (4). Despite eff orts to preserve the neurovascular bundle during radical prostatectomy, ED remains a common outcome. Although prevalence rates of ED after the procedure vary widely, recent studies report rates as high as 85% (5). This is primarily due to the lack of control over factors that significantly influence the erection recovery, such as the patient’s age, preoperative erectile function, comorbidities, surgical approach (open, laparoscopic, or robot-assisted), surgical technique (non-, uni-, or bilateral nerve-sparing), and the surgeon’s skills and experience. The pathophysiology of postoperative ED is multifactorial. The primary mechanisms are believed to be damage to the cavernous nerves, whether through dis-section or neuropraxia, and vascular injury, which includes damage to the accessory pudendal arteries, hypoxia and fibrosis of the endothelium and smooth muscle, resulting in penile shortening (6-8). Although there is no consensus on the optimal approach to PR, accepted modalities include the use of phosphodiesterase type 5 inhibitors (PDE-5i; such as sildenafil, vardenafil, tadalafil) and vacuum erection de-vices (VED) or vacuum constriction devices (VCD) as first-line therapies. Second-line treatments involve prostaglandin E1 preparations for intracavernous, or intraurethral (MUSE – “Medicated Urethral System for Erection”) administration. The final therapeutic option is the implantation of penile prostheses (3-10).

The Highs and Lows of Pornography Use: Does Motivation Affect Users’ Life Satisfaction?

"The negative outcomes of problematic pornography use (PPU) have been well documented, but there is a gap in the literature on the underlying mechanisms that influence the life satisfaction and mental health of pornography users. In the current study we have used a cross-sectional, person-centered approach in order to reveal the motivational and life satisfaction profile of problematic and non-problematic pornography users based on the theoretical framework of Self-determination Theory (SDT). We also wished to determine the role of self-determination in the life satisfaction of pornography users, as this variable is considered to be relevant for the life satisfaction and mental health of online pornography consumers. Our participants (N = 4302) were Hungarian speaking adults from Romania and Hungary (age M=27,91; SD=9,50), selected through sampling on social networking sites related to pornography, sexual dysfunction and addiction. Individuals were assigned to one of 3 groups (i.e., no symptoms, few symptoms, problematic use), based on the presence of symptoms related to pornography use. Demographic data was gathered, self-determination, life satisfaction and pornography use were assessed using the online version of validated instruments. Results indicated that SDT-based motivation and life satisfaction have a significant role in shaping the profile of pornography users. Participants with PPU felt less satisfied with their life, were less self-aware and experienced lower levels of perceived choice than both no symptom and few symptom groups. Although self-determination significantly predicted life satisfaction, this effect was not influenced by the problematic character of pornography use. Keywords: self-determined motives; life satisfaction; online sexual activities; problematic pornography use."

Assessing the prevalence and knowledge of anabolic steroid use in male athletes in Al Madina Al Munawara, Saudi Arabia.

To assess the prevalence of anabolic steroid use and the level of knowledge on anabolic steroids among the male athletes in Al Madina Al Munawara, Saudi Arabia. A cross-sectional study was conducted on male athletes randomly selected from the private athletic centers in Al Madina Al Munawara over 5 months. Data were collected from all participants using a self-administered anonymous questionnaire with 33 questions. The questionnaire covered the socio-demographic characteristics of the participants, and their knowledge, attitudes, and use of anabolic steroids. Of the 150 male athletes surveyed, 121 completed the questionnaire (response rate: 80.6%). Over half were aged between 18 and 23 years (56.2%) and were single (79.3%). Thirty-two percent reported using anabolic steroids, mainly to increase muscle mass, following coaches' advice (46.1%). Key sources included the internet (30.7%), coaches (30%), and friends (27.9%), and non-healthcare professionals. The top motivations were price, coach's/physician's advice, and availability. The perceived benefits included increased muscle mass, strength, and endurance, while the perceived adverse effects included kidney/liver damage and sexual problems. One-third of the male athletes surveyed used anabolic steroids, influenced by accessibility and social contact, rather than healthcare guidance. This highlights the need for greater awareness of the long-term health risks, ideally through education provided by sports medicine specialists.

Sexual Disorders in Men: The Main Factors of Occurrence and Their Correction.

The aim is to identify the causes of physical and emotional health disorders in men in terms of intimate interaction with partners, as well as how they can be prevented. The research used comparison, analysis, statistical methods, and surveys. The need for people to discover and study sexual health issues in the modern world in order to support not only the physical, but also the psychological aspects of their body, as well as the impact of lifestyle on this process, is shown. The research was conducted to better understand all diseases that are based on the deterioration of the psycho-emotional state of men, which leads to sexual disorders. A more detailed study of this topic will allow to better select treatment for patients and find different approaches to the problem in the future.

Incidence of Post Operative Sexual Dysfunction Following Left Sided Colon and Rectal Surgery in a Surgical Patient Cohort in Northern Saskatchewan

Incidence of Post Operative Sexual Dysfunction Following Left Sided Colon and Rectal Surgery in a Surgical Patient Cohort in Northern Saskatchewan

Exposure to Fluoxetine induced Gonado-toxicity in female rats: Modulating role of Hybanthus enneaspermus

Several scientific evidence supports the use of Hybanthus enneaspermus leaves in the management of female sexual inadequacies. Additionally, fluoxetine is a reproductive toxicant that induces sexual dysfunction. To determine the modulating role of aqueous extract of Hybanthus enneaspermus leaves on fluoxetine-induced gonado-toxicity, sixty healthy, sexually-responsive female rats (157.21 ± 6.89) were divided into six groups (A–F) comprising of 10 rats each. Group A (control group) were administered distilled water only, Group B-F received orally 15 mg/kg body weight (b.w) of fluoxetine prepared daily for 14 days for the induction of anti-oestrogenicity and subsequently received 0.5ml of distilled water, 20 mg/kg b.w of a reference drug (Tadalafil) and 0.5 mL equivalent to 250, 500 and 1000 mg/kg b.w of the extract respectively, orally, once daily (08:00-08:45h) for 7 days. Fluoxetine reduced serum oestrogen concentrations by 54.79% and significantly reduced (p<0.05) ovarian and uterine total protein, glycogen, cholesterol, the activities of alkaline phosphatase and acid phosphatase. The reductions were by (22.91%, 25.57%, 22.82 %, 15.09 % and 43.17 %) in the ovaries and (21.25 %, 26.9%, 7.20%, 16.82% and 29.85%) in the uteri of the animals respectively. In contrast, these reductions were overturned by the extract towards the control group. The extract at 1000 mg/kg b.w ameliorated the reductions of these oestrogenic indices. Hybanthus enneaspermus attenuated the deleterious effects of fluoxetine on the ovaries and uteri, restored sexual competence and promoted oogenesis. These may further lend backing to its widespread use in handling some sterility/infertility problems in women.

Prevalence of Female Sexual Dysfunction in Patients with Thyroid Disorders

Prevalence of Female Sexual Dysfunction in Patients with Thyroid Disorders

Female Sexual Function following Pelvic Organ Prolapse Reconstruction: A Case Serial Study

Background: Pelvic organ prolapse (POP) may reduce women's quality of life and is one of the most important aspects in the occurrence of sexual dysfunction. Objective: This study aimed to assess sexual function in POP women with pelvic floor dysfunction pre and post-surgery. Methods: This study was a prospective cohort study. Using the total sampling technique at Arifin Achmad Hospital, Indonesia, the study recruited women who underwent POP surgery with active sexual function from July 2020 to December 2021. The pelvic floor disorder was evaluated through Pelvic Floor Distress Inventory (PFDI) questionnaires validated in the Indonesian language, pre, and post-surgery. The assessment of sexual function was carried out using the Indonesian linguistic validation of the Female Sexual Function Index (FSFI) questionnaires before and after surgery. Results: There was a decrease in the average value of pelvic floor disorder scores before and six months after surgery (P< 0.05). However, the sexual function increased with a cut-off score of FSFI > 20.25 at 3 and 6 months post-surgery, respectively as much as 61.1% (11/18 subjects) and 72.2% (13/18 subjects), compared to the pre-surgery sexual function scores by 7.8% (5/18 subjects). Out of the 6 domains of sexual function, an increase was found in the sexual arousal domain (P<0.05). Conclusion: There is a decrease in pelvic floor disorder and an increase in sexual function, particularly an increment in sexual arousal at six months post-surgery.

The Effect of Yoga and Pelvic Floor Muscle Exercise on Sexual Function and Sexual Self-esteem of Reproductive-age Women: A Randomized Clinical Trial.

Sexual function is a part of sexual health which is an important aspect of the quality of life. Physical activity is one of the healthiest activities that can effectively reduce the risk of sexual disorders. Therefore, this study was conducted with the aim of evaluating the effect of yoga and pelvic floor muscle exercises on the sexual function and sexual self-esteem of reproductive-age women. This randomized clinical trial study was conducted from September to December 2023 on 46 women of reproductive age working in the Shahrekord University of Medical Sciences and its affiliated health centers. Multi-stage cluster sampling was used to select the subjects; later, they were randomly divided into two intervention groups A (N=21) and B (N=25). Participants in intervention groups A and B performed pelvic floor muscle exercises at home using an educational pamphlet 3 times a week for 6 weeks, with 3 times a day repetition. In addition, women in the intervention group A participated in a yoga training program for 2 sessions per week for 6 weeks. Data collection tools included a demographic information form, the Female Sexual Function Index, and Sexual Self-Esteem Inventory for women. Questionnaires were completed by both groups before, immediately, and one month after the intervention. The data were analyzed using the chi-square test, fisher's exact test, independent two-sample t-test, repeated measures test, and analysis of covariance in SPSS software version 16. A significance level of less than 0.05 was considered. The results showed no statistically significant difference between the two groups in sexual function (P=0.21) and sexual self-esteem (P=0.22) scores before the intervention. Also, the results showed no statistically significant difference between the two groups in terms of sexual function (P=0.35) and sexual self-esteem (P=0.59) scores one month after the intervention. However, the mean score of the sexual function index immediately after intervention showed a statistically significant difference between the intervention groups A (31.43±3.76) and B (29.41±2.38) (P<0.001). The mean score of the sexual self-esteem immediately after the intervention showed a statistically significant difference between the intervention groups A (181.19±19.90) and B (171.32±15.02) (P<0.001). Adding yoga exercises to pelvic floor muscle exercises can improve the sexual function and sexual self-esteem of women at their reproductive age. Trial Registration Number: IRCT20100524004015N1.

A Study of Prevalence of Sexual Dysfunction in Patients Receiving Psychotropic Drugs

Background: Sexual dysfunction is the most common side effect associated with psychotropic drugs. It is a threat to patient’s quality of life and a major reason for non –compliance. Psychotropic agents can impair the sexual response in different ways due to their neurobiological mode of action. Prevalence rates of sexual side effects are extraordinarily difficult to estimate due to a variety of factors, such as the effect of the disorder being treated, co morbid disorders and baseline sexual dysfunction. Objectives: To study the association between sexual dysfunction and psychotropic drugs in patients using various psychotropic drugs like antidepressants, anti-psychotics, anti-cravings and anxiolytics. Methods: A cross sectional study was done among 200 patients. A self-designed semi structured questionnaire consisting of socio demographic details, relevant psychiatric history and Psychotropic – Related Sexual dysfunction questionnaire (PR Sex DQ – SALSEX) was used. The obtained data was entered in MS excel and analysed using SPSS software Results: Among 200 patients ,62.5% of males and 38.5% of females felt that their psychiatric medications were causing sexual side effects. Out of them 41.7% of men and 30.03 % of women. Conclusion: The most relevant groups for impairment are antidepressants and antipsychotics due to the serotonin agonistic and anti – dopaminergic properties as well as the prolactin increasing characteristics. The treatment of psychiatric disorders should follow a comprehensive treatment plan that anticipates a likely sexual dysfunction at the initiation of treatment.

SEXUAL DYSFUNCTION IN PAKISTANI MARRIED WOMEN WITH CURRENT EPISODE OF DEPRESSION AND BIPOLAR: A QUALITATIVE STUDY

The awareness of psychological disorders in the present times is increasing with the help of dynamic psychological assessment tools, advancing with progressive investigation methods. Current psychological literature significantly emphasizes on depression and bipolar disorders, their prevalence, assessment, and treatment protocols among the married individuals. Despite the increasing prevalence of depression among women, scholarly literature scarcely addresses on the impacts of sexual dysfunction on the married women in Pakistan, experiencing depression and associated bipolar disorder. The aim of this research was to study the impact of Sexual Dysfunction in Pakistani Married Women with Depression and Bipolar Disorder. A sample of 8 participants was selected with the help of purposive sampling. Each of these participants was diagnosed with depression and/or bipolar disorder and was undergoing therapy for the same. A semi-structured interview was conducted with each of these participants to deduce information about their disorders and sexual dysfunction. Thematic analysis was employed as the qualitative analysis technique for the evaluation of results gathered from interviews. The analysis revealed two main themes: Past experiences and current relationships. In the theme, experiences sub themes of parental relationships and childhood experiences were observed. Whereas in the theme Current Relationships, subthemes of the current marital relationship and current sexual relationship were observed. The themes and sub-themes revealed that married Pakistani women who are facing Depression and Bipolar Disorder, also go through sexual dysfunction.

Acute Toxicity of 70% Ethanol Extract of Kenitu (Chrysophyllum cainito L.) Leaves of Wistar Rats (Rattus norvegicus)

The postmenopausal phase, which results in a lack of estrogen levels and is one of the triggers of menopausal symptoms, contributes to the elderly's cognitive function decline. This condition can also cause joint and bone pain, bladder and urinary tract disorders, and sexual problems. Based on several studies, it is known that kenitu (Chrysophyllum cainito L.) contains phytoestrogen compounds with a structure similar to the hormone estrogen, so kenitu has the potential as an alternative treatment for disease conditions with risk factors for estrogen deficiency. The study was conducted to determine the estimated lethal dose 50 (LD50) value based on the Globally Harmonized System (GHS) classification as well as macroscopic (physical, behavioral, and average weight gain per day) and microscopic (liver and kidney histology) values in Wistar rats against the administration of 70% ethanol extract of kenitu leaves at a dose of 2000 mg/kg body weight (BW). The Up-and-Down Procedure (UDP) acute toxicity test method was used for this study. The maximum dose was 2000 mg/kg BW of ethanol extract from 70% kenitu leaves. The study found that the 70% ethanol extract of kenitu leaves had more than 2000 mg/kg BW LD50 value against Wistar rats. Based on the classification of the GHS, it can be concluded that 70% ethanol extract of kenitu leaves against Wistar rats is classified as low toxicity.

The Effect of the Combination of Ginseng, Tribulus Terrestris, and L-arginine on the Sexual Performance of Men with Erectile Dysfunction: a randomized, double-blind, parallel, and placebo-controlled clinical trial.

Nitric oxide is the most important mediator of penile erection after the onset of sexual excitement. It activates cyclic guanosine monophosphate (cGMP), increasing penile blood flow. Most pharmaceutical medications prevent enzyme phosphodiesterase type 5 (PDE-5) from breaking down cGMP, thus keeping its level high. However, due to the adverse effects of pharmacological therapies, herbal drugs that improve sexual function have gained attention recently. This study aimed to investigate the combined effects of ginseng, Tribulus terrestris, and L-arginine amino acid on the sexual performance of individuals with erectile dysfunction (ED) using the 5-item version of the International Index of Erectile Function (IIEF-5) questionnaire. Over three months, 98 men with erectile dysfunction were randomly assigned to receive either 500 mg of herbal supplements or placebo pills. Each herbal tablet contained 100 mg of protodioscin, 35 mg of ginsenosides, and 250 mg of L-arginine. The results showed that the changes in the average scores of ILEF-5 within each group before and after the intervention indicated that all parameters related to the improvement of sexual function in patients with erectile dysfunction improved in the herbal treatment group (p < 0.001). The herbal group significantly improved IIEF-5 scores in non-diabetics (p < 0.05). However, there was no significant difference in the changes of IIEF-5 scores between the two intervention and control groups in diabetic patients. In conclusion, ginseng, Tribulus terrestris, and L-arginine have properties that increase energy and strengthen sexual function, making them suitable for patients with sexual disorders.

Using network analysis to model associations between psychological symptoms, sexual function, and sexual distress in women

BackgroundPsychological difficulties, including depression, anxiety, and somatization, are among the most important predictors for women's sexual function (i.e., arousal, desire, lubrication, pain, and satisfaction) and sexual distress. These associations have largely been studied at the construct level, with little research examining which specific symptoms might be most important for maintaining links between psychological difficulties and domains of sexual function. The present research sought to establish and characterize networks of women's psychological symptoms, sexual function, and sexual distress, and identify potential bridge symptoms that connect them. MethodsIn a cross–sectional study, 725 women reported on their sexual function, sexual distress, and depressive, anxiety, and somatization symptoms. A series of network analyses was used to identify central symptoms and connections between psychological symptoms, sexual function domains, and sexual distress. ResultsAcross the modeled networks, sexual distress and pain during sex were consistent bridges between other sexual function domains and psychological symptoms. DiscussionOverall, our models revealed sexual distress as an important potential mediator between sexual function problems and psychological symptoms that might contribute to the development and maintenance of comorbid sexual function and psychological problems.

Sexual dysfunction and marital adjustment in married men with alcohol dependence syndrome

Background: Only a few studies have systematically assessed sexual dysfunction and marital adjustment in married men with alcohol dependence in India. Aim: To assess the prevalence and pattern of sexual dysfunction and marital adjustment in a clinical sample of married men with alcohol dependence. The association of sexual dysfunction and marital adjustment with the severity of alcohol dependence was also explored. Materials and Methods: This cross-sectional study included 100 consecutive married men attending psychiatry outpatient department (OPD) with a diagnosis of alcohol dependence syndrome (ADS). A pre-designed study proformawas used for collecting relevant socio-demographic and clinical details of the study participants. Sexual dysfunction, marital adjustment, and alcohol dependence were assessed using the following validated tools: the Arizona Sexual Experiences Scale (ASEX), the Marital Adjustment Questionnaire (MAQ), and the Severity of Alcohol Dependence Questionnaire (SADQ), respectively. Results: Of 100 patients, about 15% had clinical sexual dysfunction based on ASEX. The most commonly reported sexual dysfunction was difficulty with erection (24.0%), followed by problems in desire (18.0%), sexual arousal (12.0%), ability to reach orgasm (12.0%), and satisfaction with orgasm (9.0%). Sexual dysfunction (ASEX score) showed significant positive correlation (rs = 0.345; P &lt; 0.001) with alcohol dependence severity (SADQ score). Also, the severity of alcohol dependence was negatively correlated (rs = -0.240; P = 0.016) with the overall level of marital adjustment (MAQ score) with spouse. Conclusion: Sexual dysfunction is common in married men with ADS, with both sexual dysfunction intensity and marital adjustment difficulties being positively associated with the severity of alcohol dependence.

Factors associated with persistent sexual dysfunction and pain 12 months postpartum

ObjectiveIdentify factors associated with persistent sexual dysfunction and pain 12-months postpartum in an underserved population. MethodsExtending Maternal Care After Pregnancy (eMCAP) is a program addressing health needs/disparities of patients at risk for worse perinatal outcomes. Participants completed the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) and Urinary Distress Index (UDI-6) 12-months postpartum. The PISQ-12 was dichotomized with scores < 32.5 indicating sexual dysfunction. Urinary incontinence (UI) was defined as at-least-somewhat bothersome (vs. none or not-at-all bothersome) urgency urinary incontinence (UUI) or stress urinary incontinence (SUI). Screening for anxiety and depression was completed using Generalized Anxiety Disorder-7 (GAD-7) and Edinburgh Postnatal Depression Scale (EPDS). Bivariate and multivariable logistic regression analyses were performed for sexual dysfunction vs. normal-function, and pain vs. no-pain, using demographic, peri/postpartum, and social-determinant-of-health variables as correlating factors. Results328 sexually active patients provided data. On bivariate analysis, sexual dysfunction (n = 31, 9.5%) vs. normal function (n = 297, 90.5%) groups showed no differences in age, BMI, parity, mode of delivery, episiotomy/laceration types, or breastfeeding. Sexual dysfunction was significantly associatedwith both UUI and SUI: 12 (39%) vs. 46 (15%) had UUI, p = 0.001, and 20 (65%) vs. 97 (33%) had SUI, P < 0.001; the dysfunction group also had higher GAD-7 and EPDS scores and greater overall stress levels. On multivariable analysis, SUI and stress remained significantly associated: OR (95% CI) 2.45 (1.02–6.03) and 1.81 (1.32–2.49), respectively. Comparing pain (n = 45, 13.7%) vs. no-pain (n = 283, 86.2%), dyspareunia patients endorsed greater stress levels. ConclusionThe interplay between sexual health, incontinence, and mental health deserves further study, and all three should be routinely addressed in postpartum care.

Supporting practitioners to talk about sexual wellness and pleasure during radiotherapy for gynaecological cancer

IntroductionRadiotherapy treatment for gynaecological cancer has significant negative effects on sexual wellness and pleasure (1–3). Patients undergoing radiotherapy for gynaecological cancers have more sexual dysfunction and experience more sexual and depressive symptoms than those who undergo surgery alone (4). The World Health Organization defines sexual health as a crucial part of health and wellbeing and recognizes the importance of positive and respectful approaches to sexuality, alongside safe and pleasurable sexual experiences free from violence and coercion (5). MethodsTaking a sex critical approach to sexual wellness and pleasure, this project aimed to support practitioners to have improved and impactful conversations with people receiving radiotherapy treatment for gynaecological cancers. A series of three professional development workshops were held to explore language, unpack assumptions and develop key competencies for practitioners. A fourth workshop involved co-development of resources for use by other practitioners. ResultsThe group united, sharing insights, learning, and developing practices through reflection developing critical awareness about damaging silences around sexual wellness and pleasure. Co-created resources included conversation cards and a poster. ConclusionThe project aimed to build and extend research findings to develop practitioner skills in supporting sexual wellness and pleasure for people receiving gynae-radiotherapy. The study shows the benefits of discussing norms and harms associated with biomedically focused conversations in gynae-radiotherapy to acknowledge diversity and validate concerns about sexual wellbeing and pleasure. Implications for practiceA sex critical approach to sexual wellness and pleasure should be considered a core principle of care for patients during their treatment for gynaecological cancers. Conversations are a key (free) resource within the practitioner-patient relationship that can address and improve patients’ psychosocial wellbeing.

Sexual health in transgender and gender diverse people.

Sexual health and sexual function are critical to the wellbeing of cisgender, transgender, and gender diverse populations. To date, there has been only limited patient-focused evaluation of sexual function in transgender and gender diverse patients at several stages in their gender-affirming medical care. There remains a need to better understand the impact of gender affirming medical and surgical therapy on sexual health, and to develop evidence-based treatments to address sexual dysfunction when present. The impact of gender-affirming hormone therapy on sexual health is complex and evolves over time on treatment. Despite high incidences of complications, major genital gender-affirming surgeries such as vulvovaginoplasty and penile implant placement after phalloplasty yield high patient satisfaction. While treatments to preserve or restore erections and to improve vaginal lubrication have been trialed based upon literature in cisgender populations, there remains minimal evidence to guide medical treatment of sexual dysfunction ranging from erectile dysfunction to dyspareunia. There is a continued need for ongoing efforts to develop patient-reported outcome measures and rigorous investigation of sexual health preservation and restoration treatments in transgender and gender diverse populations.

Surgical approaches for pudendal nerve entrapment: insights from a systematic review and meta-analysis.

Pudendal nerve entrapment (PNE) is an underdiagnosed condition affecting a spectrum of pelvic functions, primarily pain, as outlined by Nantes diagnostic criteria. Although numerous surgical decompression techniques are available for its management, consensus on efficacy and safety is lacking. This study conducts a systematic review and meta-analysis to assess the efficacy and complication rates of the main surgical decompression techniques. A comprehensive literature search was conducted in PubMed®, Embase®, Web of Science®, and ClinicalTrails.gov® on 19th of April 2023. Initial screening involved title and abstract evaluation, with subsequent retrieval and assessment of abstracts and full-text articles. Studies assessing pain outcomes before and after surgical release of the pudendal nerve were included. Studies without full-text, focusing on diagnostic methods or with outcomes relating solely to LUTS, digestive symptoms, or sexual dysfunction, were excluded. Risk of bias assessement was conducted using the National Institute of Health (NIH) Study Quality Assessment tool. Studies were categorized based on three surgical techniques: perineal, transgluteal, and laparoscopic transperitoneal. Random-effects meta-analysis with subgroup analysis were used. Meta-regression analyses were conducted to investigate the influence of covariates on the observed outcomes. Nineteen studies, comprising 810 patients, were included. The overall significant pain relief rate across all techniques was estimated at 0.67 (95% CI 0.54 to 0.78) with considerable heterogeneity (I2 = 80.4%). Subgroup analysis revealed success rate for different techniques: laparoscopic (0.91, 95% CI 0.64 to 0.98), perineal (0.69, 95% CI 0.52 to 0.82), and transgluteal (0.50, 95% CI 0.37 to 0.63). The laparoscopic technique exhibited a complication rate of 16.0%. Meta-regression indicated that patient age and median follow-up significantly influenced outcomes. While comparing surgical techniques is challenging, this meta-analysis highlights important outcome differences. The laparoscopic technique appears most promising for pain improvement. However, the study also emphasizes the need for further robust, long-term research due to significant heterogeneity across studies and prevelent risk of bias. PROSPERO database: CRD42023496564.

P089 Counselling and monitoring for sexual dysfunction during treatment with isotretinoin: experience of Irish dermatologists

P089 Counselling and monitoring for sexual dysfunction during treatment with isotretinoin: experience of Irish dermatologists