Penile injury and effect on male sexual function

Penile injury is common as an emergency and should be accurately diagnosed and treated. We analysed 22 patients with penile injury admitted to the emergency unit of Dubrava University Hospital during a 4-year period. According to the American Association for the Surgery of Trauma five-grade classification of penile injuries, there were 14 grade I, 6 grade II and 2 grade III cases. Diagnosis was mainly based on clinical and ultrasonography findings, and in some cases on cavernosography. Nineteen patients underwent immediate surgery and three patients received conservative therapy. On outpatient follow up, sexual function was assessed by use of the 5-item International Index of Erectile Function (IIEF-5) test at 3 and 12 months of injury. At 3-month follow up, moderate, mild and no erectile dysfunction was recorded in 5, 6 and 11 patients respectively (mean IIEF-5: 19.62). At 12-month follow up, mild erectile dysfunction was found in only one patient (IIEF-5: 20), whereas all other patients were free from erectile dysfunction (mean IIEF-5: 23.75). The 12-month follow up yielded a higher statistical difference (P < 0.001) when compared with 3-month follow up. Study results indicated that appropriate treatment of penile injuries resulted in complete recovery of sexual function within 12 months.     

Testicular and sexual function in adults with prune belly syndrome

Testicular and sexual function was investigated in 9 patients between 16 and 28 years old with prune belly syndrome. At personal interview all patients claimed to experience normal erections and orgasm but 7 had retrograde ejaculation. Examination showed a normally developed male habitus. Orchiopexies had been performed in late childhood or adolescence. Two patients were anorchic and the surviving testicles were small in the remaining 7. Serum testosterone was low in 1 patient and normal in 6 but at the expense of high luteinizing hormone levels in 4. All patients had a high serum follicle-stimulating hormone level, reflecting the azoospermia found in 5 patients tested. Three biopsies from atypical cases showed poor histological findings but 2 revealed early spermatogenesis. The testes in patients with prune belly syndrome are similar to undescended testes in otherwise normal men. Late orchiopexy produces sexually active but infertile men.     

Sexual behavior and sexual function of adults after hypospadias surgery: a comparative study

PURPOSE: We assessed sexual behavior and sexual function in adults operated on for hypospadias. MATERIALS AND METHODS: Long-term psychosexual adjustment was assessed with a standardized questionnaire which was mailed to 57 patients with hypospadias older than 18 years and 60 age matched normal control subjects. RESULTS: A total of 37 patients with hypospadias and 39 controls participated. Self-reported strength of libido on a scale of 1 to 5 was shown to be similar in the 2 groups. Patients with hypospadias did not have problems in achieving erection and average self-rated quality of erection ranging from 1 to 5 was the same as that of controls (mean value 4.5). Patients with hypospadias noted curvature in a downward direction in a significantly higher proportion compared to controls (40% vs 18%, respectively). There were 13 patients with hypospadias who had ejaculation difficulties, of whom 6 had spraying and 7 had only dribbling of ejaculate. Patients with hypospadias masturbated significantly less often, were significantly less sexually active and had a smaller total number of sexual partners compared to control subjects. Control subjects were significantly more completely satisfied with their sexual life compared to patients with hypospadias (76.92% vs 51.35%, respectively). CONCLUSIONS: Sexual function of patients who underwent surgery for hypospadias in general is not affected. However, there is clearly a difference in certain aspects of sexual behavior between patients with hypospadias and controls. Followup and adequate counselling of patients who underwent surgery for hypospadias in adult life is necessary.     

Beneficial effect of inguinal hernioplasty on testicular perfusion and sexual function

Aim  To evaluate the effects of Lichtenstein tension-free inguinal hernioplasty on sexual function and generic quality of life, testicular volume, and perfusion. Patients and methods  In a prospective study, testicular volume, testicular perfusion, sexual function, generic quality of life, chronic inguinal pain, and groin sepsis were investigated before and 3 and 9 months after surgical hernia repair. Results  Forty male patients completed this study. No differences in testicular volume or in peak systolic velocity were observed between the hernia and healthy sides of the body (P > 0.05). Preoperatively, there was a significantly higher end diastolic velocity (P < 0.04) and resistive index (P < 0.001) on the hernia side compared with the normal side; these elevations returned to normal postoperatively. Three months postoperative, the studied sexual function domains, except orgasm domain, and total sexual score presented significant improvement (P _s < 0.05 and 0.001 respectively). By the end of the study, the mean total sexual score and the number of patients with enhanced total score had showed further clinical progress. The total generic quality-of-life score, general health perception and physical function, vitality, and social domains were statistically recovered at 3 months postoperative (P < 0.05), with further improvement in total score at 9 months. Two patients developed superficial groin sepsis, and seven (17.5%) experienced chronic inguinal pain. Conclusion  Inguinal hernia impaired testicular perfusion that improved postoperatively. Lichtenstein tension-free hernioplasty improved sexual function and generic quality of life without adverse mesh effects on testicular volume or perfusion.     

The effect of pelvic floor training on sexual function of treated patients

The aim of this study was to determine the effects of improvements in urinary incontinence resulting from pelvic floor rehabilitation on the sexual function of patients. The study involved 42 clinic patients who received pelvic floor rehabilitation treatment. Their sexual histories were obtained through face-to-face interviews. Pelvic muscle strength was measured with a perineometer. Improvement in incontinence was measured with the pad test. Seventeen women reported decreased sexual desire before the treatment; 5 of these indicated improvement after treatment. Nine of 17 women who experienced dyspareunia prior to treatment reported an improvement afterwards, and four women reported complete relief from pain. Five of 15 women who complained of difficulty in reaching climax before the treatment experienced improvement in this area. In conclusion, an improvement in sexual desire, performance during coitus and achievement of orgasm were observed in women who received pelvic floor muscle rehabilitation. No change was seen in the arousal and resolution stages of sexual activity.Abbreviation FES Functional electrical stimulationEditorial Comment: Previous studies suggest that the prevalence of sexual dysfunction is high amongst women with urinary incontinence. Some data exist about the effect of surgical treatment of urinary incontinence and its effect on sexual function. Data also exist that women with sexual dysfunction due to painful conditions improve with pelvic floor therapy. It could be expected that women with urinary incontinence and sexual dysfunction show better overall improvement of both conditions when treated with pelvic floor therapy rather than with surgery. Patients in this study showed improvement in urinary incontinence with pelvic floor therapy. They also had a marked decrease in dyspareunia. Overall, there was improvement in sexual function, particularly an increase in desire. Unfortunately, the study does not address whether this improvement appears to be related to a decrease in incontinence, a decrease in pain with intercourse or an additive effect.     

Iodopovidone pleurodesis does not effect thyroid function in normal adults

Iodopovidone is an effective, safe, cheap, and easily available agent for pleurodesis. On the other hand, topical applications of iodopovidone may cause thyroid dysfunction. The purpose of this retrospective study was to determine the effects of intrapleural administration of iodopovidone on thyroid function. Twelve patients have undergone iodopovidone pleurodesis so far. A mixture of 20 ml 10% iodopovidone and 80 ml 0.9% saline solution was administered into the pleural cavity through the chest tube. Thyroid hormone (TSH, TT4, TT3, FT4, FT3) levels were routinely measured just before pleurodesis, and at the 24th and 72nd h of pleurodesis. No statistically significant alteration in thyroid function was determined (P>0.05). We did not observe any signs or symptoms of hyper- or hypothyroidism in any patient. Nine patients had a complete response to pleurodesis (75%). One patient who had undergone iodopovidone pleurodesis suffered from a moderate degree of transient chest pain. In conclusion, iodopovidone pleurodesis is safe and does not cause any thyroid dysfunction in normal adults.     

Ureterorenoscopy with stenting and its effect on male sexual function: A controlled randomised prospective study

Seventy‐two male patients, who were included in this study, underwent ureteroscopic stone surgery (study group). Forty‐two healthy males were enrolled as control group. Changes in sexual function were evaluated using International Index of Erectile Function questionnaire in pre‐operative, first and third postoperative terms. Overall satisfaction in relation to the age, operation time, presence of stents, body mass index, educational status, previous operations, International Index of Erectile Function score, International Prostate Symptom Score, Quality of Life, income status, Male Sexual Health Questionnaire, stone‐free rates and Beck's depression scale were evaluated. Erectile and ejaculatory functions, quality of life and lower urinary tract symptoms were negatively affected due to ureteroscopic stone surgery, while educational status, psychogenic aspect and income status remained stable. In conclusion, ureteroscopic stone surgery with JJ catheterisation seems to have a progressively decreasing negative effect on male sexual function and whenever possible, stenting should be avoided. If JJ stenting is necessary, patients should be informed that they may experience sexual dysfunction at least for 3 months and if stenting proves necessary the indwelling should be kept as short as possible.     

Assessment of preclinical effect of (+)-catechin hydrate on sexual function: An in silico and in vivo study

Considering dopamine-enhancing effect of (+)-catechin, the present study was designed to evaluate dopamine-2 (D2) receptor agonistic and phosphodiesterase-5 (PDE5) enzyme inhibitory effects in in silico and effect on male sexual function of Sprague Dawley rats in vivo. (+)-Catechin and standard (sildenafil and bromocriptine) were docked using Autodock Vina 1.1.2 and visualised by UCSF Chimera 1.14. Significant interactions in terms of binding energies were observed for catechin with both proteins. In in vivo study, the rats were dosed orally for 54 days with (+)-catechin hydrate (50 mg/kg), sildenafil citrate (standard, 4 mg/kg) and carboxymethylcellulose (vehicle, 0.25% w/v). The aphrodisiac effects were evaluated on the day 14, 28, 42 and 54 using the behavioural parameters of mounting and intromission. After the study, animals were sacrificed and testes and spermatozoa were assessed for safety profile. Results showed a significant increase in mount and intromission frequencies and a significant reduction in mount and intromission latencies in the catechin group on all tested days when compared to vehicle control. (+)-Catechin was found to be safe on histology of testes, sperm count, sperm motility and sperm morphology parameters. In conclusion, catechin demonstrated an enhancement in sexual behaviour without eliciting toxicity on the male reproductive system in rats.     

The effect of COVID-19 epidemic on the sexual function of healthcare professionals

Studies have shown that healthcare professionals struggling with epidemics develop symptoms of post-traumatic stress disorder. The aim of this study is to show how often and severely erectile dysfunction, one of the components of post-traumatic stress disorder, is seen among healthcare professionals during COVID-19 outbreak. The Impact of Event Scale-Revised (IES-R) and the Index of Erectile Function-5 (IIEF-5) were applied to 159 male healthcare professionals working in COVID-19 units and a control group of 200 people. Healthcare professional group was divided into subgroups according to occupation (physician, nurse), age-group (18–25, 26–30, >30), marital status and unit of work (Suspected Patient Area, Diagnosed Patient Area). Both stress disorder and erectile dysfunction were seen at higher rates in healthcare professionals group (p < .001). The median IIEF-5 scores of nurses, married subjects and those working in the Diagnosed Patient Area, were found to be higher (p < .001, p = .014, p = .011 respectively). During the COVID-19 outbreak, healthcare professionals are exposed to psychological trauma and their sexual function may be negatively affected. The measures to be taken are important to estimate which groups are more affected.     

Effect of urinary leakage on sexual function during sexual intercourse

AIM: This study was planned to determine the effect of urinary leakage on sexual function during sexual intercourse. METHODS: The study group included 32 incontinent women who had urinary leakage during sexual intercourse and the control group consisted of 60 women with no such problem. The Sexual History Form of Schover and Jensen was completed in face-to-face interviews in a private room. RESULTS: When compared with the women without any problem, the women with urinary incontinence were 4.7 times less satisfied with their sexual life and their partners had ejaculation without full erection 3.1 times more. In order to cope with the problem of urinary incontinence during coitus the women themselves adopted several methods. Trying to keep their partners unaware of the problem and deferring the intercourse were among the most frequently adopted methods. 43.7% of the study group indicated that this problem affected their sex life. CONCLUSIONS: The results of this study support the view that urinary leakage during coitus affects women's sex life adversely.     

Adult circumcision outcomes study: effect on erectile function, penile sensitivity, sexual activity and satisfaction

PURPOSE: Evidence concerning the effect of circumcision on sexual function is lacking. Men circumcised as adults are potentially in a unique position to comment on the effect of a prepuce on sexual intercourse. We examine sexual function outcomes in men who have experienced sexual intercourse in the uncircumcised and circumcised states. MATERIALS AND METHODS: Men 18 years old or older when circumcised were identified by billing records during a 5-year period at an academic medical center. Medical charts were reviewed for confirmation of the procedure and to identify the indication(s). These men were surveyed to assess erectile function, penile sensitivity, sexual activity and overall satisfaction. Data were analyzed using paired t tests to compare category scores before and after circumcision. RESULTS: A total of 123 men were circumcised as adults. Indications for circumcision included phimosis in 64% of cases, balanitis in 17%, condyloma in 10%, redundant foreskin in 9% and elective in 7%. The response rate was 44% among potential responders. Mean age of responders was 42 years at circumcision and 46 years at survey. Adult circumcision appears to result in worsened erectile function (p = 0.01), decreased penile sensitivity (p = 0.08), no change in sexual activity (p = 0.22) and improved satisfaction (p = 0.04). Of the men 50% reported benefits and 38% reported harm. Overall, 62% of men were satisfied with having been circumcised. CONCLUSIONS: Our findings may help urologists better counsel men undergoing circumcision as adults. Prospective studies are needed to better understand the relationship between circumcision and sexual function.     

The effect of overactive bladder treatment with anticholinergics on female sexual function in women: a prospective observational study

International Urology and Nephrology - The aim of the study was to determine the effect of anticholinergics used for overactive bladder treatment on the sexual function of women. Between January...     

Effects of prostatectomy on sexual function

We evaluated the effects of prostatectomy on sexual function in 210 patients, 49.6 percent of whom underwent transurethral resection of the prostate (TURP), and the remainder had suprapubic transvesical prostatectomy (SPP). Pre- and postoperative interviews with detailed questionnaires were utilized. Postoperative sexual dysfunction was reported by 18 of 152 patients (11.8%) who were functioning normally prior to surgery. The incidence of postoperative impotence was evenly distributed between the TURP and SPP groups and was age-related; it was highest among older patients. We further observed a strong correlation between the presence of a permanent sexual partner and the preservation of potency. We conclude that the risk of postoperative impotence is dependent on both the patient's age and the presence of a partner, and should be discussed with the patient preoperatively.