Stress management and sexual health of young adults: a pilot randomised controlled trial

Young people often experience excessive stress that definitely undermines their sexual life and leads them to adopt risky sexual behaviours. As such, the design and application of a stress management programme in this particular age group is, undoubtedly, a crucial matter. In this parallel randomised controlled trial, 60 psychology students of the Panteion University of Athens, aged 18–20, were randomly assigned to undergo either an 8‐week stress management programme (n = 30; diaphragmatic breathing–progressive muscle relaxation and guided imagery, twice a day) or not (n = 30). Self‐reported validated measures were used to evaluate stress, stressful life events, health locus of control, general health status, sexual behaviours, sexual desire, satisfaction from sexual life and interpersonal relationships. Between‐group analyses revealed statistically significant differences in internal health locus of control and general health evaluation. Within the intervention group analyses showed reductions in BMI, stress, the ‘chance’ subscale of multidimensional health locus of control (MHLC) and greater satisfaction from sexual life. No other significant change was reported. We deem that our results should encourage relevant future studies.     

Circumcision during the phallic period: does it affect the psychosexual functions in adulthood?

The aim of this study was to elucidate whether circumcision during the phallic period (3‐to 6‐year old) has a negative impact on psychosexual functions in adulthood. Over a 6‐month period, healthy and sexually active men between 30 and 40 years without any comorbidities were involved. Participants were evaluated with detailed history, physical examination, International Index of Erectile Function (IIEF), Premature Ejaculation Diagnostic Tool (PEDT) and Beck Depression Inventory. Cases were divided into two groups according to the age at circumcision (group‐1: phallic period, group‐2: nonphallic period). Student's t‐test and Kruskall–Wallis were used for statistical analysis. Of the 321 participants, a total of 302 men were eligible for the study (group‐1: n = 135, group‐2: n = 167). No statistical difference was found between the mean total IIEF scores (group‐1: 25.1 ± 4.8, group‐2: 25.4 ± 4.6, P > 0.05). The subdomains of IIEF; erectile function, orgasm, sexual desire, intercourse satisfaction, overall satisfaction were also found to be comparable. Additionally, the PEDT scores were similar between the two groups (group‐1: 8.2 ± 4.8, group‐2: 8.7 ± 5.4, P > 0.05). Finally, Beck depression scores were also found to be comparable between the groups (group‐1: 10.8 ± 10.4, group‐2: 9.8 ± 8.9, P > 0.05). Our results suggest that circumcision during the phallic period does not negatively affect the psychosexual functions in adulthood.     

Abnormal lipid metabolism down‐regulates adenosine triphosphate synthase β‐subunit protein expression in corpus cavernosum smooth muscle in vitro and in vivo

Metabolic syndrome is closely related to erectile dysfunction (ED), and hyperlipidaemia is considered a major risk factor for ED. Adenosine triphosphate (ATP) synthase is believed to play an important role in metabolic syndrome; it has been hypothesised that ATP synthase contributes to ED development. We have verified this hypothesis using primary cultured human corpus cavernosum smooth muscle (HCCSM) cells treated with excessive free fat acid (FFA) and a high‐fat diet (HFD) mouse model. Our results showed that high fatty factors could cause lipid accumulation in HCCSM cells, which could result in abnormal lipid metabolism, such as high levels of triglycerides, cholesterol and glucose in the HFD mice. There was a remarkable down‐regulation of ATP synthase and p‐Akt after in vivo and in vitro excessive FFA treatments. These results indicated that abnormal lipid metabolism could induce ATP synthase down‐regulation via the Akt phosphorylation pathway and that ATP synthase may be a target of lipotoxicity in corpus cavernosum smooth muscle cells.     

Altered expression of mitofusin 2 in penile tissues of diabetic rats

Diabetic erectile dysfunction (ED) is a common complication in diabetes mellitus, and the efficacy of first‐line therapies is not satisfactory. Recent studies revealed that corporal apoptosis was responsible for the nonresponsiveness of severe ED to phosphodiesterase type 5 inhibitors. Mitofusin 2 (Mfn2) is a versatile protein, regulating mitochondrial morphology and playing an important role in apoptosis. Several studies showed that expression of Mfn2 was decreased in STZ‐induced diabetic rats' kidney, myocardium and retina, which was associated with diabetic nephropathy, cardiomyopathy and retinopathy respectively. In this study, our aim was to explore the expression of Mfn2 and apoptosis in diabetic rats' penes. We found that erectile function (ICP/MAP) elicited by electrical stimulation of cavernous nerve was markedly impaired in diabetic rats compared with the normal rats. The mRNA and protein levels of Mfn2 were found to be significantly reduced in diabetic rats' penile tissues. Compared with normal rats, the content of smooth muscle and B‐cell lymphoma 2 (Bcl‐2)/Bcl‐2‐associated X protein (Bax) ratio were dramatically decreased, and penile apoptotic index and expression of activated‐caspase‐3 were dramatically increased in diabetic rats. This data indicated that repression of Mfn2 in diabetic rats' penes might be associated with excessive apoptosis in diabetes‐induced severe ED.     

Disfunción eréctil,síndrome metabólico y arteriopatía. Relación clínico-patológica mediante ecografía carotídea

IntroductionDifferent studies have shown the relationship between erectile dysfunction, metabolic syndrome and cardiovascular disease. The objective of this study was to evaluate the presence of arteriopathy performing carotid ultrasound in patients with and without erectile dysfunction.Material and methodsWe conducted a case-control study with 44 patients consulting for erectile dysfunction and 20 controls. All subjects completed the IIEF-5 test and we studied the criteria for metabolic syndrome, and a carotid ultrasound to study the intima-media thickness and the presence of atherosclerotic plaques was performed.ResultsMean intima-media thickness was .71 mm ± .21 for the right and of .71 ± .17 for the left carotid in patients with erectile dysfunction. In the control group, the means were .54 ± 0.11 and 0.59 ± 0.15 mm respectively, statistically significant differences (P = .02 and P = .05 respectively). No plaque was found in any control, but in 25% of both carotid arteries of patients with erectile dysfunction (P = .01). As metabolic syndrome, according to the American Heart Association, were diagnosed 52.8% of patients with erectile dysfunction, and 16.7% of controls, and according to the International Diabetes Federation, 52.3% of patients with erectile dysfunction and 25% of controls met diagnostic criteria. In both cases there were significant differences (P < .01 and P = .02 respectively). We found a positive linear correlation between waist circumference and the intima-media thickness in both carotid (P < .05).ConclusionsPatients with erectile dysfunction may be at increased risk of cardiovascular disease, as determined by the presence of arterial disease in the carotid arteries, which indicates that we should made a more thorough and comprehensive study of patients with erectile dysfunction.     

Apolipoprotein E-ε4 polymorphism and cognitive dysfunction after carotid endarterectomy

Approximately 25% of patients undergoing carotid endarterectomy (CEA) exhibit cognitive dysfunction (CD) 1 day and 1 month after CEA. The apolipoprotein E (apoE)-ε4 polymorphism has been previously identified as a robust independent risk factor for CD 1 month after CEA. We aimed to determine whether the apoE-ε4 polymorphism is also an independent risk factor for CD as early as 1 day after CEA and to confirm the previous findings at 1 month. Patients undergoing elective CEA (n = 411) were enrolled with written informed consent in this follow-up observational study. CD was evaluated via an extensive neuropsychometric battery. apoE-ε4 carriers exhibited significantly more CD 1 day (30.1% versus 17.9%, p = 0.01) and 1 month (25.7% versus 9.8%, p = 0.001) after CEA compared to non-carriers. Multivariate regression models were generated to determine independent predictors of CD. At 1 day, apoE-ε4 was significantly associated with higher risk of CD (odds ratio [OR]: 2.24 [95% confidence interval 1.29–3.84], p = 0.004), while statin use was significantly associated with lower risk (OR: 0.40 [0.24–0.67], p < 0.001). At 1 month, apoE-ε4 was significantly associated with higher risk of CD (OR: 3.14 [1.53–6.38], p = 0.002), while symptomatic status was significantly associated with lower risk (OR: 0.45 [0.20–0.94], p = 0.03). The apoE-ε4 polymorphism is an independent risk factor for CD as early as 1 day after CEA and is confirmed to be an independent risk factor for CD at 1 month as well.     

Management of bladder dysfunction and satisfaction of life after spinal cord injury in Norway

Background

There is limited knowledge about bladder dysfunction and bladder management in persons with spinal cord injury (SCI) after discharge from the hospital in Norway. The impact of bladder dysfunction on satisfaction of life has been rarely explored.

Setting

Community-based survey from Norway.

Methods

An anonymous cross-sectional postal survey. A questionnaire was sent to the registered members of the Norwegian Spinal Cord Injuries Association. A total of 400 participants, with traumatic or non-traumatic SCI, received the questionnaire.

Results

A total of 248 subjects (62%), 180 men and 68 women, answered the questionnaire. Mean age was 54 years and mean time since injury 13.4 years. A total of 164 participants (66.1%) used intermittent catheterization for bladder emptying (48.5% women versus 72.8% men); more paraplegics than tetraplegics (77.2% versus 55.7%). Recommendations given at the Spinal Cord Units were thoroughly followed by persons who had used catheters more than 5 years. Use of incontinence pads were associated with reduced satisfaction of life.

Conclusions

The most common method of management of bladder dysfunction is clean intermittent catheterization in Norway. Recommendations were followed more thoroughly by persons who have used intermittent catheterization for more than 5 years. Spinal Cord Units are important source for information and guidance.