Sexual Dysfunction in Puerto Rican Women with Inflammatory Bowel Disease.

OBJECTIVE: Inflammatory bowel disease (IBD) negatively impacts quality of life-related issues including intimacy, body image, and sexual activity. Sexual dysfunction in patients with IBD is often unrecognized. In this study, we aimed to describe sexual function in Puerto Rican women with IBD. METHODS: We conducted a cross-sectional study of women with IBD at the University of Puerto Rico Center for IBD. Patients were invited to anonymously complete the validated Spanish version of the Female Sexual Function Index (FSFI) questionnaire. On this 36-point scale, a score of 26.55 or less is defined as sexual dysfunction. Data were analyzed by diagnosis, presence of an ostomy, and age, using descriptive statistics, ANOVA, Student's t test, and logistic regression. RESULTS: One hundred women completed the FSFI questionnaire, with subjects having Crohn's disease (CD) outnumbering those having ulcerative colitis (UC) 2:1. The mean sexual function score was 21.92 (95% CI: 20.08-23.76). No statistical difference was observed in total FSFI scores between subjects with CD and UC (p = 0.084) and those with an ostomy (p = 0.891). Sexual function decreased with age (p = 0.001). The domains of excitation, lubrication, orgasm, and satisfaction were the most negatively affected (p<0.05) by increasing age. Multivariate analysis confirmed the effect of age on excitation, lubrication, orgasm, and pain. CONCLUSION: Our study showed sexual dysfunction to be present in this sample of Puerto Rican Hispanic women with IBD. Physicians treating patients with IBD need to be aware of these findings to explore the concerns of individuals with this disease and develop strategies to address those concerns.

The effects of cannabidiol on male reproductive system: A literature review.

Cannabidiol (CBD) is one of the most abundant phytocannabinoids present in the plant Cannabis sativa (marijuana). There have been several studies of CBD in the last few decades, mainly focused on its neuroprotective properties, particularly after the identification of the endocannabinoid system and its participation in the central nervous system. On the other hand, the peripheral effects of CBD, particularly on reproductive physiology, were also evidenced. A narrative review was conducted using the PubMed database to identify studies that analyzed the pharmacological effects of CBD on the male reproductive system of vertebrates and invertebrates. Thirty-two citations (in vivo and in vitro) were identified. Among the vertebrates, the studies were carried out with men, monkeys, rats and mice. Studies with invertebrates are centered exclusively on the sea urchin. The CBD treatment periods include mostly acute and subacute evaluations. Exposure to CBD is associated with a reduction in mammalian testis size, the number of germ and Sertoli cells in spermatogenesis, fertilization rates, and plasma concentrations of hypothalamic, pituitary and gonadal hormones. Moreover, chronic doses of CBD have impaired sexual behavior in mice. From the studies identified in this review, it is possible to conclude that CBD has negative effects on the reproductive system of males. However, knowledge is still limited, and additional research is required to elucidate fully the mechanisms of action, as well as the reversibility of CBD effects on the reproductive system.

Risk factors of postoperative sexual function in patients with urethral diverticulum and their partners: A cohort study of 83 women.

INTRODUCTION AND OBJECTIVE: Several studies have focused on the treatment and recurrence of urethral diverticulum (UD). However, few investigations have addressed sexual function in pati-ents with UD. Therefore, we sought to examine sexual function in women affected by UD. MATERIALS AND METHODS: There were 108 accepted cases involving transvaginal diverticulectomy at our institution. Ultimately, 83 women were included for further analysis, only 61 of these wo-men had sexual partners. We collected data for the Female Sexual Function Index (FSFI) from the female patients and the Male Sexual Health Questionnaire (MSHQ) from their male partners before and after surgery. RESULTS: Preoperatively, the UD size affected the female patient's arousal and lubrication (p=0.04), and the UD location affected their satisfaction. However, no significant between-group differences were found in the total FSFI score. For all women, sexual activity improved after surgery (p=0.0087). In addition to improvements in arousal for women with a large UD, improvements in lubrication were affected by the UD size, number and shape, increases in sa-tisfaction scores were impacted by the UD location and shape, and pain relief was linked to the UD number and shape. Analysis of the MSHQ results revealed no between-group differences among the male partners. CONCLUSION: Only the UD size and location affected sexual function in women with a small UD. Surgery could improve female sexual function but did not affect the sexual function of the patient's partners.

Association Between Pelvic Floor Muscle Strength and Sexual Function in Postmenopausal Women.

INTRODUCTION: Although pelvic floor muscle (PFM) weakness can be associated with pelvic floor dysfunctions, knowledge about the relationship with sexual dysfunction is limited. AIM: The aim of this study was to evaluate the association between PFM strength and sexual function in postmenopausal women. METHODS: An analytical cross-sectional study was conducted on 226 sexually active heterosexual women aged 45-65 years with amenorrhea >12 months and without pelvic floor disorders. The Female Sexual Function Index (FSFI) was used for the evaluation of sexual function (total score ≤26.5 indicating sexual dysfunction). PFM strength was assessed by bidigital vaginal palpation using the modified Oxford scale (score 0-5) and was categorized into nonfunctional (scores 0-1, without contraction) and functional (scores 2-5, with contraction). Three-dimensional transperineal ultrasound was used to evaluate total urogenital hiatus area, transverse and anteroposterior diameters, and levator ani muscle thickness. MAIN OUTCOME MEASURE: The main outcome measure was to determine the relationship between sexual dysfunction and PFM strength. RESULTS: The participants were classified as functional PFM (n = 143) and nonfunctional PFM (n = 83). There were no differences between groups in clinical and anthropometric parameters. A higher percentage of menopausal hormone therapy users was observed in the group with functional PFM (39.2%) compared to the nonfunctional group (24.1%; P = .043). Women classified as functional PFM exhibited greater levator ani muscle thickness than those classified as nonfunctional (P = .049). Women with nonfunctional PFM had poorer sexual function in the desire (P = .005), arousal (P = .001), and orgasm (P = 0.006) domains and in total FSFI score (P = .006) compared to the functional group. There was a weak positive correlation of PFM strength with the desire (r = 0.35; P = .0003), arousal (r = 0.21; P = .013), and orgasm (r = 0.23; P = .033) domains and with total FSFI score (r = 0.28; P = .004). Ultrasonographic levator ani muscle thickness showed a weak positive correlation with PFM strength (r = 0.21; P = .046) and with the arousal domain (r = 0.23; P = .044). Risk analysis adjusted for age, time since menopause, parity, and body mass index showed a lower risk of sexual dysfunction in menopausal hormone therapy users (odds ratio = 0.26; 95% CI 0.11-0.60; P = .002) and in women with greater levator ani muscle thickness (odds ratio = 0.85; 95% CI 0.73-0.98; P = .025). CLINICAL IMPLICATIONS: The maintenance of PFM strength in the climacteric period is an important factor in postmenopausal women's sexual function. STRENGTH & LIMITATIONS: The main strength of the study is that, to our knowledge, this is the first study that evaluated the correlation of PFM strength and 3D transperineal ultrasound with different domains of sexual function in postmenopausal women. The main limitation is the cross-sectional design does not permit to establish a cause-effect relationship. CONCLUSION: Postmenopausal women with PFM dysfunction have poorer sexual function than women with functional PFM. Omodei MS, Marques Gomes Delmanto LR, Carvalho-Pessoa E, et al. Association Between Pelvic Floor Muscle Strength and Sexual Function in Postmenopausal Women. J Sex Med 2019;16:1938-1946.

Risk factors of postoperative sexual function in patients with urethral diverticulum and their partners: A cohort study of 83 women

ABSTRACT Introduction and Objective: Several studies have focused on the treatment and recurrence of urethral diverticulum (UD). However, few investigations have addressed sexual function in patients with UD. Therefore, we sought to examine sexual function in women affected by UD. Materials and Methods: There were 108 accepted cases involving transvaginal diverticulectomy at our institution. Ultimately, 83 women were included for further analysis, only 61 of these women had sexual partners. We collected data for the Female Sexual Function Index (FSFI) from the female patients and the Male Sexual Health Questionnaire (MSHQ) from their male partners before and after surgery. Results: Preoperatively, the UD size affected the female patient's arousal and lubrication (p=0.04), and the UD location affected their satisfaction. However, no significant between-group differences were found in the total FSFI score. For all women, sexual activity improved after surgery (p=0.0087). In addition to improvements in arousal for women with a large UD, improvements in lubrication were affected by the UD size, number and shape, increases in satisfaction scores were impacted by the UD location and shape, and pain relief was linked to the UD number and shape. Analysis of the MSHQ results revealed no between-group differences among the male partners. Conclusion: Only the UD size and location affected sexual function in women with a small UD. Surgery could improve female sexual function but did not affect the sexual function of the patient's partners.

Medication Use and Sexual Function: A Population-Based Study in Middle Aged Women.

INTRODUCTION: Medications used to treat chronic diseases have contributed to increasing longevity and improving quality of life. These medications are considered an indispensable resource in the management of most treatable diseases. However, they can affect sexual function through their effects on the central or the peripheral nervous system or due to hormonal effects. AIM: To evaluate the association between the use of medication for chronic diseases and sexual dysfunction in Brazilian women 45-60 years of age. METHODS: A secondary analysis of household survey data from a previous cross-sectional, population-based study conducted with a sample of 749 women of a population of 257,434 female urban residents in the age bracket of interest. Sexual function was evaluated using the Short Personal Experiences Questionnaire (SPEQ). Associations between the use of medication and sexual function were evaluated, as were correlations with other variables. MAIN OUTCOME MEASURE: We found associations of the individual SPEQ domains with the use of some medications. RESULTS: Mean age of participants was 52.5 ± 4.4 years. Mean age at menopause was 46.5 ± 5.8 years. The overall prevalence of medication use was 68.8%, with the drugs predominantly consisting of those used for cardiovascular diseases. In the Poisson regression analysis, sexual dysfunction, as based on the overall SPEQ score, was associated with sexual inactivity (prevalence ratio [PR] = 4.05; 95% CI 3.16-5.20; P < .001), a sedentary lifestyle (PR = 1.49; 95% CI 1.06-2.09; P = .021), and untreated anxiety (PR = 1.44; 95% CI 1.08-1.92; P = .014). Analysis of the individual SPEQ domains revealed that women who scored low in the desire domain were more likely to use antihypertensive agents (P = .019), whereas a lower score for the arousal domain was associated with the use of antidepressants, with treatment for osteoarticular diseases and with polypharmacy (P = .003). Women with lower scores in the satisfaction domain were more likely to use antidepressants, drugs for osteoarticular diseases, diabetes medication, and polypharmacy (P = .019). A lower score in the orgasm domain was associated with the use of antidepressants, the treatment of osteoarticular diseases, and diabetes (P < .001). Hormone therapy proved protective against loss of libido (P = .036). CLINICAL IMPLICATIONS: Some medications can interfere with sexual function negatively and, clinicians have to be aware of it to choose the treatment with fewer collateral effects. STRENGTH & LIMITATIONS: The strength of our study is the large, population-based sample of middle-aged women evaluated for sexual dysfunction with the SPEQ. However, it was a self-reported cross sectional study. CONCLUSION: This study found no association between the use of medication for chronic diseases and the overall SPEQ score, whereas untreated anxiety was 1 of the main factors associated with female sexual dysfunction. On the other hand, medical treatments were found to contribute to lower scores in the different sexual function domains. Common drug culprits included antihypertensives, antidepressants, treatment for osteoarticular disease, diabetes medications, and polypharmacy. Hormone therapy protected against loss of libido. Gueldini de Moraes AV, Ribeiro Valadares AL, Lui Filho JF, et al. Medication Use and Sexual Function: A Population-Based Study in Middle Aged Women. J Sex Med 2019;16:1371-1380.

Sexual Dysfunction in Women With Polycystic Ovary Syndrome: Systematic Review and Meta-Analysis.

INTRODUCTION: Sexual dysfunction occurs in any phase of sexual performance or any period of the sexual response cycle, and polycystic ovary syndrome (PCOS) affects self-image with repercussions on sexuality. AIM: To evaluate sexual dysfunction in women with PCOS. METHODS: A systematic review was undertaken following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. The primary databases MEDLINE, EMBASE, Cochrane, and Lilacs were accessed using specific terms. There was no constraint against year of publication. The meta-analysis was conducted with RevMan program version 5.3. MAIN OUTCOME MEASURE: We evaluated the relationship between sexual dysfunction and PCOS. RESULTS: The systematic review encompassed 19 studies. The analysis indicated that 11 specific and 6 general instruments were used to measure the sexual function in PCOS women. Of these, the Female Sexual Function Index scale was used most frequently. All studies assessed different aspects of sexual performance in PCOS women, and no difference was found in between women with PCOS and control subjects. CLINICAL IMPLICATIONS: Although there were disparities regarding ethnicity, culture, religion, and economy among studies, the available evidence failed to prove a significant link between PCOS and sexual dysfunction. STRENGTH & LIMITATIONS: This systematic review addressed a multidimensional theme with many variables and with a wide diversity of measurement tools. Studies were small, and populations were not homogeneous. CONCLUSION: Despite potential risk of bias, such as inhomogeneity of study population, sexual function of both PCOS patients and women with regular menstrual cycles might, in general, be similar. Firmino Murgel AC, Santos Simões R, Maciel GAR, et al. Sexual Dysfunction in Women With Polycystic Ovary Syndrome: Systematic Review and Meta-Analysis. J Sex Med 2019;16:542-550.

Hypertension as a risk factor for female sexual dysfunction: cross-sectional study.

OBJECTIVE: to evaluate the sexual dysfunction in hypertensive patients compared to normotensive patients. METHOD: this was a cross-sectional study. Samples were composed of 54 hypertensive patients and 54 normotensive patients. The female sexual dysfunction was evaluated by the Female Sexual Function Index (FSFI). RESULTS: the average FSFI score differed highly between hypertensive and normotensive patients (22.4± 7.4 versus 26.8 ±5.4, p< 0.001). Among hypertensive patients, 63% showed sexual dysfunction in opposition to 39% of normotensive patients (p=0.02). Hypertensive women had 1.67 more chances of showing the dysfunction than women with normal blood pressure. CONCLUSION: the sexual dysfunction prevalence is higher in hypertensive than in normotensive women hence, hypertension is a potentiator factor for female sexual dysfunction.

Hypertension as a risk factor for female sexual dysfunction: cross-sectional study / Hipertensão como fator de risco para disfunção sexual feminina: estudo transversal / La hipertensión como un factor de riesgo para la disfunción sexual femenina: estudio transversal

ABSTRACT Objective: to evaluate the sexual dysfunction in hypertensive patients compared to normotensive patients. Method: this was a cross-sectional study. Samples were composed of 54 hypertensive patients and 54 normotensive patients. The female sexual dysfunction was evaluated by the Female Sexual Function Index (FSFI). Results: the average FSFI score differed highly between hypertensive and normotensive patients (22.4± 7.4 versus 26.8 ±5.4, p< 0.001). Among hypertensive patients, 63% showed sexual dysfunction in opposition to 39% of normotensive patients (p=0.02). Hypertensive women had 1.67 more chances of showing the dysfunction than women with normal blood pressure. Conclusion: the sexual dysfunction prevalence is higher in hypertensive than in normotensive women hence, hypertension is a potentiator factor for female sexual dysfunction.

RESUMO Objetivo: avaliar a disfunção sexual em pacientes hipertensas em comparação com pacientes normotensas. Método: estudio transversal. Las muestras estaban compuestas por 54 pacientes hipertensos y 54 normotensos. La disfunción sexual femenina fue evaluada por el Índice de Función Sexual Femenina (FSFI). Resultados: a pontuação média do FSFI foi muito diferente entre pacientes hipertensas e normotensas (22,4 ± 7,4 versus 26,8 ± 5,4, p <0,001). Da amostra de pacientes hipertensas, 63% apresentaram disfunção sexual, ante 39% da amostra de pacientes normotensas (p=0,02). As mulheres hipertensas apresentaram 1,67 vezes mais chances de ter a disfunção do que mulheres com pressão arterial normal. Conclusão: a prevalência de disfunção sexual é maior em mulheres hipertensas do que em mulheres normotensas. Portanto, a hipertensão é um fator que potencializa a disfunção sexual feminina.

RESUMEN Objetivo: evaluar la disfunción sexual en pacientes hipertensos en comparación con pacientes normotensos. Método: estudio transversal. Las muestras estaban compuestas por 54 pacientes hipertensos y 54 normotensos. La disfunción sexual femenina fue evaluada por el Índice de Función Sexual Femenina (FSFI). Resultados: el puntaje FSFI promedio fue muy diferente entre pacientes hipertensos y normotensos (22.4±7.4 versus 26.8 ± 5.4, p<0.001). El 63% de los pacientes de la muestra de hipertensos demonstraron disfunción sexual, en oposición al 39% de la muestra de pacientes normotensos (p=0,02). Las mujeres hipertensas presentaron 1.67 más posibilidad de mostrar la disfunción que las mujeres con presión arterial normal. Conclusión: la prevalencia de disfunción sexual es mayor en mujeres hipertensas que en mujeres normotensas. Entonces, la hipertensión es un potenciador de la disfunción sexual femenina.

What are the factors that contribute to the development of sexual dysfunction in breastfeeding women? A systematic scoping review protocol.

INTRODUCTION: Female sexual dysfunction is a public health problem. Evidence suggests that the population of nursing women is more vulnerable to the phenomenon due to breast feeding. Thus, this protocol was developed to explore the factors that contribute to the development of sexual dysfunction in breastfeeding women. METHODS AND ANALYSIS: The systematic scoping review will be conducted in six stages, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols. The databases used will be: PubMed, Excerpta Medica Database, Cumulative Index for Nursing and Allied Health Literature, PsycINFO, Science Direct, Web of Science and Google Scholar. The searches were made until 1 June 2018, and no retrospective time limit was used. For the organisation of the literature retrieved from the databases, the EndNote Basic manager will be used. The Cochrane model will be used for the data extraction. The analysis of the quantitative data will be carried out through descriptive statistics and the qualitative data will be submitted to thematic analysis. The methodological quality of the empirical studies will be evaluated using the Mixed Methods Appraisal Tool. ETHICS AND DISSEMINATION: As it will be a review study, without human involvement, there will be no need for ethical approval. The results will be disseminated in a scientific journal, as well as in various media, such as: conferences, seminars, congresses or symposia.

Validation and cultural adaptation of the qualisex questionnaire in patients with axial spondyloarthritis in Argentina.

The Qualisex questionnaire was developed and validated to assess sexuality in patients with rheumatoid arthritis. To the best of our knowledge, there is no instrument to evaluate sexuality in axial spondyloarthritis (axSpA). For this reason, the objective of this study was to validate and adapt the Qualisex questionnaire in axSpA and evaluate the impact of the disease on patients' sexuality. Cross sectional study. Consecutive patients, with ≥ 21 years of age, diagnosed with axSpA according to ASAS'09 criteria were included. Sexual health was assessed using the Qualisex questionnaire. The original version was translated to Spanish and adapted to axSpA. Internal consistency, and test re-test reliability was calculated. Criterion and construct validity were assessed by comparing the Qualisex with parameters of disease activity functional capacity and quality of life. 61 patients were invited to participate in the study, 11 of whom refused. 50 patients were included; 40 (80%) were males, with a median age of 47 years (IQR 21-72) and a median disease duration of 13 years (IQR 1-46). Reproducibility was excellent with an ICC of 0.99 (95% CI 0.65-1). The Qualisex had a good correlation with different disease evaluation parameters. The Qualisex was significantly higher among women (5.4 in women vs. 2.5 in men, p = 0.02), unemployed (4.7 in unemployed vs. 2.3 in employed, p = 0.01), in patients with higher disease activity (4.2 in active patients vs. 1.6 in inactive patients, p = 0.01), and it was lower in patients receiving biologic therapy (BT) (1.9 with BT vs. 3.8 without BT, p = 0.01). Multivariable analysis showed that female sex, longer disease duration and higher disease activity were independently associated with a greater impact on sexuality. The Qualisex adapted to axSpA is a valid and reliable questionnaire. Female axSpA patients, those with longer disease duration and higher disease activity presented a worse sexual life.

Comparison of the Kelly's plication and TOT simultaneously with vaginal hysterectomy, on the incontinence, and sexual functions

ABSTRACT Purpose: To compare the effect of vaginal hysterectomy-anterior/posterior colporrhaphy with Kelly's plication(VH-KP), versus vaginal hysterectomy-anterior/posterior colporrhaphy-transobturator tape(VH-TOT) surgeries on incontinence, quality of life, and sexual functions in patients with pelvic organ prolapse(POP), and concurrent obvious stress urinary incontinence(SUI). Materials and Methods: Between 2013 and 2017, fifty patients treated with VH-KP(n = 25), and VH-TOT(n = 25) due to POP and SUI, were evaluated prospective consecutively. Age, parity, duration of urinary incontinence, and the daily pad use were recorded. Patients were filled "rinary Distress Inventory-6(UDI-6)", "Incontinence Impact Questionnaire 7(IIQ-7)" and "Index of Female Sexual Function(IFSI)" questionnaire forms at preoperatively, and postoperative 6th month. No usage of pads was accepted as subjective cure rate. Intraoperative, and postoperative complications were noted. Results: There was no statistically significant difference between two groups, for the mean age of the patients, parity, duration of SUI, and the daily pad use, preoperatively (p > 0.05). Decreased UDI-6 scores, IIQ-7 scores and daily pad usage, and increased IFSF scores were found statistical significantly in each group, at the postoperative 6 th month (p < 0.05). However, VH-TOT group had higher improvement rates, on UDI-6 scores (69.5% vs 63.0%, p = 0.04). In addition, it was notable that the the rates of the patients had IFSF scores ≥ 25 was higher in VH-KP group (p = 0.05). Four (16%) patients had recurrent SUI in the VH-KP group (p = 0.039) and vaginal extrusion occurred in 2 (8%) patients in the VH-TOT group (p = 0.153), postoperatively. Conclusions: Although the effects of VH-TOT surgery are superior to conventional methods for incontinence and quality of life; negative effects on sexual functions are notable. In addition, although recurrence rates of TOT are low, complications such as vaginal extrusion are accompanied by drawbacks of mesh usage.

Comparison of the Kelly's plication and TOT simultaneously with vaginal hysterectomy, on the incontinence, and sexual functions.

PURPOSE: To compare the effect of vaginal hysterectomy-anterior/posterior colporrhaphy with Kelly's plication(VH-KP), versus vaginal hysterectomy-anterior/posterior colporrhaphy-transobturator tape(VH-TOT) surgeries on incontinence, quality of life, and sexual functions in patients with pelvic organ prolapse(POP), and concurrent obvious stress urinary incontinence(SUI). MATERIALS AND METHODS: Between 2013 and 2017, fifty patients treated with VH-KP(n = 25), and VH-TOT(n = 25) due to POP and SUI, were evaluated prospective consecutively. Age, parity, duration of urinary incontinence,and the daily pad use were recorded. Patients were filled "rinary Distress Inventory-6(UDI-6)", "Incontinence Impact Questionnaire 7(IIQ-7)" and "Index of Female Sexual Function(IFSI)" questionnaire forms at preoperatively,and postoperative 6th month. No usage of pads was accepted as subjective cure rate.Intraoperative,and postoperative complications were noted. RESULTS: There was no statistically significant difference between two groups, for the mean age of the patients, parity, duration of SUI, and the daily pad use, preoperatively (p > 0.05). Decreased UDI-6 scores, IIQ-7 scores and daily pad usage, and increased IFSF scores were found statistical significantly in each group, at the postoperative 6 th month (p < 0.05). However, VH-TOT group had higher improvement rates, on UDI-6 scores (69.5% vs 63.0%, p = 0.04). In addition, it was notable that the the rates of the patients had IFSF scores ≥ 25 was higher in VH-KP group (p = 0.05). Four (16%) patients had recurrent SUI in the VH-KP group (p = 0.039) and vaginal extrusion occurred in 2 (8%) patients in the VH-TOT group (p = 0.153), postoperatively. CONCLUSIONS: Although the effects of VH-TOT surgery are superior to conventional methods for incontinence and quality of life; negative effects on sexual functions are notable. In addition, although recurrence rates of TOT are low, complications such as vaginal extrusion are accompanied by drawbacks of mesh usage.

Sexual complications of penile frature in men who have sex with men.

OBJECTIVES: Evaluate the demographic data, etiology, operative findings and results of surgical treatment of penile fracture (PF) in men who have sex with men(MSM) with emphasis on sexual complications. MATERIALS AND METHODS: We studied 216 patients underwent surgical correction of PF at our hospital. Patients self-identified as MSM were followed for at least 6 months. Demographic data, presentation, operative findings, International Index of Erection Function - 5 (IIEF-5) and the Premature Ejaculation Diagnostic Tool. RESULTS: Of 216 PF cases, 4 (1.8%) were MSM. All cases resulted from sexual activity and all patients reported using the "doggy style" position during anal intercourse. Unilateral or bilateral injury of corpus cavernosum was found in 2 patients each. One (25%) patient had complete urethral injury associated with bilateral corpus cavernosum lesion. During the follow-up period, all patients developed some type of sexual complication. One patient reported penile pain during intercourse. Another patient experienced low sexual desire and premature ejaculation. This patient was also dissatisfied with the aesthetic result of the surgical scar and complained about decreased penis size after surgery. The third case developed delayed ejaculation. The fourth patient experienced mild to moderate erectile dysfunction. This same patient presented with penile curvature. Finally, palpable fibrotic nodules in the operative area were observed in all cases. CONCLUSIONS: Sexual activity in the "doggy style" position was the commonest cause of PF in MSM. Sexual dysfunction is always present in gay man after surgery for PF. However, additional studies with larger samples should be coinducted.

Evaluation of pelvic floor muscle strength and its correlation with sexual function in primigravid and non-pregnant women: A cross-sectional study.

AIMS: We aimed to compare pelvic floor muscle (PFM) strength and sexual function in primigravid and non-pregnant women and compare PFM strength between those who exhibited and did not exhibit sexual dysfunction. METHODS: A cross-sectional observational study was conducted. The sample consisted of 154 women, including 76 primigravid and 78 non-pregnant women. The inclusion criteria were as follows: non-pregnant nulliparous women or primigravid women who were pregnant with a single foetus at least 14 weeks of gestational age and reported having sexual intercourse at least once during the last 4 weeks. The exclusion criteria were as follows: inability to contract the PFMs and prior urogynaecologic surgery. PFM strength was assessed via vaginal palpation (using the Modified Oxford Scale) and vaginal squeeze pressure (using the Peritron™ manometer). Sexual function was assessedusing the Female Sexual Function Index (FSFI) questionnaire. Sexual dysfunction was identified based on low FSFI scores.The data were analyzed using the Mann-Whiney and Spearman correlation tests. RESULTS: To discussion, primigravid women had lower FSFI scores and lower PFM strength than non-pregnant women. Women with sexual dysfunction had lower PFM strength than women without sexual dysfunction, as indicated by vaginal palpation (scores of 2 out of 5 and 4 out of 5, respectively; P < 0.001) and vaginal squeeze pressure (17.5 and 36.8 cm H2 O, P < 0.001, respectively)regardless of whether they were non-pregnant nulliparous women and primigravid. CONCLUSIONS: Primigravid women exhibited worse sexual function and lower PFM strength than non-pregnant women. Women who had higher FSFI scores demonstrated greater PFM strength.

Analysis of sexual function of patients with dermatomyositis and polymyositis through self-administered questionnaires: a cross-sectional study / Análise da função sexual de pacientes com dermatomiosite e polimiosite através de questionários autoaplicados: um estudo transversal

Abstract Introduction: To date, there are no descriptions in the literature on gynecologic and sexual function evaluation in female patients with dermatomyositis (DM) and polymyositis (PM). Objective: To assess sexual function in female patients with DM/PM. Patients and methods: This is a monocentric, cross-sectional study in which 23 patients (16 DM and 7 PM), with ages between 18 and 40 years, were compared to 23 healthy women of the same age group. Characteristics on sexual function were obtained by applying the questionnaires Female Sexual Quotient (FSQ) and Female Sexual Function Index (FSFI) validated for the Brazilian Portuguese language. Results: The mean age of patients was comparable to controls (32.7 ± 5.3 vs. 31.7 ± 6.7 years), as well as the distribution of ethnicity and socioeconomic class. As for gynecological characteristics, patients and healthy controls did not differ with respect to age at menarche and percentages of dysmenorrhea, menorrhagia, premenstrual syndrome, pain at mid-cycle, mucocervical secretion, and vaginal discharge. The FSQ score, as well as all domains of the FSFI questionnaire (desire, arousal, lubrication, orgasm and satisfaction), were significantly decreased in patients vs. controls, with 60.9% of patients showing some degree of sexual dysfunction. Conclusions: This was the first study to identify sexual dysfunction in patients with DM/PM. Therefore, a multidisciplinary approach is essential for patients with idiopathic inflammatory myopathies, in order to provide prevention and care for their sexual life, providing a better quality of life, both for patients and their partners.

Resumo Introdução: Até o presente momento, não há descrições na literatura da avaliação ginecológica e da função sexual em pacientes do sexo feminino com dermatomiosite (DM) e polimiosite (PM). Objetivos: Avaliar a função sexual em pacientes do sexo feminino com DM/PM. Casuística e métodos: Estudo transversal unicêntrico em que 23 pacientes (16 DM e sete PM), entre 18 e 40 anos, foram comparadas com 23 mulheres saudáveis, com a mesma faixa etária. As características sobre a função sexual foram obtidas por meio da aplicação dos questionários Female Sexual Quotient (FSQ) e Female Sexual Function Index (FSFI) validados para a língua portuguesa do Brasil. Resultados: A média de idade das pacientes foi comparável à dos controles (32,7 ± 5,3 vs. 31,7 ± 6,7 anos), assim como a distribuição de etnia e da classe socioeconômica. Quanto às características ginecológicas, pacientes e controles saudáveis não apresentaram diferenças em relação à idade na menarca e às porcentagens de dismenorreia, menorragia, síndrome pré-menstrual, dor no meio do ciclo, secreção mucocervical e corrimento vaginal. O escore de pontuação do FSQ, assim como todos os domínios do questionário do FSFI (desejo, excitação, lubrificação, orgasmo e satisfação), estavam significantemente diminuídos nas pacientes comparativamente com os controles, 60,9% das pacientes apresentavam algum grau de disfunção sexual. Conclusões: Este foi o primeiro estudo que identificou disfunção sexual nas pacientes com DM/PM. Assim, uma abordagem multidisciplinar é essencial para pacientes com miopatias inflamatórias idiopáticas para fornecer medidas de prevenção e cuidados para sua vida sexual e propiciar uma melhor qualidade de vida das pacientes e de seus parceiros.

Analysis of sexual function of patients with dermatomyositis and polymyositis through self-administered questionnaires: a cross-sectional study.

INTRODUCTION: To date, there are no descriptions in the literature on gynecologic and sexual function evaluation in female patients with dermatomyositis (DM) and polymyositis (PM). OBJECTIVE: To assess sexual function in female patients with DM/PM. PATIENTS AND METHODS: This is a monocentric, cross-sectional study in which 23 patients (16 DM and 7 PM), with ages between 18 and 40 years, were compared to 23 healthy women of the same age group. Characteristics on sexual function were obtained by applying the questionnaires Female Sexual Quotient (FSQ) and Female Sexual Function Index (FSFI) validated for the Brazilian Portuguese language. RESULTS: The mean age of patients was comparable to controls (32.7±5.3 vs. 31.7±6.7 years), as well as the distribution of ethnicity and socioeconomic class. As for gynecological characteristics, patients and healthy controls did not differ with respect to age at menarche and percentages of dysmenorrhea, menorrhagia, premenstrual syndrome, pain at mid-cycle, mucocervical secretion, and vaginal discharge. The FSQ score, as well as all domains of the FSFI questionnaire (desire, arousal, lubrication, orgasm and satisfaction), were significantly decreased in patients vs. controls, with 60.9% of patients showing some degree of sexual dysfunction. CONCLUSIONS: This was the first study to identify sexual dysfunction in patients with DM/PM. Therefore, a multidisciplinary approach is essential for patients with idiopathic inflammatory myopathies, in order to provide prevention and care for their sexual life, providing a better quality of life, both for patients and their partners.

Female urinary incontinence and sexuality

ABSTRACT Urinary incontinence is a common problem among women and it is estimated that between 15 and 55% of them complain of lower urinary symptoms. The most prevalent form of urinary incontinence is associated with stress, followed by mixed urinary incontinence and urge urinary incontinence. It is a symptom with several effects on quality of life of women mainly in their social, familiar and sexual domains. Female reproductive and urinary systems share anatomical structures, which promotes that urinary problems interfere with sexual function in females. This article is a review of both the concepts of female urinary incontinence and its impact on global and sexual quality of life. Nowadays, it is assumed that urinary incontinence, especially urge urinary incontinence, promotes anxiety and several self-esteem damages in women. The odour and the fear of incontinence during sexual intercourse affect female sexual function and this is related with the unpredictability and the chronicity of incontinence, namely urge urinary incontinence. Female urinary incontinence management involves conservative (pelvic floor muscle training), surgical and pharmacological treatment. Both conservative and surgical treatments have been studied about its benefit in urinary incontinence and also the impact among female sexual function. Unfortunately, there are sparse articles that evaluate the benefits of female sexual function with drug management of incontinence.

Female sexual function following a novel transobturator sling procedure without paraurethral dissection (modified-TOT)

ABSTRACT Purpose To determine whether there is a difference in sexual function after modified and classical TOT procedures. Materials and Methods Of the 80 sexually active women with SUI, 36 underwent an original outside-in TOT as described by Delorme, and 44 underwent modified TOT procedure, between 2011 and 2015. The severity of incontinence and sexual function were evaluated using International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) and Female Sexual Function Index (FSFI) questionnaires preoperatively and 3 months after surgery. Results The postoperative ICIQ-SF score was significantly lower than the preoperative ICIQ-SF score in both groups (p=0.004 for modified TOT and p=0.002 for classical TOT). There was no significant difference in the ICIQ-SF score reduction between the two groups (14.1±2.1 vs. 14.4±1.9; p=0.892). Complication rates according to the Clavien-Dindo classification were also similar in both groups. In both groups, difference between preoperative and postoperative FSFI scores revealed a statistically significant improvement in all domains. Comparison of postoperative 3-month FSFI scores of modified and classical TOT groups showed statistically significant differences in arousal, lubrication and orgasm domains. Desire, satisfaction, pain and total FSFI scores did not differ significantly between two groups. Conclusion The modified TOT technique is a simple, reliable and minimal invasive procedure. The cure rate of incontinence and complication rates are the same as those of the classical TOT technique. However, due to the positive effects of minimal tissue damage on sexual arousal and orgasmic function, modified TOT has an advantage over the classical TOT.

Female urinary incontinence and sexuality.

Urinary incontinence is a common problem among women and it is estimated that between 15 and 55% of them complain of lower urinary symptoms. The most prevalent form of urinary incontinence is associated with stress, followed by mixed urinary incontinence and urge urinary incontinence. It is a symptom with several effects on quality of life of women mainly in their social, familiar and sexual domains. Female reproductive and urinary systems share anatomical structures, which promotes that urinary problems interfere with sexual function in females. This article is a review of both the concepts of female urinary incontinence and its impact on global and sexual quality of life. Nowadays, it is assumed that urinary incontinence, especially urge urinary incontinence, promotes anxiety and several self-esteem damages in women. The odour and the fear of incontinence during sexual intercourse affect female sexual function and this is related with the unpredictability and the chronicity of incontinence, namely urge urinary incontinence. Female urinary incontinence management involves conservative (pelvic floor muscle training), surgical and pharmacological treatment. Both conservative and surgical treatments have been studied about its benefit in urinary incontinence and also the impact among female sexual function. Unfortunately, there are sparse articles that evaluate the benefits of female sexual function with drug management of incontinence.