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1.
Cochrane Database Syst Rev ; 12: CD012867, 2020 12 19.
Artigo em Inglês | MEDLINE | ID: mdl-33368143

RESUMO

BACKGROUND: A variety of minimally invasive surgical approaches are available as an alternative to transurethral resection of the prostate (TURP) for management of lower urinary tract symptoms (LUTS) in men with benign prostatic hyperplasia (BPH). Prostatic arterial embolization (PAE) is a relatively new, minimally invasive treatment approach. OBJECTIVES: To assess the effects of PAE compared to other procedures for treatment of LUTS in men with BPH. SEARCH METHODS: We performed a comprehensive search using multiple databases (The Cochrane Library, MEDLINE, Embase, LILACS, Scopus, Web of Science, and Google Scholar), trials registries, other sources of grey literature, and conference proceedings with no restrictions on language of publication or publication status, up until 25 September 2020. SELECTION CRITERIA: We included parallel-group randomized controlled trials (RCTs), as well as non-randomized studies (NRS, limited to prospective cohort studies with concurrent comparison groups) enrolling men over the age of 40 with LUTS attributed to BPH undergoing PAE versus TURP or other surgical interventions.  DATA COLLECTION AND ANALYSIS: Two review authors independently classified studies for inclusion or exclusion and abstracted data from the included studies. We performed statistical analyses by using a random-effects model and interpreted them according to the Cochrane Handbook for Systematic Reviews of Interventions. We used GRADE guidance to rate the certainty of evidence of RCTs and NRSs.  MAIN RESULTS: We found data to inform two comparisons: PAE versus TURP (six RCTs and two NRSs), and PAE versus sham (one RCT). Mean age, IPSS, and prostate volume of participants were 66 years, 22.8, and 72.8 mL, respectively. This abstract focuses on the comparison of PAE versus TURP as the primary topic of interest. PAE versus TURP We included six RCTs and two NRSs with short-term (up to 12 months) follow-up and one RCT with long-term follow-up (13 to 24 months).  Short-term follow-up: based on RCT evidence, there may be little to no difference in urologic symptom score improvement (mean difference [MD] 1.55, 95% confidence interval [CI] -0.40 to 3.50; 369 participants; 6 RCTs; I² = 75%; low-certainty evidence) measured by the International Prostatic Symptom Score (IPSS) on a scale from 0 to 35, with higher scores indicating worse symptoms. There may be little to no difference in quality of life (MD 0.16, 95% CI -0.37 to 0.68; 309 participants; 5 RCTs; I² = 56%; low-certainty evidence) as measured by the IPSS quality of life question on a scale from 0 to 6, with higher scores indicating worse quality of life between PAE and TURP, respectively. While we are very uncertain about the effects of PAE on major adverse events (risk ratio [RR] 0.71, 95% CI 0.16 to 3.10; 250 participants; 4 RCTs; I² = 26%; very low-certainty evidence), PAE may increase re-treatments (RR 3.64, 95% CI 1.02 to 12.98; 204 participants; 3 RCTs; I² = 0%; low-certainty evidence). Based on 18 re-treatments per 1000 men in the TURP group, this corresponds to 47 more (0 more to 214 more) per 1000 men undergoing PAE.   We are very uncertain about the effects on erectile function (MD -0.03, 95% CI -6.35 to 6.29; 129 participants; 2 RCTs; I² = 78%; very low-certainty evidence) measured by the International Index of Erectile Function at 5 on a scale from 1 to 25, with higher scores indicating better function. NRS evidence when available yielded similar results. Based on evidence from NRS, PAE may reduce the occurrence of ejaculatory disorders (RR 0.51, 95% CI 0.35 to 0.73; 260 participants; 1 NRS; low-certainty evidence). Longer-term follow-up: based on RCT evidence, we are very uncertain about the effects of PAE on urologic symptom scores (MD 0.30, 95% CI -3.17 to 3.77; 95 participants; very low-certainty evidence) compared to TURP. Quality of life may be similar (MD 0.20, 95% CI -0.49 to 0.89; 95 participants; low-certainty evidence). We are also very uncertain about major adverse events (RR 1.96, 95% CI 0.63 to 6.13; 107 participants; very low-certainty evidence). We did not find evidence on erectile function and ejaculatory disorders. Based on evidence from NRS, PAE may increase re-treatment rates (RR 1.51, 95% CI 0.43 to 5.29; 305 participants; low-certainty evidence); based on 56 re-treatments per 1000 men in the TURP group. this corresponds to 143 more (25 more to 430 more) per 1000 men in the PAE group.  AUTHORS' CONCLUSIONS: Compared to TURP up to 12 months (short-term follow-up), PAE may provide similar improvement in urologic symptom scores and quality of life. While we are very uncertain about major adverse events, PAE may increase re-treatment rates. We are uncertain about erectile function, but PAE may reduce ejaculatory disorders. Longer term (follow-up of 13 to 24 months), we are very uncertain as to how both procedures compare with regard to urologic symptom scores, but quality of life appears to be similar. We are very uncertain about major adverse events but PAE may increase re-treatments. We did not find longer term evidence on erectile function and ejaculatory disorders. Certainty of evidence for the main outcomes of this review was low or very low, signalling that our confidence in the reported effect size is limited or very limited, and that this topic should be better informed by future research.


Assuntos
Embolização Terapêutica/métodos , Sintomas do Trato Urinário Inferior/terapia , Próstata/irrigação sanguínea , Hiperplasia Prostática/complicações , Ressecção Transuretral da Próstata , Idoso , Artérias , Ejaculação , Embolização Terapêutica/efeitos adversos , Humanos , Masculino , Ereção Peniana , Complicações Pós-Operatórias/etiologia , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Retratamento/estatística & dados numéricos , Disfunções Sexuais Fisiológicas/etiologia , Ressecção Transuretral da Próstata/efeitos adversos , Resultado do Tratamento
2.
Zhonghua Nan Ke Xue ; 26(1): 63-73, 2020 Jan.
Artigo em Chinês | MEDLINE | ID: mdl-33345480

RESUMO

Objective: To study the effect of DuzhongButiansu Capsules (DBC) on adenine-induced reproductive dysfunction (RD) in male rats. METHODS: Eighty male SD rats were randomly divided into six groups, blank control (n = 8), solvent control (n = 8), RD model control (n = 16), Shengjing Capsules (SJC) (n = 16), low-dose DBC (n = 16) and high-dose DBC (n = 16). The RD model was made by intragastric administration of adenine at 200 mg/kg/d for 5 successive weeks in the latter four groups of animals, and in the meantime the rats in the latter three groups were treated intragastrically with SJC at 0.560 mg/kg/d and DBC at 0.242 and 0.968 mg/kg/d, respectively. At the end of the fourth week, all the rats were mated with female ones in a 1:1 ratio for 7 days. Then the male rats were killed and the right epididymides collected for detection of sperm concentration and motility, and the female ones sacrificed after fed for another 2 weeks and the numbers of pregnancies and fetal rats were recorded. The heart, liver, spleen, lung, kidney, thymus, testis, epididymis and seminal vesicle were harvested for obtainment of the visceral coefficients and semen parameters, observation of the histopathological changes in the testis, epididymis and kidneys by HE staining, measurement of the levels of serum T, E2, FSH and LH by ELISA, detection of the contents of serum glutathione peroxidase (GSH-Px), superoxide dismutase (SOD), malondialdehyde (MDA) and creatinine (Scr), blood urea nitrogen (BUN), and determination of the expressions of Bax, Bcl-2, Caspase-3 and Caspase-9 proteins in the renal tissue by immunohistochemistry. RESULTS: No statistically significant difference was observed between the blank control and solvent control groups in any of the indexes obtained (P > 0.05).Compared with the blank controls, the rats in the RD model control group showed significantly decreased sperm concentration (ï¼»40.67 ± 7.37ï¼½vs ï¼»27.10 ± 2.72ï¼½ ×106/ml, P < 0.01), sperm motility (ï¼»54.75 ± 3.92ï¼½%vs ï¼»25.60 ± 4.83ï¼½%, P < 0.01) and pregnancy rate (85.7% vs 43.8%, P < 0.01). The rats in thelow- and high-dose DBCgroups exhibited remarkable increases in sperm concentration (ï¼»53.00 ± 4.55ï¼½% and ï¼»65.63 ± 12.47ï¼½% ×106/ml, P < 0.01) and sperm motility (ï¼»53.50 ± 8.83ï¼½% and ï¼»54.33 ± 7.92ï¼½ %, P < 0.01), and so did those in the high-dose DBC group in pregnancy rate (54.5%, P < 0.01).After medication, the animals showed markedly increased body weight and visceral coefficients of the testis, epididymis and seminal vesicle (P < 0.05 or P < 0.01), recovered morphology of the testis, epididymis and kidneys, reduced levels of Scr, BUN, FSH, LH and MDA in the serum (P < 0.05 or P < 0.01), increased contents of T, SOD and GSH-PX (P < 0.05 or P < 0.01), down-regulated expressions of Bax, Caspase-3 and Caspase-9 and up-regulated expression of Bcl-2 in the renal tissue (P < 0.05 or P < 0.01). CONCLUSIONS: DBC can improve adenine-induced reproductive dysfunction in male rats, which may be attributed to its effects of inhibiting the apoptosis of proteins, improving oxidative stress and elevating the levels of reproductive hormones.


Assuntos
Medicamentos de Ervas Chinesas/uso terapêutico , Disfunções Sexuais Fisiológicas/tratamento farmacológico , Motilidade Espermática , Adenina , Animais , Cápsulas , Epididimo , Feminino , Masculino , Estresse Oxidativo , Gravidez , Distribuição Aleatória , Ratos , Ratos Sprague-Dawley , Disfunções Sexuais Fisiológicas/induzido quimicamente , Espermatozoides , Testículo
3.
Tech Vasc Interv Radiol ; 23(3): 100693, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33308525

RESUMO

Many interventions to treat men with benign prostatic hyperplasia (BPH) associated lower urinary tract symptoms (LUTS) are associated with sexual side effects or complications, such as hematospermia, erectile dysfunction, or ejaculatory dysfunction. As loss of sexual function can significantly impact quality of life, an optimal treatment for BPH associated LUTS would be one without any sexual dysfunction side effects. Prostatic artery embolization is a minimally invasive treatment for men with BPH associated LUTS. The aim of this paper is to review the effects of prostatic artery embolization on sexual function and compare the sexual side effect profile to the other available BPH procedures.


Assuntos
Embolização Terapêutica/efeitos adversos , Sintomas do Trato Urinário Inferior/terapia , Próstata/irrigação sanguínea , Hiperplasia Prostática/terapia , Radiografia Intervencionista/efeitos adversos , Disfunções Sexuais Fisiológicas/etiologia , Disfunções Sexuais Psicogênicas/etiologia , Procedimentos Cirúrgicos Urológicos Masculinos/efeitos adversos , Humanos , Sintomas do Trato Urinário Inferior/diagnóstico por imagem , Sintomas do Trato Urinário Inferior/fisiopatologia , Masculino , Hiperplasia Prostática/diagnóstico por imagem , Hiperplasia Prostática/fisiopatologia , Medição de Risco , Fatores de Risco , Disfunções Sexuais Fisiológicas/diagnóstico , Disfunções Sexuais Fisiológicas/fisiopatologia , Disfunções Sexuais Psicogênicas/diagnóstico , Disfunções Sexuais Psicogênicas/psicologia , Resultado do Tratamento
4.
Zhonghua Wei Chang Wai Ke Za Zhi ; 23(12): 1187-1193, 2020 Dec 25.
Artigo em Chinês | MEDLINE | ID: mdl-33353275

RESUMO

Objective: To analyze and compare the efficacy of robotic, laparoscopic and open dorsal mesh rectopexy in the treatment of severe rectal prolapse. Methods: A retrospective cohort study was performed. Patients who had a full-thickness rectum pulled out of the anus before surgery and the length was greater than 8 cm, and underwent transabdominal dorsal mesh rectopexy were enrolled in the study. Those who had urinary or sexual dysfunction before surgery, could not perform sexual function scores due to lack of a fixed sexual partner or sexual activity after surgery, underwent laparotomy again during the perioperative period, were transferred to laparotomy during robotic or laparoscopic surgery, or had no complete information, were excluded. A total of 61 patients with severe rectal prolapse in the First Affiliated Hospital of Zhengzhou University from 2014 to 2018 were enrolled and divided into robotic group (20 cases), laparoscopic group (20 cases) and open group (21 cases) according to the operative procedure based on patients' will. Perioperative parameters were compared among the 3 groups. The International Prostatic Symptoms Score Scale (IPSS, higher score indicates more severe urinary dysfunction), the International Index of Erectile Function questionnaire (IIEF-15, lower score indicates more severe male sexual dysfunction) and the Female Sexual Function Index (FSFI-19, lower score indicates more severe female sexual dysfunction) were used to evaluate and compare the urinary and sexual function before and after operation. Results: There were no significant differences in baseline data among the 3 groups (all P>0.05). In the robotic, laparoscopic and open groups respectively, the operative time was (176.3±13.8) minutes, (160.2±12.1) minutes and (134.2±12.1) minutes; intraoperative blood loss was (58.5±18.9) ml, (67.9±15.7) ml and (114.2±8.4) ml; the first time to ambulation was (19.9±6.8) hours, (24.0±8.9) hours and (37.7±11.4) hours; the first time to gas passage was (31.8±6.8) hours, (35.7±8.9) hours and (49.2±11.2) hours; the hospitalization time was (11.0±1.4) days, (11.4±1.4) days and (13.3±2.1) days; whose differences among 3 groups were all significant (all P<0.001). While no significant differences in morbidity of complication and recurrence among 3 groups were observed (all P>0.05). In the robotic, laparoscopic and open groups respectively, the preoperative IPSS score was (4.2±1.7), (4.4±1.3), and (4.7±1.8); the IPSS score at postoperative 3-month was (8.5±2.5), (9.9±1.7), and (12.2±3.1); IPSS score at postoperative 12-month was (4.3±1.6), (5.8±1.3), and (6.3±1.5), respectively. Compared to preoperative score, postoperative IPSS score increased obviously, then decreased gradually (P<0.001). Preoperative male IIEE score was (22.8±1.8), (22.1±2.1), and (22.6±1.5). In the robotic, laparoscopic and open groups respectively, male IIEE score at postoperative 6-month was (19.6±2.1), (17.1±2.1), and (15.0±2.1); male IIEE score at postoperative 12-month was (22.4±1.6), (19.9±1.5), (17.9±1.8), respectively. Preoperative female FSFI score was (26.4±3.4), (26.6±3.2), and (26.6±3.0); female FSFI score at postoperative 6-month was (21.5±3.3), (18.9±2.9), (17.0±2.6); female FSFI score at postoperative 12-month was (26.1±2.7), (22.7±3.2), and (21.2±2.3), respectively. Postoperative male IIEE score and female FSFI score decreased significantly and then increased gradually with time, whose differences were all significant (all P<0.05). Postoperative IPSS, IIEE, and FSFI scores in the robotic group were superior to those in the laparoscopic and open groups (all P<0.05). Conclusion: Robotic surgery is safe and effective in the treatment of severe rectal prolapse, and is more advantageous in preserving urinary function and sexual function.


Assuntos
Laparoscopia , Laparotomia , Prolapso Retal , Procedimentos Cirúrgicos Robóticos , Feminino , Humanos , Laparoscopia/efeitos adversos , Laparotomia/efeitos adversos , Masculino , Prolapso Retal/complicações , Prolapso Retal/cirurgia , Estudos Retrospectivos , Procedimentos Cirúrgicos Robóticos/efeitos adversos , Disfunções Sexuais Fisiológicas/diagnóstico , Disfunções Sexuais Fisiológicas/etiologia , Telas Cirúrgicas , Resultado do Tratamento , Transtornos Urinários/diagnóstico , Transtornos Urinários/etiologia
5.
Wiad Lek ; 73(10): 2277-2281, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33310963

RESUMO

OBJECTIVE: The aim: To systematize and bring the reader closer to knowledge about the occurrence of sexual disorders in people after heart transplantation based on available bibliography. PATIENTS AND METHODS: Material and methods: A review of the literature on this topic from the last 30 years made with using the PubMed database, using a total of 17 articles. CONCLUSION: Conclusions: The incidence of sexual dysfunction (SD) is higher in heart recipients than in the general population and erectile dysfunction is the most common. When the symptoms of dysfunction occur before the transplant - they do not improve, rather they get worse, which reduces the improvement in the quality of life of these patients compared to patients without sexual dysfunction. Improvement in quality of life is observed in patients with SD after heart transplantation, but not as pronounced as in subjects without sexual dysfunction. Some patients notice an increase in libido, with the genital response being insufficient or completely disappearing, which results in a decrease in the quality of relationships between partners and a deterioration in the quality of life. The cause of SD in heart recipients is unclear, but it is associated with the type of immunosuppression used, the level of sexual activity and the state of health of patients prior to transplantation. Nowadays patients after ortotrophic heart transplant live longer and their quality of life improves, but not in sexual terms. The articles concerned almost exclusively men, that is why the topic requires exploration in subsequent research.


Assuntos
Disfunção Erétil , Transplante de Coração , Disfunções Sexuais Fisiológicas , Humanos , Libido , Masculino , Qualidade de Vida , Comportamento Sexual
6.
Khirurgiia (Mosk) ; (12): 76-82, 2020.
Artigo em Russo | MEDLINE | ID: mdl-33301258

RESUMO

OBJECTIVE: To study the effect of general magnetotherapy, muscle stimulation with biofeedback of pelvic floor muscles, and a special complex of physiotherapy exercises with and without fractional microablative CO2-laser therapy on sexual status in females after plastic surgery for rectocele. MATERIAL AND METHODS: There were 200 fertile females and women of perimenopausal and menopausal age with rectocele grade II-III. Various rehabilitation programs were used in delayed postoperative period in order to improve sexual function. Rehabilitation included various combinations general magnetotherapy, electrical muscle stimulation with biofeedback of pelvic floor muscles, intravaginal fractional microablative CO2-laser therapy and a special complex of exercise therapy. RESULTS AND CONCLUSION: Postoperative rehabilitation including general magnetotherapy, fractional microablative CO2-laser therapy, muscle stimulation with biofeedback of pelvic floor muscles and a special exercise therapy significantly improves sexual function in patients with rectocele. This is true for fertile females and women of perimenopausal and menopausal age. Significant data on PISQ-12 questionnaire (Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire) and Female Sexual Function Index of (FSFI) confirmed these results.


Assuntos
Retocele , Disfunções Sexuais Fisiológicas/terapia , Biorretroalimentação Psicológica , Terapia por Estimulação Elétrica , Terapia por Exercício , Feminino , Fertilidade , Inquéritos Epidemiológicos , Humanos , Terapia a Laser , Terapia de Campo Magnético , Perimenopausa , Pós-Menopausa , Retocele/complicações , Retocele/reabilitação , Retocele/cirurgia , Retocele/terapia , Disfunções Sexuais Fisiológicas/etiologia , Disfunções Sexuais Fisiológicas/reabilitação
8.
Niger J Clin Pract ; 23(11): 1548-1554, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33221780

RESUMO

Objective: The relationship between sexual functions and infertility remains controversial and there is a limited number of studies reporting the effects of infertility on sexual functions in women with polycystic ovary syndrome (PCOS). Aims: The present study aims to investigate the effects of infertility on sexual functions and depression levels in women with PCOS. Methods: A total of 150 participants who were either fertile patients with PCOS, infertile patients with PCOS, or fertile women without PCOS (control) (n = 50) were included for the study. Sociodemographic data were recorded and the Female Sexual Function Index (FSFI) and Beck Depression Inventory (BDI) were used for evaluation of subjects. Results: Body mass index (BMI) was found to be significantly higher in the PCOS plus infertility group (27.9 ± 2.9, P = 0.01) than the other groups. Total BDI score was higher and total FSFI score was significantly lower in the PCOS plus infertility group than in the other groups. The PCOS plus infertility group showed significantly lower FSFI scores than the PCOS group in terms of desire, lubrication, orgasm, satisfaction, and pain. A significant negative correlation was observed between BMI and BDI scores in the PCOS plus infertility group (r:-0.384, P = 0.04). Conclusion: Our study results show lower sexual functions in PCOS women with infertility and that infertility negatively affects sexual functions with obesity associated depression.


Assuntos
Obesidade/psicologia , Síndrome do Ovário Policístico/complicações , Qualidade de Vida , Comportamento Sexual/fisiologia , Disfunções Sexuais Fisiológicas/etiologia , Adulto , Índice de Massa Corporal , Estudos de Casos e Controles , Depressão/etiologia , Depressão/psicologia , Feminino , Humanos , Infertilidade Feminina , Libido/fisiologia , Orgasmo , Satisfação Pessoal , Síndrome do Ovário Policístico/psicologia , Comportamento Sexual/psicologia , Disfunções Sexuais Fisiológicas/psicologia , Turquia/epidemiologia
10.
Artigo em Inglês | MEDLINE | ID: mdl-33022931

RESUMO

The aim of this study was to examine female sexual functioning and its association with the impact of the symptoms of menopause among Spanish postmenopausal women. A total of 182 postmenopausal women (65.59 ± 7.93 years) participated in this cross-sectional study. The female sexual function index (FSFI) and the menopause rating scale (MRS) were used to analyze sexual function and severity of menopausal symptoms, respectively. Age, education, area of residence, occupation, and depression (Hospital Anxiety and Depression Scale) were considered as possible confounders. The results of a linear multivariate regression analysis showed that the severity of urogenital menopause-related symptoms was associated with lower values in the FSFI total score and the lubrication, satisfaction, arousal, and orgasm domains. These last three subscales were also linked to severe psychological impact, while the MRS total score was only related to the desire domain. Regarding confounders, being younger, working, and residing in a rural area were all linked to better sexual function. All effect sizes were large (adjusted R2 > 0.35). In conclusion, after controlling for possible confounders, postmenopausal women who experience a severe impact of menopausal symptoms endure poorer sexual function, particularly when said symptoms are urogenital or psychological in nature.


Assuntos
Menopausa , Disfunções Sexuais Fisiológicas , Estudos Transversais , Feminino , Humanos , Pós-Menopausa , Inquéritos e Questionários
11.
Obstet Gynecol ; 136(5): 922-931, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-33030874

RESUMO

OBJECTIVE: We aimed to systematically review the literature to describe sexual activity and function before and after prolapse surgery. DATA SOURCES: We searched MEDLINE, EMBASE, and ClinicalTrials.gov databases from inception to April 2018. METHODS OF STUDY SELECTION: Prospective, comparative studies of reconstructive pelvic organ prolapse (POP) surgeries that reported sexual function outcomes were included. Studies were extracted for population characteristics, sexual function outcomes, and methodologic quality. Data collected included baseline and postoperative sexual activity, dyspareunia, and validated sexual function questionnaire scores. Change in validated scores were used to categorize overall sexual function as improved, unchanged, or worsened after surgery. TABULATION, INTEGRATION, AND RESULTS: The search revealed 3,124 abstracts and identified 74 articles representing 67 original studies. The overall quality of evidence was moderate to high. Studies reporting postoperative results found higher rates of sexual activity than studies reporting preoperative sexual activity in all POP surgeries except sacrospinous suspension, transvaginal mesh, and sacrocolpopexy. The prevalence of dyspareunia decreased after all prolapse surgery types. The risk of de novo dyspareunia ranged from 0% to 9% for all POP surgeries except posterior repair, which lacked sufficient data. Overall sexual function based on PISQ-12 (Pelvic Organ Prolapse/Incontinence Sexual Questionnaire-12) scores improved for mixed native tissue repairs, anterior repairs, uterosacral suspensions, sacrospinous suspensions, and sacrocolpopexy; scores were similar for posterior repairs, transvaginal mesh, and biologic grafts. Sexual function did not worsen after any POP surgeries. CONCLUSION: Sexual function improves or remains unchanged after all types of reconstructive POP surgeries and does not worsen for any surgery type. Prevalence of total dyspareunia was lower after all POP surgery types, and de novo dyspareunia was low ranging 0-9%. This information can help surgeons counsel patients preoperatively. SYSTEMATIC REVIEW REGISTRATION: PROSPERO, CRD42019124308.


Assuntos
Procedimentos Cirúrgicos em Ginecologia/efeitos adversos , Prolapso de Órgão Pélvico/cirurgia , Complicações Pós-Operatórias/epidemiologia , Comportamento Sexual/estatística & dados numéricos , Disfunções Sexuais Fisiológicas/epidemiologia , Feminino , Humanos , Pessoa de Meia-Idade , Complicações Pós-Operatórias/etiologia , Período Pós-Operatório , Estudos Prospectivos , Disfunções Sexuais Fisiológicas/etiologia , Telas Cirúrgicas/efeitos adversos
12.
J Med Life ; 13(3): 329-335, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33072204

RESUMO

Vaginal infections are the most common gynecological diseases and one of the causes of sexual dysfunction. In more than 50% of patients, sexual dysfunction is twice as common. Evaluation of the treatment outcome of vaginal infections can be effective in identifying factors related to the sexual function. This is a descriptive-observational study that included patients referred to Imam Sajjad Shahriar Hospital during 2017-2018. Patients that met the inclusion criteria (with vaginal infections of Candida, Gardnerella and mixed infections - Candida and Gardnerella - Mixed group) completed the Female Sexual Function Index (FSFI) questionnaire before and one month after treatment. Data were analyzed by SPSS 16, paired t-test, ANOVA, and multiple regression. P-value <0.05 was considered significant. After the treatment of vaginitis, there was a significant increase in all aspects of the FSFI questionnaire. The mean and standard deviation of sexual function of women before and after treatment were 18.26 ± 4.36 and 26.27 ± 4.97 in the Candida group, 20.06 ± 4.94 and 25.87 ± 5.32 in the Gardnerella group, and 19.69 ± 4.25 and 27.05 ± 5.12 in the Mixed group. Prior to treatment in the Mixed and Gardnerella group, the most important sexual dysfunction was related to the dyspareunia component, while in the Candida group, the most important sexual dysfunction was related to the desire component. After treatment, the components of dyspareunia in the Mixed and Gardnerella group and the orgasmic component in the Candida group showed the greatest improvement. The regression test showed that the effect of age, body mass index and duration of sex on sexual function was significant (P <0.05). Duration of the disease had the greatest impact on sexual dysfunction, and after treatment of the disease, sexual function improved significantly. Proper diagnosis and treatment are effective in improving women's sexual function. The results of this study can be promoted to midwives and gynecologists.


Assuntos
Infecções/microbiologia , Disfunções Sexuais Fisiológicas/microbiologia , Vagina/microbiologia , Vagina/patologia , Adulto , Feminino , Humanos , Pessoa de Meia-Idade , Análise de Regressão , Inquéritos e Questionários , Resultado do Tratamento
13.
Bull Cancer ; 107(12): 1233-1240, 2020 Dec.
Artigo em Francês | MEDLINE | ID: mdl-33069338

RESUMO

INTRODUCTION: Despite the frequency of sexual issues during cancer care, the majority of nurses do not bring up the topic with their patients. The purpose of this study is to encourage nurses in oncology and hematology units on how to better participate in the assessment of the well-being of cancer patients as part of their sexual health. METHODS: Using an interview guide, we conducted a qualitative study by interviewing twenty nurses working in the Oncology and Hematology Units of four Belgian hospitals. The twenty semi-structured interviews were transcribed, and we performed a content analysis of the data collected. RESULTS: Sexuality is still a taboo topic, sexual dysfunction is undervalued, nurses lack knowledge on the topic which create many barriers to sexual health assessment. Obstacles are intrinsic or extrinsic towards nurses: prejudices, embarrassment, lack of evaluation tools, lack of support, resources, the environment is not always adequate. This is linked to the lack of knowledge of side effects of treatments, the lack of know-how, well-being and reflexivity. The assessment of sexual health is however part of their role. Nurses would like to have tools and better education to address the various shortcoming on how to address sexual health. CONCLUSION: Nurses must acknowledge the existence of sexual health issues in cancer patients by rectifying their perceptions of sexuality, improving their knowledge and management of care, by addressing the issue of sexual health early enough.


Assuntos
Neoplasias/complicações , Recursos Humanos de Enfermagem no Hospital/psicologia , Disfunções Sexuais Fisiológicas/psicologia , Sexualidade/psicologia , Adulto , Atitude do Pessoal de Saúde , Bélgica , Constrangimento , Conhecimentos, Atitudes e Prática em Saúde , Hematologia , Humanos , Pessoa de Meia-Idade , Enfermagem Oncológica , Preconceito , Pesquisa Qualitativa , Disfunções Sexuais Fisiológicas/etiologia , Adulto Jovem
14.
Sci Rep ; 10(1): 15180, 2020 09 16.
Artigo em Inglês | MEDLINE | ID: mdl-32938977

RESUMO

To our knowledge, little attention has been paid to the sexual function of health workers. The aim of the present study was to assess the frequency of sexual dysfunction among Chinese doctors. In addition, the risk factors for sexual dysfunction were analyzed. This was a questionnaire-based multicenter cross-sectional survey performed in five large academic medical centers in China. A total of 539 male doctors, 547 female doctors were evaluated. We analyzed doctors' demographic characteristics, quality of life, sexual function and attitudes towards sexual problems. Chinese doctors are at high risk of sexual dysfunction and poor health. The prevalence of sexual dysfunction appears to increase with age, and is associated with various social and demographic factors including monthly income, physical exercise, working hours, night shift and health-related quality. The quality of life and sexual health of doctors deserves special attention as a significant public health concern. Alleviating work pressure, increasing income, improving quality of life and therapeutic sexual problems should be considered comprehensively.


Assuntos
Médicos/estatística & dados numéricos , Disfunções Sexuais Fisiológicas/epidemiologia , Disfunções Sexuais Psicogênicas/epidemiologia , Fatores Socioeconômicos , Adulto , China/epidemiologia , Estudos Transversais , Feminino , Nível de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Qualidade de Vida , Fatores de Risco , Inquéritos e Questionários , Adulto Jovem
15.
Rev. int. androl. (Internet) ; 18(3): 85-90, jul.-sept. 2020. tab
Artigo em Português | IBECS | ID: ibc-193598

RESUMO

INTRODUÇÃO: Não existem investigações científicas suficientes, sobretudo com população normativa, que evidenciem a associação entre a qualidade do sono e o funcionamento sexual. MÉTODO: Participaram deste estudo 945 indivíduos saudáveis, 62% mulheres, 38% homens, média de 34,27 anos (desvio‐padrão=15,82), que preencheram um questionário sociodemográfico, a versão portuguesa do Questionário de Sono de Oviedo e a versão portuguesa do Questionário de Funcionamento Sexual do Massachusetts General Health Hospital. RESULTADOS: Verificaram‐se níveis moderados de satisfação subjetiva com o sono e níveis baixos de insónia e hipersónia. No entanto, as mulheres sofrem mais deste tipo de perturbações do sono. A satisfação subjetiva com qualidade do sono está positivamente correlacionada com o funcionamento sexual geral e todas as suas respetivas dimensões e a insónia está negativamente correlacionada com o funcionamento sexual e todas as suas respetivas dimensões. Da submissão dos itens à análise de regressão linear, testou‐se o modelo de predição do funcionamento sexual geral em função das variáveis da qualidade do sono, tendo‐se obtido um modelo estatisticamente significativo (p < 0,001), sendo que as variáveis em questão explicam 7% do funcionamento sexual geral, com valores β para a satisfação subjetiva com o sono de 0,189 e para a insónia de ‐0,140. DISCUSSÃO: Com base nos resultados obtidos, é possível comprovar que quanto maior a qualidade do sono, maior é o funcionamento sexual e que o mesmo é influenciado negativamente sobretudo pela insónia


INTRODUCTION: There are not enough scientific investigations, especially with a normative population, that show the association between sleep quality and sexual functioning. METHOD: 945 healthy individuals, 62% female, 38% male, mean age 34.27 years (standard deviation=15.82), who completed a sociodemographic questionnaire, the Portuguese version of the Oviedo Sleep Questionnaire and the Portuguese version of the Massachusetts General Health Hospital‐Sexual Functioning Questionnaire entered this study. RESULTS: Moderate levels of subjective satisfaction with sleep and low levels of insomnia and hypersomnia were observed. However, women suffer more from these forms of sleep disorders. Subjective satisfaction with sleep quality is positively correlated with overall sexual functioning and all of its dimensions, and insomnia is negatively correlated with sexual functioning and all of its dimensions. From the linear regression analysis, the model of prediction of general sexual functioning was tested according to sleep quality variables, and a statistically significant model was obtained (p <0.001), with the variables in question explaining 7% of general sexual functioning, with β values ??for subjective satisfaction with sleep of 0.189 and for insomnia of ‐0.140. DISCUSSION: Based on the results obtained, it is possible to demonstrate that the higher the quality of sleep, the greater the sexual functioning, and that it is negatively influenced mainly by insomnia


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Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Transtornos do Sono-Vigília/complicações , Disfunções Sexuais Fisiológicas/etiologia , Inquéritos e Questionários , Fatores Socioeconômicos , Fatores Sexuais
16.
Maturitas ; 140: 41-48, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32972634

RESUMO

OBJECTIVE: To determine the prevalence and severity of menopausal symptoms and their related risk factors among middle-aged Korean women according to their reproductive stages. METHODS: This cross-sectional study included 3039 Korean women, aged 45-65 years, who attended their routine health checkup. Their scores from the Menopause Rating Scale (MRS) were compared and participants were categorized into four groups according to stage of menopause: premenopause, early menopause (≤2 years from their last menstruation), mid-menopause (2-8 years), and late menopause (>8 years). RESULTS: The mean age of the participants was 52.81 ± 5.39 years, and 98.5 % of them reported one or more symptoms included in the MRS. The most common symptom was physical/mental exhaustion, experienced by 86.7 % of participants. The prevalence of moderate to severe symptoms, including vasomotor symptoms, heart discomfort, sleep problems, sexual problems, vaginal dryness, and joint/muscular discomfort, increased in the early menopausal period. This increased in the late menopausal period compared with its prevalence at premenopause. The prevalence of moderate to severe psychological symptoms, heart discomfort, and sleep problems followed a U-shaped trend after menopause: high at early menopause, low at mid-menopause, and high again at late menopause. A low level of physical exercise was an independent risk factor for a high total MRS score; however, the menopausal stages, age, and weight were also variously associated with menopausal symptoms. CONCLUSIONS: Several menopausal symptoms remain severe, or are aggravated, until the late menopausal period among Korean women. More attention is warranted to manage these symptoms in postmenopausal women.


Assuntos
Menopausa , Idoso , Estudos Transversais , Fadiga/epidemiologia , Feminino , Fogachos/epidemiologia , Humanos , Artropatias/epidemiologia , Menopausa/psicologia , Pessoa de Meia-Idade , Doenças Musculares/epidemiologia , Prevalência , República da Coreia/epidemiologia , Fatores de Risco , Disfunções Sexuais Fisiológicas/epidemiologia , Transtornos do Sono-Vigília/epidemiologia , Doenças Vaginais/epidemiologia
17.
J Biomed Nanotechnol ; 16(4): 505-519, 2020 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-32970982

RESUMO

The clinical studies proved the adverse effect of Propranolol on sexual function. Regarding this issue, the key research question of this study was, whether the designed herbal nanohybrid formula EGCG-chitosan-alginate has an efficacy versus Propranolol, or not? The formula was optimized according to the coacervation method. Its molecular structure and characteristics were confirmed. The entrapment efficiency was determined, and the stability, as well in vitro release study was conducted. The in vivo study was conducted for 65 days. To answer the raised question, tissue weights of the testis, epididymis seminal vesicles, and prostate were determined. Oxidative stress markers as MDA and GSH were measured in testis and epididymis, while testosterone in blood serum. The semen analysis was performed. DNA damage was detected according to the comet assay procedures. Conventional pathological examination was done in special concern to testis and epididymis. The characterization results reflected the good preparation of the formula with an amorphous structure in a range of 200 nm, high stability with ZP + 57.3 mV. The calculated EE was 84.10 ± 1.19% and the release percent was 72.11 ± 0.77% for 24 hrs. All the rats increased in the weight with variations among the groups in the tissue organs. The finding exposed a significant decrease in the average of MDA in the rats' testes with a significant increase in GSH while a non-significant difference in the epididymis, in both. The testosterone, the seminal parameters, and the DNA integrity significantly increased in the nano-formula compared to propranolol. Likewise, normal pathological findings of the nano-formula in the testis and Epididymis compared to abnormal of propranolol. In total, the current research confirmed that EGCG had no toxic effects and able to promote fertility. The most important finding was the administration of EGCG either in normal or nano-form prior to propranolol alleviated the effects of propranolol. These findings reflected the protection evident of EGCG versus propranolol.


Assuntos
Propranolol/química , Disfunções Sexuais Fisiológicas , Antagonistas Adrenérgicos beta , Alginatos , Animais , Catequina/análogos & derivados , Quitosana , Masculino , Nanoestruturas , Tamanho do Órgão , Ratos
19.
Obstet Gynecol ; 136(4): 792-801, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32925609

RESUMO

OBJECTIVE: To assess whether resting genital hiatus, perineal body, and total vaginal length measured intraoperatively at the conclusion of surgery are associated with prolapse recurrence 2 years after native tissue pelvic organ prolapse reconstruction. METHODS: This ancillary analysis of the OPTIMAL (Operations and Pelvic Muscle Training in the Management of Apical Support Loss) trial included women who had an immediate postoperative pelvic organ prolapse quantification (POP-Q) examination and 2-year follow-up. Primary outcome was bothersome bulge symptoms. Secondary outcomes were anatomic failure, surgical failure (either anatomic failure or bothersome bulge symptoms), and sexual function. Descriptive statistics assessed relationships between postprocedure POP-Q measures and these four outcomes. Multivariable models were fit to the data to control for baseline differences in bivariate comparisons. Receiver operating characteristic curves were generated to identify an optimal genital hiatus cut point associated with bothersome bulge, and this threshold was explored. RESULTS: This analysis included 368 participants. Bivariate analyses identified age, body mass index, vaginal deliveries, baseline genital hiatus, perineal body, and advanced POP-Q stage (3 or higher vs 2) as clinically relevant variables to include in multivariable models. After adjusting for these variables, the association between immediate postoperative genital hiatus and bothersome bulge (adjusted odds ratio [aOR] 1.4; 95% CI 0.9-2.1) was not significant at the P<.05 level; however, immediate postoperative genital hiatus was associated with anatomic (aOR 1.6; 95% CI 1.1-2.3) and surgical failure (aOR 1.5; 95% CI 1.0-2.1). Immediate postoperative genital hiatus of 3.5 cm was the selected cutoff (area under the curve 0.58, 95% CI 0.50-0.66 from the bothersome bulge model). Women with genital hiatus 3.5 cm or greater were more likely to have anatomic and surgical failures at 2 years. No POP-Q measures were correlated with 2-year sexual function. CONCLUSION: A larger immediate postoperative genital hiatus measurement of 3.5 cm or greater is not associated with bothersome bulge symptoms or sexual dysfunction but is associated with anatomic and surgical failures 2 years after native tissue vaginal reconstructive surgery.


Assuntos
Procedimentos Cirúrgicos em Ginecologia , Prolapso de Órgão Pélvico , Complicações Pós-Operatórias/diagnóstico , Procedimentos Cirúrgicos Reconstrutivos , Risco Ajustado/métodos , Disfunções Sexuais Fisiológicas , Feminino , Seguimentos , Procedimentos Cirúrgicos em Ginecologia/efeitos adversos , Procedimentos Cirúrgicos em Ginecologia/métodos , Humanos , Pessoa de Meia-Idade , Avaliação de Processos e Resultados em Cuidados de Saúde , Diafragma da Pelve/cirurgia , Prolapso de Órgão Pélvico/diagnóstico , Prolapso de Órgão Pélvico/fisiopatologia , Prolapso de Órgão Pélvico/cirurgia , Prognóstico , Procedimentos Cirúrgicos Reconstrutivos/efeitos adversos , Procedimentos Cirúrgicos Reconstrutivos/métodos , Recidiva , Índice de Gravidade de Doença , Disfunções Sexuais Fisiológicas/diagnóstico , Disfunções Sexuais Fisiológicas/etiologia , Avaliação de Sintomas/métodos
20.
Neurol Neurochir Pol ; 54(4): 291-293, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32870497

RESUMO

INTRODUCTION: In this edition, Szymus et al. conducted a systematic review revealing sexual dysfunction to be more prevalent in patients with Huntington's Disease compared to controls. CLINICAL REFLECTIONS: Sexual dysfunction in HD (SDHD) is common and significantly affects patient quality of life. Commonly used HD rating scales and treatment guidelines do not explicitly address SDHD, and research studies are limited by size and methodology. CLINICAL IMPLICATIONS: It is important that validated sexual dysfunction screening tools be utilised in clinical and research settings.


Assuntos
Doença de Huntington , Disfunções Sexuais Fisiológicas , Humanos , Qualidade de Vida
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