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Dickstein DR, Edwards CR, Rowan CR, Avanessian B, Chubak BM, Wheldon CW, Simoes PK, Buckstein MH, Keefer LA, Safer JD, Sigel K, Goodman KA, Rosser BRS, Goldstone SE, Wong SY, Marshall DC. Pleasurable and problematic receptive anal intercourse and diseases of the colon, rectum and anus. Nat Rev Gastroenterol Hepatol 2024; 21:377-405. [PMID: 38763974 DOI: 10.1038/s41575-024-00932-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/12/2024] [Indexed: 05/21/2024]
Abstract
The ability to experience pleasurable sexual activity is important for human health. Receptive anal intercourse (RAI) is a common, though frequently stigmatized, pleasurable sexual activity. Little is known about how diseases of the colon, rectum, and anus and their treatments affect RAI. Engaging in RAI with gastrointestinal disease can be difficult due to the unpredictability of symptoms and treatment-related toxic effects. Patients might experience sphincter hypertonicity, gastrointestinal symptom-specific anxiety, altered pelvic blood flow from structural disorders, decreased sensation from cancer-directed therapies or body image issues from stoma creation. These can result in problematic RAI - encompassing anodyspareunia (painful RAI), arousal dysfunction, orgasm dysfunction and decreased sexual desire. Therapeutic strategies for problematic RAI in patients living with gastrointestinal diseases and/or treatment-related dysfunction include pelvic floor muscle strengthening and stretching, psychological interventions, and restorative devices. Providing health-care professionals with a framework to discuss pleasurable RAI and diagnose problematic RAI can help improve patient outcomes. Normalizing RAI, affirming pleasure from RAI and acknowledging that the gastrointestinal system is involved in sexual pleasure, sexual function and sexual health will help transform the scientific paradigm of sexual health to one that is more just and equitable.
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Affiliation(s)
- Daniel R Dickstein
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Collin R Edwards
- Department of Radiology, Vagelos College of Physicians and Surgeons of Columbia University, New York, NY, USA
| | - Catherine R Rowan
- Inflammatory Bowel Disease Unit, Division of Gastroenterology and Hepatology, University of Calgary, Calgary, Alberta, Canada
| | - Bella Avanessian
- Center for Transgender Medicine and Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Division of Plastic and Reconstructive Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Barbara M Chubak
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Christopher W Wheldon
- Department of Social and Behavioral Sciences, College of Public Health at Temple University, Philadelphia, PA, USA
| | - Priya K Simoes
- The Dr. Henry D. Janowitz Division of Gastroenterology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Michael H Buckstein
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Laurie A Keefer
- The Dr. Henry D. Janowitz Division of Gastroenterology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Joshua D Safer
- Center for Transgender Medicine and Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Division of Endocrinology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Keith Sigel
- Division of Infectious Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Karyn A Goodman
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - B R Simon Rosser
- Division of Epidemiology and Community Health, School of Public Health at University of Minnesota, Minneapolis, MN, USA
| | - Stephen E Goldstone
- Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Serre-Yu Wong
- The Dr. Henry D. Janowitz Division of Gastroenterology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Deborah C Marshall
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Sala G, Hooley J, Hooley M, Stokes MA. Comparing Physical Intimacy and Romantic Relationships of Autistic and Non-autistic Adults: A Qualitative Analysis. J Autism Dev Disord 2023:10.1007/s10803-023-06109-0. [PMID: 37584763 DOI: 10.1007/s10803-023-06109-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/11/2023] [Indexed: 08/17/2023]
Affiliation(s)
- Giorgia Sala
- Healthy Autistic Life Lab, School of Psychology, Deakin University, 1 Gheringhap St, Geelong, VIC, 3220, Australia
| | - Jessica Hooley
- Dept Psychological Sciences, Swinburne University, John Street Hawthorn, VIC, Melbourne, 3122, Australia
| | - Merrilyn Hooley
- Healthy Autistic Life Lab, School of Psychology, Deakin University, 1 Gheringhap St, Geelong, VIC, 3220, Australia
| | - Mark A Stokes
- Healthy Autistic Life Lab, School of Psychology, Deakin University, 1 Gheringhap St, Geelong, VIC, 3220, Australia.
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Bachleitner K, Mahrhofer M, Knam F, Schoeller T, Weitgasser L. Corset trunkoplasty is able to preserve postoperative abdominal skin sensation in massive weight loss patients. J Plast Surg Hand Surg 2023; 57:438-444. [PMID: 36519716 DOI: 10.1080/2000656x.2022.2152822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Conventional abdominoplasty techniques commonly cause postoperative peri- and infraumbilical skin hypesthesia due to abdominal skin flap undermining. The aim of this study was to evaluate abdominal skin sensation after corset trunkoplasty in massive weight loss patients. Forty-nine massive weight loss patients suffering from excess skin underwent corset trunkoplasty between April 2017 and July 2021. Patient demographics and perioperative complications were recorded. Sensibility of the abdominal skin was measured in three qualities postoperatively using a Semmes-Weinstein monofilament, Tip-Therm® device for thermal sensation and a cotton wooden stick for sharp/blunt discrimination. Results were compared with a control group of healthy individuals to create a baseline. Revision surgery for major complications was necessary in five cases (10%) including hematoma and major wound healing disturbances. Minor complications that did not require surgical intervention were observed in eight cases (16%). Postoperative abdominal sensibility did not show any significant difference between the patient and the control group in all 16 measured areas. Sharp/blunt and thermal discrimination was positive in all patients for the whole abdominal surface area. The corset trunkoplasty technique is able to address both horizontal and vertical soft tissue excess in massive weight loss patients and at the same time limits loss of sensibility of the abdominal skin. Compared to conventional abdominoplasty techniques the abdominal sensation can mainly be preserved due to absence of undermining abdominal skin flaps.
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Affiliation(s)
- Kathrin Bachleitner
- Department of Plastic and Reconstructive Surgery, Marienhospital Stuttgart, Teaching Hospital of the Eberhard Karls University, Tübingen, Germany
| | - Maximilian Mahrhofer
- Department of Plastic and Reconstructive Surgery, Marienhospital Stuttgart, Teaching Hospital of the Eberhard Karls University, Tübingen, Germany
| | - Friedrich Knam
- Clinic for Plastic and Aesthetic Surgery/Hand Surgery, Pforzheim, Germany
| | - Thomas Schoeller
- Department of Plastic and Reconstructive Surgery, Marienhospital Stuttgart, Teaching Hospital of the Eberhard Karls University, Tübingen, Germany
| | - Laurenz Weitgasser
- Department of Plastic and Reconstructive Surgery, Marienhospital Stuttgart, Teaching Hospital of the Eberhard Karls University, Tübingen, Germany
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Fusaro M, Lisi MP, Tieri G, Aglioti SM. Heterosexual, gay, and lesbian people's reactivity to virtual caresses on their embodied avatars' taboo zones. Sci Rep 2021; 11:2221. [PMID: 33500486 PMCID: PMC7838160 DOI: 10.1038/s41598-021-81168-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Accepted: 12/22/2020] [Indexed: 01/30/2023] Open
Abstract
Embodying an artificial agent through immersive virtual reality (IVR) may lead to feeling vicariously somatosensory stimuli on one's body which are in fact never delivered. To explore whether vicarious touch in IVR reflects the basic individual and social features of real-life interpersonal interactions we tested heterosexual men/women and gay men/lesbian women reacting subjectively and physiologically to the observation of a gender-matched virtual body being touched on intimate taboo zones (like genitalia) by male and female avatars. All participants rated as most erogenous caresses on their embodied avatar taboo zones. Crucially, heterosexual men/women and gay men/lesbian women rated as most erogenous taboo touches delivered by their opposite and same gender avatar, respectively. Skin conductance was maximal when taboo touches were delivered by female avatars. Our study shows that IVR may trigger realistic experiences and ultimately allow the direct exploration of sensitive societal and individual issues that can otherwise be explored only through imagination.
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Affiliation(s)
- Martina Fusaro
- Sapienza, Università degli Studi di Roma & CLNS@Sapienza, Istituto Italiano Di Tecnologia, Rome, Italy.
- Social Neuroscience Laboratory, IRCCS Fondazione Santa Lucia, Rome, Italy.
| | - Matteo P Lisi
- Sapienza, Università degli Studi di Roma & CLNS@Sapienza, Istituto Italiano Di Tecnologia, Rome, Italy
- Social Neuroscience Laboratory, IRCCS Fondazione Santa Lucia, Rome, Italy
| | - Gaetano Tieri
- Social Neuroscience Laboratory, IRCCS Fondazione Santa Lucia, Rome, Italy
- Virtual Reality Lab, University of Rome Unitelma Sapienza, Rome, Italy
| | - Salvatore Maria Aglioti
- Sapienza, Università degli Studi di Roma & CLNS@Sapienza, Istituto Italiano Di Tecnologia, Rome, Italy.
- Social Neuroscience Laboratory, IRCCS Fondazione Santa Lucia, Rome, Italy.
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