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Perenc H, Pasieka K, Juruś K, Bierć K, Bieś R, Krzystanek M, Warchala A. The Influence of the COVID-19 Pandemic on the Sexual Lives of Polish Young Adults. J Clin Med 2024; 13:3370. [PMID: 38929899 PMCID: PMC11203741 DOI: 10.3390/jcm13123370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Revised: 05/28/2024] [Accepted: 06/04/2024] [Indexed: 06/28/2024] Open
Abstract
Background: The COVID-19 pandemic brought significant changes to daily life in Poland, with restrictions affecting various sectors, including entertainment, education, and travel. The pandemic's impact extended to intimate aspects of life. This study aimed to compare the sexual functioning of young adults in Poland before and during the pandemic, using the Changes in Sexual Functioning Questionnaire (CSFQ-14). Methods: The research involved an online survey with demographic questions, the CSFQ-14 for pre-pandemic sexual functioning, and modified CSFQ-14 questions for the pandemic period. Sexual dysfunction was determined using predefined cutoff scores. Results: Overall, the study found no significant difference in the sexual functioning of young Poles during the COVID-19 pandemic compared to before. However, there were gender-specific trends. Women reported enhanced pleasure, satisfaction, and orgasm during lockdown, while men faced challenges with erection and ejaculation. A higher proportion of women experienced overall sexual dysfunction compared to men, both before and during the pandemic. This research provides insights into the impact of the COVID-19 pandemic on the sexual lives of young Poles. While overall sexual functioning remained relatively stable, specific aspects varied by gender. Conclusions: The study emphasizes the need to consider demographic factors, such as age and gender, when assessing the effects of external stressors like a pandemic on sexual health. Further research is essential to fully grasp these complexities and their potential long-term consequences.
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Affiliation(s)
- Helena Perenc
- Students’ Scientific Association, Department and Clinic of Psychiatric Rehabilitation, Faculty of Medical Sciences in Katowice, Medical University of Katowice, ul. Ziołowa 45/47, 40-635 Katowice, Poland; (H.P.); (K.P.); (K.J.); (K.B.); (R.B.)
| | - Karolina Pasieka
- Students’ Scientific Association, Department and Clinic of Psychiatric Rehabilitation, Faculty of Medical Sciences in Katowice, Medical University of Katowice, ul. Ziołowa 45/47, 40-635 Katowice, Poland; (H.P.); (K.P.); (K.J.); (K.B.); (R.B.)
| | - Kamil Juruś
- Students’ Scientific Association, Department and Clinic of Psychiatric Rehabilitation, Faculty of Medical Sciences in Katowice, Medical University of Katowice, ul. Ziołowa 45/47, 40-635 Katowice, Poland; (H.P.); (K.P.); (K.J.); (K.B.); (R.B.)
| | - Karolina Bierć
- Students’ Scientific Association, Department and Clinic of Psychiatric Rehabilitation, Faculty of Medical Sciences in Katowice, Medical University of Katowice, ul. Ziołowa 45/47, 40-635 Katowice, Poland; (H.P.); (K.P.); (K.J.); (K.B.); (R.B.)
| | - Rafał Bieś
- Students’ Scientific Association, Department and Clinic of Psychiatric Rehabilitation, Faculty of Medical Sciences in Katowice, Medical University of Katowice, ul. Ziołowa 45/47, 40-635 Katowice, Poland; (H.P.); (K.P.); (K.J.); (K.B.); (R.B.)
| | - Marek Krzystanek
- Department and Clinic of Psychiatric Rehabilitation, Faculty of Medical Sciences, Medical University of Silesia in Katowice, ul. Ziołowa 45/47, 40-635 Katowice, Poland;
| | - Anna Warchala
- Department and Clinic of Psychiatric Rehabilitation, Faculty of Medical Sciences, Medical University of Silesia in Katowice, ul. Ziołowa 45/47, 40-635 Katowice, Poland;
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Şahin AB, Büyüktopcu E, Tükel R. Evaluation of Sexual Function According to Gender and Sexual Orientation during the COVID-19 Pandemic in Turkey: A National Online Survey Study. TURK PSIKIYATRI DERGISI = TURKISH JOURNAL OF PSYCHIATRY 2024; 35:56-62. [PMID: 38556937 PMCID: PMC11003367 DOI: 10.5080/u26948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 08/22/2022] [Indexed: 04/02/2024]
Abstract
OBJECTIVE Coronavirus Diseases-19 (COVID-19) pandemic that has caused the death of thousands of people affected negatively not only people's physical wellbeing but also their mental health. The aim of this study was to evaluate the sexual function, depression, anxiety and stress, and fear of COVID-19 of individuals according to gender and sexual orientation during the COVID-19 pandemic. METHOD The questionnaire form included sociodemographic data form, the Arizona Sexual Experiences Scale (ASEX), the Depression, Anxiety and Stress Scale-Short Form (DASS-21), and the Fear of COVID-19 Scale (FCV-19S). The form was distributed on social media platforms. RESULTS 1593 sexually active participants were included in the study. 47.5% of the participants were females and 52.5% were males. 86.9% of them were heterosexuals and 13.1% were lesbian, gay, and bisexual (LGB) individuals. ASEX, DASS-21 Depression, Anxiety, and Stress, and FCV-19S scores were significantly higher in females than males (p<0.001). When anxiety, depression, stress, and fear of COVID-19 were controlled, level of sexual dysfunction continued to be higher in women. We found that while the ASEX and FCV-19S scores were similar between the heterosexuals and LGBs (respectively p=0.66 and p=0.31), the DASS-21 Depression, Anxiety, and Stress scores were higher in LGBs (p<0.001). CONCLUSION Our results reveal the effect of the pandemic period on female sexual functions and the importance of addressing this topic in clinical practice and research.
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Affiliation(s)
| | | | - Raşit Tükel
- Prof., İstanbul University, Faculty of Medicine, Department of Psychiatry, İstanbul, Turkey
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Berdychevsky L. (Un)forgotten Sex Lives During the COVID-19 Pandemic: Coping Strategies That Work and the Role of Experience. ARCHIVES OF SEXUAL BEHAVIOR 2023; 52:3343-3363. [PMID: 37407891 DOI: 10.1007/s10508-023-02630-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 05/19/2023] [Accepted: 05/19/2023] [Indexed: 07/07/2023]
Abstract
Available literature points to a worsening trend in sexual functioning, desire, and satisfaction during the pandemic. Nevertheless, virtually no empirical research was conducted on the mechanisms of coping with the pandemic's impacts on sex life. Thus, the purpose of this exploratory study was to examine a variety of coping mechanisms and their perceived usefulness by people who have and have not tried these coping strategies to maintain and enhance their sex lives during the first year of the pandemic. The cross-sectional data were collected using an online survey methodology (N = 420; 66.9% women) and analyzed utilizing exploratory factor analysis, analysis of variance, and multiple regression. The results revealed nine factors/coping mechanisms (based on 59 items/strategies), including goal-setting strategies, risk and experimentation strategies, relational strategies, caution and logistical strategies, creativity and innovation strategies, substances and context-related strategies, online and technology strategies, diversion strategies, and educational strategies. Consistently, across all the specific coping strategies and overall coping mechanisms, people who tried them found them significantly more useful than those who had not tried these coping strategies. Moreover, a higher diversity of tried strategies per coping mechanism consistently and significantly predicted the perceived usefulness of that coping mechanism. These results emphasize the crucial role of experience with coping mechanisms and show that amidst COVID-related adversity and challenges, many people found ways to adapt their sex lives and enjoy silver-lining opportunities. This exploratory study offers promising evidence for potential sexual coping strategies during times of stress that could be informative for clinical practice and education.
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Affiliation(s)
- Liza Berdychevsky
- Department of Recreation, Sport and Tourism, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, 219 Huff Hall, 1206 South Fourth St., Champaign, IL, 61820, USA.
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Keskin F, Nacar G. The predictors of sexual quality of life and relationship happiness during the COVID-19 pandemic: a sample of Turkey. Women Health 2023; 63:684-695. [PMID: 37752714 DOI: 10.1080/03630242.2023.2262606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 09/18/2023] [Indexed: 09/28/2023]
Abstract
The purpose of this study is to examine the predictors of sexual quality of life and relationship happiness during the COVID-19 pandemic in a sample in Turkey. This study utilized a descriptive and relational screening design. It was conducted between June 2021 and November 2021 during the pandemic. The participants included 307 women who were accessed online through social networks. The linear multiple regression analysis results showed a significant relationship between changes in the family income level during the pandemic (β-coefficient -0.120; p = .006), sexual compatibility with the spouse (β-coefficient 0.541; p = .001) and experiencing problems in sexual life (β-coefficient 0.173; p = .001) and sexual quality of life. A significant relationship was found between relationship happiness and quality of the time spent with the spouse during the pandemic (β-coefficient -0.282; p = .001), sexual compatibility with the spouse (β-coefficient -0.327; p = .001) and marriage compatibility (β-coefficient -0.152; p = .019). This study found that women's sexual quality of life and relationship happiness were affected by the COVID-19 pandemic. Therefore, women should be provided with consultancy services through the evaluation of their sexual life and relationship happiness when their health problems are evaluated during the pandemic period.
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Affiliation(s)
- Fatma Keskin
- Faculty of Health Sciences, Department of Nursing, Department of Obstetrics and Gynecology Nursing, Kahramanmaraş Sutcu Imam University, Kahramanmaras, Turkey
| | - Gülçin Nacar
- Faculty of Nursing, Department of Obstetrics and Gynecology Nursing, Inonu University, Malatya, Turkey
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Yekefallah L, Mohammadi SD, Namdar P, Moghadam SM, Yekefallah F, Mafi MH. The Sexual Function, Desire, and Satisfaction of Couples during the Outbreak of COVID-19 in Qazvin. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2023; 28:544-549. [PMID: 37869690 PMCID: PMC10588913 DOI: 10.4103/ijnmr.ijnmr_273_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 06/04/2023] [Accepted: 06/14/2023] [Indexed: 10/24/2023]
Abstract
Background The COVID-19 pandemic has significantly affected the lives of the community. The resulting social constraints and the physical and psychological consequences are also expected to affect sexual health. The present study aims to determine the status of sexual function, desire, and satisfaction of couples during the outbreak of COVID-19. Materials and Methods This is a descriptive online cross-sectional study on 400 married individuals living in Qazvin, Iran, from October 15 to November 12, 2020. The multi-stage random cluster method is used for sampling. The following questionnaires have been used for data collection: Female Sexual Function Index (FSFI), Rosen male sexual function, Larson's sexual satisfaction, and Hurlbert Index of Sexual Desire (HISD). The questionnaires were sent to participants through online messengers. The obtained data were analyzed by SPSS software (v25). Results The findings show that only 19.20% of study participants had sex three or more times a week. Most of the participating women (56.90%) had sexual dysfunction, while most men (64.30%) had proper sexual function. Also, the majority of participants had moderate sexual desire (46%) and high sexual satisfaction. The primary predictors of sexual dysfunction in men and women during the outbreak of COVID-19 were "employment in health centers" (B = -9.34, p = 0.007) and "spouse working in health centers" (B = -6.16, p = 0.007), respectively. Conclusions The psychological burdens of the COVID-19 pandemic and resulting measures, such as prevention protocols, affect couples' sexual relations. Therefore, interventions are necessary to improve the quality and health of the sexual life of couples.
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Affiliation(s)
- Leili Yekefallah
- Associate Professor of Nursing, Social Determinants of Health Research Center, Faculty of Nursing and Midwifery, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Saeide Dost Mohammadi
- MSc of Nursing, Faculty of Nursing and Midwifery, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Peyman Namdar
- Associate Professor of Emergency Medicine, Social Determinants of Health Research Center, School of Medicine, Qazvin University of Medical Science, Qazvin, Iran
| | - Somaye Minaei Moghadam
- Instructor of Nursing, Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Mohamad Hossein Mafi
- Instructor of Nursing, Social Determinants of Health Research Center, Faculty of Nursing and Midwifery, Qazvin University of Medical Sciences, Qazvin, Iran
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Berdychevsky L. Sexual Coping Mechanisms During the COVID-19 Pandemic and Their Determinants of Use, Usefulness, and Effects on Sex Life. SEXUALITY RESEARCH & SOCIAL POLICY : JOURNAL OF NSRC : SR & SP 2023:1-24. [PMID: 37363354 PMCID: PMC10195656 DOI: 10.1007/s13178-023-00811-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/15/2023] [Indexed: 06/28/2023]
Abstract
Introduction The COVID-19 pandemic has taken a toll on many people's sex lives. The ways people cope with these adverse impacts are an urgent area that needs to be recognized by sexual health researchers, practitioners, and policymakers. Thus, this study investigated sexual coping mechanisms during the pandemic while clarifying their determinants of use and usefulness and examining their impacts on the quantity and quality of sex life. Methods The cross-sectional data (N = 675) were collected using an online survey methodology in February-May 2021. The data were analyzed with one-sample and independent-samples t-tests, one-way between-subjects ANOVA, and multivariate multiple regression. Results This study identified eight sexual coping mechanisms during the pandemic, including creativity and pleasure, diversion, goal-setting, relational, educational, caution and logistical, online and technological, and innovation and experimentation strategies. All the coping mechanisms were used and rated significantly useful, albeit to different degrees. Gender, availability of a sex partner, the existence of children, and age served as determinants of different coping mechanisms' scope of use and degree of usefulness. The coping mechanisms predicted the frequency of sexual activity, sexual desire, and satisfaction with sex life during the pandemic. Conclusions This study's results can help scholars and practitioners prevent or mitigate the deterioration of sex life during the pandemics and other crises and stressors. It is essential to train people concerning sexual coping resources and strategies to protect their sexual wellbeing and quality of life. Policy Implications Health researchers, practitioners, and policymakers must consider maintaining sexual health as an essential service. Recognizing sexual health, rights, education, and counseling is a prerequisite for appropriate prevention measures during the pandemic. It is vital to ensure the availability of proper resources supporting people's sexual coping processes during and after the pandemic.
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Affiliation(s)
- Liza Berdychevsky
- Department of Recreation, Sport and Tourism, The Family Resiliency Center, Center for Social and Behavioral Science, Center on Health, Aging, and Disability, Health Care Engineering Systems Center, Discovery Partners Institute, The University of Illinois at Urbana-Champaign, (MC-584), 219 Huff Hall, 1206 South Fourth St., IL 61820 Champaign, USA
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Mamuk R, Çelik SY, Sekizler ET. Evaluation of sexual function and sexual quality of life in women during the COVID-19 Pandemic: the Turkish case. Afr Health Sci 2023; 23:349-361. [PMID: 37545976 PMCID: PMC10398491 DOI: 10.4314/ahs.v23i1.37] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/08/2023] Open
Abstract
BACKGROUND Sexual health is an important component of general health. OBJECTIVE To evaluate sexual function and sexual quality of life (SQOL) in women during the COVID-19 pandemic. METHODS This descriptive, cross-sectional study was conducted in Turkey. Data were collected via a Visual Analog Scale (VAS), Female Sexual Function Index (FSFI), and Sexual Quality of Life-Female (SQOL-F) questionnaire. RESULTS The mean FSFI score was 26.91±5.62, and 39.1% of the women had an FSFI score of 26.55 or lower. The mean SQOL-F score was 79.08±20.90. FSFI score was significantly associated with employment status (β=-0.661), partner education (β=1.698), sexual compatibility between partners (β=0.518), sexual satisfaction (β=0.230), fatigue level (β= -0.120), and frequency of sexual intercourse (β=0.160). In addition, SQOL-F score was significantly associated with sexual desire (β=2.625), satisfaction (β=1.338), pain or discomfort (β=1.274), age (β= -0.356), sexual compatibility between partners (β=1.984), and fatigue level (β=-0.981) (p<0.05). CONCLUSION Less than half of the women participating in this study had sexual dysfunction, and overall SQOL was moderate to high. These results were associated with some descriptive characteristics of the women and were similar to those reported in pre-pandemic studies conducted in Turkey.
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Affiliation(s)
- Rojjin Mamuk
- Nursing Department, Faculty of Health Sciences, Eastern Mediterranean University. Famagusta, North Cyprus
| | - Sultan Yurtsever Çelik
- Wound care unit of Bağcılar Training and Research Hospital of University of Health Sciences, İstanbul, Turkey
| | - Emine Temizkan Sekizler
- Nursing Department, Faculty of Health Sciences, Eastern Mediterranean University. Famagusta, North Cyprus
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Abstract
Purpose: COVID-19, a novel infection, presented with several complications, including socioeconomical and reproductive health challenges such as erectile dysfunction (ED). The present review summarizes the available shreds of evidence on the impact of COVID-19 on ED.Materials and methods: All published peer-reviewed articles from the onset of the COVID-19 outbreak to date, relating to ED, were reviewed. Results: Available pieces of evidence that ED is a consequence of COVID-19 are convincing. COVID-19 and ED share common risk factors such as disruption of vascular integrity, cardiovascular disease (CVD), cytokine storm, diabetes, obesity, and chronic kidney disease (CKD). COVID-19 also induces impaired pulmonary haemodynamics, increased ang II, testicular damage and low serum testosterone, and reduced arginine-dependent NO bioavailability that promotes reactive oxygen species (ROS) generation and endothelial dysfunction, resulting in ED. In addition, COVID-19 triggers psychological/mental stress and suppresses testosterone-dependent dopamine concentration, which contributes to incident ED.Conclusions: In conclusion, COVID-19 exerts a detrimental effect on male reproductive function, including erectile function. This involves a cascade of events from multiple pathways. As the pandemic dwindles, identifying the long-term effects of COVID-19-induced ED, and proffering adequate and effective measures in militating against COVID-19-induced ED remains pertinent.
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Affiliation(s)
- D H Adeyemi
- Department of Physiology, Faculty of Basic Medical Sciences, College of Health Sciences, Osun State University, Nigeria
| | - A F Odetayo
- Department of Physiology, University of Ilorin, Ilorin, Nigeria
- Reproductive Biology and Toxicology Research Laboratory, Oasis of Grace Hospital, Osogbo, Nigeria
| | - M A Hamed
- Reproductive Biology and Toxicology Research Laboratory, Oasis of Grace Hospital, Osogbo, Nigeria
- The Brainwill Laboratories, Osogbo, Nigeria
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Afe Babalola University, Ado-Ekiti, Nigeria
| | - R E Akhigbe
- Reproductive Biology and Toxicology Research Laboratory, Oasis of Grace Hospital, Osogbo, Nigeria
- Department of Physiology, Ladoke Akintola University of Technology, Ogbomoso, Nigeria
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Vedovo F, Capogrosso P, Di Blas L, Cai T, Arcaniolo D, Privitera S, Palumbo F, Palmieri A, Trombetta C. Longitudinal Impact of Social Restrictions on Sexual Health in the Italian Population. J Sex Med 2022; 19:923-932. [PMID: 35513999 PMCID: PMC9060260 DOI: 10.1016/j.jsxm.2022.03.607] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 02/21/2022] [Accepted: 03/17/2022] [Indexed: 10/31/2022]
Abstract
BACKGROUND Several trials have reported on the impact of social restrictions due to SARS-CoV-2 (COVID-19) pandemic on sexual function and psycho-physical well-being. However, data showing modifications of these outcomes over time and at the end of lock-down are scant. AIM We investigated the longitudinal changes in sexual function during social restrictions for COVID-19 pandemic in Italy. METHODS A web-based survey was administered to Italian citizens of legal age via social networks. The Beck Depression Inventory Primary Care, the General Health Survey, Female Sexual Function Index, International Index of Erectile Function, UCLA Loneliness Scale-version 3 questionnaires were used to test mental, physical and sexual well-being. The questionnaires were administered at the beginning of the lockdown (T0), 15 days from the first assessment (T1) and 1 month after the end of the restrictions in 2020 (T2). OUTCOMES Descriptive statistics and multiple regression analysis were applied to investigate changes in sexual function over and at the end of social restrictions. RESULTS Data were available for 2543 people (47.2% of men; 43.4% women; 9.4% undefined). Mean age was 48.3 ± 15.1 years for males and 43.9 ± 13.4 for females. Overall, 2.6% reported depressive symptoms according to Beck Depression Inventory Primary Care, 7.4% reported a high level of UCLA loneliness and 19.4% low levels of general mental health. Mild to severe erectile dysfunction was reported by 59.1% of men at T0, while 68.4% of women reported sexual dysfunction. Sexual function levels remain generally unchanged at further follow-up over the social restriction time period (T1), although those who were sexually active at baseline showed a decrease in sexual function scores. At T2, there was an overall improvement in sexual function scores with a rate of severe erectile dysfunction decreasing from 37.1% to 24.1% from T0 to T2 among males and a significant decrease of female sexual dysfunction from 68.4% to 51.2%. CLINICAL IMPLICATIONS Young individuals and those with good mental and physical health were more likely to improve sexual function at the end of social restrictions. STRENGTHS & LIMITATIONS Valid and reliable questionnaires and longitudinal approach design represent strengths; a large but convenient sample and lack of pre-pandemic baseline data represent limits. CONCLUSION Social restrictions due to COVID-19 pandemic led to an increase in sexual dysfunctions in both genders. However, these conditions appeared temporary since an overall improvement was observed at the end of lockdown and especially in younger individuals with higher psycho-physical well-being. Vedovo F, Capogrosso P, Di Blas L, et al. Longitudinal Impact of Social Restrictions on Sexual Health in the Italian Population. J Sex Med 2022;19:923-932.
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Affiliation(s)
- Francesca Vedovo
- Urology Clinic, Department of Medical, Surgical and Health Science, University of Trieste, Trieste, Italy.
| | - Paolo Capogrosso
- Department of Urology and Andrology, Ospedale di Circolo and Macchi Foundation, Varese, Italy
| | - Lisa Di Blas
- Department of Life Sciences, University of Trieste, Italy
| | - Tommaso Cai
- Department of Urology, Santa Chiara Regional Hospital, Trento, Italy
| | - Davide Arcaniolo
- Unit of Urology, Luigi Vanvitelli University of Campania, Naples, Italy
| | | | | | | | - Carlo Trombetta
- Urology Clinic, Department of Medical, Surgical and Health Science, University of Trieste, Trieste, Italy
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Rodrigues DL, Lehmiller JJ. COVID-19 and Sexual Desire: Perceived Fear Is Associated with Enhanced Relationship Functioning. JOURNAL OF SEX RESEARCH 2022; 59:403-412. [PMID: 34431724 DOI: 10.1080/00224499.2021.1966359] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Lifestyle changes caused by the COVID-19 pandemic had mostly negative consequences for individual, relationship, and sexual functioning. However, some individuals have reported increases in sexual desire and made new additions to their sex lives. Given that stress-provoking situations can sometimes make mortality more salient and heighten sexual desire, it is possible that lifestyle changes and fear of COVID-19 infection may have benefited some relationships. We conducted a cross-sectional study with 303 romantically involved adults (58.1% men) and found that lifestyle changes were associated with negative changes in one's sex life, unrelated to wanting to spend time with one's partner, and positively associated with relationship quality. Lifestyle changes were also positively associated with sexual desire, but only for participants with high (vs. low) fear of COVID-19 infection. For these participants, sexual desire was associated with positive changes in one's sex life and wanting to spend time with one's partner, but not with overall relationship quality. Results were consistent after controlling for pandemic-related anxiety and demographic variables. This study advances literature focused on the importance of romantic relationships in stress-provoking situations such as the COVID-19 pandemic by shedding light on the association between sexual desire and personal and relational well-being.
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Affiliation(s)
- David L Rodrigues
- Department of Social and Organizational Psychology, Iscte-Instituto Universitário De Lisboa, CIS-Iscte
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Peixoto MM, Lopes J. Quality of life and emotional well-being during COVID-19 as mediators in the relationship between sexual functioning and satisfaction in Portuguese women. Women Health 2022; 62:358-368. [DOI: 10.1080/03630242.2022.2074609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Maria Manuela Peixoto
- Ciências da Educação, Universidade Lusíada-NorteCentro de Investigação em Psicologia para o Desenvolvimento Positivo, Instituto de Psicologia e, Porto, Portugal
| | - Julia Lopes
- Ciências da Educação, Universidade Lusíada-NorteInstituto de Psicologia e, Porto, Portugal
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Gönenç IM, Öztürk Özen D, Yılmaz Sezer N. The Relationship Between Fear of COVID-19, Quality of Sexual Life, and Sexual Satisfaction of Women in Turkey. INTERNATIONAL JOURNAL OF SEXUAL HEALTH : OFFICIAL JOURNAL OF THE WORLD ASSOCIATION FOR SEXUAL HEALTH 2022; 34:377-385. [PMID: 38596279 PMCID: PMC10903658 DOI: 10.1080/19317611.2022.2058145] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 02/09/2022] [Accepted: 03/17/2022] [Indexed: 04/11/2024]
Abstract
Objectives: The study investigated the relationship between fear of COVID-19, quality of sexual life, and sexual satisfaction of women in Turkey. Methods: This cross-sectional study was conducted between November 26, 2020, and January 26, 2021. The sample consisted of 811 women. Data were collected using the Fear of COVID-19 Scale, the Sexual Quality of Life-Female Scale, and the Pre-Pandemic Sexual Satisfaction and During Pandemic Sexual Satisfaction scores. Results: There was a negative correlation between the Fear of COVID-19 Scale and the Sexual Quality of Life-Female Scale and the During Pandemic Sexual Satisfaction scores. The Fear of COVID-19 Scale scores accounted for 86% of the total variance in the Sexual Quality of Life scores and 5% of the total variance in the During Pandemic Sexual Satisfaction Scores. Conclusion: Sexual problems due to the fear of COVID-19 adversely affect women's sexual quality of life. Healthcare professionals should address the fear of COVID-19 and related sexual issues during the pandemic.
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Hsieh TC, Edwards NC, Bhattacharyya SK, Nitschelm KD, Burnett AL. The Epidemic of COVID-19-Related Erectile Dysfunction: A Scoping Review and Health Care Perspective. Sex Med Rev 2022; 10:286-310. [PMID: 34732316 PMCID: PMC8450276 DOI: 10.1016/j.sxmr.2021.09.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 09/01/2021] [Accepted: 09/09/2021] [Indexed: 02/07/2023]
Abstract
INTRODUCTION COVID-19 infection is expected to be associated with an increased likelihood of erectile dysfunction (ED). Considering the high transmissibility of COVID-19, ED may be a concerning consequence for a large segment of the population. AIMS To (1) summarize existing published evidence for the impact of COVID-19 on the prevalence, severity, treatment, and management of ED; and (2) identify health-related trends in the emerging literature and identify gaps in the existing research literature and make recommendations for future research needs in the area. METHODS A scoping literature search was conducted on April 27, 2021. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (Preferred Reporting Items for Systematic Reviews and Meta-Analyses-ScR) checklist was followed. The literature search was performed in PubMed using the terms: COVID-19, erectile, sexual, and dysfunction. A total of 693 publications were screened for relevance. Studies were appraised for their level of evidence based on study design and the rigor of methodology. RESULTS The evidence that COVID-19 infection causes or impacts ED is compelling. Four topics emerged regarding the nature of the association between COVID-19 and ED: (1) the biological impact of COVID-19 infection on ED; (2) the mental health impact of COVID-19 on ED; (3) the impact of COVID-19 on the management of ED and access to ED treatment; and (4) health disparities and the impact of COVID-19 on ED. Long-term and well-designed studies are needed to clarify the extent of the impact of COVID-19 on ED. The pandemic exposed several vulnerabilities within worldwide healthcare and social systems. CONCLUSION COVID-19 has a uniquely harmful impact on men's health and erectile function through biological, mental health, and healthcare access mechanisms. As the pandemic wanes, strategies to identify long-term effects and additional health care support may be needed to adequately mitigate the impact of COVID-19 on men's health. Hsieh T-C, Edwards NC, Bhattacharyya SK, et al.The Epidemic of COVID-19-Related Erectile Dysfunction: A Scoping Review and Health Care Perspective. Sex Med Rev 2022;10:286-310.
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Affiliation(s)
| | | | - Samir K Bhattacharyya
- Health Economics and Market Access; Boston Scientific Corporation; Marlborough, MA, USA
| | - Krista D Nitschelm
- Global Health Economics & Market Access, Women's Health & Prosthetic Urology-Men's Health; Boston Scientific Corporation, Urology Pelvic Health Division; Marlborough, MA, USA
| | - Arthur L Burnett
- Department of Urology, James Buchanan Brady Urological Institute; Johns Hopkins University School of Medicine; Baltimore, MD, USA
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14
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Izdebski Z, Słowikowska-Hilczer J, Mazur J. The Effect of the COVID-19 Pandemic on the Assessment of Sexual Life-Repeated Cross-Sectional Surveys among Polish Adults in 2017, 2020 and 2021. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074110. [PMID: 35409792 PMCID: PMC8998642 DOI: 10.3390/ijerph19074110] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 03/27/2022] [Accepted: 03/28/2022] [Indexed: 02/04/2023]
Abstract
The study aims to investigate whether assessment of sexual life remained stable during the COVID-19 pandemic. Two surveys were conducted among Polish adults aged 18–70 years in June 2020 (n = 2042; perspective of last 2–3 months) and in June 2021 (n = 2418; last 12 months). Data from 2017 (n = 1980) were used as a reference point. Four questions allowed for defining five sexual life assessment profiles (k-means cluster analysis). Their characteristics were presented using 12 variables and 16 factors that contributed to difficulties in sexual life. The 2020 survey showed a temporary increase in the importance of sexual life and the frequency of sexual intercourse. However, the percentage of respondents representing the most favorable profile decreased significantly over the consecutive survey periods (47.1%, 34.2%, and 32.3%, respectively). Pandemic-induced fatigue and stress as well as the permanent presence of others at home were reported as two main factors negatively affecting the frequency of sexual intercourse during the pandemic. Respondents who assessed their sexual life as poor were more likely to consider illness, depression, and low self-esteem as factors negatively impacting their sexual life in 2021 than a year earlier. The results confirmed that as the pandemic drew on, the assessment of sexual life changed compared to the time around the first lockdown.
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Affiliation(s)
- Zbigniew Izdebski
- Department of Biomedical Aspects of Development and Sexology, Faculty of Education, Warsaw University, 00-561 Warsaw, Poland
- Department of Humanization in Medicine and Sexology, Collegium Medicum, University of Zielona Gora, 65-729 Zielona Gora, Poland
| | | | - Joanna Mazur
- Department of Humanization in Medicine and Sexology, Collegium Medicum, University of Zielona Gora, 65-729 Zielona Gora, Poland
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15
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Tip of the iceberg: erectile dysfunction and COVID-19. Int J Impot Res 2022; 34:152-157. [PMID: 35152276 PMCID: PMC8853253 DOI: 10.1038/s41443-022-00540-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 01/31/2022] [Accepted: 02/02/2022] [Indexed: 12/11/2022]
Abstract
The novel severe acute respiratory syndrome coronavirus 2 caused the coronavirus 2019 (COVID-19) pandemic that resulted in more than 150 million infections and 3.5 million deaths globally. COVID-19 affected men more than women, emerging with more severe disease and higher mortality rates. Androgens may be responsible for the underlying reason of more severe disease, as androgen receptors have been implicated to mediate viral cell entry and infection. Besides, male reproductive organs have been reported to be affected by the especially severe disease, resulting in erectile dysfunction (ED). In this narrative review, we aimed to gather possible mechanisms of the development of ED led by COVID-19. Current evidence illuminates endothelial dysfunction, direct testicular damage, and the psychological burden of COVID-19 that are of the pathways of ED. Although the proposed underlying mechanisms partly fail to answer the questions by which COVID-19 leads to ED, it is important to monitor men who recovered from COVID-19 regarding the sexual dysfunction sequelae of infection and address the long‐term consequences.
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16
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Masoudi M, Maasoumi R, Bragazzi NL. Effects of the COVID-19 pandemic on sexual functioning and activity: a systematic review and meta-analysis. BMC Public Health 2022; 22:189. [PMID: 35086497 PMCID: PMC8794736 DOI: 10.1186/s12889-021-12390-4] [Citation(s) in RCA: 54] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 12/07/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Since December 2019, when it was first reported in Wuhan, province of Hubei, China, the new virus SARS-CoV-2 has spread rapidly around the world and has become a global pandemic. During the COVID-19 pandemic, due to the public health measures implemented, people's sexual activity has also been affected. Restrictions on people's activities, reduced sports activities, economic issues, increased psychological stress, and reduced entertainment have, indeed, dramatically impacted sexual activity and functioning. The purpose of this study was tosystematically identify, collect and summarize the existing body of evidence from published studies on the effects of COVID-19 pandemic on sexual activity and functioning. METHODS Several scholarly databases, namely MEDLINE (via PubMed interface), Web of Science (WOS), Embase, CINAHL, the Cochrane Library, Scopus, and PsycINFO databases, were mined from December 2019 to the end of January 2021. We utilized a random-effect meta-analytical model to analyze all the data. More in detail, the Standardized Mean Difference (SMD) was used in order to estimate and evaluate the effects of the COVID-19 pandemic on sexual activity and functioning. RESULTS Twenty-one studies were included in the present study. In total, 2454 women and 3765 men were evaluated. In the present meta-analysis, sexual functioning and activity were assessed by means of two standardized and reliable tools, namely the "Female Sexual Function Index" (FSFI) and the "International Index of Erectile Function-5 items" (IIEF-5). A total of 5 studies reported the FSFI score before and after the COVID-19 pandemic in female participants. Based on the random-effect model, the SMD was computed to be - 4.26 [95% confidence interval or CI: - 7.26, - 1.25], being statistically significant. A total of 3 studies reported the IIEF-5 score before and after the COVID-19 pandemic in male participants. Based on the random-effect model, the SMD was computed to be - 0.66 [CI 95%: - 0.99, - 0.33], being statistically significant. In the majority of these studies, participants reported a reduction in the number of sexual relations and an increase in the frequency of solo sex activity, especially masturbation, compared to the time prior to the COVID-19 pandemic. CONCLUSION The results of the present study showed that COVID-19 related restrictions were correlated with higher rates of sexual dysfunction and reduced sexual activity; however, results of the current meta-analytical study show that this change in sexual functioning was greater in women compared to men. Sex is one of the dimensions of every person's life; therefore, researchers should identify the factors that lead to sexual dysfunction due to COVID-19 pandemic in their community. In this regard, sexologists should design and implement effective programs to reduce the heterogeneous causes affecting sexual functioning, given the psychological strain that the COVID-19 pandemic puts on individuals.
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Affiliation(s)
- Mojgan Masoudi
- grid.411705.60000 0001 0166 0922Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Raziyeh Maasoumi
- grid.411705.60000 0001 0166 0922Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran ,grid.411705.60000 0001 0166 0922Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Nicola Luigi Bragazzi
- grid.21100.320000 0004 1936 9430Laboratory for Industrial and Applied Mathematics (LIAM), Department of Mathematics and Statistics, York University, Toronto, ON Canada ,grid.5606.50000 0001 2151 3065Department of Health Sciences (DISSAL), Postgraduate School of Public Health, University of Genoa, Genoa, Italy
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Mourikis I, Kokka I, Koumantarou-Malisiova E, Kontoangelos K, Konstantakopoulos G, Papageorgiou C. Exploring the adult sexual wellbeing and behavior during the COVID-19 pandemic. A systematic review and meta-analysis. Front Psychiatry 2022; 13:949077. [PMID: 36061280 PMCID: PMC9433807 DOI: 10.3389/fpsyt.2022.949077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 07/20/2022] [Indexed: 01/09/2023] Open
Abstract
Implemented social distancing measures may have forestalled the spread of COVID-19, yet they suppressed the natural human need for contact. The aim of this systematic review was to explore the impact of the COVID-19 pandemic on adult sexual wellbeing and sexual behavior. An extensive search in Pubmed, Scopus, and PsycInfo databases based on PRISMA guidelines was conducted. After applying specific eligibility criteria, screening resulted in 38 studies. Results were drawn from 31,911 subjects and outlined the negative effect of the pandemic in sexual frequency, function, satisfaction, and the behavioral changes regarding masturbation and internet-based practices. Meta-analyses of the drawn data on 1,343 female, and 1,372 male subjects quantified the degree of sexual function change during the COVID-19 pandemic vs. prior the pandemic. A random effects model revealed the significant negative impact of the pandemic on female sexual function (SMD: 0.76, 95% CI:0.74 to 1.59), while no significant change was found for the males (SMD: 0.25, 95% Cl: -0.03 to 0.52). Significant heterogeneity was identified across included studies (p < 0.00001, I2 = 97%, I2 = 90% for females and males, respectively). As part of the global health, sexual wellbeing should be on the focus of clinicians and researchers.
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Affiliation(s)
- Iraklis Mourikis
- First Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Outpatient Specialty Clinic for Sexual Health Eginition Hospital, Athens, Greece
| | - Ioulia Kokka
- First Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Outpatient Specialty Clinic for Sexual Health Eginition Hospital, Athens, Greece
| | - Elli Koumantarou-Malisiova
- First Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Outpatient Specialty Clinic for Sexual Health Eginition Hospital, Athens, Greece
| | - Konstantinos Kontoangelos
- First Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, Athens, Greece
| | - George Konstantakopoulos
- First Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, Athens, Greece.,Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
| | - Charalabos Papageorgiou
- First Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Outpatient Specialty Clinic for Sexual Health Eginition Hospital, Athens, Greece.,Neurosciences and Precision Medicine Research Institute "Costas Stefanis" (UMHRI), University Mental Health, Athens, Greece
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18
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Women's Sexual Health During the Pandemic of COVID-19: Declines in Sexual Function and Sexual Pleasure. CURRENT SEXUAL HEALTH REPORTS 2021; 13:76-88. [PMID: 34248426 PMCID: PMC8254666 DOI: 10.1007/s11930-021-00309-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2021] [Indexed: 12/14/2022]
Abstract
Purpose of the Review The World Health Association declared COVID-19 a pandemic more than 1 year ago. We conducted a systematic review of the literature on the topic of women’s sexual health during the pandemic, with a focus on sexual function and sexual pleasure. Our aim is to describe current findings and to discuss implications for women’s sexual health during this period. Recent Findings Thirty-four articles, from 18 countries, were identified. These studies addressed topics ranging from individual aspects, such as cognitive, emotional, and personality factors affecting sexuality during the pandemic, to contextual factors, including relationship, childrearing, and employment status in this period. Summary Research identified a deterioration of women’s sexual function across countries, with an emphasis on sexual desire. Most studies found decreases in the frequency of sexual intercourse during the pandemic and increases in solitary sexual behavior. Many women also experienced declines in sexual satisfaction and relationship satisfaction. Findings suggested that gender inequalities contributed to lower indices of sexual function and satisfaction, and might have exacerbated the pleasure gap between men and women.
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19
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Salama N, Blgozah S. COVID-19 and Male Sexual Functioning: A report of 3 Recovered Cases and Literature Review. CLINICAL MEDICINE INSIGHTS-CASE REPORTS 2021; 14:11795476211020593. [PMID: 34104031 PMCID: PMC8165827 DOI: 10.1177/11795476211020593] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Accepted: 05/05/2021] [Indexed: 01/19/2023]
Abstract
COVID-19 is a new global pandemic. It can affect multiple body systems and functions. However, the relationship between COVID-19 and male sexual activity did not yet get much consideration. Herein, we report the impact of COVID-19 on sexual function in 3 men who recovered from the disease. Compared with their condition before catching the infection, the men showed, in different degrees, a decline in all aspects of sexual function as assessed by the international index of erectile function. They started to develop premature ejaculation or exacerbate an already existing condition according to the premature ejaculation diagnostic tool scoring. Beck’s depression inventory revealed deterioration of the men’s moods up to severe depression. The sex-related hormones (testosterone-total and free, luteinizing hormone, follicle-stimulating hormone, prolactin, and estradiol) of these men were within normal levels. To the best of our knowledge, this is the first case report documenting deleterious changes in mood and several aspects of sexual functioning in males after recovery from the COVID-19 using validated measurement tools. Follow-up and psychological support of the recovered men may help mend their moods and consequently upgrade their sexual functioning.
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Affiliation(s)
- Nader Salama
- Department of Urology, Alexandria Faculty of Medicine, Alexandria, Egypt
| | - Saeed Blgozah
- Department of Urology, Hadramout Faculty of Medicine, Mukalla, Yemen
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20
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Duran MB, Yildirim O, Kizilkan Y, Tosun C, Cirakoglu A, Gultekin MH, Gul U, Altan M, Sah C, Hasirci E, Ceyhan E, Ongun S, Turunc T. Variations in the Number of Patients Presenting With Andrological Problems During the Coronavirus Disease 2019 Pandemic and the Possible Reasons for These Variations: A Multicenter Study. Sex Med 2020; 9:100292. [PMID: 33318798 PMCID: PMC7721349 DOI: 10.1016/j.esxm.2020.100292] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Accepted: 11/19/2020] [Indexed: 12/13/2022] Open
Abstract
Introduction Coronavirus disease 2019 (COVID-19) pandemic caused unprecedented restrictions in outpatient services and surgical practices in urology as in other medical branches as well as in all areas of life. Aim To investigate whether there have been variations in the presentations of male patients with sexual and reproductive health problems to the outpatient urology clinics during the COVID-19 pandemic and to understand the underlying factors for these variations, if any. Methods Male patients aged ≥18 years who presented to the outpatient urology clinics in 12 centers across Turkey from February 1, 2020 to June 1, 2020 were retrospectively evaluated. The patients were divided into 2 groups: those who presented to the outpatient clinic from February 1, 2020 to March 11, 2020 comprised the “pre–COVID-19 pandemic period” group, whereas those who presented to the outpatient clinic from March 12, 2020 to June 1, 2020 comprised the “COVID-19 pandemic period” group and compared with each other. Main Outcome Measures The main outcome of this study was the number and diagnose of patients presented to urology outpatient clinics. Results Andrological problems were detected in 721 of 4,955 male patients included in the study. During the COVID-19 pandemic period, there was a significant increase in andrological diagnosis in these patients compared with the pre–COVID-19 pandemic period (n = 293 [17%] vs n = 428 [13.2%], P < .001, respectively). Similarly, there was a statistically significant increase in the number of patients diagnosed with male reproductive or sexual health problems during the COVID-19 pandemic period (n = 107 [6.2%] vs n = 149 [4.6%], P = .016 and n = 186 [10.8%] vs n = 279 [8.6%], P = .013, respectively). The number of patients diagnosed with erectile dysfunction during the pandemic was also significantly higher than the pre–COVID-19 pandemic period (n = 150 [8.7%] vs n = 214 [6.6%], P = .008). Conclusion Presentations to the outpatient urology clinics owing to andrological problems markedly increased during the pandemic period. Although these problems are of multifactorial origin, psychogenic factors are also considered to significantly trigger these problems. Duran MB, Yildirim O, Kizilkan Y, et al. Variations in the Number of Patients Presenting With Andrological Problems During the Coronavirus Disease 2019 Pandemic and the Possible Reasons for These Variations: A Multicenter Study. Sex Med 2021;9:100292.
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Affiliation(s)
- Mesut Berkan Duran
- Samsun Training and Research Hospital, Department of Urology, Samsun, Turkey.
| | - Omer Yildirim
- Istanbul University Cerrahpaşa School of Medicine, Department of Urology, Istanbul, Turkey
| | | | - Cagatay Tosun
- Haydarpasa Numune Training and Research Hospital, Department of Urology, Istanbul, Turkey
| | - Abdullah Cirakoglu
- Ordu University Faculty of Medicine, Department of Urology, Ordu, Turkey
| | | | - Umit Gul
- Başkent University Faculty of Medicine, Department of Urology, Adana, Turkey
| | - Mesut Altan
- Hacettepe University Faculty of Medicine, Department of Urology, Ankara, Turkey
| | - Cem Sah
- Medline Hospital, Clinic of Urology, Adana, Turkey
| | - Eray Hasirci
- Başkent University Faculty of Medicine, Department of Urology, Ankara, Turkey
| | - Erman Ceyhan
- Başkent University Faculty of Medicine, Department of Urology, Konya, Turkey
| | - Sakir Ongun
- Balıkesir University School of Medicine, Department of Urology, Balıkesir, Turkey
| | - Tahsin Turunc
- Iskenderun Gelişim Hospital, Clinic of Urology, Iskenderun, Turkey
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