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Su Q, Tang Q, Ma C, Wang K. Advances in the study of the relationship between gut microbiota and erectile dysfunction. Sex Med Rev 2024:qeae049. [PMID: 38984896 DOI: 10.1093/sxmrev/qeae049] [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: 04/17/2024] [Revised: 06/15/2024] [Accepted: 06/27/2024] [Indexed: 07/11/2024]
Abstract
INTRODUCTION In recent years, in-depth research has revealed that gut microbiota has an inseparable relationship with erectile dysfunction (ED) in men. OBJECTIVES (1) To review the correlation between gut microbiota and ED from the perspective of its impact on men's mental health, metabolism, immunity, and endocrine regulation and (2) to provide reference to further explore the pathogenesis of ED and the improvement of clinical treatment plans. METHODS PubMed was used for the literature search to identify publications related to ED and gut microbiota. RESULTS Gut microbiota may induce depression and anxiety through the microbiota-gut-brain axis, leading to the occurrence of psychological ED. It may also cause vascular endothelial dysfunction and androgen metabolism disorder by interfering with lipid metabolism, immunity, and endocrine regulation, leading to the occurrence of organic ED. CONCLUSION Gut microbiota and its metabolites play an important role in the occurrence and development of ED. As a new influencing factor of ED, gut microbiota disorder is expected to become a target for treatment.
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Affiliation(s)
- Quanxin Su
- Department of Urology, The First Affiliated Hospital of Dalian Medical University, Dalian 116000, China
| | - Qizhen Tang
- Department of Urology, The First Affiliated Hospital of Dalian Medical University, Dalian 116000, China
| | - Chuanyu Ma
- Department of Urology, The First Affiliated Hospital of Dalian Medical University, Dalian 116000, China
| | - Kenan Wang
- Department of Urology, The First Affiliated Hospital of Dalian Medical University, Dalian 116000, China
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2
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Scutari M, Kerob D, Salah S. Inferring skin-brain-skin connections from infodemiology data using dynamic Bayesian networks. Sci Rep 2024; 14:10266. [PMID: 38704447 PMCID: PMC11069591 DOI: 10.1038/s41598-024-60937-3] [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: 11/20/2023] [Accepted: 04/29/2024] [Indexed: 05/06/2024] Open
Abstract
The relationship between skin diseases and mental illnesses has been extensively studied using cross-sectional epidemiological data. Typically, such data can only measure association (rather than causation) and include only a subset of the diseases we may be interested in. In this paper, we complement the evidence from such analyses by learning an overarching causal network model over twelve health conditions from the Google Search Trends Symptoms public data set. We learned the causal network model using a dynamic Bayesian network, which can represent both cyclic and acyclic causal relationships, is easy to interpret and accounts for the spatio-temporal trends in the data in a probabilistically rigorous way. The causal network confirms a large number of cyclic relationships between the selected health conditions and the interplay between skin and mental diseases. For acne, we observe a cyclic relationship with anxiety and attention deficit hyperactivity disorder (ADHD) and an indirect relationship with depression through sleep disorders. For dermatitis, we observe directed links to anxiety, depression and sleep disorders and a cyclic relationship with ADHD. We also observe a link between dermatitis and ADHD and a cyclic relationship between acne and ADHD. Furthermore, the network includes several direct connections between sleep disorders and other health conditions, highlighting the impact of the former on the overall health and well-being of the patient. The average R 2 for a condition given the values of all conditions in the previous week is 0.67: in particular, 0.42 for acne, 0.85 for asthma, 0.58 for ADHD, 0.87 for burn, 0.76 for erectile dysfunction, 0.88 for scars, 0.57 for alcohol disorders, 0.57 for anxiety, 0.53 for depression, 0.74 for dermatitis, 0.60 for sleep disorders and 0.66 for obesity. Mapping disease interplay, indirect relationships, and the key role of mediators, such as sleep disorders, will allow healthcare professionals to address disease management holistically and more effectively. Even if we consider all skin and mental diseases jointly, each disease subnetwork is unique, allowing for more targeted interventions.
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Affiliation(s)
- Marco Scutari
- Istituto Dalle Molle di Studi sull'Intelligenza Artificiale (IDSIA), Lugano, Switzerland.
| | - Delphine Kerob
- La Roche-Posay Dermatological Laboratories, Levallois-Perret, France
- Department of Dermatology, AP-HP Saint-Louis Hospital, Paris, France
| | - Samir Salah
- La Roche-Posay Dermatological Laboratories, Levallois-Perret, France
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Wu X, Zhang Y, Liu G, Jiang H, Zhang X. Association between severe headache or migraine and erectile dysfunction in American adults: a cross-sectional of data study from the NHANES. Int J Impot Res 2024:10.1038/s41443-024-00867-w. [PMID: 38609543 DOI: 10.1038/s41443-024-00867-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 02/18/2024] [Accepted: 02/23/2024] [Indexed: 04/14/2024]
Abstract
Currently, few studies have explored the relationship between severe headache or migraine and erectile dysfunction (ED). The aim of our study was to assess the association between severe headache or migraine and ED in adult men in the US from the National Health and Nutrition Examination Survey (NHANES). We used data from two separate NHANES datasets for the analysis: 2001-2002 and 2003-2004. We used multiple logistic regression, subgroup analysis, and sensitivity analyses to assess the relationship between severe headache or migraine and ED. From 2001 to 2004, 3117 adult male participants (582 ED patients, 2535 non-ED patients) were identified. Categorical and continuous variables are described using counts and frequencies and means and standard errors, respectively. For continuous variables, the two groups were compared using survey-weighted linear regression, while for categorical variables, survey-weighted chi-square tests were performed. Multiple logistic regression analysis showed that in the fully adjusted Model 3, severe headache or migraine was statistically significantly associated with ED (OR 1.51; 95% CI 1.14-1.99; P = 0.0036). In the fully adjusted Model 3, the results of the subgroup analysis showed that an age of 40-60 years (OR = 1.55, 95% CI: 1.05, 2.31, P = 0.029), a body mass index (BMI) < 25 kg/m2 (OR = 1.68, 95% CI: 1.02, 2.75, P = 0.0406) or ≥30 kg/m2 (OR = 1.65, 95% CI: 1.07, 2.54, P = 0.022), hypertension (OR = 1.78, 95% CI: 1.22, 2.60, P = 0.0029), diabetes mellitus (OR = 1.71, 95% CI: 1.26, 2.31, P < 0.001), CVD (OR = 1.54, 95% CI: 1.12, 2.10, P = 0.011) and hyperlipidemia (OR = 1.83, 95% CI: 1.07, 3.13, P = 0.028) were associated with ED with severe headache or migraine. This study demonstrated a statistically significant association between severe headache or migraine and ED among adult men in the US. However, the results of the study should be interpreted with caution due to the failure to assess the effects of depression and anxiety on the outcomes.
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Affiliation(s)
- Xu Wu
- Department of Urology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
- Institute of Urology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
- Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, Anhui, China
| | - Yuyang Zhang
- Department of Urology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
- Institute of Urology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
- Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, Anhui, China
| | - Guodong Liu
- Department of Urology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
- Institute of Urology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
- Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, Anhui, China
| | - Hui Jiang
- Department of Urology, Peking University First Hospital Institute of Urology, Peking University Andrology Center, Beijing, China.
| | - Xiansheng Zhang
- Department of Urology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.
- Institute of Urology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.
- Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei, Anhui, China.
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Stamatiou K, Magri V, Trinchieri M, Trinchieri A, Perletti G. Psychological and sexological assessment of patients with chronic prostatitis. Arch Ital Urol Androl 2024; 96:12452. [PMID: 38572720 DOI: 10.4081/aiua.2024.12452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Accepted: 03/07/2024] [Indexed: 04/05/2024] Open
Abstract
PURPOSE Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is characterized by a multiform clinical presentation requiring a differentiated treatment based on different phenotypes including the psychosocial and sexual domains. The aim of this study was assessing the complex correlations between somatic, psychological, and sexual symptoms of CP/CPPS patients. MATERIALS AND METHODS We performed a cross-sectional study on patients attending a Prostatitis Clinic. Patients were administered the following questionnaires: National Institutes of Health- Chronic Prostatitis Symptom Index (NIH-CPSI), International Prostate Symptom Score (IPSS), International Index of Erectile Function (IIEF), Premature Ejaculation Diagnostic Tool (PEDT), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder 7-item (GAD-7), Oxford Happiness Questionnaire (OHQ), and Temperament Evaluation of Memphis, Pisa, Paris and San Diego Autoquestionnaire (TEMPS-A). RESULTS Linear regression analyses show highly significant correlations between scores of the NIH-CPSI and the scores of the GAD-7, PHQ-9 and OHQ psychometric questionnaires. IPSS scores correlate significantly with the psychometric scores only when a non-parametric analysis is performed. IIEF and PEDT sexual function scores did not correlate with any of the psychometric tests. NIH-CPSI scores correlate positively with most of the TEMPS-A profiles but the hyperthymic profile correlated negatively with the total and QoL NIH-CPSI and with PEDT scores. CONCLUSIONS Scores measuring anxiety, depression, and psychological well-being in patients with CP/CPPS are strictly correlated with prostatitis-like symptoms although they are poorly correlated with symptoms of prostatism, as measured by IPSS, and not correlated with scores of sexual dysfunctions, as measured by IIEF and PEDT. A hyperthymic temperament may increase resilience against the disease.
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Affiliation(s)
| | | | | | | | - Gianpaolo Perletti
- Department of Biotechnology and Life Sciences, Section of Medical and Surgical Sciences, University of Insubria, Varese.
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Quang N, Van Truong L, Chung E, Van Quang B, Long LQ, Ngoc NT, Minh NT, Anh DM, Thanh ND, Nam NT. Predicting Anxiety and Depression Among Erectile Dysfunction Patients: A Cross-Sectional Study. Am J Mens Health 2024; 18:15579883231223502. [PMID: 38288597 PMCID: PMC10826397 DOI: 10.1177/15579883231223502] [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: 10/25/2023] [Revised: 12/07/2023] [Accepted: 12/11/2023] [Indexed: 02/01/2024] Open
Abstract
In Vietnam, erectile dysfunction (ED) is prevalent and recognized to be associated with mental disorders; however, societal taboos impede a comprehensive understanding of this connection. Our study aims to investigate the factors related to higher levels of anxiety and/or depression (HAD) in individuals with ED. Between November 2022 and March 2023, a face-to-face survey was conducted at the Center for Andrology of Viet Duc University Hospital, involving 390 patients diagnosed with ED. The survey included 51 questions covering general patient information, the International Index of Erectile Function-15 (IIEF-15), the Patient Health Questionnaire-9 (PHQ-9), and the Generalized Anxiety Disorder-7 (GAD-7). The stepwise Akaike Information Criterion (AIC) method was used to identify factors associated with HAD. The study revealed an average age of 37.63 (11.84) years among participants, with a HAD prevalence of 17.69%. Several factors were associated with a higher likelihood of belonging to the HAD group in ED patients. These factors included non-office workers (OR: 1.11; 95% CI: [1.01, 1.21], p = .025), medium and high levels of work-related stress (OR: 1.23; [1.06, 1.44], p = .008; OR: 1.22; [1.04, 1.45], p = .018), multiple shameful experiences related to ED (OR: 1.16; [1.08, 1.25], p < .001), moderate and severe ED (OR: 1.17; [1.03, 1.32], p = .013; OR: 1.31; [1.14, 1.51], p < .001), and dissatisfaction with intercourse skills (OR: 1.09; [1.01, 1.17], p = .028). Our findings suggest a 16% higher likelihood of HAD status in individuals with multiple shameful experiences related to ED, while moderate and severe ED are associated with respective increases of 17% and 31% in the likelihood. These findings emphasize the importance of considering mental health in the care of individuals with ED.
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Affiliation(s)
- Nguyen Quang
- Center for Andrology, Viet Duc University Hospital, Hanoi, Vietnam
- University of Medicine and Pharmacy, Vietnam National University, Hanoi, Vietnam
| | - Le Van Truong
- Traditional Medicine Hospital, Ministry of Public Security, Hanoi, Vietnam
| | - Eric Chung
- Department of Urology, University of Queensland, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Bui Van Quang
- Center for Andrology, Viet Duc University Hospital, Hanoi, Vietnam
- University of Medicine and Pharmacy, Vietnam National University, Hanoi, Vietnam
| | - Luu Quang Long
- Center for Andrology, Viet Duc University Hospital, Hanoi, Vietnam
| | | | | | - Do Mai Anh
- Vietnam University of Traditional Medicine, Hanoi, Vietnam
| | | | - Nguyen Truong Nam
- Faculty of Traditional Medicine at Phenikaa University, Hanoi, Vietnam
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Merrill RM, Song D, Ashton MK. Comparing the Strength of Associations Between Male Genital Problems and Mental Illnesses and Sleep Disorders. Am J Mens Health 2024; 18:15579883241228243. [PMID: 38279822 PMCID: PMC10822091 DOI: 10.1177/15579883241228243] [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: 11/08/2023] [Revised: 01/05/2024] [Accepted: 01/08/2024] [Indexed: 01/29/2024] Open
Abstract
This study compares the rate of selected types of mental illnesses (stress, anxiety, depression) and sleep disorders (insomnia, sleep apnea) according to the status of eight male genital problems. Analyses utilize medical claims data for male employees aged 18 to 64 years of a large corporation, 2017 to 2021. Approximately 1,076 (7.3%) men per year have one or more genital problems. The most common being benign prostatic hyperplasia (BPH; 3.8%) and then erectile dysfunction (ED; 1.7%). For BPH patients, the rate experiencing stress, anxiety, depression, or a combination of these is 0.96%, 6.2%, 5.3%, and 5.1%, respectively. Corresponding rates for ED are 1.5%, 7.2%, 5.9%, and 7.5%. For BPH patients, the rate experiencing insomnia, sleep apnea, or both is 3.1%, 22.7%, and 2.0%, respectively. Corresponding rates for ED are 1.2%, 20.6%, and 2.2%. Male genital problems positively associate with having one or more mental illnesses (stress, anxiety, depression), except for hydrocele, with ED and penis disorder having the strongest associations. Male genital problems also positively associate with having insomnia and/or sleep apnea, except for infertility and orchitis, with BPH and ED having the strongest associations. The positive associations involving BPH and ED with mental illnesses are each more pronounced in the younger age group (18-49 vs. 50-64). Similar results are seen in the models involving sleep disorders. Thus, comorbid male genital problems, mental illnesses, and sleep disorders exist, with the strength of associations unique to the male genital problem and sometimes modified by age.
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Affiliation(s)
- Ray M. Merrill
- Department of Public Health, College of Life Sciences, Brigham Young University, Provo, UT, USA
| | - Dajeong Song
- Department of Public Health, College of Life Sciences, Brigham Young University, Provo, UT, USA
| | - McKay K. Ashton
- Department of Public Health, College of Life Sciences, Brigham Young University, Provo, UT, USA
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7
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Chiang TY, Lee HY, Chien WC, Su HC, Su YC, Lin CW. The Relationship between Allergic Disease and Sexual Dysfunction: A Scoping Review. Int Arch Allergy Immunol 2023; 185:20-32. [PMID: 37729893 DOI: 10.1159/000533403] [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: 06/17/2023] [Accepted: 07/31/2023] [Indexed: 09/22/2023] Open
Abstract
INTRODUCTION Sexual dysfunction (SD) and allergic disease are common health concerns worldwide and bear a potential relationship. This scoping review is conducted to analyze the currently available data regarding the associations between these two health issues. METHODS A comprehensive literature search was performed in the databases of PubMed, MEDLINE, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Science to retrieve studies that were published before January 2023. A narrative synthesis was conducted to analyze the effects of allergic diseases on SD based on the evaluation of the Female Sexual Function Index (FSFI) and International Index of Erectile Function (IIEF). RESULTS Twelve observational studies were included after the selection process. The results generally suggested lower FSFI or IIEF scores in patients with asthma, allergic rhinitis, allergic rhinoconjunctivitis, and urticaria compared to the healthy control groups. The underlying factors of this relationship could be inflammation, psychological factors, hormonal changes, sleep disorders, sexual behavior-related allergic reactions, social economic status, and the use of medications. CONCLUSION SD and allergic disease are interrelated based on the extant literature. This scoping review provides insights into the clinical implications of both entities, while more research studies are warranted to further elucidate this complex relationship.
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Affiliation(s)
- Ting-Yi Chiang
- Division of Urology, Department of Surgery, Chi Mei Medical Center, Tainan, Taiwan,
- Department of Education, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan,
| | - Hsiang-Ying Lee
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Department of Urology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Wei-Chen Chien
- Department of Medical Education, National Taiwan University Hospital, Taipei, Taiwan
| | - Hsiao-Chun Su
- School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yung-Chun Su
- Department of General Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chung-Wei Lin
- Department of Education, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
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Ergun O, Gudeloglu A. A commentary on: "Erectile dysfunction in patients with anxiety disorders: a systematic review". Int J Impot Res 2023:10.1038/s41443-023-00756-8. [PMID: 37626202 DOI: 10.1038/s41443-023-00756-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 08/15/2023] [Accepted: 08/16/2023] [Indexed: 08/27/2023]
Affiliation(s)
- Onuralp Ergun
- Department of Urology, University of Minnesota, Minneapolis, MN, USA.
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9
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Pecore R, McClung E, Stragapede E, Huber J, Corsini-Munt S. Self-Determined Sexual Motivation in Persons with Endometriosis and Their Partners: Dyadic Associations of Autonomous and Controlled Sexual Motivations with Sexual and Relational Well-Being and Pain. JOURNAL OF SEX RESEARCH 2023:1-12. [PMID: 37343014 DOI: 10.1080/00224499.2023.2223197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/23/2023]
Abstract
Endometriosis is a chronic pain condition characterized by the growth of endometrial-like tissue outside of the uterus. Affected individuals and their partners report consequences to sexual functioning, sexual satisfaction, and relationship quality. Previous studies in clinical and non-clinical samples have found that sexual motivation can support or detract from sexual functioning; however, similar investigations are lacking among couples with endometriosis. Informed by self-determination theory, associations between autonomous and controlled sexual motivations with sexual functioning, sexual satisfaction, and relationship satisfaction for persons with endometriosis and their partners, and pain in persons with endometriosis were investigated. Couples (n = 54) completed measures of sexual motivation, sexual functioning, sexual satisfaction, relationship satisfaction, and pain. When persons with endometriosis reported greater autonomous sexual motivation, they were more sexually and relationally satisfied. When persons with endometriosis reported higher controlled sexual motivation, their pain was more unpleasant, and they and their partners were less sexually satisfied. Finally, when partners reported greater controlled sexual motivation, both members of the couple reported significantly lower sexual functioning. While controlled sexual motivation may hinder sexual and relational well-being in couples with endometriosis, autonomous sexual motivation may support them. The findings may inform interventions to promote sexual and relational health in couples with endometriosis.
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Razzak AN, Orlando NA, Angelette A, Kumar V, Anderson DJ, Hasoon J, Viswanath O, Kaye AD, Fitz-Gerald JS, Khater N, Urits I. Rare Mental Health Disorders Affecting Urologic Care: A Comprehensive Review. Health Psychol Res 2022; 10:38674. [PMID: 36628123 PMCID: PMC9820860 DOI: 10.52965/001c.38674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Management of mental health illnesses and needs are important in fostering psychosocial support, interprofessional coordination, and greater adherence to treatment protocols in the field of urology. This can be especially true for mental health conditions that may greatly impact the presentation of a patient in the healthcare setting with urologic symptoms. This review describes the history, epidemiology, pathophysiology, clinical presentation, and treatment of somatic symptom disorder, illness anxiety disorder, compulsive sexual behavior/hypersexuality, factitious disorder, malingering symptoms, and conversion disorder in the realm of urology. Given the newly updated psychiatric diagnoses in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition, there has been a lack of studies reviewing how these illnesses may present in a urology patient encounter. Additionally, as these mental health illnesses may carry a rare incidence compared to other well-known mental health illness such as generalized depression or generalized anxiety disorder, we have found that the lack of provisions and recognition of the diseases can prolong the timeline for diagnosis and lead to an increased cost in both healthcare and quality of life of patients with these mental health illnesses. This review provides awareness on these mental health conditions which may greatly impact patient history and presentation within the field of urology. Additionally, urologic care providers may have an improved understanding of interdisciplinary management of such illnesses and the common symptoms patients may present with such diseases.
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Affiliation(s)
| | | | | | - Vinay Kumar
- Department of PathologyUniversity of California Irvine
| | | | - Jamal Hasoon
- Department of Anesthesia, Critical Care, and Pain MedicineBeth Israel Deaconess Medical Center, Harvard Medical School
| | - Omar Viswanath
- Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School; Valley Anesthesiology and Pain Consultants, Envision Physician Services; Department of Anesthesiology, University of Arizona College of Medicine; Department of Anesthesiology, Creighton University School of Medicine
| | - Alan D. Kaye
- Department of AnesthesiologyLouisiana State University Health
| | | | - Nazih Khater
- Department of UrologyLouisiana State University Health
| | - Ivan Urits
- Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School; Department of Anesthesiology, Louisiana State University Health Shreveport
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Prause N, Binnie J. Reboot/NoFap Participants Erectile Concerns Predicted by Anxiety and Not Mediated/Moderated by Pornography Viewing. JOURNAL OF PSYCHOSEXUAL HEALTH 2022. [DOI: 10.1177/26318318221116354] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023] Open
Abstract
“Reboot” coaches claiming to treat pornography addiction increasingly claim to treat erectile dysfunction (ED). They view ED as due to pornography viewing. However, anxiety has long been the best predictor of ED. We hypothesized that those involved in Reboot treatments would report erectile difficulties predicted by anxiety symptoms and not pornography viewing. Six-hundred and sixty-nine participants familiar with Reboot treatments completed a series of online questionnaires. Among those who participated in Reboot treatments, anxiety symptoms predicted ED. Pornography viewing frequency did not mediate or moderate this relationship. Licensed providers should work to dispel this apparent health disinformation by life “Reboot” coaches.
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Affiliation(s)
- Nicole Prause
- Department of Medicine, University of California, Los Angeles, California, USA
| | - James Binnie
- Department of Psychology, London South Bank University, London, UK
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12
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Tadalafil-Loaded Self-Nanoemulsifying Chewable Tablets for Improved Bioavailability: Design, In Vitro, and In Vivo Testing. Pharmaceutics 2022; 14:pharmaceutics14091927. [PMID: 36145675 PMCID: PMC9504296 DOI: 10.3390/pharmaceutics14091927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 09/08/2022] [Accepted: 09/08/2022] [Indexed: 11/17/2022] Open
Abstract
This research aimed to develop innovative self-nanoemulsifying chewable tablets (SNECT) to increase oral bioavailability of tadalafil (TDL), a nearly insoluble phosphodiesterase-5 inhibitor. Cinnamon essential oil, PEG 40 hydrogenated castor oil (Cremophor® RH 40), and polyethylene glycol 400 served as the oil, surfactant, and cosurfactant in the nanoemulsifying system, respectively. Primary liquid self-nanoemulsifying delivery systems (L-SNEDDS) were designed using phase diagrams and tested for dispersibility, droplet size, self-emulsifying capability, and thermodynamic stability. Adsorption on a carrier mix of silicon dioxide and microcrystalline cellulose was exploited to solidify the optimum L-SNEDDS formulation as self-nanoemulsifying granules (SNEG). Lack of crystalline TDL within the granules was verified by DSC and XRPD. SNEG were able to create a nanoemulsion instantaneously (165 nm), a little larger than the original nanoemulsion (159 nm). SNECT were fabricated by compressing SNEG with appropriate excipients. The obtained SNECT retained their quick dispersibility dissolving 84% of TDL within 30 min compared to only 18% dissolution from tablets of unprocessed TDL. A pharmacokinetic study in Sprague−Dawley rats showed a significant increase in Cmax (2.3-fold) and AUC0−24 h (5.33-fold) of SNECT relative to the unprocessed TDL-tablet (p < 0.05). The stability of TDL-SNECT was checked against dilutions with simulated GI fluids. In addition, accelerated stability tests were performed for three months at 40 ± 2 °C and 75% relative humidity. Results revealed the absence of obvious changes in size, PDI, or other tablet parameters before and after testing. In conclusion, current findings illustrated effectiveness of SNECT to enhance TDL dissolution and bioavailability in addition to facilitating dose administration.
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13
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He W, Yang Y, Liang H, Huang Z, Jiang J. Migraine Is Associated With High Risk of Erectile Dysfunction: A Systematic Review and Cumulative Analysis. J Sex Med 2022; 19:430-440. [PMID: 35082102 DOI: 10.1016/j.jsxm.2021.12.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 12/23/2021] [Accepted: 12/26/2021] [Indexed: 12/07/2022]
Abstract
BACKGROUND Migraine, a common chronic primary headache, has been found to be associated with a high risk of erectile dysfunction (ED). AIM The present study aims to summarize all the evidence related to this topic and demonstrate a quantified result on the association between migraine and ED, which has not been reported in the literature. METHODS MEDLINE, Excerpta Medica Database, and Cochrane Library were systematically searched for identifying the eligible studies (2000-2021). This study was registered in the PROSPERO (ID: CRD42021248013). OUTCOMES The combined effects were synthesized with the relative risks (RR) or standard mean differences (SMD) with 95% confidence intervals (CI). RESULTS 6 trials with a total of 51,657 participants were included, of which 6,175 were men with migraine. The pooled analysis indicated that migraine was associated with a significantly higher risk of ED as compared to the non-migraine general population (RR = 1.63, 95%CI: 1.34 to 2.0, P < .001). Consistently, men with migraine have a significantly lower IIEF-5 score than healthy controls (SMD = -3.64, 95%CI: -6.4 to -0.89, P = .01). Stratification analysis on the mean age indicated that the association between migraine and ED was much stronger in the migraine patients with age < 40 years (RR = 32.29, 95% CI: 6.41-162.64, P < .001; I2 = 0.0 %, P = .837) than in those with age > 40 years (RR = 1.75, 95% CI: 1.11-2.78, P = .017; I2 = 89.2%, P = .002). Sensitivity analysis indicated that no single study had dominated the combined RR and the heterogeneity. CLINICAL IMPLICATIONS ED is a common disease among migraine men, especially those patients whose age is under 40 years old. It shows a 32-fold increased risk of ED compared to the healthy controls. Migraine-induced ED may be correlated with multiple factors, that is, chronic illnesses, chronic pain, and psychosocial causes (like anxiety and depression). Since phosphodiesterase-5 inhibitors (ie, sildenafil) might induce or exacerbate migraine, thus it is not recommended to prescribe these drugs for patients with migraine-mediated ED. CONCLUSION The present study provides evidence that migraine is associated with a significantly high risk of ED, especially in those aged < 40 years. The pathophysiological mechanisms of this action deserve further study. He W, Yang Y, Liang H, et al. Migraine Is Associated With High Risk of Erectile Dysfunction: A Systematic Review and Cumulative Analysis. J Sex Med 2022;19:430-440.
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Affiliation(s)
- Weicheng He
- Department of Urology, Shawan People's Hospital, Panyu District, Guangzhou, Guangdong, China
| | - Yi Yang
- Department of Urology, Hexian Memorial Hospital of Panyu District, Guangzhou, China
| | - Hongyi Liang
- Department of Urology, Hexian Memorial Hospital of Panyu District, Guangzhou, China
| | - Zhonghua Huang
- Department of Urology, Hexian Memorial Hospital of Panyu District, Guangzhou, China
| | - Jiehong Jiang
- Department of Urology, Hexian Memorial Hospital of Panyu District, Guangzhou, China.
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Manalo TA, Biermann HD, Patil DH, Mehta A. The Temporal Association of Depression and Anxiety in Young Men With Erectile Dysfunction. J Sex Med 2022; 19:201-206. [PMID: 34969613 DOI: 10.1016/j.jsxm.2021.11.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Revised: 11/17/2021] [Accepted: 11/22/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Erectile dysfunction (ED) is a multidimensional sexual disorder that is being increasingly diagnosed in younger men. Although mental illnesses such as depression and anxiety are known risk factors for ED, the association between these conditions and ED has been understudied in young men. AIM To explore the temporal association between depression, anxiety, and ED in a population-based cohort of young men. METHODS Using 2009-2018 MarketScan Commercial Claims data, we identified all men with ED aged 18-40 years (cases). Using ICD-9/-10 codes and prescription data, we evaluated the prevalence and incidence of depression and anxiety in this cohort. Cases were matched with men without a diagnosis of ED (controls) based on age, Charlson Comorbidity Index, history of hypertension, geographic region, and year of presentation. We examined the prevalence of depression and anxiety within 12 months prior to ED diagnosis and incidence of depression and anxiety up to 36 months after ED diagnosis in cases vs controls. Differences between cases and controls were tested with Wilcoxon rank-sum test for numerical covariates, and chi-square test for categorical covariates. Significance was set at P < .05. OUTCOMES Prevalence and incidence of depression and anxiety in young men with and without ED. RESULTS Within the 12-month period preceding ED diagnosis, the prevalence of depression and anxiety in cases vs controls were 17.1% vs 12.9%, respectively (P < .001). The incidence of depression and anxiety were higher amongst cases vs controls at 12- (11.7% vs 6.3%), 24- (14.5% vs 9.0%,) and 36- (15.9% vs 10.6%) months following ED diagnosis (P < .001). CLINICAL IMPLICATIONS High incidence and prevalence of depression and anxiety in young men diagnosed with ED highlight the importance of normalizing mental health screenings and routine psychiatric follow-up in this population. STRENGTHS & LIMITATIONS Our contemporary, case-control study utilizes a population-based cohort of young men with ED to study the temporal association between depression, anxiety, and ED, which is understudied to date. The MarketScan commercial claims database used in this analysis includes men covered by private insurers only and lacks data on symptoms and treatments. CONCLUSION Young men with ED had significantly higher rates of depression and anxiety both before and after ED diagnosis in comparison to young men without ED. Manalo TA, Biermann HD, Patil DH, et al. The Temporal Association of Depression and Anxiety in Young Men With Erectile Dysfunction. J Sex Med 2022;19:201-206.
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Affiliation(s)
- Tad A Manalo
- Department of Urology, Emory University School of Medicine, Atlanta, GA, USA
| | - Henry D Biermann
- Department of Urology, Emory University School of Medicine, Atlanta, GA, USA
| | - Dattatraya H Patil
- Department of Urology, Emory University School of Medicine, Atlanta, GA, USA
| | - Akanksha Mehta
- Department of Urology, Emory University School of Medicine, Atlanta, GA, USA.
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García-Gómez B, Alonso-Isa M, Celada-Luis G, Jauregibeitia-Ansotegi I, García-Rojo E, Santos-Pérez de la Blanca R, Romero-Otero J. Analysis of the relationship between sexual satisfaction, erectile dysfunction, and penile vascular parameters in a cohort of patients. Transl Androl Urol 2022; 10:4313-4319. [PMID: 35070813 PMCID: PMC8749074 DOI: 10.21037/tau-21-792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 12/06/2021] [Indexed: 11/06/2022] Open
Abstract
Background Erectile dysfunction (ED) is the second sexual dysfunction affecting men. Penile duplex ultrasound (PDU) with intracavernous injection of a vasoactive agent as alprostadil or papaverine, may play an important role in differentiating psychogenic from vasculogenic ED (arterial or venooclusive) and may also have an important role in the secondary prevention of cardiovascular events. The aim of this study is to investigate the relationship between the vascular parameters and sexual satisfaction as established by a questionnaire. Methods Prospective, multicenter analysis of all patients who underwent a PDU between September 2018 and April 2021 in four centers, including patients who were >18 years old and underwent a PDU for ED, Peyronie's disease (PD) or other reasons, signed informed consent and completed an adapted version of the Brief Sexual Symptom Checklist (BSSC). All the patients underwent a standard technique, and from a total of 325 patients, 16 were excluded because of low testosterone levels, and 15 due to missing data. Results A total of 294 patients were included for the analysis. Significant differences were found between patients with and without ED defined by their score in the Sexual Health Inventory for Men (SHIM) questionnaire in the PSV at 10', adjusted for age (38.07 vs. 44.95 cm/s; P=0.016), and in the PSV and the EHS at 10' for sexually satisfied and non-satisfied patients, and a significant correlation with those parameters and the probability of being sexually satisfied (r=0.147, P=0.011; r=0.132, P=0.023; respectively). Conclusions In our clinical practice we used the cut-off of >35 cm/s, that seems to be quite low looking at our results. The 10' measurement may be more sensitive in order to establish a diagnosis. BSSC questionnaire is a simple, easy-to perform tool to screen those patients at risk of developing sexual dysfunctions.
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Affiliation(s)
- Borja García-Gómez
- Urology Department, Hospital Universitario HM Montepríncipe, Boadilla del Monte, Spain.,ROC Clinic, Madrid, Spain
| | - Manuel Alonso-Isa
- ROC Clinic, Madrid, Spain.,Urology Department, Hospital Universitario HM Puerta del Sur, Móstoles, Spain
| | | | | | - Esther García-Rojo
- Urology Department, Hospital Universitario HM Montepríncipe, Boadilla del Monte, Spain
| | | | - Javier Romero-Otero
- Urology Department, Hospital Universitario HM Montepríncipe, Boadilla del Monte, Spain.,ROC Clinic, Madrid, Spain.,Urology Department, Hospital Universitario HM Puerta del Sur, Móstoles, Spain.,Urology Department, Hospital Universitario HM Sanchinarro, Madrid, Spain
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Reiser E, Zippl AL, Vomstein K, Strassgschwandter E, Hofer-Tollinger S, Pinggera GM, Toth B. Sexual function in male cancer survivors is not correlated to sperm quality. Support Care Cancer 2022; 30:5231-5237. [PMID: 35266051 PMCID: PMC9046364 DOI: 10.1007/s00520-022-06957-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 03/03/2022] [Indexed: 12/24/2022]
Abstract
PURPOSE Both infertility and erectile dysfunction (ED) are known long-term consequences of cancer treatment in young male cancer survivors. In the present study, we aimed to assess whether sperm quality and sexual function in male cancer survivors are associated. METHODS In this prospective study, n = 244 patients male cancer survivors who underwent sperm analysis and cryopreservation between 2008 and 2018 prior to the initiation of gonadotoxic treatment were invited. In total n = 50 had a follow-up sperm analysis and completed two questionnaires, the Aging Males' Symptom Scale (AMS) and the International Index of Erectile Function (IIEF-EF). Differences between the individual parameters were analyzed using the Wilcoxon or Mann Whitney test. RESULTS Azoospermia was present in n = 16/50 (32.0%) patients at time of follow-up. ED occurred in n = 9/43 (20.9%) patients and was observed more frequently in patients with oligo- or azoospermia than in those with normospermia, even though this association was not statistically significant. Sperm parameters (total sperm count, sperm concentration, progressive motility) did not differ between time of cryopreservation and time of follow-up. Mean total, somatic, psychological, and sexual AMS score was 23.6, 9.9, 6.6, and 6.8, respectively. Mean total IIEF-EF score was 27.3, indicating mainly mild ED. CONCLUSIONS More than one-third of cancer patients suffered from azoospermia, and ED was primarily present in this subgroup. We recommend implementing the screening of sexual dysfunction in the annual sperm testing that should be offered to all men after gonadotoxic treatment. Our study highlights the importance of counseling young cancer patients on both aspects-future infertility and sexual function-prior to treatment and at follow-up visits.
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Affiliation(s)
- Elisabeth Reiser
- Department of Gynecological Endocrinology and Reproductive Medicine, Medical University Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
| | - Anna Lena Zippl
- Department of Gynecological Endocrinology and Reproductive Medicine, Medical University Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
| | - Kilian Vomstein
- Department of Gynecological Endocrinology and Reproductive Medicine, Medical University Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria.
| | - Elena Strassgschwandter
- Department of Gynecological Endocrinology and Reproductive Medicine, Medical University Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
| | - Susanne Hofer-Tollinger
- Department of Gynecological Endocrinology and Reproductive Medicine, Medical University Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
| | | | - Bettina Toth
- Department of Gynecological Endocrinology and Reproductive Medicine, Medical University Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
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Mills EG, Yang L, Abbara A, Dhillo WS, Comninos AN. Current Perspectives on Kisspeptins Role in Behaviour. Front Endocrinol (Lausanne) 2022; 13:928143. [PMID: 35757400 PMCID: PMC9225141 DOI: 10.3389/fendo.2022.928143] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 05/11/2022] [Indexed: 11/21/2022] Open
Abstract
The neuropeptide kisspeptin is now well-established as the master regulator of the mammalian reproductive axis. Beyond the hypothalamus, kisspeptin and its cognate receptor are also extensively distributed in extra-hypothalamic brain regions. An expanding pool of animal and human data demonstrates that kisspeptin sits within an extensive neuroanatomical and functional framework through which it can integrate a range of internal and external cues with appropriate neuroendocrine and behavioural responses. In keeping with this, recent studies reveal wide-reaching effects of kisspeptin on key behaviours such as olfactory-mediated partner preference, sexual motivation, copulatory behaviour, bonding, mood, and emotions. In this review, we provide a comprehensive update on the current animal and human literature highlighting the far-reaching behaviour and mood-altering roles of kisspeptin. A comprehensive understanding of this important area in kisspeptin biology is key to the escalating development of kisspeptin-based therapies for common reproductive and related psychological and psychosexual disorders.
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Affiliation(s)
- Edouard G. Mills
- Section of Endocrinology and Investigative Medicine, Imperial College London, London, United Kingdom
| | - Lisa Yang
- Section of Endocrinology and Investigative Medicine, Imperial College London, London, United Kingdom
| | - Ali Abbara
- Section of Endocrinology and Investigative Medicine, Imperial College London, London, United Kingdom
| | - Waljit S. Dhillo
- Section of Endocrinology and Investigative Medicine, Imperial College London, London, United Kingdom
- Department of Endocrinology, Imperial College Healthcare National Health Service (NHS) Trust, London, United Kingdom
- *Correspondence: Waljit S. Dhillo, ; Alexander N. Comninos,
| | - Alexander N. Comninos
- Section of Endocrinology and Investigative Medicine, Imperial College London, London, United Kingdom
- Department of Endocrinology, Imperial College Healthcare National Health Service (NHS) Trust, London, United Kingdom
- *Correspondence: Waljit S. Dhillo, ; Alexander N. Comninos,
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18
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Üntan İ, Sabur V, Kenan B. Psychoda albipennis myiasis as a rare cause of erectile dysfunction: A case report. Andrologia 2021; 53:e14087. [PMID: 33905161 DOI: 10.1111/and.14087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 03/27/2021] [Accepted: 04/08/2021] [Indexed: 11/29/2022] Open
Abstract
Urogenital myiasis occurring with the settlement of fly larvae of the order Diptera is facultative and is rarely encountered in humans. This study presents a case of urogenital myiasis caused by Psychoda albipennis in a 42-year-old male patient. The patient was admitted to our hospital with complaints of groin pain, pollakuria and erectile dysfunction and claimed that he saw motile larvae in his urine. Three larvae were collected from the patient's urine, microscopically examined and identified as fourth-stage larvae of P. albipennis. The patient's complaints ceased after the application of an antibiotic and urinary antiseptic. It was concluded that myiasis should be considered in patients with urogenital complaints.
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Affiliation(s)
- İbrahim Üntan
- Department of Urology, Training and Research Hospital, Ahi Evran University, Kırşehir, Turkey
| | - Volkan Sabur
- Department of Urology, Erciyes Kartal Hospital, Kayseri, Turkey
| | - Bekir Kenan
- Department of Urology, Erciyes Kartal Hospital, Kayseri, Turkey
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