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Caira-Chuquineyra B, Fernandez-Guzmán D, Garayar-Peceros H, Benites-Zapata VA, Pérez-López FR, Blümel JE, Mezones-Holguín E. Efficacy and safety of visnadine in the treatment of symptoms of sexual dysfunction in heterosexual women: a systematic review of randomized clinical trials. Gynecol Endocrinol 2024; 40:2328619. [PMID: 38528806 DOI: 10.1080/09513590.2024.2328619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 03/04/2024] [Indexed: 03/27/2024] Open
Abstract
OBJECTIVE To synthesize the primary evidence on the efficacy and safety of visnadine on symptoms of sexual dysfunction (SD) in heterosexual women. METHODS We conducted a systematic review of randomized clinical trials (RCTs) with a primary search without language restriction in PubMed/Medline, Scopus, Embase, Web of Science, Cochrane Library, and international clinical trial registries. Trials reporting the use of visnadine by any route in women with SD were eligible. We performed screening, data extraction, and risk of bias assessment in a double-blind approach. The primary outcomes were the Female Sexual Function Index (FSFI) and its domains. Secondary outcomes were safety, arousal, lubrication, pleasure, orgasm, negative sensations, duration, and overall satisfaction. RESULTS Initially, 242 records were retrieved. We selected nine papers for full-text reading and finally included two RCTs: one with a parallel design and one with a crossover design with a total of 96 patients. One study compared visnadine aerosol with a placebo, while the other compared different frequencies of visnadine aerosol use. Visnadine use showed a statistically significant improvement (p < 0.05) in overall FSFI scores, regardless of the frequency of use. A meta-analysis was not possible due to the high clinical and methodological heterogeneity between available studies. CONCLUSION RCTs regarding the use of visnadine for the Female SD are scarce and methodologically limited. This preliminary evidence shows visnadine as a potentially effective and safe option to alleviate some of the clinical symptoms of SD in heterosexual women. However, future better-designed randomized studies with larger sample numbers are required.
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Affiliation(s)
| | | | | | - Vicente A Benites-Zapata
- Research Unit for the Generation and Synthesis of Health Evidence, Universidad San Ignacio de Loyola, Lima, Peru
| | | | - Juan E Blümel
- Faculty of Medicine, Universidad de Chile, Santiago de Chile, Chile
| | - Edward Mezones-Holguín
- Centre of Excellence for Social and Economic Studies in Health, Universidad San Ignacio de Loyola, Lima, Perú
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Shaffer KM, Reese JB, Dressler EV, Glazer JV, Cohn W, Showalter SL, Clayton AH, Danhauer SC, Loch M, Kadi M, Smith C, Weaver KE, Lesser GJ, Ritterband LM. Factorial Trial to Optimize an Internet-Delivered Intervention for Sexual Health After Breast Cancer: Protocol for the WF-2202 Sexual Health and Intimacy Enhancement (SHINE) Trial. JMIR Res Protoc 2024; 13:e57781. [PMID: 39159450 DOI: 10.2196/57781] [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: 02/26/2024] [Revised: 05/15/2024] [Accepted: 06/14/2024] [Indexed: 08/21/2024] Open
Abstract
BACKGROUND Although most survivors of breast cancer report substantial sexual concerns following treatment, few receive support for these concerns. Delivering sexual health care to survivors of breast cancer via the internet could overcome many of the barriers to in-person treatment. Even when delivered remotely, survivor time constraints remain a leading barrier to sexual health intervention uptake. OBJECTIVE Guided by the multiphase optimization strategy methodological framework, the primary objective of this study is to identify the most efficient internet-delivered sexual health intervention package that is expected to provide survivors of breast cancer the greatest benefit with the fewest (and least-intensive) intervention components. This study aims to determine how intervention components work (mediators) and for whom they work best (moderators). METHODS Partnered, posttreatment adult female survivors of breast cancer (N=320) experiencing at least 1 bothersome sexual symptom (ie, pain with sex, vaginal dryness, low sexual desire, and difficulty with orgasm) related to their breast cancer treatment will be enrolled. Clinic-based recruitment will be conducted via the Wake Forest National Cancer Institute Community Oncology Research Program (NCORP) Research Base. Participants will be randomly assigned to 1 of 16 combinations of four intervention components with two levels each in this factorial trial: (1) psychoeducation about cancer-related sexual morbidity (receive either enhanced vs standard versions); (2) communication skills training for discussing concerns with health care providers (received vs not received); (3) communication skills training for discussing concerns with a partner (received vs not received); and (4) intimacy promotion skills training (received vs not received). Cores will be fully automated and implemented using a robust internet intervention platform with highly engaging elements such as animation, video, and automated email prompts. Survivors will complete web-based assessments at baseline (prerandomization time point) and again at 12 and 24 weeks later. The primary study aim will be achieved through a decision-making process based on systematically evaluating the main and interaction effects of components on sexual distress (Female Sexual Distress Scale-Desire, Arousal, Orgasm) and sexual functioning (Female Sexual Function Index) using a generalized linear model approach to ANOVA with effect coding. Mediation analyses will be conducted through a structural equation modeling approach, and moderation analyses will be conducted by extending the generalized linear model to include interaction effects. RESULTS This protocol has been reviewed and approved by the National Cancer Institute Central Institutional Review Board. Data collection is planned to begin in March 2024 and conclude in 2027. CONCLUSIONS By identifying the combination of the fewest and least-intensive intervention components likely to provide survivors of breast cancer the greatest sexual health benefit, this study will result in the first internet intervention that is optimized for maximum impact on the undertreated, prevalent, and distressing problem of breast cancer-related sexual morbidity. TRIAL REGISTRATION ClinicalTrials.gov NCT06216574; https://clinicaltrials.gov/study/NCT06216574. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/57781.
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Affiliation(s)
- Kelly M Shaffer
- University of Virginia School of Medicine, Charlottesville, VA, United States
| | | | - Emily V Dressler
- Wake Forest University School of Medicine, Winston-Salem, NC, United States
| | - Jillian V Glazer
- University of Virginia School of Medicine, Charlottesville, VA, United States
| | - Wendy Cohn
- University of Virginia School of Medicine, Charlottesville, VA, United States
| | - Shayna L Showalter
- University of Virginia School of Medicine, Charlottesville, VA, United States
| | - Anita H Clayton
- University of Virginia School of Medicine, Charlottesville, VA, United States
| | - Suzanne C Danhauer
- Wake Forest University School of Medicine, Winston-Salem, NC, United States
| | - Michelle Loch
- Louisiana State University Health Sciences Center, New Orleans, LA, United States
| | - Mai Kadi
- University of Virginia School of Medicine, Charlottesville, VA, United States
| | - Caleigh Smith
- University of Virginia School of Medicine, Charlottesville, VA, United States
| | - Kathryn E Weaver
- University of Virginia School of Medicine, Charlottesville, VA, United States
| | - Glenn J Lesser
- University of Virginia School of Medicine, Charlottesville, VA, United States
| | - Lee M Ritterband
- University of Virginia School of Medicine, Charlottesville, VA, United States
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Dag A, Ak T, Kaya E, Tulek Z, Poyraz BC, Ugurlu S, Melikoglu M, Fresko I, Seyahi E. Sexual dysfunction among female patients with rheumatic diseases. Rheumatol Int 2024:10.1007/s00296-024-05701-6. [PMID: 39154119 DOI: 10.1007/s00296-024-05701-6] [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: 06/11/2024] [Accepted: 08/10/2024] [Indexed: 08/19/2024]
Abstract
To demonstrate the burden of sexual dysfunction (SD) among females with rheumatic diseases, we conducted a cross-sectional comparative study in patients with systemic sclerosis (SSc), systemic lupus erythematosus (SLE), and Behçet's syndrome (BS) along with suitable healthy controls (HCs). Age-matched female patients with SSc (n = 50), SLE (n = 49), and BS (n = 54), along with 52 female HCs were included in this study between April and October, 2021. Sociodemographic features were recorded, and psychometric tests, i.e., female sexual function index (FSFI), Beck depression inventory (BDI), body cathexis scale, and marital adjustment test (MAT) were performed. Scale scores were compared, and binary logistic regression was used to identify predictors for SD in the whole group. The total FSFI and body cathexis scores among the patient groups were significantly lower than those of the HCs (p < 0.001). Depression was significantly more frequent in the patient groups. MAT scores did not differ significantly between the study groups. Patients with SSc had the worst scores in each psychometric index, including MAT. Decreased body cathexis score [OR 0.974, 95% CI (0.957-0.991), p = 0.003] and low MAT score [OR 0.937, 95% CI (0.896-0.980), p = 0.005], and being diagnosed with SSc [OR 6.6, 95% CI (1.975-22.498), p = 0.002], SLE [OR 2.7, 95% CI (0.998-7.753), p = 0.050], and BS [OR 2.8, 95% CI (1.100-7.359), p = 0.031], were identified as independent predictors for SD. Body cathexis seems to be the most important independent predictor for SD, and the burden of SD appears heavier in patients with SSc, probably due to poor body image satisfaction.
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Affiliation(s)
- Ayten Dag
- Institute of Graduate Studies, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Tumay Ak
- Department of Internal Medicine, Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Istanbul, Turkey
| | - Eda Kaya
- Department of Internal Medicine, Ruhr University Bochum, University Hospital Knappschaftskrankenhaus Bochum, Bochum, Germany
| | - Zeliha Tulek
- Florence Nightingale Faculty of Nursing, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Burc Cagri Poyraz
- Department of Psychiatry, Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Istanbul, Turkey
| | - Serdal Ugurlu
- Department of Internal Medicine and Behçet's Disease Research Center, Division of Rheumatology, Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Fatih, 34098, Istanbul, Turkey
| | - Melike Melikoglu
- Department of Internal Medicine and Behçet's Disease Research Center, Division of Rheumatology, Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Fatih, 34098, Istanbul, Turkey
| | - Izzet Fresko
- Department of Internal Medicine and Behçet's Disease Research Center, Division of Rheumatology, Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Fatih, 34098, Istanbul, Turkey
| | - Emire Seyahi
- Department of Internal Medicine and Behçet's Disease Research Center, Division of Rheumatology, Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Fatih, 34098, Istanbul, Turkey.
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Freitas LPG, Monaco HEMG, Pacetta AM, Nahas SC, Baracat EC, Haddad JM. Brazilian Portuguese Translation and Validation of the Pelvic Organ Prolapse/Incontinence Sexual Questionnaire-IUGA revised. Int Urogynecol J 2024:10.1007/s00192-024-05889-y. [PMID: 39153070 DOI: 10.1007/s00192-024-05889-y] [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: 02/28/2024] [Accepted: 07/13/2024] [Indexed: 08/19/2024]
Abstract
INTRODUCTION AND HYPOTHESIS Condition-specific sexual questionnaires are important patient-reported outcome measures. The aim of this study was to translate and validate the Pelvic Organ Prolapse/Incontinence Sexual Questionnaire-International Urogynecology Association Revised (PISQ-IR) into Brazilian Portuguese and to clinically validate it in a Brazilian Portuguese-speaking population. METHODS Translation and validation of the PISQ-IR was performed according to the International Urogynecological Association-recommended process and guidelines. For external validity, PISQ-IR subscales were compared with the clinical measures, Pelvic Organ Prolapse Quantification system (POP-Q) stage, pelvic floor muscle tone, and Oxford Grading Scale (Pearson correlations). Descriptive statistics, internal consistency (Cronbach's alpha coefficient), and test-retest reliability (interclass correlation coefficient) were calculated for all PISQ-IR subscales. RESULTS A total of 120 sexually active and 106 not sexually active women were enrolled in the study between March 2015 and July 2019. Internal consistency was acceptable, with Cronbach's alpha values 0.60-0.80, except for the sexual arousal and orgasm, sexual arousal and partner-related issues, sexual arousal and condition-specific issues, global rating of sexual quality and condition impact subscales. PISQ-IR demonstrated good reliability (α > 0.6, CIC = 0.996). The agreement for each individual questionnaire item also individually presented substantial agreement between the assessments (κ 0.61-0.8). There was a correlation between PISQ-IR and POP, mixed, stress and fecal incontinence diagnosis and a positive correlation with pelvic floor muscle function according to the Oxford Scale in sexually active women. For sexually inactive women there was a correlation between PISQ-IR and mixed urinary symptoms. CONCLUSIONS The Brazilian Portuguese version of PISQ-IR is a reliable and valid tool that can be easily used for the identification and assessment of sexual function in Brazilian Portuguese-speaking women with pelvic floor disorders.
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Affiliation(s)
- Luciana Pistelli Gomes Freitas
- Urogynaecology Section, Department of Obstetrics and Gynecology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Rua Isaac Krasilchik, 88. Água Branca, Sao Paulo, SP, 05036-165, Brazil.
| | - Helga Elisa Marquesini Gonzales Monaco
- Urogynaecology Section, Department of Obstetrics and Gynecology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Rua Isaac Krasilchik, 88. Água Branca, Sao Paulo, SP, 05036-165, Brazil
| | - Aparecida Maria Pacetta
- Urogynaecology Section, Department of Obstetrics and Gynecology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Rua Isaac Krasilchik, 88. Água Branca, Sao Paulo, SP, 05036-165, Brazil
| | - Sérgio Carlos Nahas
- Department of Gastroenterology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil
| | - Edmund Chada Baracat
- Urogynaecology Section, Department of Obstetrics and Gynecology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Rua Isaac Krasilchik, 88. Água Branca, Sao Paulo, SP, 05036-165, Brazil
| | - Jorge Milhem Haddad
- Urogynaecology Section, Department of Obstetrics and Gynecology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Rua Isaac Krasilchik, 88. Água Branca, Sao Paulo, SP, 05036-165, Brazil
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Xia XY, Liu ST, Song ZC, Chen PL, Hu JJ, Zhao W. Current investigation of the high prevalence of sexual dysfunction in female patients with systemic lupus erythematosus: a cross-sectional study. Rheumatol Int 2024:10.1007/s00296-024-05690-6. [PMID: 39153077 DOI: 10.1007/s00296-024-05690-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Accepted: 08/08/2024] [Indexed: 08/19/2024]
Abstract
Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that affects women of childbearing age and has been reported to cause sexual dysfunction in women. Although there are articles on sexual function in women with SLE, the number of articles is small, and the factors affecting sexual function in women with SLE are controversial. Based on this, this study aimed to investigate the prevalence of sexual dysfunction in Chinese female SLE patients and to explore the factors that influence it. The study design was a cross-sectional study conducted from December 2023 to April 2024 in the Department of Rheumatology and Immunology of a tertiary hospital in Hefei, Anhui Province. A total of 293 female patients diagnosed with SLE were enrolled using face-to-face questionnaires and online questionnaires. The questionnaire consisted of four parts: general information questionnaire, fatigue severity scale (FSS), depression-anxiety-stress scale (DASS-21), and female sexual functioning index (FSFI) scale. A total of 173 (59.04%) patients had sexual dysfunction, including 251 (85.67%) with decreased libido and 186 (63.46%) with difficulty in sexual arousal. There was a correlation between the patients' total FSFI scores and age (p = 0.028), marital satisfaction (p < 0.001), own education level (p = 0.008), partner's education level (p = 0.003), place of residence (p = 0.039), monthly household income (p < 0.001), family financial satisfaction(p < 0.001), menstrual status (p = 0.003), hormone use (p = 0.021),immunosuppressant use (p = 0.042), disease activity (p = 0.016), FSS score (p < 0.001), stress score (p < 0.001), anxiety score (p < 0.001) and depression score (p < 0.001)were correlated. The results of stepwise regression analysis showed that marital satisfaction (b = 2.011, t = 3.797, p < 0.001), monthly household income (b = 0.854, t = 2.316, p = 0.021), menstrual status (b = 1.218, t = 2.350, p = 0.019), fatigue scale score (b = - 0.069, t = - 2.302, p = 0.022), and depression score (b = - 0.117, t = - 2.910, p = 0.004) were the influencing factors of FSFI total score, and the difference was statistically significant. The incidence of sexual dysfunction in Chinese female SLE patients is high, and medical personnel should pay more attention to patients' sexual problems, to provide theoretical and practical bases for further prevention, treatment, and care of sexual dysfunction in female SLE patients.
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Affiliation(s)
- Xue-Ying Xia
- School of Nursing, Anhui Medical University, Hefei, 230601, Anhui, China
| | - Shu-Ting Liu
- School of Nursing, Anhui Medical University, Hefei, 230601, Anhui, China
| | - Zi-Cheng Song
- School of Nursing, Anhui Medical University, Hefei, 230601, Anhui, China
| | - Pei-Ling Chen
- Department of Rheumatology and Immunology, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, China
| | - Jia-Jia Hu
- Blood Purification Center, The Second People's Hospital of Hefei, Hefei, 230011, Anhui, China
| | - Wei Zhao
- School of Nursing, Anhui Medical University, Hefei, 230601, Anhui, China.
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de Carvalho MLAS, Bezerra LO, Oliveira JMP, Oliveira MCE, Micussi MTABC. Pelvic floor muscle training in women with urinary incontinence and pelvic organ prolapse: A protocol study. PLoS One 2024; 19:e0308701. [PMID: 39150919 PMCID: PMC11329135 DOI: 10.1371/journal.pone.0308701] [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: 11/11/2023] [Accepted: 07/26/2024] [Indexed: 08/18/2024] Open
Abstract
OBJECTIVE To evaluate the effectiveness of pelvic floor muscle training (PFMT) on pelvic floor muscle (PFM) function and quality of life (QoL) in women with stress urinary incontinence (SUI) and pelvic organ prolapse (POP). METHODS This study will be a randomized, controlled, parallel, and blinded clinical trial. The final sample will consist of 32 women diagnosed with SUI and cystocele (stage I and II). All volunteers will be assessed and reassessed using the same protocol: assessment form, gynecological examination, functional evaluation of PFM, and questionnaires to assess quality of life, urinary function, and sexual function. All volunteers will be evaluated for satisfaction levels post-treatment. The intervention will be PFMT, totaling 16 sessions to be conducted twice a week. Reevaluation will take place at the end of treatment and 1 month after completion of PFMT. Descriptive analysis and repeated measures ANOVA will be used for result analysis. A significance level of p<0.05 will be considered for all statistical tests. ETHICS AND DISSEMINATION This study has been submitted to the Ethics in Research Committee of the Federal University of Rio Grande do Norte and approved under protocol number 5.826.563. It has been registered with the Brazilian Clinical Trials Registry ReBec (RBR-49p6g3t). It is expected that these studies will provide a deeper understanding of the efficacy of PFMT in women with SUI and cystocele. Additionally, it aims to provide more insights into the efficacy of PFMT prior to surgery.
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Affiliation(s)
| | - Lívia Oliveira Bezerra
- Graduate Program in Physical Therapy, Federal University of Rio Grande do Norte, Natal, Brazil
| | | | | | - Maria T A B C Micussi
- Physical Therapy Department, Federal University of Rio Grande do Norte, Natal, RN, Brazil
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Aydemir D, Çıtak Karakaya İ, Günay Avcı S, Gürhan Karakaya M. Psychometric properties and feasibility of three scales assessing the level of knowledge and awareness about pelvic floor health. Eur J Obstet Gynecol Reprod Biol 2024; 301:135-141. [PMID: 39126796 DOI: 10.1016/j.ejogrb.2024.07.035] [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: 11/06/2023] [Revised: 05/27/2024] [Accepted: 07/14/2024] [Indexed: 08/12/2024]
Abstract
OBJECTIVE Despite high prevalence and burden of pelvic floor dysfunctions (PFD), there is a limited number of scales assessing knowledge of pelvic floor health (PFH), and no studies comparing their psychometric or feasibility properties. The study aimed both to investigate the psychometric properties and feasibility of Incontinence Quiz (IQ), Prolapse and Incontinence Knowledge Questionnaire (PIKQ) and Pelvic Floor Health Knowledge Questionnaire (PFHKQ), and to compare level of PFH knowledge in women with and without PFD. STUDY DESIGN In this prospective cross-sectional study, a total of 150 women were included. After recording physical-sociodemographic characteristics, obstetric histories and menstrual status, Pelvic Floor Distress Inventory-20 and Female Sexual Function Index were administered to classify them into study groups as women with and without PFD. Their PFH knowledge was assessed using IQ, PIKQ and PFHKQ, which were filled twice with one week interval for the test-retest purpose. The scores, reliability, validity, ceiling-floor effects and feasibility of the knowledge scales were compared with each other, and between the study groups. RESULTS IQ, PIKQ, and PFHKQ scores of women with and without PFD were similar. Based on response patterns to items, PFHKQ had the highest internal consistency followed by PIKQ and IQ. The PIKQ was the most stable scale across the total sample and in the PFD group. The PFHKQ had the highest ICC value in women without PFD. There was a strong correlation between the total scores of knowledge scales in both groups. Scores of knowledge and symptom scales were not significantly correlated. IQ was completed in the shortest time, and was easier to complete than PFHKQ. Only the diagnosis/treatment subscale of PFHKQ had a ceiling effect. CONCLUSION It was concluded that PFH knowledge of women with and without PFD were at a low-moderate level and similar to each other; IQ, PIKQ and PFHKQ were reliable, valid and feasible scales, which can be used in measuring knowledge level about PFH.
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Affiliation(s)
- Dilan Aydemir
- Başkent University Istanbul Hospital, Pelvic Floor Rehabilitation Unit, Altunizade, 7, Kısıklı Caddesi, Oymacı Sk., 34662 Istanbul, Turkey.
| | - İlkim Çıtak Karakaya
- Muğla Sıtkı Koçman University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, 48000 Muğla, Turkey
| | - Seçil Günay Avcı
- Haliç University, Faculty of Health Sciences, Department of Midwifery, 34060 Istanbul, Turkey
| | - Mehmet Gürhan Karakaya
- Muğla Sıtkı Koçman University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, 48000 Muğla, Turkey
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Oliveira LFTS, Arakaki JSO, Vieira EB, Lopes JDL, Lopes CT, Abuchaim EDS, Santos VB. Sexual function, health functionality, and quality of life in females with pulmonary arterial hypertension: a cross-sectional study. J Sex Med 2024:qdae092. [PMID: 39104208 DOI: 10.1093/jsxmed/qdae092] [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: 03/04/2024] [Revised: 06/17/2024] [Accepted: 07/11/2024] [Indexed: 08/07/2024]
Abstract
BACKGROUND Pulmonary arterial hypertension (PAH) can have several consequences on sexual function, which can lead to worsened quality of life. AIM The study sought to assess sexual function and its association with health functionality and quality of life in females with PAH. METHODS A descriptive cross-sectional study was carried out in pulmonary circulation outpatient clinics from January 2022 to March 2023 in females diagnosed with pulmonary hypertension. Assessment was carried out through the application of the Female Sexual Function Index, the 36-item World Health Organization Disability Assessment Schedule, and the Medical Outcome Study 36-Item Short Form Survey. OUTCOMES Data were analyzed using SPSS version 22.0 and JASP, and Spearman's correlation tests were applied between the instruments, with a P value <.05 considered significant. RESULTS A total of 91 females were assessed. It was identified that 90.1% of females had sexual dysfunction, with worse scores in females with sexual dysfunction in the domains of satisfaction, arousal, and desire, with average health functionality and quality of life. There were significant correlations between the domains of mobility, getting along, life activities, and the overall functionality score with some domains of sexual function, especially arousal and satisfaction. We found significant correlations between some domains of quality-of-life assessment with the domains of desire, arousal, and satisfaction, and with the overall score of sexual function assessment, as well as strong correlations between health functionality and quality of life. CLINICAL IMPLICATION The data reinforce the need for rehabilitation programs and social support for this population. STRENGTHS AND LIMITATIONS This is one of the few studies to evaluate sexual function, quality of life, and health functionality in women with PAH. Due to limitations in data collection, we were unable to assess certain factors such as hormone levels and a history of sexual abuse. CONCLUSION We identified a high prevalence of sexual dysfunction in females with PAH with mild functional impairment and a moderate quality-of-life score with correlations between sexual function, health functionality, and quality of life.
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Affiliation(s)
| | - Jaquelina Sonoe Ota Arakaki
- Pulmonary Circulation Service, Paulista School of Medicine, Federal University of São Paulo, São Paulo 04023-900, Brazil
| | - Elaine Brito Vieira
- Pulmonary Circulation Service, Paulista School of Medicine, Federal University of São Paulo, São Paulo 04023-900, Brazil
| | - Juliana de Lima Lopes
- Paulista Nursing School, Federal University of São Paulo, São Paulo 04024-002, Brazil
| | - Camila Takao Lopes
- Paulista Nursing School, Federal University of São Paulo, São Paulo 04024-002, Brazil
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Kappos EA, Wendelspiess SR, Stoffel J, Djedovic G, Rieger UM, Bannasch H, Fritsche E, Constantinescu M, Andric M, Croner RS, Schmidt VJ, Plock J, Schaefer DJ, Horch RE. [Reconstruction of Oncological Defects in the Pelvic-perineal Region: Report on the Consensus Workshop at the 44th Annual Meeting of the DAM 2023 in Bern, CH]. HANDCHIR MIKROCHIR P 2024; 56:269-278. [PMID: 39137788 DOI: 10.1055/a-2358-1479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/15/2024] Open
Abstract
The surgical-oncological treatment of pelvic and perineal malignancies is associated with a high complication rate and morbidity for patients. Modern multimodal treatment modalities, such as neoadjuvant radio-chemotherapy for anal or rectal cancer, increase the long-term survival rate while reducing the risk of local recurrence. Simultaneously, the increasing surgical radicality and higher oncological safety with wide resection margins is inevitably associated with larger and, due to radiation, more complex tissue defects in the perineal and sacral parts of the pelvic floor. Therefore, the plastic-surgical reconstruction of complex pelvic-perineal defects following oncological resection remains challenging. The reconstructive armamentarium, and thus the treatment of such defects, is broad and ranges from local, regional and muscle-based flaps to microvascular and perforator-based procedures. While the use of flaps is associated with a significant, well-documented reduction in postoperative complications compared to primary closure, there is still a lack of reliable data directly comparing the postoperative results of different reconstructive approaches. Additionaly, the current data shows that the quality of life of these patients is rarely recorded in a standardised manner. In a consensus workshop at the 44th annual meeting of the German-speaking Association for Microsurgery on the topic of "Reconstruction of oncological defects in the pelvic-perineal area", the current literature was discussed and recommendations for the reconstruction of complex defects in this area were developed. The aim of this workshop was to identify knowledge gaps and establish an expert consensus to ensure and continuously improve the quality of reconstruction in this challenging area. In addition, the importance of the "patient-reported outcome measures" in pelvic reconstruction was highlighted, and the commitment to its widespread use in the era of value-based healthcare was affirmed.
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Affiliation(s)
- Elisabeth A Kappos
- Klinik für Plastische, Rekonstruktive, Ästhetische und Handchirurgie, Universitätsspital Basel, Basel, Schweiz
- Medizinische Fakultät, Universität Basel, Basel, Schweiz
| | - Séverin R Wendelspiess
- Klinik für Plastische, Rekonstruktive, Ästhetische und Handchirurgie, Universitätsspital Basel, Basel, Schweiz
- Medizinische Fakultät, Universität Basel, Basel, Schweiz
| | - Julia Stoffel
- Klinik für Plastische, Rekonstruktive, Ästhetische und Handchirurgie, Universitätsspital Basel, Basel, Schweiz
- Medizinische Fakultät, Universität Basel, Basel, Schweiz
| | - Gabriel Djedovic
- Abteilung für Plastische, Ästhetische und Rekonstruktive Chirurgie, Landeskrankenhaus Feldkirch, Feldkirch, Österreich
| | - Ulrich M Rieger
- Klinik für Plastische und Ästhetische Chirurgie, Wiederherstellungs- und Handchirurgie, Agaplesion Markus Krankenhaus, Frankfurt am Main, Deutschland
| | - Holger Bannasch
- Klinik für Plastische-, Hand- und Ästhetische Chirurgie, Schwarzwald-Baar Klinikum Donaueschingen, Donaueschingen, Deutschland
| | - Elmar Fritsche
- Abteilung für Hand- und Plastische Chirurgie, Luzerner Kantonsspital, Luzern, Schweiz
| | | | - Mihailo Andric
- Klinik für Allgemein-, Viszeral-, Gefäss- und Transplantationschirurgie, Universitätsklinikum Magdeburg, Magdeburg, Deutschland
| | - Roland S Croner
- Klinik für Allgemein-, Viszeral-, Gefäss- und Transplantationschirurgie, Universitätsklinikum Magdeburg, Magdeburg, Deutschland
| | - Volker J Schmidt
- Klinik für Plastische Chirurgie und Handchirurgie, Kantonsspital St. Gallen, Sankt Gallen, Schweiz
| | - JanA Plock
- Klinik für Plastische Chirurgie und Handchirurgie, Kantonsspital Aarau, Aarau, Schweiz
| | - Dirk J Schaefer
- Klinik für Plastische, Rekonstruktive, Ästhetische und Handchirurgie, Universitätsspital Basel, Basel, Schweiz
- Medizinische Fakultät, Universität Basel, Basel, Schweiz
| | - Raymund E Horch
- Plastische und Handchirurgische Klinik, Universitätsklinikum Erlangen, Erlangen, Deutschland
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10
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Carter J, Pugh SL, Arring N, Littell RD, Page SJ, Rowland Jr. KM, Goodman JR, Razaq W, Siddique S, Borges M, Kachnic LA, Barton DL. NRG-CC004 ancillary data study-exploring the effect of bupropion on sexual desire in female cancer survivors with and without vulvovaginal symptoms. J Sex Med 2024; 21:709-715. [PMID: 38856026 PMCID: PMC11294673 DOI: 10.1093/jsxmed/qdae061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 03/12/2024] [Accepted: 05/14/2024] [Indexed: 06/11/2024]
Abstract
BACKGROUND Female cancer survivors often experience estrogen-deprivation symptoms, which may lead to decreases in sexual desire, vulvovaginal health (lubrication, dryness, discomfort), and sexual satisfaction. Interventions are needed to address these concerns. AIM The objective of this secondary analysis was to determine if women with higher (better) scores on the Female Sexual Function Index (FSFI) lubrication and pain subscales reported higher desire scores based on treatment with bupropion vs placebo. METHODS Participants were part of NRG Oncology's NRG-CC004 (NCT03180294), a randomized placebo-controlled clinical trial evaluating bupropion (150 vs 300 mg) to improve sexual desire in survivors of breast or gynecologic cancer. All participants with baseline data from the FSFI lubrication, pain, and desire subscales with 5- and/or 9-week data were analyzed. The FSFI subscale scores were correlated using Spearman correlation coefficients. Logistic regression was used to determine associations between FSFI desire and other FSFI subscales while accounting for treatment arm and other covariates. OUTCOMES The primary outcome of NRG Oncology's NRG-CC004 (NCT03180294) randomized phase II dose-finding trial was change from baseline to 9 weeks on the FSFI desire subscale score. Similar to the parent study, the primary outcome for this ancillary data study was the FSFI desire subscale score at 5 and 9 weeks. RESULTS Overall, 230 participants completed the FSFI at baseline and 189 at 9 weeks. The strongest correlations were between lubrication and pain at baseline (all participants, rho = 0.77; bupropion arms, rho = 0.82), week 5 (all participants, rho = 0.71; bupropion arms, rho = 0.68), and week 9 (all participants, rho = 0.75; bupropion arms, rho = 0.78), and the weakest correlations were between desire and pain. In patients in the treatment arms there were no interactions between lubrication or pain.The impact of various covariates on the FSFI score for desire at 9 weeks demonstrated that participants of non-White race (odds ratio [OR], 0.42; 95% CI, 0.21-0.81; P = .010), with a high lubrication score (OR, 0.36; 95% CI, 0.21-0.61; P = .0002), with a high pain score (less pain) (OR, 0.50; 95% CI, 0.29-0.87; P = .014), or with prior pelvic surgery (OR, 0.38; 95% CI, 0.23-0.63; P = .0002) had lower odds of having low desire. CLINICAL IMPLICATIONS Acute estrogen-deprivation symptoms should be addressed prior to sexual desire intervention. STRENGTHS AND LIMITATIONS This secondary analysis was not powered to examine all variables. CONCLUSION Lubrication and pain were predictors of low desire. Therefore, vulvovaginal atrophy and associated genitourinary symptoms of menopause such as vaginal dryness and dyspareunia should be addressed prior to or in parallel with interventions for sexual desire.
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Affiliation(s)
- Jeanne Carter
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY 10065, United States
| | - Stephanie L Pugh
- NRG Oncology Statistics and Data Management Center, Philadelphia, PA 19103, United States
| | - Noel Arring
- University of Tennessee, Knoxville, TN 37966, United States
| | | | - Seth J Page
- Cancer Center of Kansas, Wichita, KS 67460, United States
| | | | - Judie R Goodman
- Trinity Health St. Joseph Mercy Oakland, Pontiac, MI 48341, United States
| | - Wajeeha Razaq
- University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, United States
| | | | - Monica Borges
- NRG Oncology Statistics and Data Management Center, Philadelphia, PA 19103, United States
| | - Lisa A Kachnic
- Columbia University Medical Center, New York, NY 10032, United States
| | - Debra L Barton
- University of Tennessee College of Nursing, Knoxville, TN 37996, United States
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Mennen A, Van Lieshout E, Bisoen P, Bloemers F, Geerlings A, Koole D, Verhofstad M, Visser J, Van Embden D, Van Vledder M. Long-term musculoskeletal function after Open Pelvic ring fractures in Children (OPEC); a multicentre, retrospective case series with follow-up measurement. Trauma Case Rep 2024; 52:101050. [PMID: 38957176 PMCID: PMC11217755 DOI: 10.1016/j.tcr.2024.101050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/04/2024] [Indexed: 07/04/2024] Open
Abstract
Background The proportion of Open Pelvic fractures in the paediatric population is relatively high. While operative fixation is the primary approach for managing Open Pelvic fractures in adults, there is limited literature on treatment outcomes in Children, particularly regarding long-term musculoskeletal, neurological, and urogenital function. Methods This multicentre case series included paediatric patients (<18 years old) with Open Pelvic ring fractures treated at one of two major trauma centres in the Netherlands between January 1, 2001 and December 31, 2021. Data collection involved clinical records and long-term assessments, including musculoskeletal function, growth disorders, urogenital function, sexual dysfunction, and sensory motor function. Results A total of 11 patients were included, primarily females (73 %), with a median age at trauma of 12 years (P25-P75 7-14). Most patients had unstable Pelvic ring fractures resulting from high-energy trauma. Surgical interventions were common, with external fixation as the main initial surgical approach (n = 7, 70 %). Complications were observed in eight (73 %) patients. Musculoskeletal function revealed a range of issues in the lower extremity, daily activities, and mental and emotional domain. Long-term radiologic follow-up showed high rates of Pelvic malunion (n = 7, 64 %). Neurological function assessment showed motor and sensory function impairment in a subset of patients. Urogenital function was moderately affected, and sexual dysfunction was limited with most respondents reporting no issues. Conclusion Paediatric Open Pelvic fractures are challenging injuries associated with significant short-term complications and long-term musculoskeletal and urogenital issues. Further research is needed to develop tailored treatment strategies and improve outcomes of these patients.
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Affiliation(s)
- A.H.M. Mennen
- Amsterdam UMC location University of Amsterdam, Department of Surgery, Meibergdreef 9, Amsterdam, the Netherlands
| | - E.M.M. Van Lieshout
- Erasmus MC, University Medical Center Rotterdam, Trauma Research Unit Department of Surgery, dr. Molewaterplein 40, Rotterdam, the Netherlands
| | - P.A. Bisoen
- Erasmus MC, University Medical Center Rotterdam, Trauma Research Unit Department of Surgery, dr. Molewaterplein 40, Rotterdam, the Netherlands
| | - F.W. Bloemers
- Amsterdam UMC location University of Amsterdam, Department of Surgery, Meibergdreef 9, Amsterdam, the Netherlands
- Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Surgery, De Boelelaan 1117, Amsterdam, the Netherlands
| | - A.E. Geerlings
- Amsterdam UMC location University of Amsterdam, Department of Surgery, Meibergdreef 9, Amsterdam, the Netherlands
| | - D. Koole
- Erasmus MC, University Medical Center Rotterdam, Trauma Research Unit Department of Surgery, dr. Molewaterplein 40, Rotterdam, the Netherlands
| | - M.H.J. Verhofstad
- Erasmus MC, University Medical Center Rotterdam, Trauma Research Unit Department of Surgery, dr. Molewaterplein 40, Rotterdam, the Netherlands
| | - J.J. Visser
- Erasmus MC, University Medical Center Rotterdam, Department of Radiology, dr. Molewaterplein 40, Rotterdam, the Netherlands
| | - D. Van Embden
- Amsterdam UMC location University of Amsterdam, Department of Surgery, Meibergdreef 9, Amsterdam, the Netherlands
| | - M.G. Van Vledder
- Erasmus MC, University Medical Center Rotterdam, Trauma Research Unit Department of Surgery, dr. Molewaterplein 40, Rotterdam, the Netherlands
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12
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McKernan LC, McGonigle T, Vandekar SN, Crofford LJ, Williams DA, Clauw DJ, Bruehl S, Corbett BA, Dmochowski RR, Walsh EG, Kelly AG, Sutherland SL, Connors EL, Ryden A, Reynolds WS. A randomized-controlled pilot trial of telemedicine-delivered cognitive-behavioral therapy tailored for interstitial cystitis/bladder pain syndrome. Pain 2024; 165:1748-1760. [PMID: 38422486 PMCID: PMC11257824 DOI: 10.1097/j.pain.0000000000003188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 12/17/2023] [Indexed: 03/02/2024]
Abstract
Abstract
Interstitial cystitis/bladder pain syndrome (IC/BPS) is a debilitating urologic pain condition with few treatment advances in the past 25 years. Individuals with IC/BPS often experience significant psychological distress, which worsens symptoms and functioning. To date, there have been no large-scale, randomized controlled trials (RCTs) of comprehensive psychological interventions for IC/BPS. We conducted a 2:1 RCT of an 8-session patient-informed cognitive-behavioral therapy (CBT) intervention designed for IC/BPS for reducing pain-related symptoms and improving quality of life, delivered through telemedicine. Individuals with IC/BPS (N = 78) were randomized to receive either 8 weeks of CBT specifically designed for IC/BPS (n = 52) or an attention control condition (n = 26). Urologic symptoms (Genitourinary Pain Index, GUPI), pain-related symptoms, affective distress, and quality of life were evaluated before, immediately after, and 3 months posttreatment. Both conditions reported significant but similar reductions (P = 0.922) in the a priori primary outcome of genitourinary symptoms at posttreatment (GUPI reduction = 6.6 vs 4.8, for CBT and control, respectively) and long-term follow-up (8.1 vs 6.6, for CBT and control). However, the CBT group had significantly greater improvement in Patient Global Impression of Change (PGIC) scores and was significantly more likely to be treatment responders (PGIC ≥ 6) (37% vs 8%, P = 0.019 for CBT and control), with a large relative effect size (OR = 6.68). A subgroup analysis of CBT recipients showed that responders (PGIC
6) displayed significant reductions in genitourinary symptoms (P = 0.023), pain intensity (P = 0.027), and pain interference (P = 0.013) posttreatment. Telemedicine-delivered pain CBT for IC/BPS shows promise for improving outcomes, and this trial demonstrates the need for larger RCTs of CBT for IC/BPS.
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Affiliation(s)
- Lindsey C. McKernan
- Department of Psychiatry & Behavioral Sciences, Vanderbilt University School of Medicine
- Department of Physical Medicine & Rehabilitation, Vanderbilt University School of Medicine
| | - Trey McGonigle
- Department of Biostatistics, Vanderbilt University School of Medicine
| | - Simon N. Vandekar
- Department of Biostatistics, Vanderbilt University School of Medicine
| | | | | | | | - Stephen Bruehl
- Department of Anesthesiology, Vanderbilt University School of Medicine
| | - Blythe A. Corbett
- Department of Psychiatry & Behavioral Sciences, Vanderbilt University School of Medicine
| | | | - Elizabeth G. Walsh
- Department of Physical Medicine & Rehabilitation, Vanderbilt University School of Medicine
| | - A. Gracie Kelly
- Department of Psychiatry & Behavioral Sciences, Vanderbilt University School of Medicine
- Department of Psychology, George Mason University
| | - Susanna L. Sutherland
- Department of Physical Medicine & Rehabilitation, Vanderbilt University School of Medicine
| | - Erin L. Connors
- Department of Anesthesiology, Vanderbilt University School of Medicine
| | - Anna Ryden
- Department of Psychiatry & Behavioral Sciences, Vanderbilt University School of Medicine
| | - W. Stuart Reynolds
- Department of Urologic Surgery, Vanderbilt University School of Medicine
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Isali I, Batur AF. Commentary on: The prevalence and risk factors of sexual dysfunction among females with inflammatory bowel disease: a systematic review and meta-analysis. Int J Impot Res 2024; 36:539-540. [PMID: 38280940 DOI: 10.1038/s41443-024-00830-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 01/06/2024] [Accepted: 01/17/2024] [Indexed: 01/29/2024]
Affiliation(s)
- Ilaha Isali
- Department of Urology, University Hospitals Cleveland Medical Center, 44106, Cleveland, OH, USA
| | - Ali Furkan Batur
- Department of Urology, Selcuk University School of Medicine, 42250, Konya, Turkey.
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14
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García JC, Maraver FM, Rodríguez Jiménez I, Ríos-Pena L, Carmen Rubio Rodríguez M. Female sexual function in long-term cervical cancer survivors compared with healthy women and women affected by benign gynecological disorders. Eur J Obstet Gynecol Reprod Biol 2024; 299:43-53. [PMID: 38833773 DOI: 10.1016/j.ejogrb.2024.05.027] [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: 02/14/2024] [Revised: 04/06/2024] [Accepted: 05/22/2024] [Indexed: 06/06/2024]
Abstract
OBJECTIVE To compare the female sexual function between cervical cancer survivors and healthy women or with benign gynecological diseases. STUDY DESIGN From January 1, 2010 to January 31, 2019, a case-control study was conducted to compare the female sexual function of 106 cervical cancer survivors from a tertiary hospital and 185 women admitted to a gynecological outpatient clinic from the same health area for a routine gynecological examination (n=46) or for a benign gynecological disorder (symptomatic, n=113; asymptomatic, n=26). We prospectively assessed the female sexual function using the Female Sexual Function Index (FSFI). For the contrastive analysis hypothesis, we employed R statistical software. RESULTS Cervical cancer survivors reported lower sexual activity rates than controls, in general, did (47.12% vs. 88.65%, p=0.0001), and, particularly, compared with healthy and symptomatic controls (47.12% vs. 82.61%, p=0.003; 47.12% vs. 87.61%, p=0.0001, respectively). Sixty and fifty-eight hundredths percent of the cervical cancer survivors experienced female sexual dysfunction, mainly due to hypoactive sexual desire (93.27%). Female sexual dysfunction was diagnosed in 64.32% of the controls, with sexual arousal disorders being the most common diagnosis (44.86%). Compared with controls, cervical cancer survivors exhibited considerably lower FSFI total scores and in sexual desire and lubrication domains (p <0.000; p <0.0001; p=0.023). CONCLUSIONS Cervical cancer survivors had worse female sexual function and less sexual activity than controls did, although scores in both groups were in range of FSD. Rates of female sexual dysfunction were similar across cervical cancer survivors and controls, with hypoactive sexual desire and sexual arousal disorders as the most common diagnoses, respectively.
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Affiliation(s)
- Jorge Cea García
- Clinical Management Unit for Obstetrics and Gynecology, University Hospital Virgen Macarena, 3 Dr Fedriani Ave., 41 009 Seville, Spain.
| | - Francisco Márquez Maraver
- Clinical Management Unit for Obstetrics and Gynecology, University Hospital Virgen Macarena, 3 Dr Fedriani Ave., 41 009 Seville, Spain
| | - Inmaculada Rodríguez Jiménez
- Clinical Management Unit for Obstetrics and Gynecology, University Hospital Virgen Macarena, 3 Dr Fedriani Ave., 41 009 Seville, Spain
| | - Laura Ríos-Pena
- Institute of Science and Technology, Loyola University, De las Universidades Ave., 41 704 Dos Hermanas, Seville, Spain
| | - M Carmen Rubio Rodríguez
- Department of Radiation Oncology in HM Hospitals, University Hospital Sanchinarro, 10 De Oña St., 28 050, Madrid, Spain and Puerta del Sur, 70 Carlos V Ave., 28 938, Móstoles, Madrid, Spain.
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15
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As-Sanie S, Shafrir AL, Halvorson L, Chawla R, Hughes R, Merz M. The Burden of Pelvic Pain Associated With Endometriosis Among Women in Selected European Countries and the United States: A Restricted Systematic Review. J Minim Invasive Gynecol 2024; 31:653-666.e5. [PMID: 38729420 DOI: 10.1016/j.jmig.2024.05.002] [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: 12/23/2023] [Revised: 04/03/2024] [Accepted: 05/07/2024] [Indexed: 05/12/2024]
Abstract
OBJECTIVE To evaluate the burden of endometriosis-associated pelvic pain (EAPP) on health-related quality of life (HRQoL) among women living in similar socio-economic conditions. DATA SOURCES Searches were performed in PubMed and Embase on September 26, 2022. The review was performed in conformity with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis protocol (PRISMA-P) and was registered on PROSPERO (ID: CRD42023370363). METHODS OF STUDY SELECTION Due to the high volume of eligible publications following initial review, inclusion criteria were restricted to studies undertaken in France, Germany, Italy, Spain, the United Kingdom, and the United States. This restriction was applied before screening as these countries have broad social and economic similarities, and previous studies in the literature suggest pain reporting and experience are influenced by numerous socio-cultural factors. Eligible studies were those published between 2013 and 2022 and include a sample size of ≥50 participants. The search strategy identified all relevant publications relating to the burden of illness due to EAPP. A variety of terms are used in the literature to describe pain associated with endometriosis, and this was considered in the design of the search strategy and screening procedure. TABULATION, INTEGRATION, AND RESULTS The database searches resulted in a total of 6139 records. After removal of duplicates, 3855 records were assessed further. A total of 27 publications were identified as eligible. Fourteen (52%) were from Italy, 5 (19%) were multinational studies, 4 (15%) were from the United States, 3 (11%) were from Spain, and 1 (4%) was from Germany. Most studies were cross-sectional (n = 15; 56%); 7 (26%) were case-control studies; 3 (11%) were cohort studies; and 2 (7%) were longitudinal studies. These publications collectively highlighted an association between EAPP and reduced HRQoL. Several studies showed that EAPP was associated with lower HRQoL when compared with endometriosis without pain and potentially with chronic pelvic pain caused by other conditions, although the evidence is limited in this case. Moreover, the studies reported detrimental effects on general HRQoL, mental health functioning, and sexual functioning, culminating in reduced work productivity and difficulties in performing everyday activities. The associations were generally similar across study populations, including adolescents, as well as younger and older women. Results were consistent across the range of different patient-reported outcome tools used to assess HRQoL. CONCLUSION The existing literature suggests that, among women in selected European countries and the United States, EAPP is associated with reduced HRQoL, including impaired mental and sexual functioning, as well as reduced work performance and productivity; each of which may contribute to the societal burden of endometriosis.
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Affiliation(s)
- Sawsan As-Sanie
- Department of Obstetrics and Gynecology, University of Michigan (Dr. As-Sanie), Ann Arbor, Michigan.
| | - Amy L Shafrir
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, Boston Children's Hospital and Harvard Medical School (Dr. Shafrir), Boston, Massachusetts; Department of Nutrition and Public Health, School of Nursing and Health Sciences, Merrimack College (Dr. Shafrir), North Andover, Massachusetts; Department of Nutrition and Public Health, School of Nursing and Health Sciences, Merrimack College (Dr. Shafrir), North Andover, MA
| | - Lisa Halvorson
- Bayer US Pharmaceuticals (Dr. Halvorson), Whippany, New Jersey
| | - Rajinder Chawla
- AccuScript Consultancy (Dr. Chawla), Ludhiana, Punjab, India
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16
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Brissette V, Monton O, Demian M, Al Busaidi N, Moon J, Sabboobeh S, Vasilevsky CA, Rajabiyazdi F, Boutros M. Exploring patients' needs and expectations for information on sexual dysfunction after rectal cancer treatment: A qualitative study. Colorectal Dis 2024; 26:1535-1543. [PMID: 38890007 DOI: 10.1111/codi.17048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 03/25/2024] [Accepted: 05/15/2024] [Indexed: 06/20/2024]
Abstract
AIM Sexual dysfunction is an important, and often overlooked, sequela of rectal cancer treatment with significant implications for patients' quality of life. The aim of this study was to explore patients' information needs regarding sexual health after rectal cancer treatment and their experiences accessing information on sexual dysfunction throughout the cancer care continuum. The secondary aim was to explore surgeons' perspectives on patients' information needs and gain insight into their experiences providing information on sexual health following rectal cancer surgery. METHOD A qualitative study was conducted using semistructured interviews with 10 rectal cancer survivors and six colorectal surgeons from a Canadian tertiary care institution. Transcribed interviews were coded independently by two researchers and thematic analysis was performed. RESULTS Analysis of patient interviews revealed that patients had limited knowledge of sexual dysfunction symptoms following rectal cancer treatment and received inadequate information on sexual dysfunction from their treating medical team. Patients expressed the desire to receive information on sexual dysfunction in different formats, especially before the start of treatment. The surgeon interviews revealed that colorectal surgeons faced challenges when informing patients about sexual dysfunction. Surgeons did not routinely provide information on sexual dysfunction to all patients; however, they felt that patients should receive high-quality information on sexual dysfunction, both before and after treatment. CONCLUSION Patients' information needs related to sexual dysfunction after rectal cancer treatment were inadequately met. High-quality informational resources are needed to facilitate communication between patients and physicians and improve patients' understanding of sexual dysfunction.
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Affiliation(s)
- Vincent Brissette
- Department of Medicine (Neurology), University of Ottawa, Ottawa, Ontario, Canada
| | - Olivia Monton
- Department of Surgery, Division of General Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Marie Demian
- Division of Colon and Rectal Surgery, Department of Surgery, Jewish General Hospital, Montreal, Quebec, Canada
| | - Nasra Al Busaidi
- Department of Surgery, University of Ottawa, Ottawa, Ontario, Canada
| | - Jeongyoon Moon
- Department of Surgery, Division of General Surgery, McGill University, Montreal, Quebec, Canada
| | - Sarah Sabboobeh
- Division of Colon and Rectal Surgery, Department of Surgery, Jewish General Hospital, Montreal, Quebec, Canada
| | | | - Fateme Rajabiyazdi
- Department of Systems and Computer Engineering, Carleton University, Ottawa, Ontario, Canada
| | - Marylise Boutros
- Department of Surgery, McGill University, Montreal, Quebec, Canada
- Department of Colorectal Surgery, Cleveland Clinic Florida, Weston, Florida, USA
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17
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Rodrigues AMDBP, Neto OB, Seguro CS, da Silva WF, Gonzalez RH, Santos DDAT, de Lira CAB, Viana RB. Does yoga improve sexual function? A systematic review and meta-analysis of randomized clinical trials. Complement Ther Clin Pract 2024; 56:101864. [PMID: 38830273 DOI: 10.1016/j.ctcp.2024.101864] [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: 01/05/2024] [Revised: 05/27/2024] [Accepted: 05/27/2024] [Indexed: 06/05/2024]
Abstract
BACKGROUND Yoga practice can increase blood flow in the genital area, increase muscular strength, and improve body perception, which is related to sexual function. This study aimed to summarize the available evidence about the effects of yoga on sexual function in adults. METHODS Systematic searches of five databases were conducted from inception to April 28, with the last update on September 28, 2023. Randomized clinical trials (RCTs) that compared yoga with nonintervention control groups on sexual function in adults. Risk of bias and certainty of evidence were assessed by the Cochrane risk of bias tool 2, and the GRADE approach, respectively. Summary effect size measures were calculated using a random-effects model estimation and are reported as standardized mean differences and 95% confidence intervals. Reporting followed the PRISMA guidelines. RESULTS Ten RCTs that comprised 730 adults (range mean age, 26.64-68.2 years; 680 [93.2 %] women) were included. For the primary outcome, yoga intervention was associated with a significant small improvement in sexual function (-0.31; -0.47 to -0.15, p = 0.0002), with some concerns about risk of bias in nine RCTs (90%) and low-certainty evidence. Subgroup analyses revealed that yoga interventions performed by women (-0.36; -0.52 to -0.21, p < 0.00001), healthy individuals (-0.38; -0.59 to -0.16, p = 0.0006), or middle-aged individuals (-0.44; -0.63 to -0.25, p < 00001) significantly improved sexual function compared with control groups. CONCLUSION Yoga was associated with a small improvement in sexual function compared with nonintervention control groups in adults. However, high-quality, larger RCTs are required to draw more definitive conclusions.
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Affiliation(s)
| | - Octavio Barbosa Neto
- Instituto de Educação Física e Esportes, Universidade Federal do Ceará, Fortaleza, Brazil
| | | | | | - Ricardo Hugo Gonzalez
- Instituto de Educação Física e Esportes, Universidade Federal do Ceará, Fortaleza, Brazil
| | | | | | - Ricardo Borges Viana
- Instituto de Educação Física e Esportes, Universidade Federal do Ceará, Fortaleza, Brazil.
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18
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Yuan Y, Li S, Li F, Zhou Y, Qiang S, Che K, Wang K, Yang K, Li Q. Modified Internal Pudendal Artery Perforator Flap Interposition for Rectovaginal Fistula. UROGYNECOLOGY (PHILADELPHIA, PA.) 2024; 30:699-705. [PMID: 38373234 DOI: 10.1097/spv.0000000000001447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/21/2024]
Abstract
IMPORTANCE Rectovaginal fistula (RVF) is a challenging condition associated with recurrences and significant functional impairment. OBJECTIVES The internal pudendal artery perforator (IPAP) flap has become a viable option for reconstructing the vagina and perineal regions. This study aims to introduce a modified technique of IPAP flap interposition and evaluate its postoperative outcomes in the treatment of low RVF. STUDY DESIGN Sixteen patients with RVF who underwent modified IPAP flap interposition between 2016 and 2021 were retrospectively enrolled. Recurrence rate, the satisfaction of vulvar appearance (Visual Analog Scale), and quality of sexual life (Female Sexual Function Index score) were followed up and analyzed. RESULTS All patients presented with low fistula with a mean diameter of 8.3 mm. The mean width and length of the IPAP flaps were 3.8 and 6.2 cm, respectively. The mean follow-up period was 14.1 months. All patients achieved successful healing without recurrence. High satisfaction was reported for the cosmetic effect of the vulva with a mean Visual Analog Scale score of 8.4. The proportion of female sexual disorder exhibited a statistically significant reduction, decreasing from 100% preoperatively to 38% after surgery ( P < 0.05). CONCLUSIONS The modified IPAP flap interposition is a reliable and safe option for repairing low RVF, with high success rates and minimal donor site morbidity. Moreover, this procedure provides a suitable volume flap and preserves the vaginal physiological environment, which benefits postoperative sexual function.
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Affiliation(s)
- Ye Yuan
- From the Gynecological Plastic Surgery Department, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Senkai Li
- From the Gynecological Plastic Surgery Department, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Fengyong Li
- From the Gynecological Plastic Surgery Department, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yu Zhou
- From the Gynecological Plastic Surgery Department, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shuai Qiang
- Plastic Surgery Department, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Kexin Che
- From the Gynecological Plastic Surgery Department, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Keke Wang
- From the Gynecological Plastic Surgery Department, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Kun Yang
- From the Gynecological Plastic Surgery Department, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Qiang Li
- From the Gynecological Plastic Surgery Department, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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19
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Zhang X, Zhu Z, Tang G, Xu H. The prevalence and risk factors of sexual dysfunction among females with inflammatory bowel disease: a systematic review and meta-analysis. Int J Impot Res 2024; 36:463-473. [PMID: 37759098 DOI: 10.1038/s41443-023-00767-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 09/16/2023] [Accepted: 09/19/2023] [Indexed: 09/29/2023]
Abstract
In recent years, numerous epidemiological studies have investigated the prevalence of female sexual dysfunction (FSD) in females with inflammatory bowel disease (IBD). However, a comprehensive systematic review with meta-analysis pooling their findings is lacking. This study aimed to determine the pooled prevalence estimates of FSD and its risk factors among females with IBD based on extensive research in electronic databases (PubMed, Embase, and Web of Science) from inception until April 1, 2023. The overall prevalence of FSD among females with IBD, along with its 95% confidence interval (CI), and subgroup-specific prevalence rates, were summarized. Sources of heterogeneity were identified through subgroup analyses and meta-regression. A total of 13 studies were included in this systematic review and meta-analysis. The pooled global prevalence of FSD among females with IBD was 61.4% (95% CI: 52.8-70.1%). Sensitivity analysis, which involved excluding individual studies, indicated no significant variation in the pooled prevalence, confirming the robustness of our results. Additionally, a significant risk factor for FSD among females with IBD was the quality of life (OR = 0.39, 95% CI: 0.19-0.79). In conclusion, our systematic review and meta-analysis revealed a high prevalence of FSD among females with IBD, which warrants attention from health organizations and clinical practitioners. Importantly, the quality of life was identified as a potential risk factor for FSD in this population. Nonetheless, future prospective cohort studies with a large sample size are warranted to confirm these findings.
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Affiliation(s)
- Xiaolong Zhang
- Department of Urology, Shaoxing People's Hospital, Shaoxing, Zhejiang, China
| | - Zhirong Zhu
- Department of Urology, Shaoxing People's Hospital, Shaoxing, Zhejiang, China
| | - Guiliang Tang
- Department of Urology, Shaoxing People's Hospital, Shaoxing, Zhejiang, China.
| | - Huali Xu
- Department of Urology, Shaoxing People's Hospital, Shaoxing, Zhejiang, China.
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Buhrman M, Hällström H, Fridén A, Kettis Moden E, Grahn G, Carlfjord M, Hjo C, Gasslander N, Bohm-Starke N, McCracken LM. Guided internet-based acceptance and commitment therapy for provoked vestibulodynia: A randomized controlled trial. Eur J Pain 2024; 28:1185-1201. [PMID: 38429870 DOI: 10.1002/ejp.2253] [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: 07/18/2023] [Revised: 01/31/2024] [Accepted: 02/13/2024] [Indexed: 03/03/2024]
Abstract
BACKGROUND Provoked vestibulodynia (PVD) causes suffering in many women's lives due to its impact on relationships, sexual functioning and functioning in other key domains. OBJECTIVE Here, we report a randomized controlled trial conducted to examine whether Acceptance and Commitment Therapy (ACT) with a focus on values-based exposure, delivered online, benefits women with PVD. METHODS Participants (n = 88) were randomized to either guided online ACT for 10 weeks or a wait-list control group. Outcomes were assessed at baseline, post treatment and 1 year later. Analyses were based on intention to treat using linear mixed models. RESULTS There were significant group differences on the primary outcomes, Female Sexual Index and Female Sexual Distress Scale, in favour of online ACT with moderate effect sizes. Differences were also found on several secondary outcomes and therapeutic process measures, all in favour of ACT. No differences were found at post-treatment for depression or anxiety. At the 1-year follow-up, results were maintained and a difference between baseline and follow-up was also found for depression. CONCLUSION/SIGNIFICANCE In summary, a relatively brief, guided, online version of ACT appears to produce benefits for women with PVD and related impacts on daily functioning. 50% to 60% of the women who participated in the treatment reliably improved in sexual functioning and distress.
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Affiliation(s)
- Monica Buhrman
- Division of Clinical Psychology, Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Hanna Hällström
- Division of Clinical Psychology, Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Annika Fridén
- Division of Clinical Psychology, Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Emma Kettis Moden
- Division of Clinical Psychology, Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Gunnar Grahn
- Division of Clinical Psychology, Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Maja Carlfjord
- Division of Clinical Psychology, Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Camille Hjo
- Division of Clinical Psychology, Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Nils Gasslander
- Division of Clinical Psychology, Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Nina Bohm-Starke
- Division of Obstetrics and Gynecology, Department of Clinical Sciences, Karolinska Institute, Solna, Sweden
- Danderyd Hospital, Stockholm, Sweden
| | - Lance M McCracken
- Division of Clinical Psychology, Department of Psychology, Uppsala University, Uppsala, Sweden
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21
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Calvo‐Torres J, Rejas‐Gutiérrez J, Ramírez‐Mena M, Bradbury M, Del Pino M, González‐Granados C, Procas B, Coronado PJ. Population-based norms for the human papillomavirus-quality of life (HPV-QoL) questionnaire: A cross-sectional multicenter study. Acta Obstet Gynecol Scand 2024; 103:1584-1595. [PMID: 38872262 PMCID: PMC11266628 DOI: 10.1111/aogs.14877] [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: 10/30/2023] [Revised: 04/26/2024] [Accepted: 05/04/2024] [Indexed: 06/15/2024]
Abstract
INTRODUCTION Human papillomavirus (HPV) diagnosis has a considerable emotional and psychological impact on women. To evaluate the impairment this infection leads to regarding quality of life (QoL), several scales have been suggested, such as the human-papillomavirus-quality-of-life (HPV-QoL) questionnaire. This has been validated for the Spanish population and measures the impact of HPV on health-related-quality-of-life (HR-QoL). However, normative values are yet to be developed. Thus, the objective was to describe the population-based norms of the HPV-QoL for Spanish women aged 25-65 years and to test the questionnaire's construct validity. MATERIAL AND METHODS This was a cross-sectional nationwide multicenter study. Women from outpatient clinics in Spain aged 25-65 years, with a diagnosis of past or active HPV infection were recruited. The central tendency, dispersion, and percentiles were calculated for the total score and its dimensions for each age group. Construct validity was tested by analyzing age groups and their correlations with other related scales (12-Item General Health Questionnaire [GHQ-12], Female Sexual Function Index [FSFI], and Hospital Anxiety and Depression Scale [HADS]). RESULTS A total of 1352 women were included in the study. The norms showed moderate and significant coefficients of correlation with other related scales. Significant differences between age strata groups were found according to educational level, sexual dysfunction, sexual activity, mental deterioration, and severity of anxiety and depression symptoms (p < 0.001 in all cases). The total score differed significantly between the groups (p = 0.006). Significant differences in the contagiousness, health, and sexuality dimensions (p < 0.05) were found among the groups. It was seen that HPV infection impaired women's QoL. Dimensions within all test age groups (p < 0.001 in all cases) were significantly different, with the health dimension being the highest contributor to women's QoL impairment, whereas social well-being was the main determinant of QoL. CONCLUSIONS Population-based norms for the novel HPV-QoL questionnaire showed adequate validity and could be a useful tool for assessing the impact of QoL among women with HPV in Spain.
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Affiliation(s)
- Javier Calvo‐Torres
- Women Health Institute, Hospital Clínico San Carlos, IdISSC. School of MedicineComplutense UniversityMadridSpain
| | | | - Mar Ramírez‐Mena
- Women Health Institute, Hospital Clínico San Carlos, IdISSC. School of MedicineComplutense UniversityMadridSpain
| | - Melissa Bradbury
- Unit of Gynecologic Oncology, Service of Gynecology, Gynecology Oncology Department, Hospital Vall d'HebronUniversitat Autònoma de BarcelonaBarcelonaSpain
| | - Marta Del Pino
- Institute Clinic of Gynecology, Obstetrics, and Neonatology, Hospital ClínicUniversitat de BarcelonaBarcelonaSpain
| | | | - Beatriz Procas
- Department of Obstetrics and GynecologyHospital General Universitario San JorgeHuescaSpain
| | - Pluvio J. Coronado
- Women Health Institute, Hospital Clínico San Carlos, IdISSC. School of MedicineComplutense UniversityMadridSpain
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Calvo Moya M, Mesonero Gismero F, Suarez Ferrer C, Hernández-Camba A, Vásquez Carlón D, García Benasach F, Aguas Peris M, Delgado Oliva FJ, González-Lama Y, Millán Scheiding M, Alonso Sebastián I, Camacho Martel L, Gallardo Arriero V, Echarri Piudo A, Bella Castillo P, Cano Sanz N, Vera Mendoza MI, Serrano Labajos R, Valdivia Martínez A, Pérez Restoy L, Zabana Abdo Y, Mañosa Ciria M, Rodríguez-Moranta F, Barreiro-de Acosta M, Gutiérrez Casbas A. Position statement of the Spanish Working Group on Crohn's Disease and Ulcerative Colitis on sexuality and inflammatory bowel disease. GASTROENTEROLOGIA Y HEPATOLOGIA 2024; 47:774-792. [PMID: 38218430 DOI: 10.1016/j.gastrohep.2023.12.013] [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: 11/23/2023] [Accepted: 12/14/2023] [Indexed: 01/15/2024]
Abstract
It is widely acknowledged that inflammatory bowel disease (IBD) is associated with a high prevalence of sexual dysfunction (SD). However, there is a notable paucity of specific literature in this field. This lack of information impacts various aspects, including the understanding and comprehensive care of SD in the context of IBD. Furthermore, patients themselves express a lack of necessary attention in this area within the treatment of their disease, thus creating an unmet need in terms of their well-being. The aim of this position statement by the Spanish Working Group on Crohn's Disease and Ulcerative Colitis (GETECCU) is to provide a review on the most relevant aspects and potential areas of improvement in the detection, assessment, and management of SD in patients with IBD and to integrate the approach to sexual health into our clinical practice. Recommendations are established based on available scientific evidence and expert opinion. The development of these recommendations by GETECCU has been carried out through a collaborative multidisciplinary approach involving gastroenterologists, gynecologists, urologists, surgeons, nurses, psychologists, sexologists, and, of course, patients with IBD.
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Affiliation(s)
- Marta Calvo Moya
- Unidad de Enfermedad Inflamatoria Intestinal, Servicio de Gastroenterología, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, España.
| | - Francisco Mesonero Gismero
- Unidad de Enfermedad Inflamatoria Intestinal, Servicio de Gastroenterología. Hospital Universitario Ramón y Cajal, Madrid, España
| | - Cristina Suarez Ferrer
- Unidad de Enfermedad Inflamatoria Intestinal, Servicio de Gastroenterología, Hospital Universitario La Paz, Madrid, España; Instituto de Investigación Hospital Universitario La Paz, Madrid, España
| | - Alejandro Hernández-Camba
- Unidad de Enfermedad Inflamatoria Intestinal, Servicio de Gastroenterología. Hospital Universitario Nuestra Señora de la Candelaria, Santa Cruz de Tenerife, España
| | - Danízar Vásquez Carlón
- Centro de Asistencia a la Reproducción Humana de Canarias (FIVAP), San Cristóbal de la Laguna, Tenerife, España
| | - Fátima García Benasach
- Servicio de Ginecología y Obstetricia, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, España
| | - Mariam Aguas Peris
- Unidad de Enfermedad Inflamatoria Intestinal, Servicio de Gastroenterología. Hospital Universitari i Politécnic La Fe, Valencia, España
| | | | - Yago González-Lama
- Unidad de Enfermedad Inflamatoria Intestinal, Servicio de Gastroenterología, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, España
| | - Mónica Millán Scheiding
- Unidad de Coloproctología, Servicio de Cirugía General y Aparato Digestivo, Hospital Universitari i Politécnic La Fe, Valencia, España
| | - Isabel Alonso Sebastián
- Unidad de Coloproctología, Servicio de Cirugía general y Aparato Digestivo. Hospital Universitario Puerta de Hierro Majadahonda, Madrid, España
| | - Laura Camacho Martel
- Unidad de Enfermedad Inflamatoria Intestinal, Psicología Clínica, Hospital Virgen de la Victoria, Málaga, España
| | - Vanesa Gallardo Arriero
- Unidad de Enfermedad Inflamatoria Intestinal, Psicología Clínica, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, España
| | - Ana Echarri Piudo
- Unidad de Enfermedad Inflamatoria Intestinal, Servicio de Gastroenterología, Complejo Hospitalario Universitario de Ferrol, Ferrol, España
| | - Pablo Bella Castillo
- Unidad de Enfermedad Inflamatoria Intestinal, Enfermería, Servicio de Gastroenterología, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, España
| | - Noelia Cano Sanz
- Unidad de Enfermedad Inflamatoria Intestinal, Enfermería, Servicio de Gastroenterología, Hospital Universitario de León, León, España
| | - María Isabel Vera Mendoza
- Unidad de Enfermedad Inflamatoria Intestinal, Servicio de Gastroenterología, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, España
| | - Ruth Serrano Labajos
- Confederación Asociaciones de enfermos de Crohn y Colitis Ulcerosa de España, Madrid, España
| | | | - Lourdes Pérez Restoy
- Sexología, Clínica Bonadea, Granada, España; Neurohábilis Centro de Salud Integral, Granada, Loja y Puerto de Santa María, España
| | - Yamile Zabana Abdo
- Unidad de Enfermedad Inflamatoria Intestinal, Servicio de Gastroenterología, Hospital Universitari Mútua de Terrassa, Barcelona, España; Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, España
| | - Miriam Mañosa Ciria
- Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, España; Unidad de Enfermedad Inflamatoria Intestinal, Hospital Universitari Germans Trias i Pujol Badalona, Barcelona, España
| | - Francisco Rodríguez-Moranta
- Unidad de Enfermedad Inflamatoria Intestinal, Servicio de Gastroenterología, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España
| | - Manuel Barreiro-de Acosta
- Unidad de Enfermedad Inflamatoria Intestinal, Hospital Clínico Universitario de Santiago, Santiago de Compostela, A Coruña, España; Fundación Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), A Coruña, España
| | - Ana Gutiérrez Casbas
- Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, España; Unidad de Enfermedad Inflamatoria Intestinal, Servicio de Gastroenterología, Hospital General Universitario Dr. Balmis de Alicante, ISABIAL, Alicante, España
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Zhang X, Li B, Mao J, Richolsik, Zhang R, Faiz S, Zhao M. A Bibliometric and Visualisation Analysis on the Research of Female Genital Plastic Surgery Based on the Web of Science Core Collection Database. Aesthetic Plast Surg 2024; 48:2975-2993. [PMID: 38671242 DOI: 10.1007/s00266-024-03983-6] [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: 01/14/2024] [Accepted: 02/29/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND AND OBJECTIVES Due to the increasing demand for improving the morphology and function of the external genitalia amongst women, it is necessary to conduct statistical analysis of research data on female genital reconstruction. The current study aimed to use bibliometric analysis to analyse the research hotspots and trend frontiers of the female genital reconstructive research. METHODS Publications on the female genital reconstructive research were extracted from the Web of Science Core Collection database. VOSviewer 1.6.18 was used to establish visualisation maps and find top authors, institutions, countries, burst keywords, co-cited authors, journals, research hotspots, and trends. RESULTS A total of 2207 studies published by 364 different journals authored by 7479 researchers were contained in this study. In the co-authorship analysis, the bulk of the retrieved studies was conducted by the USA, followed by England, Italy, and Netherlands, whilst the most productive institution, journal, and author were U.S. Univ Calif San Francisco, Journal of Sexual Medicine, and Bouman Mark-Bram, respectively. In the co-cited analysis, the top most-cited author and journal were Hage JJ and Journal of Sexual Medicine, respectively. The map of keywords occurrence revealed the most active research aspects were focussed on "vaginoplasty", "feminised genitoplasty", "laser treatment of vaginal atrophy", "transsexualism", and "labiaplasty". The time overlay mapping showed that the study of female genital plastic surgery focusses on the energetic treatment of genitourinary syndromes caused by transsexualism and menopause, especially by using management and treatment of vulvovaginal atrophy for the research trends, and through the vaginoplasty, feminising genioplasty, and laser treatments in the direction of treatments related to physical and mental problems. INTERPRETATION AND CONCLUSIONS This novel inclusive bibliometric analysis can help research workers to quickly understand the potential and active researchers, landmark studies, and topics within their interests. We are willing to provide more beneficial data to contribute valuable research of female genital plastic surgery through this study. LEVEL OF EVIDENCE III The journal asks authors to assign a level of evidence to each article. For a complete description of Evidence-Based Medicine ratings, see the Table of Contents or the online Instructions for Authors at www.springer.com/00266 .
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Affiliation(s)
- Xianling Zhang
- The Second Hospital of Dalian Medical University, Zhongshan Road, Shahekou District, Dalian City, Liaoning Province, People's Republic of China
| | - Bo Li
- The Second Hospital of Dalian Medical University, Zhongshan Road, Shahekou District, Dalian City, Liaoning Province, People's Republic of China
| | - JiaXin Mao
- The Second Hospital of Dalian Medical University, Zhongshan Road, Shahekou District, Dalian City, Liaoning Province, People's Republic of China
| | - Richolsik
- The Second Hospital of Dalian Medical University, Zhongshan Road, Shahekou District, Dalian City, Liaoning Province, People's Republic of China
| | - Ruipeng Zhang
- The Second Hospital of Dalian Medical University, Zhongshan Road, Shahekou District, Dalian City, Liaoning Province, People's Republic of China
| | - Shabnam Faiz
- The Second Hospital of Dalian Medical University, Zhongshan Road, Shahekou District, Dalian City, Liaoning Province, People's Republic of China
| | - MuXin Zhao
- The Second Hospital of Dalian Medical University, Zhongshan Road, Shahekou District, Dalian City, Liaoning Province, People's Republic of China.
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Saleh SA, Almadani N, Mahfouz R, Nofal HA, El-Rafey DS, Seleem DA. Exploring the Intersection of Depression, Anxiety, and Sexual Health in Perimenopausal Women. Int J Womens Health 2024; 16:1315-1327. [PMID: 39100112 PMCID: PMC11298183 DOI: 10.2147/ijwh.s464129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Accepted: 07/18/2024] [Indexed: 08/06/2024] Open
Abstract
Purpose The perimenopausal period is marked by hormonal fluctuations that trigger a complex interplay between estrogen levels and neurotransmitters' function, contributing to increased susceptibility to depression and anxiety in women. Concurrently, hormonal changes, coupled with alterations in vaginal tissue, lead to sexual dysfunction during this transitional phase. This study aimed at evaluating the association between menopausal symptoms and sexual dysfunction among perimenopausal women and identifying the mediating effects of depression and anxiety on this association. Patients and Methods Data for the present cross-sectional study were collected from participants via Arabic versions of three questionnaires; the modified Menopausal Rating Scale (MRS), the Female Sexual Functioning Index (FSFI) and the Hospital Anxiety and Depression scale (HADS). Results Our study was conducted on 149 females with age ranged from 45 to 55 years. On studying the relation between modified MRS and HADS, the menopausal symptoms were significantly high among female with high anxiety scores. Regarding the relationship between MRS and FSFI, women with anxiety and physical and mental exhaustion had significantly lower FSFI scores than women without such symptoms (19.2 [2-31.4] vs 21.7 [3.8-30.9], p = 0.04, respectively). Furthermore, there were statistically significant negative correlations between depression scores and sexual desire (r = -0.32, p < 0.001), arousal (r = -0.25, p = 0.003), and total FSFI scores (r = -0.27, p = 0.04). Conclusion Perimenopausal women experience a confluence of challenges related to depression, anxiety, and sexual dysfunction. Understanding the interconnectedness of hormonal and psychosocial factors is essential for tailored interventions aimed at improving mental health and sexual well-being during this transitional phase.
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Affiliation(s)
- Shahenda A Saleh
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Noura Almadani
- Community and Psychiatric Mental Health Nursing Department, College of Nursing, Princess Nourah Bint Abdulrahman University, Riyadh, 11671, Saudi Arabia
| | - Rasha Mahfouz
- Community and Psychiatric Mental Health Nursing Department, College of Nursing, Princess Nourah Bint Abdulrahman University, Riyadh, 11671, Saudi Arabia
| | - Hanaa A Nofal
- Community, Environmental, and Occupational Medicine Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Dina S El-Rafey
- Community, Environmental, and Occupational Medicine Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Dina A Seleem
- Psychiatry Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
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25
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Di Stanislao M, Coada CA, De Terlizzi F, Di Costanzo S, Fiuzzi E, Mezzapesa F, Dondi G, Paoli D, Damiani GR, Raspagliesi F, Bogani G, Ditto A, Morganti AG, De Iaco P, Perrone AM. Laser Therapy in Heavily Treated Oncological Patients Improves Vaginal Health Parameters. Cancers (Basel) 2024; 16:2722. [PMID: 39123449 PMCID: PMC11311561 DOI: 10.3390/cancers16152722] [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: 06/22/2024] [Revised: 07/26/2024] [Accepted: 07/27/2024] [Indexed: 08/12/2024] Open
Abstract
This study aimed to investigate the efficacy and duration of multiple non-ablative intravaginal CO2 laser (V-lase®) cycles in breast cancer patients, gynecological and other pelvic cancers previously subjected to multiple oncological treatments. This prospective study enrolled women under the age of 65 years who reported vaginal symptoms. Data on the Vaginal Health Index (VHI), vaginal length (VL), vaginal pain measured using a Visual Analog Scale (VAS), and the Female Sexual Function Index (FSFI) were collected at baseline and before each laser application, and at subsequent follow-up visits. A total of 170 laser applications were performed on 113 women with various types of cancer. Most patients (57.5%) had received radiotherapy-based treatments before receiving laser treatment. Vaginal health parameters and sexual function improved significantly with each laser application. However, a temporary decline in these improvements occurred during the intervals between cycles. Such worsening was reversed with the subsequent cycle in all groups of patients, irrespective of the type of oncological treatments they had undergone. Multiple course vaginal laser therapy showed promising results as a potential treatment for vaginal atrophy in heavily treated gynecological and breast cancer patients, necessitating further research to determine the optimal time interval between cycles to ensure sustained positive effects.
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Affiliation(s)
- Marco Di Stanislao
- Division of Oncologic Gynecology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (M.D.S.); (E.F.); (F.M.); (G.D.); (P.D.I.); (A.M.P.)
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy; (C.A.C.); (D.P.)
| | - Camelia Alexandra Coada
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy; (C.A.C.); (D.P.)
| | | | - Stella Di Costanzo
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy; (C.A.C.); (D.P.)
| | - Enrico Fiuzzi
- Division of Oncologic Gynecology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (M.D.S.); (E.F.); (F.M.); (G.D.); (P.D.I.); (A.M.P.)
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy; (C.A.C.); (D.P.)
| | - Francesco Mezzapesa
- Division of Oncologic Gynecology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (M.D.S.); (E.F.); (F.M.); (G.D.); (P.D.I.); (A.M.P.)
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy; (C.A.C.); (D.P.)
| | - Giulia Dondi
- Division of Oncologic Gynecology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (M.D.S.); (E.F.); (F.M.); (G.D.); (P.D.I.); (A.M.P.)
| | - Damiano Paoli
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy; (C.A.C.); (D.P.)
| | | | - Francesco Raspagliesi
- Gynecologic Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy; (F.R.); (G.B.); (A.D.)
| | - Giorgio Bogani
- Gynecologic Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy; (F.R.); (G.B.); (A.D.)
| | - Antonino Ditto
- Gynecologic Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy; (F.R.); (G.B.); (A.D.)
| | | | - Pierandrea De Iaco
- Division of Oncologic Gynecology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (M.D.S.); (E.F.); (F.M.); (G.D.); (P.D.I.); (A.M.P.)
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy; (C.A.C.); (D.P.)
| | - Anna Myriam Perrone
- Division of Oncologic Gynecology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (M.D.S.); (E.F.); (F.M.); (G.D.); (P.D.I.); (A.M.P.)
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy; (C.A.C.); (D.P.)
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Zhu M, Huang F, Xu J, Chen W, Ding B, Shen Y. Risk factors and nomogram construction for predicting women with chronic pelvic pain:a cross-sectional population study. Heliyon 2024; 10:e34534. [PMID: 39156584 PMCID: PMC11330104 DOI: 10.1016/j.heliyon.2024.e34534] [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: 03/07/2024] [Revised: 07/09/2024] [Accepted: 07/11/2024] [Indexed: 08/20/2024] Open
Abstract
Background Chronic pelvic pain (CPP) in women is a critical challenge. Due to the complex etiology and difficulties in diagnosis, it has a greatly negative impact on women's physical and mental health and the healthcare system. At present, there is still a lack of research on the related factors and predictive models of chronic pelvic pain in women. Our study aims to identify risk factors associated with chronic pelvic pain in women and develop a predictive nomogram specifically tailored to high-risk women with CPP. Materials and methods From May to October 2022, trained interviewers conducted face-to-face questionnaire surveys and pelvic floor surface electromyography assessments on women from community hospitals in Nanjing. We constructed a multivariate logistic regression-based predictive model using CPP-related factors to assess the risk of chronic pelvic pain and create a predictive nomogram. Both internal and external validations were conducted, affirming the model's performance through assessments of discrimination, calibration, and practical applicability using area under the curve, calibration plots, and decision curve analysis. Results 1108 women were recruited in total (survey response rate:1108/1200), with 169 (15.3 %) being diagnosed as chronic pelvic pain. Factors contributing to CPP included weight, dysmenorrhea, sexual dysfunction, urinary incontinence, a history of pelvic inflammatory disease, and the surface electromyography value of post-baseline rest. In both the training and validation sets, the nomogram exhibited strong discrimination abilities with areas under the curve of 0.85 (95 % CI: 0.81-0.88) and 0.85 (95 % CI: 0.79-0.92), respectively. The examination of the decision curve and calibration plot showed that this model fit well and would be useful in clinical settings. Conclusions Weight, dysmenorrhea, sexual dysfunction, history of urinary incontinence and pelvic inflammatory disease, and surface electromyography value of post-baseline rest are independent predictors of chronic pelvic pain. The nomogram developed in this study serves as a valuable and straightforward tool for predicting chronic pelvic pain in women.
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Affiliation(s)
- Mingyue Zhu
- School of Medicine, Southeast University, Nanjing, 210009, Jiangsu, China
| | - Fei Huang
- Department of rehabilitation medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, 210009, Jiangsu, China
| | - Jingyun Xu
- Department of Obstetrics and Gynecology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, 210009, Jiangsu, China
- School of Medicine, Southeast University, Nanjing, 210009, Jiangsu, China
| | - Wanwen Chen
- School of Medicine, Southeast University, Nanjing, 210009, Jiangsu, China
| | - Bo Ding
- Department of Obstetrics and Gynecology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, 210009, Jiangsu, China
- School of Medicine, Southeast University, Nanjing, 210009, Jiangsu, China
| | - Yang Shen
- Department of Obstetrics and Gynecology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, 210009, Jiangsu, China
- School of Medicine, Southeast University, Nanjing, 210009, Jiangsu, China
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Johansen G, Lampic C, Flöter Rådestad A, Dahm-Kähler P, Rodriguez-Wallberg KA. Health-related quality of life, sexual function, psychological health, reproductive concerns and fertility outcome in young women treated with fertility-sparing surgery for ovarian tumors - A prospective longitudinal multicentre study. Gynecol Oncol 2024; 189:101-108. [PMID: 39084159 DOI: 10.1016/j.ygyno.2024.07.004] [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: 03/15/2024] [Revised: 06/14/2024] [Accepted: 07/07/2024] [Indexed: 08/02/2024]
Abstract
OBJECTIVE This study aimed to investigate health-related quality of life (HRQoL), sexual function, psychological-health, reproductive concerns, and fertility outcomes of women of reproductive age undergoing Fertility-Sparing Surgery (FSS) for treatment of ovarian cancer (OC) or borderline ovarian tumor (BOT), over a 2-year period. METHODS Prospective longitudinal multicentre study including women 18-40 years undergoing FSS between 2016 and 2018 in Sweden. Clinical data at diagnosis, histopathological findings and 2-year follow-up regarding oncological and reproductive outcomes were collected. Participants completed the EORTC QLQ-C30 and OV-28, FSFI, HADS and study-specific items at time of diagnosis and at one- and two-years following FSS. Data were analysed using a model for repeated measures to investigate changes over time. RESULTS Of 68 eligible women, 49 were included following exclusions due to benign pathology or subsequent radical surgery. During a mean follow-up of 20.5 months, two women experienced a recurrence and 82% reported regular menstruations. The majority (94%) had a strong desire to become biological mothers, which remained or increased over time. The conception-rate was 76%. HRQoL, psychological-health and sexual function improved over time and the proportion of women with sexual dysfunction decreased. At one-year follow-up 50% of nulliparous women had scores indicating sexual dysfunction compared to 0% of the women who had given birth either before or after surgery (p = 0.008). CONCLUSION HRQoL, psychological-health and sexual function improved during two-year follow-up after FSS in young women presenting with OC or BOT. Women who had given birth prior to or after FSS reported improved sexual function compared to nulliparous women.
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Affiliation(s)
- Gry Johansen
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden; Department of Gynecology, Division of Gynecology and Reproduction, Karolinska University Hospital, Stockholm, Sweden
| | - Claudia Lampic
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden; Department of Psychology, Umeå University, Umeå, Sweden
| | - Angelique Flöter Rådestad
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden; Department of Hereditary Cancer, Karolinska University Hospital, Stockholm, Sweden
| | - Pernilla Dahm-Kähler
- Department of Obstetrics and Gynecology, Sahlgrenska University Hospital, Gothenburg, Sweden; Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Kenny A Rodriguez-Wallberg
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden; Department of Reproductive Medicine, Division of Gynecology and Reproduction, Karolinska University Hospital, Stockholm, Sweden.
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Yousefi Afrashteh M, Blouri R, Morovati Z. Sexual anxiety mediate relationship between sexual schemas and body image with sexual function in Iranian women. PLoS One 2024; 19:e0305340. [PMID: 39058704 PMCID: PMC11280222 DOI: 10.1371/journal.pone.0305340] [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: 08/12/2022] [Accepted: 05/29/2024] [Indexed: 07/28/2024] Open
Abstract
BACKGROUND Sexual function is one of the most critical challenges in human society, especially among women. The problems associated with sexual function are significantly ambiguous in a society like Iran. This study investigated the mediating role of sexual anxiety in relationship between sexual schemas and body image with female sexual function. METHOD The research method was correlational and specifically path analysis. The statistical population included women aged 25-45 in Rasht, Iran, 2021. 365 women were selected using Cochran's formula and the convenience sampling method. The Female Sexual Function Index (FSFI), Sexual Self-Schema Scale for Women (SSSS), Body Image Scale (BIS), and Multidimensional Sexual Self-Concept Questionnaire (MSQ) were used for data collection. For data analysis, SPSS-26 and LISREL 10.2 software were used. RESULTS Descriptive data analysis showed that mean and standard deviation were for further passionate-romantic schema 22.96 and 4.83, open-direct schema 27.64 and 5.09, embarrassed-conservative 20.93 and 4.61, body image 128.96 and 27.35, sexual anxiety 13.13 and 3.91 and sexual function 49.83 and 8.67. According to the results of path analysis, passionate-romantic (β = 0.51), explicit-comfortable (β = 0.27), shy-conservative (β = -0.59), and body image (β = -0.62) schemas showed a significant relationship with sexual function. Sexual function anxiety as a mediating variable also had a significant role (β = -0.41) in female sexual function. CONCLUSION Sexual function anxiety, negative body image, and negative sexual schema negatively affect women's sexual function, and positive sexual schemas and body image positively affect sexual function anxiety.
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Affiliation(s)
| | - Rojan Blouri
- Department of Psychology, Faculty of Humanities, University of Zanjan, Zanjan, Iran
| | - Zekrollah Morovati
- Department of Psychology, Faculty of Humanities, University of Zanjan, Zanjan, Iran
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Li Y, Zheng M, Na L, Wang M. Association between bladder cancer treatment and female sexual function. Sex Med Rev 2024:qeae051. [PMID: 39059372 DOI: 10.1093/sxmrev/qeae051] [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: 01/10/2024] [Revised: 06/23/2024] [Accepted: 06/28/2024] [Indexed: 07/28/2024]
Abstract
INTRODUCTION Bladder cancer ranks 17th in prevalence of cancer types among women, and the trend is rising. The increased risk of female sexual dysfunction (FSD) after radical cystectomy (RC) underscores the need for greater focus on preserving and mitigating FSD. OBJECTIVES To place greater emphasis on the importance of female sexual function (FSF) in the treatment of bladder cancer and stimulate additional research to discover more effective solutions for enhancing the overall quality of life. METHODS This review used a narrative approach. Previous reviews on FSF after RC have provided limited and 1-sided solutions due to the lack of research. What makes this review unique is its innovative approach: it includes all available measures curing FSD as well as comparative analyses based on experimental data, thus making the findings more comprehensive. A detailed perspective of treatments for female bladder cancer is provided, including nerve- and organ-sparing RC, robot-assisted RC, and radiotherapy. We also analyze the impact of treatments for female bladder cancer on postoperative FSD. Additionally, solutions for addressing or alleviating postoperative FSD are summarized, such as urinary diversion, vaginal reconstruction, and drug and nondrug treatment. RESULTS Research has suggested that robot-assisted nerve- and organ-sparing RC is promising. Moreover, orthotopic neobladder among urinary diversions without a stoma helps to maintain a positive female body image. If part of the anterior vaginal wall must be removed during RC, vaginal reconstruction can restore the dimensions with synthetic grafts and biologic scaffolds. Additionally, postoperative measures, such as vaginal laser and hormone therapy, and use of vaginal dilators and lubricants have a significant role in reducing distress caused by FSD to provide maximum relief. CONCLUSIONS To support FSF after RC, various interventions are needed, and urologists must focus on patient recovery while minimizing treatment impact on FSF as much as possible.
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Affiliation(s)
- Yakui Li
- China Medical University, Shenyang, China
| | - Ming Zheng
- Department of Urology, Liao Yang Liao Hua Hospital
| | - Lei Na
- Department of Urology, Shengjing Hospital of China Medical University
| | - Mingli Wang
- Department of Surgery, Shengjing Hospital of China Medical University
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Rezaei N, Behboodi Moghadam Z, Tahmasebi A, Taheri S, Namazi M. Women`s sexual function during the postpartum period: A systematic review on measurement tools. Medicine (Baltimore) 2024; 103:e38975. [PMID: 39058853 PMCID: PMC11272350 DOI: 10.1097/md.0000000000038975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Accepted: 06/27/2024] [Indexed: 07/28/2024] Open
Abstract
BACKGROUND Sexual health is a critical component of overall well-being, yet discussions around sexual function, especially in the context of postpartum recovery, are often taboo or sidelined. The aim was to review measurement tools assessing women's sexual function/health during the postpartum period. METHODS We did a systematic search according to preferred reporting items for systematic reviews and meta-analyses 2020 guidelines in different databases, including PubMed, Web of Science, Scopus, Embase, ProQuest and Open Access Thesis and Dissertations, and Google scholar search engine until June 2023. Also, the reference list of the related reviews has been screened. Eligible studies included observational studies or clinical trials that evaluated women`s sexual function during the postpartum period using existing tools. Data extraction covered study characteristics, measurement tools, and their validity and reliability. RESULTS From 3064 retrieved records, after removing duplicates and excluding ineligible studies, and reviewing the reference list of the related reviews, 41 studies were included in this review. Tools measuring sexual function were developed from 1996 to 2017. Sexual activity questionnaire, female sexual function index (FSFI), sexual function questionnaire, short form of the pelvic organ prolapse/urinary incontinence sexual questionnaire, sexual health outcomes in women questionnaire, shorter version of FSFI, and sexual function questionnaire's medical impact scale and Carol scale. CONCLUSION Sexual activity questionnaire, FSFI, sexual function questionnaire, short form of the pelvic organ prolapse/urinary incontinence sexual questionnaire, sexual health outcomes in women questionnaire, shorter version of FSFI, sexual function questionnaire's medical impact scale, and Carol scale are valid and reliable measuring tools to assess sexual function or sexual health during postpartum period, which can be used in primary studies according to the study aim and objectives.
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Affiliation(s)
- Nazanin Rezaei
- School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
- Department of Midwifery, Ilam University of Medical Sciences, Ilam, Iran
| | - Zahra Behboodi Moghadam
- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Atbin Tahmasebi
- School of Medicine, Student Research Committee, Ilam University of Medical Sciences, Ilam, Iran
| | - Safoura Taheri
- Department of Midwifery, Ilam University of Medical Sciences, Ilam, Iran
| | - Masoumeh Namazi
- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
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Del Forno S, Raspollini A, Doglioli M, Andreotti A, Spagnolo E, Lenzi J, Borghese G, Raimondo D, Arena A, Rodriguez E, Hernandez A, Govoni F, Seracchioli R. Painful sexual intercourse, quality of life and sexual function in patients with endometriosis: not just deep dyspareunia. Arch Gynecol Obstet 2024:10.1007/s00404-024-07643-7. [PMID: 39052076 DOI: 10.1007/s00404-024-07643-7] [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: 06/21/2024] [Accepted: 07/07/2024] [Indexed: 07/27/2024]
Abstract
PURPOSE To evaluate the prevalence of deep and superficial dyspareunia in women with diagnosis of endometriosis. Secondly, to assess the temporal relation between deep and superficial dyspareunia in women reporting both symptoms (concomitant dyspareunia) and the impact on quality of life (QoL) and sexual function. METHODS This is a cross-sectional cohort study that included fertile women with diagnosis of endometriosis. Enrolled subjects reported pain symptoms including dyspareunia and its temporal onset and completed two one-time validated questionnaires regarding sexual function (Female Sexual Function Index) and QoL (International QoL Assessment SF-36). RESULTS Among the 334 enrolled patients, 75.7% (95%) reported dyspareunia. Women were divided into four groups according to the presence and type of dyspareunia: isolated superficial dyspareunia (6.3%), isolated deep dyspareunia (26.0%), concomitant dyspareunia (43.4%) and no dyspareunia (24.3%). Women with concomitant dyspareunia reported higher NRS scores than women with isolated dyspareunia or no dyspareunia (P ≤ 0.001). The majority of women with concomitant dyspareunia (56.6%) reported that deep dyspareunia developed before superficial dyspareunia. Women with concomitant dyspareunia reported worse QoL and worse sexual function than women with isolated dyspareunia or without dyspareunia (P ≤ 0.001). CONCLUSION Dyspareunia is a common symptom in women with endometriosis, with many reporting concomitant deep and superficial dyspareunia. Concomitant dyspareunia can significantly impact sexual function and quality of life (QoL). Therefore, it is crucial to investigate dyspareunia thoroughly and differentiate between its types to tailor effective therapeutic strategies.
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Affiliation(s)
- Simona Del Forno
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
| | - Arianna Raspollini
- Division of Gynaecology and Human Reproduction Physiopathology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 13, Bologna, Italy.
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy.
| | - Marisol Doglioli
- Division of Gynaecology and Human Reproduction Physiopathology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 13, Bologna, Italy
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
| | - Anna Andreotti
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
| | - Emanuela Spagnolo
- Department of Obstetrics and Gynecology, Hospital Universitario La Paz, Madrid, Spain
| | - Jacopo Lenzi
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Giulia Borghese
- Division of Gynaecology and Human Reproduction Physiopathology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 13, Bologna, Italy
| | - Diego Raimondo
- Division of Gynaecology and Human Reproduction Physiopathology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 13, Bologna, Italy
| | - Alessandro Arena
- Division of Gynaecology and Human Reproduction Physiopathology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 13, Bologna, Italy
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
| | - Elena Rodriguez
- Department of Obstetrics and Gynecology, Hospital Universitario La Paz, Madrid, Spain
| | - Alicia Hernandez
- Department of Obstetrics and Gynecology, Hospital Universitario La Paz, Madrid, Spain
| | - Francesca Govoni
- Division of Gynaecology and Human Reproduction Physiopathology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 13, Bologna, Italy
| | - Renato Seracchioli
- Division of Gynaecology and Human Reproduction Physiopathology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 13, Bologna, Italy
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
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Gil Haro B, Cordoba Largo S, Rodriguez Rodriguez I, Lozano Martin EM, Couselo Paniagua ML, Martinez Montesinos I, Belinchon Olmeda B, Vicente Ruiz P, Cerrolaza Pascual M, Payano Hernández S, Rey-Baltar Oramas D, Martinez Casares N, Barahona Orpinell M. Let's talk about sex: consensus guidelines of the GINECOR working group of the Spanish Society of Radiation Oncology: clinical recommendations after pelvic radiotherapy. Clin Transl Oncol 2024:10.1007/s12094-024-03562-w. [PMID: 39046683 DOI: 10.1007/s12094-024-03562-w] [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: 03/19/2024] [Accepted: 04/13/2024] [Indexed: 07/25/2024]
Abstract
PURPOSE The present consensus statement was developed by the GINECOR working group on behalf of the Spanish Society of Radiation Oncology (SEOR). This document addresses sexual health management in patients with gynaecological cancer after pelvic radiotherapy. METHODS A modified two-round online Delphi study was conducted, where GINECOR members were surveyed on the diagnosis, treatment, and follow-up of sexual health problems. An expert panel of radiation oncologists, nurses and a gynaecologist participated in the Delphi study to reach a consensus, applying GRADE criteria to establish the level of agreement. RESULTS The consensus recommendations cover both diagnosis and treatment, with an emphasis on patient-reported outcome measures (PROMs). They highlight recommendations such as the systematic assessment of genitourinary, gastrointestinal, and sexual symptoms, and the use of several treatments after radiotherapy. Recommendations include pharmacological options like vaginal lubricants and hormone therapy, and mechanical interventions such as vaginal dilators and vibrators. These suggestions stem from both scientific evidence and clinical expertise. CONCLUSION This consensus statement describes a comprehensive, multidisciplinary approach developed to address the sexual needs and enhance the quality of life of patients with gynaecological tumours after pelvic radiotherapy. It offers specific recommendations for managing sexual issues, emphasizing the importance of specialized care and regular assessment. The document underscores the significance of proactive, patient-centered sexual health management in gynaecological cancer patients.
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Affiliation(s)
- Beatriz Gil Haro
- Department of Radiation Oncology, Puerta de Hierro University Hospital, Majadahonda, Madrid, Spain
| | - Sofía Cordoba Largo
- Department of Radiation Oncology, Puerta de Hierro University Hospital, Majadahonda, Madrid, Spain.
| | | | | | - Maria Luz Couselo Paniagua
- Department of Radiation Oncology, University Hospital Clinico de Santiago, Santiago de Compostela, Spain
| | | | | | - Paula Vicente Ruiz
- Department of Radiation Oncology, Virgen Macarena University Hospital, Seville, Spain
| | | | | | - Dolores Rey-Baltar Oramas
- Department of Radiation Oncology, Gran Canaria Doctor Negrin University Hospital, Gran Canaria, Spain
| | - Nieves Martinez Casares
- Department of Radiation Oncology, Puerta de Hierro University Hospital, Majadahonda, Madrid, Spain
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Agrawal S, LaPier Z, Nagpal S, Oot A, Friedman S, Hade EM, Nachtigall L, Brucker BM, Escobar C. A randomized, pilot trial comparing vaginal hyaluronic acid to vaginal estrogen for the treatment of genitourinary syndrome of menopause. Menopause 2024:00042192-990000000-00350. [PMID: 39042017 DOI: 10.1097/gme.0000000000002390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/24/2024]
Abstract
OBJECTIVE The aim of this study was to compare the efficacy of a non-hormone alternative, vaginal hyaluronic acid (HLA), to a standard-of-care therapy, vaginal estrogen, for the treatment of genitourinary syndrome of menopause (GSM). METHODS This was a randomized, parallel arm pilot trial. Women with GSM were randomized to an HLA vaginal suppository or vaginal estrogen cream for 12 wk to compare the primary outcome, the vulvovaginal symptom questionnaire (VSQ) score. Secondary outcomes included the following: the female sexual function index (FSFI), the vaginal symptom index (VSI), visual analog scale (VAS) for dyspareunia, vaginal itching, and vaginal dryness, patient global impression of improvement (PGI-I) at follow-up, vaginal maturation index, and vaginal pH. Differences between treatment groups were estimated using the two-sided, two-sample t-test and 95% confidence intervals. RESULTS Forty-nine women were randomized and 45 participants (vaginal estrogen = 23, vaginal HLA = 22) provided data at week 12. Baseline characteristics were similar in both groups. On the VSQ, there was no observed difference in overall scores between the HLA and vaginal estrogen groups at 12 wk (P = 0.81). Improvement was seen within both treatment groups on the VSQ after 12 wk. The VAS score, total VSI score, total FSFI score, and vaginal pH improved over time; however, improvement did not differ between study arms. Over 90% participants noted improvement on the PGI-I in both groups (P = 0.61). No treatment-related serious adverse events occurred. CONCLUSIONS There were no clinically meaningful differences between vaginal HLA and vaginal estrogen for the treatment of GSM after 12 wk. Vaginal HLA may be a promising non-hormone therapy for GSM.
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Affiliation(s)
| | - Zoe LaPier
- From the Department of Urogynecology, New York University Langone Health, New York, NY
| | - Shavy Nagpal
- From the Department of Urogynecology, New York University Langone Health, New York, NY
| | - Antoinette Oot
- From the Department of Urogynecology, New York University Langone Health, New York, NY
| | - Steven Friedman
- Department of Population Health, New York University Grossman School of Medicine, New York, NY
| | - Erinn M Hade
- Department of Population Health, New York University Grossman School of Medicine, New York, NY
| | - Lila Nachtigall
- Reproductive Endocrinology and Infertility, New York University Langone Health, New York, NY
| | - Benjamin M Brucker
- From the Department of Urogynecology, New York University Langone Health, New York, NY
| | - Christina Escobar
- From the Department of Urogynecology, New York University Langone Health, New York, NY
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Gaikaiwari RU, Prinsloo C, Grover SR, Wright I, Drever N. Experiences of pelvic and generalized persistent pain syndromes in MRKH: a scoping review. J Pediatr Adolesc Gynecol 2024:S1083-3188(24)00254-7. [PMID: 39038531 DOI: 10.1016/j.jpag.2024.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 06/27/2024] [Accepted: 07/03/2024] [Indexed: 07/24/2024]
Abstract
STUDY OBJECTIVES Mayer-Rokitansky-Küster-Hauser Syndrome (MRKH) is characterized by the congenital absence of the uterus and vagina, sometimes with associated extragenital anomalies. Currently there is limited literature on pelvic pain and co-morbid pain syndromes in people with MRKH. The aims of this scoping review were to summarize existing literature on pelvic and generalized persistent pain syndromes associated with MRKH and to identify knowledge gaps for further research into this field. METHODS This scoping review followed the Joanna Briggs Institute framework. The population of interest was patients with a diagnosis of MRKH. MEDLINE, CINAHL, Scopus, Cochrane, Embase and Emcare databases were searched. Excluded were articles that did not meet the inclusion criteria or critical appraisal standards. The resultant articles were reviewed by 2 independent researchers while a third was used in cases of disagreement. A descriptive analytical method was used for data analysis. RESULTS We screened 3348 articles for eligibility, 39 articles met criteria, which described 1353 cases of MRKH. 4 studies described baseline pelvic pain in MRKH, 19 described acute presentations and 13 described post-intervention pain levels. CONCLUSION Despite the paucity of research, this review found that cyclical pelvic pain was mostly present in women with uterine remnants, whilst pelvic pain in those without remnants was poorly understood. There were no studies exploring generalized persistent pain syndromes in MRKH. Further cross-sectional studies are needed to elucidate prevalence and levels of pain syndromes in MRKH.
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Affiliation(s)
| | - C Prinsloo
- James Cook University, Cairns, Queensland, Australia
| | - S R Grover
- Department of Pediatrics, University of Melbourne, Victoria, Australia; Royal Children's Hospital, Melbourne, Victoria, Australia
| | - I Wright
- James Cook University, Cairns, Queensland, Australia; Department of Pediatrics, Cairns Hospital, Cairns, Queensland, Australia; University of Queensland Centre for Clinical Research, University of Queensland, Brisbane, Queensland, Australia
| | - N Drever
- James Cook University, Cairns, Queensland, Australia; Department of Obstetrics and Gynecology, Cairns Hospital, Cairns, Queensland, Australia
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Fouad TR, Mohamad NE, Elabd M, Abd-Elwahab R, Elsary AY, Abd-Elghafar TS, Elshimi E, Attia A. Nonalcoholic fatty liver disease and female sexual dysfunction in Egyptian premenopausal women: is there a link between metabolic syndrome and sexual function? J Sex Med 2024:qdae080. [PMID: 39003089 DOI: 10.1093/jsxmed/qdae080] [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: 03/07/2024] [Revised: 06/05/2024] [Accepted: 06/18/2024] [Indexed: 07/15/2024]
Abstract
BACKGROUND Nonalcoholic fatty liver disease (NAFLD) is a major health problem with a paucity of available information about its impact on female sexual dysfunction (FSD). AIM We aimed to study the association between NAFLD and FSD in Egyptian premenopausal women. METHODS Sexually active married premenopausal women who visited our NAFLD outpatient screening clinic (2019 to 2022) were divided into NAFLD and non-NAFLD (control) groups based on liver ultrasound and fatty liver index data. All participants completed the Arabic Female Sexual Function Index (ArFSFI) questionnaire. The resulting data were used to calculate the domains and total scores. FSD is then graded as follows: no FSD (≥28.2), minimal (21.7-28.1), mild (14.5-21.6), moderate (7.3-14.4), and severe (≤7.2). OUTCOMES We determined the proportions of patients and controls for whom ArFSFI scores indicated dissatisfaction with their sexual lives. RESULTS Of 995 women participants whose FSFI scores were available, NAFLD was detected in 487 (48.9%) and absent in 508 (51.1%). The two groups were comparable in age, socioeconomic level, residence, and history of female genital cutting. The NAFLD patients had significantly much lower mean scores for the sexual arousal, lubrication, orgasm, satisfaction, and pain domains of the FSFI (P < .001 for all), while no statistical difference was noticed in the desire domain for NAFLD patients compared with the controls. NAFLD women had significantly lower mean total FSFI scores than the controls (mean [SD] 16.7 [6.8] vs 21.7 [5.1], respectively; P < .001) with higher rates of FSD (98.5% vs 82.1%; P < .001, respectively). Most NAFLD women had higher FSD grades than controls (%): no FSD (1.5, 17.9), minimal (20.6, 51.8), mild (42.5, 38.8), moderate (26.2, 9.4), and severe (10.7, none), respectively. CLINICAL IMPLICATIONS Given the high prevalence of FSD in patients with NAFLD, greater attention to FSF could improve the quality of life in patients with NAFLD. STRENGTHS AND LIMITATIONS This study was limited by the lack of testing of sex hormones and some other important factors that were not tested (eg, age, socioeconomic level, residence, and female genital cutting), as these characteristics were previously matched. Strengths of the study include the large study size, to our knowledge the largest to date to investigate the possible link between FSD and NAFLD in premenopausal women, together with the inclusion of the detailed version of the validated ArFSFI. CONCLUSIONS In Egyptian premenopausal women, NAFLD could harm their sexual function.
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Affiliation(s)
- Tamer Refaat Fouad
- Hepatology and Gastroenterology Department, National Liver Institute, Menoufia University, Sheebin Al-Kom, Menoufia, 39111, Egypt
| | - Noha Ezzat Mohamad
- Dermatology and Venereology Department, Faculty of Medicine, Fayoum University, Al Faiyum, Faiyum, 2933110, Egypt
| | - Mona Elabd
- Department of Clinical Analysis and Hematology, National Liver Institute, Menoufia University, Sheebin Al-Kom, Menoufia, 39111, Egypt
| | - Rokia Abd-Elwahab
- Hepatology and Gastroenterology Department, National Liver Institute, Menoufia University, Sheebin Al-Kom, Menoufia, 39111, Egypt
| | - Asmaa Youness Elsary
- Department of Clinical Analysis and Hematology, National Liver Institute, Menoufia University, Sheebin Al-Kom, Menoufia, 39111, Egypt
| | - Tamer Samir Abd-Elghafar
- Hepatology and Gastroenterology Department, National Liver Institute, Menoufia University, Sheebin Al-Kom, Menoufia, 39111, Egypt
| | - Esam Elshimi
- Hepatology and Gastroenterology Department, National Liver Institute, Menoufia University, Sheebin Al-Kom, Menoufia, 39111, Egypt
| | - Ahmed Attia
- Hepatology and Gastroenterology Department, National Liver Institute, Menoufia University, Sheebin Al-Kom, Menoufia, 39111, Egypt
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Jankovic S, Rovcanin M, Zamurovic M, Jovanovic B, Raicevic T, Tomic A. Multifaceted Impact of CO 2 Laser Therapy on Genitourinary Syndrome of Menopause, Vulvovaginal Atrophy and Sexual Function. Healthcare (Basel) 2024; 12:1385. [PMID: 39057528 PMCID: PMC11275429 DOI: 10.3390/healthcare12141385] [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: 05/22/2024] [Revised: 07/08/2024] [Accepted: 07/10/2024] [Indexed: 07/28/2024] Open
Abstract
Genitourinary syndrome of menopause (GSM) encompasses a range of distressing symptoms in the vulvovaginal and/or bladder-urethral regions related to menopause changes, negatively influencing woman's quality of life and sexual activity. Fractional micro-ablative CO2 laser therapy has shown the potential to reinstate the vaginal epithelium to a condition akin to the premenopausal state, thereby ameliorating the subjective symptoms associated with GSM. We conducted a prospective, pilot study in 73 sexually active postmenopausal women treated with CO2 laser for their GSM symptoms, while assessing Vaginal Health Index Score (VHIS) and sexual function through the Female Sexual Function Index (FSFI) Questionnaire. The laser treatment resulted in a decrease in VHIS and patient-reported vulvovaginal atrophy (VVA) symptoms, with a significantly lower prevalence of vaginal itching, dryness, and burning (p < 0.001), as well as dyspareunia (p = 0.002). The occurrence of urinary incontinence, urgency, and vaginal heaviness significantly reduced, with an improvement in the staging of cystocele, either to Stage 1 or complete resolution (p < 0.001). FSFI total and domain scores were significantly higher after the treatment, indicating better sexual function, with a post-treatment score median of 25 (p < 0.001). Therefore, using a three-cycle fractional CO2 laser was an effective choice for reducing urogenital discomfort related to GSM in postmenopausal women.
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Affiliation(s)
- Svetlana Jankovic
- Clinic for Gynecology and Obstetrics, Narodni Front, Kraljice Natalije 62, 11000 Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Dr Subotica Starijeg 8, 11000 Belgrade, Serbia
| | - Marija Rovcanin
- Clinic for Gynecology and Obstetrics, Narodni Front, Kraljice Natalije 62, 11000 Belgrade, Serbia
| | - Milena Zamurovic
- Clinic for Gynecology and Obstetrics, Narodni Front, Kraljice Natalije 62, 11000 Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Dr Subotica Starijeg 8, 11000 Belgrade, Serbia
| | - Branka Jovanovic
- Clinic for Gynecology and Obstetrics, Narodni Front, Kraljice Natalije 62, 11000 Belgrade, Serbia
| | - Tatjana Raicevic
- Clinic for Gynecology and Obstetrics, Narodni Front, Kraljice Natalije 62, 11000 Belgrade, Serbia
| | - Ana Tomic
- Center for Radiology and Magnetic Resonance Imaging, University Clinical Center of Serbia, 11000 Belgrade, Serbia
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Barcelos TMR, de Oliveira Brito LG, Jorge CH, Franceschini SA, Troncon JK, Ferriani RA, da Silva Lara LA. Evaluation of Sexual Function of Transgender Individuals. Int Urogynecol J 2024:10.1007/s00192-024-05857-6. [PMID: 38980327 DOI: 10.1007/s00192-024-05857-6] [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: 03/05/2024] [Accepted: 05/10/2024] [Indexed: 07/10/2024]
Abstract
PURPOSE The current study sought to evaluate the sexual function of transgender men and women and to identify associated factors. METHODS Trans individuals who were outpatients at our gender incongruence (GI) center for follow-up of gender-affirming hormone therapy with age ranging 27 to 50 years were invited to participate in this cross-sectional study. Clinical data were collected from the medical records. Two scales, the Female Sexual Function Index (FSFI) and the Male Sexual Function Index (MSFI), were administered to all females (n = 50) and all males (n = 58). Each participant also responded to a semi-structured questionnaire that assessed feelings regarding being transgender and satisfaction with sexual life. RESULTS Relative to trans women, trans men had a higher total FSFI score, and higher scores in the FSFI domains of arousal, lubrication, orgasm, and satisfaction (all p < 0.01), and in the total MSFI score, and higher scores in the MFSI domains of arousal, erection, orgasm, and satisfaction (all p < 0.01). A separate semi-structured evaluation indicated that more than half of the trans men and almost half of the trans women were satisfied or very satisfied with their sexual life. CONCLUSIONS The total scores from the FSFI and MSFI indicated a high risk of sexual dysfunction in trans men and especially, in trans women. However, the semi-structured evaluation showed that more than half of the trans men and almost half of the trans women were satisfied with their sexual life.
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Affiliation(s)
- Thays Marina Roncato Barcelos
- University of Sao Paulo Faculty of Medicine of Ribeirao Preto, Universidade de Sao Paulo Faculdade de Medicina de Ribeirao Preto, São Paulo, Brazil.
| | - Luiz Gustavo de Oliveira Brito
- University of Sao Paulo Faculty of Medicine of Ribeirao Preto, Universidade de Sao Paulo Faculdade de Medicina de Ribeirao Preto, São Paulo, Brazil
| | - Cristine Homsi Jorge
- University of Sao Paulo Faculty of Medicine of Ribeirao Preto, Universidade de Sao Paulo Faculdade de Medicina de Ribeirao Preto, São Paulo, Brazil
| | - Silvio Antonio Franceschini
- University of Sao Paulo Faculty of Medicine of Ribeirao Preto, Universidade de Sao Paulo Faculdade de Medicina de Ribeirao Preto, São Paulo, Brazil
| | - Julia Kefalas Troncon
- University of Sao Paulo Faculty of Medicine of Ribeirao Preto, Universidade de Sao Paulo Faculdade de Medicina de Ribeirao Preto, São Paulo, Brazil
| | - Rui Alberto Ferriani
- University of Sao Paulo Faculty of Medicine of Ribeirao Preto, Universidade de Sao Paulo Faculdade de Medicina de Ribeirao Preto, São Paulo, Brazil
| | - Lucia Alves da Silva Lara
- University of Sao Paulo Faculty of Medicine of Ribeirao Preto, Universidade de Sao Paulo Faculdade de Medicina de Ribeirao Preto, São Paulo, Brazil
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Lissitsa D, Hovers M, Shamuilova M, Ezrapour T, Peled-Avron L. Update on cannabis in human sexuality. Psychopharmacology (Berl) 2024:10.1007/s00213-024-06643-4. [PMID: 38977465 DOI: 10.1007/s00213-024-06643-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 06/21/2024] [Indexed: 07/10/2024]
Abstract
RATIONALE Sexuality is a central aspect of being human that encompasses many facets. Cannabis, a widely used psychoactive substance, has been associated with various effects on sexuality. The relationship between cannabis and sexuality is complex and multifaceted, involving physiological, psychological, and social factors. OBJECTIVES This review aims to provide an overview of the current literature on the effects of cannabis on several sexual functions, including sexual desire, arousal, orgasm, and sexual satisfaction. It also discusses the potential mechanisms underlying these effects, as well as the impact of dose and frequency of use. RESULTS This review has revealed a complex relationship between cannabis dosage and its influence on sexuality. It appears that the frequency of cannabis use in humans has been associated with the frequency of sexual activities. Individuals who use cannabis more frequently tend to report higher levels of sexual activity. Moreover, there is a notable gender difference in how cannabis affects sexuality. In addition, we found lower doses of cannabis to be linked to heightened sexual desire and enjoyment, whereas higher doses may lead to a decrease in sexual desire and performance. CONCLUSIONS Overall, the association between cannabis and sexuality is complex and warrants further research to better understand the psychological and neurological mechanisms that underlie the effect of cannabis on these sexuality functions and its implications for sexual health. To advance in this endeavor, a crucial step is establishing a precise measurement of dosage in human studies.
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Affiliation(s)
- Denis Lissitsa
- The Gonda Multidisciplinary Brain Research Center, Bar-Ilan University, 5290002, Ramat Gan, Israel.
- Department of Psychology, Bar-Ilan University, 5290002, Ramat Gan, Israel.
| | - May Hovers
- The Gonda Multidisciplinary Brain Research Center, Bar-Ilan University, 5290002, Ramat Gan, Israel
| | - Michal Shamuilova
- The Gonda Multidisciplinary Brain Research Center, Bar-Ilan University, 5290002, Ramat Gan, Israel
| | - Tal Ezrapour
- The Gonda Multidisciplinary Brain Research Center, Bar-Ilan University, 5290002, Ramat Gan, Israel
| | - Leehe Peled-Avron
- The Gonda Multidisciplinary Brain Research Center, Bar-Ilan University, 5290002, Ramat Gan, Israel
- Department of Psychology, Bar-Ilan University, 5290002, Ramat Gan, Israel
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Yan J, Zhou D, Zhang S, Zhang B, Tuo X, Meng Q, Lv Q. Clinical efficacy and safety of transvaginal natural orifice transluminal endoscopic surgery for benign adnexal disease: a prospective trial. BMC Womens Health 2024; 24:390. [PMID: 38969995 PMCID: PMC11225116 DOI: 10.1186/s12905-024-03226-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Accepted: 06/24/2024] [Indexed: 07/07/2024] Open
Abstract
BACKGROUND There is a scarcity of prospective clinical research evidence regarding the utilization of transvaginal natural orifice translumenal endoscopic surgery (vNOTES) as a treatment option for ovarian cysts. The objective of this study was to assess the feasibility and safety of employing vNOTES for the management of ovarian cysts. METHODS Our study included women between the ages of 18 and 70 who intended to undergo surgical intervention for benign lesions. Stratified blocked randomization was employed to allocate participants into groups. The main objective was to assess whether the assigned group adhered to the recommended surgical technique for ovarian cystectomy or adnexectomy, without any deviation to alternative surgical methods. RESULTS A total of 196 patients were included in the study, with all surgeries in each group being conducted according to the assigned procedures. Among them, the ovarian cystectomy layer included 58 cases in the vNOTES group and 58 cases in the conventional laparoscopy (CL) groups. The adnexectomy layer included 40 cases in the vNOTES group and 40 cases in the CL group. Utilizing a sensitivity analysis, the two-sided 95% lower confidence limit was determined to be 5.5% for the disparity in proportions between the vNOTES groups and CL groups. These lower limits fell below the predetermined non-inferiority margin of 10%. CONCLUSIONS The study findings demonstrate that vNOTES was not inferior to CL in terms of adnexectomy or ovarian cystectomy. vNOTES can be considered a more minimally invasive surgical approach, as it results in reduced postoperative pain, faster recovery, and absence of visible incisions. Overall, vNOTES proves to be a safe, feasible, and less invasive treatment option. TRIAL REGISTRATION This study retrospectively registered with the China Clinical Trial Registry with the registration number ChiCTR2100052223(22-10-2021).
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Affiliation(s)
- Jinbowen Yan
- Department of obstetrics and Gynecology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, P.R. China
| | - Dan Zhou
- Department of obstetrics and Gynecology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, P.R. China.
| | - Shuo Zhang
- Department of obstetrics and Gynecology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, P.R. China
| | - Bo Zhang
- Department of obstetrics and Gynecology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, P.R. China
| | - Xunyuan Tuo
- Gansu Provincial Maternal and Child Health Center Gansu Provincial Central Hospital, Lanzhou, Gansu, P.R. China
| | - Qingwei Meng
- Department of obstetrics and Gynecology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, P.R. China
| | - Qiubo Lv
- Department of obstetrics and Gynecology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, P.R. China
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Suvaal I, Hummel SB, Mens JWM, Tuijnman-Raasveld CC, Tsonaka R, Velema LA, Westerveld H, Cnossen JS, Snyers A, Jürgenliemk-Schulz IM, Lutgens LCHW, Beukema JC, Haverkort MAD, Nowee ME, Nout RA, de Kroon CD, van den Hout WB, Creutzberg CL, van Doorn HC, Ter Kuile MM. Efficacy of a nurse-led sexual rehabilitation intervention for women with gynaecological cancers receiving radiotherapy: results of a randomised trial. Br J Cancer 2024:10.1038/s41416-024-02775-8. [PMID: 38961193 DOI: 10.1038/s41416-024-02775-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Revised: 06/13/2024] [Accepted: 06/18/2024] [Indexed: 07/05/2024] Open
Abstract
BACKGROUND The multicentre randomised SPARC trial evaluated the efficacy of a nurse-led sexual rehabilitation intervention on sexual functioning, distress, dilator use, and vaginal symptoms after radiotherapy for gynaecological cancers. METHODS Eligible women were randomised to the rehabilitation intervention or care-as-usual. Four intervention sessions were scheduled over 12 months, with concurrent validated questionnaires and clinical assessments. Primary outcome was the Female Sexual Function Index (FSFI). A generalised-mixed-effects model compared groups over time. RESULTS In total, 229 women were included (n = 112 intervention; n = 117 care-as-usual). No differences in FSFI total scores were found between groups at any timepoint (P = 0.37), with 12-month scores of 22.57 (intervention) versus 21.76 (care-as-usual). The intervention did not significantly improve dilator use, reduce sexual distress or vaginal symptoms compared to care-as-usual. At 12 months, both groups had minimal physician-reported vaginal stenosis; 70% of women were sexually active and reported no or mild vaginal symptoms. After radiotherapy and brachytherapy, 85% (intervention) versus 75% (care-as-usual) of participants reported dilation twice weekly. DISCUSSION Sexual rehabilitation for women treated with combined (chemo)radiotherapy and brachytherapy improved before and during the SPARC trial, which likely contributed to comparable study groups. Best practice involves a sexual rehabilitation appointment 1 month post-radiotherapy, including patient information, with dilator guidance, preferably by a trained nurse, and follow-up during the first year after treatment. CLINICAL TRIAL REGISTRATION NCT03611517.
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Affiliation(s)
- Isabelle Suvaal
- Department of Obstetrics and Gynaecology, Leiden University Medical Center, Leiden, The Netherlands
| | - Susanna B Hummel
- Department of Obstetrics and Gynaecology, Leiden University Medical Center, Leiden, The Netherlands
| | - Jan-Willem M Mens
- Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | | | - Roula Tsonaka
- Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, The Netherlands
| | - Laura A Velema
- Department of Radiation Oncology, Leiden University Medical Center, Leiden, The Netherlands
| | - Henrike Westerveld
- Department of Radiation Oncology, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
| | - Jeltsje S Cnossen
- Department of Radiation Oncology, Catharina Hospital, Eindhoven, The Netherlands
| | - An Snyers
- Department of Radiation Oncology, Radboudumc, Nijmegen, The Netherlands
| | | | | | - Jannet C Beukema
- Department of Radiation Oncology, University Medical Center Groningen, Groningen, The Netherlands
| | - Marie A D Haverkort
- Department of Radiation Oncology, Radiotherapiegroep, Arnhem, The Netherlands
| | - Marlies E Nowee
- Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Remi A Nout
- Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Cor D de Kroon
- Department of Obstetrics and Gynaecology, Leiden University Medical Center, Leiden, The Netherlands
| | - Wilbert B van den Hout
- Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, The Netherlands
| | - Carien L Creutzberg
- Department of Radiation Oncology, Leiden University Medical Center, Leiden, The Netherlands
| | - Helena C van Doorn
- Department of Gynaecology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Moniek M Ter Kuile
- Department of Obstetrics and Gynaecology, Leiden University Medical Center, Leiden, The Netherlands.
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Okui N, Okui MA. The Importance of Psychological Assessment in the Management of Bladder Pain Syndrome/Interstitial Cystitis and Vulvodynia: A Case Report. Cureus 2024; 16:e63617. [PMID: 39092346 PMCID: PMC11290954 DOI: 10.7759/cureus.63617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2024] [Indexed: 08/04/2024] Open
Abstract
This case report emphasizes the crucial role of psychological assessment in the management of patients with bladder pain syndrome/interstitial cystitis (BPS/IC) and vulvodynia. A 48-year-old woman with a five-year history of refractory BPS/IC and vulvodynia presented with frequent urination, pelvic pain, and severe dyspareunia, which led to sexual aversion and divorce from her partner. Previous treatments, including lifestyle modifications, analgesics, anticholinergics, hydrodistension, intravesical dimethyl sulfoxide, and psychiatric interventions, had been ineffective. Psychological assessments using the Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, and Toronto Alexithymia Scale-20 revealed severe symptoms of depression, anxiety, and alexithymia. Due to the patient's sexual aversion and the absence of a partner, a complete Female Sexual Function Index (FSFI) could not be administered. Instead, a partial FSFI and artificial intelligence-translated reference value of the Female Sexual Distress Scale-Revised were used to assess aspects relevant to the patient's condition. The patient underwent three monthly sessions of Fotona laser therapy, erbium, and neodymium laser at one-month intervals. Treatment outcomes were evaluated using the Numeric Rating Scale-11, Vulvodynia Total, Interstitial Cystitis Symptom Index, and psychological assessment tools. At the six-month follow-up, all physical and psychological symptoms showed significant improvement and complete remission was achieved at 12 months. Despite the overall positive treatment outcomes, the patient's sexual aversion persisted, and accurate measurement was not possible, highlighting the complexity of addressing sexual function in patients with BPS/IC and vulvodynia. This case report underscores the need for a holistic approach to managing these conditions, addressing both the physical and psychological aspects of the disease.
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Affiliation(s)
- Nobuo Okui
- Dentistry, Kanagawa Dental University, Kanagawa, JPN
- Urology, Yokosuka Urogynecology and Urology Clinic, Kanagawa, JPN
| | - Machiko A Okui
- Urogynecology, Yokosuka Urogynecology and Urology Clinic, Kanagawa, JPN
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Krajewski PK, Strobel A, Schultheis M, Staubach P, Grabbe S, Hennig K, Matusiak L, von Stebut E, Garcovich S, Bayer H, Heise M, Kirschner U, Nikolakis G, Szepietowski JC. Profound Sexual Dysfunction Among Patients with Hidradenitis Suppurativa: A Cross-sectional Study. Dermatol Ther (Heidelb) 2024; 14:1823-1838. [PMID: 38869824 PMCID: PMC11264523 DOI: 10.1007/s13555-024-01196-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2024] [Accepted: 05/24/2024] [Indexed: 06/14/2024] Open
Abstract
INTRODUCTION Sexual health, a critical aspect of overall well-being, is often compromised in individuals with chronic disorders. Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition that mainly affects intertriginous areas, potentially impacting sexual health as a result of its specific symptoms and psychosocial burden. METHODS This cross-sectional study utilized data from the EpiCAi project, focusing on 199 patients with HS. Participants completed digital questionnaires assessing sexual health via sex-specific instruments: the Female Sexual Function Index (FSFI) for women and the International Index of Erectile Function (IIEF) for men, alongside different psychosocial scales. The disease severity was assessed using the Hurley stage and the Lesion Identification Scheme for Acne Inversa (LISAI). RESULTS The majority of the participants reported impaired sexual health, with significant clinical sexual dysfunctions noted in 71.8% of women (FSFI score < 26) and erectile dysfunction in 63.8% of men. Sexual dysfunction was associated with several factors, including age, and marital status. Psychosocial factors, notably depression and quality of life, showed strong correlations with sexual health outcomes. Notably, women over 40 and those treated with biologics reported more severe dysfunction, while among men, employment status significantly influenced sexual health. CONCLUSIONS HS profoundly affects the sexual health of both male and female patients, with significant impacts on their quality of life and psychological well-being. The findings underscore the necessity for healthcare providers to address sexual health proactively in the management of HS, considering both physical symptoms and psychosocial impacts. This holistic approach is essential for improving patient outcomes and overall quality of life. TRIAL REGISTRATION German Register for Clinical Trials, identifier DRKS00025315.
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Affiliation(s)
- Piotr K Krajewski
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Chalubinskiego 1, 50-368, Wroclaw, Poland
| | - Alexandra Strobel
- Faculty of Medicine, Institute of Medical Epidemiology, Biostatistics, and Informatics, Martin Luther University Halle-Wittenberg, Saale, Halle, Germany
- Faculty of Medicine, Profile Centre of Health Sciences Halle, Martin Luther University Halle-Wittenberg, Saale, Halle, Germany
| | - Michael Schultheis
- Department of Dermatology, University Medical Center, Johannes Gutenberg, University, Mainz, Germany
| | - Petra Staubach
- Department of Dermatology, University Medical Center, Johannes Gutenberg, University, Mainz, Germany
| | - Stephan Grabbe
- Department of Dermatology, University Medical Center, Johannes Gutenberg, University, Mainz, Germany
| | - Katharina Hennig
- Department of Dermatology, University Medical Center, Johannes Gutenberg, University, Mainz, Germany
| | - Lukasz Matusiak
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Chalubinskiego 1, 50-368, Wroclaw, Poland
| | - Esther von Stebut
- Department of Dermatology, Faculty of Medicine, University of Cologne, Cologne, Germany
| | | | - Hans Bayer
- Dermatology Outpatient Office Hautmedizin Bad Soden, Bad Soden, Germany
| | - Marcus Heise
- Faculty of Medicine, Profile Centre of Health Sciences Halle, Martin Luther University Halle-Wittenberg, Saale, Halle, Germany
- Faculty of Medicine, Institute for Health- and Nursing Science, Martin-Luther-University Halle-Wittenberg, Saale, Halle, Germany
- Faculty of Medicine, Institute of General Practice and Family Medicine, Martin Luther University Halle-Wittenberg, Saale, Halle, Germany
| | - Uwe Kirschner
- Dermatology Outpatient Office Dr. Uwe Kirschner, Mainz, Germany
| | - Georgios Nikolakis
- Departments of Dermatology, Departments of Dermatology, Venereology, Allergology and Immunology, Dessau Medical Center, Brandenburg Medical School Theodor Fontane and Faculty of Health Sciences Brandenburg, Dessau, Germany
| | - Jacek C Szepietowski
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Chalubinskiego 1, 50-368, Wroclaw, Poland.
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Kolbuszewska MT, Tavares IM, Nobre PJ, Dawson SJ. Using network analysis to model associations between psychological symptoms, sexual function, and sexual distress in women. Int J Clin Health Psychol 2024; 24:100479. [PMID: 39040481 PMCID: PMC11262177 DOI: 10.1016/j.ijchp.2024.100479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 06/19/2024] [Indexed: 07/24/2024] Open
Abstract
Background Psychological difficulties, including depression, anxiety, and somatization, are among the most important predictors for women's sexual function (i.e., arousal, desire, lubrication, pain, and satisfaction) and sexual distress. These associations have largely been studied at the construct level, with little research examining which specific symptoms might be most important for maintaining links between psychological difficulties and domains of sexual function. The present research sought to establish and characterize networks of women's psychological symptoms, sexual function, and sexual distress, and identify potential bridge symptoms that connect them. Methods In a cross-sectional study, 725 women reported on their sexual function, sexual distress, and depressive, anxiety, and somatization symptoms. A series of network analyses was used to identify central symptoms and connections between psychological symptoms, sexual function domains, and sexual distress. Results Across the modeled networks, sexual distress and pain during sex were consistent bridges between other sexual function domains and psychological symptoms. Discussion Overall, our models revealed sexual distress as an important potential mediator between sexual function problems and psychological symptoms that might contribute to the development and maintenance of comorbid sexual function and psychological problems.
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Affiliation(s)
- Marta T. Kolbuszewska
- Department of Psychology, University of British Columbia, 2136 West Mall, Vancouver, BC V6T 1Z4, Canada
| | - Inês M. Tavares
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Pedro J. Nobre
- Faculty of Psychology and Educational Sciences, University of Porto, Porto, Portugal
| | - Samantha J. Dawson
- Department of Psychology, University of British Columbia, 2136 West Mall, Vancouver, BC V6T 1Z4, Canada
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Visser A, van Nimwegen JF, Wilbrink R, Liefers SC, van der Tuuk K, Mourits MJE, Diercks GFH, Bart J, van der Vegt B, van Kempen LC, Bootsma H, Kroese FGM, Verstappen GM. Increased Interferon Signaling in Vaginal Tissue of Patients With Primary Sjögren Syndrome. J Rheumatol 2024; 51:687-695. [PMID: 38561184 DOI: 10.3899/jrheum.2023-1068] [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] [Accepted: 03/21/2024] [Indexed: 04/04/2024]
Abstract
OBJECTIVE Vaginal dryness is an important factor influencing sexual function in women with primary Sjögren syndrome (pSS). Previous studies showed a higher degree of inflammation in vaginal biopsies from patients with pSS compared to non-pSS controls. However, the molecular pathways that drive this inflammation remain unclear. Therefore, the aim of this study was to investigate inflammatory pathway activity in the vaginal tissue of patients with pSS. METHODS Vaginal biopsies of 8 premenopausal patients with pSS experiencing vaginal dryness and 7 age-matched non-pSS controls were included. Expression of genes involved in inflammation and tissue homeostasis was measured using NanoString technology and validated using TaqMan Real-Time PCR. Vaginal tissue sections were stained by immunohistochemistry for myxovirus resistance protein 1 (MxA) and CD123 (plasmacytoid dendritic cells [pDCs]). RESULTS The most enriched pathway in vaginal biopsies from patients with pSS compared to non-pSS controls was the interferon (IFN) signaling pathway (P < 0.01). Pathway scores for Janus kinase and signal transducer and activator of transcription (JAK-STAT) and Notch signaling were also higher (P < 0.01 for both pathways). Conversely, transforming growth factor-β signaling and angiogenesis pathway scores were lower in pSS (P = 0.02 and P = 0.04, respectively). Differences in IFN signaling between patients with pSS and non-pSS controls were confirmed by PCR and MxA tissue staining. No CD123+ pDCs were detected in vaginal biopsies. IFN-stimulated gene expression levels correlated positively with CD45+ cell numbers in vaginal biopsies and serum anti-SSA/Ro positivity. CONCLUSION Upregulation of IFN signaling in vaginal tissue of women with pSS, along with its association with tissue pathology, suggests that IFNs contribute to inflammation of the vaginal wall and potentially also to clinical symptomatology (ie, vaginal dryness).
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Affiliation(s)
- Annie Visser
- A. Visser, BSc, J.F. van Nimwegen, MD, PhD, R. Wilbrink, MD, S.C. Liefers, PhD, H. Bootsma, MD, PhD, F.G.M. Kroese, PhD, G.M. Verstappen, PharmD, PhD, University of Groningen, University Medical Center Groningen, Department of Rheumatology and Clinical Immunology, Groningen, the Netherlands
| | - Jolien F van Nimwegen
- A. Visser, BSc, J.F. van Nimwegen, MD, PhD, R. Wilbrink, MD, S.C. Liefers, PhD, H. Bootsma, MD, PhD, F.G.M. Kroese, PhD, G.M. Verstappen, PharmD, PhD, University of Groningen, University Medical Center Groningen, Department of Rheumatology and Clinical Immunology, Groningen, the Netherlands
| | - Rick Wilbrink
- A. Visser, BSc, J.F. van Nimwegen, MD, PhD, R. Wilbrink, MD, S.C. Liefers, PhD, H. Bootsma, MD, PhD, F.G.M. Kroese, PhD, G.M. Verstappen, PharmD, PhD, University of Groningen, University Medical Center Groningen, Department of Rheumatology and Clinical Immunology, Groningen, the Netherlands
| | - Silvia C Liefers
- A. Visser, BSc, J.F. van Nimwegen, MD, PhD, R. Wilbrink, MD, S.C. Liefers, PhD, H. Bootsma, MD, PhD, F.G.M. Kroese, PhD, G.M. Verstappen, PharmD, PhD, University of Groningen, University Medical Center Groningen, Department of Rheumatology and Clinical Immunology, Groningen, the Netherlands
| | - Karin van der Tuuk
- K. van der Tuuk, MD, PhD, M.J.E. Mourits, MD, PhD, University of Groningen, University Medical Center Groningen, Department of Obstetrics and Gynaecology, Groningen, the Netherlands
| | - Marian J E Mourits
- K. van der Tuuk, MD, PhD, M.J.E. Mourits, MD, PhD, University of Groningen, University Medical Center Groningen, Department of Obstetrics and Gynaecology, Groningen, the Netherlands
| | - Gilles F H Diercks
- G.F.H. Diercks, MD, PhD, J. Bart, MD, PhD, B. van der Vegt, MD, PhD, University of Groningen, University Medical Center Groningen, Department of Pathology and Medical Biology, Groningen, the Netherlands
| | - Joost Bart
- G.F.H. Diercks, MD, PhD, J. Bart, MD, PhD, B. van der Vegt, MD, PhD, University of Groningen, University Medical Center Groningen, Department of Pathology and Medical Biology, Groningen, the Netherlands
| | - Bert van der Vegt
- G.F.H. Diercks, MD, PhD, J. Bart, MD, PhD, B. van der Vegt, MD, PhD, University of Groningen, University Medical Center Groningen, Department of Pathology and Medical Biology, Groningen, the Netherlands
| | - Léon C van Kempen
- L.C. van Kempen, MD, PhD, University of Antwerp, Antwerp University Hospital, Department of Pathology, Antwerp, Belgium
| | - Hendrika Bootsma
- A. Visser, BSc, J.F. van Nimwegen, MD, PhD, R. Wilbrink, MD, S.C. Liefers, PhD, H. Bootsma, MD, PhD, F.G.M. Kroese, PhD, G.M. Verstappen, PharmD, PhD, University of Groningen, University Medical Center Groningen, Department of Rheumatology and Clinical Immunology, Groningen, the Netherlands
| | - Frans G M Kroese
- A. Visser, BSc, J.F. van Nimwegen, MD, PhD, R. Wilbrink, MD, S.C. Liefers, PhD, H. Bootsma, MD, PhD, F.G.M. Kroese, PhD, G.M. Verstappen, PharmD, PhD, University of Groningen, University Medical Center Groningen, Department of Rheumatology and Clinical Immunology, Groningen, the Netherlands
| | - Gwenny M Verstappen
- A. Visser, BSc, J.F. van Nimwegen, MD, PhD, R. Wilbrink, MD, S.C. Liefers, PhD, H. Bootsma, MD, PhD, F.G.M. Kroese, PhD, G.M. Verstappen, PharmD, PhD, University of Groningen, University Medical Center Groningen, Department of Rheumatology and Clinical Immunology, Groningen, the Netherlands;
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Lei XH, Wang X, Shao SY, Hua KQ, Zhang Y. Self-esteem, depression, anxiety and sexual function in Mayer-Rokitansky-Küster-Hauser syndrome with neovagina: A case series. Eur J Obstet Gynecol Reprod Biol 2024; 298:85-90. [PMID: 38733778 DOI: 10.1016/j.ejogrb.2024.04.027] [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: 09/27/2023] [Revised: 04/17/2024] [Accepted: 04/21/2024] [Indexed: 05/13/2024]
Abstract
BACKGROUND The Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome is a rare condition with significant psychological implications. However, our understanding of its impact on postoperative sexual function and mental health is still limited. AIM Evaluate the mental health status and sexual functioning of women with MRKH syndrome after vaginoplasty surgery. METHODS We enrolled 53 cases with MRKH syndrome who underwent artificial vaginoplasty. The participants were asked to participate in a two-round survey conducted between February 2021 during the covid-19 period and March 2023. The survey included questionnaires to measure depression, anxiety, self-esteem, and sexual functioning. Differences between scores over time were analysed using a paired sample t-test, and we assessed the correlation between mental health and sexual functioning. RESULTS In the first round, patients' mean ± SD age at surgery was 23.6 ± 4.5 years old, and the mean ± SD time that had elapsed since surgery at the time of the survey was 34.2 ± 20.8 months. None of the patients reported low self-esteem, 45.3 % reported mild-to-moderate depression, and 34.0 % reported mild anxiety. Thirty patients have had vaginal intercourse during the last six months. The mean ± SD Female Sexual Functioning Index score was 24.6 ± 4.4, and 60.0 % had a score of 23.5 or higher, indicating high sexual functioning. The sexual functioning scores were positively correlated with self-esteem scores and negatively correlated with depression or anxiety scores (p < 0.05). There was no significant improvement in patient's mental health status and sexual function between the second round survey (71.3 ± 17.8 months after surgery) and the first round survey (p > 0.05). In contrast, the sexual arousal of FSFI were significantly higher in the second survey round (p < 0.05). CONCLUSION Most patients undergoing vaginoplasty reported persisting mental health challenges. However, the majority reported good sexual functioning.
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Affiliation(s)
- Xiao-Hong Lei
- Department of Gynecology, Obstetrics and Gynecology Hospital of Fudan University, 128 Shenyang Road, Shanghai 200082, China.
| | - Xiao Wang
- Department of Gynecology, Obstetrics and Gynecology Hospital of Fudan University, 128 Shenyang Road, Shanghai 200082, China.
| | - Shu-Yi Shao
- Department of Gynecology, Obstetrics and Gynecology Hospital of Fudan University, 128 Shenyang Road, Shanghai 200082, China.
| | - Ke-Qin Hua
- Department of Gynecology, Obstetrics and Gynecology Hospital of Fudan University, 128 Shenyang Road, Shanghai 200082, China.
| | - Ying Zhang
- Department of Gynecology, Obstetrics and Gynecology Hospital of Fudan University, 128 Shenyang Road, Shanghai 200082, China.
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46
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Falgares G, Costanzo G, Fontanesi L, Verrocchio MC, Bin F, Marchetti D. The role of sexual communication in the relationship between emotion regulation and sexual functioning in women: The impact of age and relationship status. Int J Clin Health Psychol 2024; 24:100482. [PMID: 39071855 PMCID: PMC11277745 DOI: 10.1016/j.ijchp.2024.100482] [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: 03/07/2024] [Accepted: 06/24/2024] [Indexed: 07/30/2024] Open
Abstract
Objective The aim of this study was to investigate sexual communication as a mechanism involved in the link between emotion regulation and sexual functioning in a sample of adult women, also testing the moderating role of relationship status and age in this association. Method 1344 sexually active cisgender women (aged 18-57, M = 27.34; SD= 6.484) were recruited from March 30, 2021, to April 12, 2021, through an online survey. From the initial sample, 1280 women were retained and included in the analysis. Participants were asked to respond to three self-report questionnaires: the Difficulties in Emotion Regulation Scale (DERS), the Communication subscale of the Sexual Satisfaction Scale for Women (SSS-W), and the Female Sexual Function Index (FSFI). Results We found that sexual communication mediated the link between emotion regulation abilities and female sexual functioning. Moreover, we found that age, but not relationship status, moderated the association between emotion regulation and sexual communication, so that older women with difficulties in emotion regulation processes showed worse sexual communication abilities as compared to younger women. Conclusions According to this study's results, clinicians and sexual therapists should carefully consider emotion regulation abilities and sexual communication as crucial factors in promoting women's sexual well-being.
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Affiliation(s)
- Giorgio Falgares
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Giulia Costanzo
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Lilybeth Fontanesi
- Department of Psychological, Health and Territorial Sciences, G. d'Annunzio University of Chieti-Pescara, Chieti, Italy
| | - Maria Cristina Verrocchio
- Department of Psychological, Health and Territorial Sciences, G. d'Annunzio University of Chieti-Pescara, Chieti, Italy
| | - Franco Bin
- Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy
| | - Daniela Marchetti
- Department of Psychological, Health and Territorial Sciences, G. d'Annunzio University of Chieti-Pescara, Chieti, Italy
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Rempert AN, Rempert TH, Liu A, Hernández A, Blanck J, Segars J, Singh B. A Systematic Review of the Psychosocial Impact of Endometriosis before and after Treatment. Reprod Sci 2024; 31:1828-1860. [PMID: 38512699 PMCID: PMC11216884 DOI: 10.1007/s43032-024-01515-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 02/28/2024] [Indexed: 03/23/2024]
Abstract
While endometriosis is a common gynecologic disease associated with infertility, the psychosocial impact of endometriosis has not been evaluated against various quality of life (QoL) instruments and compared with other chronic illnesses. We rigorously analyzed the psychosocial burden of endometriosis in adult women and compared standardized and validated QoL scores of women with and without endometriosis, before and following treatment, and against other chronic illnesses. We searched PubMed, PsychINFO Embase, and Cochrane Reviews and ClinicalTrials.gov from January 1990 to December 2022 for publications using a detailed list of search terms related to QoL, endometriosis, and questionnaires. Only English-language publications that evaluated the association between Endometriosis and QoL using standardized and validated questionnaires measured at baseline and following treatment were considered. Four reviewers first performed a title and abstract screening followed by full text-review to finalize included articles. QoL scores of women with endometriosis were measured at baseline and analyzed against women without endometriosis and women with endometriosis who had undergone treatment. Additionally, baseline endometriosis scores were assessed against the published QoL scores of populations with other chronic conditions. Assessment of risk of bias was performed in accordance with Cochrane and Newcastle-Ottawa Scale guidelines. A total of 30 articles were included in this review: 4 randomized trials and 26 observational studies. The diagnosis and experience of women with symptomatic endometriosis had an equal or worse QoL score than that of other chronic conditions including heart disease, diabetes, and breast cancer when compared using the 36-Item Short Form Survey and World Health Organization Quality of Life questionnaires. Evidence showed association between low QoL and infertility, sexual dysfunction, mental health struggles, physical pain, poor sleep and fatigue. QoL scores were lower at baseline compared to following treatment in the majority of these domains. Endometriosis is associated with significant psychosocial burden and impaired QoL scores across baseline measurements in comparison to controls and other chronic illnesses. Medical and surgical interventions significantly decreased experienced burdens and improved QoL of women with endometriosis.
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Affiliation(s)
- Ashley N Rempert
- Department of Biology, Johns Hopkins University, Baltimore, MD, USA
| | - Trevor H Rempert
- Department of Physiology and Biophysics, Casewestern Reserve University, Cleveland, OH, USA
| | - Amy Liu
- Department of Neuroscience, Johns Hopkins University, Baltimore, MD, USA
| | - Ana Hernández
- Department of Biology, Johns Hopkins University, Baltimore, MD, USA
| | - Jaime Blanck
- Informationist Services, Welch Medical Library, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - James Segars
- Department of Gynecology and Obstetrics, Division of Reproductive Sciences &, Women's Health Research, Johns Hopkins University School of Medicine, 720 Rutland Avenue, Ross Research Building, Room 624, Baltimore, MD, USA
| | - Bhuchitra Singh
- Department of Gynecology and Obstetrics, Division of Reproductive Sciences &, Women's Health Research, Johns Hopkins University School of Medicine, 720 Rutland Avenue, Ross Research Building, Room 624, Baltimore, MD, USA.
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Rogier-Mouzelas F, Piquard A, Karam E, Dussart D, Michot N, Saint-Marc O, Thebault B, Artus A, Bucur P, Pabst-Giger U, Salame E, Ouaissi M. Comparison of a robotic surgery program for rectal cancer: short- and long-term results from a comparative, retrospective study between two laparoscopic and robotic reference centers. Surg Endosc 2024; 38:3738-3757. [PMID: 38789622 DOI: 10.1007/s00464-024-10867-y] [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: 01/24/2024] [Accepted: 04/14/2024] [Indexed: 05/26/2024]
Abstract
BACKGROUND It is assumed that robotic-assisted surgery (RAS) may facilitate complex pelvic dissection for rectal cancer compared to the laparoscopic-assisted resection (LAR). The aim of this study was to compare perioperative morbidity, short- and long-term oncologic, and functional outcomes between the RAS and LAR approaches. METHODS Between 2015 and 2021, all rectal cancers operated on by (LAR) or (RAS) were retrospectively reviewed in two colorectal surgery centers. RESULTS A total of 197 patients were included in the study, with 70% in the LAR group and 30% in the RAS group. The tumor location and stage were identical in both groups (not significant = NS). The overall postoperative mortality rate was not significantly different between the two groups. (0% LAR; 0.5% RAS; NS). The postoperative morbidity was similar between the two groups (60% LAR vs 57% RAS; NS). The number of early surgical re-interventions within the first 30 days was similar (10% for the LAR group and 3% for the RAS group; NS). The rate of complete TME was similar (88% for the LAR group and 94% for the RAS group; NS). However, the rate of circumferential R1 was significantly higher in the LAR group (13%) compared to the RAS group (2%) (p = 0.009). The 3-year recurrence rate did not differ between the two groups (77% for both groups; NS). After a mean follow-up of three years, the incidence of anterior resection syndrome was significantly lower in the LAR group compared to the RAS group (54 vs 76%; p = 0.030). CONCLUSIONS The use of a RAS was found to be reliable for oncologic outcomes and morbidity. However, the expected benefits for functional outcomes were not observed. Therefore, the added value of RAS for rectal cancer needs to be reassessed in light of new laparoscopic technologies and patient management options.
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Affiliation(s)
- Fabien Rogier-Mouzelas
- Department of Digestive, Oncological, Endocrine, Hepato-Biliary and Pancreatic Surgery, and Liver Transplantation, Colorectal Surgery Unit, Trousseau Hospital, University Hospital of Tours, Avenue de La République, 37044, Tours, France
| | - Arnaud Piquard
- Department of Digestive Surgery, University Hospital of Orleans, 14 avenue de l'hôpital, 45100, Orleans, France
| | - Elias Karam
- Department of Digestive, Oncological, Endocrine, Hepato-Biliary and Pancreatic Surgery, and Liver Transplantation, Colorectal Surgery Unit, Trousseau Hospital, University Hospital of Tours, Avenue de La République, 37044, Tours, France
| | - David Dussart
- Department of Digestive Surgery, University Hospital of Orleans, 14 avenue de l'hôpital, 45100, Orleans, France
| | - Nicolas Michot
- Department of Digestive, Oncological, Endocrine, Hepato-Biliary and Pancreatic Surgery, and Liver Transplantation, Colorectal Surgery Unit, Trousseau Hospital, University Hospital of Tours, Avenue de La République, 37044, Tours, France
| | - Olivier Saint-Marc
- Department of Digestive Surgery, University Hospital of Orleans, 14 avenue de l'hôpital, 45100, Orleans, France
| | - Baudouin Thebault
- Department of Digestive Surgery, University Hospital of Orleans, 14 avenue de l'hôpital, 45100, Orleans, France
| | - Alice Artus
- Department of Digestive, Oncological, Endocrine, Hepato-Biliary and Pancreatic Surgery, and Liver Transplantation, Colorectal Surgery Unit, Trousseau Hospital, University Hospital of Tours, Avenue de La République, 37044, Tours, France
| | - Petru Bucur
- Department of Digestive, Oncological, Endocrine, Hepato-Biliary and Pancreatic Surgery, and Liver Transplantation, Colorectal Surgery Unit, Trousseau Hospital, University Hospital of Tours, Avenue de La République, 37044, Tours, France
| | - Urs Pabst-Giger
- Fliedner Fachhochschule, University of Applied Sciences, Düsseldorf, Germany
| | - Ephrem Salame
- Department of Digestive, Oncological, Endocrine, Hepato-Biliary and Pancreatic Surgery, and Liver Transplantation, Colorectal Surgery Unit, Trousseau Hospital, University Hospital of Tours, Avenue de La République, 37044, Tours, France
| | - Mehdi Ouaissi
- Department of Digestive, Oncological, Endocrine, Hepato-Biliary and Pancreatic Surgery, and Liver Transplantation, Colorectal Surgery Unit, Trousseau Hospital, University Hospital of Tours, Avenue de La République, 37044, Tours, France.
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Poston AM, Oliver TL, Lanti A, Benning SD. Why College Women and Men Refrain from Sex Despite Desire: Development of the No Sex Despite Desire (NSDD) Measure. JOURNAL OF SEX RESEARCH 2024:1-14. [PMID: 38940432 DOI: 10.1080/00224499.2024.2368695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/29/2024]
Abstract
Humans have sex for myriad reasons, many unrelated to desire. But under what conditions does sexual desire not lead to sex? We investigated reasons college students refrain from sex despite desire and having an attractive, willing partner and relationships between these reasons and other aspects of sexuality and personality. For item generation, 604 participants identified 109 reasons why individuals may refrain from sex despite desire. For construct validation, 712 participants reported the frequency they experienced these reasons on a novel measure. Every reason evidencing discernible gender differences was endorsed more by women. These items largely concentrated in factors of Personal Insecurities and Principled Concerns. No gender differences emerged on the Partner Issues factor. Factors differentially related to sexuality and personality variables. Principled Concerns related negatively to sociosexual behavior and attitudes and positively to sexual traditionalism across genders. Partner Issues positively correlated with sociosexual behavior and desire for women. Personal Insecurities negatively correlated with sociosexual attitudes for men. Principled Concerns related to sexual functioning issues for women. Personal Insecurities and Principled Concerns related to worse sexual functioning for men. Personal Insecurities related to Neuroticism across genders. These results suggest potential directions for therapeutic interventions and further research.
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50
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Boeri L, De Lorenzis E, Lucignani G, Turetti M, Silvani C, Zanetti SP, Longo F, Albo G, Salonia A, Montanari E. Oral preparation of hyaluronic acid, chondroitin sulfate, N-acetylglucosamine, and vitamin C improves sexual and urinary symptoms in participants with recurrent urinary tract infections: a randomized crossover trial. J Sex Med 2024; 21:627-634. [PMID: 38721680 DOI: 10.1093/jsxmed/qdae052] [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: 11/26/2023] [Revised: 03/22/2024] [Accepted: 03/31/2024] [Indexed: 07/02/2024]
Abstract
BACKGROUND Intravesical instillation of hyaluronic acid (HA) has been associated with reduced sexual dysfunction in participants with recurrent urinary tract infections (rUTIs), but the efficacy of an oral treatment has never been investigated. AIM To investigate the efficacy of an oral preparation of HA, chondroitin sulfate, N-acetylglucosamine, and vitamin C in improving sexual and urinary symptoms in a cohort of reproductive-age participants with rUTI. METHODS In a monocentric randomized crossover pilot trial, participants with rUTI who were referred to our institute between March 2022 and April 2023 were randomized 1:1 in 2 groups: intervention vs control. All participants had an oral preparation of cranberry, D-mannose, propolis extract, turmeric, and Boswellia twice a day for 3 months. The intervention group also included an oral preparation of HA, chondroitin sulfate, N-acetylglucosamine, and vitamin C once a day for 3 months. Crossover of treatment occurred at 3 months for an additional 3 months. At baseline and 3 and 6 months, participants were evaluated clinically and with the International Prostate Symptom Score (IPSS) and Female Sexual Function Index (FSFI). Descriptive statistics and logistic regression models tested the impact of the intervention on urinary and sexual symptoms at each follow-up assessment. OUTCOMES Improvement in sexual and urinary symptoms as measured by the FSFI and IPSS. RESULTS Overall, 27 (54%) participants had an FSFI score <26.5 at enrollment. At 3 months, FSFI scores were higher in the intervention group vs control (P < .001), but IPSS scores were lower (P = .03). After crossover of treatment, FSFI and IPSS scores remained stable in the intervention group. However, after crossover, the control group showed a significant improvement in IPSS and FSFI scores (all P < .01) vs the 3-month assessment. At last follow-up, urinary and sexual symptoms were comparable between groups. In logistic regression analyses, the intervention group was associated with early improvement in sexual symptoms (odds ratio, 3.9; P = .04) and urinary symptoms (odds ratio, 5.1; P = .01) after accounting for clinical confounders. CLINICAL IMPLICATIONS Combination treatment with HA, chondroitin sulfate, N-acetylglucosamine, and vitamin C is effective if started immediately or even after a few months from symptoms in participants with rUTI. STRENGTHS AND LIMITATIONS The main limitation is the lack of long-term follow-up. CONCLUSION The oral formulation of HA, chondroitin sulfate, N-acetylglucosamine, and vitamin C could be an effective therapy against urinary and sexual distress in participants with rUTI (NCT06268483; ClinicalTrials.gov).
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Affiliation(s)
- Luca Boeri
- Department of Urology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, 20122, Italy
| | - Elisa De Lorenzis
- Department of Urology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, 20122, Italy
| | - Gianpaolo Lucignani
- Department of Urology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, 20122, Italy
| | - Matteo Turetti
- Department of Urology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, 20122, Italy
| | - Carlo Silvani
- Department of Urology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, 20122, Italy
| | - Stefano Paolo Zanetti
- Department of Urology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, 20122, Italy
| | - Fabrizio Longo
- Department of Urology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, 20122, Italy
| | - Giancarlo Albo
- Department of Urology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, 20122, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, 20122, Italy
| | - Andrea Salonia
- Division of Experimental Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, 20143, Italy
| | - Emanuele Montanari
- Department of Urology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, 20122, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, 20122, Italy
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