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Lim C, Wu W, La J, Chan V, Schubach KM, Duns G, Lantsberg D, Katz DJ. Direct-to-Consumer Telemedicine Practices in the Health and Fertility of Men: A Systematic Review of the Literature. World J Mens Health 2024; 42:148-156. [PMID: 37652657 PMCID: PMC10782129 DOI: 10.5534/wjmh.230057] [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: 03/13/2023] [Revised: 04/11/2023] [Accepted: 04/16/2023] [Indexed: 09/02/2023] Open
Abstract
PURPOSE Men are increasingly turning toward online direct-to-consumer (DTC) men's health platforms to fulfill their health needs. Research surrounding these platforms is lacking and the motivations and predictors underlying this online health-seeking behavior is largely unknown. This review scopes the existing literature concerning DTC men's health and identifies factors influencing engagement, as well as health outcomes of this platform. MATERIALS AND METHODS A structured search was performed following PRISMA guidelines. CINAHL via EBSCO, Embase, MEDLINE via Ovid, PsycINFO, PubMed and Web of Science were searched. RESULTS Peer-reviewed quantitative and qualitative studies with a focus on demographics and characteristics of those using DTC men's health platforms, as well as studies related to patient outcomes using such platforms, were included. Ten of the 3,003 studies identified met the inclusion and exclusion criteria. Four cross-sectional descriptive studies evaluated the motivations behind men's engagement with DTC platforms. Convenience, embarrassment and health motivation were identified as predominant factors associated with DTC platform use. The review identified a lack of qualitative studies, and major limitations were noted in the quantitative studies that impacted the accuracy of findings. Six further quantitative studies explored the quality of care provided by DTC platforms. DTC platforms were found to have a varying level of adherence to established clinical guidelines, but appeared to provide satisfactory patient outcomes with low levels of patient-reported side effects and adverse events. CONCLUSIONS There is a lack of research within the DTC men's health space given the infancy of the field. Important predictors and motivations underlying men's choices in accessing these platforms have been noted across several studies. However, further studies need to be conducted to investigate the psychosocial underpinnings of this behavior. Studies across a wider variety of male health conditions treated by these platforms will also help to provide insights to guide patient-centered care within the DTC landscape.
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Affiliation(s)
- Christopher Lim
- Department of Urology, Western Health, St Albans, Australia.
| | - Winston Wu
- Department of Urology, Western Health, St Albans, Australia
| | - Justin La
- Department of Urology, Kaiser Permanente San Rafael Medical Center, San Rafael, CA, USA
| | | | | | - Glenn Duns
- Men's Health Melbourne, Melbourne, Australia
| | - Daniel Lantsberg
- Men's Health Melbourne, Melbourne, Australia
- Reproductive Services Unit, The Royal Women's Hospital, Parkville, Australia
- Melbourne IVF, East Melbourne, Australia
| | - Darren J Katz
- Department of Urology, Western Health, St Albans, Australia
- Men's Health Melbourne, Melbourne, Australia
- Department of Surgery, Western Precinct, University of Melbourne, Parkville, Australia
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Nabavizadeh B, Nguyen A, Li D, van Meijgaard J, Breyer BN. A Cost Analysis of Phosphodiesterase Type 5 Inhibitors in the United States. Urology 2024; 183:127-133. [PMID: 37951363 DOI: 10.1016/j.urology.2023.10.028] [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: 09/05/2023] [Revised: 10/22/2023] [Accepted: 10/31/2023] [Indexed: 11/14/2023]
Abstract
OBJECTIVE To perform a cost analysis of generic and brand-name Phosphodiesterase Type 5 (PDE5) inhibitors at different dosages and pharmacies across the US. METHODS Using an all-payer retail pharmacy-claims database, we analyzed prescription drug data for three generic and six brand-name oral PDE5 inhibitors at different dosages across US chain and independent pharmacies in 2019. RESULTS We obtained cash price data from 60,186 pharmacies (35,976 chain and 24,210 independent). The nationwide mean cash price per unit (PPU) ranged from $8.6 ± 5.2 (sildenafil 20 mg at chain pharmacies) to $107.1 ± 71 (Adcirca 20 mg at independent pharmacies) equal to 1145.3% difference. Chain pharmacies provided significantly lower average prices for one brand-name and six generic PDE5 inhibitors. Tadalafil PPU was cheaper at higher quantities, however, PPU increased with quantity prescribed for sildenafil. Looking at the top 10 metropolitan statistical areas, the highest PPUs were observed for tadalafil (Cialis) 10 mg and sildenafil (Viagra) 50 mg in Atlanta ($67.4 ± 8.7) and Los Angeles ($50.3 ± 24.0), while New York ($9.7 ± 2.6) and Miami ($27.9 ± 16.4) had the lowest PPUs for tadalafil (Cialis) 5 mg and sildenafil (Viagra) 100 mg, respectively. CONCLUSION A substantial variability in PDE5 inhibitor cash prices exists across manufacturer, dosage, quantity, pharmacy type, and location. In addition, the pricing does not necessarily correlate with the regional socioeconomic factors. This highlights the importance of provider awareness and patient counseling on drug price including potentially assisting patients in identifying opportunities for cost savings.
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Affiliation(s)
- Behnam Nabavizadeh
- Department of Urology, University of California San Francisco, San Francisco, CA; Department of Urology, Weill Cornell Medicine, New York, NY
| | | | | | | | - Benjamin N Breyer
- Department of Urology, University of California San Francisco, San Francisco, CA; Department of Biostatistics and Epidemiology, University of California San Francisco, San Francisco, CA.
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Kirana PS, Gudeloglu A, Sansone A, Sokolakis I. Web based research in sexual medicine: a position statement of the European Society for Sexual Medicine. Sex Med 2023; 11:qfad032. [PMID: 37426312 PMCID: PMC10324026 DOI: 10.1093/sexmed/qfad032] [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: 01/17/2023] [Revised: 05/21/2023] [Accepted: 05/26/2023] [Indexed: 07/11/2023] Open
Abstract
Background Although the use of the Web has brought major advances in every step of the research process, this also comes with several methodological challenges. Aim The article presents the European Society for Sexual Medicine's position statements on key methodological concerns relative to Web-based research in sexual medicine. Methods The authors conducted a systematic scoping review of articles using Web-based research methods in sexual medicine. For the creation of the statements, the authors processed the data from the methodology of the studies and formulated the final statements reaching 100% agreement in the group. Outcomes European Society for Sexual Medicine statements were provided on the following domains: definition of the population of interest, selection of the population of interest, data collection quality, response rate, self-reported questionnaire, consent, and legal obligations. Results Researchers should justify the relevance of the Internet population to the population of interest; should clearly describe how they identified study participants; should select and employ specific measures to avoid hoax; should explicitly describe the process of calculation of response and completion rates as well as the relative implications; should validate traditional sexual health questionnaires for online and, if possible, multilingual use; should not ignore consent in Web-based research; and need to be knowledgeable of the technical measures and legal obligations to protect anonymity. Implications Researchers are advised to include trained computer scientists in their group, have a good understanding of their legal obligations as to collecting, storing and disseminating personal data, and design their studies by taking into account the challenges of Web-based research. Strengths and limitations The heterogeneity of the included studies and methodological low quality of most of them was a limitation, which also shows the importance of this study and the need for guidelines regarding Web-based research. Conclusion Large uncontrolled samples could be a threat to the quality of the studies and increase bias if researchers are not mindful of the methodological challenges they would need to account for.
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Affiliation(s)
- Paraskevi-Sofia Kirana
- Corresponding author: Institute for the Study of Urological Diseases, Thessaloniki, Greece.
| | - Ahmet Gudeloglu
- Department of Urology, Hacettepe University Hospital, Ankara, Turkey
| | - Andrea Sansone
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Ioannis Sokolakis
- 2nd Department of Urology, Aristotle University of Thessaloniki, Thessaloniki 54640, Greece
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Agochukwu-Mmonu N, Fendrick AM. The Economics of Viagra Revisited: The Price Is Right. Urology 2021; 157:5-7. [PMID: 34087316 PMCID: PMC8272595 DOI: 10.1016/j.urology.2021.05.037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 05/11/2021] [Accepted: 05/19/2021] [Indexed: 02/08/2023]
Affiliation(s)
- Nnenaya Agochukwu-Mmonu
- Department of Urology, NYU Medical Center, New York, NY; Department of Population Health, NYU Medical Center, New York, NY.
| | - A Mark Fendrick
- Department of Health Management & Policy, University of Michigan, Ann Arbor, MI; Department of Internal Medicine, University of Michigan, Ann Arbor, MI; Center for Value-Based Insurance Design, University of Michigan, Ann Arbor, MI
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Rabinowitz MJ, Kohn TP, Ellimoottil C, Alam R, Liu JL, Herati AS. The Impact of Telemedicine on Sexual Medicine at a Major Academic Center During the COVID-19 Pandemic. Sex Med 2021; 9:100366. [PMID: 34049265 PMCID: PMC8240353 DOI: 10.1016/j.esxm.2021.100366] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 03/15/2021] [Accepted: 03/20/2021] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION Telemedicine has the potential to improve access to care; however, its utility in the field of sexual medicine remains in question. AIM To examine the importance of video visits for the treatment of male sexual medicine at our academic center during the period of peak telemedicine use in April 2020. METHODS We collected and compared deidentified data from all nonprocedure, adult outpatient encounters conducted as either office visits in April 2019 (n = 1,949) or video visits in April 2020 (n = 608). The primary International Classification of Diseases codes (ICD-10) labeled as diagnoses from all encounters were collected, with most encounters linked to several disease codes (n = 4,584). Demographic data were also collected. We performed comparative analyses on Stata (College Station, TX, USA) with significance set at α = .05. MAIN OUTCOME MEASURES Disease codes were categorized based on their use and classification in urological care and the proportion that each category made up within the outpatient practice was calculated. RESULTS In comparison to the office visits, which took place in April 2019, male sexual medicine visits in April 2020, during the peak of telemedicine use, made up a significantly larger overall share of our practice (P = .012), defined by relative rises in encounters pertaining to male hypogonadism, infertility, penile abnormalities, and testicular abnormalities. Outpatients seen over video visits were also younger than outpatients seen during the previous year over office visits (58.9 vs 60.8, P = .008). Further, race and ethnicity characteristics in the outpatient population were unaffected during the period of telemedicine use. CONCLUSIONS During the period of historically high telemedicine use following the SARS-CoV-2 outbreak, encounters associated with male sexual medicine made up a significantly larger portion of our outpatient practice. Although the full influence of the COVID-19 pandemic cannot be delineated, our findings suggest telemedicine use is compatible with the field of sexual medicine. Rabinowitz MJ, Kohn TP, Ellimoottil C, et al. The Impact of Telemedicine on Sexual Medicine at a Major Academic Center During the COVID-19 Pandemic. Sex Med 2021;9:100366.
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Affiliation(s)
- Matthew J Rabinowitz
- The James Buchanan Brady Urological Institute, Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Taylor P Kohn
- The James Buchanan Brady Urological Institute, Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Chad Ellimoottil
- Department of Urology, Michigan Medicine, Ann Arbor, MI, USA; Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA
| | - Ridwan Alam
- The James Buchanan Brady Urological Institute, Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - James L Liu
- The James Buchanan Brady Urological Institute, Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Amin S Herati
- The James Buchanan Brady Urological Institute, Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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Fode M, Nolsøe AB, Jacobsen FM, Russo GI, Østergren PB, Jensen CFS, Albersen M, Capogrosso P, Sønksen J. Quality of Information in YouTube Videos on Erectile Dysfunction. Sex Med 2020; 8:408-413. [PMID: 32593674 PMCID: PMC7471071 DOI: 10.1016/j.esxm.2020.05.007] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 05/18/2020] [Accepted: 05/18/2020] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION Many patients seek information online including on social media. AIM To assess the quality of information regarding erectile dysfunction (ED) in YouTube videos. METHODS We searched "erectile dysfunction" on YouTube in October 2019 and evaluated the first 100 videos in English sorted by relevance. MAIN OUTCOME MEASURE We recorded the user engagement, video producer, intended audience, and content. Videos containing medical information were evaluated using the Patient Education Materials Assessment Tool (PEMAT) and the DISCERN quality criteria for consumer health information. The PEMAT evaluates the understandability and actionability of materials as a percentage. The DISCERN assesses the quality of information by a scale from 1 (serious or extensive shortcomings) to 5 (minimal shortcomings). RESULTS The median number of total views was 22,450 (range 591-20,255,133) and the median number of views/month was 654 (range 9-723,398). 42 percent of the videos were posted by professional medical institutions, and 21% were posted by individual medical professionals. Most videos were aimed at the general public or patients suffering from ED. The median PEMAT understandability and actionability scores were both 100% (range 50-100% and 33-100%, respectively). The median DISCERN score was 2 (range 1-5) with 80.4% receiving a score of ≤3. Overall, 28% of the videos contained direct misinformation. DISCERN scores were higher in videos produced by medical institutions (P = .0104), not selling specific products (P = .007) and not promoting alternative medicine (P = .0002). The number of subscribers was an independent predictor of views/month (P < .0001). CONCLUSION Patients may be exposed to videos of poor quality when searching for information about ED on YouTube. The medical community needs to adapt a strategy to improve the quality of online medical information. Fode M, Nolsøe AB, Jacobsen FM, et al. Quality of Information in YouTube Videos on Erectile Dysfunction. J Sex Med 2020;8:408-413.
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Affiliation(s)
- Mikkel Fode
- Department of Urology, Zealand University Hospital, Roskilde, Denmark; Department of Urology, Herlev and Gentofte Hospital, Herlev, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
| | | | | | | | - Peter B Østergren
- Department of Urology, Herlev and Gentofte Hospital, Herlev, Denmark
| | | | - Maarten Albersen
- Department of Urology, University Hospitals Leuven, Leuven, Belgium
| | - Paolo Capogrosso
- Department of Urology, IRCCS San Raffaele Hospital, Milan, Italy; Division of Experimental Oncology/Unit of Urology, URI, IRCCS San Raffaele Hospital, Milan, Italy
| | - Jens Sønksen
- Department of Urology, Herlev and Gentofte Hospital, Herlev, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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Novara G, Checcucci E, Crestani A, Abrate A, Esperto F, Pavan N, De Nunzio C, Galfano A, Giannarini G, Gregori A, Liguori G, Bartoletti R, Porpiglia F, Scarpa RM, Simonato A, Trombetta C, Tubaro A, Ficarra V. Telehealth in Urology: A Systematic Review of the Literature. How Much Can Telemedicine Be Useful During and After the COVID-19 Pandemic? Eur Urol 2020; 78:786-811. [PMID: 32616405 PMCID: PMC7301090 DOI: 10.1016/j.eururo.2020.06.025] [Citation(s) in RCA: 127] [Impact Index Per Article: 31.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Accepted: 06/10/2020] [Indexed: 12/14/2022]
Abstract
Context Coronavirus disease 2019 (COVID-19) pandemic has caused increased interest in the application of telehealth to provide care without exposing patients and physicians to the risk of contagion. The urological literature on the topic is sparse. Objective To perform a systematic review of the literature and evaluate all the available studies on urological applications of telehealth. Evidence acquisition After registration on PROSPERO, we searched PubMed and Scopus databases to collect any kind of studies evaluating any telehealth interventions in any urological conditions. The National Toxicology Program/Office of Health Assessment and Translation Risk of Bias Rating Tool for Human and Animal Studies was used to estimate the risk of bias. A narrative synthesis was performed. Evidence synthesis We identified 45 studies (11 concerning prostate cancer [PCa], three hematuria management, six urinary stones, 14 urinary incontinence [UI], five urinary tract infections [UTIs], and six other conditions), including 12 randomized controlled trials. The available literature indicates that telemedicine has been implemented successfully in several common clinical scenarios, including the decision-making process following a diagnosis of nonmetastatic PCa, follow-up care of patients with localized PCa after curative treatments, initial diagnosis of hematuria, management diagnosis and follow-up care of uncomplicated urinary stones and uncomplicated UTIs, and initial evaluation, behavioral therapies, and pelvic floor muscle training in UI patients, as well as follow-up care after surgical treatments of stress urinary incontinence or pelvic organ prolapse. The methodological quality of most of the reports was good. Conclusions Telehealth has been implemented successfully in selected patients with PCa, UI, pelvic organ prolapse, uncomplicated urinary stones, and UTIs. Many urological conditions are suitable for telehealth, but more studies are needed on other highly prevalent urological malignant and benign conditions. Likely, the COVID-19 pandemic will give a significant boost to the use of telemedicine. More robust data on long-term efficacy, safety, and health economics are necessary. Patient summary The diffusion of coronavirus disease 2019 (COVID-19) infections has recently increased the interest in telehealth, which is the adoption of telecommunication to deliver any health care activity. The available literature indicates that telemedicine has been adopted successfully in selected patients with several common clinical urological conditions, including prostate cancer, uncomplicated urinary stones, uncomplicated urinary infections, urinary incontinence, or pelvic organ prolapse. Likely, the COVID-19 pandemic will give a significant boost to the use of telemedicine, but more robust data on long-term efficacy, safety, and costs are necessary.
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Affiliation(s)
- Giacomo Novara
- Department Surgery, Oncology and Gastroenterology, Urologic Unit, University of Padova, Italy.
| | - Enrico Checcucci
- Division of Urology, Department of Oncology, School of Medicine, San Luigi Hospital, University of Turin, Orbassano, Italy
| | | | - Alberto Abrate
- Urology Section, Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy
| | - Francesco Esperto
- Department of Urology, Campus Biomedico University of Rome, Rome, Italy
| | - Nicola Pavan
- Department of Urology, University of Trieste, Cattinara Hospital, Trieste, Italy
| | - Cosimo De Nunzio
- Department of Urology, Sant'Andrea Hospital, University La Sapienza, Rome, Italy
| | | | - Gianluca Giannarini
- Urology Unit, Academic Medical Centre, "Santa Maria della Misericordia" Hospital, Udine, Italy
| | | | - Giovanni Liguori
- Department of Urology, University of Trieste, Cattinara Hospital, Trieste, Italy
| | - Riccardo Bartoletti
- Department of Translational Research and New Technologies, Urologic Unit, University of Pisa, Italy
| | - Francesco Porpiglia
- Division of Urology, Department of Oncology, School of Medicine, San Luigi Hospital, University of Turin, Orbassano, Italy
| | | | - Alchiede Simonato
- Urology Section, Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy; Urology Unit, Department of Surgery, S. Croce e Carle Hospital, Cuneo, Italy
| | - Carlo Trombetta
- Department of Urology, University of Trieste, Cattinara Hospital, Trieste, Italy
| | - Andrea Tubaro
- Department of Urology, Sant'Andrea Hospital, University La Sapienza, Rome, Italy
| | - Vincenzo Ficarra
- Department of Human and Pediatric Pathology "Gaetano Barresi", Urologic Section, University of Messina, Italy
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Rodler S, von Büren J, Buchner A, Stief C, Elkhanova K, Wülfing C, Jungmann S. Epidemiology and Treatment Barriers of Patients With Erectile Dysfunction Using an Online Prescription Platform: A Cross-Sectional Study. Sex Med 2020; 8:370-377. [PMID: 32434669 PMCID: PMC7471089 DOI: 10.1016/j.esxm.2020.04.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 03/20/2020] [Accepted: 04/07/2020] [Indexed: 12/12/2022] Open
Abstract
Introduction Erectile dysfunction (ED) is a highly common sexual dysfunction of men but often undertreated as patients experience high treatment barriers. Aim The aims of this study were to characterize patients with ED using an online prescription platforms (OPPs) and determine treatment barriers that might prevent patients from seeking care in conventional health care settings. Methods Data from a German OPP were retrospectively analyzed with focus on patients suffering from ED with at least one online prescription of phosphodiesterase-5 (PDE5) inhibitors between May 2019 and November 2019. In addition, a voluntary questionnaire was used to assess additional social features and prior treatment barriers. Main Outcome Measure The main outcome measures were the epidemiological data, prescription metadata, and follow-up questionnaires. Results A total of 11,456 male patients received prescriptions via the OPP (mean age: 49 years [95% CI 46.92–47.45]). Patients lived mainly in rural areas (69%) and frequently sought prescriptions outside the average office times of German urologists (49%). From all patients that responded to a follow-up questionnaire (n = 242), the majority were employed full-time (81%), married (50%), and native German (94%); 63.5% had not used PDE5 inhibitors before. From all repeat users, 41% had received them from unreliable sources. Reasons to seek treatment via the OPP were convenience (48%), shame (23%), and lack of discretion (13%). Conclusion In this first study, to epidemiologically characterize ED patients of an OPP, it was confirmed that inconvenience is a treatment barrier, along with shame and perceived lack of discretion. This is the first evidence that OPPs reduce treatment barriers and ease access for patients to the medical system. Rodler S, von Büren J, Buchner A, et al. Epidemiology and Treatment Barriers of Patients With Erectile Dysfunction Using an Online Prescription Platform: A Cross-Sectional Study. Sex Med 2020;8:370–377.
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Affiliation(s)
- Severin Rodler
- Department of Urology, University of Munich, Munich, Germany.
| | | | | | - Christian Stief
- Department of Urology, University of Munich, Munich, Germany
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Fode M, Russo GI, Albersen M. A model for digital innovations in sexual medicine. Int J Impot Res 2019; 32:639-640. [PMID: 31474754 DOI: 10.1038/s41443-019-0190-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 07/25/2019] [Indexed: 11/10/2022]
Affiliation(s)
- Mikkel Fode
- Department of Urology, Zealand University Hospital, Roskilde, Denmark. .,Department of Urology, Herlev and Gentofte Hospital, Herlev, Denmark.
| | - Giorgio I Russo
- Urology Section, Department of Surgery, University of Catania, Catania, Italy
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García-Cruz E, Romero-Otero J, Fode M, Alcaraz A. The digital environment in men's sexual disorders: A systematic review. Actas Urol Esp 2018; 42:365-374. [PMID: 29102483 DOI: 10.1016/j.acuro.2017.05.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 05/15/2017] [Accepted: 05/16/2017] [Indexed: 01/23/2023]
Abstract
CONTEXT The revolution of digital technologies constitutes a new setting for the patient-physician relationship and provides patients with a scenario of privacy and universal access to a vast amount of information. However, there is little information on how digital resources are used and what their advantages and disadvantages are. OBJECTIVES To explore the scope of the scientific research on the use of digital technology related to men's sexual disorders and to analyze the primary sources of digital information related to this field. ACQUISITION OF EVIDENCE Systematic searches of the scientific literature, websites (10 first results in each google search) and mobile applications (apps). The searches combined the keywords "web" and "app" with "erectile dysfunction", "premature ejaculation", "Peyronie", "male hypogonadism", and "infertility". Websites and apps were assessed for quality according to predefined indicators. SYNTHESIS OF EVIDENCE The qualitative analysis of the scientific literature included 116 manuscripts; 47% were clinical studies based on online survey, 9% dealt with digital treatments, 11% with quality/safety of digital healthcare environment, 3% with digital activity, 21% with patient empowerment, and 9% with online drug selling. Of 50 websites assessed for quality, 29 (58%) scored 4 or 5 on a 5-point Likert scale. The app search yielded 40 apps; only 3 of them (8%) reported the identity of a health center or healthcare professional involved. CONCLUSIONS Patients and healthcare professionals may benefit from digital resources related to men's sexual disorders; however, a strong commitment by the scientific and healthcare community is essential to increase the quality of these resources.
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Affiliation(s)
- E García-Cruz
- Departmento de Urología, Hospital Plató, Barcelona, España; Departmento de Urología, Hospital Clínic de Barcelona, Barcelona, España; European Association of Urology's Young Academic Urologist's, Men's Health Group member.
| | - J Romero-Otero
- Departmento de Urología, Hospital Universitario 12 de octubre, Madrid, España
| | - M Fode
- Department of Urology, Roskilde Hospital, Roskilde, Dinamarca; Department of Urology, Herlev University Hospital, Herlev, Dinamarca
| | - A Alcaraz
- Departmento de Urología, Hospital Clínic de Barcelona, Barcelona, España
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Hummel SB, van Lankveld JJDM, Oldenburg HSA, Hahn DEE, Kieffer JM, Gerritsma MA, Kuenen MA, Bijker N, Borgstein PJ, Heuff G, Lopes Cardozo AMF, Plaisier PW, Rijna H, van der Meij S, van Dulken EJ, Vrouenraets BC, Broomans E, Aaronson NK. Efficacy of Internet-Based Cognitive Behavioral Therapy in Improving Sexual Functioning of Breast Cancer Survivors: Results of a Randomized Controlled Trial. J Clin Oncol 2017; 35:1328-1340. [PMID: 28240966 DOI: 10.1200/jco.2016.69.6021] [Citation(s) in RCA: 92] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose We evaluated the effect of Internet-based cognitive behavioral therapy (CBT) on sexual functioning and relationship intimacy (primary outcomes) and body image, menopausal symptoms, marital functioning, psychological distress, and health-related quality of life (secondary outcomes) in breast cancer survivors (BCSs) with a DSM-IV diagnosis of a sexual dysfunction. Patients and Methods We randomly assigned 169 BCSs to either Internet-based CBT or a waiting-list control group. The CBT consisted of weekly therapist-guided sessions, with a maximum duration of 24 weeks. Self-report questionnaires were completed by the intervention group at baseline (T0), midtherapy (T1), and post-therapy (T2) and at equivalent times by the control group. We used a mixed-effect modeling approach to compare the groups over time. Results Compared with the control group, the intervention group showed a significant improvement over time in overall sexual functioning (effect size for T2 [EST2] = .43; P = .031), which was reflected in an increase in sexual desire (EST1 = .48 and EST2 = .72; P < .001), sexual arousal (EST2 = .50; P = .008), and vaginal lubrication (EST2 = .46; P = .013). The intervention group reported more improvement over time in sexual pleasure (EST1 = .32 and EST2 = .62; P = .001), less discomfort during sex (EST1 = .49 and EST2 = .66; P = .001), and less sexual distress (EST2 = .59; P = .002) compared with the control group. The intervention group reported greater improvement in body image (EST2 = .45; P = .009) and fewer menopausal symptoms (EST1 = .39; P = .007) than the control group. No significant effects were observed for orgasmic function, sexual satisfaction, intercourse frequency, relationship intimacy, marital functioning, psychological distress, or health-related quality of life. Conclusion Internet-based CBT has salutary effects on sexual functioning, body image, and menopausal symptoms in BCSs with a sexual dysfunction.
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Affiliation(s)
- Susanna B Hummel
- Susanna B. Hummel, Hester S.A. Oldenburg, Daniela E.E. Hahn, Jacobien M. Kieffer, Miranda A. Gerritsma, Marianne A. Kuenen, and Neil K. Aaronson, The Netherlands Cancer Institute; Nina Bijker, Academic Medical Center; Paul J. Borgstein, Onze Lieve Vrouwe Gasthuis East; Eric J. van Dulken, Medical Center Slotervaart; Bart C. Vrouenraets, Onze Lieve Vrouwe Gasthuis West, Amsterdam; Jacques J.D.M. van Lankveld, Open University, Heerlen; Gijsbert Heuff, Spaarne Gasthuis Hoofddorp, Hoofddorp; Alexander M.F. Lopes Cardozo, Noordwest Hospital Group Alkmaar, Alkmaar; Peter W. Plaisier, Albert Schweitzer Hospital, Dordrecht; Herman Rijna, Spaarne Gasthuis Haarlem, Haarlem; Suzan van der Meij, Flevo Hospital, Almere; and Eva Broomans, Virenze Institute of Mental Health Care, Utrecht, the Netherlands
| | - Jacques J D M van Lankveld
- Susanna B. Hummel, Hester S.A. Oldenburg, Daniela E.E. Hahn, Jacobien M. Kieffer, Miranda A. Gerritsma, Marianne A. Kuenen, and Neil K. Aaronson, The Netherlands Cancer Institute; Nina Bijker, Academic Medical Center; Paul J. Borgstein, Onze Lieve Vrouwe Gasthuis East; Eric J. van Dulken, Medical Center Slotervaart; Bart C. Vrouenraets, Onze Lieve Vrouwe Gasthuis West, Amsterdam; Jacques J.D.M. van Lankveld, Open University, Heerlen; Gijsbert Heuff, Spaarne Gasthuis Hoofddorp, Hoofddorp; Alexander M.F. Lopes Cardozo, Noordwest Hospital Group Alkmaar, Alkmaar; Peter W. Plaisier, Albert Schweitzer Hospital, Dordrecht; Herman Rijna, Spaarne Gasthuis Haarlem, Haarlem; Suzan van der Meij, Flevo Hospital, Almere; and Eva Broomans, Virenze Institute of Mental Health Care, Utrecht, the Netherlands
| | - Hester S A Oldenburg
- Susanna B. Hummel, Hester S.A. Oldenburg, Daniela E.E. Hahn, Jacobien M. Kieffer, Miranda A. Gerritsma, Marianne A. Kuenen, and Neil K. Aaronson, The Netherlands Cancer Institute; Nina Bijker, Academic Medical Center; Paul J. Borgstein, Onze Lieve Vrouwe Gasthuis East; Eric J. van Dulken, Medical Center Slotervaart; Bart C. Vrouenraets, Onze Lieve Vrouwe Gasthuis West, Amsterdam; Jacques J.D.M. van Lankveld, Open University, Heerlen; Gijsbert Heuff, Spaarne Gasthuis Hoofddorp, Hoofddorp; Alexander M.F. Lopes Cardozo, Noordwest Hospital Group Alkmaar, Alkmaar; Peter W. Plaisier, Albert Schweitzer Hospital, Dordrecht; Herman Rijna, Spaarne Gasthuis Haarlem, Haarlem; Suzan van der Meij, Flevo Hospital, Almere; and Eva Broomans, Virenze Institute of Mental Health Care, Utrecht, the Netherlands
| | - Daniela E E Hahn
- Susanna B. Hummel, Hester S.A. Oldenburg, Daniela E.E. Hahn, Jacobien M. Kieffer, Miranda A. Gerritsma, Marianne A. Kuenen, and Neil K. Aaronson, The Netherlands Cancer Institute; Nina Bijker, Academic Medical Center; Paul J. Borgstein, Onze Lieve Vrouwe Gasthuis East; Eric J. van Dulken, Medical Center Slotervaart; Bart C. Vrouenraets, Onze Lieve Vrouwe Gasthuis West, Amsterdam; Jacques J.D.M. van Lankveld, Open University, Heerlen; Gijsbert Heuff, Spaarne Gasthuis Hoofddorp, Hoofddorp; Alexander M.F. Lopes Cardozo, Noordwest Hospital Group Alkmaar, Alkmaar; Peter W. Plaisier, Albert Schweitzer Hospital, Dordrecht; Herman Rijna, Spaarne Gasthuis Haarlem, Haarlem; Suzan van der Meij, Flevo Hospital, Almere; and Eva Broomans, Virenze Institute of Mental Health Care, Utrecht, the Netherlands
| | - Jacobien M Kieffer
- Susanna B. Hummel, Hester S.A. Oldenburg, Daniela E.E. Hahn, Jacobien M. Kieffer, Miranda A. Gerritsma, Marianne A. Kuenen, and Neil K. Aaronson, The Netherlands Cancer Institute; Nina Bijker, Academic Medical Center; Paul J. Borgstein, Onze Lieve Vrouwe Gasthuis East; Eric J. van Dulken, Medical Center Slotervaart; Bart C. Vrouenraets, Onze Lieve Vrouwe Gasthuis West, Amsterdam; Jacques J.D.M. van Lankveld, Open University, Heerlen; Gijsbert Heuff, Spaarne Gasthuis Hoofddorp, Hoofddorp; Alexander M.F. Lopes Cardozo, Noordwest Hospital Group Alkmaar, Alkmaar; Peter W. Plaisier, Albert Schweitzer Hospital, Dordrecht; Herman Rijna, Spaarne Gasthuis Haarlem, Haarlem; Suzan van der Meij, Flevo Hospital, Almere; and Eva Broomans, Virenze Institute of Mental Health Care, Utrecht, the Netherlands
| | - Miranda A Gerritsma
- Susanna B. Hummel, Hester S.A. Oldenburg, Daniela E.E. Hahn, Jacobien M. Kieffer, Miranda A. Gerritsma, Marianne A. Kuenen, and Neil K. Aaronson, The Netherlands Cancer Institute; Nina Bijker, Academic Medical Center; Paul J. Borgstein, Onze Lieve Vrouwe Gasthuis East; Eric J. van Dulken, Medical Center Slotervaart; Bart C. Vrouenraets, Onze Lieve Vrouwe Gasthuis West, Amsterdam; Jacques J.D.M. van Lankveld, Open University, Heerlen; Gijsbert Heuff, Spaarne Gasthuis Hoofddorp, Hoofddorp; Alexander M.F. Lopes Cardozo, Noordwest Hospital Group Alkmaar, Alkmaar; Peter W. Plaisier, Albert Schweitzer Hospital, Dordrecht; Herman Rijna, Spaarne Gasthuis Haarlem, Haarlem; Suzan van der Meij, Flevo Hospital, Almere; and Eva Broomans, Virenze Institute of Mental Health Care, Utrecht, the Netherlands
| | - Marianne A Kuenen
- Susanna B. Hummel, Hester S.A. Oldenburg, Daniela E.E. Hahn, Jacobien M. Kieffer, Miranda A. Gerritsma, Marianne A. Kuenen, and Neil K. Aaronson, The Netherlands Cancer Institute; Nina Bijker, Academic Medical Center; Paul J. Borgstein, Onze Lieve Vrouwe Gasthuis East; Eric J. van Dulken, Medical Center Slotervaart; Bart C. Vrouenraets, Onze Lieve Vrouwe Gasthuis West, Amsterdam; Jacques J.D.M. van Lankveld, Open University, Heerlen; Gijsbert Heuff, Spaarne Gasthuis Hoofddorp, Hoofddorp; Alexander M.F. Lopes Cardozo, Noordwest Hospital Group Alkmaar, Alkmaar; Peter W. Plaisier, Albert Schweitzer Hospital, Dordrecht; Herman Rijna, Spaarne Gasthuis Haarlem, Haarlem; Suzan van der Meij, Flevo Hospital, Almere; and Eva Broomans, Virenze Institute of Mental Health Care, Utrecht, the Netherlands
| | - Nina Bijker
- Susanna B. Hummel, Hester S.A. Oldenburg, Daniela E.E. Hahn, Jacobien M. Kieffer, Miranda A. Gerritsma, Marianne A. Kuenen, and Neil K. Aaronson, The Netherlands Cancer Institute; Nina Bijker, Academic Medical Center; Paul J. Borgstein, Onze Lieve Vrouwe Gasthuis East; Eric J. van Dulken, Medical Center Slotervaart; Bart C. Vrouenraets, Onze Lieve Vrouwe Gasthuis West, Amsterdam; Jacques J.D.M. van Lankveld, Open University, Heerlen; Gijsbert Heuff, Spaarne Gasthuis Hoofddorp, Hoofddorp; Alexander M.F. Lopes Cardozo, Noordwest Hospital Group Alkmaar, Alkmaar; Peter W. Plaisier, Albert Schweitzer Hospital, Dordrecht; Herman Rijna, Spaarne Gasthuis Haarlem, Haarlem; Suzan van der Meij, Flevo Hospital, Almere; and Eva Broomans, Virenze Institute of Mental Health Care, Utrecht, the Netherlands
| | - Paul J Borgstein
- Susanna B. Hummel, Hester S.A. Oldenburg, Daniela E.E. Hahn, Jacobien M. Kieffer, Miranda A. Gerritsma, Marianne A. Kuenen, and Neil K. Aaronson, The Netherlands Cancer Institute; Nina Bijker, Academic Medical Center; Paul J. Borgstein, Onze Lieve Vrouwe Gasthuis East; Eric J. van Dulken, Medical Center Slotervaart; Bart C. Vrouenraets, Onze Lieve Vrouwe Gasthuis West, Amsterdam; Jacques J.D.M. van Lankveld, Open University, Heerlen; Gijsbert Heuff, Spaarne Gasthuis Hoofddorp, Hoofddorp; Alexander M.F. Lopes Cardozo, Noordwest Hospital Group Alkmaar, Alkmaar; Peter W. Plaisier, Albert Schweitzer Hospital, Dordrecht; Herman Rijna, Spaarne Gasthuis Haarlem, Haarlem; Suzan van der Meij, Flevo Hospital, Almere; and Eva Broomans, Virenze Institute of Mental Health Care, Utrecht, the Netherlands
| | - Gijsbert Heuff
- Susanna B. Hummel, Hester S.A. Oldenburg, Daniela E.E. Hahn, Jacobien M. Kieffer, Miranda A. Gerritsma, Marianne A. Kuenen, and Neil K. Aaronson, The Netherlands Cancer Institute; Nina Bijker, Academic Medical Center; Paul J. Borgstein, Onze Lieve Vrouwe Gasthuis East; Eric J. van Dulken, Medical Center Slotervaart; Bart C. Vrouenraets, Onze Lieve Vrouwe Gasthuis West, Amsterdam; Jacques J.D.M. van Lankveld, Open University, Heerlen; Gijsbert Heuff, Spaarne Gasthuis Hoofddorp, Hoofddorp; Alexander M.F. Lopes Cardozo, Noordwest Hospital Group Alkmaar, Alkmaar; Peter W. Plaisier, Albert Schweitzer Hospital, Dordrecht; Herman Rijna, Spaarne Gasthuis Haarlem, Haarlem; Suzan van der Meij, Flevo Hospital, Almere; and Eva Broomans, Virenze Institute of Mental Health Care, Utrecht, the Netherlands
| | - Alexander M F Lopes Cardozo
- Susanna B. Hummel, Hester S.A. Oldenburg, Daniela E.E. Hahn, Jacobien M. Kieffer, Miranda A. Gerritsma, Marianne A. Kuenen, and Neil K. Aaronson, The Netherlands Cancer Institute; Nina Bijker, Academic Medical Center; Paul J. Borgstein, Onze Lieve Vrouwe Gasthuis East; Eric J. van Dulken, Medical Center Slotervaart; Bart C. Vrouenraets, Onze Lieve Vrouwe Gasthuis West, Amsterdam; Jacques J.D.M. van Lankveld, Open University, Heerlen; Gijsbert Heuff, Spaarne Gasthuis Hoofddorp, Hoofddorp; Alexander M.F. Lopes Cardozo, Noordwest Hospital Group Alkmaar, Alkmaar; Peter W. Plaisier, Albert Schweitzer Hospital, Dordrecht; Herman Rijna, Spaarne Gasthuis Haarlem, Haarlem; Suzan van der Meij, Flevo Hospital, Almere; and Eva Broomans, Virenze Institute of Mental Health Care, Utrecht, the Netherlands
| | - Peter W Plaisier
- Susanna B. Hummel, Hester S.A. Oldenburg, Daniela E.E. Hahn, Jacobien M. Kieffer, Miranda A. Gerritsma, Marianne A. Kuenen, and Neil K. Aaronson, The Netherlands Cancer Institute; Nina Bijker, Academic Medical Center; Paul J. Borgstein, Onze Lieve Vrouwe Gasthuis East; Eric J. van Dulken, Medical Center Slotervaart; Bart C. Vrouenraets, Onze Lieve Vrouwe Gasthuis West, Amsterdam; Jacques J.D.M. van Lankveld, Open University, Heerlen; Gijsbert Heuff, Spaarne Gasthuis Hoofddorp, Hoofddorp; Alexander M.F. Lopes Cardozo, Noordwest Hospital Group Alkmaar, Alkmaar; Peter W. Plaisier, Albert Schweitzer Hospital, Dordrecht; Herman Rijna, Spaarne Gasthuis Haarlem, Haarlem; Suzan van der Meij, Flevo Hospital, Almere; and Eva Broomans, Virenze Institute of Mental Health Care, Utrecht, the Netherlands
| | - Herman Rijna
- Susanna B. Hummel, Hester S.A. Oldenburg, Daniela E.E. Hahn, Jacobien M. Kieffer, Miranda A. Gerritsma, Marianne A. Kuenen, and Neil K. Aaronson, The Netherlands Cancer Institute; Nina Bijker, Academic Medical Center; Paul J. Borgstein, Onze Lieve Vrouwe Gasthuis East; Eric J. van Dulken, Medical Center Slotervaart; Bart C. Vrouenraets, Onze Lieve Vrouwe Gasthuis West, Amsterdam; Jacques J.D.M. van Lankveld, Open University, Heerlen; Gijsbert Heuff, Spaarne Gasthuis Hoofddorp, Hoofddorp; Alexander M.F. Lopes Cardozo, Noordwest Hospital Group Alkmaar, Alkmaar; Peter W. Plaisier, Albert Schweitzer Hospital, Dordrecht; Herman Rijna, Spaarne Gasthuis Haarlem, Haarlem; Suzan van der Meij, Flevo Hospital, Almere; and Eva Broomans, Virenze Institute of Mental Health Care, Utrecht, the Netherlands
| | - Suzan van der Meij
- Susanna B. Hummel, Hester S.A. Oldenburg, Daniela E.E. Hahn, Jacobien M. Kieffer, Miranda A. Gerritsma, Marianne A. Kuenen, and Neil K. Aaronson, The Netherlands Cancer Institute; Nina Bijker, Academic Medical Center; Paul J. Borgstein, Onze Lieve Vrouwe Gasthuis East; Eric J. van Dulken, Medical Center Slotervaart; Bart C. Vrouenraets, Onze Lieve Vrouwe Gasthuis West, Amsterdam; Jacques J.D.M. van Lankveld, Open University, Heerlen; Gijsbert Heuff, Spaarne Gasthuis Hoofddorp, Hoofddorp; Alexander M.F. Lopes Cardozo, Noordwest Hospital Group Alkmaar, Alkmaar; Peter W. Plaisier, Albert Schweitzer Hospital, Dordrecht; Herman Rijna, Spaarne Gasthuis Haarlem, Haarlem; Suzan van der Meij, Flevo Hospital, Almere; and Eva Broomans, Virenze Institute of Mental Health Care, Utrecht, the Netherlands
| | - Eric J van Dulken
- Susanna B. Hummel, Hester S.A. Oldenburg, Daniela E.E. Hahn, Jacobien M. Kieffer, Miranda A. Gerritsma, Marianne A. Kuenen, and Neil K. Aaronson, The Netherlands Cancer Institute; Nina Bijker, Academic Medical Center; Paul J. Borgstein, Onze Lieve Vrouwe Gasthuis East; Eric J. van Dulken, Medical Center Slotervaart; Bart C. Vrouenraets, Onze Lieve Vrouwe Gasthuis West, Amsterdam; Jacques J.D.M. van Lankveld, Open University, Heerlen; Gijsbert Heuff, Spaarne Gasthuis Hoofddorp, Hoofddorp; Alexander M.F. Lopes Cardozo, Noordwest Hospital Group Alkmaar, Alkmaar; Peter W. Plaisier, Albert Schweitzer Hospital, Dordrecht; Herman Rijna, Spaarne Gasthuis Haarlem, Haarlem; Suzan van der Meij, Flevo Hospital, Almere; and Eva Broomans, Virenze Institute of Mental Health Care, Utrecht, the Netherlands
| | - Bart C Vrouenraets
- Susanna B. Hummel, Hester S.A. Oldenburg, Daniela E.E. Hahn, Jacobien M. Kieffer, Miranda A. Gerritsma, Marianne A. Kuenen, and Neil K. Aaronson, The Netherlands Cancer Institute; Nina Bijker, Academic Medical Center; Paul J. Borgstein, Onze Lieve Vrouwe Gasthuis East; Eric J. van Dulken, Medical Center Slotervaart; Bart C. Vrouenraets, Onze Lieve Vrouwe Gasthuis West, Amsterdam; Jacques J.D.M. van Lankveld, Open University, Heerlen; Gijsbert Heuff, Spaarne Gasthuis Hoofddorp, Hoofddorp; Alexander M.F. Lopes Cardozo, Noordwest Hospital Group Alkmaar, Alkmaar; Peter W. Plaisier, Albert Schweitzer Hospital, Dordrecht; Herman Rijna, Spaarne Gasthuis Haarlem, Haarlem; Suzan van der Meij, Flevo Hospital, Almere; and Eva Broomans, Virenze Institute of Mental Health Care, Utrecht, the Netherlands
| | - Eva Broomans
- Susanna B. Hummel, Hester S.A. Oldenburg, Daniela E.E. Hahn, Jacobien M. Kieffer, Miranda A. Gerritsma, Marianne A. Kuenen, and Neil K. Aaronson, The Netherlands Cancer Institute; Nina Bijker, Academic Medical Center; Paul J. Borgstein, Onze Lieve Vrouwe Gasthuis East; Eric J. van Dulken, Medical Center Slotervaart; Bart C. Vrouenraets, Onze Lieve Vrouwe Gasthuis West, Amsterdam; Jacques J.D.M. van Lankveld, Open University, Heerlen; Gijsbert Heuff, Spaarne Gasthuis Hoofddorp, Hoofddorp; Alexander M.F. Lopes Cardozo, Noordwest Hospital Group Alkmaar, Alkmaar; Peter W. Plaisier, Albert Schweitzer Hospital, Dordrecht; Herman Rijna, Spaarne Gasthuis Haarlem, Haarlem; Suzan van der Meij, Flevo Hospital, Almere; and Eva Broomans, Virenze Institute of Mental Health Care, Utrecht, the Netherlands
| | - Neil K Aaronson
- Susanna B. Hummel, Hester S.A. Oldenburg, Daniela E.E. Hahn, Jacobien M. Kieffer, Miranda A. Gerritsma, Marianne A. Kuenen, and Neil K. Aaronson, The Netherlands Cancer Institute; Nina Bijker, Academic Medical Center; Paul J. Borgstein, Onze Lieve Vrouwe Gasthuis East; Eric J. van Dulken, Medical Center Slotervaart; Bart C. Vrouenraets, Onze Lieve Vrouwe Gasthuis West, Amsterdam; Jacques J.D.M. van Lankveld, Open University, Heerlen; Gijsbert Heuff, Spaarne Gasthuis Hoofddorp, Hoofddorp; Alexander M.F. Lopes Cardozo, Noordwest Hospital Group Alkmaar, Alkmaar; Peter W. Plaisier, Albert Schweitzer Hospital, Dordrecht; Herman Rijna, Spaarne Gasthuis Haarlem, Haarlem; Suzan van der Meij, Flevo Hospital, Almere; and Eva Broomans, Virenze Institute of Mental Health Care, Utrecht, the Netherlands
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12
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Internet-Based Guided Self-Help for Vaginal Penetration Difficulties: Results of a Randomized Controlled Pilot Trial. J Sex Med 2017; 14:238-254. [DOI: 10.1016/j.jsxm.2016.12.232] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Revised: 12/06/2016] [Accepted: 12/16/2016] [Indexed: 11/23/2022]
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Hummel SB, van Lankveld JJDM, Oldenburg HSA, Hahn DEE, Broomans E, Aaronson NK. Internet-based cognitive behavioral therapy for sexual dysfunctions in women treated for breast cancer: design of a multicenter, randomized controlled trial. BMC Cancer 2015; 15:321. [PMID: 25927495 PMCID: PMC4423483 DOI: 10.1186/s12885-015-1320-z] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2015] [Accepted: 04/16/2015] [Indexed: 02/02/2023] Open
Abstract
Background Sexual dysfunction is a prevalent, long-term complication of breast cancer and its treatment and can be treated effectively with face-to-face sexual counselling. However, relatively few women actually opt for face-to-face sex therapy, with many women indicating that it is too confronting. Internet-based interventions might be a less threatening and more acceptable approach, because of the convenience, accessibility and privacy it provides. Recent studies have demonstrated the efficacy of internet-based programs for improving sexual functioning in the general population. The objective of the current study is to investigate the efficacy of an internet-based cognitive behavioral therapy (CBT) program in alleviating problems with sexuality and intimacy in women who have been treated for breast cancer. Methods/design In a multicenter, randomized controlled trial we are evaluating the efficacy of an internet-based CBT program in reducing problems with sexuality and intimacy in breast cancer survivors. Secondary outcomes include body image, marital functioning, psychological distress, menopausal symptoms, and health-related quality of life. We will recruit 160 breast cancer survivors (aged 18-65 years) with a formal DSM-IV diagnosis of sexual dysfunction from general and academic hospitals in the Netherlands. Women are randomized to either an intervention or waiting-list control group. Self-report questionnaires are completed by the intervention group at baseline (T0), ten weeks after start of therapy (T1), post-treatment (T2), 3 months post-treatment (T3), and 9 months post-treatment (T4). The control group completes questionnaires at T0, T1 and T2. Discussion There is a need for accessible and effective interventions for the treatment of sexual dysfunctions in breast cancer survivors. This study will provide evidence about the efficacy of an internet-based approach to delivering a CBT intervention targeted specifically at these sexual health issues. If proven to be effective, internet-based CBT for problems with sexuality and intimacy will be a welcome addition to the care offered to breast cancer survivors. Hopefully this therapy will lower the barrier to seeking help for these problems, resulting in improved quality of life after breast cancer. Trial registration The study is registered at ClinicalTrials.gov (NCT02091765).
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Affiliation(s)
- Susanna B Hummel
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.
| | - Jacques J D M van Lankveld
- Faculty of Psychology and Educational Sciences, Open University, Valkenburgerweg 177, 6419 AT, Heerlen, The Netherlands.
| | - Hester S A Oldenburg
- Department of Surgical Oncology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.
| | - Daniela E E Hahn
- Department of Psychosocial Counseling, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.
| | - Eva Broomans
- Department of Adult Care, Virenze Institute of Mental Health Care, 't Goylaan 7, 3525 AA, Utrecht, The Netherlands.
| | - Neil K Aaronson
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.
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Blanken I, Leusink P, van Diest S, Gijs L, van Lankveld JJDM. Outcome predictors of Internet-based brief sex therapy for sexual dysfunctions in heterosexual men. JOURNAL OF SEX & MARITAL THERAPY 2014; 41:531-543. [PMID: 24918965 DOI: 10.1080/0092623x.2014.931317] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The authors investigated whether baseline and therapy process characteristics of 82 heterosexual men participating in an Internet-based sex therapy study predict posttreatment sexual functioning. Problem severity, baseline sexual desire and baseline sexual satisfaction, but also partner problems and quality of the therapeutic relationship are predictive for sexual functioning and sexual satisfaction after finishing Internet-based sex therapy. The obtained outcome predictors could benefit men with sexual dysfunctions by tailoring online therapy programs to their individual characteristics. In addition, therapists should realize that clients suffering from erectile dysfunction or premature ejaculation in online sex therapy attach great importance to the therapeutic relationship.
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Affiliation(s)
- Irene Blanken
- a Department of Social Psychology, Tilburg University , Tilburg , The Netherlands
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15
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Kodatt SA, Shenk JE, Williams ML, Horvath KJ. Leadership Qualities Emerging in an Online Social Support Group Intervention. SEXUAL AND RELATIONSHIP THERAPY 2014; 29:467-475. [PMID: 25642144 DOI: 10.1080/14681994.2014.941346] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Technology-delivered interventions addressing a broad range of problems for which clients present for therapy are proliferating. However, little is known of leadership dynamics that emerge in online group interventions. The purpose of this study was to assess the types of leadership qualities that would emerge in an online social support group intervention to improve medication adherence for men with HIV, and to characterize the demographic and psychosocial profiles of leaders. Written posts (n=616) from 66 men were coded using an adapted version of the Full Range Model of Leadership. Results showed that 10% (n=64) of posts reflected one of five leadership types, the most common of which was mentoring/providing feedback (40% of leadership posts). The next most common leadership style were instances in which encouragement was offered (30% of leadership posts). Leaders appeared to have lived with HIV longer and have higher Internet knowledge scores than non-leaders. Results indicate that online group interventions potentially may be useful to supplement traditional face-to-face treatment by providing an additional venue for group members to mentor and provide emotional support to each other. However, additional research is needed to more fully understand leadership qualities and group dynamics in other online group intervention settings.
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Affiliation(s)
- Stephanie A Kodatt
- Department of Health Policy and Management, Florida International University, 11200 S.W. 8th St. -AHC II-554A, Miami, FL 33199
| | - Jared E Shenk
- Division of Epidemiology and Community Health, University of Minnesota, 1300 S 2nd St, Minneapolis, MN 55454
| | - Mark L Williams
- College of Public Health and Social Work, Florida International University, 11200 S.W. 8th St. -AHC II-554A, Miami, FL 33199
| | - Keith J Horvath
- Division of Epidemiology and Community Health, University of Minnesota, 1300 S 2nd St, Minneapolis, MN 55454
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Hucker A, McCabe MP. Incorporating Mindfulness and Chat Groups Into an Online Cognitive Behavioral Therapy for Mixed Female Sexual Problems. JOURNAL OF SEX RESEARCH 2014; 52:627-639. [PMID: 24742343 DOI: 10.1080/00224499.2014.888388] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The current randomized study evaluated an online cognitive behavioral therapy program for female sexual problems. PursuingPleasure (PP) consisted of six online modules that included psychoeducation, sensate focus, communication exercises, cognitive exercises, and e-mail contact with a therapist. PP incorporated mindfulness training and online chat groups as well as assessed partner sexual functioning. Participants demonstrated a completion rate of 57%, with 26 women with female sexual problems and related distress completing the program compared to a wait-list control group of 31 women also experiencing sexual problems and distress. Sexual problems reported by women in both groups included difficulties with sexual desire, arousal, orgasm, and pain. The treatment group demonstrated significant improvements in all domains of female sexual response (except for sexual pain) and significant reductions in the reported frequency of sexual problems and distress. Partner sexual functioning showed positive change. Improvements in female sexual functioning and some improvements in male partner sexual functioning were maintained at three-month follow-up. Limitations and suitability of clients for this treatment approach for women who are geographically isolated, who are unable to attend face-to-face therapy, and who possess a high degree of motivation are discussed.
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Clarke MJ, Marks ADG, Lykins AD. Effect of normative masculinity on males' dysfunctional sexual beliefs, sexual attitudes, and perceptions of sexual functioning. JOURNAL OF SEX RESEARCH 2014; 52:327-337. [PMID: 24558985 DOI: 10.1080/00224499.2013.860072] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Male sexual dysfunction is a prevalent and distressing condition, which may be exacerbated by the sufferer's perceptions of masculinity and normative sexual behavior. This study sought to investigate the effect of social context on males' beliefs regarding sexual behavior. The research examined the effect of male role modeling and masculine cues on males' dysfunctional sexual beliefs, sexual attitudes, and self-perceptions of sexual functioning. A sample of 140 male participants, with a mean age of 29 years, was exposed to pictorial and verbal cues that presented different versions of male behavior across three conditions. Results indicated that males exposed to models and cues of traditional masculinity showed significantly increased levels of dysfunctional sexual beliefs and traditional sexual attitudes relative to males exposed to models of modern masculinity. Results also indicated that males exposed to traditional masculine stimuli reported lower levels of sexual inhibition due to fear of performance failure than males exposed to models of modern masculinity. The potential role of social context is discussed in the development and maintenance of male sexual dysfunction and its implications for treatment.
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Affiliation(s)
- Michael J Clarke
- a School of Behavioural, Cognitive, and Social Sciences , University of New England
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Hucker A, McCabe MP. An online, mindfulness-based, cognitive-behavioral therapy for female sexual difficulties: impact on relationship functioning. JOURNAL OF SEX & MARITAL THERAPY 2013; 40:561-576. [PMID: 24308322 DOI: 10.1080/0092623x.2013.796578] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
This article presents the evaluation of an online treatment for female sexual difficulties as it relates to relationship functioning. Pursuing Pleasure was an online, mindfulness-based, cognitive behavioral therapy for female sexual difficulties. In Study 1, 26 women completed treatment and changes were compared with a waitlist control group (n = 31). In Study 2, 16 women from the control group then completed treatment. The authors did not use a control group in Study 2. Results demonstrated that both treatment groups observed significant improvements in sexual intimacy and communication, and emotional intimacy improved significantly in the Study 1 treatment group. Most improvements were maintained at follow-up.
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Affiliation(s)
- Alice Hucker
- a Centre for Mental Health and Wellbeing , Deakin University , Melbourne , Australia
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Smith WB, McCaslin IR, Gokce A, Mandava SH, Trost L, Hellstrom WJ. PDE5 inhibitors: considerations for preference and long-term adherence. Int J Clin Pract 2013; 67:768-80. [PMID: 23869678 DOI: 10.1111/ijcp.12074] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION Erectile dysfunction (ED) is a highly prevalent condition affecting nearly one in five men worldwide. The advent of phosphodiesterase type 5 inhibitors (PDE5i) has revolutionised the ED treatment landscape and provided effective, minimally invasive therapies to restore male sexual function. MATERIALS AND METHODS A pubmed search was performed of all English language articles from 1996 to present reviewing PDE5i, including pharmacokinetics, efficacy profiles and comparisons, where available. RESULTS Currently available PDE5i in the United States include sildenafil, vardenafil, tadalafil and avanafil, each of which has unique side effect, pharmacokinetic and outcome profiles. Sildenafil is associated with increased rate of visual changes, vardenafil with QT prolongation and tadalafil with lower back pain. Avanafil and vardenafil orodispersible tablet rapidly achieve peak plasma concentration, which results in faster onset of action, whereas tadalafil exhibits the longest half-life. First time response to PDE5i is approximately 60-70%, with no significant differences in efficacy noted among therapies. The literature does not clearly demonstrate a preference for one drug. High-treatment success rates (89%) were reported when patients were prescribed all available PDE5i. Daily dosing with tadalafil is associated with improved erectile function (EF) over time. Finally, novel modes of patient-provider interaction, including internet-based education, communication and prescribing, may also improve long-term adherence. CONCLUSIONS PDE5i represent first line therapy for ED with excellent overall efficacy and satisfactory side effect profiles. Enhanced communciation, coupled with increased knowledge of drug characteristics, comparative treatment regimens and optimal prescribing patterns, offer compelling tools to improve long-term treatment success.
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Affiliation(s)
- W B Smith
- Department of Urology, School of Medicine, Tulane University, New Orleans, LA, USA
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Abstract
INTRODUCTION "Is there anything new in sex therapy?" Has the field of sex therapy been stagnating and failing to develop new treatments? Clearly, the important pharmaceutical advances of the past 11 years have overshadowed the developments in the field of sex therapy. AIM The goal of this manuscript is to call attention to the recent innovations in the field of sex therapy. METHOD Review of the literature. RESULTS There are four candidates to consider: (i) combination medical and psychological therapy; (ii) the technique of mindfulness for women with complaints of arousal disorder and low sexual desire; (iii) Internet sexual therapy and; and (iv) reconceptualization of genital pain and psychological interventions for women with these complaints. This article reviews the literature in these areas and offers commentary regarding the benefits and limitations of the research. Finally, future directions for research in these four areas are discussed. CONCLUSIONS Psychological innovation and intervention remains a vital aspect in the field of sexual medicine. New methods continue to be developed and appraised and the methodology, design, and sophistication of sex therapy outcome research have significantly advanced.
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Affiliation(s)
- Stanley E Althof
- Department of Psychiatry, University of Miami Miller School of Medicine, Miami, FL 33401, USA.
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Schnetzler G, Banks I, Kirby M, Zou KH, Symonds T. Characteristics, behaviors, and attitudes of men bypassing the healthcare system when obtaining phosphodiesterase type 5 inhibitors. J Sex Med 2010; 7:1237-46. [PMID: 20136707 DOI: 10.1111/j.1743-6109.2009.01674.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
INTRODUCTION Men may choose to bypass the healthcare system to obtain a phosphodiesterase type 5 inhibitor (PDE5i). AIM Evaluate the characteristics and purchasing patterns of men obtaining a PDE5i without prior healthcare professional (HCP) interaction. MAIN OUTCOME MEASURES Prior HCP interaction, defined as having a prescription for any PDE5i, having a PDE5i sample from a physician, or buying the PDE5i in a retail pharmacy; and erectile dysfunction (ED, the Massachusetts Male Aging Study single-item question) were assessed. A multivariate regression analysis determined predictive factors for PDE5i purchase without prior HCP interaction. Methods. A Web-based observational study was conducted in the United Kingdom, Germany, and Italy. RESULTS Of the 11,899 participants, 1,252 (10.5% [95% CI, 10.0-11.1%]) reported PDE5i use in the last 6 months. PDE5is were obtained without prior HCP interaction by 403 users (32.3% [95% CI, 29.6-34.8%]); 65.5% of them had ED. Overall prevalence of men using PDE5is without HCP interaction was 3.0% (95% CI, 2.6-3.5%), 4.1% (95% CI, 3.5-4.6%), and 2.8% (95% CI, 2.1-3.5%) for men aged 18-34, 35-50, and >50 years, respectively (P = 0.0045). Predictive factors for obtaining a PDE5i without prior HCP interaction were embarrassment to speak to a physician (P = 0.0009) and the perception that this would be the cheapest way to get the medicine (P = 0.03). CONCLUSIONS Based on these findings, it can be estimated that approximately 6 million men in Europe might currently bypass the healthcare system to obtain a PDE5i. In addition to the risks associated with use of PDE5is from uncontrolled sources, because most of these men have ED, they also miss the opportunity for important health information or medical follow-up. HCPs should actively address ED and offer treatment to discourage men from seeking uncontrolled sources of ED medicines.
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Van Lankveld JJ, Leusink P, Van Diest S, Gijs L, Slob AK. Internet-Based Brief Sex Therapy for Heterosexual Men with Sexual Dysfunctions: A Randomized Controlled Pilot Trial. J Sex Med 2009; 6:2224-36. [DOI: 10.1111/j.1743-6109.2009.01321.x] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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McCabe M, Price E. Internet-based psychological and oral medical treatment compared to psychological treatment alone for ED. J Sex Med 2008; 5:2338-46. [PMID: 18554261 DOI: 10.1111/j.1743-6109.2008.00885.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
INTRODUCTION Sexual function through pregnancy and the postpartum period is an important aspect of quality of life. Despite this, prospective studies are limited, and the impact of body image on sexual function has not been explored. AIMS The current study reports on a pilot study that evaluated the effectiveness of a combined Internet-based psychological treatment program and oral medication compared to an Internet-based psychological program. METHODS Twelve men with ED participated in the study. MAIN OUTCOME MEASURES Assessments were made pre and postintervention on ED, relationship satisfaction, sexual satisfaction, self-esteem, and quality of life. RESULTS Multivariate analyses of variance demonstrated that both treatment conditions showed improvements from pretest to posttest in sexual functioning, relationships, and personal well-being. CONCLUSIONS This study indicates the importance of targeting psychological and relationship variables in the treatment of ED. Further research with larger numbers of participants is necessary for a more rigorous evaluation of treatment programs that combine psychological and medication interventions for ED.
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Affiliation(s)
- Marita McCabe
- School of Psychology, Deakin University, Melbourne, Vic, Australia.
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McCabe MP, Price E, Piterman L, Lording D. Evaluation of an internet-based psychological intervention for the treatment of erectile dysfunction. Int J Impot Res 2008; 20:324-30. [DOI: 10.1038/ijir.2008.3] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Hernando-Berríos M, Soledad Rivera-Martínez M, Gualda-Vergara V. Intervenciones no farmacológicas para el tratamiento de la disfunción eréctil en varones adultos: revisión sistemática. ENFERMERIA CLINICA 2008; 18:64-9. [DOI: 10.1016/s1130-8621(08)70700-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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