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Biomedical subjects

S B Levine

Publications and source records attributed to S B Levine.

At least 73 records · Page 4Linked to original sources
PubMed1980

Conceptual suggestions for outcome research in sex therapy.

This paper makes two basic conceptual suggestions that may encourage more meaningful studies of the effectiveness of sex therapy: (1) Dysfunctions consist of deficits of one or more of the basic components of sexual life: desire, arousal, orgasm, emotional satisfaction. (2) There are three distinct perspectives for determining therapeutic success--(a) reversal of the target component deficit, (b) absence of all of an individual's component deficits, and (c) absence of all component deficits in both partners. Follow-up data should be classified according to each perspective and presented separately. The "cure" rates diminish as the criteria for success become more stringent--i.e., moving from the first to the third perspective. The use of these perspectives highlights the strengths and limitations of current treatment techniques.

Female↗
PubMed1980

Psychiatric diagnosis of patients requesting sex reassignment surgery.

This paper presents the psychiatric diagnostic findings on 51 patients who requested Sex Reassignment Surgery. The biologic females, as a group, were significantly healthier than the males. Ninety-two percent of the males and 58% of the females had psychiatric diagnoses, apart from gender dysphoria. Most of the abnormalities in both groups were character disorders; eight percent of the patients, however, were schizophrenic. Psychometric evaluation suggested that approximately one-half of the patients had more serious disorders than were indicated during clinical evaluation. The initial and ongoing diagnostic processes are helpful in the pre- and postoperative management of patients with gender dysphoria.

Adaptation, Psychological↗
PubMed1978

Preservation of erectile function after aortoiliac reconstruction.

Men with aortoiliac atherosclerosis exhibit organic erectile dysfunction caused by inadequate blood flow and/or psychological factors. After aortoiliac reconstruction, organic erectile dysfunction may be due primarily to surgical interruption of autonomic nerve fibers. To avoid this, dissection principles preserving genital autonomic plexi were developed. The results of these dissections were compared with those of conventional bypasses. Thirty nondiabetic men (age range, 43 to 67 years) were studied. A history of erectile capacity was elicited preoperatively and evaluated postoperatively in follow-up interviews every six months. Normal postoperative erectile function was not affected by nerve-sparing dissections. Each of the 11 patients requiring conventional dissections was both preoperatively and postoperatively impotent. Four of the 19 patients who underwent nerve-sparing dissection were preoperatively and postoperatively impotent. Seven of these 19 patients maintained preoperative potency after nerve-sparing dissection. The potency of the remaining eight patients was either completely restored or improved after nerve-sparing dissection. This report emphasizes the importantance of a preoperative determination of a complex interplay of physical and psychological factors in erectile dysfunction.

Adult↗
PubMed1978

The effectiveness of sex therapy for chronic secondary psychological impotence.

This paper describes the treatment results of sexual therapy with 16 couples. The men had chronic secondary psychological impotence. They were evaluated, treated, and followed up by the same sex therapist. Another psychiatrist evaluated each couple after therpay. Pre- and posttherapy Sexual Interaction inventories were administered as numberical measures of therapeutic effectiveness. By the end of treatment 6 men of the 16 were consistently potent and 4 were potent at least half of the time. Of the 11 men who had improved, 10 demonstrated considerable instability in erectile functioning over 1-year follow-up. Sex therapy can improve sexual functioning. However, it does not restore complete sexual health to couples with this complicated disorder.

Adult↗
PubMed1977

Marital sexual dysfunction: female dysfunctions.

The diagnosis, treatment, and referral of married women with sexual dysfunctions require information about the current physiologic deficit, previous sexual capacity, level of sexual desire, masturbatory experience, means of orgasmic attainment, preferred sexual partner, quality of marriage, husband's sexual capacities, and method of contraception. For classification purposes, the three basic physiologic deficits--excitement phase dysfunction, orgasmic phase dysfunction, and vaginismus--are subdivided into primary and secondary types. Primary dysfunctions represent longstanding developmental problems and are usually purely psychological in origin. Secondary dysfunctions occur after a period of normal sexual functioning and may be organic or psychological in origin. The actual determinants of dysfunctions are not well understood, but those factors commonly associated are discussed. The lack of knowledge about the nature of sexual desire, prevalence of dysfunctions, and significance of the inability to attain orgasm with coitus is emphasized. The physician's role in giving advice and treatment is defined.

Adult↗
PubMed1976

Frequency of sexual dysfunction in a general gynecological clinic: an epidemiological approach.

Epidemiological data on female sexual functioning are presented. Fifty-nine 30- to 39-year-old Black women attending a gynecology clinic at University Hospitals of Cleveland for nonsexual complants were interviewed to determine the frequency of sexual dysfunction. Seventeen percent had difficulty achieving orgasm in partner sexual behavior. Most of these women had prior history of adequate sexual functioning; 5% had never been orgasmic. Ten of the 49 women who had no orgasmic difficulty were not satisfied with their sexual relationships. The relative risk of sexual dysfunction was 5 times greater in women who had undergone pelvic surgery.

Adult↗
PubMed1976

Marital sexual dysfunction:introductory concepts.

The concepts presented in this overview of marital sexual dysfunction are derived from increasing clinical experience with couples who seek help for their sexual problems. These couples, in marked contrast to couples with good sexual functioning, usually report a steady state of emotional dissatisfaction and minimal physical pleasure from sex. The affectual and behavioral consequences of persistent dysfunction are reviewed. Sexual therapy is discussed in terms of its two elements, sensate focus and psychotherapy. The various tastks which the sexual therapist may have to accomplish with individual couples are described. Consideration is given to the specific hypothese usually offered as explanation for sexual dysfunction-i.e., organic factors, varying degrees of relationship failure, poor communication, sexual ignorance, performance anxiety, and intrapsychic residua of past experience. A protocol for the screening physician to use in the formulation of a reasonable clinical plan for dysfunctional couples is included.

Anxiety↗
PubMed1976

Marital sexual dysfunction: ejaculation disturbances.

The three clinically encountered disturbances of the male orgasmic phase--that is, premature ejaculation, inability to ejaculate, and retrograde ejaculation--are discussed. The problem of defining premature ejaculation is explained and the possible pathogenic mechanisms of its origin are reviewed. The classic premature ejaculator is described. Also included are an elaboration of the newer therapeutic approaches to the problem and a suggested clinical protocol for screening patients. The other two, less common dysfunctions are briefly discussed.

Ejaculation↗
PubMed1976

Marital sexual dysfunction: erectile dysfunction.

All clinicians are occasionally consulted by men complaining of impotence. The history is the most important step in the differential diagnostic process for this symptom. Answers to four basic questions enable the physician to recognize classic psychologic and organic patterns. In addition, these questions provide clues as to the cause of the dysfunction. Physical and laboratory examinations are usually required to identify the specific organic cause. Traditional prevalence figures for impotence may no longer be valid. This topic awaits epidemiologic data that reflect current diagnostic sophistication. Individual treatment approaches to both organic and psychologic impotence must counteract the adverse influence of performance anxiety.

Adult↗
PubMed1975

Premature ejaculation: some thoughts about its pathogenesis.

Premature ejaculation has always been assumed to be a male sexual dysfunction whose pathogenesis involved either male physiologic or psychologic considerations. A small series of unselected cases is presented that suggests that premature ejaculation may also result from hidden femal arousal difficulties. The clinical material illustrates that the newer penile stimulation therapies for premature ejaculation are not required for every couple with this complaint.

Adult↗