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PubMed2003

[Tunica plication with horizontal incisions of the tunica albuginea in the treatment of congenital penile deviations].

PURPOSE: The Schroeder-Essed plication procedure is a standard technique for the correction of penile curvature. In a retrospective analysis we compared functional results and quality of life of the original technique with inverted sutures as described by Schroeder-Essed and our slight modification consisting of horizontal incisions into the tunica albuginea. MATERIALS AND METHODS: A total of 26 patients with congenital penile deviation were treated, 11 by the original Schroeder-Essed plication with inverted sutures and 15 using the described modification. In the modified technique, horizontal and parallel incisions 4 mm - 6 mm apart and about 8 mm - 10 mm long were made through the tunica albuginea. The outer edges of the incisions were then approximated with permanent inverted sutures (Gore-Tex(R) 3-0). Mean age was 21.6 years in the first group and 23.2 years in the second group. The preoperative penile deviation angle was > 25 degrees in all patients without differention between the two groups. RESULTS: All patients in both groups reported improvement in their quality of life and full ability to engage in sexual intercourse. A total of 9 patients (88 %) in the first group and 14 patients (93 %) in the second group were satisfied with the cosmetic result, although 10 patients (91 %) in the first and 13 patients (87 %) in the second group complained of penile shortening. Recurrence of deviation was only observed in 2-males in the first group (18 %). CONCLUSIONS: Our results indicate that this simple modification of the Schroeder-Essed plication offers good functional and cosmetic results. Most patients were satisfied with the penile angle correction results.

Adult↗
PubMed2006

The prevalence of enduring postnatal perineal morbidity and its relationship to perineal trauma.

OBJECTIVE: to investigate the prevalence of enduring postnatal perineal morbidity and its relationship to perineal trauma. DESIGN: a retrospective cross-sectional community survey of postnatal women. PARTICIPANTS AND SETTING: a total population sample of 2100 women were surveyed from two maternity units within Birmingham. Women were identified from the Trust's computerised Maternity Information System (MIS). METHODS: Women were surveyed using a self-administered postal questionnaire 12 months after birth. The questionnaire included self-assessment of perineal pain, perineal healing, urinary incontinence, flatus incontinence, faecal incontinence, sexual morbidity and dyspareunia. FINDINGS: a response rate of 23.3% was achieved (n=482). A high level of perineal morbidity was reported (53.8% stress urinary incontinence, 36.6% urge urinary incontinence, 9.9% liquid faecal incontinence, 54.5% with at least one index of sexual morbidity). Women with perineal trauma reported significantly more morbidity (sexual morbidity, dyspareunia, stress and urge urinary incontinence) than women with an intact perineum. Women with perineal trauma also resumed sexual intercourse later than women with an intact perineum. Women with a first- or second-degree tear reported significantly more perineal morbidity (stress incontinence, sexual morbidity) than women with an intact perineum, and resumed sexual intercourse later. However, a high percentage of women with an intact perineum also reported new-onset perineal morbidity: stress urinary incontinence (34.8%); urge urinary incontinence (19.5%); flatus incontinence (13.8%); and dyspareunia (25.3%), highlighting that enduring perineal morbidity can occur irrespective of perineal trauma. CONCLUSION: enduring postnatal perineal morbidity is common in women with all types and grades of perineal trauma and intact perineum after childbirth. This highlights the need for further debate and research into the prevalence and experience of postnatal morbidity.

Adult↗
PubMed2005

HIV infection among low-risk first lifetime testers in Rome, 1990-2000.

BACKGROUND: HIV spread among low-risk populations through heterosexual intercourse is a major public health concern. This study was aimed at describing prevalence and determinants of HIV infection among Italian low-risk subjects seeking their first lifetime HIV test. PATIENTS AND METHODS: Information collected between January 1990 and December 2000 at a major counseling and testing site in Rome, Italy, was analyzed. Multiple logistic regression odds ratios (OR) and 95% confidence intervals (CI) were computed. RESULTS: Among the 14,313 study subjects, 64 (0.4%) were seropositive for HIV infection. HIV seropositivity increased with age (OR = 4.0, 95% CI: 2.1-7.6 for >/= 40 years vs 18-24), and it seemed to be more common among men (OR = 1.6, lower 95% CI:0.9). There was no evidence of temporal variations, whereas motivations for HIV testing were strongly associated with HIV prevalence. Testing for alarming symptoms (OR = 13.8) or for heterosexual intercourse (OR = 11.0) were associated with a more than 10-fold increased HIV risk. CONCLUSION: Our findings are consistent with data from other industrialized countries and they show a strong association between HIV seropositivity and reason for first-time testing. Moreover, they indicate a stable trend of HIV prevalence among low-risk persons in the last decade. Further studies on time trends in low-risk populations would be useful to evaluate current HIV prevention programs.

Adolescent↗
PubMed1976

[Patterns of sexual behavior. A study on gynecological patients (author's transl)].

With a standard questionnaire 7356 lying-in patients at the Department of Obstetrics and Gynecology, University Erlangen-Nürnberg, were asked about their social background and their sexual habits. First of all some statistical facts concerning the frequency of distribution: 20% of all women questioned had their first cohabitation before the age of seventeen. 53% had sexual intercourse with one man, 23% with two, the remainder with more than two men. Quite a number of social characteristics influenced the sexual behavior of women. Thus it was shown that women have their first cohabitation before the age of eighteen the sooner the lower their social status is and the more partners they had. Insufficient contraceptive precautions or the neglect of any contraception were mainly met with women of lower social status. The same correlation could be found between contraceptive behavior on the one hand and the parameters education and strong religious commitment on the other hand. In rural aereas contraceptive measures were used insufficiently or less often then in urban communities.

Adolescent↗
PubMed1994

[School children's knowledge of, need for and use of contraception before and after the AIDS campaigns. Sexual activity and contraception habits].

The purpose of the present investigation was to evaluate changes in contraceptional habits or sexual activity among adolescents as a consequence of the AIDS-campaigns. In 1986 and 1993 all pupils in their ninth school year in the municipality of Viborg answered an identical questionnaire concerning the mentioned subjects. Both in 1986 and 1993 one third had had sexual intercourse, and one seventh had had their sexual debut before the age of 15. There were significantly more condom users at the first coitus in 1993 and fewer pill users. The proportion of unprotected intercourse did not differ. More pupils had had experience using condoms in 1993, but, as in 1986, nearly half of the girls had used coitus interruptus or safe periods. The proportion of girls who had had intercourse within a week of answering the questionnaire increased from 26% to 42%, indicating a more sexually active population of girls. It is concluded that the increased sexual activity, the fewer pill users and the persisting large proportion of un- or low-protected intercourse may result in more unintended pregnancies. The coincident use of pill and condom should be encouraged.

Acquired Immunodeficiency Syndrome↗
PubMed2006

Management of honeymoon impotence.

INTRODUCTION: Honeymoon impotence can be defined as the failure to be successfully involved in sexual intercourse at the beginning of marriage, particularly in the first few nights. While its exact causes are not yet elucidated, many studies recognize this problem as related to performance anxiety. AIM: The aim of this study was to report the outcome of management of patients with honeymoon impotence. METHODS AND MAIN OUTCOME MEASURES: This study included 100 consecutive patients presenting to our department complaining of failed sexual intercourse since the beginning of their marriage. History taking, completion of the abridged form of the International Index of Erectile Function (IIEF-5) questionnaire, and combined intracavernous injection and stimulation and nocturnal penile tumescence monitoring were performed. Penile duplex was performed to elucidate vascular insufficiency. All psychogenic patients with erectile dysfunction (ED) were treated with sildenafil and sex therapy. All organic ED patients were treated either with sildenafil alone or combined therapy with either intracavernous prostaglandin E1 or vacuum constriction device. RESULTS: Seventy-four patients had psychogenic ED and 26 patients had vasculogenic ED. All psychogenic ED patients were treated successfully with sildenafil and sex therapy. Twenty-two patients with vasculogenic ED were treated successfully with sildenafil or combined therapy, while four patients needed venous surgery. Minimal side effects of all treatment modalities occurred throughout the study. CONCLUSIONS: Management of honeymoon impotence requires profound diagnosis of its causative factors. Treating physicians in areas with high prevalence of this condition should be ready to manage this problem with vigilant systematic overture. A combined approach of sildenafil and sex therapy proved highly effective in treatment of honeymoon impotence of psychogenic origin; however, controlled studies are needed. Other patients showing functional erectile abnormalities should be treated accordingly.

Adult↗
PubMed2004

The matalisi: pathway to early sexual initiation among the youth of Mpigi, Uganda.

This paper describes the role and personal characteristics of the "matalisi,'' a previously unreported phenomenon uncovered during a study of youth sexual behavior in Uganda. The "matalisi,'' a go-between, played a central role in sexual relationships of most youth in Mpigi, Uganda. The first phase of the study was an ethnographic inquiry of youth (ages 10-16) sexual behavior. During this phase it became evident that matalisis were used in most courtships and initial sexual liaisons. The second phase included a sociometric investigation of youth networks and a mini survey of youth who had been matalisis. Among youth interviewed, 47.3% of males (105/222) and 14.1% of females (42/298) had experienced sexual intercourse. For 88%, participating as someone's matalisi preceded first coitus. By understanding the role of the matalisi, interventions may be developed to improve sex education and more effectively address sexual behaviors that lead to unwanted pregnancies, STIs, and HIV infection.

Acquired Immunodeficiency Syndrome↗
PubMed2006

Characteristics of women seeking emergency contraception in general practice.

The aim of this study was to profile the users of emergency contraception (EC) attending general practices and a general practice out-of-hours co-operative service using a pre-piloted questionnaire. Questionnaires were offered to 171 women and completed by 144 (84.2%). Mean age was 24.4 years (Standard Deviation = 6.7, range 14 to 51). Most were single, 116 (80.6%). Those who had no regular partner at the time of seeking EC were more likely to have > or =6 lifetime sexual partners than those in stable relationships (OR: 3.5; CI: 1.14-10.86, p < 0.03). At the time of seeking EC 121 (84.0%) were using some method of contraception. Ninety-three (64.6%) presented within 24 hours of sexual intercourse. Concerns about condoms were the commonest reason for seeking EC. For 55 (38.2%) this was their first time to use EC. Thirty-three (22.9%) were drunk at the time of intercourse.

Adolescent↗
PubMed2000

Using complete breastfeeding and lactational amenorrhoea as birth spacing methods.

The aim of this study was to evaluate the effectiveness of lactational amenorrhoea and to determine the relationship between extended breastfeeding and the return of fertility. Breastfeeding pattern, basal body temperature, cervical mucus, salivary ferning, vaginal blood discharge, frequency of sexual intercourse, and the presence of ovulation in the first cycle after the resumption of menses with ultrasonography were evaluated in 40 women. All subjects completed the study with only one case of incomplete breastfeeding. No pregnancies were observed. The mean number of feeding sessions and mean interval between sessions decreased significantly (p <0.01) during the first six months postpartum (7.5 +/- 1.3 after 60 days postpartum vs. 5.7 +/- 2.1 after 180 days, and 3.6 +/- 0.8 vs. 5.1 +/- 0.9, respectively). Eight women (20%) menstruated before weaning, but none had an adequate thermal shift, while 32 (80%) had their first vaginal bleeding after weaning with 12 (37.5%) registering an adequate thermal shift. Both basal body temperature and salivary ferning proved to be suggestive of ovarian activity, while mucus characteristics were not reliable in identifying fertile periods. Our study showed that breastfeeding associated with lactational amenorrhoea proved to be a good method of postpartum fertility control. Since the importance of supplementation is still debated, it is recommended that a "complete" breastfeeding program be used.

Adult↗
PubMed1991

Expanding contractures of the tunica albuginea due to Peyronie's disease with temporalis fascia free grafts.

We describe a procedure to expand contractures of the tunica albuginea by multiple full thickness relaxing incisions followed by inlay of tailored temporalis fascia free grafts. This technique is performed without resection of the tunica albuginea, although in the case of calcified plaques the calcifications themselves are removed, preserving the overlying tunica. Between September 1988 and February 1990, 12 patients have undergone this procedure, all of whom have greater than 3 months of followup and have experienced spontaneous erections within the first week postoperatively. Of the patients 11 resumed intercourse within 8 weeks of surgery and 1 required 12 weeks. No patient had sensory loss postoperatively and there has been no donor site morbidity. Correction of curvature was accomplished in all patients and there have been no recurrences within a maximal followup of 22 months. Within the limitations of such a small study we believe that there is evidence supporting this approach in potent patients with severe acquired penile curvature.

Fascia↗
PubMed1991

Williams' vulvovaginoplasty after supralevator total pelvic exenteration.

Seven patients had delayed Williams' vulvovaginoplasty after supralevator total pelvic exenteration. Of the three patients who died of carcinoma of the cervix (at 2, 5, and 15 months after vulvovaginoplasty), the first died before having a chance to attempt intercourse, but the other two had reported intercourse on at least two occasions after the reconstruction. One of the patients described the experiences as neither pleasant nor unpleasant but stated that her husband seemed satisfied. The other patient described the experience as satisfactory to both herself and her husband. The remaining four patients are alive with no evidence of recurrent disease at 28, 42, 56, and 106 months after operation. Two of these patients have reported entirely satisfactory sexual relations approximating pre-exenteration frequency, but the remaining two have not had sexual relations since surgery. Both give the main reason for this as lack of opportunity. The Williams' vulvovaginoplasty appears to be a reasonable alternative for vaginal reconstruction in patients who will have and especially who have had exenteration. To improve results, other methods of vaginal reconstruction should continue to be evaluated.

Adult↗
PubMed1996

[A case of Tsutsugamushi disease infected by mountain climbing in the Republic of Korea].

A 47-year-old male was infected with Tsutsugamushi disease showing typical findings after mountain climbing in the Republic of Korea (ROK). Immunoserological examinations suggested that he had been infected in ROK. In this case, detection of the characteristic sting was useful for early diagnosis and treatment. Until now, Tsusugamushi disease has not been reported in Hokkaido. It is the first case registered in Hokkaido. With extensive international intercourse these days, this case suggests that Tsutsugamushi disease can occur potentially all over Japan.

Humans↗
PubMed1986

Sexual acquisition of urinary tract infection in a man.

A man was admitted with acute pyelonephritis due to Escherichia coli. Three days prior to the onset of his symptoms his wife presented with a 7-day history of cystitis due to E. coli. Before the wife developed her symptoms the couple were having vaginal intercourse every night, and this continued for the first 3 days of her symptoms. The organisms isolated from the urine of both patients were found to have the same biotype, an identical antibiogram, and the same serotype. The temporal sequence of events and the bacteriological findings strongly suggest the sexual transmission of this organism from the wife to her husband.

Adult↗
PubMed1984

[Importance of arteriography in complicated trophoblastic disease].

Sixty two patients with gestational trophoblastic disease were investigated and treated between January 1977-December 1983. The value of pelvic arteriography was examined. The cases included: 45 moles with a simple outcome. 14 cases of invasive trophoblastic neoplasia after evacuation of the mole. 3 choriocarcinomas after full term pregnancy. Pelvic arteriography was performed in 14 patients. 9 of the 14 patients presented with persistent HCG secretion 6 to 8 weeks after evacuation of the mole. Before chemotherapy was begun, we looked for unfavourable prognostic features such as extra-pelvic metastases, multiple pulmonary metastases, high HCG secretion, delay between the initial event and starting chemotherapy of more than six months. The Ishizuka score was calculated. Six arteriography type I readings suggested choriocarcinoma with an Ishizuka score above five. Double chemotherapy (oncovin-methotrexate) was started successfully (with a one year follow up). Only two patients had unfavourable factors. Two arteriography type III suggested persistent moles, with an Ishizuka score below five. Chemotherapy (only methotrexate) was successful). It was not possible to classify the last arteriography, so the patient was treated successfully with double chemotherapy. Three patients failed to recover with chemotherapy. Arteriography was indicated to determine the site of HCG secretion. Three hysterectomies were performed. Tissue choriocarcinoma was found. Two diagnoses of choriocarcinoma were confirmed by arteriography: In one case an unexplained pleurisy appeared six months after full term. HCG was then positive. In the other case, extrauterine pregnancy was first suspected, but the woman had not had intercourse for six months. Arteriography demonstrated tubal choriocarcinoma. So pelvic arteriography is useful for managing complicated gestational trophoblastic disease.

Adolescent↗
PubMed1994

[Modified Nesbit's operation in the treatment of incurvations of the penis. Apropos of 26 cases].

Distortion of the penis can be an obstacle to normal sexual intercourse and can lead to psychological problems. Nesbit first described an operation for the correction of three cases of congenital incurvation of the penis. Several authors later proposed modifications of the original procedure, but the principle technique relies on folding the corpus cavernosum on the side opposite the deviation. We have treated 26 cases with distorted penis: 14 congenital, 3 postsurgical, 1 post-trauma and 8 due to la Peyronie's disease. Our functional results have been excellent. The risk of postoperative retraction is considerably reduced when the fold is created without removing the albugin patches. The quality of the results is directly related to rigorous patient selection.

Adult↗
PubMed1995

Will preventive HIV vaccine efficacy trials be possible with female injection drug users?

This article examines whether preventive HIV vaccines trials will be viable among female injection drug users (IDUs). Of the 137 women who completed baseline serologic and behavioral assessments, 121 (88%) were seronegative; all enrolled in Project Jumpstart in Philadelphia (PA, U.S.A.), a vaccine preparedness initiative cosponsored by NIAID and NIDA. Subjects were seen every 3 months for risk and vaccine opinion assessment, risk reduction counseling, and HIV antibody testing. The baseline prevalence rate of HIV infection was 12% (16 of 137) with an annual incidence rate of 3.5% (4 of 114) during the first year. Of the 121 baseline seronegative women, 28% shared needles and 52% engaged in unprotected intercourse. Sixty percent of the baseline seronegative women reported being willing to be one of the first people to try an HIV vaccine. According to logistic regression, needle sharers were 12.8 times more likely, women who engaged in sex for drugs or money 6.6 times more likely, out-of-treatment women 3.5 times more likely, and those who believed that vaccines can prevent disease acquisition 3 times more likely to report willingness to try an HIV vaccine than their respective counterparts. At 1-year postbaseline assessment, 98% of the women had behavioral data collected and 95% had serologic specimens collected. Given that seroconversions occur and that these women engage in risk behaviors, report willingness to try an HIV vaccine, and can be retained for longitudinal assessment, they appear to be suitable participants for preventive HIV vaccine efficacy trials. Nonetheless, work is required to insure that these women make informed and knowledgeable decisions regarding trial enrollment.

AIDS Vaccines↗
PubMedDate not supplied

Influence of discipline of study on the sexual behaviour of Nigerian female students.

In this comparative study of the sexual behaviour of 476 Nigerian female students in tertiary institutions comprising of 243 students of the medical discipline of study (MD group) and 233 students of the non-medical discipline of study (NMD group), the overall incidence of sexual intercourse was 56.7 percent. The mean age at first sexual experience was not significantly different at & = 0.05 among the two groups. However, sexual exposure was significantly more prevalent among students of the non-medical discipline of study (NMD group)--69.1 percents compared to those of the medical discipline of study (MD group)--44.9 percent (p < 0.01). In addition, the frequency of sexual exposure was significantly higher among the former group, 5.5 +/- 6.8 times per month, than in the later, 1.7 +/- 3.8 times per month (t = 5.25 with 274 d.f.; p < 0.005). The incidence of pregnancy among the two groups of students 37.1 percent and 31.2 percent respectively for the NMD and MD groups showed no significant difference at & = 0.05. The reasons for the observed difference in the sexual behaviour between the students for the two groups are adduced. The overall implications of sexuality and the relevance of its management among the youth are also discussed.

Adolescent↗
PubMed2005

Sexual attitudes and behaviors among medical students in Dokuz Eylul university, Turkey.

Gaining a healthy sexual attitude and behavior and being able to show appropriate approaches to patients in terms of sexual issues are important acquisitions for medical students. The aim of the present study was to determine, compare, and evaluate the sexual attitudes and behaviors of Dokuz Eylul University Faculty of Medicine students. An anonymous questionnaire was filled in by first- and sixth-year students in order to determine their sexual attitudes and behaviors. While information sources in the adolescence period for both genders were friends in the first place, these sources were mostly mothers, books, newspapers--magazines for females, and newspapers--magazines and television for males. The opinion of males about having sexual intercourse before marriage for males was positive, and females were more tolerant about males having this experience before marriage as compared to females having sexual experience before marriage. Rates of expression of having sexual intercourse and masturbation were found to be higher for male students. The first sexual experience with a sex worker or sentimentally insignificant partner was high among males. In general, the rate of condom use was lower, and the rate of coitus interruptus was found to be higher than in foreign studies. All the students declared 'my own will and values' as the most frequent factor affecting their sexual attitudes and behaviors, and high rates for 'social factors', 'religious requirements', 'the expectations of families', and 'protection from sexually transmitted diseases' were observed. The findings lead to the conclusions that gender differences exist in the sexual attitudes and behaviors of medical students; the enhancing effect of the traditional structure on gender discrimination is still continuing; students are not provided with sufficient scientific approach or training prior to the university education; and beyond biomedical training, they should receive more support in those fields during their medical education.

Adolescent↗