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At least 1,423 records · Page 79Linked to original sources
PubMed1992

Intracavernous self-injection therapy for the treatment of erectile dysfunction.

Fifty-one patients with chronic erectile dysfunction were selected for this study involving intracavernous self-injection therapy with papaverine or prostaglandin E1 (PGE1). Patients were screened and grouped as follows: pronounced vasculogenic, mild vasculogenic, venous leakage, neurogenic and psychogenic impotence. The duration of follow-up in these 51 patients was from 1.5-30.5 months (average, 11.8 months). The average effective dosage of papaverine and PGE1 was variable among the different groups. This kind of therapy proved to be effective in our preliminary results, which showed that 35 patients (68.6%) were found to be good responders and eight patients (15.7%) were temporary responders. In our detailed questionnaire, answered by all 51 patients, we found 29 patients (56.9%) had increased their frequency of sexual activity, 38 patients (74.5%) had sustained their erection more than they ever had before, and 43 patients (84.3%) had enjoyed sexual orgasm following this pharmacologically assisted erection. Compared with papaverine, PGE1 was found to have fewer complications. None of the patients complained of any discomfort after long-term, self-injection with PGE1. However, two patients (3.9%) had sustained erections and two patients (3.9%) developed palpable fibrotic plaque after papaverine injection in our study.

Adult↗
PubMed1977

[Experiences in the fixation of vaginal prolapse using Fletcher's method].

The advantages of Fletcher's operation for vaginal pouch prolapse after previous hysterectomy or total extirpation are reported with a slightly modified method in eight cases. The following results show this surgical procedure to be especially advantageous: A permanent good fixation of vagina without shortening, no recurrence no pain and neither so-called antefixation complaints. A complete rehabilitation of cohabitation and orgasm was effected. Urological complications, such as obstruction of urine or micturition difficulties are eliminated by this surgical intervention.

Abdominal Muscles↗
PubMed2003

[Erectile dysfunction in kidney transplanted patients].

BACKGROUND: Erectile dysfunction (ED) is the inability to achieve and/or maintain an erection for satisfactory sexual performance or intercourse. ED profoundly affects the quality of life. While the effects of dialysis on ED are documented, the benefits of renal transplantation are unknown. METHODS: This study evaluates the prevalence of ED and the effects of transplantation on ED in kidney transplanted patients. Erectile function was assessed using the self-administered International Index of Erectile Function (IIEF). The domains investigated by IIEF are: (1) erectile function, (2) orgasmic function, (3) sexual desire, (4) intercourse satisfaction, (5) overall satisfaction. At the entry patients underwent clinical examination by urologist and neurologist; blood was collected for biochemical analysis. One-hundred-fifteen (89%) patients filled in the questionnaire. RESULTS: Fifty-two (45%) patients did not complain about ED, which was reported by sixty-three patients (55%). No clinical and/or biochemical difference was found between patients with and without ED. Hypertension was equally present among patients; administration of beta-blockers was significantly more frequent among patients without ED. ED was already present during dialysis in 40 patients. After transplantation ED disappeared in 8 (20%), ameliorated in 13 (32,5%), worsened in 2 (5%), remained unchanged in 17 (42,5%) and appeared "ex novo" in 27 (43%) patients. ED is significantly correlated (p<0.01) to the age of subjects. CONCLUSIONS: The data of the present study indicate that: 1) ED is still present in many transplanted men; 2) renal transplantation cures ED in only few cases; 3) ED may appear "ex novo" after transplantation.

Adult↗
PubMedDate not supplied

Dimensions of sexual dysfunction in Parkinson disease.

OBJECTIVE: The authors sought to better understand the factors related to sexual dysfunction in Parkinson disease (PD). METHODS: Twenty-one PD patients and their partners received the Derogatis Interview for Sexual Functioning-Self Report (DISF-SR). Additional measures assessed disease severity, autonomic dysfunction, mood, and social circumstance. RESULTS: Data from 17 male patients demonstrated profound impairment in the dimensions of sexual arousal, behavior, orgasm, and drive, with most patients scoring below the 1st percentile on these Derogatis Interview subscales. All four dimensions showed significant intercorrelations. In contrast, 53% of patients scored above the 50th percentile in sexual fantasy. Sexual fantasy subscale scores were positively correlated with duration of PD. CONCLUSIONS: The usefulness of the DISF-SR in this PD population was limited by extremely low scores and strong correlations among the subscales. The increase in sexual fantasy with greater PD duration suggests that patients with advancing disease remain interested in sex and that sexual dysfunction in PD is clinically relevant in this group.

Adult↗
PubMed2004

[Erectile dysfunction--incidence, causes and risk factors].

The inability of a male to attain and maintain an erection sufficient to allow vaginal penetration is called erectile dysfunction. It is a part of general male sexual dysfunction called impotence, which also includes libidinal, orgasmic and ejaculatory dysfunction. Erectile dysfunction affects millions of men and although it may not mean a total loss of sexual satisfaction, it often creates a mental stress that affects the man's quality of life. Knowledge of erectile dysfunction has increased remarkably over the past decade. Nowadays, about 50-85% of erectile dysfunction patients can be shown to have a somatic cause by modern methods of examination. Erectile dysfunction may also occur as a result of specific illness or medical treatment, and it is often multifactorial in etiology. Erectile dysfunction increases with age.

Erectile Dysfunction↗
PubMed2003

Sexual function outcomes following treatment for lower urinary tract symptoms. A one-year study.

The aim of this study was to assess the effects of treating lower urinary tract symptoms (LUTS) on the quality of sexual function in a one-year follow up. A total of 116 patients with LUTS received alpha-blocker treatment, 111 patients underwent transurethral resection of the prostate (TURP) and 70 patients with renal stones, with no or mild symptoms served as a control group. The patients were assessed at baseline, three months, six months and twelve months using the International Index of Erectile Function (IIEF-15). The surgical group exhibited some changes in the domain of IIEF-15. Patients in the medical group showed improvement in erectile function and intercourse satisfaction, while orgasmic, overall sexual satisfaction and sexual drive were relatively unchanged. In contrast, the surgical group suffered retrograde ejaculation and overall sexual dissatisfaction after undergoing TURP. TURP has been found to be associated with retrograde ejaculation intercourse and overall sexual dissatisfaction.

Adrenergic alpha-Antagonists↗
PubMed2004

Pregnancy by insemination of cryopreserved spermatozoa from a man with retrograde ejaculation: a case report.

BACKGROUND: Owing to the prevalence of diabetes mellitus, spinal injuries and aggressive surgical treatment of cancer, the number of younger patients with retrograde ejaculation is increasing. Since medical treatment to restore antegrade ejaculation often fails, several options for accomplishing insemination by these patients, including the use of sperm-rich urine obtained after masturbation and in vitro fertilization with sperm retrieved from the seminal tract, have been reported. We used the least invasive and most inexpensive procedure in a patient/couple with this condition. CASE: A 23-year-old man suffered from retrograde ejaculation after a spinal injury. He could achieve erection and engage in sexual intercourse but seldom had an orgasm or the sensation of ejaculation. We obtained spermatozoa from urine produced after masturbation at home and froze them. We used these frozen-thawed spermatozoa for intrauterine insemination, leading to the term birth of a healthy infant. CONCLUSION: In selected patient/couples, frozen spermatozoa obtained from postmasturbation urine can be used successfully for intrauterine insemination. This minimally invasive and most inexpensive procedure should be tried before planning in vitro fertilization.

Adult↗
PubMed1992

Sexual function and the older cancer patient.

Cancer and sexual activity are not mutually exclusive or incompatible. Cancer survival is increasing and greater efforts are turning toward enhancement of quality of life. In this regard, sexuality is as important an issue for the older cancer patient as it is for younger patients. It is also clear that there is a pressing need for sexual health information. In one study, 63% of individuals wanted more information on the impact of cancer on sexuality, and 54% wanted to discuss this topic with their physician. Unfortunately, this rarely occurs. A variety of sexual dysfunctions, including loss of libido, impotence, decreased arousability, and orgasmic difficulties, may occur in patients with cancer. This paper explores the effects on sexuality of cancer and normal aging, and reviews some of the therapeutic modalities available to enhance and improve sexual health.

Aging↗
PubMed1992

[Sexological evaluation, referral and treatment in the county psychiatric care. A retrospective study of a sexological patient population referred to a department of general psychiatry].

In a five-year period from 1984-1988, 248 patients were referred to a sexological working group located at the psychiatric departments in Frederiksborg County. The material was analysed retrospectively. Only a minor group of patients presenting sexual complaints are offered counselling or therapy. Two thirds of the patients were referred from their general practitioners. The main problems were erectile dysfunction and reduced sexual desire in men--and reduced sexual desire and orgasmic dysfunction in women. Compared to a specialized sexological clinic, a lower frequency of sexual deviations was observed. In 3/4 a need for sexological treatment was demonstrated. It is argued that it will be an appropriate task to have a unit for visitation and treatment in each county for example in a psychiatric context. In one fifth of the patients, a psychiatric diagnosis of relevance for the treatment was recorded. We need to reevaluate the actual structure for sexological treatment. Only one specialized clinic in the country seems to little, when most patients are treated as out-patients.

Adolescent↗
PubMed2004

[Female sexual dysfunction (FSD)].

Recent research suggests that a large number of women are dissatisfied with their sexual life due to sexual dysfunction. The accepted definitions of female sexual dysfunction are based on the human sexual response cycle described by Masters and Johnson and later elaborated by Kaplan. Their work formed the basis for the diagnostic systems of both the ICD-10 and DSM IV. Female sexual dysfunction may appear as lack of sexual desire, sexual pain, and arousal or orgasmic dysfunction. Although these problems are very common in women and more common than in males, for many years this field of interest was neglected both scientifically and clinically. In the past, only psychological and sexological forms of therapy were suggested. It is now better understood that, as in many other areas, the junction between the body and the mind, is responsible for many sex problems in women. Furthermore, multi professional team work is needed to treat these problems in order to enhance better quality of life for individuals and couples. This editorial calls for better education and research in this important field.

Female↗
PubMedDate not supplied

[A new pathogenetic approach and a method of erectile dysfunction treatment and prevention--modulated erectile oxygenation of penile cavernous tissue].

The analysis of sexual activity of 185 male Muscovites has revealed an age-related sharp progressive shortening of adequate and spontaneous erections. A novel, pathogenetically sound approach and a method of therapy and prevention of erectile dysfunction has been developed (RF patent N 2228754). The method, called "Modulated Erectile Oxygenation of Penile Cavernous Tissue" (MEOPCT), consists in erection activation by behavioral measures and/or erectogenic drugs which induce adequate, nocturnal spontaneous and/or artificial erections adequate in frequency and duration for providing such oxygenation of cavernous bodies that warrants maintenance of their normal structure and function. There is no continuous close correlation between sexual activity and erections, on the one side, and ejaculation and orgasm, on the other side. Application of MEOPCT in 43 patients demonstrated the method ability to improve erection and cavernous hemodynamics without negative side effects.

Adult↗
PubMed1992

Symptomatic and prophylactic treatment of migraine and tension-type headache.

Pharmacotherapy is the mainstay for patients with persistent headaches. When simple analgesics can no longer be used, combination analgesics are prescribed. Symptomatic medications also include antiemetics, ergot derivatives, corticosteroids, neuroleptics, and narcotics. Nonsteroidal anti-inflammatory drugs are commonly used both symptomatically and prophylactically, and are the treatment of choice for menstrual migraine. Exertional migraine, benign orgasmic cephalalgia, chronic paroxysmal hemicrania, cough headache, and "ice-pick" headache are treated with indomethacin. Ergotamine tartrate is often recommended when simple or combination analgesics do not relieve headaches. Dihydroergotamine (DHE) is effective for treating intractable headache; because it has fewer side effects than ergotamine, it is tolerated by patients unable to tolerate other ergotamine preparations. DHE is administered IM and, for occasional use, patients can be taught self-injection. Repetitive IV DHE therapy for chronic severe headaches requires hospitalization; most patients become headache-free within 3 days. Patients who refuse hospitalization, do not respond to the drug, or are not suitable candidates for DHE therapy may receive a short course of a corticosteroid, a neuroleptic or, rarely, a narcotic. For frequent headaches, prophylactic treatment usually begins with a tricyclic antidepressant or a beta blocker.

Analgesics↗
PubMed2004

[Female sexual dysfunction: classification, epidemiology, diagnosis and treatment].

The successful pharmacological treatment of erectile dysfunction in males has led to increasing interest in the sexual problems of women. Yet in recent years there has been growing consensus regarding the differences between male and female sexuality. William Masters and Virginia Johnson's model of sexual response, revised by Helen Singer Kaplan, has been generally accepted for many decades. This model consists of 4 successive phases: desire, excitement (arousal), orgasm and resolution. Rosemary Basson has suggested a different model, valid especially in long-term relationships. According to Basson, a woman may decide to seek a stimuli necessary to ignite sexual desire, for reasons which are not sexual (such as the need for intimacy or emotional bonding). The desire develops at a latter stage, as a consequence and not as a cause. As the understanding of the sexual response grows, new methods of classification and treatment are being developed. Female sexual dysfunction is common, frequently neglected and has a significant impact on the lives of women. It has a diverse etiology including anatomical, physiological, medical as well as psychological and social factors. The assessment of these disorders incorporates both medical and psychological evaluation. The treatment includes education, improvement of inter-personal communication, behavioral treatment and the solution of medical problems. Different medications are being developed but most have yet to be proven effective. This review presents the female sexual response as it is understood today and the different methods of classification, diagnosis and treatment of female sexual dysfunction.

Emotions↗
PubMedDate not supplied

[Adverse effects of psychiatric drugs on sexual functions].

Several groups of pharmacological agents have been reported to disrupt normal sexual function. Psychotropic medications, such as antidepressants and antipsychotics, have also been associated with sexual side effects. The procedure by which, the basic physiologic mechanisms of the normal sexual phases (libido, arousal, and orgasm) are disrupted by some psychotropics provide a framework to minimize sexual side effects when initiating and continuing treatment. Successful management of sexual complaints during treatment should begin with a systematic approach to determine the type of sexual dysfunction, potential contributing factors, and finally delineating strategies that should be tailored to the individual patient. This article provides guidelines for the assessment, management, and prevention of sexual side effects associated with antidepressant and antipsychotic treatment.

Female↗
PubMed2004

NTP-CERHR Monograph on the Potential Human Reproductive and Developmental Effects of Fluoxetine.

The National Toxicology Program (NTP) Center for the Evaluation of Risks to Human Reproduction (CERHR) conducted an evaluation of the potential for fluoxetine to cause adverse effects on reproduction and development in humans. Fluoxetine (Prozac(R); Serafemtrade mark) was selected for evaluation because of 1) sufficient reproductive and developmental studies, 2) human exposure information, 3) changing prescription patterns, and 4) public concern about potential reproductive and/or developmental hazards associated with exposure. Fluoxetine, an antidepressant, is also prescribed to treat premenstrual dysphoric disorder and has recently been approved for use in 7-17 year-olds. The results of this evaluation on fluoxetine are published in an NTP-CERHR monograph which includes: 1) the NTP Brief, 2) the Expert Panel Report on the Reproductive and Developmental Toxicity of Fluoxetine, and 3) public comments received on the Expert Panel Report. As stated in the NTP Brief, the NTP reached the following conclusions regarding the possible effects of exposure to fluoxetine on human development and reproduction. First, there is some concern for developmental effects, specifically shortened gestation and poor neonatal adaptation at therapeutic doses (20-80 mg/day). This conclusion is based on evidence from human studies that fluoxetine produces an increased rate of poor neonatal adaptation and that fluoxetine exposure during pregnancy can result in a shortened gestation and reduced birth weight at term. Second, there is minimal concern for adverse reproductive effects in fluoxetine-exposed adults. Evidence from human studies show that therapeutic doses of fluoxetine may, in both men and women, result in reversible, impaired sexual function, specifically a delay in or an inability to achieve orgasm. Finally, there are insufficient data to draw conclusions on 1) an association between fluoxetine therapy in pregnant women and pregnancy loss; and 2) on how breast milk or therapeutic exposures to fluoxetine might affect development. In a study in mice, early fluoxetine exposure affected adult behavior. However, additional data are needed to confirm and extend these findings and determine if such effects might possibly occur in humans. NTP-CERHR monographs are transmitted to federal and state agencies, interested parties, and the public and are available in electronic PDF format on the CERHR web site (http://cerhr.niehs.nih.gov) and in printed text or CD-ROM from the CERHR (National Institute of Environmental Health Sciences, P.O. Box 12233, MD EC-32, Research Triangle Park, NC; fax: 919-316-4511).

Journal Article↗
PubMed1992

Sexual aversion versus hypoactive sexual desire: a diagnostic challenge.

Our work with women with sexual aversion documents the presence of marked sexual avoidance behaviors as specified in the DSM-III-R1 diagnostic criteria for this disorder. At the same time, we demonstrate the presence of normal sexual desire and capacity for orgasm in these women. These two findings offer support for a valid diagnostic differentiation between sexual aversion disorder and hypoactive sexual desire disorder. Inherent in the diagnosis and treatment of sexual aversion disorder is an appreciation by the clinician of the tremendous approach-avoidance conflict that exists in these patients. The behavioral and cognitive avoidance features, therefore, need to be elicited actively by the clinician during all phases of assessment and treatment. These features are not always offered readily by the patients for fear of having to relinquish these strategies and their related sense of control over the overwhelming anxiety that sexual intimacy can produce. Consequently, treatment is not always straightforward and successful.

Fantasy↗
PubMed2005

[Female sexual dysfunction].

Female sexual dysfunction (FSD) is a disorder with relatively high incidence in the community. Its incidence in age-dependent and it can significantly limit the quality of life of women concerned. Dysfunction, as a multicausal and multidimensional problem, it comprises biological, psychological and interpersonal factors. Disorders are listed according to a sexual desire, arousal, experiencing an orgasm and pain incidence. Authors summarized data on incidence, diagnosis and therapy of this disorder.

Female↗
PubMed2005

[Ejaculatory disorder by alpha-1 adrenoceptor antagonist in patients with benign prostatic hyperplasia; retrospective comparison between naftopidil and tamsulosin].

We cross-sectionally studied the incidence and impact on quality of life of ejaculatory disorders caused by alpha-1 adrenoceptor antagonists (tamsulosin or naftopidil) in patients with benign prostatic hyperplasia (BPH). By questionnaire, we queried 88 clinical BPH patients concerning ejaculatory disorders, who were treated with tamsulosin or naftopidil between February 1999 and August 2003. We investigated the difference in the incidence and types of disorders between the two drugs. Of the 88 patients, 63 (71.6%) had sexual activities during the treatment. The incidence of ejaculatory disorders was significantly higher in the tamsulosin group (30.0%) than in the naftopidil group (3.0%). Eighty percent of patients having the disorders noticed the absence or reduced volume of semen although they experienced orgasms. The median quality of life index concerning the disorder was rated as 4, "mostly dissatisfied." Our results indicated that ejaculatory disorders occurred more frequently in the tamsulosin group. We should inform patients about this adverse effect caused by alpha-1 adrenoceptor antagonists prior to treatment.

Adrenergic alpha-1 Receptor Antagonists↗