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PubMed1982

[Couple therapy in the presence of severe physical disability--a case example (author's transl)].

A case report is presented describing the possible applications of couple therapy (Masters/Johnson) in couples where a severe physical disability is present, beyond disturbances of sexual functioning. In the instance reported, a severe sexual aversion was present in the wife, with disturbances of excitation and orgasm, while the husband was paralysed due to adult poliomyelitis affecting his entire trunk and limbs. Based on the course of therapy and its outcome, the author discusses the specific problems and potentialities of this type of therapeutic intervention.

Adult↗
PubMed1978

Neurologic control of prostatic secretion in the dog.

A model to record the volume of prostatic secretion was developed. The influence of both divisions of the autonomic nervous system on the prostate by pharmacologic stimulation and blockade, and by direct electrical nerve stimulation was observed. The prostate responded to parasympathetic stimulus by increasing secretion. Under sympathetic stimulation, the secretion collected in the acini and ducts was expulsed into the urethra by contraction of the smooth muscle fibers surrounding these structures. A correlation between these findings and the normal sexual function may be made: Early in the excitation phase there is parasympathetic activity with increased secretion. With onset of orgasm and emission, sympathetic activity initiates the contractile activity of the genital duct system and the prostatic muscular element. As a result, the secretion is transported to the prostatic urethra (emission) to be later ejaculated by the genital skeletal musculature of the perineum, mainly the ischiocavernosus and bulbospongiosus.

Angiotensin II↗
PubMedDate not supplied

[Surgery of impotency (author's transl)].

Psychic disorders may sometimes explain the impossibility of erection. Organic causes of impotency must not go unrecognized though, because they are numerous: lesions of the cavernous bodies, arterial occlusions and deficiencies of innervation. The implantation of silicone prostheses in the cavernous bodies insures the erection and makes possible a normal sexual activity: the orgasm and the ejaculation may reappear even after they have disappeared for many years. This operation was realized in sixteen patients according to the technique of Small and Carrion. Postoperative hospitalization is usually of 24 hours. All patients resumed a normal sexual activity. Our earliest observation occurred three years ago. Up to now there were no cases of infection, or rejection. The implantation of silicone prostheses in the cavernous bodies constitutes an important step in the treatment of organic impotency.

Erectile Dysfunction↗
PubMed1978

Sexual dysfunction following proctocolectomy.

122 patients, 66 men and 56 women, operated upon by proctocolectomy were interviewed by means of a detailed questionaire regarding any significant change in sexual function. In the majority of the patients (70% of the men and 87% of the women) the sexual relationships were considered to be unchanged or even enhanced. Impaired function was reported by 19 men (29%) and seven women (12%). Male sexual dysfunction consisted of impotence and abolition of ejaculation. True impotence occurred in five men, all above 40 years of age, corresponding to an incidence of 25%. Loss of ejaculation occurred even in young people (about 7%) but was more common in elderly patients (15%). Female dysfunction consisted of dyspareunia and/or inability to achieve orgasm. On the basis of the present results it appears unlikely that impotence is caused by the operative trauma per se. On the other hand loss of ejaculation is probably due to injury of the presacral nerves. Postoperative impotence might probably be improved by medical information and encouragement. Particular precautions during operation might reduce ejaculatory disorders. Careful handling and proper treatment of the perineal wound might prevent scarring and stricture of the posterior aspect of the vulva, a condition that appears to be a common cause of dyspareunia.

Adult↗
PubMed1984

[Wilhelm Reich--Arthur Janov--a comparison of their work].

Although he does not always mention it, A. Janov agrees with many of W. Reich's opinions on theoretical-philosophical foundations and the theory of neurosis and other illnesses; from their criticism of society both of them develop the demand for prophylaxis of neurosis as a prerequisit for their common utopia of a selfregulated society. Primal therapy and Orgon therapy are two different forms of the "New Body Therapies" group. The authors disagree with their views of the physiological nature of Pain (A. Janov) and blokked orgon, the "function of the orgasm" and "orgastic potency", concepts that were considered by Reich to be his most important. Possible reasons for the discrepancies are given.

Humans↗
PubMedDate not supplied

[Premature ejaculation].

The constant failure to control the orgasm and the following ejaculation is called premature ejaculation. After having excluded organic factors the reason for premature ejaculation is always worry. When the reason for this fear is found, a psychotherapeutic treatment can soon be successful.

Ejaculation↗
PubMed1983

The sexual experience in younger males with complete spinal cord injury.

Aspects of sexual life before and after spinal cord injury were studied in 21 younger males by means of structured interviews. Principle findings are that in spite of severe genito-sexual dysfunctions the majority continued having intercourse and about half felt orgasmic. Sexuality maintained its pre-injury significance for nearly all subjects, and most characterized their sexual lives as at least to some extent satisfactory. Loco-motor impairment and autonomous dysreflexia were more frequently given as causes of reduced sexual pleasure than were sexual dysfunctions. High spinal cord severance and lack of regular partner were negative factors for continuation of satisfying sexual experiences. Thus, genital sexual dysfunction is but one factor determining level of sexual satisfaction after a spinal cord trauma as many younger tetra- and paraplegics appear to be able to identify new and gratifying ways of sexual fulfillment.

Adult↗
PubMed1984

[Psychotropic drug-induced changes in sexuality--frequency and relevance in psychiatric practice].

As a review of the literature concerning sexual side effects of psychotropic drugs in psychiatric patients reveals, sexual disturbances (such as erectile or orgasmic dysfunctions) seem to be a common consequence of psychopharmacological treatment. The frequency and relevance of these effects in psychiatric practice were estimated in a questionnaire study with 68 psychiatrists, working either in a practice or a clinic. According to the physicians answers, few patients report sexual side effects of drugs spontaneously, through these are supposed to be more common. Different kinds of sexual impairment are reported as specific effects of the drugs. As the physicians assume these effects generally provide a problem, both for the patients self-esteem as well as for treatment and compliance. Based on the psychiatrists experience patients are in a surprisingly good position to differentiate between the influences of their basic illness and a specific medication as far as sexual changes are concerned. One part of the questionnaire asked for the observed effects of specific psychotropic substances on sexual behaviour. The results support the evidence reported in the literature that neuroleptics and antidepressants are most likely to provoke sexual impairment. The results of the study are discussed in relation to the theoretical relevance of sexual side effects for the patient and the treatment and to the possibilities of a psychiatrist to prepare and inform his patient.

Adult↗
PubMedDate not supplied

Drug-induced sexual dysfunction.

Commonly used drugs that may cause sexual dysfunction are reviewed. The anatomy and physiology of the normal sexual response are reviewed. The influence of drugs on neurogenic, hormonal, and vascular mechanisms may result in diminished libido, impotence, ejaculatory and orgasmic difficulties, inhibited vaginal lubrication, menstrual irregularities, and gynecomastia in men or painful breast enlargement in women. Parasympatholytic agents, which interfere with cholinergic transmission, may affect erectile potency, while adrenergic inhibiting agents may interfere with ejaculatory control. Central nervous system depressants or sedating drugs, drugs producing hyperprolactinemia, and antiandrogenic drugs also may affect the normal sexual response. Drugs such as antihypertensive and antipsychotic agents may induce sexual dysfunction that can result in patient noncompliance. Usually, drug-induced side effects are reversible with discontinuation of the offending agent.

Androgen Antagonists↗
PubMed1982

The treatment of vaginismus by the gynecologist: an eclectic approach.

Thirteen of 14 patients with vaginismus have been successfully treated using systematic in vivo desensitization and other simple but individualized behavioral techniques. Resolution of symptoms was usually effected within 3 to 4 weekly sessions with important supplementary home assignments. All but 1 patient were seen without partners. Neither mechanical dilators nor hymenotomy was employed. Primary orgasmic dysfunction was associated wih vaginismus in a minority of patients and was treated concomitantly. Vaginismus appears to be more frequent than the literature indicates and can be situational or absolute. Presenting symptoms include an inability to tolerate pelvic examination, severe superficial dyspareunia, and a history of unconsummated coitus. Although gynecologic experience with vaginismus has been generally limited, the gynecologist is seen as a potentially ideal therapist for establishing or confirming the diagnosis at that time of pelvic examination.

Adolescent↗
PubMed1982

[Influence of primary hyperprolactinemia on human sexual behavior].

Eighty per cent of men with hyperprolactinaemia are impotent. Sexual deficiency, which for a long time is the only sign of the disease, is partly due to inhibition of testosterone secretion by high prolactin levels but also, probably, to reduced conversion of testosterone to dihydrotestosterone and, perhaps, to a direct effect of prolactin on the neurotransmitters involved in sexual activity. Eighty per cent of women with hyperprolactinaemia have reduced sexual drive and inability to reach orgasm; the underlying mechanisms are as yet unknown. In women, however, the initial symptoms are menstrual disorders. Most sexual disorders in both sexes regress after return to normal of plasma prolactin levels.

Female↗
PubMed1981

Sexual problems of women with rheumatoid arthritis.

A questionnaire concerning sexual problems was given to 112 female rheumatoid arthritic (RA) patients. Replies were collected from 91 (81%). The results indicated that 1) recently married patients were concerned about pregnancy; 2) the sexual desire of most patients diminished, and intercourse became less frequent and less satisfying; 3) affected hip and knee joints made it difficult to assume sexual intercourse positions; and 4) patients who had unsatisfying sexual relationship reported a decreased demand for intercourse by their spouses and diminished frequency of their own orgasms. To lead a fulfilling married life, patients with RA should be counselled to adopt a positive attitude toward sexual relationship with their husbands.

Arthritis, Rheumatoid↗
PubMed1981

Sexual functioning in stroke survivors.

Investigation of sexual interest, function and attitudes of 35 patients (24 men and 11 women) before and after stroke showed no significant changes in sexual interest or desire for either men or women. However, men experienced significant decrease in ability to achieve erection and to ejaculate, and all of the 5 women who were premenopausal at the time of stroke reported major alterations in menses. Only 1 woman reported orgasm following stroke. Nineteen (79%) of the men and eight (73%) of th women reported sexual function to be of importance to themselves while all of the men and eight (73%) of the women believed it to be of importance to others of their age. The findings from this small sample indicate that although the majority of stroke survivors maintain consistent levels of sexual desire and believe that sexual function is important, most will experience sexual dysfunction following stroke. The sexual problems experienced by post-stroke patients appear to be of sufficient magnitude and frequency to warrant further investigation.

Adult↗
PubMed1978

[Sex behavior and partnership problems of the woman in climacterium with reference to her occupation].

On consideration of familiar and professional changes sexual psychologic aspects of the woman during the climacteric are being discussed. -- Changes and disturbances in sexuality, lack of libido and failure of orgasm and changed positions to sexuality expecially under the influence of the professional activity of 92 climacteric woman are stated. -- Examinations of the climacteric women were performed by the interview-method.

Age Factors↗
PubMed1980

Carcinoma of the cervix and sexual function.

Forty-six patients were interviewed more than a year after treatment for carcinoma of the cervix to establish the effects of radiation therapy and of surgical therapy on sexual feelings and performance. Group 1 consisted of 22 patients who had undergone radiation therapy for stage I, II, or III cancer of the cervix. Group 2 consisted of 20 patients who had undergone hysterectomy with or without partial vaginectomy for carcinoma in situ. The irradiated patients experienced statistically significant decreases in sexual enjoyment, ability to attain orgasm, libido, frequency of intercourse, opportunity, and sexual dreams. The surgically treated group had no significant change in sexual function after treatment. Both groups experienced a change in self-image but did not feel that their partners or family viewed them differently. Myths about cancer and the actual effects of pelvic irradiation were found to have disrupted the sexual-marital relationships of many women. Therapeutic programs are discussed through which women can be helped through this difficult time in their lives.

Adult↗
PubMed1980

Cardiovascular drugs and sexuality: a cardiologist's review.

In evaluating the factors of sexual dysfunction of the cardiovascular patient, the impact of drugs should be considered. Cardiovascular drugs may affect the sexuality of the patient through their effects on the CNS and peripheral nervous system, the vascular system, and hormonal changes. Such agents may impair the libidinal, erectile, and orgasmic phases of the human sexual response or may have effects that indirectly affect sexuality. Adrenergic inhibiting drugs, diuretics, vasdodilators, monoamine oxidase inhibitors, antiarrhythmics, hypolipidemics, and digitalis may affect the sexual response, with the former group having the most serious effects. These effects may interfere with the patient's compliance with medications, can cause emotional problems, and often have an undesirable impact on marital relations. Knowledge of the sexual side effects of the drugs and proper counseling of the patient are vital.

Cardiovascular Agents↗
PubMed1980

On masochistic enthralment a contribution to the study of moral masochism.

Freud rested his final understanding of moral masochism (the masochistic character) upon the concept of the death-instinct. Those analysts who have been unable to accept this concept have continued to define and enrich the understanding of the masochistic character. Out of their work has emerged the picture of a character structured in three discernible layers: an upper one of "nobility in adversity": a middle one of hate toward the mother; and the deepest one of primary union with the mother to which a later return is made. An abbreviated account of an analysis is given to exemplify this structure. An understanding of the relation between the deepest layers is essential to a comprehension of the total structure. Out of a primary maternal union accompanied by experiences of omnipotence and grandiosity emerges an ambivalent relationship to the omnipotent mother characterized primarily by hate. The relationship to the mother is one of masochistic enthralment. The lost omnipotence is then recaptured by a union mystica (primary identification) with the hating and hated mother now internalized as an aggressive self-ideal in which phallic characteristics become prominent. The unio mystica may be momentary and orgasmic as in the masochistic perversion or more or less enduring and characterological as in the masochistic character to which it contributes traits of haughtiness and disdain.

Character↗
PubMed1994

[A modified cervico-prostatic incision technic in hypertrophic adenoma in young subjects desiring to preserve ejaculation].

The treatment of bladder neck obstruction by transurethral resection of the prostate is responsible for retrograde ejaculation, which is poorly tolerated by our younger patients. Bladder neck incision, initially proposed as treatment for bladder neck sclerosis and for small prostates, was performed according to a modified technique in 36 patients with a mean age of 57.6 years (range: 41-72 years), with benign prostatic hypertrophy less than 30 grams and wishing to retain antegrade ejaculation. This technique consists of creating a deep groove with the resector hook extending from the ureteric orifice to 5 mm above the verumontanum, incising the full thickness of the detrusor and prostatic urethra as far as the retrocervical fat. This preserves a supramontanal ring of urethral muscle whose contraction during orgasm prevents retrograde ejaculation of semen. Resection of the median lobe was also performed in 8 patients, while sparing the cervical muscular ring. The mean follow-up was 2.4 years (range: 4-84 months). Dysuria was very considerably improved in 32 patients (91.5%), with a Madsen score of less than 2. Antegrade ejaculation was preserved in 32 patients (91.5%). Two patients had to undergo secondary prostatic resection because of persistent dysuria (these 2 patients retained antegrade ejaculation). Unilateral bladder neck incision, sparing a supramontanal muscular ring is an easy, rapid technique with low morbidity, effective in the treatment of prostatism due to a small prostate (less than 30 grams). It is the operation of choice in young patients with small prostates who wish to retain antegrade ejaculation.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗