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PubMed1998

Sexual dysfunction in men with multiple sclerosis--a comprehensive pilot-study into etiology.

UNLABELLED: Ideally, the etiological diagnosis of sexual dysfunction in patients with multiple sclerosis is established on the basis of both objective and subjective tests. Accordingly, we assessed sexual function in 16 male patients with multiple sclerosis and complaints of sexual dysfunction by means of subjective data from interviews and questionnaires and objective data, obtained from (psycho)physiological tests. Psychophysiological investigation consisted of measurement of sleep erections and of erectile response to visual erotic stimulation and penile vibration. Urodynamic investigation was used to assess the neurological status of the genital tract. Sixteen male patients with clinically definite multiple sclerosis, complaints of sexual dysfunction and a steady heterosexual relationship participated in the study. The majority of patients had no abnormalities in the objective tests. Only one (1 out of 15) patient showed disturbed sleep-erections, and four (4 out of 12) other patients showed signs of neurological dysfunction of the genital tract. CONCLUSION: In our patient-group, disturbed sleep erections and abnormal findings on urodynamic investigation appeared unrelated to the complaint of erectile dysfunction. Sexual function was related to psychological factors, decreased general sensitivity, and motor impairment.

Adolescent↗
PubMed2003

Sildenafil does not improve sexual function in men without erectile dysfunction but does reduce the postorgasmic refractory time.

Sildenafil is one of two oral drugs approved for first-line treatment of erectile dysfunction (ED). Anecdotally, some young healthy men who wish to enhance their sexual performance are requesting or abusing sildenafil. In this randomized double-blind, placebo-controlled clinical study, we investigated the effect of sildenafil in young men without ED. A total of 60 young healthy men age 20-40 y with no reported ED were enrolled for this single-dose home-use study. Subjects had used no medication in the 6 months prior to the study. All had been engaged in a stable relationship for at least 3 months. After completing the IIEF-5 questionnaire, patients were randomized in a double-blind fashion to receive either one 25 mg tablet of sildenafil (group 1) taken prior to intercourse, or an identical placebo tablet (group 2). All subjects completed a questionnaire relating to their erectile quality. There were no differences between the two groups in the reported improvement of erection quality, 12/30 sildenafil vs 10/30 placebo (Fisher's test, P=0.79). Sildenafil caused a significant reduction of the postejaculatory refractory time (12/30 vs 4/30) (chi(2) test, P=0.04). Sildenafil does not improve erections in young healthy men. Sildenafil should not be given to young healthy men to improve their erections and patients should be advised against recreational abuse of the drug. In this limited single-dose home study, sildenafil appears to reduce the postorgasmic refractory time. Although controlled studies are needed to evaluate the efficacy of erection-enhancing drugs in premature ejaculation, it is possible that sildenafil might be useful for this indication.

Adult↗
PubMedDate not supplied

A prospective analysis of sexual functions during pregnancy.

The aim of the study was to evaluate the sexual functions during pregnancy using the Female Sexual Function Index (FSFI) questionnaire. Pregnancies were recorded in a prospective cohort study comprising 40 healthy pregnant women. Pregnant women who had a stable relationship with their partner were enrolled in the study when were first diagnosed to be pregnant. During their antenatal visits, subjects were asked to complete the FSFI questionnaire and other information about their sexual life in each trimester. Each FSFI domain score was calculated and mean scores in each domain were compared according to the trimesters of pregnancy. Data of 37 subjects for the first, 36 for the second and 34 for the third trimesters of pregnancy were eligible for the analysis. The mean age was 25.5+/-4.5 y; mean parity was 0.4+/-0.7 and mean gravity was 1.6+/-0.9. The frequency of intercourse attempts during the last 4 weeks was 8.6+/-3 before pregnancy, and 6.9+/-2.5, 5.4+/-2.6 and 2.5+/-1.4 in the first, second and third trimesters of pregnancy, respectively. In all domains of FSFI, significant decline in domain scores was determined during pregnancy. The comparison of satisfaction and pain domain scores between first and second trimesters showed significant differences. All of the domain scores significantly decreased in the third trimester of pregnancy. Our results showed that sexual functions are significantly decreased during pregnancy and worsen as the pregnancy progresses. Childbearing couples should be given information about the sexual problems and fluctuations in the patterns of sexuality during pregnancy.

Adult↗
PubMedDate not supplied

The metabolic syndrome: a cause of sexual dysfunction in women.

Female sexual dysfunction (FSD) is a significant public health problem. We assessed the prevalence of FSD in premenopausal women with the metabolic syndrome as compared to the general female population. Compared with the control group (N = 80), women with the metabolic syndrome (N = 120) had reduced mean full Female Sexual Function Index (FSFI) score (23.2+/-5.4 vs 30.1+/-4.7, P < 0.001), reduced satisfaction rate (3.5+/-1.1 vs 4.7+/-1.2, P < 0.01), and higher circulating levels of C-reactive protein (CRP: 2.2 (0.6/4.9) vs 0.8 (0.2/2.9) mg/l, median (interquartile range), P = 0.01). There was an inverse relation between CRP levels and FSFI score (r = -0.32, P=0.02). Investigation of female sexuality is suggested for patients with the metabolic syndrome.

Adult↗
PubMed1997

Sexual function and clinical features of patients with Klinefelter's syndrome with the chief complaint of male infertility.

In this report, we present the overall sexual function and clinical features of patients with Klinefelter's syndrome with the chief complaint of male infertility. The study consisted of 40 patients with a control group of 55 infertile non-azoospermic males with a normal 46,XY karyotype who visited the Reproduction Center of Toho University Hospital during the 5.5-year period between January 1991 and June 1996 with the chief complaint of male infertility. Among the 40 patients with Klinefelter's syndrome, 38 cases were pure 47,XXY, one case was 47,XXY with a pericentric inversion of chromosome 9 and one case was a mosaic of 46,XY/47,XXY(2:28). Thirty-nine of these 40 patients were azoospermic and one (47,XXY) had severe oligoasthenozoospermia. The sexual function of the patients was evaluated according to their responses to a preliminary questionnaire devised by our department. There was no significant difference in the frequency of sexual function disturbances between the patients with Klinefelter's syndrome and the control group (67.5% vs. 60.0%; chi 2 analysis; p = 0.454). The mean frequency of sexual intercourse per month in the patients with Klinefelter's syndrome was significantly higher than in the control group (4.4 +/- 2.8 vs 3.3 +/- 1.6: Welch's t-test, p < 0.05). A possible explanation for this variation may lie in the fact that many of these patients were diagnosed with azoospermia poor to the administration of the questionnaire and may have wished to continue to have relations as a couple.

Adult↗
PubMed2002

Sexological approach to ejaculatory dysfunction.

Ejaculatory disorders include premature, deficient (delayed ejaculation and anejaculation) and retrograde ejaculation. A rare symptom connected to ejaculatory disorders is male anorgasmia. In the past, ejaculatory disorders were considered as typical relational and psychological symptoms. For this reason, a number of behavioural and psycho-relational approaches have flourished from the first ideas of curing sexual problems with empirical therapy, focusing on the symptoms of sexual pathology. Such treatment includes assessment, behavioural and educational components, psychotherapy in the context of the relationship and sexual timetables. Recent advances in understanding the importance and frequency of ejaculatory disorders, insights into their organic and non-organic pathophysiology and the efficacy of a growing arsenal of pharmacological therapies lead to a new challenge which can be confronted only with the development of new, integrated therapeutic alternatives from a modern somato-psychic and holistic viewpoint.

Behavior Therapy↗
PubMed2000

The postejaculatory refractory period: a neurophysiological study in the human male.

OBJECTIVE: To investigate changes in the penile sensory threshold, and the variables of cortical somatosensory evoked potential and sacral evoked response tests in the early postejaculatory period in the human male. SUBJECTS AND METHODS: Twenty healthy volunteers (mean age 25.3 years, range 17-32) were evaluated before and after ejaculation for penile sensory threshold values, and the variables of sacral evoked response and cortical somatosensory evoked potential tests. RESULTS: Three subjects were excluded from the statistical analyses because there were significant differences among the repeated tests. In the remaining 17 subjects the penile sensory threshold was significantly greater in the postejaculatory period (P < 0.05). There were no significant changes in the other variables of both the sacral evoked response and cortical somatosensory evoked potential tests after ejaculation (P > 0.05). CONCLUSION: The postejaculatory refractory period in the human male is accompanied by a greater penile sensory threshold but with no change in the values of the sacral evoked response and cortical somatosensory evoked potential.

Adolescent↗
PubMed2002

Acute and chronic hypertensive headache and hypertensive encephalopathy.

Three patients are described who experienced headache from hypertension: one had acute headache from acute hypertension, one had daily, morning headaches from chronic hypertension, and one had acute headache with generalized tonic-clonic seizure from hypertensive encephalopathy. The presumed pathophysiological mechanisms involved in the three hypertensive headache conditions are reviewed.

Acute Disease↗
PubMed1996

Long-term results after operative correction of vaginal aplasia.

OBJECTIVE: We evaluated the long-term results after operative correction of vaginal aplasia with special interest in sexual and psychologic rehabilitation. STUDY DESIGN: Forty-four patients who had undergone surgical construction of an artificial vagina took part in follow-up. The operative result was assessed by a gynecologic examination. A structured interview and five questionnaires allowed an evaluation of psychosexual rehabilitation. RESULTS: The measured length of the vagina ranged between 3.5 and 15 cm. Unimpaired sexual intercourse could be ensured in a vagina with a minimum length of > or = 6 cm. The early onset of regular sexual intercourse played an important role for the long-term success of the operation. Patients were considered for an operation if they had a steady partner and hence could guarantee early and regular coitus. This concept was substantiated in our follow-up investigation. The increase in self-confidence thanks to sexual rehabilitation was striking. In a preoperative and postoperative survey 27 of the 44 patients displayed an impressive increase in self-confidence. However, infertility still posed a problem after successful surgical intervention. The overwhelming majority of patients were still depressed about infertility many years after the operation. One way to solve this problem may be adoption. CONCLUSIONS: After surgery 82% of patients achieved a functional satisfactory postoperative result combined with overall psychosexual rehabilitation. An intensification of medical and psychologic care after discharge could further improve the long-term results. Special support is needed to solve the problem of infertility.

Adolescent↗
PubMed1985

[Sex life following hysterectomy].

The authors report on the results of an inquiry via questionnaires on the sexual activities of 164 hysterectomised women before and after surgery. 47.5 per cent of the women stated that their sexual activities had deteriorated after the operation, whereas 13% reported an improvement. There was a significant increase in the number of women with "deteriorated" sex life after simultaneous bilateral ovarectomy (p less than 0.01). The most frequent negative sequels were a decrease in sexual appetency (42.7%) and coital activity (30.5%). Sex life deterioration became evident in 43% of the women already during the first year following the operation, further deterioration being less marked (in one to three years in 52%, and after more than 3 years after the operation in 58% of the patients). The opinion has been voiced that the time a few months before and after hysterectomy is the most critical phase in respect of mental condition and sexual activities. This critical phase can be overcome only with the close co-operation between the doctor on the one hand and the married couple on the other; both partners to the marriage must be equally amenable to counselling and advice.

Adult↗
PubMed1987

[Hypospadias in adulthood].

Hypospadias should not be considered as a congenital local defect only in the development of the urethra; the problem extends beyond the local malformation to the physical and intellectual development of the patient. It would also be incorrect to regard the problem of hypospadias as settled if the operative correction is performed, since mostly with puberty, but partly also later, changes may occur in general but particularly also in sexual development, placing a difficult burden on the hypospadias sufferer. The discussion of hypospadias problems in adults therefore embraces a subject that reaches far beyond operative correction into areas of miction, fertility and sexuality and therefore represents a wide complex of physical and mental problems. Above all, the question should be examined what quality of life a hypospadias patient can expect in the future after correction of this congenital malformation in infancy. The following factors describing the special circumstances of living after hypospadias operation, appear to be worthy of discussion: 1. The physical situation which includes the ability of erection, miction, fertility, the cosmetic aspect of the outer genital organ and potential consequences of combined malformations. The mental or "psychic" situation, which reaches into sexual life, partnership and profession. Only a few clinical departments concerned with the primary correction of hypospadias in infancy have controlled a group of patients up to adult age. For these reasons we considered it necessary to collect as far as possible the experiences mentioned in the literature and to combine them with our own observations to arrive at corresponding conclusions.

Abnormalities, Multiple↗