bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sacral Neuromodulation for Lower Urinary Tract Dysfunction and Impact on Erectile Function
Authors: Lombardi Giuseppe , Mondaini Nicola , Giubilei Gianluca , Macchiarella Angelo , Lecconi Filippo , Del Popolo Giulio 
Published: October 2008

ABSTRACT

Introduction
The first sacral nerve stimulators were for urinary urgency incontinence, urgency-frequency, and nonobstructive urinary retention. Since then, observations have been made for benefits beyond voiding disorders.

Aim
To evaluate if sacral neuromodulation (SNM) using the InterStim system (Medtronic Inc., Minneapolis, MN, USA) improves erectile function.

Methods
From January 1999 to January 2007, 54 males, mean age 42.8, underwent a permanent SNM for lower urinary tract symptoms (LUTS). Pre-SNM only subjects with concomitant erectile impairment according to the five-item version of the International Index of Erectile Function (IIEF-5), with normal blood sexual hormonal status, and responding to an intracavernous injection test 10 µg were enrolled in our study. Three months after permanent implantation, the IIEF-5 was completed again. Those who benefited significantly in erectile function completed the IIEF-5 semiannually. A final checkup was performed in July 2007.

Main Outcome Measures
A score of IIEF-5 equal to or higher than 25% compared to baseline indicated remarkable clinical enhancement.

Results
Presurgery, two patients were excluded. Overall, 22 subjects (42.3%) showed erectile impairment (14 were neurogenic). In the first visit post-SNM, five retentionists of neurogenic origin and two with overactive bladder syndrome of idiopathic origin achieved noticeable erectile improvement. Their median IIEF-5 score shifted from 14.6 to 22.2, and 15.5 to 22.5, respectively. During follow-up, two neurogenics lost the benefits concerning voiding and erection and recovered them after a new implant in the controlateral sacral S3 root. In the final visit, the seven responders reached an IIEF-5 score of at least 22.

Conclusions
Our study showed a clinically important benefit of sexual function mainly for neurogenic retentionists. Future research should test SNM in a larger sample of subjects, exclusively with sexual dysfunctions, in order to better understand the mechanism of action of SNM on erectile function.
Aging Male Questionnaire in Normal and Complaining Men
Authors: Raynaud Jean-Pierre , Tichet Jean , Born Catherine , Taieb Charles , Igigabel Philippe , Giton Franck , Fiet Jean 
Published: October 2008

ABSTRACT

Introduction
Detection of androgen deficiency is at least, based on specific questionnaires, defined by sexual, psychological, and somatic variables. Their relationships with sexual hormone levels are poorly understood.

Aim
To assess the Aging Male Symptoms (AMS) score and sex hormone levels in normal and complaining men in order to define the relationship between the key parameters related to androgen deficiency.

Methods
Nine hundred and three men were interviewed via phone by a trained interviewer who completed the questionnaire; 539 men consulting for a checkup in a health center and 471 complaining men, who completed the AMS scale in clinical setting, were selected, after excluding subjects with major and/or chronic diseases, endocrine disorders, psychological dysfunctions, and metabolic syndrome.

Main Outcome Measures
Total AMS score and psychological, somatic and sexual subscores, as a function of age.

Results
The AMS questionnaires the were completed in a clinical setting or via calling-up line were comparable. In both cases, total AMS scores and subscores were significantly dependent of age and were correlated to income. In normal men, the only two parameters that significantly changed with age were the AMS sexual subscore and bioavailable testosterone (BT). Complaining men aged more than 50 years old had a significantly higher total AMS scores, subscores, and BT level than normal men up to 60 years old, and these differences weakened with increasing age. In normal and complaining men, whatever the AMS sexual subscore, any variation in testosterone (T) and BT levels was observed.

Conclusions
The AMS scale could be defined as a screening test for androgen deficiency symptoms in men between 50 and 65 years of age. The sexual AMS subscore and BT level are the key variables to identify those symptoms; the severity of sexual symptoms can not be explained by a BT level decrease.
The Current Outlook for Testosterone in the Management of Hypoactive Sexual Desire Disorder in Postmenopausal Women
Authors: Kingsberg Sheryl A. , Simon James A. , Goldstein Irwin 
Published: October 2008

ABSTRACT

Introduction
Hypoactive sexual desire disorder (HSDD) is a common clinical problem in women, especially those who have experienced surgical menopause. Because androgen levels decline with age and drop dramatically following bilateral oophorectomy, it has been hypothesized that reduced levels of testosterone are related to diminished desire.

Aim
As presented at a continuing medical education satellite symposium during the 2008 annual meeting of the International Society for the Study of Women's Sexual Health, to review the current state of knowledge about the physiologic effects of testosterone in postmenopausal women, the effects of transdermal testosterone delivery in surgically menopausal women with HSDD, and ongoing studies of a transdermal testosterone gel.

Methods
A review of the pertinent literature, including recent presentations.

Main Outcome Measures
Results from the Women's International Study of Health and Sexuality; and studies utilizing the Brief Index of Sexual Functioning for Women, the Psychological General Well-Being Index, and validated instruments that assess female sexual function: the Sexual Activity Log©, the Profile of Female Sexual Function©, and the Personal Distress Scale©.

Results
Surgically menopausal women receiving testosterone experience significant increases in total satisfying sexual activity vs. women receiving placebo, significant improvement in all domains of sexual function, and decreases in personal distress, with a favorable safety profile.

Conclusion
Testosterone deficiency may be considered among the underlying causes of HSDD. Currently, testosterone is available to women in the United States only via off-label prescribing or by unregulated compounding of testosterone preparations. New safety trials will examine the long-term safety of testosterone gel in surgically menopausal women with HSDD who are at high risk of cardiovascular disease or breast cancer.
Assessing Sexual Function in Well Women: Validity and Reliability of the Monash Women's Health Program Female Sexual Satisfaction Questionnaire
Authors: Davison Sonia L. , Bell Robin J. , La China Maria , Holden Samantha L. , Davis Susan R. 
Published: October 2008

ABSTRACT

Introduction
A validated questionnaire to assess the nature and quality of the recent female sexual experience and that can be employed to evaluate acute therapeutic effects does not exist.

Aim
To validate an instrument with which researchers can evaluate the nature and quality of the female sexual experience within 24 hours of a sexual event.

Methods
A cross-sectional questionnaire study in 349 sexually active community-based women, aged 20–65 years, who self-identified as being either satisfied or dissatisfied with their sexual life.

Main Outcome Measures
Scores from the Monash Women's Health Program Female Sexual Satisfaction Questionnaire (MFSSQ), completed within 24 hours of sexual activity, on two occasions.

Results
Participants were 349 women who were sexually active at least once per fortnight, but not necessarily partnered. Almost equal groups of self-identified satisfied, dissatisfied, premenopausal, and postmenopausal women participated. Three hundred forty-five women (99%) completed one MFSSQ, and 326 women (94%) completed two separate questionnaires, each within 24 hours of a sexual event. Missing responses were few, good inter-item correlation was seen, and excellent reliability was demonstrated for most items, based on test–retest data. The questionnaire was able to discriminate well between sexually satisfied and dissatisfied women.

Conclusions
The MFSSQ is a 12-item questionnaire specifically designed to assess the quality and nature of a recent sexual experience. It is easy and quick to administer, is reliable and valid, and has the potential to be used to assess the efficacy of acute interventions in the area of female sexual dysfunction.
Is the Relationship Between Cigarette Smoking and Male Erectile Dysfunction Independent of Cardiovascular Disease? Findings from a Population-Based Cross-Sectional Study
Authors: Chew Kew-Kim , Bremner Alexandra , Stuckey Bronwyn , Earle Carolyn , Jamrozik Konrad 
Published: October 2008

ABSTRACT

Introduction
Cigarette smoking has been implicated in the pathophysiology of cardiovascular disease (CVD) and as a risk factor for erectile dysfunction (ED). However, various aspects of the associations between cigarette smoking, ED, and CVD need further elucidation.

Aim
We explored the relationship between cigarette smoking, ED, and CVD using data from a population-based cross-sectional study of 1,580 participants.

Methods
Postal questionnaires were sent to randomly selected age-stratified male population samples obtained from the Western Australia Electoral Roll.

Main Outcome Measures
In addition to items covering sociodemographic and self-reported clinical information and smoking habits, the 5-item International Index of Erectile Function was used to assess erectile function.

Results
Compared with never smokers, the odds of ED, adjusted for age, square of age, and CVD, were significantly higher among current smokers (odds ratio [OR] = 1.40; 95% confidence interval [CI] 1.02, 1.92) and ever smokers (OR = 1.57; 95% CI 1.02, 2.42). Similarly, the adjusted odds of severe ED were significantly higher among former smokers. Albeit not statistically significant, the age-adjusted odds of ED among current smokers increased with the number of cigarettes smoked. Among former smokers, the age-adjusted odds of ED were significantly higher 6–10 years following cessation of smoking than ≤5 or &gt;10 years. Compared with never smokers without CVD, the age-adjusted odds of ED among former smokers and ever smokers without CVD were about 1.6. Regardless of smoking, these odds were significantly higher among participants with CVD.

Conclusions
Compared with never smokers, former smokers and ever smokers have significantly higher odds of ED. The relationship between smoking and ED is independent of that between smoking and CVD, and not because of confounding by CVD. Patterns of ED in former smokers suggest that there may be a latent interval between active smoking and symptomatic ED, involving a process initially triggered by smoking.
Menstrual Cycle-Related Morphometric and Vascular Modifications of the Clitoris
Authors: Battaglia Cesare , Nappi Rossella Elena , Mancini Fulvia , Cianciosi Arianna , Persico Nicola , Busacchi Paolo , Facchinetti Fabio , De Aloysio Domenico 
Published: October 2008

ABSTRACT

Introduction
The evaluation of clitoral anatomy and function is of paramount importance to understand the physiology and pathology of clitoral function.

Aim
To prospectively evaluate the clitoral volumetric and vascular modifications during the menstrual cycle, and analyze their relationship with circulating hormones and nitric oxide levels.

Methods
Thirty healthy eumenorrheic women were studied in different phases of the menstrual cycle (day 3, 10, 14, 20, and 27). They were submitted to ultrasonographic (US) and Doppler analyses, and to hormonal and biochemical evaluations.

Main Outcome Measures
Transvaginal US evaluation of uterus, ovaries, and clitoris; Doppler analysis of uterine and dorsal clitoral arteries; and measurement of plasma luteinizing hormone (LH), follicle stimulating hormone (FSH), estradiol, androstenedione, testosterone, and nitrites/nitrates concentration. Sex hormone binding globulin was assayed, and free androgen index was calculated.

Results
During the menstrual cycle, FSH, LH, and estradiol changed as expected, whereas androgens did not show any significant change. The US assessment of the clitoral body volume evidenced a progressive increase with significant modifications during the periovulatory phase, after which it remained stable until day 20. Subsequently, the clitoral body volume decreased into the premenstrual phase (day 27), reaching values similar to those observed on cycle day 3. A comparable trend was observed in the nitrite/nitrate circulating values. The uterine and clitoral arteries presented significant modifications with reduced resistances in the periovulatory period. Estradiol levels resulted positively correlated with the clitoral body volume and inversely correlated with the dorsal clitoral artery pulsatility index (PI). Furthermore, the dorsal clitoral artery PI was inversely and significantly correlated with the nitrite/nitrate circulating values and the clitoral body volume.

Conclusion
Clitoral anatomic and vascular modifications are observable during the normal menstrual cycle.
Psychosocial Factors and Therapeutic Approaches in the Context of Sexual History Taking in Men: A Study Conducted among Swiss General Practitioners and Urologists
Authors: Platano Giacomo , Margraf Jürgen , Alder Judith , Bitzer Johannes 
Published: October 2008

ABSTRACT

Introduction
Male sexual dysfunction is a common medical condition, which is addressed mainly from a biomedical perspective by Swiss general practitioners (GPs) and urologists as the results of part I of our study showed. A psychosocial orientation in sexual history taking (SHT) leads to a truly patient-centered approach and is crucial for improving therapy decisions related to sexual dysfunction.

Aim
To analyze to what extent Swiss GPs and urologists have a psychosocial orientation in SHT, and what therapeutic options they focus on when confronted with male sexual dysfunction.

Methods
A semistructured interview was developed and used in face-to-face encounters with 25 GPs and 25 urologists.

Main Outcome Measures
Content and frequency of interview responses.

Results
The GPs and urologists differed significantly from each other in 5 out of 22 psychosocial factors. Summarizing these psychosocial factors in four domains showed a difference between the GPs and urologists in only one domain. Both groups focus on an open conversation as their approach in SHT. No GP and only a minority of urologists based their diagnosis on criteria of the International Classification of Diseases (10th edition) (ICD-10) or Diagnostic and Statistical Manual of Mental Disorders (4th edition) (DSM-IV). The GPs and urologists differed significantly from each other in 4 out of 16 combinations resulting from the given therapeutic options and form of sexual dysfunction. The urologists focus more strongly on medication as a therapeutic option.

Conclusions
The results of part II additionally justify establishing guidelines and training resources related to SHT in Switzerland. Swiss physicians should be encouraged to apply a more psychosocial orientation in SHT. This will contribute to a better patient-centered approach with positive consequences on physicians’ therapeutic decisions. Optimizing the approach in SHT and the choice of therapeutic options may better facilitate real sexual satisfaction for the patient and ultimately result in fewer health insurance costs.
Sexual Dysfunction among Older Adults: Prevalence and Risk Factors from a Nationally Representative U.S. Probability Sample of Men and Women 57–85 Years of Age
Authors: Laumann Edward O. , Waite Linda J. 
Published: October 2008

ABSTRACT

Introduction
Despite increasing demand for clinical interventions into sexual problems in an aging population, epidemiological data on the subject are scarce.

Aims
To examine the prevalence of sexual problems across different sociodemographic groups, and risk factors for these problems in multiple domains of life.

Methods
Statistical analysis of data from the 2005–2006 National Social Life, Health, and Aging Project (NSHAP), a nationally representative U.S. probability sample of 1,550 women and 1,455 men aged 57–85 at the time of interview.

Main Outcome Measures
Likelihood of experiencing sexual dysfunction in the preceding 12 months.

Results
Sexual problems among the elderly are not an inevitable consequence of aging, but instead are responses to the presence of stressors in multiple life domains. This impact may partly be gender differentiated, with older women's sexual health more sensitive to their physical health than is true for men. The mechanism linking life stress with sexual problems is likely to be poor mental health and relationship dissatisfaction. The NSHAP results demonstrate the consistent impact of poor mental health on women's reports of sexual problems and the less consistent association with men's problems.

Conclusion
The results point to a need for physicians who are treating older adults experiencing sexual problems to take into account not simply their physical health, but also their psychosocial health and satisfaction with their intimate relationship.
Cylinder Aneurysm of Parylene-Coated American Medical System (AMS) 700CX Penile Prosthesis
Authors: Kaufman Joel M. , Weldon Thomas E. 
Published: October 2008

ABSTRACT

Introduction
Cylinder aneurysms and leakages are uncommon with three-layered American Medical System (AMS) CX cylinders. Since 2001, an additional parylene coating improves cylinder wear.

Aim
To report two patients in whom major cylinder aneurysms developed less than 4 years after implantation.

Methods
Two patients in separate urologic private practices developed significant cylinder aneurysms requiring reoperation.

Results
Both patients developed aneurysms in 21-cm parylene-coated CX cylinders just short of 4 years of inflatable penile prosthesis (IPP) placement. Both did well after the explantation and insertion of Coloplast Titan IPP (Coloplast; Minneapolis, MN, USA).

Conclusion
Longer AMS CX IPP cylinders may develop aneurysms more than 3 years after insertion.
Role of Increased Penile Expression of Transforming Growth Factor-β1 and Activation of the Smad Signaling Pathway in Erectile Dysfunction in Streptozotocin-Induced Diabetic Rats
Authors: Zhang Lu Wei , Piao Shuguang , Choi Min Ji , Shin Hwa-Yean , Jin Hai-Rong , Kim Woo Jean , Song Sun U. , Han Jee-Young , Park Seok Hee , Mamura Mizuko , Kim Seong-Jin , Ryu Ji-Kan , Suh Jun-Kyu 
Published: October 2008

ABSTRACT

Introduction
It has been suggested that transforming growth factor-β1 (TGF-β1) plays an important role in the pathogenesis of diabetes-induced erectile dysfunction.

Aim
To investigate the expression and activity of Smad transcriptional factors, the key molecules for the initiation of TGF-β-mediated fibrosis, in the penis of streptozotocin (STZ)-induced diabetic rats.

Methods
Fifty-two 8-week-old Sprague–Dawley rats were used and divided into control and diabetic groups. Diabetes was induced by an intravenous injection of STZ.

Main Outcome Measures
Eight weeks later, erectile function was measured by electrical stimulation of the cavernous nerve (N = 12 per group). The penis was harvested and stained with Masson trichrome or antibody to TGF-β1, phospho-Smad2 (P-Smad2), smooth muscle α-actin, and factor VIII (N = 12 per group). Penis specimens from a separate group of animals were used for TGF-β1 enzyme-linked immunosorbent assay (ELISA), P-Smad2/Smad2, phospho-Smad3 (P-Smad3)/Smad3, fibronectin, collagen I, and collagen IV western blot, or hydroxyproline determination.

Results
Erectile function was significantly reduced in diabetic rats compared with that in controls. The expression of TGF-β1, P-Smad2, and P-Smad3 protein evaluated by ELISA or western blot was higher in diabetic rats than in controls. Compared with that in control rats, P-Smad2 expression was higher mainly in smooth muscle cells and fibroblasts of diabetic rats, whereas no significant differences were noted in endothelial cells or in the dorsal nerve bundle. Cavernous smooth muscle and endothelial cell contents were lower in diabetic rats than in controls. Cavernous fibronectin, collagen IV, and hydroxyproline content was significantly higher in diabetic rats than in controls.

Conclusion
Upregulation of TGF-β1 and activation of the Smad signaling pathway in the penis of diabetic rats might play important roles in diabetes-induced structural changes and deterioration of erectile function.
Adult Male Circumcision: Effects on Sexual Function and Sexual Satisfaction in Kisumu, Kenya
Authors: Krieger John N. , Mehta Supriya D. , Bailey Robert C. , Agot Kawango , Ndinya-Achola Jeckoniah O. , Parker Corette , Moses Stephen 
Published: October 2008

ABSTRACT

Introduction
Male circumcision is being promoted for HIV prevention in high-risk heterosexual populations. However, there is a concern that circumcision may impair sexual function.

Aim
To assess adult male circumcision's effect on men's sexual function and pleasure.

Methods
Participants in a controlled trial of circumcision to reduce HIV incidence in Kisumu, Kenya were uncircumcised, HIV negative, sexually active men, aged 18–24 years, with a hemoglobin ≥9.0 mmol/L. Exclusion criteria included foreskin covering less than half the glans, a condition that might unduly increase surgical risks, or a medical indication for circumcision. Participants were randomized 1:1 to either immediate circumcision or delayed circumcision after 2 years (control group). Detailed evaluations occurred at 1, 3, 6, 12, 18, and 24 months.

Main Outcome Measures
(i) Sexual function between circumcised and uncircumcised men; and (ii) sexual satisfaction and pleasure over time following circumcision.

Results
Between February 2002 and September 2005, 2,784 participants were randomized, including the 100 excluded from this analysis because they crossed over, were not circumcised within 30 days of randomization, did not complete baseline interviews, or were outside the age range. For the circumcision and control groups, respectively, rates of any reported sexual dysfunction decreased from 23.6% and 25.9% at baseline to 6.2% and 5.8% at month 24. Changes over time were not associated with circumcision status. Compared to before they were circumcised, 64.0% of circumcised men reported their penis was “much more sensitive,” and 54.5% rated their ease of reaching orgasm as “much more” at month 24.

Conclusions
Adult male circumcision was not associated with sexual dysfunction. Circumcised men reported increased penile sensitivity and enhanced ease of reaching orgasm. These data indicate that integration of male circumcision into programs to reduce HIV risk is unlikely to adversely effect male sexual function.