bluuebunny/crossref_metadata_2025_split huggingface dataset:
(010) A Novel Collaborative Protocol for Successful Management of PGAD/GPD Mediated by Tarlov Cyst-induced Radiculopathy of Sacral Spinal Nerve Roots in the Cauda Equina
Authors: Kim C , Blevins J , Komisaruk B , Uloko M , Goldstein S , Goldstein I 
Published: June 2023

Abstract

Introduction
In 2012, Komisaruk et al introduced the concept that neurologic-based women’s sexual health issues, genito-pelvic dysesthesia (GPD), could be caused by radiculopathy of sacral spinal nerve roots within the cauda equina. Over the last 4 years, to more effectively manage patients with suspected cauda equina pathology, a robust collaboration among sexual medicine, spine surgery and neurophysiology disciplines has been established.

Objectives
The aim of this study is to review the collaborative experience in managing patients with genito-pelvic dysesthesia.

Methods
We defined GPD in the broadest sense to include both unwanted, unrelenting, distressing arousal, pain and/or itching symptoms &gt;6 mo (hyperfunction), and also persistent degrees of genital anesthesia leading to orgasmic dysfunction &gt;6 mo (hypofunction). Charts from 2015 to 2019 of GPD patients presenting to our sexual medicine facility where neurogenital testing results were consistent with radiculopathy of sacral spinal nerve roots within the cauda equina were reviewed retrospectively. Lumbar and sacral MRIs were obtained and reviewed simultaneously in collaborative bi-monthly meetings and identified as having or not having treatable spinal abnormalities, subdivided into subtle or obvious. When appropriate, a transforaminal epidural spinal injection (TFESI) or caudal block with anesthetic agent and/or steroid was administered and the outcome measured by Patient Global Impression of Improvement (PGI-I). Those with clinically significant symptom reduction were considered for minimally invasive spine surgery (MISS).

Results
734 patients (586 women; 80%; mean age 47 +/− 24) met criteria for this retrospective chart review. 637 lumbar and/or sacral MRIs were reviewed. A total of 112 TFESI were performed, 90 of which showed positive responses with more than 60% improvement on PGI-I of 1,2. 57 surgeries were performed. 17 patients (71% women) with PGAD underwent MISS for herniated nucleus pulposus and or annular tear. 76% declared post-op clinical improvement with PGI-I 1,2,3 with mean follow-up of 12 months (4 - 30 months).

Conclusions
Cauda equina pathology can cause unwanted, unrelenting, distressing neurologic-based GPD from radiculopathy of sacral spinal nerve roots. In selected cases these GPDs may be reversed by MISS. There are management benefits from collaboration among sexual medicine, spine surgery and neurophysiology specialists.

Disclosure
No.
(021) Earlier Age of First Sexual Activity Predicts Women’s Higher Sexual Pleasure, but also Higher Sexual Shame
Authors: Bogen K , Jones H , Lorenz T 
Published: June 2023

Abstract

Introduction
Despite calls for greater focus on sex-positive frameworks for understanding adolescent sexuality (Harden, 2014), the majority of research on early puberty and sexual debut has primarily focused on negative outcomes such as body shame (McKenney & Bigler, 2016; Schooler et al., 2005), sexual or vulvar pain (Bergeron et al., 2011; Latthe et al., 2006), risk for STIs (Sandfort et al., 2008; Upchurch et al., 2004), and unwanted pregnancy (O’Donnell et al., 2001; Mosher & McNalley, 1991). However, some studies suggest that early puberty is also associated with positive outcomes such as higher sexual desire (Fortenberry, 2013) and greater intimacy in early sexual relationships (Kaltiala-Heino et al., 2003). Possibly, this contradiction arises as researchers have not often distinguished between the effects of puberty – and pubertal timing – on partnered vs. solitary sexual experiences.

Objectives
The current study was designed to improve providers’ understanding of women’s early sexual experiences and later sexual wellness. Specifically, we sought to clarify associations between early puberty and partnered vs. solitary sexual debut and add to the scant literature addressing the effects of early puberty on positive outcomes such as sexual pleasure and functioning.

Methods
92 women recruited from a large university in the Midwest (Mean age = 20.51, SD = 2.7) participated in an online survey about sexual wellness. We ran a series of Pearson correlations between women’s age at puberty, menses, first masturbation, first partnered sexual activity, and their adult levels of sexual shame, sexual pleasure, and sexual functioning.

Results
Early puberty was significantly correlated with higher reported sexual shame in adulthood, whereas early partnered sexual debut was significantly correlated with higher reported sexual pleasure in adulthood. Of note, early masturbation was significantly correlated with both higher sexual shame and higher sexual pleasure in adulthood. Correlations with overall sexual functioning were not significant.

Conclusions
Results suggest that the experiences of early puberty and early masturbation are each associated with increased sexual shame, and that these experiences may be particularly important targets for intervention to decrease sexual distress in adulthood. Moreover, although early partnered sexual debut has been largely stigmatized as a sexual health risk across sexual science literature, our findings suggest that earlier partnered sexual debut may enable women to experience greater sexual pleasure, perhaps as a result of earlier negotiation of their sexual desires and sexual communication (Sprecher et al., 2019). If replicated, these findings would suggest the need for targeted sexual education for patients experiencing early adolescence to prevent development of sexual shame in adulthood.

Disclosure
No.
(022) Measures of Sexual Functioning, Particularly Pain Functioning, are Imperfect Predictors of Women’s Sexual Pleasure
Authors: Jones H , Bogen K , Lorenz T 
Published: June 2023

Abstract

Introduction
There is a complex relationship between women’s sexual functioning and positive outcomes such as satisfaction or pleasure. Some studies indicate that lower physical pleasure mediates the association between sexual function and distress (Stephenson & Metson, 2015), suggesting these constructs are related but distinct. Moreover, different aspects of sexual dysfunction are differentially associated with distress: for example, women more commonly report low desire as distressing than orgasm dysfunction (Shifren, et al., 2008). Additionally, researchers have noted that sexual pain disorders differ from other sexual dysfunctions in both etiologic mechanisms and psychosocial outcomes (Binik et al., 2002). Given that the ultimate goal of sexual medicine treatments is to improve women’s sexual satisfaction and pleasure, what are the actual associations between different aspects of sexual function and women's wellbeing?

Objectives
To explore associations between sexual function, satisfaction and pleasure in healthy young women. In particular, we were interested in associations between pain and sexual pleasure.

Methods
Women at a large Midwest university completed an online survey about sexual wellness (N= 92; Mean age = 20.5, SD = 2.7), including well- validated indices of sexual pleasure (using the Female Sexual Subjectivity Inventory, FSSI) and sexual functioning (using the Female Sexual Function Index, FSFI). Analyses were conducted examining the relationships between sexual functioning, sexual satisfaction, sexual pleasure, and sexual pain.

Results
Although there was a significant relationship between higher sexual functioning and higher sexual pleasure, less than 20% of the total variance in sexual pleasure was explained by sexual functioning (R2 = 0.176). Similarly, while there was a positive relationship between sexual pleasure and sexual satisfaction, sexual satisfaction accounted for less than 30% of the total variance in pleasure (R2 = 0.266). Sexual pain was not significantly associated with sexual pleasure and accounted for only 2% of the variance in pleasure.

Conclusions
While sexual functioning, satisfaction and pleasure all had statistically significant associations, the overlap between these constructs was considerably smaller than typically assumed. Notably, there was no association between pain and pleasure, which further supports the conceptualization of sexual pain as distinct from other types of sexual dysfunction. When conceptualizing interventions that address women’s sexual pleasure, relying solely on self- reported sexual functioning or pain may miss important sources of pleasure such as intimacy, relationship satisfaction, or positive mood.

Disclosure
No.
(044) Sex Education: Including Simulation in CME Presentations
Authors: Phillips N , Bachmann G 
Published: June 2023

Abstract

Introduction
Lectures on female sexuality often include power point and video materials. However, perhaps the addition of simulation may enhance the educational experience.

Objectives
At a recent major presentation geared to the Ob/Gyn health team, the two authors were asked to present on taking a sexual history, with inclusion of sexual dysfunction. It was decided that simulation would be included to highlight strategies and interview skills related to the patient interaction and attendee responses would be evaluated.

Methods
By way of a virtual presentation, one of the authors presented the material that had to be covered in a standard power point presentation. However, before each point was presented, the two authors role-played a health care provider talking to a patient. The presenter, in her role as health care provider, first incorrectly asked the patient about her symptoms in what was an indirect and inattentive way, which was followed by a debriefing. Next, the presenter asked the patient in a more focused and responsive manner about her symptoms, and there was debriefing after this. This process was repeated throughout the presentation.

Results
The feedback from the presentation was overall positive. Comments from attendees noted that they could clearly understand, through the simulation the difference between correct sexual history taking and poor sexual history taking, and, as a result, would feel more comfortable in future patient interactions concerning sexual issues.

Conclusions
The use of simulation/role playing should be considered in all sexual health presentations.

Disclosure
No.
(046) Signalling the Vaginal Code: A Dual Role for Oxytocin in Sexual Partner Preference and Reproduction
Authors: Mac Cionnaith C , Gomez-Perales E , Ismail H , Pfaus J , Brake W 
Published: June 2023

Abstract

Introduction
In female rats, paced copulation induces a neuroendocrine response that is necessary for pregnancy. Paced copulation is also a strong sexual reinforcer that results in both conditioned place preference and conditioned sexual partner preference. Although the neuropeptide oxytocin (OT) controls partner preference formation in female prairie voles, it is not known whether OT regulates sexual preference formation in female rats.

Objectives
The current experiments tested whether (i) OT is necessary and sufficient to induce a sexual partner preference, and (ii) OT signalling affects the reproductive effects of pacing that are necessary for both pregnancy and partner preference. These experiments also tested whether peripheral or central OT signalling regulates these behaviours by using an antagonist that enters the CNS (Cligosiban, 5mg/kg; CLG) and one that does not (L-371,257, 1mg/kg; data collection in progress).

Methods
In the first experiment, Long-Evans female rats (n = 14) were injected I.P. with either saline, 20μg OT, 50μg OT, CLG, L-371,257, one minute before their first 30-min sexual experience with a male rat scented with almond. Four days later, the females were given a drug-free 30-min partner preference test in an open field with two males, one scented and the other unscented. The second experiment tested whether OT signalling augments the facilitation of estrous termination that is reliably induced with stimulation of the cervix (VCS). Long-Evans females (n = 12) were injected with either saline, 50μg OT, CLG, or L371,257, 1min prior to sham stimulation or 50 distributed VCSs administered with a lubricated glass rod. Twelve hr after VCS or sham females copulated with a male to assess sexual receptivity.

Results
In the first experiment, females treated with both doses of OT received the scented male’s ejaculation first and more often, but they did not solicit the scented male more often than the unscented male. CLG-treated females received the unscented male’s first ejaculation preferentially and solicited the unscented male more often. In the second experiment, females treated with OT showed decreased sexual receptivity regardless of the type of stimulation, suggesting that OT mimicked the effect of VCS. In contrast, estrous termination was attenuated in females given CLG and L371,257 with VCS, suggesting that central and peripheral OT receptors play a role in activating neuroendocrine responses induced by copulation.

Conclusions
Taken together, these data suggest that OT signalling regulates aspects of both reproduction and sexual reward in female rats, biasing their preferences to receive ejaculations preferentially from males that are associated with paced copulation and terminating their sexual receptivity faster, thus, increasing the likelihood of pregnancy and paternity.

Disclosure
No.
(047) Hope and Flourishing: The Effect of Hope on Psychological Flourishing in Participants with Chronic Pain
Authors: Marino Clyne L 
Published: June 2023

Abstract

Introduction
Patients living with chronic pain conditions, especially conditions for which there is no cure, may experience feelings of hopelessness and mental health challenges with the continuation of health issues. This study explored the relationship between hope for a cure to a condition and psychological flourishing, with exploratory variables such as age, whether participants were told that their chronic condition might be curable, and whether they believed their condition to be curable.

Objectives
The hypothesis was that participants with chronic pain who score high in hope, operationalized by the Herth Hope Index, would also score high in psychological flourishing, measured by Diener’s Psychological Flourishing Scale.

Methods
Participants were 116 females with chronic conditions including endometriosis and fibromyalgia between the ages of 18 and 50-years-old recruited online via Facebook to complete a Qualtrics survey.

Results
In the testing of exploratory variables, there was a significant correlation between participant belief that their pain was curable and participant scores on the Psychological Flourishing Scale, r=.203, N=101, p&lt;0.05, two tails. A Pearson product-moment calculation explored the relationship between total scores on the Herth Hope Index (M=23.901, SD=4.072) and the Psychological Flourishing Scale (M=33.087, SD=11..372). This relationship was found to be statistically significant, r=.736, N=102, p&lt;0.01, two tails, indicating a strong positive relationship between scores on the Herth Hope Index and scores on the Psychological Flourishing Scale. Higher belief that pain was curable was associated with higher scores on the Psychological Flourishing Scale. There was not, however, a significant correlation between being told that one’s condition is incurable or participant age and scores on the Psychological Flourishing Scale. A finding of note was that believing one’s condition to be incurable was distinct from and more significant than being told by a physician that a condition was incurable.

Conclusions
Further studies should include more diverse samples, or into other factors that might promote psychological flourishing in patients with chronic pain. In particular, future studies could investigate how the discussions clinicians may have with their patients in regard to outcomes for their health conditions could affect psychological outcomes for the patients. A better understanding of language that could be detrimental for the psychological flourishing of patients with chronic conditions would be important to inform best practices for clinician-patient interactions.

Disclosure
No.
(050) Vulvodynia Viewed From a Disease Prevention Framework: Insights From Patient Perspectives
Authors: Webber V , Miller M , Gustafson D , Bajzak K 
Published: June 2023

Abstract

Introduction
Persons with vulvodynia (a chronic vulvar pain condition) suffer many barriers to diagnosis and treatment, several of which may be exacerbated by the sociocultural and geographical context in which they live.

Objectives
We drew on the experiences of patients with vulvodynia who were living in small urban and rural communities to learn what they perceived as the major barriers to diagnosis and treatment as well as to probe for possible solutions.

Methods
For this qualitative case study, we conducted 3 focus groups with a total of 10 participants, drawn from patients seen at our academic tertiary referral center, with a goal of understanding their lived experience with vulvodynia. The patient dialogue was coded into themes and temporally grouped to illustrate struggles and victories in diagnosis and treatment.

Results
Participants confirmed that healthcare provider knowledge and attitudes as well as system challenges (specialist and allied healthcare provider availability) are major barriers to timely diagnosis. Of novel interest are other factors that exacerbate distress and delay diagnosis such as patients’ inadequate knowledge of sexual functioning and sociocultural messages regarding “normal” sexual activity. Our work suggests that a disease prevention framework that includes comprehensive sexual education before or at the onset of sexual activity may be of benefit in reducing the burden of vulvodynia when added to strategies to increase healthcare provider knowledge and improve access to effective treatments.

Conclusions
While healthcare provider knowledge and attitudes are often at the forefront of barriers to diagnosis, our study suggests that to minimize patient distress and expedite diagnosis, resources must also be directed to promoting comprehensive sexual health education.

Disclosure
No.
(056) The Decreased Sexual Desire Screener: What are we missing?
Authors: Harper L , Mahar E , Powers C 
Published: June 2023

Abstract

Introduction
The Decreased Sexual Desire Screener (DSDS) is a five-item self-report questionnaire used to assist clinicians in diagnosis of generalized acquired Hypoactive Sexual Desire Disorder (HSDD). While the first four items of this questionnaire assess whether the woman has decreased sexual desire that is causing her distress, the fifth item assists in identifying possible medical and psychological factors that could confound the diagnosis of HSDD (e.g., menopausal symptoms, pain, alcohol). The present study used baseline data from users of a mobile app (Rosy). The app was designed with the goal of improving women’s sexual function, particularly sexual desire, by providing evidence-based resources to users.

Objectives
To investigate what factors—beyond those listed in question five of the DSDS—may contribute to women’s low sexual desire, and to examine what percentage of women using the mobile app may qualify for HSDD.

Methods
Women downloaded Rosy through Apple’s App Store for iOS devices or Google Play for Android devices. App users completed the DSDS when they first opened the app. From February 2019 (the launch of the app) to early-November 2019, if women felt that a factor not listed in question five of the DSDS contributed to their current desire in sexual desire or interest, they were able to respond with “other” and then type in that factor. Because the format of this study did not allow for discussion of question five responses with the women, we did not consider this question when examining whether the woman may qualify for a diagnosis of HSDD; previous research found that eliminating question five increases the sensitivity from 83.6% to 88.4% and decreases the specificity from 87.8% to 77.5% (Clayton et al., 2009).

Results
Of the 2,178 women who had the option to type in factors they felt contributed to their low sexual desire that were not already listed in question five, 122 (5.6%) wrote a response. Considering these 122 women, 25.4% attributed their low sexual desire to body-image or self-image issues (e.g., weight gain, not feeling attractive), 8.2% to trauma (e.g., sexual trauma), 7.4% to children, and 5.7% to feeling like there is not enough time in the day. Furthermore, we found that 53.5% of the 8,497 app users who reported that they were referred to the app by a professional (i.e., clinician, physician, therapist) may qualify for HSDD versus 39.1% of the 8,750 users who reported finding the app through social media or word of mouth.

Conclusions
Using mobile app data, we explore what factors not listed in question five of the DSDS women believe are linked to their low sexual desire. We also found that the majority of users who reported professional referrals to the app may qualify for HSDD. This study highlights how data from mobile apps, such as Rosy, can be used to better understand HSDD and factors that may contribute to women’s low sexual desire.

Disclosure
Yes - Rosy Wellness, Inc.
Industry initiated, executed and funded study – Yes.
(060) Dyspareunia in Patients with Female Prostatitis
Authors: Parshin A 
Published: June 2023

Abstract

Introduction
Female prostatitis (skeneitis) remains a little-studied disease and is hidden in the literature under the guise of urethral syndrome.

Objectives
To assess dyspareunia in patients with female prostatitis.

Methods
From 2015 to 2019, 79 patients with female prostatitis were examined. The diagnosis was based on complaints, anamnesis, examination of patients in a gynecological chair and urethroscopy. The analysis of patients ' complaints was made. Patients with dyspareunia were asked to localize pain in the vagina.

Results
Dyspareunia was a complaint in 28 patients. Among 61 patients who had sexual activity, this was 46%. Of these, 9 (15%) patients localized pain during sexual intercourse along the anterior wall of the vagina. This localization seems logical, because the female prostate gland is located on the side of the anterior wall of the vagina.

Conclusions
Dyspareunia occurs in almost half of patients with female prostatitis. When asking complaints from patients, it is necessary to specify the localization of pain in the vagina. Dyspareunia along the anterior wall of the vagina is proposed to be considered a new specific symptom of female prostatitis.

Disclosure
No.