bluuebunny/crossref_metadata_2025_split huggingface dataset:
190 Straining to Void is Associated with Dyspareunia in Japanese Women
Authors: Aoki Y. , Yokohama O. 
Published: May 2022

ABSTRACT

Introduction
Female lower urinary tract symptoms (LUTS) affect quality of life and sexual activity.

Objectives
This study aimed to evaluate the influences of LUTS on female dyspareunia (pain during vaginal penetration), as little is known on this topic.

Methods
The study population comprised 369 women who participated in 2-day health examinations at a single institution in Japan, from April 2010 to March 2011. All participants were asked to complete a standardized self-reported questionnaire. Using the International Prostate Symptom Score (IPSS), IPSS-QOL score, and the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), we evaluated urinary symptoms, including urinary incontinence, urgency, daytime frequency, straining, and nocturia. To assess dyspareunia, we asked the question "Over the past 4 weeks, how often did you experience discomfort or pain during vaginal penetration?", with answer choices of "Did not attempt intercourse", "Almost always or always", "Most times", "Sometimes", “A few times”, and "Almost never or never", from part of a questionnaire from the Japanese translation of the Female Sexual Function Index (Question 17 of FSFI-J) [Rosen. J Sex Marital Ther, 2000]. We analyzed relationships between dyspareunia and LUTS. The Mann-Whitney U test and logistic regression models were used for statistical analyses. Values of P&lt;0.05 were considered statistically significant.

Results
A total of 315 individuals completed the questionnaire (response rate, 84%). The mean age of respondents was 47.2 years (range, 31-69 years). Our analysis included 125 women (40%), and excluded 190 women (60%) who reported that they had not attempted intercourse over the past 4 weeks. Among sexually active women, 44% had experienced dyspareunia. Straining to void and IPSS-QOL score were significantly higher in women reporting dyspareunia. In multivariate analysis, significant correlations were found between dyspareunia and both straining to void and IPSS-QOL score (Odds ratio, 16.9 (1.38-205)).

Conclusion
Straining to void and IPSS-QOL score correlated significantly with dyspareunia among Japanese women in this study. The underlying mechanism remains unclear, and little data have been accumulated on the association between straining to void and dyspareunia, although a previous study reported LUTS as a predictor of sexual pain for women in the United States (odds ratio = 7.61) [Laumann. JAMA, 1999]. Our study confirmed straining to void and IPSS-QOL score as factors independently associated with dyspareunia. These results suggest that straining to void can offer a predictor of female dyspareunia.

Disclosure
Work supported by industry: no.
195 Sexuality of the Woman During Pregnancy: Experience of the Tunisian Woman
Authors: Boufarguine R. , Bettaieb H. , Mbarki W. , Halouani S. , Abidi I. , Makni A. , Frikha M. , Souayah N. , Mbarki C. , Oueslati H. 
Published: May 2022

ABSTRACT

Introduction
During various life transitions, sexuality can be disturbed and must be adjusted accordingly. This is particularly the case during pregnancy. This period is full of simultaneous multidimensional upheavals of a biological, physiological, psychological, emotional, social and sexual nature for the future parents.

Objective
To determine the factors associated with sexual dysfunction in a population of Tunisian women during pregnancy.

Methods
Multicentric prospective analytic study including 300 pregnant Tunisian women using the Arabic version of the Female Sexual Function Index (FSFI).

Results
We found a significant decrease in sexual frequency in rural versus urban settings (p=0.002). All sexual function items were significantly impaired in rural settings, except for orgasm and satisfaction. The FSFI score was lower for rural women (p=0.001). The type of marriage also proved to be a determining factor in the sexual life of pregnant women. In fact, in couples where the marriage was traditional, we noted a greater decrease in sexual relations (p &lt; 0.01). All sexual function items were significantly impaired compared to couples where the marriage was for love. The item most affected was arousal (p&lt;0.001). Nevertheless, pain was less during sexual intercourse for couples who had a love marriage (p&lt;0.001). The decrease in frequency of intercourse was estimated at 78.33% when the agreement was poor, compared to only 49.68% when the marital agreement was good. The items most affected were orgasm, desire and arousal for couples with poor agreement. The FSFI score was also significantly impaired for this category (p &lt;0.01). Similarly, women who frequently or always talked with their husbands about sexuality showed more desire, arousal, lubrication, orgasm and satisfaction with better overall sexual function on the FSFI. Another factor that appeared to negatively influence sexual function in pregnant women was a history of instrumental forceps delivery. Indeed, it was responsible for a significant impairment of arousal, orgasm and lubrication. It was also responsible for a more marked sexual dysfunction (FSFI score at 12.21 vs 22.76 in the absence of previous forceps delivery; p=0.01).

Conclusion
Pregnancy is certainly a period of vulnerability for the woman and her partner, but this is not a reason for it to be a desert of several months for the intimacy of the couple. Sexuality should no longer be considered as a tool for procreation only, but rather as a source of pleasure and relaxation and a privileged moment of complicity between the partners. Adapting to the events of pregnancy and the changes that are inherent to it requires the support of the family and the medical profession.

Disclosure
Work supported by industry: no.
197 Women Who Practice Commercial Sex and Chemsex in St. Petersburg (Russia)
Authors: Vykhodtcev S. , Tregubenko I. , Fedorova A. 
Published: May 2022

ABSTRACT

Introduction & objective
Evaluation of psychological defenses (i.e. psychological mechanisms that support the self-conception) and personal identity explain the reasons why female sex workers practiced chemsex. It also helps to identify targets for psychotherapy, including prevention of problems such as chemsex and risky sexual behavior.

Methods
In our study, 65 women aged 18-33 years (mean age 25.4 years) who practiced commercial sex in Saint Petersburg (Russia) were interviewed. Among them, 30 (46%) also practiced chemsex. They were compared with 35 (54%) women who did not practice chemsex. With each of participating woman we had a structured interview. We also analyzed their free self-descriptions and descriptions based on the Life Style Index (LSI) method.

Results
Women practicing chemsex identified themselves as unique and special, i.e. outstanding as well as more risky, seeking new experiences and open to unusual experiences. They also pointed out that chemsex allowed them practice sex with any client without experiencing negative emotions. Women practicing chemsex demonstrated a high level of psychological defenses. Later, this can lead to various problems such as drug addiction, commercial sex as the only possible model of sex, the risk of HIV infection, hepatitis, syphilis, etc., mental disorders, aggression towards women. Among the psychological defenses, the most non-constructive ones (such as negation, displacement, and projection) prevailed. This means that such women ignore anxiety information and repression psycho-traumatic experience. Simple recommendations such as “to be cautious because of danger” will not be effective for these women.

Conclusions
The psychotherapy of women practicing commercial sex and chemsex should be oriented towards personal identity and awareness of the risky nature of their sexual behavior. To be unique and special means to choose the path of self-defenses, and not self-destruction.

Disclosure
Work supported by industry: no.
205 Therapeutic Groups of Men with Penile or Testicular Cancer
Authors: Silva I. , Naccarato A. , Denardi F. , Ferreira U. , Matheus W. 
Published: May 2022

ABSTRACT

Testicular cancer (TC) primarily affects men aged 15 to 40 years, and the incidence is around 5/100,000. Tumors are usually aggressive and have a great psychological impact on patients.
Penile cancer (PC) represents 2% of all types of tumors that affect men in Brazil. Most of the affected population are elderly men. Usually, the tumor is identified at an advanced stage, when the only treatment available is total or partial penectomy, causing a great emotional impact.
This work aims to evaluate the impact of psychotherapy, in an open group, on Health-Related Quality of Life (HRQOL) and Sexuality in patients with TC and PC who have been diagnosed, are undergoing treatment - surgery, radiotherapy, chemotherapy or hormone therapy - or who are being followed up after treatment. Data will be collected through an initial interview (Identification, Anamnesis, Health Anamnesis, Degree of Satisfaction with Life and Sexuality, Affective-Emotional Assessment and Treatment Data), SF-36 and IIEF-5 short form questionnaire, in patients who are diagnosed, who have undergone treatment - surgery, radiotherapy, chemotherapy or hormone therapy - or who are being monitored at the clinic, and reapplication at the end of 12 sessions of group psychotherapy. Each session will be answered 5 questions related to the perception of the previous session.
The group is available for 2 years, once a week, and the patient will attend 12 sessions. The sessions last 90 minutes, conducted by the same psychologist.
The research is been developed considering the ethical principles of secrecy, privacy, confidentiality and non-identification of the interviewees' data.
The study does not pose risks to the subjects and invasive techniques of the body or psychological suffering will not be used. Before starting the process, the Informed Consent Form (TCLE) is delivered, as well as the provision of all details regarding the research. It is also explained that participation is voluntary and that the participant can leave the research at any time, without prejudice to their treatment and monitoring.
Only patients who meet all these criteria will be included, after signing the informed consent.

Disclosure
Work supported by industry: no.
213 Effect of Clomiphene Citrate Therapy for Male Infertility
Authors: Okada K , Sato K , Ohnishi A , Kaku Y , Ishida T , Chiba K , Fujisawa M 
Published: May 2022

ABSTRACT

Introduction & Objectives
To assess the efficacy and safety of clomiphene citrate (CC) for idiopathic male infertility.

Methods
We identified low testosterone (T) and male infertility patients treated with CC at our institution in the period September 2017 to May 2020. Data were gathered on patient characteristics and laboratory values at baseline. We retrospectively evaluated patients whose sperm concentration &lt; 15*106/mL and/or sperm motility &lt; 40%. FSH, LH and total T were measured before and 6-8 weeks after CC therapy. Sperm concentration, sperm motility were evaluated 3 month after CC therapy. Side effects were also recorded. In this series, 25 mg of CC was added every morning in all patients.

Results
A total of 37 men were included, with a mean age of 36.7 years. After 3month of CC therapy, sperm concentration was significantly increased from 14.07±16.21*106/ml to 30.52±38.10*106/ml. Sperm motility was also increased from 22.61±17.32% to 29.01±17.11%, but not significantly. Total T, FSH, and LH levels all significantly increased. 2 couples (5.4%) got pregnant. 2 patients experienced side effects: acne, n = 1; increased hepatic enzymes, n = 1. There were 5 patients who complained low libido and/or ED, but no improvement by T elevation.

Conclusions
According to our data, CC therapy increased sperm concentration significantly. CC therapy may be an effective and safe alternative for patients with low T and low sperm concentration. We have to evaluate more cases to know the CC therapy effect for low libido and ED.

Disclosure
Work supported by industry: no.
228 Efficacy of Combined Treatment of Intramuscular Testosterone Injection and Testosterone Ointment Application for Late-Onset Hypogonadism: an Open-Labeled, Randomized, Crossover Study
Authors: Narukawa T , Soh J , Kanemitsu N , Harikai S , Ukimura O 
Published: May 2022

ABSTRACT

Introduction
The best method for administering testosterone replacement therapy (TRT) for late-onset hypogonadism (LOH) remains controversial. This study aimed to compare the efficacy and safety of a combined treatment (CT) involving intramuscular testosterone injection and testosterone ointment application [Glowmin® (GL)] with intramuscular injection monotherapy (IMIM).

Materials and methods
Patients were randomly assigned as follows: Group 1 received IMIM for 12 weeks and CT for 12 weeks and Group 2 received CT for 12 weeks and IMIM for 12 weeks. Patients were then asked about their treatment preferences: (A) IMIM, (B) a combination of IMIM and ointment, or (C) either A or B.

Results
Patients (n = 43) completed the study without any adverse effects. No significant differences between each treatment period were found. In Group 1, most patients chose B (n = 13) while in Group 2, most chose A (n = 10). In each group, patients preferred the second treatment phase; however, statistical significance was not reached between A and B (Group 1, p = 0.11 and Group 2, p = 0.47, respectively).

Conclusions
TRT by CT is compatible with TRT by IMIM. Patients who cannot continue TRT because of polycythemia from IMIM may be suited to CT.

Disclosure
Work supported by industry: yes, by Daito pharmaceutical company.
241 Are Patients Really Willing to Undergo Surgery for Peyronie's Disease?
Authors: Capogrosso P , Candela L , Cazzaniga W , Costa A , Fallara G , Boeri L , Pozzi E , Belladelli F , Schifano N , Cignoli D , Dehò F , Abbate C , Montorsi F , Salonia A 
Published: May 2022

ABSTRACT

Introduction
There is a current lack of effective conservative treatments for Peyronie Disease (PD). Surgery represents an effective treatment, despite being associated with bothering complications, including erectile dysfunction (ED).

Objective
We investigated patients wish of being operated for PD at a single center.

Methods
Data were prospectively collected for patients managed for penile curvature because of PD in 2016-2020. Baseline data included age, time from PD onset, penile pain, curvature degree, difficulty at penetration, concomitant hour-glass deformity and ED. All patients were offered conservative treatments, including oral therapy or topical injections regardless of curvature degree. Tunical shortening or lengthening procedures were offered as an alternative to conservative treatments. Penile prosthesis implantation was offered to those with concomitant ED. Patients compliance with surgery was recorded. Logistic regression analyses tested the profile of patients who were more likely to comply with surgery.

Results
Data were available for 218 patients. Median(IQR) age was 57(49,63) yrs and length of PD after onset was 14(3,28) months. Median curvature was 30°(20,45); of 218, 8(3.7%) patients had concomitant hour-glass deformity. Pain was complained by 30(14%) patients, while difficulty at penetration and ED were reported by 62(28%) and 87(40%) patients. Of all, 78(32%) patients had been treated with tadalafil OaD; 41(19%) patients received iontophoresis with verapamil; 35(16%) SWT; and, 31(14%) CCH injections. A significant improvement (defined as a curvature reduction≥20°) was reported in 52(24%) cases. Overall, only 59 (27%) patients were willing to eventually undergo surgery for PD. Younger patients (OR:0.95, 95%CI: 0.92,0.98;p=0.003) and patients with more severe curvatures (OR:1.03; 95%CI: 1.01,1.04;p=&lt;0.001) were more likely to comply with surgery, after accounting for other clinical variables. According to this model, a man aged 50 yrs with a curvature &lt;20° would accept surgery only in 24% of cases compared to 45% for a same age man with &gt;45° of curvature (Fig1).

Conclusions
Compliance to surgery is low among patients with PD, thus further stressing the urgent need for effective conservative treatments. Surgery should be comprehensively discussed with younger patients with a severe curvature.

Disclosure
Work supported by industry: no.
261 Tocophobia
Authors: Rahne Otorepec I 
Published: May 2022

ABSTRACT

Introduction
Fear of childbirth is common during pregnancy and is believed to be the most common underlying reason for requesting a caesarean section without medical indication. Despite the fact that 17%-20% of all pregnant women report extreme fear of birth, named tocophobia, in ICD -10 International Classification for Disease-10 revision – ICD-10,) there is not established diagnose Tocophobia, which can also occurs in non-pregnant women and in men. Primary tocophobia may have its onset in adolescence, affecting nulliparous women to such degree that some women never bear a child. They also describe sexual dysfunction as vaginismus and non-consummation. Secondary tocophobia may be associated with a previous traumatic birth experience such as stillbirth. Tocophobia is not just associated with antenatal psychological morbidity, but also raised rates of postnatal depression, impact on the mental well-being of the baby for life, increased length of labour, lower birth weights and increased prevalence (8%) of admission to neonatal intensive care. They can have feelings of isolation, guilt and shame, difficulties to prepare for birth. They may have sleeplessness, nightmares, stomachaches and depression with anxiety that can leads to panic attacks. Women may also be concerned with pain, their own incapability, possible obstetric injuries, lack of control, lack of partner or family support, and loss of their baby. The interventions included psychosexual education, cognitive behavioural sex therapy. Therapeutic interventions reduce the number of women who go on to have caesarean birth. Tocophobia is a common condition with both acute and chronic implications for the welfare of mothers and babies. It can cause not only mental but also physical morbidity and needs a clear both plan for the care of women and her specific fears.

Objective
Couple has started with couple sex therapy for his problems with erection before they have children. They are married; they have already two children (5y, 3y). She has recently discovered that she is pregnant for the third time and she is in gestational week 8. As nulliparous woman, she has developed sever tocophobia. She has intensive therapy with clinical psychologist through all first pregnancy time, but she still developed minor postpartum depression but without any need for antidepressants.

Methods
We present a case of a 40-years old woman with sever tocophobia and the results of the treatment interventions.

Results
Treatments include sensitive psychosexual education about the birth process, development of problem-solving skills, teaching coping strategies for labour.

Conclusions
Tocophobia is a common condition with both acute and chronic implications for the welfare of mothers and babies. It can cause not only mental but also physical morbidity and needs a clear both plan for the care of women and her specific fears.

Disclosure
Work supported by industry: no.
268 Vaginal Non-Ablative Er:YAG Laser Sexual Dysfunction Therapy in Women with Interstitial Cystitis/Bladder Pain Syndrome: A Case Series
Authors: Okui N , Gambacciani M , Okui M , Vizintin Z 
Published: May 2022

ABSTRACT

Introduction
Interstitial cystitis/bladder pain syndrome (IC/BPS) is a chronic debilitating disease characterized by urinary frequency, urgency, and pelvic pain. Different studies have evaluated sexual well-being and e female sexual dysfunction (FSD) in IC/BPS patients. FSD in women with IC/BPS consists of dyspareunia, altered sexual desire, reduced orgasm frequency and vaginal insufficient lubrication. Recently, it has been repeatedly demonstrated that vaginal non-ablative erbium YAG laser (VEL) therapy can improve objective and subjective symptoms in different conditions. In our experience, VEL was very effective in various indications (stress urinary incontinence, mixed urinary incontinence, overactive bladder, genitourinary syndrome of menopause and FSD). In this study we evaluated the effects of VEL on FSD in women suffering from IC/BPS.

Materials and methods
This is case series study in which women with IC/BPS were also reporting FSD. The patients were treated with VEL with protocol in which the laser firstly irradiated the whole anterior vaginal wall and then also the entire vaginal canal. Local topical anesthesia was applied to the vagina before the laser irradiation. The therapy consisted in 1 treatment every 30 days, for 3 months. For the assessment of treatment effects we evaluated the personal history including: age at onset of IC/BPS and FSD, type of IC/BPS, bladder IC/BPS surgeries, the numeric rating scale-11 (NRS-11), O'Leary-Sant interstitial cystitis symptom and problem indexes (ICSI and ICPI), functional bladder capacity, daily urinary frequency, female sexual function index (FSFI) and vaginal health index score (VHIS). Follow-up was done 6 months from the first laser session. Potential adverse effects were observed at every visit as well as at 6 months follow-up.

Results
Six women were treated with the three sessions of VEL and followed for 6 months. The FSFI and VHIS significantly improved in all patients. The NRS-11 scores and the part of pain question of ICSI and ICPI improved as well. The bladder capacity and daily urinary frequency showed a marginal improvement. The therapy effects lasted for 6 months from the first treatment. All observed adverse effects were mild and transient.

Conclusion
Women suffering from IC/BPS have often impaired sexual life. Our data suggest that, besides being safe, VEL treatment can improve sexual life reducing also pain symptoms in IC/BPS patients. Further larger studies are needed in order to ascertain the relations between vaginal conditions and bladder pain, evaluating the possible role of VEL as a new approach for the treatment of FSD in IC/BPS women.

Disclosure
Work supported by industry: no.