Epidemiology of Male Sexual Dysfunction (MSD) in Patients Consulting in Some Health Services in the City of Douala, Cameroon

Sexual dysfunction is a group of diseases, disorders or difficulties experienced by men or women during any stage of normal sexual activity. In Africa in general and Cameroon in particular, statistical data concerning the prevelance and the main causes of male sexual dysfunction are rare due to socio-cultural and religious burdens and sometimes self-medication. The objective of this work was to determine the prevalences, comorbidities and the risk factors of the main sexual dysfunction in some hospitals in city of Douala. Through a descriptive retrospective study carried out from Novembre 2019 to June 2021, sociodemographic parameter, reasons of consultation, risk factors and type of male sexual dysfunction (erectile dysfunction or erectile dysfunction (ED), ejaculation disorders (EjD), libido disorders (LD) and disorders of sexual activity with pain or painful sexual intercourse (PSI)) were collected in the medical files of patients who have made urological consultation between 2016 and 2020 at the Deido District hospital, Laquintinie Douala Hospital and Douala General hospital respectively. At the end of our data collection, out of a total of 24995 consultations, 2743 (10.98%) patients were suffering from at least one male sexual dysfunction. Moreover, sexual disorders were the 2nd reason of urological consultation (13.69%) after urinary disorders (33.85%). Among sexual disorders, erectile (76%) and ejaculatory (20%) disorders were the predominant pathologies recorded with the prevalences of 9.79 et 2.62% respectively, and were mostly represented in patients from [41 - 50] for erectile dysfunction, and [18 - 30] years old for ejaculative dysfunction. In addition, the number of patients with ejaculatory and erectile dysfunctions was more important in patients from [18 - 30] and [31 - 40] years old respectively. Among patients presenting sexual disorders, several risk factors or pathologies were associated with the dysfunction: benign prostatic hyperplasia and metabolic syndrome (in patients over 50 years old);psychosocial problems, infections, and alcohol (in patients under 50 years old). These findings could be useful in the elaboration of therapeutic strategies for the management of the Cameroonian population suffering from sexual dysfunctions.

Developmental assets and age of first sexual intercourse among adolescent African American males in Mobile, Alabama

Background and Aims: Younger age at first sexual intercourse is associated with a variety of adverse health outcomes. We aimed to gain a clearer understanding of a wide range of individual, family and social factors that may influence sexual behavior of children and adolescents. Specifically, we examined the relationships of developmental assets with age of first sexual intercourse among a large sample (n = 1061) of adolescent African American males living in low-income neighborhoods in Mobile, Alabama. Methods: Using the Developmental Asset Model as a theoretical guide, we selected variables from adolescent survey data and conducted logistic regression analysis to determine predictors of early age of first sexual intercourse. Results: Nearly one half (49%) of the male survey participants reported that they first had sexual intercourse at the age of 12 or younger. The total number of assets was the strongest predictor of later age (13 years old or later) of first sexual intercourse (OR 1.49, 95% CI = 1.09, 2.04), followed by decision-making skills (OR 1.40, 95% CI = 1.04, 1.86), and positive view of the future (OR 1.36, 95% CI = 1.02, 1.74). Conclusion: There are several developmental assets related to the age of first sexual intercourse. This study found support for the Developmental Asset Model as a framework for promoting sexual and overall adolescent health. Recommendations for asset-building among this population are discussed.

Evaluation of the Functionality of the Networking of Sexual and Reproductive Health Rights Services in the Event of Gender-Based Violence in the Commune of Kpomasse in 2022

Introduction: In developing countries, gender-based violence (GBV) is a real public health problem. In Benin, GBV affects the majority of women and girls (69%). Benin has implemented strategies and set up integrated centers for the management of violence in order to reduce cases of violence and ensure the holistic management of victims. The objective of our study was to assess the functionality of the network of sexual and reproductive health rights (SRHR) in case of GBV in the commune of Kpomasse in 2022. Method: This descriptive and evaluative study was conducted from March 21 to April 11, 2022. The sampling method used was non-probabilistic. Reasoned choice and convenience were the techniques used for the different targets of the study. The functionality of the SRHR service network was assessed first by calculating scores at the structure, process and outcome levels, and then by analysis using the human rights-based approach. Results: Out of the 34 GBV victims identified, only one had received a full response and 54% of the victims had no knowledge of SRHR. The lack of knowledge about health care facilities was 41% for victims and 80% for non-victims in the community who participated in the study. In the case of gender-based violence, the community preferred to settle out of court rather than report it. The functionality of the networking of sexual and reproductive health rights services in the event of the occurrence of gender-based violence in the commune of Kpomassè is insufficient. Lack of knowledge of the roles of rights holders (DD) and duty bearers (DO) explains the insufficient functionality of networking. Conclusion: Training of SRHR service agents and community sensitization are essential to improve the functionality of SRHR service networking in the commune of Kpomasse.

Determination of Liability for Violation of “Sexual Autonomy” and Compensation for Mental Damages

At the legislative level in China,there has been insufficient theoretical preparation to explicitly include“sexual autonomy”within the scope of general personality rights.In handling the increasing number of disputes related to violations of“sexual autonomy,”judicial biases have emerged during the trial process when courts determine the attribute of the right to“sexual autonomy.”This situation necessitates a clear legal analysis of the concept and attributes of“sexual autonomy”to establish its essential attribute as a personality right,and,from the perspective of legal doctrine,enable the justification of the right to“sexual autonomy”as either a general personality right or other personality interests,thereby providing theoretical support for courts to“adjudicate according to law.”By delineating and categorizing instances of violations of“sexual autonomy,”the constitutive elements and fundamental characteristics of such violations can be clarified.By examining the legal norms governing civil litigation and civil litigation associated with criminal cases concerning violations of“sexual autonomy,”the responsibility determination,remedies,and existing regulatory loopholes regarding violations of“sexual autonomy,”especially in cases involving both criminal and civil matters,can be defined.Based on this foundation,the legal basis,determination mechanism,and compensation standards for claiming compensation for mental damages resulting from violations of“sexual autonomy”can be elucidated.

Setting Regional Research Priorities for Sexual and Reproductive Health and Rights Services in Humanitarian Settings

Background: Despite increased recognition of the need for sexual and reproductive health and rights in humanitarian settings, evidence focusing on mainstreaming reproductive health services such as maternal, neonatal mortality, human immunodeficiency virus transmission and unsafe abortion still remains inadequate. The ability to understand the magnitude of the needs and highlight existing gaps is supported by improved data which is critical to informing effective policies, programming and funding decisions. The purpose of this report is to present the results of a research prioritization exercise on sexual and reproductive health and rights services in humanitarian settings for the WHO Africa region for the next three years. Methods: We adapted the Child Health and Nutrition Research Initiative method in three phases. Experts from the region participated in an online survey to identify key areas for research in sexual and reproductive health and rights. To identify potential areas for research, the experts ensured answerability, effectiveness, deliverability, equity and potential impact of the questions. The research areas they identified were reviewed by World Health Organization technical team from headquarters. In a meeting of 67 participants, the questions were subjected to further review and analysis. Using a modified for scoring criteria, the questions were scored and ranked to provide the top ten priority questions to address sexual and reproductive health and rights services in humanitarian settings. Results: A list of 21 priority research questions on sexual and reproductive health and rights services in humanitarian settings were scored and ranked. Top ten priorities research questions were identified. Those that scored highly by scoring 30 points out of the possible maximum of 30 include: “determining the prevalence and associated factors of unwanted pregnancies and abortions performed in emergency and humanitarian settings”, “evidence on gender-based violence in humanitarian situations and its associated factors” and “defining an optimal model for coordinating sexual and reproductive health and rights interventions and responses in crisis situations”. Conclusions: Top ten research priorities in sexual and reproductive health and rights services in humanitarian settings were identified. The priority research areas have the potential to identify the best areas for programming of services in humanitarian settings. It is our hope that the identified research areas will be prioritized to support programming of services in humanitarian settings based on scientific evidence.

Research Priorities for mHealth and Innovative Strategies in Sexual and Reproductive Health and Rights in the WHO Africa Region

Background: The use of mobile phones continues to rise rapidly in the provision of health related services. Many countries have adopted the use of mobiles to provide sexual and reproductive health and rights and especially among the adolescents where specific messages are tailored for various audiences with specific messages. The purpose of this paper is to present the results of a research priority setting exercise on mHealth and innovative strategies. Methods: We adapted Child Health and Nutrition Research Initiative methodology to identify and set research priorities on mHealth and innovative strategies that respond to sexual and reproductive health and rights services. General potential research questions were gathered online from multiple stakeholders in the region and sent for consolidation consolidated to technical experts in World Health Organization headquarters. The second phase involved a meeting with experts to review and thematically analyze the questions list of 33 questions producing a list of 22 research questions. The questions were scored against a six point criteria and ranked accordingly. Ten top priority research questions were identified. Results: Lists of 33 priority research questions for mHealth and innovative strategies were proposed for discussions by 67 stakeholders. The questions were reviewed, scored and ranked in a technical meeting by experts. The highest ranking questions at 87% include evaluation of mHealth for data management and sexual and reproductive health and rights decision making, assessment of innovative local financing techniques to support community based sexual reproductive health and rights and evaluation of the role of mobile technologies in referral and counter referral. Conclusions: Information and communication technology is developing drastically and has a great potential in improving health especially in sexual and reproductive health and rights service delivery. This potential must be demonstrated with more relevant and quality research on mHealth and innovative strategies priorities identified.

The WHO African Region: Research Priorities on Sexual and Reproductive Health and Rights

Background: Many policy makers deliberating on comprehensive sexual and reproductive health and rights services need reliable evidence to make choices that benefit women, adolescents, children and the wider society. While universal health coverage discourse provides an opportunity to expand access through evidence based interventions, many gaps exist. Research prioritization has proved to be very helpful in identifying relevant areas especially in constrained resource settings. The purpose of this paper is to present the results of the World Health Organization Africa Region research prioritization for sexual and reproductive health and rights. These priorities hope to guide the region for the next three years. Methods: We used the Child Health and Nutrition Research Initiative approach to identify priority questions among many potential areas for research prioritization on sexual and reproductive health and rights. The implementation process was organized in three phases. The first phase involved sending out an online survey to various experts with experience in sexual and reproductive health rights. These questions were received by a technical team from World Health Organization headquarters for review. 634 questions were identified for potential research and grouped into 12 themes. The second phase involved experts who reviewed the questions. The team merged questions with duplications, removed the questions that were out of scope and finally refined the wordings. In the final phase, experts worked in groups to score and rank top ten priority questions for each of the 12 thematic areas. Results: A list of 120 priority questions for sexual and reproductive health and rights were prioritized by 67 participants drawn from 16 organizations. Most of the priority research questions (45%) focused on the theme of gender-based violence, 35% prioritized services in sexual and reproductive health and rights in humanitarian settings while 15% prioritized preventing unsafe abortion. 5% of the participants prioritized cervical cancer prevalence, prevention and treatment as a thematic area out of the questions in the top 20 research priority questions. Conclusions: Key priority research questions in sexual and reproductive health and rights were identified around five themes. The priority list will be of significance to World Health Organization regional Office for Africa and her stakeholders for the next three years.

Seasonal variation and synchronization of sexual behaviors in free-ranging male Tibetan macaques (Macaca thibetana) at Huangshan, China

Although seasonal breeding has been documented in many non-human primates, it is not clear whether sexual behaviors show seasonal variation among male individuals. To test this hypothesis, the focal animal sampling method and continuous recording were used to investigate seasonal variation and synchronization of sexual behaviors in five male Tibetan macaques （Macaca thibetana） at Mt. Huangshan from Oct 2005 to Sept 2006. Both copulatory and sexually motivated behaviors （i.e., sexual chase, grimace, and sexual-inspection）, which were significantly higher in the mating season than non-mating season. Furthermore, seasonal variations of sexual behaviors, including copulatory and sexually motivated behaviors, were synchronized among males. The results shed light on sexual competition and tactics for reproductive success of male M. thibetana and other non-human primates with seasonal breeding.

Estrogens in males: what have we learned in the last 10 years?

This review focuses on the role of estrogen in men, mainly in male reproduction. The continuing increase in data obtained, and recent discoveries in this area will enable a better understanding of male physiology; these, in turn, will have important clinical implications.

Effects of circumcision on male sexual functions： systematic review and meta-analysis

This meta-analysis was performed to assess sexual functions following adult male circumcision. We searched the Cochrane Central Register of Controlled Trials, PUBMED, EMBASE, the Cochrane Database of Systematic Review and Web of Science from their inception until January 2013 to identify all eligible studies that reported on men＇s sexual function after circumcision. The Cochrane Collaboration＇s RevMan 5.2 software was employed for data analysis, and the fixed or the random effect model was selected depending on the proportion of heterogeneity. We identified 10 studies, which described a total of 9317 circumcised and 9423 uncircumcised men who were evaluated for the association of circumcision with male sexual function. There were no significant differences in sexual desire （odds ratio （OR）： 0.99; 95% confidence interval （CI）： 0.92-1.06）, dyspareunia （OR： 1.12; 95% Ch 0.52-2.44）, premature ejaculation （OR. 1.13; 95% Ch 0.83-1.54）, ejaculation latency time （OR： 1.33; 95% Ch 0.69-1.97）, erectile dysfunctions （OR： 0.90; 95% Ch 0.65-1.25） and orgasm difficulties （OR： 0.97; 95% Ch 0.83-1.13）. These findings suggest that circumcision is unlikely to adversely affect male sexual functions. However, these results should be evaluated in light of the low quality of the existing evidence and the significant heterogeneity across the various studies. Well-designed and prospective studies are required for a further understanding of this topic.

Effects of Terminalia catappa seeds on sexual behaviour and fertility of male rats

Aim: To evaluate the aphrodisiac potential of Terminalia catappa Linn. seeds using a suspension of its kernel (SS)in 1% methyl cellulose in rats. Methods: Male rots were orally treated with 1500 mg/kg or 3000 mg/kg SS or ve-hicle, and their sexual behaviour was monitored 3 h later using a receptive female. Another group of rats was orallytreated with either 3000 mg/kg SS or vehicle for 7 consecutive days. Their sexual behaviour and fertility were evaluatedon days 1, 4 and 7 of treatment and day 7 post-treatment by pairing overnight with a pro-oestrous female. Results:The 1500 mg/kg dose, had a marked aphrodisiac action (prolongation of ejaculation latency) but no effect on libido(% mounting, % intromission and % ejaculation), sexual vigour (mounting-and-intromission frequency), or sexualperformance (intercopulatory interval). In contrast, the higher dose (3000 mg/kg) reversibly inhibited all the para?e-ten of sexual behaviour other than mounting-and-intromission frequency and copulatory efficiency. The effects of highdose SS were not due to general toxicity, liver toxicity, haemotoxicity, stress, muscle deficiency, muscle incoordina-fion, analgesia, hypoglycaemia or reduction in blood testosterone level. They were due to marked sedation. Conclu-sion: The kernel of T. catappa seeds has aphrodisiac activity and may be useful in the treatment of certain forms ofsexual inadequacies, such as premature ejaculation.

Evaluation of Male Sexual Dysfunction Associated with Laparoscopic versus Open Resection in Rectal Cancer in Different Age Groups

Background and goals Sexual dysfunction is a well-documented complication of rectal cancer surgery, with a reported incidence of 18% - 59%. The objective of this study is to evaluate the incidence of sexual dysfunction (SD) in males after radical resection for rectal cancer and to compare the outcome of open versus laparoscopic rectal resection for different age groups. Patients and methods This prospective randomized study assessed outcomes in male patients that underwent rectal resection for rectal cancer from January 2012 until March 2015 at two large tertiary hospitals in Cairo, Egypt. The patients were randomly allocated into two groups (laparoscopic and open technique) of 40 patients each using the odd number policy for patient allocation. Patients included in each group were further subdivided into two groups according to the type of rectal resection either anterior resection (AR) or abdominoperineal resection (APR). Erectile function was evaluated preoperatively and postoperatively at 3 and 6 months using the International Index of Erectile Function (IIEF) questionnaire. Results There was no significant difference between the laparoscopic and open total mesorectal excision (TME) groups when comparing IIEF score preoperatively. At 3 months postoperatively, the laparoscopic arm showed better results over the open arm (abnormal IIEF in 57.5% vs. 67.5%). The study demonstrated dramatic improvement in SD in both groups at 6 months postoperatively (abnormal IIEF score of 40% in the laparoscopic vs. 42.5% in the open arm) with no significant difference in IIEF score between the two groups (p-value 0.876). At 3 and 6 months postoperatively, younger patients showed significant improvement in SD compared to older patients in both groups with more significant improvement in the laparoscopic group (16.7% vs. 40%). Patients with APR show more SD compared with AR patients whether laparoscopic or open as seen by the abnormal IIEF scores for the the two groups [the laparoscopic group APR patients showed 62.5% abnormal IIEF at 3 months that decreased to 50% after 6 months compared to 56.3% and 37.5% at 3 and 6 months respectively for lap. AR patients, and in the open group APR patients also showed higher abnormal IIEF of 71.4% and improved to 42.9% at 3 and 6 months respectively compared to 66.7% and 42.3% at 3 and 6 months respectively for open AR), which shows that APR whether laparoscopic or open causes more sexual dysfunction than AR. Conclusion In this randomized prospective study, there was no significant difference between the laparoscopic and open TME when we compared IIEF scores. In patients younger than 30 years, the significant improvement in the laparoscopic arm adds to the favorable outcome of laparoscopic TME as regards postoperative complications, postoperative pain, hospital stay, the return of bowel functions and cosmetic results.

Effect of Withania somnifera root extract on the sexual behaviour of male rats

Aim: To determine the effect of a methanolic extract of Withania somnifera (L.) Dunal roots on sexual competence of male rats. Methods: Male rats were orally administered 3000 mg'kg^1.day^1 of root extract for 7 days. Their sexual behaviour was evaluated 7 days prior to treatment, day 3 and 7 of treatment, and day 7, 14 and 30 posttreatment by pairing each male with a receptive female. Results: The root extract induced a marked impairment in libido, sexual performance, sexual vigour, and penile erectile dysfunction. These effects were partly reversible on cessation of treatment. These antimasculine effects are not due to changes in testosterone levels or toxicity but may be attributed to hyperprolactinemic, GABAergic, serotonergic or sedative activities of the extract. Conclusion: Use of W. somnifera roots may be detrimental to male sexual competence. (Asian J Androl 2002 Dec;4: 295-298)

Case of Fitz-Hugh-Curtis syndrome in male without presentation of sexually transmitted disease

Fitz-Hugh-Curtis syndrome is a type of perihepatitis that causes liver capsular infection without infecting the hepatic parenchyma or pelvis. Fitz-Hugh-Curtis syndrome is known to occur commonly in women of childbearing age who do not use oral contraceptives and have sexual partners older than 25 years of age. However, the syndrome has been reported to occur rarely in males. The clinical symptoms are right upper quadrant pain and tenderness, and pleuritic right sided chest pain. The clinical presentation is similar in male and female. We experienced a case of Fitz-HughCurtis syndrome in a 60-year-old man with the chief complaint of right upper quadrant abdominal pain. Despite a previous history of gonorrhea, we have also described our experiences of improved symptoms and recovery with allopathic medicines and have thereby reported the present case with a literature review.

Brain activation patterns associated with sexual orientation in homosexual male and female: a case study with 3.0T fMRI

This study was performed to clarify the sexual orien-tation in a 19-year-old homosexual male and a 20-year-old homosexual female by using a functional magnetic resonance imaging (fMRI) with viewing male and female erotic nude pictures. The sex hor-mone levels of the homosexual male and female were in the normal range of healthy heterosexual males and females, respectively. In both homosexuals more significant brain activities were observed while view-ing the nude pictures of the same genetic sex than those of the opposite sex in the frontal cortex, parietal cortex, occipital cortex, anterior cingulate gyrus, amygdala, midbrain, hippocampus, orbitofrontal cortex, parahippocampal gyrus, thalamus, globus pallidus, and putamen, which are known to be re-sponsive to sexual arousal. The homosexual male and female showed a tendency toward higher sexual arousal to the same genetic sex as comparison with the opposite sex. This finding may be useful to un-derstand the different neural mechanisms on sexual arousal in homosexuals.

Coevolution of Male and Female Response Preferences to Sexual Signals in Music Frogs

Male signaling influences both female choice and male-male competition. Although male signaling characteristics and female preferences have been shown to coevolve in many species, few studies have examined whether male signal characteristics and male receiver responses related to male-male competition also coevolve. The present study tested the hypothesis that male and female signal receiver preferences may coevolve in parallel for flogs in the genus Babina by comparing the acoustic structure of male advertisement calls of four closely related and geographically isolated Babina species. Then we assessed the behavioral responses of both male and female B. daunchina （Emei music frog） to male call playbacks from each of the four species. The results support the hypothesis that male and female signal receiver preferences have coevolved in this species. Specifically, both male and female B. daunchina respond strongly to the heterospecific calls of B. hainanensis, suggesting that preexisting biases exist in both females and males. Both male and female individuals showed a slight response to the calls of B. adenopleura while no response was evoked by the calls ofB. lini. The manifestation of similar response profiles in male and female B. daunchina to the calls of the four species support the idea that male and female signal receiver preferences evolved in parallel and that the origin of these receiver biases reflects adaptations dependent on the same neural and cognitive systems in both sexes.

Male Blue Gourami (Trichogaster trichopterus) Nest-Building Behavior Is Affected by Other Males and Females

In this study, we examine male blue gourami (Trichogaster trichopterus) nest-building behavior that is affected by other males and interactions under experimental conditions. Males found in the area control the territory and sexual behavior, and are influenced by the behavior of other males. The results of this study show that the sexual behavior (nest-building) of male blue gourami is affected both by the behavior and pheromones of other males. We suggest that males must defend their territories in order to prevent these two factors from interfering in nest-building.

Clinical Observation on Male＇s Sexual Disorder Treated by Acupuncture and Therapeutic Instrument

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Large males have a mating advantage in a species of darter with smaller,allopaternal males Etheostoma olmstedi

Theory suggests that males that are larger than their competitors may have increased mating success, due to both greater competitive ability and increased attractiveness to females. We examined how male mating suceess varies with male size in the tessellated darter Etheostoma olmstedi. Previous work has shown that large males tend to move around and breed in vacant breeding sites, and consequently provide less care for their eggs, while smaller individuals can be allopaternal, caring for the eggs of other males as well as for their own. We studied female egg deposition in a natural breeding population using artificial breeding sites and in the laboratory, where female choice of spawning site was restricted to two breeding sites tended by two males of different sizes. In both the field and the laboratory, nests tended by larger males were more likely to receive new eggs. Additionally, the mean size of males associated with a nest was positively correlated with both the maximum coverage of eggs at the nest and the number of times new eggs were deposited. We discuss how the increased mating success of larger males, despite their decreased parental care, may help explain aUopaternal care in this species [Current Zoology 56 （1）： 1-5, 2010].

Gametogenic Cycle, the Spawning Season, First Sexual Maturity, and the Biological Minimum Size in Male Ruditapes philippinarum （Bivalvia： Veneridae） in Western Korea

The male gametogenic cycle, spawning season, first sexual maturity, and the biological minimum size in male Ruditapes philippinarum were investigated by qualitative and quantitative reproductive analyses. In the study of the male gametogenic cycle by qualitative histological analysis, the gametogenic cycle in male individuals can be classified into five successive stages： （1） early active stage, （2） late active stage, （3） ripe stage, （4） partially spawned stage, and （5） spent and inactive stage. Monthly changes in the gonad index in males measured by qualitative analysis showed a similar pattern to the male gametogenic cycle. In the study of the male gametogenic cycle by quantitative statistical analysis, monthly changes in the portions （%） of areas occupied by the testis areas to total tissue areas showed a rapid increase in March, and reached the maximum in May-June. And also monthly changes in the portions （%） of areas occupied by the spermatogenic stages to the testis area showed a maximum in May and gradually decreased from June to October. Therefore, this species showed a unimodal gametogenic cycle during the year, and the number of spawning seasons occurred once per year, from June to October, with a peak spawning between July and August. The percentage at the first sexual maturity of male clams ranging from 15.1-20.0 mm in shell length was 64.7%, and that of all individuals ranging from over 25.1 mm in shell length was 100%. The biological minimum size （shell lengths at 50% of sexual maturity （RMs0）） of male mature clams that was fitted to an exponential equation was 17.16 mm （considered to be 1 year old）. Because harvesting clams less than 17.16 mm in shell length could potentially cause a drastic reduction in recruitment, a measure indicating a prohibitory fishing size should be enacted for adequate fisheries management.