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.

Study on Female Sexual Dysfunction in Type 2 Diabetic Chinese Women

Abstract Objective To investigate the female sexual dysfunction （FSD） in type 2 diabetes patients, by comparing the sexual function between type 2 diabetic women and non-diabetic women with Female Sexual Function Index （FSFI）. Methods 215 type 2 diabetic women and 107 age-matched non-diabetes women were enrolled with similar backgrounds. Their sexual functions were evaluated with FSFI. Metabolic parameters such as body mass index, blood lipid profile, hemoglobin AlC, plasma glucose were also collected. Results Total score of FSFI of the type 2 diabetic women were significantly lower than that of the non-diabetic controls （18.27±8.96 vs. 23.02±5.78, P=0.000）. Scores of the FSFI domains （desire, arousal, lubrication, orgasm, satisfaction, pain） of the type 2 diabetic group were also lower than those of the control group. According to the FSD criterion （FSFI〈25） available in China, the percentage of FSD in the type 2 diabetic group was significantly higher than that of the control group （79.2% vs. 55.0%, P〈0.001）. These trends seemed more prominent in pre-menopause subgroups. The logistic regression analysis indicated that age and diabetes were independent risk factors of FSD. Body Mass Index （BMI） also had influence in the diabetes group. Conclusion Findings from this study showed that there are more FDS in Chinese type 2 diabetic women than in their non-diabetic counterparts, especially in pre-menopause participants.

How to recognize late-onset hypogonadism in men wit sexual dysfunction

Late-onset hypogonadism （LOH） has been considered the most common form of male hypogonadism with a prevalence of approximately 1 in 100 men. Diagnosis of LOH should be made in symptomatic men with unequivocally low serum testosterone （T） levels. However, its clinical presentation is often insidious and difficult to recognize because it is characterized by nonspecific symptoms that make differential diagnosis with physiological ageing problematic. Sexual dysfunction is the most important determinant for medical consultation and the most specific symptom associated with low T. We therefore analysed a consecutive series of 1734 subjects who attended our unit for sexual dysfunction to investigate the associations between low T （different thresholds）, sexual parameters, medical history data （delayed puberty, pituitary disease or cryptorchidism） and their physical exam results. Metabolic parameters, in particular waist circumference, display the greatest accuracy in detecting low T. We found that only the association of several symptoms and signs could significantly raise the clinical suspicion of low T. Structured inventories, which cluster together symptoms and signs of hypogonadism, can help clinicians suspect androgen deficiency. In particular, structured interviews, such as ANDROTEST, have been demonstrated to have a greater accuracy when compared to self reported questionnaires in detecting low T levels.

Multiple sclerosis and sexual dysfunction

Multiple sclerosis （MS） is a chronic inflammatory demyelinating disorder of the central nervous system characterized by episodic and progressive neurologic dysfunction resulting from inflammatory and autoimmune reactions. The underlying pathogenesis of MS remains largely unclear. However, it is currently accepted as a T cell-mediated autoimmune disease. Among other clinical manifestations, sexual dysfunction （SD） is a painful but still underreported and underdiagnosed symptom of the disorder. SD in MS patients may result from a complex set of conditions and may be associated with multiple anatomic, physiologic, biologic, medical and psychological factors. SD arises primarily from lesions affecting the neural pathways involved in physiologic function. In addition, psychological factors, the side effects of medications and physical symptoms such as fatigue, muscular weakness, menstrual changes, pain and concerns about bladder and bowel incontinence may also be involved. Since MS primarily affects young people, SD secondary to MS may have a great impact on quality of life. Thus, maintaining a healthy sexual life with MS is an important priority. The treatment of SD requires multidisciDlinarv teamwork and coooeration amone specialists,individual patients, partners and the society.

Sexual Dysfunction among Chinese Nurses:Prevalence and Predictors

This study aimed to estimate the prevalence of and identify the factors influencing female sexual dysfunction （FSD） among Chinese nurses. A cross-sectional survey was conducted from March 2013 to May 2014 among 6 hospitals in Suzhou, China. In total, 2,030 married female nurses were included in the analysis.

Sexual dysfunctions and their treatment in liver diseases

Sexual dysfunction(SD)is a prevalent but very commonly ignored aspect in the treatment of liver diseases and cirrhosis.The etiology of SD is multifactorial and therefore treatment strategies are complex,especially in females.Phosphodiesterase inhibitors are useful and effective in erectile dysfunction in males but in females,no single drug is available for SD,therefore multimodal treatment is required depending upon the cause.The foremost and fundamental requirement in both genders is to be stress-free and have adequate control of liver diseases.Improved quality of life is helpful in improving SD and vice versa is also true.Therefore,patients suffering from liver diseases should come forward and ask for treatment for SD,and physicians should actively enquire about SD while history taking and evaluating these patients.SD results in deterioration of quality of life,and both are modifiable and treatable aspects of liver diseases,which are never addressed actively,due to social taboos and fears of SD treatment in the presence of liver diseases.The diagnosis of SD does not require costly investigations,as the diagnosis can be established based on validated questionnaires available for both genders,therefore detailed targeted history taking using questionnaires is essential.Data are emerging in this area but is still at an early stage.More studies should be dedicated to SD in liver diseases.

Assessment of Female Sexual Dysfunction in Patients with Premenopausal Female Pattern Hair Loss

Introduction: Female sexual dysfunction (FSD) is a serious problem that affects negatively the quality of life, interpersonal relationships and female self- confidence and might be a direct cause of psychopathological disturbances. Female pattern hair loss (FPHL) is a common cosmetically disturbing condition affecting many women with social and psychological consequences. Aim of the Work: Assessment of the relationship between female sexual dysfunction and Female pattern hair loss in premenopausal females. Methods: A case-control study was carried on 47 female patients with FPHL and 43 age- matched control women without FPHL among premenopausal women attending dermatology and Andrology outpatient’s clinics, Suez Canal University hospital during the period from May 2018 to January 2019. History taking, clinical examination and hormonal investigation (Free Testosterone, Total Testosterone, and SHBG) were performed to all participants in the study. Main Outcome Measures: The Female Sexual Function Index (FSFI) was used to assess the key aspects of female sexual function in patients and controls. FPHL was diagnosed and graded by Ludwig’s classification. Results: Mean age of patients group was 30.12 ± 5.49 years, Regarding FPHL grading, 55.3%, 42.6% & 2.1% of patients were grades 1, 2 and 3 Ludwig’s classification respectively. FSD was found in 44.7% of patients while it was 44.2% in control group (P > 0.05). FSFI score in patients group was 26.40 ± 4.61 and in control group was 27.05 ± 3.12 (P > 0.05). Correlation between FSD prevalence and grade of FPHL by Ludwig’s classification was statistically insignificant. FSD was significantly compromised by increasing age and parity in patients and control groups (P < 0.05). Conclusions: The present study suggests that FSD was not significantly related to FPHL. Increased age and parity may have strong impact on sexual function in premenopausal women, while androgen hormones levels were not determinant factor.

Effect of Varicocelectomy on Gonadal Function among Patients Reporting with Sexual Dysfunction in Ghana

Background: Long-standing varicocele is often associated with testicular hypoxia and that might worsen Leydig cell function, a significant risk factor for hypogonadism. This may affect both the secretory and endocrine functions of the testis. This study aims to determine the effect of microsurgical sub-inguinal varicocelectomy on gonadal function among men reporting sexual dysfunction in Ghana. Methods: This was an intervention study conducted at the Tamale Teaching Hospital from September 2017 to August 2021. A total of 103 participants were randomized into two groups;the surgery group (n = 52) and the observed group (n = 51). Venous blood samples were collected at baseline, varicocelectomy was performed for the surgery group, and no intervention was given to the other. Blood samples were subsequently collected at 12-, 24-, 36-, and 48-month intervals for assay of serum total testosterone, FSH, and LH. The data were analyzed in GraphPad Prism (v8.0) at an alpha value of 0.05. Results: All the participants had varicocele and were aged between 55.0 to 69.0 years old. At the baseline of the study, all participants presented with sexual dysfunction but a significant improvement (p Conclusions: Microsurgical sub-inguinal varicocelectomy improved gonadal function among varicocele patients reporting sexual dysfunction. It is recommended to use this choice for similar patients;however, these findings should be verified by a multi-institutional study to provide more evidence for this choice.

Therapeutic Approach in Female Sexual Dysfunctions in an Outpatient Clinic of Sexology in the Public Health System: A Longitudinal and Prospective Study

INTRODUCTION: Sexuality is one of the parameters of quality of life, and it is essential to include care for sexual dysfunctions in primary health care. OBJECTIVE: To evaluate the therapeutic approach in female sexual dysfunction in a public health outpatient clinic. DESIGN: A prospective cohort of women with sexual dysfunctions in an outpatient clinic of sexology in the Public Health System. The Female Sexual Function Index (FSFI) and scored 0 - 10 their sexual satisfaction were applied at the beginning and end of the follow-up. RESULTS: Eighty-nine women were included with a median age of 45 years, 69 (77.5%) had less than 11 years of schooling and 95.5% lived with a partner. The main reasons for referral for follow-up at the outpatient clinic of sexuality were dysfunction of hypoactive sexual desire disorder in 67.4% and pain related to sexual function in 46%. The average number of consultations was five and the main therapeutic interventions were guidance and clarification on sexuality (86.5%), use of topical estrogen (56.2%), and relaxation techniques (37.1%). All FSFI-19 domains had better post-intervention rates (p ≤ 0.005). Considering the domains of the FSFI-19, the medians of desire, arousal, lubrication, orgasm, pleasure and pain were higher in the post-intervention period in relation to the pre-intervention period (p ≤ 0.0001 for all analysis). In addition, the score given by the participant on their sexual satisfaction was higher at the post-intervention time compared to the pre-intervention period (p ≤ 0.0001). CONCLUSION: In public health, even with the care being performed by different professionals in each consultation, we conclude that through simple interventions, it is possible to improve the sexualities of the women attended. Still, offering care in sexuality is fundamental as part of primary health care and the training of medical professionals.

A summary of the pharmacologically tested aphrodisiac plants for sexual dysfunction

Sexual dysfunction is a disruption of normal sexual intercourse and may be a consequence of various organic and psychological disorders. It is the most frequent at patients with cardiovascular and neurological diseases, sedentary lifestyle, arterial hypertension, diabetes, obesity and metabolic syndrome, and may disrupt their emotional life. But, sexual dysfunction may occur simply because of the physical aging of the body. Physiologic changes that occur with aging will aff ect sexual function and could be exacerbated by the above-mentioned diseases. Except for the sexual counseling and standard medications (phosphodiesterase type 5 (PDE5)– inhibitors, local estrogen therapy), some of the herbal medicines (aphrodisiacs) may be helpful in the treatment of these patients making them emotionally younger and happier. In this review, we bring a list of the pharmacologically tested aphrodisiac plants. But, we have a lack of information about their mechanisms of action, drug interaction and safety profi le. Until the relevant information is collected, uses of these products may be risky to the human being and should be prescribed only in consultation with a specialist.

Research progress of male sexual dysfunction following stroke

Stroke is a major disabling and fatal disease worldwide.There are many studies on neurological deficits and cognitive impairment after stroke,but there are few studies on sexual dysfunction,which is an important part of patients'quality of life.Studies have shown that male sexual dysfunction following stroke is very common,such as loss of libido,erectile dysfunction and ejaculatory weakness.Among them,young male stroke patients have particularly high requirements for quality of life and are ashamed to speak when they have secondary dysfunction.Related knowledge and degree of attention of medical staff are also relatively less.The location and area of stroke and the occurrence and development process of the disease may affect the sexual function of patients.Its etiology roughly includes both organic and functional aspects.Further study of post-stroke sexual dysfunction and strengthening the diagnosis and treatment of sexual dysfunction in stroke patients should be included in the category of stroke rehabilitation.

Construction and Initial Structure of Sexual Dysfunctions Tendencies Measure

Disclosure of sexual dysfunctions is difficult due to shame and social stigma.The instruments to measure sexual dysfunctions so far were quite backdated and lengthy.Moreover,there was no specific instrument available that could evaluate all the sexual dysfunctions on the Diagnostic and Statistical Manual of Mental Disorders’criteria in a single scale;separate for men and women.The objective to develop the scale was to provide the non-clinical population with a short and straight-forward measure in English which could help them in deciding about seeking professional help.The constructed scale comprised of 7 items for males and 7 for females and employed 6-points Likert scale for responses.The study involved 79 men and 105 women(N=184;Kaiser-Meyer-Olkin Measure of Sample Adequacy=0.682 for males and 0.618 for females).The inclusion criteria were the practical involvement of the participants in sexual practices and ability to respond to a questionnaire in English.Exploratory Factor Analysis was conducted to measure the reliability and validity of the scale.While employing Principal Component Analysis for extraction and Oblimin with Kaiser Normalization as Rotation,Exploratory Factor Analysis was conducted on 7 items for males and 7 items for females separately.Sampling adequacy was found good and the adequacy of correlations between items and was found highly significant.The Cronbach’s Alpha reliability was satisfactory.4 factors were extracted for males with 78.65%variance explained.3 factors were extracted for females with 66.57%variance explained.The communalities for all the 14 items ranged between 0.554 to 0.937.The study established that Sexual Dysfunctions Tendencies Measure is a valid and reliable tool to measure sexual dysfunctions with the criteria of the Diagnostic and Statistical Manual of Mental Disorders.

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.

Prevalence of Female Sexual Dysfunction among Women with Pelvic Organ Prolapse Diagnosed by Pisq-12 and Related Factors in Hung Vuong Hospital, Vietnam

Pelvic organ prolapsed is a common problem today, and it has been gradually increasing because of the longevity of women. Pelvic organ prolapse can result in negative psychological feelings that affect on women’s sexual activity. Methods: There is a cross-sectional study on sexual dysfunction in 296 women with pelvic organ prolapse grade II and III followed up at gynecological-pelvic floor unit of Hung Vuong hospital from 09/2017 to 06/2018. Results: The prevalence of female sexual dysfunction in PISQ-12 was 76.4% and 95% CI [71.6 - 81.2]. The rate of female sexual dysfunction in turn is: 1) Behavioral-Emotional: 93.6% 95% CI [90.8 - 96.4]. 2) Physiology: 62.2% CI 95% [56.7 - 67.7]. 3) Relationship to partner: 89.5% 95% CI [86.0 - 93.0]. Factor related to sexual dysfunction in women with pelvic organs (p < 0.05) is general sexual dysfunction: 1) Age group: women over age 55 increased generally the risk of sexual dysfunction, OR = 5.89, 95% CI [1.38 - 25.20]. 2) Diabetes mellitus increased the risk of sexual dysfunction with OR = 5.03, 95% CI [1.42 - 17.82]. 3) Patients with previous abortions reduced the risk of sexual dysfunction with OR = 0.49 95% CI [0.27 - 0.90]. Conclusion: Research on quality of life in pelvic organ prolapse should be considered more in the future.

The Use of Natural Products for the Treatment of Female Sexual Dysfunction: A Systematic Review of Randomized Clinical Trials

Female sexual dysfunction (FSD) affects 40% of the world’s females, most of which are disorders linked to desire or interest/excitement. Whilst all types of therapy that attempt to improve female sexual desire have long been established, the results are contradictory. Objective: To analyze all available evidence to validate the effectiveness of natural therapies in the treatment of FSD. Method: The study was registered at http://www.prospero.org (CRD42019127700). We searched the Institute for Scientific Information Web of Knowledge, MEDLINE, Pubmed, Scopus and Cochrane databases for all articles published in peer- reviewed journals in April 2019 (in any language). The PICOS standard is women with FSD;(intervention) of any type of Natural therapy;(outcome) primary outcome: frequency of changes, severity, and average mean scores on sexual symptoms measured with a validated instrument, secondary outcome: quality of life;(study design) and randomized clinical trial (RCT). Results: The literature search strategy identified 95 articles, 81 of which were excluded at the different search stages. Finally, we systematically reviewed 15 RCTs, 11 of which referred to primary FSD, and four of which analyzed women with drug-induced FSD (DFSD). Most of them analyzed hypoactive sexual desire disorder. Although differences related to placebo were found in most people, the majority of the studies are considered to be of poor quality and low external effectiveness. Conclusion: Although the quality of the evidence is not high, most natural product interventions appear to improve FSD, particularly hypoactive sexual desire disorders including those categorized as primary and drug-induced.

The Metabolic Syndrome and Sexual Dysfunction in a State of Inflammation

Background: Diabetes is amongst the most researched diseases worldwide due to its debilitating effects on patients. Diabetics have a higher risk of developing erectile dysfunction. Evidence has linked erectile dysfunction severity to increased age, duration of diabetes, the metabolic syndrome and hypogonadism. However, the role of inflammatory markers in the pathogenesis of SD is still unclear. The contributions of hormonal parameters and adipokines to both macro and micro vascular complications are still poorly understood. This study was conducted to provide some evidence of an association between SD, the metabolic syndrome and inflammatory hormones. Method: A total of 130 diabetic males participated in this study. All participants were at least 18 years and were actively engaged in a stable heterosexual relationship for a minimum of two years before they were recruited for this study. The Diabetic men were evaluated using the Golombok Rust Inventory of Sexual Satisfaction for males (GRISS-M). The NCEP-ATP III, IDF and WHO criteria were used to assess the metabolic syndrome. Blood samples were taken for biochemical and hormonal assays. Results: Participants with raised Triglyceride levels showed significantly higher leptin levels for NCEP-ATP III and IDF criteria. Participants with impotence showed significantly lower leptin/adiponectin ratio (p = 0.0184) whilst participant with non-sensuality showed significantly higher values of leptin/adiponectin ratio (p = 0.0103). A significantly higher levels of insulin (p = 0.0265) was recorded in participants with Dissatisfaction problems. Participants with Non communication problems showed significantly higher levels of insulin (p = 0.0419) and lower levels of adiponectin (p = 0.0438) whilst participants with infrequency showed significantly lower levels of adiponectin (p = 0.0042). Conclusion: The relative balance between pro inflammatory and anti-inflammatory mediators of endothelial dysfunction could possibly be essential for the progression of diabetes to SD and the MetS thus a longitudinal study which measures a range of both pro and anti-inflammatory hormones and adipokines as risk factors for SD and the MetS could potentially aid in improvements in assessing the risk of developing these conditions among diabetics.

Female Sexual Dysfunction among Chinese Primiparous Women

Objective: To compare sexual function between primiparous women who underwent cesarean section (CS) and those who delivered vaginally. Methods: This cross-sectional study was conducted from October 2011 to April 2012 in Beijing, China. The target population included women aged 18 - 45 years who had given birth only once at least 6 months prior. The questionnaire was self-administered including female sexual function measured using the Female Sexual Function Index (FSFI). Data were analyzed using R software with the significance level of 0.05. Results: A total of 1456 participants were included and 102 women (7.0%) declined. The median age of the participants was 35 years. The median time interval after childbirth was 6 years. The median FSFI score was 26.9 and prevalence of female sexual dysfunction (FSD) was 34.2%. Both the FSFI scores and the proportions of individuals with sexual disorders were similar between women undergoing CS and those having vaginal delivery for both individual domains and the full scale. Conclusion: There were insignificant differences in female sexual function scores and FSD prevalence between women undergoing CS versus vaginal delivery.

Female Sexual Dysfunction in Elfayoum Governorate

Introduction: female sexual dysfunction (FSD) is a complex and poorly understood condition that affects females of all ages. Female sexual dysfunction has been a cyclic rather than a linear process that emphasizes biologic, psychological, social, hormonal, and environmental factors. Female sexual dysfunction is a high prevalent disorder reaching up to 60% of females with reported higher levels in postmenopausal. Aim of the work: was to estimate prevalence of FSD and its related factors in Elfayoum city. Subject and Method: This study was a cross sectional descriptive study conducted in Elfayoum city included 508 married females (above 21 years old) during the period from September 2016 to March 2017. Results: The prevalence of FSD among studied group was 61.2% versus 38.8% had normal sexual function, desire dysfunction was 42.3%, arousal dysfunction was 39.2%, lubrication dysfunction was 25%, orgasm dysfunction was 58.5%, satisfaction dysfunction was 58.1% and pain was 43.3%. There was statistically significant negative correlation between Female Sexual Function Index (FSFI) score and each of female and husband age, duration of marriage, and number of children. Low mean of FSFI score was found among females with irregular menstrual cycle, using contraceptive, not pregnant, mutilated and females who’s their husband had erectile or ejaculation disorders. Conclusion and recommendation: High prevalence of FSD among females in Elfayoum governorate. Many factors are found to affect FSD as FGM, each of female and husband age, duration of marriage, and number of children.

Prospective randomized study to evaluate and compare the post-procedural sexual function in patients undergoing semi-rigid ureterorenoscopy for distal ureteric stones in three different operating room settings

Objective:To evaluate and compare the effect of semi-rigid ureterorenoscopy on post-procedural sexual function with three different operating room settings.Methods:In this prospective randomized study,consecutive sexually active patients with normal pre-operative sexual function undergoing uncomplicated semi-rigid ureterorenoscopy for distal ureteric stones were randomized into three groups,with three different operating room settings.Procedure-related anxiety and sexual function were assessed pre-operatively using Amsterdam Preoperative Anxiety and Information Scale and Brief Sexual Function Inventory(in males)and Female Sexual Function Index-6(in females),respectively.All the participants were stented following the procedure,and the stent was removed after 3 weeks.Post-procedural sexual function and general discomfort were assessed and compared between three groups at 1 week,3 weeks,and 12 weeks.The effect of surgery-related anxiety,preoperative sexual function,age,and general discomfort(including stent-related discomfort)on post-procedural sexual function were analyzed using multiple regression analysis.A p-value of less than 0.05 was considered statistically significant.Results:Totally,327 eligible patients were randomized into three groups.The group of patients who underwent the procedural with a screen separating the operating area from the patient vision,while the patient could watch the endoscopy through a separate monitor,had better post-procedural sexual function compared to those who had total vision of the operating area as well as to those whose eyes were blocked.This difference was statistically significant.This post-procedural reduction in sexual function could not be attributed to in situ stent alone.Conclusions:Our study showed that semi-rigid ureterorenoscopy can have significant negative effect on sexual function,which can be reduced with proper preoperative counseling and an ideal operating room settings.

Efficacy of tadalafil on improvement of men with erectile dysfunction caused by COVID-19:A randomized placebo-controlled trial

Objective: According to the high prevalence of COVID-19 and the subsequent risk of men's sexual health, we decided to investigate the efficacy of tadalafil on improvement of men with erectile dysfunction caused by COVID-19.Methods: In this study, 70 outpatients who were recovered from COVID-19 without acute respiratory distress syndrome with negative polymerase chain reaction test and a complaint of erectile dysfunction were divided into two groups: 35 patients who received tadalafil 5 mg daily and 35 who received placebo. For each patient, basic assessment of sexual function was performed using the 5-item version of the International Index of Erectile Function (IIEF-5) questionnaire. Then, treatment was started from 2 months after complete recovery of COVID-19 with negative polymerase chain reaction test for 3 months. At the end of the treatments, the patients were re-evaluated for sexual function using the complete version of IIEF questionnaire. Finally, the results before and after treatment in the intervention group were compared with those of the control group.Results: Treatment with both tadalafil and placebo improved the patients' sexual function criteria compared to the baseline. However, this improvement was significantly higher in the intervention group with tadalafil than the control group with placebo (p<0.05).Conclusion: Daily administration of tadalafil 5 mg seems to be effective and safe for improvement of erectile dysfunction caused by COVID-19.