Effects of oral Shilajit tablets on sexual function and sexual quality of life among reproductive-aged women: a triple-blind randomized clinical trial

Background:Shilajit is mentioned in the“Kama Sutra”as a potent enhancer of sexual desire.This study aimed to investigate the effects of oral Shilajit tablets on sexual function and sexual quality of life among women of reproductive age.Methods:Forty-eight reproductive-aged women participated in a placebo-controlled triple-blind clinical trial.The intervention group took oral Shilajit tablets(200 mg)twice daily for 60 days and the control group took the placebo.Data collection tools were Sexual Quality of Life-Female and Female Sexual Function Index.Data were collected before the intervention,30,60,and 90 days after the start of the study.Results:Forty-three women completed the study.The mean score of total sexual function in the intervention group was significantly higher than before the intervention(P<0.001).The mean score of sexual function was 28.93 after 90 days in the intervention group while it was 22.09 in the control group.This finding was observed in most domains of the sexual function index.The mean score of sexual quality of life increased after 60 days of intervention in both groups;however,the difference was not statistically significant(P=0.094).Conclusion:The study indicated that Shilajit,as a complementary therapy,may improve sexual function and most of its domains;while there was no effect on improving the quality of sexual life.

Sexual function history taking in medicine

Sexual history taking is important for the proper diagnosis and treatment of sexual dysfunction.It is often neglected in a clinical setting and it is also underre-ported by patients due to stigma and hesitation.Here we have described how we should take sexual function history taking during any sexual dysfunction.

Effects of Laparoscopic Pelvic Autonomic Nerve-Preserving Radical Resection of Rectal Cancer on Urinary and Sexual Function

Objective:To investigate and analyze the effect of laparoscopic pelvic autonomic nerve-preserving radical resection of rectal cancer on urinary and sexual function.Methods:Cases of laparoscopic radical resection of rectal cancer in our hospital from April 2018 to April 2023 were selected,and 60 patients who met the requirements were included as research subjects.The patients were divided into an experimental group and a reference group by a double-blind mechanism,with 30 cases in each group.The experimental group underwent laparoscopic pelvic autonomic radical resection,while the reference group underwent ordinary radical resection.The voiding function,urodynamics,sexual function,and blood indexes of the patients of both groups were compared.Results:The total incidence of voiding dysfunction in the experimental group was significantly lower than in the reference group(P<0.05).Urodynamics such as abdominal leak point pressure(ALPP),maximum urethral pressure(MUP),maximum urethral closure pressure(MUCP),and functional urethral length(FUL)in the experimental group were significantly better than those in the reference group(P<0.05).The incidences of erectile dysfunction and ejaculatory dysfunction in the experimental group were significantly lower than those in the reference group(P<0.05).Before the surgery,there were no significant differences in the blood indexes such as C-reactive protein(CRP),cortisol(Cor),and pre-albumin(PA)between the two groups(P>0.05);after the operation,the blood indexes of the patients in the experimental group were significantly better than those in the reference group(P<0.05).Conclusion:Laparoscopic pelvic autonomic nerve-preserving radical resection of rectal cancer has lesser effects on urinary and sexual functions.

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.

Impact du traitement carcinologique sur le fonctionnement sexuel et l’image du corps des patientes tunisiennes en rémission d’un cancer du sein localiséImpact of Cancer Treatment on Sexual Functioning and Body Image of Tunisian Patients in Remission from Localized Breast Cancer

The diagnosis and the management of breast cancer(BC)affect in a complex way women’s sexual lives and touch the symbol of femininity,which is very important in the constitution of the body image.Our objectives were to assess the sexual functioning and the body image of patients in remission of localized BC,to determine the links between these two parameters,and to study their relationship with the therapeutic modalities.We conducted a cross-sectional,descriptive,and analytical study in the medical oncology and radiotherapy departments of Habib Bourguiba University Hospital Center in Sfax(Tunisia),between February and August 2022.Patients were assessed based on a clinical information sheet and two psychometric scales exploring sexual functioning and body image:Female Sexual Function Index(FSFI)and Body Image Scale(BIS).The sample comprised 74 patients with a mean age of 51.55 years.They were treated by conservative or radical surgery(44.6%and 55.4%,respectively),chemotherapy(87.8%),hormone therapy(79.7%),targeted therapies(36.5%),and radiotherapy(97.3%).A rate of 51.4%of women had sexual dysfunction(SD),87.8%had hypoactive sexual desire and 36.5%had body image disorder.The body image disorder was significantly associated with DS(p=0.001).The total FSFI score(p=0.001)as well as the subscores of desire(p=0.005),arousal(p=0.003),orgasm(p=0.002),satisfaction(p<0.001),and pain(0.03)were significantly lower in patients with body image disorder.The presence of a SD was not associated with any therapeutic modality.In contrast,the presence of body image disorder was significantly associated with the radical type of surgery(p=0.003)and chemotherapy(p=0.001).Our results showed a relatively high frequency of SD and body image disorder in women in remission from BC.These two parameters seem to be closely linked,and this link would be maintained by mastectomy and chemotherapy,which appear to be therapeutic modalities incriminated in the disturbance of body image.Hence the importance of medical follow-up and psychological support for these operated patients to help them overcome all the physical,psychological,and sexual difficulties to which they are exposed.

The impact of minimally invasive surgeries for the treatment of symptomatic benign prostatic hyperplasia on male sexual function： a systematic review

A systematic review of randomized controlled trials and cohort studies was conducted to evaluate data for the effects of minimally invasive procedures for treatment of symptomatic benign prostatic hyperplasia （BPH） on male sexual function. The studies searched were trials that enrolled men with symptomatic BPH who were treated with laser surgeries, transurethral microwave therapy （TUMT）, transurethral needle ablation of the prostate （TUNA）, transurethral ethanol ablation of the prostate （TEAP） and high-intensity frequency ultrasound （HIFU）, in comparison with traditional transurethral resection of the prostate （TURP） or sham operations. A total of 72 studies were identified, of which 33 met the inclusion criteria. Of the 33 studies, 21 were concerned with laser surgeries, six with TUMT, four with TUNA and two with TEAP containing information regarding male sexual function. No study is available regarding the effect of HIFU for BPH on male sexual function. Our analysis shows that minimally invasive surgeries for BPH have comparable effects to those of TURP on male erectile function. Collectively, less than 15.4% or 15.2% of patients will have either decrease or increase, respectively, of erectile function after laser procedures, TUMT and TUNA. As observed with TURP, a high incidence of ejaculatory dysfunction （EjD） is common after treatment of BPH with holmium, potassium-titanyl-phosphate and thulium laser therapies （〉 33.6%）. TUMT, TUNA and neodymium：yttrium aluminum garnet visual laser ablation or interstitial laser coagulation for BPH has less incidence of EjD, but these procedures are considered less effective for BPH treatment when compared with TURP.

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.

Study on Female Sexual Dysfunction in Type 2 Diabetic Chinese Women

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.

Assessing Sexual Function amongst Hong Kong Chinese Patients with Gynecological Cancer： Translation and Validation of the Sexual Function-Vaginal Changes Questionnaire （SVQ）

OBJECTIVE The study aims to translate the Sexual FunctionVaginal Changes Questionnaire （SVQ） into Chinese and to establish its psychometric properties.METHODS A Chinese SVQ was developed by the use of the Brislin model of translation. The content validity and semantic equivalence were assessed by an expert panel. The translated version of SVQ was administered to 75 Hong Kong Chinese women who were suffered from gynecological cancer to test its psychometric properties.RESULTS The Chinese version of SVQ was compared to the original study for factor analysis. Internal consistency, itemtoscale correlations and test-retest reliability were high. The convergent and divergent validities supported the Chinese SVQ to CONCLUSION We conclude that the Chinese SVQ appears to be a valid, reliable and feasible disease-specific tool for the assessment of sexual function among Chinese patients.

Impact of Chronic Pelvic Pain on Female Sexual Function

The objective of the present study was to determine the prevalence of sexual dysfunction and depression in women with chronic pelvic pain (CPP). A case-control study was conducted on 66 women, 36 of them with CPP and 30 without this diagnosis. Depression was evaluated using the Beck Depression Inventory (BDI) and sexual dysfunction was evaluated using the Female Sexual Function Index (FSFI). Data were analyzed statistically by the Mann-Whitney test, Fisher exact test, chisquare test, and Spearman correlation test. Regarding sociodemographic data, no significant differences were detected between populations with respect to the variables studied (age, schooling, number of children, income, salary, and marital status), indicating group homogeneity and thus increasing the reliability of the data. A cut-off of 26.55 points was used to calculate the total score for sexual function. In the group of women with CPP, 94.4% were at high risk for sexual dysfunction. Comparison of FSFI scores showed that the domains of sexual function, such as orgasm, lubrication and pain differed significantly between women with and without CPPP. Correlations were detected between the following items: orgasm × age (r = -0.01904), orgasm × number of children (r =-0. 00947), orgasm × body mass index (BMI) (r =-0.00 955), relationship × age (r = 0.03952), income × relationship (r =-0.014680), relationship × number of children (r =-0.03623), depression × relationship (r =-0.16091), desire × age (r = -0.45255), desire × number of children (r = -0.01824), lubrication × excitement (r = 0.04198), and lubrication × BMI (r = -0.01608). The prevalence of depression detected in the present study was 38.9% among women with pain and 3.3% among control women. It was observed that women with CPP suffer a negative interference regarding sexual function compared to controls. Thus, it can be seen that a specific approach related to sexuality is extremely important within the context of women with CPP. Depression was clearly associated with CPP and therefore an interdisciplinary approach is fundamental in order to solve this problem.

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.

Reproductive Hormone Profiles and Their Relationships with Sexual Function in Patients with Prostate Cancer after Rapid Prostatectomy in Benin City

There are limited studies examining the relationship between serum reproductive hormone levels and sexual functions among prostate cancer (PCa) patients after rapid prostatectomy (RP). Aim: The present study aimed at evaluating the correlation between post-operative serum levels of some male reproductive hormones of PCa patients and their sexual functions in the months following RP. A total of 20 male patients with clinically localized PCa who had undergone RP within the last 12 months prior to commencement of the study, were invited to participate. The postoperative serum levels of their luteinizing hormone (LH), follicle stimulating hormone (FSH) and total testosterone (Te) were measured. They also completed a structured health and lifestyle questionnaire to obtain information on their demographic characteristics and detailed medical history. Our data indicated normal mean levels of post-operative Te (4.34 ± 4.38 ng/ml) in the patients following RP, while the mean levels of FSH (39.24 ± 34.12 miu/ml) and LH (21.67 ± 25.73 miu/ml) were on the increase and far above normal ranges for healthy men. Data indicated a significant positive correlation between Te and frequency of sexual intercourse (r = 508;p < 0.05), libido (r = 0.429;p < 0.05) and penile erection (r = 0.494;p < 0.05). However, no significant correlations were found between FSH or LH and any of the sexual function parameters. The present study indicated that radical prostatectomy affected reproductive hormones by increasing LH and FSH concentrations above normal ranges for healthy men, while Te concentrations remained within normal range in the months following RP. The postoperative serum total Te concentrations of the patients were significantly associated with their postoperative sex drive, penile erection and frequency of sexual intercourse.

Sexual Functional Prognosis of Penile Emergencies at the University Hospital of Libreville

Introduction: Penile emergencies are multiple and varied, and they can jeopardize the sexual functional prognosis of the patient. The objective of our study was to evaluate the sexual functional prognosis of patients admitted for penile emergencies. Patients and Methods: We conducted a cross-sectional study from January 1 to 31, 2021, in the urology department of the University Hospital. Variables included sociodemographic, diagnostic, and evolutionary data of sexually active patients admitted for a penile emergency. Results: During this period, 68 patients were admitted for penile emergencies. We included 45 sexually active patients, with a mean age ranging from 34.5 ± 14.1 years with extremes of 16 and 90 years. The most frequent penile emergencies were priapism (62.2%) and penile fracture (22.2%), with a mean time for treatment of 21.4 ± 52.5 hours. The sexual functional prognosis was very satisfactory (normal erection) in 71.1% (n = 32) of patients. Loss of erectile function was observed in 4.4% (n = 2) of cases. Conclusion: Penile emergencies are relatively frequent, dominated by priapism and penile fracture in our context. The sexual functional prognosis is good.

Tye &Sardi’s Psychological, Psychosocial, and Psychosexual Aspects of Penile Circumcision*

Tye and Sardi recently reviewed the evidence purporting to implicate male circumcision, especially when performed early in infancy, in psychological problems in men. Here we provide a critical evaluation to determine the veracity of their evidence and claims. Missing from their review were critiques pointing out fundamental flaws in key studies. We argue that psychological stress in some men may be caused by anti-circumcision propaganda telling them that they are victims of “genital mutilation”, a term adopted from dissimilar female practices in particular ethnic groups. Sexual dissatisfaction results. We critically discuss claims about foreskin “gliding”, the eccentric foreskin-related sexual practice of “docking”, and the use of lubricant in masturbation. We further find that a study claiming to show numerous differences in socio-affective processing in men circumcised as neonates stem from statistically flawed and one-sided data that has been misinterpreted, and in fact shows the opposite of the hypothesis that psychological problems in some men can be attributed to the pain of their circumcision as newborns. Importantly, since the brain regions responsible for empathy, namely subcortical gray matter and white matter in frontal and parietal regions, were similar in neonatally circumcised and uncircumcised men, the null hypothesis remains null. In conclusion, we find no compelling evidence to support newborn circumcision pain being responsible for psychological problems in neonatally circumcised men. Men who come to believe that they are victims of their infant circumcision are in actual fact likely victims of false claims perpetrated by activist community groups with trenchant opposition to circumcision.

Relationship between Female Sexual Function and Depression or Anxiety in Japan

Background: Sexual dysfunction is sexual complaints or disorders. There are various causes, but the onset leads to deterioration of relationships and quality of life with partners. There is still a deep-rooted awareness that sexuality is a secret in Japan. Aim: This study aims to clarify the relationship between female sexual function and depression or anxiety. Method: Four hundred and fifty-eight Japanese healthy women who worked in four randomly selected medical institutions in Okinawa Prefecture in Japan from March to May 2012 were asked to agree to a consent form of their own free will and participate in self-reported questionnaires. For their evaluation, the Female Sexual Function Index (FSFI;Rosen et al. 2000, which includes the six domains of desire, arousal, lubrication, orgasm, pain, and satisfaction) and the Kessler Psychological Distress Scale (K6;Kessler, 2002, which includes the following six items: felt nervous, hopeless, restless or fidgety, worthless, depressed, and felt that everything was an effort) was used. Moreover, participants’ characteristics showed age, marriage, menopause, annual income, and drinking. In addition, JMP16.2 and R 4.2.0 was used to perform Pearson’s chi-square test, Fisher’s exact test, Mann-Whitney U test, Kruskal-Wallis test, Steel-Dwass test, Spearman’s Rank-Order Correlation, and Cronbach’s alpha. This study was approved by the university and the medical institutional review board (IRB). Results: 178 women were included in the final analysis, and the median (IQR, interquartile range) was 39 (32 - 48) years old, and the mean ± SD (standard deviation) was 40.2 ± 10.4 years old. The median (IQR) and mean ± SD of FSFI Total Score were 22.0 (9.3 - 26.6) and 19.2 ± 9.6. The median (IQR) and the mean ± SD of K6 Total Score were 3 (0 - 7) and 4.2 ± 4.5. 16% of all women with a K6 Total Score of 10 and more, and 5% of all women with a K6 Total Score of 13 and more considered a serious mental illness. There was no clear association between female sexual function and depression or anxiety in all health worker participants between FSFI Total Score and K6 Total Score by Spearman’s Rank-Order Correlation Coefficient (ρ). However, there was a moderate correlation between the K6 Total Score and the FSFI Total Score in health worker participants with a K6 Total Score of 11 or more (n =19, ρ = ?0.62, P = 0.005). Moreover, there was a weak correlation between them in both married and drinking women or married and non-menopausal women. In the Mann-Whitney U test where few participants had morbid depression, significant relationships were found in the association between a sexual function with high depression or anxiety, whereas the low group had a K6 cut-off value of 11. Conclusion: Female sexual morbidity for high depression or anxiety should be managed with interventions. Especially, the intervention for decreasing female sexual function in the K6 Total Score of 11 or more will be needed, and a randomized study is required for more evidence.

Sexual function in women after delivery:Does episiotomy matter?

Objective: Despite the fact that a restrictive use of episiotomy has proven to be beneficial, it continues to be widely used in vaginal births. Our aim was to compare women with episiotomy, to women with an intact perineum, 3 months after delivery, regarding several sexual variables, namely: sexual desire, arousal, orgasm, pain, sexual satisfaction and sexual function. Methods: An exploratory, descriptive and quantitative study using a non-probabilistic, convenience sample of 147 Portuguese women, of which 54 belonged to a control group, was performed. The groups were not significantly different regarding socio-demographic aspects. Three instruments were used: the Female Sexual Function Index, a Socio-demographic and Clinical Questionnaire and the Female Sexual Function Questionnaire. Results: Most women mentioned a moderate level of sexual interest. Women with episiotomy present higher pain intensity, less sexual satisfaction, greater changes regarding the orgasm’s duration and intensity, lower levels of sexual arousal and total sexual function, than women with intact perineum. Discussion: We found no significant differences between women with episiotomy and women with an intact perineum in most variables. However, women with episiotomy presented higher levels of pain and a lower sexual satisfaction, being these significant differences.

Validity of self-reported male sexual function scales in a young Chinese population:a comparative study with clinician-assisted evaluation

Psychometric scales,commonly used to gauge sexual function,can sometimes be influenced by response biases.In our researchfrom June 2020 to April 2021,we examined the accuracy of self-reported sexual function scales.We invited patients from theDepartment of Infertility and Sexual Medicine at the Third Affiliated Hospital of Sun Yat-sen University(Guangzhou,China),whohave male sexual dysfunction,to participate by filling out a self-reported version of a specific questionnaire.In addition,they wentthrough a clinician-assisted version of this questionnaire,encompassing tools such as the Premature Ejaculation Diagnostic Tool(PEDT),the 6-item International Index of Erectile Function(IIEF-6),the Erection Hardness Scale(EHS),and the MasturbationErection Index(MEI).Using the clinician-assisted version as a reference,we categorized patients and applied various statisticalmethods,such as the Chi-square test,intraclass correlation coefficient(ICC),logistic regression,and the Bland–Altman plot,to gauge reliability.In our study with 322 participants,we found that while there were no notable discrepancies in error ratesbased on our categorization,certain scales showed significant differences in terms of overestimation and underestimation,withthe exception of the PEDT.The positive diagnosis rate consistency between the self-reported and clinician-assisted versions wasobserved.High ICC values between the two versions across the scales were indicative of remarkable reliability.Our findings showthat the self-reported versions of tools such as EHS,IIEF-6,MEI,and PEDT are credible and hold clinical reliability.However,employing a dual-diagnosis approach might be more prudent to circumvent potential misdiagnoses.

Impact of postoperative sexual function on health-related quality of life after robot-assisted radical prostatectomy

Background:We investigated potential disparities in health-related quality of life,particularly concerning urinary function,between patients with preserved and those with impaired sexual function after robot-assisted radical prostatectomy(RARP).Materials and methods:BetweenDecember 2012 and April 2020,704men underwent RARP in our hospital.This study included 155 patients with a preoperative 5-item International Index of Erectile Function(IIEF-5)of≥12 points and an assessable IIEF-5 at 12 months postoperatively.Health-related quality of life was assessed using the 8-item Short-Form Health Survey and Expanded Prostate Cancer Index Composite(EPIC)preoperatively and at 3,6,and 12months postoperatively.A logistic regression analysis andWilcoxon rank sum tests were performed.Results:Patients were grouped according to the median IIEF-5 score 12 months after surgery:those with preserved sexual function(n=71)and those with impaired sexual function(n=84).The mental component summary of the 8-item Short-Form Health Survey was better in the group with preserved sexual function at 6 months postoperatively than in the group with impaired sexual function(p<0.01).In the EPIC,the group with preserved sexual function performed better not only in the sexual domain but also in the urinary domain at all time points comparedwith the groupwith impaired sexual function(p<0.01).In the comparison of the urinary subdomains of the EPIC,there were no significant differences in urinary function or incontinence,but there were significant differences in urinary distress and irritative/obstructive scores(p<0.01).Conclusions:Patients with preserved postoperative sexual function after RARP showed better urinary function than those with impaired sexual function.Hence,preserved sexual function is closely associated with urinary function.

Erectile function after urethral reconstruction

Advances in urogenital plastic surgical tissue transfer techniques have enabled urethral reconstruction surgery to become the new gold-standard for treatment of refractory urethral stricture disease. Questions remain, however, regarding the long-term implications on sexual function after major genital reconstructive surgery. In this article, we review the pathologic features of urethral stricture disease and urologic trauma that may affect erectile function （EF） and assess the impact of various specific contemporary urethroplasty surgical techniques on male sexual function.

Evaluation of penile hemodynamic status and adjustment of treatment alternatives in Peyronie's disease

Aim: Erectile dysfunction may be observed in up to 80% of patients with Peyronie's disease. An objective evaluation of the erectile function is attempted to work out in patients with Peyronie's disease. Methods: Penile deformity, sexual function and penile vascular status were analyzed in 123 patients with Peyronie's disease, who had not received any pertinent treatment. Results: Penile deformity, palpable plaque and pain on erection were seen in 112 (91%), 97(78.8%) and 27 (21.9%) of the 123 patients, respectively. Of the 76 patients evaluated by color Doppler ultrasounography, veno-occlusive dysfunction as the vascular component for erectile dysfunction was found in 17 (22.3%), arterial insufficiency in 10(13.1%) and a mixed picture in 23 (30.2%). Conclusion: The documentation of penile erectile function and the determination of the vascular status using color Doppler ultrasonography can guide the appropriate therapeutic choice.