Search

This study aimed to determine sexual dysfunction (SD) and erectile disorder (ED) prevalence and analyze risk factors in older men of infertile couples. The study was a cross-sectional descriptive study conducted on male partners in infertile couples who were aged between 40–60 years. The study took place at the Hue Center for Reproductive Endocrinology and Infertility, Hue University Hospital, Viet Nam from January 2022 to August 2023. All participants were examinated and were privately asked to answer the International Index of Erectile Function (IIEF)-15 questionaires vietnamese-language version to diagnose sexual dysfunction and erectile disorder. The study sample consisted of 81 qualified men. The prevalence of SD was 51.9% (N = 42), of which the rate of ED accounted for 46.9% (N = 38). Among the 42 cases of SD, 37 were mild cases (45.8%), 1 was moderate (1.2%) and 4 were severe (4.9%). In all five sexual domains, it was found that the severity of SD was associated with lower scores (p < 0.001). Cardiovascular disease (CVD) was associated with severity of SD (p = 0.044). The decrease in scores of sexual desire and satisfaction could significantly affect sperm vitality and DNA fragmentation index. Age, number of living children and economic income were statistically correlated to SD domains (p < 0.05). Sexual dysfunction is a comprehensive disorder that affects each of the four phases of the sexual response cycle in older infertile men. It is a common disorder that could affect semen quality, leading to total sexual dysfunction and erectile disorder. Factors such as age, term births history, number of living children, geography and economic income are demography-sociology risk factors. Additionally, CVD with vascular endothelial damage mechanism has a statistically significant relationship with the severity of sexual dysfunction.

Erectile disorder (ED) is the continuous or repeated inability to achieve an erection or maintain its firmness for an adequate amount of time during sexual intercourse. Given the importance of utilizing quality clinical practice guidelines (CPGs) for the diagnosis of ED, the research team conducted a scoping review of erectile disorder CPGs to address the questions based on the clinical guideline of the best quality. This scoping review was conducted in five steps: 1 - identification of the research question, 2 - identification of relevant studies, 3 - selection of studies, 4 - data extraction, 5 - summarizing and reporting the results. The initial search yielded 1,888 articles, CPGs and books but after primary and secondary screening by two appraisers, 9 CPGs were extracted. After that, the two appraisers examined the quality of these guidelines using the AGREE II tool. Eventually, 5 CPGs extracted. After reviewing 5 guidelines, 5 questions were answered. Overall, the CPGs had desirable overlap in response to the marked questions; nevertheless, there were some differences in details too. This review shows that the first and foremost principle in examining the affected individuals is taking a complete detailed history, followed by a physical examination and use of relevant questionnaires to complete the information necessary to diagnose the problem. The next step is to perform routine lab tests; hormonal profiles may also be checked, and if necessary, special tests should be performed based on an individual's conditions. [ABSTRACT FROM AUTHOR]

Objectives: Incidence and prevalence of patients in dialytic therapy increased considerably in recent years. The onset of new issues, once overshadowed, linked to a lower quality of life like sexual dysfunction became increasingly common. The first study in this area, dating back to the 1970s, shows the high prevalence of sexual dysfunction among patients in dialytic therapy of both sexes. Later studies proved an association of sexual dysfunction with psyche disorders, anxiety, depression and lack of self-confidence. The aim of this study is to describe the incidence of male and female sexual main dysfunctions, the latter not least in literature, in patients in hemodialytic therapy. With this aim two dialytic centers have been compared, one located in northern Italy and one in southern Italy, and the different prevalence has been compared to the general population. Methods: We conducted a prospective cross-sectional observational study in patients undergoing dialytic therapy in two hemodialysis centers, one located in Palermo and one in Lecco. Male sexual dysfunction was investigated by the International Index of Erectile Function-15 (IIEF15) questionnaire and the Premature Ejaculation Diagnotic Tool (PEDT) questionnaire, and the female dysfunction by Female Sexual Function Index (FSFI) questionnaire. Criteria for inclusion in our study were: age < 75 years and dialytic age > 3 months; exclusion criteria were: advanced cancer diseases, life expectancy < 6 months, previous urological manipulation, anti-androgenic therapy, sexual dysfunction unrelated to kidney disease, psychiatric disorders. Data were compared with mean-standard deviation (SD) and with the variance analysis (ANOVA). A value of p < 0.05 is considered significant. Discrete data were analyzed with contingency analysis. A chi2 < 0.05 was considered significant. Results: Data of 78 patients have been collected. Mean age and dialytic time were 54 ± 12 years and 42 ± 35 month; 33 patients were from Palermo and 24 from Lecco; 21 patients were excluded. Age and dialytic age of the two subgroups did not demonstrate statistically significant differences. Between the two centers there was a statistically significant difference (p < 0.005) in the distribution of basic nephropathy: an higher incidence of diabetic and obstructive nephropathy has been observed in the southern center compared to northern center, while glomerulonephritis and polycystic kidney disease had an higher incidence in the northern center compared to southern one. The main sexual dysfunctions in both sexes, erectile dysfunction (ED) and premature ejaculation (PE) in men and orgasm disorder and pelvic pain in women, have been investigated. ED was present in 70% of hemodialyzed patients, which is an higher incidence compared to the general population. The severity of ED between patients of the two groups was significantly different (chi2 < 0.001) with higher incidence of moderate/severe forms in northern Italy. The score, in addition to discrete data (severe, moderate, mild, absence), of ED was significantly different (p < 0.001) between patients of the two centers (22 ± 7 Palermo vs. 9 ± 8, Lecco). The PE was absent in 20 patients (54%), present in 12 patients (32%) and probable in 5 patients (14%) (scores of 7.6 ± 4.0 and 8.9 ± 6.8, respectively in Palermo and Lecco patients). For women, orgasmic dysfunction was severe in 10 patients (50%), mild in 4 patients (20%), very mild in 5 patients (25%), while it was normal in 1 patient (5%), with a statistically significant difference (p< 0.05) between Palermo and Lecco patients (3.0 ± 1.4 vs 1.2 ± 2.0). Sexual pain in women was severe in 11 patients (55%), moderate in 4 patients (20%) and mild in 5 patients (25%). Sexual pain was present in all patients (p < 0.05). Conclusions: Regardless of sex, sexual dysfunction is one of the most common side effect in patients with end stage renal disease in dialytic therapy. Our study confirms literature data. The growing number of the dialytic population with sexual disorders needs specialist support to improve quality of life of these patients.

Objectives: Incidence and prevalence of patients in dialytic therapy increased considerably in recent years. The onset of new issues, once overshadowed, linked to a lower quality of life like sexual dysfunction became increasingly common. The first study in this area, dating back to the 1970s, shows the high prevalence of sexual dysfunction among patients in dialytic therapy of both sexes. Later studies proved an association of sexual dysfunction with psyche disorders, anxiety, depression and lack of self-confidence. The aim of this study is to describe the incidence of male and female sexual main dysfunctions, the latter not least in literature, in patients in hemodialytic therapy. With this aim two dialytic centers have been compared, one located in northern Italy and one in southern Italy, and the different prevalence has been compared to the general population. Methods: We conducted a prospective cross-sectional observational study in patients undergoing dialytic therapy in two hemodialysis centers, one located in Palermo and one in Lecco. Male sexual dysfunction was investigated by the International Index of Erectile Function-15 (IIEF15) questionnaire and the Premature Ejaculation Diagnotic Tool (PEDT) questionnaire, and the female dysfunction by Female Sexual Function Index (FSFI) questionnaire. Criteria for inclusion in our study were: age < 75 years and dialytic age > 3 months; exclusion criteria were: advanced cancer diseases, life expectancy < 6 months, previous urological manipulation, anti-androgenic therapy, sexual dysfunction unrelated to kidney disease, psychiatric disorders. Data were compared with mean-standard deviation (SD) and with the variance analysis (ANOVA). A value of p < 0.05 is considered significant. Discrete data were analyzed with contingency analysis. A chi2 < 0.05 was considered significant. Results: Data of 78 patients have been collected. Mean age and dialytic time were 54 ± 12 years and 42 ± 35 month; 33 patients were from Palermo and 24 from Lecco; 21 patients were excluded. Age and dialytic age of the two subgroups did not demonstrate statistically significant differences. Between the two centers there was a statistically significant difference (p < 0.005) in the distribution of basic nephropathy: an higher incidence of diabetic and obstructive nephropathy has been observed in the southern center compared to northern center, while glomerulonephritis and polycystic kidney disease had an higher incidence in the northern center compared to southern one. The main sexual dysfunctions in both sexes, erectile dysfunction (ED) and premature ejaculation (PE) in men and orgasm disorder and pelvic pain in women, have been investigated. ED was present in 70% of hemodialyzed patients, which is an higher incidence compared to the general population. The severity of ED between patients of the two groups was significantly different (chi2 < 0.001) with higher incidence of moderate/severe forms in northern Italy. The score, in addition to discrete data (severe, moderate, mild, absence), of ED was significantly different (p < 0.001) between patients of the two centers (22 ± 7 Palermo vs. 9 ± 8, Lecco). The PE was absent in 20 patients (54%), present in 12 patients (32%) and probable in 5 patients (14%) (scores of 7.6 ± 4.0 and 8.9 ± 6.8, respectively in Palermo and Lecco patients). For women, orgasmic dysfunction was severe in 10 patients (50%), mild in 4 patients (20%), very mild in 5 patients (25%), while it was normal in 1 patient (5%), with a statistically significant difference (p< 0.05) between Palermo and Lecco patients (3.0 ± 1.4 vs 1.2 ± 2.0). Sexual pain in women was severe in 11 patients (55%), moderate in 4 patients (20%) and mild in 5 patients (25%). Sexual pain was present in all patients (p < 0.05). Conclusions: Regardless of sex, sexual dysfunction is one of the most common side effect in patients with end stage renal disease in dialytic therapy. Our study confirms literature data. The growing number of the dialytic population with sexual disorders needs specialist support to improve quality of life of these patients. [ABSTRACT FROM AUTHOR]

Inhibitors of 5α-steroid reductase are drugs used to treat androgen-dependent conditions including prostate diseases and androgenic alopecia. Finasteride was the first on the market and is currently the most widely used inhibitor. Dutasteride was the second inhibitor to be approved and has a similar safety profile. Common adverse events of treatment consist of sexual disorders and a negative affect balance. It was described that the prolonged use of 5α-steroid reductase inhibitors in patients with alopecia can cause persistent side effects called a post-finasteride syndrome (PFS), that is not just a simple coexistence of events, but rather a definite syndrome with an iatrogenic background. PFS occurs in susceptible individuals even after small doses of the drug and can last for a long time after the discontinuation of treatment. A deterioration in the quality of life in affected individuals does not justify use of the drug. Wider recognition of PFS symptoms, its incidence, course, prevention, and treatment possibilities will allow the indications for drug use to be reconsidered and treatment to be more personalized. Knowledge about PFS will also help to provide the best treatment for affected individuals and to properly educate patients before obtaining an informed consent for therapy with 5α-steroid reductase inhibitors. [ABSTRACT FROM AUTHOR]

BACKGROUND: Sexual dysfunction is common after traumatic brain injury (TBI) but evaluation of treatment interventions have been sparse. OBJECTIVE: To report on the treatment of sexual dysfunction for two males with severe TBI. METHODS AND RESULTS: Case one was treated for erectile dysfunction (ED). After a medical examination which found no underlying physiological problems, Sildenafil was prescribed. Scores on the Golombok Rust Inventory of Sexual Satisfaction Impotence subscale found that scores had improved from the dysfunction range at baseline to the functional range at 6 weeks follow-up. There was some reduction in this improvement at 3 months follow-up, maybe associated with a co-morbid deterioration of emotional state. Case two was treated for idiopathic delayed ejaculation (DE). A standard sex therapy intervention was employed that resulted in the resolution of the problem, documented on the Sex Behavior sub-scale of the Derogatis Inventory for Sexual Functioning-Self Report (comparing baseline to post intervention and follow-up scores). CONCLUSIONS: The case reports show promise for the treatment of sexual dysfunction after severe TBI using standard medical and sex therapy treatments. In the future, controlled evaluations are required to demonstrate the efficacy of such interventions. [ABSTRACT FROM AUTHOR]

In this qualitative inquiry, we set out to explore the experience of condom use and erectile disorder (ED) among men living with HIV in a rural district of Zimbabwe. Data on condom use related erectile disorder with antiretroviral (ART) medication were collected from a purposive sample of 18 men living with HIV and AIDS (age range 23–54 years). These data were supplemented with those from a convenience sample of 23 women living with HIV who self-identified as partners of men living with HIV and AIDS (age range 26–37 years). The data were thematically analyzed. Results suggest that men attributed their experiencing of erectile problems to two main explanations: use of condoms and ART medication. These men reported inconsistent use of condoms and/or adherance to ART therapy due to a belief that these cause their ED. The women informants reported similar observations, including the shared gendered perspective that the men perceived a loss of sense of manhood from ED. Beliefs that influence health promotion with men living with HIV and AIDS are important to public health interventions with them. [ABSTRACT FROM PUBLISHER]

Case: A shy, depressed 30 year old male discussed his frequent ego-syntonic indoor prostitution consumption in small peer groups. Several distinctive non-sexual functions of this paid sex habit were identified. Design and method: The patient had 40 hourly psychiatric sessions in the private practice setting over 14 months. The Arizona Sexual Experience Scale was applied to compare the subjective appraisal of both paid sex and sex in a relationship. The informal Social Atom elucidates social preferences and the Operationalized Psychodynamic Diagnostic-procedure was applied to describe a dominant relationship pattern. Results: The paid sex consumption functioned as a proud male life style choice to reinforce the patients fragile identity. The effect on self esteem was a release similar to his favorite past-time of kick-boxing. With paid sex asserted as a group ritual, it was practiced even with frequent erectile dysfunction and when sex with a stable romantic partner was more enjoyable and satisfying. The therapeutic attitude of the female psychiatrist, with her own ethical values, is put in to context with two opposing theories about prostitution: the ‘Sex-Work-model’ and the ‘Oppression-model’. The therapist’s reaction to the patients’ information was seen as a starting point to understanding the intrapsychic function of paid sex as a coping mechanism against depressive feelings. Conclusions: Exploring and understanding prostitution consumption patterns in young men can benefit the treatment of psychiatric disorders in the private practice setting. It is the psychiatrists task to investigate the patients hidden motives behind paid sex use to help patients achieve a greater inner and relational freedom.

Case: A shy, depressed 30 year old male discussed his frequent ego-syntonic indoor prostitution consumption in small peer groups. Several distinctive non-sexual functions of this paid sex habit were identified. Design and method: The patient had 40 hourly psychiatric sessions in the private practice setting over 14 months. The Arizona Sexual Experience Scale was applied to compare the subjective appraisal of both paid sex and sex in a relationship. Results: The paid sex consumption functioned as a proud male life style choice to reinforce the patients fragile identity. The effect on self esteem was a release similar to his favorite past-time of kick-boxing. With paid sex asserted as a group ritual, it was practiced even with frequent erectile dysfunction and when sex with a stable romantic partner was more enjoyable and satisfying. The therapeutic attitude of the female psychiatrist, with her own ethical values, is put in to context with two opposing theories about prostitution: the ‘Sex-Work-model’ and the ‘Oppression-model’. The therapist’s reaction to the patients’ information was seen as a starting point to understanding the intrapsychic function of paid sex as a coping mechanism against depressive feelings. Conclusions: Exploring and understanding prostitution consumption patterns in young men can benefit the treatment of psychiatric disorders in the private practice setting. It is the psychiatrists task to investigate the patients hidden motives behind paid sex use to help patients achieve a greater inner and relational freedom.

ABSTRACT Introduction. Disgust may be involved in sexual problems by disrupting sexual arousal and motivating avoidance of sexual intercourse. To test whether heightened disgust for sexual contaminants is related to sexual dysfunctions, the Sexual Disgust Questionnaire (SDQ) has recently been developed. Previous research showed that particularly women with vaginismus display a generally heightened dispositional disgust propensity and heightened disgust toward stimuli depicting sexual intercourse. Aim. To determine the psychometric properties of the SDQ and test whether heightened disgust toward sexual stimuli is specific to vaginismus or can be observed in other sexual dysfunctions as well. Methods. First, a large sample of undergraduates and university employees completed the SDQ (N = 762) and several trait disgust indices. Next, women with vaginismus (N = 39), dyspareunia (N = 45), and men with erectile disorder (N = 28) completed the SDQ and were compared to participants without sexual problems (N = 70). Main Outcome Measure. SDQ to index sexual disgust. Results. The SDQ proved a valid and reliable index to establish disgust propensity for sexual stimuli. Supporting construct validity of the SDQ, sexual disgust correlated with established trait indices. Furthermore, sexual disgust and willingness to handle sexually contaminated stimuli were associated with sexual functioning in women, but not in men. Specifically women with vaginismus displayed heightened sexual disgust compared to women without sexual problems, while men with erectile disorders demonstrated a lower willingness to handle sexually contaminated stimuli compared to men without sexual problems. Conclusions. The SDQ appears a valid and reliable measure of sexual disgust. The pattern of SDQ-scores across males and females with and without sexual dysfunctions corroborates earlier research suggesting that disgust appraisals are involved especially in vaginismus and supports the view that the difficulty with vaginal penetration experienced by women in vaginismus may partly be due to disgust-induced defensive reflexes that could disrupt sexual arousal. van Overveld M, de Jong PJ, Peters ML, van Lankveld J, Melles R, and ter Kuile MM. The Sexual Disgust Questionnaire; a psychometric study and a first exploration in patients with sexual dysfunctions. J Sex Med **;**:**-**. [ABSTRACT FROM AUTHOR]

Objective: Sociocultural factors may have significant effects on sexual behavior. Research in different cultures may contribute to our understanding of sexuality and sexual dysfunction. The study aims to present the soci-odemographic characteristics and clinical symptomatology of male sexual dysfunctions in a Turkish sample. Method: Subjects who were referred to the Sexual Dysfunction Unit in the Psychiatry Department of Gulha-ne Military Medical Academy, Turkey, during September 1986-November 2008 have been included in the study. The subjects' presenting complaints, diagnostic distribution, and socio-demographic characteristics we-re analyzed retrospectively. Findings: Out of 1226 cases, 903 males' data were evaluated. The diagnostic distribution of subjects were as following: Erectile disorder due to psychological factors 60.2%, erectile disorder due to organic factors 18.9%, premature ejaculation 10.7%, sexual desire disorder 3.8%, orgasmic disorder 0.7%, and other disorders 5.7%. On the other hand, the subjects' presenting complaints were erectile inadequacy 50.1%, erectile failure 26.0%, premature ejaculation 11.7%, low sexual desire 9.2%, and retarded ejaculation 1.0%, other 1.9%. Discussion: In this study the male/female ratio was 7/1, in favor of males which may reflect sociocultural va-lues attributed to sexuality. The incidence of erectile dysfunction was higher, whereas premature ejaculation, orgasmic disorder and sexual desire disorder was lower compared with literature. Conclusion: These findings may be related to cultural effects influencing the acceptance of sexual dysfunc-tions, and were discussed in the light of sociocultural factors. [ABSTRACT FROM AUTHOR]

Penile incarceration for erotic or autoerotic purposes has been reported in a wide range of age groups, and often presents a significant challenge to urologic surgeons. No ready method has been reported for removing a polyvinylchloride (PVC) pipe entrapped on the penis. To present our experience in using hot-melt method to remove a constricted PVC pipe on the penis. A long melting split was made on the PVC pipe entrapped on the penis by using the long narrow branch of forceps heated on a gas stove. The heated forceps was able to make a melt split on the PVC pipe. Consequently, the PVC pipe was removed by pulling the edges of the pipe apart without much difficulty. The total operation time was 20 minutes. Penile incarceration is a urologic emergency, for which resourcefulness is required in some unexpected cases. Hot-melting has proved to be an easy and effective method for removing penile strangulation by a PVC pipe. To our knowledge, it is the first report about the removal of PVC pipe entrapped on a penis. [ABSTRACT FROM AUTHOR]

Introduction. The Diagnostic and Statistical Manual of Mental Disorders, 4th Ed., text revision (DSM-IV-TR) criteria for erectile disorder have been criticized as multiple grounds including that the criteria lack precision, that the requirement of marked distress is inappropriate, and that the specification of etiological subtypes should be deleted. Aim. The goal of this manuscript is to review evidence relevant to diagnostic criteria for erectile disorder published since 1990. Method. Medline searches from 1990 forward were conducted using the terms erectile disorder and impotence. Early drafts of proposed alterations in diagnostic criteria were submitted to advisors. Main Outcome Measure. Evidence regarding modification of criteria for DSM V diagnostic criteria for erectile dysfunction was judged by whether existing data justified the adoption of precise criteria which would lead to homogenous groups for research. Another outcome measure was whether data exist to reliably differentiate fluctuations in normal function from pathological states. Results. The literature review revealed a large literature concerning erectile disorder but minimal evidence concerning an operational definition for this disorder. Conclusions. It is recommended that erectile disorder be precisely defined in order to clearly differentiate alterations in normal function from a condition requiring medial intervention and to facilitate clinical research. It is specifically proposed that erectile dysfunction be defined as failure to obtain and maintain an erection sufficient for sexual activity or decreased erectile turgidity on 75% of sexual occasions and lasting for at least 6 months. It is also recommended that erectile disorder be defined independently of distress. Segraves RT. Considerations for diagnostic criteria for erectile dysfunction in DSM V. J Sex Med 2010;7:654–671. [ABSTRACT FROM AUTHOR]

Introduction. Entrapment or strangulation of the penis is a rare emergency situation that can lead to a wide range of vascular and mechanical injuries. Aim. The aim of this article is to present our experience dealing with penile strangulation. A review of the literature is also summarized in this report. Current treatment options and outcomes are also evaluated. Methods. We performed a computerized MEDLINE search followed by a manual bibliographic review of cross-references. These reports were analyzed and the important findings summarized. Results. Penile strangulation has been first time reported in 1755. Since that time, sporadic reports have appeared in the literature describing a variety of foreign bodies on the penis that have in common only the property of circularity. We noted motives, types of objects, types of strangulation, symptomatology, trauma grades, diagnoses, including psychological involvement, as well as possible treatment options. Furthermore, two cases of penile strangulation from our clinical practice are presented involving different degrees of vascular insult leading to different pathogenesis, clinical presentation, and surgical approach. Conclusion. Penile strangulation is an unusual clinical condition and the consequences can be severe. Penile strangulation could lead to different degrees of vascular obstruction. Consequently, several clinical syndromes can occur: from mild nonsignificant vascular obstruction that resolves after decompression to severe gangrene of the penis accompanied with impaired renal function. The most common motive associated with foreign bodies on the penis is sexual or erotic in nature. The choice of method for removal depends upon type, size, incarceration time, trauma grade, and availability of the equipment. Prompt diagnosis and early treatment are essential to avoid the potential complications of ischemic necrosis and autoamputation. Ivanovski O, Stankov O, Kuzmanoski M, Saidi S, Banev S, Filipovski V, Lekovski L, and Popov Z. Penile strangulation: Two case reports and review of the literature. J Sex Med 2007;4:1775–1780. [ABSTRACT FROM AUTHOR]

Copyright of Der Urologe A is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This study investigated the attributional styles of men with and without sexual dysfunction for both positive and negative sexual and general events using a sex-specific version of the Attributional Style Questionnaire (Sex-ASQ), and ascertained the preliminary psychometric properties of the measure. The Sex-ASQ was created by embedding 8 hypothetical sexual events (4 positive, 4 negative) among the original 12 events in the Attributional Style Questionnaire (ASQ; C. Peterson, A. Semmel, C. von Baeyer, L. Y. Abramson, G. I. Metalsky, & M. E. Seligman, 1982). The Sex-ASQ was completed by 2! men with a principal DSM-IV diagnosis of Male Erectile Disorder (MED) and 32 male control participants. The psychometrics of the Sex-ASQ were satisfactory, but with the positive sexual event scales found to be less stable and internally consistent than the negative sexual event scales. Reasons for modest reliability of the positive event scales are discussed in terms of the original ASQ. As expected, men with MED did not differ significantly from men without sexual dysfunction in their causal attributions for general events, indicating that both groups exhibited an optimistic attributional style in general. Also as predicted, men with MED made more internal and stable causal attributions for negative sexual events than men without sexual dysfunction, and also rated negative sexual events as more important. For positive sexual events, the 2 groups did not differ in attributional style, with both groups making more external/unstable/specific causal attributions than for positive general events. Differences between explanatory style for sexual versus nonsexual events found in both sexually functional and dysfunctional men lend support for explanatory style models that propose both cross-situational consistency and situational specificity. [ABSTRACT FROM AUTHOR]

A follow-up study conducted among 39 implanted patients and 30 partners shows that subject's satisfaction towards prosthetic-sexuality depends on their representation of male erotic value. The less satisfied patients are sensitive to a normative representation that associates erotic value to criteria of 'spontaneity', 'naturalness', 'tall and non-assisted erections'. Their main dissatisfaction likely derives from the insufficiency of a prosthetic solution to restore a male self-image based on such criteria. This induces a more important impact on satisfaction rates than do functional problems (e.g. difficulties in manipulating the device, unwanted deflations, uncomfortable sensations). These patients also show an attribution bias consisting in attributing erroneously the same dissatisfaction and negative attitude towards prosthetic sexuality to their partner. Therefore, in addition to surgery, a psychosexual support is necessary to modify erotic representations and to improve the communication between the partners in order to increase sexual satisfaction with prosthesis-assisted sexuality. [ABSTRACT FROM AUTHOR]

Introduction: Polycythemia vera is a polyglobular myeloproliferative syndrome related to the mutation of multipotent hemopoietic stem cells. This case report describes a patient whose bladder tumor was associated with polycythemia vera and erectile dysfunction. The association of bladder neoplasia with polycythemia vera and erectile dysfunction has not previously been reported in the literature.Case Presentation: A 40-year-old Moroccan man was followed up for a bladder tumor which manifested with coagulant hematuria and a facial erythrosis with a hemoglobin level of 20.3g/L suggesting polycythemia vera. The patient also suffered from an erectile disorder. Considering the anesthesia difficulty due to polyglobulia, the patient was treated by bleeding. This treatment enabled the patient's sexual performance to be improved and adjustment of his hemoglobin to a level allowing anesthesia, and hence surgical resection of his bladder tumor.Conclusion: Erectile dysfunction associated with polycythemia vera is elucidated by rheological disorders. Bleeding contributed to satisfactory sexual performance and facilitated treatment of polycythemia vera because it enabled anesthesia to be performed and hence the surgical resection of the bladder tumor. [ABSTRACT FROM AUTHOR]