Sexual

  • 文章类型: Journal Article
    血清甲状腺激素水平或甲状腺相关功能障碍的波动会对性行为或行为产生负面影响,以及夫妻关系或满意度的中断。因此,本系统综述和荟萃分析研究旨在调查甲状腺疾病(TGD)男性性功能障碍的全球患病率.
    这项系统评价和荟萃分析研究是根据PRISMA陈述标准进行的,该标准涉及代表TGD男性性功能障碍患病率的可用证据。最初的搜索过程是在7月应用的,2023年。在这个时代,“患病率”的主要关键词,“性障碍”,“性障碍”,“性功能障碍”,“男性性功能障碍”,“勃起功能障碍”,\"男性\",\"男人\",“甲状腺疾病”,“甲状腺疾病”,“甲状腺功能亢进”,\"甲状腺\",和“甲状腺炎”被雇佣了。此外,\"AND\"和\"OR\"运算符用于关键字组合。所有预期的研究都是使用WebofScience的数据库进行搜索的,谷歌学者,Scopus,ScienceDirect,PubMed,和Embase。采用随机效应模型进行分析,并通过I2指数评估研究的异质性。数据分析采用CMA软件(v.2)。
    对17项符合条件的研究进行评估,样本量为501人,TGD男性性功能障碍的全球患病率为51.5%(95%CI:38.7-64).此外,男性性功能障碍在甲状腺功能减退和甲状腺功能亢进病例中的患病率分别为59.1%(95%CI:37.2-77.8)和41.5%(95%CI:25.9-59.1),分别。荟萃回归分析表明,随着样本量的递增趋势,TGD男性性功能障碍的全球患病率下降。这项评估还显示,男性性功能障碍的患病率随着研究进行的年份而增加,显著(p<0.05)。
    发现TGD男性性功能障碍的全球患病率相对较高。还,据报道,在甲状腺功能减退病例中,性功能障碍的患病率最高.因此,建议卫生政策制定者告知容易出现这种病理的个体关于TGD对性功能障碍的负面影响。此外,受TGD影响的病例可以通过及时的药物治疗来预防性功能障碍和不愉快的后果。
    UNASSIGNED: fluctuation in serum levels of thyroid hormones or thyroid-associated dysfunction can negatively affect the sexual behaviors or performance, and disruption in couples` relationship or satisfaction. Thus, this systematic review and meta-analysis study was aimed to investigate the global prevalence of sexual dysfunction in men with thyroid gland disorders (TGD).
    UNASSIGNED: this systematic review and meta-analysis study conducted based on PRISMA statement criteria regarding the available evidences representing the prevalence of sexual dysfunction in men with TGD. The initial searching process was applied on July, 2023. In this era, the main keywords of \"Prevalence\", \"Sexual disorders\", \"Sexual disorder\", \"Sexual dysfunction\", \"Male sexual dysfunction\", \"Erectile dysfunction\", \"Males\", \"Men\", \"Thyroid disorders\", \"Thyroid diseases\", \"Hyperthyroidism\", \"Thyroid\", and \"Thyroiditis\" were hired. Also, \"AND\" and \"OR\" operators were used for keywords combination. All intended studies were searched using the databases of Web of Science, Google Scholar, Scopus, ScienceDirect, PubMed, and Embase. Random effects model was used to perform the analysis and the heterogeneity of the studies was assessed through I2 index. Data analysis was applied with CMA software (v.2).
    UNASSIGNED: following the assessment of 17 eligible studies with a sample size of 501 individuals, the global prevalence of male sexual dysfunction with TGD was found 51.5% (95% CI:38.7-64). Also, the prevalence of male sexual dysfunction in hypothyroidism and hyperthyroidism cases was 59.1% (95% CI:37.2-77.8) and 41.5% (95% CI:25.9-59.1), respectively. The meta-regression analysis showed that following incremental trend in sample size, the global prevalence of male sexual dysfunction with TGD decreases. This assessment also revealed that the prevalence of male sexual dysfunction increases with the year of study conduction, significantly (p < 0.05).
    UNASSIGNED: the global prevalence of sexual dysfunction in men with TGD was found relatively high. also, the highest prevalence of sexual disorders was reported in hypothyroid cases. Thus, health policymakers are suggested to inform the individuals prone to this pathology regarding the negative effects of TGD on sexual dysfunction. Besides, TGD-affected cases can prevent sexual disorders and unpleasant consequences through timely medical treatments.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Systematic Review
    自闭症谱系障碍(ASD)和性犯罪(SO)之间的关系是一个被忽视的问题,在临床实践和研究中。基于预先指定的协议(PROSPERO:CRD42024501598),我们系统地搜索了Pubmed和Scopus,1月1日之间,1994年1月12日,2024年,有关ASD中与SO相关的文章。使用特定于研究设计的工具评估研究质量(研究质量评估工具,NHLBI,NIH)。我们发现了19篇相关出版物(五项横断面研究,两项病例对照研究,和12例病例报告)。其中七项研究被认为质量“好”,其余的为“公平”。纳入的研究涉及三个关键方面:1)ASD患者的心理病理学特征增加了SO的风险;2)ASD和SO患者的干预策略;3)ASD和SO患者参与司法系统。总的来说,虽然人们对这个话题的兴趣越来越大,更严格的研究设计,包括随机对照试验,需要为临床实践、医疗保健和社会政策提供信息。
    The relationship between autism spectrum disorder (ASD) and sexual offending (SO) is an overlooked issue, both in clinical practice and in research. Based on a pre-specified protocol (PROSPERO: CRD42024501598), we systematically searched Pubmed and Scopus, between January 1st, 1994 and January 12th, 2024, for articles related to SO in ASD. Study quality was assessed with study design-specific tools (Study Quality Assessment Tools, NHLBI, NIH). We found 19 relevant publications (five cross-sectional studies, two case-control studies, and 12 case reports). Seven of the studies were deemed of \"good\" quality, the rest as \"fair\". Included studies addressed three key aspects: 1) psychopathological characteristics of individuals with ASD that increase the risk of committing SO; 2) intervention strategies for individuals with ASD and SO; 3) involvement of individuals with ASD and SO in the justice system. Overall, while there is an increasing interest in this topic, more rigorous study designs, including randomised controlled trials, are needed to inform clinical practice and healthcare and social policies.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    背景:尽管亨廷顿病(HD)通常被认为是运动的三联症,认知,和精神症状,人们越来越认识到HD是一种影响整个身体的系统性疾病。
    目的:这篇综述旨在引起人们对HD患者这些系统性非运动症状的关注。
    方法:我们通过搜索MEDLINE(从1966年到2023年9月)确定了以英文发表的相关研究,使用以下主题词:亨廷顿病,自主性,系统性,心血管,呼吸,胃肠,泌尿,性和皮肤,和其他特定症状。
    结果:对123篇文章的数据进行了严格审查,重点关注与HD相关的系统特征,比如心血管,呼吸,胃肠,泌尿,性和出汗
    结论:本系统综述提请注意HD患者的各种系统性和自主神经并发症。并非所有这些都与原发性HD症状或CAG重复的严重程度相关。需要更多的研究来更好地了解HD的全身和自主神经功能障碍的病理生理学和治疗。
    BACKGROUND: Although Huntington\'s disease (HD) is usually thought of as a triad of motor, cognitive, and psychiatric symptoms, there is growing appreciation of HD as a systemic illness affecting the entire body.
    OBJECTIVE: This review aims to draw attention to these systemic non-motor symptoms in HD.
    METHODS: We identified relevant studies published in English by searching MEDLINE (from 1966 to September 2023), using the following subject headings: Huntington disease, autonomic, systemic, cardiovascular, respiratory, gastrointestinal, urinary, sexual and cutaneous, and additional specific symptoms.
    RESULTS: Data from 123 articles were critically reviewed with focus on systemic features associated with HD, such as cardiovascular, respiratory, gastrointestinal, urinary, sexual and sweating.
    CONCLUSIONS: This systematic review draws attention to a variety of systemic and autonomic co-morbidities in patients with HD. Not all of them correlate with the severity of the primary HD symptoms or CAG repeats. More research is needed to better understand the pathophysiology and treatment of systemic and autonomic dysfunction in HD.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    目的:根治性膀胱切除术(RC)对泌尿系统有不利影响,性,和生殖系统。减轻术后功能生活质量下降的方法包括保留器官和保留神经的RC变化;然而,关于女性性别特定结局的高质量数据仍然很少.我们的目的是确定和总结有关泌尿的可用数据,性,和健康相关的生活质量(HRQOL)结果,女性膀胱癌(BCa)的生殖器官保留(ROPRC)和神经保留RC(NSRC)。
    方法:PubMed,Scopus,搜索和WebofScience数据库以确定报告接受RC和尿路改道治疗BCa的女性患者功能结局的研究。感兴趣的结果是排尿功能(对于原位新膀胱),性功能,HRQOL。得出以下独立变量并将其纳入荟萃分析:白天和夜间失禁/失禁的合并率以及间歇性自我导管插入(ISC)率。对传统的,保留器官和/或神经的手术方法。
    结果:53项研究包括2,740名女性患者(1,201名接受传统治疗;1,539-器官/NS-保留,或264-NS单独RC)符合定性合成的条件;包括2,418名女性患者的44项研究纳入定量合成。在原位新膀胱(ONB)转移的女性中,传统的白天节制后的汇总率,ROPRC和NSRC分别为75.2%,79.3%,71.2%,分别。传统RC后夜间失禁的合并率为59.5%;在接受ROPRC和NSRC的女性中,这一比率分别增加到70.7%和71.7%,分别。女性患者传统RC合并ONB转流后ISC的合并率为27.6%,ROPRC和NSRC降低至20.6%和16.8%,分别。在评估术后性和HRQOL结果时使用不同的定义和问卷无法进行系统比较。
    结论:在RC期间女性保留器官和神经的手术入路似乎可以改善排尿功能。非常需要精心设计的研究探索性和HRQOL结果,以建立基于证据的管理策略,以支持针对患者期望和满意度的共享决策过程。理解预期的功能,性,和生活质量的结果是必要的,以便在计划接受RC的女性患者中进行个性化的前后咨询和护理。
    OBJECTIVE: To determine and summarize the available data on urinary, sexual, and health-related quality-of-life (HRQOL) outcomes after traditional radical cystectomy (RC), reproductive organ-preserving RC (ROPRC) and nerve-sparing RC (NSRC) for bladder cancer (BCa) in female patients.
    METHODS: The PubMed, SCOPUS and Web of Science databases were searched to identify studies reporting functional outcomes in female patients undergoing RC and urinary diversion for the treatment of BCa. The outcomes of interest were voiding function (for orthotopic neobladder [ONB]), sexual function and HRQOL. The following independent variables were derived and included in the meta-analysis: pooled rate of daytime and nighttime continence/incontinence, and intermittent self-catheterization (ISC) rates. Analyses were performed separately for traditional, organ- and/or nerve-sparing surgical approaches.
    RESULTS: Fifty-three studies comprising 2740 female patients (1201 traditional RC and 1539 organ-/nerve-sparing RC, and 264 nerve-sparing-alone RC) were eligible for qualitative synthesis; 44 studies comprising 2418 female patients were included in the quantitative synthesis. In women with ONB diversion, the pooled rates of daytime continence after traditional RC, ROPRC and NSRC were 75.2%, 79.3% and 71.2%, respectively. The pooled rate of nighttime continence after traditional RC was 59.5%; this rate increased to 70.7% and 71.7% in women who underwent ROPRC and NSRC, respectively. The pooled rate of ISC after traditional RC with ONB diversion in female patients was 27.6% and decreased to 20.6% and 16.8% in patients undergoing ROPRC and NSRC, respectively. The use of different definitions and questionnaires in the assessment of postoperative sexual and HRQOL outcomes did not allow a systematic comparison.
    CONCLUSIONS: Female organ- and nerve-sparing surgical approaches during RC seem to result in improved voiding function. There is a significant need for well-designed studies exploring sexual and HRQOL outcomes to establish evidence-based management strategies to support a shared decision-making process tailored towards patient expectations and satisfaction. Understanding expected functional, sexual and quality-of-life outcomes is necessary to allow individualized pre- and postoperative counselling and care delivery in female patients planned to undergo RC.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Systematic Review
    近期多国爆发的猴痘(Monkeypoxdisease)已构成突发公共卫生事件。尽管已知动物到人的传播是主要的传播方式,据报告,通过人与人接触传播的病例越来越多。在最近的水痘爆发期间,性或亲密接触被认为是最重要的传播方式。然而,其他传播途径不可忽视。猴痘病毒(MPXV)如何传播的知识对于实施适当的措施来遏制疾病的传播至关重要。因此,这项系统评价旨在收集发表的关于性互动以外的其他牵连感染源的科学数据,比如呼吸微粒的参与,接触污染表面和皮肤与皮肤接触。本研究采用系统评价和荟萃分析(PRISMA)的首选报告项目指南进行。包括分析Mpox指数病例的接触及其接触后结果的出版物。共调查了7319人与人之间的接触,其中273人成为阳性病例。在与同居的人接触后,验证了MPXV的阳性二次传播,和家人在一起,与医护人员一起,或在医疗保健设施内,以及性接触或与污染表面接触。用同一个杯子,分享同样的菜肴,在同一房间或床上睡觉也与传播呈正相关。五项研究表明,尽管与表面接触,但没有传播的证据,皮肤与皮肤的接触,或通过采取控制措施的医疗机构内的气道颗粒。这些记录支持人与人之间传播的情况,并表明性接触以外的其他类型的接触会带来感染的巨大风险。进一步的研究对于阐明MPXV传输动力学至关重要,并采取适当措施遏制感染的传播。
    The recent multi-country outbreak of Mpox (Monkeypox disease) constituted a public health emergency. Although animal-to-human transmission is known to be the primary way of transmission, an increasing number of cases transmitted by person-to-person contact have been reported. During the recent Mpox outbreak sexual or intimate contact has been considered the most important way of transmission. However, other routes of transmission must not be ignored. The knowledge of how the Monkeypox Virus (MPXV) spreads is crucial to implement adequate measures to contain the spread of the disease. Therefore, this systematic review aimed to collect scientific data published concerning other implicated sources of infection beyond sexual interaction, such as the involvement of respiratory particles, contact with contaminated surfaces and skin-to-skin contact. The current study was performed using the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Publications analyzing contacts of Mpox index cases and their outcome after contact were included. A total of 7319 person-to-person contacts were surveyed and 273 of them became positive cases. Positive secondary transmission of MPXV was verified after contact with people cohabiting in the same household, with family members, with healthcare workers, or within healthcare facilities, and sexual contact or contact with contaminated surfaces. Using the same cup, sharing the same dishes, and sleeping in the same room or bed were also positively associated with transmission. Five studies showed no evidence of transmission despite contact with surfaces, skin-to-skin contact, or through airway particles within healthcare facilities where containment measures were taken. These records support the case for person-to-person transmission and suggest that other types of contact beyond sexual contact pose a significant risk of acquiring the infection. Further investigation is crucial to elucidate MPXV transmission dynamics, and to implement adequate measures to contain the spread of the infection.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Meta-Analysis
    工作场所暴力(WPV)是一种普遍存在的现象,尤其是在医疗保健方面。在COVID-19流行期间,针对医护人员(HCWs)的WPV有所增加。这项荟萃分析确定了WPV的患病率和危险因素。2022年5月对六个数据库进行了数据库搜索,并于2022年10月进行了更新。HCW中WPV的患病率是主要结果。数据按WPV/HCW类型分层,大流行期(早期,mid,late),和医学专业。WPV危险因素是次要结果。所有分析均通过STATA进行。纽卡斯尔渥太华量表评价质量。敏感性分析确定了影响估计的变化。共分析了38项研究(63,672HCWs)。任何类型的WPV的患病率(43%),物理(9%),口头(48%),和情感(26%)高。从大流行中期到大流行后期,WPV(40-47%),身体暴力(12-23%)言语暴力(45-58%)增加。护士的身体暴力发生率是前者的两倍多(13%vs.5%)比医生,而WPV和言语暴力是平等的。性别,职业,COVID-19的时机没有影响WPV,物理,或言语暴力风险。COVID-19医护人员更有可能受到身体攻击(logOR=0.54;95%CI:0.10:0.97)。大多数医护人员遭受言语暴力,其次是情感,欺凌,性骚扰,和人身攻击。与大流行有关的工作场所暴力增加。护士的暴力程度是医生的两倍。COVID-19医护人员遭受身体和工作场所暴力的风险更高。
    Workplace violence (WPV) is a prevalent phenomenon, especially in the healthcare setting. WPV against healthcare workers (HCWs) has increased during the COVID-19 epidemic. This meta-analysis determined the prevalence and risk factors of WPV. A database search was conducted across six databases in May 2022, which was updated in October 2022. WPV prevalence among HCWs was the main outcome. Data were stratified by WPV/HCW type, pandemic period (early, mid, late), and medical specialty. WPV risk factors were the secondary outcome. All analyses were conducted through STATA. Newcastle Ottawa Scale evaluated the quality. Sensitivity analysis identified effect estimate changes. A total of 38 studies (63,672 HCWs) were analyzed. The prevalence of WPV of any kind (43%), physical (9%), verbal (48%), and emotional (26%) was high. From mid-pandemic to late-pandemic, WPV (40-47%), physical violence (12-23%), and verbal violence (45-58%) increased. Nurses had more than double the rate of physical violence (13% vs. 5%) than physicians, while WPV and verbal violence were equal. Gender, profession, and COVID-19 timing did not affect WPV, physical, or verbal violence risk. COVID-19 HCWs were more likely to be physically assaulted (logOR = 0.54; 95% CI: 0.10: 0.97). Most healthcare employees suffer verbal violence, followed by emotional, bullying, sexual harassment, and physical assault. Pandemic-related workplace violence increased. Nurses were twice as violent as doctors. COVID-19 healthcare employees had a higher risk of physical and workplace violence.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Systematic Review
    背景:提出不良儿童经历(ACE)会增加以后患多发性硬化症(MS)的风险。本系统综述旨在探讨ACE与MS发展的相关性。发病年龄,MS患者的生活质量和MS复发率。
    方法:我们在2022年6月共检索了6个数据库,检索了相关研究。人群包括已被诊断或有患MS的风险并且也暴露于ACE的成年(18)个体。我们的主要结果包括MS发展的风险,MS发病年龄,暴露于不同类型ACE的患者的MS复发率。
    结果:共有11项研究纳入我们的综述。一项研究报告说,在300名被诊断患有MS的女性中,71(24%)报告了儿童虐待史;此外,随着进一步的研究,结论是ACE与MS的发展有关。与未暴露样品相比,每周发生2-3次的滥用与MS风险增加18.81倍相关。与未报告任何ACE的个体相比,在严重的ACE病例中,MS的复发率明显更高。
    结论:结果支持ACE与MS发展之间的显著关联;具有ACE阳性病史的个体较早发展MS症状。此外,ACEs的严重程度也与MS的复发率增加有关。
    Adverse childhood experiences (ACEs) are proposed to increase the risk of developing multiple sclerosis (MS) later in life. This systematic review aimed to explore the correlation between ACEs and MS development, age of onset, quality of life in MS patients and MS relapse rates.
    We searched a total of six databases in June 2022 and retrieved the relevant studies. The population included adult (18+) individuals who either had been diagnosed or were at risk for developing MS and also had exposure to ACEs. Our primary outcomes include the risks of MS development, age of MS onset, and MS relapse rate in patients who were exposed to different types of ACEs.
    A total of 11 studies were included in our review. A study reported that among 300 women diagnosed with MS, 71 (24%) reported a history of childhood abuse; moreover, with further research, it was concluded that ACEs were associated with the development of MS. Abuse that occurred 2-3 times per week was associated with an 18.81-fold increased risk of having MS when compared to the unexposed sample. The relapse rate of MS was found to be substantially greater in severe cases of ACEs compared to individuals who did not report any ACEs.
    Results support a significant association between ACEs and the development of MS; individuals with a positive history of ACEs develop MS symptoms earlier. Moreover, the severity of ACEs is also linked with increased relapse rates of MS.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Review
    背景:血精症(HS)是射精液中存在血液。这是一种罕见的疾病,是历史上特发性或与性行为有关。技术进步已经确定了HS背后的许多病因,改善治疗。虽然通常是良性的,HS仍然是患者严重性焦虑的来源。很少有论文概述了HS的诊断和治疗方法,没有人明确解决它的性后果。
    目的:为全面概述HS,强调它的性后果。
    方法:到2021年5月进行了PubMed文献检索,以确定与病因学相关的所有相关出版物,诊断,治疗,和HS的性影响。对原始研究和评论进行了分析,相关研究纳入本综述.
    结果:医源性干预措施(例如,经直肠超声引导下的前列腺活检)是HS的最常见原因。感染和/或非特异性炎症是最常见的非医源性病因。恶性肿瘤,包括前列腺,睾丸,和其他泌尿生殖系统癌症,很少是HS的原因。可以根据患者年龄(小于或大于40岁)组织HS的诊断方法,持续出血,以及相关症状的存在/不存在。尽管HS经常自发解决,治疗可能需要各种药物(例如,抗生素,抗炎药)或手术干预。HS有几个性影响,包括影响性欲的焦虑,性伴侣和非性附属机构的社会影响,勃起功能障碍或性传播感染的风险增加,生育能力受损,特别是当使用冷冻保存时。
    结论:HS可能通过多种机制显著影响性健康,尽管关于这个问题的正式数据很少。需要进一步的研究来充分了解HS对性生活的影响的严重程度和程度,尤其是那些顽固性出血的患者.
    Hematospermia (HS) is the presence of blood in ejaculatory fluid. It is a rare condition that is historically idiopathic or associated with sexual behavior. Technological advances have identified many of the etiologies behind HS, improving treatment. Though often benign, HS remains a source of considerable sexual anxiety for patients. Few papers have outlined a diagnostic and therapeutic approach to HS, and none have explicitly addressed its sexual consequences.
    To provide a comprehensive overview of HS, emphasizing its sexual ramifications.
    A PubMed literature search was performed through May 2021 to identify all relevant publications related to etiology, diagnosis, treatment, and sexual effects of HS. Original research and reviews were analyzed, and pertinent studies were included in this review.
    Iatrogenic interventions (eg, transrectal ultrasound-guided prostate biopsies) are the most common cause of HS. Infection and/or nonspecific inflammation is the most common non-iatrogenic etiology. Malignancies, including prostate, testicular, and other genitourinary cancers, are rarely the cause of HS. Diagnostic approaches to HS can be organized according to patient age (less than or greater than 40 years old), persistence of bleeding, and the presence/absence of concerning symptoms. Though HS often spontaneously resolves, treatment may require various medications (eg, antibiotics, anti-inflammatories) or surgical interventions. HS has several sexual ramifications, including libido-affecting anxiety, social repercussions from sexual partners and non-sexual affiliates, increased risk of erectile dysfunction or transmission of sexual infections, and compromised fertility, especially when cryopreservation is utilized.
    HS may significantly affect sexual health through several mechanisms, though there is a paucity of formal data on this subject. Further research is needed to fully understand the severity and extent of HS\'s effect on sexual well-being, especially in those with refractory bleeding.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    UNASSIGNED:根治性膀胱切除术(RC)历来被认为是治疗肌肉浸润性和高危非肌肉浸润性膀胱癌的黄金标准。然而,这种技术使大多数男女患者的性功能和泌尿功能较差。保留器官的膀胱切除术(OSC)技术正在成为保留这些功能的标准程序的替代方法。在不影响肿瘤结果的情况下。我们对已发表的文献进行了系统的综述和荟萃分析。
    未经批准:MEDLINE,在2021年4月6日对Embase和WebofScience进行了系统搜索,以寻找合格的研究。研究的主要结果是肿瘤结果,特别是整体复发,和功能结果,特别是性功能,白天和夜间节制。计算具有95%置信区间(95%CI)的赔率比(OR)。PROSPERO注册参考号为CRD42018118897。
    未经评估:从13894个确定的摘要中,19项研究(1886名男性和305名女性患者)符合纳入本综述的条件。这些研究包括接受了整个前列腺的患者,前列腺囊,精囊,神经,子宫,子房,阴道和输卵管保留技术。四项研究仅包括女性患者。13项研究报告了肿瘤结果,两组间的总复发率相似(5项研究;OR0.73;95%CI0.38-1.40,p=0.34).13项研究报道了男性性功能。在男人中,OSC具有显著更大的保留效力的几率(5项研究;OR9.05;95%CI5.07-16.16,p<0.00001)。14项研究(男性13项,女性1项)报告了泌尿结局。在男人中,OSC显示白天(7项研究;OR2.61;95%CI1.74至3.92,p<0.00001)和夜间节制(7项研究;OR2.62;95%CI1.76至3.89,p<0.00001)的几率更大。
    未经证实:在精心挑选的患者中,OSC允许在不损害肿瘤结果的情况下提供更好的性功能和泌尿功能的潜力。仍然存在,然而,女性OSC研究很少。需要进一步的研究以基于可靠的临床证据提出建议。
    UNASSIGNED: Radical cystectomy (RC) is historically considered the gold standard treatment for muscle invasive and high-risk non-muscle invasive bladder cancer. However, this technique leaves the majority of patients of both sexes with poor sexual and urinary function. Organ-sparing cystectomy (OSC) techniques are emerging as an alternative to the standard procedure to preserve these functions, without compromising the oncological outcomes. We present a systematic review and meta-analysis of the published literature.
    UNASSIGNED: MEDLINE, Embase and Web of Science were systematically searched for eligible studies on 6 April 2021. Primary outcomes studied were both oncological outcomes, specifically overall recurrence, and functional outcomes, specifically sexual function, and daytime and nighttime continence. Odds ratios (OR) with 95% confidence intervals (95% CI) were calculated. The PROSPERO registration reference number was CRD42018118897.
    UNASSIGNED: From 13 894 identified abstracts, 19 studies (1886 male and 305 female patients) were eligible for inclusion in this review. These studies included patients who underwent either whole prostate, prostate capsule, seminal vesicle, nerve, uterus, ovary, vagina and fallopian tube sparing techniques. Four studies included only female patients.Thirteen studies reported oncological outcomes, and overall recurrence rate was similar between the two groups (five studies; OR 0.73; 95% CI 0.38-1.40, p = 0.34). Thirteen studies reported on male sexual function. In men, OSC had significantly greater odds of retaining potency (five studies; OR 9.05; 95% CI 5.07-16.16, p < 0.00001). Fourteen studies (13 on males and 1 female) reported urinary outcomes. In men, OSC demonstrated greater odds of daytime (seven studies; OR 2.61; 95% CI 1.74 to 3.92, p < 0.00001) and nighttime continence (seven studies; OR 2.62; 95% CI 1.76 to 3.89, p < 0.00001).
    UNASSIGNED: In carefully selected patients, OSC allows the potential to provide better sexual and urinary function without compromising oncological outcomes. There remains, however, a paucity of OSC studies in females. Further studies are required to make recommendations based on robust clinical evidence.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Systematic Review
    近年来,围绕不孕症后果的社会研究越来越关注男性的观点;然而,对男性不育治疗经验的理解存在差距。这篇综述旨在综合现有的证据,社会,男性不育治疗对男性的性负担,以及临床护理期间的患者需求。一项系统的搜索确定了12项设计多样化的研究,设置,和方法。心理评估发现,泌尿外科手术可能对不孕症特异性压力产生持久影响,治疗失败会导致抑郁,悲伤,和不足。男性在整个生育治疗过程中往往有一种回避的应对机制,和他们的自尊,关系质量,性功能可以与治疗结果联系在一起。可以通过相互支持和加强沟通来加强合作伙伴关系;夫妻分离,然而,已被认为是停止男性不育治疗的主要原因,并且可能与严重男性不育的困难情况有关。手术治疗会影响不育男性的性功能;然而,睾丸精子提取结局的影响似乎是心理驱动的,而显微外科精索静脉曲张切除术后的改善仅在性腺功能减退的男性中明显.临床上,需要更好的包容,通信,教育,和资源供应,解决据报道的男性边缘化和不确定性问题。在严重男性不育症的情况下进行常规的社会心理筛查,在手术治疗失败的情况下进行随访可能是有益的。
    In recent years, social research surrounding the consequences of infertility has increasingly focused on the male perspective; however, a gap exists in the understanding of men\'s experiences of male infertility treatment. This review aims to synthesize the existing evidence concerning the psychological, social, and sexual burden of male infertility treatment on men, as well as patient needs during clinical care. A systematic search identified 12 studies that are diverse in design, setting, and methods. Psychological evaluations have found that urological surgery may have a lasting impact on infertility-specific stress, and treatment failure can lead to feelings of depression, grief, and inadequacy. Men tended to have an avoidant coping mechanism throughout fertility treatment, and their self-esteem, relationship quality, and sexual functions can be tied to outcomes of treatment. Partner bonds can be strengthened by mutual support and enhanced communication; couple separation, however, has been noted as a predominant reason for discontinuing male infertility treatment and may be associated with difficult circumstances surrounding severe male infertility. Surgical treatments can affect the sexual functioning of infertile men; however, the impact of testicular sperm extraction outcomes appears to be psychologically driven whereas the improvements after microsurgical varicocelectomy are only evident in hypogonadal men. Clinically, there is a need for better inclusion, communication, education, and resource provision, to address reported issues of marginalization and uncertainty in men. Routine psychosocial screening in cases of severe male infertility and follow-up in cases of surgical treatment failure are likely beneficial.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

公众号