UNASSIGNED: There is a paucity of long-term objective and patient-reported outcomes after definitive perineal urethrostomy for complex urethral strictures. Our objective is to determine comprehensive long-term success of perineal urethrostomy with our 15-year experience at a reconstructive referral center.
UNASSIGNED: Patients who underwent perineal urethrostomy between 2009 and 2023 were identified. A comprehensive long-term follow-up was conducted, evaluating both objective outcomes (retreatment-free survival) and subjective outcomes through the use of validated questionnaires. Additionally, to provide further context for our findings, we conducted a scoping review of all studies reporting outcomes following perineal urethrostomy.
UNASSIGNED: Among 76 patients, 55% had iatrogenic strictures, with 82% previously undergoing urethral interventions. At a median follow-up of 55 months, retreatment-free survival was 84%, with 16% of patients experiencing perineal urethrostomy recurrent stenosis. Patient-reported outcomes revealed a generally satisfactory voiding function (Urethral Stricture Surgery patient-reported outcome measure Lower Urinary Tract Symptoms score) and continence (International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form), with median scores of 4 (range 0-24) and 0 (range 0-21), but with bimodal distributions of sexual function scores (median International Index of Erectile Function-Erectile Function domain: 3.5; median Male Sexual Health Questionnaire-Ejaculation Scale: 21). Treatment satisfaction was very high with a median International Consultation on Incontinence Questionnaire-Satisfaction outcome score of 21 (range 0-24). The scoping review revealed varying success rates ranging from 51% to 95%, highlighting difficulties in comparison due to variable success definitions and patient case mix.
UNASSIGNED: Perineal urethrostomy provides effective treatment for complex anterior urethral strictures, with high patient satisfaction, preserved continence function, and favorable voiding outcomes. It presents a viable option for older and comorbid patients, especially after thorough counseling on expected outcomes and potential risks.

UNASSIGNED: Deep Brain Stimulation (DBS) effectively treats Parkinson\'s motor symptoms, but its effects on the urogenital system are debated.
UNASSIGNED: A research was conducted in PubMed, Embase, Cochrane Library, Web of Science, and Scopus until February 27, 2024. We primarily focused on DBS\'s impact on Parkinson\'s patients\' Urine storage function, voiding function, sexual function, and quality of life.
UNASSIGNED: Our meta-analysis included 14 studies. The main results showed that DBS resulted in fewer instances of urinary urgency (OR = 1.85, 95% CI: 1.26 to 2.70, p = 0.002) and increased maximum bladder capacity (MD = -66.10, 95% CI: -119.37 to -12.82, p = 0.02) in terms of urinary storage function. However, there were no significant differences in first desire to void and strong desire to void. In terms of voiding function, DBS showed significant improvements in maximum flow rate (MD = -0.64, 95% CI: -1.23 to -0.05, p = 0.03), post-void residual (MD = -6.79, 95% CI: 4.54 to 9.05, P < 0.00001) and detrusor pressure during maximum flow (MD = -1.37, 95% CI: -2.73 to -0.02, p = 0.05). Additionally, there was no significant difference in sexual function between the two groups (MD = -1.41, 95% CI: -12.40 to 9.57, p = 0.80).
UNASSIGNED: DBS has demonstrated a certain degree of efficacy in ameliorating urinary storage and voiding function in patients with Parkinson\'s disease. However, certain urodynamic parameters or scores do not demonstrate any statistically significant disparities. Furthermore, DBS has no significant impact on erectile function in male Parkinson\'s patients.
UNASSIGNED: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023476661, identifier CRD42023476661.

BACKGROUND: One of the changes caused by pelvic cancers is the decrease in patients\' sexual function, which influences their quality of life (QoL) during and after treatment. Sexual dysfunction (SD) is associated with severe ejaculatory dysfunction, sexual dissatisfaction, reduced libido and sexual desire, decreased intensity of orgasm, difficulty in erection, and lower sexual frequency.
OBJECTIVE: This systematic review investigated the effectiveness of conservative treatments (nonsurgical and nonpharmacologic) for SD in males with pelvic cancer.
METHODS: Systematic searches were performed in the Cochrane Library, PubMed, CINAHL, PEDro, Embase, and VHL databases in September 2023 by using MeSH terms related to population, study design, intervention, and outcome.
RESULTS: Only prostate cancer studies were included due to a lack of studies in other treatments. Studies used pelvic floor muscle training (8 studies); biofeedback (1 study); a penile vibrator (1 study); electrostimulation (2 studies); shock wave therapy (2 studies); aerobic, resistance, and flexibility exercises (2 studies); and a vacuum erection device (1 study). All articles assessed sexual function and reported improvements in the intervention group, including 5 with no differences between the groups. Articles involving shock wave therapy described improvements in SD but were not clinically relevant. Studies evaluating QoL reported benefits in the experimental groups. Adverse effects of a vacuum erection device and penile vibrator were reported.
CONCLUSIONS: Conservative treatments are more effective than others in treating SD in men with prostate cancer. Further studies are needed to assess the unwanted effects of these treatments. In this study, we found evidence that this type of therapy improves sexual function and QoL in this population.

The purpose of the study was to compare the protective effects of robotic rectal cancer surgery (RRCS) and laparoscopic rectal cancer surgery (LRCS) on urinary and sexual function of patients. We conducted a systematic search in the PubMed, Web of Science, Cochrane Library, and Embase for studies comparing the impact of RRCS and LRCS on urinary function and sexual function. The International Prostate Symptom Score (IPSS), the five-item version of the International Index of Erectile Function (IIEF-5) and the Female Sexual Function Index(FSFI) were used to evaluate the urinary function and sexual function of patients. A total of 13 studies comprising 1964 patients were included in this meta-analysis, including 3 randomized controlled trials, 5 retrospective cohort studies, 3 prospective cohort studies, and 2 propensity score-matched studies. Nine hundred and fifty-nine patients underwent RRCS and 1005 patients underwent LRCS. Statistical analysis of the IPSS scores indicated urinary function was significantly better in the RRCS group than in the LRCS group at 3, 6 and 12 months postoperatively [mean difference (MD), - 1.06, 95% CI - 1.85 to - 0.28; and MD, - 0.96, 95% CI - 1.60 to - 0.32; and MD, - 1.09, 95% CI - 1.72 to - 0.46]. Statistical analysis of the IIEF-5 scores indicated male sexual function was significantly better in the RRCS group than in the LRCS group at 3, 6 and 12 months postoperatively (MD, 1.76, 95% CI 0.80 to 2.72; and MD, 1.83, 95% CI 0.34 to 3.33; and MD, 1.05, 95% CI 0.09 to 2.01). Statistical analysis of the FSFI scores indicated female sexual function was significantly better in the RRCS group than in the LRCS group at 6 and 12 months postoperatively (MD, 2.86; 95% CI 1.38 to 4.35; and MD, 4.19; 95% CI 1.85 to 6.54). RRCS is more favorable than LRCS in preserving the urinary and sexual function of patients with rectal cancer.

This systematic review and meta-analysis study aimed to investigate the effect of sexual counseling based on PLISSIT (Permission, Limited Information, Specific Suggestions, and Intensive Therapy) and EX-PLISSIT models on sexual function, satisfaction, and quality of sexual life. We searched seven electronic databases (MEDLINE, CINAHL, Web of Science, Cochrane Library, ProQuest, Scopus, and PubMed). Studies published between January 1, 2010, and August 16, 2022, were included in the search. Eighteen articles were eligible for inclusion in the analysis. There was a significant difference in the sexual function scores of the PLISSIT and EX-PLISSIT groups and the comparison groups (standardized mean difference (SMD): 1.677; 95% CI 0.668, 2.686; p < 0.05) and \"sexual and communication satisfaction\" sub-dimension of sexual life quality (SMD: 0.748; 95% CI 0.022, 1.475; p < 0.05). There was no difference in the sexual satisfaction (SMD: 0.425; 95% CI - 0.335, 1.184; p > 0.05) and quality of sexual life scores of the PLISSIT and EX-PLISSIT groups and the comparison groups (SMD: - 0.09; 95% CI - 0.211, 0.032; p > 0.05). PLISSIT and EX-PLISSIT models-based sexual counseling on sexual function was affected by the moderator variables of the time of evaluation of the results after the intervention, type of comparison group, the study population, and by whom the intervention was applied. Sexual counseling based on the PLISSIT and EX-PLISSIT models improved sexual function scores and \"sexual and communication satisfaction\" sub-dimension of sexual life quality.

BACKGROUND: Yoga practice can increase blood flow in the genital area, increase muscular strength, and improve body perception, which is related to sexual function. This study aimed to summarize the available evidence about the effects of yoga on sexual function in adults.
METHODS: Systematic searches of five databases were conducted from inception to April 28, with the last update on September 28, 2023. Randomized clinical trials (RCTs) that compared yoga with nonintervention control groups on sexual function in adults. Risk of bias and certainty of evidence were assessed by the Cochrane risk of bias tool 2, and the GRADE approach, respectively. Summary effect size measures were calculated using a random-effects model estimation and are reported as standardized mean differences and 95% confidence intervals. Reporting followed the PRISMA guidelines.
RESULTS: Ten RCTs that comprised 730 adults (range mean age, 26.64-68.2 years; 680 [93.2 %] women) were included. For the primary outcome, yoga intervention was associated with a significant small improvement in sexual function (-0.31; -0.47 to -0.15, p = 0.0002), with some concerns about risk of bias in nine RCTs (90%) and low-certainty evidence. Subgroup analyses revealed that yoga interventions performed by women (-0.36; -0.52 to -0.21, p < 0.00001), healthy individuals (-0.38; -0.59 to -0.16, p = 0.0006), or middle-aged individuals (-0.44; -0.63 to -0.25, p < 00001) significantly improved sexual function compared with control groups.
CONCLUSIONS: Yoga was associated with a small improvement in sexual function compared with nonintervention control groups in adults. However, high-quality, larger RCTs are required to draw more definitive conclusions.

Most sexually active women of reproductive age have used contraception, with hormonal methods constituting approximately 40% of contraceptive choices. Among these hormonal options, combined oral contraceptives stand out as the most selected. Within this same demographic, sexual issues are prevalent. Although specific hormonal contraceptives have been implicated in sexual dysfunction among these women, the correlation lacks consistency across studies and varies between different types of hormonal contraception. This article assesses the available literature on the associations between various hormonal contraceptive methods and sexual function and provides practical management insights.

Pelvic floor disorders can result in laxity, hypertonicity or spasm, all of which can impact sexual function. It is important for clinicians to understand this impact in order to appropriately counsel and treat their patients.

BACKGROUND: Overactive bladder (OAB) is a condition defined by urgency with or without incontinence which disproportionately affects female patients and has a negative impact on sexual enjoyment and avoidance behaviour. Pharmacotherapy can be considered one of the main options for treating OAB. This research set out to determine the impact of pharmacotherapy on sexual function in females with OAB.
METHODS: This research used the robust methodology of a systematic review. The clinical question was formulated using the PICO (population, intervention, control, and outcomes) format to include females being treated with pharmacotherapy (anticholinergics or beta-3 adrenergic agonists) for idiopathic OAB with the use of a validated questionnaire assessing self-reported sexual function at baseline and post-treatment. The review incorporated the MEDLINE, PubMed and EMBASE databases. The AMSTAR 2 (A Measurement Tool to Assess Systematic Reviews) appraisal tool was used to guide the review process. Two reviewers worked independently in screening abstracts, deciding on the inclusion of full-texts, data extraction and risk of bias assessment.
RESULTS: In female patients with OAB, pharmacotherapy does seem to offer at least partial improvement in self-reported sexual function outcomes after 12 weeks of therapy. Still, the value of this finding is limited by an overall poor quality of evidence. Patients with a higher degree of bother at baseline stand to benefit the most from treatment when an improvement within this health-related quality of life domain is sought.
CONCLUSIONS: This research should form the basis for a well-conducted randomized controlled study to accurately assess sexual function improvements in females being treated with pharmacotherapy for OAB.

Premature ovarian insufficiency (POI) is a rare condition characterized by loss of ovarian function before the age of 40. POI seems associated with mood disorders and sexual dysfunction. However, there is a lack of high-quality evidence relating to the impact of POI on sexual function. Therefore, we conducted a systematic review and meta-analysis to evaluate sexual function in women with POI compared to women without the condition. The following online databases were systematically searched up to January 2023: EMBASE, Medline (Ovid), Web of Science, Cochrane, PsychInfo, and Google Scholar. Random effects models were used for analyses, with data reported as Hedges\' g and 95 % confidence interval, and the risk of heterogeneity was evaluated. The protocol of this study was registered with PROSPERO (CRD42023437203). A total of 10 studies were included in the systematic review and 5 studies involving 352 women with POI were included in the meta-analysis. Eight of the ten studies concluded that women with POI have reduced sexual function. An overall medium Hedges\' g effect size of -0.72 was found (ranging between -0.20 and -1.29) in favor of control women, with moderate heterogeneity (I2 = 64 %). Stratified studies of women on systemic hormone replacement therapy (HRT) showed an even higher Hedges\' g effect size, of -0.82 (95 % CI -1.18, -0.47). In conclusion, sexual function in women with POI is reduced compared with control women. Sexual function should be discussed with women with POI and they should be offered psychosexual counseling.