To explore the efficacy, in terms of sensitivity and specificity, of Erection Hardness Score (EHS) applied to masturbation in diagnosing predominantly organic erectile dysfunction (ED), compared to the actual standard, which is nocturnal penile tumescence and rigidity (NPTR).
A total of 189 consecutive patients who came to our outpatient clinic from October 2019 to October 2020, reporting ED and an abridged International Index of Erectile Function (IIEF-6) score <26 were enrolled. Patients filled out two psychometric questionnaires: the IIEF-6 applied to partnered intercourse and the EHS applied to masturbation, then they underwent the NPTR test with Rigiscan for 2 consecutive nights in good sleep condition. Sensitivity, specificity, positive predictive value, and negative predictive value of EHS and IIEF-6 scales with NPTR as the standard, as well as the correlation between EHS, IIEF-6, and NPTR results were calculated.
Results show that the sensitivity of the EHS scale for the diagnosis of ED was 60.0%, the specificity was 95.7%, the positive predictive value was 83.3%, the negative predictive value was 86.9%, and the coincidence rate was 86.2%. The correlation coefficient was 0.572 and the area under the ROC curve was 0.78, which means the strength of erection in masturbation as evaluated by the EHS can effectively help in discriminating between predominantly organic and apparently nonorganic ED.
An EHS score of 3-4, meaning good-optimal erectile function during masturbation, decreases the likelihood of predominantly organic ED and reduces the need for further NPTR testing.

We investigated the prevalence of problematic masturbation using different criteria. We also investigated if masturbation-related distress was associated with sexual abuse history, family attitudes towards sexuality during childhood, and depression and anxiety symptoms. Here, 12,271 Finnish men and women completed a survey reporting masturbation frequency, desired masturbation frequency, sexual distress, childhood sexual abuse, sex-positive family background, as well as depression and anxiety symptoms. Among both sexes, those whose masturbation frequency did not match with desired frequency experienced more sexual distress. Different conceptualizations of problematic masturbation resulted in different proportions of individuals categorized as having it (i.e., 8.3% of men and 2.7% of women experienced self-perceived problematic masturbation, that is masturbating more than they desired and experiencing sexual distress; 2% of men and 0.6% of women masturbated more frequently than average and meanwhile experienced self-perceived problematic masturbation; 6.3% of men and 2.1% of women masturbated less frequently than average but still experienced self-perceived problematic masturbation). Moreover, among both sexes, self-perceived problematic masturbation was positively associated with childhood sexual abuse, depression, and anxiety, while negatively associated with a sex-positive family background. Our results point to the complexity of defining problematic masturbation. Causes of sexual distress related to masturbation need to be carefully examined case by case to choose an appropriate clinical approach.

About 6 million men in China engage in jiese (abstaining from masturbation and porn) and call themselves jieyou (porn-free self-help community members). In this article, we sought to unpack how the idea of jiese took root in Chinese historical, social, and cultural contexts by interviewing 32 jieyou. Guided by the sensemaking theory, we conducted a critical discourse analysis of participants\' responses and ended up identifying four major themes: embodied experiences, jiese as rational and noble, reconstructing the subjectivity of jieyou, and nationalistic sentiments. We found out that jieyou tended to justify their abstinence by seeking sources of legitimacy in traditional Chinese culture, the ideology of healthism, science, and patriotic discourses. We argue that jiese reflects young men\'s contradictory cultural practices of conservatism, self-medicalization, and neoliberal governmentality.

OBJECTIVE: Several randomized-controlled trials (RCTs) were performed to compare the efficacy of sexual intercourse or masturbation and no sexual activity in treating distal ureteral stones, indicating conflicting results. The meta-analysis was conducted to assess the role of sexual intercourse or masturbation in the treatment of distal ureteral calculi.
METHODS: PubMed, Cochrane Library, EMBASE, Scopus, Clinicaltrail.gov, and Web of Science were searched by October 2021. Men who were instructed of no sexual intercourse or masturbation, and only received standard symptomatic treatment are comparators. Relative risk (RR), weighted mean difference (WMD), and their 95% confidence intervals (CIs) were calculated using random or fixed effects models.
RESULTS: Five RCTs including 500 subjects were analyzed in the study. Compared with controls, subjects in experimental group had significantly higher expulsion rate at 2nd and 4th week (95%CI: 1.334 to 2.638, RR: 1.876, I2 = 73.6%, P < .001; 95%CI: 1.148 to 1.752, RR: 1.418, I2 = 55.9%, P < .001), significantly decreased requirement for analgesic injections (95%CI: -1.071 to -.126, WMD: -.598, I2 = 90.3%, P = .013), and significantly shorter expulsion time (95%CI: -6.941 to -.436, WMD: -3.689, I2 = 83.7%, P = .026).
CONCLUSIONS: Performing sexual intercourse or masturbation 3 or 4 times a week can be an alternative treatment option of distal ureteral calculi (0-10 mm in size). However, more clinical evidence with better designs solving raised concerns is warranted.

BACKGROUND: Negative experiences of and beliefs regarding masturbation frequently affect people\'s psychological well-being and health behaviors, but there is currently no specific assessment tool to measure Chinese people\'s beliefs about masturbation.
OBJECTIVE: The goal of the present study was to develop a brief scale (the Masturbation Beliefs Scale, BMS) for Chinese university students.
METHODS: The BMS was developed and administered online to 2 different samples, with a total sample of 3,231 respondents (1,527 males and 1,704 females). The items were formulated based on previous qualitative research data. Exploratory and confirmatory factor analyses were performed.
RESULTS: The BMS scale contains 3 dimensions with good internal consistency and construct validity, which can well measure Chinese people\'s belief about masturbation.
RESULTS: The results of the two samples showed that the 17-item culturally based BMS demonstrated good internal consistency and construct validity. Three factors capturing university students\' beliefs regarding masturbation emerged. The 3 factors were labeled beliefs about male masturbation (BAMM), beliefs about female masturbation (BAFM), and negative affect toward masturbation (NATM). The participants\' culturally based masturbation beliefs were negatively related to independent self-construal and sexual compulsivity. In addition, their culturally based masturbation beliefs consistently predicted their likelihood of premarital sexual behavior.
CONCLUSIONS: Clinicians and researchers could utilize this culturally sensitive instrument to evaluate individuals\' experiences of masturbation, which could help clinicians deliver efficacious sex therapy and sexual education to individuals who have misconceptions or phobias regarding masturbation.
UNASSIGNED: The scale is an innovative tool that measures culturally relevant beliefs regarding masturbation among Chinese students. A limitation of this study is that several constructs were measured by single questions. This may attenuate the estimated correlation since single items are less reliable than multiple-item scales.
CONCLUSIONS: The present research demonstrates that a culturally sensitive scale is necessary to understand the culturally based values that influence university students\' beliefs regarding masturbation and sexual behavior. Ren Z, Liu Y, Deng J. Development and Validation of the Chinese Version of The Masturbation Beliefs Scale. Sex Med 2022;10:100501.

Background Neisseria gonorrhoeae can be cultured from saliva in men with pharyngeal gonorrhoea and could theoretically be transmitted from the pharynx to the urethra when saliva is used as a lubricant for masturbation. In this work, we proposed that saliva use during masturbation may be a potential transmission route of gonorrhoea. Methods We analysed the transmission of Neisseria gonorrhoeae at the oropharynx, urethra and anorectum with mathematical models among men who have sex with men using data from six different studies. Model 1 included transmission routes (oral sex, anal sex, rimming, kissing, and three sequential sex practices). In Model 2, we added saliva use during solo masturbation and mutual masturbation to model 1. Results Model 2 could replicate single site infection at the oropharynx, urethra and anorectum and multi-site infection across six different datasets. However, the calibration of Model 2 was not significantly different from Model 1 across four datasets. Model 2 generated an incidence of gonorrhoea from masturbation of between 5.2% (95% CI: 3.2-10.1) to 10.6% (95% CI: 5.8-17.3) across six data sets. Model 2 also estimated that about one in four cases of urethral gonorrhoea might arise from solo masturbation and mutual masturbation. Conclusions Our models raise the possibility that saliva use during masturbation may play a role in transmitting gonorrhoea. This is an important area to explore because it contributes to the knowledge base about gonorrhoea transmission.

BACKGROUND: Premature ejaculation (PE) is a highly prevalent male sexual dysfunction. Its current definition, together with the most used diagnostic tools, does not include non-vaginal sexual intercourse such as anal sex, self-masturbation and/or partnered-masturbation, and other forms of sexual stimulation. However, diagnostic psychometry currently available is exclusively evaluating PE in the vaginal coitus.
OBJECTIVE: To validate a new tool, the Masturbatory Premature Ejaculation Diagnostic Tool (MPEDT), by assessing the control over ejaculation and its psychological effects during self-masturbation, rather than heterosexual vaginal intercourse.
METHODS: We studied 135 male patients aging from 18 to 40 years seeking medical care for PE in the Infertility and Sexual Medicine Department from June to September 2020. All the participants were asked to fill the PEDT and MPEDT questionnaires to estimate the PE symptoms during, respectively, intercourse and self-masturbation. The reliability/validity, the factor analysis of the tool, and the diagnostic sensitivity/specificity of MPEDT were calculated.
RESULTS: The overall Cronbach alpha was 0.884. In our adjusted model, both RMSEA (Root Mean Square Error of Approximation) and SRMR (Standardized Root Mean Square Residual) were lower than 0.08, while Goodness of Fit Index (GFI), Adjusted Goodness of Fit Index (AGFI), Non-Normed Fit Index (NNFI), and Comparative Fit Index (CFI) were higher than 0.9. The area under the ROC curve (AUC) is 0.943±0.015. The results suggest MPEDT points being ≤5 as \"normal\", ≥7 as \"PE during self-masturbation\" and 6 as \"suspected PE\", with the sensitivity of 91.9% and specificity of 88.1%.
CONCLUSIONS: An efficient diagnostic psychometric tool is needed for the individuals who, based on the impaired control over ejaculation during self-masturbation, may also suffer from PE during partnered intercourse. MPEDT is able to evaluate the existence of PE symptoms not necessarily during heterosexual intercourse but rather during self-masturbation, possibly aiding to the diagnosis, as well as planning and follow-up of a prompt therapeutical strategy.
CONCLUSIONS: MPEDT could be considered a new, objective and reliable diagnostic tool for the evaluation of the existence of PE symptoms. This article is protected by copyright. All rights reserved.

To explore the efficacy of regular penis-root masturbation (PRM) versus Kegel exercise (KE) in the treatment of primary premature ejaculation (PPE). This study was a prospective quasi-randomised controlled trial. Thirty-seven heterosexual males with PPE were selected according to the time sequence of outpatient consultations and the preliminary results of a pre-experiment and were assigned to an PRM group and a KE group. Differences in intravaginal ejaculatory latency times (IELTs) and premature ejaculation diagnostic tool (PEDT) scores were compared between the two groups. The study was approved by the Ethics Committee of the First Affiliated Hospital of Guangxi Medical University. Among the 37 PPE patients, 18 performed PRM and 19 patients performed KE. The IELTs of patients who performed PRM and KE were significantly prolonged before treatment, and the difference after treatment was statistically significant (p < .05). Compared with the KE group, the IELT prolongation effect in the PRM group was more significant PRM (p < .05). The PEDT scores of patients after performing PRM and KE were significantly lower than those before performing these exercises (p < .05). Compared with the KE group, the PEDT scores of the PRM group exhibited a greater decrease (p < .05). Thus, both PRM and KE have therapeutic effects on PPE. Compared with KE, PRM is more effective in the treatment of PPE.

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OBJECTIVE: To investigate the diagnosis and management of penile fracture.
METHODS: From June 1993 to May 2017, 46 cases of penile fracture were treated in our hospital, averaging 33.5 (25－42) years of age and 3.45 (1－10) hours in duration, of which 41 occurred during sexual intercourse, 4 during masturbation and 1 during prone sleeping, 4 with hematuria, but none with dysuria or urethral bleeding. Hematoma was confined to the penis. Emergency surgical repair was performed for all the patients, 45 under spinal anesthesia and 1 under local anesthesia, 16 by coronal proximal circular incision and the other 30 by local longitudinal incision according to the rupture location on ultrasonogram. The tunica albuginea ruptures averaged 1.31 (0.5－2.5) cm in length, which were sutured in the \"8\" pattern for 6 cases and with the 3－0 absorbable thread for 18 cases. The skin graft or negative pressure drainage tube was routinely placed, catheters indwelt, and gauze used for early pressure dressing. In the recent few years, elastic bandages were employed for 3－5 days of pressure dressing and antibiotics administered to prevent infection. The stitches and catheter were removed at 7 days after surgery.
RESULTS: Short-term postoperative foreskin edema occurred in 14 of the 16 cases of circular degloving incision, but no postoperative complications were observed in any of the cases of local incision. Twenty-eight of the patients completed a long-term follow-up of 49.4 (10－125) months, which revealed good erectile function, painless erection, and satisfactory sexual intercourse.
CONCLUSIONS: For most penile fractures, local longitudinal incision is sufficient for successful repair of the tunica albuginea, with mild injury, no influence on the blood supply or lymph reflux, and a low rate complications. It therefore is obviously advantageous over circular degloving incision except when the cavernous body of urethra is to be explored, which necessitates circular degloving incision below the coronal groove.
目的： 探讨阴茎折断的诊断和治疗。方法： 1993年6月至2017年5月, 我院共收治阴茎折断46例, 平均年龄33.5岁（25~42岁），病程平均3.45 h（1～10 h）。性交时发生41例,手淫4例，俯卧睡觉时发生1例。均无排尿困难及尿道口出血，4例发生了血尿，血肿局限于阴茎。45例在腰麻下行急诊手术治疗,1例局部麻醉下手术，16例采用冠状沟近侧环行切口, 30例根据B超显示的破裂位置采用局部纵形纵切口。术中发现白膜破口平均1.31 cm（0.5~2.5 cm）,6例采用丝线“8”字缝合白膜裂口, 18例改用3-0可吸收线缝合白膜。常规放置皮片或负压引流管，留置导尿，早期使用纱布加压包扎,近年使用弹力绷带加压包扎3~5 d ,应用抗生素预防感染。术后1周拆线并拔除导尿管。结果： 46 例均行急诊手术修补,术后环形脱套切口的16例患者中，14例短期内发生了包皮水肿，而采取局部切口的患者则没有任何并发症，远期随访到的28例阴茎勃起功能均保持良好，无痛性勃起，能维持满意性交。结论: 大多数阴茎折断局部纵行的小切口足以保证手术顺利完成，损伤小，不破坏血供和淋巴回流，不易发生手术并发症，相比环形脱套切口，优势明显，但如需探查尿道海绵体，应采用冠状沟下方的环形脱套式切口。.