No abstract available.

PURPOSE: Pelvic floor muscles play an important role in female sexual function. Urinary incontinence is one of the complex symptoms of pelvic floor relaxation. The purpose of the present study was to evaluate the effects of behavioral treatment on the sexual life variables and quality of life in stress urinary incontinent women. MATERIALS AND METHODS: Fifty women with clinically and urodynamically proven stress urinary incontinence were randomly selected, and treated with functional electrical stimulation (FES) -Biofeedback. The FES-Biofeedback treatment was performed for 20 min per session, 2 sessions a week, for 6 weeks. The treatment consisted of electrical stimulation (35Hz and 50Hz, simultaneously) for 24 seconds, and the biofeedback, composed of 3 phases of contraction, lasted for 32 seconds. The outcome measures on the sexual life variables and quality of life scales were assessed by the Bristol Female Lower Urinary Tract Symptoms questionnaire and a self-developed questionnaire, based on the Brief index of sexual Functioning for women (BISF-W). RESULTS: The general quality of life scores were significantly improved after 6 weeks of FES-Biofeedback (p<0.05). The quality of orgasms, sexual interest, sexual activity and sexual anxiety were significantly improved after the FES-Biofeedback (p<0.05). Changes in the scores for the degree of satisfaction in those variables also showed statistical significance (p<0.05). CONCLUSIONS: Women with incontinence were dissatisfied with their sexual life due to various symptoms associated with their urinary symptoms or symptoms that result from pelvic floor relaxation. The FES-Biofeedback therapy showed positive effects on improving, not only stress incontinence, but also sexual life variables and the life quality.
Anxiety ; Biofeedback, Psychology* ; Electric Stimulation ; Female* ; Humans ; Lower Urinary Tract Symptoms ; Muscles ; Orgasm ; Outcome Assessment (Health Care) ; Pelvic Floor ; Quality of Life* ; Surveys and Questionnaires ; Relaxation ; Sexual Behavior* ; Sexuality ; Urinary Incontinence* ; Urinary Incontinence, Stress ; Weights and Measures

No abstract available.
Humans

PURPOSE: We investigated how the symptoms of interstitial cystitis/painful bladder syndrome (IC/PBS) are correlated with the sexual activity of these patients. MATERIALS AND METHODS: A total of 87 patients were included in this study; 18 patients were diagnosed with IC and the other 69 had PBS. The diagnosis was made on the basis of the concept of IC/PBS proposed by the ICS in 2002. Patients were asked to fill in a Bristol female lower urinary tract symptom questionnaire, and symptoms were rated on a scale of from 1 to 4 or 5. Pearson's correlation coefficient was used to analyze the correlation of pain and urinary symptoms with quality of life and sexual activity. RESULTS: The average age of the patients was 51+/-14.7 years (range, 28-74 years). Age and vulvodynia were positively correlated with one another (r=0.232), and there was a negative correlation between age and dyspareunia (r=-0.302). Among the items regarding IC/PBS and sexual activity, frequency showed a positive correlation with vulvodynia (r=0.258) in addition to an inhibited sex life (r=0.403). Urgency showed a positive correlation with an inhibited sex life (r=0.346). Vulvodynia showed a positive correlation with an inhibited sex life (r=0.259) and dyspareunia (r=0.401). The main symptoms of IC/PBS (frequency, urgency, and pelvic pain) showed a positive correlation with almost all items related to quality of life (p<0.05). CONCLUSIONS: Frequency, urgency, and various types of pain are negatively correlated with the sexual activity of patients. This suggests that physicians should consider sexual function in the management of patients with IC/PBS.
Cystitis, Interstitial ; Dyspareunia ; Female ; Humans ; Quality of Life ; Sexual Behavior ; Urinary Bladder ; Urinary Tract ; Vulvodynia

In female sexual dysfunction (FSD), psychological and contextual factors significantly influence organic components of sexual response and behavior. The hormonal environment also affects FSD. Therefore, a tailored medical approach to each individual's sexual symptom is inevitable. This paper reviews currently available pharmacological treatment of FSD including the most recent advances and future targets in pharmacotherapy. In hormonal therapies for FSD, efficacy of estrogens and androgens on the treatment of vaginal atrophy, low sexual desire, and small subsets of genital arousal disorder, respectively, have been demonstrated. However, we need more data regarding long-term safety. There are two non-hormonal agents approved by the US Food and Drug Administration. Flibanserin has shown marginal benefit over placebo for the treatment of hypoactive sexual desire disorder. Ospemifen has shown beneficial effect on vulvovaginal pain from hormone related atrophy although it requires a longer period data to assess safety in other female genital organs, such as uterus and ovaries. Controversies still remain regarding hormonal therapies for FSD. Besides, some of the developing drugs still require more reliable safety and efficacy data. However, pharmacologic treatment of FSD is a promising field yet to be explored.
Androgens ; Arousal ; Atrophy ; Drug Therapy ; Estrogens ; Female* ; Genitalia, Female ; Humans ; Ovary ; Sexual Dysfunctions, Psychological ; United States Food and Drug Administration ; Uterus

PURPOSE: This study was designed to examine the effect of stress on the pathophysiology of bladder stability via the Rho-kinase and nitric oxide synthase activity, which are required for muscle contraction and relaxation within the bladder. MATERIALS AND METHODS: Animal testing was conducted in two separate sessions. In the first experiment, 36 female Sprague-Dawley rats weighing about 230-270g each were employed. 18 rats were placed in the control group and 18 rats were placed in the test group. The second testing was conducted using metabolic cages. Six rats were placed in the control group and six rats were placed in the test group under a stressful environment. RESULTS: The results showed that the frequency of urination was significantly increased with time in the test group(p<0.05). However, the volume of voided urine decreased, thereby suggesting stress was a cause of overactive bladder. Analysis of bladder tissue for nitric oxide synthase (NOS) and RhoA-binding kinase(ROKalpha), important components of contraction and relaxation of bladder muscle, revealed that the levels of iNOS and ROKalpha were significantly increased with continued application of stress. This suggests that stress affects the levels of NOS and ROKalpha in an overactive bladder to influence contraction and relaxation of the bladder muscle. CONCLUSIONS: An increase in the ROKalpha expression and changes of the NOS expressions in the rats with chronic stress pathophysiologicaly support that stress contributes to the clinical symptoms of overactive bladder.
Animals ; Female ; Humans ; Muscle Contraction ; Nitric Oxide Synthase ; Rats ; Rats, Sprague-Dawley ; Relaxation ; rho-Associated Kinases ; Urinary Bladder* ; Urinary Bladder, Overactive ; Urination

PURPOSE: The autonomic nervous system (ANS) and stress hormones are important mediators in the stress response. The ANS controls the tone of corpus cavernosal smooth muscle. Clinically, it is not uncommon to develop erectile dysfunction as the sequelae of acute or chronic stress, with or without loss of libido. In this study, we investigated the effect of stress on the expression of mediators of penile corpus cavernosal smooth muscle relaxation and contraction. MATERIALS AND METHODS: Forty-eight male Sprague-Dawley rats were used, with 8 rats in each group. They were divided into six groups; stress+10, stress+20, and stress+30, which were named after their duration (days) of exposure, and a control group for each stress group. The stress group was maintained under a scheduled stress condition, while the control group was provided a comfortable general environment. Penile tissues were sampled and expressions of Rho-kinase, inducible nitric oxide synthase (iNOS), endothelial NOS (eNOS) and neuronal NOS (nNOS) were measured and analyzed by Western blotting. RESULTS: Penile Rho-kinase expression was significantly increased in the stress groups compared with the control group (p<0.05), with a greater increase during longer stress. Expression of iNOS was increased in stress+30 group (p<0.05). Expression of eNOS, nNOS, and Rho-kinase were increased in stress+20, stress+30 group (p<0.05). CONCLUSIONS: These results suggest that stress may alter penile corpus cavernosal smooth muscle relaxation by affecting mediators.
Animals ; Autonomic Nervous System ; Erectile Dysfunction ; Humans ; Libido ; Male ; Muscle, Smooth ; Neurons ; Nitric Oxide ; Nitric Oxide Synthase ; Nitric Oxide Synthase Type II ; Rats ; Rats, Sprague-Dawley ; Relaxation ; rho-Associated Kinases

PURPOSE: The autonomic nervous system (ANS) and stress hormones are important mediators in the stress response. The ANS controls the tone of corpus cavernosal smooth muscle. Clinically, it is not uncommon to develop erectile dysfunction as the sequelae of acute or chronic stress, with or without loss of libido. In this study, we investigated the effect of stress on the expression of mediators of penile corpus cavernosal smooth muscle relaxation and contraction. MATERIALS AND METHODS: Forty-eight male Sprague-Dawley rats were used, with 8 rats in each group. They were divided into six groups; stress+10, stress+20, and stress+30, which were named after their duration (days) of exposure, and a control group for each stress group. The stress group was maintained under a scheduled stress condition, while the control group was provided a comfortable general environment. Penile tissues were sampled and expressions of Rho-kinase, inducible nitric oxide synthase (iNOS), endothelial NOS (eNOS) and neuronal NOS (nNOS) were measured and analyzed by Western blotting. RESULTS: Penile Rho-kinase expression was significantly increased in the stress groups compared with the control group (p<0.05), with a greater increase during longer stress. Expression of iNOS was increased in stress+30 group (p<0.05). Expression of eNOS, nNOS, and Rho-kinase were increased in stress+20, stress+30 group (p<0.05). CONCLUSIONS: These results suggest that stress may alter penile corpus cavernosal smooth muscle relaxation by affecting mediators.
Animals ; Autonomic Nervous System ; Erectile Dysfunction ; Humans ; Libido ; Male ; Muscle, Smooth ; Neurons ; Nitric Oxide ; Nitric Oxide Synthase ; Nitric Oxide Synthase Type II ; Rats ; Rats, Sprague-Dawley ; Relaxation ; rho-Associated Kinases

PURPOSE: Sacral neuromodulation has become an effective option for controlling intractable symptoms of overactive bladder: urgency and urge incontinence. However, it has its limitations in that an intermittent pulse generator (IPG) is insertable only in patients with symptom improvement of at least 50%. In this study, we aimed to investigate the parameters that predict surgical outcomes. MATERIALS AND METHODS: Data from 31 candidates for sacral neuromodulation were retrospectively analyzed. Twenty patients out of 31 candidates had satisfactory symptom improvement after tinned lead test implantation, which resulted in IPG implantation. Data and neural stimulation parameters were compared and analyzed between successful IPG implants (group 1) and test failures (group 2). RESULTS: The percentage of female patients was higher in the IPG implant group (group 1: 95%, group 2: 64%). There was a significant difference in symptom duration, between the two groups (group 1: 40.5 months, group 2: 91 months). There was a significant difference in the number of episodes of urgency between the two groups (group 1: 6.83/day, group 2: 9.66/day, p=0.012), and severity of urgency showed significant difference between two groups (group 1 Female ; Humans ; Lower Urinary Tract Symptoms ; Operative Time ; Retrospective Studies ; Statistics as Topic ; Tin ; Urinary Incontinence, Urge

Female sexual function is highly complex and deeply influenced by hormonal and non-hormonal factors. As sexual dysfunction becomes a common and important problem for women of all ages with related quality of life issues, we need to understand more about the effect of sex steroid hormones in female sexual function. However, there are limited data about the correlation between the value of sex steroid hormones- testosterone, in particular-and female sexual function. In a certain type of female sexual dysfunction (FSD), hypoactive sexual desire disorder, for example, there is evidence that treatment with androgens or with estrogens is effective. To widen the therapeutic options of hormone replacement therapy in FSD, further research is needed as to the benefits and risks of hormonal treatments in both pre- and post-menopausal women. Although important unanswered questions still exist in hormonal treatment of FSD, new therapeutic strategies are being studied and many ongoing clinical trials are expecting favorable results leading to more successful treatment of FSD.
Androgens ; Estrogens ; Female ; Gonadal Steroid Hormones ; Hormone Replacement Therapy ; Humans ; Quality of Life ; Risk Assessment ; Sexual Dysfunctions, Psychological ; Testosterone