Sexual dysfunction is a highly prevalent problem among patients with chronic renal failure, which affects patients in the quality of life. However, it has not received enough attention. The genesis of sexual dysfunction is multifactorial, including physiological, psychological and organic factors. This review summarized the incidence, main manifestation, evaluation, risk factors and treatments associated with sexual dysfunction in patient of the chronic renal failure.
Female ; Humans ; Kidney Failure, Chronic ; complications ; physiopathology ; psychology ; Male ; Sexual Dysfunction, Physiological ; etiology ; therapy ; Sexual Dysfunctions, Psychological ; etiology ; therapy

Male patients with prolactinomas usually present with typical hyperprolactinemia symptoms, including sexual dysfunction and infertility. However, clinical factors related to sexual dysfunction and surgical outcomes in these patients remain unclear. This study aimed to investigate the outcomes of male patients with prolactinomas after transsphenoidal surgery and the risk factors affecting sexual dysfunction. This study was conducted on 58 male patients who underwent transsphenoidal surgery for prolactinomas between May 2014 and December 2020 at the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China. We evaluated the sexual function of patients before and after surgery through International Index of Erectile Function-5 scores, libido, and frequency of morning erection. Of the 58 patients, 48 (82.8%) patients had sexual intercourse preoperatively. Among those 48 patients, 41 (85.4%) patients presented with erectile dysfunction. The preoperative International Index of Erectile Function-5 scores in patients with macroprolactinomas were significantly higher than those in patients with giant prolactinomas (17.63 ± 0.91 vs 13.28 ± 1.43; P = 0.01). Postoperatively, the incidence of erectile dysfunction was 47.9%, which was significantly lower than that preoperatively (85.4%; P = 0.01). Twenty-eight (68.3%) patients demonstrated an improvement in erectile dysfunction. Tumor size and invasiveness were significantly correlated with the improvement of erectile dysfunction. Preoperative testosterone <2.3 ng ml^-1 was an independent predictor of improvement in erectile dysfunction. In conclusion, our results indicated that tumor size and invasiveness were important factors affecting the improvement of sexual dysfunction in male patients with prolactinoma. The preoperative testosterone level was an independent predictor related to the improvement of erectile dysfunction.
Humans ; Male ; Prolactinoma/surgery* ; Erectile Dysfunction/etiology* ; Retrospective Studies ; Sexual Dysfunction, Physiological/complications* ; Testosterone ; Pituitary Neoplasms/pathology*

OBJECTIVETo investigate the female sexual dysfunction (FSD) in type 2 diabetes patients, by comparing the sexual function between type 2 diabetic women and non-diabetic women with Female Sexual Function Index (FSFI).

METHODS115 type 2 diabetic women and 107 age-matched non-diabetes women were enrolled with similar backgrounds. Their sexual functions were evaluated with FSFI. Metabolic parameters such as body mass index, blood lipid profile, hemoglobin A1C, plasma glucose were also collected.

RESULTSTotal score of FSFI of the type 2 diabetic women were significantly lower than that of the non-diabetic controls (18.27±8.96 vs. 23.02±5.78, P=0.000). Scores of the FSFI domains (desire, arousal, lubrication, orgasm, satisfaction, pain) of the type 2 diabetic group were also lower than those of the control group. According to the FSD criterion (FSFI<25) available in China, the percentage of FSD in the type 2 diabetic group was significantly higher than that of the control group (79.2%vs. 55.0%, P<0.001). These trends seemed more prominent in pre-menopause subgroups. The logistic regression analysis indicated that age and diabetes were independent risk factors of FSD. Body Mass Index (BMI) also had influence in the diabetes group.

CONCLUSIONFindings from this study showed that there are more FDS in Chinese type 2 diabetic women than in their non-diabetic counterparts, especially in pre-menopause participants.

Adult ; Asian Continental Ancestry Group ; Diabetes Mellitus, Type 2 ; complications ; Female ; Humans ; Middle Aged ; Sexual Dysfunction, Physiological ; etiology

OBJECTIVETo investigate the correlation of premature ejaculation (PE) with central lumber intervertebral disc herniation (CLIDH) and the pathogenesis of PE, and to search for a convenient, effective and non-invasive method for the treatment of PE.

METHODSA total of 263 selected PE patients underwent CT, and those that were found with CLIDH were randomized into a treatment group (n=180) and a control (n=60), the former treated by lumbar traction and the latter with sertraline hydrochloride tablets, both for 24 weeks. CIPE-5 scores of all the patients were analyzed, and the ejaculation latency and sexual satisfaction were recorded before and after the treatment.

RESULTSAmong the 263 PE patients, CLIDH was confirmed in 240 (91%). After the treatment, CIPE-5 scores, ejaculation latency and sexual satisfaction were markedly improved in the treatment group, with significant statistic difference from pre-treatment (P < 0.01). Significant differences were also observed between the treatment and the control groups after the treatment (P < 0.05), but not in the control group between pre- and post-treatment.

CONCLUSIONCLIDH may be one of the important causes of most "unexplainable" PE cases. And lumbar traction, non-invasive, highly effective and easily manipulable, has provided a new access to the diagnosis and treatment of the PE patients with CLIDH.

Adult ; Ejaculation ; Humans ; Intervertebral Disc Displacement ; complications ; surgery ; Lumbar Vertebrae ; Male ; Middle Aged ; Sexual Dysfunction, Physiological ; etiology ; therapy ; Traction

OBJECTIVETo investigate the prevalence of chronic prostatitis in men with premature ejaculation.

METHODSThe segmented urine specimens before and after prostatic massage and the expressed prostatic secretion specimens from 106 patients with premature ejaculation and 38 controls were evaluated by microscopic and/or bacteriological studies. The prevalence of premature ejaculation was also investigated in 120 patients with chronic prostatitis.

RESULTSProstatic inflammation was found in 46.2% and chronic bacterial prostatitis in 34.7% of the subjects with premature ejaculation, respectively. Compared with the controls, the findings were statistically significant (P < 0.05). The prevalence of premature ejaculation in the patients with chronic prostatitis was 47.5% (57/120).

CONCLUSIONSChronic prostatic inflammation may play a role in the pathogenesis of some cases of premature ejaculation and it is important to give a careful examination of the prostate before initiating any therapy for premature ejaculation.

Adult ; Chronic Disease ; Ejaculation ; Humans ; Male ; Middle Aged ; Prevalence ; Prostate ; diagnostic imaging ; Prostatitis ; complications ; epidemiology ; Sexual Dysfunction, Physiological ; etiology ; Sexual Dysfunctions, Psychological ; etiology ; Ultrasonography

OBJECTIVESTo evaluate the efficacy and safety of sildenafil citrate in the treatment of premature ejaculation (PE) complicated by erectile dysfunction (ED).

METHODSForty-five patients of PE complicated by ED received flexible doses of sildenafil from 50 to 100 mg for 1 to 3 months. Intravaginal ejaculatory latency time (IELT) and sexual satisfaction ratio (SSR) of partner were recorded to evaluate the effect of PE treatment, as well as the general efficacy and satisfaction of ED treatment. And the difference of IIEF-5 before and after the treatment were compared.

RESULTSTwenty-seven patients had their PE improved and the effective rate was 60%. Forty patients reported the improvement in erection and the percentage of erectile improvement was 88.88%. All the 27 patients with improvement of PE achieved effective erection through the administration of 50 mg sildenafil and the satisfaction rate reached 81.48%. On the other hand, only 1 case (5.56%) reported satisfaction over the treatment in the 18 patients who did not obtain improvement of PE. Between the PE improvement group and non-improvement group, there were significant differences (P < 0.001) shown in IIEF-5 scores before and after the treatment. Mild or moderate side effects were reported in 9 patients(20%), who recovered without any treatment.

CONCLUSIONSTo premature ejaculation patients with ED, sildenafil can safely and effectively improve their erectile function, the satisfaction over the ED treatment outcome means that their PE symptoms could be alleviated.

Adult ; Aged ; Aged, 80 and over ; Ejaculation ; drug effects ; Erectile Dysfunction ; complications ; drug therapy ; Humans ; Male ; Middle Aged ; Piperazines ; therapeutic use ; Purines ; Sexual Dysfunction, Physiological ; complications ; drug therapy ; Sildenafil Citrate ; Sulfones ; Treatment Outcome ; Vasodilator Agents ; therapeutic use

The genital organ is innervated by autonomic and somatic nerve. The former is both sympathetic and parasympathetic nerve and the later is comprised by sensory and motor fibers. The symptoms of male sexual dysfunction are sexopathy, erectile dysfunction, disorder of ejaculation and orgasm, and pianism. Not only different symptom but the same symptom can be induced by different injured nerve. The relationship between peripheral nerve injury and male sexual dysfunction should be understood correctly.
Erectile Dysfunction/etiology* ; Humans ; Male ; Parasympathetic Nervous System/injuries* ; Pelvis/innervation* ; Peripheral Nerve Injuries ; Peripheral Nerves/anatomy & histology* ; Sexual Dysfunction, Physiological/etiology* ; Spinal Cord Injuries/complications* ; Sympathetic Nervous System/injuries* ; Trauma, Nervous System/complications*

OBJECTIVETo reveal the roles of Rho kinase (ROCK) in the mechanisms of complications in diabetes by reviewing the correlations between ROCK and related complications in diabetes.

DATA SOURCESThe data used in the present article were mainly from PubMed with relevant English articles published from 1998 to 2010. The search terms were "ROCK" and "diabetes".

STUDY SELECTIONOriginal articles including the roles of ROCK or its inhibitors in diabetic complications and review articles about the biological character of ROCK were selected.

RESULTSThe activity and expression of ROCK were up-regulated in the models of type 1 or type 2 diabetes animals and the cultured cells with concentrations of high glucose, ROCK activation was associated with the development or progression of complications in diabetes. Inhibition of RhoA/ROCK pathway prevented or ameliorated the pathologic changes of diabetic complications, and ROCK has been regarded as a key target for treatment of these complications.

CONCLUSIONRhoA/ROCK signaling plays important roles in the pathogenesis of long-term complications in diabetes and ROCK inhibitors are becoming a promising solution to treatments of complications in diabetes.

Animals ; Cardiomyopathies ; etiology ; Diabetes Complications ; etiology ; therapy ; Humans ; Sexual Dysfunction, Physiological ; etiology ; Signal Transduction ; Urinary Bladder Diseases ; etiology ; rho-Associated Kinases ; antagonists & inhibitors ; chemistry ; physiology ; rhoA GTP-Binding Protein ; antagonists & inhibitors ; chemistry ; physiology

OBJECTIVESTo investigate the prevalence, main manifestation and related factors of sexual dysfunction in male patients with chronic renal insufficiency (CRI).

METHODSA cross-section study was conducted by six hospitals in Sichuan Province. The prevalence and severity of sexual dysfunction were assessed by SCASF microsoft among patients with chronic renal disease. Logistic regression was used to examine and test the association between sexual dysfunction and other medical conditions.

RESULTSThe prevalence of sexual dysfunction was wider in patients with CRI than in those without. The main manifestations in male patients were decreased libido, erectile dysfunction and premature ejaculation. Stratified analysis in uremia showed that the prevalence and severity of sexual dysfunction were similar between patients on haemodialysis(HD) and those on peritoneal dialysis(PD). The patients receiving no replacement treatment suffered more decreased libido and performance anxiety than dialyzed patients (HD and PD) and transplantation patients(Tx). The patients receiving no replacement treatment and dialysis suffered more erectile dysfunction than Tx men. A multivariable analysis demonstrated that the duration, creatinine clearance(Ccr), parathyroid hormone (PTH), albumin(Alb) were not associated with sexual dysfunction. The use of beta-blocker, anemia and depression were risky factors for decreased libido, and increasing age was a risky factor for erectile dysfunction. The use of angiotensin-converting-enzyme inhibitor(ACEI)/angiotention receptor antagonist (ARB) and recombinant human erythropoietin(r-HuEpo) were protective factors for erectile dysfunction.

CONCLUSIONSThe main manifestations of sexual dysfunction in male patients with CRI are decreased libido, erectile dysfunction and premature ejaculation. The replacement therapy, especially transplantation, can decrease the prevalence or severity of sexual dysfunction. The genesis of sexual dysfunction is multifactorial, including age, physiological factors, psychological factors and medical conditions.

Adult ; Age Factors ; Case-Control Studies ; China ; epidemiology ; Cross-Sectional Studies ; Humans ; Kidney Failure, Chronic ; complications ; Logistic Models ; Male ; Middle Aged ; Multivariate Analysis ; Prevalence ; Risk Factors ; Sexual Dysfunction, Physiological ; epidemiology

The clinical effect of laparoscopic rectal cancer curative excision with pelvic autonomic nerve preservation (PANP) was investigated. This study evaluated the frequency of urinary and sexual dysfunction of 149 male patients with middle and low rectal cancer who underwent laparoscopic or open total mesorectal excision with pelvic autonomic nerve preservation (PANP) from March 2011 to March 2013. Eighty-four patients were subjected to laparoscopic surgery, and 65 to open surgery respectively. The patients were followed up for 12 months, interviewed, and administered a standardized questionnaire about postoperative functional outcomes and quality of life. In the laparoscopic group, 13 patients (18.37%) presented transitory postoperative urinary dysfunction, and were medically treated. So did 12 patients (21.82%) in open group. Sexual desire was maintained by 52.86%, un-ability to engage in intercourse by 47.15%, and un-ability to achieve orgasm and ejaculation by 34.29% of the patients in the laparoscopic group. Sexual desire was maintained by 56.36%, un-ability to engage in intercourse by 43.63%, and un-ability to achieve orgasm and ejaculation by 33.73% of the patients in the open group. No significant differences in urinary and sexual dysfunction between the laparoscopic and open rectal resection groups were observed (P>0.05). It was concluded that laparoscopic rectal cancer radical excision with PANP did not aggravate or improve sexual and urinary dysfunction.
Adult ; Autonomic Nervous System ; injuries ; Humans ; Laparoscopy ; adverse effects ; Male ; Middle Aged ; Peripheral Nerve Injuries ; etiology ; prevention & control ; Postoperative Complications ; Rectal Neoplasms ; surgery ; Sexual Dysfunction, Physiological ; etiology ; Urologic Diseases ; etiology