| 1. |
- CARLSSON, STEFAN, 1987, et al.
(författare)
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Orgasm-Associated Urinary Incontinence and Sexual Life after Radical Prostatectomy.
- 2011
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Ingår i: The journal of sexual medicine. - : Oxford University Press (OUP). - 1743-6109 .- 1743-6095.
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Tidskriftsartikel (refereegranskat)abstract
- Introduction. Involuntary release of urine during sexual climax, orgasm-associated urinary incontinence, occurs frequently after radical prostatectomy. We know little about its prevalence and its effect on sexual satisfaction. Aim. To determine the prevalence of orgasm-associated incontinence after radical prostatectomy and its effect on sexual satisfaction. Methods. Consecutive series, follow-up at one point in calendar time of men having undergone radical prostatectomy (open surgery or robot-assisted laparoscopic surgery) at Karolinska University Hospital, Stockholm, Sweden, 2002-2006. Of the 1,411 eligible men, 1,288 (91%) men completed a study-specific questionnaire. Main Outcome Measure. Prevalence rate of orgasm-associated incontinence. Results. Of the 1,288 men providing information, 691 were sexually active. Altogether, 268 men reported orgasm-associated urinary incontinence, of whom 230 (86%) were otherwise continent. When comparing them with the 422 not reporting the symptom but being sexually active, we found a prevalence ratio (with 95% confidence interval) of 1.5 (1.2-1.8) for not being able to satisfy the partner, 2.1 (1.1-3.5) for avoiding sexual activity because of fear of failing, 1.5 (1.1-2.1) for low orgasmic satisfaction, and 1.4 (1.2-1.7) for having sexual intercourse infrequently. Prevalence ratios increase in prostate-cancer survivors with a higher frequency of orgasm-associated urinary incontinence. Conclusion. We found orgasm-associated urinary incontinence to occur among a fifth of prostate cancer survivors having undergone radical prostatectomy, most of whom are continent when not engaged in sexual activity. The symptom was associated with several aspects of sexual life. Nilsson AE, Carlsson S, Johansson E, Jonsson MN, Adding C, Nyberg T, Steineck G, and Wiklund NP. Orgasm-associated urinary incontinence and sexual life after radical prostatectomy. J Sex Med **;**:**-**.
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| 2. |
- Corona, Giovanni, et al.
(författare)
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Age-Related Changes in General and Sexual Health in Middle-Aged and Older Men: Results from the European Male Ageing Study (EMAS)
- 2010
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Ingår i: Journal of Sexual Medicine. - : Oxford University Press (OUP). - 1743-6109 .- 1743-6095. ; 7:4, s. 1362-1380
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Tidskriftsartikel (refereegranskat)abstract
- Introduction. Limited information is available concerning the general and sexual health status of European men. Aim. To investigate the age-related changes in general and sexual health in middle-aged and older men from different countries of the European Union. Methods. This is a cross-sectional multicenter survey performed on a sample of 3,369 community-dwelling men aged 40-79 years old (mean 60 +/- 11 years). Subjects were randomly selected from eight European centers including centers from nontransitional (Florence [Italy], Leuven [Belgium], Malmo [Sweden], Manchester [United Kingdom], Santiago de Compostela [Spain]) and transitional countries (Lodz [Poland], Szeged [Hungary], Tartu [Estonia]). Main Outcome Measures. Different parameters were evaluated including the Beck's Depression Inventory for the quantification of depressive symptoms, the Short Form-36 Health Survey for the assessment of the quality of life (QoL), the International Prostate Symptom Score for the evaluation of lower urinary tract symptoms, and the European Male Ageing Study sexual function questionnaire for the study of sexual function. Results. More than 50% of subjects reported the presence of one or more common morbidities. Overall, hypertension (29%), obesity (24%), and heart diseases (16%) were the most prevalent conditions. Around 30% of men reported erectile dysfunction (ED) and 6% reported severe orgasmic impairment, both of which were closely associated with age and concomitant morbidities. Only 38% of men reporting ED were concerned about it. Furthermore, concern about ED increased with age, peaking in the 50-59 years age band, but decreased thereafter. Men in transitional countries reported a higher prevalence of morbidities and impairment of sexual function as well as a lower QoL. Conclusion. Sexual health declined while concomitant morbidities increased in European men as a function of age. The burden of general and sexual health is higher in transitional countries, emphasizing the need to develop more effective strategies to promote healthy aging for men in these countries. Corona G, Lee DM, Forti G, O'Connor DB, Maggi M, O'Neill TW, Pendleton N, Bartfai G, Boonen S, Casanueva FF, Finn JD, Giwercman A, Han TS, Huhtaniemi IT, Kula K, Lean MEJ, Punab M, Silman AJ, Vanderschueren D, Wu FCW, and EMAS Study Group. Age-related changes in general and sexual health in middle-aged and older men: Results from the European Male Ageing Study (EMAS). J Sex Med 2010;7:1362-1380.
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| 3. |
- Giuliano, Francois, et al.
(författare)
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Experimental Models for the Study of Female and Male Sexual Function
- 2010
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Ingår i: Journal of Sexual Medicine. - : Oxford University Press (OUP). - 1743-6109 .- 1743-6095. ; 7:9, s. 2970-2995
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Tidskriftsartikel (refereegranskat)abstract
- Introduction. Significant progress has been made in the understanding of physiological and pharmacological mechanisms of human sexual functioning through preclinical research in animal models. Aim. To provide an evidence-based documentation of the experimental models evaluating male and female sexual function for useful clinical translation. Methods. Consensus discussion over the past 18 months leading to summarized views of seven experts from six countries. Main Outcome Measure. Report was based on the critical analysis of scientific information available in literature and subcommittee presentations, discussions, and exchanges of ideas and feedback. Results. Fundamental research in animal models has led to considerable understanding of the physiological mechanisms underlying desire, arousal, genital, and other sexual responses and the design of rational pharmacological treatments for certain sexual dysfunctions in the male and female. Tissue and cellular in vitro systems have provided critical information on the in vivo interactions and modulations in the presence and absence of chemical, biological, vascular, neurologic, endocrine, and genetic inputs. The animal models seem indispensable for elucidating the biophysiological and etiopathological aspects of male and female sexual disorders. Conclusions. Useful insights into the human experience have been derived from basic research in ways that are far more difficult to obtain in humans, both scientifically and ethically. The animal model with a good predictive value can be used as a successful preclinical tool so long as the functional end points are homologous or analogous. The key issue is whether further evaluations are warranted to extrapolate the results in a clinical setting. Giuliano F, Pfaus J, Balasubramanian S, Hedlund P, Hisasue S, Marson L, and Wallen K. Experimental models for the study of female and male sexual function. J Sex Med 2010;7:2970-2995.
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| 4. |
- Kjellgren, Cecilia, et al.
(författare)
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Female Youth Who Sexually Coerce : Prevalence, Risk, and Protective Factors in Two National High School Surveys
- 2011
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Ingår i: Journal of Sexual Medicine. - : Elsevier. - 1743-6095 .- 1743-6109. ; 8:12, s. 3354-3362
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Tidskriftsartikel (refereegranskat)abstract
- Introduction. Sexual coercion is recognized as a serious societal problem. Correlates and risk factors of sexually abusive behavior in females are not well known. Aim. Etiological theory and empirical study of female perpetrators of sexual coercion are usually based on small or highly selected samples. Specifically, population-based data are needed to elucidate risk/protective factors. Main Outcome Measures. Main outcome measures include a self-report questionnaire containing 65 items tapping socio-demographic and health conditions, social relations, sexual victimization, conduct problems and a set of normative and deviant sexual cognitions, attitudes, and behaviors. Methods. We used a 2003-2004 survey of sexual attitudes and experiences among high school students in Norway and Sweden to identify risk factors and correlates to sexually coercive behavior (response rate 80%); 4,363 females participated (Mean = 18.1 years). Results. Thirty-seven women (0.8%) reported sexual coercion (ever talked someone into, used pressure, or forced somebody to have sex). Sexually coercive compared with non-coercive women were similar on socio-demographic variables, but reported less parental care and more parental overprotection, aggression, depressive symptoms, and substance misuse. Also, sexually coercive females reported more sexual lust, sex partners, penetrative sexual victimization, rape myths, use of violent porn, and friends more likely to use porn. When using the Swedish subsample to differentiate risk factors specific for sexual coercion from those for antisocial behavior in general, we found less cannabis use, but more sexual preoccupation, pro-rape attitudes, and friends using violent porn in sexually coercive compared with non-sex conduct problem females. Conclusions. Sexually coercive behavior in high school women was associated with general risk/needs factors for antisocial behavior, but also with specific sexuality-related risk factors. This differential effect has previously been overlooked, agrees with similar findings in men, and should have substantial etiological importance. Kjellgren C, Priebe G, Svedin CG, Mossige S, and Langstrom N. Female youth who sexually coerce: Prevalence, risk, and protective factors in two national high school surveys. J Sex Med 2011;8:3354-3362.
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| 5. |
- Petersen, Marian, et al.
(författare)
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Sexual Function in Female Patients with Obstructive Sleep Apnea.
- 2011
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Ingår i: Journal of Sexual Medicine. - : Oxford University Press (OUP). - 1743-6109 .- 1743-6095. ; 8, s. 2560-2568
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Tidskriftsartikel (refereegranskat)abstract
- Introduction. Obstructive sleep apnea is defined as repetitive (≥5/hour) partial or complete cessation of breathing during sleep. Whereas obstructive sleep apnea is often considered to be associated with sexual problems in men, studies concerning effects of obstructive sleep apnea on female sexual function and distress are sparse. Aim. To investigate sexual dysfunction and sexual distress in female patients with obstructive sleep apnea and to determine which factors are of importance for their sexual function. Methods. We investigated 80 female patients (ages 28-64) admitted to a sleep laboratory and who after investigation received a diagnosis of obstructive sleep apnea. All subjects answered questions drawn from three self-administered questionnaires on sexuality. The results were compared with a population sample (N = 240). Main Outcome Measure. Data from nocturnal respiratory recordings. Female Sexual Function Index, Female Sexual Distress Scale and four questions from Life Satisfaction-11 (Lisat-11). Results. Female Sexual Function Index indicated that obstructive sleep apnea patients were at a higher risk for having sexual difficulties. Female Sexual Distress Scale showed significantly more sexual distress in the obstructive sleep apnea group. Manifest Female Sexual Dysfunction (combined data from Female Sexual Function Index and Female Sexual Distress Scale) showed that female patients with obstructive sleep apnea also had more sexual dysfunction. Severity of sleep apnea was, however, not related to any of these indices but consumption of psychopharmaca was. In Lisat-11, we found that obstructive sleep apnea females scored lower than women in the population sample regarding life as a whole but not regarding domains of closeness. Conclusions. This study indicates that sexuality of women with untreated obstructive sleep apnea is negatively affected compared with a female population sample. This was not related to severity of obstructive sleep apnea, whereas psychopharmaca may act as an important confounder.
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| 6. |
- Uckert, Stefan, et al.
(författare)
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Expression and Distribution of Phosphodiesterase Isoenzymes in the Human Seminal Vesicles.
- 2011
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Ingår i: Journal of Sexual Medicine. - : Oxford University Press (OUP). - 1743-6109 .- 1743-6095. ; 8:11, s. 3058-3065
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Tidskriftsartikel (refereegranskat)abstract
- Phosphodiesterase (PDE) isoenzymes have been shown to play a role in the control of human male genital tissues. There are hints from basic research and clinical studies that PDE5 inhibitors may have the ability to retard the male ejaculatory response. While the expression of PDE isoenzymes in the human seminal vesicles (SVs) has been described, the distribution of cyclic adenosine monophosphate (AMP)- and cyclic guanosine monophosphate (GMP)-PDEs has not yet been investigated. Aim. The aim of this study was to elucidate the expression and distribution of PDE isoenzymes PDE3A, PDE4 (isoforms A and B), PDE5A, and PDE11A in human SV tissue. Methods. Using immunohistochemistry (double-labeling techniques, laser fluorescence microscopy), the occurrence of PDE3A, PDE4A, PDE4B, PDE5A, and PDE11A, the vasoactive intestinal polypeptide (VIP), calcitonin gene-related peptide (CGRP), and protein gene product 9.5 (PGP 9.5) was examined in sections of SV. Cytosolic supernatants prepared from isolated human SV tissue were subjected to Western blot analysis using specific anti-PDE antibodies. Main Outcome Measure. The expression and distribution by of PDE3A, PDE4A, PDE4B, PDE5A, and PDE11A in the human SV were investigated by means of immunohistochemistry and Western blot analysis. Results. Immunosignals specific for PDE3A were seen in both the smooth muscle and the glandular epithelium, whereas staining for PDE4A, PDE5A, and PDE11A was mainly limited to epithelial cells. Varicose nerve fibers transversing the sections also presented staining for PDE3A. In nerve fibers and nerve endings, PDE4A and PDE4B were found co-localized with VIP; PDE5A-positive nerves also presented immunosignals specific for CGRP. The expression of said PDE isoenzymes was confirmed by Western blotting. Conclusions. The results indicate that cyclic AMP- and cyclic GMP-PDE isoenzymes are involved in the control of secretory activity and efferent neurotransmission in the SV. These findings might be of importance with regard to the identification of new therapeutic avenues to treat premature ejaculation.
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| 7. |
- Uckert, Stefan, et al.
(författare)
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Rho Kinase-related Proteins in Human Vaginal Arteries: An Immunohistochemical and Functional Study
- 2011
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Ingår i: Journal of Sexual Medicine. - : Oxford University Press (OUP). - 1743-6109 .- 1743-6095. ; 8:10, s. 2739-2745
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Tidskriftsartikel (refereegranskat)abstract
- The calcium-sensitizing Rho A/Rho kinase pathway has been suggested to play a role in the control of nongenital vascular smooth muscle. Rho-associated kinases (ROKs) cause calcium-independent modulation of smooth muscle contraction, and have been demonstrated in the bladder, prostate, and corpus cavernosum. Until now, it is not known whether ROKs and related proteins play a role in the control of vaginal blood flow. Aim. To investigate by means of functional studies and immunohistochemistry the significance of the Rho pathway in human vaginal arteries. Methods. Vaginal tissue was obtained from five postmenopausal women. Specimens were processed for immunohistochemistry for ROK1, ROK2, RhoA, and RhoGDI. Segments of sub-epithelial vaginal arteries were mounted in a tissue bath. Effects of Y27632 on the concentration-response curves to phenylephrine (Phe) or Phe-precontracted preparations were investigated. Main Outcome Measure. The expression of Rho kinases ROK1, ROK2, and the Rho-associated protein RhoGDI in human vaginal arteries was investigated by means of immunohistochemistry. Tissue bath studies were conducted in order to characterize the effects of the ROK inhibitor Y27632 on isolated vaginal arteries. Results. A meshwork of α-actin immunoreactive arterioles was located in the sub-epithelium of human vaginal specimens. Immunoreactivities for ROK1, ROK2, RhoA, and RhoGDI were expressed in the smooth musculature of these arteries. At 0.1 and 1 µM Y27632, the contraction to Phe (10 µM) was 99 ± 17% and 28 ± 12% that of 124 mM K(+) . In Phe-contracted preparations, Y27632 produced relaxant responses. Conclusions. The activation of alpha(1) -adrenoceptors contracts sub-epithelial human vaginal arteries via ROK-sensitive mechanisms. A role for these signals in the regulation of vaginal blood flow might be considered
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| 8. |
- Ueckert, Stefan, et al.
(författare)
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Expression and Distribution of Cyclic AMP- and Cyclic GMP-Binding Protein Kinases in the Human Vagina-An Immunohistochemical Study
- 2010
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Ingår i: Journal of Sexual Medicine. - : Oxford University Press (OUP). - 1743-6109 .- 1743-6095. ; 7:2, s. 888-895
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Tidskriftsartikel (refereegranskat)abstract
- Introduction. In contrast to research findings describing the localization of nitric oxide synthases (NOS), guanylyl cyclases, and cyclic adenosine monophosphate (cAMP)- and cyclic guanosine monophosphate (cGMP)-degrading phosphodiesterase isoenzymes in the human vagina, the distribution of proteins known as major targets for cyclic nucleotides has not yet been evaluated. cAMP- and cGMP-dependent protein kinases (cAK, cGKI) have been identified as important receptors for cyclic nucleotides downstream the signaling cascades. Aim. To investigate, by means of immunohistochemistry, the expression of cAK and cGKI in relation to endothelial NOS (eNOS), vasoactive intestinal polypeptide (VIP), and protein gene product 9.5 (PGP 9.5) in the human vagina. Main Outcome Measures. Expression and distribution of cAK and cGKI(alpha,beta) in relation to eNOS, VIP, and PGP 9.5 in human vaginal tissue. Methods. Immunohistochemical techniques were applied to sections of human vaginal full wall specimens in order to evaluate the presence of cAK and cGKI(alpha,beta) in relation to VIP, PGP 9.5, and eNOS, respectively. Western blot analyses were conducted using cytosolic supernatants of homogenized specimens of the vaginal wall and epithelium. Results. Immunostaining specific for cGKI beta was observed in vascular and nonvascular smooth muscle of the vagina. In the endothelial layer, cGKI beta was found colocalized with eNOS. In contrast, no signals indicating cGKI alpha were registered. cAK-positive subepithelial vessels were found to be innervated by a dense meshwork of PGP-containing varicose nerve fibers, some of which presented expression of VIP. The expression of cAK and cGKI beta was confirmed by Western blotting. Conclusions. Our results demonstrate the expression of cAK and cGKI beta in the human vagina. The colocalization with VIP and eNOS underlines the significance of both the cAMP and GMP pathway in the control of human vaginal vascular and nonvascular smooth muscle. Uckert S, Waldkirch ES, Albrecht K, Sonnenberg J, Langnase K, Richter K, Hedlund P, and Kuczyk MA. Expression and distribution of cyclic AMP- and cyclic GMP-binding protein kinases in the human vagina-An immunohistochemical study.
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| 9. |
- Waldkirch, Eginhard S, et al.
(författare)
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Rho Kinase (ROK)-Related Proteins in Human Cavernous Arteries: An Immunohistochemical and Functional Approach.
- 2012
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Ingår i: Journal of Sexual Medicine. - : Oxford University Press (OUP). - 1743-6109 .- 1743-6095. ; 9:5, s. 1337-1343
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Tidskriftsartikel (refereegranskat)abstract
- Introduction. Rho kinases (ROKs) cause calcium-independent modulation of smooth muscle contraction. A significant role for the RhoA/ROK pathway in mediating the contraction of the penile erectile tissue has been suggested. Moreover, it has been postulated that ROK activity might represent a key factor in the pathophysiology of erectile dysfunction. Up until today, little is known on the significance of ROK and related proteins in the control of blood flow in the corpus cavernosum. Aim. To investigate by means of immunohistochemistry and organ bath studies the significance of the Rho pathway in human cavernous arteries. Main Outcome Measures. The expression of ROK1, ROK2, RhoA, and RhoGDI in human cavernous arteries was investigated by means of immunohistochemistry; myographic studies were conducted in order to characterize the effects of the ROK inhibitor Y27632 on isolated cavernous arteries. Methods. Specimens of human cavernous arteries were processed for immunohistochemistry for ROK1, ROK2, RhoA, and RhoGDI. Circular penile vascular segments were mounted in a tissue bath and the effects of increasing concentrations of the ROK inhibitor Y27632 on the tension induced by norepinephrine (NE, 1 µM) were investigated. Results. Alpha-actin immunoreactive cavernous arterioles also presented abundant staining specific for ROK1, ROK2, RhoA, and RhoGDI in the smooth musculature of the vascular wall. Cumulative addition of Y27632 dose-dependently reversed the tension induced by NE of isolated arterial segments. Y27632 produced relaxant responses with a reversion of tension of 34.3 ± 11.8% at a concentration of 1 µM. Conclusion. The findings are in support for a role of the Rho/ROK-mediated signaling in the regulation of muscle tone of human cavernous arteries. Waldkirch ES, Ückert S, Sohn M, Kuczyk MA, and Hedlund P. Rho kinase (Rok)-related proteins in human cavernous arteries: An immunohistochemical and functional approach. J Sex Med **;**:**-**.
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| 10. |
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