The journal of sexual medicine
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Chronic widespread pain (CWP) is a prevalent musculoskeletal problem and a cardinal symptom of fibromyalgia, affecting up to 15% of the population. CWP is associated with substantial physical and psychological impairment and reduced quality of life. ⋯ CWP patients report more sexual pain and sexual distress compared with controls. Assessment of sexual problems should therefore be added to routine care of patients with CWP.
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Provoked vestibulodynia (PVD), a recurrent, localized vulvovaginal pain problem, carries a significant psychosexual burden for afflicted women, who report impoverished sexual function and decreased frequency of sexual activity and pleasure. Interpersonal factors such as partner responses to pain, partner distress, and attachment style are associated with pain outcomes for women and with sexuality outcomes for both women and partners. Despite these findings, no treatment for PVD has systematically included the partner. ⋯ Treatment outcomes, along with treatment satisfaction ratings, confirm the preliminary success of CBCT in reducing pain and psychosexual burden for women with PVD and their partners. Further large-scale randomized controlled trials are necessary to examine the efficacy of CBCT compared with and in conjunction with first-line biomedical interventions for PVD.
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Neuroimaging studies have reported differences in brain structure and function between homosexual and heterosexual men. The neural basis for homosexual orientation, however, is still unknown. ⋯ Differences in fALFF and FC suggest male sexual preference may influence the pattern activity in the default mode network.
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Sexual dysfunction (SD) is prevalent in multiple sclerosis (MS) patients and affects quality of life. Furthermore, lower urinary tract dysfunction (LUTD) is common in MS patients. ⋯ Neurological disability, depression and DO are significantly predictive of SD in MS patients, irrespective of gender. An EDSS ≥ 4.5 may significantly predict the presence of SD.
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Erectile dysfunction (ED) is a common problem with significant impact on patient quality of life. Penile prosthesis implantation provides an effective treatment for ED but as an invasive procedure carries with it an increased risk of medicolegal liability. ⋯ The main issues involved in malpractice litigation for penile prosthesis implants included surgical performance, informed consent, and postoperative management. Urologists must be aware of these potential issues in order to minimize their malpractice liability.