The journal of sexual medicine
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Observational Study
Sexual dysfunction induced by intrathecal baclofen administration: is this the price to pay for severe spasticity management?
Intrathecal administration of baclofen (ITB) is widely recognized as an effective treatment for severe spasticity of both spinal and supraspinal origin with fewer side effects. The lower drug dosages used for spinal intrathecal administration, acting directly on the receptor sites, result in greater therapeutic efficacy with less systemic toxicity than with oral preparations. ⋯ This study supports previous findings on a possible negative effect of ITB on sexual function, with regard to erection. Patients who are considering ITB for treatment of severe spasticity should be informed about possible but reversible sexual side effects, especially at higher dosage. Future studies with larger samples should be fostered to confirm these findings for a better management of these, often young, patients.
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Provoked vestibulodynia (PVD) is a highly prevalent and taxing female genital pain condition. Despite the intimate nature of this pain and the fact that affective factors such as anxiety have been shown to modulate its manifestations, no study has yet explored the emotional regulation of couples in which the woman suffers from PVD. ⋯ Findings suggest that, for couples in which the woman suffers from PVD, an emotional regulation that is low in ambivalence in both partners is associated with better psychological, sexual, and relational outcomes. Results indicate that emotional regulation may be important to consider in the assessment and treatment of couples coping with PVD.
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Despite the impact of provoked vulvar pain on women's sexuality and the partnered sexual context in which the pain typically occurs, partners have not been included widely in research. ⋯ Provoked vulvar pain partners appear negatively impacted with regard to some sexual and physical aspects of their relationship. As one of the few controlled studies to investigate partner functioning in the context of provoked vulvar pain, this study has future research implications and supports the involvement of partners in treatment.
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Postcoital nonobstetric vaginal lacerations due to consensual sexual act are generally minute mucosal tears. In some cases, the vaginal mucosa is lacerated deeper and the bleeding may require suturing of opened vessel ends or even transfusion. ⋯ Simple suturing of rectal and vaginal mucosa, appropriate antiseptic precautions, and antibiotic coverage are enough to treat acutely formed low rectovaginal fistulas resulting from coitus. Decision to form colostomy and diversion of feces in the repair of such injuries should be taken cautiously.
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Radical hysterectomy (RH) has negative consequences on sexual function due to a shortened vagina, vaginal dryness, and dyspareunia. Peritoneovaginoplasty aims to extend vagina by vesical peritoneum and anterior rectal wall to improve postoperative sexual function. ⋯ Shortened vagina was significantly less reported in study group, while no difference was observed in other sex-related dimensions. Vaginal extension does not worsen pelvic floor symptoms. Sexual rehabilitation interventions are of significance and should be paid more attention to the CCSs in China.