The journal of sexual medicine
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Provoked vestibulodynia is a female genital pain condition that results in sexual dysfunction and impacts negatively on the couple. Although patients' causal attributions have been linked to worse psychosexual outcomes, no study has documented the male partners' perspective of this distressing problem and its potential influence on their psychosexual adaptation. ⋯ Evaluation and treatment of sexual pain problems should involve both partners and should explore the role of negative attributions.
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Health-related quality of life (HRQOL) is a multidimensional concept, which subjectively measures a patient's physical, social, and emotional well-being. This information is becoming increasingly important in policy and clinical decisions. With such a wide range of tools available, careful selection is required to ensure they adequately reflect patient's concerns. ⋯ Instruments used to measure HRQOL display variable measurement properties and often lack adequate clinical face validity. There are well-validated disease-specific HRQOL measures for age-related TDS, but none for classical TDS patients. Clinical and political decision-makers require HRQOL information using a combination of well-validated generic questionnaires and patient-focused, disease specific instruments relevant to the target TDS population under study.
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Case Reports
Glucose-6-phosphate dehydrogenase deficiency associated stuttering priapism: report of a case.
Stuttering priapism is an uncommon form of recurrent priapism whose etiology if often unknown. To date, there has been one report of a patient with stuttering priapism and glucose-6-phosphate dehydrogenase (G6PD) deficiency. Herein we describe the second-known case of recurrent priapism in a patient with G6PD deficiency. The pathophysiology of G6PD deficiency and its potential to cause priapism is reviewed. ⋯ Idiopathic recurrent priapism may be explained by underlying hemolytic anemia associated with G6PD deficiency. Several possible mechanisms exist to explain this association, including hyperviscosity, direct endothelial dysfunction secondary to bare hemoglobin vasculotoxicity, and relative nitric oxide deficiency causing vasoconstriction and vascular smooth muscle proliferation.
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With the advances in penile vibrator stimulation (PVS), most spinal cord injured (SCI) men can self-ejaculate. Oral midodrine may further increase ejaculation success, while maintaining autonomy. Since most SCI men attempt ejaculation for sexual rather than reproductive purposes, self-ejaculation should be emphasized and sensations explored. ⋯ Most SCI men can self-ejaculate and perceive physiological and orgasmic sensations. The climactic experience of ejaculation seems related to AD, few sensations being reported when AD is not reached, pleasurable climactic sensations being reported when mild to moderate AD is reached, and unpleasant or painful sensations reported with severe AD. Sexual rehabilitation should emphasize self-ejaculation and self-exploration and consider cognitive reframing to maximize sexual perceptions.
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Penile fracture is a traumatic rupture of the tunica albuginea because of blunt injury of an erect penis. ⋯ Surgical repair of penile fracture after a conservative treatment is an effective method for patients with delayed presentation devoid of urethral involvement.