ESSM Newsletter # 40

19 ESSM Today Have you read? Best of the best: Clinical research by Bruno Jorge Pereira Male sexual dysfunction Stephenson KR, Truong L, Shimazu L. Why is Impaired sexual function distressing to men? Consequences of impaired male sexual function and their associations with sexual well-being . J Sex Med 2018; 15: 1336-1349. The complex association between male sex- ual function and subjective sexual well-being (sexual satisfaction and distress) may be par- tially mediated by specific “consequences” of impaired function. This study aimed to pilot a scale assessing consequences of impaired male sexual function in 166 men in sexually active heterosexual relationships, and test whether specific consequences (disruption of sexual activity, negative partner responses) mediated the association between sexual function and well-being. Clinical implications: Sexual conse- quences represent potential maintaining factors of male sexual dysfunction and may represent key targets of cognitive behavioral treatments. Baas WR, Butcher MJ, Lwin A et al. A review of the FAERS data on 5-alpha reductase inhibitors: Implications for post finasteride syndrome. Urology 2018; 120: 143-149. To quantify reports made to the FDA Adverse Event Reporting System (FAERS), create a de- mographic of patient reports, and examine the cluster of symptoms to correlate consistency of post finasteride syndrome (PFS) complaints. PFS is a provisional diagnosis encompassing a cluster of sexual, physical, and psychological and/or neurologic symptoms associated with 5-alpha reductase inhibitor use that emerge or continue after discontinuation of medica- tion. Statistical analysis compared variables of interest between the 2 doses of finasteride (1 mg vs. 5 mg). From FAERS, 2048 monotherapy cases were identified: 1581 of finasteride 1 mg, 240 of finasteride 5 mg, and 226 of unreported doses. Possibly related to labeling changes, from 2011 to 2014, there was a significant increase in adverse events (AEs) reported involving 1 mg dosing. Finasteride use was reported with many sexual AEs including diminished libido, erectile dysfunction, and ejaculatory complaints. Other common AEs included dermatologic, metabolic, and psychological and/or neurologic complaints. FAERS data suggests that finasteride exposure is reported with a diverse collection of symptoms, particularly in younger men on 1mg dosage compared to older men on 5mg. Premature ejaculation Verze P, Arcaniolo D, Imbimbo C et al. General and Sex profile of women with partner af- fected by premature ejaculation: Results of a large observational, non-interventional, cross-sectional, epidemiological study (IPER-F). Andrology 2018; 6(5): 714-719. Couple distress is a crucial point in premature ejaculation (PE). PE has been associated with significant bother, inter-personal problems, and dissatisfaction with sexual intercourse for both men and their partners. Adult women aged 18 to 80 years old, sexually active, were randomly sampled from the patient lists of General Practitioners in Italy and were in- cluded in this observational, non-interven- tional, cross-sectional epidemiological study to assess the effect of PE on female sexuality in female partners of men affected from PE and the impact of PE on female sexual quality of life, the presence of sexual problems of the male partner, and to evaluate the prevalence and characteristics of comorbidities. Subjects were asked to fill: A general question- naire regarding anthropometric data, lifestyle, marital status, education, occupation, economic conditions, general health status, comorbidi- ties, and sexual habits; SQoL-F, FSDS-R-PE, SDS and SAS questionnaires. In addition, females reported about their partner’s ejaculation time and the presence of sexual dysfunctions. Re- sults: A total of 3,104 women were included with a mean age of 45.1 years. Woman with PE partners presented a higher percentage of sexual dysfunction and reported more anxiety compared with female partners of men not affected from PE (42.69% vs. 20.56% and 30.95% vs. 15,34%, respectively). In addition, they referred more sexual dysfunction in their partners. Hypertension, hypercholesterolemia, arthritis, heart diseases, thyroid disease, a his- tory of menopause, or hysterectomy resulted in significantly more prevalence in women with PE partners. Conclusions: Female partners of PE pa- tients present an increased prevalence of sexual distress, a reduced quality of sexual life, and an increased anxiety score when compared to women whose partners are not affected from PE. Peyronie’s disease Capece M, Cocci A, Russo G et al. Collagenase clostridium histolyticum for the treatment of peyronie's disease: A prospective Ital- ian multicentric study. Andrology 2018; 6(4): 564-567. Collagenase clostridium histolyticum (CCH) is the first licensed drug for the treatment of PD and is indicated in patients with palpable plaque and curvature deformity of at least 30° of curvature. Only few monocentric studies are available in the current literature and this is the first national multicentric study focusing on CCH injection. In five Italian centers, 135 patients have com- pleted the treatment with three injections fo CCH (0.9 mg) given at 4-weekly intervals in combina- tion to home modelling, stretching and vacuum device using Ralph’s shortened modified proto- col. An improvement in the angle of curvature was recorded in 94,8% of the patients by a mean (range) of 19.1 (0 – 40)° or 42.9 (0 – 67)% from baseline (p < 0.001). There was also a statistically significant improvement in all IIEF and PDQ questionnaires. This prospective mul- ticentric study confirms that the three-injection protocol is effective enough to achieve a good result and to minimize the cost of the treatment. Bruno Jorge Pereira MD, FEBU, FECSM Department of Urology University of Beira Interior (FCS-UBI) Covilhã, Portugal brunoalexpereira@gmail.com