4
ESSM
Today
Scientific Highlights from Istanbul:
Men’s Health, Women’s Health
sible synergic effect of the combined therapy
in more than 100 subjects with PD. Surgical
treatment of PD includes excision of the plaque
and using autologous or hererologous graft
material for defect closure. The optimal graft
material has not been defined yet. Herwig and
Kuehhas (PS-09-004) reported good outcomes
in 51 patients treated using a derma-graft which
could be considered another viable approach.
Premature ejaculation (PE) has been considered
the most common male sexual complaint in the
general population. The pathogenesis of lifelong
PE remains poor understood. Jern et al., (HP-
01-007) reported a possible association between
PE polymorphism of catechol-o-methyltrasferase
(COMT) and PE providing a possible further in-
sights to the pathogenesis of PE.
In conclusion ESSM Istanbul congress con-
firmed the high quality of studies submitted and
presented. The contribution of all other com-
munications not emphasized in this section, for
obvious space limitation, should be considered
equally valuable.
Women’s Health Issue
Similar to what observed in past years a strong
focus has been laid on female sexuality with a
number of posters, podium sessions and mas-
ter lectures being dedicated to this particular
research area.
Out of 961 couples with unconsummated mar-
riage, Promodu et al., (PS-04-004) reported that
in 327 cases female factors alone was the main
cause of the problem. In particular, vaginismus
accounted for 96.33% of cases. In line with
these data, vaginismus is considered as one of
the most common psychosexual female sexual
dysfunction. Muammar and McWalther (PS-10-
001) reported that insufficient education was
the major contributor to vaginismus in 100 Arab
women. Molaei et al., (PS-04-007) developed a
new multidimensional case-history tool which
represents a valid and reliable self-reported
questionnaire for women complaining of lifelong
vaginismus. Various therapeutic approaches have
been proposed for vaginismus. Beronio et al.,
(PS-04-006) presented a two steps approach for
this problem on 135 couples. In the first step, the
female participant performed vaginal penetration
exercise on herself in the presence and with the
direct help of a therapist. In the second step the
couple performed at home vaginal penetration
exercises on themselves. With this approach
95% of the women were able to achieve full
vaginal penetration. The mean duration for the
treatment was between 8 and 9 therapy ses-
sions. The use of sex therapy was a successful
approach used also by Promodu to treat couples
with unconsummated marriage (PS-04-012).
Out of 78 couples, 76 had successful coitus by
the end of therapeutic programme. Conversely,
Sabra and Eid (HP-08-003) used cognitive-
behavioural therapy based on education (visual
illustrations and mirror), desensitization and vagi-
nal dilators in Lebanon patients with vaginismus
with good outcomes.
Lack of sex education represents a crucial point
in the evaluation of both women and male sexual
problems. In a telephone counselling survey on
more than 1000 subjects Tripodi et al., (PS-06-
008) reported that reduced sexual desire and
vaginismus were the most common women
sexual problems. Interestingly, among the pa-
tients evaluated almost 60% had never consulted
for their problems.
Chronic pelvic inflammatory diseases (CPID)
could profoundly affect both female sexual
function and quality of life. Romashchenko et
al., (PS-06-001) reported data on more than
400 women with CPID. Decreased sexual desire
was reported by 25.5%, decreased arousal in
26.2%, anaorgasmia in 10.2% and dyspareunia
in 52.6%. All these problems improved after a
specific inflammatory therapy.
Women sexual dysfunction and urinary incon-
tinence should be frequently associated, both
representing a marker of pelvic floor dysfunction.
Cayan et al., (PS-10-004) documented for the
first time the association between female sexual
dysfunction and urinary incontinence in a series
of 1217 Turkey women.
Metabolic syndrome (MetS) is a multifactorial
disease characterized by impaired glucose
tolerance / diabetes, central obesity, elevated
triglyceride levels, reduced HDL levels and hy-
pertension. The association between MetS and
male sexual dysfunction is well documented.
Otunctemur et al., (HP-08-007) in a series of
400 pre and postmenopausal documented that
sexual dysfunctions were present even in women
with MetS being more frequent in postmenopau-
sal than in premenopausal women. Polycystic
ovarian syndrome (POS) is frequently associ-
ated with MetS. Altay and Erkurt (HP-08-004)
reported that total female sexual function index
score, lubrication, orgasm and pain scores were
significantly lower in women with POS but sexual
desire and arousal scores were found similar to
normal controls.
Other factors affecting female sexual function
include liver cirrhosis (HP-08-005), HIV (HP-
08-006) and diabetes mellitus (PS-06-004).
In particular, diabetic women may be affected
by sexual dysfunction mainly due to peripheral
vascular diseases. Caruso et al., (PS-06-004) in
an open label study involving a limited number
of women with type 1 diabetes documented that
daily tadalafil 5mg treatment improved clitoral
blood flow improving women sexual aspects.
Similar results were reported by Krychman et al.,
(PS-06-005) in a double blind placebo controlled
trial using bremelanotide (a melanocortin-recep-
tor-4 agonist) in 397 premenopausal women with
hypoactive sexual desire and or female sexual
arousal disorder.
In conclusion ESSM Istanbul congress confirmed
the high quality of studies submitted and pre-
sented. The contribution of all other commu-
nications not emphasized in this section, for
obvious space limitation, should be considered
equally valuable.
