ESSM Newsletter # 33

11 / 16

11 ESSMToday
Have you read ? Best of the Best: Clinical
A brief summary of the best papers and abstracts published in the main journals
related to Sexual Medicine by Nicola Mondaini
dr. nicola Mondaini
Associate Editor
Department of Urology
Ospedale Santa Maria Annunziata
(Ponte a Niccheri)
Via dell’Antella, 58 – Bagno a Ripoli
Florence, Italy
Erectile dysfunction
Efficacy of Avanafil fifteen minutes after
dosing in men with erectile dysfunction:
A randomized, double-blind, placebo-con-
trolled study
Hellstrom WJ et alt: J Urol. 2015 Jan 12.
To examine the therapeutic effects of avanafil
15 minutes after dosing in men with mild to se-
vere ED.This randomized, double-blind, placebo-
controlled 12-week study (4-week run-in; 8-week
treatment period) randomized men to placebo
(n=145), avanafil 100 mg (n=147), or avanafil
200 mg (n=148) on demand. The primary ef-
ficacy variable was the per-subject proportion
of sexual attempts within the treatment period
in which subjects obtained an erection sufficient
for vaginal penetration within approximately 15
minutes after dosing (measured by stopwatch)
that enabled successful completion of sexual
intercourse (Sexual Encounter Profile question
3 [SEP3]).Significantly greater mean per-subject
percentages of successful intercourse attempts
within approximately 15 minutes after dosing
were observed for avanafil 100 mg (mean,
25.9%, LS mean [SE], 24.7% [2.9]) and 200
mg (mean, 29.1%, LS mean [SE], 28.2% [2.9])
vs placebo (mean, 14.9% LS mean [SE], 13.8%
[2.9], p=0.001 and p<0.001). After treatment, a
statistically significant difference between avana-
fil and placebo in the average per-subject propor-
tion of successful intercourse attempts (SEP3)
was noted as early as 10 minutes in the 200
mg group and 12 minutes in the 100 mg group.
Treatment-emergent adverse events included
headache, upper respiratory tract infection, and
nasal congestion; most were mild or moderate
in severity.Treatment with avanafil produced ef-
ficacy, compared with placebo, within approxi-
mately 15 minutes of dosing, and a statistically
significant treatment difference in the percentage
of successful sexual attempts was demonstrated
as early as 10 minutes after treatment.
Priapism impact profile questionnaire: De-
velopment and initial validation
Burnett AL et alt: Urology. 2015 Apr 8
To create and evaluate a psychometric instru-
ment that measures the impact of experienc-
ing priapism from the patient perspective.The
research protocol consisted of several phases
as follows: (1) generating items, (2) composing
a patient questionnaire, (3) administering the
questionnaire to patients with both active and
remitted (≥ 1 year without priapism episodes)
histories of priapism, (4) performing internal con-
sistency and criterion-oriented validity analyses
in correlation with clinical histories and erectile
function assessment tools, and (5) ascertaining
psychometric properties of the instrument.The
final instrument comprised a 12-item Priapism
Impact Profile (PIP) questionnaire, representing
the following 3 domains adversely impacted by
priapism: Quality of life (QoL), sexual function (SF),
and physical wellness (PW), with higher scores
indicating inferior experience in respective do-
mains. Internal consistency reliability coefficients
for the total PIP score and the 3 domain scores
were >0.75. Fifty-four patients (mean age, 31.7
± 11.4 years) completed the questionnaire. Pa-
tients with active priapism (n = 42) had higher
total, QoL, SF, and PW scores than those with
priapism remission (n = 8; P <.05, P <.05, P =
.09, and P <.01, respectively). Patients with a
history of recurrent priapism episodes >2 hours
in duration had higher total, QoL, SF, and PW
scores than those with “very minor” priapism
recurrences (≤ 2 hours in duration; P <.01,
P <.01, P <.05, and P <.001, respectively). Pa-
tients with “mild-to-moderate” to “severe” erectile
dysfunction had higher total, QoL, SF, and PW
scores than those with no or “mild” erectile dys-
function (P <.05, P = .14, P <.01, and P = .25,
respectively).The PIP questionnaire is a novel
psychometric instrument that offers a means to
quantify the adverse health impact of the patient’s
experience with priapism
Psychology
Sexuality and romantic relationships in
young adult cancer survivors: Satisfaction
and supportive care needs
Geue K et alt: Psychooncology. 2015 Mar 31.
In recent years, psycho-oncology has focused
more and more on adolescents and young adults
with cancer (AYA). Many studies have concen-
trated on fertility issues in AYAs, but romantic
relationships and sexuality have only been re-
searched to a limited extent. This cross-sectional
study examined AYAs’ quality of relationships
and sexuality satisfaction thereby identifying sex
differences.Ninety-nine cancer patients (N=33
males) diagnosed between 15 and 39 years who
were in a romantic relationship at the time of
the survey completed questionnaires on their
relationship (Partnership Questionnaire), sexuality
(Life Satisfaction Questionnaire), and sexuality
needs (Supportive Care Needs Survey). Test for
mean differences and regression analyses to
determine associated variables were performed.
Seventy-six percent of AYAs (N=75) rated their
relationship quality as high. About 64% of pa-
tients reported having less sexual intercourse
since diagnosis, more women than men (72%
vs. 45%; p= .011). The need for support was
strongest for changes in sexual feelings (N=38;
38.3%). Duration of relationship (β = -0.224),
being on sick leave (β=0.325), and satisfac-
tion with sexuality (β =0.409) were associated
with satisfaction with relationship (R2 =0.256).
Satisfaction with sexuality (R2 = 0.344) was
regressed on physical function (β =0.419), sat-
isfaction with relationship (β =0.428), and male
gender (β =-0.175). Sexuality need (R2 =0.436)
was associated with fatigue (β=0.232) and satis-
faction with sexuality (β=-0.522). Although they
reported high satisfaction with their relationships,
AYA patients experienced sexual problems and