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Have you read ? Best of the Best: Clinical
need support with sexual issues. As a substantial
proportion of patients felt stressed because of
sexual changes, communication and interventions
addressing post-cancer sexuality, particularly in
women, are indicated.
FSD
Advances in pharmacotherapy for treating
female sexual dysfunction
Nappi RE1, Cucinella L.
Expert Opin Pharmaco-
ther. 2015 Apr;16(6):875-87.
‘Female sexual dysfunction’ (FSD) is an um-
brella term comprising a range of common dis-
orders, including hypoactive sexual desire, re-
duced subjective and/or physical genital arousal
(poor sensation, vasocongestion, lubrication),
sexual pain and inability to achieve orgasm/
satisfaction, which are multidimensional by na-
ture and often coexisting. Psychological and
contextual factors have a significant influence
on organic components of sexual response and
behavior and a tailored medical approach to
sexual symptoms is inevitably limited.The pa-
per reports the most recent advances in phar-
macotherapy for women taking into account
the biopsychosocial model. Hormone therapy,
including estrogens, testosterone, tibolone
and dehydroepiandrosterone, are discussed
in term of efficacy and safety in postmeno-
pausal women both for female sexual interest/
arousal disorder (FSIAD) and genito-pelvic pain/
penetration disorder. Ospemifene, a selective
estrogen receptor modulator, approved to treat
dyspareunia at menopause, is also discussed.
Data on psychoactive agents for treatment of
FSIAD in premenopausal women are discussed,
including the potential use of on-demand
combined hormonal (testosterone) and non-
hormonal (buspirone or sildenafil) treatments
to address possible neurophysiological profiles
of
women.Weare still waiting for an approved
pharmacotherapy for FSD. This is not the result
of gender inequality in sexual medicine, but it
reflects the need of balancing benefits and risks
in order to provide effective and safe treatments
to women of any age.
SURGERY
Penile length is a very important factor
for cosmesis, function and psychosexual
development in patients affected by hy-
pospadias: Results from a long-term lon-
gitudinal cohort study
Ciancio F et alt:
Int J Immunopathol Pharmacol.
2015 Mar 26.
Few studies of long-term outcome of hypo-
spadias treatment in terms of voiding, surgi-
cal complications, sexual functioning, intimate
relationships and cosmetic results have been
investigated and contrasting results have been
obtained so far. The aim of our study is to in-
vestigate the long-term outcome of urinary and
sexual function, cosmesis and the quality of
intimate relationships in a series of hypospa-
dias. In this study, 42 patients who underwent
surgery for hypospadias were prospectively fol-
lowed for 15 years. Medical records provided
the hypospadias data, the number of recon-
structive operations and the reconstruction
technique that was used. Patients underwent
physical examination, including penile length
measurement and completed International Pro-
static Symptoms Score (I-PSS), International
Index Of Erectile Function (IIEF 15) and the
Penile Perception Score questionnaire (PPPS).
Twenty patients agreed to participate in the
study. At the enrolment, the median value of
HOSE was 13, as regards PPPS, 18/20 (90%)
were satisfied, while in 1998 only 80% were
satisfied. No significant statistical difference
has been reported from the results obtained
at enrolment and those obtained at follow-up,
in terms of PPPS (P = 0.81), IPSS and IIEF-15.
Penile length was 6.5 cm flaccid and 10.5 cm
stretched. Our data show how cosmesis, func-
tion and psychosexual development for these
patients are highly connected to surgical out-
come, which is understood to be a decrease
in penile size.
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