Current Sexual Health Reports

Mason, Matthew M.; Schuppe, Kyle; Weber, Alexander; Gurayah, Aaron; Muthigi, Akhil; Ramasamy, Ranjith

doi: 10.1007/s11930-022-00340-zpmid: 36908762

Purpose of ReviewSemen analysis serves as the initial step in the evaluation of male infertility. However, given the difficulty in interpreting abnormal findings, physicians and patients often struggle with understanding the results. In this review, we aim to review the normal physiology of ejaculation and create an accessible resource for interpreting abnormal semen volume, viscosity, liquefaction, pH, appearance, and color.Recent FindingsEmerging evidence has revealed that men with genitourinary tract infections have a greater number of seminal leukocytes, which may result in clumping of motile sperm and altered morphology. Hence, these patients may have abnormal sperm parameters secondary to their health status. Recent findings have further characterized the semen liquefaction process, suggesting that increased levels of semenogelin and decreased levels of proteases and plasminogen activators (e.g., urokinase and chymotrypsin) may be associated with the failure of semen to convert to a watery consistency.SummaryThis article creates a resource which may be referenced when abnormalities in semen analysis are encountered. We offer a comprehensive overview of normal ejaculation physiology and abnormal variants in male ejaculate volume—including aspermia, anejaculation, retrograde ejaculation, and hypo- and hyperspermia—and their potential etiologies. Additionally, we discuss several processes (infection, inflammation, and dysfunction of male sex glands) which may affect semen viscosity, liquefaction, and pH. Finally, our discussion of the potential colors of male ejaculate is meant to reduce the anxiety of both patient and provider. Through a better understanding of the process and varying characteristics of ejaculation, physicians may adequately counsel their patients on abnormal findings and concerns regarding infertility.

Patel, Rutul D.; Gross, Martin S.

doi: 10.1007/s11930-022-00353-8pmid: N/A

Purpose of ReviewThere is a dearth of robust, peer-reviewed literature detailing the epidemiology, natural history, and sequelae associated with fungal infections of urologic implants, prostheses, and permanent devices. We curated and analyzed the available literature on this topic in concordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses system (PRISMA) criteria. The purpose of this systematic review is to consolidate the available research and highlight areas that require greater exploration.Recent FindingsAs hypothesized, the literature investigating fungal infections of urologic implants and prostheses is scant. There were, however, several studies detailing the mycobiome, clinical outcomes, and risk factors associated with fungal infections of indwelling urinary catheters. Of the 20 studies that met inclusion criteria, only 4 focused on prosthetic devices, 3 for inflatable penile prosthetics and 1 for the adjustable transobturator male system. There were 15 studies pertaining to chronic indwelling urinary catheters and 1 study about chronic nephrostomy tubes. Furthermore, there were no studies investigating fungal infections of common urologic implants such as slings, sacral neuromodulators, or artificial urinary sphincters.SummaryThis detailed systematic review found that the vast majority of studies focus on fungal infections associated with indwelling urinary catheters. There are virtually no retrospective or prospective studies investigating fungal infections of the various urologic implants and prostheses routinely used. Moreover, nearly half the studies included in this review were published over 20 years ago. There is a pressing need for more foundational literature on this topic that may ultimately yield sound prophylactic and management strategies.

Solsrud, Emily; Louters, Marne; Pearlman, Amy

doi: 10.1007/s11930-022-00351-wpmid: N/A

Purpose of ReviewTestosterone deficiency (TD) disproportionately affects men with cancer due to several risk factors, including treatments and direct physiologic effects of the cancer disease process. Research and formal guidelines to aid physicians in diagnosing and treating TD in cancer patients are limited, causing this population to be grossly under-treated. There is an opportunity to safely treat these patients and positively impact several aspects of quality of life.Recent FindingsWhile the treatment of TD has been well studied in non-oncologic patients, studies in cancer patients are limited and include retrospective, observational, pilot, and randomized-controlled trials.SummaryCancer patients have a high symptom burden, many of which may overlap with symptoms of TD. Treatment of TD in cancer patients may provide benefit in various aspects of health including functional outcomes, quality of life, and cancer-induced cachexia. Given the impact of TD in cancer patients, the authors believe it reasonable to assess for TD in men with cancer and hypogonadal symptoms and consider trial of TRT as a shared decision-making approach with close monitoring of adverse events and side effects.

Evans, Leighton

doi: 10.1007/s11930-022-00352-9pmid: 36467871

Purpose of ReviewVirtual reality (VR) pornography is a relatively new medium for the experience of pornography. In juxtaposition with traditional modes of experiencing pornography, such as two-dimensional (2D) displays, VR promises a new experience of pornography for the user. VR can offer the feeling of ‘being there’: an increased sense of immersion and presence in a mediated experience thanks to the sensory affordances of the medium. In an effective VR environment, the user is immersed in the experience itself, feeling an embodied presence in the world presented to them and able to interact with the environment and others in the environment in ways that cannot be achieved in other media. In terms of pornography, this is potentially revolutionary. The user can be embodied in one of the performers and experience a unique perspective. Alternatively, there are interfaces that will allow for the performer and viewer to physically interact with one another and experience physical arousal from the actions of the other at a distance. The possibilities of VR pornography are therefore related to the intensity of experience, the changing relationship with the performers and others in pornographic media, and the possibility of new, embodied experiences of arousal utilising networked, embodied technologies. This research review assesses to what extent research on VR pornography has supported these possibilities, affordances, and developments.Recent Findings23 articles were included in the present review. Findings demonstrate some increases in arousal and empathy in using VR pornography. However, further empirical evidence for these findings is still needed. In addition, teledildonic technology is lacking empirical research and the effects of the use of this technology in conjunction with VR requires research.SummaryCollectively, the results underscore the notion that VR improves immersion and presence for subjects, and this can translate to increased sexual desire, empathy for performers in pornography, and sexual anxiety in watching pornography. This is a field in infancy, and the initial results of empirical work suggest that VR can intensify some key aspects of the experience of pornography. Theoretical reflections on VR pornography indicate many areas that require further empirical research.

Quattrocchi, Patrizia

doi: 10.1007/s11930-022-00354-7pmid: 36530373

Purpose of ReviewThe purpose of this review is to summarize the current knowledge on out-of-hospital births (at home or in an independent birth center) in high-income countries in the time of coronavirus. Qualitative studies published between 2020 and 2022 providing findings on women’s and health providers’ perspectives and experiences, as well as policies and practices implemented, are synthetized.Recent FindingsDuring the COVID-19 pandemic, the number of women choosing the home or a birth center to deliver has grown considerably. Main reasons for this choice include fear of contagion in facilities and restrictions during delivery and the post-partum period, especially women’s separation from their companion of choice and their newborn. Findings suggest that homebirth within a public model has several advantages in the experience of birth for both women and professionals during the pandemic period, maintaining the benefits of biomedicine when needed.SummaryDuring the COVID-19 pandemic, the interest in out-of-hospital birth increased in high-income countries, and the number of women choosing the home or a birth center to deliver has grown considerably. This review aims to give a more in-depth understanding of women’s and health providers’ perspectives on and experiences of out-of-hospital birth services during this period. Twenty-five studies in different countries, including the USA, Canada, Australia, Switzerland, the Netherlands, the UK, Spain, Croatia, and Norway, were reviewed. Findings stress that out-of-hospital birth has allowed women to deliver according to their wishes and needs. In addition, the pandemic experience represents an opportunity for policy to better support and integrate out-of-hospital services in the health care system in the future.