The effect of radical resection of male rectal cancer on sexual function has been the focus of attention. Despite this, there remains a dearth of robust evidence regarding the influence of robotic radical resection of rectal cancer on postoperative sexual function, particularly in men diagnosed at an early age. This study aims to explore the implications of robotic radical resection of rectal cancer on sexual function in early-onset overweight male patients diagnosed with this disease. A retrospective analysis was performed on male patients under 50 years old and over 20 years old who were diagnosed with rectal cancer (cT1-3N0M0) and underwent surgical treatment in the First Affiliated Hospital of Nanchang University from May 2015 to August 2020. Sexual function was evaluated by the International Index of Erectile Function (IIEF) test and scored at 1, 3, 6, and 12 months postoperatively. The sexual function of traditional laparoscopic radical resection of rectal cancer (L-RE) and robotic radical resection of rectal cancer (R-RE) were compared. According to body mass index, L-RE and R-RE groups were further divided into normal body weight groups (LN-RE and RN-RE) and overweight groups (LO-RE and RO-RE), and the sexual function of each group was compared successively. Neither L-RE nor R-RE patients had significant differences in number of lymph nodes removed, tumour size, pathological TNM stage, or first exhaust time or time to eat liquids. The OS and DFS of the L-RE and R-RE groups, as well as the LO-RE and RO-RE groups, did not differ statistically after the logarithmic rank test (P > 0.05). IIEF scores in both the L-RE and R-RE groups declined sharply 1 month after surgery and then steadily increased. The R-RE group's IIEF scores significantly recovered in 6 months, compared to 12 months in the L-RE group. In comparison of subgroups, the results of sexual function in the LN-RE and RN-RE groups were similar to those in the L-RE and R-RE groups. Conversely, the RO-RE group showed slightly improved sexual function recovery than the LO-RE group 3 and 6 months post-surgery. 12 months after surgery, no significant difference was observed between the two groups. With similar long-term oncology outcomes, the robot-assisted surgical approach provided better protection of sexual function for men with early-onset rectal cancer, especially for those with a higher body mass index (BMI).

Although society still holds age-related stereotypes dismissing the sexuality of aging individuals, older adults remain sexually active and find sexuality to be an important part of their quality of life. Primarily oriented toward a biomedical and dysfunctional lens, prior research neglected the subjective well-being of elderly individuals, especially partnered adults and couples aged 60 years or more. Shedding a more positive light on this area of life could promote older individuals' and couples' sexual well-being.

This scoping review aimed to synthetize the studies including community samples of partnered adults or couples over 60 who reported on various indicators of subjective sexual well-being including sexual satisfaction, distress, and function using validated measures.

Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMAScR), the electronic literature search was conducted using PubMed, PsycINFO, Medline, and CINAHL for peer-reviewed journal articles published before July 2023.

Results showed how relational variables such as relationship satisfaction and intimacy emerge as important correlates of older adults' sexual well-being.

Avenues for future research arising from gaps in the studies identified thorough this scoping review, including the underrepresentation of sexual/gender diverse individuals and the use of single and/or non-validated items to assess sexual well-being, are discussed.

Sexual activity can be broadly defined to include not only sexual intercourse but also physical intimacy. However, most studies of sexual activity in older adults have a limited focus on sexual intercourse only.

The aim was to investigate sexual activities including sexual intercourse and physical intimacy in community-dwelling older Korean adults.

This study was based on cross-sectional data to measure sexual activities (sexual intercourse and physical intimacy) in 209 participants (100 men and 109 women) aged 65 years or older. Sexual intercourse and physical intimacy were defined as vaginal penetration and as any sexual behavior with sexual arousing (eg, kissing, caressing), respectively. Erectile dysfunction was evaluated by the use of the International Index of Erectile Function questionnaire, and female sexual dysfunction was evaluated by Female Sexual Function Index scores.

Trained interviewers collected the survey information on sexual activities in the last 6 months at the senior welfare center.

The participants' mean age was 73.4 ± 4.8 years (men, 74.2 ± 5.0 years; women, 71.6 ± 5.3 years). The prevalence of erectile dysfunction was 91.0% (91/100), and the prevalence of female sexual dysfunction was 96.3% (105/109). In the previous 6 months, 122 participants (58.4%) reported sexual activities, and men reported more sexual activities than women (P = .001). A total of 69.6% of men and 41.9% of women engaged in sexual activity with intercourse, whereas 30.4% of men and 58.1% of women engaged in physical intimacy only. The physical intimacy-only group was more likely to have erectile dysfunction or female sexual dysfunction than the sexual intercourse group (P = .035 and P = .012, respectively).

Although sexual intercourse is an important part of sexual activity, our study results suggest that physical intimacy is also a considerable component of sexual activity that should not be neglected in older adults, especially in women. Our findings imply that health-care professionals need to consider physical intimacy as part of sexual activity in the assessment of geriatric patients with sexual dysfunction. Chung HS, Kim GH, Shin M-H, et al. Physical Intimacy Is an Important Part of Sexual Activities: Korean Older Adults Study. Sex Med 2020;8:643-649.

Male sexual response is controlled by a series of neurally mediated phenomena regulating libido, motivation, arousal and genital responses such as penile erection and ejaculation. These neural events that occur in a hormonally defined milieu involve different neurophysiological, neurochemical, and neuropsychological parameters controlled by central mechanisms, spinal reflexes and peripheral nervous system. Epidemiologic studies have suggested the high prevalence of male sexual dysfunction worldwide with significant impact on the quality of life of patients suffering from this problem. The incidence of sexual dysfunction is particularly high among men with neurologic disorders. Sexual dysfunction in men, such as loss of sexual desire, erectile dysfunction (ED), changes in arousal, and disturbances in orgasm and ejaculation may involve organic causes, psychological problems, or both. Organic male sexual disorders include a wide variety of neurologic, vasculogenic, neurovascular or hormonal factors that interfere with libido, erection, ejaculation and orgasm. Neurogenic sexual dysfunction may result from a specific neurologic problem or it could be the presenting symptom of a developing neurologic disease. Neurologic ED could result from complications of chronic neurologic disorders, trauma, surgical injury or iatrogenic causes. These etiologic factors and the underlying pathophysiologic conditions could overlap, which should be considered when making a diagnosis and selecting a treatment. A detailed history of physical examination, neurologic disorders, as well as any past history of psychological and psychiatric disturbances, and a thorough neurological examination will provide better understanding of the underlying causes of neurogenic sexual dysfunction. In patients with spinal cord injury, the location of the lesion and the time of onset of injury should be determined. Therapeutic strategies against erectile dysfunction are initiated with the least invasive options using the phosphodiesterase inhibitors. When oral medication options are exhausted, intraurethral and intracavernosal therapies and ultimately vacuum constriction devices and penile implants are considered. Recent basic research has suggested the potential role of stem cell-based therapeutic strategies to protect penile neural integrity and reverse cavernosal neurodegeneration in experimental models. Further insight into the central, spinal and peripheral neural mechanisms of male sexual response may help precise diagnosis and better management of neurogenic sexual dysfunction in men.

To assess semen parameters and couple fecundity as measured by time to pregnancy (TTP).

Observational prospective cohort with longitudinal measurement of TTP.

Sixteen Michigan/Texas counties.

A total of 501 couples discontinuing contraception were followed for 1 year while trying to conceive; 473 men (94%) provided one semen sample, and 80% provided two samples.

None.

Using prospectively measured TTP, fecundability odds ratios (FORs) and 95% confidence intervals (CIs) were estimated for 36 individual semen quality parameters accounting for repeated semen samples, time off contraception, abstinence, enrollment site, and couples' ages, body mass indices, and serum cotinine concentrations.

In adjusted models, semen quality parameters were associated with significantly shorter TTP as measured by FORs >1: percent motility, strict and traditional morphology, sperm head width, elongation factor, and acrosome area. Significantly longer TTPs or FORs <1 were observed for morphologic categories amorphous and round sperm heads and neck/midpiece abnormalities. No semen quality parameters achieved significance when simultaneously modeling all other significant semen parameters and covariates, except for percent coiled tail when adjusting for sperm concentration (FOR 0.99; 95% CI 0.99-1.00). Male age was consistently associated with reduced couple fecundity (FOR 0.96; 95% CI 0.93-0.99), reflecting a longer TTP across all combined models. Female but not male body mass index also conferred a longer TTP (FOR 0.98; 95% CI 0.96-0.99).

Several semen measures were significantly associated with TTP when modeled individually but not jointly and in the context of relevant couple-based covariates.

The burden of sexual dysfunction among older people in many low- and middle-income countries is not well known. Understanding sexual dysfunction among older people and its impact on quality of life is essential in the design of appropriate health promotion programs.

To assess levels of sexual function and their association with quality of life while controlling for different sociodemographic determinants and chronic diseases among men and women over 50 years of age in rural Indonesia.

A cross-sectional study was conducted in the Purworejo District, Central Java, Indonesia in 2007. The study involved 14,958 men and women over 50 years old. The association between sexual dysfunction and quality of life after controlling for potential confounders (e.g., sociodemographic determinants and self-reported chronic diseases) was analyzed by multivariable logistic regression.

Self-reported quality of life.

Older men more commonly reported sexual activity, and sexual problems were more common among older women. The majority of older men and women reported their quality of life as good. Lack of sexual activity, dissatisfaction in sexual life, and presence of sexual problems were associated with poor self-reported quality of life in older men after adjustment for age, marital status, education, and history of chronic diseases. A presence of sexual problems was the only factor associated with poor self-reported quality of life in women. Being in a marital relationship might buffer the effect of sexual problems on quality of life in men and women.

Sexual dysfunction is associated with poor quality of life among older people in a rural Javanese setting. Therefore, promotion of sexual health should be an integral part of physical and mental health campaigns in older populations.

Obstructive sleep apnea syndrome (OSAS) is known to induce erectile dysfunction and to reduce overall sexual satisfaction in affected men. Data on the effects of disease severity and other contributing factors such as the age of the patient are missing.

To compare self-reported sexuality in men with newly diagnosed sleep apnea with a group of disease-free men, and to evaluate the impact of disease severity and age on the response pattern.

Self-reported erectile function, desire, and frequencies for petting, tenderness, masturbation, sexual intercourse, and overall satisfaction with sexuality over a recall period of 3 months.

A prospective survey in men admitted to a multidisciplinary sleep center using a standardized validated German questionnaire.

One hundred-sixteen men 51.1 +/- 11.4 years (mean +/- standard deviation) with OSAS (OSAS+) and 42 men age 46.6 +/- 13.7 years without OSAS (OSAS-) completed the survey. OSAS+ men were older (P = 0.01) and more often divorced (P = 0.048). OSAS was significantly associated with erection problems (P = 0.024) and decreased overall sexual satisfaction (P = 0.04). In contrast disease severity did affect masturbation frequency only (P = 0.02), whereas patient age affected erection (P = 0.001), and the desire for tenderness (P = 0.02) and intercourse (P = 0.0003).

Patient age might be a more important factor affecting sexuality in men with sleep apnea than the disease severity. Future studies assessing sexuality in men with OSAS should include age as an additional variable.