Search Results (441)

Background/Objectives: Prostate cancer (PC) is one of the most commonly diagnosed malignancies globally; depending on the treatment strategy used, erectile dysfunction (ED) is a frequently reported adverse outcome among PC patients. The current study evaluated ED prevalence among Pakistani PC patients and its effects on physical, psychological, and social well-being, aiming to address critical gaps in survivorship care for this population. Methods: A cross-sectional, multicenter, observational, questionnaire-based study was conducted in Rawalpindi and Islamabad, Pakistan, from February to April 2025. Health-related quality of life (HRQoL) among PC patients was measured using the Short Form Health Survey 36 (SF-36), while ED prevalence and severity were assessed by the International Index of Erectile Function (IIEF) instrument. Results: Among N = 400 PC patients, surgical treatments predominated (radical prostatectomy: 61.0%; n = 244), while hormonal (androgen-deprivation therapy: 31.5%; n = 126) and chemotherapy (23.3%; n = 93) were also commonly utilized. ED experience was high among PC patients in the erectile function (40.8%; n = 163) and in the intercourse satisfaction (45.0%; n = 180) domains; these showed moderately strong and significant positive correlations across all SF-36 domains, particularly physical functioning (r = 0.52; p < 0.001) and social functioning (r = 0.49; p < 0.001). Regression analysis confirmed sexual function domains explained 60% of HRQoL variance (adjusted R² = 0.60). Conclusions: This study reveals high rates of treatment-related ED—and its biopsychosocial impact–among Pakistani PC patients, with significant negative impacts on HRQoL. The findings underscore the urgent need to integrate sexual health management into standard oncological care practices to improve holistic patient outcomes. Full article

Research suggests that the impact of childhood sexual trauma (CST) on adult well-being varies in relation to characteristics of CST experiences (e.g., age of onset and duration/frequency) that influence the degree of trauma severity. Yet there remains a need for a CST severity measure that consistently delineates survivors with an elevated risk of adverse adult outcomes (AAOs) and accounts for correlations between severity characteristics. We compared two theory-based, categorical proxy measures of CST severity (duration and developmental timing) in their relationship with three AAOs, among a national probability sample of U.S. adult CST survivors (N = 568). We found a strong relationship between CST duration and developmental timing (p < 0.001), and redundancy in their impact on AAOs (i.e., no meaningful difference in how well they predicted AAOs). Participants with more chronic CST (≥4 years duration or occurring across childhood and adolescence) were twice as likely to report AAOs as other participants. Findings support the importance of assessing trauma chronicity in research and practice, to focus prevention and intervention strategies on CST survivors with the greatest long-term health risk. A categorical CST duration measure offers a theory-based assessment strategy that accounts for both the temporal and developmental effects of trauma severity on health outcomes. Full article

Background and Objectives: Sleep disruption and reduced physical activity are common in pregnancy and may impair sexual function through mood, body-image, and relational pathways. We prospectively examined whether sleep quality and physical activity predicted third-trimester sexual function in a Romanian antenatal cohort, and explored psychosocial correlates. Materials and Methods: In a single-center cohort, 102 pregnant adults were enrolled ≤ 20 weeks and followed to the third trimester. Sleep (Pittsburgh Sleep Quality Index, PSQI), sexual function (Female Sexual Function Index–Romanian version, FSFI-RO), physical activity (IPAQ-SF), depressive symptoms (PHQ-9), body-image avoidance (Body Exposure during Sexual Activities Questionnaire, BESAQ), and perceived social support (MSPSS) were assessed. Groups were defined by mid-/late-pregnancy sleep (good, PSQI ≤ 5; poor, PSQI > 5). Analyses used t-tests, Pearson correlations, multivariable linear regression for FSFI-Total, and logistic regression for FSFI-Total < 26.55. Results: Compared with good sleepers (n = 56), women with poor sleep (n = 46) had lower third-trimester FSFI-Total (24.4 ± 3.9 vs. 27.9 ± 4.3; p < 0.001) and higher odds of FSFI-defined dysfunction (adjusted OR 121.1; 95% CI 19.2–763.0; p < 0.001). FSFI-Total correlated with worse sleep (PSQI r = −0.42), depressive symptoms (PHQ-9 r = −0.36), social support (MSPSS r = 0.40), body-image avoidance (BESAQ r = −0.34) and physical activity (IPAQ-SF r = 0.24; all p ≤ 0.015). In adjusted models (R² = 0.42), higher MSPSS (β = 0.26; p = 0.004) was protective, whereas PSQI (β = −0.24; p = 0.008), ΔPHQ-9 (β = −0.19; p = 0.023), BESAQ (β = −0.17; p = 0.031), and higher BMI (β = −0.14; p = 0.049) predicted lower FSFI-Total. Conclusions: In this antenatal cohort, poor sleep was strongly and independently associated with lower sexual function, with meaningful contributions from social support, mood, body-image cognition, and physical activity, highlighting sleep as a clinically actionable target for preserving sexual well-being in pregnancy. Full article

Background: Sexual dysfunction (SD) affects up to two-thirds of individuals with early-onset Parkinson’s disease (PD), yet it remains underexplored in developing countries where stigma, depression, and treatment side effects may worsen its burden. This study investigated the magnitude and correlation of SD in early-onset PD. Methods: A cross-sectional study included 74 individuals with PD onset at ≤55 years of age. SD was assessed using the Medical Outcomes Study Sexual Functioning Scale, alongside interviews on sexual experiences after initiating PD medication. Prevalence was estimated descriptively, and Spearman’s correlation identified correlates of SD. Results: Half of participants reported SD, including lack of sexual interest (52.7%), difficulty relaxing or enjoying sex (52.7%), and impaired arousal (50%). Among men, 48% experienced erectile problems, while 44% of women reported difficulty achieving orgasm. After starting anti-Parkinson’s medication, 16% noted markedly reduced sexual desire, whereas nearly 10% reported increased desire. In men, SD correlated with levodopa dose (r = 0.411, p < 0.01). In women, SD correlated with stigma (r = 0.389, p < 0.05), depression (r = 0.529, p < 0.01), and anxiety (r = 0.629, p < 0.01). Conclusions: One in two individuals with early-onset PD experiences SD, independent of gender. Findings highlight the need for routine sexual health assessment and careful monitoring of treatment side effects. Interventions targeting stigma, depression, and anxiety are critical to improve sexual well-being in this population. Full article

Background/Objectives: Investigating how placement of a contralateral breast implant in the context of unilateral implant-based breast reconstruction influences aesthetic and patient-reported outcomes. Methods: A retrospective analysis was performed on a single-center prospectively maintained database (January 2021–March 2025) including patients who underwent unilateral implant-based breast reconstruction in association with a contralateral implant placement or not. Exclusion criteria were bilateral implant-based reconstruction or autologous reconstruction, follow-up of less than 6 months and missing data. Demographics and complications were analyzed. Aesthetic outcomes were evaluated by independent blinded surgeons using the Kroll Scale, patient satisfaction was investigated with the BREAST-Q Reconstruction Module v2.0. Statistical analysis used the Student’s t-test, Multivariate regression analysis and Mann–Whitney U test with significance set at p < 0.05. Results: The study group included 21 patients (40.4%) who received a contralateral implant, while the control group included 31 patients (59.6%) who did not receive a contralateral implant. Patients who received contralateral implants showed a significant improvement in cosmetic outcomes evaluated with the Kroll Scale and a raw increment, without statistical significance, in BREAST-Q scores in all subsections investigated (Psychosocial well-being, Sexual well-being and Satisfaction with breasts). Conclusions: Placing a contralateral breast implant in the context of unilateral implant-based breast reconstruction significantly improves aesthetic outcomes and correlates with higher patient satisfaction scores for the reconstructed breast, compared to placing no contralateral implant, without increasing the overall complication rate. Full article

Background: Peer-led Active Rehabilitation Camps (ARC) aim to enhance functional independence and self-management among people with spinal cord injury (SCI). In Poland, where access to specialized spinal units and lifelong follow-up is limited, these programs may help address key health priorities—mobility, bowel and bladder management, sexual well-being, and upper-limb function. This study examined whether participation in ARC helped individuals achieve these priorities and identified factors associated with outcomes. Methods: This prospective cohort study, part of the Inter-PEER project, included 125 adults with SCI who attended one of 16 consecutive ARCs in Poland (2023–2024). Eligible participants used a manual wheelchair, were aged ≥ 16 years, and could complete written questionnaires. Data were collected at camp start (T1), completion (T2), and 3-month follow-up (T3) using surveys and wheelchair skills assessments. Validated instruments (SCIM-SR, MSES, QEWS, WST-Q, LiSat-11) were used and were aligned with the four priority domains. Associations with demographic and injury variables were examined using multivariate regression analyses. Results: Participants showed significant gains across priorities during the 10-day ARC. Mobility improved on all wheelchair-skill measures (e.g., QEWS + 2.6 points, p < 0.001), with most gains sustained at T3. Among participants with tetraplegia, self-care and hygiene scores increased by 24% and remained elevated at follow-up. Confidence in achieving a satisfying sexual relationship increased by camp end and was accompanied by higher sexual-life satisfaction at T3. Regression analyses found only modest associations between outcomes and demographic or injury characteristics. Conclusions: Participation in peer-led ARC programs was associated with rapid, clinically meaningful improvements in several health domains prioritized by people with SCI, especially upper-limb function, sexual well-being, and wheelchair mobility. Our findings highlight the value of integrating structured, peer-based community programs into the continuum of SCI rehabilitation. Full article

Background and Objectives: Autologous hematopoietic stem cell transplantation (AHSCT) offers life-saving treatment for hematologic malignancies but can result in persistent sexual dysfunction and relationship challenges. Attachment theory provides a valuable framework for understanding how enduring relational patterns influence sexual well-being. This study aimed to assess sexual function and attachment styles in AHSCT survivors and examine correlations between attachment and sexual health outcomes. Materials and Methods: A multicenter, cross-sectional study was conducted from December 2019 to March 2022 in five public hospitals in Athens, Greece. Participants were 127 adult survivors who had undergone AHSCT between 6 months and 5 years before enrollment. Sexual function was evaluated with the International Index of Erectile Function (IIEF) for men and the Female Sexual Function Index (FSFI) for women. Attachment style was measured using the Experience in Close Relationships Scale–Short Form (ECRSHORT-FORMSCALE). Results: Men demonstrated high erectile function (IIEF total: 54.10 ± 20.1), whereas women reported moderate sexual dysfunction (FSFI total: 22.51 ± 8.95). Both genders showed average attachment levels, with anxiety scoring lowest and discomfort with closeness highest. Between-group comparisons revealed no significant difference in anxiety (p = 0.95), a near-significant difference in avoidance (p = 0.056), and a significant difference in discomfort with closeness (p < 0.0001), with women scoring higher. In men, no significant correlations emerged between attachment and sexual function. In women, higher attachment anxiety correlated negatively with all FSFI domains except pain, avoidance correlated positively with lubrication, and discomfort with closeness correlated negatively with desire and pain. Conclusions: Findings reveal gender-specific patterns in attachment and their influence on sexual function of AHSCT survivors, highlighting the need for attachment-informed interventions to support intimacy, relationship satisfaction, and overall quality of life in survivorship care. Full article

Background: Advances in breast reconstruction have transformed the recovery pathway for women undergoing mastectomy. What was once viewed mainly as a cosmetic option is now recognized as part of modern oncologic care, restoring not only body image but also confidence and quality of life. Yet, surgeons still face the same central dilemma: choosing between implant-based (IBR) and autologous reconstruction (ABR), particularly when postmastectomy radiotherapy (PMRT) is planned. Methods: We reviewed major studies published between 2014 and 2024, combining evidence from observational cohorts and recent meta-analyses that together report on more than 60,000 reconstructed breasts. Outcomes of interest included surgical complications, reconstructive failure, BREAST-Q patient-reported domains, and the impact of PMRT on both techniques. Data were interpreted in light of contemporary reconstructive innovations such as prepectoral implants, acellular dermal matrices, and robotic or sensory-nerve–enhanced autologous procedures. Results: Autologous reconstruction generally provided higher satisfaction and better psychosocial and sexual well-being, particularly in patients who received PMRT. Implant-based reconstruction offered faster recovery and shorter hospitalization but was more vulnerable to capsular contracture and reconstructive loss after irradiation. Across all eligible cohorts, reconstruction—immediate or delayed—did not increase local recurrence or compromise overall survival when adjuvant therapy was delivered without delay. Conclusions: Both IBR and ABR are oncologically safe and contribute meaningfully to recovery after mastectomy. Future progress will depend on combining precise surgical execution with new technologies—prepectoral implant positioning, robotic flap harvest, and sensory nerve coaptation—to achieve durable, natural, and patient-centered reconstruction. Full article

Background/Objectives: Workplace violence in the healthcare sector is a growing global concern. Defined as incidents where staff are abused, threatened, or assaulted in work-related contexts, this issue affects over half of healthcare personnel worldwide, with nurses being particularly vulnerable. The consequences are far-reaching, leading to diminished service quality, workforce turnover, reduced healthcare access, and increased costs. Despite its physical and psychological impact, workplace violence remains underreported, especially in its psychological forms, which have historically been underestimated. Methods: This study applies Per Isdal’s typology of violence to analyze incident reports from a hospital setting. By doing so, it offers a structured framework for understanding the multifaceted nature of workplace violence. By categorizing and examining how different forms of violence co-occur and manifest in daily professional interactions, the study aims to contribute to more systematic documentation and theoretical understanding of the field. Results: In total, 247 incidents were analyzed. Physical violence was the most frequently reported type with 167 incidents, followed by psychological violence with 125 cases. Material violence accounted for 28 reports, sexual violence for 10, and latent violence for 4, indicating that physical and psychological aggression dominates the spectrum of workplace violence in this context. Conclusions: The prevalence and complexity of violent incidents targeting healthcare personnel highlight the pressing need for actionable policies and evidence-based interventions that prioritize staff safety and psychological well-being. Establishing clear definitions of violence, alongside fostering a culture of reporting, is essential to create safer and more resilient healthcare environments. Full article

Background: Vulvodynia is a chronic vulvar pain syndrome with multifactorial etiology and unclear pathophysiology. Despite its high prevalence, it remains underdiagnosed and under-researched, with significant repercussions for women’s physical, psychological, and social well-being. Objective: To synthesize the available scientific evidence on quality of life (QoL) in women diagnosed with vulvodynia, identifying the main affected domains and the assessment tools used in the literature. Methods: A rapid review was conducted following PRISMA 2020 and Cochrane Rapid Reviews guidelines. Searches were performed in PubMed, Web of Science, Scopus, CINAHL, Biblioteca Virtual en Salud, and CUIDEN without date or geographic restrictions. Studies including adult women diagnosed with vulvodynia and reporting QoL outcomes were eligible. Data was extracted and synthesized narratively, and methodological quality was assessed using the Mixed Methods Appraisal Tool (MMAT). Results: Twenty studies published between 2006 and 2025 met the inclusion criteria (13 quantitative and 7 qualitative). Vulvodynia was consistently associated with reduced QoL across physical, psychological, and social dimensions. The most frequently reported issues were chronic vulvar pain, sexual dysfunction, anxiety, depression, and social withdrawal. Tools such as SF-12, SF-36, WHOQOL-BREF, DLQI, Skindex-29, and SQLQ-F were commonly used, although heterogeneity among instruments limited comparability. Multidisciplinary interventions combining physiotherapy and psychological therapy showed improvements in emotional and physical well-being, though sexual dysfunction often persisted. Conclusions: Vulvodynia substantially impairs women’s quality of life, reflecting complex biopsychosocial interactions. The findings highlight the need for standardized QoL measures and gender-sensitive, multidisciplinary approaches to diagnosis, management, and research. Full article

This study investigated the impact of sexual and bystander harassment experiences on work attitudes, stress, withdrawal, and psychological well-being of part-time employees. Participants included 314 female employees who worked part-time in their organizations. All participants completed a computer-administered workplace experience survey assessing various aspects of their work environment, including personal and bystander harassment experiences, work-related attitudes (supervisor satisfaction, coworker satisfaction, and general job stress), work behaviors (work and job withdrawal), and psychological well-being. Experiences of sexual harassment and bystander harassment were predicted to be negatively related to satisfaction and psychological health and positively related to stress and withdrawal. Both forms of harassment were expected to contribute additively to the prediction of work outcomes and psychological health. Moderator models were examined to explore the potential interactions between sexual and bystander harassment. Results indicated that both forms of harassment were related to work attitudes, stress, and withdrawal. Sexual harassment was the strongest predictor of work outcomes. Discriminant Function Analysis provided additional support for group-based distinctions. The results are discussed in terms of interpersonal and organizational implications, limitations, and future research directions. Full article

Romantic relationship satisfaction is widely recognized as a foundational contributor to both psychological and physical well-being. However, research on its association with other key constructs, such as body appreciation, sexual esteem and sexual assertiveness, is still lacking, especially in reference to romantic relationships. The present study investigates the interplay between body appreciation, sexual esteem, and sexual assertiveness, and their combined influence on relationship satisfaction in individuals in heterosexual relationships in Italy. Participants were 473 adults (50.1% men, 49.7% women, 0.2% other; age range 18–49). Structural equation modeling revealed that while body appreciation was indirectly associated with sexual assertiveness, it significantly predicted sexual esteem. Sexual assertiveness, but not sexual esteem, was positively associated with relationship satisfaction. No significant gender differences were found in the structural relationships among the variables. These findings underscore a process through which sexual assertiveness and body appreciation can enhance relational well-being and inform educational programs aimed at promoting healthy romantic relationships. Full article

Child sexual abuse (CSA) has consequences beyond the direct victim, affecting non-offending mothers, who may experience psychological, physical, and social symptoms after disclosure. This systematic review examined the impact of CSA on these mothers and the variables that influence coping and recovery. Searches were run in EBSCOhost (MEDLINE, PsycInfo, CINAHL) following PRISMA 2020 and a PEO framework. Three reviewers screened 128 records in Rayyan (Cohen’s κ = 0.73), and 17 empirical studies met the inclusion criteria. Risk of bias was appraised with ROBINS-E. Distress, anxiety, depression, and secondary traumatic stress were the most frequently reported symptoms. These consequences were associated with factors such as maternal history of abuse, perceived social support, coping style, and cultural or religious beliefs, highlighting potentially modifiable cognitive and contextual targets for support. A key contribution of this review is the identification of modifiable cognitive variables that are clinically relevant. Methodological limitations of the evidence base warrant cautious interpretation–comprising seven qualitative, nine quantitative cross-sectional, and one mixed-methods study, with heterogeneity that precluded meta-analysis and limited causal inference. Overall, the findings highlight the need for comprehensive, trauma-informed interventions that address not only the child’s recovery but also the well-being and resilience of their mothers. Full article

The recent trends in decreasing population all over the world are cause of concern, especially in developed countries. Socioeconomic factors as well as age, physiological, and environmental issues are the main contributors in limiting the number of children in modern families. In this regard, male reproductive health has recently attracted significant attention not only in the research community but also in our social platform. Key issues such as infertility and sexual dysfunction contribute to the decline in male reproduction. Socioeconomic status (SES) is the least understood factor that plays a critical role in influencing male reproductive health. The SES of an individual can be a key determinant of the type of infertility care they receive and may also predict fertility outcomes for couples undergoing assisted reproductive technology procedures. This mini review seeks to deepen our understanding of reproductive health equity by exploring the impact of socioeconomic and social factors on men’s sexual health and fertility outcomes. Our attempt is to reveal the complex interconnections between SES and male reproductive well-being. Full article

Background: Pelvic floor dysfunctions, congenital anomalies, and acquired defects of the female genital, urethral, and anal tract represent complex conditions requiring multidisciplinary management. This review synthesizes current evidence and aims to evaluate reconstructive surgical techniques, prosthetic use, and cosmetic approaches with a focus on functional and aesthetic outcomes. Methods: A structured literature search of PubMed, Embase, and the Cochrane Library was performed for the period from January 2000 to May 2025 (last search: 31 May 2025). Eligible studies included randomized controlled trials, prospective or retrospective clinical studies, and case series in English or Italian, enrolling women aged ≥18 years with a minimum follow-up of 6 months. Primary outcomes were anatomical restoration, continence, sexual function, and quality of life; secondary outcomes included patient satisfaction, wound complications, donor-site morbidity, and recurrence. Recent high-quality studies published after 2018 were prioritized to ensure an updated and evidence-based synthesis. Results: Out of 532 records, 94 full texts were assessed and 41 studies met the eligibility criteria, comprising a total of 1862 women. Flap-based reconstruction (gluteus maximus, VRAM, gracilis, ALT) remained the cornerstone for large or irradiated defects, while prosthetic meshes improved anatomical outcomes but raised concerns of erosion and chronic pain, leading to a shift toward autologous tissue. Cosmetic gynecology procedures (labiaplasty, vaginoplasty, perineoplasty) showed high patient satisfaction, although the evidence was limited and heterogeneous. Across studies, improvements were observed in continence, sexual function, quality of life, and self-image when reconstructive and aesthetic principles were integrated. Conclusions: Reconstructive and cosmetic pelvic surgery significantly impacts functional recovery and psychological well-being. Standardized outcome reporting, prospective multicenter trials, and the integration of plastic surgery, physiotherapy, and psychological support are needed to optimize patient-centered care. The findings highlight the growing role of personalized surgical planning, with reconstructive decisions increasingly guided by patient-specific anatomy, functional goals, and validated patient-reported outcome measures. Full article