A Survey on the Experience of Singaporean Trainees in Obstetrics/Gynecology and Family Medicine of Sexual Problems and Views on Training in Sexual Medicine.

Introduction: Asian patients may have more difficulty seeking help for their sexual problems because of a largely conservative culture. Residents from both obstetrics and gynecology (OBGYN) and family medicine (FM) departments are ideally placed to address sexual problems.

Aim: This survey explored the experience of residents from OBGYN and FM in managing sexual problems and their views on training in sexual medicine (SM).

A Public Health Communication Intervention Using Edutainment and Communication Technology to Promote Safer Sex among Heterosexual Men Patronizing Entertainment Establishments.

It is a challenge to reach out, develop and implement a communication intervention for heterosexual men (HSM) patronizing entertainment establishments (EEs) to promote safer sex. We described the theoretical basis and process from assessment to implementation where edutainment (talk shows) and communication technology (interactive web portal) was implemented. A female comedian hosted the talk shows.

Role of the serotonergic pathway in uterotonic activity of Ananas comosus (L.) Merr. - An in vitro and in vivo study.

Background: Ananas comosus (L.) Merr. has been used as a traditional medicine in inducing abortion in many countries.

Potent tocolytic activity of ethyl acetate fraction of Ananas comosus on rat and human uteri.

The aim of this study was to investigate the tocolytic properties of Ananas comosus extract in rat and human uterine tissue in vitro and in the rat in vivo. Organ bath technique was employed to perform functional studies in vitro. The PhysioTel transmitter was implanted in SD rats to measure the changes in intrauterine pressure (IUP) in vivo.

Use of single-question screening for erectile dysfunction: a study of at-risk Asian men in primary health care.

This study assesses the validity of a single-question screener for erectile dysfunction (ED) in men at risk in comparison to a standard validated tool - the five-item version of the International Index of Erectile Function (IIEF-5). A total of 174 men with at least one risk factor for ED were studied, with 58.0% and 10.

Endothelial colony forming cells from human umbilical cord blood improved severe erectile dysfunction in obese type II diabetic rats.

Aim: To investigate the effect of intracavernous injection of human umbilical cord blood derived endothelial colony forming cells (HUCB ECFCs) on erectile dysfunction (ED) in Zucker Diabetic Fatty (ZDF) rat model.

Methods: Erectile function was assessed by cavernous nerve electrostimulation in ZDF rats aged 20-28 weeks. Following confirmation of severe ED at the age of 28 weeks, 21 ZDF rats were randomly assigned to three experimental groups: 1 million ECFCs, 2 million ECFCs, and phosphate buffered saline (PBS).

Efficacy of Human Immunodeficiency Virus/Sexually Transmitted Infection Trial on Condom Use Among Heterosexual Men Patronizing Entertainment Establishments Who Engaged in Casual or Paid Sex in Singapore.

Background: We assessed the efficacy of a multi-component sexual health promotion program on condom use and human immunodeficiency virus (HIV)/sexually transmitted infection (STI) testing among heterosexual men (HSM) patronizing entertainment establishments who engaged in casual or paid sex in Singapore.

Methods: This was a quasi-experimental trial with a comparison group using cross-sectional surveys at baseline and 6 months postintervention. A locality patronized by local HSM was assigned the intervention, a comparable and distant area served as the comparison site.

Investigation of uterotonic properties of Ananas comosus extracts.

Ethnopharmacological Relevance: In folklore medicine Ananas comosus (pineapple) is reputed to act as an abortifacient and in expectant women as a means of inducing labor. Several reports have claimed abortifacient property of A. comosus fruit (ripe or unripe).

An Update of the International Society of Sexual Medicine's Guidelines for the Diagnosis and Treatment of Premature Ejaculation (PE).

Introduction: In 2009, the International Society for Sexual Medicine (ISSM) convened a select panel of experts to develop an evidence-based set of guidelines for patients suffering from lifelong premature ejaculation (PE). That document reviewed definitions, etiology, impact on the patient and partner, assessment, and pharmacological, psychological, and combined treatments. It concluded by recognizing the continually evolving nature of clinical research and recommended a subsequent guideline review and revision every fourth year.

An update of the International Society of Sexual Medicine's guidelines for the diagnosis and treatment of premature ejaculation (PE).

Introduction: In 2009, the International Society for Sexual Medicine (ISSM) convened a select panel of experts to develop an evidence-based set of guidelines for patients suffering from lifelong premature ejaculation (PE). That document reviewed definitions, etiology, impact on the patient and partner, assessment, and pharmacological, psychological, and combined treatments. It concluded by recognizing the continually evolving nature of clinical research and recommended a subsequent guideline review and revision every fourth year.

Endogenous hydrogen sulfide insufficiency as a predictor of sexual dysfunction in aging rats.

Objective: Our earlier studies showed that endogenous hydrogen sulfide (H(2)S) pathway contributed significantly to erectile function. In this study, we tested the hypothesis that age-dependent changes in the bioavailability of H(2)S increased the risk of erectile dysfunction (ED).

Methods: Young, adult (3-month) and older (18-month) male Sprague-Dawley rats (n = 6-8/group) were treated daily with sodium hydrosulfide hydrate (NaHS), DL-propargylglycine, sildenafil or l-NAME for 10 weeks.

Characterizing behavior of corpus cavernosum in chloride-free condition.

Objective: To elucidate the role of chloride currents in erectile function through characterizing the behavior of corpus cavernosum (CC) in chloride-free (Cf) medium, which has not been evaluated before.

Methods: Isolated rabbit CC strips were suspended in thermo-regulated organ baths containing oxygenated Tyrode for isometric tension recording. Cf Tyrode was prepared by substituting sodium chloride, calcium chloride, and potassium chloride (KCl) with equivalent molar concentrations of sodium acetate, calcium acetate, and potassium acetate salts.

Effects of hydrogen sulfide on erectile function and its possible mechanism(s) of action.

Introduction: The current pharmacotherapy for erectile dysfunction (ED) relies significantly on the use of phosphodiesterase type 5 (PDE5) inhibitors, but quite a proportion of ED patients are resistant to this therapy, necessitating a search for an alternative treatment. We reviewed available published data to analyze current evidence of hydrogen sulfide (H(2) S) as a novel pharmacotherapeutic agent with supportive role in sexual function.

Aim: To discuss the role of H(2) S in erectile function, its possible mechanism of action, and how this knowledge may be exploited for therapeutic use.

Endocrine milieu and erectile dysfunction: is oestradiol-testosterone imbalance, a risk factor in the elderly?

Oestrogens are not exclusive to the female gender but occur in moderate circulating levels of 25-70 pg ml⁻¹ in men, compared to 44-153 pg ml⁻¹ in women. Arising from aromatisation of testosterone (T), oestrogen is considered to have many opposing physiological functions and the progressive T decline in the aging male is associated with relative and/or absolute increase in serum oestradiol (E₂). Sexual disinterest and erectile dysfunction (ED) in the elderly may well be due to pathophysiological E₂-T imbalance; the altered hormonal ratio may also explain the higher incidence of ED in hyperestrogenism or following exposure to environmental/plant oestrogens.

Efficacy of red clover isoflavones in the menopausal rabbit model.

Objective: To evaluate the effectiveness of phytoestrogens as alternatives for selective dysfunctional changes in the menopausal rabbit model.

Design: Prospective, vehicle-controlled experimental study.

Setting: Reproductive pharmacology laboratory in a university department.

Role of chloride channels in the regulation of corpus cavernosum tone: a potential therapeutic target for erectile dysfunction.

Introduction: Recent electrophysiological recordings have identified the existence of outward, excitatory chloride (Cl(-)) currents in rat, rabbit, and human corpus cavernosum (CC) muscle cells.

Aim: The aim of this study was to investigate the physiological role of Cl(-) currents in the maintenance of cavernosal muscle tone in isolated rabbit CC tissues.

Methods: CC strips (1 x 1 x 5 mm) were suspended in tissue bath chambers for isometric tension experiments.

The hormonal effects of Tribulus terrestris and its role in the management of male erectile dysfunction--an evaluation using primates, rabbit and rat.

Hormonal effects of Tribulus terrestris (TT) were evaluated in primates, rabbit and rat to identify its usefulness in the management of erectile dysfunction (ED). TT extract was administered intravenously, as a bolus dose of 7.5, 15 and 30 mg/kg, in primates for acute study.

Hydrogen sulphide: a novel endogenous gasotransmitter facilitates erectile function.

Introduction: In a pilot study, we found that the novel gasotransmitter, hydrogen sulfide (H2S), had a vasodilatory and proerectile action on the cavernosum. In the present work, we explored the ability of the cavernosum to synthesize H2S and its mechanism on the cavernosal pathways.

Aim: To evaluate the physiopharmacological responses and mechanism in the erectile function of H2S in rabbit cavernosum.

Effect of sildenafil and rolipram on adrenergic responses in isolated human and monkey corpus cavernosum.

Objective: Evaluate and compare effects of phosphodiesterase inhibitors (PDEIs), sildenafil and rolipram, on adrenergic contractile responses of human and monkey cavernosal smooth muscle.

Methods: Human penises were obtained from patients undergoing gender reassignment surgery. Isolated human and monkey corpus cavernosum (CC) strips were suspended in tissue bath chambers for isometric tension experiments.

Mechanisms of direct relaxant effect of sildenafil, tadalafil and vardenafil on corpus cavernosum.

Sildenafil, tadalafil, vardenafil and verapamil induced concentration-dependent relaxation of the rabbit corpus cavernosum muscle precontracted with noradrenaline. The maximal relaxation (%) at 20 microM was 61.4 +/- 6.

Possible role for the novel gasotransmitter hydrogen sulphide in erectile dysfunction--a pilot study.

Penile erectile tissue is a highly vascularised smooth muscle which hitherto has been an unexplored target for the neuromodulatory effect of hydrogen sulphide. In this study, intracavernous injection of sodium hydrogen sulphide to primates resulted in significant increases in penile length and cavernous pressure. In another set of experiments, administration of DL-propargylglycine (inhibitor of cystathionine gamma-lyase) to rats resulted in significant reduction in cavernous nerve stimulation-evoked perfusion pressure.