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IntroductionFemale sexual dysfunction (FSD) is a common problem, and many self‐report questionnaires are available for its evaluation. Pakistani women with sexual problems feel shy to consult with their physician. A validated self‐report questionnaire, in the local language with modest expressions is required for these women.AimThe aim of this study was to translate, cross‐culturally adapt, and perform a psychometric validation of an Urdu translation of the Female Sexual Function Index (FSFI).MethodsThe FSFI was translated in Urdu, and its precision was ascertained through reverse translation. It was pretested on 22 bilingual women and refined again to reach at a reliable Urdu version of the questionnaire FSFI‐U. One hundred sixteen bilingual women, in a stable sexual relationship over the previous 6 months were finally asked to fill out the FSFI and FSFI‐U. Their sexual function was then clinically evaluated and responses were compared with the clinical assessment as well as with each other.Main Outcome MeasuresThe responses were analyzed through descriptive statistics for reliability, face validity, agreement between the responses to the original English version and to the FSFI‐U, and also for test–retest consistency. The data were analyzed statistically using Cronbach's alpha analysis, Intraclass correlation coefficients, Pearson correlation, and Student's t‐test.Results FSFI was found to be easily understandable and capable of adequately evaluating and measuring various aspects of female sexual function. A high degree of internal consistency was demonstrated on Cronbach's alpha analysis. Cronbach's α coefficient for various domains was sufficiently high ranging from 0.84 to 0.97. The clinical assessment of the presence and severity of FSD also matched with the self‐report questionnaire. Similarly, various domains of FSFI had high degree of correlation in the Urdu version of FSFI (P < 0.001).ConclusionThe Urdu translation version of FSFI is valid and reliable for use in the literate population of Pakistan. Rehman KU, Asif Mahmood M, Sheikh SS, Sultan T, Khan MA. The Female Sexual Function Index (FSFI): Translation, Validation, and Cross‐Cultural Adaptation of an Urdu Version “FSFI–U”. Sex Med 2015;3:244–250.

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The pressure pattern in varicocele veins of infertile patients and its correlation with semen quality and testicular blood flow was determined. Consecutive patients at andro-urology clinic of a teaching hospital undergoing microsurgical varicocelectomy were included. Their semen quality and testicular blood flow were determined. Peak systolic velocity (PSV) and resistive index (RI) of subcapsular and intraparenchymal branches of testicular artery were noted by colour Doppler ultrasonography. During surgery before ligation of varicocele veins, intravenous pressures of internal spermatic (ISV) and external spermatic (ESV) veins were determined at baseline and after Valsalva manoeuvre. Thirty patients, 20-45 years old, were evaluated. Baseline pressure for maximum dilated ISV (A), less dilated ISV (B) and ESV was 15.93 ± 6.34, 12.38 ± 4.60 and 12.92 ± 5.65 mm. Hg, respectively, which increased after Valsalva by 104.4%, 116.2% and 38.22% respectively. Correlation (r = -.71; p < .05) was appreciated between percentage increase in pressure of ISV B with PSV of intraparenchymal testicular arteries and progressive motility (r = -.759; p < .05), nonprogressive motility (r = -.738; p < .05) and morphology (r = -.653; p = .07) of spermatozoa. In conclusion, ISV develops higher pressure on Valsalva as compared to ESV and has correlation with semen quality and testicular blood flow.

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Varicocele, a vascular event, is associated with infertility due to testicular damage that causes abnormal spermatogenesis in males. The goal of this study is to ascertain the diagnostic significance of scrotal color Doppler ultrasonography (CDUS) by measuring peak systolic value (PSV) and resistive index (RI) of the arteries supplying blood to the testis and their association with semen quality attributes. Sixty prospective patients (age: 20-50 years) undergoing microsurgical varicocelectomy at a teaching hospital were included in the study. Semen parameters and CDUS were recorded and testicular blood flow was determined as PSV and RI of subcapsular artery and intraparenchymal artery of the testes. Nonparametric statistics was applied to test the correlation/association of the semen quality with the PSV, RI, and other variables. Results revealed a significant negative correlation (r = -0.28; p < 0.05) between progressive motility of spermatozoa and resistive index of the intraparenchymal arterial blood flow. Furthermore, it was noticed that the progressive motility of spermatozoa was tended to be negatively correlated (r = -0.236) with resistive index of subcapsular arterial blood flow. In conclusion, this study has revealed that progressive motility of sperms has correlation with the intraparenchymal blood flow of testes. The progressive motility of sperms could be correlated with RI of testicular blood flow. The apparent lack of association between diameter of varicocele vein and semen quality signifies the need of investigating some other factors that may be involved in pathogenicity of varicocele. The diagnostic value of CDUS may be carefully interpreted and clinically correlated in assessment of severity of varicocele.

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