BACKGROUND: The coronavirus disease (COVID-19) pandemic has been a global challenge since its first encounter. It has changed the daily lives of families including the sexual behavior of couples due to public health concerns and government policy to restrict people’s movement. It has changed both interpersonal and partner relationships; the time availability at home, the continued presence of children at home, the fear of infection, and the inability to physically interact with others have changed most people’s sexual behavior. AIM: This study aims to evaluate sexual behavior changes in marriage people of Indonesia during the COVID-19 pandemic. METHODS: A cross-sectional online study was conducted, using self-constructed questionnaires. The convenience sample was collected from married males and females for at least 10 months from November 2020 to January 2021. The participants were asked 19 and 20 questions for female and male, respectively, which was an adaptation of the previous questionnaires. Furthermore, a study was conducted to analyze descriptively the changes of sexuality among married people before and during the COVID-19 pandemic. RESULTS: About 201 participants who completed the survey, 110 males (54.7%) and 91 females (45.3%) were included in the analyses. The mean age of participants was 37 years old. Most of the participants have middle to high socio-economy classes and have children at home. Shifting in the work schedule is the main reason to change sexual behaviors. Participants experienced significant changes in sexual behaviors and some sexual responses before and during the restriction time. CONCLUSION: The pandemic has changed sexual behaviors due to social restrictions in Indonesia. These findings imply messages about the consequences of the pandemic on sexual behaviors that may affect the sexual relationship, marriage stability, and physical health itself to fight coronavirus.
Adult male genotype and phenotype with aphallia are men born without a penis. The effectiveness of male sex assignment or female sex reassignment as a treatment for aphallia has been debated. The study's goal was to address the gonadal existence and supporting investigation related to the reproductive health care of reported cases of aphallia patients such as karyotyping, physical examination, semen analysis, hormone reproduction level, sperm retrieval, radiological investigation type of intervention. In this narrative review, data were obtained from Pubmed and Google Scholar that contains keywords "absence penis", "penile agenesis", "phalloplasty" "fertility function". We excluded pediatric patients with aphallia or adult patients with aphallia that reassignments to be female. Only five of the case reports were adult patients with aphallia that reported their fertility function and remains the gonadal existence. All samples have fertility potential disregard their aphallia based on primary testicular function, semen analysis, hormonal profile radiological investigation. Radiology supporting to the investigation of fertility function has aimed to detect genitourinary anomaly related to the site of urinary meatus associated with death rate. Four patients showed post sphincteric meatus urinary and one patient was presphincteric meatus urinary. Gonadal existence is addressed in the case report. This report suggested that sex assignment on aphallia patients should be considered based on the gonadal existence because even though they do not have a penis, they can have children through assisted reproductive technology provided that their phenotype and genotype are matched.
Ginekomasti adalah pembesaran payudara laki-laki yang mengacu pada proliferasi komponen duktal. Ditemukan kasus ginekomasti yang jarang terjadi. Seorang pria berusia 44 tahun datang dengan keluhan utama pembesaran kedua payudara sejak tiga tahun terakhir. Pada pemeriksaan fisik, ditemukan ginekomasti kelas II (tanner IV) dengan galaktorhea. Pemeriksaan genitalia menunjukkan panjang penis 10cm dan volume testis 6mL dengan konsistensi lunak. Nilai testosteron 22,65ng/dL, LH <0,07mIU/mL, dan FSH <0,3mIU/mL. Pemeriksaan ultrasonografi (USG) payudara menunjukkan ginekomasti bilateral dengan ektasis duktal bilateral. Ultrasonografi (USG) abdomen menunjukkan tidak ada signifikansi yang terkait ginekomasti. Ultrasonografi (USG) skrotum menunjukkan testis yang normal di kedua sisi. Magnetic Resonansi Imagine (MRI) kepala (dengan kontras) ditemukan mikroadenoma hipofisis. Pasien didiagnosis sebagai ginekomasti dengan mikroadenoma hipofisis. Pasien direncanakan untuk mendapatkan terapi penggantian testosteron.
Background: Primary Testicular Failure (PTF) in men with unilateral cryptorchidism is a rare case, which might be the first time reported. Case: A 34-year-old man came with infertility and azoospermia. Signs of secondary sex found. FSH levels: 60.68 mIU / ml, LH levels: 15.96 mIU / ml, T levels: 336.14 ng / dl, E2 levels: 27.81 ng / dl. Ultrasound showed the left testis in the left inguinal +/- 2,4x1,1x3,6 cm in size, with decrease vascularization; +/- 4.1 cm from the base of the penis. The right testis size +/- 2,8x1,1x2,2 cm in the right scrotum accompanied by spermatocele. The patient was referred to the Urology department for orchidopexy of the left testis in the inguinal. Discussion: Primary testicular failure, in this case, may occur due to idiopathic but does not rule out the mosaic type of Klinefelter syndrome. The patient has unilateral cryptorchidism for 20 years, there will be a risk of testicular cancer. Management of cryptorchidism must be performed orchidopexy the first year after birth. After orchidopexy, monitoring is needed every year until at least 5 years. Conclusion: PTF occurs when the parenchymal tissue contained in the testes is no longer able to produce sperm or testosterone. PTF diagnosis is only possible through pathology and testicular cytology, but the combination of FSH and Inhibin B examination remains the best recommendation as a biomarker for patients with PTF.
Background: Twenty two percent of men aged over 40 years suffer from erectile dysfunction moderate to severe degree. Twelve to twenty eight percent of men with erectile dysfunction report an impact on the relationship with the partner, body image, lowered self-esteem that might be a psychosocial stressor that cause symptoms of depression. Treatment of erectile dysfunction holistically is expected to improve a better life.Objective: This study analyzed the correlation between erectile dysfunction and severity of depressive symptoms through the role of self-esteem and psychosocial stressors on patients with erectile dysfunction in Andrology Outpatient Clinic of Dr. Soetomo General Hospital.Methods: This study using correlation analytic with cross sectional design. Research subject were patients who have erectile dysfunction in Andrology Outpatient Clinic of Dr. Soetomo General Hospital, collected using consecutive sampling. The research instruments used were The International Index of Erectile Function-5, Holmes-Rahe, Self-Esteem Rosenberg and Beck Depression InventoryResults: Thirty eight research subjects met the inclusion criteria. Statistical analysis revealed erectile dysfunction correlated with self-esteem (p=0.016 r=0,388), no correlation between self-esteem and the severity of depressive symptoms (p=0.116 r=0,259), psychosocial stressors correlated with the severity of depressive symptoms (p=0.001 r=0,001), erectile dysfunction correlated with the severity of depressive symptoms (p=0,000 r=-0,559)Conclusion: This study found correlation between erectile dysfunction and severity of depressive symptoms both directly, but in this case does not involve the role of self-esteem and psychosocial stressors
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