Introduction Bipolar disorder is an episodic mood disorder that causes unusual shifts in mood and affects the ability to carry out day-to-day tasks. Aim Evaluation of the sexual function in men and women with bipolar disorder during remission. Methods 60 men and women with bipolar disorder and 60 age-matched control subjects were included. A Structured Clinical Interview of Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition was performed to confirm the diagnosis, and Hamilton Depression Rating Scale (HAM-D) to assess the depressive symptoms and Young Mania Rating Scale (YMRS) to assess the manic symptoms. We assessed sexual function in both sexes using international indices of erectile function for men and sexual function of women. Main Outcome Measures Scores of HAM-D, YMRS, Arabic versions of International Index of Erectile Function (IIEF) and female sexual function (FSFI). Results Depressive symptoms showed insignificant adverse correlation with the IIEF in men, whereas they revealed adverse significant correlations with the items of female sexual function index (FSFI) except pain (correlation coefficients [r] = 0.349 [P = .059], r = 0.680 [P < .001], r = 0.574 [P = .001], r = 0.517 [P = .003], r = 0.569 [P = .001], r = 0.532 [P = .002], r = 0.609 [P < .001], r = 0.342 [P = .065], respectively). Interestingly, the manic symptoms were associated with sexual hyperfunctioning in the men and were insignificantly correlated with the different items of FSFI in the women (r = 0.414 [P = .023], r = 0.043 [P = .821], r = 0.100 [P = .601], r = 0.108 [P = .571], r = 0.183 [P = .332), r = 0.086 [P = .651], r = 0.022 (P = .907), r = 0.109 [P = .565], respectively). There was a positive correlation between the affected women’s satisfaction and their partners’ score (r = 0.374, P =.042). Finally, the mean score of pain was statistically higher in the female cases than the normal ones (mean ± SD = 3.6 ± 0.4, 3.4, ± 0.6; P = .036). Clinical implications A different approach may be mandatory for manic female patients. Strengths & Limitations This study is one of the few studies that evaluated the sexual function in patients with bipolar disorder especially during remission. Some limitations of this study must be mentioned. We failed to evaluate the female partners of the diseased males. Quality of life of the recruited patients was not assessed. Finally, the study included patients who were not drug free. Conclusion Manic symptoms in female bipolar I patients are associated with sexual hypofunctioning.

Erectile dysfunction is a highly prevalent disorder. It is estimated that more than 50% of men who ranged in age from 40 to 70 years old suffer from erectile dysfunction to some degree. We aimed in this pilot cross-sectional study to determine female sexual function and social satisfaction before and 6 months after penile prosthesis implant. This study was carried on 50 consecutive married women whose husbands underwent malleable penile prosthesis implant in our department from July 2015 to July 2016. Our results showed significant increase in desire, lubrication, orgasm, and satisfaction scores after 6 months of penile prosthesis operation compared to scores before penile prosthesis implant (p < 0.001). Moreover, our study demonstrated significant increase in lubrication score in non-female genital mutilation after penile prosthesis implant (p 0.049). In addition, the results showed inverse correlations between age and female genital mutilation and female sexual function index scores after penile prosthesis implant. On the contrary, there were no correlations between number of offsprings and residence and duration of marriage and different domains of female sexual function index scores. Finally, penile prosthesis operation for patients with erectile dysfunction has a great impact on sexual functions of their female partners. We recommend preoperative and postoperative female partner involvement as a part of the treatment strategy for men undergoing penile prosthesis implant.

Introduction: Among the reasons for patient dissatisfaction following penile prosthesis implantation (PPI) is decreased length, possibly due to implantation as per the flaccid stretched length, which is shorter than the erect length. Aim of Study: To examine safety of sizing implant length as per the erect state, and its efficacy in enhancing patient satisfaction, by evaluating outcome of implantation in patients with refractory ischemic priapism operated upon early enough before fibrosis sets in. Patients and Methods: Patients for the study were recruited in the past 2 years. Nineteen post-priapism patients comprised the study group (SG), and 21 non-priabitic cases comprised the control group (CG) who were treated for ED refractory to oral medication and intr-cavernosal injection. PPI was performed as per the erect length for the SG and the flaccid stretched length for the CG. At final follow up (46 ± 12.4 months), subjective patient's impression of length compared to his recall of erect pre-ED/pre-priapism length was recorded as either "almost the same", "shorter" or "longer", and patient's satisfaction with length was recorded on a 5-point Lickert scale. Complications were reported. Results: In the CG all patients reported a shorter length (100%), in contrast to 5.3% in the SG .Satisfaction with length was 57.1 % higher in the SG compared to CG (mean satisfaction 5, and 2.1 ± 0.96 respectively, p=0.048). None of the cases in either groups encountered anterior or posterior perforation/extrusion) or persistent pain beyond 2 months postoperatively. Clinical Implications : Penile prosthesis implantation as per the erect length and not the flaccid stretched length may be safe and effective in preserving length. Conclusion: Penile prosthesis implantation in the erect state post-priapism was safe and offered higher satisfaction with length, and it is therefore safe and favorable to implant prostheses as per the erect length in other cases.

Introduction: Punctal obstruction is the narrowing or complete blocking of the external opening of the lacrimal canaliculus. Acquired punctal obstruction with profuse epiphora is a rather common illness, with a prevalence ranging from 8.3% to 54.3%. Aim of the study:Aim of the study: To perform a meta-analysis on the management options for idiopathic inflammatory pyloric stenosis. Subjects and Methods:This meta-analysis follows the PRISMA flow diagram. We searched PubMed, Cochrane, Web of Science, Embase, and local databases for relevant clinical trials evaluating the management of idiopathic inflammatory punctal stenosis. The analysis was performed using the risk ratio (RR) for dichotomous data and the mean difference (MD) for continuous data, in addition to the 95% confidence interval (CI). The data were considered homogenous if the I2 was 50% and heterogenous if the I2 was > 50%.Results: Results showed significantly improved punctal staging in groups (I) and (III) compared to baseline, (P = 0.007 and 0.017, respectively). However, no significant improvement was observed in group II. The relative risk (RR) across all groups was 1.68 (95% CI: 1.03, 2.75, P = 0.04), indicating a significant improvement in the treatment at the assessment time. The analysis of individual stages showed that the treatment effect varied across stages, with a significant improvement observed in stage 3. The study also found a substantial increase in Outer Punctal Diameter (OPD) in the groups (I) and (III) immediately after the treatment compared to baseline, with a pooled effect size of -58.22 (95% CI: -108.50, -7.93, P = 0.02).Conclusions: Dexamethasone (0.1% non-preserved, 0.4% non-preserved) showed an effective, symptomrelieving, and outer punctal diameter (OPD) improvement as compared with the 0.1% preserved dexamethasone; on the other hand, the 0.4% non-preserved dexamethasone carried more risk of increasing the intra-ocular pressure (IOP).