The aim of this study was to collect data of what ordinary people think on chemical castration and the proper punishment for sex offenders. An online survey was conducted through a questionnaire (N = 36; 19 males and 17 females). Average age was between 19 and 61; all participants have heard and known about sexual harassment. Results showed that 21% of respondents concluded that the Internet was the main cause, 36% accused the pornographic films, 18% said that the harassment was due to how the victims behave and dress themselves, and 21% said that psychopathological factors also played a role. Most of the respondents advised that the proper punishment should be death penalty (47%), while 29% chose the chemical castration and 20% chose imprisonment. Since psychoterapy (in this context cognitive-behavioral therapy) combined with pharmacological therapy has shown better outcome compared to monotherapy, the author considers to involve cognitive behavioral therapy as part of rehabilitation, so psychotherapy should be part of punishment in lieu of chemical castration. Causes underlying the sexual harassments especially the psy-chological aspects are discussed.

Background: Vaginismus described as persistent or reccurent difficulties for woman to allow vaginal entry of a penis, a finger or there is often avoidance and anticipation, fear or experience of pain, along with variable involuntary contraction of pelvic muscle. Reviews: Vaginismus can lead to unconsummated marriage, and also can be hidden caused of infertility. Vaginismus can be categorized as primary (lifelong), patient has never experiences non painful intercourse or secondary (acquired), patient has previously normal but now experience pain. Vaginismus should be considered as part of differential diagnosis in patient who has no satisfaction in sexual intercourse or do not tolerate penetration.  Diagnosis is made by making a good history taking. A variety of intervention have been suggested in some case report study. Effective treatment to vaginismus include sex education, psychosexual therapy, systematic desensitization, anxiolytic and Botulinum Toxin (botox). While there are few controlled studies on the management of vaginismus, they are limited and poorly designed. Summary: Goal of treatment is not only to achieve pregnancy but also increase quality of life. Either natural or assisted, vaginismus is still have to be cured. A great teamwork is required to successfull therapy.

Background: Phosphodiesterase type-5 (PDE5) inhibitors was the first choice for the oral treatment of erectile dysfunction because of its ability to prevent endothelial dysfunction and restored erectile function properly. However, the inflammatory parameter such as hs-CRP can be used to assess the performance of PDE5 inhibitors as well as clinical questionnaires, IIEF-5, and EHS. So that, this study aims to determine the effect of PDE5 inhibitors administration such as sildenafil citrate 50 mg per day can decrease the value of hs-CRP, as well as increased the IIEF-5 and EHS at Dr. Soetomo General Hospital. Methods: A true clinical experimental studies used pretest and posttest control group design were carried out among 20 patients during 4 weeks. In the next 2 weeks, the crossover was conducted among respondents for the washout period whereas divided into 2 groups, control (K1 and K2) and treatment (P1 and P2). Data were analyzed using Statistical Package for the Social Sciences (SPSS) version 16.0 software for Windows. Results: The average age of group K1 and P2 was 51 ± 12.07 years old whereas 48.60 ± 15.40 years old in group P1 and K2. The research was conducted in Andrology Clinic of Doctor Soetomo Hospital in Surabaya during June to November 2017. The research data were not normally distributed, then analyzed by two-tail T-group tests and Wilcoxon test at significance level α=0.05. The results showed that PDE5 inhibitors did not decrease the hs-CRP significantly (p>0.05), but increased EHS (p<0.05) and increased IIEF-5 (p<0.05) significantly. Conclusion: This study concluded that the administration of sildenafil citrate per day by oral increased the EHS and IIEF-5, but not able to reduced hs-CRP in patients with erectile dysfunction significantly.

Background: A good erectile function  and normal sexual arousal are indicators of male health. Impaired sexual function due to loss of libido and erectile dysfunction can interfere with quality of life and relationships with partners. Erectile dysfunction can be caused by  vasculogenic, endocrinopathy, hormonal imbalance, neurogenic, trauma, iatrogenic and also due to psychological causes. This research  to understand and overcome the problems related to sexual function in man with genetic abnormality. Case: A 32-year-old patient came for a sperm analysis examination because he was planning to get married soon. At first, there were no sexual problems complained of but the patient  admitted that he was not too much interested in sexual matters since he was young. Nocturnal and  morning erection happened rarely. Puberty at 15 years old and currently in a relationship with a woman and planning to get married. At this time libido was good. There was no history of mumps and orchitis. From the physical examination, it was found that the height was 180 cm, weight was 100 kg, and the arm span was 186 cm. waist circumference 104 cm. It means that he was obese.  Other physical examinations were within normal limits. Examination of the genitalia showed testicle size of 4 cc right and 4 cc left and soft in consistency. Penis size 8 cm in stretched condition. Sperm analysis showed azoospermia. Cytogenetic examination showed 46XY inv(9)(p11q13) and no Klinefelter syndrome was found. Hormone examination results showed LH 11.92 mIU/ml, FSH 30.29 mIU/ml.He showed hyperprolactinemia 25.89 ng/ml, estradiol 16 pg/ml and total testosterone 2.33 ng/ml. HbA1c 5,9 %. Discussion: The patient was treated with cabergoline 0.25 mg 3 times a week and  to overcome hormone imbalance ,we used letrozole 2.5 mg once a day for 2 months.After two months have passed, there is an increase in sexual arousal, morning erections occur at least 4 days a week, erections begin to improve. weight 94 kg, arm span 186 cm. waist circumference 99 cm. Other physical examinations were within normal limits. Examination of the genitalia showed testicle size of 5 cc right and 5 cc left and  soft in consistency.Recent investigations showed LH 7.89 mIU/ml, FSH 14.53 mIU/ml, prolactin 15.00 ng/ml, estradiol 10 pg/ml and total testosterone 1.69 ng/ml. Until now, evaluation and treatment is still ongoing. Conclusion: Management of erectile dysfunction can not only be seen from one side  but also requires a holistic and multidisciplinary approach. Risk factors that can cause erectile dysfunction problems must be assessed and controlled every single cause. The goal of erectile dysfunction management is not only for sexual satisfaction but also to improve fertility and quality of life.

Background: The massive development of Assisted Reproductive Technology (ART) offers new hope for the infertile couple. However, the advanced storage methods to preserve the quality of sperm has been raising by cryopreservation technique. This study aims to analyze the motility rate, recovery rate, and viability in subgroups of cryopreserved spermatozoa from the oligozoospermic patient as the quality parameter.Method: A true-experimental study by pre-test and post-test group design was conducted among 13 oligozoospermic patients with a very low sperm counts at Medical Biology Laboratory Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia. Parameters assessed in this study include motility, viability, and concentration of spermatozoa according to Laboratory Manual for the Examination and Processing of Human Sperm 5th edition. The samples were divided into 4 groups such as Group 1 (71-100 sperm), Group 2 (31-70 sperm), Group 3 (11-30 sperm), and Group 4 (1-10 sperm) based on sperm counts which underwent 30 repetitions of cryopreservation. Data were analyzed using SPSS version 17 for Windows. Results: There was a significant difference in the recovery rate among Group 1 (34.88±1.87), Group 2 (44.77±1.89), Group 3 (61.83±2.09), and Group 4 (70.90±2.71) of cryopreservation technique (P<0.001). However, there was no significantly different in the motility rate of sperm-cryopreservation technique among Group 1 (65.60±14.63), Group 2 (52.50±26.28), Group 3 (39.90±9.95), and Group 4 (44.70±41.77) (p=0.070). Based on the sperm-viability parameter assessed in this study, there was no significant difference among Group 1 (56.40±3.89), Group 2 (58.60±5.99), Group 3 (59.60±9.96), and Group 4 (56.70±11.30) (p=0.504).Conclusions: The sperm-cryopreservation technique significantly affected the recovery rate of very low sperm number count among groups. However, there was no significantly different in the motility rate and viability parameter in this study.Â