Tehran University Medical Journal

Background: Sexually transmitted infections are the most common human infections that lead to severe complications. Mycoplasma genitalium (MG) and Ureaplasma urealyticum (UU) are common and important cause of genitourinary tract infections. MG is a member of genital mycoplasmas which is emerging as an important causative agent of sexually transmitted infections both in males and females. This study aimed to determine the prevalence of UU and MG in pregnant women and to assess the risk factors which may contribute to the predisposition of the individuals to the infection.
Methods: In this cross-sectional study, The population of 210 pregnant women admitted to the Rasoul Akram Hospital in Tehran, were selected for the study using non-random sampling. The urine specimens were collected from 194 pregnant women from May to December, 2015. The samples were transferred to the Infectious Disease Research Center of Rasoul Akram Hospital under sterile condition. Samples were exposed to DNA extraction followed by multiplex polymerase chain reaction (PCR) to detect the infection. Data including sex, age, history of abortion, history of genitourinary tract infections were collected subsequently.
Results: The prevalence of MG and UU infections in urine samples was 5.6%, 11.2%, respectively. The mean and standard deviation of the risk of UU was 2.08 (3.56-1.22) in women with a history of abortion and 0.70 (1.03-0.47) in women without a history of abortion. There was a significant relationship between the history of sexually transmitted diseases and the frequency of UU (P<0.022). From 22 patients with UU infection, six patients had a history of sexually transmitted diseases. A significant correlation was found between prevalence of MG and UU infections. The History of abortion was significantly related with the frequency of UU and MG infections. The prevalence of MG infection is negatively correlated with pregnancy trimesters. The History of genitourinary tract infections was significantly associated with the frequency of UU.
Conclusion: The presence of UU and MG could be associated with abortion.

Background: Genital warts are one of the most common sexually transmitted infections, 1% of sexually active population have anogenital warts (AGWs). According to previous studies, the disease affects people's quality of life and imposes financial costs on health systems.
Methods: The present study is a case-control study at spring of 2018. The quality of life of 65 patients with anogenital warts that were referred to Boali-sina Hospital in Sari, Iran compared with 65 control subjects. The World Health Organization Quality of Life Brief (WHOQOL-BREF) questionnaires was used.
Results: According to the results, among the patients with anogenital warts, the quality of sexual contact in majority them were not affected by the disease (70%). The total cost of treatment was less than the monthly income of the family until the time of participating in the study (92%). There was no significant difference between the mean and standard deviation of physical health scores and mental health scores in the control and patient groups. (Respectively P=0.14, P=0.93). There was no significant relationship between the mean of physical health scores with disease severity. However, there was a significant difference between the mental health score in the two groups of patients with low and high levels of severity (P=0.01). Physical health scores in the whole sample have a significant relationship with gender, so that, in women, physical health score was lower than that of male, but the mean score of mental health in both male and female patients was not significantly different (P=0.18). In the control group the score of mental health was lower in women (P=0.041).
Conclusion: In patients with anogenital wart, quality of life doesn’t change significantly, although, mental health scores directly related with disease severity.

Background: Sexual issues are one of the most important aspects of human life and sexual disorders are issues that can cause some problems in any society. Paying attention to sexual problems can help to deepen the couple's relationship by reducing potential problems. It is also important to note that communication problems between couples and their interplay patterns are effective in shaping sexual behavior between couples and can be a source of sexual behavior disorders for couples. The goal of this research was to determine prevalence of sexual satisfaction of participants and some related factors.
Methods: This descriptive-analytical study was conducted on 564 married women between the ages of 18 and 55 under the cover of Zanjan University of Medical Sciences (ZUMJ), Zanjan City, Iran, among whom referring to ZUMJ educational centers from March to August 2012. A simple random sampling method was used. The data collection tool was a 14-item changes in sexual functioning questionnaire (CSFQ-14) completed by the self-efficacy method.

Results: The results of this study showed that 79.5% of women studied had some degree of sexual dissatisfaction. The study showed that with increasing age, the degree of dissatisfaction with marital relationships increased from 3.1% in the age group of 14-19 years to 38.2% in the age group of 30-39 years. Also, the rate of sexual dissatisfaction increased with the increase in education, and the highest degree of dissatisfaction was in the group with diploma education and the next stage, those with university education. The results of the study reported the highest proportion of dissatisfaction with sexual relations in the housewife group, and dissatisfaction with sexual relations increased significantly with an increasing number of years of marital life. Conclusion: According to the results of this study, the prevalence of dissatisfaction especially with respect to sexual orientation among women is higher than expected, which is a threat to the individual and social health of individuals.

Background: Normal vaginal delivery causes sexual dysfunction as well as urinary and fecal incontinence, which can threaten a person's quality of life. It is believed that pelvic floor muscle strength is the most important factor in improving sexual satisfaction and function and urinary control. Therefore, This study aimed to investigate the role of physiotherapy and pelvic floor exercises in reducing sexual dysfunction and incontinence in primiparous women.
Methods: This study was performed as a prospective randomized clinical trial on primiparous women who were referred to Al-Zahra and Shahid Beheshti educational hospitals in Isfahan between march 2019-Mars 2020. In this study, after obtaining ethics approval from the Medical Ethics Committee of Isfahan University of Medical Sciences, patients were divided into control (n=57) and intervention (n=57) groups. In the control group, no intervention was performed and only routine postpartum recommendations (multivitamin tablets and 500 mg calcium tablets once daily for two months) were prescribed. For the intervention group the pelvic floor physiotherapy was performed Sexual function and urinary and fecal incontinence were assessed in both groups at 8 and 16 weeks postpartum by completing two questionnaires.

Conclusion: it seems that simultaneous performance of physiotherapy (biofeedback) and pelvic floor exercises by strengthening the strength of the pelvic floor muscles increases sexual function as well as a relative improvement of pelvic floor irritation in the postpartum period.

Background: Patients with severe mental illnesses are more prone to experience sexual health problems. Herein, we developed a "Safe Sex Knowledge and Behavior Questionnaire for Patients with Severe Mental Illnesses"(SSKBQ-SMI).
Methods: The present study was conducted in the form of methodological research in 4 stages. In the first stage, items of the questionnaire were selected and the item pool was formed by using similar studies and experts' opinions. During the next steps, the psychometric properties of the questionnaire were assessed using content validity, face validity, reliability and construct validity. The content validity was tested using the Content Validity Index and Content Validity Ratio. The charts of content validity were given to 13 specialists expert in sexual health including psychiatrists, clinical psychologists, gynecologists, urologists, and infectious disease specialists. The reliability was tested by using the test-retest method in 70 patients with two-week intervals. The construct validity was tested using exploratory factor analysis in 265 patients. The internal consistency was calculated by using Cronbach's alpha index.

Background: The present study was performed to evaluate carboxytherapy as an outpatient and non-hormonal strategy for the treatment of a number of pelvic floor disorders.
Methods: This randomized block controlled clinical trial study was performed on 60 women aged 35-65 years in 1399-1400 to evaluate the effect of carboxytherapy on the treatment of stress urinary incontinence and sexual dysfunction in comparison with the control group. At the beginning of the study, vaginal examination, cough test and POP-Q test were performed for all patients. Eligible individuals were randomly assigned to either carboxytherapy or control groups. Stress urinary incontinence was assessed using the ICIQ-UI SF questionnaire and sexual dysfunction was assessed using the PISQ-12 questionnaire. In the intervention group, 30 cc of CO₂ gas with a 90-degree angle was injected in three areas of the bladder neck with the help of a needle gauge 30 with a length of 12 mm, so that each person underwent carboxytherapy twice a week for one month. The control group received the same protocol but without CO₂ injection. The results were assessed both at the beginning of the study and one month and three months after the intervention through physical examination and two questionnaires.

Results: The results of the present study showed that the mean of general sexual function index and also the mean index of sexual function of patients in the physical dimension and in the dimension related to sexual partner in the intervention group was significantly different during the two stages of measurement but no significant difference was observed in the control group. The overall score of urinary function, frequency of leakage and the effect of leakage on the quality of life of women in both control and intervention groups were significantly different between the three stages of measurement. While the rate of urine leakage in the intervention group was significantly different between times, no difference was observed in the control group.