Eleventh Congress of the European Federation of Sexology, Madrid 2012, ABSTRACTS BOOK

DSM task force has proposed a new category of Hypersexual Disorder - although it is unclear where this will fit in the schema of sexual disorders. Each model makes assumptions about etiology and treatment and these will be explored.

SEX AS A PLEASURE CYCLE: A HUMAN BRAIN IMAGING PERSPECTIVE

J. Georgiadis

University Medical Center Groningen - Dept. Neuroscience, Groningen, The Netherlands

Sex is a fundamental pleasure, and crucial to the survival of our species. Though not many people would disagree with the proposition that sexual behavior depends on the brain, the neuroscientific study of human sex is still relatively taboo and much remains to be discovered. The recent advent of human brain imaging techniques has opened up numerous possibilities to study the central sexual system, though, and in this lecture I will review some of the evidence from such studies. I will stress that human sexual behavior adheres to the structure of a pleasure cycle, whereby the behaviours wax and wane in frequency over time as different goals are identified, desired and consummated. According to this view, sexual reward, especially orgasm, is pivotal as it reinforces sexual behaviour and drives future expectations about sex (sexual learning), and I will present compelling animal and human data that virtually anything can become a sexual incentive stimulus through coupling with sexual reward. Further, I will present data to prove that, like in similar pleasure cycles (drugs, eating), wanting and liking sex draw upon fundamentally distinct behaviour, brain networks and neurotransmitter systems. Before making some closing comments regarding exciting future directions in this research field, I will argue that the social and moral affiliations of sex determine which sexual incentive stimuli are acceptable to enter the sexual pleasure cycle, and that this moral-sex interaction is potentially strong and measurable at the brain level.

SEXUAL ASSISTANCE FOR HANDICAPPED INDIVIDUALS: THE REVIVAL OF THE SURROGATE PARTNER OR A LIMITATION TO ACCESS TO SEX LIFE

A. Giami

INSERM U 1018, Paris, France

The project of offering some kind of sexual assistance is currently developed in some European countries such as Switzerland, Belgium or Denmark. The project is based on the assumption that those labeled handicapped individuals have some sexual capacities but are not in the position to fulfill their needs without the help/assistance of a carer. There are currently two types of sexual assistance: (1) physical aid for those who have a partner or want to perform masturbation but encounter mechanical difficulties to perform sexual and body acts and (2) offering direct sexual services for those who do not have a partner and want to engage in sexual partnered acts. This new proposal of sexual assistance is currently the object of important controversies between those in favour of such assistance and those who consider that it is a kind of sex work, which in many European countries is not consider as the best way to perform a healthy sexual life. Until recently there has been little discussion about the similarities of this new form of sexual assistance and the traditional approach of sex surrogates developed in the early sixties in the Masters

& Johnson clinics. The presentation will present and analyse the elements of the controversies regarding sexual assistance for thoss labeled handicapped, it will develop the argument that beyond the accuracy of this approach, the use of sexual assistance may favour the reinforcement of the social and institutional barrers limiting the access to sex for those labeled as handicapped.

SEXUALITY, SEXUAL HEALTH AND WELL BEING

R. Hernandez Serrano ¹, A. Parra Colmenarez ²

¹Universidad Central de Venezuela, Caracas, Venezuela,² Federación de Psicólogos de Venezuela, Caracas, Venezuela

WHO in 1975 produced a brochure on trainning of professionals about Human Sexuality.

In 1997, at Valencia, Spain World Congress of Sexology we produced the DECLARATION OF HUMAN SExUAL RIGHTS, later aproved unanimously in WAS WCS Hong Kong, China

(1999) PAHO organized a Consultation in Antigua, Guatemala

(2000) producing a Document SExUAL HEALTH PROMOTION, Later Amnecy, Geneva and WAS wrote and published a techincal document SExUAL HEALTH FOR THE MILLENNIUM, following the track.

These 4 documents in a period of almost 30 years followed the advance of SExOLOGY AND SExUAL HEALTH.

However, oscurantism,ignorance,resistances and lack of political will remains in may regions of the world.

The data on poverty,adolescents pregnancies, HIV new cases,child trafficking, sexual violence are increasing everywhere. Economic crisis is typical of our world today,neglecting resources in this important area.

We have a lot to do.

A clear example is the resistance to include sexual health aspects in Q of L scales, ignoring its importance and relevance, in serach of Happiness and Medicine.

The Good of Sex was the main theme at CLASES 2002 in Margarita Island.

We believed in a paradigm change regarding our Life Mission. Reviewing this scales will be a major step forward in SExUAL HEALTH, good trainning of mental health professionals, postgraduate university Courses, Transcultural Research, Being visible in mass media resources including social networks and lobbying political leaderships to create a good atmosphere regarding our topics. We need consensus strategies in order to overcome these absolute misunderstandings and differences between human beings. We present these figures. Lets go forward.

PLOTS OF SECRET Garden: THE Dimensions OF FEMALE SEXUAL FANTASY CONTENTS

K. Klapilova, J. Binter

Faculty of Humanities, Charles University, Prague, Czech Republic

Objective: The aim of the study was to identify dimensions of female sexual fantasy (SF) contents in sample of Czech women. In contrast with previous authors we separated two main groups of SF contents: 1.) Specific subjects appearing in SFs (e.g. inexperienced man) - we expected inherent evolutionary origin, 2.) SF focused on activities appearing in the fantasy (e.g. you seduce a man) rather gained by previous sexual experience.

Methods: We asked 142 heterosexual Czech females (mean age = 23.8 years; 58 students/84 non-students) living in longterm relationship to fill in questionnaires about their sexual life that included checklist of SF contents (based on previous literature) divided to subject-focused SFs (10) and activity- focused SFs (47). These were rated on excitability and usualness on 7-point scales. Factor analysis with Varimax rotation was provided using SPSS 19.0.

Results: 3 dimensions of subject-focused SFs were identified: 1. Extra-pair male subject oriented (explains 34.8 % of variability, 7 items, e.g. experienced male), 2. Same- sex subject oriented (13.7%, 2 items, e.g. female), 3. Primary partner oriented (10.8%, 1 item). In case of activity-focused SF, 5 dimensions were identified: sadomasochistic (24.7%, 16 items), exploratory (9.7%, 12 items), intimate (5.6%, 9 items), dominance (4.7%, 4 items), romantic (4.4%, 6 items). Conclusions: In case of activity-focused SFs we confirmed the structure found in previous studies even after subject separation. Findings concerning the structure and frequency of subject-focused SFs are in accordance with evolutionary- psychological assumptions. Participants tended to fantasize more about subjects that bring evolutionary benefits for their reproductive strategy.

PSYCHOSIS AND SEXUAL DYSFUNCTION:

GOOD BYE TO LOVE?

A.L. Montejo González

University of Salamanca, Salamanca, Spain

Treatment of severe mental illness (bipolar disorder and schizophrenia) is usually initiated in the acute phase and must be maintained in the long term to provide continued symptom control and enable recovery. Improving adherence as a means of obtaining better outcomes should be a priority for all clinicians working in mental health. Patients with schizophrenia consider the most important adverse effects of antipsychotics to be extrapyramidal symptoms, weight gain, impairment of sexual function, and sedation. To these must be added drug-induced cognitive impairment which may worsen adherence by reducing the patient’s ability to manage their treatment. Second-generation antipsychotics (SGAs) offer similar efficacy. However, they differ markedly in their adverse effect profiles, particularly in the adverse effects considered by patients to be most important. This makes it essential to obtain a balance between efficacy and side effects tailored to the needs of the individual patient. Endocrino- metabolic disease is likely to have a severe impact on the patient’s physical health, but many patients may consider drug-induced impairment of sexual function to be equally important. There are clinically important differences between the available treatments in respect of their propensity to increased serum prolactin levels and sexual dysfunction.

PSYCHOSEXUAL THERAPY: NEW DEVELOPMENTS FROM THE BASIC SCIENCE TO TREATMENT APPROACHES

P. Nobre

Departamento de Educaçao da Universidade de Aveiro, Aveiro, Portugal

In the last two decades, several clinical and laboratorial studies have been emphasizing the role played by psychological and neurophysiological variables on sexual response and functioning. Sexual beliefs (Hawton, 1985; Heiman & LoPiccolo, 1988; Zilbergeld, 1999), efficacy expectations (Bach et al., 1999), cognitive distraction and attentional focus (Dove & Wiederman, 2000; Elliot & O’Donohue, 1997), attributional style (Weisberg et al., 2001), affect (Mitchell et al., 1998; Nobre et al., 2003), and neurophysiological variables (Barlow, et al., 1983; Maravilla, & Yang, 2007; Meston & Gorzalka, 1996; Mouras, 2006; Walter et al., 2008) are among the most studied variables.

Despite these diverse contributions little effort has been made to develop integrated comprehensive models that explain the factors involved in predisposing and maintaining sexual dysfunction.

In order to cover that gap, the authors have recently conducted a series of studies on the influence of cognitive schemas (Nobre & Pinto-Gouveia, 2010), sexual beliefs (Nobre et al., 2003, 2006a), automatic thoughts (Nobre & Pinto-Gouveia, 2003, 2008), and emotions (Nobre & Pinto-Gouveia, 2003, 2006b) on sexual dysfunction. Results showed the strong influence of cognitive and emotional variables on sexual response and allowed the development of explaining models for sexual dysfunction in men and women (Nobre, 2010a, 2010b).

These conceptual models are currently being tested in our SexLab using experimental and longitudinal designs, and a treatment outcome study is also undergoing to test the efficacy of Cognitive behaviour therapy for sexual dysfunction. Preliminary findings from these projects and its implications for treatment will be presented and discussed.

IS THERE A SPACE FOR SEX THERAPY IN THE ERA OF 5PDEIS?

M.Sungur

Psychiatry Department of Marmara University, Istanbul, Turkey

Every time a new physical/pharmacological method of treatment is discovered, predictions are made that sex therapy will no longer have a role to play in the management of erectile dysfunction (ED). The most serious previous threat to sex therapy came from the introduction of the intracavernosal injections (ICE). But predictions did not materialize due to problems of administration, acceptability, discontinuation, potential side effects and production of erections irrespective of sexual stimulation. However introduction of new oral pharmacological drugs poses a new and real threat to sex therapy as it is easy to administer, acceptable with excellent compliance, effective with safety profile and produces a stimulation dependent response. Thus the aim of this presentation is to ask and answer the same question Is there any need for sex therapy in the era of effective oral treatments? Putting too much emphasis on the erect penis and ignoring the person to whom the penis belongs is only a quick fix as achieving an erection and translating that into sexual intercourse with satisfaction are two different things.

MINDFULNESS AND SEXUAL THERAPY

S. Vilarinho

Aveiro University, Aveiro, Portugal

Mindfulness is the practice of intentionally being fully aware of the present moment, watching one’s own thoughts, feelings, and actions as they occur, and giving attention to them in a non-judgmental manner. This practice facilitates the opportunity of responding to events rather than just reacting. The practice of mindfulness has a long history in Eastern tradition, being rooted in Buddhist meditation. In Western, only in recent years mindfulness has made its way into health care but with very encouraging results.

Even more recently, mindfulness has been revealing potential and promising effects for sexual health. In a qualitative study with women, extended mindfulness meditation practice (mean practice around 19 years) was found to be associated with an increase in sexual awareness and self-acceptance, and higher levels of sexual satisfaction. In two non-controlled studies, a mindfulness-based CBT in group format (3-sessions) resulted in significant improvements in mood, sexual desire and other domains of sexual response, together with reduced sexual distress in women with sexual desire and arousal problems, and in women with sexual arousal disorder associated with gynecologic cancer. In both studies, mindfulness component was explicitly reported by the participants as being the most valuable aspect of the treatment. In a qualitative study with non-distressed couples, a mindfulness-based intervention revealed to enhance relationship satisfaction and reduced. In general, results revealed that teaching how to practice mindfulness in and out of sexual scenarios may be associated with a beneficial effect to their sexual responses.

A summary of empirical evidences will be presented, along with theoretical background considerations.

CHRONIC Disease, AGEING And SEXUALITY

K.R. Wylie

Porterbrook Clinic, Sheffield, UK

Sexual activity continues for many men and women well into older age, and in women the menopause. This has been noted as being considered very important in the general relationship for many couples. A recent study of cohorts of individuals aged 70 years has highlighted that the proportion of 70 year old men and women with higher satisfaction with sexuality, fewer sexual dysfunctions and more positive attitudes to sexuality has increased over recent decades. Ageism and condescension towards older adults no longer has a place in modern society. Clinicians must help people in their later life to have a fulfilling and enjoyable sex life if this is desired and part of managing this will involve finding ways to broach the topic. Whilst increasing degrees of pathology and prescribing medications may lead to a decline in both sexual interest and function in both men, women and their partners, a number of interventions can be helpful in placing men and women in charge of keeping their sexual life alive and well. A move away from this ageist preoccupation by viewing sexuality in the elderly as problematic and not requiring help will encourage the population to seek medical help in a more informed and engaged manner. Interventions that ensure that marital and relationship satisfaction and maintenance of the frequency of desired sexual activity can occur are likely to lead to increased satisfaction within the sexual relationship.

speakers’ abstracts

YOUTH SEXUAL HEALTH: SEX EDUCATION ON EGYPTIAN TV

R. Abdel Azim

Psychiatry Department Cairo University Hospital - Faculty of medicine, Cairo, Egypt

In the Northern part of Africa lies some of the arab countries including Egypt, Sudan, Lybia, Tunisia, Algeria, Morocco and Mauritania. Islam is the predominant religion in most of arab community with minorities of other religions mainly christianity however the community follow more or less the same cultural norms. Sex is taboo except for married couples and talking about sex is shameful and often perceived as deviance from norms or even taken for delinquent behaviour. Masturbation, safe sex, virginity, polygamy, incest, use of contraceptives, sexual hygiene, HIV and other STDs, male and female sexual roles and rights for pleasure, sex talk, gender dysphoria and homosexuality are all very debatable hot topics when raised and discussed on Egyptian national Tv, nevertheless; audience interactions interestingly defies a great deal of what was expected from it on the preliminary hypothesis. Still the ill concept of women’s rights as well as violence against them with focus on their bodies,wearing Hijab, sexual harassment, the habit of circumcision, relation between lack of sex education and prevalence of substance use and abuse among youth especially population at risk are topics that need to be tackled from more than one perspective, not only the sexual one. Some interactions on the Tv program will be shown in video during presentation for audience discussion.

PSYCHOLOGICAL METHODS IN THE TREATMENT OF SEXUAL PROBLEMS

C. Almas ¹, E. Almas ²

¹Psychiatric ward, Sorlandet Hospital, Kristiansand, Norway,

²Department of psychosocial health, University of Agder, Grimstad, Norway

Psychological methods in the treatment of sexual problems will be presented and discussed. The questions that will be addressed are: What is meant by psychological method? How are psychological methods integrated in sexological treatment, and how do they fall outside?

We have learned from many studies that a wide variety of professionals are using what is called a psychological method

- who are they, and what does it mean?

FROM GENDER DYSPHORIA TO GENDER EUPHORIA, AN ASSISTED JOURNEY

E. Benestad

Grimstad Mpat-institute, Grimstad, Norway

People of unusual gender talents have long been labeled “dysphoric” or as “suffering from”. These labels may at best

have worked as tickets to systems where one could get the medical support needed on a path to gender fulfillment. Pathologisations create feelings of dysphoria and will thus contribute to its own justification. This is immoral.

In an ambience of transe-, inter-, no gender and/or genderqueer positivity, the path to positive gender belonging will also be a path to gender euphoria.

Positive gender belonging is to be perceived and affirmed as gender by others, the same way one perceives and affirms oneself.

Ordinarily cultures offer two gender options. This does not reflect all known gendered or non-gendered talents. In order to make it possible for all to reach positive gender belonging, cultures must offer more than two positive gender options. This author is comfortable with offering seven genders, but several of these offers still carry labels of pathology.

The path to positive gender belonging involves processes both on inner and outer arenas. The inner process concerns questions of who one might be in the world of gender. An able gender therapist and gender path assistant must have the capacity to know and convey positive images of all the seven options, for the client to be mirrored in an optimal way. Simultaneously the therapist/assistant must work with networks in order for them to be able toperceive and affirm the individual as gender the same way as the individualperceives her/him/hir/sinhir self.

Key words: Seven gender options, positive gender belonging, therapeutic assistance.

TEACHING MEDICAL SEXOLOGY

FJ. Bianco Colmenares, R. Cardenas, E. Pazmino

CIPPSV. Research and Postgraduate Institute, Caracas, Venezuela

Objective: to describe the Postgraduate Training in Medical Sexology.

Material and Methods: Since September of 1986 in Venezuela Medical Sexology is recognized as a Specialty in the field of clinical medicine as is Cardiology, Urology, Internal Medicine, etc.

The Sociedad Venezolana de Sexologia Medica (Medical Sexology Venezuelan Society) was founded in December of 1984 and the Postgraduate Training in Medical Sexology started in July of 1985.

The Postgraduate Training in Medical Sexology started in 1985, is three-year program which has six academic semester and full time clinical training.

During the first year the objective is to learn to make a Medical Sexology History, syndromatic diagnoses and diagnostics procedures.

During the Second Year emphasis are done in the different Therapeutic approaches and the learning of the Fundamental Therapeutic Program applied to Medical Sexology During the third year a teaching experience in gain given lectures and class in the Postgraduate Training Program in Sexual Counseling. Skill in Promotion of Sex and Sexual Health, Prevention and Anticipation of sex and sexual diseases are taught.

During the entire Residency Program a full exposure to research in mandatory and a final thesis is a requisite for getting the degree of Master in Science mention Medical Sexology.

Clinical rotations includes: Psychiatry, Urology, Gynecology, Rehabilitation and Family Medicine.

Since 1985 to present 54 Medical Doctors has being trained. Doctors from Ecuador, Colombia and Espana had taken our Program.

The Venezuelan’s Public Health System so far has opened 10 positions in seven different hospitals were a Medical Sexology Unit has been created. Five of them are University related.

UPDATE ON DESIRE: “DESEA” PROJECT

F. Cabello Santamaria, F. Del Río Olvera

Instituto Andaluz de Sexología y Psicología, Malaga, Spain

Key words: Sexual Aversion, Hipoactive Sexual Desire Disorder,

Introduction: DESEA (DEsire, SExual, Aversion) is the acronym of an ambitious project divided into three parts. The first is the development of a questionnaire designed to asses and differentiates hypoactive sexual desire (HSDD) and sexual aversion. The second part is to develop a scale of disgust. We have evidence from our clinical experience that disgust directly correlates with sexual aversion and HSDD. Third part is the validation of our therapeutic approach with different strategies for HSDD and sexual aversion.

In the current study, we have focused on validating a new questionnaire to enhance the sensitivity of the instrument with patients suffering from hypoactive sexual desire disorder (HSDD) and sexual aversion. We have attempted to have a tool with reliability and discriminative validity in premenopausal and postmenopausal women.

Aim: To assess the validity of DESEA a new questionnaire for measuring sexual aversion and HSDD in women.

Methods: A prospective methodological study carried out at 12 centers in Spain, Venezuela, Cuba, Ecuador and Chile, through a conglomerate sampling, forming two groups: Experimental (females with DSM IV-TR criteria of Sexual Aversion or HSDD) and Control (subjects without sexual dysfunction).

Main Outcome Measures: Cronbach’s coefficient alpha was used to measure the internal consistency (0,822) in a first approximation with only a sample of 313 women. The overall proportion of variance explained by the questionnaire was 61.742% (Rotation Sums of Squared Loadings) and from the 15 items composing the questionnaire was only necessary to remove one of them.

Results and Conclusions will be show in the lecture of the congress.

FROM EAST TO WEST: RE-IMAGINING YOUTH’S SEXUAL HEALTH

A. Castellanos Usigli

Youth Initiative Committee, World Association for Sexual Health (WAS), Mexico City, Mexico

From the East to the West Hemisphere, young people across the globe are facing various sexual health challenges. Globalization, urbanization, technology and overpopulation are some of the factors that affect youth’s sexual health in both developing and developed nations.

Due to the current demographic importance of young people (UNFPA calculates that there are more than 1.8 billion youths), governments and NGOs are developing more sexual health programs targeting them. However, more global efforts are needed to reach consensus about the most important challenges faced by young people in each continent and the most urgent public policies that are needed to enhance their sexual health, as well as efforts to involve young people in the design of proposals for sexual health programs and strategies.

Thus, the Youth Initiative Committee (YIC) of the World Association for Sexual Health is undertaking an International Consultation about youth’s sexual health in the 21st century focusing on sexual health challenges, needed public policies and youth-friendly proposals. The process will involve young and adult experts, and it will promote future networking among individuals and organizations to develop effective international responses to the new scenarios of the current century.

RIGHTS OF TRANSSEXUAL PEOPLE

M. Castro Espin ¹²

¹ National Commission for Comprehensive Care of Transsexual Persons, Cuba,² National Center for Sexual Education, Cuba

The strategy of comprehensive care of transsexual persons in Cuba has become part of the political transformations of the country, in which for the first time there is an explicit commitment to overcome all forms of social discrimination, including those related to sexual orientation and gender identity. This has made possible for social integration of transsexual persons and the full exercise of their rights to go beyond the individual, family and medical contexts and become the focus of public interest. The strategy is characterized by a social vision with a gender, human rights and diversity approach, contributing to overcome the exclusively biomedical and pathology approach prevailing in the scientific discourse on transsexuality. The disadvantages of transsexual persons are articulated in the universe of social relations and the equality status characterizing a given society. Thus, the experiences of these persons are analyzed within their complex relation with other social and structural aspects such as class, gender, social background, race, territory, religion, among others, with a crosscutting approach. This strategy has come to fill the vacuum of the lack of information and methodological resources indispensable in the political decision-making process committed to defending the human rights of transsexuals.

ATTENTION, CONSULTING SERVICE AND SEX THERAPY FOR PEOPLE WITH Disabilities

C. De La Cruz Martín Romo

Universidad Camilo José Cela, Madrid, Spain

The Sexuality Consultancy for people with disability, professionals and families is a service created by the Leganes Town Council (Madrid.Spain) and it aims to provide with support to disabled people's sexuality, whatever disability it is and whatever their autonomy degree or need of support is: Intellectual disability, physical disability , sensorial disability, cerebral palsy, autistic spectrum disorder, mental illness, rare illnesses...It is a place for personal consultation, free of charge and where you can talk about different aspects related to sexuality : anatomy and physiology, development, contraception, fertility, sexual identity and desire orientation .But it is also a place where you can look for support in view of the difficulties that the people with a disability live: in couple relationships, in sexual relationships, in their experiences ..or where professionals and families find keys and abilities to face situations such as the presence of inadequate behavior, the suspicion of abuse, and the demands or questions of the disabled people. In the first year more than 200 queries have been answered and the Consultancy stands out for the following characteristics:

- INNOVATION: It's the first Sexuality Consultancy of the kind)

- COORDINATION: The Consultancy does not intend to substitute for other services or compete with them.

- INTEGRATED ASSISTANCE: Everybody is helped.

- SYSTEMIC: The whole context of disabled people is attended to.

- VISIBILITY: The disable people's sexuality is placed on the same level as the rest of the different sexualities.

- SPECIFIC: It requires to handle both sexological and disability keys.

- PROMINENCE OF THE DISABLED PERSON: We do not attend to demands,” people with demands and needs are attended to”.

- ALL KIND OF DISABILITIES: It is aimed at all kind of disabilities.

RESOURCES And CHALLENGES IN EUROPE

S. Eleuteri

Faculty of Medicine & Psychology Sapienza University of Rome; WAS Youth Initiative Committee, Rome, Italy

Youths in the European Region face many challenges with regard to sexual health: rising rates of HIV and other sexually transmitted infections (STI), unintended teenage pregnancies, sexual violence and risky behaviors also connected to the diffusion of new media. Modern media, above all cellphones and the Internet, have in a very short period of time become important sources of information. However, a lot of that information, particularly regarding sexuality, is distorted, unbalanced, unrealistic and often degrading. Therefore, a new sexual health aim has emerged, which is the need to counteract and correct misleading information and images conveyed through the media.

Sexual education from early age, new media and the fight against homophobia and transphobia diffuse in many European countries will be explored as some of the resources that could be used to promote youths’ sexual health, discussing existing differences in such themes between European Countries. Children and young people are crucial to the improvement of sexual health in general and have to be seen as the most important resource to reinforce an idea of sexuality as based on gender equality and self-determination. The reinterpretation of youths as active sexual health subjects, instead that only as sexual education recipients, may contribute to a social climate that is tolerant, open and respectful towards sexuality, various lifestyles, attitudes and values.

SEXUALITY AND INFERTILITY

M.F. Ferreira Lourenco

Couple s Clinic Psychiatry and Mental Health Department Alto Ave Hospital Center, Guimaraes, Portugal

The influences of culture and social norms are present in different areas of human health, as is the case of reproductive behaviors.

Infertility is not only a fault of nature, but it is also something that does not respect the established order, a fact that puts in doubt the truth of the femininity and the masculinity representations prevailing in the culture of many societies.

All couples undergoing infertility treatment experienced life changes, which included: lifestyle changes, various physical and emotional changes, and changes in their relationships. There is a perceived loss of control over many aspects of their lives.

Men and women are affected by infertility in different ways. Most couples experience the struggle in much the same way. This is related to the traditional ways men and women have been trained to think, feel and act.

In light of data suggesting that psychosexual symptoms may interfere with fertility, success of infertility treatment and the ability to tolerate ongoing treatment should pay attention to them. The dominant values and cultural practices indelibly affect the sexuality of infertile couples.

The humanization of the treatment protocols of infertile couples, to be credible, must take into account the problems of intimacy and the sexual health of those people.

There will be a reflection on the impact of infertility in couple intimacy, from the perspective of Couple’s Clinic - Department of Psychiatry and Mental Health - Alto Ave Hospital Center, reporting the experience of the last decade.

INTIMACY, POWER RELATIONSHIPS AND SEXUAL SATISFACTION IN YOUNG COUPLES

A. Fuertes

Universidad de Salamanca. Departamento de Psicología Evolutiva y de la Educación, Salamanca, Spain

The study of sexuality and sexual satisfaction requires an examination of the relational context in which sexual behavior takes place. Intimacy needs and dynamics of power are crucial factors that can exercise an important influence on the couple's sexual satisfaction. Attachment theory and research, has shown that securely attached persons have more positive sexual experiences and higher levels of sexual satisfaction in their relationships, compared with insecurely attached persons. Meanwhile, although dynamics of interpersonal power have received less attention, research also shows that perceived equity is associated with relationship and sexual satisfaction.

Previous research has been conducted primarily with individuals, but in view of the interdependent nature of these variables it would be preferable and more suitable to study it at the dyadic level of analysis.

Our longitudinal study with young couples means a modest contribution in this direction. To do this, measures of attachment anxiety and avoidance in relationship, perception of partner influence and perceived control in decision making were assessed. These variables were measured again ten months later as well as sexual satisfaction. The final sample consisted of 58 young couples aged 20-25 years. Most important results revealed that women’s sexual satisfaction was negatively associated with her avoidance (only concurrently) and her perception of partner influence attempts (concurrently and longitudinally). For men, sexual satisfaction was negatively related to his attachment anxiety and the woman's perception of partner influence (both concurrently and longitudinally) and positively associated with personal and partner perception of control in decision making (concurrently).

A RARE CASE OF PRIMARY ANEJACULATION

F. García

Institut Marqués, Andrology Department. Service of Reproduction, Barcelona, Spain

Clinical Case: Man of 34 years-old was referred for infertility study. He reported an anejaculation and anorgasmia since the beginning of his sexual activity, normal libido and erectile function, and occasionally nocturnal emissions.

Frequent headaches of unknown origin. Never had consulted about his dysfunctions with a physician.

Results on physical examination were unremarkable. Hormone determination revealed normal FSH 1.6 UI/mL (114), low LH 0.5 UI/mL (2-12) and testosterone 7 nmol/L (1052), high Prolactin 1000 ng/mL (2-18).

Magnetic resonance imaging of the hypothalamic-pituitary region showed a 4 cm lesion in the pituitary, consistent with a macroadenoma.

Was treated with bromocriptine in increasing doses up to 30 mg/day for six months.

To solve his infertility problem, the couple decided to undergo for a testicular sperm extraction by punction-aspiration (TESA) and subsequent intracytoplasmic sperm injection (ICSI). A twin pregnancy was conceived after one cycle of ICSI.

Due to car accident, he had a cranial trauma and a cerebroespinal fluid fistula was produced. An endoscopic transnasal transsphenoidal was proceeded to the sealing of the fistula and the subtotal resection of the tumor was performed. Bromocriptine treatment was kept 10mg/day. Patient had a normal sexual activity, ejaculation and orgasm after 3 months surgery.

Comments and Conclusions: The incidence of anejaculation is low, 0,14% in general population and of 0,39% in men who consults sterility problem. Although the prolactinoma is an uncommon but treatable cause of anejaculation, the prolactin should be measured in any man presenting with anejaculation.

SEXUAL EDUCATION TO OLDER PEOPLE

A.D. García Rojas

Universidad de Huelva, Huelva, Spain

The Classroom Experience is a joint program of the University of Huelva and the Ministry for Equality and Social Welfare of the Government of Andalusia, to promote social and cultural development of people over 55 who are not enrolled in regulated education university.

In the 2008/09 presented the project of the subject "Sexuality, gender and relationships" to serve on the Curriculum Classroom Experience, being accepted in the call.

Objective: We are used to refer to the sexual experiences of women and men between the ages of youth and adulthood, stretching more for men than for women. This subject aims to raise "another speech," another way to understand, accept and experience sexuality. This is "the value of being and living" as a woman or man, with different desires, desire to be accompanied, to be valued for what it is, feel desire to touch and be touched, caressed, fantasizing possibility for I fantasize that once lived, currently live and want to live. Method: The methodology is active and participatory at all times encouraging reflection and discussion of the students argued. For this, the teacher assumes the role of motivator, and facilitator of learning dynamic. They use different teaching resources (videos, magazines, newspapers, advertising, case studies, etc.).

Results and Conclusions: The subject has gone through all the offices of the Classroom Experience at the University of Huelva, forming part of the core subjects of the curriculum, it is currently the highest rated and most requested by students.

THE UNESCO CHAIRE: SEXUAL HEALTH AND HUMAN RIGHTS MISSION, OBJECTIVES AND PERSPECTIVES

A. Giami ¹²

¹1NSERM U 1018, Paris, France,² Unesco Chair

The Unesco Chair was created in December 2010 under the initiative of late Dr Marc Ganem. After his death, Dr Troussier, Chairperson & Dr Giami Scientific Director, were appointed by the Unesco and the University Paris-Diderot to take charge of the Chair.

Chair mission

The Unesco Chair mission is based on the promotion of Sexual health and Human rights, free choice for individuals and prevention of sexually related health risks. The major objectives are to increase awareness and provide education on sexual health, among health professionals and build an international policy.

Chair sustainable goals

Advancing training and research in institutions of higher education to train health professionals (MD, nurses, educators, midwives) and also "relational professionals" such as ecclesiastics, police, legal professions to deal with sexual issues when presented to them and when they are involved in this kind of situation (sexual abuse, sexual crimes, etc.). Most of these professionals have received no training about sexuality and they are not aware of their personal and ideological attitudes towards sexuality, which interfere with the accomplishment of their mission and the benefit of their patient.

Chair work process

- Educating and increasing awareness and competence among health professionals

- Implementing innovation centers: networks of health professionals and NGO's to develop Sexual health and Human rights promotion

- Building university networks "UNITWIN network" and cooperation through transfer of knowledge

- Upgrading to Excellence Centers: developing research, validation of experience and confrontation between sites

- Elaborating international recommendations based on experience and evidence

The lecture will present in details the mission of the Chair and its objectives: academic, professional and political.

A MULTILINGUAL OPEN ACCESS ONLINE CURRICULUM IN SEXUAL HEALTH

E. Haeberle ¹, A. Pacheco Palha ²

¹ Archive for Sexology, Berlin, Germany ² University of Porto/ Saint John University Hospital, Porto, Portugal

The Archive for Sexology, following WHO guidelines, has created a multilingual “open access” curriculum of 6 courses (6 semesters) for the internet. The complete curriculum is available in English, Chinese, Russian, Czech, and Hungarian. It is also partially available in 6 other languages.

Using an ongoing translation into Portuguese as a model, other features of the online Archive will also be presented.

Its wider implications for e-learning and the “open access” movement will be discussed.

With monthly over 10 million hits (over 400 000 visits) in over 200 countries, the freely accessible curiculum is now the world’s largest sex education project.

NEW INSIGHTS ON FEMALE EJACULATION

E. Jannini ¹, A. Rubio Casillas ²

¹University of L’Aquila, L’Aquila, Italy,² Universidad de Guadalajara, Guadalajara, Mexico

Introduction: Although there are historical records showing its existence for over 2000 years, the so called female ejaculation is still a controversial phenomenon. A shared paradigm has been created that includes any fluid expulsion during sexual activities with the name of female ejaculation.

Aim: To demonstrate that the “real” female ejaculation and the squirting or gushing are two different phenomena. Methods: Biochemical studies on female fluids expelled during orgasm.

Results: In this case report we provided new biochemical evidences demonstrating that the clear and abundant fluid, which is ejected in gushes (squirting), is different from the real female ejaculation. While the first has the features of diluted urines (density: 1001.67±2.89; urea: 417.0±42.88 mg/dl; creatinine: 21.37±4,16 mg/dl; uric acid: 10.37±1.48 mg/dl), the second is biochemically comparable to some components of male semen (PSA: 3.99±0.60 x 103 ng/ml). Conclusions: Female ejaculation and squirting/ gushing are two different phenomena. The organs and the mechanisms that produce them are bona fide different. The real female ejaculation is the release of a very scanty, thick and whitish fluid from the female prostate, while the squirting is the expulsion of a diluted fluid from the urinary bladder.

MEDICO-LEGAL SEXOLOGY

R. Hernandez Serrano ¹, F. Navarro Cremades ², A. Parra Colmenarez ³

¹Universidad Central de Venezuela, Caracas, Venezuela,² Universidad Miguel Hernandez, Alicante, Spain,³ Federación de Psicólogos de Venezuela, Caracas, Venezuela

Medico Legal, related to Human Sexuality issues are so frequent in Justice Courts.

After 40 years of experience in this subject we present the main issues in Latin America regarding the main concern areas:

1. Virginity determination. In Venezuela forced marriage is a way to arranged sexual relations with minors ( under 18 years old ).

2. Paternity Determination

3. Use of DNA in criminal and civil cases 4.Sexual Identity Disorders

5.Sex Reassignation

7. Transexualism. Sex Legal Change.

8. Compulsory Paraphilias treatment

9. Child Sexual Abuse. Victim and Offender Treatment. Kristy

Houses and Shelters.

10.Sexual Violence. Rape,Passional Crimes

11. AIDS. Treatment and Couples participation and counselling

12.Informed Consent

13. Human Sexual Rights Treatment and Standards of Care

14. Civil cases: Marriage ,Separation and Caution Issues.

Sexual Incompatibility Peyronie Disease Medical Mal Praxis The Law differences according countries legal systems complicates this issues.

However we must establish some guidelines in order to avoid Human Sexual Rights violations.

Cultural differences are also a very important factor to consider. Clinical and empirical experience is there. Lets make comparisons.

SEXUAL FUNCTION (EVAS): A NEW BRIEF SCALE

P. La Calle Marcos ¹, I. Fernandez Agis ², L. Serra Duart ³, R.C. Liñan Baena ³, M. Garcia Cantero ³

¹Dep. Ginecologia Y Obstetricia Ch Torrecardenas, Almería, Spain,

²Dep. Neurociencias. Universidad De Almería, Almería, Spain,³ Dep. Psicología Social. Univ. De Sevilla, Sevilla, Spain

We present Evas-M, a new scale, as seen need of a quick and easy tool for screening and management of female sexual dysfunction in medical practice. This is a short scale consisting of seven items that assess six main domains of female sexual activity. We tested first psychometric properties and reliability on a sample of 144 women obtaining a coefficient Cronbach’s alpha of 0.66. We found a correlation between total scores on the scale and the clinical criteria of 0.586, which is adequate evidence of the validity of the scores of EVAS-M with a statistically significant prognostic capability (R = - .208, Wald X2 = 16.876, p <.001) and a predictive accuracy of 76.1%. We conducted a cross sectional study in a gynecological center of Madrid and we found that prevalence of sexual dysfunction was 7.9% in a population of 620 users who answered all items of questionnaire. Domains most frequently problematic were sexual interest (11.89%) and satisfaction (10.43%). The domain more predictive of sexual dysfunction was difficulty in subjective sexual arousal (PPV 78.1%). Orgasm, pain and sexual interest are related to sexual response (subjective arousal and lubrication) while satisfaction is evaluative domain. In this conference will also present preliminary data validation EVAS- H, version for men.

ULTRASOUND IN THE ASSESSMENT OF FEMALE SEXUAL FUNCTION

P. La Calle Marcos ¹, M.A. Herraiz ², P. Coronado ², J. Montalvo ²,

I. Fernandez ³

1 Dep. Ginecologia Y Obstetricia Ch Torrecardenas, Almería, Spain,

2 Dep. Ginecología Y Obstetricia Hu San Carlos, Madrid, Spain,

3 Universidad De Almería, Almería, Spain

At the present ultrasound is an essential complementary procedure in urogynecology and therefore in sexual medicine. Perineal or introital ultrasound allows anatomical and functional assessment of the lower urogenital tract. Main utility of this technique is uretral and parauretral pathology diagnosis and as test to value corrective surgical interventions. Perineal ultrasound linear probe through the clitoral artery velocimetry can assess changes in postoperative genital response or efficacy of drug therapies (Caruso, 2006, 2009). However, the genital flow, particularly sexual lubrication has been poorly studied despite that originate structures are clearly visible to ultrasound-vaginal introitus. Recently the glands of ‘female prostate’ have been described by MRI showing that the volume ranged between 2-4 cc in 85.7% of patients with any signs or symptoms suggesting paraurethral secretion (Wimpissinger, 2009). We reported two studies in which ultrasound is associated with genital discharge report. Both studies found a significant association between the perception of women flow and quantity of paraurettral and paravatinal areas anechoic images anechoic. It was also found association between less anechoic images and vaginal dryness in menopause. Nowaday we try to demonstrate the change in urethra volume of the urethra during sexual response of women. Early data suggest that there is a slight increase in size perhaps due to the strong muscular sheath of urethral sphincter. Ultrasound can contribute to debate about anatomy and physiology of erectile female system.

GENOME SEXUAL POLLUTION AND SEXUAL PRACTICES

G. Llanos De Ordonex

Ecuasex, Quito, Ecuador

The sex chromosomes are the first structure of sex.Like all multicellular sexed beings, the human being begins life and history at the time of the union of gametes, sperm and egg, 2 sexually differentiated cells from each other. Each cell has half the genetic material carried by the body’s normal cells. They are different from one another genetically, even those from the same individual.

If a sperm carrying an X sex chromosome is attached to the egg, the sex of the resulting cell is female: XX. If a sperm carrying a Y sex chromosome joins the egg, the sex of the resulting cell will be male: XY.

Environmental influences the genetic structure of the adaptation processes. In the phylogenetic scale continue sexual differentiation marked by the intrinsic factors that determine a specific chromosome take responsibility for sex determination. It is estimated that the Y chromosome has undergone over evolution genetic deletion does lose much of their genetic material to the Y chromosome with reduced size. The risks are greater now because the virus is very common. It can be transmitted through oral sex and both men and women to become infected. There is increasing oral cancer and more than 25% of cases are linked to HPV. As bleak forecast advocate the need to create vaccines not only for women but for men and demand the need to implement sex education programs in order to prevent viral contamination especially by inadequate sexual practices increasingly common as oral anal group sex and multiple partners.

NON-TRANSMISSIBLE CHRONIC ILLNESS AND SEXUAL FUNCTION

M. Lucas Matheu

Sociedad Española de Intervención en Sexología (S.E.I.S.), Academia Internacional de Sexología Médica (A.I.S.M.)

Objectives: Understand the consequences of non- transmissible chronic illnesses on sexual health. And in turn, comprehend the impact of sexual health on the development of chronic processes. Additionally, learn the implication of attention to sexual health in the protocols of the healthcare processes of chronic diseases.

Desing/method: Analyze the different studies on the prevalence and origin of sexual dysfunctions that occur in the principal and most frequent chronic diseases that can affect the organ systems which are involved in sexual response physiology. Analyze the different care protocols of chronic conditions in the Andalusian Public Health System (Spain) to see to what extent attention is paid to sexual health. Results:The prevalence of sexual dysfunction is higher in chronic processes which involve organs and functions that are actively involved in sexual response physiology: nervous system, cardiovascular system, endocrine and metabolic system and genitourinary system. Attention to sexual health is only anecdotal in the protocols of care for healthcare processes of chronic diseases.

Conclusion: The high prevalence of sexual dysfunction in chronic illnesses implies the need for care protocols for all of these diseases. Where attention to sexual health is treated as an important element of rehabilitation and improvement in their treatment.

SEXUAL EDUCATION TRAINING IN VIRTUAL WORLDS

M. Lucas Matheu

Sociedad Española de Intervención en Sexología (S.E.I.S.), Academia Internacional de Sexología Médica (A.I.S.M.)

Objective: Sexology is a science which has always been averse to the non-physi- cal, to the amputation of the sensorial and therefore to any training that is not face-to-face. Desing/method: In conjunction with Iavante, sexology professionals have explored virtual sexology training - initially using online platforms, which has enabled access to sexual health training to a large amount of health professionals (2,400 in four years) - and later in the training of a more select minority of sexology professionals in Second Life.?Second Life is a virtual 3D space which allows intense interaction ba- sed on the creation of objects, actions and structures. This interaction is carried out via an avatar that represents the user’s “second self”. Iavante proposed that we carry out a pilot experience using this virtual space and SEIS (Spanish Society for Intervention in Sexology) accepted the challenge, which initially presented many unknown factors and also great creative potential. Results: This is a working in progress. The experience was very enriching for all involved: authors and creators, teachers and students. Despite the te- chnical difficulties related to learning how to use this virtual space and the IT problems with the PCs of some participants, the possibilities for innovation, creation and imagination provide opportunities for creating training scenarios which would be impossible in the real world.

Conclusion: The experience opened new fields for teaching activities and combi- ned with on-line training and classic face-to-face sessions, constituted another innovative experience in sexual health training.

EMOTIONAL And SEXUAL dependence

A.S. Mansukhani

Instituto Andaluz de Sexología y Psicología, Malaga, Spain

Introduction: Interpersonal dependence is a major problem from a clinical and social point of view. To the subjective pain suffered by people in disruptive relationships, we have to add the suffering that arises from comorbility of emotional dependence with other clinical problems such as gender violence, substance addiction or sexual dependence, to all of which it is closely related. If we sum up the amount of patients that consult due to emotional dependence directly and those in which this condition is an underlying feature (such as substance addiction, anxiety problems, depression or PTSD) it’s clear that emotional dependence is a condition that health professionals in general and mental health professionals in particular have to know how to asses and treat. At the same time, we observe a lack of integrative models from which professionals can handle this condition.

Aims: Our aim in the present conference is to provide mental health professionals with a integrative model, as well as with specific techniques and tools, to asses and treat emotional dependence.

Method and Results: After revising the existing scientific literature on interpersonal dependence and major mental health theories relevant to understand this condition (like Attachment Theory, EMDR-AIP, or Structural Dissociation Theory) and based on our case experience, due to more than 15 years working at the Instituto Andaluz de Sexología y Psicologia with this type of cases with a multidisciplinary approach, we will outline a comprehensive and integrative framework to understand, assess and treat interpersonal dependence.

PREMATURE EjACULATION 2012. QUO VADIS?

J. Martinez Salamanca

Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain

Premature ejaculation (PE) is recognized to be one of the most common male sexual disorder. PE provides difficulties for professionals who treat this condition because there is neither a universally accepted definition. Since several years ago we have different treatment options including oral drugs r behavioral therapies or off-label medications. This talk will focus on current and emerging treatment options and medications for PE. Advantages and limitations of each treatment option are discussed in the light of current published peer-reviewed literature.

ERECTILE DYSFUNCTION AND METABOLIC SYNDROME

I. Moncada ¹, M. Lemos

¹ Hospital La Zarzuela, Madrid, Spain

Objective: To explore the connection between erectile dysfunction and metabolic syndrome (obesity, hypertension, dyslipidemia, impaired glucose regulation and insulin resistance) which often occur in men with low testosterone levels.

Erectile dysfunction is multifactorial and with increasing age is predominantly associated with vascular disease and endothelial dysfunction. However, adequate testosterone concentrations are important for normal sexual function and lower levels affect the central nervous system and peripheral penile erectile mechanisms. Studies suggest that a high proportion of men (~52%) aged 40-70 years have some degree of ED and that approximately 10% of men with ED also have lower than normal testosterone levels. Metabolic syndrome (obesity, hypertension, dyslipidemia, impaired glucose regulation and insulin resistance) occur in men with low testosterone levels. Age-related decrease of testosterone has been well known for many decades, but has only recently attracted considerable interest. The reason for this change has been the understanding that testosterone decrease impacts negatively on the sexual functioning of the male but equally it affects many organs with the presence of a number of co morbidities. In fact, the physical symptoms of testosterone decrease are far more dramatic than the impact on sexuality. Conclusions: Erectile dysfunction can be a warning sign that should lead us to investigate the possibility of low testosterone levels which in turn are directly related to metabolic syndrome (obesity, hypertension, dyslipidemia, impaired glucose regulation and insulin resistance). Keywords: testosterone deficiency, erectile dysfunction, metabolic syndrome.

FORENSIC MEDICAL SEXOLOGY

F. Navarro Cremades ¹, R. Hernández Serrano ², J. Rodriguez Marín ³, P. Vinci ⁴

¹ Faculty of Medicine UMH. Departament of Clinical Medicine, San Juan (Alicante), Spain,² Central University of Venezuela, Caracas, Venezuela, ³ Faculty of Medicine UMH. Departament of Health Psychology, San Juan (Alicante), Spain, ⁴ CMT Association. Italy, Rome, Italy

Objective Main: To describe and to discuss the sexual rights as parts of the human rights (HHRR) in connection with the human values of dignity, liberty and equality of the natural person, relating the human and sexual rights with the legal system (mainly the european legal system).

Objective Secundary: To define and to evaluate the presence of the triadic construction Law-Sexual offender-Victim, mainly from a forensic and penal point of view.

Design and method Using a social sciences methodology of legal technical opinion including the access to main legal sources and related psychological and sexological aspects, rationally interconnected.

Results: 1.Sexual rights are described as parts of the human rights (HHRR).

Human rights are recognized in national and European (as EUCFR) laws, international human rights documents (as UDHR) and other.

HHRR include the right of all persons to sexual health, sexuality education and its legal recognition (as the National Constitutions and European Treaties).

2. Its current protection (mainly by the penal system) presents differences within the different countries mainly regarding to the sexual offender and the victim.

Conclusions: 1.Despite the recognition and the protection of human and sexual rights by the International standards and national Law systems its effective satisfaction is far of the general harmonization of these rights at a desirable top level.

2. Is need to enhance the prevention function of the penal system; and the sexual offender’ rehabilitation and the full assistance to the victim, including the broad forensic aspects.

DIABETES AND SEXUALITY

A. Pacheco Palha

University of Porto/Saint John University Hospital, Porto, Portugal

The main purpose of this lecture is to try to define some sexual problems of diabetic patients, to stress the importance of a better attention to their problems by the health professionals, and to insist in the implementation of a biopsicosocial approach to them.

It is present the socio psychological impact of this chronic disease and its consequences at somatic and psychic levels. It is comments the results of studies on the sexual health of diabetic patients and some data of an portuguese outpatients sexologic clinic.

THE NON-SEXUAL FUNCTIONS OF SEX

W. Pasini

AISPA, Milan, Italy

For many centuries, sex was considered indispensable for procreation.

Later on, sexuality was considered helpful for eroticism. Many people make sex for other reasons.

Sexuality has many therapeutic functions: sleeping drug, tranquillizer, antidepressant.

Sexuality serves to reinforce the identity and is a good way to communicate.

Sexuality makes money for some people and is a good vector of publicity.

G-SPOT. THE VENUS’ DREAM

C. Pol Bravo

Central Médica de Sexologfa - Colombia, Bogota, Colombia

The clinical and academic significance of new knowledge is always well-founded. It is necessary to enrich our experience, even more in medical sexology, since, through disinformation and lacking education, much is done without knowledgeable directions.

Venus, embodying the woman herself, has always sought for knowing her body, her sensitivity, her sensuality. In contrast, the negative millenary transculturality has tried to prevent this.

New legitimate academic, non-moderating theories are adequate. Ernst Grafenberg, father of the IUD, spoke first of this pleasure core, which later Beverly Whipple called G-point. Nevertheless, Aristotle considered the existence of the female ejaculation, and the currently called G-spot.

The thesis and its antithesis, unveiling legitimate concepts, confirming and denying the existence of the G-spot, connect with the physiological function of the feminine ejaculation, prime fundament of women’s sexuality, as the studies of Dr. Cabello Santamaría show. The G-spot is still bound to its embryological origin, as the extension of the clitoris.

The G-spot neurophysiology and its concept of erogenous sensitivity, stimulation and potentiators confront quiet actualized terms.

Within the antithesis, myths, legends, and clinical and socio-cultural aspects drive to conclusions that prevent its universalization. Even less should it be turned into the greatest possible factor of feminine pleasure, preventing misunderstandings and frustrations in the woman seeking for the Venus’ dream, and her partner.

Sex is not only physiological pleasure, but desire, tenderness, education and communication, among other indispensable factors for the optimal sexual quality of life of women and for the couple.

The controversy is open.

UPDATE ON THE CLINICAL MANAGEMENT OF TESTOSTERONE DEFICIENCY SYNDROME (TDS)

J. Pomerol Monseny

Instituto de Andrología y Medicina Sexual (IANDROMS), Barcelona, Spain

TDS id defined as a biochemical syndrome associated with advancing age and characterized by a deficiency in serum androgen levels with or without a decreased genomic sensitivity to androgens. It may result in significant alterations in the quality of life and adversely affect the function of multiple organ systems. According to different studies, the prevalence of TDS varies between 2 and 40% in men older than 40 years of age, being more frequent in the last decades of life. The most frequent signs and symptoms of TDS are: reduce libido, erectile dysfunction, gynecomastia, loss of body hair, reduced muscle mass, decreased energy, depression, poor concentration, increase body fat, lowered bone mineral density and mild anemia. The diagnosis of TDS is based on clinical symptoms and biochemical serum investigations ( total T, calculated free T, FSH, LH and prolactin). Testosterone replacement therapy (TRT) should be considered when clinical complaints are accompanied by decreased hormone levels. Transdermal T gels and patches applied daily or to alterning days, as well as intramuscular injections (Testosterone undecanoate) every 3 months are the

TRT used more frequently. Currently available preparations of testosterone are safe and effective. The presence of prostate cancer or male breast cancer is an absolute contraindication for TRT. The follow-up of the treatment has to be done every 3-4 months and later once a year, by means of biochemical serum investigations (hormonal, lypidic profile, PSA) and digital rectal examination.

CLINICAL CASE: ERECTILE DYSFUNCTION

R. Prieto Castro

Andrology Unit. Hospital Regional Reina Sofía, Córdoba, Spain

A 66-year-old patient, who comes to our office sent by Reumatology Service, because of an erectile dysfunction for

4 years.

To stand out in his personal history:

-No Allergies -Obesity

-Hypercholesterolemia

-Osteopenia

-Severe depression in treatment with SSRI and Lormetazepam for 2 years

-Hip fracture with placement of prosthesis 1 year ago -Smoker (40 cigarettes daily). No alcohol.

Current Disease: He recounts inability to achieve an erection with enough quality to penetrate for 4 years, with a slow and progressive beginning. He is only able to get certain degree of tumescence. There is an absence of morning and night erections and he does not get erection in special situations. The patient has diminished libido and it makes him depressed. Clinical Examination:

-Obesity - abdominal perimeter: 165 cms.

-Genital examination (penis and testicles) without alterations. Rectal exam: volume I-II/IV without signs of pathology. -Femoral and pedis pulses are present with normal extent. Complementary Examinations:

-Blood test:

Glucose 237 mg/dl

Cholesterol 291 mg/dl Triglycerides 358 mg/dl Insulinemia 22 mU/L Haemoglobin A1C 10.8%

Testosterone 1,50 ng/dl

PSA 4,6 (total PSAT/free PSA: 23% )

-Urine and semen culture: negative

-Prostate biopsy: glandular hyperplasia with areas of chronic

prostatitis.

What can we do with our patient?

We start the treatment with Testosterone and the patient was referred to the cardiologist without iPDE5 treatment, because we considered this patient had an intermediate cardiovascular risk.

Later, the patient underwent a cardiac catheterization, which demonstrated a critical arterial stenosis with 3 stent placements.

Comment: With this information, we must think about the METABOLIC SYNDROME and a DEFICIT OF TESTOSTERONE

SYNDROME.

a) Metabolic syndrome according to the WHO. Criteria:

The WHO indicates that is needed the presence of Resistance of insulin and / or alteration in the glucose tolerance for the diagnosis of Metabolic Syndrome.

To this one, it must be added at least two of the following: arterial hypertension, dyslipidemia, obesity, microalbuminuria. It is important to emphasize that the microalbuminuria is for the WHO an important predictor of cardiovascular risk.

b) What cardiovascular risks have these patients?

According to the information of the study Framingham, the cardiovascular risk for males with metabolic syndrome is between 10-20 % in 10 years and for women would be below 10 %.

Therefore, those patients with established Cardiovascular Disease, whom the risk in 10 years is superior to 5 %. (System score) and / or Diabetes, will be considered of high cardiovascular risk and they will receive priority interventions.

PHALLOPLASTY FOR FEMALE TO MALE GENDER DYSPHORIA

D. Ralph

St. Peters Andrology Centre, London, UK

The final stage of gender reassignment in female-to-male gender reassignment is phalloplasty of which there are various types. All patients should be fully counselled, shown photographs of the techniques and, if possible, discuss with patients who have had the various operations.

The main objectives are to stand and void, have penetrative sexual intercourse and to have a good cosmetically acceptable phallus.

The various types include a metatoidioplasty which involes bringing the urethral meatus forwards to the tip of the clitoris, extending the clitoris to allow patients to stand to void only. Approximately 50% of patients can manage this. A total phalloplasty can be either raised from the abdominal skin (pubic) or from the arm (forearm free flap). The superior phalloplasty with regards to urinary function is the forearm free flap phalloplasty, which has a better cosmetic appearance and is sensate. The urethral complications with this procedure is far less than with the pubic variety, although scars with the latter are hidden below the belt. Both types of phalloplasty will allow the insertion of a penile prosthesis for penetrative sexual intercourse and it is important that an inflatable variety is used, as this will reduce post-operative complications such as erosion. Testicular implants improve the cosmetic appearance as does sculpture of the glans penis to give a reliable looking phallus.

Over 200 pubic phalloplasties and 50 forearm free flap procedures have now been performed and the results and complications will be discussed.

SEX EDUCATION AND PEOPLE WITH DISABILITY.

TEACHING / PEDAGOGICAL RESOURCES

M.V. Ramírez Crespo Asociación LaSexologia.com

Provided that the objectives of Sex Education, offering knowledge, procedures and attitudes which allow you to live the fact that everybody has inherent sex characteristics and with reference to the sexological framework of the Human Sexual Fact, we would cover all kind of sexual behaviour and in every period of life. In our presentation we will try that the disabled learn how to express their erotica in such a way that it turns out to be pleasant and their quality of life is improved. We must not forget that Sex Education is not exclusively risk prevention. It is aimed to every kind of people ....men and women , including disabled people, ignoring which their erotica activity is or whether they show interest in it or nor . In the current paper, we will talk about Pedagogical Programs, resources, materials, environment,. adapted to different groups, adapted to people, to every person with disability ( person-centred planning). Design, carrying out and adaptation of materials, resources, support as well as technical help to educate, support and attend to disabled people's sexuality.

SEXUAL QUALITY OF LIFE OF INDIVIDUALS WITH 46,XY DISORDERS OF SEX DEVELOPMENT- RESULTS FROM THE HAMBURG STUDY

H. Richter-Appelt

Department of Sex Research, University Hospital, Hamburg, Germany

There has recently been a growing acceptance that it is not only heterosexual functioning of surgically adjusted genitalia which should be considered when measuring the treatment outcome of persons with disorders of sex development (DSD) but also their overall sexual quality of life (SexQoL).

At the Instituts for Sex Research in Hamburg, Germany, a comprehensive cross-sectional investigation of SexQoL of persons with 46,XY DSD was conducted.

Forty-seven persons with 46,XY DSD (age 17-60 years) were examined by means of a questionnaire on various aspects of SexQoL. Scores were compared to a nonclinical convenience sample consisting of 145 women.

Data were analyzed separately for diagnostic subgroups. Furthermore, persons whose external genitalia had been surgically corrected were compared with persons whose genitalia had been left unaltered.

The Multidimensional Scale of Sexuality, the German Questionnaire on Feelings of Inadequacy in Social and Sexual Situations (FUSS), items on sexual dysfunctions according to DSM-IV-TR and self-constructed measures on sexual-activity history (e.g., previous sexual experience), sexual anxieties, and satisfaction with overall sex life and sexual function comprised the standardized assessment instruments. Compared with the nonclinical group, persons with 46,xY DSD had more often no partner, felt more insecure in social and sexual situations, and were less satisfied with overall sex life and sexual function. Results were inconsistent with regard to sexual-activity history (e.g., previous sexual experience). Participants who underwent genital surgery showed less dyspareunia but more fear of injuries during intercourse than those whose genitals were left unaltered.

SexQoL of persons with 46,XY DSD may be impaired. Differences in SexQoL between diagnostic subgroups, effect of corrective genital surgery, and the influence of gender assignment will have to be further investigated in future studies.

AWARENESS AND KNOWLEDGE IN SEX EDUCATION

R. Rossi ¹, L. Pierleoni ¹, V. Cosmi ¹, C. Simonelli ²

¹1nstitute of Clinical Sexology, Rome, Italy,² University “Sapienza”, Rome, Italy

Objective: The boundaries between different models of sex programs are not strict and mainly depend on definition and strategies of application. The evidence based research shows that integrated sex programs have positive effects on: relevant knowledge, awareness of risk, values and attitudes, self efficacy, and intentions. On the other hand, traditional sex education programs lent to focus solely on student acquisition of knowledge not involving any skills development related to that knowledge. This work describes sex programs characteristics as focused by the Standard for Sexuality Education in Europe, comparing different kind of them; also, pays attention to gender variability in the acquisition of awareness and knowledge of school-going adolescents. Methods: A brief and focused literature review on this matter was made. We selected sex education models based on different type of programs in developing and developed countries, with a specific focus on gender difference.

Results: Many studies on adolescent sexual behaviour found that the rate of sexual intercourse increased for both genders as age increased. Sex programs are often based on strategies male focused and do not extrapolate well to young women who face pregnancy risk and rigid social gender norms which rule sexual behaviour. The main difference between developing and develop countries is the lack of information for the firsts and that knowledge does not always translate into behavioural change in the seconds. All over the world, school is the institution attended by most young people on regular basis, but in developing countries, not all youth ever attend school and not all youth remain in school until they initiate sex.

Conclusion: A comprehensive approach to effective sexual health education emphasizes the shared responsibility of the community including parents, peers, places of worship, schools, health care systems, governments and the media. Educational basis for the programs asserts that learning follows from action. The students need to actively participate in role-play situations simulating those that they are likely to confront in the real life. Also, it may be interesting, for future studies, focus on behavioural outcome changes.

ATTENTION, EDUCATION AND PROVIDE SUPPORT SEXUALITY PEOPLE WITH DISABILITY

N. Rubio Arribas ¹²

¹ Fundación Aspanias, Burgos, Spain,² Asociación Estatal Sexualidad per Discapacidad, Spain

The sexuality of disabled people is a fact, ignored in many cases. In this presentation it is intended to take it back to the place it deserves, which is the same as the rest of sexualities. In order to get it, apart from offering theoretical contents about sexuality and disability, strategies will be offered onhow to tackle situations where the sex fact goes into action, and in front of which silence or ignorance is useless: questions, behavior, demands, needs, The current proposal of intervention in Sex Education for disabled people is all part of the State Training Plan in Sexualities and Disabilities. A program aimed at and adapted to all kind of Disabilities (Intellectual Disability , Cerebral Palsy, Acquired Brain Injury, Mental Illness, Sensorial Disabilities: visual and auditory, Physical Disability, Autism and ADSs,...) for all kinds of people. With the nuances and peculiarities of every Disability case, for every age and evolutionary moment, with their needs, intensity and frequency in support. It is intended not to forget any kind of sexuality or evolutionary stage. We consider from childhood to adulthood and from those people who need a higher frequency and intensity in support to those ones who may get a more autonomous life. It is taken for granted that when confronting the sexuality of disabled people, it is not ignored the role that families play as well as the essential coordination among professionals and other mediators such as volunteers. Its objective is to make interventions transversal in an easier way. Our participation is always directed to the fact that the disabled person , the same as any other person , learns to get to know themselves, to accept themselves and to express their sexuality in a pleasant way.

MAPPING THE SEXUAL REVOLUTION OF EUROPEAN YOUTH

C. Savoie Pérez

Statal Federation of Lesbian, Gay, Transexual and Bisexual, Madrid, Spain

Time, youth, the ways we express ourselves and also the ways we manage our sexuality have changed. This has had an influence on how young people have taken care of our own sexual health, so right now, it is our turn to reflect on the mistakes and the achievements of our predecessors, to analyze the present situation of our sexual health as European youth and design the guidelines for an unprecedented sexual revolution, to be a milestone in our sexual health.

This speech means the start of that cartography process, just notes to be taken into account in the sexual revolution that is supposed to be led by the European young people to make us visible, to empower ourselves and to take the reins of our sexuality to make a necessary change on the way we handle the prevention and de promotion of our sexual health.

CLINICAL CASE: PREMATURE EJACULATION

A. Segura Paños

Adrology Unit. Hospital General Universitario, Alicante, Spain

34-year-old patient, without history of illness, who comes to our office for Primary Premature Ejaculation.

He told us he used to ejaculate before or immediately after penetration.

He had no problem with his erectile function nor with the rest of sexual sphere (libido and orgasm).

Sexual History: The beginning of his sexual relations was at the age of 16. Steady partner for 6 years. They had not desires of descendants and used feminine hormone pills as a birth control method. Sexual relations were frequent: every 15 days.

Physical Exploration: General and genital exploration without outstanding findings.

Diagnostic and Therapeutic Plan and Evolution: The patient underwent treatment in other medical clinic. He was prescribed Imipramine 75 mg. There was a clinical improvement (delay of the ejaculation to 15 days of the beginning of the treatment) but with side effects (hand quake), which lead him to leave it. Furthermore he went to see a sexology specialist, following a therapy during 3 months without clinical improvement.

When he came to our consultation, we advised him to start treatment with Dapoxetine 60 mg on demand and to increase his sexual relations frequency.

After 2 months of treatment with 2 weekly pills, he stops again the treatment due to side effects, like nausea, general discomfort and stress for loose of spontaneity (to programme the relations).

Then we stopped Dapoxetine and we began with Sertraline 50 mg (1 pill daily) for 4 months with good medical response. After 6 months of non-stopping treatment, we initiated Sertraline withdrawal and restored Dapoxentine 30 mg on demand, with good clinical evolution at this time.

YOUNG SEXOLOGISTS: WHERE WE COME FROM? WHERE ARE WE GOING?

C. Silvaggi

Institute of Clinical Sexology/ “Tor Vergata” University,, Rome, Italy

The 90s of last century saw both the beginning of the “Viagra era” and the evolution of the debate to overcome the biology- culture dichotomy through a paradigm shift to a broader interdisciplinary study of human sexuality.

The failures derived from sequential approaches and the sharp division of languages and skills of different specialists, have increasingly led professionals to suggest treatments of sexual dysfunction involving the integration of models and techniques. Combination or integrated treatment is the logical extension of the biopsychosocial model.

In spite of a growing demand for help in the sexual field, there is paradox regarding the professional figure of the sexologist. In many European countries neither a specific university degree nor a professional register exists, so the position of the sexologist is that of title without legal protection. Even more at risk is the status and professional practice of sexologists who are not physicians. Sexology sometimes appears as a part of some specialization courses in the Faculty of Medicine, or as an exam in the Faculty of Psychology. Therefore, professional training in this field is traditionally left up to the initiative of private institutes or associations, that “independently” establish the training requirements for the figures of sex educator, sex counsellor, clinical sexologist or specialist in sexual medicine.

Establishing standard criteria of appropriate training is therefore another important challenge that the most prestigious sexological associations are still facing.

INTEGRATIVE APPROACH

C. Simonelli

“Sapienza” University of Rome, Rome, Italy

Challenging perspectives on integration are the future of sexology. The available evidence in our Federation about different experts working together is a great resource for 3 different but connected areas: clinical work, research and training/education.

During the past three decades, integration in sexology between specialists, models and intervention techniques has decidedly increased, both in clinical practice, in educational programs and in international research contributions and guidelines. The training of the sexologist, a figure often not officially recognized in spite of growing client demand, is still a critical issue.

The Italian situation through more than 20-year experience of Rome’s Clinical Sexology Institute in training doctors and psychologists, is a very special experience strictly connected with clinical work both in a private and in a public context. Adjournment and research of the ICS team serves as a natural basis for transmitting flexible theoretical and technical knowledge, as required by the integrated approach. We have to underline the limits and resources of this approach, a modality which ideally takes into consideration and puts on the same level of importance body, mind and relationship. This model allows targeted and tailor-made interventions but, at the same time, this flexibility can also be a weakness: without any standard protocols the risk of errors can be higher, even if that could be limited by appropriate training of experts. Progress and selection of the clinical options allow clinicians to combine both psychotherapeutic and medical practice and the evidence base for such a combination of approaches will be challenged.

Frequent dialogue and confrontation with other important scientific societies in the field seem necessary for a fruitful future of sexology. Currently in Madrid we will share this great opportunity.

workshop abstracts

SEXUAL TECHNIQUES USED IN MEDICAL SEXOLOGY. STATE OF THE ART

FJ. Bianco Colmenares

CIPPSV. Research and Postgraduate Institute, Caracas, Venezuela

27 techniques used in the treatment of Sexual Disorders are described.

Each Technique is approached as follow:

Author(s)

Definition

Constructs

Fundament

Objective

Methodology

Evaluation

Indications

Contraindications

Observations

Recommendation

Bibliography

Among the Techniques described are:

Perineal muscles exercises, Observation, Vaginal Blind Exploration with Dilatation. Little Paper Technique, Digit Palmer Auto Massage Technique, Coitus program, Orgasmic Channing, Mirror Technique.

Each Technique will be demonstrated and practice by the attendance.

ORGASMIC CHAINING

FJ. Bianco Colmenares, R. Cardenas, B. Baena, C. Quijada,

E. Mejias, E. Pazmino, M. Guache, S. Guevara, P. Correa, J. Rivero

CIPPSV. Research and Postgraduate Institute, Caracas, Venezuela

Objective: To teach women to have an orgasms using the pubococcygeal muscles, the pelvic movements, the respiratory rate and verbalization.

Design and Methods: 20 women with orgasmic dysfunction were taught the Orgasmic Chaining Technique and compare with 20 women that achieve orgasms regularity that learn the Orgasmic Chaining Technique.. A Electrovaginogram was taken prior, during and after the experimental process. Results: 8 women with orgasmic dysfunction syndrome learn to achieve orgasms, using the Chaining Technique. They improved their pubococcygeal muscle strength, the coordination of the pelvic movements, the respiratory rate and the vocalization.

Conclusion: Is possible to obtain and improve the orgasmic phase of the sexual response using the Orgasmic Chaining Technique. The electrovaginogram is an acceptable tool for the measurement of the strength of the pubococcygeal muscles.

SEXO SABIO - WISE SEX

A. Bolinches i Sanchez

Institut Psicológic Antoni Bolinches, Barcelona, Spain

Wise Sex is not just the title of one my best known books. It is also the summary of a sexual behavior model that allows keeping sexual interest within the stable couple context for longer than if the model were not applied.

To accomplish such effect, one must practice sexuality from a relationship model that allows decreasing risk factors that inhibit sexual desire in long-term relationships. The most relevant risks are saturation in the initial phase of the relationship, and routine and paraphilia after the third or fourth year of living together. To lessen their harmful effects we propose three major strategies. First, to always practice sexual intercourse from the golden rule created by the author. Second, to know and correctly apply the four principles that make a good sexual attachment possible. And third, to incorporate in a self-regulated, desired, and mutually consented way the adaptive paraphilic variants that maintain sexual interest.

APPROACH TO THE EXPERIENCE OF PREGNANCY, CHILDBIRTH, POSTPARTUM WOMEN BLIND OR VISUALLY IMPAIRED

M. Chacón Sánchez ¹, E. Sanchez Raja ¹, M. Honrubia Perez ²

¹ANSSYD, Barcelona, Spain,² UB, Barcelona, Spain

Objectives:

• Meet the experience of pregnancy, birth and puerperium in women with disabilities visual.

• Discuss that information get in pregnancy, childbirth and puerperium.

• Describe sources of information.

• Assessing satisfaction

Method: Qualitative methodology Phenomenology. Women with visual disabilities from 17 to 44 with one child from 0 to 4 years, associated with the National Organization for the blind in Barcelona (ONCE). Collection of data with semi-structured in-depth interview: experiences and perceptions with regard to pregnancy, childbirth, and postpartum period. Information received, sources of information and degree of satisfaction. Interviews recorded and transcribed. With the results on a report on the needs of these women.

Results and Conclusion: Pregnancy: concern about the stigma of disability in his son, fear of having a baby with Visual problems, not knowing how to take care of the baby, loneliness and lack of support without a partner. Limitation of autonomy at the end of the gestation. All with a less satisfactory experience. Birth: Emotion in the expulsion, fear of pain, early nervousness decreases when advances dilation, anxiety to find one before delivery, need to explore the baby reborn to internalize his image, lived as a traumatic birth. Postpartum: 1 woman was found badly after being in the room, alteration in the welfare and comfort, unpleasant lack of information.

They had not received enough information during pregnancy, childbirth and puerperium. Different experiences. Sources of information: midwives, medical, rehabilitative, nurses, books, magazines, videos.

SEXUALIDAD EN SITUACIONES ESPECIALES

E. Cladellas

ICS, Canovelles, Spain

The main objective: to demonstrate the usefulness of the intervention on sexuality in primary care consultation in person with special situations such as cancer.

Sexuality in consultation is still underserved and is one of the most important areas of people, especially in situations of cancer disease. These guidelines and work with women and their partners (workshops on sexuality in women with breast cancer), have motivated my interest to go ahead and research in this field.

An analysis of the intervention with brief interview about sexuality and its relation to those diseases that most affect physical and emotional impact to the person. We analyzed the sexuality in cancer: breast, liver, prostate, colon ..). The query is performed from a single i / or with a partner who consults with emphasis on the fundamental aspect of the person and his complaint. The initial focus is medical surge. We aim to detect possible additional problems and often hidden, after a slight or negligible demand for them, which may affect their relationship and sexual function. Presented by PowerPoint. The result shows that addressing the situation allowed them to face the illness with less anxiety and are able to incorporate the world of work or activities of daily living early. Conclusion: a preventive approach allows early action lines for the situation. Patients are informed of the impact it may have sexually, treating it better. The workshops have given excellent results. The intervention from primary care is key, giving normalization of sexual approach in medical practice.

SUB CLINICAL DEPRESSION AND SEXUAL FUNCTION

R. Hernández Serrano

Universidad Central de Venezuela, Caracas, Venezuela

Depression and Sexual Function are extremely related. From clinical point of view to determine which one is first is usually a dilemma.

The problem is more severe when you have to make a differential diagnosis with several entities usually not discussed in scientific papers, journals, or textbooks. -Masked depression -Depressive Personality Disorders -Hypotimia and Dysthimia.

-Stress Disorders -Anxiety Depression

-Mood Disorders due to a General Medical Condition -Substance Induced Mood Disorders: Alcohol, Amphetamines, Cocaine, Hallucinogens, Opioids, etc.

-Melancholia

-Post partum Depression'

-Schizoaffective Disorders

-Bipolar Disorders, types I and II DSM IV establishes some diagnostic criteria for some of these entities. However the Sexual Function is generally ignored. The Monoamine Hypothesis of Depression, involving Dopamine, Norepinephrine and Serotonin may be a pharmacological explication of symptoms.

This paper establishes the differences between Diagnosis and Treatment of these issues.

Ref: Psychiatry and Sexual Health, Mezzich JE,Hernandez SR, WPA. Jason Aronson Ed (2006).

LOOK AT THE SEXUAL AND REPRODUCTIVE RIGHTS IN THE PEOPLE WITH FUNCTIONAL DIVERSITY

M. Honrubia Perez ¹, E. Sanchez Raja ², M.D.G. Chacón Sánchez ²

¹ University of Barcelona, Barcelona, Spain, ² University Autonoma Barcelona, Barcelona, Spain

Objectives:

- Know the sexual and reproductive rights.

- Explain these sexual and reproductive rights of persons with disabilities.

- Determine how you can exercise the sexual and reproductive rights.

- To involve professionals in the development of the sexual and reproductive rights of the people in their care.

Method: From the exhibition on the sexual and reproductive rights there will be mentioned how the persons with disability can request to enjoy a satisfactory sexuality being adapted to the severity grade and like (as) putting at its disposal the necessary mechanisms so that they enjoy her(it).

On the other hand it will be exhibited from the current legislation, the duty of the professionals to advise,to educate and to inform about the sexual and reproductive health the persons with disability.

Conclusion: The World Health Organization (WHO) in the year 1975 defined and stated the importance of having a satisfactory sexuality in human behaviour. In 2002 extended this statement, adding that it was a health indicator and therefore directly implicate the professionals of the health and education to help their development.

In persons with disabilities or in special situations in which their sexuality is altered and denied, increases the importance of having the support of trained professionals to ensure compliance with these guidelines.

CORPORAL DYNAMIC IN MEDICAL SEXOLOGY

M. Lucas Matheu

Sociedad Española de Intervención en Sexología (S.E.I.S.), Academia Internacional de Sexología Médica (A.I.S.M.)

Objective: To define the protocols and therapeutic tools used in the sexual therapy, related techniques of body dynamics. Desing and Method: For four years, discusses the different techniques of body dynamics, they could bring positive effects in sex therapy. A group of 12 professionals of Sexology is a research group in Sexual communication (GICS), which you are in work of experiential groups for 1,100 hours, techniques were lived, analysed and evaluated.

Results: Four areas of the body dynamics were identified as really useful for application in sex therapy: bioenergetics, relaxation, body expression and sensitive massage techniques. Techniques of bioenergy for dysfunctions Orgasmic, muscle relaxation and knowledge of the body schema, to vaginismus and premature ejaculation, sensitive massage for hypoactive sexual desire and erectile dysfunction. On the other hand, other techniques, such as many Oriental techniques were discarded. In the case of the Oriental techniques that use isolated, without forming part of a lifestyle, not they considered applicable.

Conclusion: Body and mind are often considered to be two separate entities. This is an artificial separation, as the mind

- which includes our thoughts, emotions, perceptions and fantasies - is located in the brain and is therefore part of our body, as well. Body dynamics is an essential instrument in sex therapy, to improvements in sexual dysfunctions, in a shorter period of time can be.

CONTROVERSIES AND CHALLENGES OF XXI CENTURY SEXOLOGY

R.M Montaña Hernández ¹, J.R Landarroitajauregi Garai ²,

E. Domínguez del Brío ³, R. Carbajal Martinez ³

¹1SESUS (Instituto de Sexología Sustantiva), Valladolid, Spain, ²ISESUS (Instituto de Sexología Sustantiva), Bilbao, Spain,³ Hospital Rio CARRION, Palencia, Spain

With more of less accuracy, we come building a New Sexual Order in which we're redefining close and public relationships between sex. Thus, the biggest challenge for the XXI century in the occidentals democracies, is the lack of culture in this new order.

This cultural company requires a moral, social, politic and scientific reformulation that allows men and women to coexist, to be respected, to share, to understand... with respect, consideration and valorization. There's no doubt that for arrive at good port in this profit it's essential to invest energy and resources. Therefore, those of us that dedicate to this discipline have some responsibility in offer the culture some kind of knowledge around this challenge. For it, we've to clear ourselves and produce a quality sexology, a discipline that try to understand the sexes, their identities, their differences, their mixtures and their interactions. All this, lead us to the need to resolve our deficits and to aboard some of our controversies.

One definition of Sexology could be: “A scientific discipline dedicate to the sex”. The controversy begins at the time to define: “What sex is?, what discipline is?, what scientific is? and what is to dedicate?"

The Science has been interested for the three kinds of sexes: a sex “that is”, a sex “that is had” and a sex “that is made”. But there's a way to make a sexology that deserves that name, if this restricts to a “fucklogy”, with its corresponding moral treatment, hygienic, docent and sanitary. Nor that to say that behind this bets underlies an epistemological controversy not resolve yet: “Sexus versus genus”.

On a second place, sexology has been define as a: self and specific discipline; an specialization area of an other discipline; an interdisciplinary gap; a multidisciplinary amalgam. Lately has prevailed the “sexological sanitization” to the point that sexology and sexual health have been taken as synonyms. Nor that to say that each one of this produce well opposed results. As much it's that today syncretically coexist the sexual knowledge, the “parasexologic”, the “perisexologic”, the “asexologic” (even the antisexologic”).

On a third place, scientific can be understand as a methodological question or epistemological. Thus, can be to consider sexological any study about sex that follows the scientific method; or that one that takes place inside a epistemic frame properly sexological.

On a fourth place, in terms of dedication, have prevailed transforming, sanitary and demographic bets over the comprehensive ones. Therefore, we put in front the action over the reflexion, the strategy over the epistemology and to transform over to understand.

At last, XXI sexology has to resolve several issues around the singular and plural; it has to bet for the plural sexes, leaving the singular sex, it has to leave the plural sciences, to produce a singular discipline, specific and proper, it has to leave the isomorphy to understand the intersexual multiform” and finally it has to resolve the “sexual centrisms” by means of “intersexual eccentricity.

TREATMENT OF FEMALE SEXUAL DYSFUNCTIONS BY PAIN: VAGINISMUS, DYSPAREUNIA

J.A. Navas Expósito

Censepsan, Cordoba, Spain

Both dysfunctions can be encompass within the socalled disorder of penetration. The vaginismus affects 2-3% of women. Among the women who have sexual dysfunctions, vaginismus is 25 per cent it is estimated that 34 % of women suffer from genital pain in their first.In postmenopausal women the figme is higher than 45,3%. Thetreatment has been evolucionando over time. If there is just cause organic, it should be dealt with. Have multiple media employee teraeuticos from drugs (anxiolytics, botulinum toxin),quirurgicos, sex education with assignement of tasks, hypnotherapy, fooding, sexual therapy with substitutes: but most of us agree that the sex therapy is the treatment for greaten efficiency, in practice consists of a systematic desensitization, which carries the individual coaching.

HOMOSEXUALITY LOOK AT DISABILITY

E. Sánchez Raja ¹, M. Honrubia Pérez ², M.D.G. Chacón Sánchez ³

¹ ANSSYD, Barcelona, Spain, ² UB, Barcelona, Spain, ³ ANSSYD, Barcelona, Spain

Abstract: The sexual development of people with disabilities evolve in environments where personal relationships are with the family and the professionals who serve them, both from

the health aspect as the teacher. Therefore, addressing the issue of affectivity and sexuality is difficult and delicate. General Objective: To explore from the perspective of LGBT (Lesbians, Gays, Transsexuals and Bisexuals) disabled and perceive their sex life.

Specific Objectives: 1) Knowing how these people feel about the social environment. 2) To describe sexual behaviour based on their disability and orientation of desire.

Design: A qualitative descriptive methodological perspective study from the point of view of ethnography.

Study subjects: Disabled LGBT sexual orientation that is associated with the National Association of LGBT disabled. For the ethnographic study will be a sampling LGBT men and women with disabilities.

Information collection: It will be through focus group with a semi structured interview that asks to explain how they live and have perceptions about their sexuality. The recorded session was transcribed to establish the categories. With the results obtained is performed a report that can generate knowledge about a topic.

Conclusion: Considered asexual beings, the acceptance of homosexuality is much more complex for people with disabilities. Recognize homosexual orientation with a disability is more difficult because of the physical and emotional dependence, greater isolation and a fear of losing the support and affection of parents and carers.

SEXUAL DYNAMICS AND HUMAN SEXUALITY

D. Trotta , T. Strepetova

ISA, Istituto italiano disessoanalisi, Salerno, Italy, ACTS, Associazione Clinica e Terapia in Sessuologia, Salerno, Italy

Sexuality is the final outcome of multiple and interactive force. Among them drive, motivational forces, and wish desire. Forces not necessarily in the same direction: while in some cases they share a common path, in other they are completely in contrast. Conflict are, in many cases inevitable. Psychosexual causes of sexual problems are many. The most common and known among them are the superficial causes, like minor anxieties (i.e. anticipatory negative anxiety and performance anxiety), cognitive behavioral factors or cultural factors. The less common and known are the deep causes. In some cases, specific sexual aspects connected to the identity, to the relationship one individual has with the other man or woman, and to the sexual dynamic, are the basis of sexual disturbances.The sex oriented dynamic approach focuses on the importance of early childhood experiences and aims at determining potential underlying unconscious sources of difficulties. Main areas of interests are gender identity, relation with intimacy, erotic dynamic and pathway. Clinical disturbances. The disturbances range from inability to penetrate to sexual anhedonia, delayed ejaculation or other ejaculatory difficulties, desire disorders and scarce or absent interest for sex and sexual penetration.Gender inadequacy is a feeling of uncertainty and insecurity about sexual identity. Men doubt about their manhood and project their uncertainties on their penises. Fear of intimacy. Fear towards the other sex is normally present, at least at an unconscious level, in every man. Dystonic erotisation refers to an erotic desire not accepted by the individual. It is a condition characterized by having an attraction that is at odds with one's personal beliefs, values and norms. Sex is associated with danger, guilt, shame and other negative thoughts and feelings.

CONNECTING AND FEELING THE SEXUALITY. APPLICATIONS OF THE CHARACTER-ANALITIC PSYCHOTHERAPY

J. Vilchez Cambronero

Spanish School of Reichian Therapy (Es.Te.R), Valencia, Spain

Objectives: The connection with the emotional level is important to reach sexual health and harmony in our relationships. When connecting with the body and being aware of what we really feel here and now, we can transform the consequences of sexual experiences gained in our history. Design and Methods: The Character-Analytic Psychotherapy originates from Wilhelm Reich, and we have continued to develop it in the Spanish School of Reichian Therapy (Es. Te.R.). Using psychological and body techniques, we explore and expand our capacity to feel and connect with ourselves and with others. We loosen up our sexual blocks (energy, emotional, mental, physical and behavioral) and change the way we function.

Results: We achieve returning to our natural tendency toward pleasure and love, restructuring and updating our identity, daring to make the changes necessary to overcome internal and external constraints that condition us.

Conclusions: We enable creativity and openness to other ways of functioning and find more pleasurable, loving and healthy ways enjoying our sexuality. We help to create more humanized and ecological relationship systems .

Keywords: Character-analytic psychotherapy, sex therapy, emotional health, sexual health, human ecology.

symposia abstracts

ERECTILE DYSFUNCTION IN EGYPT:

COUPLE AND FAMILY PROBLEMS

S. Abdel Azim

Psychiatry Department - Cairo University Hospital Faculty of Medicine, Cairo, Egypt

ED in Egypt is a disorder handled by gynecologists, andrologists, urologists, psychiatrists and psychologists. Patients usually go to andrologists or urologists first where they are treated medically using PDIS or other procedures as ICI up to penile prosthesis, and unfortunately the integration of psychological procedures is not usual with poor referrals. Not all psychiatrists and psychologists are oriented and familiar enough with sexual disorders or know how to manage, as well as many patients are unaware of the role of psychological intervention. In middle and uppder social strata, they often do not seek sexual therapy early enough, deliberately choosing to endure the problem which usually presevere and may grow to mount to marriage failure. The role of families of both partners is important. many cases of vaginismus can me responsible for non-consummation marriage and the negative role of women during the sexual act is as well significant in depicting the nature of the couple sexual relation affecting directly and indirectly the dynamics in between the couple in everyday life.

TRANSGENDER AND ORIENTATION ISSUES IN A MUSLIM COUNTRY

S. Abdel Azim

Psychiatry Department - Cairo University Hospital Faculty of Medicine, Cairo, Egypt

Transgender and orientation disorders are not uncommon in muslem countries, where patients of primary types atart their complaints early in childhood, but not declared overtly; and can be detected later in adolescence. Orientation problems although not accepted in muslem religion and as well among christians in Egypt, no punishment by law except if they are expressed in public. So gay people can socially mix but only covertly. They also come for medical and psychological therapies and are treated differently according to beliefs and attitudes of therapists. Transgender patients usually go to plastic surgeons and andrologists or urologists before they are referred to psychiatrists, but the final decision to undergo a sexual reassignment surgery is left to medical syndicate who still refuses to approve of these operations except for cases of intersex.

WISDOM FROM THE THERAPY ROOM - STORIES OF COMPLEXITY

E. Almas ¹, E. Benestad ², A. Lindskog, R. Pristed ³⁴, A. Skrautvol ⁵

¹ University of Agder, Grimstad, Norway,² Grimstad Mpat-Institute, Grimstad, Norway,³ Jysk Sexologisk Klinic, Randers C, Denmark,

⁴Agder University, Sexologiutdannelsen, Grimstad, Norway

⁵Institute of Clinical Sexology and Therapy

It is important to keep in mind the fact that methods that are used in “evidence-base research” address only one aspect of the process that therapy is about. Research to find evidence for the effectiveness of therapy focus on methods that must be described in a therapy-manual, repeated the same way independent of the therapist. The problems are described by diagnostic criteria, based on symptoms. The ideal model behind this research is the bio-medical treatment model where one single agent (antibiotics) alleviates a symptom (infection). There are both medical and psychological problems that can be treated by this model, but many problems require more complex treatment approaches. Evidence-based practice in psychology is the integration of the best available research with clinical expertise in the context of patient characteristics, culture and preferences (American Psychological Association). It is a challenge for therapists to present experience from the therapy room that describe what is clinical expertise, what is the importance of the therapeutic relationship, the resources and the motivation of the client? The need for therapeutic expertise increases as problems become deeper and more complex. The presenters in this symposium are asked to describe therapeutic experience (in ten minutes each!) in an effort to acknowledge and utilize this wisdom, which often is developed and practiced, locked inside the therapy room.

TRANSGENDER AND HORMONES:

MYTHS, FEARS AND REALITY IN THE 21ST CENTURY

H. Asscheman

HAJAP, Amsterdam, The Netherlands

Objective: To analyze the myths (beliefs), the fears (side effects) and the reality of cross-sex hormone treatment in transgender persons and to give a science-based realistic response.

Design: Review of published literature, internet-based questions and personal experience in over 2000 transgender subjects.

Method: Search of scientific papers, internet fora and questions asked in clinical practice.

Results: Many myths surround the effects of cross-sex hormones, magic bullets that transform a body into the desired physical shapes. More hormones are not always better and effects are limited. “Natural” hormones are not devoid of side effects and not more effective than synthetic hormones. Progestative agents are not necessary for optimal breast development. Injections are not more “powerful” than oral or transdermal administration. Also a lot a fears, from subjects but even more from society and physicians, regarding side effects are expressed like estrogens cause breast cancer to testosterone causes myocardial infarction. Cancer risk is not clearly increased in cross-sex hormone-treated transgender subjects. Breast cancer has been described in MtF subjects with high dose synthetic estrogen therapy in the 1980s but is rare. Other cancers are occasionally seen but appear not increased compared to the natal sex if corrected for age and risk factors. Mortality in MtF is 1.5 times higher but this is due to suicide and AIDS. Current ethinyl estradiol (EE) use is associated with increased cardiovascular mortality but past use of EE is not.

Conclusions: Optimal cross-sex hormone treatment is an effective therapy to obtain the desired physical changes

UNTOLD STORIES FROM THE THERAPY ROOM

E. Benestad ¹²

¹University of Agder, Grimstad, Norway² Grimstad MPAT-Institute, Grimstad, Norway

It has been shown that many, if not all, varieties of therapy do work. Some “schools” have, however, invested more in proving their efficiency than others and thus reached a higher level of bureaucratic credibility. This has rendered health bureaucrats power to impose “evidence based” strategies into the therapy room.

Many therapists have remained silent, not always knowing how to express these insights and give them transfer value. These are the untold stories from the therapy room.

This presenter has extensive experience as a family doctor, as a family therapist, as a sex and gender therapist and is knowledgeable concerning several therapeutic methods.

On the background of how one can work with individuals who are gender or transe-gifted, the presenter will describe and discuss some elements from the therapy room that can give insight not only to what might be useful for this special and heterogeneous group, but useful also in other therapeutic settings and senses.

One common denominator for this therapist is to move into the clients’ subjective space, explore the clients narrative, qualify the clients’ talents, leave out the diagnostic manuals and pathologizations and focus on leaving insights and viewpoints for the clients to explore within their own subjective frameworks.

VAGINISMUS AND DYSPAREUNIA: THE ABILITY TO DIFFERENTIALLY DIAGNOSE THE TWO DISORDERS

R. Bernorio

Associazione Italiana Sessuologia Psicologia Applicata, Milan, Italy

Vaginismus is commonly described as a persistent difficulty in allowing vaginal entry of a penis or other object, despite the woman’s expressed wish to do so. Dyspareunia is commonly described as a persistent or recurrant genital pain associated with sexual intercourse.

There are a number of studies which try to differentiate vaginismus from dyspareunia on a variety of muscle and nonmuscle spasm based measures or methods.

According to the proposed revision of dsm V, the two dysfunctions should be addressed to the same diagnostic category.

They are, on the contrary, representative of two markly distinct problems, with different models of therapy and different end points.

The aim of the presentation is to show the clinical evidence of this difference through the analysis of exemplificative clinical cases supported by the vision of direct in-vivo gynaecological examination videos.

MALE PEDOPHILIAC

F. Cabello Santamaria

Instituto Andaluz de Sexología y Psicología, Malaga, Spain

Introduction: The sexual interest in prepubescent children is one of the strongest social problems. A deep revision of bibliography on the issue shows that about 20% of de children have suffered some kind of sexual abuse.

Aims: To describe the features of the pedophilic men an our model of treatment.

Method: An assessment of the clinical histories of men meeting all the criteria of Pedophilia (DSM IV-TR) coming to Instituto Andaluz de SexologAa y PsicologAa (N=32). Results: Pedophiles showed significantly shorter empathy with children, they had a big compulsivity, perfectionism, and usually lie about the process, despite they come to our center after being denounced (except three cases who come for own decision). The most common traits in MILLON was in decreasing order compulsivity, phobic and esquizoide personality.

Conclusions: Despite some methodological limitations usual in the clinical work, the best results in the treatment of pedophilic men was a combination of behaviour therapy (cognitive approaches do not work in our experience) with antiadrogens and ISRS plus topiramato. In case of pedosexual offense recidivism we add atypical antipsychotics.

Keywords: Pedophilia, sexual abuse Paraphilia, Sex Offenders, Antiandrogen Therapy.

CORRELATES OF SEXUAL INTEREST AMONG MEN FROM THREE EUROPEAN COUNTRIES

A. Carvalheira ¹, T. Bente ², A. Stulhofer ³

¹University Institute of Applied Psychology, Lisbon, Portugal,

²University of Tromso, Tromso, Norway, ³ University of Zagreb, Zagreb, Croatia

The main goal was to evaluate the predictors of men’s low sexual interest. We examined associated distress, and comorbidity.

A total of 5,255 men from three countries completed a web- based survey of previously pilot-tested items: 2863 from Portugal, 1735 from Croatia, and 657 from Norway. All analyzes were performed with a sample of men who reported an exclusively heterosexual behaviour during last five years (82.4%).

Overall, 20.3% of men reported lacking interest in sex for a period of 2 months or longer in the year prior to the survey. From those, 69.2 reported personal distress. The most prevalent comorbidity was erectile difficulty (37.9%), and premature ejaculation (27.1%). A logistic regression (excluding men who were taking antidepressants) revealed that men with a higher educational level (odds ratio [OR] = 1.21, p < .05), having children (OR = 0.71, p < .05), with a lower rate of confidence in getting or keeping an erection (OR = 1.56, p < .001), with higher rates of anxiety and depression (OR = 1.06; p < .001), with a problematic use of pornography (OR = 1.19; p < .001), and with a lower body self-image (OR = .97, p < .05), were more likely to report lack of sexual interest. The overall model was found to be significant in the three country samples.

Results revealed significant predictors of men’s lack of sexual interest. Interestingly, having children and body selfimage was associated to men’s sexual desire, both variables considerably demonstrated in female sexual response but not yet investigated among men.

PATTERNS OF MALE SEXUAL FUNCTIONING: CONTRIBUTIONS TO DSM-V DIAGNOSTIC CRITERIA

J. Carvalho, A.L. Vieira, P. Nobre

Universidade de Aveiro, Aveiro, Portugal

Strong debate has been brought out around the upcoming editions of the International Classification of Diseases (ICD, World Health Organization), and the Diagnostic and Statistical Manual of Mental Disorders (DSM, American Psychiatric Association) regarding new criteria for sexual dysfunction. Although criteria for male sexual dysfunction have been supported by traditional models of sexual response (Kaplan, 1979; Masters & Johnson, 1966), recent data suggest that male sexual functioning could be conceptualized differently, offering new directions for diagnostic and assessment tools. Aim: The aim of this study was to test, through structural equation modeling, four conceptual alternative models of male sexual response.

Methods: A total of 1558 men from the Portuguese population participated in the study. Participants were divided into two groups according to the presence or absence of sexual difficulties. A modified version of the International Index of Erectile Function was used, assessing sexual desire, erectile function, orgasmic function, and premature ejaculation. Results: Findings suggested different factor solutions for men with and without sexual difficulties. Male sexual response of men with sexual difficulties was best characterized by a two- factor structure: 1) a general sexual function factor (including sexual desire, erectile function, and orgasmic function); and 2) premature ejaculation; while a three-factor solution was the model that best fitted the data regarding men without sexual difficulties: 1) sexual desire, 2) erectile and orgasmic function (which merged into a single dimension), and 3) premature ejaculation. Discriminant validity between factors was strongly supported, suggesting that these dimensions measure distinct phenomena in both samples.

SEXUAL RIGHTS OF PERSONS WITHOUT RIGHTS:

OLD PEOPLE, HANDICAPPED, MENTALLY ILL

A. Casaubón Alcaraz ¹²

¹Academia Española de Sexología y Medicina Sexual, Spain,

²FLASSES, Montevideo, Uruguay

If the first sexual revolution, was linked to women's access to contraception, the second revolution hatched with the access of women to the enjoyment ... the third will take shape with access to all human beings to sexual rights, this revolution being the more fundamental social and human.

And unfortunately, in the twenty-first century access for the entire world population to sexual rights, is the unfinished business of health systems, social and education in most of the world. This absence of the opportunity to enjoy these rights, it becomes a utopia for certain sectors of the population: Elderly / Mentally Ill / Disabled.

As raised in 1978 Masters and Johnson:

"Repressive attitudes of the Western tradition (Christianity, Puritanism) have been applied more intense for the disabled, chronically ill and the elderly."

This inability to access the sexual rights of these populations, acquire a special drama to be a limitation of one's physical and emotional development of stigmatized groups to prioritize the false beliefs, fears and repression against the basic needs of individuals of affection, closeness, pleasure and love.

Get in the general population harmonious development of their sexual health as defined by the Antigua meeting in 2000: "Sexual health is the experience of an ongoing process of physical, psychological and socio-cultural related to sexuality." Thus the "asexuación" that forced these populations, not only curtails their sexual rights, but hinders the harmonious development of the individual both physically, and psychologically, socially and spiritually.

TRANSSEXUALS SENSITIVITY AND SEXUALITY AFTER SURGERY

F. Courtois ¹, N. Morel Journel ²

¹ UQAM, Montréal, Canada,² Hospices civils de Lyon, Lyon, France

Forearm free flap and suprapubic phalloplasties differ in terms of techniques but lack comparisons amongst themselves and controls.

Objective: Compare forearm free flap and suprapubic phalloplasty against controls on penile sensitivity and sexual outcomes.

Materials and Methods: Twelve control men compared to fourteen transsexuals with forearm free flap (n=6) and suprapubic (n=7) phalloplasty on penile sensitivity, medical complications, psychological well-being and sexual function. Results: Sensitivity decreased compared to controls on glans penis and froenulum (glans M=0,21g Co, M=2g supra, M=1,7g forearm; Froenulum M=0,23g Co, M=3g supra, M=3g forearm), but not at the base of the penis for suprapubic phalloplasty (M=0,19g Co, M=0,5g supra, M=3,5g forearm). Both phalloplasties yielded similar complication rates (M=2,8 supra vs M=3 forearm). Suprapubic phalloplasty revealed better satisfaction than forearm free flap on appearance (M=8,9 supra vs M=7,3 forearm), happiness (M=4,3 supra vs M=3,8 forearm) optimism (M=4,4 supra vs M=3,8 forearm) and Beck Depression Inventory (M=0,6 supra vs M=4,3 forearm). Sexuality was improved in forearm free flap (Sexual repertoire M=10,6 PreSurg vs M=18,2 PostSurg; Fantasies M=3,7 PreSurg vs M=4,2 PostSurg; Orgasm (M=8,3 PreSurg vs M=13 PostSurg), but unchanged in suprapubic (Sexual repertoire M=10,6 PreSurg vs M=7 PostSurg; Fantasies M=1,9 PreSurg vs M=2,3 PostSurg; Orgasm M=7,6 PreSurg M=7,0 PostSurg).

Conclusion: Suprapubic phalloplasty maintains comparable sensitivity to normal at the base of the penis, but better sensitivity than forearm freeflap. Complication rates are similar, but suprapubic phalloplasty yields better psychological functioning, while forearm free flap better sexuality.

PROFILES OF BATTERED WOMEN AND ABUSIVE MEN IN CASTILLA Y LEÓN (SPAIN)

M.A. Cueto ¹, Y. Fernández ², B. Pérez ², N. Merino ¹, D. Cueto ³

¹ Cepteco, León, Spain, ² Centro Psicológico, León, Spain, ³ Univ. Oviedo, Oviedo, Spain

Objective: 134 subjects (96 women and 38 men) from the Emotional Support Program for Battered Women (since 2001) and Fénix Program for Abusive Men (since 2005) were observed by analysing descriptive variables, sociodemographic characteristics and personality profiles prominent in battered women and abusive men. The objective was the study of the more likely personality profiles to carry out or receive abuse. Consejería de Familia e Igualdad de Oportunidades de la Junta de Castilla y León (España) sponsor both.

Design and method: Using interviews and questionnaires to battered women and abusive men made the descriptive study. The personality profiles were assessed with Millon Clinical Multiaxial Inventory II (MCMI-II). All these data were scaled, tabulated and analysed statistically with the program SPSS 15.0.

Results: The conclusion is that both the men and the women of the study, at any age, may happen to abuse or to be abused. Neither most of abusive men nor most of battered women come from a family where there has been ill treatment during childhood.

The frequency of the compulsive-dependent disorder is very high both in abusive men and battered women. The longer women have been battered the more liable they are to become more dependent.

Conclusions: Everything hints at the necessity of deepening in the study of the role that personality plays in the psychological response and of considering specific personalities as a prominent aspect to be taken into account in the different preventive and therapeutical approaches used with the victims of this violence.

MALE SEXUAL PAIN DISORDERS: NEW APPROACH

G. Del Noce

Societa Piemontese di Sessuologia Clinica, Turin, Italy

The male sexual pain in DSM IV TR has something to do with Dyspareunia. But I can say by experience very few men feel pain during penetration and if sometimes it happens it is always due to organic causes. If we look Vulvodinia up in the Web we find about 200.000 items, but if we look penodinia up we can find only 640 items, wich are above all due to dermatologic causes. In reality, in andrologic surgery activities, male genital sine materia pains are very often referred and enphasized and I think they can be divided into several groups.

The first group, wich is the most frequent, hits above all testicles, persist for a lifetime and it is often correlated to a positive anamnesis for surgical operation (Hypospadia, Cryptorchidism,.) and/or frequent genital medical examination in pediatric age. It may be considered as a defensive reaction to what I think is a “controlled sexual abuse”. The pain sometimes appears only when the palpation is made by foreign hands and not by the subject himself.

A second group may be related to a very real penodinia. The patient shows his discomfort above all during his digital glans uncovering, wich is almost never executed. Not always he shows pain, but very often he feels discomfort and sometimes vomiting sensation. Sexual intercourses are allowed and, paradoxically, during sexual intercourses few symptoms are manifested. The patient very often undergoes andrologic examination to perform circumcision, wich has usually postoperative complications.

A third group may be compared to a very real vaginismus. The patient does not even tolerate the approaching of a hand to his penis and make the same actions and movements of a vaginismic female. The patients cannot have sexual intercourses owing to this inconvenience. This symptom causes a very important psychological distress, but that is fortunately relatively rare.

The fourth and last group may be defined as a real male Dyspareunia. The patient complain pain during sexual intercours and, above all, during ejaculation. The symptom is felt in pelvic-perineum area and it is often diagnosed as prostatis, but in reality no organic therapy is effective at all. Finally, I think that, up to now, male sexual pain has been studied in a superficial way and that there are many aspect that need to be further investigated and reported.

ABUSE OF DRUGS AND SEXUAL DYSFUNCTION

F. Del Río Olvera

Instituto Andaluz de Sexologia y Psicología, Málaga, Spain

Sexual health, for drug abuser people, is one of the therapeutic targets in this population, although it is one of the areas neglected at the same time. From adolescence to adulthood is often to find together fun, sex and drugs. Recent studies indicate that taking drugs increases 10 times the risk of erectile dysfunction over the not consuming population. There have been studies on consumption from the analysis of the effects at low doses and short-term, to studies with higher doses of consumption and more time consuming, which shows the devastating effects on sexual function. The Instituto Andaluz de Sexología y Psicología has made an investigation where

28 drug treatment centres in 27 Spanish provinces have participated. It has been done with an experimental group of people who have a history as addictive substances user (1054 people) and a control group who have not consumed addictive substances ever (211 people).

The results show that the experimental group presented higher percentages than the control group in erectile dysfunction (36.7%> 15.9%), premature ejaculation (44.3%> 15.9%), anorgasmia (13.2%> 2.3%) and vaginismus (65.1 %> 39.5%), with significant differences between groups.

As a conclusion, taking drugs has very negative influence on sexual health.

SEXUALITY AND COUPLE SATISFACTION IN CHRONIC ILLNESS

A. Fabrizi

Institute of Clinical Sexology, Rome, Italy

Sexuality is integral to a person’s identity and is an important contributor to quality of life in many patients with chronic illness and their partners. All illness and related treatments have the potential to affect sexuality and sexual function and can impact on all phases of sexual response. This may result from impaired body function or alterate body image or from the emotional and psychological distress that often accompany diagnosis and treatment. Many chronic illness patients may appreciate the opportunity to discuss psychological issues of sexuality and intimacy with a trusted health professional and want to learn about the implication of the treatment and medication on their sexuality. But health professional struggle to accept that people with chronic illness continue to be sexual being, so patient sexuality and intimacy are widely medicalised. Sexual counselling offer useful tools to address sexuality and sexual health and provide a graded approach that allow doctors and nurses to deal with sexual issues at their own level of expertise and comfort.

MALE SEXUAL COSMETIC SURGERY

A. Faix

Clinique Beausoleil, Montpellier, France

In a society where appearances have became the norm and many women have resorted to plastic surgery - with those that can be seen (breasts, face, figure), but also those that cannot (Nymphoplasty, amplification of the G-spot) - men increasingly seek to improve their appearance, and in particular their genital organs. Support should be primarily psychological, not only scholarly scientific society providing specific criteria or surgical intervention is indicated. The size of the penis (length and width) should be evaluated together with anatomical criteria, but also with a psychological evaluation team before considering surgery. Lengthening techniques consist essentially in the sectioning of the suspensor ligament that brings increased length mainly at rest, with potential drawbacks. Enlargement techniques are also random, with varying results and random durability. Support must therefore be collegiate (surgeon, psychiatrist, sexologist) with several consultations and sufficient time for reflection for the patient. Satisfaction studies are few and contradictory, as it lacks a reference to an anatomical and psychological standardized therapy for patients seeking this treatment.

A CLINICAL TARGET: MANAGEMENT OF ANTIDEPRESSANT- INDUCED SEXUAL DYSFUNCTION

M.F. Ferreira Lourenco

Couple Clinical - Psychiatry and Mental Health Department- Alto A ve Hospital Center, Guimaraes, Portugal

Depression is a clinical entity increasingly frequent as a result of economic difficulties and the profound changes affecting modern societies.

This pathology is present in the profissional life of all doctors. It is present as a primary entity or as a result of another health problem.While not always verbalized by patients, sexual problems can be a direct consequence of the use of antidepressants. One of the great ironies of depression treatment is that while depression can rob the desire for sex, the drugs that treat it can be much worse, causing not only low libido, but also erectile dysfunction and difficulties with orgasm.

Sexual dysfunction is a relatively common adverse effect of many of the antidepressants in common use today. Rates of sexual dysfunction observed in clinical practice may be higher than those reported in the product information for several agents. Selective serotonin-reuptake inhibitors (SSRIs) appear to be the class of antidepressants most likely to cause sexual dysfunction. Published studies suggest that between 30% and 60% of SSRI-treated patients may experience some form of treatment-induced sexual dysfunction.

In this communication we discuss the mechanisms by which antidepressants cause sexual dysfunction and established some guidelines to manage this clinical problem. Physicians should monitor their patients for antidepressant-induced sexual adverse effects, as these may affect compliance with therapy and ultimate treatment success.

TRATAMIENTO DE LAS TRASTORNOS DEL DESEO

J. Florido ¹, E. Martinez Lopera

¹ University of Granada, Department Obstetrics And Gynecology, Granada, Spain

Desire disorders are the most common sexual problems among women but also more complex treatment. At present there has been progress in understanding the pathophysiology of this disorder such as neuroimaging techniques (NMR active) that are enabling the emergence of new medical treatments. Desire disorders tend to explain in this day based on three pillars: psychological, hormonal and neurotransmitter changes, from which activacionals factors and inhibitors of desire will be enhanced and inhibited, (Dual theory of Jenssen and Bancroft). Drugs that can act on the desire to be hormonal (androgens and tibolone), the _ neurocentral action (dopamine, serotonin and melanocortin agonists) and last but by indirection the peripheral _. Special interest has been in recent years the description of androgen insufficiency syndrome, especially related to oophorectomy, which Allow the development of specific medication for it. But in the future is likely to appear new drugs _ as the ill-fated neurocentral action flibanserin or gespirona-ER or perhaps bromelanotido. However, in no other field and desire disorders need an individualized approach of the couple and to address psychosocial and relationship factors. The drugs were helpful but not a panacea.

CYBERSEX ADDICTION: MYTH OR REALITY? AN APPROACH TO ITS CONCEPTUALIZATION, ASSESSMENT AND TREATMENT

F. Fora Eroles

Centro Médico Teknon, Barcelona, Spain

Sexual addiction is not catalogued as pathological behaviour by any international psychiatric classification, in spite of the fact that they appear in the literature each time more studies about the subject. The current version of DSM, published in 2000 (DSM-IV-TR), does not mention sexual addiction as a mental disorder and this diagnosis has been rejected for inclusion in the DSM-V, expected out in 2013.

Sexologists have not reached any consensus regarding whether sexual addiction exists or if it is a psychiatric condition, which can be better explained in terms of sexual compulsivity or sexual impulsivity. While some experts believe that sexual addiction is directly analogous to drug addictions, other experts claim that it is only a myth, a product of social influences that can be a way of projecting social stigma onto patients.

Furthermore, it is unclear to what extent Internet has created a new category of sex addicts or simply has provided a new way of expression to the existing ones.

The aim of this presentation is to raise the debate that involves the conceptualization of this disorder and to approach us to its diagnosis, assessment and treatment.

WHO ARE THE TRANS INDIVIDUALS? RESULTS OF A 2010 SURVEY CARRIED IN FRANCE

A. Giami

INSERM U 1018, Paris, France

Introduction: Demographic data on the transgender population in France are scarce. The Inserm carried out a survey on Trans individuals in order to identify their sociodemographic characteristics, their medical and psychological transition processes, and some mental health issues. Material and Method: A questionnaire has been elaborated and circulated from July to October 2010 in partnership with transgender NGOs, public hospital practitioners and private practice practitioners.

Results: 381 individuals responded the self-administered questionnaire and sent it back anonymously to the research team. Sex assigned at birth and gender identification, which was expressed by the individuals in their own words, were the two key variables that enabled to outline different profiles, medical transition pathway and mental health problems. Socio-demographic profiles of the transgender population vary according to the sex assigned at birth, and the participation in the medical transition process also varies according to the sex at birth but mainly according to gender identification.

Discussion and Perspectvives: This survey is innovative insofar as it used a sampling methodology that was based on partnerships with the Trans individuals’ main networks of socialization, and partly based its analyze on gender selfidentification categories. The results highlight the diversity of the Trans population and the necessity, in future research, to take into account the differences between its subgroups. The possibility to develop such such a project on a European scale will be discussed.

MDS III DIAGNOSTIC MANUAL OF SEXOLOGY THIRD EDITION

R.J. Hernández Serrano ¹, FJ. Bianco Colmenares ²

¹ Universidad Central de Venezuela, Caracas, Venezuela,² CIPPSV. Research and Postgraduate Institute, Caracas, Venezuela

Diagnosis in Clinical Sexology:

B. At the process of Sexual Function B3. Sexual Response Phase In Men

At the Sexual Response Phase in Men:

Mixed Excitability Disorder (know as Erectile Dysfunction) Subjective Excitability Disorder

Subjective feeling of “not feeling much” with functional erection and ejaculation

Excess Excitability Disorder (excess lubrication)

Excitability Persistent Disorder Glands Hypersensitivity Orgasmic Disorder:

Ejaculatory Incompetence (previously known as Masculine Orgasmic Dysfunction)

Coital Ejaculatory Incompetence Masturbatory Ejaculatory Incompetence Orgasmic Anhedonia Painful Orgasm/Ejaculation

Ejaculatory Incompetence due to Urinary Incontinence Resolution Phase Disorder:

Postcoital Dysphoria Refractory Period-Related Postcoital Symptomatology:

- Headache

- Fever

Pain Disorders:

Superficial Penile Pain Genital pain during intercourse

Genital pain after intercourse Pain during masturbation Acute testicular pain Painful Orgasm

Case: At level of sexual function in men.

55 year old male

PMH: Type II Diabetes II. Hypertension, Prostatectomized CC: “I have Sexual Impotence”

HPI: Patient refers that after surgery, 2 years ago, he has

had difficulties obtaining and maintaining the erection during

the ESF with a partner, as well as during the auto-ESF, which

worries him, also been recriminated by his partner

PE: BP: 150/90. CP normal. Genitals weak bulbocavernous

reflex

Intracavernous Injection: Positive DI: Erectile Dysfunction.

SCIENCE-BASED SEXUALITY EDUCATION

F. Hurtado Murillo ¹², M. Pérez Conchillo ¹², E. Rubio Aurioles, R. Coates, E. Coleman, E. Corona Vargas, R. Mazín, P. Horno Goicoechea

¹Centro De Salud Sexual Y Reproductiva Fuente De San Luis De Valencia, Valencia, Spain ² Departamento Dr. Peset. Agencia Valenciana D, Valencia, Spain

Madrid Consensus Paper.

Recommendations of an International Expert Group. Summary.

In order to ensure the development of healthy sexuality, free of discomfort, risks, suffering, guilt, and shame, sexual rights must be recognized, promoted, respected, protected, and defended by all societies, through all available means. Sexual rights include the right to comprehensive science-based sexuality education which fosters the right to make free, responsible reproductive decisions, and the autonomous exercise of other sexual rights.

In recent years, professionals and institutions working on sexual health have found that:

Sexuality education is still a work in progress in many countries.

Many practitioners, institutions, and groups involved in sexuality education face barriers and stumbling blocks in carrying out their work.

In some cases, far from progress, there appear to have been setbacks in many of the victories achieved in the realm of sexual rights and sexual health.

In order to get an education for science-based sexuality as a basic strategy for moving the sexual rights agenda forward and, with this in mind, it was decided to make a World Meeting of Sex Education Experts.

The meeting of experts was organized and convened by the Spanish Academy of Sexology and Sexual Medicine (AESMES); the Spanish Association of Sexology Specialists (AEES); the World Association for Sexual Health (WAS); the Latin American Federation of Sexology and Sexual Education (FLASSES); the Modular Sexual Health Program of the National University of Distance Education (UNED); and the

Institute of Sexology and Psychotherapy (Espill).

The Ministry of Health, Social Policy and Equality of Spain lent its support to the meeting, which included the participation of the following international organizations: Regional Office for Europe of the World Health Organization (WHO); Federal Centre for Health Education (BZgA) of Cologne (Germany); Pan American Health Organization (PAHO); United Nations Educational, Scientific and Cultural Organization (UNESCO); International Planned Parenthood Federation (IPPF); United Nations Population Fund (UNFPA); University of Minnesota Program in Human Sexuality, University of Alberta (Canada); National Pedagogical University of Mexico; and the Universities of Salamanca and Vigo in Spain.

The objective of the World Meeting of Experts on Sex Education was to develop a document that would serve as a reference and source of support for practitioners and institutions working on sexuality education, and to propose specific, consensus-based strategies and actions geared towards implementing science-based sexuality education with a view to attaining the full exercise of sexual rights.

The document is divided into two sections.The first section describes the conclusions of the meeting of experts, which set out the basis for sexuality education and strategies needed to promote it, including advocacy strategies, and strategies to obtain the necessary resources and to implement programs. The second section offers relevant information and reflections to promote science-based sexuality education. This section includes standards for sexuality education, general and specific factors for the success of education programs that have been carried out in different regions of the world, and technical guidance on sexuality education that describes the characteristics of effective programs and the learning components of comprehensive sexuality education.

A POSITIVE APPROACH TO SEXUALITY BEFORE PUBERTY: SEXUAL ABUSE TO THE DIFFERENT FORMS OF SEXUAL ABUSE

F. López Sánchez

University of Salamanca, Salamanca, Spain

We expose the need to adopt a positive focus about prepuberty sex, with the goal of favoring present and future wellbeing of minors, and the need to change the international taxonomy of battering, presenting a new taxonomy in which, apart from the sexual abuse to minors, we include as new forms the following: sexual mutilation of girls, non acceptance of sexual identity in cases of problems in the identity in childhood and transsexual identity in adolescence, non acceptance of homosexuality, forced marriages in prepuberty minors, etc.

On the other hand, we will analyze forms of neglect in sexual education that should be considered child mistreatment.

This new classification will serve the purpose of a better defense of childhood against the familiar, social and educational sexual mistreatment, aiding professionals in defense of childhood and favoring a better sexual education.

MANAGEMENT OF SEXUAL DYSFUNCTION IN PERIMENOPAUSAL WOMEN

F. Molero Rodriguez^1-2

¹Federación Española de Sociedades de Sexologia, Malaga, Spain,

²Institut de Sexologia de Barcelona, Barcelona, Spain

Introduction: Sexual problems are highly prevalent in women. Female sexual dysfunction takes different forms, including lack of sexual desire, impaired arousal, inability to achieve orgasm, pain with sexual activity, or a combination of these issues.

Treatment must be tailored to the sexual dysfunction diagnosis or diagnoses and to underlying physical and psychological factors.

The management of female sexual dysfunction will be reviewed here.

Many of the sexual problems of the women are not dysfunctions. It is indeed the existence of personal malaise associated to the sexual problem one that determines if it is dysfunction or complaint

An abnormal sexual function without the upheaval presence can exist, if come together with personal distress .Only one part of the women with sexual difficulty does not appear sexual dysfunction

It is difficult to determine the prevalence accurately. The studies use different diagnoses criteria and very heterogeneous populations

Objective: Bibliographical search revision is to know which are the most effective treatments in the conduct of the sexual dysfunctions of the perimenopausal woman Methods: We have evaluate de available bibliographical information by consulting the data bases from 2000 to 2012 years

Results: The prevalence of female sexual dysfunction was found to be 43%. Although the experts believe that this percentage is oversized.

The sexual complaint commonest in the women is the low desire, although sometimes she is secondary to sexual discrepancies with the pair, upheavals of the excitation and aversion to sex. Secondly we would have the upheavals of orgasm

Therapeutic approach.

Currently available pharmacologic therapies for female. Sexual dysfunctions are of limited efficacy and associated with side effects and potential risks, non-pharmacologic options should comprise the initial treatment for most women. Counseling.

Sexual Therapy.

Surgical and pharmacological treatment.

Conclusion: Sexual disorders can be complex and their treatment can be time intensive and require special expertise. With the patient’s consent, communication and management decisions should be shared between the patient’s clinician and other health care providers who treat the patient.

In addition, for women with partners, the partner must be involved in the treatment.

It must become on individualized a treatment with an integrating approach. The first step is to offer objective information and appropriate to the language of the patient on anatomy and physiology of the sexual answer and positive messages. On many occasions are erroneous beliefs and myths that generate dysfunction.

To offer positive messages and of well-being, recognition of the right to the pleasure and promoting the sexuality not only based on the genitality. To make a careful evaluation of the problem and the expectations lives of the patient as far as which it wants to obtain.

Optimize the psychic and physical health. Improve climacteric symptomatology and make pharmacologic treatments when it is necessary.

It is very important to maintain a good state of vaginal health: local estrogens and hydration and lubrication.

SEXUALITY IN PERIMENOPAUSE

F. Molero Rodriguez ¹²

¹Federación española de Sociedades de Sexologia (FESS), Malaga, Spain, ² Institut de Sexologia de Barcelona, Barcelona, Spain

Abstract: Perimenopause is a time of anatomic, physiological and psychological changes that often influence in the sexuality of female.

It is a time of change, which is related to an evolutionary crisis where in addition to all known hormonal changes, psychological and relational changes occupy a prominent place.

A sexual history is probably the most important aspect in the diagnostic and treatment of sexual problems.

Sexual functioning is an important aspect of health and wellbeing. Doctors should have a holistic approach about the sexuality. They advise on sexuality at this stage and treat the symptoms that may impair sexual satisfaction.

Objective: The objective of the present exposition is to evaluate the sexuality in perimenopause.

Methods: We have evaluate de available bibliographical information by consulting the data bases from 2000 to 2012 years.

Results: Main factors associated with female sexual function are:

- The availability of a couple The quality of the relationship

Emotional satisfaction with partner was strongly associated with sexual satisfaction

- the perception by women of their physical and psychological. Depression and its treatments on all SSRIs, are factors related to sexual dysfunction.

The symptoms associated with menopause such as hot flashes and vaginal dryness, dyspareunia by were associated with less excitement, less physical pleasure and emotional satisfaction lower.

- importance of sex, age and attitudes toward aging and menopause

Conclusion: Women live in a very variable its climacteric. Psychological factors, socio-cultural, health, relationships, information or experiences ... which influence this experience. A positive attitude to adapt to changes and make responsible

decisions is what promotes health and wellbeing.

Women consider sex important in your life's and their sexual functioning, however this decreases with age, leading to debate on the contribution of menopause on sexual functioning in women.

Most studies in this area are transverse, and are not large enough to separate the effects of menopause, chronological age and other variables for which there is evidence of that influence female sexual function. Factors that are often more decisive than ovarian function.

SURGERY OF TRANSSEXUALISM

N. Morel Journel ¹, F. Courtois ², J. Terrier ¹

¹ Centre Hospitalier Lyon Sud, Lyon, France, ² Uqam, Montreal, Canada

There are a lot of techniques in the sex reassignement surgery. In our work, we wanted to analyze several items:

Sex reassignment surgery is a very challenging surgery. Surgeons helped by a multidisciplinary team have to be skilled not only in plastic and reconstructive surgery, but also in functional urology and psychology. This type of surgery has to be adapted for each patient because they have very different demands.

For female to male (FtM) transformation, main surgical challenges are the following: maintaining sexual sensitivity, aesthetic, functional phalloplasty and aesthetic mastectomy. The huge number of surgical techniques for phalloplasty is probably explained by the fact that none reaches all the “ideal goals” they should reach. However, among these techniques, two seem to emerge: antebrachial phalloplasty and abdominal phalloplasty.

For male to female more plastic surgery procedures are necessary face, throat, breast, and of course vaginal and vulva construction. There are also big functional challenges: clitoris sensitivity, vaginal functional length and width and urinary function. Losing sight of patient due to there huge mobility made study and evaluation difficult. Despite difficulties of evaluation, vaginoplasty with inversion of penile shaft and scrotal skin graft is still the referential treatment but secondary techniques like colic vaginoplasty are possible. To help patients’ and physicians’ decision making we propose algorithms. The huge diversity of techniques and the lack of good evaluation should encourage us to standardize evaluation of patients. Evaluation can’t be only physical, we have to cross results from sexual, psychological, physical and sociological view points.

WHAT PREDICTS MEN'S LEVEL OF DISTRESS WHEN EXPERIENCING LOW SEXUAL DESIRE?

P. Pascoal ¹, N. Pereira ²

¹Faculty of psychology, University of Lisbon, Lisbon, Portugal,

²Universidade Lusofona, Lisbon, Portugal

Introduction: There is scarce research about levels of distress experienced with low sexual desire in the male population. However, distress is a central feature for the diagnosis of

Male Hypoactive Sexual Desire Disorder (MHSDD) according to the APA new criteria proposed for DMS-5.

Objective: The aim of this study was to examine the extent to which aspects of individual and relationship variables predict distress with MHSDD.

Method: A total of 1656 heterosexual men in a relationship completed an anonymous online survey. The survey included a socio- demographic questionnaire and a set of questionnaires assessing individual and relationship related variables. We used level of distress with low sexual desire as outcome variable. As predictors we used the Global Body Dissatisfaction Subscale of the Body Attitudes Test (GBD); Cognitive Distraction Scale (CDS), Rosenberg Self-Esteem Scale (RSES), the Global Measure of Relationship Satisfaction (GMREL); the Inclusion of Other in Self Scale (IOS), level of distress with partner’s sexual functioning, cohabitation with romantic partner and relationship length.

Results: Multiple regression using stepwise method indicated that level of distress with partner's sexual problem, CDS, RSES and cohabitation significantly predicted distress with low sexual desire. The variance explained, after controlling for health, medication and psychological adjustment was 42% (R2= .42). Distress with partner’s sexual problem was the strongest predictor ( = .332).

Conclusions: Our results support that a combination of individual and relationship factors contribute to the level of distress with low sexual desire in men.

46,XX DDS

E. Pazmiño, FJ Bianco Colmenares

Centro de Investigaciones Psiquiátricas Psicológicas y Sexologicas de Venezuela, Caracas, Venezuela

Objective: Evaluate 46, XX Ovotesticular Disorder of Sex Development (DSD) in a patient from the pediatrics ward at Baca Ortiz Hospital, Quito.

Method: Case study, 1 year-old patient. Reason for consultation: "difficulty urinating" since birth. Physical examination: Genitals: presence of an aprox 2,5 cm-long, small phallus, with a ventral incurvation, asymmetrical, with glandular hypospadias, midline fusion of scrotal tissue, left cryptorchidia, rest of physical examination appears normal. Results: Genitography: previous ecographic study demonstrated the presence of gonads within the inguinal canals, did not show the presence of uterus, testosterone <0.020 ng/ml, 17-OH progesterone 1.24 ng/ml, testosterone after hCG situmulus 2.11 ng/ml. Caryotype: 46,XX/XY, exploratory laparotomy does not show müllerian elements, left gonad biopsy: ovaric and testicular tissue. Right gonad: testicular tissue. After interdisciplinary medical board, and according to the more masculinized clinical features of the patient, it is decided the assignation of a masculine expression phenotype.

Conclusion: 46, XX Ovotesticular DSD presents in 12,8% of these cases, therefore its frequency is low. Verification of caryotype and gonadal biopsy are determinants for diagnosis. This will depend on the patient's clinical situation as well as clinical and behavioral evaluation, in order to define surgical conduct. Nevertheless, nowadays surgical approach of this cases most be very careful, since it is evident that the sexual behavior pattern the patient will develop as an adult is unknown, and behavioral expression may manifest towards man or woman, according to how the individual identifies during its process of social construction.

MEN’S SEXUAL DESIRE - SPONTANEOUS AND ALSO RESPONSIVE?

M. Peixoto, P. Nobre, S. Vilarinho

Departamento de Educagao da Universidade de Aveiro, Aveiro, Portugal

The classical models of human sexual response conceptualized sexual desire as spontaneous sexual thoughts and biological urges.

Several studies have been revealing that women in long-term relationships, even if satisfying, frequently report the lack of spontaneous desire.

According to Basson’s circular model of sexual response, most women consciously decide to engage in sex based on reasons that are not primarily sexual; more common motives for sexual involvement usually include enhancement of emotional closeness, bonding, commitment, desire to increase a sense of attractiveness and attraction to a partner, and desire to share physical sexual pleasure.

In men’s sexual desire, biological factors are generally more emphasized.

Some empirical work suggests that men experience sexual desire more frequently and for different reasons than do women. However, sex differences in motivation and cues for sexual desire, particularly as a relationship progresses, have received less investigation.

Our main goals are to explore gender differences regarding cues to sexual desire as a relationship progresses; and to examine how different cues to sexual desire are related to frequency and sexual functioning in men and women. Participants are men and women drawn from general population, ages between 18 and 75, and relationship for 6 months or more.

Questionnaires assess: medical condition (MHF); relationship adjustment (DAS-7); cognitive-affective variables (SMQ; PANAS); sexual activity; fantasies, focus of attention and worries during sexual activity; cues for sexual desire (CSDS-P); and sexual functioning (IIEF, FSFI and SIDI). The study is cross-sectional.

Findings will be discussed in terms of men’s desire and motivation for sex, as compared to women.

ED MANAGEMENT IN THE PRACTICE SETTING: SATISFYING BOTH THE COUPLE AND THE DOC

H. Porst

European Society for Sexual Medicine (ESSM), Hamburg, Germany

As a rule of thumb manifestation of ED in men < 40 years has often a more psychogenic background with dominance of performance anxiety and increased sympathetic tone resulting in elevated adrenalin and noradrenalin concentrations. On the opposite men with ED > 40-45 years often have a more organic etiology such as arterial and/or veno- occlusive insufficiency. In addition testosterone deficiency (hypogonadism) , contributing to ED, is found in about 30 % of men with ED 45 years. Typical other risk factors for ED are BPH (Benign Prostate Hyperplasia - risk for ED 70-80 % !), diabetes mellitus (risk for ED 50-70 %), hypertension (risk for ED 50-70 %), dyslipidemia (risk for ED > 50 %), coronary artery disease (CAD - risk for ED 70 to 80 %) and depression (risk for ED > 70 %). Moreover many medications may cause or aggravate ED such as SSRIs, tricyclic antidepressants, diuretics and non-selective R-blockers ,with some of the cited drugs causing hyperprolactinemia and in addition libido-and ejaculatory disorders.

Besides a thorough sexual history a detailed risk factor analysis covering all the typical risk factors and medications is highly recommended in all men with ED. In the own institute each man with ED is subject to a thorough history , physical evaluation including the genitals and prostate as well as focused lab exams (serum glucose, testosterone, prolactin and cholesterol). Information about the sexual partner is always collected and questions focusing on the partner’s general interest in sexual activities and the partner’s sexual health should complete the sexual history.

The findings and the consequences of the diagnostic work-up are discussed with the patient and where possible with the partner too. If hypogonadism (total T < 3,5 ng/ml or 12,4 nmol/l) is present T-replacement therapy must be initiated followed by prescription of a PDE 5 inhibitor if T-replacement therapy alone is not able to solve the ED problem. Many men/ couples with hypogonadism need both T-substitution and PDE 5 inhibitor therapy to be satisfied with the outcome. Changes in life-style with regular physical activity where sedentary lifestyle is prevailing, active risk factor managements such as good diabetes control (HbAIC < 7 %!) and reconsideration of antihypertensive drugs with preference of erection protective drugs such as sartans or nebivolol can contribute to better erectile function or may improve the efficacy of PDE 5 inhibitors. Finally besides on demand therapy with PDE 5 inhibitors daily dosing with tadalafil 5 mg has been proven in own hands to be the treatment of choice where either performance anxieties are prevailing (young patients with psychogenic ED), regular sexual activities are anticipated or endothelial dysfunction is highly suspected (diabetes mellitus, CAD or hypertension).

USEFULNESS OF A PSYCHIATRIC ASSESSMENT BEFORE SEXUAL SURGERY

R. Porto, A. Gorin Lazard

AIUS, Marseille, France

Purpose: The aim of our contribution is to propose a reflection concerning the relevance of a psychiatric evaluation before sexual surgery.

Design and Method: Our work is based on a review of the current literature as on our clinical experience.

Results: The body image is eminently subjective, so much for the patient who suffer of his inadequacy than for the expert who gives a positive opinion on the relevance of a corrective surgery. In the field of sexuality, the difficulties of the patient concerning his body image can be the indicator:

- of a lack of assurance and self-confidence, which requires to be treated before every surgical gesture,

- of a gender identity disorder (GID) with feeling of incongruence which requires a surgery of sexual reassignment.

Between these two extremes, it is necessary to carefully seek dysmophophobic problems which can leads to detect-in particular with young subjects-a schizophrenia onset.

Thus, before any sexual surgery, it is advisable to carefully assess the psychological factors concerned and benefit-risk ratio.

Conclusions: The sexual surgery is a medical field often confronted with vulnerabilities of the personality and emotional sphere often underestimated. Their tracking enables us to avoid unrealistic waitings, source of disappointment and/or depression in the event of insufficient evaluation. The particular problems of the GID, which implies “ heavy “ and irreversible surgery, needs even more vigilance specially in detecting the differential diagnosis, source of regrets

THE IMPORTANCE OF SAR, AND DISTINGUISHING BETWEEN MORALS AND ETHICS IN SEX THERAPY

R. Pristed ¹²

¹ Jysk Sexologisk Klinik, Randers C, Denmark,² Agder University, sexologiutdannelsen, Grimstad, Norway

In Norway, we find that SAR (Sexual Attitude Restructuring/ Reassessment) is a very important part of the education of future sexological counsellors.

Adultery, polyamori, genderbending, groupsex, fetishes, S/m, prostitution.

These are among subjects that stir reactions in most people, and that many people, including therapists, have predjudices about. But as therapists I believe we have an ethical obligation, not to judge clients who come to us with these and other issues. Some might say that this is obvious, but for some it is neither obvious nor easy to see when we are lead by our own moral standards and feelings, and when we take en ethical viewpoint. SAR invites the students to reflect upon, and encounter some of these things, and find out how they are influenced by them, before meeting them in the therapy- room.

It is definitely my impression that most practitioners take pride in doing therapy in an ethical way.

But for many people, including therapists, no matter how good their intentions are, moral values often get mistaken for ethical values, and are used to judge others as “strange”, “abnormal”, “wrong”. This is of huge importance in the therapeutic setting, as it is important for establishing and maintaining contact, trust and alliance with clients.

SAR attempts to help future sexologists to identify and distinguish between moral reactions, and ethical considerations, and is therefore a very important contribution in the training of sex-positive sexologists.

SEXUAL SATISFACTION IN INDIVIDUALS WITH GENDER IDENTITY DISORDER AFTER SEXUAL REASSIGNMENT SURGERY: A CASE REPORT

F. Quattrini ¹, R.S. Calabro ², M. Fulcheri ³

¹ Department of Biomedical Sciences University “G. D’Annunzio”, Chieti, Italy,² RCCS Centro Neurolesi “Bonino-Pulejo”,³ University “G. D’Annunzio”, Chieti, Italy

In order to obtain adequate and consistent data, studies on the Gender Identity Disorder (GID) have paid attention to an early diagnosis, to the association between GID and personality disorders and traits, including homoerotic sexual orientation. Moreover, interesting studies dealing with new GID medical (hormones) and surgical techniques have also been described.

To the best of our knowledge, only few studies have attempt to evaluate sexual and relational well-being after Surgical Sex Reassignment (SSR).

Aim of the present study is to critically review the current and relevant literature dealing with the erotic and sexual representation after SSR, focusing on the orgasmic pleasure in individuals with GID (with regard to Male to Female transexuals).

A possible and promising psycho-clinical approach in MtF individuals is the possibility to enable them, before SSR, to reach a greater self awareness of their body and sex, internalizing their orgasmic experience and avoiding the denial of pleasure originating from the same genitalia. Thus, the psychodynamic and psycho-bodily psychotherapy, during the entire real life test, may be considered a useful approach leading to an important reinforcement of the “orgasmic pleasure consciousness.

TREATMENT CONSIDERATIONS IN PEYRONIE DISEASE

D. Ralph

St. Peters Andrology Centre, London, UK

This lecture will concentrate on the new issues in managing patients with Peyronie’s Disease in 2012. There have not been any major advances in the oral medical management of the disease but the use of interferon and latterly intralesional injections of collagenase seem promising. Extrcorporeal shockwave therapy is now a historical treatment once again but the use of the vacuum devices to mechanically stretch and straighten the penis is gaining popularity.

Many patients have vascular disease and therefore are at risk of developing erectile dysfunction (ED) post-operatively. Grafting techniques, that have a 15% risk of causing ED, should therefore be reserved for patients that do not have vascular disease and have a complex or significant curvature ( > 60degrees). Patients with vascular risk factors or ED should have either a Nesbit operation or a penile prosthesis implantation, particularly if a significant penile shortening is an issue.

COMBINED MODALITIES FOR THE TREATMENT OF PREMATURE EJACULATION (PE)

Y. Reisman

Men’s Health Clinics, Amstelveen, The Netherlands

PE cannot be considered purely a psychological or “lifestyle” problem but rather a multidimensional disorder involves the integration of physiological, psycho-behavioral, cultural, and relationship dimensions. PE is more than just a shortened time to ejaculation, its affects in addition sexual satisfaction, well-being, and relationship. PE. The relative contribution of these dimensions may vary across individuals and situations and all elements need to be considered in the etiology and treatment of PE.

Numerous treatments with varying degrees of efficacy have been used; behavioral, cognitive, and sex therapy techniques, and pharmacologic management with antidepressants, phosphodiesterase-5 inhibitors, and topical anesthetics. Psychotherapy is best when the partner is involved and strategy can be tailored to the needs of the individual. Overall, there is weak and inconsistent evidence regarding the effectiveness of psychological interventions for the treatment of premature ejaculation. Three of the four included randomized controlled studies of psychotherapy for PE reported pour primary outcome (Improvement in IELT) and have a small sample size. The early success reports (97.8%) of Masters and Johnson could not be replicated.

The approach most likely to provide success is a combination of cognitive and sex therapy with a pharmacologic agent of proven efficacy that has an easy-to-follow dosing regimen. Future studies combining psychological therapies with pharmacologic agents developed specifically for PE may treat the dysfunction more effectively and immediately, while also enabling couples to achieve a more mutually rewarding sexual and general relationship.

ENCOURAGING CURIOSITY AND PLAYFULNESS IN THE CLIENT THROUGH BODY WORK

A. Skrautvol

Institute of Clinical Sexology and Therapy, Oslo, Norway

Wilhelm Reich and other contributors made us aware of how the body also constitutes a form of protective ‘armour’, and is an important part of - and home to - our defense mechanisms. Findings from research on mirror neurons and imitation, in turn, are excellent sources of ideas and inspiration as to working with the body in the therapy room. Insights from this field can provide valuable information about the client and the client’s problems and resources. Approaching sexuality and sexual problems through concrete techniques where the clients manipulate their body in ways they are not used to, is a useful tool that can be used in addition to more traditional sexological techniques - and of course the general thereapeutic framework of the therapist. Such work may for example include experimenting with breathing, posture, walking, and imitating different role models that represent different qualities the client aspires to possess. Encouraging a degree of curiosity and playfulness in this regard is always helpful. In my experience, this approach gives an additional leverage. I have found it to be particularly useful for the groups of overly empathic clients, who are so preoccupied with pleasing others that it has almost eliminated their own authenticity. Playing with ways of carrying themselves that signal confidence and hightened body awareness can quickly lead to big changes, both in how they view themselves and in how they relate to others - and ultimately arrange their lives and sexuality.

PSYCHOTHERAPY, RELIGION AND SEX THERAPY: DOES BEING A MUSLIM CHANGE THE PRACTICE OF SEX THERAPY

M.Sungur

Medical School of Marmara Universtiy, Faculty of Psychiatry Istanbul, Turkey

Religion and mental disorders always had some kind of troubled historical relation. Further collaboration on certain dimensions between religion and behavioural sciences is therefore needed for human betterment. As religion is the most popular form of voluntary organizations and few human concerns are taken more seriously than religion, it may not be realistic to leave religion out of the scope of our routine psychotherapy practices. Sex therapists do not practice in an ideal standard world. Therefore, they must be flexible enough to adapt their interventions to the needs of different cultures and religions. Societies with different religions (even in same religion) differ about what sexual behaviours will be accepted or tolerated and thus sexual problems and their management are not free from religion and culture. It is therefore crucial to tailor and modify sex therapy programmes to the needs of the people and value systems of their culture and religion, if religious and cultural factors do influence the way sex therapy is offered and welcomed.

This presentation will address some of the challenges that the religious dimension presents on sex therapists. It will also addresses the views of a therapist coming from a secular Muslim country on the effects of religion in sex therapy practice.

MALE ORGASM AND DESIRE

D. Trotta ¹², T. Strepetova ¹²

¹1SA, Istituto Italiano Sessoanalisi, Salerno, Italy,²ACTS, Associazione Clinica e Terapia in Sessuologia, Salerno, Italy

Male orgasm is the result of a complex interaction among several biological, psychological, and phylogenetic components. For men orgasm is a common experience for most of their life and is usually associated with pleasure and satisfaction. Sexual desire is a crucial component of male orgasm. It facilitates - when lively and sparkling, male final sexual response, it precludes or hampers its occurrence when low or troubled. Male orgasm can be impaired in several conditions. Premature ejaculation is when ejaculation occurs

oral presentations 06

sexual dysfunctions 1

OP.06.01 EFFECTS OF SEXUAL MYTHS TO FEMALE SEXUAL DYSFUNCTION OF TURKISH WOMEN

I. Hattat ¹, E. Hattat ², H. Hattat ³, F. Gultekin ²

¹ European Sexual Health Alliance Turkey, Istanbul, Turkey,² Hattat Uro-andrology Clinic, Istanbul, Turkey, ³ Family Health Research Association, Istanbul, Turkey

Introduction: Recent reports suggest that sexual myths play a role in female sexual health problems. False expectations about sexual behaviors are related to lower sexual selfconfidence, lower levels of sexual experience.

Aim: The aim of this study was to assess the effects of sexual myths on the sexual functioning of Turkish women.

Methods: European Sexual Health Alliance Turkey sent a questionnaire including sexual believes ,the FSFI,consisting of 43 questions to 3000 internet members between March 2011 and August 2011. 2400 women (25-56 years old) participated.

Results: 64% believe that “to reach orgasm at the same time” is the most important goal of intercourse, 39% that any sexual problem is the woman’s fault and responsibility, 23% that women who start sexual intimacy are corrupt, 32% that sexual fantasies are forbidden,53% that virginity is very important,92% that all female sexual problems are psychological .

Out of 1536 women with the goal of orgasm , 62% had less than 3 points in the sexual desire domain of FSFI, 72% in the orgasm , 68% in the satisfaction , compared to the remaining group with 39% less than 3 points in the sexual desire domain , 37% in the orgasm , 38% in the satisfaction domain. Out of 936 women who believe that sexual problems are the woman’s fault, 73% had less than 3 points in the sexual desire domain , 74% in the satisfaction domain.

Conclusion: Expectations from sexuality, sexual knowledge and level of exposure to sexual myths are important determinants of female sexual health problems.

OP.06.02 SEXUAL DYSFUNCTION IN PATIENTS MONITORED FOR COCAINE USE DISORDER

A. Romaguera, J.A. Navarro, F. Eiroá, L. Grau López, C. Roncero, M. Casas

Unitat d’Aguts Hospital General de Granollers - Hospital de Dia de Granollers - Germanes Hospitaláries del sagrat Cor de Jesús, Benito Menni - Complex Assistencial en Salut Mental, Barcelona, Spain

Introduction: Although cocaine is seen as a powerful aphrodisiac by the drug user population, it has been shown in previous studies that chronic use adversely affects sexual function.

Objective: To analyse the structure of sexual function and prevalence of Sexual Dysfunction in patients monitored for Cocaine Use Disorder and the evolution of Sexual Dysfunction during the time of consumption and abstinence.

Design and Method: A cross-sectional study was conducted in a 37 sample of male patients consulting for Cocaine Dependence. Sexual function was assessed using the CSFQ- 14 scale and the ASEX , the latter applied retrospectively 4 times (previous to consumption, during acute consumption, during chronic use and during abstinence).

Results: The CSFQ-14 showed very good internal consistency ( = 0.9), showing in these patients a different structure of sexual function from other populations. According to the CSFQ-14, 21.6% of patients in the study presented sexual dysfunction. Using the ASEX it was observed in patients that previous to consumption they presented better sexual function (mean = 10.08 ± 2.40) than during acute consumption (mean = 13.32 ± 3.99) and that this worsened further during chronic use (mean = 15.46 ± 5.43), and that in times of abstinence the mean improved when compared with chronic use (mean = 13.13 ± 3.85).

Conclusions: The study shows that acute consumption of cocaine and especially chronic use impair sexual function, which can be partially recovered if abstinence is achieved. Sexual dysfunction may be a factor in the initiation, maintenance, relapse or cessation of cocaine consumption.

OP.06.03 TADALAFIL 5 MG DAILY TREATMENT FOR TYPE 1 DIABETIC PREMENOPAUSAL WOMEN AFFECTED BY SEXUAL GENITAL AROUSAL DISORDER

C. Cicero, S. Caruso, M. Romano, L. Lo Presti, B. Ventura, C. Malandrino

Azienda Ospedaliero-Universitaria Policlinico di Catania, Department of Medical and Surgical Specialties, Catania, Italy

Objective: Type 1 diabetic women may be affected by sexual dysfunction, mainly due to peripheral vascular disease.The objective of our study was to determine whether daily tadalafil

5 mg is effective in type 1 diabetic premenopausal women affected by sexual genital arousal disorder.

Design and Method: Thirty-three volunteers were enrolled in a 12 week prospective study performed by the Research Group for Sexology of the Department of Medical and Surgical Specialties, School of Medicine, University of Catania. The efficacy of daily tadalafil 5 mg on sexual genital arousal (primary endpoint),desire, orgasm, enjoyment, frequency of sexual activity and genital pain (secondaryendpoints) were assessed (a) subjectively by the Short Personal Experiences Questionnaire(SPEQ) and (b) objectively by Translabial Color Doppler sonography of clitoral blood flow.Moreover, the Short Form-36 (SF-36) questionnaire was used to assess Quality of Life (QoL).

Results: Twenty-nine women completed the study. Women reported a QoL improvement at the 12th week follow-up (p<.05). Tadalafil improved the experience of sexual genital arousal and orgasm, sexual enjoyment, satisfaction by frequency of sexual activity, and frequency of sexual thoughts or fantasies (p<.05). Finally, dyspareunia decreased with respect to baseline (p<.001). After tadalafil administration, the mean peak systolic velocity increased and the mean diastolic velocity decreased from baseline (p<.001). Moreover, the mean resistance index and the mean pulsatility index were significantly higher compared with baseline values (p<.001). Conclusions: Daily tadalafil 5mg treatment seems to improve subjective sexual aspects and could be used to treat genital arousal disorder of premenopausal women with type 1 diabetes.

0P.06.04 SEVERE TRAUMATIC BRAIN INJURY AND SEXUALITY CHANGING IN PATIENTS AND THEIR PARTNERS

U. Bivona ¹, F. Rizza ², G. Antonucci ¹'², F. Leoni 1, R. Formisano ¹

¹ Irccs Fondazione Santa Lucia, Rome, Italy, ² Sapienza Universita di Roma, Rome, Italy

Aim of the Study: To investigate the possible relationship between a severe traumatic brain injury (TBI) and the onset of sexual disorders in the patients and their partners.

Design and Method: Partecipants: a cohort of 25 severe TBI patients and their relatives, and a cohort of 25 control couples (without TBI). Measures: Sex relation Evaluation Schedule Assesment Monitoring (SESAMO) (Boccadoro e Perillo., 1996); Hamilton Depression Rating Scale (HDSR) (Hamilton et al., 1960); State-Trait Anxiety Inventory (STAI) (Spielberger et al., 1983); Awareness Questionnaire (AQ) (Sherer et al., 1998) and Neuropsychiatryc Inventory (NPI) (Cummings et al., 1994), for the evaluation of: the sexual, mood, self awareness and behavioural disorders.

Results: The study showed after the onset of TBI a statistically significant higher frequency of TBI patients’ pathological answers at the SESAMO, than in the control subjects, in 6 of 9 SESAMO sub-areas. Similarly, the TBIs’ partners gave a significant higher frequency of pathological answers than control partners in the SESAMO as a whole. Moreover, the patients showed mean pathological scores lower than their partners.

Conclusion: The onset of a severe TBI seems to determine a sexual worsening in both patients and their partners. In particular, probably due to low self-awareness in TBI’s, this changing seems to be better perceived by the partners than the patients. The study suggests the opportunity of a specific assessment of sexual disorders after a TBI, in order to include this kind of disorders into the rehabilitation project, with the aim of improving the outcome of the patients.

THE EFFECTS OF SEXUAL THERAPY INTERVENTIONS FOR SEXUAL PROBLEMS IN WOMEN: A SYSTEMATIC REVIEW

B. Landmark, E. Almas, D. Sorensen, H. Aars, W. Fjeld, W. Haaland, K.G. Brurberg, L.M. Reinar

Gj0vik University College, Gj0vik, Norway

A systematic review commissioned by the Norwegian Directorate of Health in 2006 has resulted in a 250 page report on the extant evidence base for sexual therapy. We did systematic literature searches in Cochrane Library, Medline, Embase, CINAHL, Psycinfo and Swemed and retrieved 320 articles in fulltext, written in 10 different languages.

The effect, benefits or risks, of sexological interventions for sexual problems in women, has been reviews and are presented in meta-analysis. Altogether 101 separate studies on the sexual dysfunctions of women were covered in four previous reviews. We have quality graded and included a further 12 studies on hypoactive sexual dysfunction, lack of genital response, orgasmic dysfunction, mixed dysfunctions and pain disorders.

We found and included four recent studies on sexual dysfunctions after cancer, and no controlled studies on sexual dysfunction after other diseases.

Studies on women after sexual abuse had outcome on posttraumatic stress symptoms, and although all state that sexual dysfunction may ensue, there were no treatment effects reported on sexual dysfunctions.

We will present the first metaanalysis of these studies and report on the efforts to summarize the results.

0P.06.06 SEXUAL FANTASIES AND SEXUAL PROBLEMS

D. Trotta ¹², T. Strepetova ¹², E. Fattorusso ¹², A. Crudele ¹²,

G. De Maio ¹², E. Troiano ¹², L. Otranto ¹

¹1SA, Istituto Italiano Sessoanalisi, Salerno, Italy,²ACTS, Associazione di Clinica e Terapia in Sessuologia, Salerno, Italy

Objective: The importance of sexual fantasies in human sexuality, in the physiology as well as in the sexual pathology, is often under evaluated. Anyway, the erotic and sexual imaginary, is a pillar of male and female sexuality and has a central role in every man and woman’s sexual life.

Design and Method: Typical fantasies. Sexual fantasies are present in most men and women. Most typical male fantasies are centered on identity affirmation and consolidation, sexual domination, woman detachment, phallic aggressiveness. Most common female fantasies regard sexual power and erotic fascination, exhibitionism and sex without direct involvement and consequent sense of guilt. Submission fantasies, competitive as well as degradation fantasies are also common in men and women. Importance of sexual imaginary. The study of erotic imaginary is important to understand sexual health and to treat sexual limits and sexual pathology; especially in structured and complex cases which are often difficult to understand. Systematic observation of sexual and erotic imaginary helps go beyond the gaps left empty by otherwise meaningless behavior. This is the case when only objective and observable behavior is considered. Results: The analysis of sexual fantasies and dreams is a very useful tool, when used on its own or with other therapeutic aids, like medicaments and behavioral -cognitive therapy. Conclusions: There is a strong relationship between sexual fantasies and sexual behavior. The study of imaginary is also a powerful prognostic tool in clinical practice

OP.06.07 DR FAROOQ MODEL OF NON CONSUMMATED MARRIAGE TREATMENT IS COMPREHENSIVE, TIME AND COST SAVING SO REPLACES OTHER MODELS OF TREATMENT

M. Nasim

Nasim Fertilty Center, Lahore, Pakistan

Introduction: Non consummated marriage is very common in societies where sex and sex education is a taboo due to religious and socio cultural factors. Early recovery in matter of days or few weeks is required to save the marriage. Male factor was cause in 100% cases and female factor was responsible in 80% cases. In Dr Farooq model of treatment by combining sex therapy with pharmacotherapy 100% success is achieved in 2-3 weeks by restoring sexual functions. Objective: To introduce a new treatment model by combining sex therapy and pharmacotherapy in non consummated marriage, that gives early recovery and best accepted by patients and time saving.(specially suitable for subcontinent culture)

Material and Methods: 3050 patients of non consummated marriage were treated at Nasim Fertility Center Lahore, Islamabad and Faisalabad during 1999-2011. 58% of the males complained of having good erection to enter vagina but ejaculated outside vagina. 24% complained on having good erection but erection failed on entering vagina entry. 18% of patients had no erection on going to wife.

In female vaginismus was present in 74% cases and 26% had dysparunia with other sexual dysfunction. In Dr Farooq vaginal intercourse was sure in 10-15 days in 90% cases after two sessions of sex therapy and administering pharmacological agents (SSRI, Benzodiazipines) to balance autonomic nervous system necessary for normal sexual response and excitement in males and females. Another 10% having severe vaginismus recovered in 3-4 weeks in 3-4 sessions of sex therapy vaginal desensitization is achieved by encouraging the male to enter the vagina with fingers progressively and in severe cases vaginal dilatation and hymenectomy was performed. By sex education and explaining easy intercourse positions the couple was encouraged first intercourse by using I/C injection or vacuum therapy device. The treatment continued for 10 weeks with weekly sessions and pharmacotherapy to remove associated performance anxiety and normal sexual life was restored.

Result: 100% success was achieved in restoring normal sexual activity in short time as compared with other models of treatment.

Conclusion: Dr Farooq model of treatment for Non Consummated marriage is best suited due to short treatment time and full reward to patient as compared with other models of treatment for non Consummated marriage.

OP.06.08 DYSTONIC EROTISATION

D. Trotta ¹², T. Strepetova ¹², E. Fattorusso ¹², A. Di Marco ¹²,

G. De Maio ¹²

¹1SA, Istituto Italiano Sessoanalisi, Salerno, Italy,²ACTS, Associazione di Clinica e Terapia in Sessuologia, Salerno, Italy

Objective: Sexual problems are common in men. They can interfere with the erectile and ejaculatory function. In other cases sexual desire is involved. Desire problems are less known and usually difficult to explore and to “understand”. Our presentation focuses on eroticism and its disorders. Design and Method: Dystonic erotisation refers to an erotic desire not accepted by the individual. It is a condition characterized by having an attraction that is at odds with one’s personal beliefs, values and norms, causing anxiety and sexual disturbances. For these persons sex is associated with danger, guilt, shame and other negative thoughts and feelings. Our presentation explores the world of dystonic erotisation as seen and lived in clinical patients. Patients are explored by investigating his behavioral sexual activity and by exploring his sexual imaginary.

Results: Sexual disorders caused by a disturbed erotisation can be related to the gender identity, to the relationship one individual has with the other, man or woman, and to the sexual dynamic. They can affect not sexual desire as well as excitatory and ejaculatory response.

Conclusions: Dystonic erotisation is a symptom of deep rooted sexual disturbances. Therapists should take it into consideration in cases of poor response to traditional cognitive-behavioral therapy.

OP.06.09 SEXUAL DYSFUNCTIONS - A SYSTEMATIC REVIEW OF SEXOLOGICAL TREATMENTS

B. Landmark ¹, D. Sorensen ²

¹ UniversityCollege ofGj0vik, Gj0vik, Norway² Norwegian Knowledge Centre for the Health Services, Oslo, Norway

The effects of sexual therapy interventions for sexual problems have been subjected to a systematic review commissioned by the Norwegian Directorate of Health. The review was limited to psychological, psychosocial and educational interventions, within the context of information, counseling and treatment for sexual dysfunction. We excluded studies of sex offender treatment.

After appraisal in full text, relevant articles were critically appraised concerning methodical quality. We identified 2805 unique titles of which nine systematic reviews and 33 randomised controlled trials were included in the final report. The review included all languages, and includes updated systematic searches to 2011.

In addition to published systematic reviews for sexological interventions in men we found four randomized, controlled trials, and in addition to four systematic reviews we found 12 randomised controlled trials on the effects of sexological interventions in women.

Many of the included studies were of moderate methodological quality. For many comparisons it was not possible to pool the results and we could only report from single studies. We have pooled results in metaanalyses, but the total study population is small.

There is an overall positive effect across interventions and populations. This is shown for both a broad spectrum of populations and sexual problems. However, we can not rule out a possible publication bias in the material. Interventions in the research literature do not appear to be entirely representative for the array of treatment methods that are offered for sexual problems and dysfunctions in men and women.

OP.06.10

VAGINISM AND SEXODYNAMICS

R. Bochicchio ¹², T. Strepetova ¹², L. Otranto ¹², A. Di Marco ¹²,

D. Trotta ¹²

¹1SA, Istituto Italiano Sessoanalisi, Salerno, Italy,²ACTS, Associazione di Clinica e Terapia in Sessuologia, Salerno, Italy

Objective: Vaginismus is one of the most important disorders of female sexuality. From the functional point of view consists in an involuntary and uncontrollable contraction of the vulvoperineal muscles that oppose to any attempt of vaginal penetration.

Design and Method: The classic therapeutic approach to vaginismus is based on use of cognitive behavioral techniques that are based on body techniques capable of acting on the pelvic floor and vaginal muscles. The purpose is negotiating an obstacle to the mechanical penetration and the achievement of the coital capacity. Vaginismus can be primary or secondary and have phobic or fusional characteristics. Results: A sexodinamical approach to vaginismus allows a better understanding of motivations and the thickness of the disorder as well as a distinction between different types of difficulty or inability to penetrate. Thus dropouts during treatment can be reduced as well as the therapeutic escapes. Conclusions: An integrated sexological approach that takes into account aspects of bodily, emotional and cognitive factors that contribute to the development and maintenance of vaginismus has best chance to remove disturbance and to avoid the appearance of recurrence even in the short time.

SEXUALITY, HYPNOSIS AND SEXOANALYSIS

L. Otranto ¹², T. Strepetova ¹², R. Bochicchio ¹², E. Troiano ¹-²,

D. Trotta ¹²

¹1SA, Istituto Italiano Sessoanalisi, Salerno, Italy,²ACTS, Associazione di Clinica e Terapia in Sessuologia, Salerno, Italy

Objective: The speech analyzes the relations between hypnosis and sexuality and its relationship with the sexoanalytical approach. If the latter has as privileged subject of its attention the sexuality, we have to take into consideration the role of the eroticism into the hypnotic field.

Materials and Methods: Since the first hypnotic experiences of Charcot and Bernheim, several authors of the hypnotic school (DL Araoz, HG Beigel, P Cantafio et al.) were concerned with the comprehension and the treatment of the different sexual problems. Hypnosis, through the trance, the induction of a relaxation state and the reduction of the conscious resistance, eases the access at the individual’s inner world, with the intent to modify the cognitive and emotional dynamics that cause the sexual dysfunction. The main aim of the sexoanalysis is the erotic dynamics comprehension. For this purpose it makes use of the systematic observation of the dreams and of the erotic fantasy.

Results and conclusions: Hypnosis and sexoanalysis share the treatment of the erotic imagery. In the sexoanalysis, the disturbed imagery’s modification, that in some kinds of hypnosis is influenced by the therapist’s intervention, is entrusted to the patient.

oral presentations 07

sexually transmitted infections and sexual rights

OP .07.01 CONTACT TRACING FOR HIV: CHARACTERISTICS AND PRACTICES OF A GROUP IN HIGH RISK FOR HIV INFECTION

L. Leal, E. Fernández, C. Ligero, A. León, B. Torres, L. Moreno, J. Gatell, F. García

Hospital Clinic I Provincial de Barcelona. Infectious Diseases Department - Hiv Unit, Barcelona, Spain

Objective: In Spain there are no protocols for HIV or STD contact tracing. The objective for this study was to investigate HIV and other STD transmissions among sexual contacts of newly diagnosed and describe the characteristics and practices of a group in high risk for HIV infection.

Design and Method: We trace the sexual contacts of persons recently diagnosed with HIV infection (< 6 months) coming to our service from 2008-2011. We included the index case and at least 1 unprotected sexual partner. They were interviewed for demographic characteristics, sexual practices and tested for STD.

Results: There were 559 patients recently diagnosed, most of them men (90% n=506) and MSM (82% n=461), solely 4% (n=20) had a known HIV partner. A 7% (n=39) reported never use condoms and 5% (n=28) were sexual workers. We could only trace 43 sexual contacts of which 9 (20%) had a positive result for HIV, 1 (2%) for VHB and 1 (2%) for Syphilis. They were mostly men (74% n=32), almost half of them reported never been tested for HIV before and never use condoms (45% n=17), a considerable 17% (n=4) had a STD history. Conclusions: High risk sexual practices are still a major issue in our community. Contact tracing was difficult in this study; this could mean missed opportunities to diagnose HIV or STD. It is a priority to develop an adequate contact tracing system in Spain.

OP .07.02 SEXUAL LIFE IN WOMEN WITH HPV INFECTION

C. Malandrino, C. Cicero, L. Lo Presti, M.T. Bruno, G. Musumeci, S. Caruso

Dipartimento di Specialitá Medico-Chirurgiche. U.o. Ginecologia e Ostetricia. P.o.g. Rodolico, Universitá di Catania, Catania, Italy

Objective: HPV infection is one of the most common sexually transmitted diseases. Studies on women who have had anomalous Pap Test results have highlighted psychological consequences like anxiety, fear of cancer, sexual problems, changes in body image, difficulty in reproductive functions, changes in the relationship with the partner, a sense of neglect, anger, and fear of being stigmatised and labelled. The objective of our study was to evaluate changes of the sexual function of women before and after receiving diagnosis of HPV infection.

Design and Method: We enrolled 121 women with Pap test cytologic atypia suspicious for HPV infection. They undergone HPV Dna test and colposcopy. It was administrated the FSFI questionnaire to evaluate the quality of their sexual life before and three months after the communication of the HPV dna test results. 86 women were HPV positive and 35 were HPV negative.

Results: There was an important reduction of the total FSFI score of all of the women receiving the diagnosis of HPV infection. The items more affected were sexual desire, lubrication and dysperunia (p< 0.01) in both the positive women before and after diagnosis.

Conclusions: HPV diagnosis caused emotional reactions as fear and anxiety in most subjects of our sample. Our study has shown significant changes of the sexual life of the women affected by HPV infection.

OP .07.03 GLOBALIZATION, SEXUAL POLITICS & THE FUTURE OF SEXUAL ETHICS

T. Claes ¹²³

¹ Ghent University, Department of Philosophy and Moral Science, Ghent, Belgium, ² Ghent University, Center for Ethics and Value Inquiry, Ghent, Belgium,³ International Network for Sexual Ethics and Politics, Ghent, Belgium

Recent developments in the wake of the globalization of sexualities can and should reorient sexual ethics. In this paper I argue that a sexual rights and health agenda, realized in and through global sexual activism and politics, should inform and be the basis of any globally viable sexual ethic.

I start with a review of some of the main issues and themes in contemporary sexual ethics. Next, I will document and evaluate, using Ritzer’s model of gl/robalization, the ethical significance of recent thinking and global activism on sexual rights and health. Following up on this I will show how this sexual rights and health agenda enables us to formulate and safeguard an emancipatory as well as pluralistic outlook on how ethically to deal with and think about global sexual issues and the diversity of sexual repertoires, identities, relationships, meanings, etc. Further development of the notions and formulations of sexual rights and health is called for - from tools for the prevention of harm, to levers and ideals for positive and emancipatory sexual empowerment. Recent thinking and developments concerning ‘global sexual citizenship’ can bolster these developments. I will also discuss some of the mechanisms (e.g., Benhabib’s ‘democratic iterations’ and Kurasawa’s notion of human rights as practices) that frame and canalize these ongoing processes.

I conclude with a SWOT analysis of the proposed model, reviewing issues like universalism, (ethical) imperialism, traditionalism, religion and culture.

oral presentations 08

sexual orientation

OP .08.01 A CROSS-CULTURAL STUDY OF BOTH POSITIVE AND NEGATIVE ASPECTS OF BEING NON-HETEROSEXUAL

J. Strizzi, I. Fernández Agis, T. Parrón Careño, R. Alarcón Rodríguez

University of Almería, Department of Neuroscience and Health Science, Almería, Spain

Objective: The final aim is cross-cultural study on the positive and negative aspects of being gay, lesbian and bisexual in the United States and Spain. The authors seek to repudiate the tendency to study non-heterosexual sexual orientations from a marked pathological viewpoint and create a method which more adequately represents GLB experiences.

Design and Method: 10 scales were selected, all validated in English by other authors. Those not previously validated in Spanish were translated and in validation process at the time of abstract submission. Positive aspects are operationally defined as social support, self-esteem, social activism/justice, and sexual satisfaction. Negative aspects are defined as: violence, social stigma, homo/bi negativity, and depression (measured through subjective happiness).

Results: The negative psychological sequelae due to social stigma and victimisation have been well document within US populations. As the GLB movements of two countries have had differing trajectories (gai vs gay) and currently have disparate legislative same-sex marriage statuses. Furthermore, adversive therapies are not used in Spain as they are in the US. The authors hypothesise that place of residence (state in USA or gay ghetto in Spain) will be a key variable.

Conclusions: While there claiming a causal relationship is imprudent, if the data show important differences between US and Spanish populations, it could be interpreted that the legal recognition of GLB couples in Spain has positive psychological influences.

OP .08.02 THE POSITIVE ASPECTS OF BEING GAY, LESBIAN OR BISEXUAL

J. Strizzi, R. Alarcón Rodríguez, T. Parrón Careño, I. Fernández Agis

University of Almería, Department of Neuroscience and Health Science, Almería, Spain

Objective: An alarming quantity of academic literature has studied sexual orientation from a negative or pathological point of view, fuelling detrimental stereotypes. The goal of this study was to develop a questionnaire and collect data about non-heterosexual sexual orientations based on a positive psychological view point to identify the positive aspects of being gay, lesbian or bisexual. Thus, provide data of positive experiences of non-heterosexual sexual orientation.

Design and Method: An online survey based on the findings of Riggle, Whitman, Olson, Rostosky and Strong’s 2008 qualitative study “Positive Aspects of Being Gay or Lesbian” was developed. There were 150 participants from various GLB associations in Spain.

Results: The results showed that more than 63% of the participants believe that there are positive aspects of being gay, lesbian or bisexual. While, 75,4% affirmed that being their sexual orientation is only part of who they are, therefore does not imply anything either positive or negative.

Conclusions: It was concluded the participants believe that living an “out” life is a political act, and by living their lives “out of the closet”, their lives reflect their socio-political ideals. After “coming out”, they reported enjoying a feeling of wellbeing due to the sincerity with one’s self, the ability to be his / herself, freedom to live a satisfactory and unique lifestyle, and honesty with one’s self.

OP .08.03 SEXUAL ORIENTATION MICROAGRESSIONS IN THE CLINICAL SETTING: THE EXPERIENCES OF LESBIAN, GAY AND BISSEXUAL CLIENTS IN PORTUGAL

C. Moleiro, A. Delgado, N. Pinto

Lisbon University Institute Iscte-lul, Psychology Department, Lisbon, Portugal

Recent literature has focused not only on overt discriminatory attitudes and behaviors towards Lesbian, Gay and Bisexual (LGB) persons, but also on more subtle forms of microaggressions in everyday life and their effects (Sue, 2010). Some researchers have highlighted that these microaggressions occur even in clinical settings, in particular in mental health practice (e.g. Sheldon & Delgado-Romero, 2011), recognizing that clinicians display uneven responsiveness to LGB clients and issues despite the increased visibility, training opportunities and affirmative- treatments available. These aggressions range from overt forms of discriminatory practices such as conversion therapy, to subtle and covert forms of heterosexism, oftentimes unconscious and unintentional, including microassaults, microinsults an microinvaliations (Sue, 2010). The present study uses a mixed qualitative and quantitative approach to identify and describe the experiences of microaggressions of LGB clients in Portugal. To be included in the study, participants (i) had to be 18 or over, (ii) identify as LGB and (iii) have had at least one session with a mental health professional such as a psychologist, psychotherapist, psychiatrist, sexologist, counselor, or marriage and family therapist. Recruitment was conducted in clinical and non-clinical settings, through LGBTQ community associations and networks. A web-based questionnaire was developed, with closed and open questions, and data was collected. Participants were asked the degree to which they had experienced a number of identified sexual orientation microaggressions, and also to describe a salient microaggression in clinical context and its effects. Results will be discussed in light of international literature, including implications for practice and training.

oral presentations 09

education, social sciences and theory of sexuality

OP.09.01 STORY OF A PASSION. 16 YEARS OF SEXUAL AFFECTIVE EDUCATION IN SCHOOLS IN LA BANEZA. LEON. SPAIN

S. Parrado Chamorro ¹, L. Alonso ¹, A. Parrado ², F. Calzado

^3,P. Garcia ¹, N. De La Fuente ³, J.C. Garcia ³, E. Chico ¹, N. Martinez ¹, M. Alvarez ⁴

¹ Sacyl, La Baneza, Spain, ² Ministerio Sanidad, Avila, Spain,

³Consejeria Educacion Leon, Leon, Spain,⁴ None, La Baneza, Spain

How did thIs passion arise? Because both parents and teachers felt that teenagers had aun urgent necessity about their sexual education.

Objectives: Providing some place and time to encourage the pupils and parents to live their affective and sexual life in a positive way.

Raising the pupils' awareness about their need to get certain knowledge, attitudes and behavior that help them lead a healthy private life.

Methods: It has been implemented through an active and participative methodology,

Taught by professionals from the Health Centre in collaboration with teachers.

There are 31 one-hour-long workshops of one hour over 9 years for children aged 8 to 17, with specific activities for the parents.

From the initial workshops and interpersonal approach, with games and group dynamics, to pregnancy prevention workshops and STDs, to those working the field of emotions, and the anatomical and physiological knowledge about sexuality.

Results: ad hoc satisfaction survey of students, parents and teachers

Ad hoc evaluation test based on previous studies validated on habits attitudes and knowledge acquired by students Complacency felt and perceived by the professionals who perform the workshops ... Story of a Passion.

Export program to other schools in the state and a twinned school in France Gennevilliers

Conclusions: Validity of sexual affective education as continuing education within the public schools of the city. Efficiency of the program because they have no costs. Simplicity and portability of the program.

OP.09.02 ROLE OF SEX EDUCATION IN CONSERVATIVE MUSLIM SOCIETY LIKE PAKISTAN WHERE MASTURBATION IS A TABOO AND MAIN CAUSE OF SEXUAL DYSFUNCTION

M. Nasim

Nasim Fertility Center, Lahore, Pakistan

Objective: This study is designed to elaborate the need for sex education in conservative Muslim society where masturbation is a taboo and considered to be the cause of different sexual dysfunctions, and it is not religiously allowed.

Introduction: Masturbation is a taboo and prohibited by Islam. There is wrong information in society by quaks and Hakims (unani medical parishioners) that masturbation destroys the sexual health and weakens the muscles if penis required for normal erection and sexual activity. Due to this masturbation is most important cause (as perceived by patient) of sexual dysfunction in conservative Muslim society like Pakistan. Large proportion of sexual dysfunction can be prevented by right sex education on masturbation.

Material and Methods: Patients of sexual dysfunctions were treated at Nasim fertility center, Lahore, Islamabad,

& Faisalabad. The patients suffering from early ejaculation impotence and giant were 54%, 32% and 10% respectively. All the patients attributed masturbation as the cause of dysfunction. Scientist explanation oof masturbation and sex organs and sexual response cycle in humans removed the preconceived idea of masturbation as cause of sexual dysfunction.

Conclusion: Guilt feeling to masturbation due to Islamic restrictions and wrong information by quacks and hakims that masturbation destroys the sexual health and muscles of penis leads to sexual neurosis and is underlying major cause of common sexual dysfunction. By providing sex education on masturbation much of sexual dysfunction can be prevented in conservative Muslim society like Pakistan.

OP.09.03 SEXUAL DOUBLE STANDARD IN A PORTUGUESE MASCULINE SAMPLE: A TRANSGENERATIONAL POINT OF VIEW

N. Marques, R. Xavier Vieira

Faculty of Medicine, Lisbon, Portugal

The purpose of this study was to analyze the evolution of the sexual double standard and its relations with sexual satisfaction into the Portuguese context. To do so, two different age heterosexual male samples were compared: group 1(N=132,X=23.9±2.4 , ranging 20-30 years) and group2 (N= 130,X=46.3±3.1, ranging 40-50 years), considering the possibility of a certain transgenerational effect in transmitting sexual standards. In this study, the Questionnaire for the Evaluation of the Sexual Double Standard (QADPS) and the Index of Sexual Satisfaction (ISS) were applied to 262 males living in Lisbon area. Results show that sexual satisfaction is not correlated with the personal acceptance of the sexual double standard, and that we are in a time of transition concerning the latter: we are abandoning the sexual double standard in order to establish a more igualitarian one. However, this transition has not been made on an effortless way: although both groups recognize the social pervasiveness of the sexual double standard, younger men are more attached to the sexual double standard, when compared to older ones (t=2.04,p.05). Such results can be seen a possible resultant of a certain masculine fear about women’s emancipation, and the need of a social adequateness from man, according to what is socially expected from them. In the end, some suggestions are made considering the results. However, in order to understand more accurately the extension of these phenomena, further studies are needed to better understand them.

0P.09.04

SEXUALITIES: DESIRE, REPRESENTATIONS AND REALITIES. AN APPROACH TO SEXUALITIES IN THE CONTEXT OF HUMAN RIGHTS FROM A GENDER AND SOCIOLOGICAL POINT OF VIEW

D. Mieville Manni

Mekare, Gender&Enviromental Solutions, Madrid, Spain

In our changing times, spearheaded by social vertigo, a person is forced to de-construct and then reconstruct themselves over and over. It’s therefore essential to ask ourselves how sexualities fit in our daily lives and how we live them out. Existential vertigo in it’s most intimate manifestation: sexuality and sexualities.

I propose a micro/macro approach to sexualities, to see how and if existing texts, studies and rights coincide with reality in order to contribute to our professional practice in a more comprehensive and less theoretical way. To achieve this, I propose a three-part analysis:

A-Corporeal Symbology: A brief analysis of desire (female desire in particular) represented in film and social discourse. Female desire as a response to male desire. Male desire as mandatory. Representations are performatives, that is to say they take precedence over personal experience creating a preconceived idea of what one should desire, what is in fact desirable and what isn’t.

B-The sexual body as a ‘body of rights’ and a ‘rightful body’. Difference between legal equality and actual actuality.

C-Why sexuality continues to be ‘a problem’ and the emerging problems of sexuality and sexualities. Autonomy, independence, identity and sense of belonging are some of the key points to be analysed.

The aim is to apply a macro-social and micro social approach to understanding and pursuit of well-being. To discover whether it is possible a single autopoiesis within social realities.

Key words: Gender, Sexology, Feminism, Cooperation, Human Rights, Diversity.

ATTITUDES TOWARDS SEX AND SEXUALITY AMONG ROMANIAN WOMEN-AN EXPLORATORY STUDY

R. Florea ¹, B. Radu ², O. Rus ³

¹University of Medicine and Pharmacy, Cluj-Napoca, Romania,

²Babes-Bolyai University, Cluj-Napoca, Romania, ³ Emergency Hospital for Children, Cluj-Napoca, Romania

In this paper, we aim to unravel the intricate ways in which women in Romania conceptualize, evaluate and approach their sexuality. This is the first kind of research on how women conceptualize sexual freedom carried out in Romania, a post communist country with a traumatizing history of state regulated sexual and reproductive policies. After 1989 abortion became legal, and women in Romania re-established possession over their own bodies. More than twenty years after the end of communism, we investigate how women in Romania perceived and evaluate sexual freedom and the behavioral consequences deriving from it.

More specifically, we explore whether different measures of socioeconomic status influence conceptualizations and perceptions of sexual freedom. We collected primary data reflecting the views of several hundred women in Romania resulting in a representative sample. Through univariate and multivariate analysis we analyze quantitative individual data that allow us to relate variables measuring attitudes towards sexual freedom and core beliefs on sexuality with socioeconomic indicators. The main objective is to be able to ascertain how different social and economic status measurements and broad beliefs on society, religion and politics influence one’s view of her own sexual identity, liberties and practices.

0P.09.06

RAPE IN FEMALE EROTIC IMAGINARY. LOOKING FOR A COMPREHENSIVE APPROACH

A. García Mañas

Universidad Complutense de Madrid, Madrid, Spain

Nowadays we find a lot of different approaches which try to explain feminine rape fantasies. Most of them assume blaming- or-victimizing attitudes towards women who enjoy these erotic imaginary: on the one hand we find theories which assert that women secretly want to be raped, on the other; some authors claim women are just internalizing a male-domination system that oppresses them. This way, rape fantasies are always considered as a shameful (conscious or unconscious) desire or as a pathology symptom, but since it is a specific feminine experience, it is disregarded by science, its inner value hardly ever been taken into account.

I aim at a critical review of the subject, analyzing both intervention therapy and educational programs derived from each theoretical frame. With this information, I intend to offer a theoretical/practical proposal from the sexological perspective, including a more comprehensive approach to the experience.

oral presentations 12

sexual dysfunctions 2 and sexual medicine

0P.12.01 CLINICAL STUDY OF TESTOSTERONE GEL AS ADJUNCTIVE THERAPY TO TADALAFIL IN HYPOGONADAL MEN WITH ERECTILE DYSFUNCTION

S. Hakobyan

Yerevan State Medical University, Dept, of Sexology,, Yerevan, Armenia

Purpose: We compare the efficacy of testosterone gel (T-gel) versus placebo as adjunctive therapy to tadalafil in hypogonadal men with erectile dysfunction who do not respond to tadalafil alone. We have recently shown that, in men with erectile dysfunction (ED), free testosterone (FT) directly correlates with penile arterial inflow. Laboratory experiments indicate that the nitric oxide erectile pathway is testosterone-dependent. In humans, testosterone therapy improves erectile function in men with hypogonadism. However, the efficacy of testosterone monotherapy may not be adequate because of the multifactorial nature of the pathophysiology of ED.

Materials and Methods: A randomized, placebo controlled, double-blind, parallel group, multicenter study was performed. All patients with arteriogenic ED as evaluated by dynamic colour duplex ultrasound (D-CDU) studies, normal sexual desire but testosterone (T) and FT in the lower quartile of normal range (low-normal), not responding to tadalafil treatment (10mg) on six consecutive attempts.

Measurements: All patients had D-CDU, hormonal [LH, prostate-specific antigen (PSA), total and free testosterone, sex hormone-binding protein (SHBG), oestradiol], biochemical [haematocrit, low-density lipoprotein (LDL) and HDL cholesterol, triglycerides], and sexual evaluations [International Index of Erectile Function (IIEF)] before and after 1 month of therapy with transdermal testosterone (5 mg/day, n = 10) or placebo along with tadalafil treatment on demand. A total of 75 hypogonadal men (18 to 80 years old, morning serum total testosterone 400 ng/dl or less) with confirmed lack of response to tadalafil monotherapy were randomized (1:1) to receive a daily dose of 1% T-gel or 5 gm placebo gel as adjunctive therapy to 10 mg tadalafil during a 12-week period. Subjects were evaluated for sexual function, primarily based on the International Index of Erectile Function (IIEF), quality of life and serum testosterone levels at baseline and weeks 4, 8 and 12. Results: Testosterone treated subjects had greater improvement in erectile function compared to those who received placebo, reaching statistical significance at week 4 (4.4 vs 2.1, p =

0. 029, 95.1% CI 0.3, 4.7). T-gel significantly (p < or =0.004) increased total and free testosterone levels throughout the study, although no significant correlations were made between testosterone levels and the IIEF at end point. In addition testosterone administration induced a significant increase in arterial inflow to cavernous arteries measured by D-CDU (32 +/- 3.6 vs. 25.2 +/- 4 cm/s, P < 0.05), with no adverse effects. Conclusions: In patients with arteriogenic ED and low-normal androgen levels, short-term testosterone administration increases T and FT levels and improves the erectile response to tadalafil likely by increasing arterial inflow to the penis during sexual stimulation. The combination of testosterone plus PDE5 inhibitors may be considered for the treatment of ED in men with low to low-normal testosterone levels, who had inadequate response to prior treatment with PDE5 inhibitors alone. So, in hypogonadal patients with ED, androgen supplementation is first-line therapy

OP.12.02 ALEXITHYMIA AND DELAYED EJACULATION: PRELIMINARY RESULTS

S. Eleuteri ¹, P.M. Michetti ², M. Giuliani ³, R. Rossi ³,

C. Leonardo ², G. Franco ², C. De Dominicis ², C. Simonelli ¹

¹ Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy,² Urology Department, Sapienza University of Rome, Rome, Italy,,³ Institute of Clinical Sexology,, Rome, Rome, Italy

Objectives: Alexithymia construct characterizes individuals who have difficulty in identifying or reporting their specific emotions. Researchers have found high or moderate alexithymia levels in men with Erectile Dysfunction (ED) and Premature Ejaculation (PE). The goal of this study was to investigate the presence of alexithymia in men with Delayed Ejaculation (DE), comparing such results with data found from other Male Sexual Dysfunctions (MSD).

Design and Methods: 48 patients with DE, age range 20-63, were administered Toronto Alexithymia Scale (TAS-20) and an ad hoc questionnaire to evaluate clinical features of the symptom.

Results: 10.4% of patients could be categorized as alexithymics, 6.3% of them as bordeline, while 83.3% of the sample were found to be non-alexithymic. The overall average score of TAS- 20 was 45.33. Preliminary results show that alexithymia is not correlated with DE, differently from other MSD, where this condition was found in more than 40% of patients. Conclusions: Presented data seem to suggest that DE, not being correlated to alexithymia construct, is related to other psychogenic features such as hyper-control configuration. No difficulty in identifying and communicating emotions in our sample is probably connected to the greater social acceptance of DE than PE and ED. As the symptom doesn’t affect the core male identity, cultural approval may be considered as an important protective factor from creating or exacerbating high levels of alexithymia. These results suggest to carry out more researches on this aspect, in order to identify possible specific implications and ameliorate the standard clinical practice of the DE.

PENILE REAUGMENTATION SURGERY USING BOVINE PERICARDIUM COLLAGEN IMPLANT

J. Kim

Phiiip and Paul Medical Institute, Department of Plastic Surgery, Seoul, South Korea

Objective: Recently, penile augmentation surgery has been performed in cases where the patient suffers from psychological and sexual complexes caused by his small penis. However, in some cases when the patient has a higher expectation, secondary reaugmentation may be necessary. This study reports on the use of a xenograft material in reaugmentation surgery

Methods: For the xenogenic implant, type I collagen extracted from bovine pericardium. Through a transverse incision of 4 - 6 cm at the distal penis, girth enhancement was performed. After separating the existing grafted area from the Buck’s fascia and obtained a widened space to the prepubic junction.

Results: Penile reaugmentation procedures performed between July 2005 and July 2009. This study included 67 patients with the following first augmentation surgery in the past: autologous dermal fat graft(43.3 %); silicon injection(26.9 %); xenograft such as bovine collagen(13.4 %); autologous fat graft(7.5 %); allograft(4.5 %); hyaluronic acid injection(3.0 %); restorative scaffold(poly lactic-co-glycolic acid) insertion(1.5 %). The diameter of the penis had increased by 5.6 ± 1.2 mm after surgery. Active treatment was required in 2 cases(3 %): removal of the graft because of infection.

Conclusions: Penile reaugmentation surgery with xenogenic type I collagen has the advantages of being a simple surgical procedure and fewer complications. For the patient group that received penile augmentation surgery with diverse materials in the past, The use of xenogenic type I collagen in this procedure also demonstrated a effective profile.

OP.12.04 SEXUAL SATISFACTION IN PATIENTS WITH PEYRONIE’S DISEASE

F. Tripodi ¹, R. Rossi ¹, S. Sansalone ², P.M. Michetti ³, D. Tienforti ⁴, G. Gambino ¹, C. Silvaggi ¹, V. Rossi ¹, C. Simonelli ⁵

¹ Institute of Clinical Sexology, Rome, Italy, ² Department of Urology, School of Medicine Tor Vergata University of Rome, Rome, Italy,

³Department of Urology, Sapienza University of Rome, Rome, Italy,

⁴Urologic Surgery,, Catholic University Medical School, Rome, Italy,

⁵Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy

Objective: to analyze factors related to sexual satisfaction measured through frequency and quality of intercourse in patients affected by Peyronie’s Disease (PD).

Design and Methods: 85 patients diagnosed with PD, without prior pharmacological, physical or surgical therapy, were recruited. They were administered a self-report questionnaire about their socio-demographic data, medical history and sexual satisfaction, the Visual Analogic Scale (VAS) to assess pain presence and severity, the International Index of Erectile Function (IIEF-15), and the General Health Questionnaire 12- item reduced version (GHQ-12) to investigate their level of psychological distress.

Results: 80 patients completed the questionnaires. Mean age was 53 (range 27-72) and mean duration of symptoms 18 months (range 1-72). All patients showed normal GHQ values, 46 patients (57.5%) had erectile dysfunction (IIEF<25), while orgasm, desire, satisfaction during intercourse and overall satisfaction dysfunctions were reported by 46 (57.5%), 64 (80%), 78 (97.5%), and 66 (82.5%) patients respectively. Frequency, quality of relationships and perceived partner’s satisfaction did not statistically correlate significantly with GHQ scores, VAS values and disease duration. IIEF and overall satisfaction values strongly correlated with higher frequency and better quality of sexual intercourse as well as with higher perceived partner’s satisfaction (<0.001).

Conclusions: Our study showed that PD has a deeply negative impact on overall sexual satisfaction and relational areas of men affected. In these patients the presence of associated erectile dysfunction seems to be the most important factor affecting frequency and quality of sexual activity, as well as perceived partner’s satisfaction.

OP.12.05 TREATMENT OF MALE SEXUAL DYSFUNCTION: A SYSTEMATIC REVIEW

H. Aars ¹, E. Almas ², K.G. Brurberg ³, W. Fjeld ⁴, W. Haaland ⁴, K.A. Hammerstram ³, K.O. Svendsen ³, D. Sorensen ⁴, L.M. Reinar ³, B. Landmark ³

¹1nstitute of Clinical Sexology and Therapy, Oslo, Norway,² University of Agder, Grimstad, Norway,³ Norwegian Knowledge Centre for the Health Services, Oslo, Norway,⁴ Gj0vik University College, Gj0vik, Norway

The Norwegian Knowledge Centre for the Health Sciences has produced a systematic review of the literature. An extensive, systematic search yielded 2805 unique titles of which 320 articles were retrieved in full text. There were no language restrictions. Pharmaceutical, surgical and technical aids were not included. We have summarized results from nine systematic reviews and 33 randomized, controlled trials, of which one review and four RCTs evaluated the effects of sexological interventions in men. No studies on desire, delayed ejaculation, orgastic dysfunction or pain problems in men met the inclusion criteria. Despite male sexual dysfunction being fairly common, men have been reluctant to seek help. The advent of PDE5-inhibitors (sildenafil) improved this situation. There is some documentation on group therapies, while clinical experience in Norway has mostly faced individual therapies. Treatment effects are shown for overall effects and by treatment modality. Our results will be presented compared to other published reviews, and single studies We also found one systematic review and seven RCTs on the treatment effects on sexual problems for men after chronic disease. Five RCTs were on treatment for dysfunctions after cancer of the prostate or testicles, and two studies were on therapy effects after heart attack or spinal chord injury. We found no controlled studies or previous reviews on sexual dysfunctions among gay men or gender identity orders or on sexual dysfunction among males having suffered previous sexual abuse. Results, sexual response models and metaanalysis will be presented in the light of a lifetime of clinical experience.

0P.12.06 IS TRANSURETHRAL RESECTION OF PROSTATE AMONG PATIENTS WITH BENIGN PROSTATE HYPERPLASIA RISK FACTOR FOR ERECTILE DYSFUNCTION?

Z. Marshania

Enmedic Clinic, Faculty of Psychology of the Georgian National University, Tbilisi, Georgia

Objective: More prospective studies are needed to assess the impact of transurethral resection of prostate (TURP) in patients with benign prostate hyperplasia (BPH) on erectile function. Design and Method: 36 Georgian men from 51 up to 70 years of age were evaluated. TURP was performed in 24 cases of BPH. Erectile function and low urinary tract symptoms (LUTS) were assessed based on the international index of erectile function (IIEF-15) questionnaire and international prostate symptom score (I-PSS).

Results: Some characteristics of erectile function according to IIEF-15 (mean score in orgasmic function) after TURP was statistically significantly (P<0,05) less than before surgery as well as decrease of I-PSS scores was observed. We also indicated after TURP a statistically significant (P<0,05) decrease of other characteristic of erectile function (sexual desire) in patients with BPH in comparison to control group. It is our belief that erectile dysfunction (ED) after TURP was associated with severity of postoperative retrograde ejaculation (RE) so far as we observed postoperative RE in 58,3% of our cases. It was confirmed by results of comparison the IIEF-15 characteristic of patients with BPH pre and post-operatively as well as by comparison of erectile function of these patients with control group.

Conclusion: RE after TURP is linked to risk of ED among patients with BPH. ED always causes more negative impact on the quality of life than RE. Therefore in patients with BPH after TURP ED may be prevented by more careful preoperative psychological counseling concerning RE.

0P.12.07 SYNCHRONOUS TREATMENT OF LUTS AND DE WITH A EW NATURAL COMPOUND ALONE AND IN COMBINATION WITH ALPHA BLOCKERS

D. Prezioso, F. Iacono, E. Illiano, A. Ruffo

Department of Urology University Federico II, Naples, Italy

Objective: Benign prostatic hyperplasia (BPH) is a condition often associated with lower urinary tract symptoms (LUTS) and also sexual dysfunction(SD).LUTS,especially the bother symtoms have a negative impact on health-related quality of life. The aim of this study is to investigate the effectiveness of a new natural compound (Tradaprost®) in treating men with LUTS.

Design and Method: A double-blind study:84 patients (mean age of 52 years) presenting BPH( Qmax<10 ml/sec; PVR>50 ml;BOOI>40) and LUTS symptoms were enrolled. They were randomly separated in 2 groups A-B of 42 pts. To group A was administered once a day Tamsulosin 0.4 mg plus Tradaprost ® (Alga Ecklonia Bicyclis 80 mg ,Tribulus Terrestris 100 mg and D-Glucosamine 100 mg, Serenoa Repens 320 mg)while Group B received once a day Tamsulosin 0.4 mg for 3 months.Physical examination, uroflowmetry, urinary system ultrasonography and PVR, a self-administered IQoL, IPSS, IIEF questionnaires were evaluated at baseline and after 90 days of treatment Results: An improvement in symptom score, storage symptom score, Qmax ,PVR, voiding efficiency, IPSS , IQoL, questionnaire was observed in all patients, but a good therapeutic response with improved IIEF score and bother symptoms was observed in 62,7% of the patients in only group A.

Conclusions: Tradaprost® can be used to improve the male sexual function due its antioxidant, anti-aging action, and the bother symptoms due its anti-inflammatory action. Infact it neutralizes the action ROS,LPS,COx2,NFk-beta,reducing the concentrations of TNF-alpha ,MMP-1also.

0P.12.08 COGNITIVE-BEHAVIORAL INTERVENTION FOR RETARDED EJACULATION

D. Wattelman ¹²

¹ Beit Berl College, School of Education, Kfar Saba, Israel,² Rambam Healthcare Campus and Clalit Health Services - Center for Improved Sexual Function, Haifa, Israel

Objective: Success rates when treating Retarded Ejaculation (RE) are relatively low and in order to overcome therapeutic difficulties and increase success rates, it is highly important to create precise therapeutic protocols. The presentation will describe an integrative therapy aimed at increasing successful treatment outcomes.

Design and Method: Ten married clients with primary RE and no biological etiology underwent sex therapy at a private clinic in Tel Aviv, Israel. Clients participated in 15-18 sessions of 50 minutes each. Various techniques were utilized during the therapeutic process - anxiety reduction techniques, masturbation moratorium, changing hands while masturbating, sexual fantasy reconstruction and changing idiosyncratic masturbatory patterns. Participation of clients’ partners in the therapy process and home assignments was mandatory. Results: seven of the ten clients reported full recovery (the ability to ejaculate in the vagina during coitus). The three clients whose partners did not fully cooperate in the treatment process failed to resolve their RE. Most clients had difficulty implementing the sexual fantasy reconstruction.

Conclusions: Partner participation and cooperation constitute an essential condition for successful therapy. Therefore, it seems reasonable to make an extra effort in the intake process to ensure partner cooperation during the treatment. Implementing ‘sexual fantasy reconstruction’ does not appear to provide the anticipated benefits and may increase resistance not only to that technique but to the whole therapeutic process. Limitations of the work presented and future recommendations for research and therapy will be discussed.

OP.12.09 ERECTILE DISFUNCTION IN YOUNG PEOPLE

S. Frago Valls

Instituto Amaltea de Sexología, Zaragoza, España Introduction and Objectives: After an extensive professional experience in sexual counselling , I am prepared to present the professional body experts my most relevant conclusions on how to deal with the erectile dysfunction in young couples using the pharmacological therapy as a therapeutic strategy . The basic objective of the paper is to show the etiology / biographical /sociological key which explains the high frequency of ED with the young, as well as to present the way to move from pharmacological therapy to sexual therapy . Design and Method: The Annual Reports of the Sexology Counselling Service of the University of Zaragoza in the last 6 years show that the most common complaint among the university community are erectile dysfunctions in the relation aspect.

We will see the use of pharmacotherapy both as a resource and as a strategy in the framework of a non-organic etiology ED among young couples.

I will also comment on how the fact of using medicines to solve their erotic problem is experienced by the young couple and how to get the therapeutic adhesion.

Results and C onclusions: The results show the usefulness of pharmacotherapy as a way to break the persistent fact of “erectile failure” of non-organic etiology.

Pharmacologic therapy as a resource and sexual therapy as an objective make up the best strategic design with this kind of young patients.

OP.12.10 SEXUALITY AFTER PROSTATE CARCINOMA: A MAN OR COUPLE ISSUE?

C. Silvaggi ¹², F. Tripodi ¹, C. Simonelli ³

¹1nstitute of Clinical Sexology, Rome, Italy,,² University Tor Vergata, Rome, Italy,,³ University Sapienza, Rome, Italy

Objective: SD especially ED, following prostate cancer, is a common complication. ED, which affects 33-98% of men diagnosed with prostate cancer is a frequently compromised aspect of patient quality of life .The goal of this work is to compare results and to highlight the implication for sexological treatment. The Authors will comment results in the light of their own clinical experience.

Design and Method: Review of articles on this subject published in the Medline (PubMed) database, selected according to their scientific relevance.

Results: A number of effective treatments have been developed for ED. Despite a high success rate of these treatments, evidence indicates that many men do not continue to utilize these treatments; one explanation for this drop-off is that the treatment for ED does not lead to resumption of satisfactory sexual relations for all couples. It was shown that the intimacy and affection between the partners are the most important predictors of sexual satisfaction.

Studies suggest that successful coping efforts often occur within the context of the relationship and frequently include a process of adjusting one’s concept of sexual function and activity through shifting to thoughts and behaviours that based on intimacy and sexual activities other than intercourse. Conclusion: sexual functioning can be much improved by adequate couple’s counselling and intervention. An integrative approach is recommended

OP.12.11 CHRONIC PAIN AND EROTICISM IN THE COUPLE

S. Frago Valls

Instituto Amaltea de Sexología, Zaragoza, España

Introduction and Objectives: The sexuality of people with chronic pain is a reality, rather frequently ignored. In this presentation we try to take it back to the place where it should be, which is the same game place as in the rest of sexualities. The basic objective of the communication/ paper is to make a professional journey from Sexual Medicine and Sexology to the Pain Unit and reconcile and administer the triangle Pain - Pleasure - Love

Go and seek the erotic visibility of people who coexist with chronic pain.

Design and Method: The clinical experience of the Sexual Medicine Service in Amaltea Institute shows that the person suffering from chronic pain shows different erotical and relation difficulties which come from the actual painful process and the pharmacological iatrogenesis.

I will present the erotic features of the people suffering from chronic pain.

Apart from that, I will comment on how the partner living with the person who suffers from chronic pain copes with the the erotic detriment of his /her partner.

Results and Conclusions: The results show the usefulness of the sexual and couple therapy as a way to break the persistent way of sexual dysfunction and, as a result, to make the couple’s erotic life more dynamic.

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basic research

PD.01.01 SEXUAL ADDICTION QUESTIONNAIRE (SAQ). VALIDATION PROOFS: CONFIRM AND EXPLORATION OF THE SEXUAL ADDICTION CONSTRUCT

F. Quattrini ¹, M. Spaccarotella ², R. Sarracino ², F. Palpini ², R.S. Calabro ³

¹ Department of Biomedical Sciences, Chieti, Italy,² Italian Institute of Scientific Sexology, Rome, Italy,³IRCSS Neurolesi, Messina, Italy

Objective: Following the preliminary data presented to the World Congress for Sexual Health (Goteborg 2009); we were aimed to continue the SAQ validation proofs in a wider sample. To verify the questionnaire’ utility as a clinical- diagnostic support, we wanted to give the SAQ a higher level of validity, with regard to the Sexual Addiction construct. Method: Using the online version of SAQ, which was available at the Italian Institute of Scientific Sexology’s website from January 2010 to December 2012, 1000 subjects entered the study. However, because of missing data, only 714 subjects (Male 56% and Female 44%; average age M 33.3 sd 10; F 26,5 sd 7) were included in the statistical analysis. In particular, data analysis was conducted using factorial analysis, and the extraction of principal components has been realized with VARIMAX rotation method.

Results: Eleven factors were found to underlie the Sexual Addiction construct. Each factor established what links exist among behaviors investigated by the 65 items of SAQ. Interestingly, four (30%) of these 11 factors were shown to play a key role, i.e. Control and Persistence, Centrality of Sex, Consequences and Craving. The other seven factors were useful to support interesting hypotheses for future investigations and possible structural changes of the SAQ. Conclusions: Our findings demonstrated that the main factors of this questionnaire may be pathognomonic of the sexual addiction construct. Nevertheless, further studies using comparative “gold standard” tests should be fostered in large clinical samples, in order to highly support the validity of this promising test.

PD.01.02 EVALUATION OF QUALITY OF LIFE AND SEXUAL SATISFACTION IN WOMEN SUFFERING FROM ENDOMETRIOSIS

V. Cosmi ¹, L. Pierleoni ¹, M. Giuliani ¹, R. Rossi ¹, A. Recine ¹, M. Pieroni ¹, C. Simonelli ²

¹Institute of Clinical Sexology, Rome, Italy, ² University Sapienza, Rome, Italy

Objective: Endometriosis is a chronic gynaecological disease that has had a growing rate over last years. It mainly affects

females during reproductive years and it is strongly associated with pelvic pain. The aim of the present study is to evaluate quality of life and sexual satisfaction in an Italian group of women affected by endometriosis.

Design and Method: 60 participants who had been diagnosed with endometriosis were recruited at the Endometriosis Outpatient Clinic at the Policlinico Agostino Gemelli of Rome from January to March 2012. The controls were 60 healthy women, matched for age and relational status. The WHOQOL- Bref and the Italian version of McCoy Female Sexuality Questionnaire (MFSQ) were administered to participants. Data were analyzed using SPSS 19.0 for Windows.

Results: Clinical group (EG) had lower score than control group (CG) both in MFSQ (sexuality and relationship domains) and WHOQOL areas (physical, psychological and social relationship domains). Instead of that, environmental factor seems do not influence women perception of their quality of life. 68.4% of the EG reported pain in more than half of their sexual intercourse, versus 13.6% of the CG.

Conclusions: Results indicate that women with endometriosis perceived lower level in quality of life and sexuality than healthy ones. Our data seem to underline that pain is one of major patients concerns; its effect on quality of life is more important than endometriosis per se.

PD.01.03 REQUEST ASSISTANCE OF THE IMMIGRANT POPULATION IN SEXUAL HEALTH AND GENDER

F. Hurtado Murillo ¹, F. Donat Colomer ¹, R. Pellicer Faro ¹, A. Royo Martinez ¹, M. Alcaraz Quevedo ², J. Cantero Llorca ³

¹Centerfor Sexual and Reproductive Health Fuente San Luis. Hospital Department Dr. Peset. Agencia Valenciana de Salud, Valencia, Spain,

²Directorate of Public Health, Valencia, Spain, ³ Directorate of Primary Care. Hospital Department Dr. Peset. Agencia Valenciana de Salud, Valencia, Spain

Objective: Determine the demand for care in sexual health and sexual habits of the immigrant population and whether there are differences with the autochthonous population and between sexes.

Design: Observational study, cross-sectional analytical components.

Method: Audit of 829 medical records of users of different origin, which in 2008 requested assistance at the Center for Sexual and Reproductive Health (CSSR). Study variables: origin, age, sex, reason for consultation and sexual habits. Descriptive analysis was performed and the differences by chi-square for qualitative variables and Student’s t in quantitative.

Results: The mean age of coital onset is 17.92 years. There are differences in sexual desire by origin (X2=32.688; p=0.000), more normal rate of immigrants. Men have more sexual desire (80.3%) than women (57.1%). The differences in sexual satisfaction, by origin are minimal and not significant, they are significant gender (X2=1.358; p=0.000), women report higher rates than men (76.2% vs. 41.6%). Demand for health care there are differences according to origin and with a higher rate for autochthonous the two main reasons (X2=49.868; p=0.000): sexual dysfunction and transsexuality. Between sexes, the differences are significant (X2=4.219; p=0.000), highlighting the demand for sexual dysfunction in men accounted for 75.8% and females 40%

Conclusions: The first cause of consultation for Spanish was the sexual arousal disorder, premature ejaculation for immigrants. Men outnumber women in arousal disorder. Women outnumber men in inhibited sexual desire and orgasmic dysfunction.

PD.01.04 SEXUAL DYSFUNCTION IN PARKINSON’S DISEASE: FACTS OR FANCIES?

V. Raoli ¹, R. Ferrucci ², F. Cogiamanian ³, P. Barone ⁴, L. Bertolasi ⁵, A. Padovani ⁶, M. Panzeri ⁷, L. Ronconi ⁷, M. Ciocca ⁸, A. Priori ⁸

¹ Fondazione IRCSS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy,² Fondazione IRCSS Ca’ Granda - Universita degli Studi di Milano, Milan, Italy ³ U.O. di Neurofisiopatologia - Fondazione IRCSS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy,

⁴Dipartimento di Medicina e Chirurgia - Universita degli Studi di Salerno, Salerno, Italy,⁵ Unita di Neurologia - Azienda Ospedaliera Universitaria di Verona, Verona, Italy, ⁶ Dipartimento di Scienze Mediche e Chirurgiche - Universita degli Studi di Brescia, Brescia, Italy,⁷ Dipartimento di Psicologia - Universita degli Studi di Padova, Padua, Italy, ⁸ Fondazione IRCSS Ca’ Granda Ospedale Maggiore Policlinico - Universita degli Studi di Milano, Milan, Italy

Objective: To assess sexual dysfunction (SD) in Parkinson’ s disease (PD).

Methods: 121 patients with idiopathic PD and 123 controls were recruited from four Italian Movement Disorders Clinics. To assess sexual function in PD we used the Brief Index of Sexual Functioning, the International Index of Erectile Function (IIEF) and the Female Sexual Function Index (FSFI). Also Beck Depression Inventory (BDI).was assessed.

Results: Scales of sexual function did not significantly differ between the two groups.

BDI score in PD patients was significantly higher than in controls.

Regarding the interaction of drug therapy, only MAOI-B appeared to increase sexuality both in male (IIEF: MAOI-B: 54.7Ä±14.0, without MAOI-B 39.4Ä±20.3, p<0.05) and female patients (BISF-W: MAOI-B: 20.9Ä±12.60, without MAOI-B 9.2Ä±11.3, p<0.05).

Discussion: Though considered a non motor symptom in PD, our study overall fails to detect SD in patients. Previous studies, concluding for the presence of SD in PD, differ from the present for evaluation scales, types of patients, sample size and, therefore, are difficult to be compared. Despite patients have overall normal scores, within the PD group there is a correlation between sexual function and specific classes of drugs. Drug effects on sexual function could therefore lead to an underevaluation of SD and partly explain the difference between this research and the previous studies.

Conclusion: Sexual function is comparable in patients with PD and in controls subjects. Nonetheless specific antiparkinsonian drug classes could positively influence sexual function in PD patients, thus leading to an undervaluation of SD in PD.

PD.01.05 EVOLUTION IN THE FIRST COITAL INTERCOURSE

E. Sueiro Dominguez ¹², A. Lopez ¹², J.L. Dieguez ¹²

¹ Faculty of Science of Education - Vigo University, Ourense, Spain,² C.o.f. “Novoa Santos" (Sergas-Ourense), Ourense, Spain

Objective: To know about how the first coital intercourse have changed in recent years.

Material And Method: A cross descriptive study on students of the first and last year of all degrees from Vigo University (Ourense), in 97-98 (5594) and 2007-08 (2284). They all answered a structured survey designed to check their age and identity variables related to their first coitus.

The data were analyzed with the SPSS.

Results: The average age of the student body in 1997-1998 is 20,71 years old, in 2007-2008 is 21,13. The 59,2% and the 61,6% of the first and last course, respectively, are women. We found significant differences (p<.05) between the student in 97-98 and 07-08 in the percentage of people with different sexual practices, the age of beginning, and several variables related to the 1th coitus.

Conclusions: These results make it necessary to design interventions seeking for the prevention and reduction of the risks associated with the sexual practices before such behaviours take place and/or once they have taken place.

PD.01.06 EVOLUTION OF THE LAST COITAL INTERCOURSE

E. Sueiro Dominguez ¹², A. Lopez ¹², J.L. Dieguez ¹²

¹ Faculty of Sciences of The Education - Vigo University, Ourense, Spain,² C.o.f. “Novoa Santos" (Sergas-ourense), Ourense, Spain

Objective: To know about the evolution the several variable related to the last coital intercourse.

Material and Method: A cross descriptive study on students of the first and last year of all degrees from Vigo University (7878), in 97-98 and 2007-08 courses. They all answered a structured survey designed to check identity variables of aged and related to their last coitus.

The data were analyzed with the SPSS.

Results: The average age of the student body in 1997-1998 is 20,71 years old, in 2007-2004 is 21,13. The 40,1% and the 37,6% of the first and last year, respectively, are men.

We found significant differences (p<.05) between the student in 97-98 and 07-08 in several variables related to the last coitus.

Conclusions: These results make it necessary to make Sexual Education since the first ages.

EVOLUTION OF SEVERAL SEXUAL BEHAVIORS IN UNIVERSITARY STUDENTS MEN AND THEIR AGE OF BEGINNING

E. Sueiro Dominguez ¹², A. Lopez ¹², J.L. Dieguez ¹²

¹ Faculty of Sciences of The Education - Vigo University, Ourense, Spain,² C.o.f. “Novoa Santos" (Sergas-Ourense), Ourense, Spain

Objective: To know about the changes in several sexual behaviors of the men and their of the beginning.

Material and Method: A cross descriptive study on men students of the first and last year of all degrees from Vigo University (Ourense, Pontevedra and Vigo), in 97-98 (2197) and 2007-08 (824). They all answered a structured survey designed to check the age and the variables related to several sexual practices and their beginning age.

The data were analyzed with the SPSS.

Results: The average age of the student men in 1997-1998 is 20,85 years old and in 2007-2004 is the 21,42.

We found significant differences (p<.05) between the men student in 97-98 and 2007-08 in the percentage of people with different sexual practices and the age of beginning. Conclusions: These results make it necessary to design interventions since the first ages and since all educative agents.

EVOLUTION OF SEVERAL SEXUAL BEHAVIORS IN UNIVERSITARY STUDENTS WOMEN AND THEIR AGE OF BEGINNING

E. Sueiro Dominguez ¹², A. Lopez ¹², J.L. Dieguez ¹²

¹ Faculty of Sciences of The Education - Vigo University, Ourense, Spain,² C.o.f. “Novoa Santos" (Sergas-Ourense), Ourense, Spain

Objective: To know about the changes in several sexual behaviors of the women and their age of beginning.

Material and Method: A cross descriptive study on women students of the first and last year of all degrees from Vigo University (Ourense, Pontevedra and Vigo), in 97-98 (3223) and 2007-08 (1362). They all answered a structured survey designed to check the age and the variables related to several sexual practices and their beginning age.

The data were analyzed with the SPSS.

Results: The average age of the student women in 1997-1998 is 20,61 years old and in 2007-2004 is 20,96.

We found significant differences (p<.05) between the women student in 97-98 and 2007-08 in the percentage of people with different sexual practices and the age of beginning. Conclusions: These results make it necessary to design interventions seeking for the prevention and reduction of the risks associated with the sexual practices before such behaviour take place.

with hypersexual behavior are quite similar to that of drug addiction. They argued that sex ‘addicts’ can experience a psychological withdrawal as experienced by those addicted to drugs of abuse. Some proponents of sex addiction even advise a 12-step treatment program. Critics of sex addiction argue that increased sexual activity is a way of alleviating affective symptoms, or is reflective of the impulsivity, associated with concomitant Axis I or Axis II pathology. They postulate that treating the underlying psychiatric disorder would ameliorate hypersexual behavior.

Discussion: Despite standard, and even increasing use of the term ‘sex addiction’ in media and popular culture, mental health professionals remain divided in regards to this subject. The proposed inclusion and subsequent rejection of hypersexual disorder in DSM-V highlights this existing debate. The notion of hypersexual behavior as an addiction warrants further exploration, especially since how it is defined may dictate treatment modality.

PD.01.31 EFFECTIVENESS OF MANAGING STRATEGIES FOR ANTIDEPRESSANT-RELATED SEXUAL DYSFUNCTION.

THE SALSEX-II STUDY. INTERIM ANALYSIS

A.L. Montejo González ¹², S. Majadas ¹, J. De La Gándara ¹³, P. Álvarez Lobato ¹⁴, F. Alonso ¹⁵, R. Martínez ¹⁶, M.A. Albarrán ⁷, M.A. Espiñeira ⁸, L. Pacheco ⁹, S. Project Working Group

¹ Spanish Association of Sexuality and Mental Health (aesexsame), Salamanca, Spain,² University Hospital of Salamanca. University of Salamanca, Salamanca, Spain, ³ Service of Psychiatry. Complejo Asistencial de Burgos, Burgos, Spain,⁴ Mental Health Centre I Este, Valladolid, Spain, ⁵ Mental Health Of Benavente, Zamora, Spain, ⁶ Service of Psychiatry Hospital Virgen del Mirón, Soria, Spain,⁷ Mental Health Centre of Ventorrillo, A Coruña, Spain,⁸ Dep of Psychiatry - Universidad de Santiago de Compostela, Santiago de Compostela, Spain,⁹ Mental Health Center Bombero Echániz, Bilbao, Spain

Despite the high incidence and relevance of antidepressant- related sexual dysfunction (AD-SD), managing strategies in clinical practice haven been barely explored to date. Objective: To describe therapeutic interventions for AD-SD and their outcome in usual clinical practice.

Design and Method: Multicentric prospective naturalistic study. Patients in antidepressant treatment developing secondary SD were included. The AD-SD managing strategy selected by the clinician was recorded and a second follow-up visit was performed in the 2-6 months period post-baseline. The outcome variable was the mean change from baseline to endpoint in the global score of the Psychotropic Related Sexual Dysfunction Questionnaire (PR-Sex-DQ-SALSEX). Results: 251 out of 2000 patients recruited completed the follow-up visit to date and resulted eligible for the analysis. Mean length of follow-up period was 13.58 weeks (DT: 7.08). Antidepressant switching was the most frequent strategy reported (38.65%), followed by waiting for SD spontaneous remission (25.10%) and antidepressant dosage reduction (20.72%); 6.77% choose “weekend holidays”, 5.58% associated another antidepressant or a phosphodiesterase-5 inhibitor (PDE-5-I) and 3.19% discontinued the antidepressant. Agomelatine and bupropion were the antidepressants most frequently selected for the switching strategy. Changing the antidepressant or adding a new antidepressant or a PDE-5-I were selected in those patients with more severe SD when compared to waiting for SD spontaneous remission or dose reduction. According to the SALSEX score reduction after

2- 6 months, AD-switching and treatment discontinuation resulted the most effective strategies (p<0.01).

Conclusions: Given its high incidence and relevance, effective therapeutic strategies to manage antidepressant-related sexual dysfunction have been proved.

PD.01.32 FREQUENCY OF ANTIDEPRESSANTS-RELATED SEXUAL DYSFUNCTION. RESULTS FROM A MULTICENTRIC STUDY WITH 2163 PATIENTS IN SPAIN: THE SALSEX-I STUDY

A.L. Montejo González ¹², J. Calama ², S. Majadas ¹, D. Ciprian ², A.I. Hernández ², S.P. Working Group

¹ Spanish Association of Sexuality and Mental Health (AESEXSAME), Salamanca, Spain,² University Hospital of Salamanca, University of Salamanca, Salamanca, Spain

Study Objective: Evaluation of the prevalence and severity of sexual dysfunction (SD) in 2163 patients (876 males, 1202 females) following antidepressant treatment.

Design and Methods: Cross-sectional, multicentric, naturalistic study in different outpatient settings in Spain. Inclusion criteria: Adult patients following antidepressant treatment for at least 2 months, sexually active and without previous sexual dysfunction (SD). We used the validated Psychotropic-Related Sexual Dysfunction Questionnaire (PRSexDQ-Salsex) (a 5 item questionnaire evaluating the different domains of SD) and the severity Clinical Global Impression Scale.

Results: 79,2% of the patients experimented SD. Only 40,5% communicated SD spontaneously.

Risk of discontinuing treatment was showed by 17, 8% of patients with SD (showing bad to very bad tolerance of SD, measured with item 5 of PR-Sex-DQ). ISRS (69,75%) SNRIs (75,1%) and Clomipramine (76,20%) were associated to high rates of moderate to severe SD. Non serotonergic antidepressant (bupropion, agomelatine and mirtazapine) showed a much better profile compared with SSRI, SNRI and Clomipramine (p < 0,05 ). ODS ratio serotonergic versus non serotonergic drugs was = 6,17. There weren’t statistically significant gender differences. More depressed patients and older patients were more likely to present SD (p< 0,05). The statistical model showed that the treatment with serotonergic drug was related to SD appearance.

Conclusions: Near 20% of the patients were at risk of treatment withdrawal due to SD. This highlights the need of consideration by clinicians on the individual patient’s perception of sexual life and the profile of tolerability of each antidepressant before and after initiating any antidepressant treatment.

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sexual dysfunctions

PD.01.33 SEXUAL SELF-CONSCIOUSNESS IN A SAMPLE OF MEN AND WOMEN WITH AND WITHOUT SEXUAL DIFFICULTIES: AN EXPLORATORY STUDY

A. Quinta Gomes, P. Nobre

Aveiro University, Aveiro, Portugal

Objective: Sexual self-consciousness refers to the dispositional propensity for self-consciousness as experienced in sexual situations and it has been proposed as a vulnerability factor for the development and maintenance of sexual dysfunction (van Lankveld, Geijen, & Sykora, 2008). The aim of the present study was to explore gender differences in sexual self-consciousness in a sample of undergraduate Portuguese men and women.

Design and Method: 154 men and 164 women (M = 22 years; SD = 4.7) from a Portuguese University participated in this study. All the participants were informed about the purpose of the study and clarified about anonymity and confidentiality issues. Four groups were constituted according to men’s and women’s level of sexual function, using the cut-off points of the International Index of Erectile Function and the Female Sexual Function Index.

Results: A 2 (Gender: male vs. female) X 2 (Group: high sexual functioning vs. low sexual functioning) MANOVA indicated a significant gender effect for sexual self-focus with men reporting higher levels of self-focus than women during sexual activity (p < .001). A significant group effect was found for sexual embarrassment with individuals with low sexual functioning reporting higher levels of sexual embarrassment compared to individuals with higher sexual functioning (p < .001). No interaction effects were found.

Conclusions: Our findings suggest that men and women with or without sexual difficulties demonstrate different propensities for sexual self-consciousness during sexual activity.

PD.01.34 THE ROLE OF MINDFULNESS FACETS IN WOMEN’S SEXUAL PAIN

C. Oliveira, P. Nobre, S. Vilarinho

Universidade de Aveiro, Departamento de Educagao, Aveiro, Portugal

The aim of the present study was to evaluate the influence and predictive capacity of several mindfulness facets (paying attention, describing, non-judging) in women reporting sexual pain in comparison with women with chronic pain, sexual dysfunction, and sexually healthy women from general population. A total of 1129 women participated in this study: sexual pain group (N = 355), chronic pain group (N = 146), sexual dysfunction group (N = 105), and healthy control group (N = 523). Participants answered to a set of questionnaires online: MAAS (Brown & Ryan, 2003), FFMQ (Baer et al., 2006), FSFI (Rosen et al., 2000) and SF- MPQ (Melzack, 1987). Findings indicated that women with sexual pain, chronic pain, and sexual dysfunction present a significantly lower tendency to be attentive and aware of the present moment in daily life (p <.001) compared to women from the control group. More specifically, women with sexual pain presented lower scores on the describing facet (p <.001) than women from the chronic pain and control groups, and lower scores on the non-judging facet (p <.001) than women from the control group. The total of MAAS was a significant predictor of the pain intensity for the sexual pain group ( =-.24, p<05). Results supported the role played by the capacity to be mindful in the daily life in women with sexual pain and have several clinical and treatment implications.

PD.01.35 MALE SEXUAL FUNCTION AFTER ACUTE MYOCARDIAL INFARCTION TREATED WITH PERCUTANEOUS CORONARY ANGIOPLASTY

C. Golawski ¹, R. Kowalczyk ², E. Kostarska Srokosz ¹, J. Syska Suminska ¹, M. Janiszewski ¹, E. Wujek Krajewska ¹, M. Dluzniewski ¹

¹Medical University of Warsaw - Department of Cardiology, Hypertension and Internal Medicine, Warsaw, Poland,² Department of Sexology in Andrzej Frycz Modrzewski Cracow University, Cracow, Poland

Objective: In Poland approximately 140.000 patients/year are hospitalized due to acute myocardial infarction (AMI). The majority of them are treated with percutaneous coronary angioplasty (PCI), which enables rapid return to professional and social activity. Still not much is known about their sexual functioning. Thus the aim of this study was to determine changes in male sexual function after AMI treated with PCI. Design and Method: The study was prospective and were done in the Department of Cardiology, Hypertension and Internal Medicine in 2nd Faculty of Medicine of Medical University of Warsaw, Poland. For further analysis 60 patients aged 29 to 68 were enrolled. The study proceeded in two stages. First: during hospitalization for AMI, the second: 5-6 months after discharge. Demographic and clinical data was collected, concerning current medical history, lifestyle, smoking history, pharmacotherapy and participation in cardiological rehabilitation. For further analysis some laboratory results have also been selected, e.g. the serum levels of testosterone, estradiol, prolactin and left ventricular ejection fraction. To dermine changes in sexual functions two questionnaires were used: Changes in Sexual Functioning Questionnaire (CSFQ) and International Index of Erectile Function (IIEF).

Results: The mean score obtained in the CSFQ prior AMI was 50.08 points., and in the follow-up: 49.18 points, while in the IIEF respectively: 39.35 points and 41.57 points. Interesting results were found in the further analysis of sexual functions and clinical parameters.

Conclusions: In males treated for AMI with PCI sexual function vary depending on numerous parameters.

PD.01.36 DIFFERENCES ON GENITAL AND SUBJECTIVE AROUSAL BETWEEN MEN WITH AND WITHOUT SEXUAL DYSFUNCTION WHEN PRESENTED TO SEXUAL EXPLICIT FILMS

P. Laja, P. Nobre

Universidade de Aveiro, Aveiro, Portugal

Objective: Men with sexual dysfunction tend to respond with lower levels of sexual arousal (particularly subjective arousal) when exposed to erotica, compared to sexually healthy controls (Beck & Barlow, 1986). Cognitive distraction has been presented as a main explaining factor, but less is known about the content of the cognitions during exposure to erotica. The main goal was to investigate the role of cognitive schemas and automatic thoughts in explaining the differences on sexual response between men with and without sexual dysfunction during exposure to sexually explicit films.

Design and Methods: A total of 40 individuals (20 men without sexual dysfunction and 20 men with sexual dysfunction), were exposed to sexually explicit films. Genital arousal was assessed by indium gallium gauges (changes in penile circumference). All data were collected using a MP100 system (BIOPAC) with Acknowledge software. After each film, participants answered to a list of measures assessing subjective sexual arousal, affect (PANAS), cognitive schemas (QCSASC), and automatic thoughts (SMQ).

Results and Conclusions: We expect to find differences between the groups in their sexual response to erotica. Moreover, we also expect that negative cognitive schemas and automatic thoughts would be significant predictors of the differences between the clinical and control groups. Preliminary results will be presented in the summit.

PD.01.37 SOCIODEMOGRAPHIC AND CLINICAL CHARACTERISTICS OF 3381 SUBJECTS REFERRED TO A SEXUAL DYSFUNCTION CLINIC IN TURKEY

C. Incesu ¹, F. Simsek ², O. Ozdemir ³, E. Orhan ⁴, B. Goksan Yavuz ⁵

1 Acibadem University, Department of Psychiatry, Istanbul, Turkey,

2 Marmara University, Department of Urology, Istanbul, Turkey,

3 Pasabahce Hospital, Department of Psychiatry, Istanbul, Turkey,

4 Acibadem Hospital Bakirkoy, Department of Psychology Istanbul, Turkey, ⁵ Acibadem Hospital Maslak, Department of Psychiatry, Istanbul, Turkey

Objective: To determine socio-demographic and clinical characteristics of subjects referred to a multidisciplinary sexual dysfunction outpatient clinic in Turkey.

Method: This study which was conducted between January 2000 and December 2009 comprised of 3381 patients

who referred to the multidisciplinary sexual dysfunction clinic in Acibadem Health Institutions, Istanbul, Turkey. A standart data form was used to record socio-demographic characteristics and data such as diagnosis, treatments and results of all referrals. Any problem that was defined as a sexual dysfunction was diagnosed according to DSM-IV. Result: 66% (n=2208) of the participants were male and 34% were female (n=1139). Male subjects were significantly older than the female participants (37.65±11.08 vs 29.59±5.83). 77.6% of the subjects were married. The most common sexual dysfunctions in male subjects were erectile dysfunction (47.5%), premature ejaculation (30%) and hypoactive sexual desire disorder (7.4%). The most common sexual dysfunctions in female participants were vaginismus (60%), hypoactive sexual desire disorder (15%), dyspareunia (10.3%) and orgasmic dysfunction (6.7%). Hypoactive sexual desire disorder was significantly higher in female participants compared to male participants (15% vs 7.4%).

Conclusion: Erectile dysfunction was the most common disorder in male presenters and vaginismus was the most common dysfunction in female subjects. Various psychosocial and cultural factors such as perception of sexuality, lack of a formal sexual education and sexual experience in Turkey play role in the emergence of sexual problems.

PD.01.38 SECONDARY SEXUAL DYSFUNCTION AS A RESULT OF ANTIHYPERTENSIVE TREATMENT; AN OBSERVATIONAL AND MULTI-APPROACH EPIDEMILOGICAL STUDY

A.L. Montejo González ¹², G. Llorca Ramón ¹², B. Buch Vicente ¹², J.A. Martin Oterino ¹², L. García Ortiz ², E. Rodriguez ², S. Majadas ², M. Gómez Marcos ², M.A. Puente Del Rey ², Grupo Español de Trabajo ²

¹Universidad de Salamanca, Salamanca, Spain, ² Grupo Español de Trabajo Para el Estudio de Disfunción Sexual Secundaria a Antihipertensivos, Salamanca, Spain

Background: Hypertension is a relevant public health issue being one of the main cardiovascular risk factors. Available treatments lead to common adverse events deteriorating patient quality of life, adherence and effectiveness. Antihypertensive-related Sexual Dysfunction (SD) including arousal, desire and orgasm difficulties seems to be quite frequent although very often under reported. Objectives. 1) To evaluate frequency and severity of SD associated to each different antihypertensive in 89 patients treated in Spain. Methods and Design: an observational, naturalistic, transversal (cross-sectional) epidemiological study in patients suffering for chronic hypertension has been carried out. Inclusion criteria: males and females up to 18 years old showing an adequate sexual response prior to taking antihypertensive drugs after at least 2 months of treatment. Data was obtained throughout a structured interview and using the SALSEx questionnaire (Montejo et al 2000) evaluating sexual dysfunction after the beginning of the treatment (spontaneous communication, arousal, desire and orgasm difficulties.) Tolerability to SD and non compliance risk was also obtained with SALSEX .

Results: Majority of patients suffered for SD (72, 9%) mainly in those receiving ad-on treatment with diuretics. Spontaneous communication was low. Mono-therapy different from diuretics (mainly ARA II) reported fewer cases of sexual dysfunction in comparison with treatments combining diuretics.

Conclusions: Doctor should openly interview their patients about SD to avoid under estimation and quality of life deterioration. Some strategies should be investigated to cope with this frequent adverse event. Well-controlled studies with bigger samples are needed.

PD.01.39 ERECTILE DYSFUNCTION AND EDMS: RESULTS OF AN ITALIAN RESEARCH IN A PUBLIC HOSPITAL

G. Gambino ¹, V. Gentile ², C. Silvaggi ¹, F. Tripodi ¹, L. Pierleoni ¹, V. Cosmi ¹, M. Giuliani ¹, C. Simonelli ²

¹1nstitute of Clinical Sexology, Rome, ITALY,² Sapienza University, Rome, ITALY

Objective: Erectile Dysfunction (ED) is the most common sexual disorder that affects male intimacy and identity. The scientific community recognized the psychogenic factors role in symptom onset and maintenance, but most patients prefer a pharmacological solution as a first step of treatment rather than an extensive deeper testing evaluation. This study investigates the previous use of Erectile Dysfunction Medications (EDMs) among subjects that attend a public psycho-sexual counselling service. The aim is to verify the efficacy of an integrated approach in contrast to a medical/ pharmacological treatment only.

Design and Method: 119 subjects (age range 20-71, |j=39.22, sd=12.61), were recruited at Policlinico Umberto I, Gynaecologic-Obstetrics and Urologic Science Department between 2009-2011. Data were collected by a semi-structured interview including socio-demographic information, medical history, relationship and sexual-affective satisfaction, current sexual functioning, EDMs use.

Results: Data showed that more than 70% of the subjects is healthy (without organic and urological pathologies). About 80% of our sample have consulted a doctor before attending our psycho-sexological service and 35% of these have used at least one EDMs (Cialis®, Viagra® or Levitra®). Conclusions: The majority of men with ED have consulted a medical structure at first, hoping to receive a pharmacological solution for the symptom. Nevertheless, our results stress the only use of EDMs do not completely help male patient to walk over the dysfunction. Combined treatment for ED, considering both organic/pharmacological and psychological/sexological aspects, seems to be the right way to manage this kind of disease.

THE ROLE OF TRAIT-AFFECT, SEXUAL BELIEFS, AND AUTOMATIC THOUGHTS ON WOMEN’S SEXUAL PAIN

C. Oliveira, P. Nobre, S. Vilarinho

Universidade de Aveiro - Departamento de Educagao, Aveiro, Portugal

The aim of this study was to evaluate the role of trait affect, sexual beliefs, and automatic thoughts in women reporting sexual pain when compared with women reporting chronic pain, sexual dysfunction, and sexually healthy women from the general population. A total of 1129 women participated in this study: sexual pain group (N = 355), chronic pain group (N = 146), sexual dysfunction group (N = 105), and healthy control group (N = 523). Participants answered to a set of questionnaires online: the PANAS-X (Watson & Clark, 1994), SDBQ (Nobre & Pinto-Gouveia, 2000), SMQ (Nobre

& Pinto-Gouveia, 2002), FSFI (Rosen et al., 2000) and SF- MPQ (Melzack, 1987). Findings indicated that women with sexual pain and sexual dysfunction presented significantly more failure thoughts (p <.001) and lack of erotic thoughts (p <.001), when compared with women from the chronic pain and control groups. No significant differences were found regarding trait affect and sexual beliefs. Failure thoughts were also the best predictors of pain intensity in the sexual pain group ( =.30, p<001), while negative trait-affect was the most significant predictor in the chronic pain group ( =.56, p<001). Results supported the role played by negative automatic thoughts on sexual pain and other sexual dysfunctions in women. These findings have important clinical implications suggesting the need to address cognitions during the treatment process.

PD.01.41 PSYCHOSEXUALITY AND MULTIPLE SCLEROSIS: AN ITALIAN PRELIMINARY STUDY

J. Grisolaghi ¹, L. De Santi ², C. Stefanile ³, G. Digangi ⁴, P. Bramanti ⁴, R.S. Calabro ⁴

¹Faculty of Psychology - University of Florence, Florence, Italy,

²Department of Neurological, Neurosurgical and Behavioural Sciences, University ofSiena, Siena, Italy,³ Department of Psychology, University of Florence, Florence, Italy, ⁴ IRCSS Centro Neurolesi Bonino-Pulejo, Messina, Italy

Introduction: Sexual dysfunctions (SD) are very common in patients with a diagnosis of Multiple Sclerosis (MS). Indeed, MS can directly affect the neurophysiological process of psychosexual function. This study was aimed at investigating the prevalence of SD in a hospital cohort of MS patients compared to a control group.

Methods: All the subjects were asked to fill a proper questionnaire built to explore patient psychosexual life with regard to frequency and kind of sexual intercourse, kind of sexual dysfunction and couple relationship. The clinical group also completed a scale to measure the relation between sexuality and MS, and the Expanded Disability Status Scale (EDSS) to evaluate the physical disability.

Results: Preliminary results showed that the clinical population differs significantly from the control group. Sixty- nine % of the patients complained at least a SD, and in 22% the disorder was reported as frequent. Forty-two % of patients presented a reduced libido, the most frequent SD, in the year before the observation. Libido and self-esteem showed a significantly negative correlation with disability but not with the disease duration.

Conclusions: Our findings showed a high prevalence of SD in patients with MS, compared to our control group. The diagnosis of MS determines a psychological distress with an important reduction in self-esteem. Disability seems to restrict sexual behavior. Since preventive strategies are needed, it is necessary to increase the focus on psychosexual aspects when counselling MS patients.

PD.01.42

FEMALE SEXUAL DESIRE: THE ROLE OF PSYCHOSOCIAL FACTORS ON SPONTANEOUS VERSUS RESPONSIVE DESIRE

P. Nobre ¹, L. Junot Rocha ²

¹ Utad, Vila Real, Portugal,² Universidade de Aveiro, Aveiro, Portugal

Aim: The purpose of this study was to evaluate the role of psychosocial variables in women with difficulties in spontaneous versus responsive sexual desire: sexual beliefs, psychopathology, sexual functioning, dyadic adjustment and automatic thoughts during sexual activity.

Methods: A total of 107 women participated in the study, 34 women in the Control Group (without sexual problems), 43 in the Low Spontaneous Desire Group and 30 women in the Low Global Desire Group (Low Spontaneous and responsive Sexual Desire). The participants answered to different questionnaires: Sexual Dysfunction Inventory (SDI; Sbroco, 1992), Brief Symptom Inventory (BSI; Derogatis, 1982), Female Sexual Function Index (FSFI; Rosen et al., 2000), Dyadic Adjustment Scale (DAS; Spanier, 1976), Sexual Modes Questionnaire (QMS; Nobre & Pinto-Gouveia, 2003) and Sexual Dysfunctional Beliefs Questionnaire (QCSD; Nobre & Pinto-Gouveia, 2003).

Results: The results showed that women in the Low Global Desire Group exhibit significantly lower rates of dyadic adjustment and higher sexual dysfunctional beliefs regarding the body, age and sexual conservatism, compared to the Control and the Low Desire Spontaneous Group. Additionally, women in the Low Global Desire Group showed significantly higher levels of psychopathology, namely depression, paranoid ideation, anxiety, and hostility when compared to the Control Group. Finally, these women also presented with lower levels of sexual functioning and higher frequency of negative automatic thoughts during sexual activity when compared to the control and the low spontaneous desire group. Conclusions: These results suggest that women with low spontaneous sexual desire but without difficulties in responsive sexual desire are closer to women without sexual problems than to women with low global sexual desire, supporting the DSM-V proposal for the exclusion of this first group of women from the Sexual Interest/Arousal disorder.

PD.01.43

GENDER DIFFERENCES IN SEXUAL SELF-ESTEEM IN A SAMPLE OF UNDERGRADUATE STUDENTS WITH AND WITHOUT SEXUAL DIFFICULTIES

A. Quinta Gomes, P. Nobre

Aveiro University, Aveiro, Portugal

Objective: Sexual self-esteem is the tendency to evaluate positively one’s ability to relate sexually with a partner. The aim of the present study was to explore gender differences in sexual self-esteem in a sample of undergraduate Portuguese men and women with and without sexual difficulties.

Results: A 2 (Gender: male vs. female) X 2 (Group: high sexual functioning vs. low sexual functioning) MANOVA indicated a significant gender effect for sexual self-esteem with men reporting higher levels of sexual self-esteem than women (p < .01). A significant group effect was also found for sexual self-esteem with individuals with lower levels of sexual functioning reporting a poorer sexual self-esteem (p < .001). No interaction effects were found.

Conclusions: Our findings suggest that men and women with or without sexual difficulties differ in how they evaluate themselves as sexual partners.

PD.01.44

PSYCHOSOCIAL FACTORS OF SEXUAL DYSFUNCTION IN HETEROSEXUAL, GAY AND LESBIAN: THE ROLE OF COGNITIVE, AFFECTIVE, EMOTIONAL, AND RELATIONSHIP VARIABLES

M. Peixoto, P. Nobre

Departamento de Educagao - Universidade de Aveiro, Aveiro, Portugal

Objective: Research on heterosexual sexual functioning has grown exponentially, however studies about gay and lesbian sexual functioning are limited. Sex risk-taking and HIV have been the main topics on research about gays; while lesbian studies have been focused on intimacy and sexual desire. Therefore, little is known about the central similarities and differences regarding to heterosexual, gay and lesbian sexual functioning, as well as cognitive, affective, emotional and relationship factors associated. The present study aims to analyze heterosexual, gay and lesbian sexual (dys)function. Additionally, we aim to study the role of cognitive, affective, emotional, and relationship variables on heterosexual, gay and lesbian sexual functioning.

Design and Method: A total of 600 adult volunteers from the general population will participate in the study (150 heterosexual men, 150 gay men, 150 heterosexual women and 150 lesbian). Participants will complete the following self-reported measures in order to assess: Personality (NEO- Five Factor Inventory); Psychopathology (Brief Symptom Inventory); State-affect (Positive and Negative Affect Scale); Relationship satisfaction (Dyadic Adjustment Scale); Sexual beliefs (Sexual Dysfunctional Beliefs Questionnaire); Cognitive schemas (Questionnaire of Cognitive Schema Activation in Sexual Context); Automatic thoughts (Sexual Modes Questionnaire); and Sexual functioning (International Index of Erectile Function; Female Sexual Functioning Index). Results and Conclusions: We expect that the results of this exploratory study contribute to a better understanding of the similarities and differences between heterosexual, gay, and lesbian sexual functioning. Additionally, we also expect to explore the role of psychological vulnerability and maintenance factors for sexual dysfunctions, in order to adjust treatment approaches.

PD.01.45 CLINICAL RESULTS OF VENOUS LIGATION SURGERY IN ERECTION

J. Kim

Philip and Paul Medical Institute, Department of Urology, Seoul, South Korea

Objectives: According to the American Urological Association clinical guidelines panel is not justified for routine use. Although penile venous surgery has almost been abandoned and the venous factor eliminated as a contributing factor to erectile dysfunction, new concepts of erection related veins has recently been described and reported in literature. We are to report clinical result of venous ligation surgery.

Materials and Methods: They were evaluated using the International Index of Erectile Function(IIEF-5) scoring system. In the dorsal area of penis, 1-2 cm from the subglans was incised with depth sufficient to expose the Buck’s fascia and was then bluntly dissected. The incised area was widened, so that the prepubic area could be seen. We ligated deep deep dorsal vein, cavernosal veins and para-arterial veins.

Results: Retrospective investigation was done for this study with 13 cases from January 2007 to September 2010. Median patient age at surgery was 45.2 years (range 22 to 54) and mean follow up was 13 months (range 2 to 39). Pre-operation average IIEF-5 score was 11 and post-operation average IIEF-

5 score was 17. 1 case of infection was reported. Conclusions: Though the patients group was small in number, this venous drainage reduction surgery as the modified venous ligation surgery appears to deliver reasonable positive results with low morbidity. Patients showed improvement of IIEF-5 score by this surgery. The results obtained in this limited number of patients are promising and justify trials in larger groups.

HYPNOSIS AND SEX THERAPY: ERECTILE DISFUNCTION

A. Cernuda Lago

Universidad Rey Juan Carlos, Madrid, Spain

Introduction: Sexual problems that benefit by enhancing self esteem and confidence are prime candidates for success with hypnosis; by facilitating change and allowing for the release of negative or limiting habits and associated ideas and by identifying triggers that summon negative behavior or feelings; and by learning to manage the internal processing of hurt feelings, anger and stress.

Most sexual problems have a strong psychological component, hence hypnotism can be a method to overcome anorgasmia, impotente and premature ejaculation. Changing the way the subconscious responds can produce dramatic results. Hypnotism, as part of a multimodal approach that includes medical treatment and/or psychological treatment is the right choice. According to the British Journal of Urology, hypnosis improved the sexual function of men with no organic cause for their impotence at a rate of 80%. The interesting part about this study is that hypnosis outperformed testosterone Objectives: The aims of the study are to verify the efficiency of the hypnosis in sexual dysfunction Design and Method: In the present communication as example of the usefulness of the hypnosis, one presents an analysis of the efficiency of the hypnosis therapy with 35 men with erectile dysfunction

Results: Of 35 treated men, 11 solved successfully his problem, 17 improved his situation, and 7 did not feel any benefit.

Conclusions: The hypnosis is a therapeutic tool very to bearing in mind in the sexual problems, for his positive contribution for therapists and affected persons.

PD.01.47 SEXUAL IMAGINARY, SEXUAL BODY AND SEXUAL DYSFUNCTIONS IN WOMEN

R. Bochicchio ¹², T. Strepetova ¹², A. Di Marco ¹², L. Otranto ¹²,

E. Arduino ¹², D. Trotta ¹²

¹1SA, Istituto Italiano Sessoanalisi, Salerno, Italy,²ACTS, Associazione di Clinica e Terapia in Sessuologia, Salerno, Italy

Objective: Vaginismus is a condition that affects a woman’s ability to engage in any form of vaginal penetration, including sexual intercourse, insertion of tampons and/or menstrual cups, and the penetration involved in gynecological examinations.

Design and Method: The woman does not directly control or ‘will’ the tightness to occur; it is an involuntary pelvic response. She may not even have any awareness that the muscle response is causing the tightness or penetration problem. We correlate the bodily components of vaginismus to its the mental counterpart and in the same time we take into consideration the voluntary as well as the unconscious aspect of this classical female sexual dysfunction.

Result: Vaginismus is better understood and treated when a body approach is coupled with a cognitive one. The ability and willingness to explore the imaginative world of the vaginismic woman is also important in the understanding and treatment of the dysfunction. It is also useful in the prevention of relapses.

Conclusion: Vaginismus is highly treatable and a full recovery from vaginismus is the normal outcome of treatment. Successful vaginismus treatment can be incremented by a clinical approach focusing on both the corporal and affective aspects of the dysfunctions.

PD.01.48 DIALOGUES ABOUT SEXUAL (DYS)FUNCTION: UNDERSTANDING SEXUAL (C0N)TRADI(C)TI0NS THROUGH AN IN-DEPTH INTERVIEW STUDY

V. Alarcao ¹, A. Beato ¹, L. Roxo ¹, F. Miranda ¹, M. Carreira ¹,

A. Galvao Teles ^{1 2}

¹1nstitute of Preventive Medicine, Faculty of Medicine, University of Lisbon, Lisbon, Portugal,² Endocrinology, Diabetes and Obesity Unit, Lisbon, Portugal

Objective: Using a qualitative analysis, our aim was to explore male attitudes towards, and experiences of, sexual problems. Design and Method: This study is part of a multi-methods approach and data triangulation, with a sample of Sexual Dysfunction Observational Study in Portugal participants. In order to maximize the variation in sexual function experience individuals were recruited from four different groups: Problematic, Functional; Dissatisfied; Contradictory. This subset consists of 10 in-depth interviews with men with and without sexual difficulties complemented by 5 interviews with (unrelated) women whose partners had experience of sexual problems, conducted between July-September 2011 by a male and a female researcher, respectively.

Results: Data was catalogued according to broad themes: Sexual Dysfunctions and Sexuality Representations; Beliefs about Treatments; Intimacy and Sexual Satisfaction; Masculinity Perceptions; Women perceptions about their partners’ sexual difficulties. A multiple variety of perceptions and representations attached to sexual difficulties and a diverse range of treatment experiences emerged from the participants’ dialogues. It seems though that despite their comprehensive views concerning sexuality and the fact that medical constructions of ‘normal’ and ‘healthy’ sexuality were frequently questioned, causes for sexual problems and, therefore their treatments, remained part of the medical domain, being psychological, social and cultural aspects less considered.

Conclusions: Results seem to indicate that men discourses on sexuality are more challenging of the biomedical model than their perceptions of the treatment options for sexual difficulties, that remain dominantly biological, reinforcing sexual naturalism.

LOGOTHERAPY FOR SEXUAL DYSFUNCTION

R. Sgambato ¹²

¹1SC, Roma, Italy,²ISUE, Naples, Italy

Objective: Dysfunctional sexuality, if not properly treated, in his persistence and worsening, can invalidate personal and interpersonal dynamics. The purpose of this article is to discuss the applicability of the techniques of logotherapy, more specifically “paradoxical intention” and “dereflection”, in the treatment of male and female sexual dysfunction. Logotherapy is based on the meaning-focused existential philosophy of Viktor E. Frankl (1905-1997). Literally, logotherapy means “therapy through meaning”. Whilst Freud says humans have a “will to pleasure” and Adler “a will to power”, Frankl says humans have a “will to meaning”.

Design and Method: Psychogenic sexual disorders a central role is played by anxiety, full of meaning, even from a sociocultural perspective. This work describes 2 techniques of logotherapy, paradoxical intention and dereflection, utilizing a number of case reports; both can be used to treat sexual disorders in which the patient’s fight for sexual pleasure becomes an obstacle to achieving it. The dereflection and paradoxical intention can be considered elective tools to break the vicious circle that keeps certain psychogenic disorders of sexuality (especially male erectile impotence) and change the wrong attitude to the problem of patient compliance.

Results: A review of the existing literature reveals that the essential outcome of treatment is to effect a change in attitudes of the patient perceives the source of sexual pathology existential distress.

Conclusions: Logotherapy can be a valid and efficient tool in the treatment of sexual dysfunctions restoring appropriate value to sexuality.

PD.01.50 SEX THERAPY AND SEX COUNSELLING PROGRAM AT THE UNIVERSITY OF ALICANTE

V. Briet García, R. Suriá Martinez

C.A.E:. Student Support Center (university of Alicante), Alicante, Spain

Psycological counselling and clinical intervention in the field of sexuality are nowadays more and more requested by young people. In response to this interest the University of Alicante has developed a program to provide students, staff and teachers with the knowledge needed to help them improve their sexual health by means of sex therapy and professional counselling.

Aims: To describe the type of queries received in our department according to clinical parameters.

Methods: Our analysis will be descriptive. Frequencies and percentages of the study will be calculated. The chi-square test will be used to check the dissimilarities between the different groups. All the cases attended in our department since 2003 will be analysed and classified according to the sexual dysfunction criteria normally used in clinical practice. The number of cases studied will range from 400 to 600.

Results: The collected data will be assessed at the end of this academic year, when the percentages of the different types of sexual dysfunctions and sex related problems will be defined. Conclusion: The conclusions will be presented at the end of the academic year, after the analysis of the collected data.

PD.01.51 COGNITIVE INTERFERENCE AND SEXUAL DYSFUNCTION: TESTING THE MODIFIED STROOP EFFECT ON MEN WITH AND WITHOUT ERECTILE DYSFUNCTION

P. Laja ¹, P. Nobre ²

¹ Universidade de Aveiro, Aveiro, Portugal,² Universidade de Aveiro, Aveiro, Portugal

Objective: The role of cognitive interference on sexual dysfunction is strongly supported, with findings indicating that men with sexual dysfunction differ from sexually healthy men on attentional focus and affect during sexual events (Barlow, 1986, Nobre, 2010). Despite this, there is a lack of studies using the modified stroop task with clinical samples. The aim of this research project was to examine the differences between men with erectile dysfunction and sexually healthy men, when presented to a modified stroop test after exposure to erotica.

Design and Methods: A total of 40 individuals (20 men without erectile dysfunction and 20 men with erectile dysfunction), participate in this study. After being presented to a series of sexual visual stimuli, both groups performed a modified stroop test, where they were presented to a series of words with neutral, positive valence, global negative valence, and specific negative sex valence.

Results and Conclusion: We expect to find a stroop effect (longer time in naming a colour word) in men with sexual dysfunction, mainly in those words specially related to sex content. Preliminary results will be presented in the summit.

PD.01.52 SEXUALITY IN MALE WITH SPINAL CORD INJURY: AN OVERVIEW

F. Quattrini^{1 3}, C. Pastura ², S. Romano ³, V. Conti Nibali ², P. Bramanti ², R.S. Calabro ², ³

¹ Dipartimento di Scienze Biomediche, Université di Chieti-Pescara, Chieti, Italy,² IRCSS Centro Neurolesi Bonino-Pulejo, Messina, Italy,

³Istituto Italiano di Sessuologia Scientifica, Rome, Italy

Despite advances in the field of medicine, injury to the spinal cord remains a devastating problem. Spinal cord Injury (SCI) often results in permanent neurological deficit and, depending on the level of injury, may leave the patient severely disabled. SCI has a dramatic emotional impact on the patient and his family and represents a high burden to society. Moreover, patients with SCI have a poor quality of life (QoL), often worsened by the presence of sexual dysfunction (SD), which is really dramatic especially at a young age.

Ejaculation and erection are mostly autonomic reflex with specific spine-located centers, coordinated by cortical and brainstem pathways. Thus, it has been shown that level and completeness of spinal cord damage determine the extent to which erectile and ejaculatory capacity is affected. However, since individuals with SCI are often sexually active, a proper counselling, diagnosis and treatment of SD is needed in order to improve their sexuality, and thus QoL.

Nowadays, the mainstay of SD therapy is the use of PDE- inhibitors; but individuals with SCI and their partners may realize a sex life that is less genitally-focused, more creative and mutually rewarding, and physicians should discuss about sexual issues while approaching SCI patients, since sexuality is a fundamental part of any individual’s life. Indeed, it is important to continue counselling and education in this area to prevent health professionals perpetuating the myth that disabled persons are asexual.

PD.01.53 A NEW TREATMENT FOR VAGINISMUS

L.M. Roque Ortega, M.D. Maurisset Moraguez, A. Cordove Maurisset

Hospital de Dia - Mental Health Community Center - “Maria Elisa Rodriguez Del Rey Bocalandro”, Havana, CUBA

We understood for vaginismus a feminine sexual dysfunction, that’s consist in the involuntary contraction of the muscles that belongs to the exterior of the feminine genitals, a disease that’s affect women of any age and with different grades of intensity. In extreme cases, the vaginismus may be so apparatus than the vaginal aperture closed complete, not allowed the coitus realization or the simple insertion of a finger. There is another vaginismus, not so grave, but anyway produces considerable’s molests because all tentative to do the coitus produce pain. Experts estimate that 2 or 3 % of the woman suffer vaginismus.

We intent, in this presentation, prove the efficiency of draw in the treatment of resistant vaginismus. The use of drawing and painting in diagnostic and treatment has a long and voluminous history, most usual are the human figure for diagnostic objectives, to explore personality. In this case we present a new utilization as a therapeutic resource.

poster display 54-60

sexual medicine

PD.01.55

NEW METHODS FOR PENILE AUGMENTATION USING ACELLULAR HUMAN DERMAL TISSUE WITH INJECTION

J. Kim

Philip and Paul Medical Institute, Department of Urology, Seoul, South Korea

Objectives: Penile augmentation surgery with tissue grafts through incision so far has been performed ; however, there might be adverse effects such as a wound problem. Another augmentation method is the injection of chemical filler or fat but there is the disadvantage of histological instability and a high reabsorption rate. We are to introduce new methods for penile augmentation using acellular human dermal tissue with injection.

Methods: Under the local anesthesia, according to the size of the penis and the augmentation size the patient desired, about

3- 6cc of dried acellular particulate dermal matrix (BellagenTM, MegafillTM) combined with 1.5-1.8cc of lidocaine and 0.3cc of gentamicin per 1cc of the tissue were injected into the subcutaneous tissue.

Results: Retrospective investigation was done for this study with 126 cases from December 2007 to Jan 2012. 4cc of tissues on average were used for a one-time injection and the average surgery time was 20 minutes. 2 cases of local skin necrosis was reported but it was treated through the conservatory treatment. No other adverse reaction was occurred. There was little migration of the injected tissues after the graft.

Conclusions: This surgical method does not require an incision and resulting in short operation and rapid recovery time. There are few side effects. Therefore, for the men who experienced difficulty with penile augmentation surgery with the pre-existing techniques, this surgical method could be recommended . It also may be considered a new technique that can be applied for partial augmentation, correction of deformity, and reconstructive surgery as well.

PD.01.55

EVIDENCE OF IMPLICIT EFFECTS OF TESTOSTERONE ON SEXUAL DESIRE MECHANISMS USING EYE-TRACKING AND BEHAVIORAL MEASURES IN A MALE PATIENT WITH HYPO- ACTIVE SEXUAL DESIRE DISORDER

M. Bolmont ¹, F. Bianchi Demicheli ², J.T. Cacioppo ³, S. Cacioppo ¹

¹University of Geneva, Geneva, Switzerland,² University Hospital of Geneva, Geneva, Switzerland,³ University of Chicago, Chicago, USA

Objective: The main aim of the present study was to investigate the implicit influence of testosterone on sexual desire mechanisms in a 58 year-old heterosexual male patient with hypo-active sexual desire disorder.

Design and Method: To address this question, we combined eye-tracking and behavioral measures, while the patient performed a behavioral desire inference paradigm using a before/after design. Self-report questionnaires, investigating subjective levels of sexual desire, perceived social isolation, inclusion of other-in-the-self, anxiety and depression, were also performed. Patient was tested before and four weeks after the administration of testosterone (TOSTRAN; 50 mg/day). Results: Behavioral results revealed faster sexual desire- related reaction times (p < .05) after treatment than before treatment. Eye-tracking results expanded these behavioral findings. Before treatment, when asked to decide whether (or not) he could desire the stimuli, the patient had less (and shorter) eye fixations on the body (than the face) of the stimuli, while no significant difference was observed between body and face after treatment. In other words, the patient showed more (p < .001) and longer (p < .01) eye fixations on the stimuli body after than before treatment, which reinforces the importance of bodily cues for sexual desire-related decision making. Significant differences were observed in self-report questionnaires after treatment, as follows: higher sexual desire scores (p < .001) and lower depression scores (p < .05).

Conclusions: Testosterone administration affects not only consciously experienced feelings of sexual desire but also subconscious mechanisms. This finding opens a new avenue to better understand the desiring mind.

PD.01.56

POSTOPERATIVE MANAGEMENT TO REDUCE COMPLICATION RATE AFTER PENILE ENHANCEMENT SURGERY

S.Jang

Lj Genitourinary Surgery institute, Seoul, South Korea

Objective: Following penile enhancement surgeries, postoperative managements are performed differently. We aimed to develop better methods to reduce complication rates.

Design & Method: We have experienced 2200 penile enhancement surgery. We adopted a pre-pubic minimal incision and dissected penile shaft. Inserted graft materials were Allograft dermal grafts which were fixed at the Buck’s fascia. And we dissected fundiform ligaments and sutured transversely pre-pubic dead space with PDS 2.0. For the dressing, we used Peha-haft (very soft and thin elastic bandage) to cover the penile shaft in 1620 cases.

Post-op dressings were done at POD 1 or 2 (1st), 3~4 (2nd),

11 or 12 (3rd). At 1st and 2nd dressing, we checked bleeding, skin status such as bruising, swelling and body temperature. At 3rd dressing, wound healing was checked and aspiration under penile skin was done to check collected fluid that might cause delayed infection around inserted graft.

Results: Our experiences showed that our method could completely prevent skin necrosis that might be caused by a bandage being too tight. Delayed infection was completely prevented by follow-up aspiration under penile skin. Postoperative wound infection occurred at 1.4% and all cases were completely fixed.

Conclusions: Our follow-up schedule and method after 3m penile augmentation surgery was considerably effective to prevent complication that includes such as skin necrosis and delayed graft infection.

PD.01.57 EXPERIENCES OF SIMULTANEOUS FOREIGN MATERIAL REMOVAL IN PENIS AND PENILE ENHANCEMENT SURGERY

S.Jang

Lj Genitourinary Srugery Institute, Seoul, South Korea

Objective: Many people who wish to have a larger penis have undergone insertion or injection of several kinds of foreign material into the penis. We try to introduce our experiences that could remove these materials and simultaneously perform penile enhancement surgery.

Design and Method: From 2007 to 2010, we experienced 52 cases of simultaneous foreign material removal and penile enhancement surgery.

48 cases previously underwent insertion of silicon prosthesis and 4 cases had inserted unknown plastic-like material. Under local anesthesia, we performed a minimal incision on the pre-pubic area. Dissecting procedure using fingers and electro-cauterization were done from pre-pubic subcutaneous tissue to penile skin covering the penile shaft.

At the same time, we removed previously inserted foreign material and epithelized capsulation tissue was dissected and detached.

And then we fixed artificial dermal graft (cadaveric dermis or bovine collagen) on the bucks’ fascia. After dissecting the fundiform ligament, transverse multiple sutures were done in the deep pre-pubic space.

Results: We followed up 6 months on average (3 months to

13 months). 2 cases had a wound inflammation and wound dehiscence and could be fixed within 2 weeks. The rest of the cases had no complications. Postoperative penile length at last follow-up was 6.6±0.4 cm compared with preoperative length of 5.0±0.6 cm.

Conclusions: Simultaneous foreign material removal and penile enhancement surgery could be performed safely and effectively.

PD.01.58 INFLUENCE OF THE CONSTRICTIVE PENILE BAND AND THE PENILE CIRCUMFERENCE

J. Kim, P.B.M. Kim

Philip and Paul Medical Institute, Department of Urology, Seoul, South Korea

Purpose: The penile constrictive band is commonly observed on the penis of men who were not circumcised. In the event that a serious constrictive band was created clinically, it is often observed that circumference around the band is thinner than other areas. The authors aim to report the influence of constrictive bands on the penile circumference of men who were not circumcised.

Method: The circumference of the penis was measured in three areas: it was measured at the back of the distal penis that is 1.5-2.0 cm from the glans corona; on the constrictive band area and on the front area of the proximal penis that is 1.5cm from the penopubic junction.

Results: The number of subjects were 18 and the average age was 41.6 years old. As to the circumference of the three measured areas, it was 7.4 cm of the penile distal area; 7.1 cm of the constrictive band area; and 7.9 cm of the penile proximal area. The circumference of the proximal area was longer than that of the distal area.

Conclusions: This study confirmed a decrease in the circumference of the constrictive band. Although more research is required to confirm these conclusions, considering the possibility that a serious constrictive band may deter the growth of the penis, circumcision may be considered in a positive light in order to insure preventive effects, Furthermore, the circumference of the distal penis is shorter than that of the proximal penis in phimosis.

PD.01.59 MEDICATION IN THE INTEGRATED TREATMENT METHOD OF SEXUAL DYSFUNCTIONS

G. Barbero ¹, G. Cociglio ¹, C. Manieri ², S. Allasia ², F. Lanfranco ²

¹ Scuola Superiore di Sessuologia Clinica di Torino, Turin, Italy,² S.s. Andrology, S.c.d.u. Endocrinology, Diabetology and Metabolism, S. G.

B, Molinette Hospital - University of Torino, Turin, Italy

Introduction and Aim: The authors agree with integration between bio-drugs (hormones, pro-erectogenic vasoactive drugs) and psychotherapy in treating sexual dysfunctions as currently widespread practice (bi-integration), but they support the use of a triple integration as a further therapeutic interaction between bio-drugs, psychotherapy and psychiatric medications. The latter, which have so far been rarely used in sexology, may be decisive in treating psychogenic sexual disorders. Moreover, they often prove to be extremely useful in those conditions of prevalently organic aetiology. Antidepressant drugs act on phobic and depressive factors, ansiolitic drugs on anxiety, neuroleptic medication on aggressive or delirious symptoms, which may be present in organic sexual disorders.

Case Report: A 60 year old patient had attended the andrologist’s for a secondary organic erectile dysfunction (metabolic syndrome and hypogonadism). Initially the andrologist-endocrinologist treated the patient with a diet, increased physical exercise, testosterone replacement therapy, and pro-erectogenic medication when needed. A psycho-sexologist also assisted the patient with sexual

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sexual orientation

PD.01.61 HOMOPHOBIC BULLYING AT SCHOOL: OUTLINING BULLIES’ AND VICTIMS’ PSYCHOLOGICAL PROFILES

S. Picariello, M.C. Coppola, M.R. Nappa

University of Naples - Department of Theories and Methods of Human and Social Sciences, Naples, Italy

Objectives: Assuming the numerous evidences about severe effects of homophobic bullying on psychological wellbeing, and keeping the concept of minority stress in our mind, we can thus consider homophobic bullying as a strong predictor of psychological distress and psychopathological risk.

School context and peer groups have been considered central potential protective factors from such a risk, while few researchers have taken into account more intra-personal dimensions.

The main purpose of the study is to investigate which psychological features can be attributed respectively to perpetrators and victims of homophobic bullying, with regard to personality dimensions, adherence to universal values, use of specific defensive mechanisms.

Design and Method: 318 11-18-year-old adolescent (46,2% males and 53,8% females) were randomly recruited in two colleges in Naples. They were administrated a battery of self-report questionnaire in two sessions (pre- and postintervention): Homophobic Content Agent Target (HCAT, 2010); Big Five Questionnaire Revised (BFQ-R, 1996); Response Evaluation Measure (REM-71, 2009); Portrait Values Questionnaire (PVQ, 2001, 2005). Bivariate correlations between HCAT items and each one of other scales, and linear regressions were carried out.

Results: Several significant results let us identify specific characteristics with regard to all three factors considered, pertaining bullies and victims of homophobic bullying. Some unexpected similarities between each other were found. Conclusions: Just such similarities between bully’s and victim’s profiles lead to reflect about common psychological dynamics and characteristics that make them two sides of the same coin and that should be further investigated.

PD.01.62 PEER-EDUCATION TO PREVENT HOMOPHOBIC BULLYING IN SCHOOLS. AN INTERVENTION IN AN ITALIAN HIGH SCHOOL

S. Picariello, L. De Gennaro Aquino, C. Ricci, E. Micillo

University of Naples - Department of Theories and Methods of Human and Social Sciences, Naples, Italy

Objective: This work describes an experience carried out within an action-research project promoted by Centre SInAPSi

- Section “Bullismo Omofobico”- of the University of Naples

“Federico II”, aimed to prevent homophobic bullying at school. The main purpose was to train some students to become peertrainers on sexual orientation, gender identity, homophobia and homophobic bullying, sexual and gender stigma.

Design and Method: This study involved 4 classroom from a Neapolitan high school and used peer-education method, based on experiential activities, such as role playing, focus groups, game sessions . Four students from each classroom were selected and trained by two psychologists through 6 meetings of the duration of two hours each one. Then, each classroom, helped by its peer-educators, has been invited to create a message to prevent homophobic bullying, choosing themselves the medium.

Results: Peer-educators took part at every meeting, learning information about project’s topics and improving their relational skills. As products of the project, two classrooms chose to make a video and the other two chose to make a comics. Conclusion: Peer-education was an excellent method to train the students and to pass on information about sexual orientation, gender identity, homophobia and homophobic bullying, sexual and gender stigma.

PD.01.63 MIDWIFE PROFESSIONAL CARE BEFORE THE TEEN VTOP

R. Gonzalez Segura ¹, N. Benayas Perez ², R. Benayas Perez¹, M. Jodar Martin ³, M.D. Jimenez Lechuga ³, S. Valladolid Benayas ³

¹Out of Work, Almeria, Spain, ² Chare Hospital Poniente El Ejido, Atmeria, Spain,³ Hospital Comarcal Melilla, Melilla, Spain

Introduction: Adolescence is the period when sexual relations are usually initiated, making teenagers a risk group of unwanted pregnancies. Voluntary termination of pregnancy (VTOP) is an important decision by the emotional duty involved. It is therefore necessary the midwife performance, which begins before VTOP and continues through VTOP griefing process. Objectives: The midwife must get to know the professional skills before the teen

VTOP, and protecting the adolescent rights.

Tools and method: Extensive literature review of recent years in data base: Pubmed, Cochrane, Ime, Cuiden y Preevid.

Results: With the entry into effect in 2010 of the new VTOP law, women aged 16 and 17, can consent by themselves. Healthcare professionals directly involved in VTOP will have the right to exercise conscientious objection, but they will always give appropriate care for women before and after the VTOP.

In reviewed studies it was found that midwives’ attitudes towards adolescents seeking VTOP are mostly positive. Various international organizations agreed on the importance of the midwife role in the pre and post-VTOP.

Conclusions: Every woman has the right to decide about her reproductive health and impartial information to make an informed decision, so we must support with a non-judgmental, respectful and empathetic character, without leading the patient to our own ideology or convictions.

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sexual psychotherapy

PD.01.64 SEXUAL ADDICTION AND ITS TREATMENT

A. Cismaru Inescu ¹, R. Andrianne ², J.M. Triffaux ³

¹University of Liège, Liège, Belgium,² Chu Liège, Liège, Belgium,

³Hôpital de Jour La Clé, Liège, Belgium

Objectives: The sexual addiction is an abnormal sexual practice. It becomes the center of the subject’s existence, by depriving him from other investments and without bringing him real satisfaction. This research project intends to explore the field of sexual addiction and a possible treatment for it. Several studies on sexual dysfunction treated with psychotherapy and virtual reality have shown that we obtain better results than if we use just the psychotherapy.

Through this study we would like to test the efficiency of virtual reality on patients treated with virtual reality and CBT. Better results should be registered in this group of patients than in the other, treated just with the CBT.

Design and Methods: Acoustic therapy (a CD with two voices that tell a story)

Cognitive behavioral therapy (CBT)

Virtual Reality (PC, joystick, headset)

²groups-25 patients treated with CBT

-25 patients treated with CBT and Virtual Reality Estimated Results: Given the proven effectiveness of virtual reality on other psychopathological disorders, our study aims to evaluate the therapeutic effect of virtual reality in patients treated with CBT and virtual reality compared to patients treated only by CBT.

The use of virtual reality should accelerate the process, should improve the person’s condition until complete remission of symptoms

Conclusions: Normally after 25 sessions of CBT and virtual reality, we should see better therapeutic results than with CBT alone.

The only side effect found in studies of psychotherapy and virtual reality on sexual dysfunction was the dizziness. This can occur due to long exposure to virtual reality.

PD.01.65 REEDUCATION OF COUPLES WITH A HYPOACTIVE SEXUAL DESIRE

R. Gonzalez Segura ¹, N. Benayas Perez ², R. Benayas Perez ¹, M. Jodar Martin ³, M.D. Jimenez Lechuga ³, S. Valladolid Benayas ³

¹ Out of Work, Almeria, Spain,² Chare Hospital Poniente El Ejido, Almeria, Spain,³ Hospital Comarcal Melilla, Melilla, Spain

Introduction: is the absence or the decrease of feelings or sexual fantasies as an interest by starting a sexual meeting, in the presence of a person external expert to help to work on

desire, having into account the life cycle.

Objectives: To have the power to intimate with a person. Design and Method: Extensive literature review of recent years.

Discussion and Conclusions: There are several therapeutical modelsWe are going to work with the model Instituto Andaluz de Sexología y Psicología which offers a wider and safer version at the moment of exposing it to women.

It consists on:

1. A short evolved HSD without any loathing components: The one who feels more desire must not pleasure the other and does not take the initiative. Increase of tolerance and understanding the situation.

Focusing on helping to facilitate the external supporters of desire:

• To work on sexual fantasies

• To use readings, films or any other erotic tool.

• To Change our appareance, visiting other erotic shows, etc...

• Autoestimulation

2. If the woman masturbates regularly and in a pleassuring way, it is recommended to have erotism with the couple, genital erotism and orgasmic erotism.

3. Long evoluting DSH:

Erothophilia potenciation, development of therapy for couples focused on the interexchange of nice behaviours and generating a proper level of intimacy, and in the end, a sistematic desensibilization of imagination must stimulate the desire leadings.

Women learn how to be desired and are able to interact with their couples in a quiet and sensual way to reach full sex.

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sexuality and education

PD.01.66 SEXUALITY AND GENDER OF TEENAGERS STUDENTS,

IN TEACHER’S CONSIDERATIONS

A. Oliveira, A.C.B. Maia

State University of Sao Paulo, Bauru, Brazil

Objective: This descriptive-qualitative research investigated the views of teachers about sexuality and gender considering their teenage students.

Method: eleven teachers, eight female and tree male, aged between 32 and 64 years who answered a questionnaire with open questions for content analysis.

Results: 1) Concept of Sexuality: concept of sexuality was related to sexual activity and knowledge of the body involving pleasure and love linked to the heterosexual relationship. 2) The noted sexual attitudes of students: students’ expression of sexuality in school was remembered by affective behaviors, body touches and verbalization, in addition, was also highlighted the growth of body and sex and love interest. Gender questions were highlighted in the expressions of sexuality, and the vulgar interest in sex something common in boys and seduction and sensuality something related to girls. 3) Gender: Gender has been defined mainly as the characterization of biological and social differences between men and women. Some believe that girls are more interested, sensitive and obedient in school than boys; other teachers consider the individual performance of each student regardless of gender.

Discussion and Conclusions: In general, teachers have a vision centralized in the genitals and heteronormative sexuality and gender. There is a belief that there are gender differences in academic achievement in advantage to girls. It is concluded that teachers should receive training on sexuality and opportunities to discuss social gender issues, thus minimizing sexist education also in the school environment.

PD.01.67 MASTURBATORY BEHAVIOUR AS A METAPHORIC CHANNAL SYMBOLIZED PULSIONS IN CHILDREN WITH AUTISTIC DISORDER

F. Sandri ¹, F. Pavissich ²

¹University of Trieste, Trieste, Italy,² University of Paris, Paris, France

Sexuality includes much more than just sexual behavior. It includes the representation of the self, the emotional component, the value system, the behavioral attitudes, the system of beliefs, the relationships; as communication and social interaction levels are strongly interfered in autistics, sexuality for this patients is manifested as a container of significants, as a metaphoric canal through which are symbolized different pulsions which don’t necessarily have erotic significance. The bibliography regarding the sexuality of individuals with autism is very fragmented. In people belonging to the autistic spectrum disorder (ADS) social and communication difficulties affect significantly the expression of sexuality; understanding and managing emotions and stress are sometimes manifested through different patterns to their non autistics peers, it means, with a higher involvement of the erogenous path. It is important to remember and understand that masturbation may be the individual’s only way of appropriately relieving normal sexual urges, and give vent to the tensions embodied.

We intend to review specifically the masturbatory behavior, not just in its condition of erogenous release, but also under the connotation of its most hidden significants: autoerotic action can be the way to handle relational anxiety, the anguish of emptiness and of the outside world. It could be a compulsion to repeat or a way to define self-sufficiency, a behaviour to define their self-esteem or an attempt to construct.

Our work aims to give an interpretive analysis performed in base to the data from the literature extant, and integrating them to the deductions outcoming from the observation of children and teenagers with Autism Spectrum Disorders. The goal is to give some alternative interpretations than erotic to the masturbation of children with autism, providing caregivers, educators, doctors and sexologists, which can interpret the different aspects of its significance.

PD.01.68 DISCREPANCY BETWEEN SELF-PERCEIVED KNOWLEDGE AND ACTUAL KNOWLEDGE ON SEXUALITY

E. Garcia Vega ¹, E. Menéndez Robledo ², P. Fernández García ¹, A. Menéndez Robledo ³

¹University of Oviedo - Department of Psychology, Oviedo, Spain,

²Servicio Público de Salud Principado de Asturias, Oviedo, Spain,

³Principado de Asturias, Oviedo, Spain

Introduction: Information campaigns about sexual and reproductive health care for adolescents doesn’t have been effective, and unwanted pregnancies or AIDS/ sexually transmitted diseases, are growing. The objective of the study is to know the difference between the knowledge about sexuality that the adolescent have and the knowledge they think they have.

Methods: Self-reported questionnaires were distributed to 815 teenagers between 13 and 19 years (52.8% of girl and 47.2% of boys), from a state school in Spain. The questionnaire was designed to appraise self-perceived knowledge about sexuality and the real knowledge they had about this topic. Pupils were asked if they thought that they had good knowledge about sexuality (physiology, sexuality, contraception and sexually transmitted diseases), about their real knowledge and about their sources of information. The data were analyzed according to gender. We use the SPSS statistical program.

Results: Almost 76% of teenagers reported they had good or very good knowledge about sexuality. Of the students who said to be well or very well informed, a 44.2% showed a poor knowledge. Girls showed better knowledge than boys, especially about contraception and sexually transmitted diseases. Young people who had the best scores had obtained their knowledge of their experience and health professionals. Discussion: Student believed to be better informed of what they really are.

Girls have more knowledge than boys on issues of sexuality, especially contraception and sexually transmitted diseases.

PD.01.69 SEX LIFE EDUCATION

M. Jodar Martin ¹, R. Gonzalez Segura ², N. Benayas Pérez ³, R. Benayas Perez ², M.D. Jimenez Lechuga ¹, S. Valladolid Benayas ¹

¹ Comarcal Melilla Hospital, Melilla, Spain,² Out of Work, Almeria, Spain,³ Chare Poniente El Ejido, Almeria, Spain

Introduction: Sexuality throughout life has been essential; it is an experience of emotional exchange and communication between people. It is a dynamic process that changes over along our lives. A process where the body, emotions, feelings, knowledge we have about our lives and the society we live in are involved.

Objectives: Learning to get to know ourselves, accept ourselves, live and express our eroticism to get happiness. Design and Method: Extensive literature review of recent years

Results and Conclusions: Sexuality is an important part of people's lives that affects their welfare.

Human sexuality encompasses three main aspects: -Reproduction: ensuring the continuity and survival of the species.

-Sexual pleasure desire: the search for erotic pleasure. -Communication of affections: it is a way of communication, expression of feelings, which tends to seek physical and psychological fusion with another person For a proper sexual development, it is essential to establish a basis of values, which have some emotional ties, between the couple who must share sincerity and tenderness, communication and responsibility.

It is important to have a sexual health training in order to have a full well-being, because sexuality has been forgotten and has been a taboo for many years. Educating young people is very important for the knowledge of their body, prevent STDs and unwanted pregnancies. Educating and teaching teens in a broad and clear way will make much easier to promote and create a healthy sex life without any complex and love their personalities.

DISCUSSION GROUP ABOUT SEXUALITY, GENDER AND MEDIA: CONTRIBUTIONS FOR THE FORMATION OF PSYCHOLOGY AND COMMUNICATION STUDENTS

A. Oliveira, A.C.B. Maia, M. Pastana

State University of Sao Paulo, Bauru, Brazil

Objective: The Project “Discussion Group about Sexuality, Gender and Media” was based on the importance of the dialogue about how issues like sexuality and gender have been represented in the media. It was aimed to create a space of dialogue between the areas of Psychology and Communication, with discussions about academic researches and materials from the media like magazines, newspapers, television and radio programs, movies, advertisements, websites, with discussions and reflections that contributed to the formation of students of both areas.

Design and Methods: Ten students of the graduation courses of Communication and Psychology from a Brazilian University participated of 17 meetings, with the duration of one hour and a half every week in the second semester of 2011.

Results: The discussion were mainly about how the media produces and reproduces normative patterns, stereotypes, prejudices and a repressive comprehension of sexuality and gender, thinking together about possible ways of approaching this thematic considering the plurality, diversity and multiplicity of human sexuality. It was also reflected about the participants’ process of sexual education, the personal and professional trajectory and their influence in the construction of materials about sexuality and gender.

Conclusions: The presentation, discussion and reflection about how sexuality, gender, sexual education, sexual repression, sexual diversity, heteronormativity are presented in the media were important for a broader comprehension of sexuality considering the historical, cultural and social factors

PD.01.71 SEX EDUCATION TO YOUNG DEAF AND DEFBLIND WEB SEXEJOVES ACCESIBLE AND ADAPTED (WWW.SEXEJOVES.GENCAT.CAT)

C. Leon Ortega, G. Falguera Puig, D. Guix Llistuella, P. Soteras Guasch, M. Villanueva Guevara, I. Sombrero Torres, S. Abajo Llamas, S. Morell Capel, E. Barnés Sarra, D. Costa Sempere

Institute Calana Of Health. Department of Health, Catalonia, Spain

Introduction: Sexejoves web takes cares of the sexual&affective care of the young people since 2006.

Necessary changes have been implemented to the sexual&affectivity virtual care web in order to make it accessible and reach out to all possible spectra of young people, hence including functional and sensorial diversity young population.

Methodology: By means of the translation and interpretation of the contents to the Catalan signs language (LSC), adapting the IT for the deaf and blind people, or improving the accessibility of the web (antaviana), a pioneering educational tool was obtained in the area of sexual and reproductive health.

Results: Outstanding results were obtained after a counter was installed on the website accounting for all the hits to the videos translated to LSC; 19900 visits were registered in 43 days, (from the first of February to fifteenth of March 2011). Conclusions: The professionals that constitute the deaf community (professors, care personnel, parents etc.) have shown their interest for this pioneering initiative. Being a unique initiative has made the deaf linguistic community agree on new terminology or update signs that were overlooked due to under use.

The fact that a phenomenon does not have tangible evidences (inquiries from young deaf individuals) does not mean there is not a realistic need. Sometimes the professional has to follow a reverse path; provide the tool to allow the manifestation of the problem or need.

PD.01.72 REQUEST ASSISTANCE OF IMMIGRANT POPULATION IN REPRODUCTIVE HEALTH

F. Hurtado Murillo ¹, F. Donat Colomer ², L. Margaix Fontestad ², R. Pellicer Faro ¹, A. Royo Martínez ¹, M. Alcaraz Quevedo ³

¹ Centro de Salud Sexual y Reproductiva Fuente de San Luis de Valencia. Departamento Dr Peset. Agencia Valenciana D, Valencia, Spain,² Universitat de Valencia, Departament d'infermeria, Valencia, Spain, ³ Dirección de Salud Pública de Valencia. Conselleria de Sanitat, Valencia, Spain

Objective: To determine the demand for services and identify the health practices of the immigrant population in the reproductive area.

Design: Observational study, cross- sectional of analytical components.

Method: We analyzed 829 medical records of immigrants from different backgrounds who have come in 2008 a Centre Sexual and Reproductive Health. Study variables are: geographical origin, age, sex, reason for consultation and breeding habits .Descriptive analysis was performed analyzing the differences, by chi-square for the qualitative variables and student's T for the quantitative.

Results: The main demand of both groups is contraception. (52,3% immigrants vs 30,8% Immigrants use more methods of low effectiveness. High efficacy, condom use (53.9%) less than the autochthonous (73.9%).Hormonal methods more than the Spanish (47.4 and 33.6%) and IUD more than the Spanish (18.9 vs. 6.2%). All these differences are statistically significant ..

Regarding the number of pregnancies significant difference, being higher immigrants. The IVES present significantly higher rate of immigrants. (16,6% vs 5,4%)

As for STI. the average rate is low (5.5%) higher in immigrants (6.8%) than in Spanish(3.7%). Least in the genital herpes, the immigrant group exceeds that in all STIs. By gender, the overall rate is higher in women (5.7%) than men (3.9%).

None of these differences showed statistical significance. Conclusions: Contraception and IVE, more demand rate among immigrants.

Preferred method of contraception condom, well over by the Spanish .In the other methods, immigrants outnumber the Spanish use.

Overall rates of STIs are low, slightly higher for immigrants, and among women

PD.01.74 EDUCATION WOMAN WITH VAGINISMUS

N. Benayas Pérez ¹, R. Gonzalez Segura ², R. Benayas Perez ², M. Jodar Martin ³, M.D. Jimenez Lechuga ³, S. Valladolid Benayas ³

¹ Chare Poniente Institute El Ejido, Almería, Spain,² Out of Work, Almería, Spain,³ Comarcal Institute Melilla, Melilla, Spain

Introduction: Involuntary contraction of the perineal muscles of external tertiary vagina, against the introduction of the penis, fingers, tampons, specula, etc. It is common to be associated with other dysfunctions such as anorgasmia, hypoactive sexual desire disorder, Sexual Aversion Disorder and excitability disorder.The disorder is chronic.

Objectives: Methods for women to enjoy a full sexual life. Design And Method: extensive literature review of recent years.

Results and Conclusions: If there are any erotic games, an intercourse is not necessary, but in some couples some disorders appear after the impossibility of penetration. Guidelines:

• Boosting of erotophilia: Elimination of negative attitudes, exercises of kege, autoestimulation.

• Individual vaginal permeabilization: Prohibited the penetration, masturbation is allowed and taking advantage of the lubrication, the woman must introduce a finger first; later two and soon a vaginal expander.

• Vaginal permeabilization in pairs: Position non plaintiff: both seated, supported her on his chest. She will take one of his fingers and will introduce it into her vagina, he won’t make any movement. Getting over this point, she will take a finger and will introduce it in her vagina. Having passed this step, he will do the same with the expander.

• Introducing the expanders in different positions is advised especially at riding. If this step had been already done, they are advised to move with short rhythms and improving it until getting a natural movement.

• If the woman doesn’t have difficulties to follow our instructions, a progressive introduction of expanders would be carried out.

SEX EDUCATION IN PATIENTS COLOSTOMIZE: ROLE OF THE HOSPITAL NURSE

A. Baena Morales, F.J. Ramos Aliaga, E.M. Quesada Bravo

Empresa Publica Hospital de Poniente, Almeria, Spain

Colostomy surgery makes it possible to see altered body image and self esteem, leading to possible changes in the patient’s sexual health colostomy. It is at this point that the hospital nurse has a key role in sex education to mitigate and minimize any sexual fears related to colostomy and educate the patient to adapt the new situation.

Main Objetct: provide sex education necessary to ensure proper adaptation to possible changes in sexuality arising from the colostomy.

Materials and Methods: They undertake a plan of nursing care colostomy patient, focusing on sexual function. This plan will be implemented immediately and individualized to the patient’s arrival to the ward. You will conduct an interview and was complimentara complete a sexual history to see what their concerns, doubts, fears .... and from data collection to conduct an individualized care plan based on the diagnostic NANDA, NIC, NOC. This claim that the functional pattern of Gordon: sexuality reproduction looks positively covered. Results: With the identification and early diagnosis of potential sexual problems in the colostomy patient is achieved that the possibility that these patients have impaired sexual function reproduction is significantly lower, making the sex education is appropriate to the new situation and psychological body. Conclusion: With good sex education and individualized care plans by nurses will ensure that sexuality is not disrupted and we will get a high state of satisfaction by the individual colostomy.

PD.01.75 DATING VIOLENCE DURING THE TEEN AND YOUNG OF THE DEGREE OF MEDICINE UNIVERSITY OF HEALTH SCIENCES UNIVERSITY OF GUADALAJARA

S. Lerma Partida, J.V.M. Lara Velez

Center for Health Science, University of Guadalajara, Guadalajara, Mexico

Summary: We performed a study on dating violence in the University Center for Health Sciences at the University of Guadalajara, Jalisco, Mexico. In adolescents and young people aged 14 to 23 years of age. This study used an instrument designed in 2007 by the National Institute of Statistics and Geography (INEGI) on violence.

Methods: We performed in this research is quantitative, descriptive and cross, with a sample of 220 undergraduate students of medicine, which have or had a dating relationship. The type of sample used was stratified two-stage assessments. Objective: To diagnose dating violence among youth and young university and determine the type of violence most commonly used in this area: psychological, physical or sexual.

Results: We found that dating relationships among adolescents and young participants is affected by violence in more than 60%, the most frequent psychological type, followed by physical violence and ultimately ended by sexual violence.

Conclusions: As we conclude that dating violence is a phenomenon existing in this population and unfortunately you guys are learning risky behavior, coming to regard as a normal way of relating to their romantic partners, so that indispensable to develop intervention models that promote healthier dating and free of violence in this age group.

PD.01.76 IMPLEMENTATION OF SEXUAL EDUCATION IN THE 2ND CYCLE OF BASIC EDUCATION IN FRANCISCO ARRUDA SCHOOL IN LISBON

I. Xavier Vieira ¹, C. Nabais ¹, J. Rodrigues ¹, N. Marques ¹, R. Leitao ¹, V. Nobre ¹, R. Xavier Vieira ²

¹ Escola Francisco de Arruda, Lisbon, Portugal, ² Faculdade de Medicina de Lisboa, Lisbon, Portugal

For the implementation of Sexual Education in Francisco de Arruda School in Lisbon, during the school year 2010-2011, in accordance with applicable law (Administrative Rule n.° 196-A/2010 of April 9 that regulates Law n.° 60/2009 of 6 August), the coordinator of Health Education invited in July

2010, a group of teachers from various disciplines of the 2nd cycle of basic education to collaborate in the analysis of that legislation and draw up plans and diagnostic tests (based on content issued by the Ministry of Education).

The hours devoted to sexual education should be adapted to each level of education and each class, and can not be less than six hours per year for the 2nd cycle, distributed evenly over the year by the school.

The contents of sexual education can be addressed in disciplinary curricular areas or in not disciplinary curricular areas.The aim of this study is to provide a broad discussion on this topic at the 2nd cycle.

PD.01.77 RELIGIOUS PRINCIPLES AND SEXUALITY AND MASTURBATION CONCEPTIONS: OPINIONS OF YOUNG UNIVERSITY STUDENTS

P. Pereira ¹, A.C.B. Maia ²

¹ Unesp - Universidade Estadual Paulista - Department of Psychology of Education, Araraquara, Brazil,² Unesp - Universidade Estadual Paulista - Department of Psychology, Bauru, Brazil

Masturbation is a cultural construction, so consonant with the values and social behavior that have a strong influence of religious morality. This study investigated the connexion between the importance of religious principles among college students and their views about masturbation and sexuality. Data were collected through a questionnaire, which involved 232 college students. The open questions were categorized using content analysis.

The results indicate that participants who attributed greater importance to religious values perceived sexuality as a synonym for Loving Relationship. Among individuals who religious principles are very important there's no understanding of the practice as healthy and necessary, like there's in the group that give low or medium importance to religion values. The group of participants who religious values are important presents higher number of participants who indicated discomfort face the practice, also showed the greatest number of abstentions.

In general, it's possible to realize that for this sample there is an indication that religious principles tend to influence the individual’s conceptions about sexuality and masturbation. While sexuality is not perceived as a wide concept and its expression is conditioned by affective relationship with a partner, masturbation appears as less legitimate form of sexual expression-generating constraints and discomforts. Understanding the determinants in the formation of opinions and attitudes related to sexual behavior is fundamental to creating more emancipatory education projects

PD.01.78 LEARNING THROUGH PLAY: THE TUPPERSEX AS AN EDUCATIONAL TOOL, THERAPEUTIC AND SEXUAL HEALTH PROMOTION

M. González Veiga ¹-²-³

¹ Con Mucho Gusto! Centro de Sexología, Santiago de Compostela, Spain, ² Sociedade Galega de Sexoloxía, Pontevedra, Spain,

³Asociación Galega de Comunicación de Cultura Científica e Tecnolóxica, Santiago de Compostela, Spain

The aim of this poster is to present the tuppersex meetings from therapeutic and educational approach, understood as a powerful tool for education and sexual health promotion.

A tuppersex is a meeting at which articles erotic are shown to group of people or a couple who request and is usually performed in a private home or in a specialized center. The tuppersex raised from a professional approach from sexology can treat many issues related to sexuality like the relationship with the genitals and knowledge of sexual body, pelvic floor health, menstruation, desire, communication, fantasies, difficulties and sexual dysfunctions, etc... Attitudes can be worked th and break taboos and myths. We can work with adult audiences of all ages from 18, in a playful and relaxed environment. It is a tool that can also work in consulting, especially in couples therapy.

In this poster the methodology is applied in regular work at Con Mucho Gusto! Center for Sexology. The tuppersex, is a powerful mobilizing emotions, it is important to manage them properly.

Tuppersex meetings have great potential both at school and in therapy, and is a tool to be considered by professional sexology, to promote positive sexuality and sexual health among adult audiences.

SEXUALITY IN A GROUP OF ADOLESCENTS IN VENEZUELA

C. Cotiz

Editorial Nuevo Dia, Coro, Venezuela

Sexuality is a very complex aspect of life of every adolescent to build the essential dimension of the person and it is present since the moment of conception fulfilling the individual in a profoundly personal reality that makes adolescents become adults.

It is adolescence when the sexual phenomenon arises due to the need to reaffirm sexual and personal identity, what guides adolescents to have a greater interest on erotic and sexual topics, searching for information about sexual organs development, reproduction and sexual intercourse among others.

There are many authors who consider that, nowadays, adolescents have a variable information, distorted and insufficient about sex coming from different sources as other adolescents, significative adults for them, television, and internet, but this information does not result in preventive behaviors of young people in their sexual practices, showing a non deniable reality: adolescents are beginning their sexual lives in a more premature way as time goes by and, if measures are not assumed, adolescent pregnancy ratios, STD’s (specially HIV/AIDS) and risky abortion will continue being frequent in youth.

In the state of Falcon, Venezuela, a study was performed in adolescents attending school in the third phase of basic education which main objective was to determine sexuality in this sample of adolescents. It is descriptive field study. The sample was compound by 1170 adolescents and sampling was performed randomly.

Interestingly, the study concludes that, however the instrument was anonymous, almost half of the surveyed adolescents denied to answer most questions related to sexuality, probably due to social prejudices through which they focus sexuality . Nevertheless, answered questions related to sexual education, sexual function, sexual physiological variants, contraceptive methods and relationship are very worrying and confirm what it has been already discussed on ignorance, false believes and lack of communication on the sexual topic between parents and their adolescent children.

PD.01.80 IMPLEMENTATION OF SEXUAL EDUCATION IN THE 1ST CYCLE OF BASIC EDUCATION IN SCHOOLS GROUPING FRANCISCO DE ARRUDA IN LISBON

I. Xavier Vieira ¹, C. Nabais ¹, M. Joao Alves ¹, E. Ribeiro ¹, C. Costa ¹, S. Santos ¹, D. Silva ¹, A. Gomes ¹, C. Santiago ¹, R. xavier Vieira ²

¹ Escola Franciusco De Arruda, Lisbon, Portugal, ² Faculdade de Medicina de Lisboa, Lisbon, Portugal

For the implementation of Sexual Education in Schools

poster display 81-94

sexual health & wellbeing

PD.01.81 PORTUGUESE WOMENS SEXUAL SATISFACTION AND AGEING: THE ROLE OF SEXUAL BELIEFS

S. Vilarinho, P. Nobre

Aveiro University, Aveiro, Portugal

Objective: Our aim was to compare Portuguese women with different ages with regards to sexual satisfaction and its predictors. Additionally, we wanted to investigate the relationship between age and sexual beliefs.

Design and Method: Participants were women from the general population distributed by age into 3 groups: 15-35 (N=259), 36-45 (N=103), 46-75 (N=123). Questionnaires assessed: menopause status; relationship (GRIMS and relationship duration); life satisfaction (SWLS); affect (PANAS-x); sexual beliefs (QCSD); sexual self-esteem (SSEs); sexual satisfaction (GRISS); sexual functioning (FSFI). Results: Results for women aged 15-35, revealed sexual functioning (=.52, p<001) as the main predictor of sexual satisfaction; positive affect during sexual activity (=.18, p<001) and relationship status (=.17, p<001) were also significant. Best predictors for women aged 36-45, were sexual functioning ( =.42, p<001), less negative affect ( =-.28, p<001) and relationship status (=.17, p<001). For women aged 46-75, relationship status (=.27, p<001), less sexual beliefs ( =-.25, p<.001), sexual functioning (=.24, p<05) and less negative affect (=-.21, p<.001) emerged as significant predictors.

Older women scored higher on all dimensions of sexual beliefs, with major group differences for sexual conservatism and sexual desire as sin.

Results evidenced significantly higher levels of sexual satisfaction in younger women. However, after controlling for sexual beliefs, religion and education, no significant differences between groups were found.

Conclusions: Overall, findings supported the important role played by sexual functioning in younger women’s sexual satisfaction and the principal role of relationship and cognitive-afective factors mostly in older women’s sexual satisfaction.

PD.01.82 AN ANALYSIS OF SEXUAL SATISFACTION AND ITS RELATIONSHIP WITH HEALTH

M. Sánchez Fuentes, P. Santos Iglesias, J.C. Sierra, N. Moyano, P. Vallejo Medina, R. Granados

Faculty of Psychology - Department of Personality, Evaluation and Psychological Treatment/University of Granada, Granada, Spain

Objective: Studies report that sexual satisfaction is an

important element of sexual health and sexual health is a key factor for the well being of people. However, few studies examining the relationship between sexual satisfaction and health. Therefore, the aim was to examine sexual satisfaction and its relationship with physical and psychological health status in a Spanish sample.

Design and Methods: Ex post facto study. Using quota sampling 1,500 subjects were evaluated. Participants were divided into three age ranges: 18-30, 31-54 and from 55 and older. All the participants maintained a relationship for at least 6 months and they had sexual activity. The assessment instruments were: socio-demographic questionnaire, the Spanish adaptation of the Interpersonal Exchange Model of Sexual Satisfaction Questionnaire, the Spanish version of the Health Questionnaire SF-36 and the Spanish adaptation of the Symptom Assessment-45. The participants were selected through incidental sampling of the general population. Results: Using partial correlations controlling for relationship satisfaction, it was found that sexual satisfaction was positively and significantly related with vitality and negatively with somatization. That is, greater vitality was associated with higher levels of sexual satisfaction and greater somatization was associated with lower levels of sexual satisfaction. In addition, the obtained results from regression analysis, controlling for relationship satisfaction, showed that sexual satisfaction was explained by relationship satisfaction, vitality, somatization and interpersonal sensitivity.

Conclusions: Relationship satisfaction and mental health, specifically, vitality, somatization and interpersonal sensitivity are factors that contribute to the level of sexual satisfaction of Spanish adults.

PD.01.83 SEXUAL FUNCTION IN WOMEN AFTER MASTECTOMY: A SURVEY OF POLISH PATIENTS

R. Kowalczyk ¹, Z. Lew Starowicz ², I. Glogowska ³, K. Krzemieniecki ⁴, A. Bialek ⁵, M. Krzystanek ⁵

¹ Department of Sexology in Andrzej Frycz Modrzewski Cracow University, Cracow, Poland,² Department of Sexual Rehabilitation, AcademyofPhysicalEducation, Warsaw, Poland,³ Maria Sklodowska- Curie Memorial Cancer Center and Institute of Oncology, Warsaw, Poland,⁴ DepartmentofClinical Oncology, Cracow University Hospital, Cracow, Poland, ⁵ Department of Psychiatry and Psychotherapy, Medical University of Silesia, Katowice, Poland

Objective: As various studies show, women after mastectomy are accompanied by many problems in the sexual sphere; it considerably lowers their quality of life.

Goal of the study is to describe the relationship between the illness as well as the treatment of choice and the sexuality of Polish patients. Another goal is a comparison of the study results with results obtained in similar studies in Europe. Design and Method: The target group of 300 women after mastectomy is in the process of assessment (to be completed by July 2012). The subjects are recruited among Polish patients diagnosed and treated at the Department of Clinical

Oncology, Cracow University Hospital in Cracow, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology in Warsaw and its branches in Katowice and Cracow.The following questionnaires are used: Changes in Sexual Functioning Questionnaire (CSFQ - F - C), Body Image Questionnaire (KOC-BR), Sexual Interaction Inventory (SII), Quality of Life Questionnaire QLQ - BR23. Questionnaires were supplemented by questions related to social-economic status and oncology treatment.

Results: The hypotheses tested are:

1) Polish women after mastectomy (PWAM) experience a decline of sexual functioning in comparison to the time before the surgery.

2) Body image of PWAM influences their sexual functioning depending on type of treatment involved.

3) Experience of mastectomy induces changes in relationship with sexual partners.

4) Quality of life decreases after mastectomy depending on treatment type.

5) Polish women of mastectomy experience similar changes in sexual functioning as women in Europe.

PD.01.84 ASSESSMENT OF LIVING AND SEXUAL SATISFACTION IN WOMEN WITH FIBROMYALGIA

I. Lopez Cobos ¹, R. Alarcon Rodriguez ², E.M. Quesada Bravo ¹

¹Nursery Department Of Hospital Poniente, Almería, Spain,² Health Sciences Deparment, Almería University, Almería, Spain

Fibromyalgia was defined as a painful condition that primarily affects non-articular muscles, expressed as widespread musculoskeletal pain and multiple tender points in the absence of other changes which would explain your symptoms. (Martinez, Gonzalez and Crespo, 2003).

The published data suggest that there is a sexual dysfunction in women with FM. The phase of sexual response that is most affected, mainly, the phase of desire. The symptoms associated with fibromyalgia have a negative impact on women’s sexual satisfaction.

Main objective of this study is to describe and characterize the experience and sexual satisfaction of women with fibromyalgia.

Methods: The study sample consists of 63 women FM diagnostic region of the West and the city of Almeria. Each participant answered two questionnaires. The first evaluator of sexual function in women (FSM). The second evaluator GRISS sexual satisfaction for women. It also took into account the descriptive variables of age, number of children, marital status and occupation.

Main Results and Conclusions: According to the results obtained in our sample, over 50% rated without disorder, all domains of sexual response evaluators (58% in desire, arousal 62%, 78% in orgasm).

Regarding GRISS questionnaire, 51% of the sample show the absence of dissatisfaction, a condition observed in the

frequency range is more evident, with 80.3% and 78% avoidance problems.

PD.01.85 SEXUALITY AND FEMININITY IN WOMEN WITH TREATMENT FOR BREAST CANCER

M. Ciendones Carbonell ¹, E. Juan Linares ¹, S. Parrado Chamorro ²

¹ Hospital Sant Pablo, Barcelona, Spain,² Sacyl, La Baneza, Spain

Summary: Women diagnosed with breast cancer often express adverse effects on your sex life and their body image negatively impacting their quality of life.

The shock of diagnosis, vulnerability, surgical treatment (mastectomy, tumeroctomy) chemotherapy, radiotherapy and induced menopause, will affect their sexuality.

Objective: To explore the effects on sexuality and femininity of women undergoing cancer treatment for breast cancer. Design and Method: The study group included 117 women who were followed up at the Hospital Sant Pau in Barcelona. Aged ranged between 27 and 85 years in treatment since January 2011.

The sample data were collected using the EORTC C30 and BR23 questionnaires, completed confidentially. The collection of data was made twice: the first at the beginning of treatment with hormone inhibitors and the second one year after. Biomedical data were also collected and processed using SPSS 19.

Results: All the treatments caused significant side effects on sexuality and femininity, and perception of decrease in the quality of life.

Conclusions: Women treated with breast cancer need educational and emotional support and specific recommendations regarding sexuality to improve their quality of life and perception of body image.

PD.01.86 SEXUAL FANTASIES IN THE PERSONAL HEALTH:

GENDER DIFFERENCES

E. M. Quesada Bravo ¹, I. Lopez Cobos ¹, I. Fernandez Agis ²

¹Nursery Department of Poniente Hospital, Almeria, Spain,

²Neuroscience and Health Sciences Deparment, Almeria University, Almeria, Spain

Sexual fantasies are a core element in the process of stimulation of sexual behavior. Also contribute to the induction, emergence and empowerment of sexual desire, which is taken as a real emotional and cognitive readiness of the subject (Strong, 1995)

Objective: To describe the differences in sexual fantasies of men and women in the health field.

Methods: 168 respondents, divided into three categories: medical / as, nurses / as, technical nursing care. For data collection the questionnaire was SFQ (Wilson, 1988) (Adaptation of Sierra, 2005). Main Results: Statistically significant differences were observed between men and women in the exploratory type of sexual fantasies (p <0.05), men earned an average of 6.7 points on the exploration of sexual fantasies and women an average of 3.79.

Conclusions: As stated in Fisher (2000) most men fantasize about having sex with people who do not know and have sex with different races (exploratory fantasies). Similar to the results obtained in our study, men have an average higher than women in the exploratory fantasies, these differences were statistically significant. However, Plaud and Bigwood (1997) to compare men and women indicate that men are significantly more exploratory fantasies, intimate and impersonal. In our study only statistically significant differences in exploratory sexual fantasies.

PD.01.87 SEXUALITY AND VULNERABILITY: ANALYSIS OF THE REPORT OF YOUNG PEOPLE WITH INTELLECTUAL DISABILITIES

A.C.B. Maia

Sao Paulo State University Unesp. Cnpq and Fapesp, Bauru, Brazil

Objective: These work is a case study and the authors investigated the emotional and sexual issues of people with disability.

Method: Qualitative research in which a man and a woman with acquired spinal cord injury responded to an interview for content analysis.

Results: 1) Perception of body and beauty. The concept of beauty refers more personal characteristics than physical. The body bothered more by not meet the standards of aesthetics than for the non-functionality; 2) Affective and sexual life. After the injury, the man separates from his wife and has a new partner also deficient; tells about feel desire, but erection occurs only with medication and does not feel orgasm. The woman was a virgin before the accident but nowadays has dated and sexual intercourse; she reported feeling little desire and arousal, and she does not feel orgasm. Both subjects related that the romantic relationship requires intimacy and trust with the partner. They don't receive sexual guidance by doctors and get their sex information with friends. Discussion and Conclusions: Spinal cord injury can affect people’s sex lives, although the expression of sexuality is always preserved. The stereotypes exacerbate the difficulties of loving and sexual relationship when the person has an acquired disability. The data are not generalizable, but are in line with the literature. The authors appoint sexual education is important and necessary in rehabilitation programs.

WOMEN’S SEXUAL FUNCTIONING: THE ROLE OF SEXUAL BELIEFS, FOCUS OF ATTENTION, SEXUAL FANTASIES AND WORRIES DURING SEXUAL ACTIVITY

S. Vilarinho, P. Nobre

Aveiro University, Aveiro, Portugal

Objective: The aim of this study was to investigate the role of cognitive variables, particularly sexual beliefs, focus of attention, sexual fantasies and worries during sexual activity, in women’s sexual functioning.

Design And Method: A total of 497 women from the general population participated in this study. Questionnaires assessed: demographics; medical condition; psychopathology (BSI); sexual beliefs (QCSD); sexual activity, worries, focus of attention and sexual fantasies (QAS); sexual functioning (FSFI). The study was cross-sectional.

Results: Resulted revealed that women with higher levels of sexual functioning presented significantly lower levels in all dimensions of sexual beliefs (p<.001), particularly “sexual desire as sin” (partial 2=.15); less worries (p<.001), and more sexual fantasies during sexual activity (p<.001); and tended to focus more their attention on own and partner’s sexual pleasure (p<.001) and own and partner’s sexual behavior (p<.001).

A multiple regression analysis, considering all the cognitive variables assessed, revealed a significant model for women’s sexual functioning (explaining 40% of the variance) with focus of attention on own pleasure during sexual activity (=.28, p<.001) and absence of worries regarding pain or physical discomfort during sexual activity ( =-.22, p<.001) as main predictors.

Conclusions: Results reveal the important role played by cognitive variables, particularly the more proximal ones namely focus of attention and absence of distraction (by worries) during sexual activity.

Findings will be discussed in terms of implications for promotion/protection of sexual functioning.

PD.01.89 FIBROMYALGIA AND SEXUALITY: RESULTS OF LITERATURE REVIEW VS OUR SAMPLE RESULTS

I. Lopez Cobos ¹, R. Alarcón Rodriguez ², E.M. Quesada Bravo ¹

¹ Nursery Department of Poniente Hospital, Almería, Spain,² Health Sciences Deparment, Almeria University, Almeria, Spain

Following the literature review that relates Fibromilgia and sexual dysfunction in women, we get these conclusions: The dysfunction is often severe, affecting all areas of sexuality. There is evidence that depression may be the main factor affecting the phase of desire and arousal, decreased experience of orgasm and increased pain during intercourse. Objective: Comparison of the results of the studies reviewed and the results of our sample.

Method: Pubmed literature search of studies that link women with fibromyalgia and sexual dysfunction. Our sample consists of 63 women diagnosed with FM who responded to the questionnaires: FSM evaluator and GRISS for women). Main Results and Conclusion: There are discrepancies between the data obtained in our sample and published studies. Depending on the sample of Garcia and Alba (2004), there is a 90% relationship little or very poor, with the median frequency of intercourse, 1coito/2meses. In our sample included all sexual activity, not just intercourse, obtaining 20.6% of female respondents had not had sex in the last 4 weeks.

It also highlights the differences in sexual satisfaction. According to Print (2006), the number of women studied, not differ in arousal and orgasm, compared with a control group of healthy women between 21-54 years. Yes they do about desire and satisfaction. In our sample, however, yields a 80% overall sexual satisfaction.

PD.01.90 SEXUALITY AND SPINAL CORD INJURY: A CASE STUDY

A.C.B. Maia, P. Ribeiro

¹ Sao Paulo State University Unesp. Cnpq and Fapesp, Bauru, Brazil,

Objective: These work is a case study and the authors investigated the emotional and sexual issues of people with disability.

Method: Qualitative research in which a man and a woman with acquired spinal cord injury responded to an interview for content analysis.

SEXUALITY WITH CERVIX CANCER

M. Jodar Martin ¹, R. Gonzalez Segura ², N. Benayas Perez ³, R. Benayas Perez ², M.D. Jimenez Lechuga ¹, S. Valladolid Benayas ¹

¹ Comarcal Hospital, Melilla, Spain,² Out of Work, Almería, Spain,³ Chare Poniente Hospital El Ejido, Almeria, Spain

Introduction: Sexuality accompanies us from birth to death and starts manifesting and transforming throughout our lives. When a disease process such as cervical cancer, patients face a change in their quality of life while this disease also affects their partners.

Cervical cancer is the second most frequent women's neoplasm in the world, so it is so important their reaction to sexuality.

Objectives: Publicizing the problems of having sexual intercourse after a hysterectomy due to cervical cancer. Design and methods: Extensive literature review of recent years

Results and Conclusions: When a surgery such as hysterectomy in this type of cancer, you have to interrupt sex from four to eight weeks, depending also on the recovery of each woman. Sexual desire and the ability to have sex are not affected by hysterectomy.

In general, hysterectomies in a period of six or eight months usually do not imply any consequences for women’s sexuality. Women are not physically altered so that makes the body image it is not affected.

The only affectation is psychological. To avoid disturbances, it is necessary to prepare pre-and postoperative preparation, because some women think in cervix lost as a fact of losing the capacity to have children. It is important to support the couple and the strengthening of the multidisciplinary team will be with the patient all along this process.

PD.01.92 WOMEN WHO DO NOT HAVE SEX (VAGINAL INTERCOURSE). CLINICAL CHARACTERISTICS AND REASONS

J. Lopez Olmos

Centro de Especialidades de Monteolviete - Ginecología, Valencia, Spain

Objective: To study the clinical characteristics and reasons of women who abstain from sexual intercourse.

Design and Method: We present a series of 54 women who never had sexual relations of vaginal intercourse, older of 20 years, and were attended during 2009 in gynecologic clinics of the author. They represent the 0,78 % over 6839 consultations.

Results: The mean age was 39 years. In 12 cases they were menopausal women. The BMI in 53,70 % of them was normal. In 59,25 % there were medical antecedents, and in 48,14 % there were surgical antecedents. In 72,72 % there were gynaecologic antecedents: oligomenorrheas, in 20,51 %; amenorrheas and metrorrhages in 10,25 %, respectively. We can divide the series in two groups, first (A) with the more affected by diseases and deformity, and second (B), the more normals. No significant differences were found in the age nor the tabac habit. But, there were significant differences in not having studies, p =0,02 (more in group A ), in having universitary studies, p = 0,02 ( more in group B ), and in not having job, p < 0,05 ( more in group A ).

Conclusions: The reasons for not having intercourse were: self diseases in 19 cases (35,18 %), and not having found an adequate partner in 19 cases (35,18 %). The religious factor was found in 5 cases (9,25 %).

PD.01.93 EFFECT OF CIRCUMCISION ON PENIS SENSITIVITY

J. Kim, P.B.M. Kim

Philip and Paul Medical Institute, Department of Urology, Seoul, South Korea

Purpose: Circumcision may cause edema and histologic changes and there might be a decrease in sensitivity in the distal penis. This study aims to report the correlation between circumcision and a decrease in penile sensitivity.

Method: A biothesiometry test was conducted on men who have phimosis and those who were circumcised. For those who have phimosis, it was measured on the distal penis that is 1.5-2.0 cm from the corona and on the proximal penis that is 1.5-2.0 cm from the penopubic junction. For those who were circumcised, it was measured at the area between the corona and the incision line and on the the proximal penis that is 1.5-2.0 cm from the penopubic junction.

Results: The average age of men having phimosis(22cases) is 41 years old. The threshold from the distal penis and that from the proximal penis was 6.4 and 6.3. The average age of men (81cases) who were circumcised is 39 years old. The threshold from the distal penis and that from the proximal penis was 5.6 and 6.1.

Conclusion: This study showed that the sensitivity that was expected to decrease turned out to be more sensitive on the distal area than on the proximal area. On the other hand, the men who were uncircumcised showed less sensitivity on the distal area than on the proximal area. It is assumed from the findings that circumcision would not have any influence on a decrease in sensitivity of the penis.

PD.01.94 STUDY ON THE NURSING BELIEFS AND KNOWLEDGE OF THE PREGNANT WOMEN DURING PREGNANCY AND THEIR INFLUENCE ON SEXUAL ACTIVITY

J. Garcia González, M. Ventura Miranda, J. Valdivieso Pérez, Y. García González, M. García Chalud, F. Villanueva Millán, I.M. Jodar López, M.R. Sanchez Navarro, V. Fernández Puerta, S. Hernández Vivancos

Hospital Rafael Mendez, Lorca (Murcia), Spain

The present study has as objectives (a) to know if the beliefs on the consequences of pregnancy influence the activity of sexual practice; and (b) to obtain information on the knowledge that pregnant women have about sexual activity. 115 gestating women participated. The results obtained from the information received about the consequence of pregnancy in sexual activity highlights that 60% of the puerperal women indicated that “they have not told me anything”. The time that they plan to abstain the gestating ones from maintaining sexual relationships after childbirth 57.4% think that she enters 0 = < 3 months. Majority of the gestating ones say that they have a decrease in sexual fantasies during pregnancy. Also, 65.22% say changes took place in their sexual fantasies during pregnancy, generally in the second trimester. And most of the gestating ones, describe sexual activity as “coitus” (74.8%). 5.2% only report “complicity with my couple” and “pleasure,” and 1.7% “caresses/ kisses” and “oral sex”. This discusses the importance of controlling the formation of false beliefs on sexual activity in gestating women.

PD.01.95 SEXUAL HEALTH OF DEMENTIA PATIENTS DIAGNOSED WITH LEWY BODIES

N. Pardo ¹, T. Garcia ¹, P. La Calle Marcos ², I. Fernandez ³

¹ Neurologic Clinic Neurodem, Almeria, Spain, ² Gynecology Department of Torrecardenas Hospital, Almeria, Spain,³ Neuroscience and Health Sciences Department, Almeria, Spain

Sexuality in old age is still a taboo today surrounded by myth, if we add to this, age-related diseases such as dementia, we face a world virtually unknown in terms of sexual health. In our study we have analyzed global and sexual health of participants diagnosed of dementia and specially diagnosed of Dementia with Lewy Bodies. We observed that the group of patients diagnosed with Lewy Body dementia showed worse global health, we observed significant differences in dimensions of Mental Health and Vitality, energy or fatigue. In addition, women showed sexual dysfunction but we didn't observe any difference in sexual health in men. Therefore, we conclude that sexuality in dementia diseases may be affected. Nowadays we are increasing sample to know better sexual health of these patients and trying to explain differences in terms of brain damage areas in this kind of dementia.

poster display 96-97

sexually transmitted infections

PD.01.96 BALANCE PSYCHO-SEXUAL CHANGES IN A SAMPLE OF WOMEN WITH HPV INFECTION. A PRELIMINARY STUDY

A. Fabrizi ¹, A. Criscuolo ², G. Morosetti ², M. Pazzola ², C. Simonelli ³

¹1nstitute of Clinical Sexology, Rome, Italy,² Department of Surgery, Section of Gynecology, Tor Vergata University Hospital, Rome, Italy,

³“Sapienza” University, Rome, Italy

Introduction: Human papillomavirus (HPV) is actually considered the main cause of cervical cancer. Several studies showed that women with an abnormal result at cervical screening may head for anxiety and distress. Such situation is generally solved after a correct diagnosis and treatment. However, it is quite evident that HPV testing may result in adverse psychosocial impact.

Aims: The purpose of the study was to assess the psychosocial impact of HPV testing.

Methods: 20 HPV-DNA positive women were recruited at the Colposcopy and Cervical Pathology Clinic of “Tor Vergata”University Hospital of Rome, Rome, Italy. The mean age of women was 29.75 years. Mean age of menarche and mean age at first sexual intercourse were 11.35 and 16.25 years, respectively. Contraception methods were used by 13 women. The most prevalent HPV genotypes were: HPV 16 (8), HPV 39 (4), HPV 18 (3) and HPV 6 (2). Data about HPV risk factors were collected by an oral interview. After the communication of the diagnosis of viral infection several questionnaires to evaluate some psychosocial variables were administered. The General Health Questionnaire (GHQ-28) was administered to assess the psychological distress over the past few weeks. A cut off score of 4 was considered to estimate the probable cases of affective disorders among the tested women. Spielberger State-Trait Anxiety Inventory (STAI) was used to assess both the state and the trait anxiety levels. At least, McCoy questionnaire was administered to evaluate the sexual satisfaction of women.

Results: Somatic symptoms were generally more prevalent among women with HPV 16 infection. Intermediate levels of anxiety were reported by women with HPV 16 and HPV 39 infection. Three women with HPV 39 infection reported the presence of sexual dysfunction. In total, 7 women revealed to have sexual dysfunctions while 2 women reported alterations of the affective relationship.

Conclusions: No association between HPV and severe depression was found. However, somatic symptoms and intermediate levels of anxiety were reported by several women. Finally, only 7 women revealed to have impairment of psychosexual activity. The differences with the literature may be due to the low number of the analysed patients. A

follow up study could reveal if the persistence of HPV may cause alteration of the psychosexual balance of women.

PD.01.97 VAGINAL INFECTION BY TRICOMONAS AND CELLULAR ATYPIAS IN THE CERVICOVAGINAL CYTOLOGY

J. Lopez Olmos

Centro de Especialidades de Monteolivete. Ginecología, Valencia, Spain

Objective: to study the vaginal infections by Tricomonas and cellular atypias in the cervicovaginal cytology.

Design and Method: We present a series of 380 cytologies with the diagnostic of vaginal infection by Trichomonas vaginalis. They represented the 0,31 % of 121688 cytologies in a ten-years period (2000-2009). We compared them with a control group of 535 cytologies.

Results: The cytology with Trichomonas is more inflammatory, and there were mixed infections in 36 cases ( 9,47 % ). We found atypias in 19 cases ( 5% ).

Conclusions: In our study, the vaginal infection by Trichomonas in the cytology was associated significantly with bacterial vaginosis, p<0,05, and atypias of undetermined significance, ASCUS, p< 0,01.

poster display 98-104

social sciences and sexuality

PD.01.98 ATYPICAL ONLINE SEXUAL PREFERENCES IN SWEDISH AND ITALIAN YOUNG ADULTS

M. Giuliani ¹, S. Eleuteri ², F. Tripodi ¹, S. Livi ², K. Daneback ³, R. Rossi ¹, C. Simonelli ²

¹1nstitute of Clinical Sexology, Rome, Italy,² Faculty of Medicine & Psychology, Sapienza University of Rome, Rome, Italy,³ University of Gothenburgh, Gothenburgh, Sweden

Objectives: In the last years, the Internet has become an important medium through which to experience own sexuality as people can easily and without embarrassment explore and enhance their sexual fantasies, coming into contact with atypical sexual behaviours. The aim of the current study was to evaluate atypical online sexual preferences in a large selected population of Italian and Swedish young adults. It was examined the association between preferences, online sexual behaviour, sexual compulsivity, and a set of sociodemographic variables.

Design and Methods: Data were collected in Italy and Sweden in a 1 year period through a pen and paper questionnaire. The population comprised 421 Italians and 426 Swedes heterosexual university students aged 20-30 and had an equal sex distribution. Participants completed a set of measures regarding their sociodemographic characteristics, Internet sexual behavior (ISST), sexual compulsivity (SAST-A) and atypical online sexual preferences (AOSePreQ).

Results: Scatophilia, gangbang, spermatophagia and spanking were seen by more than half of the participants; bondage, tattoos and stuffing by 40-50%; exhibitionism, fisting and fetishism by 30-40%; the other scenes were seen by less than 30% of participants. Gender appears the most important intercultural variable, related both to online seen scenes and the excitement connected to them.

Conclusions: Atypical online sexual preferences have been found to be quite diffuse in our population. To be male is a predictor of viewing and to feel excited for all the different atypical sexual behaviors analyzed, while relationship status has not a significant impact.

PD.01.99 NEGATIVE ATTITUDES TOWARD MASTURBATION INVENTORY: PSYCHOMETRIC PROPERTIES OF A REDUCED VERSION

J.C. Sierra, P. Santos Iglesias, N. Moyano, M. Sanchez, R. Granados, P. Vallejo Medina

Universidad De Granada, Granada, Spain

Objective: The Negative Attitudes toward Masturbation Inventory (NAMI) in one among the scarce self-reports developed to assess attitudes toward masturbation. The present study aims to examine its factorial structure through confirmatory factorial analysis (CFA), but also to analyse its reliability and give evidences about its convergent and discriminant validity.

Design and Methods: A sample made up of 1,083 adolescents (13-17 years old) responded to the NAMI, the Sexual Opinion Survey, and the Hurlbert Index of Sexual Fantasies.

Results: Exploratory factor analysis yielded three factors, but one of them was eliminated because of its poor psychometric properties. Later CFA supported the resulting two-factor structure, showing appropriate internal consistency values, and good convergent and discriminant validity evidences. Conclusions: This reduced version of the NAMI is reliable an valid for use in Spanish adolescents.

PD.01.100 SELF-SILENCING AND SEXUAL SUBJECTIVITY IN YOUNG FEMALES

M. Nekic, A. Moric, I. Macuka

University of Zadar, Department of Psychology, Zadar, Croatia

Objective: Viewing development of sexuality in adolescence trough normative perspective created new body of research especially on the development of sexual self-conception (sexual subjectivity). Sexual subjectivity is multidimensional phenomenon which is often defined as having a sense of entitlement to sexual pleasure and sexual safety - interacted with intraindividual and psychological well-being. Previous studies showed that among adolescent girls, sexual subjectivity was associated with higher self-esteem and resistance to sexual double standards. Purpose of this study is to examine relation between dimensions of sexual subjectivity and self-silencing in Croatian sample of young women.

Design and Method: In this study 141 female college students between the ages 19 to 26 were assessed with Self-silencing scale, the Female sexual subjectivity inventory and Sexual experience scale.

Results: All participants were sexually active. Average age of sexual initiation was 18, which is slightly later than in other similar studies. It was found that self-silencing is in significant negative correlation with four dimensions of sexual subjectivity; with sexual body-esteem, sense of entitlement to sexual pleasure from partner, self-efficacy in achieving sexual pleasure, and sexual self-reflection. Further, dimensions of sexual subjectivity are in positive relations. Hence, sexual body-esteem correlates positively only with self-efficacy in achieving sexual pleasure, while intercorrelations of other dimensions of sexual subjectivity are positive and significant. Conclusions: It seems that in general if young women silence their feeling, thoughts and actions in close relationships they will experience low level of sexual subjectivity.

authors

AARS H.

S54, S70

ABAJO LLAMAS S.

S100

ABDEL AZIM R.

ABDEL AZIM S.

S24

AHMAD S.

S41

ALARCÄO V.

S76, S92

ALARCÓN RODRÍGUEZ R.

S58, S106, S107

ALBARRÁN M.A.

S86

ALCARAZ L.

S51

ALCARAZ QUEVEDO M.

S73, S101

ALLASIA S.

S95

ALMAS C.

S8, S38

ALMAS E.

S8, S24, S38, S68, S54, S70

ALMENDROS C.

S77

ALONSO F.

S86

ALONSO L.

S59

ALVAREZ CASTEL L.

S63

ALVAREZ M.

S59

ÁLVAREZ LOBATO P.

S86

AMODEO A.L.

S39, S62

AMORÓS A.

S51

AMORÓS FERRER P.

S76

ANDRÉS I.M.

S67

ANDRÉS M.A.

S64

ANDRIANNE R.

S98

ANTONA A.

S64

ANTONUCCI G.

S54

ARANDA VISO O.

S38

ARDUINO E.

S47, S91, S112

ASSCHEMAN H.

S24, S41

BAENA B.

S4, S20

BAENA MORALES A.

S96, S102

BAHIA S.

S64

BARAJAS A.

S43

BARBARANELLI C.

S66

BARBERO G.

S65, S95

BARNÉS SARRA E.

S100

BARNES HOLMES D.

S37

BARONE P.

S74

BEATO A.

S76, S92

BEDIN R.

S79

BENAYAS PEREZ N.

S84, S97, S98, S100, S101, S108

BENAYAS PEREZ R.

S84, S97, S98, S100, S101, S108

BENESTAD E.

S8, S24, S25, S68

BENTE T.

S25

BERGAL A.

S85

BERNORIO R.

S25, S43

BERTOLASI L.

S74

BIALEK A.

S105

BIANCHI DEMICHELI F.

S4, S94

BIANCO COLMENARES F.J.

S4, S8, S20, S29, S32

BINTER J.

BIVONA U.

S54

BOBI B.

S51

BOCCARDI P.

S43

BOCHICCHIO R.

S47, S56, S91, S112

BOGETTO F.

S40

BOHANE K.

S47

BOLINCHES i SANCHEZ A.

S20

BOLMONT M.

S94

BOROWIECKA KLUZA J.

S85

BRAMANTI P.

S89, S93

BRIET GARCÍA V.

S92

BRUNO M.T.

S57

BRURBERG K.G.

S70

BUCH VICENTE B.

S54

BUENO LÓPEZ V.

S51, S76

CABALLERO JÁUREGUI M.

S63

CABELLO SANTAMARIA F.

S9, S25

CACIOPPO J.T.

S94

CACIOPPO S.

S94

CALAMA J.

S86

CALVEIRO HERMOSILLA M.

S76

CALZADO F.

S59

CAMPOS ALMEDA M.

S76

CANTERO LLORCA J.

S73

CARBAJAL MARTINEZ R.

S22

CARCEDO GONZÁLEZ R.J.

S50

CARDENAS R.

S8, S20

CARIOLA M.

S64

CARLAVILLA SAEZ S.

S63

CAROSA E.

S80

CARRACEDO R.

S67

CARREIRA M.

S76, S92

CARROBLES J.A.

S77

CARTA R.

S80

CARUSO S.

S4, S53, S57, S64

CARVALHEIRA A.

S25, S42, S62

CARVALHO J.

S26, 81

CASAS M.

S53

CASAUBÓN ALCARAZ A.

S26

CASTELLANOS USIGLI A.

CASTELLI L.

S41

CASTRO ESPÍN M.

CAUBET GUALDO M.

S76

CAUCI S.

S83

CERNUDA LAGO A.

S91

CESTARI C.

S79

CHACÓN SÁNCHEZ M.D.G.

S20, S21, S22

CHECCHIN E.

S83

CHICO E.

S59

CIANCI S.

S64

CIANCIO F.

S64

CICERO C.

S53, S57, S64

CIENDONES CARBONELL M.

S106

CIOCCA G.

S43, S80

CIOCCA M.

S74

CIPRIAN D.

S86

CISMARU INESCU A.

S98

CLADELLAS E.

S21

CLAES T.

S57, S64

CLEFFI L.

S112

COATES R.

S30

COCIGLIO G.

S95

COGIAMANIAN F.

S74

COLEMAN E.

S4, S30

CONTI NIBALI V.

S93

COPPOLA M.C.

S97

CORDOVÉ MAURISSET A.

S93

CORONADO P.

S13

CORONA VARGAS E.

S30

CORREA P.

S4, S20

COSMI V.

S18, S73, S89

COSTA C.

S103

COSTA SEMPERE D.

S100

COTIZ C.

S103

COURTOIS F.

S26, S32

CRESPI C.

S40, S77

CRISCUOLO A.

S110

CRUDELE A.

S54, S112

CUCCURULLO A.

S62

CUETO D.

S27, S67

CUETO M.A.

S27, S67

DANEBACK K.

S111

DAVIES A.

S41

DE DOMINICIS C.

S69

DE GENNARO AQUINO L.

S97

DE LA CRUZ MARTÍN ROMO C. S10, S49

DE LA FUENTE J.M.

S38

DE LA FUENTE N.

S59

DE LA GÁNDARA J.

S86

DE MAIO G.

S54, S55, S112

DE SANTI L.

S89

DEL CAMPO A.

S66

DEL NOCE G.

S27

DEL RÍO OLVERA F.

S9, S27

DELGADO A.

S58

DI LORETO C.

S83

DI MARCO A.

S47, S55, S56, S91

DI SANTO S.

S43

DIÉGUEZ J.L.

S74, A75

DIGANGI G.

S89

DLUZNIEWSKI M.

S87

DOLZ M.

S43

DOMÍNGUEZ DEL BRÍO E.

S22

DONAT COLOMER F.

S73, S101

DUARTE C.

S76

DUDEK D.

S85

DURETTO V.

S65

EIROÁ F.

S53

ELEUTERI S.

S10, S69, S111

ESCARPA BESGA E.

S63

ESPIÑEIRA M.A.

S86

FABRIZI A.

S28, S110

FAIX A.

S28

FALCONE M.

S41

FALGUERA PUIG G.

S100

FARRENY A.

S43

FATTORUSSO E.

S47, S54, S55

FAVERO M.

S66, S67

FELDMAN J.

S41

FERNÁNDEZ E.

S57

FERNANDEZ I.

S13, S109

FERNÁNDEZ Y.

S27

FERNÁNDEZ AGIS I.

S13, S58, S63, S106

FERNÁNDEZ GARCÍA P.

S99

FERNÁNDEZ FUERTES A.A.

S50, S52

FERNÁNDEZ MARTÍN M.P

S49, S51

FERNÁNDEZ PUERTA V.

S109

FERNÁNDEZ RODRÍGUEZ M.

S42

FERREIRA F.

S66

FERREIRA LOURENQO M.F

S10, S28

FERRUCCI R.

S74

FJELD W.

S54, S70

FLOREA R.

S60

FLORIDO J.

S28

FONTANA D.

S40

FORA EROLES F.

S29

FORMISANO R.

S54

FRAGO VALLS S.

S72

FRANCO G.

S69

FUERTES A.

S11, S66

FULCHERI M.

S34

GALLETTO E.

S41

GALVAO TELES A.

S76, S92

GAMBINO G.

S70, S89

GÁMEZ GUADIX M.

S77

GARCÍA F.

S11, S57

GARCIA J.

S112

GARCIA J.C.

S59

GARCIA M.I.

S112

GARCIA P.

S59

GARCIA T.

S109

GARCIA Y.

S112

GARCIA CANTERO M.

S13

GARCÍA CHALUD M.

S109

GARCIA GONZÁLEZ J.

S109

GARCÍA GONZÁLEZ Y.

S109

GARCÍA MAÑAS A.

S60

GARCÍA ORTIZ L.

S88

GARCÍA ROJAS A.D.

S11

GARCÍA SÁNCHEZ R.

S77

GARCIA VEGA E.

S42,S99

GARGIULO P.

S38

GATELL J.

S57

GENTILE V.

S89

GEORGIADIS J.

GERZ E.

S85

GEUENS S.

S64

GIAMI A.

S5,S12,S29

GIL GUILLEN V.

GILI JAUREGUI E.

S76

GIULIANI M.

S69, S73, S89, S111

GLOGOWSKA I.

S105

GOKSAN YAVUZ B.

S88

GOLAWSKI C.

S85,S87

GOMES A.

S103

GÓMEZ MARCOS M.

S88

GONCALVES D.

S77

GONCALVES M.

S77

GONZÁLEZ J.L.

S37

GONZÁLEZ ORTEGA E.

S49, S50

GONZALEZ SEGURA R.

S84, S97, S98, S100,

S101, S108

GONZÁLEZ SERRATOS S.

S62

GONZÁLEZ VEIGA M.

S103

GOOREN L.J.

S41, S116

GORIN LAZARD A.

S33

GRABSKI B.

S85

GRANADOS R.

S80, S105, S111

GRAU LÓPEZ L.

S53

GRAVINA G.L.

S80

GRIFFIOEN J.G.

S67

GRIFFIOEN T.

S44

GRILLI S.

S66

GRISOLAGHI J.

S89

GROSSO B.

S41

GUACHE M.

S20

GUALERZI A.

S40

GUERRA MORA P.

S42

GUEVARA S.

S4,S20

GUIX LLISTUELLA D.

S100

GULTEKIN F.

S53, S63, S43

GYSIN F.

S45

HAALAND W.

S54,S70

HAEBERLE E.

S12

HAKOBYAN S.

S69

HAMMERSTR0M K.A.

S70

HATTAT E.

S53, S63, S43

HATTAT H.

S53, S63, S43

HATTAT I.

S53, S63, S43

HERNÁNDEZ A.I.

S86

HERNÁNDEZ M.

S51

HERNÁNDEZ COTERÓN L.N.

S40

HERNÁNDEZ MARTIN M.D.

S64

HERNÁNDEZ SERRANO R.

S15,S21

HERNÁNDEZ SERRANO R.J.

S29

HERNÁNDEZ VIVANCOS S.

S109

HERRAIZ M.A.

S13

HORNO GOICOECHEA P.

S30

HONRUBIA PÉREZ M.

S20, S21

HUERTA E.

S43

HURTADO MURILLO F.

S30, S73, S101

IACONO F.

S46, S71

ILLIANO E.

S46, S71

INCESU C.

S88

INFANTE M.

S112

INYANG M.P

S49, S50

ISIDORI A.M.

S80

JAKELIC I.

S112

JANG S.

S94,S95

JANISZEWSKI M.

S87

JANNINI E.A.

S43, S80

JANNINI E.

S12

JIMENEZ LECHUGA M.D.

S84, S97, S98, S100, S101, S108

JOÄO ALVES M.

S103

JODAR LÓPEZ I.M.

S109

JODAR MARTIN M.

S84, S97, S98, S100, S101, S108

JUAN LINARES E.

S106

JUNOT ROCHA L.

S90

KIM J.

S70, S91, S94, S95, S109

KIM P.B.M.

S95,S109

KLAPILOVA K.

KOSTARSKA SROKOSZ E.

S87

KOWALCZYK R.

S85, S87, S105

KRUPKA MATUSZCZYK I.

S85

KRZEMIENIECKI K.

S105

KRZYSTANEK M.

S105

LA CALLE MARCOS P.

S13, S109

LAJA P.

S88, S93

LANDARROITAJAUREGI GARAI J.R S22

LANDMARK B.

S54, S55, S70

LANFRANCO F.

S65, S95

LARA VÉLEZ J.V.M.

S102

LEAL L.

S57, S77

LEITÄO R.

S102

LEMOS M.

S15

LENZI A.

S80

LEÓN A.

S57

LEON ORTEGA C.

S76, S100

LEONARDO C.

S69

LEONI F.

S54

LERMA PARTIDA S.

S102

LEW STAROWICZ M.

S85

LEW STAROWICZ Z.

S105

LIGERO C.

S57

LIGUORI G.

S83

LIMONCIN E.

S43, S80

LIN D.

S50, S85

LIÑAN BAENA R.C.

S13

LINDSKOG A.

S24

LIVI S.

S111

LLANOS DE ORDOÑEZ G.

S13

LLORCA RAMÓN G.

S73, S88

LO PRESTI L.

S53, S57

LOPES LINO T.

S64

LOPEZ A.

S74,S75

LOPEZ COBOS I.

S106,S107

LOPEZ OLMOS J.

S108,S110

LÓPEZ SÁNCHEZ F.

S30

LUCAS MATHEU M.

S14,S21

LUCIANO C.

S37

MACUKA I.

S111

MADRID GUTIERREZ J.

Sea

MAIA BORTOLOZZI A.C.

S/e

MAIA A.C.B.

S99, S100, S102, S10/, S10S

MAJADAS S.

SSe, SSS

MAJÁN SESMERO C.

S/e

MALANDRINO C.

S5a, S5/, Se4

MANIERI C.

S40, S65, S95

MANSUKHANI A.S.

S14

MARGAIX FONTESTAD L.

S101

MARKOVIC D.

Sei

MARQUES N.

S59, S102

MARSHANIA Z.

S/1

MARTIN OTERINO J.A.

SSS

MARTÍNEZ N.

S59

MARTÍNEZ R.

SSe

MÁRTINEZ ÁLVAREZ J.L.

S50

MARTINEZ LOPERA E.

S2S

MARTINEZ SALAMANCA J.

S14

MAS M.

Sa/

MATAS GRANADOS M.

S/e

MAURISSET MORÁGUEZ M.D.

S93

MAZÍN R.

S30

MAZZON G.

SSa

MCFARLAND R.

S4/

MEJIAS E.

S20

MÉNDEZ GÓMEZ C.N.

S40

MENÉNDEZ ROBLEDO A.

S99

MENÉNDEZ ROBLEDO E.

S99

MERINO N.

S2/

MERK W.

SS5

MICHETTI P.M.

S69, S/0

MICILLO E.

S9/

MIEVILLE MANNI D.

S60

MINECCIA M.

S//

MINECCIA V.

S40

MIRANDA F.

S/e, S92

MODROÑO C.

Sa/

MOLEIRO C.

S5S

MOLERO RODRIGUEZ F.

S31

MOLO M.T.

S40,S41,S//

MONCADA I.

S15

MONTALVO J.

S13

MONTAÑA HERNÁNDEZ R.M

S22

MONTEJO GONZÁLEZ A.L.

Se, SSe, SSS

MONTES E.

Se/

MOREL JOURNEL N.

S26, S32

MORELL CAPEL S.

S//, S100

MORENO L.

S5/

MORI G.

S43

MORIC A.

S111

MOROSETTI G.

S110

MOYANO M.

S80

MOYANO N.

S80, S105, S111

MUNNO D.

S40

MUSUMECI G.

S57

MUZZETI L.

S79

NABAIS C.

S102,S103

NAPPA M.R.

S97

NAVAS EXPÓSITO J.A.

S22

NASIM M.

S55, S59

NAVARRO J.A.

S53

NAVARRO CREMADES F.

S12, S15, S38

NEKIC M.

S111, S112

NIJS. P

NOBRE P.

S6, S26, S33, S81, S85, S87, S88, S89, S90, S93, S105,S107

NOBRE V.

S102

NOGALES BERLANA T.

S63

NOVO R.

S77

OBONGANYIE I.

S49, S50

OCHOA S.

S43

OLIVEIRA A.

S99, S100

OLIVEIRA C.

S87, S89

OLIVERA G.

S51

OLLANDINI G.

S83

ORGAZ BAZ B.

S49, S50, S52

ORHAN E.

S88

ORTIZ M.

OTRANTO L.

S47, S54, S56, S91, S112

OZDEMIR O.

S88

PACHECO L.

S86

PACHECO PALHA A.

S12, S15

PADOVANI A.

S74

PALAZÓN BRU A.

S38

PALPINI F.

S73

PANZERI M.

S46, S74

PARDO N.

S109

PARRA COLMENAREZ A.

S5, S12

PARRADO A.

S59

PARRADO CHAMORRO S.

S59, S106

PARRÓN CAREÑO T.

S58

PASCOAL P.

S32

PASINI U.

S48

PASINI W.

S15

PASTANA M.

S100

PASTURA C.

S93

PATRICIO D.

S51

PAVISSICH F.

S99

PAZMIÑO E.

S20, S32

PAZZOLA M.

S110

PEDRO LACALLE P.

S63

PEICHERT K.

S44

PEIXOTO M.

S33, S85, S90

PELLICER FARO R.

S73, S101

PEREIRA N.

S32

PEREIRA P.

S102

PEREZ AVALOS M.

S37

PÉREZ B.

S27

PÉREZ CONCHILLO M.

S30

PÉREZ NIETO M.A.

S51

PEREZ FERNANDEZ M.

S67

PEROZZO P.

S41

PETRUCCELLI I.

S66

PICARIELLO S.

S97

PIERLEONI L.

S18, S73, S89

PIERONI M.

S73

PINTO N.

S58

PIRUAT DE PAREJA J.J.

S45

POL BRAVO C.

S15

POMBO P.

S67

POMEROL MONSENY J.

S16

PORST H.

S33

PORTO R.

S33

POYATO GALÁN J.

S45

PREZIOSO D.

S46, S71

PRIETO CASTRO R.

S16, S77

PRIORI A.

S74

PRISTED R.

S24, S34

PUENTE DEL REY M.A.

S88

QUATTRINI F.

S34, S73, S93

QUESADA BRAVO E.M.

S63, S96, S102, S106, S107

QUIJADA C.

S20

QUINONEZ F.

S37

QUINTA GOMES A.

S87, S90

RADU B.

S60

RALPH D.

S17, S34

RAMÍREZ CRESPO M.V.

S17

RAMÍREZ M.M.

S65

RAMOS ALIAGA F.

S96

RAMOS ALIAGA FJ.

S102

RAOLI V.

S74

RECINE A.

S73

REINAR L.M.

S54, S70

REISMAN Y.

S35

RELLINI A.H.

S38

REVODELLO H.

RIBEIRO E.

S103

RIBEIRO P.

S79, S108

RICCI C.

S97

RICHTER APPELT H.

S17

RITA ACOSTA M.J.

S45

RIVERO J.

S4,S20

RIVERO N.

RIZZA F.

S54

RODRIGUES J.

S102

RODRIGUEZ E.

S88

RODRIGUEZ MARIN J.

S15, S38

ROJAS ZUASNABAR L.

S40

ROLLE L.

S40, S41

ROMAGUERA A.

S53

ROMANO M.

S53

ROMANO S.

S93

RONCERO C.

S53

RONCONI L.

S74

ROQUE ORTEGA L.M.

S93

ROSSI R.

S17, S69, S70, S73, S111

ROSSI V.

S70

ROXO L.

S76, S92

ROYO MARTÍNEZ A.

S73, S101

RUBIO ARRIBAS N.

S18

RUBIO AURIOLES E.

S30

RUBIO CASILLAS A.

S12

RUFFO A.

S46, S71

RUS O.

S60

SÁEZ S.

S37

SÁEZ SESMA S.

S51

SAKIEV S.

S112

SALAZAR N.

S77

SANCEZ M.R.

S112

SÁNCHEZ A.

S37

SÁNCHEZ B.

S43

SANCHEZ M.

S111

SÁNCHEZ M.M.

S80

SÁNCHEZ BURÓN A.

S49, S51

SÁNCHEZ FUENTES M.

S105

SANCHEZ NAVARRO M.R.

S109

SÁNCHEZ RAJA E.

S20, S21

SÁNCHEZ SÁNCHEZ L.

S37, S68

SANDRI F.

S83, S99

SANSALONE S.

S70

SANTAMARIA SANCHEZ I.

S63

SANTIAGO C.

S103

SANTOS S.

S103

SANTOS IGLESIAS P.

S80, S105, S111

SARRACINO R.

S73

SAVOIE PÉREZ C.

S18

SCANDURRA C.

S39, S62

SEGURA PAÑOS A.

S19

SERRA DUART L.

S13

SGAMBATO R.

S92

SIERRA A.

S46, S51

SIERRA J.C.

S80, S105, S111

SIGRE LEIRÓS V.

S81

SILVA A.

S76

SILVA D.

S103

SILVAGGI C.

S19, S47, S70, S72, S89

SILVAGGI M.

S47

SIMONELLI C.

S18, S19, S66, S47, S69, S70, S72, S73, S89, S110, S111

SIMSEK F.

S88

SIWEK M.

S85

SKRAUTVOL A.

S24, S35

SOARES C.

S77

SOMBRERO TORRES I.

S100

S0RENSEN D.

S54, S55, S70

SOTERAS GUASCH P.

S100

SPACCAROTELLA M.

S73

STEFANILE C.

S89

STREPETOVA T.

S23, S35, S47, S54, S55, S56, S91, S112

STRIZZI J.

S58

STULHOFER A.

S25, S42, S62

SUEIRO DOMINGUEZ E.

S74, S75

SUNGUR M.

S6, S35

SURIÁ MARTINEZ R.

S92

SVENDSEN K.O.

S70

SYSKA SUMINSKA J.

S87

TERRIER J.

S32

TEVA CALAHORRO A.

S76

TIENFORTI D.

S70

TOFFOLI G.

S83

TORRES B.

S57

TORRES GÓMEZ F.J.

S45

TRAEN B.

S42, S62

TRIFFAUX J.M.

S98

TRIPODI F.

S66, S47, S70, S72, S89, S111

TRIUZZI A.

S47

TROIANO E.

S47, S54, S56

TROMBETTA C.

S83

TROTTA D.

S23, S35, S47, S54, S55, S56, S91, S112