Middle East Society for Sexual Medicine March 2013 Issue 4 In this Issue: Pregnancy and Sexuality Phalloplasty for the Genetic Male Small Penis Syndrome: Fact or Fiction 1st announcement / call for abstracts 2nd Biennial Meeting of the Middle East Society for Sexual Medicine 3 - 5 October 2013 - Cairo, Egypt MESSM President: Amr El-Meliegy Scientific Chair: Hussein Ghanem Local Organizing Committee Chair: Ahmed El-Sakka Local Organizing Committee Members: Tarek Anis Yasser Elkhiat Amr Gadalla Mona Reda Adham Zaazaa Abdel Rahman Zahran www.messm.org NEWSLETTER Middle East Society for Sexual Medicine March 2013 – Issue 4 NEWSLETTER FAMILY Abdul Aziz Baazeem Mohamed Arafa Chairman of MESSM Chief Editor Communication Committee MESSM Newsletter (Saudi Arabia) (Qatar) MD, FRCS(C) MD Assistant Professor Assistant Professor Department of Surgery Andrology Department Umm Al-Qura University. Makkah, Saudi Arabia Cairo University, Egypt Adham Zaazaa Elham Attallah MESSM Newsletter Editor MESSM Newsletter Editor (Egypt) (Bahrain) MD MD Lecturer Consultant Family Physician Andrology Department & Clinical Sexologist Cairo University, Egypt Ahmed Shamsodini Dr Gamal Alhadad MESSM Newsletter Editor MESSM Newsletter Editor (Qatar) (Kuwait) Consultant MD Urology Department, MD. Andrology and Sexology Hamad Medical Corporation, Qatar MSc. Dermatology and Cosmotology Diploma of Urology Health Care Clinic - Kuwait Musab Ahmed Abo Ghefreh Omar Farid Elgebaly MESSM Newsletter Editor MESSM Newsletter Editor (Kuwait) (Egypt) MSc of Dermatology and Veneriology Assistant lecturer of Genitourinary Surgery. Urology department, Alexandria University, Egypt. Fellow of the European Board of Urology (FEBU). 3 / 38 NEWSLETTER Middle East Society for Sexual Medicine March 2013 – Issue 4 TABLE OF CONTENTS Editorial 5 Letter from the President 5 Letter from the Editor 6 MESSM News 7 Review Articles 8 Pregnancy and Sexuality 8 Woet L. Gianotten Phalloplasty for the genetic male 15 Abbas Khadra, Giulio Garaffa and David J. Ralph Small Penis Syndrome: Facts and Fiction 21 Maher Zabaneh Have you read these papers? 24 Case Reports in Sexual Medicine 31 Educational Calendar 36 4 / 38 NEWSLETTER Middle East Society for Sexual Medicine March 2013 – Issue 4 EDITORIAL Letter from the President Dear friends and colleagues, We are happy to announce that the Egyptian society of In our first issue for 2013, I wish you all a happy and Andrology will join MESSM in preparation for the Cairo successful year. meeting. Also the World Association of Sexology My congratulations to our eleven members who Society will be organizing a symposium during the obtained the new qualification as Fellows of the meeting. European Committee of Sexual Medicine. The qualifying exam was held by the European Society for I encourage you all to participate in our Cairo meeting Sexual Medicine for the first time ever in December, and to spread the message to your colleagues who 2012. are interested in sexual medicine. After the success of the MESSM pharmacists symposium sponsored by Lilly which was conducted in Amr El-Meliegy several Middle Eastern countries, another symposium MESSM President named ‘Men’s Health Workshop’ is about to start soon. Also sponsored by Lilly, this will be a more interactive symposium dedicated to pharmacists. In preparation for our 2nd Biennial Meeting in Cairo on 3 – 5 October, 2013, the Scientific Committee welcomes the submission of abstracts for oral and poster presentations. All abstracts presented at the meeting will be published in the Journal of Sexual Medicine. 5 / 38 NEWSLETTER Middle East Society for Sexual Medicine March 2013 – Issue 4 EDITORIAL Letter from the Editor Dear colleagues, contribution from all our colleagues from Middle East Welcome to our fourth edition of MESSM newsletter. and from the whole world. We will try our best to fulfill On our second birthday we tried to make this edition all your expectations but again the success of the as interesting and beneficial as always. We have a meeting depends on every one of you. very nice review by Dr. Gianotten regarding At last, I hope all of you the best and if anyone finds a pregnancy and sexuality which is indeed a missed way to make this newsletter more beneficial, please issue in human sexuality. Another article is written by a contact me or the executive office and I am always group of highly pronounced professionals Dr. Khadra, waiting for your criticism and ideas. Dr. Garaffa and Dr. Ralph about phalloplasty in the genetic male. What is a genetic male? You will find the See you soon in Cairo. answer in the must read article. Then at last but not least Dr Zabaneh, wrote a very interesting article Mohamed Arafa regarding an issue that is consuming the minds of big Chief Editor portion of the male population, small penis syndrome. [email protected] Read about the facts and the fictions about this issue. I [email protected] am sure you will enjoy these articles as much as I did. We also tried to keep you updated with the latest studies and cases reports from different journals. I must thank the editors for their great job in this regard. MESSM 2nd meeting is approaching and all of us are very enthusiastic about it. We are waiting for the great 6 / 38 NEWSLETTER Middle East Society for Sexual Medicine March 2013 – Issue 4 MESSM NEWS Fellowship of MJCSM: We proudly announce that 11 MESSM members have passed the exam of the fellowship of MJCSM and are now Fellows of the European Committee of Sexual Medicine. This was the first exam for the fellowship and was held in Amsterdam in December 2012. 2nd Biennial Meeting of MESSM Please be informed that due to the regional situation"2nd Biennial Meeting of MESSM" is shifted from Beirut, Lebanon to Cairo, Egypt and will be held from 3 – 5 October, 2013. MESSM Facebook page The MESSM facebook page is now available for all MESSM members and colleagues. Please visit our page and share with us any information that will help us improve MESSM services in the future. http://www.facebook.com/pages/Middle-East-Society-for-Sexual-Medicine-MESSM/208135919197719 7 / 38 NEWSLETTER Middle East Society for Sexual Medicine March 2013 – Issue 4 REVIEW ARTICLES Pregnancy and Sexuality Woet L. Gianotten MD-psychotherapist, Senior lecturer in medical sexology The relation between sexuality and pregnancy is rather and postpartum. On the contrary, preexisting sexual complex. Without childwish, the risk of becoming problems don’t simply disappear but can later on pregnant can easily diminish sexual pleasure as long become exacerbated by the stress of caring for a as a couple doesn’t trust their contraceptive method. baby. That is even more when the baby is planned as When on the other hand, a couple decides to make a a solution to relationship problems. An unplanned baby, sexual pleasure and sexual activities usually pregnancy more easily will contribute to relationship increase. When actually pregnant, that will change dissatisfaction, whereas a by both dearly desired again, depending on many different factors. One factor pregnancy has higher chances for sexual enjoyment. is the importance of sexuality in the couple. If for However, even then, the couple may experience some instance pregnancy was the sole reason to have ambivalence to this life transition. intercourse, sex may stop as soon as the pregnancy is Couples that tried for a longer period to conceive, have established, whereas for others being pregnant less frequent intercourse during pregnancy and the terminates the fear of becoming pregnant and finally three months postpartum. allows them to fully enjoy sexuality. Sexual disturbances in the first pregnancy and after Many cultures nourish the idea that sex is only for the the birth of the first baby could become a starting point young, the healthy and the non-pregnant. Accordingly for sexual relationship problems in later life. many obstetricians never discuss anything sexual with We should be aware that sexuality and relationship their pregnant or postpartum patients, although most quality of pregnant couples and young parents are no couples continue sexual activity during pregnancy.[1-2] stable factors, but on a meta-level also influenced by A complex set of physical, emotional, existential, changing healthcare (caesarean sections), relational, social and cultural factors cause a wide socioeconomic changes (internet) and the changing range of sexual behavior changes during pregnancy roles of men.[4] and in the postpartum period. There is so much variety that nearly all conditions may be considered ‘normal’, Physiological aspects although some conditions can cause worries or be the In early pregnancy, sexual desire and behavior are reason for long-term consequences. Much information influenced by disturbing symptoms like nausea and in in this text originated from several meta-analysis.[2-5] late pregnancy by backache and fatigue. Middle A higher amount of pre-pregnancy sexuality is pregnancy is less characterized by disturbing correlated with more coital activity during pregnancy symptoms, and more by hypercongestion. This 8 / 38 NEWSLETTER Middle East Society for Sexual Medicine March 2013 – Issue 4 hypercongestion is in fact the same as what happens accordingly they have more sexual desire. However, during sexual arousal. other women may react totally differently, with physical Outside pregnancy, breast volume increases with 25% disgust and no desire at all. Whereas 12% feel more during full sexual arousal. Combined with the fast attractive, 25-50% of pregnant women feel less growing breast in middle pregnancy, this can cause attractive than before.[3] pain. High arousal pain can also happen in the vaginal Men experience also a wide range of feelings on the entrance. woman’s pregnant appearance. From erotic Pregnancy hypercongestion can on the other hand fascination to repulsion and avoidance of contact. facilitate desire, lubrication and orgasm (with more Whereas corresponding reactions of both partners will sexual dreams, stronger orgasm, or several orgasms in be convenient, discordant reactions can cause real a row).