Several publications from specialized units report changes in the demands of children with gender dysphoria.

Attention to ultraceuticals has become extremely prevalent. A large surge of male enhancement ultraceuticals hashit the U.S. market through online retail stores such as eBay, Amazon, GNC, and Alibaba that consist of unverified therapeutic label claims. The issue at hand is the increase in the production, marketing and sale of adulterated products from these online retail stores that falsify the safety, efficacy, and therapeutic claims on their websites. These products are further provoked to continue their false claims due to the absence of strict regulatory laws to govern label claims, manufacturing, and marketing in U.S. and global markets. The online retail stores that sponsor and advertise the sales of these ultraceuticals neglect the literature that show many of the products were discovered to be counterfeit, mislabeled, or adulterated with active pharmaceutical ingredients (API). Ultimately, regulatory authorities should instill regulations in order to monitor, examine, and test the ultraceutical market and the research community should draw public attention to the possible effects of these products on consumers.

Disorders of Sexual Development (DSD) consist of ‘congenital conditions with atypical development of chromosomal, gonadal, or anatomic sex’. They cause significant psychological impact upon patients and their families. A search of MEDLINE, EMBASE and Clinical trials USA and Australia was conducted using MESH terms ‘disorders of sexual development,’ ‘psychology’ and ‘quality of life.’ Four themes emerged from the literature search; psychological support and treatment for parents and patients, the need for holistic management, quality of life assessment and identification of sociocultural factors that impact psychological health in DSD patients. Educating medical and paramedical staff is crucial to ensure adequate early assessment, diagnosis, counselling, and where appropriate management. Caution should be exercised in early genital surgery to ease parental distress; rather this should be a team-based decision at an appropriate age where the individual can be involved in the consent process. Psychological input should be specialised to the individual and more readily accessible.

Objective: Here we present our findings assessing the biomechanical properties of IPPs with differing lengths of RTEs.

Materials and Methods: This is a biomechanical study of the interaction of penile implant cylinders and RTE as assessed by column compression and modified cantilever deflection. X-Ray (XR) photography was also used to identify the precise location of kink formation after failure. The IPPs were surgically placed into two fresh cadavers via a penoscrotal technique by a single large volume implanter. A biomechanical evaluation of the properties of the IPP and RTE inside the fibroelastic tunica albuginea was assessed in unblinded testing and analyses were based on industry standard methods for assessment.

Results: In the 20 and 24 cm phallus respectively, the maximum load before kink was shown to be highest with no RTEs. This is to say device failure was at lower force when more RTE were present versus when no RTE were present. We also see in the shorter phallus there is a higher overall resistance to kink formation, even with increasing RTE lengths. Results from the horizontal studies were mixed and no direct conclusions can be drawn.

Conclusions: Column load testing to the maximum load before kink formation increases sequentially with decreasing RTE. This suggests no RTE will translate to a higher load tolerance for patients when we consider the physiologic act of intromission. Our data also suggest that even with more RTE, shorter phalluses can resist higher loads. Surgeons should use this as a guide to maximize cylinder lengths when performing IPP surgery. Further research will be required to validate these findings.

Introduction: The issues of sexual activity of representatives of different sexes who have suffered a stroke are poorly covered in the literature. However, this problem has a distinct clinical significance.

Objective: Determination of the prevalence and clinical variability of sexual disorders in people of different sex and age at different times – before and after cerebral stroke, and the need to take into account sexual history in predicting the consequences of stroke and in treatment and rehabilitation measures

Materials and Methods: In the process of a targeted survey of 111 patients (58 men and 53 women) of different ages, conducted in the acute period of stroke, their sexual activity was studied in the pre – stroke period, and then in 77 of these patients-after 3-24 months. Sexual partners of the respondents were involved in the survey. The obtained data were compared with age, stroke background pathology, and stroke variant, severity of neurological defect, cognitive and emotional disorders, and results of neuroimaging studies.

Results: The decrease in sexual activity before stroke is of clear importance along with age in the development of background pathology for stroke, the formation of the consequences of stroke in cognitive and emotional functions. At the age of 55 years the most severe functional consequences of stroke were formed in 8.3% of persons who had normal sexual relations before stroke and in 27.6% in the absence of such (p=0.09). The negative dynamics of sexual activity after stroke is associated with the presence and severity of neurological deficits, especially among women, and the presence of cerebral atrophic changes, more often in men.

Conclusion: The initial quality of intimate relationships largely determines the clinical features of stroke and its consequences, and the negative dynamics of sexual activity after stroke is associated with different causal factors in different sexes, and this must be taken into account in the process of rehabilitation treatment.