The 24th Annual Meeting of The Sexual Medicine Society of North America (SMSNA) will take place on Friday May 12, 2017 at the Boston Convention Center in Boston, Massachusetts. This year’s program will start with a focus on female sexual dysfunction, moderated by Drs. Irwin Goldstein and Stanley Althof, both pioneers in the field. This exciting session will highlight 3 important talks that include a review of brain activity in relation to female sexual dysfunction by James Pfaus, Ph.D., an internationally recognized researcher with expertise and extensive publications in neurochemical and molecular events related to sexual behavior. Dr. Sharon Parish will review the new evidence-based nomenclature that form the core definitions for various categories of female sexual dysfunction. The update on FSD nomenclature which serves as a basis for International Classification of Diseases (ICD) codes provides much needed regulatory guidance for the range of interventions aimed at treating FSD and is certain to be of utmost interest to clinicians managing FSD 1
Lastly, Professor Ojvind Lidegaard from Denmark will speak on the association of hormonal contraception with depression. Dr. Lidegaard was most recently the senior author on a landmark study published in JAMA Psychiatry. Aiming to investigate the influence of hormonal contraception on mood disturbances and diagnosis of depression in some women, the authors completed a 13-year prospective cohort study of more than 1 million women aged 15-34 using combined data from the National Prescription Register and the Psychiatric Central Research Register in Denmark.2 We are indeed fortunate to host Dr. Lidegaard as the invited guest speaker on this highly important topic.
Following the FSD session, the meeting will highlight 3 Grand Master lectures by speakers who represent the pinnacle of excellence and achievement in sexual medicine. In this session, Dr. Raymond Rosen from the New England Research Institute will start the program with his talk: “Clinical Trials, Registries, Outcomes, and Quality of Life Assessments: Impact on Sexual Medicine.” Chief scientist at the New England Research Institute, Dr. Rosen is widely regarded as one of the global leaders in his area of research and provides expertise in clinical trial design and various requirements for the NIH, FDA, and the pharmaceutical industry. The next talk in the session is given by my own mentor and teacher, Dr. Irwin Goldstein, who is widely regarded as one of the world leaders in both male and female sexual medicine. Dr. Goldstein will present a talk on diagnostic and therapeutic milestones in sexual medicine, much of it surely spanning his own career as a scientist and educator. The session will conclude with a talk by Dr. Steven K. Wilson on the evolution of penile prosthesis surgery in the last 40 years. The techniques that are currently used by many high and low volume implanters are frequently adopted from the many invaluable teachings and innovations pioneered by Dr. Wilson. Having been witness to the earliest stages in the development of the inflatable penile prosthesis surgery, Dr. Wilson will discuss significant historical developments in both semi-rigid and inflatable implants that will include topics such as design changes, dilators, retractors, and bioflex vs silicone cylinders, reservoir placement and lock out valves, various incisions, and strategies for managing infections as well as the dreaded scarred corpora encountered in post-infectious or post-priapism ED cases.
Our traditional point-counterpoint session will be devoted to two separate topics. The first session will focus on the role of prostate biopsy in prostate cancer active surveillance protocols as a potential cause of erectile dysfunction. Drs. Trinity Bivalacqua and Andrew McCullough will debate the Pro and Con positions respectively.
The decision to undergo circumcision or to have the procedure performed on a child may be rooted in causes as wide ranging as esthetics, hygiene, religious beliefs, or more acute medical conditions such as phimosis. Drs. Justine Schober (pro) and Ira Sharlip (con) will have a debate on the highly controversial topic: “Circumcision will significantly reduce penile sensitivity.” Despite a number of peer reviewed publications, a consensus opinion remains elusive and the topic therefore perfectly lends itself to a lively debate.
The 4th session of our annual meeting is devoted to novel concepts and presentations on SMSNA Fellowships. Part of the mission of SMSNA is an unwavering commitment to the support of basic and clinical research in men’s sexual health to supplement post-doctoral research activities. As such, two specific fellowship grants are funded through SMSNA directly (SMSNA Pfizer Fellowship in Men’s Health) or through our partnership and support of the American Urological Association’s Urology Care Foundation. The two grant recipients, Drs. Andrew Draganski and Ranjith Ramasamy will give presentations on Transdermal delivery of curcumin, a natural anti-inflammatory compound, through the use of a novel nanoparticle delivery system (Draganski, Pfizer Fellow) and stem cell therapy in the management of erectile dysfunction (Ramasamy, AUA Urology Care Foundation Fellow). For a change of pace prior to our lunch symposium, Dr. Gerald Brock, SMSNA member and recently elected secretary to the International Society of Sexual Medicine, will give the annual Ira Sharlip lecture entitled The Ten Craziest Sex Scandals.
The afternoon session will commence with the Cancer and Sexual function session where the first part is devoted to quality of life issues in cancer survivors. Apart from their impact on survival rates, many male and female malignancies exact a devastating emotional toll that effectively transforms them into couples’ pathologies. Traditional research on cancer survival was more focused on years added to life rather than the quality of life issues. In the first talk, Dr. Gregory Broderick, will review sexual function in male cancer survivors while Dr. Don Dizon will present a talk on sexual dysfunction in women with cancer: navigating intimacy and intercourse between women and their partners. The second half of the cancer and sexual function session looks at the ongoing debate revolving around the risks and benefits of testosterone therapy in hypogonadal prostate cancer patients. In view of the recent FDA-approved labeling changes for all prescription testosterone products, the presentations in this segment are indeed very thought provoking and promise to be especially relevant to practitioners challenged with explaining the new recommendations to their patients. Dr. Abraham Morgentaler, one of the world’s leading experts on testosterone therapy will present evidence supporting the use of testosterone in hypogonadal prostate cancer survivors while Dr. Landon Trost, SMSNA member at large on the board of directors, will present evidence against testosterone therapy in this group of patients.
The following session on medical and hormonal therapy continues to highlight issues surrounding testosterone therapy with a talk titled: “Defining hypogonadism that does not fit the classical primary or secondary hypogonadism definitions- time for a reset?” presented by Dr. Mohit Khera. Drawing on his leadership role in an expert colloquium commissioned by the Sexual Medicine Society of North America (SMSNA) convened in Washington, DC, Dr. Khera will discuss the common clinical scenario of men who present with low testosterone (T) and low or normal gonadotropin levels who do not fit the standard definitions of primary or secondary hypogonadism, but instead may have elements of both presentations3. Following this presentation, Dr. Stanton Honig, will present the latest update on managing the difficult clinical scenarios that frequently surround the treatment of delayed ejaculation. We will then move on to highlight some of the psychological factors in sexual dysfunction, a session that is moderated by Drs. Annamaria Giraldi and Michael Perelman. The first talk by Marita McCabe from Australia will address some of the important global epidemiological issues in sexual medicine while Dr. Chris Nelson of Memorial Sloan Kettering Cancer Center will give an overview of the psychological and relationship impact of male sexual dysfunction.
The surgical therapy segment of the program draws on the expertise of highly recognized surgeons serving as speakers as well as moderators who will lead an active Q&A session. Presentations on penile plication and grafting for complex Peyronie’s Disease will be presented by Drs. Wayne Hellstrom and Laurence Levine, both SMSNA past presidents, and will focus on technique as well as optimal patient selection criteria for each of these procedures. Dr. Alan Morey, a leader in urogential reconstructive surgery, will talk on the current concepts for the diagnosis and repair of penile fractures. Dr. Paul Perito, one of the world’s highest volume implant surgeons and a key opinion leader in the infrapubic approach for implantation of inflatable penile prostheses will present strategies for avoiding the common pitfalls encountered in this approach. The session will then end with a talk by Dr. Ricardo Munarriz, associate professor of urology at Boston University School of Medicine on strategies for optimizing outcomes in surgery for priapism. The last session of the day will cover ED in BPH procedures, diagnostic testing in ED, and novel therapies for premature ejaculation. Despite a number of peer reviewed publications on penile duplex Doppler sonography, universal guidelines for performing the test have not been adopted. Dr. John Mulhall, SMSNA past president and the editor of the Journal of Sexual Medicine will review the pertinent literature and present a talk on reassessing the standards and make recommendations for strategies for optimizing outcomes. In the same session, Dr. Stan Althof will present the latest phase 2 clinical trial data on UK based Ixchelsis company’s IX-01 for the treatment of premature ejaculation. Finally, the session will include a current update on sexual function in relation to various BPH therapies presented by Dr. Kevin McVary, Professor and Chair at the division of urology, Southern Illinois University School of Medicine. Dr. McVary serves as is chairman of the International Committee for Urologic Diseases (ICUD), Co-Chair of the AUA 2016 BPH Clinical Guidelines and a co-chair of the NIH/NIDDK Strategic Planning Committee for Prostate Research/Men’s Health. SMSNA, providing a forum for the free exchange and discussion of new ideas, thoughts and concepts in this field, strives to promote the highest standards of practice, research, education, and ethics in the study of all aspects of human sexual function and dysfunction. The speakers and moderators have been carefully selected to represent the height of excellence in their respective fields. We welcome and encourage all urologists and practitioners including nurses and advanced practice nurses, mental health specialists, physician assistants, sex counselors, and residents as well as research scientists with an interest in sexual medicine to attend this very exciting meeting in Boston.
Hossein Sadeghi-Nejad, MD, FACS
SMSNA President-Elect and Scientific Meeting Chair
1. Derogatis LR, Sand M, Balon R, Rosen R, Parish SJ. Toward a more evidence-based nosology and nomenclature for female sexual dysfunctions-part I. J Sex Med. 2016;13(12):1881-1887.↩
2. Skovlund CW, Morch LS, Kessing LV, Lidegaard O. Association of hormonal contraception with depression. JAMA Psychiatry. 2016;73(11):1154-1162.↩
3. Khera M, Broderick GA, Carson CC,3rd, et al. Adult-onset hypogonadism. Mayo Clin Proc. 2016;91(7):908-926.↩