BACKGROUND:Premature ejaculation is a prevalent male sexual dysfunction, yet real-world clinical practices in China remain poorly characterized. OBJECTIVES:To evaluate current premature ejaculation management practices among Chinese physicians. MATERIALS AND METHODS:A nationwide cross-sectional survey of 1000 physicians was conducted using a structured, self-administered questionnaire exploring diagnostic practices, treatment modalities, and perceived therapeutic effectiveness. Associations between physician characteristics and treatment choices were analyzed using chi-square tests. RESULTS:Diagnostic reliance on clinical history (67.4%) exceeded that on standardized tools (32.6%). Around 46.5% of physicians reported treating intravaginal ejaculation latency time < 1 min without distress, while 32.6% reported treating intravaginal ejaculation latency time > 10 min with distress. Oral dapoxetine (59.7%) and psychotherapy (92.1%) were preferred first-line therapies, followed by long-acting selective serotonin reuptake inhibitors (13.7%). Prescriptions for long-acting selective serotonin reuptake inhibitors were primarily driven by guideline adherence (25.95%), anxiety/depression comorbidity (17.56%), dapoxetine inefficacy (6.11%), and clinician experience (6.11%). Combination therapy was common (52.1%), whereas surgical interventions remained rare (14.7%) but more prevalent among andrologists than among non-andrologists (p < 0.001). Compared with non-andrologists, andrologists demonstrated greater use of behavioral therapy (p = 0.001) and topical agents (p = 0.006) than non-andrologists. Drug selection (54.5%) and psychological factors (16.6%) were identified as key efficacy determinants. DISCUSSION AND CONCLUSION:Chinese physicians commonly use combined pharmacological and psychological approaches for premature ejaculation treatment, but significant challenges persist, including inappropriate treatment of non-premature ejaculation cases, unwarranted surgical interventions, and insufficient utilization of evidence-based selective serotonin reuptake inhibitors, highlighting the need for standardized diagnostic criteria and enhanced physician education on guideline-recommended therapies.

BACKGROUND:Microsurgical vasoepididymostomy (MVE) is the standard treatment for epididymal obstructive azoospermia (EOA). However, existing studies report inconsistent pregnancy and patency rates. OBJECTIVES:To comprehensively review the therapeutic effects of various MVE techniques on EOA, address prior research controversies, and identify factors influencing MVE efficacy. MATERIALS AND METHODS:Eligible studies focused on MVE outcomes, such as patency, pregnancy, or natural pregnancy rates. Relative pregnancy rate refers to natural pregnancies occurring in partners of patients with post-operative patency. Meta-analyses were performed using the "meta" R package. Heterogeneity was assessed with Q and I2 tests. RESULTS:A total of 56 studies involving 3204 patients were included. End-to-end/end-to-side (EE/ES) techniques were associated with patency, pregnancy, and relative pregnancy rates of 65.0%, 23.0%, and 38.0%, respectively, whereas longitudinal intussusception vasoepididymostomy (LIVE) technique demonstrated slightly higher rates (68.0%, 27.0%, 40.0%). However these differences were not statistically significant (all p > 0.05). Compared with the 2-suture TIVE (72.0%) and LIVE (58.0%; p < 0.01) techniques, the 3-suture transverse intussusception vasoepididymostomy (TIVE) technique demonstrated significantly higher patency rates (89.0%). Pregnancy rates (33.0% vs. 26.0% vs. 28.0%) and relative pregnancy rates (38.0% vs. 33.0% vs. 42.0%) did not significantly differ among the three techniques (p > 0.05). Single-armed LIVE (SA-LIVE) demonstrated numerically higher patency (69.0% vs. 64.0%), pregnancy (31.0% vs. 26.0%), and relative pregnancy rates (46.0% vs. 39.0%) compared with double-armed LIVE (DA-LIVE). However, these differences were not statistically significant (all p > 0.05). Vessel-sparing SA-LIVE demonstrated superior patency (83.0%) compared with classical SA-LIVE (67.0%; p < 0.01), whereas pregnancy (38.0% vs. 31.0%) and relative pregnancy rates (both 47.0%) were not significantly different (p > 0.05). Bilateral MVE, genital infections, and the presence of motile spermatozoa were associated with increased patency rates. The overall late failure rate was 23.0%, with significantly higher rates for the EE/ES techniques (32.0%) than the IVE technique (15.0%; p = 0.03). CONCLUSION:This meta-analysis confirms the efficacy of MVE for EOA. IVE has supplanted ES/EE, likely owing to its technical superiority and reduced rate of late failures, with LIVE emerging as the dominant approach. SA-LIVE and DA-LIVE yield comparable outcomes, and both should be recommended. Bilateral cases, infectious etiology, and motile epididymal spermatozoa predict increased patency rate. The relative pregnancy rate may better reflect effectiveness.

The long-term safety and effectiveness of once-daily tadalafil is crucial, but limited data are available in Chinese patients with erectile dysfunction (ED). In this post-marketing, multicenter, randomized, open-label trial with 2-year follow-up, 635 ED cases were randomized to receive daily oral tadalafil 2.5 mg or 5 mg for 3 months, of whom 580 continued once-daily tadalafil 5 mg for 21 months. Treatment-emergent adverse events in the 12-month and 24-month period were similar, with the most common being viral upper respiratory tract infection, upper respiratory tract infection, and headache. Significant improvement from baseline in the International Index of Erectile Function-Erectile Function (IIEF-EF) score was detected at month 12 (least squares mean [LSM] change: 7.9, 95% confidence interval [CI]: 7.5–8.4, P < 0.001) and was maintained to month 24 (LSM change: 8.6, 95% CI: 8.1–9.0, P < 0.001). The proportions of patients regaining normal erectile function (IIEF-EF score ≥26) were 43.7% and 48.0% at months 12 and 24, respectively. Global Assessment Questionnaire results showed improved erection function in 97.5% of patients and improved ability to engage in sexual activity in 95.9% of patients at month 12; these values were 96.1% and 95.0% at month 24, respectively. The quality of sexual life score based on the Sexual Life Quality Questionnaire (SLQQ) was increased by 52.2% at month 12 and by 55.3% at month 24 (both P < 0.001). The treatment satisfaction score determined by SLQQ (mean ± standard deviation) was 62.4 ± 21.0 at month 12 versus 65.9 ± 20.2 at month 24. Two-year daily application of tadalafil 5 mg in Chinese men with ED showed a favorable safety profile and durable improvement in sexual performance and satisfaction.

Introduction:Penile fracture is an uncommon urological emergency resulting from tunica albuginea rupture during penile erection. It is a rare condition requiring urgent surgery. Despite immediate surgical repair, the patients' erectile functions may still be impacted by penile fracture. This study aims to investigate the efficacy of surgical repair in penile fractures and its impact on erectile function. Methods:Our cohort was composed of patients diagnosed with penile fractures and received surgical repair from September 2014 to August 2022 in Peking University First Hospital. Penile color Doppler ultrasound confirmed the diagnosis. Surgical exploration was conducted, and postoperative complications were evaluated during follow-up. Erectile function was assessed using the International Index of Erectile Function-5 (IIEF-5) score. Univariate analysis was conducted employing the chi-square test, t-test, and Mann-Whitney U test to identify factors that may impact postoperative erectile function. Furthermore, multivariate analysis was conducted using logistic regression and linear regression to determine the independent risk factors influencing postoperative erectile function. Results:A total of 58 patients were enrolled in our study. The majority of injuries (69.0 %, 40/58) resulted from vigorous sexual intercourse. Most of the patients (69.0 %, 40/58) presented within 24 h. Sixteen patients (27.6 %) presented with concomitant urethral injury. The median size of the tunical tear was 1.5 (IQR, 1.0-2.0) cm. Presentation delay correlated significantly with the difference in IIEF-5 score before and after surgery, with corresponding p values of 0.028. Urethral injury correlated significantly with postoperative erectile dysfunction (ED), postoperative IIEF-5 score, and the difference in IIEF-5 score before and after surgery, with corresponding p values of 0.002, 0.004, and 0.002, respectively. Conclusions:To conclude, surgical repair of penile fracture provides good functional results with few morbidities and urethral injury may adversely affect postoperative erectile function after penile fracture repair.

勃起功能障碍(erectile dysfunction,ED)是最常见的男性性功能障碍,严重影响个人心理、生活质量和人际关系.ED可能由器质性病变、心理因素等许多原因导致[1],神经源性、血管源性、医源性、内分泌因素都可能参与ED的病生理过程[1-2].

Purpose:To explore the association between thyroid parameters and subclinical atherosclerosis (AS) in hospitalised euthyroid patients with type 2 diabetes mellitus (T2DM). Patients and Methods:A retrospective analysis was conducted involving 1245 inpatients with T2DM. Free triiodothyronine (FT3), free thyroxine (FT4), and thyroid stimulating hormone (TSH) levels were measured, and carotid artery ultrasonography was performed. Thyroid hormone (TH) sensitivity was evaluated using thyroid feedback quantile-based index (TFQI), TSH index (TSHI), thyrotropin thyroxine resistance index (TT4RI), and free triiodothyronine/free thyroxine ratio (FT3/FT4). Results:In inpatients with T2DM having normal thyroid function, the incidence of subclinical AS declined with increasing levels of FT3, FT4, and FT3/FT4 (P trend < 0.05). Logistic regression analysis revealed that FT4 (OR, 0.914; 95% CI, 0.845-0.989), FT3 (OR, 0.374; 95% CI, 0.277-0.504), and FT3/FT4 (OR, 0.036; 95% CI, 0.013-0.061) were independently associated with subclinical AS (P < 0.05). However, TSH, TFQI, TSHI, and TT4RI levels were not associated with subclinical AS (P > 0.05). FT3/FT4 demonstrated superior predictive accuracy for subclinical AS than that of FT3 or FT4 alone (P < 0.001), with a cutoff point of 0.25. Conclusion:In euthyroid inpatients with T2DM, subclinical AS exhibited negative correlation with FT3, FT4, and FT3/FT4 levels, independent of other risk factors for AS. Additionally, FT3/FT4 ratio had a good predictive value for subclinical AS.

There is a close relationship between male erectile dysfunction (ED) and premature ejaculation (PE) on the pathogenesis, leading a high comorbidity rate and a need of simultaneous treatment in clinical practice. Phosphodiesterase 5 inhibitors (PDE5i) and selective serotonin reuptake inhibitor (SSRI) Dapoxetine are first-line oral drugs for ED and PE, respectively. In recent years, multi-country clinical guidelines have provided suggestions and guidance for the combination of these two drugs, with the safety and effectiveness being further explored and verified. This review summarized the status of ED and PE comorbidity, treatment principles, and research progress on the safety and effectiveness of Dapoxetine combined with PDE5i, in order to provide reference for the combination therapy of ED and PE comorbidity.

射精管不完全梗阻(partial ejaculatory duct obstruc-tion,PEDO)是指因射精管内、管外或其他因素,使射精管不完全闭塞,导致精液排出时受阻,可引起少精、弱精或死精子症,约占男性不育病因的 4％ [1]. PEDO分为单侧PEDO或双侧PEDO. 近些年来,随着辅助检查技术的完善,临床上PEDO患者的检出率有了很大提高. 本文综述了PEDO相关的胚胎和解剖学、病理生理学、临床表现及近年来的诊治进展.

Objective:To investigate the Efficacy,Safety and Cost of Ureteroscopic Laser Lithotripsy and Percutane-ous Nephrolithotomy in the Treatment of Upper Ureteral Stones.Methods:The clinical data of 80 patients with up-per ureteral stones who underwent surgical treatment in our hospital from December 2019 to December 2020 were retrospectively analyzed.According to the treatment methods in the data,the patients were divided into group A(40 cases)and group B(40 cases),in which group A underwent ureteroscopic holmium laser lithotripsy and group B underwent percutaneous nephrolithotomy.The operation time,intraoperative blood loss,hospital stay,hospitaliza-tion cost,stone clearance rate and complication rate were observed and compared between the two groups.Results:The operation time of group A was significantly longer than that of group B(P＜0.05),but the amount of intraop-erative bleeding,length of hospital stay and hospitalization costs were significantly lower than those of group B(P＜0.05).There were 37 patients without calculi in group A after operation,and the stone clearance rate was 92.50%;there were 35 patients without calculi in group B after operation,and the stone clearance rate was 87.50%,and there was no significant difference between the two groups(P＞0.05).The incidence of postoperative complications was 20.00%in group A and 30.00%in group B,and there was no significant difference in the inci-dence of complications between the two groups(P＞0.05).Conclusion:Ureteroscopic laser lithotripsy and percuta-neous nephrolithotomy have better efficacy and safety in the treatment of upper ureteral stones,but patients with ureteroscopic laser lithotripsy have less intraoperative bleeding,shorter hospital stay,and lower hospitalization costs,so it is more worthy of clinical application and promotion.

PROBLEM:Draining lymph nodes (LNs) are pivotal sites for maintaining tolerance to self-antigens as well as eliciting immune responses to exogenous antigens. The epididymis is a male reproductive organ with a unique local immune environment. Although mice are the most commonly used laboratory animals for immunology research, there are no detailed descriptions of the anatomical location and function of LNs that drain the epididymis.METHOD OF STUDY:Evans blue labeling was utilized to explore lymphatic drainage of the epididymis in eight- to ten-week-old male C57BL/6 mice. We confirmed the lymphatic drainage of the epididymis in mice using the objective technique of carboxyfluorescein succinimidyl ester (CFSE)-labeled cells.RESULTS:By combined Evans blue labeling and fluorescent labeling, we found that 1) the patterns of epididymal LN drainage are highly heterogeneous between individual mice; 2) the leftside LNs participate in drainage more frequently than the right-side LNs; and 3) epididymal lymphatic drainage bypasses both the paraaortic and renal LNs in some mice.CONCLUSIONS:These data highlighted the need to consider the individual variation in and lateral asymmetry of draining LNs when characterizing the regional immunology of the mouse epididymis.

Purpose To assess the diverse cell populations of human corpus cavernosum in patients with severe erectile dysfunction (ED) at the single-cell level. Methods Penile tissues collected from three patients were subjected to single-cell RNA sequencing using the BD Rhapsody™ platform. Common bioinformatics tools were used to analyze cellular heterogeneity and gene expression profiles from generated raw data, including the packages Seurat, Monocle, and CellPhoneDB. Results Disease-related heterogeneity of cell types was determined in the cavernous tissue such as endothelial cells (ECs), smooth muscle cells, fibroblasts, and immune cells. Reclustering analysis of ECs identified an arteriole ECs subcluster and another one with gene signatures of fibroblasts. The proportion of fibroblasts was higher than the other cell populations and had the most significant cellular heterogeneity, in which a distinct subcluster co-expressed endothelial markers. The transition trajectory of differentiation from smooth muscle cells into fibroblasts was depicted using the pseudotime analysis, suggesting that the expansion of corpus cavernosum is possibly compromised as a result of fibrosis. Cell-cell communications among ECs, smooth muscle cells, fibroblasts, and macrophages were robust, which indicated that inflammation may also have a crucial role in the development of ED. Conclusions Our study has demonstrated a comprehensive single-cell atlas of cellular components in human corpus cavernosum of ED, providing in-depth insights into the pathogenesis. Future research is warranted to explore disease-specific alterations for individualized treatment of ED.

OBJECTIVE:To assess the accuracy and value of ultrasonography in the diagnosis of ruptured tunica albuginea (RTA) of the corpus cavernosum penis. Factors affecting prognosis were analyzed.METHODS:This retrospective study included 57 cases of RTA of the corpus cavernosum penis ultrasonographically diagnosed and surgically treated in Peking University First Hospital from 2013 to 2021. We analyzed the location, size and number of ruptures and the presence or absence of urethral injury, and compared the intraoperative with the ultrasonographic findings.RESULTS:Of the 57 cases of RTA of the corpus cavernosum penis diagnosed by ultrasonography, 54 (94.7%) were confirmed by surgery. Preoperative ultrasonography indicated 2 cases of bilateral RTA and 6 cases of urethral injury, while surgery revealed 7 cases of bilateral RTA and 13 cases of combined urethral injury. Those with urethral injury developed no urethral stricture or urinary fistula after one-stage urethral repair. And no severe or moderate ED was found in any of the patients during the 12-month follow-up.CONCLUSION:Ultrasonography has a high accuracy in the diagnosis of ruptured tunica albuginea of the corpus cavernosum penis, and contributes to the determination of the site of surgical incision.

早泄是最常见的男性性功能障碍之一,发生率为21％～33％[1-2].早泄严重影响男性的自信、性生活满意度、伴侣关系以及对男性和伴侣的整体生活质量产生负性影响[3-5]. 早泄的病理生理机制还不完全清楚,但生理和心理因素可能都与早泄有关.精神药理学研究提示早泄可能与控制射精的 5 羟色胺神经递质减少有关[6-7].用于治疗抑郁症和其他精神疾病的选择性5 羟色胺再摄取抑制剂(SSRI),由于有延长射精的作用而越来越多地用来治疗早泄[8-9].SSRI治疗早泄的机制与抑制5 羟色胺地摄取和随后的5 羟色胺活性有关.但是,SSRI 治疗早泄属于非适应证用药.

OBJECTIVE:To evaluate the influence of epididymitis history on the results of microsurgical vasoepididymostomy and spontaneous pregnancy in patients with epididymal obstruction.METHODS:Totally 205 patients with epididymal obstruction underwent microsurgical two-suture longitudinal intussusception vasoepididymostomy from January 2014 to December 2016. After surgery, we evaluated the semen quality of the patients every 3 months till conception and compared the rates of patency and spontaneous pregnancy between the patients with and those without an epididymitis history.RESULTS:The patients ranged in age from 22 to 46 (mean 31) years, 37 (22.2%) with and 126 (77.8%) without an epididymitis history among the 163 patients for whom a 25.4-month follow-up (from 7 to 42 months) was completed. No statistically significant differences were observed postoperatively between the patients with and those without an epididymitis history in the patency rate (73.0% vs 81.7%, P = 0.243), sperm concentration (18 ［1.3－33.6］ vs 15.2 ［0.8－33.4］ ×10⁶/ml, P = 0.710), percentage of progressively motile sperm (27.5 ［0－46.1］% vs 19.3 ［0－41］% (P = 0.592) or rate of spontaneous pregnancy (24.3% vs 38.9%, P = 0.104).CONCLUSION:Microsurgical vasoepididymostomy is an effective method for the treatment of epididymal obstruction, and epididymitis history does not affect the results of the strategy.

Concentrated animal feeding operations have long extensively used antibiotics to prevent and treat infectious animal diseases and promote the growth of farmed animals, which have resulted in discharges of large quantities of un-metabolized veterinary antibiotics into agricultural soils along with the land application of animal manure. These veterinary antibiotics in soils could exert a range of ecotoxicological effects and even induce the emergence and development of antimicrobial-resistant microbes and genes, which pose a potential threat to human health. This review provides a systematic overview of the transport and fate processes of antibiotics in the soil environment and the corresponding mechanism, their ecotoxicological effects on crops, soil fauna, and soil microorganisms, and the strategies that can be used to mitigate the risk of antimicrobial pollution and the related mechanism. The major environmental processes of antibiotics in soil, including adsorption/desorption, biodegradation, and abiotic degradation, all strongly depend on the soil’s physical and chemical properties (e.g., pH and organic matter content) and the chemical structures and properties of antibiotics (e.g., functional group and hydrophobicity). The ecotoxicological effects of veterinary antibiotics on crops, soil fauna, and soil microorganisms are mainly determined by their types and concentrations and the soil’s physical and chemical properties. Antibiotic degradation during manure composting and anaerobic digestion primarily occurs through biodegradation and hydrolysis. The antibiotics in manure can be effectively degraded by high-temperature pyrolysis. In addition, biochar and graphene-based composite materials can stabilize the antibiotics in soils through hydrogen bonding, surface complexation, electrostatic interaction, and ion exchange. Important questions that must be addressed and recommendations for future research are proposed herein based on the summary of the recent research progresses on soil pollution by antibiotics.

Background: Histological and functional recovery after peripheral nerve injury (PNI) is of significant clinical value as delayed surgical repair and longer distances to innervate terminal organs may account for poor outcomes. Low-intensity extracorporeal shock wave therapy (LiESWT) has already been proven to be beneficial for injured tissue recovery on various pathological conditions. The objective of this study was to explore the potential effect and mechanism of LiESWT on PNI recovery. Methods: In this project, we explored LiESWT's role using an animal model of sciatic nerve injury (SNI). Shockwave was delivered to the region of the SNI site with a special probe at 3 Hz, 500 shocks each time, and 3 times a week for 3 weeks. Rat Schwann cells (SCs) and rat perineurial fibroblasts (PNFs) cells, the two main compositional cell types in peripheral nerve tissue, were cultured in vitro, and LiESWT was applied through the cultured dish to the adherent cells. Tissues and cell cultures were harvested at corresponding time points for a reverse transcription-polymerase chain reaction, Western blotting, and immunofluorescence staining. Multiple groups were compared by using one-way analysis of variance followed by the Tukey-Kramer test for post hoc comparisons. Results: LiESWT treatment promoted the functional recovery of lower extremities with SNI. More nerve fibers and myelin sheath were found after LiESWT treatment associated with local upregulation of mechanical sensitive yes-associated protein (YAP)/transcriptional co-activator with a PDZ-binding domain (TAZ) signaling pathway. In vitro results showed that SCs were more sensitive to LiESWT than PNFs. LiESWT promoted SCs activation with more expression of p75 (a SCs dedifferentiation marker) and Ki67 (a SCs proliferation marker). The SCs activation process was dependent on the intact YAP/TAZ signaling pathway as knockdown of TAZ by TAZ small interfering RNA significantly attenuated this process. Conclusion: The LiESWT mechanical signal perception and YAP/TAZ upregulation in SCs might be one of the underlying mechanisms for SCs activation and injured nerve axon regeneration.

BACKGROUND:Nerve injury-related erectile dysfunction (ED) is one of the types that respond poorly to conventional ED treatments. Our previous experiments have demonstrated the paracrine of various neurotrophic factors (NTFs) by stem cells or other treatment modalities as a potential mechanism in the recovery of nerve injury-related ED. Glial cell derived neurotrophic factor (GDNF) is one of the essential NTFs for the regeneration of nerve fibers, especially for parasympathetic nerves. The aim of this study is to explore if local continuous GDNF administration is beneficial for the functional and histological recovery of nerve injury induced ED.METHODS:Eight-week-old male Sprague-Dawley rats were used for this study. Rats were randomly grouped into 5: Sham surgery (Sham), bilateral cavernous nerve injury (BCNI) and placebo treatment, BCNI and 0.1 µg/100 µL GDNF treatment (BCNI+GDNF 0.1), BCNI and 1 µg/100 µL GDNF treatment (BCNI+GDNF 1), BCNI and 10 µg/100 µL GDNF treatment (BCNI+GDNF 10). GDNF was administered using an osmotic pump technique which would deliver GDNF locally and continuously for 28 days without the need for external connections or frequent handling of animals. Recovery of sexual function, nerve fibers regeneration, and expression of neurotrophic receptors were examined and compared among groups after the treatment.RESULTS:Local continuous GDNF release treatment increased the average number of intromissions in the sexual behavior test and intracavernous pressure (ICP) in the erectile function test in a dose dependent manner. Osmotic pump implantation induced increased local GDNF concentration and mild inflammatory response. Gene expression of GDNF receptors in major pelvic ganglion (MPG) and nerve regeneration along the urethra were partially promoted by GDNF. These changes were associated with increased nerve fibers especially the parasympathetic nerve fibers in dorsal nerve of penis (DNP) in GDNF treated groups.CONCLUSIONS:In conclusion, our project illustrated the promising effects of local continuous GDNF administration for the functional and histological recovery of nerve injury-induced ED.

Introduction: There has been no report regarding the impact on male sexual life or sexual function by changes in lifestyle during the coronavirus disease 2019 (COVID-19) epidemic. Aim: To investigate the changes in sexual life and sexual function of Chinese men during the COVID-19 epidemic. Methods: An online questionnaire was created and the survey was administered through social media to Chinese adult men. Main Outcome Measure: The main end point was the deteriorated erectile function or ejaculatory control ability, defined by self-evaluation or by decreased International Index of Erectile Function-5 items (IIEF-5) scores or increased premature ejaculation diagnostic tool (PEDT) scores. Results: Altogether, 612 questionnaires were collected. About 322 (52.6%) subjects were unmarried. About 8.4% and 8.5% subjects reported deteriorated erectile function or ejaculation control ability by self-evaluation, whereas 31.9% and 17.9% subjects showed decreased IIEF-5 scores or increased PEDT scores. Subjects with deteriorated erectile function by self-evaluation and decreased IIEF-5 scores had higher General Anxiety Dis-order-7 (P <.001 and P =.001) and higher Patient Health Questionnaire-9 score (P <.001 and P =.002) after the epidemic, decreased frequency of sexual life (P <.001 and P <.001) and physical exercise (P =.009 and .007) after the epidemic. Subjects with deteriorated ejaculation control ability by self-evaluation and increased PEDT scores had higher General Anxiety Disorder-7 (P <.001 and P <.001) and higher Patient Health Questionnaire-9 score (P <.001 and P =.002) after the epidemic. Subjects with decreased frequency of sexual life had reduced income (P <.001), increased anxiety (P <.001) and depression (P <.001). Married subjects had higher proportion of improved depression (P =.048) and increased frequency of sexual life (P =.010). Conclusion: During the COVID-19 epidemic, decreased sexual function was present in a certain proportion of adult men, and the risk factors include increased anxiety and depression, and decreased frequency of sexual life. Copyright (C) 2020, The Authors. Published by Elsevier Inc.