Introduction
Male Sexual Disorder or Dysfunction is a comprehensive entity with unknowingly historic roots and encroaching on various dimensions of a healthy individual. WHO defines health as - "health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity”. 1 The physical and mental domains of WHO health definition is the ones imprinted by the male sexual disorders.
Immense research work was done in the past for exploring the density of this topic, but still not sufficient to generalize it, the researchers are still digging into a continuum, and people with different backgrounds are having different perceptions of male sexual disorders. Male Sexual Disorders remain taboo, particularly in a developing country like India.
Social media is the comprehensible option for most of the patients in the present scenario who hesitate to communicate regarding their sexual health, so encompassing various platforms like Youtube, Facebook, and many more. Most of the patients browse the content on the internet, related to sexual problems and blindly follow the instructions without knowing its authenticity. Every day plenty of videos are uploaded and many are being viewed, despite knowing their reliability and scientific panorama. The affected census for the male sexual disorder is under-depicted as of privacy issues, unawareness about the disease complex, a phobia about being affected, and many more counting on it, with advancing digitalization and many friendly social media platforms, the affected individual logs onto the Cybernet for perception and here comes the role of content reliability. In literature, there is a scarcity of studies for online authentic videos related to male sexual disorders.
Male sexual disorders comprise erectile dysfunction, premature ejaculation, and decrease libido. A research article advocates that 72% of internet users have used the internet for their health-related issues in one way or other, in the past year. 2 As per the data from Statista 2022, Youtube is used by more than 2.2 billion users in a single month, and the Indian population accounts for the major chunk in 2022, around 467 million. 3 There are some studies in the past advocating Youtube and chronic health conditions like Epilepsy, 4 Alzheimer’s Disease,5 and Chronic Obstructive Pulmonary Disease. 6 These studies have published data on views, discussion, and the reliability of these online posted videos. 4, 5, 6 Video-based information has also been evaluated as a source of information on vaccination, breastfeeding, tobacco use, influenza pandemic, and basic life support. In these studies, the investigators implemented different criteria for quality assessment. 7, 8, 9, 10, 11, 12 This study is first in itself advocating its work on such an important topic of male sexual disorders videos reliability, as such, there is no similar study has been done in the past, which proves its need of the time. Such a large influence of these social platforms can serve as a boon for public health awareness or, conversely can be a doom by spreading misinformation to the common public. The purpose of this study is to provide a benchmark for the internet active users, regarding the verity of the content uploaded in the context of male sexual disorders.
Materials and Methods
Methodology
The top trending social media platforms were used as a ground for work-up. They were considered as most accountable and readily available sources. This is an Observational (Cross-sectional) study. Considering the layman's point of understanding, four keywords were used for male sexual disorders- "Male Sexual Disorders", "Erectile Dysfunction", "Pre-Mature Ejaculation" and "Male Sex Problems" and searched on social media using BuzzSumo, an online analytic tool. 13 This analytical tool provides information for various parameters as per the applied filters. This software application searches for articles based on key words and provides data for various parameters on popular social media platforms.13 The keywords were searched on the Buzzsumo online application for videos in April 2022. Initial 500 videos were selected. Repeated videos, advertisements, non-medical videos, and videos with languages other than Hindi were excluded. The collected videos were analyzed on various parameters and their verity as per EAU guidelines 2022. All the screening and video analyses were done by urology residents, under the supervision of a senior specialist.
Statistical analysis
The data was analyzed and reviewed via the windows statistical package for social sciences(SPSS) for Windows (version 24.0). Numerical values were presented as mean, median, and percentage (%). Kappa test was used to assess inter-observer agreement. Overall, the critical alpha value of 0.05 was considered significant.
Results
We analyzed the first 500 videos from social media platforms with the help of Buzzsumo online application with searching keywords of "Male Sexual Disorders", "Erectile Dysfunction", "Pre-Mature Ejaculation" and "Male Sex Problems". Given a better understanding, the result was categorized into three main domains.
Classification of videos
As per our study protocol, videos were scrutinized, among which 191(38.2%) videos were following inclusion criteria, and the remaining 309 videos (61.8%) were excluded. In excluded videos, videos on alternative medicines shared the maximum number (n=141, 45.63%) followed by foreign vocabulary videos (n=101, 32.68%). Alternative medicine videos had the maximum number of likes among excluded videos. There were 28 advertisement and promotional videos (9.06%). Non-medical videos and repeated videos shared the lowest contribution to excluded videos (n=20, 6.47% and n=19, 6.14%).
Characteristic of videos following inclusion criteria
As per Table 1, we analyzed 191 videos for their characteristics which showed the maximum number of videos uploaded before 2020 (n=89, 46.59%) and the minimum number of videos in the year 2022 till our study period (n=9, 4.74%). Among the included videos, the highest number of videos were uploaded by a specialist (n=119,62.3%). Our study showed mean views and likes of included videos were 361105 and 560 respectively. Included videos maximally fall in < 4 minutes duration (n=99, 51.83%). The mean duration of included videos was 7.2 minutes with a SD of 8.3 minutes. Videos with animation and sound were more appealing based on views and likes, although the contribution of animated videos was rather less in number (n=49,25.65%).
Table 1
Details of basic characteristics of included videos (n=191).
Details of the content of included videos
As per Table 2, Table 3 , maximum number of uploaded videos explained general information (n=129,67.53%) and provide information about diagnosis (n=55, 28.79%). Information about treatment was provided in the majority (n=149, 78.01%), among which maximum videos favored medical management (n=146, 97.9%).
Table 2
Details of content of included videos (n=191).
|
Content Details |
Yes |
No |
|
Basic information |
129 |
62 |
|
Information about diagnosis |
55 |
136 |
|
Information about treatment |
149 |
42 |
Table 3
Details of various treatment option (n=149).
|
Treatment Options |
Frequency |
Percentage (%) |
|
Medical |
146.0 |
97.98% |
|
Surgical |
3.0 |
2.01% |
|
Total |
149.0 |
100 |
Out of 191 included videos, 158 videos (82.72%) were following EAU guidelines. In our analysis for detection of differences between assessments of two researchers, the interobserver’s kappa value was calculated as 0.811 (95% CI: 0.693-0.920).
Discussion
This study was the first to review male sexual disorders videos on the social media platforms. These videos had a high number of likes, views, and comments indicating that a countless number of individuals seek out and surf these videos routinely to figure out their dilemmas. Although videos on alternative medicines had more views which we excluded from the study, concluding that the mass is lured more towards these types of treatment options and resulting in a delay in diagnosis and actual management. A similar outcome on alternative medicine videos was advocated by Serinken et al., 2016. 14 In our study, most of the videos are less than 4 minutes duration (51.83%), which shares a common consensus with previous studies that most of the YouTube videos are less than 10 minutes duration, and people are more inclined towards these types of shorter videos. 15, 16
The prevalence of male sexual disorders ranges from 10% to 52%.17, 18, 19, 20, 21 and the affected age group majorly falls between the range of 40-60 years 12 which makes a significant number in terms of the affected individual but still due to social disgrace and unawareness, majority of diseased, presented a tip of the iceberg.
The present recommendation for the management of male sexual disorders is a shared decision-making approach (Makarov et al., 2016). 22 The treatment options as a solo or on a shared basis range from lifestyle modification, psychosexual therapy, hormonal therapy, pharmacologic therapy, intracavernosal injection, intraurethral suppositories, medical devices, penile prosthesis surgery, and penile revascularization surgeries. In our study, a maximum number of videos for treatment options were offering medical management (n=146, 97.9%) over surgical which is the most common and easily approachable option available. Serinken et al., 14 conducted a study on the reliability of videos on kidney stones, in which 89.2% of videos were following EAU guidelines in comparison to our study which showed 82.72% of included videos followed EAU guidelines.
In recent years, there is an increase in the number of medical professionals using social media platforms other than outdoor practices for advocating the management of various diseases which are not readily addressed like sexual disorders, which positively makes them approachable to patients. The majority of videos fall in the exclusion category (n=309,61.8%), which can be explained as videos of alternative medicine and in a foreign language forming the larger proportion. Despite any authentic information provided by excluded videos, there was more social engagement which could be explained based on attractive presentation aided by animation, simple language, and more endeavor.
Conclusion
Video content on Male Sexual Disorders is on trend. Usually, the content with delusive information, small size samples, and individual opinion are having more luring appeasement. Hence, this study firms its ground by stressing the verity of content and the need for scrutiny by the medical community.
