bluuebunny/crossref_metadata_2025 huggingface dataset:
Omission of postoperative radiotherapy after breast-conserving surgery in low-risk breast cancer
Authors: Palmér Sofia , Valachis Antonis , Lindman Henrik , Smith Daniel Robert , Wickberg Åsa , Killander Fredrika , Bjöhle Judith , Einbeigi Zakaria , Nilsson Greger , Ahlgren Johan , Villman Kenneth
Published: December 2024

Background

This prospective cohort study aimed to assess whether postoperative radiotherapy could safely be omitted in women ≥ 65 years with low-risk, estrogen receptor (ER)-positive T1N0 breast cancer treated with breast-conserving surgery and adjuvant endocrine therapy.

Methods

Eligible patients were women ≥ 65 years with unifocal, non-lobular, grade 1 or 2, ER-positive, pT1N0 breast cancer treated with breast-conserving surgery and endocrine therapy for five years. Patients were followed up with mammography at least annually for 10 years. The primary endpoint was local recurrence. Secondary endpoints were contralateral breast cancer, recurrence-free survival, and overall survival.

Results

The final study cohort included 601 patients with a median age of 71 years (range: 65 to 90 years) and a median tumor size of 11 mm (range: 3 to 20 mm). Median follow-up time was 119 months (interquartile range: 103 to 121 months). The cumulative incidence of local recurrence was 1.5% (95% confidence interval (CI): 0.8 to 2.8%) and 5.5% (95% CI: 3.8 to 7.6%) at 5 and 10 years, respectively. The cumulative incidence of contralateral breast cancer was 1.7% (95% CI: 0.9 to 3.0%) at 5 years and 4.5% (95% CI: 3.0 to 6.6%) at 10 years. The overall survival rate at 10 years was 83.1% (95% CI: 80.8 to 85.4%). In total, three patients (0.5%) died due to breast cancer.

Conclusion

Our results support the possibility to omit radiotherapy after breast-conserving surgery in a well-defined subgroup of women aged ≥ 65 years with low-risk, ER-positive, pT1N0 breast cancer receiving adjuvant endocrine therapy.
Unconditional Lotteries in Web Surveys—Evidence from a Large-Scale Experiment
Authors: Holtermann Helge , Skjelbred Siv-Elisabeth , Wiborg Vegard
Published: December 2024

Extensive research suggests that upfront unconditional payments boost response rates compared to a promised payment conditional upon completion. However, we do not know whether the benefits of unconditionality also apply to lottery incentives, which are now commonly used. This study examines how unconditional lotteries affect response rates by randomly allocating sample members in a large web-survey of Norwegian master’s graduates (N = 11,291) to three groups—no-incentive, unconditional lottery, and conditional lottery—during the winter 2021/2022. Comparing response rates across treatments, we find that the unconditional lottery incentive does not outperform the conditional lottery incentive, but both types of lottery incentives modestly boost the response rate compared to no incentive. Moreover, although respondents differ from the population on some background characteristics, the lottery incentives neither alleviate nor increase this bias.
(008) FIRST SAFETY AND PATIENT SATISFACTION STUDY FOR THE NEW RIGICON INFLA10® INFLATABLE PENILE PROSTHESIS
Authors: Cinar B , Wilson S , Gross M , Saribacek A , Atwater B , Culha M
Published: December 2024

Introduction

For 51 and 36 years there have been two inflatable penile prostheses (IPP) manufactured in the United States (US) by Boston Scientific and Coloplast. Since 2019 another US manufactured IPP, Rigicon Infla10®, has been available in countries outside the US. Federal Drug Administration (FDA) studies for approval of Infla10® in the US are presently underway.

Objective

This study aims to report the very first efficacy and safety study of the newly available Rigicon Infla10 inflatable penile prosthesis (IPP).

Methods

We report a single surgeon’s first 58 patients who underwent Rigicon Infla10® IPP between March 2019 and October 2023. Among them, 41 patients (70%) received the Infla10 X (girth expansion) cylinder, and 17 patients (30%) received the Infla10 AX (length and girth expansion) model. Follow-up ranged from 4 to 42 months (median 19 months).

Results

Reoperation was required in 5 patients (8.6%). Adverse events were urethral erosion in one patient (1.7%) at day 45 post-surgery, infection necessitating prosthesis removal in one patient (1.7%) at day 55 post-surgery, and mechanical malfunction due to tubing breakage at pump junction in 3 (5%) patients. The problem was addressed by the manufacturer and the last 20 patients in the series have been mechanically sound. Kaplan–Meier analysis showed the rates of cumulative survival of the device at 12 and 24 months were 96.6% and 93.8%, respectively. Patient-reported outcomes showed that 53 patients (91.4%) were satisfied and would recommend the procedure to others with similar conditions. Diminished satisfaction in the remainder were because of perceived penile shortening in 3 patients (5.1%), and difficulty learning the pump in 2 patients (3.4%).

Conclusions

In the very first safety and efficacy study for the Rigicon Infla10®, this single surgeon series demonstrates high rates of patient satisfaction with appropriate early safety from revision. While very new in the marketplace, the Infla10® IPP shows early comparable efficacy and safety from revision compared to competitive 3-piece devices available for decades.

Disclosure

Any of the authors act as a consultant, employee or shareholder of an industry for: Steven Wilson is a consultant for International Medical Devices, Rigicon and Uramix.
(009) THE PENIS SCORE AND PROPOSAL OF THE PACKAGE CHECKLIST: A META-EPIDEMIOLOGIC STUDY ON PENILE AMPUTATION AND REPLANTATION
Authors: Hellstrom W , Tran A , Machado B , Kuykendall K , Spencer H , Scherzer N , Almajed W , Saghir N , Saghir R
Published: December 2024

Introduction

Penile amputation causes severe physical and psychosocial distress. Microsurgical implementation in penile replantation is presumed to be superior to surgical repair. This assumption has been difficult to verify.

Objective

The purpose of this study was threefold: (1) to produce an updated review of penile replantation, substantiated by the largest sample size to date; (2) to appraise the comparative value of the novel PENIS Score and propose the PACKAGE Checklist, a guide for standardization of future case reports and reviews; and (3) to improve confusing terminology and recommend the standardization of vocabulary.

Methods

A literature review assessed 432 full-text case reports in 20 languages and identified 123 microsurgical and 40 surgical cases of penile replantation. The novel PENIS Score stratified penile amputations based on 5 criteria: position along the shaft, extension through the penis, neurovascular repair, ischemia time and type, and severed edge condition and contamination. For the outcome measurements, a Kendall tau coefficient evaluated the association between each PENIS criterion for short-term postoperative complications and 3 outcome measures: erection, urination, and sensation.

Results

Less than half of surgical reports on penile replantation are sufficiently detailed to complete all PENIS Score criteria. The viability of microsurgical and surgical replantation was equivalent at 92% and 94%, respectively. A statistically significant correlation was found between microsurgical repair and the return of sensation but not with nerve repair. Return of sensation with nerve repair was 51%, and microsurgical replantation without nerve repair was 42%; both were significantly higher than the 14% for surgical replantation. Preservation of a skin bridge was associated with a 40% reduction in severe postoperative complications.

Conclusions

Microsurgical replantation is superior in return of sensation, with or without nerve repair. Implementing the PACKAGE Checklist and PENIS Score will help inform case reports and reviews.

Disclosure

No.
(012) A NOVEL TECHNIQUE OF CORPORAL REPAIR DURING TRANS CORPORAL ARTIFICIAL URINARY SPHINCTER CUFF PLACEMENT WITH AN INFLATABLE PENILE PROSTHESIS IN PLACE USING ALLOGENIC PERICARDIAL GRAFT (TUTOPLAST®)
Authors: Mahdi M , Westney OL , Wang R
Published: December 2024

Introduction

The Number of patients with post prostatectomy stress urinary incontinence (SUI) and erectile dysfunction (ED) is growing. And the use Artificial urinary sphincter (AUS) and inflatable penile prosthesis (IPP) in the management of such conditions has proven its efficacy, especially for the refractory cases. Many patients have both devices, and since the AUS revision rates are higher, some will need further AUS procedures with their IPP in place. This might constitute a challenge that require special consideration.

Objective

We review a new technique for corporal repair using allogenic pericardial graft (Tutoplast®) in patients undergoing AUS revision procedure with trans corporal (TC) AUS cuff placement with IPP cylinders in situ. The intent is to separate and protect the IPP cylinders and AUS cuff.

Methods

We report a new technique of corporal repair during TC AUS revision procedure with in situ IPP. The technique has been done for two patients so far. In both patients a 3 cm bilateral corporotomies were done to create a corporal flap on the dorsal side of the urethra for the new cuff TC placement. Then a Tutoplast® graft of a proper size was sutured to the lateral edges of corporotomies to isolate the IPP in situ cylinders from the planned new TC cuff (fig. 1). Next, the AUS cuff was placed between the graft and the corporal flap/urethra followed by the placement of other AUS component.

Results

No early post-operative complications noted. Patients presented for AUS activation six weeks following the surgery. Functions of both AUS and IPP were confirmed during the visit and patients were instructed to use both devices. During the three and six months post-operative visits both patients were completely continent (using <1 pad/day) and were using the IPPs without any issues or complains.

Conclusions

A preliminary data supports the safety and short-term efficacy of using allogenic pericardial graft (Tutoplast®) in corporal repair for patients undergoing TC AUS cuff placement with an IPP cylinders in place. The technique might protect both the functioning IPP and the new AUS cuff and decrease the mechanical failure with ideal hemostasis during the surgery. Further studies on larger populations are needed to support the long-term efficacy of this technique.

Disclosure

No.
(056) VAS DEFERENS TO RETE TESTIS ANASTOMOSIS: STEP-BY-STEP MICROSURGICAL RECONSTRUCTION
Authors: Savio LF , Mesquita F , Campos L , Miller D , Codrington J , White JT , Muthigi A , Ramasamy R
Published: December 2024

Introduction

This video aims to present an in-depth, step-by-step tutorial on microsurgical reconstruction for obstructive azoospermia, featuring a distinctive case involving anastomosis from vas deferens to rete testis. The video endeavors to disseminate expertise, methodologies, and perspectives that can be advantageous to individuals grappling with obstructive azoospermia, providing a significant contribution to the progress of reproductive medicine and the augmentation of existing treatment alternatives.

Objective

The primary aim of this endeavor is to offer thorough and practical insights for healthcare professionals and researchers within the realm of reproductive medicine.

Methods

Surgical footage was recorded using the ORBEYE 4 K 3D Orbital Camera System by Olympus America, with patient consent acquired for research purposes. Additionally, a retrospective examination of patient records was undertaken to compile relevant medical histories.

Results

This video furnishes an exhaustive guide to microsurgical reconstruction for obstructive azoospermia, encompassing a distinctive instance of anastomosis from vas deferens to rete testis. State-of-the-art technology, such as the ORBEYE 4 K 3D Orbital Camera, heightens procedural transparency, accentuating the significance of advanced instrumentation. The ethical underpinning is emphasized by obtaining patient consent for footage utilization, and a retrospective chart review augments the repository of valuable patient data. This comprehensive approach serves as an invaluable reservoir of knowledge for medical professionals and underscores excellence in clinical and ethical healthcare research.

Conclusions

Anastomosis from vas deferens to rete testis emerges as a viable surgical reconstruction alternative for obstructive azoospermia, particularly when confronted with non-dilated tubules within the epididymis.

Disclosure

No.
(059) DEVELOPMENT OF AN ANIMAL MODEL TO DEMONSTRATE THE EFFECTIVENESS OF COLLAGEN-FLEECE (TACHOSIL) PATCHES FOR REPAIRING TUNICA ALBUGINEA DEFECTS IN RATS
Authors: Seyam R , Mandourah H , Al-Hussain T , Kattan S , Altaweel W
Published: December 2024

Introduction

A penile tunica defect may arise during penile prosthesis surgery or reconstruction of the penis in patients with Peyronie’s disease. Collagen fleece (TachoSil) was recently reported in penile surgery to cover the tunica defect with reported clinical success. However, there is no animal model to study the histological and hemodynamic outcomes of these grafts in the penis.

Objective

We demonstrate TachoSil patching in a murine animal model. The rat is an excellent model for studying histopathology and the physiology of erection after Tachosil patching.

Methods

Seven adult male Sprague Dawley rats were used. All procedures were carried out under general inhalation anesthesia. The penis was degloved through a circumferential subcoronal incision. A longitudinal 1x10 mm defect was created at the base of the lateral aspect of the penis. A TachoSil patch (Takeda, Japan) was applied to the defect. The penile skin covering is restored and fixed with interrupted 5-6 zero absorbable sutures.

Results

The video demonstrates how to create a tunica albuginea defect and patch it with TachoSil. At the surgery, the rats weighed 390 gm (SD 33.8). All animals survived to the endpoint of two months.

Conclusions

The rat model for TachoSil penile patching is feasible and robust. It permits evaluation of the histological and physiological changes that may occur after surgery. The animal model may be adapted to different short-and long-term endpoints, variable tunica albuginea defect size, and to compare Tachosil to other grafting materials.

Disclosure

No.
(081) FEMALE SEXUAL DYSFUNCTION AFTER RADICAL CYSTECTOMY FOR BLADDER CANCER: A SINGLE CENTRE EXPERIENCE
Authors: Tran V , Attwell-Heap A
Published: December 2024

Introduction

Radical cystectomy (RC) for bladder cancer significantly impacts sexual function in both men and women. While post-operative erectile dysfunction is thoroughly addressed in men, there is a glaring lack of attention directed towards female sexual function and organ preservation. Current literature regarding functional outcomes in females after RC demonstrates significant heterogeneity, lack of standardized reporting, and poor discussions surrounding the impact of different surgical approaches on sexual function, such as organ-sparing surgery or vaginal reconstruction. In particular, orthotopic neobladder (ON) as a method for urinary diversion is associated with improved sexual and urinary function after RC.

Objective

We aim to study trends in the rate of females undergoing RC at our institution, and explore the extent of counselling surrounding surgical approach and impact on sexual function.

Methods

A retrospective chart review was performed of all female patients who underwent RC our institution in the last 5 years. Data was collected for patient demographics, histopathology, and documented discussions in medical records regarding surgical approach and sexual function pre- and post-operatively.

Results

From 2019 to May 2024, there were 44 patients who underwent radical cystectomy at our institution for bladder cancer, with females comprising 11 (25%) of cases. Among females, the median age was 67 years old. Based on histopathology alone, ON would have been a reasonable consideration for urinary diversion in all women. There was no documentation of discussions surrounding urinary diversion approaches, organ sparing, or sexual function pre- and post-operatively.

Conclusions

Given increasing awareness surrounding the importance of sexual function, this highlights an important area of oncosexology that remains inadequately addressed in clinical practice. At our institution, we are moving to introducing pre-operative functional assessments and counselling regarding sexual function using a multidisciplinary approach to guide the shared decision-making process prior to RC.

Disclosure

No.
(095) GRIEF AND SEXUAL INTIMACY: EXPLORING THERAPISTS’ VIEWS OF BEREAVED CLIENTS
Authors: Pascoal PM , Jones S , Albuquerque S
Published: December 2024

Introduction

The interaction between sexual intimacy and grief remains unexplored despite its potential to offer valuable insights into how individuals, couples, and society perspectives shape bereaved individuals’ sexual intimacy.

Objective

Through semi-structured interviews with ten clinical psychologists and psychotherapists specialized in grief therapy, this study explores the impact of grief on sexual intimacy, the challenges faced by bereaved individuals, and the role of sexual intimacy in the grieving process. The study also investigates therapists’ approaches to addressing sexual intimacy within grief therapy sessions.

Methods

Semi-structured interviews with licensed clinical psychologists specialized in Grief were conducted and analyzed using Grounded Theory framework.

Results

Findings reveal that grief often disrupts sexual intimacy, affecting individuals’ ability to engage emotionally and physically with their partners. Factors such as secondary loss, emotional availability, traumatic experiences, and the nature of the loss contribute to difficulties in resuming sexual intimacy. Nevertheless, the helpful role of sexual intimacy in grief was also highlighted. Therapists note the significance of communication, mutual empathy, and understanding in overcoming these challenges, advocating for therapy to address these issues comprehensively. Moreover, therapist-related, client-related, and shared factors hindering the exploration of sexual intimacy in grief therapy were identified. Strategies for managing these challenges include normalizing discussions around sexual intimacy and death, integrating systemic approaches into therapy, and providing training in sexuality or sexual therapy for grief therapists.

Conclusions

Overall, this study underscores the importance of recognizing and addressing the interplay between sexual intimacy and grief to support bereaved individuals effectively. Insights from therapists shed light on potential avenues for enhancing clinical interventions and fostering awareness of the complex dynamics surrounding bereavement and sexuality.

Disclosure

No.
(104) REDUCING THE GRAFTING AREA IN PEYRONIE’S DISEASE: INITIAL RESULTS OF THE IGRAFTER TECHNIQUE IN THE UNITED STATES
Authors: Lopes Cancado Machado B , Kuykendall K , Smith A , Puente C , Dietrich G
Published: December 2024

Introduction

Erectile dysfunction (ED) is commonly associated with plaque incision and graft techniques (PIG) for the treatment of severe Peyronie’s disease (curvatures ≥60°), and graft size is one of the factors that correlate with postoperative development of ED. The iGrafter technique, which reduces the total grafting area by approximately one-half compared to the Double-Y technique, could prevent the progression of ED postoperatively. In this study, we aimed to determine whether patients with severe Peyronie’s disease who underwent surgery with the iGrafter technique developed ED and sexual dissatisfaction.

Objective

Evaluate the erection function after penile curvature correction using iGrafter in a single center.

Methods

This retrospective study included 8 patients between the ages of 49 and 69 (mean: 59.5 ± 6.63) who underwent surgery for penile curvature correction. The surgery was performed by the same surgeon at the University of Arkansas for Medical Sciences between August 2017 and December 2023, and the surgeon used the iGrafter technique. Those with an inflatable penile prosthesis were excluded. Erectile function and intercourse satisfaction were evaluated preoperatively and postoperatively via international index of erectile function (IIEF-5) questionnaires obtained from chart reviews and telephone interviews.

Results

Follow-up was available for 6 (75%) of the 8 patients. The mean preoperative IIEF-5 score was 18.75 ± 7.5, and the mean postoperative IIEF-5 score was 21.75 ± 3.3, with an average follow-up of 1.5 years. No significant difference was observed between preoperative and postoperative IIEF-5 scores (P = 0.52) (Table 1). Eighty percent of patients reported satisfaction with the procedure, and all would opt for the procedure again.

Conclusions

The size of the grafting area contributes to postoperative ED in patients with severe Peyronie’s disease who undergo surgical correction by PIG. The iGrafter technique yields promising outcomes by reducing the grafting area by one-half when compared to the Double-Y technique. Our series showed no significant long-term declines in IIEF-5, consistent with high patient sexual satisfaction. Thus, our preliminary study revealed that patients undergoing surgery utilizing the iGrafter technique for severe Peyronie’s disease experienced no adverse effects on erectile function in the long-term postoperative phase compared to the preoperative period. Although current data is limited by a small sample size, our ongoing multicenter study aims to further validate these findings.

Disclosure

No.
(144) PREVALENCE OF FEMALE SEXUAL DYSFUNCTION IN A GROUP OF ARGENTINE WOMEN
Authors: Valente S , Gomez Cherey F , Leyton E , Bolognessi V , Soloa P , Ortiz J , Maldonado V
Published: December 2024

Introduction

Sexuality lived satisfactorily is essential for the development of a good quality of life and the preservation of health. Changes and difficulties in the dynamics of sexual experiences can cause different problems in sexual activity until reaching sexual dysfunctions. Health professionals should be attentive to the sexuality of our patients, since we could identify situations of this nature early to avoid recurring health problems and with an appropriate referral to a specialist, provide greater comfort in their quality of life.

Objective

To evaluate the domains of the Female Sexual Function Index (FSFI) in patients >45 years old and those consulting for vulvar symptoms (VS) versus control.

Methods

The mean age was 42.1 (±13.7) years, 42.4% were > 45 years old, 32.6% (47/144) were menopausal, 41% consulted for VS. FSFI scores in patients >45 years: Desire 3.05 vs 3.64 (p = 0.002), Arousal 3.45 vs 4.20 (p = 0.001), Lubrication 3.21 vs 3.91 (p < 0.01), Orgasm 3.92 vs 4.38 (p = 0.08), Satisfaction 4.22 vs 4.82 (p = 0.02), Pain 3.41 vs 4.18 (p = 0.02). FSFI scores in patients with VS: Desire 3.35 vs 3.48 (p = 0.75), Arousal 3.55 vs 4.11 (p = 0.06), Lubrication 3.2 vs 3.9 (p < 0.01), Orgasm 3.78 vs 4.46 (p = 0.02), Satisfaction 4.35 vs 4.72 (p = 0.22), Pain 2.94 vs 4.48 (p < 0.01).

Results

The mean age was 42.1 (±13.7) years, 42.4% were > 45 years old, 32.6% (47/144) were menopausal, 41% consulted for VS. FSFI scores in patients >45 years: Desire 3.05 vs 3.64 (p = 0.002), Arousal 3.45 vs 4.20 (p = 0.001), Lubrication 3.21 vs 3.91 (p < 0.01), Orgasm 3.92 vs 4.38 (p = 0.08), Satisfaction 4.22 vs 4.82 (p = 0.02), Pain 3.41 vs 4.18 (p = 0.02). FSFI scores in patients with VS: Desire 3.35 vs 3.48 (p = 0.75), Arousal 3.55 vs 4.11 (p = 0.06), Lubrication 3.2 vs 3.9 (p < 0.01), Orgasm 3.78 vs 4.46 (p = 0.02), Satisfaction 4.35 vs 4.72 (p = 0.22), Pain 2.94 vs 4.48 (p < 0.01).

Conclusions

The domains of desire, arousal, lubrication, satisfaction are decreased in patients >45 years old and those consulting for VS. Pain is the most involved domain. The satisfaction domain would be the least affected among both groups.

Disclosure

No.
(147) IMPACT OF THE RITE OF TASFIH ON THE SEXUAL HEALTH OF YOUNG ADULT WOMEN
Authors: Kaabia O , Gharbi I , Smaali H , Guefrech O , Maya Bahri Y
Published: December 2024

Introduction

Tasfih is a magical practice exercised by an old woman on girls before puberty, in some North African countries to prevent any pre-marital vaginal penetration. In doing so, it is believed that the hymen becomes unbreachable. It is a taboo practice frequently reported as a cause of unconsummated marriage.

Objective

We aim to study the association between the rite of Tasfih and the domains of sexual function among young adult women.

Methods

This nested case–control study included young adult women aged between 18 and 45. The cases are participants self-reporting a personal history of Tasfih and the controls are self-reported healthy women matching for medical history, age, and relationship status. Data was collected through an online self-administered questionnaire. The sexual function was assessed through validated translations of the Female Sexual Function Index. Female sexual dysfunction is defined by an FSFI score ≤ 26.55.

Results

This study included 104 women with a personal history of Tasfih and 208 controls. Age and other main socio-demographic components were similar between groups. The prevalence of female sexual dysfunction among women with a history of Tasfih was 64.4% compared to 61.2% in the controls. (p = 0.66). There was no statistical difference between both groups in terms of total FSFI score (p = 0.88). There was also no difference between the groups among the six FSFI domains’ scores (Desire, Orgasm, Excitation, Lubrication, Pain, and Satisfaction).

Conclusions

In this study population that has a high prevalence of sexual dysfunction, the magic rite of Tasfih is not associated with worse sexual function scores or more sexual dysfunction.

Disclosure

No.
(194) QUALITY OF SEXUAL LIFE IN PATIENTS WITH NEURO-UROLOGICAL DISEASES
Authors: Utiyamada N , Konishi Y , Cintra C , Bicudo MC , Glina S
Published: December 2024

Introduction

Neuro-urological symptoms can be caused by a variety of diseases and events affecting the nervous system that are directly related to the location and extent of the injury. The survival rate of patients with these conditions has increased significantly in recent years, but there is not information enought about the quality of life of this population, especially in relation to sexual quality. We know that sexual function has a direct relationship with the level of spinal cord injury and physical, psychological and social factors. This study aims to analyze the demographic profile and evaluate the quality of life and sexual quality of patients, being monitored at our service, with neuro-urological diseases.

Objective

This study aims to analyze the demographic profile and evaluate the quality of life and sexual quality of patients, being monitored at our service, with neuro-urological diseases.

Methods

The WHOQoL-BREF questionnaires associated with IIEF5 were applied for male patients and FSFI for female patients who met the inclusion criteria after reading the informed consent form.

Results

Were collected from 27 patients. Of these, 5 were women and 22 men. 80% of patients had spinal cord trauma, with a median injury time of 10 years (7 months to 36 years). The average age was 41.7 years. We identified 48% are Catholic, 52% consider themselves white, 68% do not have a formal job and 64% of them do not have any children (80% of which are female); 1 patient is bisexual. Forty percent of men show an erectile response to pharmacotherapy (97% oral and 13% intracavernous injection). Sixty percent of patients are satisfied with their level of sexual activity and 40% are dissatisfied; 75% of women are not sexually active – 75% due to lack of a partner and 25% due to marital problems. In relation to quality of life, the domain with the worst evaluation score is related to the environment (58%) and the best evaluated is linked to psychological health (66%). Physical health and social relationships averaged 59% and 60%, respectively.

Conclusions

We can infer that spinal cord injury negatively impacts the quality of life of individuals in the environmental domain, probably due to the mobility limitations imposed by the condition. On the other hand, the domain of psychological health does not seem to be affected in such a significant way. In relation to sexual health, 70% of individuals feel satisfied with their sexual life, despite the usual need for adjuvant pharmacotherapy in males, regardless of the route of administration. However, we observed similarity in the rates of satisfaction and dissatisfaction among men with severe erectile dysfunction and 100% satisfaction of women, even no sexual activity, highlighting the need for further studies in order to evaluate the concreteness of these data and/or the complexities defining interrelations of sexual satisfaction and quality of life, in this particular group of individuals.

Disclosure

No.
(216) THE RELATIONSHIP BETWEEN SLEEP DISORDERS, QUALITY, AND DURATION AND SEXUAL DYSFUNCTION: A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: Dilixiati D , Kadier K , Lu J , Laihaiti D , Rezhake R , Azhati B , Rexiati M
Published: December 2024

Introduction

The associations between sexual dysfunction (SD) and sleep disorders, sleep quality, and sleep duration remain unclear.

Objective

To assess the relationship between sleep and SD through a literature review and meta-analysis.

Methods

The PubMed, Scopus, Embase, Ovid MEDLINE, and Cochrane Library databases were systematically searched from inception to November 10, 2022.

Results

Forty-three articles, including 11 longitudinal studies and 32 cross-sectional studies, were included in the quantitative analysis. The pooled relative risk of SD in patients with sleep disorders was 1.97 in longitudinal studies (95% CI, 1.46-2.67, P < .001; heterogeneity: I 2 = 95.0%, P < .001), while the pooled OR of SD in patients with sleep disorders was 2.05 in cross-sectional studies (95% CI, 1.76-2.39, P < .001; heterogeneity: I 2 = 91.4%, P < .001). When compared with controls, subjects with poor sleep quality had a 1.49-fold increased risk of SD (OR, 1.49; 95% CI, 1.31-1.71, P < .001; heterogeneity: I 2 = 73.4%, P < .001). In addition, short sleep duration was associated with the risk of SD (OR, 1.14; 95% CI, 1.06-1.22, P < .001; heterogeneity: I 2 = 0.0%, P = .849).

Conclusions

Our systematic review and meta-analysis results suggest that sleep disorders, especially obstructive sleep apnea, increase the risk of SD in men and women. Poor sleep quality is significantly associated with SD. Short sleep duration is associated with an increased risk of SD.

Disclosure

No.
(224) ICSI SUCCESS RATES IN PATIENTS WITH AZOOSPERMIA: FRESH OR CRYOPRESERVED SPERM?
Authors: Vinay J , Pieressa N , Saez N , Urrutia C
Published: December 2024

Introduction

Intracytoplasmic sperm injection (ICSI) is a highly complex assisted fertilization technique with several male and female factor indications, including azoospermia. It is not clear whether there is a benefit of using fresh sperm after testicular extraction (TESE) versus frozen–thawed testicular sperm from a previous TESE.

Objective

The objective of the present study is to compare the success rates of ICSI using cryopreserved vs fresh testicular sperm in a single fertility center.

Methods

Analytical study. All patients underwent TESE in a single fertility center between 2017 and 2022. Data was retrospectively studied. The success rate of ICSI, defined as the formation of at least 1 euploid embryo on day 5, was compared between the fresh testicular sperm group vs frozen–thawed testicular sperm and posterior ICSI.

Results

Of the 138 patients who underwent TESE, sperm recovery was achieved in 100 (72.5%). ICSI was performed in 91 cases, 63 (69.2%) with fresh sperm and 28 (30.8%) with frozen–thawed sperm. Of those patients who used fresh sperm, 53 (84.1%) achieved at least 1 euploid embryo in ICSI and of these 30 (56.6%) achieved at least 1 pregnancy. Of those patients who used cryopreserved sperm, 18 (64.3%) achieved at least 1 euploid embryo after ICSI, and of these 11 (61.1%) achieved at least 1 pregnancy. No significant differences were found in the success rate of ICSI with the use of fresh and cryopreserved sperm (p = 0.819).

Conclusions

In the present study, no significant differences were observed in the success rate of ICSI when using fresh or frozen–thawed sperm from TESE. This data could be of great importance when planning assisted reproduction treatments for couples with a severe male factor.

Disclosure

No.
(234) TWENTY-TWO TECHNIQUES TO IMPROVE SEXUAL DESIRE IN WOMEN
Authors: Brendler J
Published: December 2024

Introduction

Hypoactive sexual desire that generates distress is the most common problem in women in sexology offices. It is important for sexologists to be aware of the numerous techniques already published in order to choose the best techniques for each person.

Objective

List the Cognitive Behavioral and Sexual Therapy techniques that can be used for hypoactive Sexual Desire in women.

Methods

Literature review was carried out on Cognitive Behavioral Line and Sexual Therapy techniques from the last 70 years using English and Portuguese language databases.

Results

Twenty-one published techniques were found, namely: 1) Improving self-esteem; 2) Support; 3) Clarification: about spontaneous and responsive sexual desire, as well as sexual response and sexuality, etc.; 4) Use cognitive restructuring to undo myths, beliefs and taboos and eliminate anti-sexual thoughts; 5) Prohibited coitus; 6) Non-demanding touch with Sexual Fantasy stimulation; 7) Focusing Sensations I; 8) Focusing sensations II; 9) Kegel exercise; 10) Non-demanding coitus; 11) Distract yourself from what distracts you or Distraction from Distraction; 12) Improve communication between the couple; 13 Improve sexual intimacy; 14) Invest in the relationship; 15) Negotiate the division of domestic tasks; 16) Identify with the role of “sexual woman” as you identify with other roles; 17) Invest in yourself; 18) Invest in and validate the partner’s behavior; 19) Sexual Menu Technique based on thinking about sex and romance at least three times a day; 20) Anticipate sexual activity in your mind; 21) Use full attention or Mindfulness; 22) use Diaries to detect “erotic events”.

Conclusions

We found Twenty-one psychotherapeutic techniques published in English (the majority) and Portuguese within the Cognitive Behavioral and Sexual Therapy Line. This set of techniques will help sexologists improve sexual desire and, as a consequence, women’s sexual health and quality of life.

Disclosure

No.
(028) ANALYZING GOOGLE SEARCH TRENDS FOR “VAGINAL ESTROGEN” AND ITS RELATIONSHIP TO MEDICAL RECOMMENDATIONS FOR POST-MENOPAUSAL WOMEN
Authors: Hammad MAM , Chawareb EA , Nakamura H , Miller J , Kadakia Y , Lee J , Yih JM , Yafi FA , Chang OH
Published: December 2024

Introduction

Over two million women reach menopause each year in the United States, subsequently creating a demand for medical symptomatic relief. This can come in many forms, ranging from topical treatments to oral hormone therapy. It is important to examine closely the popularity and awareness of these different types of treatment options in the U.S. to fully gauge how sexual healthcare is administered to women. The study focuses on vaginal estrogen treatment, specifically its relevance to post-menopausal women over the years, through Google search trends and rising literature recommendations.

Objective

Our study aims to investigate the correlation between Google search trends for the term "vaginal estrogen" and the rising literature recommendations of vaginal estrogen for postmenopausal women.

Methods

We conducted a retrospective analysis of Google search trends data for the term "vaginal estrogen" and other related words. The word “weather” (a term that is consistently searched) was used as a control to compare against when analyzing the trends. We simultaneously examined medical recommendations in major urology societies’ websites and social media forums for vaginal estrogen in the context of post-menopausal symptom management. Time series analysis (a 6-month simple moving average) and statistical modeling were employed to evaluate the trends and relationships between these variables.

Results

Our results reveal a positive correlation (R2 = 0.721) between the increasing search interest in "vaginal estrogen" and the number of articles on this treatment option among post-menopausal women. While it may or may not be causative, it suggests that there is a growing interest in this treatment from the public. With the recent increase in physician recommendations to include vaginal estrogen as part of the treatment regimen for post-menopausal women, we found an increasing public awareness and interest in this treatment option.

Conclusions

Our study demonstrates a noteworthy connection between the rising medical recommendations for vaginal estrogen in the management of postmenopausal symptoms and the growing search interest for the term "vaginal estrogen" on Google. The data underscores that the medical community's endorsement of vaginal estrogen is fostering greater awareness and acceptance of this therapy among post-menopausal women. Further research is needed to determine its equal accessibility to all patients.

Disclosure

Any of the authors act as a consultant, employee or shareholder of an industry for: Coloplast.
(030) HUUDDII: THE CLITORAL SUCTION DEVICE
Authors: Paulsen O , Dann J , Rubin R
Published: December 2024

Introduction

Clitoral blood flow plays an important role in female sexual arousal and overall sexual satisfaction. Typically, sexual arousal results in smooth muscle relaxation and arterial vasodilation within the clitoris. The result is an increase in blood flow and intra-cavernous pressure leading to tumescence and extrusion of the glans clitoris. Several health conditions can impact this mechanism, leading to decreased sexual desire, arousal, orgasm, and satisfaction. Huuddii is a simple, hands-free, disposable product that fits over the clitoris and improves sexual function by combining initial gentle suction and frictional force that stimulates the clitoris and activates the sexual arousal cascade. Huuddii underwent a multicenter non-significant risk clinical and over-the-counter (OTC) label comprehension 510 k study for FDA approval in 2004-2005. The label comprehension test portion of the study was designed to test subject’s ability to correctly self-select for use of this product to treat symptoms related to female sexual dysfunction and understand and correctly use the product as outlined in the consumer instruction guide. The clinical portion of the study was designed to test the safety and efficacy of the device in an OTC environment.

Objective

To assess the clinical efficacy, safety, and user-friendly nature of Huuddii in improving female sexual function with the goal of OTC FDA approval.

Methods

Objective data was collected using the Female Sexual Function Index (FSFI). Subjects completed an FSFI questionnaire as a baseline and after device utilization. Subjective data was collected using the Sexual Life Quality Questionnaire (SLQQ) and Female Intervention Efficacy Index (FIEI). The SLQQ and FIEI were completed post-intervention.

Results

Our objective results as measured by the FSFI revealed that individual success was achieved in “overall improvement in sexual function” in 87% of subjects. Percentages for the following sub-domains of “desire,” “arousal,” “lubrication,” “orgasm,” “satisfaction,” and “pain” were 63%, 92%, 82%, 84%, 79%, and 55%, respectively. Subjective result, 87% of subjects who completed the SLQQ reported improved sexual quality of life and satisfaction while wearing Huuddii. Results of the FIEI demonstrated a 74% improvement in lubrication, 82% increase in genital sensitivity, 66% increase in pleasure associated with intercourse, 63% improvement in orgasm, and 82% increase in overall sexual satisfaction. Ninety-two percent (92%) of subjects claimed they would like to continue using the device after the study was completed.

Conclusions

Huuddii is a safe, simple, disposable, non-invasive suction cup that assists in achieving and maintaining clitoral tumescence, increases blood flow to the clitoris, and ultimately enhances female sexual function.

Disclosure

No.
(037) CATCHING THE CURVE: LEVERAGING DISEASE PHASES FOR OPTIMAL COLLAGENASE THERAPY IN PEYRONIE’S PATIENTS
Authors: Saffati G , Orozco Rendon D , Hinojosa-Gonzalez DE , Kronstedt S , Khera M
Published: December 2024

Introduction

In the United States, collagenase clostridium histolyticum (CCH) injections are widely used as a treatment for patients with Peyronie’s disease (PD). While CCH is an approved treatment for PD, it is unclear from existing evidence if initiating this intervention during the acute phase vs the later chronic phase leads to different outcomes.

Objective

We sought to investigate the effectiveness and safety of CCH treatment in patients with PD, comparing outcomes between those in the active versus stable phase of the disease.

Methods

We performed an IRB-approved single-center retrospective study from 2009-2023 on patients with CCH injections for PD. Clinical and demographic information was extracted from patient medical records. Patients were stratified into two groups based on the phase of their disease at the time of treatment: active (acute) phase or stable (chronic) phase. Both groups were compared Pearson's Chi-square or Fisher's exact tests for categorical data.

Results

This study included 169 patients with a mean age of 57.9 (SD: 8.63). The patient cohort is summarized in Table 1. Of these, 144 and 25 patients received CCH in the chronic and acute phases, respectively. No significant difference was observed between the change in curvature of the active and stable phase (-7.4 [SD:14.73] vs. -7.82 [SD:16.04], p = 0.37, respectively). No significant difference was observed in curve improvement between the two phases (p = 0.864), indicating that treatment was equally effective in both phases. More patients in the stable phase had progression to surgery (p = 0.032). In terms of side effects, the incidences of bruising (p = 0.368), swelling (p = 0.811), pain (p = 0.846), hematoma (p = 0.479), and fracture (p = 0.457) did not differ significantly between the active and stable phases. The chi-square test results for new ED and loss of length should be interpreted cautiously due to small size cell counts.

Conclusions

These results suggest that CCH injection is a viable treatment option for PD patients in both the active and stable phases, with comparable efficacy in improving penile curvature deformity. Further prospective studies with larger sample sizes are warranted to validate these findings.

Disclosure

Any of the authors act as a consultant, employee or shareholder of an industry for: Disclosures: Consultant for AbbVie, Marius, Tolmar, Endo, Petros, Boston Scientific, Coloplast, Halozyme Investor: Sprout.
(039) THE EFFICACY AND SAFETY OF OFFICE-BASED PENILE PLICATION
Authors: Parikh N , Premo H , Ziegelmann M
Published: December 2024

Introduction

Penile plication is an excellent approach for patients with congenital penile curvature and Peyronie’s disease. Beginning in March of 2023, patients who were candidates for penile plication were offered the procedure in the operating room under general anesthesia or in the office setting with no sedation. Fourteen patients opted for the procedure in the clinic.

Objective

We therefore sought to assess patient responses and experience after undergoing surgery in the clinic setting.

Methods

Fifteen patients, ages ranging from 21 to 74 were seen in clinic for penile plication surgery. Exclusion criteria included patients younger than 18 years and preoperative systolic blood pressure greater than 160. One patient was noted to have a systolic blood pressure over 200 and thus was unable to have the procedure. Five patients had a penile plication for congenital curvature, eight patients for Peyronie’s disease, and 1 patient had a release of a previously placed palpable plication suture. Degree of curvature, direction of curvature, presence of secondary curvature, presence of hinge defect, and indentation were not considerations in patient selection. Three patients were on anticoagulation, which was held prior to surgery. Twelve patients underwent a ventral approach and two a degloving approach.

Results

Patients are allowed and encouraged to eat and drink prior to the procedure. All patients were given a preoperative antibiotic, normally either Bactrim or ciprofloxacin prior to the procedure and 20 mg of oral versed. They were then taken to the in-office procedure room after consent was obtained. The procedure room contains a television for patients to watch. At the end of the procedure, an Exparel block was performed. Patients are then prepped and draped in standard sterile fashion. A dorsal penile nerve block and circumferential block were utilized at the beginning of the case. A catheter is not placed to help reduce patient discomfort. Alprostadil is injected to help identify curvature. Ten patients were noted to have dorsal, 2 patients’ ventral, and 2 patients’ lateral curvature with degree of curvature ranging from 30 to 60 degrees. Eight patients had a secondary curvature identified. Total number of plication sutures utilized ranged from 2 to 8. All procedures were successfully conducted, and patients discharged home. Patients were then contacted to determine their experiences with the procedure. Only seven patients were able to be reached. One patient did have a vasovagal response in the procedure room, but this resolved with a small snack. Average intraoperative discomfort was rated as a 2/10 and was mainly present during the initial block. All patients stated that they would choose this surgical approach again and have noted clinically significant improvement to their curvature.

Conclusions

Penile plication in the clinic setting reduces anesthetic risks as well as costs associated with the operating room. This study shows the safety and feasibility of this approach.

Disclosure

No.