bluuebunny/crossref_metadata_2025 huggingface dataset:
Insights into the metabolism of CH-PIATA—A novel synthetic cannabinoid featuring an acetamide linker
Authors: Zschiesche Annette , Scheu Martin , Thieme Detlef , Keiler Annekathrin M , Pulver Benedikt , Huppertz Laura M , Auwärter Volker
Published: March 2024

The recent change from the popular carboxamide to an acetamide (ATA) linker scaffold in synthetic cannabinoid receptor agonists (SCRAs) can be interpreted as an attempt to circumvent legal regulations, setting new analytical challenges. Metabolites of N-cyclohexyl-2-(1-pentyl-1 H-indol-3-yl)acetamide: CH-PIATA, the second ATA type SCRA detected in the EU, were investigated in urine and serum samples by LC–HRMS-MS and LC–MS-MS. Two different in vitro models, a pHLM assay and HepG2-cells, as well as an in silico prediction by GLORYx freeware assisted in metabolite formation/identification. CH-PIATA was extensively metabolized, leading to metabolites formed primarily by mono- and dihydroxylation. For urine and serum specimens, monohydroxylation at the indole core or the methylene spacer of the acetamide linker (M1.8), carboxylic acid formation at the N-pentyl side chain (M3.1) and degradation of the latter leading to a tentatively identified N-propionic acid metabolite (M5.1) are suggested as reliable markers for substance intake. The N-propionic acid metabolite could not be confirmed in the in vitro assays as it includes multiple consecutive metabolic reactions. Furthermore, CH-PIATA could be detected as parent substance in blood samples, but not in urine. Both in vitro assays and the in silico tool proved suitable for predicting metabolites of CH-PIATA. Considering effort and costs, pHLM incubations seem to be more effective for metabolite prediction in forensic toxicology than HepG2 cells. The highlighted Phase I metabolites serve as reliable urinary targets for confirming CH-PIATA use. The in silico approach is advantageous when reference material is unavailable.
Simultaneous analysis of acyclovir and its metabolite using hydrophilic interaction liquid chromatography–tandem mass spectrometry
Authors: Takeda Saki , Ueno Satoshi , Zenda Rie , Muto Kazuya , Iseki Ken , Harada Kazuki
Published: March 2024

The antiviral drug acyclovir (ACV) may induce drug-induced neuropsychiatric symptoms as side effects. The detailed pathogenic mechanism remains unclear; however, it is hypothesized that 9-carboxymethoxymethylguanine (CMMG), a metabolite of ACV, is the causative compound. Therefore, the blood concentrations of ACV and CMMG should be analyzed in ACV toxicity studies. However, it is rare to find methods that can sufficiently separate the ACV and CMMG peaks during simultaneous analysis of both compounds. Therefore, we intended to develop a liquid chromatography–tandem mass spectrometry method with improved peak separation of analytes. Samples were deproteinized using methanol/acetonitrile solution (6:4, v/v). Analytes were separated on an InertSustain® Amide column (3 μm, 2.1 mm × 150 mm). The mobile phase consisted of acetonitrile/10 mM ammonium formate (5:95, v/v) (A) and acetonitrile/10 mM ammonium formate (95:5, v/v, pH 5.0) (B) and samples were eluted in the gradient mode. The separation of analytes was satisfactory and the peak shapes were good. Linear regression models weighted 1/x2 were obtained in the range of 0.25–10 μg/mL. The range of quality control (QC) bias was between 3.6% and 19.8%, and the within-run and between-run precisions of QC were within 13.5%. Recovery ranged from 83.6% to 103.7%, but ion suppression was observed. Samples from a patient with ACV encephalopathy were analyzed using this method. The resulting blood ACV and CMMG concentrations were 8.2 and 8.5 μg/mL, respectively. This method, with sufficient separation of ACV and CMMG, proved useful for use in ACV toxicity studies.
Experimentation at the WTO lab: towards a better ‘Interface’ to accommodate State-owned enterprises
Authors: Bi Ying
Published: March 2024

This article advocates for a more inclusive and adaptable interface mechanism at the World Trade Organization (WTO), specifically tailored to address the nuanced dynamics of State-Owned Enterprises (SOEs). It revisits the foundational ‘Interface Theory’ by John H. Jackson, a cornerstone in shaping initial WTO rules for non-market economies. Drawing upon the critiques of David Kennedy, this article identifies three key limitations inherent in the existing interface theory. It then delves into a critical examination of the regulations pertaining to SOEs within the frameworks of the Trans-Pacific Partnership / the Comprehensive and Progressive Agreement for Trans-Pacific Partnership, arguing that these models inadequately address the complexity of state participation in the economy, with a particular focus on non-market economies like China. This article suggests leveraging the WTO as a global policy laboratory, a forum for the exploration and discussion of varied national strategies concerning SOE management. It posits China’s mixed-ownership reform as an exemplary starting point for such experimental endeavours.
(021) Eight-Dot Extended Corporotomy versus Conventional Corporotomy for Malleable Penile Prosthesis Implantation
Authors: Ragheb A , Emadeldin M , Abdallah R , Mohamed A , Elmarakby A
Published: March 2024

Introduction

To date, malleable type penile prosthesis implantation (MPPI) remains the more popular in developing countries, owing to its relative economic cost. Despite the simplicity of the procedure, there still may be areas of improvement and refinement to optimize procedure efficiency and accuracy subsequently improving postoperative outcomes while reducing complication risk.

Objective

We aimed to compare the eight-dot extended corporotomy and the conventional corporotomy techniques for MPPI with regard to operative time and postoperative complications.

Methods

We conducted a prospective randomized interventional clinical study on 51 subjects. Patients were randomized into 2 groups: the eight-dot group (n=27) and the conventional group (n=24). The eight-dot group underwent MPPI using the eight-dot extended corporotomy as previously described (VJPU - Eight-dot Extended Corporotomy: A More Secure, Aesthetic and Time Efficient Technique for Semirigid Penile Prosthesis Implantation, n.d.). The conventional group underwent MPPI using conventional limited corporotomies that were closed via continuous running sutures. We compared both groups in terms of corporotomy opening to closure time, overall procedure time, and perioperative complications. The follow-up period was 3 months.

Results

Upon timing in seconds (s), a significant time difference between the 2 groups was demonstrated for suture placement, corporotomy incision and implant placement, corporotomy closure, and total procedure duration. Although patients in the eight-dot group required a longer time for suture placement vs the conventional group (486 vs 201 s, respectively, p < 0.001), the durations for the remaining implantation steps, as well as the whole procedure, were significantly shorter for the former group. Corporotomy opening followed by implant placement took significantly less time for the eight-dot group (1090 s) vs the conventional group (1313 s), p <0.001. Moreover, insertion of implant rods was subjectively easier with no need for aggressive bending owing to the extended corporotomy length. Similarly, corporotomy closure using the 8-dot technique was 10.13 minutes swifter than the conventional group (220 s vs. 828 s, respectively, p < 0.001). The total procedure length was over 8 minutes shorter for the eight-dot group as opposed to the conventional group (2527 vs 3027 s, respectively, p < 0.001). In terms of postoperative complications in the form of pain, swelling, hematoma, and infection, there were no significant differences between both groups.

Conclusions

The eight-dot extended corporotomy technique is a safe and time-saving approach compared to the conventional limited corporotomy technique, making the MPPI procedure more efficient. A swifter procedure decreases both patient exposure to anesthesia and device exposure to air which in turn lowers the risk for potential postoperative complications.

Disclosure

No.
(029) Safety and Efficacy of Botulinum Neurotoxin in the Treatment of Erectile Dysfunction Refractory to Phosphodiesterase Inhibitors: Results of a Randomized Controlled Trial
Authors: Abdel Raheem A , Abdelrahman I , Elkhiat Y , A  Aburahma A , Abdel-Raheem T , Ghanem H
Published: March 2024

Introduction

There has been recent interest in the use of botulinum neurotoxin (BoNT) in the field of Andrology, whereby it has been investigated in the treatment of penile retraction and premature ejaculation.

Objective

To evaluate the safety and efficacy of intracavernosal BoNT-A injection in the treatment of patients with erectile dysfunction (ED) refractory to oral phosphodiesterase inhibitors (PDE5Is).

Methods

A double-blind randomized placebo-controlled prospective comparative study conducted at one center and involved 70 patients with ED refractory to PDE5Is. At baseline, the following data were collected: erection hardness score (EHS), peak systolic velocity (PSV), end diastolic velocity (EDV), sexual health inventory for men (SHIM), and the sexual encounter profile 2&3 (SEP-2&3) questionnaires. Treatment group (n = 35) received a single ICI of 100 units of BoNT-A in 2 ml of saline and control group (n = 35) received a single ICI of 2 ml of saline. EHS, PSV, and EDV were assessed at 2 weeks post treatment. SHIM, SEP-2, SEP-3, and global assessment questionnaire (GAQ-Q1&Q2) were completed at 2-, 6-, and 12-weeks post treatment.

Results

Two weeks post treatment, the treatment group showed a statistically significant improvement in the mean EHS, PSV, EDV, and GAQ-Q1 positive responders (p < 0.001) compared to the control group. At 6- and 12-weeks post treatment, the treatment group showed a statistically significant improvement in the SHIM scores, SEP-2, and GAQ-Q1&Q2 positive responders compared to the control group. At 6 weeks, where there was a 5-point improvement in the mean SHIM score of the treatment group (10±5.9 from 5.4±1.7 at baseline) versus no improvement in the placebo group, 18 patients in the treatment group (53%) were able to have an erection hard enough for vaginal penetration versus only one patient in the control group.

Conclusions

BoNT-A is safe and effective as a potential treatment for ED refractory to PDE5I therapy.

Disclosure

No.
(047) Experience of Sexuality After Breast Cancer: A Qualitative Study
Authors: Sghaier A , Kaabia O , Bouchahda R
Published: March 2024

Introduction

Breast cancer is the most frequently diagnosed cancer in women. But its efficient therapeutic arsenal have major impacts on the quality of life of breast cancer survivors. Breasts are symbolic of sexuality, femininity and beauty. Their invasion by cancerous cells or mutilated by local treatments can disrupt a woman's sexual life, endangering their couples' relationships.

Objective

We aim to evaluate the qualitative impact of breast cancer on survivors' sexuality after mastectomy.

Methods

A prospective qualitative study was carried out using semi-structured interviews until saturation of findings. The patients included were women diagnosed and treated for breast cancer, followed in our department. All participants were sexually active and no older than 55. The study enrolled 20 participants over a 6-month period (February 2022-July 2022).

Results

Exploring the sexual health of breast cancer patients following surgery and treatment with chemotherapy and/or radiotherapy, we found that the participants had a common pattern to adapt to the significant changes in their bodies and cope with the modifications concerning their sexuality. Some important and recurrent themes resulted of the analysis of our interviews: participants reported lower desire, arousal and satisfaction of their sexual life. They also asked for more emotional bonding and sexual bonding with their partners.

Conclusions

Knowledge of the psychosocial and cultural aspects that influence women's sexuality after breast cancer is important in helping to improve healthcare.

Disclosure

No.
(052) Sexual Health and Clinical Sexology Specific Training Needs of Residents in Gynecology and Obstetrics
Authors: Kaabia O , Dimassi K
Published: March 2024

Introduction

Assuming that the Obstetrician and Gynecologist (ObGyn) is the natural and first interlocutor for sexual questions in women, particular attention should be paid to their specific training in sexual health and clinical sexology. However, it turns out that the latter is neglected with little attention given to the development or implementation of specific curricular programs within the gynecologists’ residency programs.

Objective

This study aims to: - Identify and analyze the specific needs of the ObGyn residents in terms of education and training in Sexual Health and Clinical Sexology. - Discuss the methods of integrating a specific sexology training into their residency program to be adapted to the needs thus identified.

Methods

It is a knowledge, attitudes, and practices cross-sectional online study that took place over 5 weeks starting May 1st, 2021. All the ObGyn residents registered at the National College of Gynecology and Obstetrics were contacted through the College’s social media groups. The online questionnaire was a 9-item Google form elaborated in concertation with the Frequency, Gravity Problem (FGP) grid leading to 33 questions.

Results

With a response rate of 34 %, 94 residents participated in the survey. The participants were representative of the local population of ObGyn residents with an equal proportion of participants from the 5 years of the program. According to 69% of the participants, complaints or sexual disorders are rarely encountered during the ObGyn residency program courses. This finding was not correlated with the participants' residency level (R= 0.258, p> 0.05). The most frequently encountered sexual disorders during the clinical consultations were sexual disorders with pain (44.68%) and in particular vaginismus (75%). Regardless of the frequency of the disorders, the difficulties reported were primarily in the domain of knowledge (67.5%); then in the domain of know-how or practices (68%), and often in the domain of interpersonal skills (42.2%). Following the application of the rating system of the FGP grid, the main problems identified concerned sexual disorders with pain, in particular, vaginismus and then a decrease in female desire.

Conclusions

Following the analysis of these results and a review of the literature, we were able to propose the outline of a project to implement basic academic education and training in clinical sexology for the ObGyn residents.

Disclosure

No.
(057) Influence of Circadian Disruption on Erectile Function in Chronic Jet-Lagged Young Rats
Authors: Kataoka T , Hidaka J , Hotta Y , Furukawa-Hibi Y , Kimura K
Published: March 2024

Introduction

Sleep is crucial during the developing stage of one’s life and has been associated with physical activity. However, as the number of 24-hour stores such as convenience stores and supermarkets have increased, along with increased internet usage, people have developed the habit of staying up late, resulting in sleep deprivation due to disruption in the light-dark cycle. Jet lag is widely used in animal models for inducing irregular circadian rhythms. Chronic jet lagged model animals are known to develop a variety of disorders.

Objective

To investigate the influences of chronic jet lag on erectile function in rats in order to elucidate the effects of irregular circadian rhythms on future sexual function.

Methods

4-week-old rats underwent randomly assigned to remain either under the control light/dark cycle (Cont group) or under chronic light/dark shift schedule to simulate the conditions of chronic jet lag (CJL group). The shift-lag protocol consisted of 8 h light/dark phase advances repeated every 3 days for 4 weeks. Erectile function was examined at 1, 2, and 4 weeks post CJL treatment. After 4 weeks of CJL treatment, the rats were returned to control light/dark cycle for 4 and 8 weeks, as CJL(4w)+Rest(4w) group and CJL(4w)+Rest(8w) group, and erectile function was examined correspondingly. Erectile function was tested using intracavernous pharmacotherapy (ICP) measurements, and endothelial function was tested through an isometric tension study. Western blot analysis was used to assess the levels of endothelial nitric oxide (eNOS) and phosphorylated eNOS (p-eNOS). Additionally, mRNA expressions of clock genes (Bmal1 and Cry 1) and growth factors (TGF-β1 and ICAM-1) were tested using real-time PCR.

Results

The ICP/MAP ratio was significantly lower in the CJL group (0.35 ± 0.05) at 4 weeks than in the control group (0.66 ± 0.05) (P < 0.05). CJL group exhibited significantly lower testosterone levels, Bmal1, Cry 1, TGF-β1, and ICAM-1 expression, and p-eNOS and cGMP levels. The ICP/MAP ratio in the CJL(4w)+Rest(4w) group (0.47 ± 0.06) was lower than that in the control group (P < 0.01) whereas the ratio in the CJL(4w)+Rest(8w) group (0.81 ± 0.03) was similar to that in the control group (P > 0.05).

Conclusions

In this study, chronic jet lagged (4 weeks) rats exhibited a decreased ICP/MAP ratio, reduced testosterone level, and decreased p-eNOS expression, indicating the development of erectile dysfunction (ED). Upon 8 weeks of normal light/dark shift schedule, erectile function was recovered. This study suggests that irregular circadian rhythms induced by repeated jet lag, especially in childhood, may affect the production of sex hormones and erectile function in the future. Therefore, it is necessary for children to follow a regular circadian rhythm and healthy lifestyle.

Disclosure

No.
(066) A Low Androgen State Impairs Erectile Function by Suppressing EPAC1 in Rat Corpus Cavernosum Penis
Authors: Rui J , Xi L , Hao L , Xiangjun K , Wen-Ju X , Rui J
Published: March 2024

Introduction

The relationship among exchange proteins activated by cAMP 1(EPAC1), androgen and erectile function is still unknown.

Objective

To explore whether EPAC1 expresses in penile corpus cavernosum of rats and how EPAC1 affects erectile function under low androgenic conditions.

Methods

Thirty 8-week-old healthy male rats were randomly divided into six groups (n=5): sham operation (sham), castrated, castrated + testosterone replacement (castrated + T), sham + EPAC1 over-expression lentivirus (sham + EPAC1), castrated + empty lentivirus vector (castrated + empty vector), and castrated + EPAC1. Four weeks after the operation, the lentivirus vectors carrying the EPAC1 gene were injected into the corpus cavernosum penis tissues of the sham + EPAC1 and castrated + EPAC1 groups (1×108TU/ml, 20 μl per rat). A week after injection, the ratio of maximum intracavernous pressure to mean arterial pressure (ICPmax/MAP) and the levels of serum testosterone (T), nitric oxide (NO), the active form of ras homolog gene family, member A (RhoA-GTP), protein kinase B (AKT), phospho-AKT (p-AKT), endothelial nitric oxide synthase (eNOS), phospho-eNOS (p-eNOS), p-AKT/AKT, p-eNOS/eNOS and EPAC1 levels were measured.

Results

EPAC1 is primarily located in the cytoplasm of endothelial cells and smooth muscle cells in the rat corpus cavernosum penis. In comparison to the sham group, the T, ICPmax/MAP and NO levels of the castrated group were notably reduced (p < 0.01). Meanwhile, the RhoA-GTP concentration in the castrated + EPAC1 group was reduced in comparison with the castrated + empty vector group (p < 0.01). Compared with the castrated + empty vector group, the p-AKT/AKT, EPAC1 and p-eNOS/eNOS levels in the castrated + EPAC1 group were significantly increased (p < 0.05).

Conclusions

Androgen deficiency can suppress EPAC1 expression in the penile corpus cavernosum of rats, while the up-regulation of which can improve the erectile function of castrated rats.

Disclosure

Yes, this is sponsored by industry/sponsor: This study was supported by the Research Foundation of the Department of Human Resources and Social Security of Sichuan Province of Returned Scholars grant 2019-76.

Clarification: No industry support in study design or execution.
(090) Depression Among Infertile Women: Prevalence and Risk Factors
Authors: Thi Huyen Trang N , Pham Thi My H , Nguyen Thi Thu T , Nguyen Thanh K , Pham Van H
Published: March 2024

Introduction

Infertility is a significant issue that affects many couples worldwide. Depression is one of the most common psychiatric disorders among infertile patients.

Objective

This study aims to determine the prevalence of depression and its determinant factors among infertile patients in the Andrology and Fertility Hospital of Hanoi based on the PHQ-9.

Methods

The study was conducted among 360 infertile patients who visited the Andrology and Fertility Hospital of Hanoi between August 2022 and January 2023. Depression was measured using the Patient Health Questionnaire-9 (PHQ-9). The relationships between depression and demographic/fertility characteristics were explored using univariate and multiple logistic regression with an odds ratio (OR) and 95% confidence interval (CI).

Results

The mean total PHQ-9 score was 4.47 (SD = 4.14). Using a cut-off value of 10, the prevalence of depression was 11.7%. Depression was significantly associated with being age over 35 years old (OR = 2.24, 95% CI =1.05 – 4.76), having an income per month of less than 10 million VND (OR=2.01; 95%CI (1.01 – 4.72), husbands feeling pressured to have children (OR = 2.26, 95%CI = 1.08 – 4.72), feeling uncomfortable when others find out about infertility (OR=2.78, 95%CI = 1.36 – 5.67), not receiving support from the workplace (OR=2.55, 95%CI = 1.25 – 5.20) and believing they can be happy without children (OR=4.41, 95%CI = 1.37 – 14.18).

Conclusions

The high prevalence of depression among infertile patients in this study highlights the need for healthcare providers to screen and provide psychological support to this population. The finding that female aged above 35, low income, with husbands pressuring them to have kids, feeling uncomfortable when others know about their infertility, and lacking support from their workplace was found to be significant risk factors for depression are significant determinants of depression among infertile patients suggests that interventions should be targeted toward these groups.

Disclosure

No.
(094) Evaluation of Female Sexuality After Vaginal Hysterectomy in a Cohort of Tunisian Women
Authors: Souayeh N , Bettaieb H , Rouis H , Mbarki C , Hsayaoui N
Published: March 2024

Introduction

Researchers indicate that hysterectomy might adversely affect pelvic anatomy and therefore female sexuality. However, only a few studies focused on evaluating female sexuality after vaginal hysterectomy.

Objective

This study aimed to evaluate female sexual function after a vaginal hysterectomy.

Methods

This was a monocentric prospective study conducted in the gynecology-obstetrics department of Ben Arous regional hospital over a period of 5 years [January 2016-December 2020]. We included all patients who underwent vaginal hysterectomy. Selected women received a preoperative evaluation of their sexual function using the Female sexual function index (FSFI). They were invited for two follow-ups at 12 and 24 months after surgery. The main outcomes measured were frequency of sexual intercourse, dyspareunia, orgasm, vaginal dryness, sexual desire, and FSFI scores.

Results

A total number of 109 women underwent vaginal hysterectomy over the study period. The mean age was 41 years ranging from 31 to 69 years. Only 79 patients completed the required follow-ups in order to evaluate their satisfaction and the impact of surgery on their sexuality. The percentage of women engaging in sexual intercourse increased significantly from 70.8% before vaginal hysterectomy (VH) to 77.21% and 75.9% at 12 and 24 months after respectively. The rate of dyspareunia dropped significantly from 40.5% before surgery to 5% and 3.8 % at 12 and 14 months after VH. The rate of women experiencing orgasm increased significantly from 63.2% before VH to 72.1% and 70.8 % after 12 and 24 months. Low sexual desire also decreased significantly from 10.1% before VH to 6.3% and 5% respectively at 12 and 24 months. The percentage of women experiencing satisfactory vaginal lubrication increased from 36.7% to 46.8% and 45.5%. Average FSFI significantly increased from 24.58 prior to the surgery to 26.82 and 27.55 at the 12 months and 24 months follow-ups respectively.

Conclusions

Female sexual function is a major cause of women's concern for scheduled hysterectomy. Our results showed a significant improvement in female sexual function after a vaginal hysterectomy. Therefore, the vaginal route for hysterectomy should be encouraged among middle-aged women as a minimally invasive technique that does not affect female sexual function or feminine shape.

Disclosure

No.
(098) Does Early Implantation of Penile Prosthesis for Ischemic Priapism Associated with Decreased Complication Rate? A Systematic Review of Literature
Authors: Savira M , Atmoko W
Published: March 2024

Introduction

Ischemic priapism (IP) is a prolonged undesired erection that accounts for >95% of all priapism episodes. Like compartment syndrome, it is characterized by diminished corporal blood flow and can lead to corporal fibrosis, penile shortening, and refractory erectile dysfunction. Penile prosthesis (PP) implantation is the treatment option in IP to treat the priapic episode and to preserve erectile function. However, no standardization exists regarding the optimal timing of PP implantation surgery.

Objective

The present review aims to systematically analyse the literature comparing early and delayed PP implantation in patients with IP.

Methods

A systematic search on PubMed, Scopus, and EMBASE databases were searched from inception to July 1st, 2023 and followed by hand searching. All the steps were performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. We assess the quality of evidence and the risk of bias in each included study.

Results

Three retrospective cohort studies comprising 199 subjects were included in this systematic review. All studies have different definitions of the timing of early PP implantation, ranging from within one week to ≤6 months from the onset of priapism. Despite different types of PP used, all studies agreed that early PP implantation results in lower intraoperative complications, such as corporeal perforation and urethral injury, greater preservation of penile length and girth, and a lower rate of prosthetic revision. On the other hand, the delayed insertion was linked to a longer surgical time because of challenges brought on by fibrotic tissue, with most of them also requiring a smaller cylinder. In regards to post-operative complication, the majority of studies demonstrated that delayed implantation would result in a higher rate of complication rate; however, one study demonstrated that early PP implantation had a higher likelihood of prosthesis erosion and infection, which was believed due to a higher rate of bacterial invasion during the earlier shunt surgeries.

Conclusions

The majority of current evidence favours early penile prosthesis insertion in term of lower complication rate for IP, especially the intraoperative complication, for IP, compared to the delayed implantation. Nevertheless, better quality evidence is still needed from RCT to determine the exact timing for early implantation, patient selection, and the best penile prosthesis types.

Disclosure

No.
(099) A Preliminary Investigation on the Incidence of Complications and Patient Contentment Following the Surgical Implantation of Inflatable Penile Prosthesis After Salvage Radical Prostatectomy
Authors: Khalaf Alla K , Mehr J , Wang R
Published: March 2024

Introduction

Erectile dysfunction (ED) is a common complication post salvage radical prostatectomy (RP). Yet, there is scant data in the literature on complication rates and patient satisfaction in those that undergo inflatable penile prosthesis (IPP) insertion post salvage radical prostatectomy (RP) following targeted radiotherapy for treatment of localized prostate cancer. It is understood that these patients have a higher rate of complications as they have experienced both radiation and prostatectomy adverse events which could alter their overall satisfaction after prosthetic surgeries.

Objective

Our aim is to conduct a preliminary analysis of IPP complication rates and satisfaction rates in patients that had 3-piece IPP implantation following salvage radical prostatectomy.

Methods

A retrospective chart review from our institutional database was done from 2018 to 2021. The inclusion criteria were patients that had an inserted 3-piece IPP and a history of salvage RP following radiation therapy. Only patients that participated Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) questionnaire at least 6 months from implant date were included. Data on satisfaction, IPP infection rates, mechanical failure rates, and overall complications was also collected. Complications include hematoma, erosion, reservoir hernia.

Results

A total of 22 patients were included in the study. The median age (IQR) is 65 (64–67) years and the median time (IQR) from RP to IPP insertion is 23 (11–49) months. All patients were approached in a penoscrotal manner with submuscular placement of reservoir (Table 1). The satisfaction rate was high at 91.8% on follow up. Overall complications rate was observed in 2 patients. One patient had a mechanical pump failure at 37.9 months while another patient had signs and symptoms of scrotal wall infection at 15 months. Both devices were easily replaced with no post op complication and remained functional on further follow up.

Conclusions

In patients that underwent salvage prostatectomy IPP insertion, they reported high satisfaction rates and low complication rates despite the exposure to both prostate cancer treatments adverse events. Further research is needed to confirm the results obtained and to investigate the underlying causes for the observed outcomes. The scientific process is iterative, and the answers obtained from one study often lead to more questions and the need for additional investigations.

Disclosure

No.
(121) Acceptant and Commitment Therapy to Increase Compliance to Sexual Dysfunction Treatments in Men with Prostate Cancer: 6- and 12-Month Data from a Randomized Controlled Trial
Authors: Nelson C , Boukhalfa N , Pessin H , Schofield E , Mulhall J
Published: March 2024

Introduction

For many men with prostate cancer, difficulty with sexual dysfunction, in particular erectile dysfunction (ED), can trigger a psychological process which leads to avoidance of utilizing sexual dysfunction treatments.

Objective

This study tests a novel psychological intervention based on Acceptance and Commitment Therapy (ACT) concepts to help men utilize these treatments.

Methods

This ongoing study recruited men with prostate cancer starting intracavernosal injection therapy (ICIT) for the treatment of ED. The recruitment goal is N=220. Subjects are randomized to ICIT + ACT (ACT), which focuses on reducing avoidance, or ICIT + Enhanced Monitoring and Education (EME), which includes enhanced follow-up. Both groups receive ICIT plus 3 sessions (30–45 min) and 10 booster sessions (10 min). The interventions are delivered over the course of a year. Subjects are assessed at entry and every 6 months (m) for two years. The primary outcomes are the number of penile injections/week (verified by syringe count), and compliance (defined as ≥2 injections/week). Secondary outcomes assess psychosexual variables. Preliminary 6m and 12m data is presented. Since these are preliminary analyses, effect sizes (d) are reported for secondary variables (d=0.2, small effect; d=0.5, medium effect; d=0.8, large effect).

Results

To date, 191 subjects have been randomized; 112 have completed the 6m assessment (ACT n=57, EME n=55) and 97 completed the 12m assessment (ACT n=48, EME n=49). Mean age at baseline was 60±7 years. At 6m and 12m, the ACT group utilized more injections/week vs. the EME group (6m: median 1.8 vs. 1.2, p=0.01; 12m: median 2.0 vs. 1.4, p=0.01) and were more compliant with ICI vs. the EME group (6m: 65% vs. 35%, p=0.01, RR=1.86; 12m: 79% vs. 41%, p=0.01, RR=1.93). At 6m and 12m, the ACT group reported greater: satisfaction with ED treatment (d=0.6) and overall sexual relationship (d=0.2). The ACT group also reported lower: sexual bother (d=0.2), prostate cancer treatment regret (d=0.3), negative psychological impact of cancer (d=0.3), and depressive symptoms (d=0.4).

Conclusions

Preliminary analysis suggests ACT significantly increases ICI use. Data also indicate that ACT helps increase men’s satisfaction with injections and sexual relationship, while reducing sexual bother, prostate cancer treatment regret, the psychological impact of cancer, and depressive symptoms.

Disclosure

No.
(138) Efficacy and Patient Satisfaction of Low-Intensity Shockwave Treatment for Erectile Dysfunction in a Retrospective Real-World Study in Japan
Authors: Md M , Kurosawa M , Tsujimura A , Morino J , Anno Y , Yoshiyama A , Kure A , Uesaka Y , Nozaki T , Kobayashi K , Horie S
Published: March 2024

Introduction

In Japan, the treatment options for erectile dysfunction (ED) are very restricted, if phosphodiesterase type 5 inhibitors (PDE5Is) are not effective. In this situation, low-intensity extracorporeal shockwave therapy (LiESWT) has gained increased attention as a new option for ED treatment in Japan.

Objective

To clarify the efficacy of low-intensity extracorporeal shockwave therapy for patients with erectile dysfunction, compare the efficacy between two types of lithotripters (ED1000 [focused type] and Renova [linear type]), and detect factors indicative of therapeutic gain with the treatment.

Methods

This retrospective study included 76 patients (52.8 +/- 11.7 years) treated by ED1000 (12 times over 9 weeks) and 484 patients (52.5 +/- 11.6 years) treated by Renova (4 times over 4 weeks). Age, sexual symptoms scores, and blood examinations were assessed. Efficacy was judged by improvement of the scores and patient satisfaction and compared between patients at 1 month after treatment with the lithotripters. Independent factors influencing efficacy by Renova were also assessed.

Results

Sexual symptom scores were improved significantly by both lithotripters, although the changes in the scores did not differ significantly between them. Efficacy rate as judged by patient satisfaction was 65.8% with the ED1000 and 71.1% with Renova, also without significant difference. Among several factors including age, sexual symptoms scores, endocrinological factors, metabolic factors, and the rate of phosphodiesterase type 5 inhibitor use, only age was found to be an independent factor influencing the efficacy of Renova.

Conclusions

We clearly showed the high efficacy of both lithotripters. Although the efficacy rate did not differ between them, we speculated that the fewer treatment sessions needed with the Renova versus the ED1000 would be a great advantage for patients. We also suggest that Renova should be recommended for patients younger than 70 years of age.

Disclosure

No.
(164) Technique of Plaque Excision and Coroporoplasty Using Free Tunica Vaginalis Graft
Authors: Pardeshi A
Published: March 2024

Introduction

Severe penile curvature causing inability to perform pleasurable sexual activity is the most dreadful sequel of Peyronie disease. Surgical plication methods have their limitations of recurrence of curvature or penile shortening which is not acceptable to patients. In cases of severely calcified plaques, excision of the plaque with grafting of the defect remains the only viable option. Several graft materials have been used for repairing the defect. We present our experience of Plaque excision and coroporoplasty using local tunica vaginalis free graft.

Objective

To demonstrate the technique of free tunica vaginalis free graft corporoplasty for severe curvature due to Peyronie plaque. Following steps of corporoplasty are demonstrated. Penile degloving, artificial erection and plaque demarcation, dissection of the neuro-vascular bundle, plaque excision, harvesting the tunica vaginalis graft, corporoplasty using tunica vaginalis, restoration of neuro-vascular bundle, closure of scrotal wound and completion of circumcision.

Methods

7 patients between the age group of 47 to 68 years (mean age 54.6 years) were operated using this technique between 2018 to 2022. All patients had dorsal penile curvature with hard palpable plaque ranging from 2.5 cm to 5.2 cm. All patients were evaluated objectively using auto-photography. Penile doppler was done in all patients to confirm pre-operative arterial flow. Plaque exposure was done by penile degloving. Tunical graft was harvested by midline scrotal incision. Complete plaque excision was done and graft was sutured with 3–0 Prolene sutures.

Results

All patients had normal erectile function after the surgery. The maximum follow-up period was 42 months. All patients reported normal sexual function after a month of surgery. 2 patients complained of persistent induration and hardness at the site of graft, however the function being normal. Penile length shortening was noted in 4 patients which ranged between 4–6% of previous length, however it did not alter the sexual function.

Conclusions

Complete excision of the Peyronie plaque with corporoplasty using free tunica-vaginals graft is an effective, cost-effective and functionally acceptable technique for patients with hard and calcified plaque offering excellent functional outcomes.

Disclosure

No.
(174) Sexual Dysfunction and Coping Mechanisms among Women Using Hormonal Contraceptives at Kawempe Hospital - A Cross-Sectional Study
Authors: Aujo B T , Nakasujja N , Turiho A , Gumikiriza J L , Kakaire O
Published: March 2024

Introduction

Sexual dysfunction is a significant problem among women, and it is associated with maladaptive coping mechanisms that can further worsen the situation. In African regions, the prevalence of female sexual dysfunction (FSD) is highly linked to hormonal contraceptives (HCs), a popular method of birth control. Uganda has a relatively high prevalence of HC use among women of reproductive age. However, there is limited research on sexual dysfunction and coping mechanisms among women who use HCs in Kawempe Hospital.

Objective

This study aimed to (1) estimate the prevalence of sexual dysfunction among women who use hormonal contraceptives, (2) describe the coping mechanisms used by women who use hormonal contraceptives, and (3) identify the sociodemographic and clinical characteristics associated with sexual dysfunction among women using hormonal contraceptives at Kawempe Hospital.

Methods

This was a cross-sectional study where sexually active adult females who were on hormonal contraceptives and gave informed consent were consecutively sampled. The female sexual function index and the SexFlex scale were used to assess sexual dysfunction and coping mechanisms of women using hormonal contraceptives. Means, proportions, chi squares and logistic regression were used to describe the population and determine characteristics associated with sexual dysfunction.

Results

Of the 401 participants recruited for the study, 386 were analyzed due to 15 incomplete questionnaires. The average age of participants was 29.4 years. Of the participants, almost half 46.6% used implants. The prevalence of FSD was 74.6%. Participants with FSD reported more reflexive 82 (28.47%) and less approach coping 62 (21.53%) than participants without FSD. Factors associated with FSD were relationship dissatisfaction (OR=3.78, 95% CI: 1.68, 8.5), psychological distress (OR=2.12, 95% CI: 1.17, 3.86), finding sex important (OR=0.22, 95%CI: 0.05, 0.88) and approach coping mechanisms (OR=0.49, 95%CI: 0.26, 0.95). FSD was not significantly associated with HCs

Conclusions

This study found that women HCs have a high prevalence of FSD that is associated with psychological factors such as relationship dissatisfaction and psychological distress. The study suggests that women using HCs should be regularly screened for FSD and that clinicians should help them find solutions to the underlying causes.

Disclosure

No.
(181) Female Sexuality During the Menopausal Transition: The Experience of Tunisian women
Authors: Souayeh N , Bettaieb H , Rouis H , Mbarki C , Hsayaoui N
Published: March 2024

Introduction

The menopausal transition is a gradual passage from pre-menopause to menopause. It is characterized by hormonal changes that affect a woman's reproductive and sexual health. Understanding the impact of the menopausal transition on sexual functioning is important for providing comprehensive care to these women.

Objective

Objective: In this study, we aimed to evaluate female sexuality in middle-aged Tunisian women using the female sexual function index (FSFI)

Methods

This was a descriptive and analytic transversal study, conducted at the Hammam-Lif sexual and reproductive health center over a period of 06 months from February 1st to July 31st, 2022. We included 162 women aged between 40 and 65 years old. We used a validated Arabic version of the Female Sexual Function Index to assess female sexual function.

Results

The average age of women included in our study was 48.27 years. The majority of questioned women were peri-menopausal, i.e. 40.74%, 35.8% were in pre-menopause and 23.6% were in post-menopause. Moreover, among postmenopausal women, only one patient took hormone replacement therapy. The mean gestity was 3.6 and mean parity was 2.5 in our study population. The majority of women had a gestation greater than or equal to three [0 to 8] and a parity greater than or equal to 2 [0 to 8], i.e. in 80.25% of cases. The mean FSFI score was 18.83 ±7.19, with extremes ranging from 2 to 30.4. The prevalence of sexual dysfunction in our study was as high as 88.9 %. The analysis of our results showed a degradation of the FSFI score from perimenopause to postmenopausal: it went from 21.21±6.4 in pre-menopause, to 18.56±7.33 in perimenopause and 15.65±7.11 in postmenopausal. The difference between the three periods was statistically significant (p=0.030). This decline was statistically significant for three domains namely desire (p=0.033), arousal (p=0.047), and orgasm (p<0.01).

Conclusions

The prevalence of female sexual dysfunction is quite high and tends to increase with age. The role of healthcare professionals is essential in caring for women and helping them overcome sexual health problems that arise during the menopausal transition period.

Disclosure

No.
(183) The Predictive Value of AMH, FSH, and Inhibin B for Sperm Retrieval in Azoospermic Men
Authors: Mendelson T , Dekalo S , Azem F , Hauser R , Barda S
Published: March 2024

Introduction

Several studies assessed the sensitivity and specificity of plasma concentrations of hormones such as FSH and AMH as biomarkers that can predict the presence of sperm cells, prior to testicular sperm extraction (TESE) in azoospermic men. However, the literature contains conflicting reports in this context.

Objective

To evaluate the potential of hormonal profile as a non-invasive predictor of mature sperm cells' presence in the testis of azoospermic men, and to assess if the source of these hormones- testicular or peripheral blood makes any difference.

Methods

Clinical data, hormonal profile, and histological classification of 57 azoospermic men were analyzed. They were categorized into 4 following groups by their testicular pathologies: obstructive azoospermia, hypospermatogenesis, spermatocyte maturation arrest, and Sertoli cells only. The level of hormones was measured by the enzyme-linked immunosorbent assay. Statistical analyses tested the predictability of hormone values for sperm retrieval.

Results

Overall, 28 patients (49%) had spermatozoa detected. FSH and Inhibin B measurements were statistically significantly different between the 4 groups with different testicular pathologies (p<0.001). AMH, FSH and Inhibin B were found to be independent predictor for positive sperm retrieval (p<0.05). However, a decision tree with random forest classifying the predictive ability of the variables to indicate the presence of sperm produced low accuracy. There was no significant difference between the hormone levels of peripheral blood source and testicular blood source hormone levels.

Conclusions

AMH, FSH, and Inhibin B are optional markers for positive sperm retrieval in TESE. Increasing the research group may contribute to their ability to predict the presence of mature sperm cells in the testis of azoospermic men.

Disclosure

No.
(189) Associated Between Covid-19 Vaccination and Erectile Dysfunction
Authors: Thi Huyen Nguyen T , Anh Nguyen T , Huu Ho P , Thi Thu Le H
Published: March 2024

Introduction

The COVID-19 pandemic negatively affected the sexual health of individuals. While SARS-CoV-2 vaccines have not been linked to dysfunction erectile, several reports have identified COVID-19 as a potential etiology of dysfunction erectile

Objective

To investigate the impact of COVID-19 vaccination on erectile dysfunction.

Methods

A cross-sectional study was conducted on 264 male patients who visited for fertility and infertility health check-ups at Andrology and Fertility Hospital of Hanoi, Vietnam from December 2022 to Mar 2023. We used the International Index of Erectile Function (IIEF) questionnaire for data collection.

Results

The mean age was 29.17. Most patients were vaccinated (97.4%); in which almost patients were vaccinated 3 doses (62.6%); 63.8% were injected with the same vaccine. The mean erectile dysfunction score was 18.64; the proportion of erectile dysfunction was 40.1%. There was no association between COVID-19 vaccination (the number of COVID-19 vaccinations, the combined injection) and the risk of erectile dysfunction in men.

Conclusions

COVID-19 vaccination was not associated with an increased risk of erectile dysfunction in males.

Disclosure

No.
(246) Sexual Functioning of Women with Affective Disorders in the Light of Ego-Resiliency and their Quality of Life
Authors: Dębski P , Smolarczyk J , Madejczyk W , Piegza M , Gorczyca P
Published: March 2024

Introduction

Sexuality is a complex and multidimensional issue. Human sexuality is important for psychological functioning, as it is related to the satisfaction of basic needs, such as the need for security or acceptance. The assessment of sexual functioning, which is associated with sexual satisfaction, may be an important factor that affects the quality of life, and may also translate into the assessment of the fulfillment of basic psychosocial needs.

Objective

The aim of the study was to assess the relationships between sexual functioning, quality of life and ego-resiliency among women diagnosed with affective disorders. The aim of the study was to assess the prevalence of the risk of sexual dysfunction in this group of patients.

Methods

23 sexually active women diagnosed with affective disorders, who were hospitalized in a psychiatric ward, were qualified for the study. The mean age of the patients was 45.36±16.15 years. The study used a self-designed sociodemographic questionnaire as well as Polish adaptations of standardized questionnaires: FSFI (Female Sexual Function Index), ER89-R12 (Ego-Resiliency Scale) and WHOQOL-Bref (The World Health Organization Quality of Life). As part of statistical procedures, descriptive statistics of variables were estimated. Spearman’s rank correlation coefficient was also used.

Results

Positive and moderate correlations were found between ego-resiliency (p=0.498), its optimal regulation subscale (p=0.497) and sexual functioning. A positive relationship also connected the assessment of the sexual functioning of the respondents with the social domain of their quality of life (p=0.498).

Conclusions

Ego-resiliency, including optimal regulation may be important factors for improving the self-assessment of sexual functioning among women suffering from affective disorders. The assessment of sexual functioning may also play an important role in relation to the social sphere of quality of life.

Disclosure

No.