bluuebunny/crossref_metadata_2025 huggingface dataset:
(188) ISOFORMS OF THE CYCLIC GMP-DEPENDENT PROTEIN KINASE ARE EXPRESSED IN HUMAN PENILE ERECTILE TISSUE
Authors: Dr. Viktoria Märker , Prof. Stefan Ueckert , Priv-Doz. Eginhard Waldkirch , Prof. Petter Hedlund
Published: July 2023

Objectives

Aside from the activity of the gaseous transmitter molecule nitric oxide (NO) and the cyclic GMP producing enzyme soluble guanylyl cyclase (sGC) in human penile erectile tissue, intracellular receptor proteins activated by the binding of cyclic GMP have been considered to play a significant role in the erection process. In animal models, a down-regulation of the cyclic GMP-dependent/binding protein kinase I (cGKI) has been linked to the on-set of diabetes mellitus and erectile dysfunction (ED). Our study aimed to investigate in human penile erectile tissue (corpus cavernosum and cavernous arteries) the expression of cGKI (isoforms alpha and beta) in relation to smooth muscle alpha-actin, cyclic GMP and the endothelial nitric oxide synthase (eNOS).

Methods

Cryostat sections of human penile erectile tissue were exposed to primary antibodies (ABs) directed against alpha-actin, cGKI, cGKI alpha and cGKI beta, cyclic GMP and eNOS, followed by the incubation with fluorochrome-labeled secondary ABs. Visualization was commenced by means of laser fluorescence microscopy. Western blot analysis was also performed.

Results

Abundant immunoreactivities indicating the presence of cGKI alpha and beta and the second messenger cyclic cGMP were observed in the trabecular smooth musculature as well as in the smooth muscle layer of tiny cavernous arteries. Double staining revealed the co-localization of cGKI and eNOS within the endothelium of small arterial vessels. The expression of cGKI alpha and beta was confirmed by Western blot analysis.

Conclusions

Theclose relation of isoforms of the cGKI to key mediators of the NO pathway (eNOS, cyclic GMP), as demonstrated by conventional immunohistochemistry, provides further evidence for a significant role of cyclic GMP-binding intracellular function proteins in the control of vascular and non-vascular penile erectile smooth muscle.

Conflicts of Interest

no conflict of interest.
(60) THE PREVALENCE AND SEVERITY OF SEXUAL DYSFUNCTION IN MALE IBD PATIENTS: AN OBSERVATIONAL SINGLE-CENTER STUDY
Authors: Dr. Alessandro Brunetti , Dr. Walter Vena , Dr. Arianna Dal Buono , Dr. Ludovico Alfarone , Dr. Roberto Gabbiadini , Dr. Laura Loy , Dr. Virginia Solitano , Dr. Ferdinando D'Amico , Dr. Simone Antonini , Prof. Andrea Lania , Prof. Gherardo Mazziotti , Prof. Alessandro Armuzzi , Dr. Alessandro Pizzocaro
Published: July 2023

Objectives

Inflammatory bowel diseases (IBD), including Crohn’s disease (CD) and ulcerative colitis (UC), are lifelong disabling disorders with a significant impact on the quality of life (QoL). Previous studies reported that sexual dysfunction (SD) could affect 25-45% of male IBD patients, compared to 5-15% in the general population of the same age. However, this topic has not attracted widespread attention, and thus research studies are scarce. Our study aims to determine prevalence and severity of SD in a cohort of male IBD patients and to identify the associated risk factors.

Methods

This is an observational single-center study. From July 2021 to June 2022, male IBD patients were invited to fill the International Index of Erectile Function (IIEF-15) questionnaire during scheduled visits. Clinical data, including treatment history, disease activity and previous surgery, were collected.

Results

61 patients, 33 with CD and 28 UC, were enrolled. Median age was 33.8 years (range, 19.7–63.7); median body mass index (BMI) was 26.5 kg/m2 (range, 17.6–31.9). Almost half of the subjects were active or former smokers (49.1%). 81.9% of patients were receiving biological therapies and 42.6% had an history of IBD-related surgery. The median total IIEF score was 64 (range, 18-75). 25.4% of patients reported erectile dysfunction (ED), according to EF subscore (EF-S). At univariate analysis age (p=0.001), calprotectin levels (p<0.05) and biological therapy (p<0.05) were significantly associated with total IIEF score; age (p=0.003) and calprotectin levels (p<0.05) significantly correlated with EF-S. At multivariate analysis, age and calprotectin levels maintained significant association with both total IIEF score (p=0.003 and p= 0.002, respectively) and EF-S (p=0.001 and p=0.01, respectively).

Conclusions

A quarter of IBD patients reported ED in our study, a remarkably higher proportion compared to healthy subjects of the same age. Therefore, gastroenterologist should investigate sexual function in IBD patients and, if indicated, promptly refer them for andrological evaluation ito improve their QoL.

Conflicts of Interest

Authors report no conflicts of interest.
(141) DETAILED CHARACTERISATION OF PATIENTS UNDERGOING DYNAMIC PENILE COLOR DOPPLER DUPLEX ULTRASOUND FOR ERECTILE DYSFUNCTION – FINDINGS FROM A REAL-LIFE CROSS-SECTIONAL STUDY
Authors: Dr. Edoardo Pozzi , Dr. Alessandro Bertini , Dr. Giuseppe Fallara , Dr. Federico Belladelli , Dr. Simone Cilio , Dr. Massimiliano Raffo , Fausto Negri , Ludovica Cella , Margherita Fantin , Dr. Christian Corsini , Dr. Francesco Lanzaro , Dr. Luigi Candela , Dr. Paolo Capogrosso , Dr. Luca Boeri , Dr. Alessia d'Arma , Prof. Francesco Montorsi , Prof. Andrea Salonia
Published: July 2023

Objectives

Dynamic penile Color Doppler Duplex Ultrasound (CDDU) is an effective tool to assess of men with vasculogenic erectile dysfunction (ED). We aimed to describe clinical and sociodemographic characteristics of men with parameters suggestive of normal vs. arteriogenic ED at CDDU, and to identify potential predictors of arteriogenic ED at CDDU.

Methods

Complete data of 245 consecutive patients undergoing CDDU for ED were analysed. Comorbidities were scored using the Charlson comorbidity index (CCI). All patients completed the International Index of Erectile Function (IIEF) at baseline. Serum hormones were dosed for every patient. CDDU was performed after intracavernosal injection of Alprostadil 20 microGr. Arteriogenic ED was defined with a peak systolic velocity (PSV) <35cm/s at CDDU. Patients with deficient veno-occlusive mechanisms were excluded from the analyses. Patients were divided into with normal parameter vs. parameters suggestive for arteriogenic ED at CDDU. Descriptive statistics compared the clinical and sociodemographic characteristics of the two groups. Logistic regression models explored the potential predictive factors of arteriogenic ED at CDDU.

Results

Overall, median (IQR) age was 53 (42-60) yr and right/left PSV were 42.3(32.4-55.1) and 42.4(31.9-54.1) cm/s respectively. Of all, 81 (33.1%) had arteriogenic ED at CDDU. Patients with arteriogenic ED were older (59vs.50yr, p<0.001), had higher BMI (26.54vs.25.12 kg/m2, p=0.005), higher rates of CCI≥1 (64.2%vs. 43.9%, p=0.006), arterial hypertension (37%vs. 19.5%, p=0.005), smoking (28%vs. 13.6%, p=0.002) but lower rates of regular physical exercise (50.6%vs. 54.9%, p=0.04) compared to patients with normal CDDU parameters. No other statistical differences were found. At multivariable logistic regression analysis, the only predictor of arteriogenic ED was age (OR: 1.07, 95%CI: 1.01-1.14, p=0.03) after adjusting for BMI, CCI≥1, arterial hypertension, severe ED, and regular physical exercise.

Conclusions

One out of three men undergoing CDDU for ED depict criteria suggestive of arteriogenic ED. Similar rates of severe ED were found between men with normal and pathological CDDU parameters. Older age was identified as the only predictive factor of arteriogenic ED at CDDU.

Conflicts of Interest

N/A
(228) SATISFACTION AND PERSPECTIVES OF TELEMEDICINE IN ANDROLOGY
Authors: Rodrigo Garcia-Baquero , Araceli Ogalla Garcia , Margarita Fernandez Avila Cristina , Luis Alvarez Ossorio Jose
Published: July 2023

Objectives

Telemedicine was established as an essential tool for healthcare due to the last pandemic by COVID19. The objective of this study is to know the assessment of the patients of the Andrology thematic consultation of the telephone teleconsultations carried out during the pandemic.

Methods

We conducted a retrospective study by reviewing medical records, and cross-sectional by telephone survey, of a group of patients randomly selected from our Andrology section. Satisfaction with remote assistance was carried out using the validated TSQ questionnaire (Telemedicine Satisfaction Questionnaire) and a self-designed opinion questionnaire with 7 items in relation to their attitude towards teleconsultation as a regular practice in the future.

Results

A total of 92 patients were selected, of whom 78 participated in the study (response rate of 84.8%). All of them were men with a mean age of 58 years. 67.5% consulted for erectile dysfunction, 22.1% for Peyronie's disease, 2.6% for premature ejaculation, and 7.8% for infertility. Overall, 70.0% were satisfied with the quality of the service provided during the pandemic. 48.1% would agree with incorporating teleconsultation as an option for their assistance in the future, preferably for reading the results of complementary tests requested (57.1%). We found no correlations between satisfaction with the telephone consultation and age (p 0.49), sociocultural level (p 0.34), employment status (p 0.31), distance from the hospital (p 0.83), disease risk factors severe by Covid19 (p 0.35), the Charlson index (p 0.59), nor the pathology for which they suffered (p 0.26).

Conclusions

The telephone consultation as a telemedicine option has been well received by the majority of our patients with andrological pathology. The predisposition of a good part of our patients for their use in the future can be a useful tool to reduce the usual care load, considering the situation and individual preferences.

Conflicts of Interest

No conflict of interest with this presentation.
(27) FEELING HOT: EVALUATING NOCTURNAL ERECTION DETECTION WITH PENILE TEMPERATURE MEASUREMENTS IN THE SEARCH OF A MODERN ERECTILE DYSFUNCTION DIAGNOSTIC TOOL
Authors: Hille Torenvlied , Evelien Trip , Dr. Wouter Olthuis , Dr. Jack Beck
Published: July 2023

Objectives

In the search of a modernized tool for erectile dysfunction nature differentiation, implementation of overnight penile temperature measurements as a patient-friendly alternative for RigiScan® diagnostics, has gained interest. Until now, no study has investigated the effect of overnight environmental circumstances on the penile temperature during erection. The Feeling Hot study aims to determine the feasibility of (mimicked) nocturnal erection detection with penile temperature sensing.

Methods

Ten healthy young men obtained two visually aroused erections with commercially available pornography. Measurements of the penile temperature during erection in naked and blankets & underwear circumstance were performed with a thermistor sensor. Additionally, overnight penile temperature and simultaneous recorded RigiScan® measurements were conducted in the same test subjects. Data was analyzed to study the absolute penile temperature change during (mimicked) nocturnal erections as well as the visible detectability.

Results

Significant increase in penile temperature was found in the naked and mimicked overnight circumstance measurements at a mean temperature increase of respectively 1.70 0C and 0.67 0C. The first nocturnal erections, which showed a significant average temperature increase of 1.47 0C, were visibly detectable in all subjects. The penile temperature remained at peak levels for over 30-minutes after visually aroused erection. This lasting elevated temperature was also seen during overnight measurements and resulted in challenging detection of subsequent nocturnal erections.

Conclusions

The Feeling Hot study has shown that nocturnal erection detection with penile temperature measurements is feasible. Especially the first nocturnal erection can be validly detected. The detection of subsequent erections, which is challenged due to the low conductivity of overnight environmental circumstances, could be assisted by reference temperature measurements, slope analysis, artificial intelligence techniques or penile saturation measurements. Further research should focus on result validation and studying implementation for erectile dysfunction patients.

Conflicts of Interest

The Feeling Hot studies are part of a PhD studies investigating the feasibility of nocturnal erection detection with penile temperature measurements as an alternative for RigiScan diagnostics. There are no conflicts of interest and the used sensing system was created solely to perform the clinical studies of the research.
(54) MANAGING SMALL PENIS SYNDROME USING FILLER INJECTION FOR PENILE AUGMENTATION
Authors: Prof. Mykola I Boiko , Notsek S Mykola
Published: July 2023

Objectives

Research is conducted to evaluate the effectiveness of filler injection techniques for penile augmentation in managing small penis syndrome (SPS) or small penis anxiety.

Methods

We included 57 patients with SPS elected using Cosmetic Procedure Screening Scale for Penile Dysmorphic Disorder (COPS-P) in the study. Each patient underwent the procedure of penile augmentation with the injection of hyaluronic acid filler in the shaft (10 ml) and glans (4 ml) of the penis. The effectiveness was evaluated with Self-Esteem And Relationship (SEAR) questionnaire before and 3 months after the procedure.

Results

Regarding the SEAR questionnaire, the satisfaction of sexual life and self-esteem improved significantly compared with the results before surgery by 8.6 ± 0.46 (P <0.001) points. The most serious complications after the procedure we observed in 2 patients: nodal formations and irregular filler distribution. These complications were resolved with hyaluronidase injections. It was reflected in the SEAR scores of those patients and had some effect on overall statistical results.

Conclusions

The injection method of penile augmentation significantly improves psychosexual status of the patients. It could be considered for the management of small penis syndrome after more detailed research as a safe and effective alternative to conservative approaches to therapy.

Conflicts of Interest

None
(161) COMPLICATIONS IN A SMALL VOLUME PENILE PROSTHESIS IMPLANT CENTRE.
Authors: Dr. Antonio Tienza , C Vega , M Guldris , R J Escribano , M A Podadera , A Pieras , Dr. Xavier Brugarolas
Published: July 2023

Objectives

To assess the complications that have occurred in a small volume centre.

Methods

The andrology unit started to perform penile prosthesis implant after a programmed organization five years ago, two urologist/andrologist were working together. Prospective data of consecutive patients were included from 2017 to 2021.

The following characteristics were collected: date of birth, chronic diseases, year of beginning of (erectile dysfuction) ED and the cause, treatments received, toxic habits, American Society of Anesthesiologist score, height and weight, date of the surgery, type of implant. Complications were collected as local: haematoma, infection; difficulties to learn to use it, limited use of the device.

Descriptive analysis: mean and range and percentage.

Results

20 male patients were collected. Mean age was 62 years (49-79). By cause of ED: 5 radical pelvic surgery, 3 multifactorial, 2 vascular, 1 diabetes, 1 peyronie disease, 6 unknown, 1 medullary lesion. Seven patients have concomitant peyronie disease. By chronic disease: 14 have hypertension, 8 diabetes, 7 obese, 10 overweight. 12 were activo or ex smokers.

2 were replacements and 18 first-implant surgeries. By type of implant we performed: 3 semirrigid, 7 2-piece and 10 3-piece.

Complications: 1 patients died due to previous oncological disease, 1 required to extract the device, 4 peno-escrotal haematoma without requiring drain, 3 reported difficulties to learn how to use it and 9 lack of use. The pandemic period, limited operating room available and reduced budget are the main enemies to increase the volume of implants.

Conclusions

Few complications were reported in our small volume center. A step period of surgeries and small group of surgeons are the key of the results.

Conflicts of Interest

None.
(133) BETTER PREOPERATIVE SEXUAL FUNCTION IS CORRELATED WITH FEWER DEPRESSIVE SYMPTOMS POSTOPERATIVELY: A RETROSPECTIVE STUDY OF PATIENTS OF A SEXUAL REHABILITATION AFTER RADICAL PROSTATECTOMY CLINIC
Authors: Stavros Kontogiannis , Anastasios Natsos , Mohammed Obaidat , Spyridon Tsounakos , Evangelia Goulimi , Konstantinos Asimakopoulos , Evangelos Liatsikos , Petros Drettas
Published: July 2023

Objectives

Prostate cancer has not only oncological and sexual effects, but psychological effects as well. The objective of this study was to evaluate the postoperative psychological state of patients after radical prostatectomy and to investigate the potential correlation with erectile function and prostate cancer aggressiveness.

Methods

We studied patients who visited the Sexual Rehabilitation after Radical Prostatectomy Clinic in the last 18 months. In our Clinic, we apply the biopsychosocial model in the evaluation of sexual dysfunctions. Because of this approach, patients were asked to fill in the Hospital Anxiety and Depressions Scale (HADS) questionary. HADS is an instrument used to evaluate anxiety (HADS-A) and depression (HADS-D) separately. Scores above 8 raise suspicion for underlying mental conditions. International Index of Erectile Function-5 (IIEF-5) was utilized to evaluate the erectile function. IIEF-5 was completed one day before surgery, while, both IIEF-5 and HADS were completed two months postoperatively. Postoperative Gleason score (GS)>8 and pT3 according to pTNM staging were used as indicators of aggressive disease.

Results

In a total of 70 patients, the mean age was 65.7 years and the mean PSA of 9.4 ng/dl. Of those, 62.8% had pT3 staging and 28.5% had a GS of 8-10. Mean HADS-A & HADS-D scores were 7.4 and 5.8 respectively. Mean IIEF-5 score was 20.2 preoperatively and 6.5 postoperatively. The frequency of patients scoring above 8 for HADS-A and HADS-D was 40.2% and 28.5% respectively. A correlation between postoperative HADS-D and preoperative IEEF-5 was found. More specifically, higher preoperative IIEF-5 scores were associated with lower HADS-D scores (p=0.016). No correlation was found between both questionnaires and pT3 or GS of 8-10.

Conclusions

Patients with good preoperative erectile function have fewer depressive symptoms after radical prostatectomy. Mental state and erectile function are not correlated with prostate cancer agressiveness.

Conflicts of Interest

There is no conflict of interest for any of the authors.
(16) PEYRONIE’S DISEASE: MALE AND FEMALE PERSONAL EXPERIENCE
Authors: Vanessa Andrade , Thiago Guimarães , Mariana Medeiros , João Guerra , Miguel Gil , João Cunha , Pedro Silva , Fernando Calais , Luís C Pinheiro
Published: July 2023

Objectives

Evaluate the sexual impact of Peyronie’s disease in male and their female partners.

Methods

Retrospective analysis of all men submitted to a surgical repair of Peyronie’s disease from 2011 to 2021. The patients answered the “Peyronie’s Disease Questionnaire” and their female partners the “Peyronie’s Disease Questionnaire for Female Sexual Partners”.

Results

During this period, 25 patient had surgery to correct penile curvature due to Peyronie’s disease. 20 male patients and 16 female answered the questionnaires. Mean age was 61 years old. The majority of the patients had dorsal 30° curvature. Male and female partners reported a similar difficulty during vaginal intercourse (70% vs 68.4%, p=0,915) and similar discomfort during intercourse (85% vs 72.2%, p=0,438). Male were more frequently “very bothered” or “extremely bothered” about penis appearance than female partners (55% vs 20%, p=0,036), but female were more concern about damaging their partner’s penis than male (66,7% vs 5%, p<0,001). Only 40% of men who answered the questionnaire were satisfied about penis appearance after surgery, with major problem being the shortening of penis.

Conclusions

Peyronie’s disease have similar impact during sexual intercourse for both male and female. Male have more concern about appearance and female about the possibility of damaging the partner’s penis. Most of the patients were not satisfied with the results of the surgery, mainly because of shortening of penis, a well-known complication of the surgery. It is really important to manage this condition with the couple and managing expectations about the results after correction.

Conflicts of Interest

None
(42) TREATMENT OF ACUTE PHASE OF PEYRONIE’S DISEASE WITH TAMOXIFEN AND VARDENAFIL/TADALAFIL OFF LABEL
Authors: Jeannette Verkerk-Geelhoed , Prof. Igle Jan D Jong , Dr. Jack Beck
Published: July 2023

Objectives

Peyronie’s Disease (PD) is a collagen disorder causing fibrotic tissue and curvature of the erect penis, with painful erections in the acute phase and difficulty with sexual intercourse. In two studies, rodent model and in vitro, Tamoxifen/Vardenafil together showed to be effective in the acute phase. In literature, spontaneous resolution of curvature is reported in 3-13%.

Aim: To investigate the effect of Tamoxifen and Tadalafil (T&T) off label on PD patients in the acute phase of PD.

Methods

Patients were included at the outpatient clinic for off label T&T treatment and vacuum erection device (VED) after extensive informed consent. Tadalafil 5mg prescribed once daily, Tamoxifen 10mg and VED twice daily. Descriptive statistics used for Baseline and outcome characteristics. Subgroup analysis by Fisher Exact and Chi-Square test for unpaired groups based on nominal or ordinal data.

Results

48 men included with mean age 53.0 (SD 9.5) and penile curvature at baseline 46.7° (SD 18.8). Median duration was four months, 70.8% (n=48) painful erections. Dorsal curvature in 27 (56.3%), mean stretched penile length 13.4 cm. Mean use of T&T was 13 weeks (1-52 weeks). Curvature improvement in 27.7%, pain reduction in 48.5%, sexual intercourse/coitus improvement in 34.2%, erection improvement in 14.6%. Adverse reactions of T&T in 39.6% (n=19), 1% dose related, 6% stopped within 3 months. No serious side effects reported on VED.

Conclusions

Drug treatment is combined with the VED. Due to the Covid-19, pandemic several patients were consulted by phone or video consultation only. Therefore missing data on penile length and location of nodule, due to not being able to perform physical examination. Some patients got lost to follow up, therefore creating missing data in the reported outcomes. Conclusion: 27.7% reported improvement of curvature with T&T. This is a better outcome than spontaneous improvement as described in literature.

Conflicts of Interest

Payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events J. Verkerk-Geelhoed form Ipsen and Besins Healthcare I.J. de Jong from Astra Zeneca J. Beck from MSD, Astellas, Sobi, Besins Healthcare, Health investment.
(55) “PENILE GRAFTING FOR PEYRONIE'S DISEASE WITH TACHOSIL: OUR EXPERIENCE”
Authors: Dr. Christos Fliatouras , Dr. Nikos Karypidis , Dr. Theodoros Spinos , Dr. Konstantinos Konstantinidis
Published: July 2023

Objectives

The purpose of this presentation is to report the results of penile grafting with the use of Tachosil for the restoration of Peyronie's disease.

Methods

The Egydio geometrical procedure was applied in patients with large penile curvature for whom penetration was extremely difficult. Interestingly, all patients had a preoperative penile curvature of 60 degrees or more. The decision for surgery was made following the guidelines of the European Association of Urology (EAU). The penile deformity has been stabilised preoperatively, while pain was absent in all patients for at least six months. All patients were potent or had mild erectile dysfunction preoperatively. All procedures were performed by the same high-volume surgeon who was highly experienced in the field of Andrology. All patients were older than 45 years, while many of them had comorbidities, such as coronary artery disease or diabetes mellitus. Most of them, had a dorsal curvature, while 1 patient had a left-sided curvature and another 1 had a simultaneous hourglass-type lesion.

Results

The penile curvature was successfully repaired in all patients, with concomitant preservation of penile length. Interestingly, the vast majority of patients had excellent erectile function postoperatively, as well as preoperatively, while in most patients with pre-existing erectile dysfunction this did not worsen postoperatively. Even the most complex cases were able to have sex postoperatively, using PDE5 inhibitors or penile self-injections and benefiting from the use of stem cells and/or shockwave therapy.

Conclusions

We thus concluded that penile grafting with tachosil, for Peyronie's disease repair with the Egydio geometrical procedure, perfectly improves the shape of the penis, maintaining its length, without significantly affecting erectile function postoperatively. The mild degree of erectile dysfunction which may arise from this procedure can be efficiently managed with applying various treatment methods.

Conflicts of Interest

The authors declare no conflicts of interest.
(162) PENILE TRAUMA ANALYSIS AND FOLLOW-UP OF A SERIES
Authors: Dr. Antonio Tienza , Dr. Cristian V Casu , Dr. Jorge Guimera , Dr. Luis Ladaria , Dr. Priscila Benito , Dr. Jose Luis Bauza , Prof. Enrique Pieras , Dr. Xavier Brugarolas
Published: July 2023

Objectives

To describe and review a series of penile trauma.

Methods

Patients with suspicions of penile fracture that received surgical treatment were included from 2015 to 2022. Characteristics were collected: date of birth, type of fracture and affected parts of the penis, evolution after surgery. Description of complications and outcomes.

Results

11 consecutive patients received surgical treatment due to suspicion of penile trauma. 3 patients had negative previous ultrasonography. 3 showed bleeding without rupture, 2 rupture of both corpora cavernosa and urethra, 6 only one corpora. After recovery time 9 patients reported altered erectile function. 1 urethral stenosis. 2 penile curvature. 1 skin necrosis that required surgery. The prefered repairing technique was single stitch of resorbable suture.

Conclusions

Penile trauma is an emergency disease that requires surgical treatment. Once the damage is done serious and permanent impairment may occur.

Conflicts of Interest

None.
(273) WHAT IS THE EFFICACY OF CBT INTERVENTIONS ON MENTAL AND SEXUAL HEALTH OF PROSTATE CANCER SURVIVORS? A SYSTEMATIC REVIEW
Authors: Sonia Pieramico , Rita Castro , Sandra Aguiar , Francisca Bismarck , Diana Ferreira , Ana L Quinta Gomes , Prof. Joana Carvalho , Prof. Pedro Nobre
Published: July 2023

Objectives

Prostate cancer (PCa) is the second most frequently diagnosed oncological condition among biological men, impacting physical and psychological well-being, as well as sexual health and quality of life. Cognitive behavioral interventions (CBT) have shown to be an effective approach for a wide range of psychological and sexual difficulties and have more recently been tested as an intervention to improve sexual and mental health of PCa survivors. The present systematic review aimed to methodically research and summarize results regarding CBT’s effectiveness regarding mental and sexual health variables of prostate cancer survivors.

Methods

A systematic search was carried out using electronic databases until August 2022. By means of a combination of search words (such as prostate cancer, psychological interventions, mental health, cognitive behavioral intervention, CBT, cognitive behavioral therapy, sexuality, sexual dysfunction, sexual health, depression, anxiety, quality of life, and randomized control trial) and by selecting articles according to inclusion and exclusion criteria, 15 randomized controlled trials were considered.

Results

Three studies showed evidence of intervention efficacy for the improvement of sexual health while other eight for mental health dimensions. More specifically, CBT interventions may be effective for PCa survivors to overcome cancer-related distress, and depressive symptoms while improving relaxation skills, emotional well-being, benefit finding, and their outlook on the future. Furthermore, such interventions may have the potential to improve sexual satisfaction, sexual function (such as erectile function), and sexuality-related self-esteem.

Conclusions

However, further research is needed to confirm these findings, and increase efficacy as well as assure generalizability. While there is evidence for the effectiveness of such interventions on mental and sexual health dimensions, further research with a larger and more diverse population is needed.

The present research is supported by the project “SexHealth & ProstateCancer” (NORTE-010145-FEDER-000057) financed by the Horizon Europe Funding Program.

Conflicts of Interest

We have no conflict of interest do disclose.
(247) VASECTOMY METHODS, THEIR RESULTS AND COMPLICATIONS
Authors: Marek Broul
Published: July 2023

Objectives

Vasectomy is a common method of male sterilization. However, it is less popular worldwide than tubal ligation in women. Vasectomy is also a potential cause of lawsuits related to its complications. This paper summarizes the early and late complications of this surgical procedure.

Methods

Data from the Medline database were used and the search terms used were "vasectomy complications", "vasectomy + infection", "vasectomy + endocarditis", "vasectomy + failure", vasectomy + cancer" and "vasectomy + death".

Results

According to the Guidelines of the European Urological Society, vasectomy is evaluated as a safe and effective method and is recommended as one of the methods of male contraception. The recommended vasectomy procedure is a scalpel-free approach to the fallopian tube, followed by dissection with fascia interposition or coagulation of the fallopian tube lumen. This method has fewer complications immediately after surgery and a higher long-term success rate than the method with a scalpel approach and without coagulation or fascial interposition. Furthermore, it is generally recommended to perform the procedure under local anaesthesia only, which again has fewer complications than general anaesthesia.

Conclusions

Vasectomy is a safe and relatively simple method of male contraception. It has a lower morbidity and mortality rate than tubal ligation in women. No relationship between vasectomy and the development of immunological, cardiovascular or cancer diseases has been confirmed. The possible complications are summarized in Table 1. Patients must always be informed before the procedure about the possible complications and the possibility of irreversibility of the procedure.

Conflicts of Interest

None.
(83) SERUM TESTOSTERONE MIRRORS INFLAMMATION PARAMETERS IN FEMALES HOSPITALIZED WITH COVID-19
Authors: Dr. Walter Vena , Dr. Maria F Birtolo , Dr. Alessandro Pizzocaro , Dr. Alessandro Brunetti , Dr. Simona Jaafar , Dr. Nazarena Betella , Dr. Antonio C Bossi , Prof. Gherardo Mazziotti , Prof. Andrea G Lania
Published: July 2023

Objectives

While low testosterone (T) was described as a predictor of unfavorable coronavirus-disease 19 (COVID-19) outcome in men, data concerning the role of T in women with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are scant and limited to small cohorts. This study aimed to investigate the relationship between serum T values and outcomes of COVID-19 in a large female hospitalized cohort.

Methods

One-hundred-sixty-eight adult women (median age 77, range 18-100 years; 154 in post-menopause) hospitalized for COVID-19 were assessed for PaO2/Fio2 ratio, serum T and inflammatory parameters.

Results

Median duration for hospital stay was 14.2 days (range 1-115) with overall mortality of 26% (n=44). Subjects who died were significantly older (p< 0.001), had significantly more comorbidities (p=0.015) and higher serum T (p=0.040), white blood cells (p=0.007), c-reactive protein (CRP; p<0.001), interleukin-6 (IL-6; p< 0.001), procalcitonin (PCT; p<0.001), lactate dehydrogenase (LDH; p=0.001), D-dimer (p=0.035), fibrinogen (p=0.038) and lower serum free-triiodothyronine (FT3; p<0.001) and luteinizing hormone (LH; p=0.024) values. In post-menopausal women, significant associations were observed between T levels and serum CRP (rho: 0.23; p=0.002), IL-6 (rho: 0.41; p<0.001), LDH (rho: 0.34; p<0.001), D-Dimer (rho: 0.21; p=0.008), PCT (rho: 0.26; p=0.001) and HDL cholesterol (rho: -0,22, p = 0.008). In multivariate regression analyses, serum T maintained the significant association with mortality after correction for age, coexistent comorbidities and serum LH and FT3, whereas it was lost after correction for inflammatory parameters.

Conclusions

In females, high serum T levels might be a mirror of inflammatory phenotype and worse COVID-19 course.

Conflicts of Interest

Walter Vena received a project grant from IBSA. All other authors declare they do not have conflict of interest that is relevant to the subject matter or materials included in this work.
(176) THE PREVALENCE OF SEXUAL DYSFUNCTIONS IN IRAN DURING 2008-2017
Authors: Dr. Mohsen Ghorbani , Prof. Mahnoosh Foroughi
Published: July 2023

Objectives

The sexual issues education is a forgotten subject in Iran. With consideration of the significance role of sexual health in the quality of life, different types of sexual dysfunctions are common problems in Iran. The aim of this study is to determine the prevalence of different kinds of sexual dysfunctions.

Methods

All published Iranian articles with keywords of “sex” or “sexual dysfunction” in Google Scholar and interior databases (same as governmental reports) during 2008-2017 have been reviewed. Regarding to criteria, 32 studies were selected. Cause of heterogeneity was evaluated by meta-regression model.

Results

With consideration of inclusion and exclusion criteria, 32 studies with 16750 persons were completed. The prevalence of female sexual dysfunction was 67.9% and male sexual dysfunction was 58.2%. Overall prevalence has been increased significantly in recent years. Also the sexual satisfaction has very poor condition.

Conclusions

This meta-analysis study shows us a comprehensive view about sexual problems in Iran and suggests that Iranian population don’t have a suitable condition in sexual health. Further studies for detection of etiologic factors may be necessary.

Conflicts of Interest

Our abstract is free commercial influence or bias.
(158) FEMALE STUDENTS OF PHYSIOTHERAPY AND DYSPAREUNIA
Authors: Gabrijela Simetinger , Darija Scepanovic , Boni Peterle
Published: July 2023

Objectives

Since sexuality is still a taboo in most Slovenian faculties pelvic floor physiotherapy and its sexual function are not included in physiotherapy curriculum. The aim of the study was to find out how much female students of physiotherapy suffering from dyspareunia actually know about it.

Methods

Qualitative study included in-depth interviews with female students of physiotherapy with dyspareunia regarding their problem and awareness about it. A total of 20 semi-structured in-depth interviews with students from 4 different Slovenian faculties were carried out between April 2021 and July 2021.

Results

Results show that students with dyspareunia most often feel pain at the entrance of vagina during sexual intercourse. Interviewees have a negative physical and psychological experience during painful sexual intercourse. They feel fear and/or shame and try to avoid sexual intercourse. They attribute the cause of pain to the size of the penis, sexual position, partner’s excessive sexual desire and partner’s physical and psychological violence. Six students never talk about pain with their partners. They rather confide in friends. Half of the students believe dyspareunia is curable and mention that professional help is needed but less than a half have actually sought it. Ten students asked gynaecologists for help. They suggested alternative sexual positions and lubricants without giving them basic information on dyspareunia, only two were satisfied with counselling. Despite the pain interviewees continue having sexual intercourse and use alternative methods. Six students consider dyspareunia a normal part of sexual intercourse and do not see it as a sexual dysfunction.

Conclusions

Pelvic floor physiotherapy and its sexual function are still not included in the physiotherapist education programme in Slovenia, consequently female students of physiotherapy are not aware of the importance pelvic floor muscles have in maintaining sexual function.

Conflicts of Interest

No conflict of interest.
(283) LEVERAGING REAL WORLD EVIDENCE FOR NEGLECTED MEDICAL NEEDS: PUTTING WOMEN’S NEEDS AT THE CENTRE OF A DIGITAL HEALTH APPLICATION DEVELOPMENT
Authors: Kronthaler Selina M , Dr. Anna Tatzber , Eden Kosman , Prof. Klaus M Beier , Dr. Laura Hatzler
Published: July 2023

Objectives

Although a large number of women affected by sexual dysfunctions seek medical help, their needs are barely addressed in the health care system. Regulatory pathways are key for the translation of real world evidence into accessible personalized health care solutions. Since 2019 the Digital Healthcare Act creates a pathway in Germany for the development and reimbursement of digital tools collecting patient-reported outcome measures (PROMs), patient-reported experience measures (PREMs) and product's meta-data. The purpose of this study is to develop a mobile digital intervention for women with gynecological conditions and sexual distress.

Methods

Women with sexual distress participate in the iterative process during the software and content development of a mobile digital application. Health care needs, relevance of therapeutic content, desired outcomes and exercises for sexual distress, partner involvement, integration of health care professionals and dissemination strategies are addressed in qualitative interviews and focus groups including up to 50 women. Results will be validated in user testings. Additionally, prototypes of the app will be tested for usability and feasibility with affected women.

Results

The preliminary results show the outcomes of qualitative research and active patient involvement to design a digital therapy for women with sexual pain disorders. The findings have an important impact on the iterative development of the software, the content and the regulatory pathway of the application. Furthermore the results are translated into a study design which meets the requirements of innovative regulatory and reimbursement pathways in Germany.

Conclusions

The findings show how to translate women’s need into patient-centered therapy and how to tailor a digital intervention to target outcomes which are relevant to women affected by sexual distress. Evidence based research implemented in innovative regulatory pathways has potential to give rise to value based health solutions.

Conflicts of Interest

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(278) WOMEN AFTER CANCER: CAN WE IMPROVE SEXUAL ATTITUDES? EVALUATION OF A PILOT WORKSHOP
Authors: Dr. Alba Bartolomé
Published: July 2023

Objectives

The aim was to evaluate the effect of a workshop for sexual health promotion on sexual attitudes among oncological women.

Methods

Eleven women who had had an oncological process attended a two-days (4-hours) pilot workshop for promotion of sexual health in Hospital 12 de Octubre, in Madrid, in June 2022. Before the first session, patients answered a scale to evaluate “sexual attitudes in oncological women” designed for this study (not validated). Seven of these women came back to the second session and fulfilled the same scale at the end of the workshop.

The “Sexual Attitudes in Oncological Women Scale” consisted of 20 items, answered with a likert-scale. Total score ranged from 20 to 100. Questions explored attitudes after cancer towards sexual health, sexual relationships, consent, pleasure, desire, body image, sexual diversity and communication about sex issues with professionals and partner.

Results

Women were 36 to 62 years old (median 49.5 years), all Caucasian but one Hispanic and 9 had had breast cancer, one lung cancer and one metastatic.

Total score pre-intervention ranged from 66 to 87 (mean score 77). Total score post-intervention ranged from 73 to 99 (mean 84).

Mean increase in total score after intervention was 6.9 points (standard deviation 6.1), ranging from 3 to 18 points. Just one woman had the same score and none of them had a lower one. Figure 1 shows changes in mean total score.

Conclusions

A validated scale to measure sexual attitudes in women after cancer could be very useful to evaluate interventions in this field. Although this one is not validated, the fact that all women raised their score after the intervention suggests a change towards more positive attitudes about sexuality among this group of oncological women after this workshop.

Further studies are needed to validate these results as well as an appropriated scale.

Conflicts of Interest

The authors report no conflicts of interest.
(324) HEALTH INSURANCE COVERAGE AND OTHER BARRIERS TO CONTRACEPTIVE USE AMONG WOMEN WITH UNPLANNED PREGNANCY
Authors: Dr. Clair Enthoven , Prof. Hanan El Marroun , Dr. Jeremy Labrecque , Prof. Nicole Lucassen , Prof. Marco Varkevisser , Dr. Femke Truijens , Hilmar Bijma , Prof. Pauline Jansen
Published: July 2023

Objectives

In 2004, contraception was removed from the national public health insurance fund for women aged >21 years in the Netherlands. The objectives of this study were: 1) to determine the association of birth control coverage on contraceptive use and unplanned pregnancies; 2) to assess the sociodemographic characteristics of women with unplanned pregnancy who did and did not use contraception five years preceding pregnancy; and 3) to explore what role women themselves attribute to the use of contraception in unplanned pregnancies.

Methods

Data from the population-based birth cohort Generation R of pregnant women with delivery dates between 2002 and 2006 (N=7424), and data from 10 semi-structured interviews among women with (a history of) an unplanned pregnancy was used. Logistic, multinomial regression analyses and thematic analyses were performed.

Results

Of the women with unplanned pregnancy (29.3%), 80.4% used contraception in the five years prior to pregnancy, and 13.8% used contraception in the month of conception. Age ≥35 years, migration background, being married and a household income of ≤€2000/month were associated with not using contraception in the last five years. The prevalence of unplanned pregnancy did not differ before and after the policy change in 2004, but women with unplanned pregnancy less likely used contraception after the policy change (OR=0.59; 95%CI=0.35-0.97) in sensitivity analyses. Thematic analyses revealed that resistance against (hormonal) contraception because of side effects or negative stories, not being able to take hormonal contraception due to medical reasons or currently not having a partner were prominent arguments for not using contraception.

Conclusions

Within our sample of pregnant women, health insurance coverage did not affect the prevalence of unplanned pregnancy, but it may influenced the use of contraception. Dissatisfaction with the current available birth control options may be an important argument that needs more attention in future studies.

Conflicts of Interest

The authors do not have any conflict of interest regaring this study.
(223) PERCEPTION OF SIGNALS OF SEXUAL INTEREST IN PATIENTS WITH SCHIZOPHRENIA
Authors: Paula Biedková , Ondřej Novák , Filip Španiel , Renáta Androvičová
Published: July 2023

Objectives

Patients with schizophrenia (SCH) commonly report difficulties in forming sexual partnerships. Surprisingly, there is very little research addressing this phenomenon. To fill this knowledge gap, we aim to identify the underlying factors of these difficulties. We will test first, whether patients detect and recognize signals of sexual interest, second, whether these signals are sexually salient to them, and third, whether patients can adequately respond to these signals.

Methods

Sample: Thirty male patients with schizophrenia and a control group of the same size, matched for demographic parameters, will be recruited from the Study of first episodes of schizophrenia (ESO, National Institute of Mental Health Czech Republic). ESO is an extensive prospective database dedicated to the longitudinal follow-up of first-episode patients with SCH, which contains a wealth of information on bio-psycho-social markers. Procedure: We will test variables of interest using an experiment developed in our laboratory, which depicts male and female actors showing behavioral displays conveying signals of a) sexual interest, b) neutral but friendly attitude, and c) aversive attitude towards an observer. Statistical analysis: We will use a multivariate linear mixed model regression analysis. Group and a type of behavioral signal will serve as predictors, and physiological, psychological and behavioral responses of patients and control subjects will function as dependent variables. The model will be enriched by including several covariates, most importantly hormonal markers.

Results

Currently, data are being collected.

Conclusions

Our study will identify whether difficulties in forming sexual partnerships reported by patients with SCH could be connected to a compromised ability of patients to detect, interpret and respond to signals of sexual interest. Our findings could lead to the development of sexual remediation strategies. To our best knowledge, no such instrument is available for patients with SCH. This project is funded by the Czech Health Research Council, registration number NU21J-04-00024.

Conflicts of Interest

All authors declare that they have no conflicts of interest.
(321) CONTRIBUTIONS OF DYADIC APPROACHES TO THE PSYCHOSOCIAL ADAPTATION OF COUPLES TO PROSTATE CANCER: A SCOPING REVIEW PROTOCOL
Authors: Rita Castro , Sonia Pieramico , Sandra Aguiar , Francisca Bismarck , Diana Ferreira , Inês Tavares , Prof. Joana Carvalho , Prof. Ana Q Gomes , Prof. Pedro Nobre
Published: July 2023

Objectives

Prostate cancer is the second most prevalent cancer diagnosed in men around the world. The available treatments have negative side effects on the mental and sexual health of patients, but also their partners. There is evidence of the relevance of taking dyadic approaches to the study of relational stress that chronic diseases bring to couples’ dynamics. Although, less is known about the application of dyadic approaches to the psychosocial adaptation to prostate cancer. Despite the recent increase of studies conducted with both patients and partners, there are different approaches used. The goal of this scoping review is to map and summarize the evidence of existing dyadic studies that examine the psychosocial adaptation of couples to prostate cancer.

Methods

To this end, we are conducting a systematic search of studies published from 2005 to September 2022 on electronic databases (Scopus, Web of Science, PubMed, Cochrane, and EBSCOHost), with the following search terms “prostat* cancer” OR “prostat* carcinoma” OR “prostat* tumor” OR “prostat* adenocarcinoma” OR “prostat* neoplasia” OR “pca” AND “dyad*” OR “couple*” OR “partner*” OR “spouse” OR “caregiver*” OR “APIM” OR “Actor Partner Interdependence Model” OR “Actor Partner” OR “Actor Partner Model” AND “psychosocial” OR “pychology*” OR “impact” OR “mental health” OR “sexual health” OR “adaptati*”. This review follows the PRISMA guidelines.

Results

This work will give, researchers on prostate cancer and professionals working on oncological care, an overview of the potential use of dyadic approaches to help with the psychosocial adaptation of couples’ mental and sexual health during prostate cancer.

Conclusions

The present work strengthens the need to do more research on how couples adapt together to prostate cancer diagnosis and treatments and to raise awareness among professionals to include both patients and partners and their needs in the interventions to promote mental and sexual health recovery after the prostate cancer journey.

Conflicts of Interest

All the authors declare no known conflict of interest. This project is funded by Horizonte Europa (NORTE-01-0145-FEDER-000057) and by Fundação para a Ciência e Tecnologia (2022.11670.BD.).