bluuebunny/crossref_metadata_2025 huggingface dataset:
(114) A Comparative Meta-Analysis of Revision Strategies for Malfunctioning Inflatable Penile Prosthesis: Partial vs Complete Component Replacement With or Without Retained Reservoir
Authors: El-Achkar A , Khalaf Alla K , Nguyen T , Mahdi M , Wang R
Published: March 2024

Introduction

In cases of non-infected malfunctioning Inflatable penile prosthesis (IPP) device, surgeon often opt to exchange all the device rather than the defective component for fear of increased infection rate and future mechanical dysfunction.

Objective

To assess whether partial component exchange of IPP device has comparable outcomes to complete explant and replacement of IPP device with or without retained reservoir.

Methods

A meta-analysis was completed in line with PRISMA 2020 and AMSTAR guidelines. A comprehensive search was done on MEDLINE (OVID), PubMed, and Cochrane Library electronic databases from their inceptions until May 2023, identifying studies that reported on outcomes and complications of revision surgery for non-infected malfunctioning IPP device. Three groups were compared: the first group underwent a single or two-component exchange, the second group had a complete explant replacement of the entire device, and the third group had replacement of all components with a drained and retained primary reservoir.

Results

A total of 9 articles were included in the analysis. 12,152 patients had complete replacement of their device, 128 had partial exchange of their device and 151 patients had “drained and retained” reservoir following revision. The mean age was similar among the 3 groups between 62–68 years. The median follows up time ranged between 12 and 79 months. Partial component ex change had a higher rate of mechanical failure 10.3% versus 1.3% and 2.3 % (p=0.03) for complete and “drain and retain” groups respectively. (Figure 1) Similarly, partial component exchange had higher peri-operative complications at 21.2% compared to complete replacement group 9.5% and “drain and retain” group 14.5% (p=0.022). However, the infection rate was similar among the three groups, 7.7%, 2.7% and 3.3% respectively (p= 0.301). (Figure 2)

Conclusions

Partial component exchange during IPP revision has higher rates of perioperative complication and future mechanical failure but has similar rate of infection compared to complete component replacement with or without “drain and retain” of original reservoir.

Disclosure

No.
(129) Penile Girth Enhancement Using UroFill™: The Brazilian Experience
Authors: Cavalcanti Filho M T , Ramalho G , Monteiro L , Lacerda D , Braga G
Published: March 2024

Introduction

Demands for penile girth enhancement are increasing. UroFill™ is the innovative approach that offers non-surgical and reproducible penile girth enhancement.

Objective

To demonstrate the penile girth before and after the application of hyaluronic acid with the UroFill™ technique

Methods

A retrospective, single-center study included men who sought private care to realize penile girth enhancement using UroFill™ technique from April to June 2023. All patients signed an informed consent form. Excluded men with dysmorphophobia, active inflammatory-infectious genital lesion, and prior application of another filler. Penile girth was measured with a tape measure at baseline and after 21 days.

Results

21 patients were included in this analysis. Mean injected volume was 5.81ml. Compared a mean with a basal girth of 9.11±1.1cm and after 1 application 10.85±0.9cm and the Test t result was significant p < 0.001. There were no inflammatory signs or serious adverse reactions in all cases, and no patient requested a reversal of the procedure.

Conclusions

This study demonstrates the increase in penile girth after just one application of hyaluronic acid using the Urofill technique. In addition, we did not find any cases of complications in the evaluated patients, which suggests a safe procedure.

Disclosure

No.
(133) Non-Occupational SCC of the Scrotum; Case Presentation and Management
Authors: El-Bahnasawy M , Alanazi M , Talahmeh G , Abolhasan A , Kamal A
Published: March 2024

Introduction

Although the incidence of scrotal malignancies is extremely low Squamous cell carcinoma (SCC) is the most common scrotal malignancy. Its overall annual incidence is approximately 1.5 per 1,000,000 persons in Western countries. It was first linked to the chronic irritation of scrotal skin by the effect of soot in occurring in chimney sweepers hence known as the first described occupational disease. Occupational scrotal SCC was also later described in association with other occupations with chronic carcinogen exposure including cotton mule spinners, paraffin and tar workers, creosote workers, shale oil workers, lathe workers, pitch workers and machine tool setters and operators. Currently most cases result from poor hygiene and chronic inflammation

Objective

Herein we present a very rare case of SCC of the scrotum referred to us from Dermatology department

Methods

This 55 years old male patient was referred from dermatology department. He had no underlying occupational hazard. He has been treated for several months of itchy inflammation of the scrotumfor 6 months. Scrotal punch biosy showed moderately differentiated SCC. Clinically there was malignant scrotal ulcer of 4x3 cm with no palpable inguinal lymph nodes. CT staging confirmed localized tumor with no LN or metastatic deposits. Complete excision with 2 cm safety margin confirmed to be negative by frozen section. Final histopathology come to be moderately differentiated SCC pT2Nx. All margins and underlying Dartos were free of tumor infiltration.

Results

Complete excision could be achieved with intra-operative negative frozen section. Uneventful post-operative course with complete healing of scrotal wound.

Conclusions

Although rare, scrotal SCC continues to be serious urogenital malignancy which should be suspected even in the absence of occupational exposure. Cooperation and awareness of Dermatologists is important for early detection and management of such rare malignancy. Complete excision with safety margin is usually sufficient for cure. Inguinal Lymphadenectomy is indicated if grossly infiltrated

Disclosure

No.
(136) Sexual Behavior among Asexual Men and Women in the Czech Population
Authors: Krejčová C , Klapilová K , Bártová K
Published: March 2024

Introduction

Asexuality is usually defined as a lack of sexual attraction to others; however, asexuals may engage in sexual activity. Previous research has shown that asexuals are less likely to engage in sexual intercourse and masturbation than allosexuals. But information about detailed aspects of sexual behavior among asexuals is still scattered.

Objectives

The main aim of this study was to map the sexual behavior of asexual men and women. In addition, the usage and pleasurability of various sex positions in asexuals were explored.

Methods

Participants were recruited in 2020 via a sociodemographic agency using computer-assisted web interviewing software. Stratified random sampling with quotas on Czech nationality, region, size of the place of residence, sex, age, and education was applied. A representative sample of 1,616 adult men (n = 806; 21–85 years; mage = 50.65; SD = 15.52) and women (n = 810; 20–91 years; mage = 50,62; SD = 16.15) answered questions about selected dimensions of sexual behavior in the last year.

Results

Approximately 2.1 % (n = 17) of men and 1.6 % (n = 13) of women indicated they were asexual. Preliminary results showed that asexual women had more sexual intercourse per month in the last year (7–10 vs. 4–6 occasions) compared to asexual men. Asexual women and men had the same average number of orgasms per month achieved during partner sexual activities with a long-term partner in the last year (2–3x). Asexual men had a stronger desire for sexual activity with a partner per month (7–10x vs. 4–6x), a higher number of masturbations per month and orgasms achieved during masturbation (2–3x vs. none), and a higher number of searches for erotic/pornographic materials per month in the last year (2–3x vs. none). Asexual women expressed a higher preference for sexual activities with a partner, whereas asexual men expressed a similar preference for sexual activities with a partner and masturbation. Based on median frequencies of sexual positions used in the last year, asexual women reported engaging in most penile-vaginal sexual positions (1–2x) but not sexual positions with oral-genital contact. Among asexual men, face-to-face/male above was the only reported sexual position used in the last year (1–2x). Asexual women and men reported face-to-face/male above, face-to-face/female above, and kneeling/rear entry as the most pleasurable sexual positions.

Conclusion

Consistent with previous research, we found that asexuals may engage in sexual intercourse and masturbation. Asexual women were more likely to engage in sexual intercourse with various penile-vaginal sexual positions. In contrast, asexual men experienced stronger sexual desire and were more likely to engage in masturbation. No discrepancy was found in the rated pleasurability of several sexual positions. Thus, our results suggest that asexual women may prefer sexual activities with a partner, whereas asexual men may prefer autosexual activities.

Disclosure

No.
(148) The Prevalence and Genotype Distribution of Human Papillomaviruses in Korean
Authors: Moon D G , Ahn S T , Lee H S , Cho S B , Moon S J , Hwang W K , Kim H J
Published: March 2024

Introduction

Human papillomavirus (HPV) prevalence and genotype distribution are different between various nations and regions. Additionally, previous studies have mainly focused on HPV infection in western female and epidemiological studies of HPV infection in regional populations have been rarely reported. The lack of information on the HPV genotype distribution of the regional population in each individual country or region raises questions about the effectiveness of the current 9-valent vaccination.

Objective

To assess the prevalence and genotype of HPV(+) Korean and to know whether currently available 9-valent vaccine can cover the most prevalent and high risk genotype as HPV vaccine in Korean.

Methods

Between January 2014 to June 2022, samples of 44,065 men (Study I, M) and 564,499 females (Study II, F), who were volunteered for testing or recommended by a clinician, were tested for HPV detection and genotyping. Samples were collected swabs from the pap smear test. HPV detection and typing were conducted using the Anyplex™ II HPV 28 Detection system, which detects 19 high-risk (HR) HPVs and 9 low-risk (LR) HPVs.

Results

In Study I & Study II, overall prevalence were 59.7% (M), 44.3%(F), prevalence of HR were 30.6%(M), 37.5%(F) and LR HPVs were 50.1%(M), 18.3%(F), respectively. Overall HPV prevalence was higher in teens (34.1% in M and 58.3% in F) and 20s (33.8% in M and 51.9% in F) with age [Table 1]. The most prevalent genotypes of HR were 16 (5.2%), 53 (4.6%), 51 (4.2%), 52 (3.8%), 58 (3.7%), 39(3.6%) and 66(3.4%) in Study I. In Study II of Female, the most prevalent genotypes of HR were 52 (7.1%), 53 (6.2%), 58 (5.0%), 68 (4.8%), and 16 (4.3%). In Study I of 26,299 men with HPV infection, 9,259 (35.2%) had a genotype with HR; 53 (4.6%), 51 (4.2%), 39(3.6%) and 66(3.4%), which could not prevented by the 9-valent vaccine. In Study II of 211,883 females with HPV infection, 72,252 (34.1%) had a genotype with HR, 68 (4.8%), 51 (4.1%), 39 (3.8%), and 56 (3.7%) which could not be prevented by the 9-valent vaccine.

Conclusions

In this study, Korea male and female aged under 30 years showed a high prevalence of HR HPVs. In both Male and Female groups, a significant number of HR HPVs infections were not prevented by 9-valent vaccine. Based on this result, it is necessary to develop nation-specific HPV vaccination for Korean. Further, this approach can be applied in other countries.

Disclosure

No.
(151) Knowledge, Attitude, and Practice of Nursing and Midwifery Students Regarding Sexually Transmitted Infections
Authors: Souayeh N , Bettaieb H , Rouis H , Mbarki C , Hsayaoui N
Published: March 2024

Introduction

Sexually transmitted infections (STIs) are a global health problem. Nursing and obstetrics students are the future workers whose role in health education and promotion is undeniable. Hence we became interested in evaluating their knowledge of STIs.

Objective

The aim of our study was to assess the knowledge, attitude, and practice of nursing and midwifery students regarding sexually transmitted diseases.

Methods

This was a prospective, cross-sectional, quantitative, and descriptive study, conducted in the Higher Institute of Nursing Sciences of Tunis (ISSIT) and the Higher Institute of Health Sciences and Techniques of Tunis (ESSTST) over the period of to months (March 1st, 2022 to April 30, 2022). The target population of our study included 568 students. The information was collected via a self-administered questionnaire.

Results

Our study population sample was mainly composed of women (72%) versus 28% men. The average age of our sample was 21 years old. The majority of students (95%) have already heard of STIs. The main source of information was the academic background of these students (79%), followed by the media (15%) and only 1% comes from the family circle. Students rated their knowledge as fairly good and good in 37% and 34% of cases, respectively. Only 5% admitted having very good knowledge and 2% with zero knowledge. For their knowledge of the modes of transmission of STIs: 98.4% retained vaginal penetration, 69.1% for anal penetration against 40.7% for oral sex. The best-known germ was the human immunodeficiency virus (HIV) (87.8%) followed closely by syphilis (82.9%). The least known agent was Neisseria Gonorrhoeae (Gonococcus), identified only in 28.4% of cases. 65% of the students recognized syphilis as a bacterial infection. However, 34.1% of students in the sample did not know that it can be associated with HIV infection. Most students (52.8%) had no information regarding HPV infection and only a minority of 18.7% knew that there is an HPV vaccine. 7% already had sex and the medium age of their first sexual intercourse was 18, With an average of 1.33 partners during the last 12 months. Only 2% of them had used a condom during their first sexual intercourse with a new partner. 43%had justified the nonuse of condoms with decreased feelings of pleasure, 29% get embarrassed to purchase it, 14%had some difficulties using it, and 14% did not use a condom because they simply wanted to get pregnant. 75%had the intention to use a condom during their first sexual intercourse while 25% did not.

Conclusions

The knowledge of health students regarding sexually transmitted infections needs a boost in order to improve the involvement of awareness of the whole population. Besides, they are not taking the necessary measures to avoid sexually transmitted infections for multiple reasons and the lack of knowledge might be the main cause.

Disclosure

No.
(154) Corporal Tissue Ingrowth: A Rare but Operable Challenge in Revision Surgery for Inflatable Penile Prosthesis
Authors: Khalaf Alla K , Calopedos R , Mehr J , Wang R
Published: March 2024

Introduction

Corporal tissue ingrowth into previously implanted cylinder is a rare but possible issue encountered during penile prosthesis (PP) revision surgery. To prevent cylinder aneurysms, a middle layer of woven and expandable polypropylene-like material was incorporated into the implant design in 1987. While the outer silicone layer usually prevents its contact with tissue, in cases of ruptured cylinders, there is a risk of cavernous ingrowth into the exposed woven layer. Collagen deposition within the inflammatory tongue of tissue can lead to significant difficulty in implant removal. Having a degree of suspicion about this phenomenon is important, especially as an implant may remain somewhat functional if the inner silicone layer remains intact. If encountered, its recognition is paramount in triggering operative countermeasures. To our knowledge, this is the only contemporary and second case series describing this phenomenon in English literature.

Objective

To highlight the existence of this difficult phenomenon in revision surgery and demonstrate our approach.

Methods

We report 3 patients over the past 3 years who underwent complex penile revision surgery. All had AMS penile implantation 10–15 years prior and presented with inability to inflate device. Each case began routinely through a vertical penoscrotal incision; however, the stuck cylinders were unable to be removed through the traditional corporotomy. Penoscrotal incision and corporotomy were extended until the location of ingrowth was identified. A combination of sharp and blunt dissection was required to liberate the cylinder from the surrounding corporal tissue. Care was taken to maintain a plane just outside the ruptured cylinder to prevent more proximal or distal injury to the tunica albuginea. Once liberated and new device implanted, corpora are closed in the usual fashion without the need for elaborate tunica albuginea reconstruction.

Results

All 3 patients had successful revision of impacted cylinder from the corpora through extension of the vertical penoscrotal incision. No secondary distal incision was necessary in these cases. Patients were followed for 6–12 months in which time all prosthesis remained functional and no deviation from the usual post-operative course was encountered.

Conclusions

Implanters should not shy away from maximizing exposure if ingrowth is suspected. The vertical penoscrotal incision was a versatile approach that could be easily extended and should be considered for suspected complex revision surgery. Furthermore, this phenomenon also adds credence to early revision surgery in the cases of device malfunction from suspected cylinder rupture. Despite the difficulty this issue poses, corporal tissue readily integrates into porous synthetic materials. This ability may be useful in future device development in the tissue engineering space.

Disclosure

No.
(158) Comparison Implants for Penile Girth Enlargement: PPLA Shaft vs Silicone Implant
Authors: Knigavko O , Aguilar I
Published: March 2024

Introduction

Male dissatisfaction with the penis size is the most common manifestation of penile dysmorphophobia. Despite the diversity of penis enlargement methods a single safe technique that fully satisfies patients has not yet been developed.

Objective

The aim of this work is to compare the results of a combined operation on installation of a silicone implant or a porous polylactic acid (PPLA) scaffold impregnated with autologous stem cells with simultaneous ligamenotaxis to increase the length and circumference of the penis.

Methods

In 2017–2023 there were performed penis enlargement surgeries in 3 centers. In Ukraine and Poland 38 patients from were operated with implantation of a porous Max Pol PLLA scaffold, and in Mexico implantation of silicone implants Peniflex in 36 patients was performed. The results of penis enlargement were evaluated in the early (2 months) and long-term (36 months) periods.

Results

While implanting a silicone implant the majority of the patients - 31 (86.1%) are satisfied with the result, 27 (75%) patients mention an improvement in sexual life, 31 (86.1%) also mention an increase in their own self-sufficiency. At the same time, some patients mentioned the following complications: 2 (5.6%) patients mentioned displacement of the silicone matrix, 1 (2.8%) patient mentioned prolapse of the implant, 1 (2.8%) patient mentioned a decrease in erection (which did not improve after removal of the implant), in 1 (2.8%) case the silicone implant had to be removed due to the fact that the patient did not liked the appearance. While using a collagen-like matrix made of polymerized polylactic acid impregnated with autological stem cells in 38 patients, we have seen one significant complication - prolapse that caused the removal of the matrix (in men that had denied circumcision before implantation). However, 5 (13.2%) patients required additional polylactic acid gel injections between 6 and 36 months to optimize the shape or volume of the penis. 34 (89.5%) patients mentioned an improvement in the sexual function and sexual sensations of their partner, harmonization of relationships in a couple, and 36 (97.4%) men - an increase in a sense of self-sufficiency. In 3 years most of the patients 26 (68,4%) have been satisfied with particularly resolved implant but 13 (34.2) patients want to add some PLA gel as injection for penile girth recovery.

Conclusions

Thus, modern implants can improve the size and appearance of the penis, improve the quality of sexual life and the feeling of self-sufficiency in operated men. The use of silicone implants is simpler, it require only long drain 3–5 days. Most of operated patients were satisfied results of silicone implant. The use of a polymer matrix impregnated with autologuous stem cells requires a special biostem cell laboratory, more time for preoperative rehabilitation, but can be considered as more philological. Both methods can be considered as permanent and quite safe for penis enlargement.

Disclosure

No.
(163) Is There a Place for Immediate 3-Component Prosthesis Implantation Following Priapism?
Authors: Obaidat M , Kontogiannis S , Drettas P , Anastasios N
Published: March 2024

Introduction

One of the most difficult challenges in prosthetic urology is the insertion of penile implants into corpora scarred from an episode of priapism. In cases of scarred penile cavernosal bodies, surgery becomes challenging even for experienced surgeons, as it can be very difficult to dilate the corpora.

Objective

Usually, the initial insertion of a malleable device is used as a temporary measure, to maintain the penile length and simplify the subsequent insertion of an inflatable one. So our objective is to decrease the number of surgeries from 2 to 1.

Methods

In this case, we dilated the corpora cavernosa initially with Metzenbaum scissors thoroughly and carefully. We placed the tip of the scissors at the outer side of each cavernous body (away from the urethra) and advanced it to the tip of the corpus cavernosum. Then, we used the cavernotomes

Results

Till now the prostheses are functional. We do believe that in certain cases, with the right choice of the patient, the implant of the IPP after priapism is a viable solution

Conclusions

Cavernotomes are a good option for dilating the fibrotic corpora. And it is safe

Disclosure

No.
(187) Efficiency and Safety of Combining Long-Acting and Short-Acting PDE5 Inhibitors
Authors: Jamali M , Chmitah T , Bahri A , Louardi N , Alami M , Ameur A
Published: March 2024

Introduction

Erectile dysfunction is a condition that affects many men worldwide, significantly impacting their quality of life. PDE5 inhibitors (PDE5i) are commonly prescribed medications for treating this condition, but some patients do not adequately respond to these treatments

Objective

This study aims to evaluate the efficacy and safety of a combination of long-acting and short-acting PDE5 inhibitors in non-responding patients

Methods

The study was conducted on 40 men with erectile dysfunction refractory to PDE5 inhibitors. Participants were evaluated using questionnaires, clinical examinations, and paraclinical tests. All patients received a combination treatment of daily 5 mg tadalafil and 100 mg sildenafil on-demand, one hour before sexual intercourse. Patients were followed up for 12 weeks, and the results were assessed using questionnaires and recording of side effects.

Results

The average age of the participants was 47.4 years. The main etiologies of erectile dysfunction were vascular, psychogenic, age-related, or neurological. After 6 weeks of treatment, a statistically significant improvement was observed in erectile function scores (SHIM) and erectile rigidity scores (EHS). This improvement was maintained until the 12th week, although not significantly. Side effects were generally minor and well-tolerated.

Conclusions

The combination of long-acting and short-acting PDE5 inhibitors proved to be effective and safe in non-responding patients to PDE5 inhibitors. This therapeutic approach offers a promising alternative before resorting to other more invasive options, such as prostaglandins or penile prosthesis. The combined use of these two types of inhibitors improves erectile function while minimizing undesirable side effects. Further studies could explore the addition of vacuum devices, shockwave therapy, or platelet-rich plasma injections to optimize outcomes. Overall, this study provides valuable insights for urologists in the treatment of non-responding patients to a single type of PDE5 inhibitor, opening up new therapeutic perspectives.

Disclosure

No.
(216) Benefit of Closed Wound Drainage System with Negative Pressure in Penile Enhancement Surgery
Authors: Jang S
Published: March 2024

Introduction

Many patients have had penile enhancement surgery and the surgeon try to reduce postoperative complications including hemorrage, infection, wound dehiscence etc. we want to evaluate the benefits of closed wound drainage system with negative pressure in penile enhancement surgery.

Objective

we want to evaluate the benefits of closed wound drainage system with negative pressure in penile enhancement surgery.

Methods

We have experienced 500 penile enhancement surgery. We adopted a pre-pubic minimal incision and dissected penile shaft and pre-pubic space. Inserted graft materials were Allograft dermal grafts which were fixed at the Buck's fascia. And we dissected fundi-form ligaments and sutured transversely pre-pubic dead space with PDS 2.0. In group 1, silastic drain were inserted in 250cases in order to drain postoperative bleeding and prevent inflammation. In group 2, the remain 250 cases adopted closed wound drainage system with negative pressure.

Results

In group 1, the wound infecton rate was 2.9% and no dermal graft infection was showed. In group 2, the wound infection rate was 0.6% and no dermal graft infection was appeared. Group 1 using closed wound drainage system with negative pressure is more effective than group 2 using silastic drain in order to reduce wound infection rate.

Conclusions

In penile augmentation surgery using Allogenic dermis, Using closed wound drainage system with negative pressure is safer than using silastic drain as postoperative drainage system.

Disclosure

No.
(221) Anatomical Transcriptome Atlas of the Male Mouse Reproductive System During Aging
Authors: Huang Y , Li X , Yao J , Liu W , Lu M , Xie Y
Published: March 2024

Introduction

The elderly males undergo degenerative fertility and testicular endocrine function that jeopardize the reproductive health and well-being. However, the mechanisms underlying reproductive aging are unclear.

Objective

This study aims to investigate the phenotypes and transcriptomes of seven regions of the male mouse reproductive tract: the testis, efferent ductules, initial segment, caput, corpus and cauda epididymidis, and vas deferens, in adult (3 months) and aged (21 months) mice.

Methods

Quantitative PCR, immunohistochemistry, immunofluorescent staining, and enzyme-linked immunosorbent assay were performed for the analysis of gene expression in mice, human tissues, and semen samples. Aged male mice showed both systematic and reproductive changes, and remarkable histological changes were detected in the testis and proximal epididymis. Transcriptomes of the male reproductive tract were mapped, and a series of region-specific genes were identified and validated in mouse and/or human tissues, including Protamine 1 (Prm2), ADAM metallopeptidase domain 28 (Adam28), Ribonuclease A family member 13 (Rnase13), WAP four-disulfide core domain 13 (Wfdc13), and Wfdc9. Meanwhile, age-related transcriptome changes of different regions of the male reproductive tract were characterized.

Results

Notably, increased immune response was functionally related to the male reproductive aging, especially the T cell activation. An immune response-associated factor, phospholipase A2 group IID (Pla2g2d), was identified as a potential biomarker for reproductive aging in mice. And the PLA2G2D level in human seminal plasma surged at approximately 35 years of age. Furthermore, we highlighted Protein tyrosine phosphatase receptor type C (Ptprc), Lymphocyte protein tyrosine kinase (Lck), Microtubule associated protein tau (Mapt), and Interferon induced protein with tetratricopeptide repeats 3 (Ifit3) as critical molecules in the aging of initial segment, caput, caput, and cauda epididymidis, respectively.

Conclusions

This study provides an RNA-seq resource for the male reproductive system during aging in mice, and is expected to improve our understanding of male reproductive aging and infertility.

Disclosure

No.
(239) Postoperative Outcomes and Risk Factors in Patients Receiving Partial vs Total Penectomy for Penile Malignancy
Authors: Raheem O , Liu A , Kalidoss S , Khalil M
Published: March 2024

Introduction

Partial penectomies (PP) and total penectomies (TP) are both performed for penile cancer in the United States. Compared to TP, PP is performed more frequently to preserve functional urinary outcomes. To date TP and PP outcomes have not been compared, in this study we compared clinical characteristics and post-operative outcomes between TP and PP conducted between 2006–2016.

Objective

We conducted a retrospective review of penile cancer patients from National Surgical Quality Improvement Program (NSQIP) database for the years 2010–2016 using international classification of diseases clinical modification (ICD-CM) ninth revision codes. A total of 260 patients, 67 TP and 193 PP patients, were included.

Methods

We conducted a retrospective review of penile cancer patients from National Surgical Quality Improvement Program (NSQIP) database for the years 2010–2016 using international classification of diseases clinical modification (ICD-CM) ninth revision codes. A total of 260 patients, 67 TP and 193 PP patients, were included.

Results

Partial penectomy patients were less likely to be transferred patients (7.3% vs 20.9%, p=0.002), less likely to be suffering from diabetes (25.9% vs 40.3%, p=0.026), and were more likely to have preoperative laboratory values within normal limits. TP was associated with increased preoperative white blood cell count x109, preoperative white blood cell count > 7.5x109 (p<0.001), preoperative hematocrit (p<0.001). PP patients were, in contrast, shown to have higher pre-operative creatinine levels (p=.037) and lower platelet levels than TP patients (p=.045). PP patients had shorter operation times (78.8 vs 145.5 min, p<0.001). PP patients also had decreased levels of inpatient stay length (1.67 vs 4.31, p<0.001), any 30-day post-surgery complication (7% vs 31%, p<0.001), deep incisional surgical site infection (0.5% vs 6% p=0.017), wound disruption (0.5% vs 6.0%p=0.017), intraoperative or postoperative transfusion (1.6% vs 7.5%, p=0.029), and sepsis (0.5% vs 7.5%, p=0.005), when compared to patients who underwent TP. TP patients displayed a significantly greater number of concurrent surgical procedures (p<0.001), when compared to PP patients. There was no information on urinary, sexual, and erectile outcomes in the database.

Conclusions

PP is associated with fewer post-operative complications, shorter surgeries, shorter hospital stays, and fewer concurrent surgical procedures. Total penectomy is associated with a greater proportion of patients suffering from comorbid conditions, suggesting that TP patients are at higher risk for post-surgical complications and longer hospital stays. There is a gap in reported data pertaining to post-operative sexual function and erectile outcomes for PP at a national level.

Disclosure

No.
(260) Effects of Surface Delay Agents on Penile Sensibility in Premature Ejaculation
Authors: Zheng L , Wei L , Jiang T
Published: March 2024

Introduction

The penis is an important sensory organ during sexual intercourse, transforming the sensations experienced from intercourse into neural impulses and transmitting them to the central nervous system. Our previous research has found that the sensitivity of the penis varies due to histological and neuroanatomical differences between the penile shaft and glans. We have identified hypersensitivity zones within the penis, classifying them into three subtypes，namely, glans penis, penile shaft, and whole-penis hypersensitivity. However, it remains unknown whether there are differences in sensitivity after the application of surface anesthetics to these subtypes.

Objective

As the hypersensitivity of the penis is not uniform throughout, with specific sensitive zones, this study aims to investigate whether there are differences in sensitivity after surface delay agents are applied to the hypersensitive and hyposensitive areas. This will aid in the precise use of surface delay agents and reduce their side effects.

Methods

Based on the neurophysiological results, 290 patients with primary premature ejaculation were categorized into the group with single glans penis hypersensitivity, the group with single penile shaft hypersensitivity, the group with the whole penis hypersensitivity, and the group with the whole penis being hyposensitivity. Differences in sensory thresholds, latencies, and amplitudes between the hypersensitive and hyposensitive areas of the penis were compared between patients before and after the use of delaying agents on the surface of the penis.

Results

The surface delay agent can indiscriminately increase the sensory threshold of both the hypersensitive and hyposensitive areas of the penis (P<0.001), but it only prolongs the latency of the hypersensitive area (P<0.001), without affecting the latency of the hyposensitive area of the penis.

Conclusions

The effects of the surface delay agent on the hypersensitive and hyposensitive areas of the penis are different. The delay agent only extends the latency of the hypersensitive area, suggesting that there may be differences in receptors, sensory cells, and synaptic transmission of sensory nerve fibers between the hypersensitive and hyposensitive areas of the penis.

Disclosure

No.
(271) Assessment of Varicocele Bilaterality in Infertile Men
Authors: Almekaty K , Elsharkawy A , Zahran M , Ragab M , Rashed A , Soliman M , Salem K , Ghaith A
Published: March 2024

Introduction

Varicocele is the most common correctable cause of male factor infertility. It has always been a debatable subject as regard how it affects fertility and the best way to treat. However, there is a wide consensus nowadays that varicocelectomy improve male fertility potentials. Proper assessment of the disease bilaterality is crucial not to miss one side and not to jeopardize treatment outcome.

Objective

The primary outcome measure was to assess disease bilaterality and the secondary outcome measure was to report on improvement in semen 3 and 6 months post varicocelectomy and pregnancy rate 1 year post surgery.

Methods

This prospective study was conducted between January 2019 and January 2022. Infertile males with varicoceles underwent microsurgical subinguinal varicocelectomy by expert uroandrologists. Patients who were referred as unilateral varicoceles had their CDUS repeated for assessment of missed concomitant contralateral varicocele. Then, patients who were diagnosed with bilateral varicoceles underwent bilateral subinguinal ligation straight away. Those who were referred with unilateral varicocele had their palpable sides operated on first; then the contralateral side was also explored using an intraoperative Doppler device and the maximal vein diameter was measured. Patients came for follow for at least 6 months after surgery to evaluate any complications and assess improvement in semen parameters. Gynecologists also reported on normal pregnancy rate 1 year after surgery.

Results

A total of 329 cases completed the study. A hundred cases (30.4%) were initially referred as unilateral varicoceles and 229 (69.6%) as bilateral varicoceles. After reassessment of the study population, bilaterality of varicocele was found to be as high as 98.5% (324/329). This is statistically significantly higher than initial US (P<0.001). Repeat CDUS strongly correlated with the intraoperative measured varicocele diameter [r=0.9, P<0.001]. Moreover, sperm parameters showed significant improvement 3 and 6 months post varicocelectomy. Normal pregnancy after 1 year of surgery occurred in 118 cases (35.9%).

Conclusions

Varicocele bilaterality is underreported. Thorough assessment by expert radiologists and andrologists is of paramount importance not to miss significant pathology or hazard treatment outcome.

Disclosure

No.
(281) Low-Intensity Shockwave Therapy Combined with Tadalafil 5mg Daily has Better Efficacy for Mild and Moderate Erectile Dysfunction: The Preliminary Results of a Multicenter Clinical Study in China
Authors: Lu M , Huang Y , Chen Y , Yuan S
Published: March 2024

Introduction

Most clinical studies have demonstrated that low-intensity extracorporeal shockwave therapy (Li-ESWT) can improved erectile function in patients with erectile dysfunction (ED). The EAU guideline recommended to use Li-ESWT for mild vasculogenic ED patients. However, the therapeutic advantages of Li-ESWT combined with phosphodiesterase type 5 inhibitors (PDE5i) have not been explored clearly in clinical practice for mild and moderate ED patients.

Objective

To compare the therapeutic effects of Li-ESWT and Li-ESWT combined with PDE5i in mild and moderate ED patients with 8≤IIEF-5≤16 from a multicenter clinical study in China.

Methods

Patients with ED which IIEF-5 score is less than 22 and aged 18–60 years old were enrolled from three clinical centers from Jun. 2019 to Mar. 2023. The demographic data, International Index of Erectile Function-5 (IIEF-5), erectile hardness score (EHS) and self-reported symptom questions were collected. Patients were treated by a linear low-energy shock waves generator (Renova). Low-intensity shock wave (energy density of 0.09mJ/mm2) treatments were applied (once a week, 4 weeks in total, 5000 shocks each time). Patients in Li-ESWT combined with PDE5i group took 5mg of tadalafil once a day for one continuous month during ESWT. Comparative analyses of pre- and post-treatment and intergroup were used for statistics.

Results

In total, 42 ED cases (37.43±11.86 years) in Li-ESWT group and 116 cases (37.41±10.14 years) in combined group were enrolled for analysis. The IIEF-5 score and EHS in both groups were significantly improved after 1 month treatment (p<0.01). Compared with Li-ESWT group, patients in combined group significantly had higher self-reported efficiency (61.2% vs. 47.6%, p=0.013), IIEF-5 scores (15.34±7.15 vs. 13.96±7.71, p=0.039) and EHS (2.85±0.82 vs. 2.69±0.89, p=0.050). In the mild and moderate ED (with 8≤IIEF-5≤16) sub-group, 30 ED cases (36.81±10.99 years) in Li-ESWT group and 96 cases (36.80±10.69 years) in combined group were enrolled for analysis. The combined regimen showed better therapeutic advantages, including effective parameters IIEF-5(14.50±6.74 vs. 12.87±8.54, p=0.040), EHS (2.85±0.75 vs. 2.81±0.67, p=0.046) and self-reported efficiency (64.2% vs. 54.1%, p=0.001).

Conclusions

Li-ESWT can effectively improve erectile function in this multicenter clinical study in China, and the combination of Li-ESWT with daily use PDE5i had a better therapeutic effect on Chinese ED patients, especially on mild and moderate ED. Long-term follow-up with large sample study need to be developed for exploring the optimal therapeutic regimen.

Disclosure

No.
(289) Combined Therapy with Low-intensity Shockwave Therapy and Daily PDE5i Showed Better Pain Relieve and Sexual Function Improvement in Acute Phase of Peyronie Disease
Authors: Lu M , Huang Y
Published: March 2024

Introduction

To compare the efficacy and safety of daily use PDE5i and PDE5i combined with linear low-intensity shockwave therapy (Li-SWT) in the treatment of acute phase of Peyronie disease (PD).

Objective

68 patients with acute PD within 6 month onset were collected. The patients were 26–56 years old with an average of 42.3 years. The patients were randomly divided into two groups, 35 of which were orally administered with 5 mg of tadalafil every night for 3 months; the other 33 received 4 times of Li-SWT with daily PDE5i. Li-SWT uses the Renova shock wave therapy device with an energy density of 0.09mJ/mm2, each time 3200 times in the penile plaque, 900 times in the left and right penile shaft, and once a week for 4 consecutive treatments as a cycle. All patients underwent ultrasound or MRI, penile bending angle measurement, improvement of subjective symptoms, and IIEF-5 scale before and after treatment.

Methods

68 patients with acute PD within 6 month onset were collected. The patients were 26–56 years old with an average of 42.3 years. The patients were randomly divided into two groups, 35 of which were orally administered with 5 mg of tadalafil every night for 3 months; the other 33 received 4 times of Li-SWT with daily PDE5i. Li-SWT uses the Renova shock wave therapy device with an energy density of 0.09mJ/mm2, each time 3200 times in the penile plaque, 900 times in the left and right penile shaft, and once a week for 4 consecutive treatments as a cycle. All patients underwent ultrasound or MRI, penile bending angle measurement, improvement of subjective symptoms, and IIEF-5 scale before and after treatment.

Results

In the PDE5i group, the pain symptom relieve were improved in 80% patients (28 of 35 cases), while the combined group (PDE5i+Li-SWT) were improved in 90.9% patients (30 of 33 cases). The IIEF5 score in the PDE5i group improved from 13.8±7.9 to 19.5±8.1 and from 13.4±7.6 to 21.3±9.2 in the combined group, with both improvement between two groups. The plaque size were shrinkage 5 cases in PDE5i group and 12 cases in combined group, but penile curvature did not change significantly in both groups. In the PDE5i group, 5 patients had mild dizziness and back pain, while 3 patients had mild dizziness and back pain in combined group. There was no obvious adverse reaction observed for Li-SWT treatment.

Conclusions

Both the daily use PDE5i and the PDE5i combined with Li-SWT can improve the symptoms of acute PD patients, mainly to relieve pain and improve erectile function in some patients. The combined group had a better pain symptom relieve rate and more improvement for sexual function. The two methods can reduce PD plaque size in some cases, while both groups did not significantly change penile curvature. Both methods have good safety in the treatment of acute phase PD.

Disclosure

No.
A healthy lifestyle can support future sexual satisfaction: results from a 9-year longitudinal survey
Authors: Stenlund Säde , Sillanmäki Lauri , Koivumaa-Honkanen Heli , Rautava Päivi , Lagström Hanna , Suominen Sakari
Published: March 2024

Background

Previous follow-up studies have demonstrated the association between good health behavior and good sexual functioning for men, but the longitudinal relationship between multiple health behaviors and satisfaction with sex life remains understudied.

Aim

The aim of the study was to explore whether good health behavior associates with improved satisfaction with sex life for men and women in a follow-up of 9 years.

Methods

This cohort study utilized survey data from the population-based Health and Social Support study. It includes responses from 10 671 working-aged Finns. Using linear regression models, we examined a composite sum score representing 4 health behaviors (range, 0–4) in 2003 as a predictor of satisfaction with sex life in 2012. The analyses adjusted for various covariates in 2003, including satisfaction with sex life, living status, age, gender, education, number of diseases, and importance of sex life in 2012.

Outcomes

The outcome in the study was satisfaction with sex life in the year 2012.

Results

Participants who exhibited better health behavior at baseline demonstrated improved satisfaction with sex life when compared with those with poorer health behavior (β = −0.046, P = .009), even when controlling for the aforementioned covariates. The positive effect of reporting all beneficial health behaviors vs none of them was greater than having none vs 3 chronic conditions. Furthermore, this was almost half the effect of how satisfaction with sex life in 2003 predicted its level in 2012. These findings were supported by an analysis of the congruence of health behavior in the observation period from 2003 to 2012 predicting changes in satisfaction with sex life.

Clinical Implications

The results could serve as a motivator for a healthy lifestyle.

Strengths and Limitations

The current study used a longitudinal large sample and a consistent survey procedure, and it explored the personal experience of satisfaction instead of sexual function. However, the study is limited in representing today’s diversity of gender, since the options for gender at the time of survey were only male and female.

Conclusion

These findings indicate that engaging in healthy behaviors contributes to the maintenance and enhancement of satisfaction with sex life over time.
‘I think he will be able to adjust’. Letters of Recommendation Accompanying Jewish Refugees in Transit during National Socialism
Authors: Gerlach Lisa
Published: March 2024

Letters of recommendation are a specific subgenre of professional writing that both have their own history and shape the histories of the people they recommend. In the context of National Socialist persecution, recommendations typically accompanied well-educated German-Jewish refugees fleeing from Germany. Such letters can be seen as relics of an established support system, trying to enable and/or ease the period of internal transit into new and mostly unknown territories. Many Jews experienced a phase of internal transit as they adjusted to new demands and new social structures. This phase was usually a difficult one, as they not only had to adjust to a new country but also to process the events leading up to their forced migration, as well as navigating the psychological and often financial difficulties of organizing refuge. This article aims to show what kinds of information such letters of recommendation contained about transit. Focusing on the United States and on Palestine, the article challenges the understanding of these countries purely as ‘destination countries’, and shows how immigrants had to live through processes of internal transit. It also asks what content was the most useful to include in letters of recommendation—what kind of armour of good words was needed in transit—and how that content may have differed between the United States and Palestine.
Microscopic Focus on the Thyroid Follicles of the One-Humped Camel (Camelus dromedarius)
Authors: Roshdy Karam , Alsafy Mohamed A M , El-Gendy Samir A A , El-Mansi Ahmed A , Rezk Shaymaa
Published: March 2024

The microstructure of the thyroid gland of the one-humped camel (Camelus dromedarius) was described using morphometric, histological, immunohistochemical staining, and ultrastructural standard techniques. The follicular secretory units of the thyroid glands displayed comparable and variable sizes where the large follicles were situated at the peripheral margins; however, the small ones were located in the central region. Semisquamous epithelium (low cuboidal) lined the large thyroid follicles, while high cuboidal (columnar) epithelium lined the small ones. Our electron microscopic findings revealed that the low-sized cuboidal follicular cells lack organelles and are hypoactive. The high cuboidal follicular cells are active cells and rich in cellular organelles such as cisternae of rough endoplasmic reticulum, mitochondria, colloid droplets, scrolled Golgi apparatus, and secretory vesicles. A few degenerate follicular cells appeared on rare occasions. The parafollicular cells appeared with a more prominent and conspicuous nucleus than the follicular cells. The follicular cells were classified as active, inactive, or degenerated using transmission electron microscopy. The follicular and parafollicular cells showed calcitonin-positive immunoreactivity. Overall, the presented results showed particular convergences of the morphostructural aspects of the thyroid gland of C. dromedarius to that of other mammals with some distinctive features to cope with their physiology and harsh niche.