bluuebunny/crossref_metadata_2025 huggingface dataset:
Finite-difference frequency-domain method with QR-decomposition-based complex-valued adaptive coefficients for 3D diffusive viscous wave modelling
Authors: Xu Wenhao , Ba Jing , Wang Shaoru , Zhao Haixia , Wu Chunfang , Cao Jianxiong , Liu Xu
Published: March 2024

The diffusive viscous (DV) model is a useful tool for interpreting low-frequency seismic attenuation and the influence of fluid saturation on frequency-dependent reflections. Among present methods for the numerical solution of the corresponding DV wave equation, the finite-difference frequency-domain (FDFD) method with complex-valued adaptive coefficients (CVAC) has the advantage of efficiently suppressing both numerical dispersion and numerical attenuation. In this research, the FDFD method with CVAC is first generalized to a 3D DV equation. In addition, the current calculation of CVAC involves the numerical integration of propagation angles, conjugate gradient (CG) iterative optimization, and the sequential selection of initial values, which is difficult and inefficient for implementation. An improved method is developed for calculating CVAC, in which a complex-valued least-squares problem is constructed by substituting the 3D complex-valued plane-wave solutions into the FDFD scheme. The QR-decomposition method is used to efficiently solve the least-squares problem. Numerical dispersion and attenuation analyses reveal that the FDFD method with CVAC requires ∼2.5 spatial points in a wavelength within a dispersion deviation of 1% and an attenuation deviation of 10% for the 3D DV equation. An analytic solution for 3D DV wave equation in homogeneous media is proposed to verify the effectiveness of the proposed method. Numerical examples also demonstrate that the FDFD method with CVAC can obtain accurate wavefield modelling results for 3D DV models with a limited number of spatial points in a wavelength, and the FDFD method with QR-based CVAC requires less computational time than the FDFD method with CG-based CVAC.
(030) Hand Held, Self-Applicable Radio Frequency Device for the Treatment of Erectile Dysfunction. A Pilot Study with 6 Months Follow-Up
Authors: Gruenwald I , Appel B , Shechter A , Greenstein A , Reisman Y
Published: March 2024

Introduction

Collagen is an essential component of the structures involved in the erectile mechanism. Radiofrequency (RF) energy has been shown to renew and restore the spatial structural arrangement of collagen fibers and may improve erectile function of men suffering from erectile dysfunction (ED).

Objective

To assess the feasibility, safety, and efficacy of low-intensity radiofrequency (RF) therapy in men with ED.

Methods

Men with moderate & mild to moderate ED, with or without the use of PDE5-inhibitors were included. After instructions, each patient treated himself with the radiofrequency device (Vertica®), applying his selected individual RF intensity. Patients underwent, according to the protocol, 12 sessions of 30-minute treatments over 2 months. Patients were evaluated at baseline, 1, 3 and 6 months after treatment using validated questionnaires; International Index of Erectile Function (Full IIEF), IIEF-EF, and erection Hardness score (EHS), satisfaction (EDITS, BSW), and disease-specific quality and quality of life (QEQ, SQOL). In each session, patients filled safety and side-effect questions (pain, fever, burning, discomfort, urinary disorders). The Wilcoxon signed ranks test and the Marginal Homogeneity test were used for statistical processing.

Results

Twenty-seven out of 28 men treated, were available for 6 months follow-up, mean age 59.2±9.7. The mean ED duration was 41.2±29 months. Mean baseline IIEF-EF was 16.8±1 and improved significantly to 24.8±1.6, 24.3±1.8, and 24.2±2.08 at 1, 3 and 6 months respectively (p<0.001). The Minimal Clinical Important Difference (MCID) criteria were met by 25/28 (89%) at 1-month follow-up and 20/27(74%) at 6-month follow-up (p<0.001). A statistically and clinically significant improvement was demonstrated in the Full IIEF and EHS scores at baseline and during follow-up. No correlation was found between IIEF improvement and the age of the patients. Borderline significance (p=0.05) was found between the duration of ED and IIEF-EF improvement. No side effects were reported and participants rated the device as very comfortable and easy to operate.

Conclusions

The novel radiofrequency, home-use device for the treatment of ED shows promising results and the potential to improve erectile function. In this study, it was feasible and safe. Further high-quality randomized controlled trials are needed to determine the long-term efficacy of the treatment.

Disclosure

Yes, this is sponsored by industry/sponsor: Ohhmed, Israel.

Clarification: No industry support in study design or execution.

Any of the authors act as a consultant, employee or shareholder of an industry for: Ohhmed, Freya, Besins, Verility.
(042) Bilateral Orchiectomy as a Standalone Gender-Affirming Procedure: Does it Compromise Skin Grafts Available for Later Vaginoplasty?
Authors: Stelmar J , Zaliznyak M , Mallavarapu S , Sandhu S , Smith S , Garcia M
Published: March 2024

Introduction

Penile inversion vaginoplasty is the gold-standard gender-affirming surgical technique for creating a neovaginal canal. While bilateral simple orchiectomy (BSO) is usually completed at the same time as vaginoplasty, long wait times associated with vaginoplasty have highlighted pre-vaginoplasty BSO as a more immediate opportunity to mitigate gender dysphoria, decrease estrogen dosages, and completely eliminate antiandrogen hormone therapy. The impact of standalone BSO on later vaginoplasty is defined by a single study that associated BSO with a decrease in scrotal skin and a need for extragenital skin grafts-findings that have fueled hesitation around pre-vaginoplasty BSO.

Objective

To provide a detailed comparison of pre- and intraoperative skin graft measurements and postoperative neovaginal depth between patients who underwent BSO prior to versus concurrent with vaginoplasty.

Methods

All consecutive patients who underwent penile inversion vaginoplasty at a single institution were identified in a retrospective chart review. Demographic characteristics and the following measurements of vaginoplasty skin grafts were collected and compared between groups: preoperative stretched penile length (measured from base to 1cm proximal to the glans ridge on gentle stretch), preoperative stretched scrotal skin length (measured on gentle stretch in two parts: from the penoscrotal junction to mid scrotum, then from midscrotum to mid perineum), and intraoperative scrotal skin tube length (defined as the amount of scrotal skin that could be harvested and tubularized on a metal dilator (Figure 1A)).

Results

57 patients completed penile inversion vaginoplasty between August 2017 and May 2023: 17(30%) completed pre-vaginoplasty BSO and 40(70%) BSO concurrent with vaginoplasty (mean age ± SD = 36.6 ± 12.6y and 37.4 ± 12.8y, p>0.05). Notably, there was no significant difference in length of preoperative scrotal skin or intraoperative tubularized scrotal skin grafts (Figure 1B). While pre-vaginoplasty BSO patients had less neovaginal depth (p<0.05), they also had significantly less preoperative penile skin (p<0.01).

Conclusions

Contrary to the singular study in the literature, we found no between-group differences in scrotal skin measurements. Furthermore, zero patients required extragenital skin grafts to achieve mean neovaginal depth of 14.4±1.0cm, which approximates the average depth among studies reporting routine use of extragenital skin. Less neovaginal depth amongst BSO patients is expected, as this group had less penile skin available to line the canal. Findings from this study may help address patient and provider fears that BSO decreases scrotal skin available for later vaginoplasty, thereby lessening the decision-making burden of balancing the pros and cons of early BSO.

Disclosure

No.
(048) Women's Knowledge about Female Masturbation
Authors: Kaabia O , Mkaouer L
Published: March 2024

Introduction

The scarcity of in-depth studies on female masturbation testifies to the lack of attention paid to this crucial subject and to the cultural hurdles to talking about such a subject. This absence of evidence prevents healthcare practitioners from understanding women's experiences, needs, and challenges regarding their sexuality and sexual autonomy. It is therefore imperative to fill this knowledge gap with research studies that look at the cultural, social, and religious specificities specific to female masturbation.

Objective

The main objective of this study is to assess the knowledge of women regarding female masturbation taking into consideration their cultural, social, and religious backgrounds.

Methods

We present a cross-sectional study based on an online 15-item questionnaire posted once per week, 5 weeks in a row from March 14, 2023. The online self-administered questionnaire was presented in the local written dialect. The questionnaire was divided into a sociodemographic section, a general knowledge assessment of genitalia and the sexual female function, and a section about the misconceptions and knowledge about female masturbation. All participants were self-designated female participants over the age of 18, recruited from sports centers' Facebook and Instagram pages.

Results

The study included 213 participants, 82% of who have attended high education institutions, and 70% were single. The mean age was 25 [18, 45]. Internet was the participants' primary informational source in 64%. Friends were the second source of information with 15%. With regard to the participants' knowledge, the results of the study reveal a diversity of levels of knowledge within our population. Some participants demonstrated a limited or incorrect understanding of female masturbation, often influenced by cultural, and religious beliefs or preconceived ideas. This inaccurate knowledge contributes to the spread of negative stereotypes and judgments about practice.

Conclusions

It is important to recognize that female masturbation often remains a difficult subject to discuss and is surrounded by social taboos. In light of our findings, it is clear that additional efforts are needed to promote better understanding and acceptance of female masturbation through comprehensive sexuality education programs.

Disclosure

No.
(051) Urodynamic Profiles of Young Aged Women with Genital Pain Disorder
Authors: Yoon H , Kim M
Published: March 2024

Introduction

It is not uncommon in young female patients with genital pain disorder, they also complain urethral discomfort or unusual sensitivity, bothering symptoms on their urethra and genital area with LUTS. Although urodynamic studies or pressure flow studies are one of very optional studies of diagnostic steps, pressure flow studies provide detailed information of patient bladder-urethral synergistic function that may contribute proper function of the pelvic floor and related organs. However, studies are limited providing their relationship between urethral functional status and etiology of pain.

Objective

In this study, we aimed to evaluate female patients pressure flow profiles, urethral pressure profiles (UPP) in particular and to investigate their correlation of clinical symptoms in terms of genital pain disorder in 20’s-30’s aged young female.

Methods

Data of 30 female patients age between 20–39 years old with genital pain and LUTS for more than 6 months were retrospectively analyzed. Pressure flow study (PFS) with free uroflowmetry, overactive bladder symptom score (OABSS), visual analogue scale (VAS), female sexual function index (FSFI) were retrospectively analyzed according to aged groups of 20’s and 30’s. Data were statistically analyzed using t-test (p<0.05).

Results

We divided the subject patients into 2 groups; age of 20’s (n=16, 20–28, median 25 years old) and age of 30’s (n=14, 30–39, median 34 years old). Average MUCP of all patients was 104 cmH2O. In the group of aged 20’s, mean MUCP was 98.75 cmH2O, mean VAS was 5.81; in the group of aged 30’s, mean MUCP was 111.07 cmH2O, mean VAS was 5.57, respectively. All of the data showed high pressure of MUCP in PFS, >60 cmH2O. In group of 30’s, all the parameters of PFS showed higher compared with 20’s. Mean OAB symptom scores (OABSS) showed 3.63 (20’s) and 3.07 (30’s) respectively (p>0.05)

Conclusions

Urethral pressure, PdetQmax and Qmax showed significantly high in young females with genital pain. This study suggests that increased urethral tone or resistance may contribute to urethral/genital pain. Proper evaluation of urethral pressure profile and pelvic floor tone would be helpful to provide optimal management of genital pain disorder.

Disclosure

No.
(068) The Men’s Training Cup Keep Training: A Masturbation Aid Improves Intravaginal Ejaculatory Latency Time and Erection Hardness Score in Patients who are Unable to Delay Ejaculation
Authors: Shirai M , Ishikawa K , Hiramatsu I , Mizushima K , Tsuru T , Kurosawa M , Kure A , Uesaka Y , Nozaki T , Tsujimura A
Published: March 2024

Introduction

Premature ejaculation (PE) has negative personal consequences, such as distress, bother, frustration, and/or the avoidance of sexual intimacy. In Japan, no oral drugs or devices are approved or used clinically to treat PE. The Men’s Training Cup Keep Training (MTCK), a masturbation aid, was developed for PE. MTCK offers 5 grades of tightness and strength.

Objective

We aimed to investigate the efficacy of the MTCK in patients who are unable to delay ejaculation.

Methods

Inclusion criteria were 20- to 60-year-old men feeling distressed and frustrated by PE and who had the same sexual partners throughout the study period. Exclusion criteria were neurologic disease and uncontrolled diabetes mellitus, as well as the use of antidepressants, α-blockers, and 5α-reductase inhibitors. The protocol comprised an 8-week training period with the MTCK from level 1 to level5, with each level used twice before moving to the next level. The main outcome measure was the extension of intravaginal ejaculation latency time (IELT). The secondary outcome measures were score improvements on the Premature Ejaculation Diagnostic Tool, Sexual Health Inventory for Men, Erection Hardness Score, and Difficulty in Performing Sexual Intercourse Questionnaire–5.

Results

We enrolled 37 patients, and after 19 patients withdrew, 18 concluded the study without experiencing any adverse events. The mean patient age was 39.9 years. Geometric IELT after the 8 week training with the MTCK increased significantly (mean ± SE; 232.10 ± 72.16 seconds) vs baseline (103.91 ± 50.61 seconds, P=.006). Mean scores on the Premature Ejaculation Diagnostic Tool, Difficulty in Performing Sexual Intercourse Questionnaire–5, and Erection Hardness Score after 8-week training improved significantly vs the baseline values. The mean score on the Sexual Health Inventory for Men did not improve significantly after the 8-week training, but domain 1 did significantly improve after 8 weeks of MTCK use.

Conclusions

The MTCK may be one possible treatment option for patients who are unable to delay ejaculation. Also, the MTCK may offer benefits for erectile function.

Disclosure

No.
(085) Investigating the Relationship Between Experiences of Sexual Health Education and Sexual Health Outcomes
Authors: Bednarczyk E , Orogun L , Perna A , Edokpayi K
Published: March 2024

Introduction

Young people (16–24-year-olds) experience the highest diagnosis rates of STIs. Lack of engagement, public awareness, lack of training, and long-standing, widespread stigma around STIs remain barriers to greater and more effective use of interventions such as sexual health education and other services. Whilst relationship and sexual health education (RSE) has been part of many school curriculums for generations, young people’s experiences of RSE can vary widely.

Objective

This research aims to provide insight into the experiences of sexual health education, sexual health behaviours and recommendations to improve engagement and sexual health outcomes amongst adolescents.

Methods

An online quantitative survey was conducted between June and July 2021 (n=5,457). 855 respondents were recruited from a market research panel (answering a 20-minute survey) and a further 4,602 respondents were recruited via public links (answering a cut-down survey). All respondents were living in the UK and aged 18+. Data were analysed using descriptive statistics and adjusted to reflect the sample size of LGBTQ+ and heterosexual respondents.

Results

90% of respondents received formal sex education, however, only 12% agreed sex education had a positive long-lasting effect on their sexual life. Reproductive biology, pregnancy, safe sex, and avoiding STIs were the core pillars of sex education, whilst different sexualities, pleasurable intimate relations, gender identity and trans-specific topics were covered less than 13% of the time. Although 90% of respondents declared they have a good understanding of sexual health risks, sexual health outcomes in this group were sub-optimal; safe sex was only consistently practiced by 43% of respondents and regular testing only carried out by 25% of respondents.

Conclusions

Whilst most participants reported receiving sexual health education, their experiences varied. Despite a high self-reported understanding of sexual health risks, sexual health outcomes were sub-optimal. This research highlights the potential beneficial effects of an exhaustive sexual health education on attitude, knowledge, and behaviours among adolescents to improve the long-term sexual health outcomes. Recommendations include designing programmes based on young people’s experiences of sexual education, reviewing current guidance and practices adding on key topics outside the main pillars of sexual education, increasing guidance and training for educational institutions and supporting RSE provisions in alliance with external educators and services.

Disclosure

Yes, this is sponsored by industry/sponsor: Reckitt.

Clarification: Industry initiated, executed and funded study.

Any of the authors act as a consultant, employee or shareholder of an industry for: Reckitt.
(089) Psychological Distress and Coping Mechanisms among Women with Sexual Dysfunction Using Hormonal Contraceptives at Kawempe Hospital - A Cross-sectional Study
Authors: Aujo B T , Nakasujja N , Turiho A , Gumikiriza J L , Kakaire O
Published: March 2024

Introduction

Sexual dysfunction is very distressing to women of reproductive age. Hormonal contraceptives (HC) are often reported to be highly associated with sexual dysfunction. The occurrence of female sexual dysfunction (FSD) varies across African regions however, the literature is scanty. This study, therefore aimed to assess the psychological distress (PD) and coping mechanisms of women with sexual dysfunction using hormonal contraceptives at Kawempe Hospital (KH).

Objective

To determine the prevalence of psychological distress among women with sexual dysfunction using hormonal contraceptives at Kawempe Hospital To examine the factors associated with psychological distress among women with sexual dysfunction using hormonal contraceptives at Kawempe Hospital To evaluate the coping mechanisms of women with sexual dysfunction using hormonal contraceptives at Kawempe Hospital

Methods

The study was cross-sectional and conducted by a female team at the family planning clinic of KH. Participants were sexually active females aged 18 to 50 years, who had used HCs for at least six months, and had a positive FSD score below 26.55 on the female sexual function index. PD was assessed using the Kessler Psychological Distress Scale K-6, with a score over 13 indicating PD. Coping mechanisms were determined using the SexFlex scale. The data was analyzed using proportions, means, chi-squares and logistic regression to determine characteristics associated with PD at a significance level of 0.05.

Results

Of the 401 individuals screened, 288 who had positive FSD scores were enrolled. The average age of the participants was 28.8 years, and 46.18% used implants for contraception. The prevalence of PD was 55.56%, with 28.47% using reflexive-only coping mechanisms, 24.35% using approach-only mechanisms, 13.19% using both, and 63.19% using neither. Being married (AOR=0.45) and breastfeeding (AOR=0.41) were negatively associated with PD, while using injectables (AOR=7.43), implants (AOR=5.17), levonorgestrel IUD (AOR=4.17), having relationship dissatisfaction (AOR=4.65), and sexual pain (AOR=2.60) were positively associated with PD.

Conclusions

PD was prevalent among women with FSD using HCs at Kawempe Hospital and associated with modifiable characteristics. It is recommended that health workers regularly screen for PD among women with FSD using HCs and provide education on malleable characteristics, such as breastfeeding and relationship satisfaction.

Disclosure

No.
(096) Attachment Orientation Moderates the Sexual and Relational Implications of Sexual Desire Discrepancies
Authors: Attaky A , Kok G , Dewitte M
Published: March 2024

Introduction

Discrepancies in partners’ levels of sexual desire (SDD) are common in long-term relationships and can be experienced as distressing. Because sexual compatibility is a strong prescriptive among Western couples, it is relevant to examine the sexual and relational implications of SDD in relationships that are marked by cultural restrictions and gender stereotypic norms.

Objective

We examined discrepancies in sexual desire between partners and assessed how such discrepancy relates to sexual and relational functioning, taking into account both partners’ attachment orientation

Methods

100 couples of which more than half experienced sexual problems completed an Arabic version of questionnaires on sexual desire, sexual function, sexual satisfaction, relationship satisfaction and attachment orientation.

Results

Men and women reported better sexual function, sexual satisfaction, and relational satisfaction when they matched on higher levels compared to lower levels of sexual desire. In case there was a mismatch between partners, women reported higher sexual satisfaction when their partner’s level of sexual desire was higher than their own desire. Attachment orientation was found to moderate the associations between the degree and direction of SDD and the outcome variables. Male attachment avoidance moderated the association between SDD and both male and female sexual function. Male attachment anxiety moderated only the association with female sexual function, indicating that women with high anxious partners reported better sexual function when their partner’s level of desire was higher than their own desire. In addition, the female attachment dimensions moderated the association between SDD and female satisfaction outcomes, with attachment anxiety moderating the association with sexual satisfaction and attachment avoidance moderating the association with relational satisfaction.

Conclusions

We showed the importance of considering both the level and direction of SDD and the partners’ attachment history to understand its sexual and relational implications. Therapeutic interventions should be directed at understanding the attachment meaning of sexual desire, facilitators and barriers of sexual desire across time and context, and the reasons why some couples cope better with SDD than others.

Disclosure

No.
(110) Evaluation of Penile Anatomy with MRI
Authors: Baran C , Culha M G , Aksoy K , Bayraktarli R Y , Ozcan L , Otunctemur A
Published: March 2024

Introduction

Penile enlargement interventions have become increasingly popular in recent years. The common lengthening procedure involves dividing the fundiform and suspensory ligaments to enable the outward movement of the concealed part of the penis. Nevertheless, the outcomes of these surgeries can vary, and clear patient selection criteria have yet to be established.

Objective

In this study, our objective was to assess penile anatomy using MRI and to identify penile anatomical variations that can aid in the selection of patients for penile enlargement surgeries.

Methods

We conducted a retrospective study to assess penile anatomy in the context of lengthening surgery. Pelvic MRIs taken for various reasons were evaluated, and the angle between the penile shaft and the symphysis pubis (a), as well as the distance from the pubis to the skin (b), were measured. Patients were categorized into three groups (I, II, III) based on the highest point of the penis relative to the symphysis pubis in the sagittal plane (Figure 1).

Results

A total of 519 pelvic MRIs were initially reviewed, and 344 met the protocol's eligibility criteria. The participants had a median age of 53 years (IQR 38-65) and a median body mass index of 26 (IQR 24-29). The median angle between the penile shaft and pubis was 23 degrees, with a pubis-skin distance of 38 mm. Age was significantly correlated with the angle between the penile shaft and pubis (r=0.61, p<0.01). Patient distribution across the groups based on penis highest point and pubis location was as follows: 36.1% in Group I, 47.4% in Group II, and 16.5% in Group III. Additionally, a significant positive correlation existed between BMI and suprapubic fat thickness (r=0.65, p<0.01). The analysis unveiled noteworthy variations in penile anatomy, suprapubic fat distribution, peno-pubic angle, and the anchoring point of the fundiform ligament to the penis. Some penises also displayed an S-shaped anatomy. Figure 2 visually illustrates the range of observed penile anatomical variations.

Conclusions

Our study revealed a significant variability in penile anatomy. The distinctions among patients should be carefully considered when planning any penile enhancement intervention.

Disclosure

No.
(152) Efficiency Improvement Veno-Occlusive Surgeries for Treatment of Venous Leak with Autologous Stem Cell, VEGF and PRP
Authors: Knigavko O
Published: March 2024

Introduction

The venous leakage is one of the most often reason of erectile dysfunction (ED) in young and middle age men. The main reason of venous leakage or veno-occlusive Erectile Dysfunction (VOED) is the insufficiency venous obstruction under tunica albuginea of corpora cavernosa. Accordingly all types of veno-occlusive operations have particular and short term effect up to renovation of venous leakage in half year. Conservative treatment of VOED with PDE-5 has a low or mild effectiveness. Evermore young patients deny penile prosthesis implantation for psychological reason.

Objective

We want to stimulate growth of endothelial valves under tunica albuginea with injections autological mesenchymal stem cells (ASC) and autological VEGF (Vascular endothelial growth factor) and combine it with veno-occlusive surgeries.

Methods

2012–2022 we treated 178 patients with VOED. The average patient age is 36.5 +4.1 years. Patients with prostatitis or depression/anxiety were excluded from the investigation or treated previously. We embolizated deep dorsal and Santorini plexus veins for patients with distal form of VOED–47 patients -Group 1. We ligated deep dorsal and penile veins for proximal form of VOED – 68 patients – Group 2. And we made both methods together for 65 patients –Group 3 with combination of proximal and distal leak. Patients with only surgical methods created subgroup A – 105 men. For improving of veno-occlusive mechanism for 73 patients (subgroup B) we injected to each corpus cavernosa 1 mln of autological stem cells 6 times (2 times before, during surgery and 3 times after surgery) each month and we performed 15 microinjections of VEGF each 10 days. Then we compared short (2 months) and long term (10 months) results.

Results

The efficacy of surgical treatment according to subjective data (questionnaires on IIEF-5) in 2 months was almost equal (16.7+3.1 and 16.9+3.0), but in 10 months significantly higher in SubGroup B(14.3+3.2 and 19.6+3.4). According to Doppler Penile Ultrasound in 10 months adding microinjections ASC and VEGF to surgery significantly improves Erectile function (absence of venous leakage) 56.4% - subgroup A and 87.4% - subgroup B. Only 6.8% patients subgroup B (opposite to 35.9% subgroup A) have to take PDE-5 inhibitors for maintain erectile function.

Conclusions

Half year injections of ASC and VEGF improve of veno-occlusive mechanism and increases effectiveness and long term result of veno-occlusive operations for treatment of VOED. Combine occlusive method (embolisation and ligation of veins) has the highest effectiveness and should be used in different types of leakage.

Disclosure

No.
(171) Tunical Incision and Grafting for Severe Peyronie’s Disease Using Human Fascia Lata: Surgical Technique
Authors: Kalidoss S , Barreto Guimaraes P , Nusbaum D , Raheem O , Kocjancic E
Published: March 2024

Introduction

Management of Peyronie’s disease is challenging for patients and can present with deformed penile angulation, pain, and reduction in erectile function. This video demonstrates the usage of cadaveric fascia lata grafting to rectify severe ventral penile curvature symptomatic of advanced Peyronie’s disease.

Objective

We outline a surgical technique to use fascia lata allografting for the correction of excessive ventral penile curvature caused by Peyronie’s disease if non-surgical treatments are insufficient.

Methods

A 65 year-old African-American male patient with severe Peyronie’s disease and a history of hypertension presented with a ventral penile curvature of 110 degrees at the proximal third of the shaft. Consequently, he was unable to engage in penetrative sexual intercourse. An artificial hydraulic erection confirmed the curvature, and the areas of fibrotic plaque were palpated. A degloving incision was made proximal to the glans, and a 6 cm segment of Buck’s fascia was elevated ventrally. The neurovascular bundle and urethra were separated from the corporae. A second hydraulic erection was induced, exposing a 6 cm by 3.5 cm rectangular tunical defect which was marked for excision. Bovie electrocautery was utilized to excise the fibrotic section of tunica albuginea. A rectangular section of Biosure human cadaveric fascia lata graft was soaked in saline solution and trimmed to 6 cm by 4 cm. The graft was sutured to the excised region of the tunica albuginea with 4–0 Maxon in a watertight fashion with a running stitch. A final hydraulic erection confirmed the mitigation of the penile curvature, and Buck’s fascia and the shaft skin were re-approximated to the subcoronal skin with 3–0 Vycril suture.

Results

This grafting procedure resulted in a near complete resolution of the ventral penile curvature with no complications. The patient was admitted overnight for observation and discharged POD 1 with a 3-layer dressing and mesh underwear. The postoperative penile length increased to 17.5cm from 16cm preoperatively as a result of the grafting and mitigation of the penile curvature.

Conclusions

Fascia lata allografts are robust and easily obtainable, which is ideal for the corporal reconstruction of fibrotic tunica albuginea in patients with Peyronie’s disease. This procedure demonstrates the utility of cadaveric fascia lata as an alternative surgical grafting material for the surgical correction of penile curvature associated with severe Peyronie’s disease.

Disclosure

No.
(205) The Psychological, Sexual, and Financial Impact of Infertility on Couples: An Urological Approach
Authors: Jamali M , El Rhaz A , Oukouhou H , Nabil L , Alami M , Ameur A
Published: March 2024

Introduction

Infertility is a public health issue with socioeconomic and demographic impact. Understanding the psychological, sexual, and financial repercussions on couples is crucial for comprehensive treatment.

Objective

Infertility can evoke complex emotions and disrupt the couple's sexual relationship. The aim of this study is to examine the psychological, sexual, and financial aspects of this condition on infertile couples.

Methods

A retrospective study was conducted on 50 couples undergoing infertility treatment at a military hospital. Data, including medical records, questionnaires, and follow-up information, were collected.

Results

1. Psychological Impact: Infertility represents a failure of the parental project, leading to negative emotions. Women are more likely to report the psychological impact and seek help. Family pressure and potential divorce due to societal expectations were observed. 2. Sexual Impact: Infertility can significantly affect sexual life, causing decreased satisfaction, stress, and anxiety. Communication and emotional intimacy may suffer. Contrary to literature, men reported more sexual disorders due to socio-cultural factors and female partners' discomfort discussing sexuality. 3. Financial Impact: Infertility treatments incur substantial costs, adding to emotional and physical burdens. Financial implications vary by country, and lack of national funding policies lead to debt or abandonment of conception plans. In the study, half of the couples spent over $1000.

Conclusions

Infertility has a significant psychological, sexual, and financial impact on couples. A comprehensive approach involving healthcare practitioners and policymakers is necessary for significant improvement in the well-being of infertile couples.

Disclosure

No.
(207) Premature Ejaculation and Varicocele, are they Associated? Systematic Review
Authors: Mahdi M , Khalafalla K , Arafa M , Elbardisi H , Majzoub A
Published: March 2024

Introduction

Premature ejaculation (PE) is one of the most common sexual disorders that negatively impacts couple’s satisfaction. Varicocele on the other hand is a highly prevalent condition affecting men population. A higher incidence of PE is observed among patients with varicocele, which incited several authors to evaluate the possible correlation between varicocele and PE. Others went beyond that to investigate whether varicocele repair can lead to an improvement in PE.

Objective

To systematically review the literature for all the studies exploring the relationship between PE and varicocele.

Methods

A systemic review was performed utilizing (PRISMA) statement. The PubMed, Google scholar and Scopus databases were used to look for articles published up to June 2023 using the appropriate keywords. Articles reporting an association between the presence of varicocele and PE and exploring changes in ejaculation latency time after varicocele correction were included. Data including study design, sample size, varicocele details, PE diagnostic method, outcome measured and tools used to measure it were collected. The Newcastle-Ottawa scale was used for assessing the quality of the included studies.

Results

A total of eight studies were identified, two of them were retrospective and six were prospective. Intravaginal ejaculation latency time (IELT) was used as a diagnostic tool for PE in 5 studies, Premature Ejaculation Diagnostic Tool (PEDT) in 1 study, Chinese Index of Sexual Function for Premature Ejaculation-5 (CIPE-5) scores in 1 study, and subjective assessment in 2 studies. Two studies looked for the prevalence of PE among patients with and without varicocele. Both studies showed a significantly higher frequency of PE among varicocele patients. Whereas six studies evaluated the improvement in ejaculatory function after varicocelectomy; five of them revealed a statistically significant improvement. Quality check: only one study was of strong quality while the remaining 7 studies were of fair quality.

Conclusions

Limited evidence suggests the presence of positive relation between varicocele and PE. The small number of studies and patients, lack of enough prospective clinical trials, short term follow up, heterogenous study design and absence or diversity in the diagnostic tools used prevent our ability to build strong evidence. For the purpose of supporting the relation and validate it, further prospective studies on a larger number of patients with long-term follow up are needed to reach a solid verdict.

Disclosure

No.
(208) Enhancing Opportunities for Sexuality Assessment During Initial Mental Health Assessments: Barriers and Enablers for Psychiatric Registrars
Authors: Gunawan J , Fox C , Ramanathan V
Published: March 2024

Introduction

Assessments of sexuality and sexual wellbeing is recommended as “best practice” in psychiatric assessments, however, education opportunities on sexuality and sexual wellbeing do not feature prominently in the training curriculum of psychiatric trainees in Australia.

Objective

To explore the training experiences of psychiatric trainees and identify barriers and enablers to enhance human sexuality assessments within mental health assessments.

Methods

Qualitative inquiry was adopted to allow for exploration of the issues. Semi-structured interviews of psychiatric trainees based at a metropolitan hospital and health service were conducted and analysed with a thematic analysis approach.

Results

Seven emergent themes were identified: barriers and enablers, skills and competence, inadequate training within the psychiatry training program, the belief that human sexuality is important to psychiatry, and training needs.

Conclusions

Psychiatric trainees believe that human sexuality and sexual wellbeing are an important part of mental health assessments. Despite this belief, participants reported a lack of direct training in sexual history taking, treatment of sexual issues, and sexual wellbeing, leading to an overall lack of confidence in assessing patients’ sexuality within mental health assessments. Psychiatrists of all levels of training require specific, regular education regarding human sexuality to ensure sound knowledge and consistent patient care.

Disclosure

No.
(249) Association of Single Nucleotide Polymorphisms (rs2301365 & Rs737008) in PRM1 Gene and Male Infertility: A Meta-Analysis
Authors: Ejaz H , Arshad A , Irfan M , Ismail S B , Hussain N H N
Published: March 2024

Introduction

In the sperm nucleus, protamine is a major DNA-binding protein that replaces histone. It is a basic arginine-rich protein responsible for DNA compaction. Protamin I (PRM1) is one of the important genes that produces protamine. Mutations and polymorphisms in PRM1 may increase the odds of male infertility.

Objective

The present meta-analysis investigated the association of single nucleotide polymorphisms (SNPs) (rs2301365 & rs737008) in the PRM1 gene and male infertility.

Methods

The original research articles, published till July 2023 in the English language, on the association of rs2301365 and rs737008 in the PRM1 gene and male infertility, were retrieved from Science Direct, PubMed, NCBI and Google Scholar.

Results

A total of 129 studies were retrieved by searching in the different databases, after the removal of duplicates, meta-analysis, and abstracts, 14 were finally selected. In 11 case-control studies, the association of the rs2301365 (-190C >A) polymorphism was presented as the meta-analysis of different models, Allelic model (C vs. A), Dominant model (CC + CA vs. AA), Recessive model (CC vs. CA + AA), Additive model (CC vs. AA), Heterozygous model (AC vs. AA). Allelic, additive, dominant and heterozygous models reported that the -190C>A (rs2301365) increased the odds of male infertility. The ethnic subgroup analysis showed the same pattern of association for the Caucasian infertile men. However, none of these overall and subgroup analyses based on ethnicity showed an association between rs2301365 (-190C >A) and infertility in Asian men. For rs737008 (139C > A) in the meta-analysis of 14 studies, none of these overall and subgroup analyses based on ethnicity showed an association with male infertility. Trial sequential analysis (TSA) for the allelic model of rs2301365 (-190C >A) showed the required sample size was 2252 at 90% power and 5% type-I error, whereas the cumulative z-curve crossed the trial sequential monitoring boundaries of harm. However, the sample size was greater than required therefore further studies will not likely change results. For rs737008 (139C > A), TSA recommended more studies to be conducted.

Conclusions

The PRM1 rs2301365 (-190C >A) was associated with male infertility in overall analysis and Caucasian men. Further studies on this SNP may not change results. However, rs737008 (139C > A) was not associated with male infertility. However, further studies are recommended.

Disclosure

No.
(252) Has the COVID-19 Pandemic Impacted Penile Implant Public Interest in the US?
Authors: Hammad M A M , Nakamura H , Miller J , Azad B , Yafi F A
Published: March 2024

Introduction

The COVID-19 pandemic has significantly impacted various aspects of society, including healthcare-seeking behaviors. Online search trends have become valuable indicators of public health concerns and interests.

Objective

This study focuses on the search trends for penile implants to understand how these trends have changed in different metro/county income levels pre- and post-COVID-19.

Methods

Data on Google search trends for penile implant procedures were collected for specific metropolitan areas before and after the COVID-19 pandemic. The metropolitan areas with the highest search intents were further analyzed. Average household income and per capita income, based off 2021 US Census Bureau, were calculated for the top five metropolitan hot spots (household income, per capita income before and after the pandemic) then visualized in a linear model.

Results

Between 2016 and 2023, pre- and post- COVID-19, the interest in penile implants has been steadily increasing on average in the US (figure 1). Within these interest groups, a handful of counties account for the most searches that result in the following surges, and are associated with specific socioeconomic backgrounds and events. Before COVID-19, the average household income of counties most interested in penile implants was $53,215.80 (39th percentile) and the per capita median income was $34,626.80 (37th percentile). Post-COVID-19, both of these averages decreased over time to $50, 945.17 (37th percentile) and $31, 435.17, respectively (34th percentile) (figure 2).

Conclusions

This study demonstrates significant increases in Google search trends for penile implant procedures after the COVID-19 pandemic. Before the pandemic, higher-income regions demonstrated more interest in penile implant searches, potentially linked to affluence and investment in men’s health, compared to more interest in lower income regions post-pandemic.

Disclosure

Any of the authors act as a consultant, employee or shareholder of an industry for: Advisory board and speaker for Coloplast; consultant for Cynosure; advisory board and speaker for Halozyme; intellectual property with Masimo; advisory board for Promescent; consultant for Sprout; advisory board for Xialla.
(267) Penile Length and Circumference in Vietnamese Men
Authors: Ho Huu P , Nguyen Anh T , Le Thi Thu H , Nguyen Thi Huyen T
Published: March 2024

Introduction

Penile size has long been an important fixation in men's lives. Establishing what the normal size of the penis is very important to have a yardstick for men, which is a challenge and depends on the culture, race, and form of measurement applied.

Objective

To evaluate the size of the penis in flaccidity, erection, and stretch of Vietnamese men.

Methods

A total of 259 men who visited the Andrology and Fertility Hospital of Hanoi, VietNam were involved in the study between October 2022 and April 2023. Penile measurements (flaccid, erect length/circumference, stretched length) were predominantly taken by 1 investigator using a tape measure and the same measurement technique. All statistical analyses were completed using STATA 17.0. Statistical analysis was performed with the Spearman correlation as tested by the Kolmogorov–Smirnov test (p<0.05).

Results

The mean age of 259 patients was 29,24 (range: 15–48). The mean penile lengths were: flaccid length 9.21 cm (SD 1.71 cm), flaccid circumference at the middle of the shaft 8.25 cm (SD 0.96 cm), erect length 13.22 (SD 1.46cm), erect circumference at the middle of the shaft 10.42 cm (SD 0.94 cm), and stretched length 12.47 cm (SD 1.61 cm). The mean testicular volume was 12.47 mL (SD 6.37 mL) and 12.65 (SD 4.03 mL) for the left and right testicles, respectively. Stretched length is most closely correlated with erect length with r=0.68. We also observed that the testicular volume, erect length was a significant inverse correlation with age, which ranged from r = -0.14 to -0.21.

Conclusions

The results of this study help to establish a reference range for male genital size in Vietnam, which should be helpful for urologists and andrologist in counseling patient

Disclosure

No.
(287) Influence of Severe Chronic Scrotal Pain on Men’s Sexual Activity: An Indication for Surgery?
Authors: Le Anh Tuan , Mai Ba Tien Dung , Vu Le Chuyen , Dang Quang Tuan
Published: March 2024

Introduction

Severe chronic scrotal pain significantly influences numerous aspects of a patient’s life and activities, particularly sexual activity.

Objectives

This study seeks to explore the clinical characteristics and the effects of chronic scrotal pain on male sexual activity, with a focus on patients with severe chronic scrotal pain who were candidates for microsurgical denervation of the spermatic cord.

Methods

This is an observational study that encompassed all patients with severe chronic scrotal pain who underwent microsurgical denervation of the spermatic cord at the Department of Andrology, Binh Dan Hospital, from January 1, 2022, to May 31, 2023, after other causes had been excluded.

Results

Thirty-one patients with chronic scrotal pain underwent surgery, with a mean age of 24.2 ± 4.3 years and a pain duration of 2.3 ± 1.6 years. Pain was located in the scrotum (41.3%), testis-epididymis (47.8%), spermatic cord (24.6%), and inguinal (15.1%), with postepididymitis (45.3%) being the predominant cause. The average Numerical Rating Scale (NRS) pain score before surgery was 6.8 ± 2.3. Thirteen out of thirty-one patients experienced severe pain (NRS = 7-10). The Quality of Life (QOL) scores were 6.75 ± 1.1 for patients with moderate pain and 4.6 ± 4.0 for those with severe pain. A smaller testicle size was observed in 43.5% of patients, and 51.6% had varicose veins on ultrasound, measuring 3.4 ± 1.2 mm. Sixteen out of thirty-one patients reported that scrotal pain impacted their sexual activity. Patients with higher pain scales (NRS 7-10) had significant effects on erectile function compared to those with moderate pain (P < 0.05). Decreased libido was reported in 34.1%, and lowered testosterone levels in 37.5% of the patient group. Sexual activity induced pain in 60.9% of cases, and the incidence of erectile dysfunction was significantly higher in the high pain scale group (P = 0.02). No significant statistical difference was observed between the duration of intercourse and the severity of scrotal pain.

Conclusion

Chronic scrotal pain, predominantly observed in young patients, has substantial impacts on the quality of life and sexual performance. Therefore, a meticulous consideration of sexual factors is imperative in male patients with chronic scrotal pain. Surgical indications for chronic scrotal pain treatment may be deemed necessary for sexual disorders associated with scrotal pain.

Disclosure

No.