bluuebunny/crossref_metadata_2025 huggingface dataset:
Stress triggering and future seismic hazards implied by four large earthquakes in the Pamir from 2015 to 2023 revealed by Sentinel-1 radar interferometry
Authors: Liu Zhenjiang , Li Zhenhong , Yu Chen , Zhang Xuesong , Peng Jianbing
Published: March 2024

The Mw 6.8 Murghob earthquake is the third earthquake in an Mw 6.4+ sequence occurring in the Pamir initiated by the 2015 Sarez Mw 7.2 earthquake. It is of great significance to investigate their interactions and to assess future seismic hazards in the region. In this paper, we use Sentinel-1 radar interferometric data to retrieve coseismic deformation, invert for the slip distributions of the four events, and then investigate their interactions. The cumulative Coulomb failure stress changes (ΔCFS) suggest that the 2023 Murghob earthquake was promoted by the three prior earthquakes in the sequence. Pre-stress from historical earthquakes is a key factor in explaining the triggering mechanism of the two 2016 Mw 6.4+ earthquakes. Stress loading and unloading effects on major faults in the region indicate that future attention should be paid in (1) the segment of the Sarez-Karakul fault north of the Kokuibel Valley, (2) the segment of the Sarez-Murghab thrust fault west of the Sarez-Karakul fault and (3) the east segments of the Pamir thrust fault system, all with a large positive ΔCFS.
Spatial distribution of mid-lower crustal flow in the SE Tibetan Plateau revealed by P-wave velocity and azimuthal anisotropy beneath the Lijiang–Xiaojinhe fault and its vicinity
Authors: Dong Guiju , Liu Shaolin , Sun Kailin , Yang Dinghui , Li Mengyang , Wang Wenshuai , Chang Kai
Published: March 2024

The Lijiang–Xiaojinhe fault (LXF) and its vicinity are located in the transition zone among the Tibetan Plateau (TP), the South China block and the Indochina block. Researchers believe that this area has acted as a key tectonic zone during the evolution of the TP. Owing to the continuous growth and SE-ward expansion of the TP, the LXF and its vicinity have experienced intense deformation. Although different models, such as the rigid block extrusion and mid-lower crustal flow models, have been proposed to explain this intense deformation, a consensus has not yet been achieved. To better understand the deformation of the LXF and its vicinity, a high-resolution image of the subsurface structure must be constructed. In this study, we construct images of P-wave velocity and azimuthal anisotropy structures by using an eikonal equation-based traveltime tomography method. We collect high-quality seismic data from 276 broad-band seismic stations and manually pick a total of 48 037 first arrivals for the tomography study. Our tomographic results reveal a strong low-velocity body below the LXF and its vicinity. In addition, a strong azimuthal anisotropy structure with an N–S-oriented fast velocity direction is distributed along the low-velocity body. These features indicate the occurrence of mid-lower crustal flow, that penetrates across the LXF and extends to the Dianzhong block (DZB). In addition, we find obvious low-velocity perturbations in the mid-lower crust and uppermost mantle beneath the DZB. The low velocities may be attributed to the upwelling of hot materials from the upper mantle. We consider the limited distribution of mid-lower crustal flow on the margin of the SE TP, and mid-lower crustal flow may not play a significant role in the expansion of the TP.
Early developments of psychiatric epidemiology in Chile: a local history with global implications
Authors: Mascayano Franco , Cuadra-Malinarich Gonzalo , Almeida-Filho Naomar , Susser Ezra
Published: March 2024

This viewpoint discusses a conference paper titled: “Epidemiological research on mental morbidity in Chile”, which summarizes a handful of studies from 1950s in Chile covering conditions such as alcoholism, psychosis, epilepsy, and neurosis. These were the first psychiatric epidemiological population studies conducted in the Southern hemisphere, but they are largely unknown globally. We argue that the Chilean studies have important implications for modern psychiatric epidemiology, as well as for related fields such as global mental health and mental health services research. This piece starts by describing the general sociopolitical context and presenting the main methodological features of the studies. It focuses then on three specific implications for the field: 1) promoting decoloniality in psychiatric epidemiology; 2) ensuring methodological rigor and feasibility; and 3) informing the development of mental health policy and services.
Impact of CFTR Modulation on Pseudomonas aeruginosa Infection in People With Cystic Fibrosis
Authors: Ledger Emma L , Smith Daniel J , Teh Jing Jie , Wood Michelle E , Whibley Page E , Morrison Mark , Goldberg Joanna B , Reid David W , Wells Timothy J
Published: March 2024

Background

Pseudomonas aeruginosa is a multidrug-resistant pathogen causing recalcitrant pulmonary infections in people with cystic fibrosis (pwCF). Cystic fibrosis transmembrane conductance regulator (CFTR) modulators have been developed that partially correct the defective chloride channel driving disease. Despite the many clinical benefits, studies in adults have demonstrated that while P. aeruginosa sputum load decreases, chronic infection persists. Here, we investigate how P. aeruginosa in pwCF may change in the altered lung environment after CFTR modulation.

Methods

P. aeruginosa strains (n = 105) were isolated from the sputum of 11 chronically colonized pwCF at baseline and up to 21 months posttreatment with elexacaftor-tezacaftor-ivacaftor or tezacaftor-ivacaftor. Phenotypic characterization and comparative genomics were performed.

Results

Clonal lineages of P. aeruginosa persisted after therapy, with no evidence of displacement by alternative strains. We identified commonly mutated genes among patient isolates that may be positively selected for in the CFTR-modulated lung. However, classic chronic P. aeruginosa phenotypes such as mucoid morphology were sustained, and isolates remained just as resistant to clinically relevant antibiotics.

Conclusions

Despite the clinical benefits of CFTR modulators, clonal lineages of P. aeruginosa persist that may prove just as difficult to manage in the future, especially in pwCF with advanced lung disease.
Functional and Immunologic Mapping of Domains of the Reticulocyte-Binding Protein Plasmodium vivax PvRBP2a
Authors: Tay Matthew Zirui , Tang Weiyi , Lee Wenn-Chyau , Ong Alice Soh Meoy , Novera Wisna , Malleret Benoît , Carissimo Guillaume , Chacko Ann-Marie , El-Sahili Abbas , Lescar Julien , Fan Yiping , McGready Rose M , Chu Cindy S , Chan Jerry Kok Yen , Ng Lisa F P , Russell Bruce , Nosten François , Rénia Laurent
Published: March 2024

We previously described a novel Plasmodium vivax invasion mechanism into human reticulocytes via the PvRBP2a-CD98 receptor-ligand pair. Using linear epitope mapping, we assessed the PvRBP2a epitopes involved in CD98 binding and recognized by antibodies from patients who were infected. We identified 2 epitope clusters mediating PvRBP2a-CD98 interaction. Cluster B (PvRBP2a431-448, TAALKEKGKLLANLYNKL) was the target of antibody responses in humans infected by P vivax. Peptides from each cluster were able to prevent live parasite invasion of human reticulocytes. These results provide new insights for development of a malaria blood-stage vaccine against P vivax.
Not surprising: a rebound in antibacterial consumption in Europe, with Cyprus and Greece on the podium
Authors: Spernovasilis Nikolaos , Tsioutis Constantinos
Published: March 2024

Recent European-wide data place Cyprus and Greece in the highest positions of total antimicrobial consumption. While this level of consumption might be partly attributed to the high rates of infections due to MDR bacteria in these countries, several other reasons should be sought to help apply local measures, to decrease inappropriate and excess antimicrobial use. The present viewpoint aims to provide a roadmap for interventions, by briefly discussing the various factors that underlie antimicrobial use and prescribing practices in Greece and Cyprus.
Determination of fentanyl contamination on United States paper currency by LC–QQQ-MS
Authors: Hewes Matthew P , Papsun Donna M , Logan Barry K , Krotulski Alex J
Published: March 2024

Previous research has evaluated the extent to which cocaine and other drugs were detectable on currency in the USA. The literature was in agreement that the majority of bills exhibited some degree of contamination. With the increase of fentanyl in the illicit drug supply, this study was designed to evaluate the extent that fentanyl, cocaine, methamphetamine and other substances were present on circulating currency in 2022. A quantitative assay using liquid chromatography–triple quadrupole mass spectrometry was developed and validated to detect six analytes: fentanyl, 4-anilino-N-phenethylpiperidine, acetylfentanyl, benzylfentanyl, cocaine and methamphetamine. One-dollar bills were collected from 13 cities across the country. Sample preparation consisted of soaking the bills in methanol followed by liquid–liquid extraction. Chromatographic separation was achieved using a C18 analytical column and gradient elution with ammonium formate in water (5 mM, pH 3) and 0.1% formic acid in acetonitrile. The quantitative working range for this assay was 0.1 μg to 1.0 μg per bill (equivalent to 1 ng/mL to 100 ng/mL of extract). Fentanyl was detected on the majority (63%) of samples, with 61% of samples having ≥0.1 μg of fentanyl and 4% of samples having ≥1.0 μg. Cocaine and methamphetamine were detected on 100% and 98% of bills, respectively, typically in amounts >1.0 μg. The remaining fentanyl-related substances were detected in 15% of samples in amounts no >0.69 μg per bill and exclusively in the presence of fentanyl. Unsurprisingly, areas of the country with higher incidence of fentanyl use yielded higher frequency of contaminated bills and higher concentrations. Human exposure to drugs on currency is unlikely to have any significant impacts toxicologically or pharmacologically; however, our research findings suggest that paper currency could serve as a useful substrate for surveillance of drug trends regionally, nationally and/or internationally.
Improving the Efficiency of Outbound CATI As a Nonresponse Follow-Up Mode in Address-Based Samples: A Quasi-Experimental Evaluation of a Dynamic Adaptive Design
Authors: Jackson Michael T , Hughes Todd , Fu Jiangzhou
Published: March 2024

This article evaluates the use of dynamic adaptive design methods to target outbound computer-assisted telephone interviewing (CATI) in the California Health Interview Survey (CHIS). CHIS is a large-scale, annual study that uses an address-based sample (ABS) with push-to-Web mailings, followed by outbound CATI follow-up for addresses with appended phone numbers. CHIS 2022 implemented a dynamic adaptive design in which predictive models were used to end dialing early for some cases. For addresses that received outbound CATI follow-up, dialing was paused after three calls. A response propensity (RP) model was applied to predict the probability that the address would respond to continued dialing, based on the outcomes of the first three calls. Low-RP addresses were permanently retired with no additional dialing, while the rest continued through six or more attempts. We use a difference-in-difference design to evaluate the effect of the adaptive design on calling effort, completion rates, and the demographic composition of respondents. We find that the adaptive design reduced the mean number of calls per sampled unit by about 14 percent (relative to a modeled no-adaptive-design counterfactual) with a minimal reduction in the completion rate and no strong evidence of changes in the prevalence of target demographics. This suggests that RP modeling can meaningfully distinguish between ABS sample units for which additional dialing is and is not productive, helping to control outbound dialing costs without compromising sample representativeness.
(006) Can Vibrator Use Improve Well-Being?
Authors: Dubinskaya A , Kohli P , Shoureshi P , Bresee C , Eilber K
Published: March 2024

Introduction

In limited studies vibrators have been shown to improve sexual function and improve pelvic floor health; however, there are even less studies on the effect of vibrator use on overall genitourinary and mental health.

Objective

This study aimed to investigate the effect of regular vibrator use on sexual, genitourinary, and mental health in addition to quality of life.

Methods

We performed a prospective pilot study of women aged 18 to 99 years recruited from a urogynecology clinic. Study participants were instructed to use a vibrator for five to ten minutes, two to three times a week for three months on their external genitalia. Sexual function, pelvic floor function, mental health, and pelvic examination were assessed at the initial visit and at three months follow-up using validated questionnaires.

Results

Of the 79 participants enrolled in the study, 53 women (66%) completed the study. The mean age of the participants was 54.7 years (range 19 – 80 years), and the majority of participants were Caucasian (n=59, 74.7%), post-menopausal (n=48, 60.8%), and not receiving systemic (n=63, 79.7%) or local (n=63, 79.7%) hormone therapy. Sexual function significantly improved over time (p =0.002), while the rate of bothersome pelvic organ prolapse symptoms and pain scores significantly decreased (p=0.034 and 0.0008, respectively). Rates of urge urinary incontinence decreased although this was not statistically significant (p=0.059). There was a significant improvement in gross appearance of lichen sclerosus lesions (p=0.025) and in severity of vaginal atrophy (p=0.018). Rates of depression were significantly decreased (p=0.011). Patients who completed the study were more likely to report having partnered sexual activity (p=0.067), and significantly more likely to have vaginal penetration during intercourse (p=0.017).

Conclusions

Vibrator use was associated with improved sexual, genitourinary, and mental health.

Disclosure

No.
(013) Glycated Serum Albumin Decreases Connexin 43 Phosphorylation in the Corpus Cavernosum
Authors: Huang Y , Liu W , Liu Y , Zhang M , Hu K , Xu S , Lu M
Published: March 2024

Introduction

Glycated serum albumin (GSA) is an early glycosylation product that participates in diabetic vascular complications, including retinopathy, nephropathy, neuropathy, and coronary artery disease. Elevated GSA levels and the associated damage to the corpus cavernosum might be limited to not only diabetic patients but also non-diabetic patients and even individuals with normal glucose levels.

Objective

This study aimed to examine the role of GSA in early damage to the corpus cavernosum and identify the pathways involved in GSA-induced endothelium damage.

Methods

Nine 8-week-old male Sprague-Dawley (SD) rats (250–300 g) were divided into the control (saline vehicle, n=3) and GSA (200 μg/kg, n=6) groups. The corpus cavernosum tissues were harvested. Phosphorylated and non-phosphorylated connexin 43 (Cx43), endothelial nitric oxide synthase (eNOS), phosphatidylinositol 3-kinase (PI3K), and serine-threonine kinase (Akt) were tested by immunohistochemistry and western blotting. Human umbilical vein endothelial cells (HUVECs) overexpressing Cx43 were used to analyze the Cx43 phosphorylation sites (S368, S262, Y265, S255, and S279/282) using western blotting.

Results

The expression of phosphorylated Cx43 in the penis was significantly lower in GSA-treated rats than in controls. The expression levels of p-Cx43, p-eNOS, p-PI3K, and p-Akt were significantly decreased in HUVECs exposed to GSA in dose- and time-dependent manners. The most significant impact on all four proteins was observed with 1 μg/mL of GSA for 12 h. Phosphorylation at the S368, S262, Y265, S255, and S279/282 sites of Cx43 was downregulated by GSA, and S368 was the most significantly suppressed phosphorylation site compared with the other sites.

Conclusions

GSA decreases the expression of p-Cx43 in the corpus cavernosum of rats. This effect might be also related to the decreased phosphorylation of p-eNOS, p-PI3K, and p-Akt, as well as by the downregulation of phosphorylation at the S368 site.

Disclosure

No.
(014) Safety and Efficacy of Platelet-Rich Plasma Injection for the Treatment of Erectile Dysfunction; A Randomized Prospective Study
Authors: Ragheb A , Fahmy M , Lotfy A , Elmarakby A
Published: March 2024

Introduction

Platelet-rich plasma (PRP) intracorporeal injection is one of the popular regenerative therapies that has been gaining much interest in recent years as an adjunct or alternative treatment for erectile dysfunction (ED). Nevertheless, scientific evidence to support its clinical efficacy remains controversial.

Objective

The aim of this study was to evaluate the safety and efficacy of PRP injections for the treatment of ED.

Methods

A prospective, randomized, double-blinded, placebo-controlled, interventional clinical study was conducted on 52 subjects at the Department of Urology, Faculty of Medicine, Beni-Suef University. Patients were randomized into two groups: the PRP group (n=26) and the placebo (saline) group (n=26). Each participant received three sessions (at two-week intervals) of PRP or saline injections according to his assigned group. International index of erectile function-5 (IIEF-5) scores and safety-related observations were collected at the 1st, 3rd, and 6th months of follow-up.

Results

The median age and ED duration were statistically comparable for both groups, 52.2 versus 52.5 years and 12.87 versus 11.8, respectively (P = 0.285). With regards to the efficacy of PRP, there were no statistically significant differences between both groups after 1, 3, and 6 months of treatment. After 1 month of treatment, the mean IIEF-5 score for the PRP group was 16.12 ± 1.25 versus 15.99 ± 1.21 for the placebo group (P = 0.683). After 3 months, the IIEF-5 score for the PRP group was 16.44 ± 1.17 compared to 16.31 ± 1.06 for the placebo group (P = 0.653). Also after 6 months, the IIEF-5 score for the PRP group was 16.35 ± 1.45 close to 16.23 ± 1.19 for the placebo group (P = 0.727). No transient hemorrhagic adverse events (hematuria, local petechial bleeding, or ecchymosis) or other side effects were reported during the injection and follow-up period for both groups.

Conclusions

The results of this trial suggest that although the treatment of ED with 3 injections of intracavernosal PRP separated by two-week intervals may be safe, it is not more effective than a placebo injection.

Disclosure

No.
(061) Xenon Facilitates Schwann Cell Demyelination via Inhibition of SPRY2 in Treating Erectile Function After Cavernous Nerve Injury
Authors: Yang B , Zhao X , Wang R , Dai Y
Published: March 2024

Introduction

Cavernous nerve injury induced erectile dysfunction (ED) is the most common complication after radical prostatectomy for prostate cancer. Our previous studies found that xenon (Xe) can partially restore the erectile function and cavernous nerve function of rats with neurogenic ED, but the mechanism is unclear. Schwann cells (SC) play an important role in peripheral nerve repair, and after axonal injury, SC undergo demyelination and transform into repair-type SC to promote repair.

Objective

The purpose of this study is to verify whether Xe promotes the demyelination of Schwann cells and its molecular mechanism.

Methods

Human SCs were cultured in vitro and given Echo-lipid particles (ELIPs) carrying Xe. The control group was given empty ELIPs. Ultrasound was performed above the culture dish to break ELIPs and release the gas. After treatment, the expression level of the EGR2 gene, a marker of SC demyelination, was detected, and RNA was extracted for mRNA sequencing. Sequencing results were validated in SC and rat dorsal root ganglion (MRP) tissues through Western blot and qPCR.

Results

After Xe treatment, the level of EGR2 in SC cultured in vitro decreased, indicating that Xe treatment can promote the demyelination process of SC. RNA-sequencing results showed that after Xe treatment, 88 genes were up-regulated and 231 genes were down-regulated. Top 10 KEGG pathway enrichment analysis suggested an increase in MAPK pathway expression. Meanwhile, among the differentially expressed genes, we found that the expression of SPRY2 (Sprouty RTK Signaling Antagonist 2) decreased, a negative feedback regulator of the MAPK pathway. Using qPCR and Western blot on SC and rat MPG tissues in vitro, we validated the sequencing results and found that after Xe treatment, the expression level of SPRY2 decreased, and the level of pERK increased.

Conclusions

Xe may promote the demyelination of Schwann cells and the repair of cavernous nerves by inhibiting the SPRY2 level of SC, reducing its inhibition of the MAPK/ERK pathway.

Disclosure

No.
(073) A Novel Method——Identifying Anejaculation or Retrograde Ejaculation by Transrectal Dynamic Ultrasound (Report of 11 Cases)
Authors: Wei L , Zheng L , Jiang T
Published: March 2024

Introduction

Ejaculation is what we can see whereas orgasm is what we feel. Hence, the presence of ejaculate does not indicate the ability to experience orgasm. Having orgasm without ejaculate may be due to anejaculation (AE) or retrograde ejaculation (RE). Retrograde ejaculation is usually diagnosed by finding sperm in a urine sample after orgasm. However, it can be difficult to differentiate in cases of very low semen volume, previous vasectomy, ejaculatory duct obstruction, or azoospermia.

Objective

This study aims to explore the use of transrectal dynamic ultrasonographic (US) to observe the process of ejaculation, direction of seminal flow, and changes in seminal vesicles, ejaculatory ducts, and bladder neck during orgasm, providing visual differentiation between AE and RE.

Methods

US observations were conducted on 11 patients who experienced orgasm without ejaculate.

Results

Among the 11 patients (7 with diabetes, 1 with congenital megacolon surgery, 1 with urethral stricture), 3 patients had unsuccessful examinations due to discomfort or technical issues with the transrectal ultrasound probe. Successful observations were made in 8 patients, where 5 patients showed contraction of the seminal vesicles and incomplete closure of the bladder neck during orgasm, leading to RE. In 3 cases, no changes in the seminal vesicles or bladder neck were observed, and no seminal flow was seen, leading to AE.

Conclusions

Dynamic ultrasonographic allows for the observation of the ejaculation process and understanding of the changes in seminal vesicles and bladder neck during orgasm, enabling differentiation between AE and RE.

Disclosure

No.
(074) The Sensitivity Difference Between the Glans Penis and Penile Shaft in Primary Premature Ejaculation
Authors: Zheng L , Wei L , Jiang T
Published: March 2024

Introduction

The penis is a vital organ of perception that transmits perceived signals to ejaculation-related centers. The penis consists of the glans penis and penile shaft, which differ considerably in both histology and innervation.

Objective

This paper aims to investigate whether the glans penis or the penile shaft is the main source of sensory signals from the penis and whether penile hypersensitivity affects the whole organ or only part of it.

Methods

The thresholds, latencies, and amplitudes of somatosensory evoked potentials (SSEPs) were recorded in 290 individuals with primary premature ejaculation using the glans penis and penile shaft as the sensory areas.

Results

The thresholds, latencies, and amplitudes of SSEPs from the glans penis and penile shaft in patients were significantly different (all P < 0.0001). The latency of the glans penis or penile shaft was shorter than average (indicating hypersensitivity) in 141 (48.6%) cases, of which 50 (35.5%) cases were sensitive in both the glans penis and penile shaft, 14 (9.9%) cases were sensitive in the glans penis only, and 77 (54.6%) cases were sensitive in the penile shaft only (P < 0.0001).

Conclusions

There are statistical differences in the signals perceived through the glans penis and the penile shaft. Penile hypersensitivity does not necessarily mean that the whole penis is hypersensitive. We classify penile hypersensitivity into three categories, namely, glans penis, penile shaft, and whole-penis hypersensitivity, and we propose the new concept of penile hypersensitive zone.

Disclosure

No.
(097) 3 Year Follow Up After Modified Grid Incision and Sealing with Collagen Fleece for Treatment of Peyronie’s Disease
Authors: Moon D G , Ahn S T , Lee W K , Cho S B
Published: March 2024

Introduction

Previously, we introduced a less invasive modified technique by multiple grid incisions of Peyronie’s plaque.

Objective

To assess the efficacy of technique in 32 patients with 3 year follow-up.

Methods

From 2018, 32 patients with stable Peyronie’s disease were included with 3 major steps of surgery; 1) dissection of neurovascular bundle/urethra according to plaque location, 2) multiple deep grid incisions of plaque for complete correction of curvature/deformity, 3) sealing with TachoSil®. Prospectively, the stretched penile length (SPL), totally straightness, penile sono, erectile function at preoperative, and 6, 12, 24, 36 months postoperatively under approval of Institutional Review Board.

Results

Mean age was 59.2 years (46–72). Mean curvature was 53.5 (40–80) degree, 8 with hinge and 7 with hourglass deformity. IPP was inserted in 4 and 1 at postoperative 30 months for poor erectile function. Mean follow-up was 35.4 months (12–57). Daily massage softened the hard thickening of penis gradually from 3 months until 3 year. On follow-up sonography, subcutaneous thickening gradually decreased to near normal at 1–3 year and tunical breakage by grid incision reunited at postoperative 10–12 months. 2 patients immediately recurred dorsal curvature but most patients achieved totally straightness. Most patients gained preoperative length after 1.6 year. 96% of patients satisfied in GAQ at 2 year. Minor skin problem was occurred in two of IPP. Subcutaneous bulging hematoma was occurred in 3 patients but subsided in two within 3 months. One patients need revision surgery. In postoperative erectile function of 23 patients without IPP, spontaneous hard erection was recovered in 5 and the rest are satisfied with PED5 inhibitors.

Conclusions

Our prospective progress reports with technical modification of various plaque incisions shows that one can achieve a sufficient surgical effect without making defect of tunica albuginea but need long term follow up for 3 years at best.

Disclosure

No.
(117) Is Platelet-Rich Plasma Effective and Safe for Managing Erectile Dysfunction? A Meta-Analysis of Before-After Data from Clinical Studies
Authors: Savira M , Atmoko W
Published: March 2024

Introduction

Erectile dysfunction (ED) is common health issues among men with increasing prevalence along with age. With the advancement of technology, the aim of therapy for ED is start to shift in reversing the pathology and not only relieving the symptoms. Platelet-rich plasma (PRP) are one of the regenerative modalities that has gained popularity in many medical disciplines. Many studies have been conducted that favour PRP in improving erectile function. However, no relevant meta-analysis of PRP have been performed to date.

Objective

A single-arm meta-analysis were conducted to evaluate the outcome of PRP for the treatment of ED based on the data before and after the procedures.

Methods

We systematically searched PubMed, Embase, Scopus in June 2023 to find the relevant articles based on the Preferred Reporting Items for Systematic Review and Meta-analysis statement. All randomized controlled trials (RCTs), observational, and case control studies in English with 10 or more subjects and a minimum of 1 month follow-up after PRP treatment reporting International Index of Erectile Function-Erectile Function (IIEF-EF) score were included. Pooled analysis on outcomes that were reported in at least 2 studies were performed using RevMan 5.4 and STATA18 with 95% confidence intervals (CIs). We also conduct heterogeneity test and a leave-one-out sensitivity analysis.

Results

A total of three RCTs, three observational studies and one case-control study, comprising 236 patients, were included from 183 studies identified. The pooled analysis showed that PRP injection significantly increased the IIEF-EF score by 3.87 (95% CI: 2.92, 4.83, p<0.00001), 3.01 (95% CI: 2.27, 3.74, p<0.0001), 3.29 (95% CI: 2.26, 4.32, p<0.00001), at 1, 3, and 6, months follow-up. Subgroup analysis of IIEF-EF based on the use of PDE5i in the protocol or during follow-up period also found the same finding result. The proportion of patient who met MCID after 6 months of follow of was 70% (95% CI: 59%, 80%). In term of penile hemodynamic, a significant improvement was found in peak systolic velocity and end diastolic velocity at the end-point of follow-up. On contrary, there was no significant improvement were found for IIEF score of intercourse satisfaction and overall satisfaction domain. The most common complication reported were transient subcutaneous bruising. Two cases reported a formation of painless plaque but no other major adverse events were reported. Consistent result was found after a leave-one-out sensitivity analysis.

Conclusions

PRP is a promising restorative modality for ED with improvement in IIEF-EF score and penile hemodynamic. However, further studies and human trials are required to confirm the efficacy and durability of this novel treatment as well as to find out the best protocol of administration.

Disclosure

No.
(123) Postoperative Changes of Serum Total Testosterone Levels in Patients with Prostate Cancer After Robot-Assisted Radical Prostatectomy
Authors: Horiguchi Y , Hagiwara K , Shimizu T , Kawano Y , Sakamoto N , Tsukuda F , Koga S
Published: March 2024

Introduction

Although a relationship between prostate cancer and serum total testosterone (TT) has been studied, previous evidences were contradictory. Although a relationship between prostate cancer and serum total testosterone (TT) in terms of cancer biology as well as sexual function has been studied, previous evidences were contradictory and not organized very well.

Objective

We investigated the changes in TT levels after robot-assisted radical prostatectomy (RARP) for prostate cancer as a prospective surveillance.

Methods

From July 2015 to January 2022, 290 patients out of 1,343 prostate biopsies performed in our hospital underwent RARP with a diagnosis of localized prostate cancer. TT measurements were performed at 6:00 early morning on admission to all patients for biopsy. Of these, we studied 76 patients whose TT values have been measured during postoperative follow-up. TT values were measured 1 month after RARP, every 3 months until 36 months thereafter, and every 6 to 12 months thereafter for up to 72 months postoperatively.

Results

The median and quartile of age, serum PSA and TT (pre-TT) values at biopsy of the 76 patients were 69 years (64–72 years), 7.47 ng/mL (5.65–12.74 ng/mL) and 4.03 ng/mL (2.96–4.83 ng/mL), respectively. There was no significant correlation between age and pre-TT values (p = 0.21). RARP was performed an average of 2.9 months after biopsy. The median follow-up period was 43 months (31–60 months). PSA recurrence was observed in 18 patients (23.7%), with 3- and 5-year PSA non-recurrence rates of 77.4% and 74.9%, respectively. There was no significant difference in pre-TT values between patients with or without PSA recurrence (p = 0.107). Analysis of TT values at each observation period after RARP showed relative increase by an average of 23.4% (after 1 month) to 41.6% (after 36 months) when compared with pre-TT values. Further analysis of dividing 76 patients into 2 groups by a pre-TT value of 3.00 ng/mL showed that only in the low pre-TT group (pre-TT < 3.00 ng/mL: 21 cases, 27.6%), the rate of increase in TT values over pre-TT was significantly higher than that in the normal pre-TT group (pre-TT ≥ 3.00 ng/mL: 55 cases, 72.4%) at each observation period up to 72 months after RARP except 33 and 54 months

Conclusions

The transition of postoperative TT values in the patients who underwent RARP continued to show a significant increase at each observation period only in the group with low TT values preoperatively, suggesting that biochemical hypogonadism may have been presumably caused by prostate cancer-bearing conditions preoperatively in these patients with low TT values.

Disclosure

No.
(128) Penile Replantation in Patient with Klingsor Syndrome; Case Report and Review of Literature
Authors: EL-Bahnasawy M , Elgazzar K , Alzahrani T , Aljohani M
Published: March 2024

Introduction

Penile amputation has multiple etiologies including self-mutilation, work-related accidents, circumcision, assault motivated by jealousy, rage and feelings of betrayal and animal attacks. By far self –mutilation due to underlying psychiatric disorders (Klingsor Syndrome) are the commonest cause. Re-implantation is the gold standard for management, however it may always not be possible to achieve because of significant local ischemia, tissue damage and prolonged duration post trauma.

Objective

We are reporting our experience with one case of Klingsor Syndrome and its stepwise management.

Methods

A 31 years old male Schizophrenic patient self-mutilated his penile shaft due to fixed illusion (get rid of devil in his penis). He also attempted to remove his entire scrotum. His father brought his son with the amputated penile part put in ice. Immediate application of wet saline towel to penile stump and putting of amputated penile part into cold iced saline. Anti-tetanic serum was given together with i.v. antibiotics. Urology team, Plastic microsurgery team together with Psychiatry treating consultant all were emergently called at once. Amputated penile shaft was prepared by the microsurgeon to identify the dorsal artery, vein and nerves and marked by micro-bulldogs. Urology team started by fixation of s.p. cath and preparing, cleaning penile stump. End-to end anastomosis of the urethra was done. Next, the corporal bodies, were reattached using interrupted sutures. Dorsal vein and artery were re-anastomosed microsurgically

Results

Few days post-operatively skin necrosis started inspite of positive needle brick to the glans indicating healthy underlying glans. Second stage debridement of necrotic skin with later skin grafting resulted in cosmetically and functionally excellent penis regarding erectile and voiding functions

Conclusions

Penile amputation is a rare surgical emergency mostly found in the literature as isolated case reports. Klingsor syndrome is well known etiology for this type of penile injury and warrants psychiatric control. A multidisciplinary approach involving a urologist, micro-vascular surgeons as well as a psychiatrist ensures good outcome. Microvascular re-implantation remains the treatment of choice with the highest probability of adequate cosmetic as well as functional outcomes

Disclosure

No.
(168) Combining Varicocelectomy and Penile Venous Stripping for Patients with Varicocele and Erectile Dysfunction on an Ambulatory Basis
Authors: Hsu G , Chueh J , Chiang I , Fang C
Published: March 2024

Introduction

Varicocelectomy is a well-established procedure for varicocele testis over one century. It has recently been advanced to minimally invasive surgery types such as laparoscopic or Da Vinci varicocelectomy. Should we question why the approach is beyond the shortest-cut route? Despite penile venous surgery is still cautious in treating patients with erection dysfunction (ED), an anatomy-based penile venous stripping has been conducted for decades, however. It is common to encounter patients with two disease entities. Could the shortest-cut approach be available?

Objective

We sought to report a novel approach for this purpose on an ambulatory basis.

Methods

From October 2013 to October 2020, 68 men aged from 28 to 68 years consulted us with erectile dysfunction and varicocele testis, at least grade II. Dual pharmaco-cavernosography and sonography are the primary tools for confirmation, respectively. The abridged five-item version of the International Index of Erectile Function (IIEF-5) erection hardness scales (EHS) was used to assess erection restoration. Acupuncture-assisted local anesthesia was routinely applied on an ambulatory basis. Neither electrocautery nor suction apparatus was used in the entire procedure. They underwent penile venous stripping (PVS) via circumferential approach and, subsequently, to the deeper portion of the erection-related veins via a pubic longitudinal method; later, bi-lateral varicocelectomy was conducted while the spermatic cord was hooked out. The PVS entails stripping one deep dorsal vein and two cavernosal veins after every specific emissary vein is microscopically ligated closest to the outer tunica, whereas the para-arterial veins are segmentally ligated. The visibility of the pampiniform plexus was enhanced by the squeezing method. Finally, the wound was meticulously repaired using a 6–0 nylon suture. Postoperative cavernosography was routinely made for comparison. Radiopacity was used to compare the penile crus, Corpora cavernosa, and femur cortex. Follow-up was made via INTERNET every six months, one year, and then yearly.

Results

The average follow-up period was 5.2±1.2 years, and the surgery time was 6.3±1. 5 hours, respectively. The blood loss is negligible. The radiopacity was unexceptionally enhanced postoperatively. There was a significant difference (P<0.01) between the preoperative (9.9±2.6) vs. Postoperative IIEF-5 scores (20.6±2.4). The EHS improved on at least one scale. Overall, the post-ejaculation testicular aching was no more bothered in all 23 patients who sustained preoperatively in 6 months postoperatively.

Conclusions

This combination of physiologically penile venous stripping and bilateral varicocelectomy appears feasible for patients with erectile dysfunction and varicocele via a circumferential and pubic approach on an ambulatory basis.

Disclosure

No.
(169) Penile Fracture and Urethral Injury Repair
Authors: Megson M , Tagdiwala P , Pasyar A , Lee W G
Published: March 2024

Introduction

Penile fracture refers to the rupture of tunica albuginea of the penile corpora cavernosum which most often occur due to trauma during coitus or manual manipulation. This can be associated with either a partial or a complete urethral injury up to 39% of cases, usually those fractures crossing the septum. It is important to address both conditions to ensure sexual and voiding function is maintained.

Objective

The patient presented in this video is a 35-year-old gentleman who presented to the emergency department post-trauma related to sexual intercourse causing immediate detumescence and swelling.

Methods

This video describes the penile fracture repair performed using a midline ventral incision repair technique. Prior to surgery the patient is imaged, usually ultrasound, to allow location and marking of the suspected penile fracture. Due to the suspected urethral injury requiring a suprapubic catheter insertion at the presenting hospital, a flexible cystoscopy was performed initially. This showed the urethra was inaccessible at the level of the penile scrotal junction but within the penile urethra. A ventral midline incision along the penile raphe over the suspected fracture site is made. Dartos and Bucks Fascia were dissected to expose the tunica albuginea and allow identification of the fracture site. Further dissection was required to determine the lateral extents of the injury. Stay sutures can then be placed to allow easier closure of the injury. The tunica albuginea was then sutured with PDS sutures, care was taken to ensure these are buried sutures to ensure the patient is unable to palpate these. Subsequently, urethral injury was addressed by performing primary urethral anastomosis. A catheter was introduced through the urethra, a complete transection was seen and the ends were then dissected out to allow an end to end anastomosis to be performed. The anastomosis was checked for a leak with a table urethrogram using dilute betadine. Upon adequate closure of the urethra the ventral midline incision was closed.

Results

The procedure was successful and uneventful. He has a urethrogram 3 weeks post-op on which no evidence of a leak was shown. This patient went on to have good erectile function at 2 months post-operatively. However, he has a 30-degree ventral curvature which he finds bothersome. This is currently being treated conservatively with a vacuum device.

Conclusions

The BAUS consensus documents reports erectile dysfunction and penile curvature rates following surgery for penile fracture repair are reported to be 5% and 5% respectively. Conservative management results have a much higher rate of complication with 62% chance of erectile dysfunction and 35% chance of curvature.

Disclosure

No.
(200) Demographic, Clinical, and Socioeconomic Variables and Risk Assessment Perpetrators of Sexual Crimes in Poland
Authors: Kołomańska A
Published: March 2024

Introduction

The study of sexual recidivism has been attracting the attention of the mental health services and criminal justice system, as well as researchers. A significant problem for clinical judicial experts when issuing court opinions is assessing the risk of recidivism.

Objective

The aim of the study was to assess the demographic, clinical and socioeconomic variables of adult male sex offenders convicted of sexual crimes in Poland, as well as assessing their risk of recidivism.

Methods

The participants of the study consisted of 30 sexual offenders (66% preferential and 34% non-preferential) serving prison sentences in a dozen Polish prisons. A retrospective file review was completed for 30 medical and medicolegal files. Medical records included documentation such as psychiatric notes, psychological assessments, medicolegal assessments, and medical consultation notes. The analysis took variables including age, sex, marital status, and education. The risk of recidivism was estimated based on the participants’ files, using semi-structured interviews, and calculated using the Sex Offender Treatment Intervention and Progress Scale (SOTIPS) (McGrath, et al., 2013).

Results

Data analysis was done with Statistical Package for Social Sciences (SPSS). Participants of this study were mostly single (67%) males (100%), with an average age of 43 years (range = 24–63 years). Only 3% had completed higher education. Table 1 for a summary of the study results. Clinically, more than half of the sex offenders had a personality disorder (67%) diagnosis, with 66% of the sample diagnosed with sexual preference disorders. The Pearson correlation analysis was used to analyze the relationships between sexual preference disorders and age (r = 0,36; p < 0,05). The correlation also analysis showed that marital status was positively related to age (r = 0,34; p < 0,05). SOTIPS score was positively correlated with sexual preference disorders (r = 0,30; p < 0,05). A positive correlation, although very weak, was found between the score on the SOTIPS scale and age (r = 0,22; p < 0,05).

Conclusions

The results of the study showed that, sexual offenders are heterogeneous in terms of age. Most sex offenders (67%) have never been married before. The study also found a high proportion (64%) of sex offenders who reoffend. The larger proportion of sex offenders has sexual preference disorders. Therefore, one can conclude that sex offenders should be subject to preferential offender therapy.

Disclosure

No.
(225) Female Sexual Function During the Last Trimester of Pregnancy
Authors: Kaabia O , Toumi E
Published: March 2024

Introduction

Since antiquity and until today, sexuality remains a taboo and complex subject, often little discussed either in private circles or with healthcare professionals. Although advertising and the media sometimes use it to attract attention, sexuality is still synonymous with the unknown, raising several interrogations. These concerns are accentuated during the onset of pregnancy and all the physical, psychological, and environmental upheavals associated with this physiological state.

Objective

This study aims to assess the changes in female sexual function during the third trimester of pregnancy

Methods

It is a cross-sectional online study that took place over 5 weeks starting March 1st, 2023. All low-risk singleton third-trimester pregnant and newly delivered women enrolled in the public and private prenatal care centers of the region were contacted through the institutions’ social media groups to be recruited. The online questionnaire was a 4-item Google form elaborated in concertation with the literature and included the validated translated version of the Female Sexual Function Index (FSFI).

Results

The study included 81 married participants (8% response rate). The median age of the participants was 30,4± 6,9 years and 65,4% of them were employed when pregnant. The mean pregnancy rate per participant was 2,7± 1,9 and 90% of the pregnancies were spontaneous. When questioned about their sexual life during the 3rd trimester of pregnancy, 68% of the participants report being uncomfortable when the subject of sexuality is on the table. Most of the respondents (78%) were unsatisfied with their couple's sexuality during pregnancy. A low sexual desire was reported in 84,0%, dyspareunia in 55,6% with a decrease in lubrification in 16,0%, and orgasm disorders in 17,3%. Secondary vaginismus was described by 12,3%. Partners initiated sexual intercourse according to 72,8% of the respondent. Sexual intercourses were mutually initiated in 27,2%. Pregnant women reported a change in their sexual life during the 3rd trimester in 96,3%: the 7th month of pregnancy is associated with less frequent (70,5%) and shorter (69,2%) penetrative intercourses with lower female sexual desire (48,7%). The 8th and 9th months are associated with lower sexual desire (80,8%; 94,9%), lower sexual pleasure (75,6%; 92,3%), and less frequent orgasms (67,9%; 82,1%) and penetrative intercourses (85,9%; 93,6%).

Conclusions

Our results suggest that the third trimester in singleton low-risk pregnancies is associated with severe impairment of the female sexual function in relation to less frequent and shorter penetrative intercourses, lower desire, and pleasure associated with a general sexual unsatisfaction.

Disclosure

No.