bluuebunny/crossref_metadata_2025 huggingface dataset:
Prosecutions Across Borders
Authors: Mehta Kalika , Imani Sarah , Melchior Leokadia
Published: December 2024

The practice of universal jurisdiction (UJ), meaning the prosecutions of international crimes before national courts regardless of where the crimes took place, who committed the crimes and against whom these crimes were committed, has been facing critique and praise alike. This article analyses the practice of UJ from the perspective of the Third World Approaches to International Law (TWAIL). It has been argued that over the years, UJ practice has also reflected the double standards that characterize the practice of international criminal law (ICL) more broadly. The reasons for this are manifold. UJ, like international (criminal) law in general, comes with certain foundational challenges, systematically and substantively. On the one hand, the modern practice of ICL is often critiqued for its selective and uneven enforcement, both in international and national courtrooms. On the other hand, we encounter systemic and doctrinal obstacles to the prosecution of Western actors, including most importantly Western corporations. There are only limited grounds within the UJ system for addressing the root causes of the structural violence that inform a hegemonic ‘dynamic of difference’ between the ‘Third World’ peoples and Western states and corporations. This article explores the duality of this system and practice as it unfolds in Germany under the Code of Crimes Against International Law (‘V ölkerstrafgesetzbuch’, VStGB), using a TWAIL lens. We argue that the practice of UJ needs to be viewed in a nuanced manner: while there is a risk of furthering Eurocentrism, with Western European states selectively pursuing low- to mid-level perpetrators predominantly from countries of the so-called Global South, while Western actors enjoy impunity, this practice is also the result of mobilization and efforts of victims/non-state actors who see UJ processes as an important avenue for accountability, empowerment and agency.
Arts, cultural heritage, sciences, and micro-/bio-/technology: Impact of biomaterials and biocolorants from antiquity till today!
Authors: De Mol Maarten L , Vandamme Erick J
Published: December 2024

Nature has inspired and provided humans with ideas, concepts, and thoughts on design, art, and performance for millennia. From early societies when humankind often took shelter in caves, until today, many materials and colorants to express feelings or communicate with one another were derived from plants, animals, or microbes. In this manuscript, an overview of these natural products used in the creation of art is given, from paintings on rocks to fashionable dresses made from bacterial cellulose. Besides offering many examples of art works, the origin and application of various biomaterials and colorants are discussed. While many facets of our daily lives have changed over millennia, one certainty has been that humans have an intrinsic need to conceptualize and create to express themselves. Driven by technological advances in the past decades and in the light of global warming, new and often more sustainable materials and colorants have been discovered and implemented. The impact of art on human societies remains relevant and powerful.

One-Sentence Summary

This manuscript discusses the use of biomaterials and biocolorants in art from a historical perspective, spanning 37,000 bc until today.
Choice of law in trade secret cases: a Chinese perspective
Authors: Nanrui Chen
Published: December 2024

In consequence of the growth of global trade, cross-border protection of trade secrets is of vital importance for any business, whether to stimulate innovation or promote competition. In recent years, there has been a steady increase in the number of disputes over cross-border misappropriation of trade secrets. Given the inconsistencies in substantive laws for trade secret protection among countries, conflict of laws thus has a significant impact on the effectiveness of cross-border protection as it does affect the determination of the applicable law. With the in-depth implementation of the Belt and Road Initiative, China has stepped up efforts to enhance IP protection, with special emphasis on trade secrets. This article reviews the relevant Chinese conflict rules and their judicial application in trade secret misappropriation cases to clarify whether they are appropriate or need further improvement instead. This article holds that the relevant Chinese conflict rules and their judicial application require further improvement. First, ‘the country for which protection is sought’ is appropriate as the principal connecting factor for trade secret misappropriation, but it should be interpreted according to the factual circumstances of the case at different stages of misappropriation. Second, the parties should be allowed to choose or change any law as applicable any time before the ending of the court debate at first instance, and the court may apply public policy or mandatory rules as last resort in exceptional cases. Third, China may employ the closest connection doctrine as a supplementary rule to determine the applicable law.
Patterns of genetic variation and parentage in a population of desert kit foxes (Vulpes macrotis arsipus) in California
Authors: Honeycutt Rodney L , Monty Olivier , Vanherweg William , Randel Charles J
Published: December 2024

Kit foxes represent a small canid in semi-arid and arid regions in the southwestern United States. The San Joaquin Kit Fox (Vulpes macrotis mutica) is listed as federally endangered, and based on more recent studies, populations of the Nevada Kit Fox (V. m. nevadensis) are declining in Utah. These 2 subspecies show a loss of genetic variation in response to population declines. Various anthropogenic activities threaten kit foxes throughout other regions of their distribution, but less is known about the basic biology and genetics of other subspecies of kit foxes. Here, we used sequences from the mitochondrial cytochrome b (Cytb) gene and 12 DNA microsatellites to investigate patterns of genetic variation and test for mating fidelity in a population of the socially monogamous Desert Kit Fox, V. m. arsipus. In the current study, the mitochondrial haplotype diversity (Hd) was higher than or comparable to other canids and terrestrial mammals. The mitochondrial results also provided evidence for male-biased dispersal and female philopatry. Expected heterozygosity (He) and number of alleles per locus (Na) for the 12 microsatellite loci were higher relative to other species of foxes and canids. As seen for nearly all species of socially monogamous canids, 17% of the pups of the mated pairs of the Desert Kit Fox revealed evidence of extra-pair mating, a value like small canids. Additionally, we observed 1 case of mate switching between breeding seasons, even though the previous mate was still alive. These data suggest that long-term pair bonding may not be as extensive as once thought.
Neurological Disorders and Use of Healthcare Services After Bacterial Meningitis in Childhood: A Nationwide, Population-Based Cohort Study
Authors: Graham Emma E , Tetens Malte M , Bodilsen Jacob , Andersen Nanna S , Dessau Ram , Ellermann-Eriksen Svend , Franck Kristina , Midgley Sofie , Møller Jens Kjølseth , Nielsen Alex Christian , Nielsen Lene , Søgaard Kirstine K , Østergaard Christian , Lebech Anne-Mette , Nygaard Ulrikka , Omland Lars H , Obel Niels
Published: December 2024

In this population-based, nationwide Danish cohort study, bacterial meningitis in childhood was associated with increased neurological morbidity. The risks were highest among young children, who also received more antiepileptic medication. All children had increased frequency of hospital visits. These findings highlight the importance of follow-up after bacterial meningitis in children.
Clinical workload profile of medical physics professionals at particle therapy Centers: a National Survey in Japan
Authors: Ota Seiichi , Yasui Keisuke , Ogata Toshiyuki , Mori Yutaro , Nishio Teiji , Tohyama Naoki , Okamoto Hiroyuki , Kurooka Masahiko , Shimomura Kohei , Kojima Toru , Onishi Hiroshi
Published: December 2024

The current research on staffing models is primarily focused on conventional external photon beam therapy, which predominantly involves using linear accelerators. This emphasizes the need for comprehensive studies to understand better and define specific particle therapy facilities’ staffing requirements. In a 2022 survey of 25 particle therapy facilities in Japan with an 84% response rate, significant insights were obtained regarding workload distribution, defined as the product of personnel count and task time (person-minutes), for patient-related tasks and equipment quality assurance and quality control (QA/QC). The survey revealed that machinery QA/QC tasks were particularly demanding, with an average monthly workload of 376.9 min and weekly tasks averaging 162.1 min. In comparison, patient-related workloads focused on treatment planning, exhibiting substantial time commitments, particularly for scanning and passive scattering techniques. The average workloads for treatment planning per patient were 291.3 and 195.4 min, respectively. In addition, specific patient scenarios such as pre-treatment sedation in pediatric cases require longer durations (averaging 84.5 min), which likely include the workloads of not only the physician responsible for sedation but also the radiotherapy technology and medical physics specialists providing support during sedation and the nursing staff involved in sedation care. These findings underscore the significant time investments required for machinery QA/QC and patient-specific treatment planning in particle therapy facilities, along with the need for specialized care procedures in pediatric cases. The results of this survey also emphasized the challenges and staffing requirements to ensure QA/QC in high-precision medical environments.
Dieulafoy lesion with rare vascular complications: diagnostic and therapeutic approach
Authors: Abdoh Qusay , Samara Enas , Zayed Alaa , Khader Mohammed , Maqboul Iyad , Rashed Mohammed A M
Published: December 2024

Dieulafoy lesions are a rare cause of gastrointestinal bleeding, characterized by an enlarged submucosal blood vessel that bleeds without visible abnormalities. The diagnosis is typically made via endoscopy, and treatment usually involves endoscopic therapy. This case involves a 46-year-old female who presented with upper gastrointestinal bleeding due to a Dieulafoy’s lesion, treated with band ligation and later embolization after the lesion was found to originate from the left phrenic artery. The patient developed rare complications, including splenic infarction and pleural effusion, which required additional management. Upon initial investigations, the patients had an accidental finding on computed tomography of asymptomatic celiac artery compression that was advised to take into consideration for the possibility of developing median arcuate ligament syndrome and was treated conservatively. The case highlights the diagnostic and therapeutic challenges of Dieulafoy’s lesion and underscores the need for individualized treatment and further research.
(005) ENDOTHELIUM-DERIVED 6-NITRODOPAMINE RELAXES THE HUMAN CORPUS CAVERNOSUM
Authors: Lorenzon F , Caliani Mathias-Netto F , Placco Araujo Glina F , Glina S , Paiva O , Fregonesi A , De Miranda Cará A , Cintra Júnior W , Itocazo Rocha R , De Nucci G
Published: December 2024

Introduction

Endothelium-derived 6-nitrodopamine (6-ND) has been identified as the most potent endogenous relaxant agent in the rabbit corpus cavernosum, presenting a novel mechanism by which endothelium-derived and nitrergic NO induces corpus cavernosum relaxation.

Objective

To investigate the release and action of 6-ND in human corpus cavernosum.

Methods

Human corpus cavernosum (HCC) was obtained from 13 patients (mean age: 45 years) who had undergone male-to-female gender reassignment surgery. All the patients received antiandrogen and estrogen treatment for at least two years before surgery. One HCC was suspended in a 3-ml glass chamber containing Krebs–Henseleit solution (KHS), warmed to 37°C and oxygenated with a gas mixture of 95% O₂ and 5% CO₂, supplemented with ascorbic acid (3 mM) to prevent catecholamine oxidation. The tissues were incubated for 30 minutes with NO synthase inhibitor N(ω)-nitro-L-arginine methyl ester (L-NAME-100 μM) and the voltage-gated sodium channel blocker tetodrotoxin (TTX-1 μM). Subsequently, samples of the KHS were transferred to amber Eppendorf vials and stored at −80°C for subsequent analysis by liquid chromatography–tandem mass spectrometry (LC–MS/MS). For functional evaluation, the HCC strip (1.5 cm length) was mounted vertically in a glass chamber tissue bath containing 10 mL of KHS at 37°C, with a fine sewing thread, one end attached through a loop to a metal hook and the other end tied to an isometric force transducer. The tissues were allowed to equilibrate for 45 minutes under a resting tension of 10 mN, and the isometric tension was registered using a PowerLab system (ADInstruments). The strips were precontracted with the thromboxane A2 mimetic U-46619 (30 nM) and cumulative concentration-response curves to 6-ND (1 nM-100 μM) was performed to investigate the relaxation induced by this drug.

Results

6-ND was detected in HCC via LC–MS/MS. Incubation with L-NAME significantly decreased 6-ND levels (0.6 ± 0.2 vs 0.4 ± 0.4, ng/mL; n = 8), while incubation with TTX had no effect on 6-ND release (n = 6). In HCC pre-contracted strips, incubation with 6-ND produced concentration-dependent relaxations with pEC50 and Emax values of 7.3 ± 0.4 and 35.1 ± 14.5%, respectively (n = 5).

Conclusions

The findings establish 6-ND as a novel endogenous non-neurogenic mediator of HCC relaxation, establishing a new mechanism of action for NO in HCC relaxation.

Disclosure

No.
(018) A PILOT STUDY OF ONLINE GROUP COGNITIVE-BEHAVIORAL PSYCHOTHERAPY AND SEX EDUCATION FOR BRAZILIAN WOMEN WITH SEXUAL DYSFUNCTION OR ISSUES
Authors: Bonato F , Mussi A , Pellizzer C , Gund B , Genez L , Gobbi R , Cardoso N
Published: December 2024

Introduction

Group psychotherapy (GP) is a modality of health intervention whose benefits and effectiveness have been demonstrated in a variety of studies, but there there is still a scientific gap when it comes to online GP interventions for the treatment of female sexual dysfunctions (FSD).

Objective

This study aimed to assess the efficacy of an online group cognitive-behavioral therapy (GCBT) combined with sex education intervention for Brazilian women experiencing sexual issues or female sexual dysfunction (FSD).

Methods

Using a quasi-experimental design, a single-group pre-posttest intervention was conducted over 12 weeks. Seven women aged 25-58, reporting female sexual issues and/or FSD, participated in weekly online psychotherapy sessions. Sexual function and satisfaction were evaluated using the Female Sexual Function Index (FSFI) and Female Sexual Quotient (FSQ).

Results

Following the intervention, there was a significant improvement in overall sexual function among participants (d = 1.29). Substantial effect sizes were observed particularly in desire (d = 1.53), satisfaction measured by both FSQ (d = 1.55) and FSFI (d = 1.41), as well as arousal (d = 1.21) and lubrication (d = 1.16). Moderate effects were noted for orgasm (d = .66). However, no significant differences were found in sexual function scores when controlling for variables such as medication use, diagnoses, and occupation status. The intervention did not show efficacy in reducing pain associated with sexual activity.

Conclusions

This pilot study highlights the feasibility and effectiveness of a brief online GCBT and sex education program in improving sexual function and satisfaction among women facing sexual issues or FSD. Keywords: Cognitive Behavior Therapy; Sex Education; Sexual Health; Sexual Dysfunction; Group Psychotherapy; Online Therapy.

Disclosure

No.
(020) BRIDGING GAPS: EXPLORING SEXUAL HEALTH EDUCATION PROVISION AMONG TUNISIAN PRIMARY HEALTHCARE PROVIDERS
Authors: Makhlouf E , Kaabia O , Smaali MH , Ben Hassine SA , Cherif W
Published: December 2024

Introduction

Many studies have shown that approaching sexuality during consultations is influenced by different barriers including cultural specificities and the anxiety health professionals experience towards this sensitive topic.

Objective

Since primary healthcare encompasses a crucial preventative role, our aim was to explore the information shared with patients by physicians regarding sexual health. We examined the correlation between sexual health education provision during medical visits with the training of doctors, their perception of their training, and their attitudes toward addressing sexual health matters.

Methods

We conducted this cross-sectional study among Tunisian family medicine physicians and residents, using an anonymous online self-administered questionnaire in French.

Results

The study involved 400 participants, predominantly female (72.1%). The sample included general practitioners (40.8%), family medicine residents (38.2%), and physicians (21%). Regarding sexual health training, 55.4% of the respondents deemed their training “unsatisfactory” or “absent”. Over 85% believed the basic medical curriculum lacked knowledge for sexual history taking and ¾ felt it didn’t cover sexual dysfunctions adequately. For STIs screening and treatment, 34.7% felt their training was insufficient. Regarding patient education, 16.9% of the participants never discussed risky sexual behaviors, while a majority frequently provided information on contraceptive methods (44.4% “often,” 14.1% “always”) as well as STIs protective measures (40%). As shown by the graph below, over 36% never provided information concerning sexual well-being to their patients. Regarding general sexual and reproductive health services, 40.8% never provided information. When it comes to sexual violence, the majority reported providing information infrequently or never (34.1%). Statistically significant relationships were found between receiving sexual health training as well as having a positive perception of sexual health training and skills and a higher provision of educational information (p < 0.05).

Conclusions

Our study highlights gaps in sexual health training and information provision among Tunisian family physicians and residents. Discussions about sexual well-being, violence and reproductive health services remain rare. Our results advocate for improvements in sexual health training and capacitation of primary healthcare professionals in order to enhance the quality of sexual healthcare in Tunisia.

Disclosure

No.
(026) PENILE REHABILITATION AFTER RADICAL PROSTATECTOMY USING LOW-INTENSITY SHOCKWAVE THERAPY FOR ERECTILE FUNCTION: LATE RESULTS FINDINGS FROM A RANDOMIZED CLINICAL TRIAL
Authors: Lessa P , Seligra Lopes L , Salles M , Cordeiro R , Pazeto C , Baccaglini W , Glina S
Published: December 2024

Introduction

There is still few evidence to support the use of low-intensity extracorporeal shockwave therapy (LiESWT) in the management of erectile dysfunction (ED) after radical prostatectomy (RP).

Objective

The aim of this study is to assess the long-term results of LiWEST as a penile rehabilitation method in patients who underwent RP.

Methods

This is an assessment of the late results outcomes of our previous clinical trial registered in ReBEC (ensaiosclinicos.gov.br) RBR-85HGCG. Patients were randomized in two groups with 2 parallel arms and an allocation ratio of 1:1. The control group received tadalafil 5 mg/day, while the experimental group were submitted to tadalafil 5 mg/day plus 2400 shocks/session-week distributed on 4 different penile regions across 8 weeks of treatment. Both groups started the penile rehabilitation after the removal of the transurethral catheter. Sexual function was assessed by IIEF-5 score.

Results

Among 77 patients included in our previous analysis, 35 patients were reassessed after a median follow-up of 45 months (42-50 months; CI 95%). 17 of them had to be excluded from the analysis for biochemical recurrence and/or new interventions. Remaining 7 and 11 patients in the experimental and control group, respectively. The final mean IIEF-5 score between experimental and control groups showed a difference in favor of the LiWEST group, not statistics significantly (18.85, SD 5.66, 95% CI 13.61-24.1 x 16.63, SD 5.48, 95%CI 12.9-20.31; respectively; p = 0.42). Subgroup analysis in patients still using IPDE5 there is a higher difference between mean IIEF5, however not statistics significantly (18.5, SD 6.12, 95%CI 12.07-24.92 x 15.85, SD 3.62, 95% CI 12.50-19.20; p = 0.35).

Conclusions

LiESWT showed a slight benefit on sexual function rehabilitation in patients submitted to RP after a long-term evaluation in the sexually active subgroup which uses daily IPDE5. A larger sample is necessary in further trials to evaluate these results.

Disclosure

No.
(032) ENHANCING THE THERAPY JOURNEY: INTEGRATING AI INTO SEXUAL DYSFUNCTION TREATMENT AT QUAREB
Authors: Issa M
Published: December 2024

Introduction

In the evolving landscape of psychosexual therapy, Artificial Intelligence (AI) offers unprecedented opportunities to enhance therapeutic outcomes. Utilizing AI, a pioneering online platform has transformed the therapy journey for clients experiencing sexual dysfunctions, optimizing interactions between clients, therapists, and therapeutic mediums.

Objective

To demonstrate how AI integration into a psychosexual therapy platform enhances the efficacy of treatments, reduces therapy duration, and supports therapists in clinical decision-making, ultimately improving patient and therapist experiences.

Methods

The platform employs AI in several key areas: 1. Client Interface: AI-driven self-assessment tools help clients understand their sexual dysfunctions before and during the therapy process. AI also generates personalized questions to encourage deeper exploration of their issues. 2. Therapist Support: AI aids therapists by suggesting targeted questions, selecting appropriate interventions, and recommending laboratory investigations based on AI analysis of client data. 3. Medium Analysis: The platform analyzes therapy sessions in real-time, providing therapists with feedback and suggesting effective tools and interventions based on the conversation’s context and progress. Data was collected on therapy outcome efficacy, session duration, client satisfaction, and therapist feedback regarding AI utility.

Results

Clients reported a faster understanding of their sexual issues, reflected by a reduced average number of sessions needed to reach significant therapeutic milestones. Therapists noted improved clinical outcomes due to AI-assisted personalization of therapy approaches and more precise diagnostic support. The medium’s ability to analyze and adapt therapy flows in real-time was found to significantly contribute to the overall effectiveness of sessions.

Conclusions

While human intervention remains irreplaceable in therapy, AI significantly enhances both the patient and therapist experience, making psychosexual therapy more efficient and tailored. The integration of AI into sexual dysfunction therapy not only facilitates a deeper understanding of complex sexual health issues but also streamlines the therapeutic process, ensuring that treatments are more accessible, timely, and effective. Future initiatives will focus on expanding AI capabilities to encompass a broader range of psychosexual disorders and integrating more comprehensive diagnostic tools. This abstract aims to clearly highlight the multifaceted benefits of AI in enhancing the therapeutic journey, based on the practical experiences from Quareb.

Disclosure

No.
(033) UTILIZING ARTIFICIAL INTELLIGENCE TO SUPPORT MEN WITH ERECTILE DYSFUNCTION: A NOVEL MOBILE APPLICATION APPROACH
Authors: Batandjiovski S
Published: December 2024

Introduction

Erectile dysfunction (ED) poses significant challenges to men’s physical and emotional wellbeing, with prevalence increasing with age, affecting approximately 50% of men aged 40 to 70 years. Various factors such as lifestyle habits, medical conditions, and psychological factors influence ED severity, highlighting the need for personalised interventions.

Objectives

This abstract proposes the development of a innovative mobile application leveraging artificial intelligence (AI) to provide comprehensive support for individuals suffering from ED, targeting improved treatment adherence, symptom management, and quality of life enhancement. By integrating parameters such as International Index of Erectile Function (IIEF-5) score, BMI index, activity and exercise levels, calorie intake, smoking status, medications, history of previous surgeries, and current medical conditions, the app aims to offer tailored recommendations to individual needs and circumstances.

Methods

The proposed app will use AI algorithms to analyse self reported user data, including the aforementioned parameters, alongside medical history, lifestyle factors, and psychological aspects, to offer personalised recommendations and interventions. Data input mechanisms will be user-friendly and intuitive, facilitating smooth integration of relevant information into the app’s algorithms. Key features of the application may include discreet symptom tracking, medication reminders (with dosages adjusted based on individual responses and side effects), lifestyle modification suggestions tailored to user preferences and goals, and access to expert advice through teleconsultation services, with specialists in urology and sexual health. The app will prioritize user privacy and confidentiality, adhering to stringent data protection protocols compliant with healthcare regulations such as HIPAA and GDPR, ensuring the security of sensitive information and maintaining anonymity during interactions with healthcare providers.

Results

The results of the preliminary testing of the mobile application will be showen here after the investigation and feedback is received.

Conclusions

This innovative approach holds promise in enhancing accessibility to comprehensive support for men with ED, empowering them to take proactive steps towards improving their sexual health and overall quality of life. By using AI and integrating diverse parameters, the app not only addresses the complex nature of ED but also facilitates personalised care and treatment optimisation, ultimately improving patient outcomes and satisfaction.

Disclosure

No.
(037) ULTRASOUND EVALUATION OUTCOMES OF THE CORPUS CAVERNOSUM IN THE GLANS: A CROSS-SECTION STUDY
Authors: Cavalcanti Filho M , Monteiro L , Fernandes G , Lemos C
Published: December 2024

Introduction

The penile Doppler ultrasound is a versatile diagnostic tool that allows for a detailed assessment of penile anatomy and hemodynamic variables. The ability to measure the length of the cavernous body that extends into the glans adds an additional dimension to the evaluation, potentially improving the clinical management of men with sexual dysfunction.

Objective

Our objective was to estimate the length of the corpus cavernosum extending into the gland using penile Doppler ultrasound.

Methods

A cross-sectional study was conducted using a penile Doppler ultrasound examination, performed by an experienced urologist, with a high-frequency linear transducer, in a standardized manner as described by Carneiro et al., 2020. To measure the shape of the corpus cavernosum in the intraglandular section, the transducer was placed in the longitudinal coronal groove topography as shown in the attached image 1. All statistical and graphical analyzes presented in this study were performed using RStudio.

Results

From January to April 2024, a total of 170 men were subjected to Doppler ultrasound examinations. The clinical data for the sample revealed an average age of 57.89 years, an average weight of 85.88 kg, an average height of 1.76 m, and an average Body Mass Index (BMI) of 27.61. The reasons for the exams were based on the medical diagnosis of Erectile Dysfunction, Peyronie’s Disease, or both. The clinical data were stratified based on the reason for the examination, and the results of the hypothesis tests demonstrated no differences between the groups. Findings for the corpus cavernosum in the glans revealed a range of values from a minimum of 0.53 cm to a maximum of 2.04 cm, with a mean measurement of 1.40 cm. The first quartile was observed at 1.10 cm, the median at 1.40 cm, and the third quartile at 1.70 cm. Upon scrutiny of the boxplot (image 2), the lack of marked outliers suggests that the entirety of the data adheres to an acceptable range. When evaluating the association with the chi-square test between cavernous length in the glans between three groups (Erectile Dysfunction, Peyronie’s Disease or both) there was no significant difference between the groups (p = 0.768). Pertaining to the dimensions of the penis, the average measurement of the stretched penis was found to be 13.04 cm, while the erect penis exhibited an average length of 12.48 cm.

Conclusions

In this pilot study, it could be suggested that Doppler ultrasonography may be a method for measuring the corpus cavernosum in the glans, and subsequently, for computing the average of this measurement. This approach might be worth considering in future studies.

Disclosure

No.
(041) PREVALENCE OF FEMALE SEXUAL DYSFUNCTION (FSD) IN THE FIRST FEMALE SEXUALITY CLINIC IN CHINA BY USING THE DR. EROS FSD SCALE
Authors: Jannini E , Yu Z , Li Z , Sun F , Colonnello E , Sansone A
Published: December 2024

Introduction

Female sexual dysfunctions (FSDs) represent a common issue among the general population. However, in many cultures and societies, such as China, FSD still needs to be addressed in the urological setting, so far more focused on Andrology. However, FSDs can be easily investigated in clinical practice, and for research purposes using validated psychometric tools, including the Female Sexual Function Index (FSFI), the most commonly used diagnostic instrument, also validated in Mandarin. While the scientific interest in this field is growing, several issues remain unaddressed by the FSFI, such as orgasmic intensity or satisfaction associated with the frequency of sex. The Dr. Eros FSD scale aims to fill this gap.

Objective

We aimed to explore FSDs in the general population in order to address the unmet expectations and needs of Chinese women in China.

Methods

In our Clinic, the first established in China aiming to treat FSDs, we developed a modified version of the FSFI, which also focuses on sex frequency, sexual urges, satisfaction related to orgasm and sexual activity, and vaginal discomfort during sexual activity. These 5 questions were added to the 19 items of the FSFI, for 24 questions. The two questions on sex frequency and sexual urges were added to the desire domain of the FSFI, whereas the following three were included in the Orgasm, Satisfaction, and Pain domains, respectively.

Results

The Dr. Eros FSD scale was administered to 14 896 women (age: 36.2 ± 8.1 years, range 18-18) admitted to the outpatient service of our Clinic, from March 2020 to May 2024. Mean ± SD for the 6 domains were as follows: Desire, 12.9 ± 3.2; Arousal, 12.8 ± 5.4; Lubrication, 15.6 ± 5.9; Orgasm, 13.2 ± 5.7; Satisfaction, 13.8 ± 4.4; Pain, 14.0 ± 5.06. Since a lower score is suggestive of increased severity of SDs, the most severe female sexual complaints in China are seemingly hypoactive sexual desire disorder and poor overall satisfaction, in an age-dependent manner. Regression analysis showed a significant effect of aging on all six domains (p < 0.001 for all, fig. 1) when stratifying the population by age (age < 45, N = 12 666; age 45-55, N = 1924, age ≥ 55, N = 306).

Conclusions

The new Clinic, dealing with all FSDs, from HSSD to hypolubrication, from anorgasmia to vaginismus, from dyspareunia to couple’s problems, is the unique institution systematically addressing female sexual health in China. Our experimental data demonstrate that this is a major unmet need in this part of the world. The prevalence and severity of SDs among Chinese women are clinically relevant issues for healthcare, which should urgently be addressed with the instruments of modern Sexual Medicine, possibly involving both Western and traditional Chinese medicine (TCM) in a holistic perspective.

Disclosure

Any of the authors act as a consultant, employee or shareholder of an industry for: Mia Clinic.
(049) THE RITE OF TASFIH IN TUNISIA
Authors: Kaabia O , Gharbi I , Smaali H , Guefrech O , Maya Bahri Y
Published: December 2024

Introduction

Tasfih is a magical practice exercised by an old woman on girls before puberty, in some North African countries to prevent any pre-marital vaginal penetration. In doing so, it is believed that the hymen becomes unbreachable. It is a taboo practice that is frequently reported as a cause of vaginismus.

Objective

The primary aim of this study is to assess the prevalence of the rite of Tasfih among young Tunisian women. The secondary objective is to evaluate the epidemiological profile of this rite’s victims.

Methods

This is a cross-sectional study including Tunisian women aged between 18 and 45. The study was conducted through an online self-administered questionnaire to provide a nuanced analysis of the topic through the collection of both quantitative and qualitative data from the participants. It was conducted over a 5-week period, by sharing the questionnaire on social media platforms.

Results

This study included 1207 women. The prevalence of the rite of Tasfih was 8.62%. The mean age among the victims of the rite of Tasfih was 28.66 +/−6.04 years. Among the women who self-reported Tasfih, 71% went to university, 94% came from a conservative family, 22% had rural origins, and 26% were unemployed at the time of the study. A history of physical abuse was reported in 30% and sexual harassment in 63%. Regarding their medical history, 26% were smokers, 12.5% had a mental health history, 41% reported a history of vaginismus and 38% had at least one child.

Conclusions

The prevalence of the magic rite of Tasfih among young adult Tunisian women is 8.62%. It is associated with a conservative family but is not limited to rural origins. Participants who self-reported Tasfih also reported high rates of vaginismus, physical abuse, and sexual harassment.

Disclosure

No.
(052) APPLICATION AND VALIDATION IN SPANISH OF THE “VULVAR PAIN SCREENING QUESTIONNAIRE” IN WOMEN WITH CHRONIC VULVAR PAIN
Authors: Valente S , Gomez Cherey F , Bolognessi V , Soloa P , Maldonado V , Ortiz J
Published: December 2024

Introduction

Persistent vulvar pain without a clearly identifiable cause has a prevalence of 8-21%. However, many patients have difficulty obtaining a diagnosis. It is known that multiple factors participate in the painful process. In order to speed up treatment arrival, it is essential to have an effective tool to be able to evaluate and make a diagnosis by health professionals. The VPA-Q Questionnaire (Vulvar Pain Assessment Questionnaire) was developed in Canada to contribute to the evaluation and diagnosis of chronic vulvar pain, considering an altered subscale, an average value ≥2.

Objective

This study sought to adapt and validate the VPA-Q to a population of Argentine women.

Methods

The translation and cross-cultural adaptation was carried out according to the Principles of Good Practice for the Translation and Cultural Adaptation Process for Patient-Reported Outcomes (PRO) Measures guidelines. Once approved, validation was carried out in Argentina in a cohort of patients. 184 women were recruited and completed the FSFI (Female Sexual Function Index) questionnaire. 65 women presented the altered pain domain and were included in the study to complete the VPAQ-full (63 items). Statistical analysis: Epidemiological analysis of population variables was performed, internal consistency with Cronbach’s alpha in each subscale, a value >0.8 and p < 0.05 were considered significant.

Results

The average age was 53.1 (± 11.2) years, 90.8% were Argentine, 66.2% were married, 81.5% were menopausal. The predominant associated symptom was vaginal dryness (83.1%). 33.8% never looked at their vulva. 44.6% had pain for 2-5 years. 66.2% presented pain during sexual activity, 40% did not tolerate the entry of any object into the vulva. The reliability analyzes of the subscales were: Pain Severity (mean: 2.72; Cronbach’s α: 0.94), Emotional Response (mean: 1.78; Cronbach’s α: 0.96), Cognitive Response (mean: 1.17; Cronbach’s α: 0.89), Interference in life (mean: 1.04; Cronbach’s α: 0.95), Interference in sexual life (mean: 2.02; Cronbach’s α: 0.9), Interference in self-stimulation (mean: 1.03; Cronbach’s α: 0.86).

Conclusions

Exploratory and confirmatory factor analyzes demonstrated that the adapted version of the VPAQ-full, into Spanish, satisfactorily meets the validation requirements. Measuring and understanding vulvar pain and its impact on sexual, emotional and cognitive health is key to evaluating the sexual health and quality of life of women and their relationships.

Disclosure

No.
(053) SOCIOSEXUAL SKILLS INVENTORY: CONFIRMATORY FACTOR ANALYSIS INTRODUCTION
Authors: Soares Alves Mendes V , Benevides Soares A
Published: December 2024

Introduction

Casual sexual relationships can be a way to achieve sexual pleasure without the need to establish bonds or succumb to pressures typical of a romantic relationship. However, despite the erotic satisfaction obtained, Casual Sex (CS) is associated with sexual risks such as sexually transmitted infections, abuse, harassment, unwanted pregnancy, and regret. In this regard, the scientific literature explicates that Social Skills (SS) are associated with promoting sexual health and preventing problems such as those aforementioned. Thus, the acquisition of SS can function as protection in CS contexts, contributing to self-protection and better performance. Consequently, in a previous study, the Sociosexual Skills Inventory (SSSI) was developed, a psychological assessment instrument that identifies SS in the context of seeking CS. The instrument has two factors that reveal direct and indirect approaches.

Objective

To confirm the internal structure and seek new validity indicators for the SSSI.

Methods

374 young adults aged 18 to 29 (M = 23.37 and SD = 2.79) participated. The SSSI, the Love Styles Inventory (LSI), and the Condom Use Self-Efficacy Scale (CUSES) were administered. Confirmatory Factor Analysis (CFA) was conducted using JASP 0.16.2 software, and correlation analyses between the instruments were performed. All participants signed the Informed Consent Form, and the project was approved by the Research Ethics Committee.

Results

Two different models were tested through CFA, one with 18 items (as per the original instrument) (χ2: 269.204; df: 134; χ2/df: 2.01; TFI: 0.966; TLI: 0.961; RMSEA: 0.052) and the other with the suppression of items 8 and 10 (factor loadings of 0.34 and 0.17 respectively), with 16 items (χ2: 194.567; df: 103; χ2/df: 1.89; TFI: 0.976; TLI: 0.971; RMSEA: 0.049). The second was considered more suitable for excluding two items with loadings below 0.40, presenting better fit indices, and being theoretically more coherent. The final 16-item model maintained the two-factor structure: 1) Direct Sociosexual Skills (DSSS) (α = 0.81; ω = 0.82) and 2) Indirect Sociosexual Skills (ISSS) (α = 0.78; ω = 0.79). Regarding Pearson Correlation analysis, DSSS correlated with the Skill (0.18) and Assertiveness (0.20) dimensions of CUSES and with the Direct (0.65) and Subtle (0.53) styles of LSI; whereas ISSS correlated with Skill (0.15), STI (-0.12), and Assertiveness (0.23) dimensions of CUSES and Direct (0.52) and Subtle (0.65) Love Styles.

Conclusions

It was possible to verify that the SSSI remains with the internal factorial structure almost unchanged and with more validity indicators. Thus, it is noted that the instrument can be used by psychologists and researchers to evaluate the repertoire of SS for approaches in favor of CS, as well as possible behavioral problems that may contribute to sexual risks and the approach style employed in these contexts.

Disclosure

No.
(055) MANAGING PROXIMAL CORPORAL PERFORATION DURING PENILE IMPLANT SURGERY USING RE-DILATATION ONLY: DEMONSTRATING A CASE OF INFRAPUBLIC APPROACH
Authors: Slovacek H , Mahdi M , Albakr A , Wang R
Published: December 2024

Introduction

Many options have been described for the surgical management of proximal corporal perforation during penile implant surgery with the intent to prevent the risk of cylinder migration and device failure. These methods include the historical formal corporal repair, windsock technique using non-absorbable grafts, absorbable mesh plugs/patch, and fixation of the rear tip extender or shod material covering implant tubing by sutures.

Objective

We aim to demonstrate by video our simple technique in the management of proximal corporal perforation using only re dilatation into the normal proper tract without the need of corporal repair or cylinder fixation.

Methods

We are demonstrating by video and graphs a case of 69-year-old gentleman undergoing penile implant procedure using infra pubic approach. The patient presented for the surgery after he failed the medical treatment for erectile dysfunction. He was known to have controlled diabetes and a past surgical history of bilateral hernia repair and Robotic assisted radical prostatectomy. We prefer the infra pubic approach for patient with bilateral hernia repair as infra pubic incision allows inserting the reservoir under direct vision into the sub muscular space. During the procedure, while trying to overcome the right corporal fibrosis, proximal perforation occurred. The perforation seemed to be on the medial side of the corpora. It was managed by re dilatation of the proximal corpora into a new tract starting from the corporotomy site away from the initial tract, following a more lateral direction up to the most proximal part of the corpora at the pubic bone. Sequential dilatation using up to size 13 Brooks dilator was done. Following that, the cylinders were inserted and confirmed to be in the proper position after full inflation.

Results

The patient recovered well and was able to use the device after 6 weeks. During the follow up period up to 6 months there was no reported cylinder migration or other device related complications. We have used the demonstrated technique in many patients, with favorable outcome.

Conclusions

Managing proximal corporal perforation during penile implant surgery using re dilatation of a new proper tract is an effective technique. It is less time and cost consuming than the reported methods. Further studies are needed to support the efficacy of using this technique.

Disclosure

No.
(058) CAVERNOSAL BANDING: A NEW PROCEDURE TO ADDRESS SIGNIFICANT WEAKENING OF ALBUGINEA IN COMPLEX PENILE PROSTHESIS SURGERY: A PROOF-OF-CONCEPT CASE WITH A FOLLOW-UP OF 2 YEARS
Authors: Pescatori E , Loreto A
Published: December 2024

Introduction

In cases of penile prosthesis redo-surgery the finding of albuginea weakening may represent a challenging issue to deal with.

Objective

We present an original technique to address weakening of albuginea in patients with inflatable penile prostheses.

Methods

A 52 y.o. white male with four former implant surgeries (penoscrotal) reported that upon activation no erection developed, while the scrotum enlarged. In the latest surgery initial weakening of albuginea was reinforced with absorbable collagen fibrin sealant patches. MRI disclosed bilateral cylinders herniation at the site of former corporotomies. Surgical procedure. Penoscrotal approach: in the herniation area there was bilaterally a wide albuginea defect. In the involved area we circumferentially isolated the albuginea dorsally from Buck’s fascia, inclusive of the neurovascular bundle, and ventrally from urethra. We developed some tissue planes to cover the albuginea defect. The old device was removed and replaced with a new AMS 700CX. We measured: circumference of isolated corpora in tumescence state (12 cm), and distance between the limits of the two isolated circumferences -proximal and distal- (5 cm). A 12x5 cm rectangle of bovine pericardium was fashioned. CAVERNOSAL BANDING was achieved transferring the fashioned rectangle patch around the isolated albuginea of the two corpora cavernosa. The two short sides were sutured together and to the ventral albuginea, beneath the urethra, and anchoring stitches fixed the patch to the albuginea, to keep it flat (figure). Patient had to daily cycle the device for three months, not exceeding the tumescence status, to allow a sound remodelling process of the graft.

Results

At 3 months: MRI: normal appearance of the inflated cylinders, without bulging; IIEF score = 24; QoLSPP scores: 25 - functional domain, 15 - social domain, 19 - relational domain, 18 - personal domain. At 2 years from surgery patient is having regular sexual intercourse without any clinical evidence of bulging, with high satisfaction.

Conclusions

The outcomes of this first case suggest that CAVERNOSAL BANDING with bovine pericardium is a working solution for challenging cases of albuginea weakening/loss in patients with penile prosthesis.

Disclosure

No.
(060) THE NO-TOUCH TECHNIQUE FOR PENILE PROSTHESIS IMPLANTATION
Authors: Feghali J , Meilika K , Eid J
Published: December 2024

Introduction

The No-Touch Technique, a surgical approach to penile prosthesis implantation, was developed by Dr. J. Francois Eid in 2005. Its primary goal is to reduce the risk of bacterial contamination of the prosthesis during penile implant surgery.

Objective

This video presents the step-by-step details of the technique, showcasing the precision and care taken to ensure proper isolation of the device from the patient’s skin.

Methods

The video, filmed with a special high-definition camera, guides viewers through the entire process of the “No-Touch Technique” for a three-piece penile implant. It begins with the preparation of the surgical field, followed by detailed procedural steps. These steps include the use of a sterile fluoroscopy transparent drape, which prevents direct skin contact with the implant, as well as the use of gloves and instruments. The technique allows for surgical manipulation of the penis and scrotum while maintaining isolation. Additionally, the method emphasizes minimal dissection, small corporotomies, and hemostatic closure of the tunica albuginea combined with intracorporal injection of a hemostatic agent. These maneuvers are critical in preventing infection and render the placement of a drain unnecessary.

Results

Data collected since 2006, based on nearly 5000 consecutive implants, validates the effectiveness of the No-Touch Technique that was shown in this detailed video. The infection rate remains remarkably low at 0.7%, supporting the theory that isolation from skin significantly reduces the risk of postoperative infections.

Conclusions

Through this visual presentation, the “No-Touch Technique” is demystified, providing a clear and comprehensive understanding of this best practice in penile prosthesis surgery. The video serves as an invaluable resource for urologists and surgical teams worldwide, promoting a safer surgical environment and improved patient outcomes.

Disclosure

Any of the authors act as a consultant, employee or shareholder of an industry for: Dr J. Francois Eid (consultant for Coloplast, Boston, Rigicon).