bluuebunny/crossref_metadata_2025 huggingface dataset:
(203) A NOVEL METHOD USING MRI FOR PREOPERATIVE PENILE IMPLANT SIZE PREDICTION: A CASE SERIES
Authors: Nabil M , Ragheb A , Elbatanouny A , Badawy H , Nabil N , Emad M , Youssef M , Elmarakby A , A shaker H
Published: December 2024

Introduction

Penile prosthesis implantation (PPI) is the main treatment for patients with organic factor-related erectile dysfunction (ED) who did not respond to other treatments. Traditionally, diverse intraoperative techniques are used to determine penile implant size.

Objective

This case series aimed to evaluate the efficacy of a novel method for preoperative penile implant size prediction using magnetic resonance imaging (MRI).

Methods

Thirteen Egyptian patients with refractory ED who underwent PPI were examined. Prior to surgery, a biparametric MRI of the penis was performed to measure the length of the right and left corpora cavernosum before and after prostaglandin injection. Then, during surgery, the measurements were repeated to check the accuracy of the preoperative results.

Results

Thirteen patients with mean age of 48.69 ± 10.19 years suffering from refractory ED were included in our series. They underwent implant surgery, five of them with inflatable (infla 10®) implant, four with malleable (tactra®), and four with malleable (rigi 10®). ANOVA test showed that there was statistically significant difference between MRI length measurements before and after prostaglandin injection in the length of both the right (mean = 192.308, VS 154.615, p = 0.011) and left corpora cavernosum (mean = 192.477 VS 164.938, p = 0.001). After prostaglandin injection, ANOVA test showed that there was not a statistically significant difference between MRI length measurement and in operative length measurement in the length of both the right (mean = 192.308, VS 187.769, p = 0.526) and left corpus cavernosum (mean = 192.477, VS 187.769, p = 0.522).

Conclusions

No difference was detected between MRI measurements taken before operation and the measurements taken during the operation of the length of the right and left corpora cavernosum, which shows the ability of MRI to predict the length that can be reached after implantation which could be beneficial in patient’s counselling.

Disclosure

No.
(204) PSYCHOMETRIC PROPERTIES OF THE COMPULSIVE SEXUAL BEHAVIOR INVENTORY (CBSI-13) BRAZILIAN ADAPTATION
Authors: Finotelli Junior I
Published: December 2024

Introduction

The Compulsive Sexual Behavior Inventory is a scale for use in individuals suffering from problems associated with excessive, impulsive, compulsive, and/or out-of-control sexual behavior. The inventory is recognized for its psychometric capabilities and has cutoff points capable of discriminating individuals with sexual compulsivity issues. Only the 22-item version translated into Brazilian Portuguese was investigated and validated.

Objective

The purpose of this study is to investigate the psychometric characteristics of the 13-item Brazilian-adapted version.

Methods

The data were gathered from archived records of a sexually specialized clinic in Brazil. A total of 225 CSBI-13 applications were identified (cis_male = 142; cis_female = 83; age_mean = 40.11; age_SD = 13.47). Complaints about sexual control concerns were reported by 31% of those surveyed. Confirmatory factor analysis using weighted-least-squares and variance, internal consistency assessment (Cronbach’s alpha coefficient), and t-test were among the analyses performed.

Results

A single-factor model with 13 items was validated, and the fit indices were satisfactory (x2(63) = 39.25; x2/df = .62; CFI = 1.00; TLI = 1.07; RMSEA (90% CI) = .00[.00-.01]; SRMR = .05). Strong internal consistency was estimated. Only the items “felt emotionally distant” and “caused financial problems” had lower factor loadings, whereas the majority loaded <.70. Modification indices suggested proximity between “trouble controlling sexual urges” and “unable to control sexual behavior”, as well “felt guilty or shamed” and “concealed or hidden”. Individuals who reported sexual control concerns scored higher on the total score and eight inventory items.

Conclusions

The findings suggested two evidences of validity for the CSBI-13 Brazilian-adapted version. The 13-item unidimensional model fit the data best, corresponding to the original validation. Score differences showed the instrument’s ability to identify sexual control concerns. The modification items suggested well-known divergences that have been discussed in this field of research.

Disclosure

No.
(206) EXPLORING THE IMPACT OF VARICOCELE ON PROSTATE CANCER PATIENTS: A PROPENSITY-SCORE MATCHED ANALYSIS USING GLOBAL REAL-WORLD DATA
Authors: Hammad MAM , Miller J , Abou Chawareb E , Gryzinski G , Ahlering TE , Yafi FA
Published: December 2024

Introduction

Varicocele is the most common cause of male infertility. Emerging evidence has raised questions about a potential association between infertility and aggressive prostate cancer (PCa).

Objective

Our aim was to investigate whether having a varicocele affects PCa.

Methods

We queried the TriNetX database with access to electronic medical records from 108 partner healthcare organizations worldwide, covering over 129 million patients. We focused on adult males with prostate cancer between 2003 and 2023. Scrotal varices (ICD-10-CM: I86.1) were used to identify varicocele, while prostate cancer patients were identified by ICD-10-CM: C61 codes. We compared the baseline characteristics of PCa patients with and without varicocele, including erectile dysfunction (ED) (ICD-10-CM: N52) and “rising PSA level following PCa treatment” (coded as R97.21). We adjusted for age, BMI, diabetes mellitus, hypertensive diseases, total and free serum/plasma PSA levels, and Gleason score through logistic regression with a 1:1 propensity score matching (PSM). Calculated risk ratios (RR) and Kaplan Meier survival (KM) were calculated after PSM.

Results

Following PSM, 3809 PCa patients were divided into two groups, with an average age of 66.9 +/−10.6 years. Of the varicocele group, 50.97% were coded for “elevated PSA levels”, compared to 33.87% in the non-varicocele group, (p = < 0.001). Additionally, 33.89% of the varicocele group experienced ED, compared to 11.84% in the non-varicocele group, (p = < 0.001). Rising PSA level following PCa treatment was observed in 1.60% of the varicocele group, significantly higher than the non-varicocele group at 0.53%, (p = <0.001). Varicocele patients also exhibited a significantly higher rate of PCa screening, biopsy, and ultrasound-guided needle placement. On KM 5-year survival analysis for ED, patients without varicocele had 78.04% survival probability compared to 70.96% for patients with varicocele, (p = < 0.001).

Conclusions

Our study suggests a potential hypothetical association between varicocele and adverse outcomes in prostate cancer patients, including elevated PSA, ED, and rising PSA after PCa treatment. Further research is warranted to understand the clinical implications of this association and determine the usefulness of varicocelectomy on PCa outcomes.

Disclosure

Any of the authors act as a consultant, employee or shareholder of an industry for: Coloplast, Clarus Therapeutics, Antares Pharma, Acerus.
(209) IT CAN ONLY GET WORSE: AN ANALYSIS OF FACTORS IMPACTING ONLINE PHYSICIAN REVIEWS
Authors: Miller J , Ahmed Z , Gryzinski G , Hammad M , Chawareb E , Yafi F
Published: December 2024

Introduction

Physician review websites offer patients insight to their potential care teams when seeking a new provider. A firm understanding of the factors which patients deem important when assigning these ratings may allow sexual medicine providers an opportunity to improve patient satisfaction.

Objective

To analyze the impact of commonly cited positive and negative qualities of a sexual medicine providers’ practice on online provider ratings.

Methods

Online ratings and reviews through Healthgrade.com and Vitals.com were collected for all physicians listed in the SMSNA Healthcare Provider Directory. Physicians were included if they had received more than 10 ratings and 5 written reviews. The frequency for which specific positive and negative descriptors were included in written reviews was compared to a provider’s average online rating using Wilcoxon-Mann–Whitney tests and non-parametric correlation. Factors which were significantly associated with changes in average ratings were then tested using multiple regression.

Results

Of 331 SMSNA providers, 145 (43.8%) met the inclusion criteria, including 129 male and 16 female providers, receiving an average of 57.0 ratings and 22.6 written reviews each. The average rating was 3.96/5. Factors significantly associated with worsened online ratings included physicians appearing rude or uncaring (-47.0%, p = 0.013), poor clinic staff or nurse quality (-39.2%, p = 0.000), lack of email or phone availability (-37.2%, p = 0.001), poor facilities appearance (-29.5%, p = 0.045), and complications following procedures (-22.7%, p = 0.028). No factors were significantly associated with improved rating scores (Table 1).

Conclusions

Physicians can gain insight to the patient perspective through a careful review of common trends in online physician reviews. On an analysis of reviews for SMSNA providers, multiple factors which remain in the provider’s control, including appearing caring to patients, quality of clinic staff or nurses, and availability by phone or email, appeared to significantly impact online ratings. By focusing on these factors, sexual medicine providers may be able to maintain positive online reviews while offsetting the impact of factors which may remain outside of their control, including the quality of clinic or hospital facilities and complications following procedures. Despite frequent emphasis, wait times and cost of care did not appear to impact overall ratings.

Disclosure

Any of the authors act as a consultant, employee or shareholder of an industry for: Coloplast.
(210) IMPACT OF DIET AND FLUID INTAKE ON ERECTILE FUNCTION: A QUESTIONNAIRE-BASED ANALYSIS
Authors: Abou Chawareb E , Hammad M , Lumbiganon S , Azad B , Yafi N , Osman M , Yafi F
Published: December 2024

Introduction

Erectile Dysfunction (ED), a prevalent and distressing condition affecting men globally, has a multifactorial etiology.

Objective

To investigate the potential role of diet and fluid intake on development and severity of ED.

Methods

Retrospective chart review of a prospectively collected database was performed for patients presenting to our Men’s Health clinic at a single academic institution between July 2018 and March 2020. Demographics, SHIM (Sexual Health Inventory for Men) and ADAM (Androgen Deficiency in Aging Males) questionnaire scores, dietary patterns, fluid consumption habits. Were documented. Patients were categorized into two groups based on their ED status determined by questionnaire scores, and comparisons were made regarding demographics, dietary preferences, and fluid intake.

Results

The study included 618 males, of which 513 (83%) had ED, and 105 (17%) had a normal erectile function. As expected, patients with ED were older, diabetic and hypertensive, p < 0.05. Paleo diet (p 0.030) and organic food consumption (p 0.011) were associated with a lower risk of ED, while consumption of artificial sugary drinks was linked to a higher risk of ED (p 0.036). Other diets such as vegan, vegetarian, gluten-free, keto, low-fat and Mediterranean, as well as quantity of water fluid intake were not associated with ED risks. When accounting for diabetes and hypertension on multivariate analysis, none of the dietary patterns and fluid choices maintained statistical significance.

Conclusions

This study highlights the complex relationship between different factors that contribute to ED. While certain dietary and fluid preferences seemed promising based on initial analysis, their significance diminished when considering the presence of diabetes and hypertension. It is evident that diet plays a role in the development of ED, but further investigation through extensive and prospective studies is needed to gain a deeper understanding.

Disclosure

Any of the authors act as a consultant, employee or shareholder of an industry for: sprout.
(211) TRANSLATION, SEMANTIC EQUIVALENCE, AND CULTURAL ADAPTATION OF THE COMPULSIVE SEXUAL BEHAVIOR DISORDER DIAGNOSTIC INVENTORY (CSBD-DI)
Authors: Finotelli Junior I
Published: December 2024

Introduction

The Compulsive Sexual Behavior Disorder Diagnostic Inventory (CSBD-DI) was developed in response to a novel diagnosis that is both contentious and significant in that it is the first to categorize a disorder associated with excessive, impulsive, compulsive, and/or out-of-control sexual behavior. The scale has versions in four languages and demonstrates good psychometric qualities.

Objective

The study focused on CSBD-DI translation, semantic equivalence, and cultural adaptation to Brazilian Portuguese. Initial step of the Brazilian psychometric study for future studies.

Methods

The scale contains nine items and was developed to measure compulsive sexual behavior disorder (CSBD). The level of measurement of the items ranges from “being true for at least 6 months during the last 12 months” to “never being true of me”. This process was composed of eight professionals qualified for such a method and a convenience sample of 35 participants for the evaluation of intelligibility. The stages were translation, back-translation, assessment of semantic-equivalence, final review by experts, and pre-test version.

Results

Assessing semantic-equivalency showed significant agreement among judges, varying from moderate to strong. This assessment classified the translated items as unaltered or somewhat changed. The expert review met challenges when reaching agreement on descriptions related to sexual practices or behaviors. As indicated in the pre-test version application, incorporating colloquial language descriptions proved critical to the final version’s composition.

Conclusions

The findings indicated a good level of linguistic comprehension. While it was difficult to find proper vocabulary for the general comprehension of excessive, impulsive, compulsive, and/or out-of-control sexual behavior. This version kept the inventory’s name in English but added “Brazilian Adaptation” in Portuguese at the end.

Disclosure

No.
(214) MULTIPLE GRID INCISION OF TUNICA ALBUGINEA AND SEALING WITH COLLAGEN FLEECE FOR IPP, A PILOT STUDY
Authors: Moon DG , Jo SB , Ahn ST , Park MG , Hwang WK , Kim HJ
Published: December 2024

Introduction

Recently, there have been reports on partial plaque excision and grafting with collagen fleece technique for the treatment of Peyronie’s disease. Previously, the authors reported the modification of this technique as multiple grid incisions of Peyronie’s plaque due to lack of hitological evidence of new tunical regeneration from the collagen fleece graft.

Objective

In this pilot study, we assessed the feasibility of this technique to insert IPP in patients of severe corporal fibrosis from previous failed IPP or Peyronie’s disease with severe deformity.

Methods

From Aug 2018, inflatable IPP (AMS700) was inserted in a total of 9 patients, 4 patients of failed IPP and 5 patients of Peyronie’s disease with severe deformity, respectively. After dissection of the neurovascular bundle or urethra according to the location of plaque or deformity, surgical technique was composed 3 major steps; 1) multiple deep longitudinal tunical incisions over Hegar dilator to achieve enough tunical diameter for insertion of sylinder into the corpus cavernosum and correct bottle neck deformity, 2) multiple transverse incision of tunica to correct penile curvature and gain enough length of corporal body and 3) sealing with collagen fleece (TachoSil®) without suturing. Prospectively, we assessed the stretched penile length (SPL), totally straightness, erectile function were evaluated at 3, 6 and 12 months.

Results

Mean patient age was 61.7 years (range: 56–67). In 5 patients of Peyronie’s disease, mean curvature was 53.5 (40-80) degree and all with hinge and hourglass deformity. Inflatable IPP(AMS 700CX) was inserted in all 5 patients and achieved total straightness after mean operative time of 150 min.. Glans necrosis was occurred in two patients and skin necrosis in 3 but resolved with cell therapy after 3 months. All 5 patients satisfied in GAQ at 1 year. In 4 patients of previous failed IPP, 2 were prothesis infection and prothesis protrusion in 2. Two patients were satisfied with a little short 15 cm sylinder insertion and 2 patients still dissatisfied with short length of penis.

Conclusions

In patients of failed IPP with resultant severe corporal fibrosis or Peyronie’s disease with severe deformity, multiple longitudinal incision to achieve enough diameter and transverse incision to gain the coporal length enable successful insertion of IPP. Postopeartive skin necrosis or glans necrosis were troublesome in patients of diabetes or compressive dressing.

Disclosure

No.
(218) EFFECT OF MICROSURGICAL VARICOCELECTOMY ON SEX HORMONES LEVELS
Authors: Tenorio Lira Neto F , Miranda E
Published: December 2024

Introduction

Varicocele is defined as abnormal dilation of the internal spermatic veins due to incompetent venous valves, leading to venous reflux. This condition is found in 15% of all men, and its prevalence increases to 40% in men with primary infertility and to 80% in men with secondary infertility. Furthermore, clinical studies have demonstrated that this condition might impair Leydig cell function, and that varicocele repair can improve testosterone production.

Objective

To evaluate the effect of microsurgical varicocelectomy (MV) on serum sex hormone levels in infertile men with varicocele.

Methods

We reviewed a database of infertile men with palpable varicocele who underwent MV performed by a single surgeon and identified men who had preoperative and postoperative serum sex hormone data available. Total testosterone (TT), estradiol, luteinizing hormone (LH), and follicle-stimulating hormone (FSH) were measured in real-time by a solid-phase chemiluminescent immunoassay, while free testosterone (FT) levels were calculated using the validated formula of Vermeulen. The testosterone/estradiol ratio was also calculated. Descriptive statistics, paired t-test, and Wilcoxon signed-rank test were used to compare the variables before and after MV. Significance was set at p < 0.05. We performed a subanalysis including only participants with TT levels less than 300 ng/dL.

Results

Overall, we included 132 participants. When analyzing the entire cohort, there was a decrease in postoperative luteinizing hormone levels compared to baseline (4.8 vs. 5.2 mUI/mL, p < 0.05), and no statistically significant differences were observed concerning the other sex hormone levels. However, in the 17 participants with preoperative TT levels less than 300 ng/dL, we found increases in TT levels (205 vs. 376 ng/dL, p < 0.05) and estradiol levels (24.9 vs. 33.1 pg/mL, p < 0.05) after MV. In this subgroup, the mean increase in testosterone was 125 ± 83 ng/dL compared to preoperative levels, whereas the median increase in estradiol was 4.6 (-1.0, 11) pg/mL. No other statistically significant differences were observed regarding preoperative and postoperative sex hormone levels. Seventy-six percent of the participants with preoperative TT levels less than 300 ng/dL achieved levels higher than 300 ng/dL postoperatively.

Conclusions

We demonstrated that microsurgical varicocelectomy increases total testosterone levels only in men with low baseline levels of this hormone. In this scenario, 76% of men achieved levels higher than 300 ng/dL postoperatively. We also found an increase in estradiol levels in these men. Moreover, luteinizing hormone increased after the procedure. However, the clinical relevance of such changes remains unclear.

Disclosure

No.
(235) IMPACT OF INTESTINAL OSTOMY ON THE SEXUAL QUALITY OF LIFE OF MEN AND WOMEN IN A BRAZILIAN HOSPITAL: A STUDY OF OCCURRENCE
Authors: Pfeifer B , Grossi F , Moy V
Published: December 2024

Introduction

Sexuality is an important contributor to quality of life, and there is a known high prevalence of sexual dysfunction in the general population. It is understood to be a complex phenomenon that involves, among other aspects, body image, which is affected in patients undergoing intestinal ostomy.

Objective

To assess the occurrence of sexual dysfunction in men and women with intestinal ostomy who underwent the procedure at a Brazilian hospital between 2010 and 2023.

Methods

Observational, descriptive study, type case series, retrospective. The validated questionnaires IIEF-5 and FSFI-6 were used to assess sexual dysfunction in men and women, respectively, via digital form, after agreeing to the informed consent form.

Results

Out of 55 patients, only 29 responded to the questionnaire, and only 19 were included. Of these 19 patients, 42% had sexual dysfunction, with 50% being women and 33.3% men. Due to the much lower than expected number of patients, it was decided not to perform inferential tests.

Conclusions

Sexual dysfunction was observed in 50% of women and 33.3% of men with ostomies, which resembles data from the general population. However, the scarcity of participants had a substantial impact on the results, suggesting the presence of stigma in exploring sexuality. This retrospective study highlights the need to educate healthcare professionals and patients on sexuality and serves as motivation for further prospective studies.

Disclosure

No.
(239) STUDY OF THE THERAPEUTIC POTENTIAL OF NANOFORMULATION CONTAINING ACMELLA OLERACEA (L.) EXTRACT FOR THE TREATMENT OF MEN WITH PREMATURE EJACULATION
Authors: Lira Batista L , Afonso Teixeira T , Rocha Lopes G , Santos Almeida HK , Prado Dantas HV , Garcia De Azevedo ME , Tenório Da Silva F , Dias Rocha K , Tavares Carvalho JC
Published: December 2024

Introduction

Acmella oleracea, also known as the toothache plant, is a plant species popular in the Amazon region for treating sexual dysfunctions. Its unique sensory properties have gained attention, producing a tingling sensation.

Objective

We evaluated the clinical action of a nanoformulation containing ethanolic extract of A. oleracea inflorescences in men with premature ejaculation. Significant constituents in the extracts were identified based on gas chromatographic analysis.

Methods

During the study, participants were given a spray preparation that contained A. oleracea extract and were instructed to use it locally on the penis for five minutes before sexual intercourse for 12 weeks. Patient couples were required to record the mean intravaginal latency time to ejaculation (IELT). We also assessed participants using the HAMA scale, which scored respondents according to their level of anxiety.

Results

During spray treatment, the A. oleracea nanoformulation increased participants’ IELT values (293 s) compared to baseline values (193 s), confirming the clinical action in men with premature ejaculation. Participants demonstrated good tolerance to the spray and had no systemic side effects or incidence of local effects. In terms of pathological anxiety, three of the participants were classified as moderate, three as mild and one as severe and, in relation to the IIEF-5, three were normal, three were mild and one was moderate.

Conclusions

A. oleracea can be considered a potential therapeutic alternative with benefits for male patients with premature ejaculation. This formulation promotes penile desensitization, attributed to spilanthol in an extract derived from A. oleracea inflorescences. However, as this study involved few participants, further multicenter studies must confirm the observations.

Disclosure

No.
(255) MASTURBATORY HABIT IN MEN WITH SEXUAL DYSFUNCTION IN BRAZIL – AN OVERVIEW OF FREQUENCY, SOCIAL AND RELIGIOUS FACTORS
Authors: Vasconcelos Sanvido L , A Rosseti C , Bessa Jr. J , C Nahas W , V Coimbra I , Gabriel Fraga L , Z S Pato E , Hallak J , C G Nascimento B
Published: December 2024

Introduction

Masturbation is a very common form of sexual manifestation. Despite this, there is great heterogeneity of masturbatory habits in the population, with possible social and cultural influences. Our objective was to evaluate masturbation habits (presence, frequency and predictors) in men seeking care for sexual dysfunctions (SD) in Brazil.

Objective

Report on the social profile, masturbatory habits, and frequency among a group of 354 men with Sexual Dysfunction (SD) attending a sexual medicine clinic at a leading teaching hospital in Brazil.

Methods

We retrospectively evaluated a database of prospective documentation of patients seeking treatment for SD in Brazil. All underwent a structured consultation, with social and demographic data obtained, such as age, education, religion, and income. Personal factors such as the presence of a partner, complaint of erectile dysfunction (ED), penile curvature (PC) and libido (0-10 scale) were also questioned. Finally, self-reported frequency of masturbatory sexual activity (monthly rate) were documented.

Results

356 patients were analyzed, the average age of this population was 63.11 ± 12.55 years, 79.6% had a partner, with mean age of 53.5 ± 11,6 and 3,1% of the population identified as homosexual. The family income of 42% of the men was between R$2000.00 – R$4000.00 and only 46% of them completed high school. In this population, 86.6% declared themselves religious, 53,8% as catholics and 23.51% as evangelical, whereas 9.6% declared no religion. Overall, 67.4% of patients reported masturbating at least once a month, with an average frequency of 6,19 ± 5.97 times/month. Evangelical men had a mean 3,09 times/month while men without religion had a mean of 5,12 times/month. of Men married had a mean of 3,46 times/month, while single men had a mean of 4,94 times/month and divorced presented a mean of 6 times/month. Libido mean rate was 8.14 ± 2.08.

Conclusions

Our data shows that the masturbatory habit in men with sexual dysfunction in Brazil is a habit, impacted by religious and social aspects. In general, men without a partner are more likely to masturbate, and men evangelicals have a significantly lower rate of masturbation.

Disclosure

No.
(267) IMPACT ON THE SEXUALITY OF COUPLES WITH INFERTILITY
Authors: Valente S , Santini F , Zeitler E , Vazquez L , Ortiz J
Published: December 2024

Introduction

The World Health Organization (WHO) defines infertility as the inability to conceive a pregnancy after one year of regular vaginal intercourse without the use of contraceptive methods. It is a stress factor for those seeking parenthood. It affects between 10-15% of the world’s population. In bibliographic reviews, sexual dysfunctions as a cause of infertility are little investigated in both gender.

Objective

To analyze the sexual function of couples who consult the University Institute of Fertility and Human Reproduction for the first time and identify if couples have disorders in their sexual function that cause infertility.

Methods

People between 18 and 44 years old who consulted the Institute, who were heterosexual couples without fertility treatments in the last six months and in the last year had sought pregnancy in a traditional way, were studied. They were given the Golombok Rust Inventory of Sexual Satisfaction Questionnaire (GRISS), self-administered to both, with 5 ratings (Never, Almost never, Occasionally, Usually, Always) and 9 different scales: infrequency, no communication, dissatisfaction, avoidance, no sensuality, erectile dysfunction, premature ejaculation, vaginismus, anorgasmia.

Results

We studied 170 individuals, 85 couples. Age average: men 34.4 women 35.6. Educational level 55% completed secondary school. 21,18% had impotence, 32,94% premature eyaculation, 62,35% vaginismus, 1,18 anorgasmia. Female sexual dysfunction 61,18 and male sexual dysfunction 44,71%.Infrequency in sexual relations 30,5%. Couple sexual dysfunction with inability to conceive 33%.

Conclusions

The tendency for dyadic sexual dysfunction is high, at 33%, but the incidence of vaginismus is higher, which rises to more than 60%, identifying that many of the couples who consult for infertility have as their primary etiology a sexual dysfunction, which could be solved with sexual therapy if identified. It is of radical importance that professionals who work in infertility services or are related to women’s and men’s health give space and relevance to the sexual behavior of couples, guaranteeing sexual psycholearning, increasing the quality of life, trying to provide behaviors adapted to sexuality, and thus, avoid iatrogenesis and/or negligence at the time of conception.

Disclosure

No.
(290) SURGICAL TREATMENT OF PEYRONIE’S DISEASE WITH AUTOLOGOUS BUCCAL MUCOSA GRAFT IN COMPLEX CURVATURES
Authors: Martinucci De Oliveira L , Favero Ambar R , Claudio Rocha A , Panhoca R , Augusto Seabra Rios L , Aparecido França W , Francisco Atílio Gorga C , Berna Bertero E
Published: December 2024

Introduction

Peyronie’s disease (PD) affects a considerable proportion of middle-aged men, characterized by the development of fibrotic plaques in the tunica albuginea and corpus cavernosum of the penis. It is a benign pathology that affects 3.2% of men aged 40-70 years, and its etiology is multifactorial and mainly related to traumatic events, which trigger penile deformities, pain and sexual dysfunction. Surgical treatment is indicated in advanced chronic cases of the disease, and in cases of complex PD (curvature >60°), one of the recommended surgical approaches is corporoplasty with autologous buccal mucosa graft (BMG).

Objective

To evaluate the surgical efficacy of penile corporoplasty with autologous BMG for treatment of PD with complex curvatures (> 60°).

Methods

We retrospectively evaluated patients with PD in stable phase with >60° curvatures (proven in pharmaco-induction erection test), naïve to penile surgeries, who were treated by plaque incision and BMG between 2022 and 2024 in a tertiary hospital. Exclusion criteria were PD lasting less than 12 months or in an active inflammatory phase, history of penile trauma, severe erectile dysfunction and congenital penile curvature. All patients signed informed consent forms.

Results

A total of 7 patients were included in the study, with a mean age of 58 (± 8) years. In the preoperative period, the mean curvature observed was 75°, the mean plaque size was 1.8 cm, and the mean penile length was 12 cm. 5 patients (71.4%) had dorsal curvature and 2 patients (28.6%) had dorsolateral curvature. At the 6-month follow-up after surgery, the mean penile curvature was 32.1° as in 85.7% of the sample had satisfactory residual curvature (< 45°) and the mean penile length was 10.6 cm. None of the patients had erectile dysfunction in the late postoperative period. Regarding the degree of postoperative satisfaction, we found that 85.7% of the patients were satisfied or very satisfied with the final result.

Conclusions

The buccal mucosa is a highly promising biological material for the replacement of penile plaque, demonstrating a remarkable capacity for adaptation and revascularization. This material provides good clinical results, both anatomical and functional, and maintains stable elasticity. The method described is simple to apply and may be recommended in the surgical treatment of Peyronie’s disease. Despite its limitations, our study contributes significantly to the current knowledge on the safety and efficacy of BMG in the treatment of PD. Our findings were consistent with those of previous studies, showing that penile corporoplasty using BMG results in excellent structural and functional outcomes and high levels of patient satisfaction.

Disclosure

No.
(291) PREVALENCE OF ERECTILE DYSFUNCTION AFTER TREATMENT FOR ISCHAEMIC PRIAPISM IN AN UROLOGICAL REFERRAL CENTER
Authors: Cambui Castro Lima G , Miolaro De Mello LG , Moreira Fonseca W , Pucharelli Resuto D , Rodrigues Beal P , Martini Perini G , Hagerman M , Gaspar Peão JC , Nardozza Junior A , Brandão Vasco M , Lima Lemos CI , Barbosa Garofo Stabile Moura D , Fonseca Ribeiro JV
Published: December 2024

Introduction

Ischaemic priapism is an urologic emergency characterized by an acute compartment syndrome of the penis. Its treatment is time-sensitive, with success rates directly correlated to the timing between onset of symptoms and urological intervention. The development of erectile dysfunction (ED) after an episode of priapism is an undesirable clinical outcome. Prolonged erection can lead to tissue damage on the corpora cavernosa due to sustained hypoxia and acidosis. Such damage can result in fibrosis of the erectile tissue, impairing an individual’s capacity to initiate and maintain an adequate erection. Studies indicate that the duration of priapism is linked to the severity of erectile dysfunction. Though ED is the most relevant complication associated with the treatment of ischaemic priapism, its prevalence is not well-reported in the current literature.

Objective

To evaluate the prevalence of ED in patients who underwent treatment for ischaemic priapism.

Methods

Retrospective cohort of patients diagnosed with ischaemic priapism in an urological referral center between 2016 and 2024, with subsequent analysis of the prevalence of ED in periodic outpatient consults after urological intervention. Statistical analysis was done with data systematically collected via Excel and proportions were calculated in a single sample using binomial testing. Results showed a statistical power of 93%.

Results

Data was collected from forty-two patients treated in an urological referral center for ischaemic priapism between 2016 and 2024. Timing between onset of symptoms and initial treatment ranged from 5 to 240 hours (median 54 hours). Patient age ranged from 8 to 69 years (mean 35,4 years). 52,4% of patients underwent cavernous aspiration, with or without sympathomimetics. 21,4% of patients underwent Winter’s shunt. 19% of patients underwent Al-Ghorab’s procedure. 4,8% of patients underwent corporal snake maneuver for distal shunting. 2,4% of patients underwent Ebbehoj’s shunt. Thirty-four patients were evaluated for erectile function during post-procedure follow-up, of wich 73,5% reported ED.

Conclusions

Patients who underwent urological intervention for the treatment of ischaemic priapism presented with a high rate of ED during post-procedure follow-up.

Disclosure

No.
(293) EFFICACY OF ALPHA LIPOIC ACID SUPPLEMENTATION IN SPERM PARAMETERS: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED TRIALS
Authors: Zang Pires I , Oberto Da Silva Gobbo M , Yuji Ura Sudo R , Louize Milbradt T , Marquardt Filho N , Teodósio Da Ros C
Published: December 2024

Introduction

Male factors contribute to 30 to 50% of infertility in couples. Treatment options for male infertility are limited, thus antioxidant supplementation for idiopathic male infertility is currently being studied. Alpha lipoic acid (ALA) has a high antioxidant capacity and the potential to penetrate tissues, cells and organelles, including mitochondria, due to its water and lipo solubility properties. The recent inclusion of randomized trials in the literature has required a new systematic review and meta-analysis to evaluate the efficacy of alpha lipoic acid in sperm parameters changes.

Objective

We aimed to perform a systematic review and meta-analysis of the currently available randomized trials comparing the effects of ALA supplementation versus placebo on sperm function in infertile male patients.

Methods

Pubmed, Embase, Cochrane Library, and ClinicalTrials.gov databases were searched from inception to June 2024. A random-effects model was employed to compute mean differences and risk ratios for continuous and binary endpoints. Heterogeneity was evaluated through the prediction interval. All statistical analysis was conducted using R software 4.4.1. The certainty of evidence was evaluated with the GRADE approach. Results were reported following the PRISMA statement guidelines. PROSPERO identification: CRD42024564932.

Results

Five randomized trials comprising 250 patients with a mean age of 28 to 40 years were included in this analysis. Over a mean follow-up time of 3 months, ALA was associated with a reduced proportion of abnormal sperm morphology (MD −0.89; 95% CI −1.48 to −0.29; p = 0.003), increased total motility (MD 13.49; 95% CI 3.52 to 23.46; p = 0.008), and increased sperm progressive motility (MD 12.43; 95% CI 2.89 to 21.97; p = 0.01). Additionally, ALA was associated with a higher pregnancy rate in two individual studies reporting the outcome, however, no significance was found in our pooled analysis (RR 2.28; 95% CI 0.66 to 7.85; p = 0.1). Finally, ALA did not change ejaculation volume (MD 0.14; 95% CI −0.54 to 0.83; p = 0.6), sperm concentration (MD 11.99; 95% CI −0.67 to 24.66; p = 0.06), live sperm (MD 4.42; 95% CI −3.17 to 12.02; p = 0.2), or total antioxidant capacity (MD 0.43; 95% CI −0.02 to 0.87; p = 0.06). No adverse events were reported.

Conclusions

In this meta-analysis of 5 studies, ALA was associated with a favorable change in sperm function. However, there were no effects on the pregnancy rates. This could be explained by the small sample size and short follow-up time. Therefore, more prospective randomized controlled trials are needed, especially including pregnancy rates and longer follow-up.

Disclosure

No.
(309) CASE REPORT: SEXUAL COGNITIVE THERAPY FOR PATIENTS DIAGNOSED WITH ERECTILE DYSFUNCTION ASSOCIATED WITH OBSESSIVE COMPULSIVE DISORDER
Authors: Soares Alves Mendes V
Published: December 2024

Introduction

Erectile Dysfunction (ED) and Obsessive Compulsive Disorder (OCD) can significantly impair an individual’s quality of life, affecting sexual functioning and mental health. Understanding the interplay between these conditions is essential for developing effective therapeutic interventions.

Objective

To report the efficacy of Sexual Cognitive Therapy in treating a patient with comorbid ED and OCD.

Methods

Case Presentation: A 20-year-old cisgender heterosexual male presented with difficulties in achieving and maintaining an erection, feelings of failure in sexual and academic domains, and anxious symptoms. The patient had a family history of OCD and generalized anxiety disorder. Initial diagnostic hypotheses included erectile dysfunction and anxious symptoms, later confirmed as OCD and ED. Intervention: The intervention comprised cognitive-behavioral techniques and specific sexual therapy strategies, including psychoeducation on sexual myths and the sexual response cycle, cognitive restructuring, mindful sex practices, and sensory focus exercises. The therapy aimed to identify and modify dysfunctional thoughts, beliefs, and behaviors contributing to sexual problems.

Results

Results: The patient exhibited significant improvement in cognitive flexibility, a reduction in OCD and ED symptoms, and increased confidence in sexual performance. He transitioned from reliance on medication (Viagra) to successful sexual activity without it. The intervention effectively addressed underlying cognitive distortions and sexual myths, contributing to overall symptom reduction and partial remission of OCD.

Conclusions

Conclusions: This case report demonstrates that Sexual Cognitive Therapy can effectively manage the complex relationship between ED and OCD. The patient’s progress highlights the potential of a tailored, integrative therapeutic approach for treating comorbid sexual and mental health disorders. Further studies are warranted to validate these findings and refine therapeutic strategies for similar cases.

Disclosure

No.
(316) ASSESSMENT OF ERECTILE DYSFUNCTION AND PEYRONIE DISEASE: A STUDY USING THE ERECTION HARDNESS SCORE AND LIEF QUESTIONNAIRE
Authors: Rocha Chavez Zambrana D , Cambuí Castro Lima G , Fonseca Ribeiro JV , Souza JH , Barbosa Garofo Stabile Moura D , Lazzarini Marani A , Miolaro De Mello LG , Fonseca Moreira W , Noffs S , Lemos C , Nardozza Junior A , Brandão Vasco M , De Souza Carneiro MP
Published: December 2024

Introduction

Erectile dysfunction (ED) and Peyronie’s disease (PD) are common conditions that affect men’s sexual health. Erectile dysfunction may manifest as a subsequent symptom in Peyronie’s disease, occurring in 30-70.6% of patients, due to the formation of fibrotic plaques in the tunica albuginea, along with penile shortening and deformity. Consequently, it is essential to evaluate these conditions using validated clinical scales that are straight forward to administer.

Objective

To assess the severity of erectile dysfunction and the erection hardness score in men with erectile dysfunction only and erectile dysfunction coexisting with Peyronie’s disease.

Methods

A cross-sectional study investigation involving male patients diagnosed with Erectile Dysfunction and Peyronie’s Disease. We selected patients with surgical indications for PD and those with ED unresponsive to oral medication therapy. The International Index of Erectile Function (IIEF-15) questionnaire was administered to assess sexual function. Additionally, we evaluated the Erection Hardness Score (EHS) in patients who underwent penile Doppler Ultrasound with pharmacological induction 15 minutes after medication application. All statistical analyses were conducted using RStudio and we performed Pearson’s chi-squared test with a significance level of p < 0.05.

Results

We evaluated 135 men from January 2022 to April 2024. The participant has a mean age of 61.44 ± 9.6 years. The results stratified by IIEF, Erectile Dysfunction (ED) vs. ED with Peyronie’s Disease (ED + PD): Mild ED: 3.5% vs. 14.3%; Mild to Moderate ED: 7.0% vs.14.3%; Moderate ED: 12.8% vs. 26.5%; Severe ED: 73.3% vs. 32.7%; No ED: 3.5% vs. 12.2%. The EHS demonstrated an average ED 2.41 ± 1.09 and ED + PD 3.29 ± 0.87. The chi-square test indicates significant association between IIEF score with DE vs ED + PD (p < 0.001) and between the EHS with ED vs ED + PD (p < 0.001).

Conclusions

The severity of erectile dysfunction according to the IIEF and the degree of erection according to the EHS are associated with the type of erectile dysfunction - ED only or erectile dysfunction with Peyronie’s disease.

Disclosure

No.
Floret development and fertility of barley as affected by Photoperiod-H1 under contrasting photoperiods and PHYTOCHROME C backgrounds
Authors: Parrado Jorge D , Savin Roxana , Slafer Gustavo A
Published: December 2024

The photoperiod-insensitive allele of Photoperiod-H1 (ppd-H1) increases spike fertility in barley, both indirectly by lengthening flowering time and directly when flowering time is accelerated under extra long photoperiods. To determine if the effect of PPD-H1 on spike fertility is related to the initiation or the mortality of spikelets/florets, we performed detailed analysis of the dynamics of floret development along the barley spikes. Four near-isogenic lines (NILs) combining ppd-H1 and Ppd-H1 alleles with two PHYTOCHROME C (PhyC-l and PhyC-e) backgrounds were compared under 12 h and 24 h photoperiods. The ppd-H1 line consistently showed higher survival rates of floret primordia. Fertility differences were observed within spikes, with the insensitive ppd-H1 line improving fertility in the less favoured distal florets, and even inducing more developmental progress before floret mortality in apical spikelets. The ppd-H1 allele constitutively enhanced floret primordia survival, as the effect was seen even under long photoperiods when lines had similar phenology. The dynamics of floret development affecting spike fertility resulted in a parallel effect on grain setting. Together, these results indicate that photoperiod insensitivity in barley contributes to greater yield potential by reducing floret primordia mortality and improving spike fertility.
The Epilepsy Centers of Excellence at the Veterans Health Administration
Authors: Haneef Zulfi , Casanova Caleb A , Zhang Vincent , Bonds King Jennifer R , Rehman Rizwana , Garga Nina I , Graham Glenn D , Towne Alan R
Published: December 2024

Introduction

The Veterans Health Administration (VHA) Epilepsy Centers of Excellence (ECoE) was established in 2008 to provide specialized care for veterans with epilepsy. Although established more than a decade ago, there has been no systematic evaluation of the ECoE’s performance in key mission areas. We evaluated their performance in several key mission areas—clinical care, research, education, and outreach—since inception to evaluate their success in meeting the initial mandate.

Materials and Methods

We analyzed available data from relevant literature, ECoE annual reports, and the ECoE website between 2011 and 2023. Clinical care is the primary mission of the ECoE and was evaluated by examining utilization data for various clinical services and published literature. Research was assessed based on academic output and funding reported in the annual reports. Education and outreach were qualitatively assessed using recent data on the ECoE website and annual reports.

Results

Total unique patient clinical visits for therapeutic/diagnostic encounters increased by 74% (from 10,487 in 2011 to 18,285 in 2023), which was nearly twice the 39.5% growth in workforce strength (from 119 in 2011 to 166 in 2022) over a similar period. Care provided by the ECoE is associated with decreased mortality rates compared to patients who do not receive ECoE neurology care. Tele-epilepsy visits increased considerably following the COVID-19 pandemic, from 1,928 in 2019 to 4,950 in 2021 (a 157% increase over 2 years). Research grant funding in fiscal year 2023 totaled approximately $4 million for ECoE-affiliated investigators. Outreach efforts included several VHA/non-VHA collaborations. The ECoE organizational structure was found to be highly interconnected and regionally represented, with special committees devoted to many key mission areas of epilepsy care.

Conclusions

Our analysis reveals progressive growth and improvements in the ECoE mission areas of clinical care, research, education, and outreach. Clinical utilization data have shown growth since inception, while also leading to lower mortality rates and lower costs per patient, fulfilling the organizational mandate to improve the care of veterans with epilepsy. There is substantial activity in research, education, and outreach. The ECoE governance hierarchy aims to facilitate smooth resource allocation both regionally and for the key mission areas. Our findings can help policymakers assess and prioritize future ECoE initiatives, while other clinical care organizations can seek to model their care based on the ECoE.
Mpox (Monkeypox) On Board a Naval Warship
Authors: López Lourdes M , Newkirk Russell E , McAuliffe Liane , Bloomquist Luke , Zenilman Jonathan M
Published: December 2024

We report a case of mpox in an active duty male on board a naval warship, who presented with a chancre-like penile lesion and ulcerating lymphadenopathy in the setting of a nonreactive treponemal test. Despite empirical therapy for sexually transmitted infections, he developed a fever and a generalized pustular rash. The patient was placed in isolation, and contact tracing was performed. No further spread of mpox was identified despite close contact with multiple shipmates and a pet rabbit. This case highlights the obligation of medical providers who care for our military personnel and veterans to offer JYNNEOS vaccine to high-risk individuals. Additionally, with the rise in clade I mpox cases prompting a recent global health emergency declaration by the World Health Organization, it is essential to implement proper testing methods and treatments when considering mpox in the differential diagnosis because of its association with other sexually transmitted infections.