bluuebunny/crossref_metadata_2025 huggingface dataset:
221 Incidence of Climacturia in Men with Sexual Dysfunction after Radical Prostatectomy
Authors: Gamberini P , Ribeiro H , Sayao R , Pedrenho R , Barbosa Neto C , Goes P , Nascimento B , de Bessa Júnior J , Nahas W , Srougi M , Amoedo F
Published: May 2022

Introduction

Many series report the incidence of climacturia after radical prostatectomy (RP) as greater than 50%, and yet it is remarkable the short space for its discussion, which remains largely unrecognized and unaddressed.

Objective

Our aim was to describe the incidence and characterize climacturia in patients with erectile dysfunction (ED) after RP.

Methods

We performed a retrospective analysis of a prospectively maintained database of men after RP with complaints of ED not responsive to oral therapy. Patients seen in the sexual medicine group of our institution underwent a structured visit which included the investigation of the presence of climacturia and a detailed characterization (frequency, intensity, discomfort). Other factors such as the presence of stress urinary incontinence (SUI) and demographics were also recorded. Finally, patients were asked if they were counseled of this possible side effect of RP.

Results

Data from 56 patients were available, with a mean age of 66 years. Climacturia was reported by 37 patients (66,07%). Of these, 62,2% reported to occur rarely or occasionally, while 37,8% reported to occur frequently. In terms of the amount of urinary leakage, the vast majority (79%) reported leakage in small amounts, with only 8 patient (21%) reporting leakage in moderate volume. In general, 28,6% reported that climacturia generated significant discomfort, and only 10,5% recalled being warned preoperatively. Among patients with climacturia, 19,35% had SUI.

Conclusions

Our analysis supports a high incidence of climacturia, with perceived negative impact on approximately half of patients and with almost 90% of them not being aware of this possible complication. This preliminary analysis is one of the first on sexual urinary incontinence in Brazil and highlights the importance of its recognition and better patient counseling.

Disclosure

Work supported by industry: no.
222 Determinants of Female Orgasm in Medical Students from Southern Brazil
Authors: Castralli H , Tronco G , Salatino L , Motta G , Zancan M
Published: May 2022

Introduction

The female orgasm is understood as a physiological experience within a psychosocial context. As such, inter and intrapersonal factors can cause orgasmic inconsistency. Since women not only achieve orgasm at substantially lower rates than men, but also fake orgasms more often than these, it is important to identify determinants of orgasm in this population.

Objective

To analyze the factors associated with female orgasm among medical students in southern Brazil.

Method

Cross-sectional study developed with young female adults that answered an online survey with 34 questions covering sociodemographic, behavioral and sexuality aspects. The validated Portuguese version of the Female Sexual Function Index questionnaire (FSFI-6) was applied, which is composed of six questions scored from 0 to 5, addressing the main sexual domains: desire, arousal, lubrication, orgasm, satisfaction and pain. A total FSFI-6 score ≤ 19 was considered a positive screening for female sexual dysfunction. The practice of physical activity was divided in not practice, practice 1 or 2 times, 3 or 5 times and 6 or more times. We used the Kruskall-Wallis statistical test for quantitative analysis.

Results

Of the 169 participants, 96.4% (n=163) were sexually active. The analysis of the FSFI-6 revealed a statistically significant association between the worst medians in the orgasm parameter and the variables: lack of physical activity (p=0.01), single marital status (p=<0.001), use of oral contraceptives (p=0.012) and condom (p=0.003) as contraceptive methods. In contrast, in this study, no association was observed between orgasm and sexual orientation, consumption of alcohol, tobacco or illicit drugs.

Conclusion

The findings reinforce the hypothesis that female orgasm is determined by several factors, some of them modifiable, and its recognition is relevant in the approach to sexual dysfunctions in women.

Disclosure

Work supported by industry: no.
230 Relationship Between Self- Image of Penile Size and Erectile Function in Japanese Men
Authors: Suetomi T , Ichioka D , Iimura T , Kojo K , Ikeda A , Kimura T , Kawahara T , Hoshi A , Kandori S , Negoro H , Nishiyama H
Published: May 2022

Background

Many studies on penile size have been conducted in other countries, but very few in Japan. Furthermore, there are no reports about men's self-image of penile size or the effect of self-image on erectile function.

Objectives

We investigated penile size in male urology outpatients and examined the difference between subjective and objective penile size and the relationship between self-image and erectile function.

Materials and Methods

186 patients who visited our clinic between April 2007 and March 2015 with the chief complaint of late-onset hypogonadism symptoms were enrolled. Patients were asked to complete a questionnaire that included their self-assessed flaccid and erect penile length, self-image of their penile size, SHIM (Sexual Health Inventory for Men) score, and time to ejaculation. All objective penile measurements including stretched length and circumference were performed by the same physician (s).

Results

The mean self-assessed flaccid and erect penile lengths were 6.8 cm and 12.5 cm, respectively. The mean objectively measured flaccid and stretched penile lengths were 8.3 cm and 12.6 cm, respectively. Most of the patients (71.0%) rated their penis as normal, 27.9% as small, and only 1.1% as large. 28.5% of the patients described their penis as short, and 17.2% as thin. The mean SHIM score of patients who rated their penis as small (7.9) was significantly lower than that of patients who rated their penis as normal (10.5) (p<0.05). The mean time to ejaculation of all patients was 8.7 minutes, and that of the patients with premature ejaculation was 4.6 minutes. Fewer cases (8.6%) desired treatment for penile length, compared to those desiring treatment for ED (31.7%) or premature ejaculation (18.3%).

Conclusion

Compared with reports from other countries, a high percentage of Japanese patients are dissatisfied with their penile size, and these patients may have a lower self-esteem with respect to their erectile function.

Disclosure

Work supported by industry: no.
232 The Outcome of Gracilis Muscle Flap Wrapping Around the Neourethra-Native Urethral Anastomosis after Radial Forearm Free Flap Phalloplasty on the Incidence of Fistula Formation
Authors: Elsayed A , Shorbagi G El , Abdel-Rassoul M , Ghoneimy M El , Hamid M Abdel , Fayad A , Rahman S Abdel
Published: May 2022

Introduction

The radial artery-based free-flap phalloplasty (RFFP) is accompanied by high rates of fistula formation and urological complications. We thought to investigate the impact of pedicled gracilis muscle flap wrapping around the urethral anastomosis on the occurrence of fistula at the neourethra-native urethral junction.

Materials and Methods

Prospective study was conducted at the urology department of Cairo University Hospitals. Patients presenting with micropenis (stretched penile length ≤7 cm) underwent RFFP. The RFF was harvested from the non-dominant forearm after ensuring of good collateral supply to the hand. All patients underwent RFFP with pedicled gracilis muscle flap wrapping. Under microscopic guidance, the radial artery was anastomosed with the inferior epigastric artery, the cephalic vein with the great saphenous vein and the medial and the lateral ante-brachial nerves with the ilioinguinal nerve and the dorsal penile nerve, respectively. Data were reviewed for demographics and perioperative outcomes.

Results

Nineteen patients were included in the study with a median follow up of 11 months (3, 22). Median age of 26 yrs (16, 43), hospital stay was 7 days (7, 30) and. Indications for RFFP were: micropenis (40%), post-surgery crippled penis (25%), amputated penis (20%), aphallia (5%), epispadias (5%) and gender dysphoria (5%). Median ischemia time was 88 mins (60, 120), ebl was 600 cc (300, 2000) and operative time 11 hrs (8, 14). Intraoperative complications were a case of transection of the radial artery during graft harvesting, failure to tubularize the graft and significant blood loss during vaginectomy. Overall success rate was 70%. 5 cases had a complete success, only one case had a fistula at the neo-uretheral native urethral anastomosis, one patient had a distal fistula and another patient had a ring stricture at site of anastomosis. 8 cases were complicated by complete disruption of the urethra. 6 cases were complicated by total graft loss (2 cases due to arterial causes and 4 cases due to venous congestion).

No donor site morbidity was noted. During follow up patients reported shortness in the mean length of the phallus was 2.1cms. All patients reported recovery of both general and erogenous sensations in the neo-phallus. The recovery of the general sensation (tactile stimulation and two-point discriminations) ranged between 2 to 4 weeks post-operatively while recovery of the erogenous sensation occurred between 8 to 16 weeks.

Conclusion

The use of pedicled garcilis flap during RFFP resulted in a fistulae rate of 20%.

Disclosure

Work supported by industry: no.
237 Gender Differences in Internet Use for Sexual Purposes in Individuals Aged 55 Years and Over
Authors: Oliveira M , Scanavino M
Published: May 2022

Introduction

Surveys indicate gender differences in the general population in the use and frequency of the internet and in the use of applications for the expression of sexuality online, with the majority of users being male. Despite several studies already carried out regarding the gender difference in the expression of sexuality online, there is a lack of scientific studies seeking to identify the influence of gender in individuals aged 55 years and over in the expression of sexuality

Objective

The aim of this descriptive study is to compare the distribution the internet use for sexual purposes behavior among the male and female gender in individuals aged 55 years and over.

Methods

119 (66.39%] female and 33,61% male) participated in this research, conducted through an online survey in Brazil, aged 55 years or more. The instruments that were applied in the online survey include the Sociodemographic Questionnaire, Internet Use, General Technical Interest and Protocol Online Sexual Behaviour and Satisfaction. Statistical analyzes were performed using Stata software.

Results

Regarding sociodemographic variables, no statistically significant differences were identified in relation to education and marital status by gender, and a greater number of participants of both genders with a complete postgraduate degree (51.26%) and married (48.74%) were registered. On the other hand, with regard to age, there were statistically significant differences (p value=0.040) in relation to gender, with the sample of men (M=63.47%, SD=4.66) older than women (M=61.65%, SD=5.13) Similarities were identified in the results by gender of participants aged 55 and over in this study regarding interest in new technologies (91.60% of participants are interested in new technologies), internet usage (96.64% of the sample uses it daily) and frequency of use of social networks (47.06% use up to three hours a day), dating sites (91.60% do not use it), online games (97.48% of the sample does not use it) and applications/chats (45.38 % of the sample use between one to three hours a day) for the expression of sexuality. Regarding the frequency of use of pornographic sites, there was a significant difference (p<0.001) by gender with the sample of men (65%) using sites with explicit content compared to women (11.39%).

Conclusions

In the present study, it was identified that the significant differences between genders only occurred in relation to the age of the sample, with men older than women and in relation to the consumption of pornography, with men using pornographic websites for sexual purposes in a greater proportion compared to the women's group. Through this research with individuals aged 55 years or more, it was found that the differences between genders are less significant than expected with regard to the frequency of internet use and behavior for sexual purposes on the Internet.

Disclosure

Work supported by industry: no.
239 Improved Peyronie's Disease Curvature Outcomes Using a More Aggressive Collagenase Technique
Authors: Tyler A , Green B , Savage J , Brearton K , Burgon H , Trost L
Published: May 2022

Introduction

Since the FDA approval of Collagenase Clostridium Histolyticum (CCH) for the treatment of Peyronie's Disease (PD), several investigators have reported outcomes of CCH, with improvements ranging from approximately 15-30%. More recently, we reported improved results (49% mean improvement) when CCH was combined with RestoreX penile traction therapy (RxPTT). Since then, we have made additional modifications to create a more aggressive injection / traction protocol to further optimize outcomes.

Objective

To report outcomes of a more aggressive CCH injection / traction protocol in men with PD.

Methods

A prospective database has been maintained of all individuals undergoing CCH injections since 2014. Our CCH injection protocol has evolved from the one described in the IMPRESS trials to a more aggressive use of injections and manual and mechanical traction. Currently, the protocol consists of injecting 0.9 mg of CCH in 0.7 ml of saline into approximately 15-20 sites around the point of maximal curvature (pharmacologically-induced erection performed with the first injection of each series). Injections are only performed on subsequent days (not 2-3 days apart), and very aggressive (i.e. 10-15 lbs of force) modeling is performed with the 2nd injection. Patients are counseled to begin RestoreX traction at 24-48 hours after the 2nd injection for 30-60 minutes daily, and to continue aggressive manual modeling for at least the first week post injection. Penile wraps are applied for 5 days post injection. A descriptive analysis was subsequently performed to review outcomes.

Results

A total of 320 men underwent at least 1 series of CCH and had baseline and follow-up curve assessment data available. Mean age was 55.8 (SD 10.4), with a mean PD duration of 27.8 months (SD 53) and a median baseline composite curvature of 64 degrees (IQR 45-80). Curvature improvements (most recent minus baseline) improved over time, correlating with increased injection experience and implementation of more aggressive traction protocols: 2014-2020 (20 degrees, 29% improvement) vs 2020-mid 2021 (27.8 degrees, 50%, p<0.001). When men were stratified by those who either completed 8 injections or indicated that they were satisfied with outcomes (n=147), median results were more pronounced: 2014-2017 (29% improvement), 2018 (38%), 2019 (47%), 2020-mid 2021 (59%), p<0.01.

Conclusions

Progressive implementation of a more aggressive CCH injection protocol has resulted in improved curvature outcomes. Given the specialized nature of technique modifications described, these results would argue for a center-of-excellence model for CCH administration to achieve optimal outcomes.

Disclosure

Work supported by industry: no.
254 A Study on Knowledge, Attitude and Practices of Andrological Problems Among Male Patients at a Public Tertiary Care Hospital in Western India
Authors: Hegde A
Published: May 2022

Introduction

Patients with andrological problems especially in developing countries do not readily seek treatment with health care professionals. Various barriers to treatment exist including cultural taboos associated with these problems. This has been an unexplored area among Indian patients especially in the public healthcare domain. Public health care set ups in India deal with a huge volume of patients and many set ups do not have dedicated andrology services to handle such patients.

Objectives

To evaluate the knowledge, attitudes and practices related to andrological problems among the out-patient population, an observational questionnaire survey was administered.

Methods

A cross sectional questionnaire survey was conducted on 400 andrology OPD patients over one year. They were given a questionaire that asked basic questions about demographics, sexual habits, education and income level. Subsequent questions assessed the knowledge, attitudes, practices and help seeking behaviour about andrological problems. On follow up, questionnaire recorded the same details along with satisfaction with the andology services.

Results

The mean age of the 400 men was 46.4 years; 73% were <50-years-old and 74% had a low income, 60% had low education. The mean time between noticing a symptom and first hospital visit was 5.3 months. Of the 400 respondents, peer groups (30%) and internet (26%) were most frequently consulted sources for information about ED initially. Older patients preferred consulting with physicians. Side effects of treatment were the greatest concern, especially for older patients. More than 95% of the respondents were satisfied with the andrology services and hospital environment. All patients felt a confidential environment in a dedicated OPD helped them.

Conclusion

Patients frequently consult their peer groups and the internet for information about andrology issues. We believe there should be more awareness about men's health issues and the options available for treatment. Dedicated andrology services among others, go a long way in bridging the gap.

Disclosure

Work supported by industry: no.
270 Sexually Transmitted Infections in Sexually Compulsive Women
Authors: Bubola Lima NR , Nisida I , Sant'Ana do Amaral ML , Scanavino MDT
Published: May 2022

Introduction

There is a large evidence in literature associating compulsive sexual behavior (CSB) with negative outcomes, including increased risk of sexually transmitted infections (STI), unwanted pregnancies, work or educational role impairment, excessive financial expenses, and others. Most research supports that CSB is substantially more frequent among men than women, which could explain the paucity of data about distribution, accurate clinical picture and particularities in this population.

Objective

we proposed an investigation of lifetime reported serological tests and STI in women who are outpatients of a compulsive sexual behavior clinic in Sao Paulo, Brazil.

Methods

we conducted a cross-sectional analysis of data from women who sought treatment in the clinic between 2012 to 2019. Participants are submitted by throughout clinical evaluation to assessing sexual compulsivity severity. Data of lifetime STI, previous treatment and serological tests are asked by a semi-structured interview. The participants who met diagnostic criteria for sexual preference disorder, sexual identity disorder, schizophrenia or other psychotic disorders, hypomanic or manic episode of mood disorder and other mental disorders due to brain dysfunction, injury or physical illness were excluded.

Results

thirty-two women completed baseline evaluation. Of this, twenty-two (68%) met criteria to CSB and twelve (32%) did not. There was no difference in mean of age, proportion of sexual orientation, race, marital status, years of education or income (TABLE 1). Most of women were white, heterosexual and weren't in a stable relationship. The median (Md) of Sexual Compulsivity Scale (SCS) score had significant difference (Md 32,5 IQR [26; 36] to sexually compulsive and Md 11,5 IQR [10,5; 14] to non sexually compulsive; p<0.05) (TABLE 2). Self-reported history of STI was present in 40% of compulsive women while 8% of non-compulsive reported it (p 0.75). About 91% of compulsive and 75% of non-compulsive women reported previous serological tests.

Conclusion

Sexually compulsive women reported more STI than non sexually compulsive women. We believe that small sample size was determinant to do not find statistical difference between the groups due the low statistical power of the test. Further research with greater sample is needed to confirm this inference. However, sexually compulsive women presented high severity of sexual compulsivity which support our inference. The study points out to the importance of psychiatrist to assess STI in sexually compulsive women.

Disclosure

Work supported by industry: no.
271 Synergistic Effect of Berberine and Tea Tree Oil Against Neisseria Gonorrhea, in Vitro T84 Cell Mucosa Model
Authors: Cho M , Wang L , Chang F
Published: May 2022

Introduction

Neisseria gonorrhea could spread through oral sex located at the genitals with one who has pharyngeal gonorrhea—and becoming the most common cause of gonorrhea urethritis in the outpatient clinic. Previous studies revealed oral chlorhexidine rinse could reduce the transmission of gonorrhea. However, chlorhexidine gluconate oral rinses may cause: 1) an increase in staining of teeth and other oral surfaces; 2) an increase in calculus formation; and 3) an alteration in taste perception. In literature reviews, tea tree oil-containing mouth rinses are the most common alternative in treating or preventing oral infectious diseases, such as gingivitis.

Objective

The study aimed to demonstrate if tea tree oil alone or combines with other safe, natural product extracts are effective and could be a suitable alternative to chlorhexidine in preventing oral gonorrhea from spreading.

Methods

We use in vitro T84 cells as mucosa model and Neisseria gonorrhea strain MS11 by testing minimal inhibitory concentration and bacterial adherence, invasion, and transmigration across mucosal layer. In addition, we've tested Berberine, an active alkaloid ingredient extract from Coptis Chinensis, in the absence or presence of the tea tree oil in the MS11 MIC test, epithelial cell viability test using ceftriaxone as control.

Results

We found the minimal inhibitory concentration in Tea tree oil, Berberine, and Ceftriaxone in MS11 strain is 0.2%, 5 μg/ml, and 0.0125 μg/ml . However, when combine the Tea tree oil and barberine, the MIC decreased to 0.000625% Tea tree oil + 1.25μg/ml Berberine. The result showed the highest protective effect from tea tree oil with Berberine in the MIC as well as infectivity. No cell death was observed in 0.2% diluted tea tree oil, 5 μg/ml Berberine, and 0.000625% Tea tree oil + 1.25μg/ml Berberine in epithelial cell viability test.

Conclusions

Berberine, an alkaloid extract from Coptis Chinensis, shows a synergistic effect when combining with tea tree oil against Neisseria gonorrhea MS11 strain in the T84 cell mucosa model. It may serve as an alternative choice from chlorhexidine gluconate.

Disclosure

Work supported by industry: no.
280 Male to Female Gender Reassignment Surgery; Developing Personalised Outcomes to Minimise Complications
Authors: Attwell-Heap A , Duncan C
Published: May 2022

Introduction & Objectives

The Diagnostic and Statistical Manual of Mental Disorders has defined gender dysphoria as incongruence between gender identity and birth-assigned gender. Whilst the definition has been evolving in recent times, the first practice of Gender Reassignment surgery hates back to the mid-late 16th century. Over time, more sophisticated techniques have developed to customise techniques to the individual to minimise post operative complications and ensure patient satisfaction.

Methods

A review of the literature was performed on pubmed with key word searches; Gender Dysphoria, Gender Reassignment Surgery and history.

Results

Gender affirming surgery was first described in the mid 16th century, however precise documention of techniques was not seen until 1931 when the first gender affirming vaginoplasty was performed. Split skin grafts from the back, thigh or buttock were used for vaginoplasty, and less frequently, from intestines. It was Paul Fogh-Anderson in 1953 that widely publicised transformation on George Jorgensen in Denmark and popularised the penile skin graft neovagina. This technique of penile skin inversion was first used in Casablanca, Morocco in 1956. The intestinal vaginoplasty technique was described in the 1900s but not utilised in transgender vaginoplasty until 1974. Throughout the 80s, non genital skin flaps from the medial thigh were used. These multitude of techniques have meant that current practice goals are to construct a neopvagina individualised to patients needs. For patients wanting a functional rather than an asthetic, the neovagina should ideally be self-lubricating and with compliance allowing penetration. Currently, the recognised practices for creation of neovagina are penile inversion, skin grafts, local flaps and bowel vaginoplasty. As long term surgical outcome data for GRS is minimal, institutions should be encourage to gather long term data to aid in personalising the surgical approach to the individual patient.

Conclusions

When counselling patients for Gender affirming surgery, it is important to understand the patients’ needs to help minimise potential complications. Different surgical techniques of male to female GRS have been described and evolved over the 20th century to the point of current best practice. Long term data will enable more personalisation and risk minimisation measures to ensure patient satisfaction.

Disclosure

Work supported by industry: no.
003 The Advance Sling and Male Sexual Function: A Prospective Analysis on the Impact of Pelvic Mesh on Erectile and Orgasmic Domains in Sexually Active Men with Post-Prostatectomy Stress Urinary Incontinence
Authors: Chung E. , Wang J.
Published: May 2022

Introduction

The transvaginal pelvic mesh surgery has been shown to cause female sexual dysfunction. Given this pelvic mesh concern in women, there is similar concern whether men who received pelvic mesh for postprostatectomy stress incontinence (PPSI) may suffer from sexual dysfunction too.

Objective

To evaluate the sexual function impact of AdVance pelvic male sling (PMS) on erectile and orgasmic domains.

Methods

A review of a prospectively collected database was conducted in all sexually active men who underwent AdVance MS for PPSI between 2012 and 2018. Patient demographics, clinical outcomes and validated questionnaires such as the Brief Sexual Function Inventory (BSFI), International Index of Erectile Function (IIEF) and Patient Global Impression of Improvement (PGI-I) were reviewed at 6, 12 and 48 months.

Results

Of the total of 65 men who received AdVance PMS, an increase in IIEF-5 score ≥ 5 points were reported in 10 (15%) patients with no patients complained of deteriorating erectile function at 24 months. The improvement in orgasmic function (Question 10 on IIEF-15) was reported in 22 (34%) patients while 3 (5%) patients reported lower orgasmic score. The sexual domains scores in BMSFI were higher in 40 (62%) patients especially with regards to sexual desire (Question 1 and 2) and satisfaction with sex life (Question 11). No patient reports pelvic or urethral pain. The reported improvement in erectile and orgasm scores remained similar throughout the 24-months follow-up period. All 20 patients with preoperative climacturia reported resolution of their symptoms during sexual activity. The overall PGI-I was 1.4 (1-3) and men with a higher continence rate were more likely to report better male sexual function (p=0.044).

Conclusions

Despite the reported adverse outcomes of pelvic mesh in female sexual dysfunction, the AdVance PMS appears to improve male sexual function with regards to erectile and orgasm domains.

Disclosure

Work supported by industry: no.
024 Effects of the Light-Controlled Nitric Oxide Donor “NORD-1” and Light Irradiation in Rats with Neurogenic Erectile Dysfunction
Authors: Hotta Y. , Mori T. , Ieda N. , Kataoka T. , Nakagawa H. , Kimura K.
Published: May 2022

Introduction

Radical prostatectomy often causes erectile dysfunction (ED). This is considered to be due to surgery-induced nerve damage. Impairments in neurotransmission result in the release of nitric oxide (NO) in penile corpus cavernosum insufficiency. Therefore, phosphodiesterase-5 inhibitors are not necessarily effective for this type of ED. NO supplementation may be effective for this type of ED. However, NO acts on the whole body and thus may cause adverse effects. Recently, we have developed a light-controlled NO donor that enables spatially and temporally controlled NO release by light irradiation. Whether this type of NO donor is useful for neurogenic ED remains unknown.

Objective

We investigated whether this light-controlled NO donor “NORD-1” and light irradiation were effective for managing neurogenic ED in rats with bilateral cavernous nerve injury (BCNI).

Methods

We used eight-week-old male Wistar-ST rats. The rats were divided into four groups: Sham+SiR650 (control compound) (n=5), Sham+NORD-1 (n=5), BCNI+SiR650 (n=6), and BCNI+NORD-1 (n=6). Initially, sham or BCNI surgery was performed under anesthesia in each group. BCNI surgery was performed by crushing the bilateral cavernous nerves. Four weeks post-surgery, erectile function before and after the injection of each compound into the penile corpus cavernosum was evaluated based on the change in intracavernous pressure (ICP) under electrical stimulation of the cavernous nerve. The changes in ICP with and without light irradiation were also evaluated after the administration of each compound.

Results

Before administering each treatment without light irradiation, the ICP/mean arterial pressure (MAP) ratio under stimulation in the BCNI+SiR650 and BCNI+NORD-1 groups were lower than those in the Sham+SiR650 (P<0.01) and Sham+NORD-1 (P=0.06) groups. After the each treatment without light irradiation, the ICP/MAP ratio under stimulation in the Sham+NORD-1 group was slightly higher than that in the Sham+SiR650 group. However, the ICP/MAP ratio under stimulation in the BCNI+SiR650 and BCNI+NORD-1 groups remained significantly lower (P<0.05 and P<0.01, respectively). After the treatment with light irradiation, the ICP/MAP ratios under stimulation in the Sham+NORD-1 and BCNI+NORD-1 groups were significantly higher than those in the Sham+SiR650 (P<0.01) and BCNI+NORD-1 (P<0.01) groups, respectively.

Conclusions

The combination of NORD-1 and light irradiation may be useful for treating neurogenic ED, although its toxicity must be evaluated.

Disclosure

Work supported by industry: no.
040 Central Mechanisms Contribute to Pro-Ejaculatory Response Induced by the Combination of Dopamine and 5-HT2 Receptor Agonist in Rats
Authors: Yoshizumi M. , Yonezawa A. , Kimura Y. , Watanabe C. , Kawatani M. , Sakurada S. , Mizoguchi H.
Published: May 2022

Introduction

Although we previously demonstrated in rats that combination of a dopamine (DA) receptor agonist and 5-HT2 receptor agonist potently and selectively facilitates the ejaculatory response through the activation of D2-like and 5-HT2C receptors, these central mechanisms are not fully understood. We therefore investigated to clarify the target level of the pro-ejaculatory effects by combination of these agonists.

Methods

The ejaculatory response was evaluated 30 min after drug administration by the presence of seminal materials on the paper towel as well as that adhering to the shaft of the penis. In addition, we examined isolated rat seminal vesicle contraction.

Results

Intrathecal administration of 5-HT2 receptor agonist m-CPP (10 μg) but not in intracerebroventricular evoked the synergistic action for ejaculation in the combination with systemic administrated DA receptor agonist apomorphine (0.1 mg/kg, s.c.). Synergy effects of combination were completely inhibited by intrathecal 5-HT2C receptor antagonist SB242084 (10 μg). Intrathecal or intracerebroventricular apomorphine (1-10 μg) evoked the pro-ejaculatory effects in the combination with systemic administrated m-CPP (0.3 mg/kg, i.p.) The selective peripherally acting D2-like receptor agonist carmoxirole did not evoked in the combination with m-CPP. Furthermore, the combination of apomorphine and m-CPP did not produce contraction of rat seminal vesicle.

Conclusion

These results suggest that this synergistic action for ejaculation induces in the spinal or supraspinal level but not the peripheral sites. Furthermore, the present study suggests that the activation of the spinal ejaculatory pattern generator through 5-HT2C receptors is synergistically potentiated by both spinal and supraspinal DA receptors.

Disclosure

Work supported by industry: no.
041 Effect of DPP-4 Inhibitors on Erectile Dysfunction Caused by Vincristine in Rats
Authors: Kataoka T. , Sanagawa A. , Hotta Y. , Kimura K.
Published: May 2022

Introduction

Various chemotherapeutic agents are administered to cancer patients worldwide. Previously, an analysis of the US Food and Drug Administration (FDA) Adverse Event Reporting System (AERS) database showed that vincristine (VCR) increased the risk of erectile dysfunction (ED), as reported in the world meeting on Sexual Medicine 2018. As such, countermeasures for late complications after anticancer drug treatment are required. Neuropathy is a well-known side effect of VCR; however, in recent years, it has been reported that DPP-4 inhibitors improve neuropathy.

Objective

To investigate the effect of DPP-4 inhibitors to ED caused by VCR in rats.

Methods

Twelve-week-old male Wistar ST rats were separated into Control, VCR, and VCR+DPP-4i groups. VCR (0.1 mg/kg) was intravenously administered on days 1, 8, 15, and 22 in the VCR and VCR+DPP-4i groups. Two types of long-term preparations, toleragliptin (TGP; 3 mg/kg/week, po.) and omaligliptin (OGP; 3 mg/kg/week, po.), were examined for DPP-4i. Erectile function was tested using intracavernous pharmacotherapy (ICP) measurements, and endothelial function was tested through an isometric tension study. Additionally, mRNA expressions were tested using real-time PCR.

Results

After the 4-week observation period, the ICP/mean arterial pressure (MAP) ratio in the VCR group (0.42 ± 0.04) was significantly decreased compared to the Control group (0.72 ± 0.05) (P <0.01). The ICP/MAP ratio in the VCR+TGP group (0.64 ± 0.02) increased significantly compared to the VCR group (P <0.05), however the ICP/MAP ratio in the VCR+OGP (0.50 ± 0.08) did not increase significantly compared to the VCR group (P > 0.05). Real-time PCR analysis showed that the catalase, VEGF, MCP-1, and PAI-1 mRNA expressions were increased, while the IL-6 mRNA expression decreased significantly in the VCR+TGP and VCR+OGP groups. In contrast, the nNOS mRNA expression level was higher in the VCR+TGP group than in the VCR+OGP group.

Conclusions

In this study, we determined that DPP-4 inhibitors may improve ED by VCR administration. For ED associated with VCR administration, long-term DPP-4 inhibitor TGP administration suggested a significant improvement in erectile function, but OGP did not show a significant improvement effect. An increase in antioxidant activity and a decrease in inflammatory cytokines were observed for both drugs, including a surge in vascular increase factors. In contrast, the nNOS expression level was higher in TGP, suggesting that there may be a difference in the amount of NO production via nerves. Therefore, TGP may be useful for male sexual dysfunction associated with vincristine administration.

Disclosure

Work supported by industry: no.
047 Anti-Inflammatory Effect of Indoleamine 2,3-Dioxygenase 1 Inhibition for Lipopolysaccharide Induced Epididymitis
Authors: Ohira S. , Tone S. , Nakatsuka T. , Morinaka H. , Takasaki H. , Hirata K. , Shimizu S. , Nagai A.
Published: May 2022

Introduction and Objective

Even though antimicrobial therapy is received, some patients with epididymitis remaining inflammatory changes and led to refractory condition. Innovative therapy focused on the inflammatory changes is needed for epididymitis. Indoleamine 2,3-dioxygenase 1 (IDO1) catalyzes the first and rate-limiting step of tryptophan catabolism. IDO1 plays a key role in immune response and shows high expression in male genitalia. Furthermore, protective effect of IDO1 inhibition for various inflammatory disease was indicated in some reports. We hypothesize that IDO1 plays a central role for immunological reaction in epididymal inflammation. We investigated the relevance between IDO1 inhibition and epididymal inflammation. This study was approved by the safety committee for DNA experiments and the animal research committee of our facility (Approval No.14-35, 18-52).

Materials and Methods

Ten to twelve weeks old, C57BL/6 IDO1 knock out (IDO1 KO) mice were used through the research. Same conditional wild type (WT) mice were set as control. Lipopolysaccharide (LPS) 5μg/g(weight) was injected into epididymis from the vas deferens side. Epididymis was removed at a to 7 days after epididymitis modeling. Inflammatory changes in epididymis were investigated using histological, biochemical and immunohistochemical analysis. Series of these analysis were duplicated at least.

Results

Histological analysis using HE staining showed decreased effect of inflammation in IDO1 KO mice compared with WT mice. Proteomic analysis showed decreased effect of both inflammatory promoting cytokines (IL-1α, IL-6) and chemokines (CCL3, CXCL1) in IDO KO mice. On the other hand, increased effect of inflammatory inhibiting cytokines (IL-4, IL-10) were showed in IDO KO mice. Same results were obtained from immunohistochemical analysis using immunofluorescent staining.

Conclusions

IDO1 is involved in epididymal inflammation via cytokine and chemokine. IDO1 inhibition contribute to tissue protection for epididymitis. Therefore, IDO1 inhibition might be an innovative therapy for epididymitis.

Disclosure

Work supported by industry: no.
066 Haemospermia in the Real-Life Setting: Challenging the EAU Guidelines
Authors: Pozzi E. , Ventimiglia E. , Fallara G. , Boeri L. , Belladelli F. , Cignoli D. , Candela L. , Capogrosso P. , Schifano N. , Raffo M. , Colandrea G. , Cornelius J. , Mattei A. , Montorsi F. , Salonia A.
Published: May 2022

Introduction

The Sexual and Reproductive Health guidelines of the European Association of Urology (EAU) suggest stratifying patients complaining of haemospermia into low versus high-risk categories for treatable aetiologies.

Objective

To validate EAU guidelines in a homogeneous cohort of men with haemospermia and to identify a novel and better performing risk stratification compared to EAU guidelines.

Methods

Data from 283 consecutive patients complaining of a single episode/recurrent haemospermia were retrospectively analysed. Patients were stratified into low vs. high-risk according to EAU guidelines, whose diagnostic performance was then validated. We identified a new risk stratification model based on clinical factors associated with i) positive semen culture and ii) prostate cancer (PCa) and bladder cancer (BC). Diagnostic accuracy of the two predictive models (EAU vs. New) was assessed and decision curve analyses (DCA) tested their clinical benefit.

Results

Overall, 259 (91.5%) were high-risk and 24 (8.5%) low risk according to the EAU guidelines. Recurrent haemospermia was reported by 134 (47.4%) patients. 126 (44.5%) had baseline CCI score ≥ 1. At MVA logistic regression analysis, history of recurrent genito – urinary tract infections was identified as a predictor for positive semen culture (OR: 3.39, 95% CI: 1.77 – 6.57, p=0.002). Likewise, baseline CCI ≥ 1 was identified as a predictor for PCa and BC (OR: 1.55, 95% CI: 1.17 – 2.04, p=0.009). Sensitivity, specificity, and AUC of the EAU guidelines were 13.3%, 89.2% and 51% respectively, whereas the new model performed substantially better: 98.9%, 58% and 78% respectively.

Conclusion

The application of the EAU risk stratification does not ensure proper identification of high-risk patients complaining of haemospermia. We propose a novel, better performing and easily implementable risk stratification.

Disclosure

Work supported by industry: no.
Determination of the H2O‐Saturated Solidus of Albite by Electrical Conductivity
Authors: Guo Xuan , Li Wan‐Cai , Zhang Li , Ni Huaiwei
Published: May 2022

In the study of subduction zone processes, there has been much debate on slab dehydration against slab melting, as well as on flux melting of the mantle wedge against metasomatism and a prolonged period of storage and heating before mantle melting. H2O‐saturated solidus of rock is critical to the debate. Unfortunately, there is a significant discrepancy in H2O‐saturated solidus between different experimental studies, mainly due to the difficulty in distinguishing hydrous melt from aqueous fluid in quenched experimental products. In this study, we developed a new approach to locating H2O‐saturated solidus of rock systems by monitoring the electrical conductivity of the system in situ. A mixture of albite and >10 wt% H2O was heated stepwise in the range of 0.35–1.7 GPa in a piston cylinder apparatus. A jump in electrical conductivity (up to 1.8 log units) was observed over a small temperature interval (10–20°C). The temperature corresponding to the electrical jump decreased from 790 ± 10°C at 0.35 GPa to 640 ± 10°C at 1.7 GPa, in good agreement with previously reported H2O‐saturated solidus of albite. Examination of the experimental products quenched immediately after observation of the electrical conductivity jump confirmed the occurrence of albite melting. Our experimental results suggest that the electrical conductivity jump serves as a good indicator for rock melting under H2O‐saturated conditions, and this in situ approach can overcome the ambiguity in phase identification in quench experiments. This new approach has the potential to solve the discrepancy over H2O‐saturated solidus of a variety of rock systems and shed light on subduction zone processes.
Impact of Estuarine Dams on the Estuarine Parameter Space and Sediment Flux Decomposition: Idealized Numerical Modeling Study
Authors: Figueroa Steven M. , Lee Guan‐hong , Chang Jongwi , Jung Nathalie W.
Published: May 2022

Estuarine dams are constructed for securing freshwater resources, flood control, and improving upstream navigability. However, their impact on estuarine currents, stratification, and sediment fluxes is not well understood. To develop a general understanding, an idealized modeling study was carried out using the COAWST modeling system. Idealized estuarine geometry was based on 10 estuaries with estuarine dams located near their mouth. Tide and river forcing were varied to produce strongly stratified, partially mixed, periodically stratified, and well‐mixed estuaries. Each model ran for 1 year. Next, the models were subject to the construction of an estuarine dam and run for another year. Then, the predam and postdam conditions were compared. Results showed that estuarine dams can amplify the tidal range and reduce the tidal currents. The postdam estuaries tended to be salt wedge, strongly stratified, partially mixed, or periodically stratified types during freshwater discharge, but during no freshwater discharge they became fjord, bay, periodically stratified, or well‐mixed types based on the estuarine parameter space. For all estuaries, the estuarine turbidity maximum moved seaward, and the suspended sediment concentrations tended to decrease. While the depth changes depended on the estuary type, the surficial sediment texture shifted to being muddier for all types. In terms of sediment flux mechanisms, the estuarine dam increased the seaward river runoff for cases with strong river, and increased the landward tidal pumping for cases with strong tides. This study is one of the first to generalize the effect of estuarine dams to a range of estuarine types.
MALAT1 as master regulator of biomarkers predictive of pan-cancer multi-drug resistance in the context of recalcitrant NRAS signaling pathway identified using systems-oriented approach
Authors: Kumar Santosh , Mishra Seema
Published: May 2022

NRAS, a protein mutated in several cancer types, is involved in key drug resistance mechanisms and is an intractable target. The development of drug resistance is one of the major impediments in targeted therapy. Currently, gene expression data is used as the most predictive molecular profile in pan-cancer drug sensitivity and resistance studies. However, the common regulatory mechanisms that drive drug sensitivity/resistance across cancer types are as yet, not fully understood. We focused on GDSC data on NRAS-mutant pan-cancer cell lines, to pinpoint key signaling targets in direct or indirect associations with NRAS, in order to identify other druggable targets involved in drug resistance. Large-scale gene expression, comparative gene co-expression and protein–protein interaction network analyses were performed on selected drugs inducing drug sensitivity/resistance. We validated our data from cell lines with those obtained from primary tissues from TCGA. From our big data studies validated with independent datasets, protein-coding hub genes FN1, CD44, TIMP1, SNAI2, and SPARC were found significantly enriched in signal transduction, proteolysis, cell adhesion and proteoglycans pathways in cancer as well as the PI3K/Akt-signaling pathway. Further studies of the regulation of these hub/driver genes by lncRNAs revealed several lncRNAs as prominent regulators, with MALAT1 as a possible master regulator. Transcription factor EGR1 may control the transcription rate of MALAT1 transcript. Synergizing these studies, we zeroed in on a pan-cancer regulatory axis comprising EGR1-MALAT1-driver coding genes playing a role. These identified gene regulators are bound to provide new paradigms in pan-cancer targeted therapy, a foundation for precision medicine, through the targeting of these key driver genes in the improvement of multi-drug sensitivity or resistance.
In vitro synergistic antimicrobial activity of a combination of meropenem, colistin, tigecycline, rifampin, and ceftolozane/tazobactam against carbapenem-resistant Acinetobacter baumannii
Authors: Ju Yong Guk , Lee Hak Joon , Yim Hong Soon , Lee Min-Goo , Sohn Jang Wook , Yoon Young Kyung
Published: May 2022

We investigated the in vitro activity of various antimicrobial combinations against carbapenem-resistant Acinetobacter baumannii (CRAB) isolates. The in vitro activity of six two-drug combinations against CRAB isolates collected from the blood samples of patients with bloodstream infection was evaluated using the checkerboard method and time-kill assay [0.5 ×, 1 ×, and 2 × minimum inhibitory concentration (MIC)] to identify potential synergistic and bactericidal two-drug combinations against CRAB isolates. The effects of meropenem, colistin, tigecycline, rifampin, and ceftolozane/tazobactam combinations were investigated. All 10 CRAB isolates in our study produced the OXA-58-type and OXA-23-type carbapenem-hydrolyzing oxacillinases. The colistin-ceftolozane/tazobactam combination showed synergistic effects in both the time-kill assay (using an antibiotic concentration of 1 × MIC) and the checkerboard method. It also showed bactericidal effects in the time-kill assay. For all 10 CRAB isolates, time-kill curves showed synergistic bactericidal activity of the colistin-ceftolozane/tazobactam combination at 0.5 × MIC. Overall, there was substantial discordance of synergistic activity between the checkerboard microdilution and time-kill assays (with a concordance of 31.7%). Our study demonstrated that two-drug combinations of colistin and ceftolozane/tazobactam could be useful treatment alternatives for CRAB infections. The effects of these antibiotic combinations should be evaluated using in vivo experimental models.